Minnesota 2023 2023-2024 Regular Session

Minnesota House Bill HF17 Introduced / Bill

Filed 01/04/2023

                    1.1	A bill for an act​
1.2 relating to health; prohibiting excessive price increases by manufacturers to generic​
1.3 or off-patent drugs; authorizing the attorney general to take action against​
1.4 manufacturers for certain price increases; prohibiting withdrawal of certain generic​
1.5 or off-patent drugs sales; establishing a prescription drug affordability board and​
1.6 prescription drug affordability advisory council; providing for prescription drug​
1.7 cost reviews and remedies; providing appointments; imposing civil penalties;​
1.8 requiring a report; appropriating money; amending Minnesota Statutes 2022,​
1.9 section 151.071, subdivisions 1, 2; proposing coding for new law in Minnesota​
1.10 Statutes, chapter 62J.​
1.11BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:​
1.12 Section 1. [62J.841] DEFINITIONS.​
1.13 Subdivision 1.Scope.For purposes of sections 62J.841 to 62J.845, the following​
1.14definitions apply.​
1.15 Subd. 2.Consumer Price Index."Consumer Price Index" means the Consumer Price​
1.16Index, Annual Average, for All Urban Consumers, CPI-U: U.S. City Average, All Items,​
1.17reported by the United States Department of Labor, Bureau of Labor Statistics, or its​
1.18successor or, if the index is discontinued, an equivalent index reported by a federal authority​
1.19or, if no such index is reported, "Consumer Price Index" means a comparable index chosen​
1.20by the Bureau of Labor Statistics.​
1.21 Subd. 3.Generic or off-patent drug."Generic or off-patent drug" means any prescription​
1.22drug for which any exclusive marketing rights granted under the Federal Food, Drug, and​
1.23Cosmetic Act, section 351 of the federal Public Health Service Act, and federal patent law​
1.24have expired, including any drug-device combination product for the delivery of a generic​
1.25drug.​
1​Section 1.​
REVISOR AGW/BM 23-00549​12/19/22 ​
State of Minnesota​
This Document can be made available​
in alternative formats upon request​
HOUSE OF REPRESENTATIVES​
H. F. No.  17​
NINETY-THIRD SESSION​
Authored by Stephenson, Liebling, Howard, Klevorn, Lislegard and others​01/04/2023​
The bill was read for the first time and referred to the Committee on Commerce Finance and Policy​ 2.1 Subd. 4.Manufacturer."Manufacturer" has the meaning provided in section 151.01,​
2.2subdivision 14a.​
2.3 Subd. 5.Prescription drug."Prescription drug" means a drug for human use subject​
2.4to United States Code, title 21, section 353(b)(1).​
2.5 Subd. 6.Wholesale acquisition cost."Wholesale acquisition cost" has the meaning​
2.6provided in United States Code, title 42, section 1395w-3a.​
2.7 Subd. 7.Wholesale distributor."Wholesale distributor" has the meaning provided in​
2.8section 151.441, subdivision 14.​
2.9 Sec. 2. [62J.842] EXCESSIVE PRICE INCREASES PROHIBITED.​
2.10 Subdivision 1.Prohibition.No manufacturer shall impose, or cause to be imposed, an​
2.11excessive price increase, whether directly or through a wholesale distributor, pharmacy, or​
2.12similar intermediary, on the sale of any generic or off-patent drug sold, dispensed, or​
2.13delivered to any consumer in the state.​
2.14 Subd. 2.Excessive price increase.A price increase is excessive for purposes of this​
2.15section when:​
2.16 (1) the price increase, adjusted for inflation utilizing the Consumer Price Index, exceeds:​
2.17 (i) 15 percent of the wholesale acquisition cost over the immediately preceding calendar​
2.18year; or​
2.19 (ii) 40 percent of the wholesale acquisition cost over the immediately preceding three​
2.20calendar years; and​
2.21 (2) the price increase, adjusted for inflation utilizing the Consumer Price Index, exceeds​
2.22$30 for:​
2.23 (i) a 30-day supply of the drug; or​
2.24 (ii) a course of treatment lasting less than 30 days.​
2.25 Subd. 3.Exemption.It is not a violation of this section for a wholesale distributor or​
2.26pharmacy to increase the price of a generic or off-patent drug if the price increase is directly​
2.27attributable to additional costs for the drug imposed on the wholesale distributor or pharmacy​
2.28by the manufacturer of the drug.​
2​Sec. 2.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 3.1 Sec. 3. [62J.843] REGISTERED AGENT AND OFFICE WITHIN THE STATE.​
3.2 Any manufacturer that sells, distributes, delivers, or offers for sale any generic or​
3.3off-patent drug in the state must maintain a registered agent and office within the state.​
3.4 Sec. 4. [62J.844] ENFORCEMENT .​
3.5 Subdivision 1.Notification.The commissioner of management and budget and any​
3.6other state agency that provides or purchases a pharmacy benefit except the Department of​
3.7Human Services, and any entity under contract with a state agency to provide a pharmacy​
3.8benefit other than an entity under contract with the Department of Human Services, shall​
3.9notify the manufacturer of a generic or off-patent drug, the attorney general, and the Board​
3.10of Pharmacy of any price increase that the commissioner or entity believes may violate​
3.11section 62J.842.​
3.12 Subd. 2.Submission of drug cost statement and other information by manufacturer;​
3.13investigation by attorney general.(a) Within 45 days of receiving a notice under subdivision​
3.141, the manufacturer of the generic or off-patent drug shall submit a drug cost statement to​
3.15the attorney general. The statement must:​
3.16 (1) itemize the cost components related to production of the drug;​
3.17 (2) identify the circumstances and timing of any increase in materials or manufacturing​
3.18costs that caused any increase during the preceding calendar year, or preceding three calendar​
3.19years as applicable, in the price of the drug; and​
3.20 (3) provide any other information that the manufacturer believes to be relevant to a​
3.21determination of whether a violation of section 62J.842 has occurred.​
3.22 (b) The attorney general may investigate whether a violation of section 62J.842 has​
