MN HF3931

Prohibits pharmacy benefit managers (PBMs) from engaging in spread pricing, where they charge health plans more for drugs than they pay pharmacies, and bars PBMs from deriving income except through flat, defined pharmacy benefit management fees disclosed to health carriers

Imposes fiduciary duties on PBMs toward health carriers, requiring them to act with care, skill, prudence, and professionalism, and to disclose conflicts of interest in writing

Increases PBM license application and renewal fees from $8,500 to a range between $15,000 and an unspecified maximum, with late fees rising from $500 to at least $1,000, and raises unlicensed operation penalties from $5,000/day to at least $10,000/day

Prohibits PBMs from charging pharmacies claim-related fees, reimbursing pharmacies below national average drug acquisition cost, making retroactive payment reductions except for fraud or billing errors, and paying affiliated pharmacies more than non-affiliated pharmacies

Appropriates unspecified funding in fiscal year 2027 to the Commissioner of Commerce to increase staff for PBM investigation and enforcement under Minnesota Statutes chapter 62W