The proposed bill aims to establish fair pricing standards for community pharmacy reimbursements in Minnesota, as outlined in a new section of the Minnesota Statutes, chapter 62J. It mandates that the total reimbursement for any prescription drug dispensed by a community pharmacy must be at least equal to the National Average Drug Acquisition Cost (NADAC) or, if unavailable, the Wholesale Acquisition Cost (WAC), along with a professional dispensing fee that is adjusted biennially based on an independent cost-of-dispensing survey. The bill also clarifies that reimbursement for covered entities participating in the federal 340B program will be determined according to federal and state law, without requiring reimbursement at or above NADAC or WAC.

Additionally, the bill prohibits below-cost reimbursements and negative adjustments for community pharmacies. It sets forth specific requirements for pharmacy benefit managers (PBMs) and managed care organizations (MCOs), including that they must reimburse community pharmacies at or above the established reimbursement standard without applying any reductions. The bill also ensures parity in reimbursement rates between community pharmacies and PBM-owned or affiliated pharmacies, preventing PBMs from offering higher rates to their own pharmacies. Furthermore, it prohibits any direct or indirect fees that would reduce the net reimbursement to community pharmacies below the mandated standard.