This Minnesota House bill (H.F. No. 2047) aims to require that any rebates and discounts on prescription drugs accrued by health carriers be passed directly to enrollees at the point of sale. It introduces a new section (62A.3096) in the Minnesota Statutes under Chapter 62A, focusing on cost-sharing reductions.

Key Provisions:

1. Definitions:

   • Defined cost-sharing: The deductible or coinsurance amount an enrollee pays for a covered prescription drug.
   • Health carrier: Includes insurance companies and pharmacy benefit managers (PBMs) managing prescription drug benefits.
   • Price protection rebate: A price concession that applies when a drug’s wholesale cost exceeds a specified threshold.
   • Rebate: Any negotiated price concessions, including base price rebates and performance-based reductions.

2. Cost-Sharing Reduction:

   • Enrollees' cost-sharing for prescription drugs must be calculated using a price that reflects 100% of all rebates received or expected for that drug.
   • Health carriers may reduce cost-sharing by even more than this requirement.

3. Confidentiality:

   • Health carriers and their agents cannot disclose specific rebate amounts, whether by product, manufacturer, or pharmacy.
   • Rebate information is designated as a trade secret and not public information.
   • Vendors or third parties handling health care services on behalf of a health carrier must also adhere to these confidentiality protections.

4. Enforcement:

   • Health carriers or pharmacy benefit managers that fail to comply with these requirements may face penalties, including:
     • Civil fines,
     • Suspension or revocation of their licenses.

Summary:

This bill mandates that insurers and PBMs pass prescription drug rebates directly to consumers at the point of sale, lowering their out-of-pocket costs. It also establishes strict confidentiality protections for rebate information and sets penalties for non-compliance.

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