3.23occurred, is occurring, or is about to occur, in accordance with section 8.31, subdivision 2.​
3.24 Subd. 3.Petition to court.(a) On petition of the attorney general, a court may issue an​
3.25order:​
3.26 (1) compelling the manufacturer of a generic or off-patent drug to:​
3.27 (i) provide the drug cost statement required under subdivision 2, paragraph (a); and​
3.28 (ii) answer interrogatories, produce records or documents, or be examined under oath,​
3.29as required by the attorney general under subdivision 2, paragraph (b);​
3.30 (2) restraining or enjoining a violation of sections 62J.841 to 62J.845, including issuing​
3.31an order requiring that drug prices be restored to levels that comply with section 62J.842;​
3​Sec. 4.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 4.1 (3) requiring the manufacturer to provide an accounting to the attorney general of all​
4.2revenues resulting from a violation of section 62J.842;​
4.3 (4) requiring the manufacturer to repay to all consumers, including any third-party payers,​
4.4any money acquired as a result of a price increase that violates section 62J.842;​
4.5 (5) notwithstanding section 16A.151, requiring that all revenues generated from a​
4.6violation of section 62J.842 be remitted to the state and deposited into a special fund, to be​
4.7used for initiatives to reduce the cost to consumers of acquiring prescription drugs, if a​
4.8manufacturer is unable to determine the individual transactions necessary to provide the​
4.9repayments described in clause (4);​
4.10 (6) imposing a civil penalty of up to $10,000 per day for each violation of section 62J.842;​
4.11 (7) providing for the attorney general's recovery of costs and disbursements incurred in​
4.12bringing an action against a manufacturer found in violation of section 62J.842, including​
4.13the costs of investigation and reasonable attorney's fees; and​
4.14 (8) providing any other appropriate relief, including any other equitable relief as​
4.15determined by the court.​
4.16 (b) For purposes of paragraph (a), clause (6), every individual transaction in violation​
4.17of section 62J.842 is considered a separate violation.​
4.18 Subd. 4.Private right of action.Any action brought pursuant to section 8.31, subdivision​
4.193a, by a person injured by a violation of section 62J.842 is for the benefit of the public.​
4.20 Sec. 5. [62J.845] PROHIBITION ON WITHDRAWAL OF GENERIC OR​
4.21OFF-PATENT DRUGS FOR SALE.​
4.22 Subdivision 1.Prohibition.A manufacturer of a generic or off-patent drug is prohibited​
4.23from withdrawing that drug from sale or distribution within this state for the purpose of​
4.24avoiding the prohibition on excessive price increases under section 62J.842.​
4.25 Subd. 2.Notice to board and attorney general.Any manufacturer that intends to​
4.26withdraw a generic or off-patent drug from sale or distribution within the state shall provide​
4.27a written notice of withdrawal to the Board of Pharmacy and the attorney general, at least​
4.28180 days prior to the withdrawal.​
4.29 Subd. 3.Financial penalty.The attorney general shall assess a penalty of $500,000 on​
4.30any manufacturer of a generic or off-patent drug that the attorney general determines has​
4.31failed to comply with the requirements of this section.​
4​Sec. 5.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 5.1 Sec. 6. [62J.846] SEVERABILITY.​
5.2 If any provision of sections 62J.841 to 62J.845 or the application thereof to any person​
5.3or circumstance is held invalid for any reason in a court of competent jurisdiction, the​
5.4invalidity does not affect other provisions or any other application of sections 62J.841 to​
5.562J.845 that can be given effect without the invalid provision or application.​
5.6 Sec. 7. [62J.85] CITATION.​
5.7 Sections 62J.85 to 62J.95 may be cited as the "Prescription Drug Affordability Act."​
5.8 Sec. 8. [62J.86] DEFINITIONS.​
5.9 Subdivision 1.Definitions.For the purposes of sections 62J.85 to 62J.95, the following​
5.10terms have the meanings given them.​
5.11 Subd. 2.Advisory council."Advisory council" means the Prescription Drug Affordability​
5.12Advisory Council established under section 62J.88.​
5.13 Subd. 3.Biologic."Biologic" means a drug that is produced or distributed in accordance​
5.14with a biologics license application approved under Code of Federal Regulations, title 42,​
5.15section 447.502.​
5.16 Subd. 4.Biosimilar."Biosimilar" has the meaning provided in section 62J.84, subdivision​
5.172, paragraph (b).​
5.18 Subd. 5.Board."Board" means the Prescription Drug Affordability Board established​
5.19under section 62J.87.​
5.20 Subd. 6.Brand name drug."Brand name drug" has the meaning provided in section​
5.2162J.84, subdivision 2, paragraph (c).​
5.22 Subd. 7.Generic drug."Generic drug" has the meaning provided in section 62J.84,​
5.23subdivision 2, paragraph (e).​
5.24 Subd. 8.Group purchaser."Group purchaser" has the meaning given in section 62J.03,​
5.25subdivision 6, and includes pharmacy benefit managers as defined in section 62W.02,​
5.26subdivision 15.​
5.27 Subd. 9.Manufacturer."Manufacturer" means an entity that:​
5.28 (1) engages in the manufacture of a prescription drug product or enters into a lease with​
5.29another manufacturer to market and distribute a prescription drug product under the entity's​
5.30own name; and​
5​Sec. 8.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 6.1 (2) sets or changes the wholesale acquisition cost of the prescription drug product it​
6.2manufacturers or markets.​
6.3 Subd. 10.Prescription drug product."Prescription drug product" means a brand name​
6.4drug, a generic drug, a biologic, or a biosimilar.​
6.5 Subd. 11.Wholesale acquisition cost or WAC."Wholesale acquisition cost" or "WAC"​
6.6has the meaning given in United States Code, title 42, section 1395W-3a(c)(6)(B).​
6.7 Sec. 9. [62J.87] PRESCRIPTION DRUG AFFORDABILITY BOARD.​
6.8 Subdivision 1.Establishment.The Legislative Coordinating Commission shall establish​
