SF1574

SF1574 (Legislative Session 94 (2025-2026))

Commissioner of human services selection of a state pharmacy benefit manager through procurement requirement provision, commissioner of human services entrance into a master contract with the state pharmacy benefit manager requirement provision, and program authority and eligibility requirements specification provision

Related bill: HF2242

AI Generated Summary

This bill requires the Minnesota Commissioner of Human Services to select a single state pharmacy benefit manager (PBM) through a competitive procurement process in order to manage prescription drug benefits for Medical Assistance and MinnesotaCare enrollees under the managed care system.

Key provisions of the bill include: - Establishing eligibility criteria for selecting the PBM and entering into a master contract. - Prohibiting the PBM from requiring enrollees to obtain specialty drugs from affiliated pharmacies. - Requiring transparency in PBM operations, such as disclosure of financial arrangements, rebates, and fees. - Giving the commissioner authority to oversee prescription drug utilization, pricing, and formulary management while ensuring compliance with federal and state laws. - Mandating reporting requirements for the PBM regarding drug prices, pharmacy reimbursements, and savings passed on to enrollees. - Allowing the commissioner to review and amend contracts between the PBM and pharmacies to ensure compliance. - Seeking necessary federal approvals to implement the program.

The bill aims to enhance cost efficiency, manage drug costs effectively, increase transparency, and improve prescription drug access and affordability for enrollees.

Bill text versions

Introduction PDF file

Actions

Date	Chamber	Where	Type	Name	Committee Name
February 19, 2025	Senate	Floor	Action	Introduction and first reading
February 19, 2025	Senate	Floor	Action	Referred to	Health and Human Services
March 09, 2025	Senate	Floor	Action	Author added

Citations

[
  {
    "analysis": {
      "added": [
        "Introduces a requirement for selecting a state pharmacy benefit manager through a competitive procurement process."
      ],
      "removed": [
        "Eliminates the unrestricted ability for managed care plans to determine their drug coverage strategies."
      ],
      "summary": "This bill modifies provisions related to the procurement and regulation of pharmacy benefit managers under section 256B.69, subdivision 6d.",
      "modified": [
        "Changes the structure of managed care contracts to include new regulatory obligations."
      ]
    },
    "citation": "256B.69"
  },
  {
    "analysis": {
      "added": [
        "Integration of the Formulary Committee's role in advising and developing preferred drug lists."
      ],
      "removed": [],
      "summary": "References the Formulary Committee established under section 256B.0625, subdivision 13c, which is utilized by the commissioner for certain pharmacy benefit decisions.",
      "modified": [
        "Broadens the scope of the committee's advisory capacity in prescription drug management for managed care plans."
      ]
    },
    "citation": "256B.0625, subdivision 13c"
  }
]