Signed by Governor Tim Walz

Vote Smart's Synopsis:

Vote to adopt a conference report that establishes a $35 co-pay per 30-day insulin supply.

Highlights:

• Requires group health plans and health plan companies that offer group or individual health plans with dependent coverage to provide written notice to an enrollee with dependent child coverage that the dependent child's coverage ends when the child reaches the age of 26 (Sec. 2).

• Requires the board to publish a page on its website that provides regularly updated information concerning the insulin safety net program, including information on how to access the program (Sec. 3).

• Requires each manufacturer, by July 1, 2020, to establish procedures to make insulin available to eligible individuals who are in urgent need of insulin or who are in need of access to an affordable insulin supply (Sec. 4).

• Exempts any manufacturer with an annual gross revenue of $2 million or less from insulin sales in Minnesota from this section (Sec. 4).

• Exempts an insulin product from this section if the wholesale acquisition cost of the insulin is $8 or less per milliliter or applicable National Council for Prescription Drug Plan billing unit, for the entire assessment time period, adjusted annually based on the consumer price index (Sec. 4).

• Establishes eligibility for receiving an urgent-need supply of insulin based on the individual (Sec. 4):

• Being a resident of Minnesota;

• Not being enrolled in medical assistance or MinnesotaCare;

• Not being enrolled in prescription drug coverage that limits the total amount of cost sharing that the enrollee is required to pay for a 30-day supply of insulin, including co-payments, deductibles, or coinsurance, to $75 or less;

• Not having received an urgent need supply of insulin through this program within the previous 12 months, unless otherwise authorized; and

• Being in urgent need of insulin.

• Specifies that if the individual is in urgent need of insulin, the individual can present a completed, signed, and dated application form to a pharmacy (Sec. 4).

• Requires a pharmacist, upon receipt of a complete and signed application, to dispense the prescribed insulin in an amount that will provide the individual with a 30-day supply (Sec. 4).

• Authorizes the pharmacy to collect an insulin co-payment from the individual to cover the pharmacy’s costs of processing and dispensing in an amount not to exceed $35 for the 30 day supply (Sec. 4).

• Requires the pharmacy to provide each eligible individual with the information sheet and a list of trained navigators provided by the Board of Pharmacy for the individual to contact if the individual is in need of accessing ongoing insulin coverage options (Sec. 4).

• Requires each manufacturer to make a patient assistance program available to any individual who meets the specified requirements (Sec. 4).

• Specifies that if an individual has applied for medical assistance or MinnesotaCare but has not been determined eligible or has been determined eligible but coverage has not become effective or the individual has been determined ineligible for the manufacturers' patient assistance program by the manufacturer and the individual has requested a review but the panel has not rendered a decision, the individual may access urgent-need insulin if the individual is in urgent need of insulin (Sec. 4).

• Authorizes the board to assess an administrative penalty of $200,000 per month if a manufacturer fails to comply with this section, with the penalty increasing $400,000 per month if the manufacturer continues to be in noncompliance after 6 months, and increasing to $600,000 per month if the manufacturer continues to be in noncompliance after one year (Sec. 4).

• Specifies that this section is effective the day following final enactment (Sec. 5).

Full Bill Text