Maddy summaryThis bill regulates how pharmacy benefit managers operate in Minnesota by establishing clearer rules for reimbursement and pricing. It directly affects pharmacy benefit managers, pharmacies, and health insurance plans by requiring fair dealing and prohibiting deceptive practices. Key provisions ban charging pharmacies fees for processing claims, forbid paying pharmacies less than the rates given to the manager's own affiliates, and explicitly outlaw the use of spread pricing. Additionally, the law mandates that managers provide transparent pricing data to pharmacies and update these lists frequently when drug costs rise significantly.
Rep. Kristin Bahner
Sponsored bills
Maddy summaryThis bill requires pharmacy benefit managers and health carriers in Minnesota to include lower-cost generic and biosimilar drugs on their drug lists whenever a more expensive brand-name version is covered. It mandates that these plans structure their coverage tiers to prioritize medications that result in the lowest out-of-pocket costs for patients, such as co-pays and coinsurance. Additionally, the law forces plans to immediately add new generic or biosimilar drugs to their lists if they are cheaper than existing options and removes barriers like prior authorization for the lowest-cost alternatives. These changes directly affect health insurance companies and pharmacy benefit managers by altering how they select and organize covered medications to reduce expenses for individuals.