6.9the Prescription Drug Affordability Board, which shall be governed as a board under section​
6.1015.012, paragraph (a), to protect consumers, state and local governments, health plan​
6.11companies, providers, pharmacies, and other health care system stakeholders from​
6.12unaffordable costs of certain prescription drugs.​
6.13 Subd. 2.Membership.(a) The Prescription Drug Affordability Board consists of seven​
6.14members appointed as follows:​
6.15 (1) three members appointed by the governor;​
6.16 (2) one member appointed by the majority leader of the senate;​
6.17 (3) one member appointed by the minority leader of the senate;​
6.18 (4) one member appointed by the speaker of the house; and​
6.19 (5) one member appointed by the minority leader of the house of representatives.​
6.20 (b) All members appointed must have knowledge and demonstrated expertise in​
6.21pharmaceutical economics and finance or health care economics and finance. A member​
6.22must not be an employee of, a board member of, or a consultant to a manufacturer or trade​
6.23association for manufacturers or a pharmacy benefit manager or trade association for​
6.24pharmacy benefit managers.​
6.25 (c) Initial appointments must be made by January 1, 2024.​
6.26 Subd. 3.Terms.(a) Board appointees shall serve four-year terms, except that initial​
6.27appointees shall serve staggered terms of two, three, or four years as determined by lot by​
6.28the secretary of state. A board member shall serve no more than two consecutive terms.​
6.29 (b) A board member may resign at any time by giving written notice to the board.​
6.30 Subd. 4.Chair; other officers.(a) The governor shall designate an acting chair from​
6.31the members appointed by the governor.​
6​Sec. 9.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 7.1 (b) The board shall elect a chair to replace the acting chair at the first meeting of the​
7.2board by a majority of the members. The chair shall serve for one year.​
7.3 (c) The board shall elect a vice-chair and other officers from its membership as it deems​
7.4necessary.​
7.5 Subd. 5.Staff; technical assistance.(a) The board shall hire an executive director and​
7.6other staff, who shall serve in the unclassified service. The executive director must have​
7.7knowledge and demonstrated expertise in pharmacoeconomics, pharmacology, health policy,​
7.8health services research, medicine, or a related field or discipline. The board may employ​
7.9or contract for professional and technical assistance as the board deems necessary to perform​
7.10the board's duties.​
7.11 (b) The attorney general shall provide legal services to the board.​
7.12 Subd. 6.Compensation.The board members shall not receive compensation but may​
7.13receive reimbursement for expenses as authorized under section 15.059, subdivision 3.​
7.14 Subd. 7.Meetings.(a) Meetings of the board are subject to chapter 13D. The board shall​
7.15meet publicly at least every three months to review prescription drug product information​
7.16submitted to the board under section 62J.90. If there are no pending submissions, the chair​
7.17of the board may cancel or postpone the required meeting. The board may meet in closed​
7.18session when reviewing proprietary information as determined under the standards developed​
7.19in accordance with section 62J.91, subdivision 4.​
7.20 (b) The board shall announce each public meeting at least two weeks prior to the​
7.21scheduled date of the meeting. Any materials for the meeting shall be made public at least​
7.22one week prior to the scheduled date of the meeting.​
7.23 (c) At each public meeting, the board shall provide the opportunity for comments from​
7.24the public, including the opportunity for written comments to be submitted to the board​
7.25prior to a decision by the board.​
7.26 Sec. 10. [62J.88] PRESCRIPTION DRUG AFFORDABILITY ADVISORY​
7.27COUNCIL.​
7.28 Subdivision 1.Establishment.The governor shall appoint a 12-member stakeholder​
7.29advisory council to provide advice to the board on drug cost issues and to represent​
7.30stakeholders' views. The governor shall appoint the members of the advisory council based​
7.31on the members' knowledge and demonstrated expertise in one or more of the following​
7.32areas: the pharmaceutical business; practice of medicine; patient perspectives; health care​
7.33cost trends and drivers; clinical and health services research; and the health care marketplace.​
7​Sec. 10.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 8.1 Subd. 2.Membership.The council's membership shall consist of the following:​
8.2 (1) two members representing patients and health care consumers;​
8.3 (2) two members representing health care providers;​
8.4 (3) one member representing health plan companies;​
8.5 (4) two members representing employers, with one member representing large employers​
8.6and one member representing small employers;​
8.7 (5) one member representing government employee benefit plans;​
8.8 (6) one member representing pharmaceutical manufacturers;​
8.9 (7) one member who is a health services clinical researcher;​
8.10 (8) one member who is a pharmacologist; and​
8.11 (9) one member representing the commissioner of health with expertise in health​
8.12economics.​
8.13 Subd. 3.Terms.(a) The initial appointments to the advisory council must be made by​
8.14January 1, 2024. The initial appointed advisory council members shall serve staggered terms​
8.15of two, three, or four years determined by lot by the secretary of state. Following the initial​
8.16appointments, the advisory council members shall serve four-year terms.​
8.17 (b) Removal and vacancies of advisory council members shall be governed by section​
8.1815.059.​
8.19 Subd. 4.Compensation.Advisory council members may be compensated according to​
8.20section 15.059.​
8.21 Subd. 5.Meetings.Meetings of the advisory council are subject to chapter 13D. The​
8.22advisory council shall meet publicly at least every three months to advise the board on drug​
8.23cost issues related to the prescription drug product information submitted to the board under​
