Bill > HF1076

This bill requires pharmacy benefit managers and health carriers to include lower-cost drugs in their drug formularies (lists of covered medications) and structure their health plans to prioritize medications with the lowest out-of-pocket costs for patients. Specifically, the bill mandates that if a brand-name drug is included in a formulary, the equivalent generic drug with the lowest wholesale acquisition cost must also be included, and vice versa. The same requirement applies to brand-name biologics and their biosimilar equivalents. The bill defines key terms like "generic drug," "biosimilar," and "out-of-pocket cost," and requires that when new generic or biosimilar drugs are approved and have a lower wholesale acquisition cost, they must be immediately added to the formulary. Additionally, pharmacy benefit managers and health carriers must structure their formularies to give preference to drugs with the lowest patient costs and cannot impose prior authorization, step therapy, or other restrictions that make it difficult for patients to access the most affordable medication options. The provisions of this bill will take effect on January 1, 2026, aiming to help patients access more affordable prescription medications.

Health and Social Services

https://www.revisor.mn.gov/bills/bill.php?b=House&f=HF1076&ssn=0&y=2025