Bill > SF3063

This bill modifies regulations for pharmacy benefit managers (PBMs) in Minnesota, introducing several key provisions designed to increase transparency, fairness, and accountability in pharmaceutical pricing and services. The bill defines "spread pricing" as a pricing model where PBMs charge health plans a different price for prescription drugs than what they pay pharmacies, and explicitly prohibits this practice. It increases license application and renewal fees for PBMs from $8,500 to at least $15,000 and introduces more substantial penalties for violations. The bill establishes new fiduciary duties for PBMs, requiring them to act in good faith, discharge duties with care and professionalism, and not charge pharmacies fees for claim processing. It also mandates more transparent reporting requirements, including detailed annual transparency reports to the commissioner of commerce, and creates stricter rules around maximum allowable cost pricing, including a comprehensive appeals process for pharmacies. Additionally, the bill prohibits PBMs from reimbursing pharmacies less than they reimburse their own affiliates, ensures pharmacies are paid at least the national average drug acquisition cost, and prevents retroactive claim adjustments except under specific circumstances. The bill is accompanied by an appropriation to fund increased staff for investigating and enforcing these new PBM regulations.

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https://www.revisor.mn.gov/bills/bill.php?b=Senate&f=SF3063&ssn=0&y=2025