8.24section 62J.90.​
8.25 Subd. 6.Exemption.Notwithstanding section 15.059, the advisory council shall not​
8.26expire.​
8.27 Sec. 11. [62J.89] CONFLICTS OF INTEREST.​
8.28 Subdivision 1.Definition.For purposes of this section, "conflict of interest" means a​
8.29financial or personal association that has the potential to bias or have the appearance of​
8.30biasing a person's decisions in matters related to the board, the advisory council, or in the​
8​Sec. 11.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 9.1conduct of the board's or council's activities. A conflict of interest includes any instance in​
9.2which a person, a person's immediate family member, including a spouse, parent, child, or​
9.3other legal dependent, or an in-law of any of the preceding individuals, has received or​
9.4could receive a direct or indirect financial benefit of any amount deriving from the result​
9.5or findings of a decision or determination of the board. For purposes of this section, a​
9.6financial benefit includes honoraria, fees, stock, the value of the member's, immediate family​
9.7member's, or in-law's stock holdings, and any direct financial benefit deriving from the​
9.8finding of a review conducted under sections 62J.85 to 62J.95. Ownership of securities is​
9.9not a conflict of interest if the securities are: (1) part of a diversified mutual or exchange​
9.10traded fund; or (2) in a tax-deferred or tax-exempt retirement account that is administered​
9.11by an independent trustee.​
9.12 Subd. 2.General.(a) Prior to the acceptance of an appointment or employment, or prior​
9.13to entering into a contractual agreement, a board or advisory council member, board staff​
9.14member, or third-party contractor must disclose to the appointing authority or the board​
9.15any conflicts of interest. The information disclosed must include the type, nature, and​
9.16magnitude of the interests involved.​
9.17 (b) A board member, board staff member, or third-party contractor with a conflict of​
9.18interest with regard to any prescription drug product under review must recuse themselves​
9.19from any discussion, review, decision, or determination made by the board relating to the​
9.20prescription drug product.​
9.21 (c) Any conflict of interest must be disclosed in advance of the first meeting after the​
9.22conflict is identified or within five days after the conflict is identified, whichever is earlier.​
9.23 Subd. 3.Prohibitions.Board members, board staff, or third-party contractors are​
9.24prohibited from accepting gifts, bequeaths, or donations of services or property that raise​
9.25the specter of a conflict of interest or have the appearance of injecting bias into the activities​
9.26of the board.​
9.27 Sec. 12. [62J.90] PRESCRIPTION DRUG PRICE INFORMATION; DECISION​
9.28TO CONDUCT COST REVIEW.​
9.29 Subdivision 1.Drug price information from the commissioner of health and other​
9.30sources.(a) The commissioner of health shall provide to the board the information reported​
9.31to the commissioner by drug manufacturers under section 62J.84, subdivisions 3, 4, and 5.​
9.32The commissioner shall provide this information to the board within 30 days of the date the​
9.33information is received from drug manufacturers.​
9​Sec. 12.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 10.1 (b) The board shall subscribe to one or more prescription drug pricing files, such as​
10.2Medispan or FirstDatabank, or as otherwise determined by the board.​
10.3 Subd. 2.Identification of certain prescription drug products.(a) The board, in​
10.4consultation with the advisory council, shall identify the following prescription drug products:​
10.5 (1) brand name drugs or biologics for which the WAC increases by more than ten percent​
10.6or by more than $10,000 during any 12-month period or course of treatment if less than 12​
10.7months, after adjusting for changes in the consumer price index (CPI);​
10.8 (2) brand name drugs or biologics that have been introduced at a WAC of $30,000 or​
10.9more per calendar year or per course of treatment;​
10.10 (3) biosimilar drugs that have been introduced at a WAC that is not at least 15 percent​
10.11lower than the referenced brand name biologic at the time the biosimilar is introduced; and​
10.12 (4) generic drugs for which the WAC:​
10.13 (i) is $100 or more, after adjusting for changes in the CPI, for:​
10.14 (A) a 30-day supply lasting a patient for 30 consecutive days based on the recommended​
10.15dosage approved for labeling by the United States Food and Drug Administration (FDA);​
10.16 (B) a supply lasting a patient for fewer than 30 days based on recommended dosage​
10.17approved for labeling by the FDA; or​
10.18 (C) one unit of the drug if the labeling approved by the FDA does not recommend a​
10.19finite dosage; and​
10.20 (ii) is increased by 200 percent or more during the immediate preceding 12-month period,​
10.21as determined by the difference between the resulting WAC and the average of the WAC​
10.22reported over the preceding 12 months, after adjusting for changes in the CPI.​
10.23 (b) The board, in consultation with the advisory council, shall identify prescription drug​
10.24products not described in paragraph (a) that may impose costs that create significant​
10.25affordability challenges for the state health care system or for patients, including but not​
10.26limited to drugs to address public health emergencies.​
10.27 (c) The board shall make available to the public the names and related price information​
10.28of the prescription drug products identified under this subdivision, with the exception of​
10.29information determined by the board to be proprietary under the standards developed by​
10.30the board under section 62J.91, subdivision 4.​
10.31 Subd. 3.Determination to proceed with review.(a) The board may initiate a cost​
10.32review of a prescription drug product identified by the board under this section.​
