MN HF1257

Create new Minnesota Statutes section 62Q.83 requiring health plan companies to make formularies and related benefit information available electronically and in writing at least 30 days before annual renewal dates.

Require formularies to be organized and disclosed consistent with United States Pharmacopeia's Model Guidelines, with specific enrollee cost-sharing and expected out-of-pocket costs identified for each item or category.

Restrict health plan companies from removing brand name drugs from formularies or increasing enrollee costs during a contract term unless a therapeutically equivalent generic, multisource, or interchangeable biologic drug at lower cost is added, with at least 60-day notice to prescribers, pharmacists, and affected enrollees.

Allow health plan companies to change utilization review requirements or increase enrollee costs during contract term with 60-day notice, provided changes do not apply to enrollees currently taking affected drugs for the remainder of their contract term.

Permit removal of drugs from formularies only if deemed unsafe by FDA, withdrawn by FDA or manufacturer, or when independent research or clinical guidelines recommend changes in drug usage.

Amend Minnesota Statutes section 256B.69, subdivision 6, to require managed care plans and county-based purchasing plans to comply with the new transparency and disclosure requirements.