HF 1523

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 03/09/2020 05:54pm

A bill for an act
relating to human services; directing commissioner of human services to establish
a prescription drug purchasing program; specifying program authority and eligibility
requirements; amending Minnesota Statutes 2018, section 62J.23, subdivision 2;
proposing coding for new law in Minnesota Statutes, chapter 256B.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2018, section 62J.23, subdivision 2, is amended to read:

Subd. 2.

Restrictions.

(a) From July 1, 1992, until rules are adopted by the commissioner
under this section, the restrictions in the federal Medicare antikickback statutes in section
1128B(b) of the Social Security Act, United States Code, title 42, section 1320a-7b(b), and
rules adopted under the federal statutes, apply to all persons in the state, regardless of whether
the person participates in any state health care program.

(b) Nothing in paragraph (a) shall be construed to prohibit an individual from receiving
a discount or other reduction in price or a limited-time free supply or samples of a prescription
drug, medical supply, or medical equipment offered by a pharmaceutical manufacturer,
medical supply or device manufacturer, health plan company, or pharmacy benefit manager,
so long as:

(1) the discount or reduction in price is provided to the individual in connection with
the purchase of a prescription drug, medical supply, or medical equipment prescribed for
that individual;

(2) it otherwise complies with the requirements of state and federal law applicable to
enrollees of state and federal public health care programs;

(3) the discount or reduction in price does not exceed the amount paid directly by the
individual for the prescription drug, medical supply, or medical equipment; and

(4) the limited-time free supply or samples are provided by a physician or pharmacist,
as provided by the federal Prescription Drug Marketing Act.

new text begin For purposes of this paragraph, "prescription drug" includes prescription drugs that are
administered through infusion, and related services and supplies.
new text end

(c) No benefit, reward, remuneration, or incentive for continued product use may be
provided to an individual or an individual's family by a pharmaceutical manufacturer,
medical supply or device manufacturer, or pharmacy benefit manager, except that this
prohibition does not apply to:

(1) activities permitted under paragraph (b);

(2) a pharmaceutical manufacturer, medical supply or device manufacturer, health plan
company, or pharmacy benefit manager providing to a patient, at a discount or reduced
price or free of charge, ancillary products necessary for treatment of the medical condition
for which the prescription drug, medical supply, or medical equipment was prescribed or
provided; and

(3) a pharmaceutical manufacturer, medical supply or device manufacturer, health plan
company, or pharmacy benefit manager providing to a patient a trinket or memento of
insignificant value.

(d) Nothing in this subdivision shall be construed to prohibit a health plan company
from offering a tiered formulary with different co-payment or cost-sharing amounts for
different drugs.

Sec. 2.

new text begin [256B.86] PRESCRIPTION DRUG PURCHASING PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following definitions
apply.
new text end

new text begin (b) "Health plan company" has the meaning given in section 62Q.01, subdivision 4.
new text end

new text begin (c) "MNsure" means the state health insurance exchange established under chapter 62V.
new text end

new text begin (d) "Program participants" means:
new text end

new text begin (1) medical assistance and MinnesotaCare enrollees served under the fee-for-service
and managed care delivery systems; and
new text end

new text begin (2) enrollees who have purchased individual health coverage through MNsure, or off
MNsure, from a health plan company that has contracted with the commissioner to participate
in the Minnesota prescription drug purchasing program.
new text end

new text begin Subd. 2. new text end

new text begin Establishment of program. new text end

new text begin The commissioner of human services shall
administer and oversee a Minnesota prescription drug purchasing program for prescription
drugs provided to program participants.
new text end

new text begin Subd. 3. new text end

new text begin Duties of commissioner. new text end

new text begin The commissioner, through the Minnesota prescription
drug purchasing program, shall:
new text end

new text begin (1) make prescription drugs available at the lowest possible cost to program participants;
new text end

new text begin (2) promote health through the purchase and provision of discounted prescription drugs
and coordination of comprehensive prescription benefit services for program participants;
new text end

new text begin (3) maintain a list of prescription drugs recommended as the most effective prescription
drugs available at the best possible prices;
new text end

new text begin (4) administer prescription drug benefits for medical assistance and MinnesotaCare, and
administer prescription drug benefits for health plan companies that contract with the
commissioner to participate in the purchasing program; and
new text end

new text begin (5) adjudicate pharmacy claims and transmit program prices and other information to
pharmacies.
new text end

new text begin Subd. 4. new text end

new text begin Program authority. new text end

new text begin (a) In order to accomplish the purpose of the Minnesota
prescription drug purchasing program, the commissioner, in consultation with the formulary
committee established under section 256B.0625, subdivision 13c, has the authority to:
new text end

new text begin (1) adopt or develop a preferred drug list;
new text end

new text begin (2) engage in price negotiations with prescription drug manufacturers, wholesalers, or
group purchasing organizations to obtain price discounts and rebates for prescription drugs
for program participants; and
new text end

new text begin (3) develop a drug formulary for MinnesotaCare and the individual insurance market.
new text end

new text begin (b) The commissioner may contract with one or more entities to perform any of the
functions described in paragraph (a).
new text end

new text begin Subd. 5. new text end

new text begin Pharmacies. new text end

new text begin The commissioner shall set the terms and conditions for pharmacies
to participate in the program. All pharmacies participating as medical assistance providers,
and any other pharmacy licensed under chapter 151 willing to accept the terms and
conditions, shall be enrolled in the program.
new text end

new text begin Subd. 6. new text end

new text begin Federal approval. new text end

new text begin The commissioner shall seek any necessary federal approvals
to implement this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end