10​Sec. 12.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 11.1 (b) The board shall consider requests by the public for the board to proceed with a cost​
11.2review of any prescription drug product identified under this section.​
11.3 (c) If there is no consensus among the members of the board on whether to initiate a​
11.4cost review of a prescription drug product, any member of the board may request a vote to​
11.5determine whether to review the cost of the prescription drug product.​
11.6 Sec. 13. [62J.91] PRESCRIPTION DRUG PRODUCT REVIEWS.​
11.7 Subdivision 1.General.Once a decision by the board has been made to proceed with​
11.8a cost review of a prescription drug product, the board shall conduct the review and make​
11.9a determination as to whether appropriate utilization of the prescription drug under review,​
11.10based on utilization that is consistent with the United States Food and Drug Administration​
11.11(FDA) label or standard medical practice, has led or will lead to affordability challenges​
11.12for the state health care system or for patients.​
11.13 Subd. 2.Review considerations.In reviewing the cost of a prescription drug product,​
11.14the board may consider the following factors:​
11.15 (1) the price at which the prescription drug product has been and will be sold in the state;​
11.16 (2) the average monetary price concession, discount, or rebate the manufacturer provides​
11.17to a group purchaser in this state as reported by the manufacturer and the group purchaser​
11.18expressed as a percent of the WAC for the prescription drug product under review;​
11.19 (3) the price at which therapeutic alternatives have been or will be sold in the state;​
11.20 (4) the average monetary price concession, discount, or rebate the manufacturer provides​
11.21or is expected to provide to a group purchaser in the state or is expected to provide to group​
11.22purchasers in the state for therapeutic alternatives;​
11.23 (5) the cost to group purchasers based on patient access consistent with the FDA-labeled​
11.24indications;​
11.25 (6) the impact on patient access resulting from the cost of the prescription drug product​
11.26relative to insurance benefit design;​
11.27 (7) the current or expected dollar value of drug-specific patient access programs that are​
11.28supported by manufacturers;​
11.29 (8) the relative financial impacts to health, medical, or other social services costs that​
11.30can be quantified and compared to baseline effects of existing therapeutic alternatives;​
11​Sec. 13.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 12.1 (9) the average patient co-pay or other cost-sharing for the prescription drug product in​
12.2the state;​
12.3 (10) any information a manufacturer chooses to provide; and​
12.4 (11) any other factors as determined by the board.​
12.5 Subd. 3.Further review factors.If, after considering the factors described in subdivision​
12.62, the board is unable to determine whether a prescription drug product will produce or has​
12.7produced an affordability challenge, the board may consider:​
12.8 (1) manufacturer research and development costs, as indicated on the manufacturer's​
12.9federal tax filing for the most recent tax year in proportion to the manufacturer's sales in​
12.10the state;​
12.11 (2) that portion of direct-to-consumer marketing costs eligible for favorable federal tax​
12.12treatment in the most recent tax year that are specific to the prescription drug product under​
12.13review and that are multiplied by the ratio of total manufacturer in-state sales to total​
12.14manufacturer sales in the United States for the product under review;​
12.15 (3) gross and net manufacturer revenues for the most recent tax year;​
12.16 (4) any information and research related to the manufacturer's selection of the introductory​
12.17price or price increase, including but not limited to:​
12.18 (i) life cycle management;​
12.19 (ii) market competition and context; and​
12.20 (iii) projected revenue; and​
12.21 (5) any additional factors determined by the board to be relevant.​
12.22 Subd. 4.Public data; proprietary information.(a) Any submission made to the board​
12.23related to a drug cost review must be made available to the public with the exception of​
12.24information determined by the board to be proprietary.​
12.25 (b) The board shall establish the standards for the information to be considered proprietary​
12.26under paragraph (a) and section 62J.90, subdivision 2, including standards for heightened​
12.27consideration of proprietary information for submissions for a cost review of a drug that is​
12.28not yet approved by the FDA.​
12.29 (c) Prior to the board establishing the standards under paragraph (b), the public shall be​
12.30provided notice and the opportunity to submit comments.​
12​Sec. 13.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 13.1 (d) The establishment of standards under this subdivision is exempt from the rulemaking​
13.2requirements under chapter 14, and section 14.386 does not apply.​
13.3 Sec. 14. [62J.92] DETERMINATIONS; COMPLIANCE; REMEDIES.​
13.4 Subdivision 1.Upper payment limit.(a) In the event the board finds that the spending​
13.5on a prescription drug product reviewed under section 62J.91 creates an affordability​
13.6challenge for the state health care system or for patients, the board shall establish an upper​
13.7payment limit after considering:​
13.8 (1) the cost of administering the drug;​
13.9 (2) the cost of delivering the drug to consumers;​
13.10 (3) the range of prices at which the drug is sold in the United States according to one or​
13.11more pricing files accessed under section 62J.90, subdivision 1, and the range at which​
13.12pharmacies are reimbursed in Canada; and​
13.13 (4) any other relevant pricing and administrative cost information for the drug.​
13.14 (b) The upper payment limit must apply to all public and private purchases, payments,​
13.15and payer reimbursements for the prescription drug product that is intended for individuals​
13.16in the state in person, by mail, or by other means.​
