Bill > HF2242

This bill establishes a comprehensive framework for managing prescription drug benefits in Minnesota's Medicaid and MinnesotaCare programs by requiring the commissioner of human services to select a single state pharmacy benefit manager (PBM) through a competitive procurement process. The bill mandates that the selected PBM must be transparent about its financial arrangements, disclose potential conflicts of interest, and provide quarterly reports detailing drug prices, rebates, and savings. The PBM will be responsible for processing pharmacy claims for managed care plans and must operate under strict oversight, with the commissioner having the authority to approve or disapprove utilization review limitations and reimbursement rates. Key provisions include prohibiting the PBM from requiring enrollees to use specialty pharmacies affiliated with the PBM, ensuring the lowest possible drug costs for managed care enrollees, and increasing transparency in prescription drug pricing. The bill aims to improve drug benefit administration by giving the commissioner broad powers to negotiate drug prices, develop preferred drug lists, and manage drug formularies, with the ultimate goals of reducing costs, promoting health, and ensuring proper prescription drug benefit administration. The provisions will become effective on January 1, 2027, or upon federal approval, whichever occurs later.

Health and Social Services

https://www.revisor.mn.gov/bills/bill.php?b=House&f=HF2242&ssn=0&y=2025