Minnesota 2025-2026 Regular Session

Minnesota House Bill HF3922

Introduced
3/2/26  

Caption

Fair pricing in community pharmacy reimbursement required.

Impact

By implementing HF3922, Minnesota aims to enhance patient access to pharmacy services while preserving the financial stability of community pharmacies. One of the crucial aspects of the bill is the prohibition against below-cost reimbursements from pharmacy benefit managers (PBMs) and managed care organizations (MCOs). This regulation indicates a significant shift in how reimbursement practices are evaluated and enforced, potentially leading to broader financial stability within the pharmacy sector, crucial for patient care continuity.

Summary

HF3922, introduced in the Minnesota House, focuses on establishing fair pricing practices for community pharmacies regarding reimbursement rates for prescriptions. This legislation seeks to ensure that all community pharmacies receive at least the National Average Drug Acquisition Cost (NADAC) or Wholesale Acquisition Cost (WAC) for their services, coupled with a professional dispensing fee tailored to adequately compensate their operational costs. The bill emphasizes the importance of equitable treatment for community pharmacies in the reimbursement process.

Contention

However, the bill is not without points of contention. Critics may argue that increased reimbursements could lead to higher overall costs for healthcare systems or that the regulation might induce a backlash from PBMs concerning reimbursement practices. Additionally, there's concern regarding how the bill interacts with the federal 340B program, as it outlines exclusions that could complicate the implementation of fair pricing across various pharmacy types.

Notable_points

The finishing touches to HF3922 are also designed to promote parity in reimbursement rates, ensuring that PBM-owned and affiliated pharmacies do not receive preferential treatment over community pharmacies. This aim at transparency and fairness in reimbursement practices marks a positive step towards a more equitable health service landscape in Minnesota.

Companion Bills

MN SF3299

Similar To Community pharmacy reimbursement fair pricing requirement provision

Previously Filed As

MN SF3299

Community pharmacy reimbursement fair pricing requirement provision

MN HF4140

Minnesota Community Pharmacy Patient Access and Fair Reimbursement Act established, and rulemaking required.

MN S3212

"New Jersey Pharmacy Fair Reimbursement and Anti-Steering Act."

MN LD180

An Act Regarding Reimbursements by Health Insurance Carriers or Pharmacy Benefits Managers to Pharmacies

MN SF4062

Prohibit the use of spread pricing by pharmacy benefit managers

MN HB2208

Pharmacists; pharmacies; reimbursement costs; appeals

MN HB2196

Pharmacists; pharmacies; reimbursement costs; appeals

MN HB866

Prohibits pharmacy benefit managers and managed care plans from reducing pharmacy reimbursements (OR +$11,093,778 SG EX See Note)

MN HB1236

Provides relative to pharmacy benefit managers reimbursements (RE1 +$2,265,844 SG EX See Note)

MN S517

Fair Pricing & Trnspncy/340B Covered Entities

Similar Bills

AZ HB2196

Pharmacists; pharmacies; reimbursement costs; appeals

AZ HB2208

Pharmacists; pharmacies; reimbursement costs; appeals

TX HB2978

Relating to the minimum reimbursement amount for prescription drugs and devices to health benefit plan network pharmacists and pharmacies.

TX SB1354

Relating to the minimum reimbursement amount for prescription drugs and devices to health benefit plan network pharmacists and pharmacies.

HI HB2225

Relating To Health.

IA SF383

A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions. (Formerly SSB 1074.) Effective date: 07/01/2025. Applicability date: 07/01/2025.

IA HSB99

A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(See HF 852.)

IA SSB1074

A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(See SF 383.)