Commissioner of human services selection of a state pharmacy benefit manager through procurement requirement provision, commissioner of human services entrance into a master contract with the state pharmacy benefit manager requirement provision, and program authority and eligibility requirements specification provision
Impact
If enacted, S.F. No. 1574 would modify existing statutes regarding prescription drug management under state-funded health care programs. By consolidating the role of pharmacy benefit managers, the bill aims to increase the state's bargaining power in drug price negotiations, potentially leading to reduced costs for both the state and enrollees. Additionally, the bill emphasizes the need for transparency in drug pricing, requiring the state PBM to regularly report on pricing and rebate practices, which may improve accountability within the drug pricing system.
Summary
S.F. No. 1574, introduced in Minnesota, mandates the commissioner of human services to select a single state pharmacy benefit manager (PBM) through a competitive procurement process. The objective of this bill is to streamline and enhance the effectiveness of managing prescription drug coverage under the state’s medical assistance and MinnesotaCare programs. The commissioner will establish eligibility criteria for entities wishing to serve as the PBM and will enter into a master contract that includes provisions regarding drug pricing, rebates, and the overall management of drug utilization.
Contention
Notable points of contention surrounding S.F. No. 1574 include concerns about the potential impact on smaller health care providers and how the single PBM model might affect competition. Critics argue that a centralized PBM may lead to a lack of competition, which could ultimately affect the quality of service and options available to enrollees. Advocates for the bill contend that a single PBM would simplify the complexities of drug management and improve cost efficiency, claiming it is essential for managing the state's health care expenses effectively.
Similar To
Commissioner of human services required to select a state pharmacy benefit manager through procurement, commissioner required to enter into a master contract with the state pharmacy benefit manager, program authority and eligibility requirements specified, and report required.
Commissioner of human services directed to establish a prescription drug purchasing program, program authority and eligibility requirements specified, and report required.
Equal coverage of services provided by pharmacist required, and medical assistance and MinnesotaCare requirements for coverage and payment of pharmacy services set.
Pharmacy benefit manager business practices modified, pharmacy benefit manager general reimbursement practices established, and maximum allowable cost pricing requirements modified.
Commissioner of human services required to select a state pharmacy benefit manager through procurement, commissioner required to enter into a master contract with the state pharmacy benefit manager, program authority and eligibility requirements specified, and report required.