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SF2152 (Legislative Session 94 (2025-2026))

Commissioner of Human Services establishment of a directed pharmacy dispensing payment to improve and maintain access to pharmaceutical services; appropriating money

Related bill: HF1100

AI Generated Summary

This bill (S.F. No. 2152) proposes an amendment to Minnesota Statutes 2024, section 256B.69, by adding a new subdivision to establish a Directed Pharmacy Dispensing Payment program. The purpose is to improve and maintain access to pharmaceutical services in rural and underserved areas of the state by providing an additional $4.50 per filled prescription to eligible outpatient retail pharmacies.

Key Provisions:

  1. Eligibility for Payment:

    • The payment applies to eligible outpatient retail pharmacies in Minnesota.
    • Pharmacies must be licensed under chapter 151 and must not be owned by a pharmacy benefit manager (PBM) or health carrier.
    • The pharmacy must either:
      • Be located in a medically underserved area or primarily serve a medically underserved population, as designated by the U.S. Department of Health and Human Services.
      • Share common ownership with 12 or fewer Minnesota pharmacies.

  2. Payment Administration:

    • Managed care and county-based purchasing plans, as well as PBMs under contract with these entities, must pay the additional $4.50 per prescription for drugs dispensed to Medical Assistance enrollees.
    • The payment must not replace or reduce any other dispensing fee currently paid.
    • Entities making these payments cannot offset them by reducing other payments to pharmacies.

  3. Verification Process:

    • Pharmacies must submit a form to the commissioner of human services attesting to their eligibility.

  4. Funding Adjustments:

    • The commissioner has the authority to set and adjust the payment amount based on available state and federal funding.
    • If federal approval is not received for the directed payment in a contract year, the capitation rates for managed care and county-based purchasing plans will be adjusted accordingly.
    • Contracts must allow recovery of payments from providers if capitation rates are adjusted.
    • If federal approval is permanently denied, the provision will expire.

Purpose:

This bill aims to preserve access to pharmacy services in rural and underserved areas, ensuring small and independent pharmacies can remain financially viable while serving Medical Assistance recipients.

Financial Implication:

The bill allocates state funding and leverages federal support, but the exact financial impact would depend on federal approval and state budget allocations.

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Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
March 02, 2025SenateFloorActionIntroduction and first reading
March 02, 2025SenateFloorActionReferred toHealth and Human Services
March 05, 2025SenateFloorActionAuthor added

Citations

 
[
  {
    "analysis": {
      "added": [
        "A new subsection introducing a pharmacy dispensing payment for pharmacies in underserved areas."
      ],
      "removed": [],
      "summary": "This bill amends Minnesota Statutes section 256B.69 to add a new subdivision requiring a directed pharmacy dispensing payment.",
      "modified": []
    },
    "citation": "256B.69"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "This bill references the definition of a health carrier as found in section 62A.011 subdivision 2.",
      "modified": []
    },
    "citation": "62A.011"
  }
]

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