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A bill for an act
relating to health care; establishing prices for prescription drugs subject to the
Medicare Drug Price Negotiation Program; proposing coding for new law in
Minnesota Statutes, chapter 62Q.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
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[62Q.586] MAXIMUM FAIR PRICE FOR CERTAIN PRESCRIPTION
DRUGS.
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Subdivision 1.
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Definitions.
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(a) For purposes of this section, the following terms have
the meanings given.
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(b) "Manufacturer" has the meaning given in section 151.01, subdivision 14a.
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(c) "Maximum fair price" means the maximum fair price established for a prescription
drug by the United States Department of Health and Human Services under United States
Code, title 42, section 1320f-3.
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(d) "NADAC" means the national average drug acquisition cost.
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(e) "Pharmacy benefit manager" means a pharmacy benefit manager licensed under
chapter 62W.
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(f) "Referenced drug" means a prescription drug subject to a maximum fair price.
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Subd. 2.
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Maximum fair price requirements.
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(a) A manufacturer is prohibited from
accepting payment at an amount higher than the maximum fair price for the sale of a
referenced drug intended for use by individuals in the state in person, by mail, or by any
other means, plus any applicable pharmacy dispensing fees and provider administration
fees.
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(b) A health plan and a pharmacy benefit manager must not reimburse a pharmacy for
a referenced drug at an amount that is less than the maximum fair price or the NADAC,
whichever is greater, plus any established dispensing fee for the referenced drug. No
provision of this section shall be construed to prevent a pharmacy from receiving a dispensing
fee above the maximum fair price for a referenced drug.
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(c) A health plan and a pharmacy benefit manager must, upon request, provide to the
Prescription Drug Affordability Board established under section 62J.87, financial information,
including administrative fees, formulary management fees, rebate retention, network access
fees, shared savings programs, and the total and final payment details, including the ingredient
cost and any dispensing fee, paid or payable by the health plan or pharmacy benefit manager
to a pharmacy for dispensing a referenced drug. The information must include all associated
fees, adjustments, and reconciliations. The information is subject to the data requirements
under section 62J.91, subdivision 3.
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Subd. 3.
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Prohibition on withdrawing a referenced drug from sale.
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(a) A manufacturer
is prohibited from removing a drug from sale or distribution in the state for the purpose of
avoiding the impact of the rate limitations in this section unless the manufacturer provides
a written notice of withdrawal to the commissioner of health within 180 days prior to the
withdrawal.
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(b) The commissioner of health shall assess a penalty on any manufacturer that has
withdrawn a referenced drug from sale or distribution in the state in violation of paragraph
(a). With respect to each referenced drug withdrawn by the manufacturer, the civil penalty
shall be equal to the greater of:
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(1) $100,000; or
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(2) the total amount of annual savings for the referenced drug, as determined by the
Prescription Drug Affordability Board.
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EFFECTIVE DATE.
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This section is effective January 1, 2027.
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