13.17 Subd. 2.Noncompliance.(a) The board shall, and other persons may, notify the Office​
13.18of the Attorney General of a potential failure by an entity subject to an upper payment limit​
13.19to comply with that limit.​
13.20 (b) If the Office of the Attorney General finds that an entity was noncompliant with the​
13.21upper payment limit requirements, the attorney general may pursue remedies consistent​
13.22with chapter 8 or appropriate criminal charges if there is evidence of intentional profiteering.​
13.23 (c) An entity who obtains price concessions from a drug manufacturer that result in a​
13.24lower net cost to the stakeholder than the upper payment limit established by the board is​
13.25not considered noncompliant.​
13.26 (d) The Office of the Attorney General may provide guidance to stakeholders concerning​
13.27activities that could be considered noncompliant.​
13.28 Subd. 3.Appeals.(a) Persons affected by a decision of the board may request an appeal​
13.29of the board's decision within 30 days of the date of the decision. The board shall hear the​
13.30appeal and render a decision within 60 days of the hearing.​
13.31 (b) All appeal decisions are subject to judicial review in accordance with chapter 14.​
13​Sec. 14.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 14.1 Sec. 15. [62J.93] REPORTS.​
14.2 Beginning March 1, 2024, and each March 1 thereafter, the board shall submit a report​
14.3to the governor and legislature on general price trends for prescription drug products and​
14.4the number of prescription drug products that were subject to the board's cost review and​
14.5analysis, including the result of any analysis as well as the number and disposition of appeals​
14.6and judicial reviews.​
14.7 Sec. 16. [62J.94] ERISA PLANS AND MEDICARE DRUG PLANS.​
14.8 (a) Nothing in sections 62J.85 to 62J.95 shall be construed to require ERISA plans or​
14.9Medicare Part D plans to comply with decisions of the board. ERISA plans or Medicare​
14.10Part D plans are free to choose to exceed the upper payment limit established by the board​
14.11under section 62J.92.​
14.12 (b) Providers who dispense and administer drugs in the state must bill all payers no more​
14.13than the upper payment limit without regard to whether an ERISA plan or Medicare Part​
14.14D plan chooses to reimburse the provider in an amount greater than the upper payment limit​
14.15established by the board.​
14.16 (c) For purposes of this section, an ERISA plan or group health plan is an employee​
14.17welfare benefit plan established by or maintained by an employer or an employee​
14.18organization, or both, that provides employer sponsored health coverage to employees and​
14.19the employee's dependents and is subject to the Employee Retirement Income Security Act​
14.20of 1974 (ERISA).​
14.21Sec. 17. [62J.95] SEVERABILITY.​
14.22 If any provision of sections 62J.85 to 62J.94 or the application thereof to any person or​
14.23circumstance is held invalid for any reason in a court of competent jurisdiction, the invalidity​
14.24does not affect other provisions or any other application of sections 62J.85 to 62J.94 that​
14.25can be given effect without the invalid provision or application.​
14.26Sec. 18. Minnesota Statutes 2022, section 151.071, subdivision 1, is amended to read:​
14.27 Subdivision 1.Forms of disciplinary action.When the board finds that a licensee,​
14.28registrant, or applicant has engaged in conduct prohibited under subdivision 2, it may do​
14.29one or more of the following:​
14.30 (1) deny the issuance of a license or registration;​
14.31 (2) refuse to renew a license or registration;​
14​Sec. 18.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 15.1 (3) revoke the license or registration;​
15.2 (4) suspend the license or registration;​
15.3 (5) impose limitations, conditions, or both on the license or registration, including but​
15.4not limited to: the limitation of practice to designated settings; the limitation of the scope​
15.5of practice within designated settings; the imposition of retraining or rehabilitation​
15.6requirements; the requirement of practice under supervision; the requirement of participation​
15.7in a diversion program such as that established pursuant to section 214.31 or the conditioning​
15.8of continued practice on demonstration of knowledge or skills by appropriate examination​
15.9or other review of skill and competence;​
15.10 (6) impose a civil penalty not exceeding $10,000 for each separate violation, except that​
15.11a civil penalty not exceeding $25,000 may be imposed for each separate violation of section​
15.1262J.842, the amount of the civil penalty to be fixed so as to deprive a licensee or registrant​
15.13of any economic advantage gained by reason of the violation, to discourage similar violations​
15.14by the licensee or registrant or any other licensee or registrant, or to reimburse the board​
15.15for the cost of the investigation and proceeding, including but not limited to, fees paid for​
15.16services provided by the Office of Administrative Hearings, legal and investigative services​
15.17provided by the Office of the Attorney General, court reporters, witnesses, reproduction of​
15.18records, board members' per diem compensation, board staff time, and travel costs and​
15.19expenses incurred by board staff and board members; and​
15.20 (7) reprimand the licensee or registrant.​
15.21Sec. 19. Minnesota Statutes 2022, section 151.071, subdivision 2, is amended to read:​
15.22 Subd. 2.Grounds for disciplinary action.The following conduct is prohibited and is​
15.23grounds for disciplinary action:​
15.24 (1) failure to demonstrate the qualifications or satisfy the requirements for a license or​
15.25registration contained in this chapter or the rules of the board. The burden of proof is on​
15.26the applicant to demonstrate such qualifications or satisfaction of such requirements;​
15.27 (2) obtaining a license by fraud or by misleading the board in any way during the​
