HF 5156

05/13/26   REVISOR  SGS/BH  26-08624
This Document can be made available
in alternative formats upon request  State of Minnesota
  HOUSE OF REPRESENTATIVES
  NINETY-FOURTH SESSION
  H. F. No.   5156
05/17/2026     Authored by Howard, Finke, Elkins, Mahamoud, Cha and others
  The bill was read for the first time and referred to the Committee on Health Finance and Policy
1.1A bill for an act
1.2relating to health care; establishing prices for prescription drugs subject to the
1.3Medicare Drug Price Negotiation Program; proposing coding for new law in
1.4Minnesota Statutes, chapter 62Q.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6Section 1. [62Q.586] MAXIMUM FAIR PRICE FOR CERTAIN PRESCRIPTION
1.7DRUGS.
1.8Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
1.9the meanings given.
1.10(b) "Manufacturer" has the meaning given in section 151.01, subdivision 14a.
1.11(c) "Maximum fair price" means the maximum fair price established for a prescription
1.12drug by the United States Department of Health and Human Services under United States
1.13Code, title 42, section 1320f-3.
1.14(d) "NADAC" means the national average drug acquisition cost.
1.15(e) "Pharmacy benefit manager" means a pharmacy benefit manager licensed under
1.16chapter 62W.
1.17(f) "Referenced drug" means a prescription drug subject to a maximum fair price.
1.18Subd. 2. Maximum fair price requirements. (a) A manufacturer is prohibited from
1.19accepting payment at an amount higher than the maximum fair price for the sale of a
1.20referenced drug intended for use by individuals in the state in person, by mail, or by any
1.21other means, plus any applicable pharmacy dispensing fees and provider administration
1.22fees.
Section 1.  1
05/13/26   REVISOR  SGS/BH  26-08624
2.1      (b) A health plan and a pharmacy benefit manager must not reimburse a pharmacy for
2.2  a referenced drug at an amount that is less than the maximum fair price or the NADAC,
2.3  whichever is greater, plus any established dispensing fee for the referenced drug. No
2.4  provision of this section shall be construed to prevent a pharmacy from receiving a dispensing
2.5  fee above the maximum fair price for a referenced drug.
2.6      (c) A health plan and a pharmacy benefit manager must, upon request, provide to the
2.7  Prescription Drug Affordability Board established under section 62J.87, financial information,
2.8  including administrative fees, formulary management fees, rebate retention, network access
2.9  fees, shared savings programs, and the total and final payment details, including the ingredient
2.10 cost and any dispensing fee, paid or payable by the health plan or pharmacy benefit manager
2.11 to a pharmacy for dispensing a referenced drug. The information must include all associated
2.12 fees, adjustments, and reconciliations. The information is subject to the data requirements
2.13 under section 62J.91, subdivision 3.
2.14     Subd. 3. Prohibition on withdrawing a referenced drug from sale. (a) A manufacturer
2.15 is prohibited from removing a drug from sale or distribution in the state for the purpose of
2.16 avoiding the impact of the rate limitations in this section unless the manufacturer provides
2.17 a written notice of withdrawal to the commissioner of health within 180 days prior to the
2.18 withdrawal.
2.19     (b) The commissioner of health shall assess a penalty on any manufacturer that has
2.20 withdrawn a referenced drug from sale or distribution in the state in violation of paragraph
2.21 (a). With respect to each referenced drug withdrawn by the manufacturer, the civil penalty
2.22 shall be equal to the greater of:
2.23     (1) $100,000; or
2.24     (2) the total amount of annual savings for the referenced drug, as determined by the
2.25 Prescription Drug Affordability Board.
2.26     EFFECTIVE DATE. This section is effective January 1, 2027.
Section 1.  2