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SF2176 (Legislative Session 94 (2025-2026))

Requirements that an enrollee receive any rebates and discounts accrued directly or indirectly to health carriers

Related bill: HF2047

AI Generated Summary

This bill, S.F. No. 2176, introduced in the Minnesota Senate, relates to healthcare and aims to ensure that health plan enrollees receive the full benefit of rebates and discounts associated with prescription drugs. The bill proposes adding a new section to Minnesota Statutes, Chapter 62A, addressing cost-sharing reductions at the point of sale.

Key Provisions:

  1. Definitions (Subdivision 1):

    • Defined cost-sharing: Refers to deductibles or coinsurance amounts for covered prescription drugs.
    • Health carrier: Includes insurers and pharmacy benefit managers (PBMs) managing pharmacy benefits.
    • Price protection rebate: A concession that kicks in when a drug's price surpasses a set threshold.
    • Rebate: Includes negotiated price concessions and other reductions passed to health carriers.

  2. Cost-Sharing Reductions (Subdivision 2):

    • Enrollees' out-of-pocket costs for prescription drugs must be reduced at the point of sale by an amount equal to 100% of all rebates a health carrier receives.
    • Health carriers have the option to further reduce cost-sharing beyond the required minimum.

  3. Confidentiality (Subdivision 3):

    • Health carriers and their agents cannot disclose rebate amounts at the product, therapeutic class, manufacturer, or pharmacy-specific level to protect trade secrets.
    • Rebate data is not public record and must remain confidential.
    • Any third-party vendors handling rebate data must comply with these confidentiality requirements.

  4. Enforcement (Subdivision 4):

    • Health carriers or PBMs that fail to comply may face sanctions, including civil penalties, license suspension, or revocation.

Purpose of the Bill:

The proposed law seeks to pass prescription drug rebates directly to consumers at the pharmacy counter, ensuring that patients benefit from cost savings rather than insurers or PBMs. It also includes protection for proprietary rebate information while enforcing compliance through potential penalties.

This bill has been referred to the Senate Committee on Commerce and Consumer Protection for further consideration.

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
March 05, 2025SenateFloorActionIntroduction and first reading
March 05, 2025SenateFloorActionReferred toCommerce and Consumer Protection

Citations

 
[
  {
    "analysis": {
      "added": [
        "A new provision requiring the passing of rebates to enrollees."
      ],
      "removed": [],
      "summary": "The bill references the definition of 'health carrier' as provided in section 62A.011.",
      "modified": []
    },
    "citation": "62A.011"
  },
  {
    "analysis": {
      "added": [
        "Clarification that pharmacy benefit managers are included under the definition of health carriers for the purpose of rebate management."
      ],
      "removed": [],
      "summary": "The bill includes a reference to section 62W.02 to define pharmacy benefit managers in relation to health carriers.",
      "modified": []
    },
    "citation": "62W.02"
  },
  {
    "analysis": {
      "added": [
        "Rebate information classified as trade secret, not a public record."
      ],
      "removed": [],
      "summary": "Cites chapter 13 in relation to the protection and non-disclosure of rebate information.",
      "modified": []
    },
    "citation": "13"
  }
]

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