Minnesota Legislature
SF 3055
as introduced - 94th Legislature (2025 - 2026) Posted on 03/28/2025 10:08am
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A bill for an act
relating to state government; changing provisions covering technology platform,
pharmacy benefit manager, and data protection in vendor contracts; amending
Minnesota Statutes 2024, section 43A.231, subdivisions 3, 4, 6.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2024, section 43A.231, subdivision 3, is amended to read:
Subd. 3.
Procurement of a pharmacy benefit manager.
(a) Notwithstanding any law
to the contrary, the commissioner of management and budget shall procure a contract for
the services of a pharmacy benefit manager to administer the prescription drug benefit and
pharmacy benefit management services, effective January 1, 2023.new text begin For subsequent
procurements, if the commissioner intends to separate prescription drug benefit and pharmacy
benefit management services into multiple vendors or intends to fold prescription drug
benefits into the overall medical benefit, rather than a single full-service pharmacy benefit
manager, this section shall not apply.
new text end
(b) For the contract effective January 1, 2023, the commissioner shall conduct a reverse
auction as described in this section to select the pharmacy benefit manager and use a reverse
auction for procurement of subsequent pharmacy benefit manager contracts as provided in
subdivision 5, paragraph (b).
(c) In consultation with the technology platform vendor selected under subdivision 4,
the commissioner shall specify the terms of a participant bidding agreement that all bidders
must accept as a prerequisite for participation in the reverse auction process, including:
(1) common definitions;
(2) prescription drug classifications;
(3) retail pricing rules, including maximum allowable cost price lists and dispensing
fees; and
(4) any other contract terms the commissioner deems necessary to further the purpose
of this section as specified under subdivision 2.
(d) A pharmacy benefit manager who submits a bid under this subdivision must provide
the commissioner access to complete pharmacy claims data necessary for the commissioner
to conduct the reverse auction and to carry out administrative and management duties.
(e) The terms of a contract entered into under this subdivision shall not be modified by
the pharmacy benefit manager except with the approval of the commissioner.
(f) The commissioner may structure the contract awarded under this subdivision to pay
the cost of the technology platform and the associated professional services contracted for
under this subdivision by assessing a fee per prescription to be paid directly by the pharmacy
benefit manager to the technology platform vendor.
(g) The commissioner must perform annual market checks on pharmacy benefit manager
services performed by the pharmacy benefit manager during the term of the contract. A
market check performed under this paragraph may include an evaluation of the effect of
alternative drug pricing metrics, such as the national average drug acquisition cost and
average wholesale price, on the cost of prescription drugs and savings to the state.
(h) The commissioner shall make regular, periodic payment of invoices within the time
periods specified in the contract based on the automated adjudication of invoiced claims
using the technology platform to validate that claims payments comply with the terms of
the contract.
(i) The joint labor-management committee on health plans shall assist in the process
through which the commissioner conducts the reverse auction, evaluation, and comparison
of the competing pharmacy benefit manager bids for award of the contract.
Sec. 2.
Minnesota Statutes 2024, section 43A.231, subdivision 4, is amended to read:
Subd. 4.
Technology platform.
(a) deleted text begin At least three months before the reverse auction
process is scheduled to be completed,deleted text end The commissioner shall procure through a competitive
bidding process a contract with a professional services vendor for a technology platform
and any associated professional services necessary to operate the platform to:
(1) evaluate the qualifications of prospective pharmacy benefit manager bidders for the
pharmacy benefit manager procurement;
(2) automatically adjudicate prescription drug claims; and
(3) collect data on pharmacy reimbursement.
(b) The platform procured under paragraph (a) must have the following capabilities to
ensure optimal performance of the reverse auction and security of data:
(1) host and conduct an online automated reverse auction:
(i) using a software application and high-performance data infrastructure to intake,
cleanse, and normalize pharmacy benefit manager data; and
(ii) with development methods and information security standards that have been validated
by receiving Service Organization Control 2 (SOC 2) and National Institute of Standards
and Technology certification;
(2) automate repricing of diverse and complex pharmacy benefit manager prescription
drug pricing proposals to enable direct comparisons of the price of bids using all annual
claims data available for the program using code-based classification or prescription drugs
from nationally accepted drug sources;
(3) simultaneously evaluatedeleted text begin , within six hours,deleted text end diverse and complex multiple proposals
from full-service pharmacy benefit managers that shall include at least guaranteed net cost,
Average Wholesale Price and National Average Drug Acquisition Cost (NADAC) pricing
models, as well as proposals from pharmacy benefit administrators and specialty drug and
rebate carve-out services providers;new text begin and
new text end
(4) produce an automated report and analysis of bids, including ranking of bids on the
comparative costs and qualitative aspects of the costs deleted text begin within six hoursdeleted text end after the close of
each round of reverse auction biddingdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(5) after the close of the reverse auction process, perform an electronic, line-by-line,
claim-by-claim review of all invoiced pharmacy benefit manager claims within six hours
of receipt that allows for an online comparison of pharmacy benefit manager invoices and
identifies all deviations from the specific terms of the services contract resulting from the
reverse auction.
deleted text end
(c) The commissioner may require additional capabilities or more rigorous standards
than those specified in paragraph (b).
(d) The commissioner shall not award the platform technology vendor contract under
this subdivision to:
(1) a pharmacy benefit manager;
(2) a subsidiary or affiliate of a pharmacy benefit manager; or
(3) a vendor who is managed by a pharmacy benefit manager or who receives, directly
or indirectly, remuneration from a pharmacy benefit manager for aggregating clients into
a contractual relationship with a pharmacy benefit manager.
(e) deleted text begin The vendor who is awarded the contract under this subdivision must not subcontract
any part of the reverse auction process or the review described under paragraph (b), clause
(5)deleted text end new text begin The commissioner shall also hire a vendor to perform an electronic, line-by-line,
claim-by-claim review of all invoiced pharmacy benefit manager claims that allows for an
online comparison of pharmacy benefit manager invoices and identifies all deviations from
the specific terms of the services contract resulting from the reverse auction. The claim
review vendor and the platform vendor may be the same or they may be distinctnew text end .
Sec. 3.
Minnesota Statutes 2024, section 43A.231, subdivision 6, is amended to read:
Subd. 6.
Data protections.
The commissioner of management and budget may only
enter into an agreement with deleted text begin a technology platform vendordeleted text end new text begin vendors under this sectionnew text end if the
deleted text begin agreement providesdeleted text end new text begin agreements provide new text end privacy protections for data collected and maintained
by the deleted text begin technology platform vendordeleted text end new text begin vendorsnew text end , including:
(1) procedures for the prevention of unauthorized access or use;
(2) a prohibition on the sale of data collected and maintained as provided in the
agreement; and
(3) a prohibition on dissemination of data unless authorized by state or federal law or
the agreement.