15.28application process or obtaining a license by cheating, or attempting to subvert the licensing​
15.29examination process. Conduct that subverts or attempts to subvert the licensing examination​
15.30process includes, but is not limited to: (i) conduct that violates the security of the examination​
15.31materials, such as removing examination materials from the examination room or having​
15.32unauthorized possession of any portion of a future, current, or previously administered​
15.33licensing examination; (ii) conduct that violates the standard of test administration, such as​
15​Sec. 19.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 16.1communicating with another examinee during administration of the examination, copying​
16.2another examinee's answers, permitting another examinee to copy one's answers, or​
16.3possessing unauthorized materials; or (iii) impersonating an examinee or permitting an​
16.4impersonator to take the examination on one's own behalf;​
16.5 (3) for a pharmacist, pharmacy technician, pharmacist intern, applicant for a pharmacist​
16.6or pharmacy license, or applicant for a pharmacy technician or pharmacist intern registration,​
16.7conviction of a felony reasonably related to the practice of pharmacy. Conviction as used​
16.8in this subdivision includes a conviction of an offense that if committed in this state would​
16.9be deemed a felony without regard to its designation elsewhere, or a criminal proceeding​
16.10where a finding or verdict of guilt is made or returned but the adjudication of guilt is either​
16.11withheld or not entered thereon. The board may delay the issuance of a new license or​
16.12registration if the applicant has been charged with a felony until the matter has been​
16.13adjudicated;​
16.14 (4) for a facility, other than a pharmacy, licensed or registered by the board, if an owner​
16.15or applicant is convicted of a felony reasonably related to the operation of the facility. The​
16.16board may delay the issuance of a new license or registration if the owner or applicant has​
16.17been charged with a felony until the matter has been adjudicated;​
16.18 (5) for a controlled substance researcher, conviction of a felony reasonably related to​
16.19controlled substances or to the practice of the researcher's profession. The board may delay​
16.20the issuance of a registration if the applicant has been charged with a felony until the matter​
16.21has been adjudicated;​
16.22 (6) disciplinary action taken by another state or by one of this state's health licensing​
16.23agencies:​
16.24 (i) revocation, suspension, restriction, limitation, or other disciplinary action against a​
16.25license or registration in another state or jurisdiction, failure to report to the board that​
16.26charges or allegations regarding the person's license or registration have been brought in​
16.27another state or jurisdiction, or having been refused a license or registration by any other​
16.28state or jurisdiction. The board may delay the issuance of a new license or registration if an​
16.29investigation or disciplinary action is pending in another state or jurisdiction until the​
16.30investigation or action has been dismissed or otherwise resolved; and​
16.31 (ii) revocation, suspension, restriction, limitation, or other disciplinary action against a​
16.32license or registration issued by another of this state's health licensing agencies, failure to​
16.33report to the board that charges regarding the person's license or registration have been​
16.34brought by another of this state's health licensing agencies, or having been refused a license​
16​Sec. 19.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 17.1or registration by another of this state's health licensing agencies. The board may delay the​
17.2issuance of a new license or registration if a disciplinary action is pending before another​
17.3of this state's health licensing agencies until the action has been dismissed or otherwise​
17.4resolved;​
17.5 (7) for a pharmacist, pharmacy, pharmacy technician, or pharmacist intern, violation of​
17.6any order of the board, of any of the provisions of this chapter or any rules of the board or​
17.7violation of any federal, state, or local law or rule reasonably pertaining to the practice of​
17.8pharmacy;​
17.9 (8) for a facility, other than a pharmacy, licensed by the board, violations of any order​
17.10of the board, of any of the provisions of this chapter or the rules of the board or violation​
17.11of any federal, state, or local law relating to the operation of the facility;​
17.12 (9) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the​
17.13public, or demonstrating a willful or careless disregard for the health, welfare, or safety of​
17.14a patient; or pharmacy practice that is professionally incompetent, in that it may create​
17.15unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of​
17.16actual injury need not be established;​
17.17 (10) aiding or abetting an unlicensed person in the practice of pharmacy, except that it​
17.18is not a violation of this clause for a pharmacist to supervise a properly registered pharmacy​
17.19technician or pharmacist intern if that person is performing duties allowed by this chapter​
17.20or the rules of the board;​
17.21 (11) for an individual licensed or registered by the board, adjudication as mentally ill​
17.22or developmentally disabled, or as a chemically dependent person, a person dangerous to​
17.23the public, a sexually dangerous person, or a person who has a sexual psychopathic​
17.24personality, by a court of competent jurisdiction, within or without this state. Such​
17.25adjudication shall automatically suspend a license for the duration thereof unless the board​
17.26orders otherwise;​
17.27 (12) for a pharmacist or pharmacy intern, engaging in unprofessional conduct as specified​
17.28in the board's rules. In the case of a pharmacy technician, engaging in conduct specified in​
17.29board rules that would be unprofessional if it were engaged in by a pharmacist or pharmacist​
