1.1 A bill for an act
1.2 relating to health care; requiring that an enrollee receive any rebates and discounts
1.3 accrued directly or indirectly to health carriers; proposing coding for new law in
1.4 Minnesota Statutes, chapter 62A.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. [62A.3096] COST-SHARING REDUCTIONS AT POINT OF SALE.
1.7 Subdivision 1.Definitions.(a) For purposes of this section, the following terms have
1.8the meanings given.
1.9 (b) "Defined cost-sharing" means a deductible or coinsurance amount imposed on an
1.10enrollee for a covered prescription drug under the terms of the enrollee's health plan.
1.11 (c) "Health carrier" has the meaning given in section 62A.011, subdivision 2. Health
1.12carrier includes a pharmacy benefit manager as defined in section 62W.02, subdivision 15,
1.13with respect to the pharmacy benefit management services provided on behalf of a health
1.14carrier.
1.15 (d) "Price protection rebate" means a negotiated price concession that accrues directly
1.16or indirectly to the health carrier, or other party on behalf of the health carrier, in the event
1.17the wholesale acquisition cost of a drug increases above a specified threshold.
1.18 (e) "Rebate" means:
1.19 (1) negotiated price concessions, including but not limited to base price concessions,
1.20whether described as a rebate or otherwise, and reasonable estimates of any price protection
1.21rebates and performance-based price concessions that may accrue directly or indirectly to
1Section 1.
25-02751 as introduced02/07/25 REVISOR RSI/AC
SENATE
STATE OF MINNESOTA
S.F. No. 2176NINETY-FOURTH SESSION
(SENATE AUTHORS: NELSON)
OFFICIAL STATUSD-PGDATE
Introduction and first reading03/06/2025
Referred to Commerce and Consumer Protection 2.1the health carrier during the coverage year from a manufacturer, dispensing pharmacy, or
2.2other party in connection with dispensing or administering a prescription drug; and
2.3 (2) reasonable estimates of any negotiated prices, concessions, fees, and other
2.4administrative costs that are passed through to the health carrier and serve to reduce the
2.5health carrier's liabilities for a prescription drug.
2.6 Subd. 2.Decrease in cost-sharing.(a) An enrollee's defined cost-sharing for each
2.7prescription drug must be calculated at the point of sale based on a price that is reduced by
2.8an amount equal to 100 percent of all rebates received or to be received in connection with
2.9dispensing or administering the prescription drug.
2.10 (b) Nothing in this section precludes a health carrier from decreasing an enrollee's defined
2.11cost-sharing by an amount greater than is required under this subdivision.
2.12 Subd. 3.Confidentiality.(a) When complying with this section, a health carrier or the
2.13health carrier's agents must not publish or otherwise reveal information regarding the actual
2.14amount of rebates a health carrier receives on a product, therapeutic class of products,
2.15manufacturer-specific basis, or pharmacy-specific basis.
2.16 (b) Rebate information is protected as a trade secret, is not a public record under chapter
2.1713, and must not be disclosed:
2.18 (1) directly;
2.19 (2) indirectly;
2.20 (3) in a manner that may identify an individual product, therapeutic class of products,
2.21or manufacturer; or
2.22 (4) in a manner that has the potential to compromise the financial, competitive, or
2.23proprietary nature of the information.
2.24 (c) A health carrier must impose the confidentiality protections of this section on any
2.25vendor or downstream third party that performs health care or administrative services on
2.26behalf of the health carrier that may receive or have access to rebate information.
2.27 Subd. 4.Enforcement.A health carrier or pharmacy benefit manager that fails to comply
2.28with this section may be subject to sanctions under the appropriate chapters regulating the
2.29health carrier or pharmacy benefit manager, including civil penalties and suspension or
2.30revocation of the health carrier's or pharmacy benefit manager's license.
2Section 1.
25-02751 as introduced02/07/25 REVISOR RSI/AC