Minnesota Administrative Rules

2737.1300 OUT-OF-POCKET COST COMPARISONS.

Subpart 1.

Request format.

A pharmacy benefit manager may create specific forms, rules, or guidelines for an enrollee to request out-of-pocket cost information. Any forms, rules, or guidelines a pharmacy benefit manager creates must not be unreasonably onerous or burdensome.

Subp. 2.

Response format.

The pharmacy benefit manager's response to an enrollee's request must be consistent with the manner in which the request is made. If a pharmacy benefit manager creates specific forms, rules, or guidelines for out-of-pocket cost information requests, the pharmacy benefit manager must provide an enrollee with information regarding the format of the pharmacy benefit manager's response. The response must use plain language that clearly delineates the difference in out-of-pocket costs based on the pharmacy used.

Subp. 3.

Time to respond.

A pharmacy benefit manager must respond to an enrollee's request for out-of-pocket cost information within five business days of the date of the request.

Subp. 4.

Existing system.

If an enrollee seeks the information available under Minnesota Statutes, section 62W.076 or 62W.077, and if a pharmacy benefit manager maintains an online system that is easily accessible, the pharmacy benefit manager may comply with this part by directing the enrollee to the online system.

Statutory Authority:

L 2019 c 39 s 20

History:

46 SR 809

Published Electronically:

September 21, 2022