17.30intern or performing duties specifically reserved for pharmacists under this chapter or the​
17.31rules of the board;​
17.32 (13) for a pharmacy, operation of the pharmacy without a pharmacist present and on​
17.33duty except as allowed by a variance approved by the board;​
17​Sec. 19.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 18.1 (14) for a pharmacist, the inability to practice pharmacy with reasonable skill and safety​
18.2to patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type​
18.3of material or as a result of any mental or physical condition, including deterioration through​
18.4the aging process or loss of motor skills. In the case of registered pharmacy technicians,​
18.5pharmacist interns, or controlled substance researchers, the inability to carry out duties​
18.6allowed under this chapter or the rules of the board with reasonable skill and safety to​
18.7patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type​
18.8of material or as a result of any mental or physical condition, including deterioration through​
18.9the aging process or loss of motor skills;​
18.10 (15) for a pharmacist, pharmacy, pharmacist intern, pharmacy technician, medical gas​
18.11dispenser, or controlled substance researcher, revealing a privileged communication from​
18.12or relating to a patient except when otherwise required or permitted by law;​
18.13 (16) for a pharmacist or pharmacy, improper management of patient records, including​
18.14failure to maintain adequate patient records, to comply with a patient's request made pursuant​
18.15to sections 144.291 to 144.298, or to furnish a patient record or report required by law;​
18.16 (17) fee splitting, including without limitation:​
18.17 (i) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate,​
18.18kickback, or other form of remuneration, directly or indirectly, for the referral of patients;​
18.19 (ii) referring a patient to any health care provider as defined in sections 144.291 to​
18.20144.298 in which the licensee or registrant has a financial or economic interest as defined​
18.21in section 144.6521, subdivision 3, unless the licensee or registrant has disclosed the​
18.22licensee's or registrant's financial or economic interest in accordance with section 144.6521;​
18.23and​
18.24 (iii) any arrangement through which a pharmacy, in which the prescribing practitioner​
18.25does not have a significant ownership interest, fills a prescription drug order and the​
18.26prescribing practitioner is involved in any manner, directly or indirectly, in setting the price​
18.27for the filled prescription that is charged to the patient, the patient's insurer or pharmacy​
18.28benefit manager, or other person paying for the prescription or, in the case of veterinary​
18.29patients, the price for the filled prescription that is charged to the client or other person​
18.30paying for the prescription, except that a veterinarian and a pharmacy may enter into such​
18.31an arrangement provided that the client or other person paying for the prescription is notified,​
18.32in writing and with each prescription dispensed, about the arrangement, unless such​
18.33arrangement involves pharmacy services provided for livestock, poultry, and agricultural​
18.34production systems, in which case client notification would not be required;​
18​Sec. 19.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 19.1 (18) engaging in abusive or fraudulent billing practices, including violations of the​
19.2federal Medicare and Medicaid laws or state medical assistance laws or rules;​
19.3 (19) engaging in conduct with a patient that is sexual or may reasonably be interpreted​
19.4by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning​
19.5to a patient;​
19.6 (20) failure to make reports as required by section 151.072 or to cooperate with an​
19.7investigation of the board as required by section 151.074;​
19.8 (21) knowingly providing false or misleading information that is directly related to the​
19.9care of a patient unless done for an accepted therapeutic purpose such as the dispensing and​
19.10administration of a placebo;​
19.11 (22) aiding suicide or aiding attempted suicide in violation of section 609.215 as​
19.12established by any of the following:​
19.13 (i) a copy of the record of criminal conviction or plea of guilty for a felony in violation​
19.14of section 609.215, subdivision 1 or 2;​
19.15 (ii) a copy of the record of a judgment of contempt of court for violating an injunction​
19.16issued under section 609.215, subdivision 4;​
19.17 (iii) a copy of the record of a judgment assessing damages under section 609.215,​
19.18subdivision 5; or​
19.19 (iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.​
19.20The board must investigate any complaint of a violation of section 609.215, subdivision 1​
19.21or 2;​
19.22 (23) for a pharmacist, practice of pharmacy under a lapsed or nonrenewed license. For​
19.23a pharmacist intern, pharmacy technician, or controlled substance researcher, performing​
19.24duties permitted to such individuals by this chapter or the rules of the board under a lapsed​
19.25or nonrenewed registration. For a facility required to be licensed under this chapter, operation​
19.26of the facility under a lapsed or nonrenewed license or registration; and​
19.27 (24) for a pharmacist, pharmacist intern, or pharmacy technician, termination or discharge​
19.28from the health professionals services program for reasons other than the satisfactory​
19.29completion of the program.; and​
19.30 (25) for a manufacturer, a violation of section 62J.842 or section 62J.845.​
19​Sec. 19.​
REVISOR AGW/BM 23-00549​12/19/22 ​ 20.1 Sec. 20. APPROPRIATION.​
20.2 $....... in fiscal year 2024 and $....... in fiscal year 2025 are appropriated from the general​
20.3fund to the Prescription Drug Affordability Board established under Minnesota Statutes,​
20.4section 62J.87, for implementation of the Prescription Drug Affordability Act.​
20​Sec. 20.​
REVISOR AGW/BM 23-00549​12/19/22 ​