SF 2719

as introduced - 93rd Legislature (2023 - 2024) Posted on 06/30/2023 08:53am

A bill for an act
relating to health; modifying identification requirements for the insulin safety net
program; amending Minnesota Statutes 2022, section 151.74, subdivisions 3, 4.

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

Section 1.

Minnesota Statutes 2022, section 151.74, subdivision 3, is amended to read:

Subd. 3.

Access to urgent-need insulin.

(a) MNsure shall develop an application form
to be used by an individual who is in urgent need of insulin. The application must ask the
individual to attest to the eligibility requirements described in subdivision 2. The form shall
be accessible through MNsure's website. MNsure shall also make the form available to
pharmacies and health care providers who prescribe or dispense insulin, hospital emergency
departments, urgent care clinics, and community health clinics. By submitting a completed,
signed, and dated application to a pharmacy, the individual attests that the information
contained in the application is correct.

(b) If the individual is in urgent need of insulin, the individual may present a completed,
signed, and dated application form to a pharmacy. The individual must also:

(1) have a valid insulin prescription; and

(2) present the pharmacist with identification indicating Minnesota residency in the form
of a valid Minnesota identification card, driver's license or permit, new text begin individual taxpayer
identification number, new text end or Tribal identification card as defined in section 171.072, paragraph
(b). If the individual in urgent need of insulin is under the age of 18, the individual's parent
or legal guardian must provide the pharmacist with proof of residency.

(c) Upon receipt of a completed and signed application, the pharmacist shall dispense
the prescribed insulin in an amount that will provide the individual with a 30-day supply.
The pharmacy must notify the health care practitioner who issued the prescription order no
later than 72 hours after the insulin is dispensed.

(d) The pharmacy may submit to the manufacturer of the dispensed insulin product or
to the manufacturer's vendor a claim for payment that is in accordance with the National
Council for Prescription Drug Program standards for electronic claims processing, unless
the manufacturer agrees to send to the pharmacy a replacement supply of the same insulin
as dispensed in the amount dispensed. If the pharmacy submits an electronic claim to the
manufacturer or the manufacturer's vendor, the manufacturer or vendor shall reimburse the
pharmacy in an amount that covers the pharmacy's acquisition cost.

(e) The pharmacy may collect an insulin co-payment from the individual to cover the
pharmacy's costs of processing and dispensing in an amount not to exceed $35 for the 30-day
supply of insulin dispensed.

(f) The pharmacy shall also provide each eligible individual with the information sheet
described in subdivision 7 and a list of trained navigators provided by the Board of Pharmacy
for the individual to contact if the individual is in need of accessing ongoing insulin coverage
options, including assistance in:

(1) applying for medical assistance or MinnesotaCare;

(2) applying for a qualified health plan offered through MNsure, subject to open and
special enrollment periods;

(3) accessing information on providers who participate in prescription drug discount
programs, including providers who are authorized to participate in the 340B program under
section 340b of the federal Public Health Services Act, United States Code, title 42, section
256b; and

(4) accessing insulin manufacturers' patient assistance programs, co-payment assistance
programs, and other foundation-based programs.

(g) The pharmacist shall retain a copy of the application form submitted by the individual
to the pharmacy for reporting and auditing purposes.

Sec. 2.

Minnesota Statutes 2022, section 151.74, subdivision 4, is amended to read:

Subd. 4.

Continuing safety net program; general.

(a) Each manufacturer shall make
a patient assistance program available to any individual who meets the requirements of this
subdivision. Each manufacturer's patient assistance programs must meet the requirements
of this section. Each manufacturer shall provide the Board of Pharmacy with information
regarding the manufacturer's patient assistance program, including contact information for
individuals to call for assistance in accessing their patient assistance program.

(b) To be eligible to participate in a manufacturer's patient assistance program, the
individual must:

(1) be a Minnesota resident with a valid Minnesota identification card that indicates
Minnesota residency in the form of a Minnesota identification card, driver's license or
permit, new text begin individual taxpayer identification number, new text end or Tribal identification card as defined
in section 171.072, paragraph (b). If the individual is under the age of 18, the individual's
parent or legal guardian must provide proof of residency;

(2) have a family income that is equal to or less than 400 percent of the federal poverty
guidelines;

(3) not be enrolled in medical assistance or MinnesotaCare;

(4) not be eligible to receive health care through a federally funded program or receive
prescription drug benefits through the Department of Veterans Affairs; and

(5) not be enrolled in prescription drug coverage through an individual or group health
plan that limits the total amount of cost-sharing that an enrollee is required to pay for a
30-day supply of insulin, including co-payments, deductibles, or coinsurance to $75 or less,
regardless of the type or amount of insulin needed.

(c) Notwithstanding the requirement in paragraph (b), clause (4), an individual who is
enrolled in Medicare Part D is eligible for a manufacturer's patient assistance program if
the individual has spent $1,000 on prescription drugs in the current calendar year and meets
the eligibility requirements in paragraph (b), clauses (1) to (3).

(d) An individual who is interested in participating in a manufacturer's patient assistance
program may apply directly to the manufacturer; apply through the individual's health care
practitioner, if the practitioner participates; or contact a trained navigator for assistance in
finding a long-term insulin supply solution, including assistance in applying to a
manufacturer's patient assistance program.