MN HF1516

Pharmacy benefit managers and health carriers are prohibited from requiring or demonstrating preference for specific pharmacies or health care providers to prescribe or dispense reference biological products, biosimilar products, or interchangeable biological products effective January 1, 2022.

If a pharmacy benefit manager or health carrier covers any of the three product types (reference biological, biosimilar, or interchangeable biological products), it must provide equivalent coverage for all three types.

Patients cannot be required to switch from a currently prescribed biological product to another product with a higher retail price.

The bill does not apply to coverage provided through public health care programs (chapters 256B or 256L) or the State Employee Group Insurance Plan (SEGIP).

The Commissioner of Health must analyze the effect of these requirements on net pricing for different payors and report findings to legislative committees with health and insurance jurisdiction by December 15, 2023.