MN SF3063

Prohibits pharmacy benefit managers (PBMs) from engaging in "spread pricing," where PBMs charge health plans more for drugs than they pay pharmacies, keeping the difference as profit

Increases PBM license application and renewal fees from $8,500 to a minimum of $15,000, and late fees from $500 to a minimum of $1,000, with penalties for operating without a license raised from $5,000 to at least $10,000 per day

Imposes fiduciary duties on PBMs toward health carriers, requiring them to act with care, skill, prudence, and diligence, and prohibits PBMs from charging pharmacies claim adjudication fees

Establishes pharmacy reimbursement protections requiring PBMs to pay pharmacies at least the national average drug acquisition cost and prohibiting reimbursement rates lower than what PBM-affiliated pharmacies receive

Strengthens maximum allowable cost pricing rules, requiring price list updates within seven days of significant cost increases and allowing pharmacies to decline to fill prescriptions if reimbursement falls below their acquisition cost