Two bills that could lead to patients getting their needed medication without interference from pharmacy benefit managers (PBMs) and other third-parties are moving through the Capitol.
One bill (HF 3024
), authored by Rep. Matt Dean (R-Dellwood), would prohibit PBMs from “gagging” pharmacists from informing patients when paying cash may be cheaper than the patient’s co-payment or deductible for the drug they are prescribed. Currently, some PBM contracts prohibit pharmacists from doing this. The other bill (HF 3012
), authored by Rep. Roz Peterson (R-Lakeville), makes it clear that patients would only be required to pay the lowest price for a medication. Again, some PBMs prohibit this in contracts with pharmacists.
Both bills are designed to ensure patients know the lowest price and are not forced to pay more than that price.
The senate version of the Dean bill was heard in committee on March 20 where it was laid over. It was then offered as an amendment to an omnibus price transparency bill on March 22. The omnibus includes provisions that came out of the Senate Select Committee on Health Care Cost that met over the summer. That select committee was chaired by Sen. Scott Jensen (R-Chaska), one of two physicians in the senate. The omnibus bill also calls for more cost transparency for pharmacy costs, physician costs, and hospital costs, including the posting of the average payment rates for certain codes and providing good faith estimates to patients of what their costs will be.