Minnesota Legislature
SF 2836
1st Engrossment - 90th Legislature (2017 - 2018) Posted on 07/05/2018 02:36pm
Current Version - 1st Engrossment
1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 2.1 2.2
2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26
A bill for an act
relating to health care; prohibiting a health plan company from contractually
preventing a pharmacist from informing a patient of a price differential; amending
Minnesota Statutes 2016, sections 151.214; 151.71, by adding a subdivision.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2016, section 151.214, is amended to read:
151.214 PAYMENT DISCLOSURE.
Subdivision 1.
Explanation of pharmacy benefits.
A pharmacist licensed under this
chapter must provide to a patient, for each prescription dispensed where part or all of the
cost of the prescription is being paid or reimbursed by an employer-sponsored plan or health
plan company, or its contracted pharmacy benefit manager, the patient's co-payment amount
deleted text begin anddeleted text end new text begin ,new text end the pharmacy's own usual and customary price of the prescription deleted text begin ordeleted text end new text begin , andnew text end the new text begin net new text end amount
the pharmacy will deleted text begin be paid for the prescription drugdeleted text end new text begin receive from all sources for dispensing
the prescription drug, once the claim has been completed new text end by the patient's employer-sponsored
plan or health plan company, or its contracted pharmacy benefit manager.
Subd. 2.
No prohibition on disclosure.
No contracting agreement between an
employer-sponsored health plan or health plan company, or its contracted pharmacy benefit
manager, and a resident or nonresident pharmacy deleted text begin registereddeleted text end new text begin licensednew text end under this chapter,
may prohibit deleted text begin thedeleted text end new text begin :
new text end
new text begin (1) a new text end pharmacy from disclosing to patients information a pharmacy is required or given
the option to provide under subdivision 1new text begin ; or
new text end
new text begin (2) a pharmacist from informing a patient when the amount the patient is required to
pay under the patient's health plan for a particular drug is greater than the amount the patient
would be required to pay for the same drug if purchased out-of-pocket at the pharmacy's
usual and customary pricenew text end .
Sec. 2.
Minnesota Statutes 2016, section 151.71, is amended by adding a subdivision to
read:
new text begin Subd. 3. new text end
new text begin Synchronization of refills. new text end
new text begin
(a) For purposes of this subdivision,
"synchronization" means the coordination of prescription drug refills for a patient taking
two or more medications for one or more chronic conditions, to allow the patient's
medications to be refilled on the same schedule for a given period of time.
new text end
new text begin
(b) A contract between a pharmacy benefit manager and a pharmacy must allow for
synchronization of prescription drug refills for a patient on at least one occasion per year,
if the following criteria are met:
new text end
new text begin
(1) the prescription drugs are covered under the patient's health plan or have been
approved by a formulary exceptions process;
new text end
new text begin
(2) the prescription drugs are maintenance medications as defined by the health plan
and have one or more refills available at the time of synchronization;
new text end
new text begin
(3) the prescription drugs are not Schedule II, III, or IV controlled substances;
new text end
new text begin
(4) the patient meets all utilization management criteria relevant to the prescription drug
at the time of synchronization;
new text end
new text begin
(5) the prescription drugs are of a formulation that can be safely split into short-fill
periods to achieve synchronization; and
new text end
new text begin
(6) the prescription drugs do not have special handling or sourcing needs that require a
single, designated pharmacy to fill or refill the prescription.
new text end
new text begin
(c) When necessary to permit synchronization, the pharmacy benefit manager shall apply
a prorated, daily patient cost-sharing rate to any prescription drug dispensed by a pharmacy
under this subdivision. The dispensing fee shall not be prorated, and all dispensing fees
shall be based on the number of prescriptions filled or refilled.
new text end