Legislation to increase transparency and accountability for pharmacy benefit managers (PBMs) took its final step with the adoption of the conference committee’s recommendations by both the House (130-2) and Senate (67-0). The bill was sent to the governor for his signature on May 16.

The bill creates a new licensure requirement for any PBM operating in Minnesota. It also requires annual reporting on the aggregate cost spend on wholesale drugs by the PBM, the aggregate amount of rebates received from drug manufacturers, whether the PMB has any exclusive contracts with manufacturers, and any spread between the amount charged to plan sponsors and the amount paid to pharmacies.  

The bill also includes several provisions designed to ensure patients can get their medications as the best price. It prohibits PBMs from requiring enrollees from filling their prescriptions at a retail, mail order, or specialty pharmacy for which the PBM has an ownership interest; prohibits pharmacies from telling enrollees that there may be a cheaper drug other than the covered drug available, called “gag clauses” and says a PBM can’t require patients to pay a higher price if they elect to pay cash rather than use their health insurance.  

The House bill is authored by Rep. Alice Mann, MD, (DFL – Lakeville). The Senate version of the bill is authored by Sen. Scott Jensen, MD, (R – Chaska). The agreed-to conference committee language will now go back to each body for final action before being sent to Gov. Walz for his signature.

All four of the physicians in the Legislature were members of the six-member conference committee.
 

Originally posted at: https://www.mnmed.org/news-and-publications/News/MMA-supported-PBM-Bill-Passes-Through-Conference-C

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