State Initiatives
The bills below are currently in-progress in the Minnesota Legislature
and need your MN Senator’s (1) and MN Representative’s (1) support!
Each bill’s section includes a brief description of Why it’s important, the bill’s Status, and What you can do to help get that bill passed. Next to the title of each piece of legislation you’ll find links to its status page (one for the House of Representatives’ version and one for the Senate’s version) on the MN Legislature’s website so that you can read up on where that bill is at in the policy-making process.
Bills in the MN House of Representatives and MN Senate can have up to 35 and 5 total authors, respectively, so we recommend that you prioritize reaching out to your legislators about bills they have yet to co-sponsor.
To find out who represents you in our state and federal governments, visit the MN Legislature’s website and enter the address where you’re registered to vote.
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If you don't vote in the state of Minnesota, check out what’s happening in your state currently to address pharmacy-related issues such as PBM abuse, provider status for pharmacists, test-to-treat legislation, equal payment for medical services, etc.
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Click here to access the National Community Pharmacists Association (NCPA)’s 2024 State Wins for Community Pharmacy to see the positive gains that have been made across state governments this year (notably, you’ll see that our state of Minnesota is NOT among them… we’ve got work to do!).
LEGISLATIVE TRACKER
Easily access the names, contact information, relevant committee assignments, and more for ALL of Minnesota’s state and federal legislators.
Stay up to date with MyBills
Did you know that you can also “subscribe” to email updates from your legislators to keep tabs on their legislative activity and community outreach?
To subscribe, head to the MN Legislature’s website and locate your legislator by clicking on “Members” under either the House of Representatives or Senate. Once you locate their profile, select “Click to subscribe” next to “Email updates” (located to the right of the legislator’s headshot).
If you’d like to stay up to date on the trajectory of these and other bills being debated in the Minnesota State Legislature, click here to set up a free MyBills account.
MyBills allows you to track House and Senate bills by bill number and topic. When you log in, your bills of interst will be listed along with information about recent or upcoming actions. Please note that MyBills does NOT send email notifications when actions are taken on bills; rather, you must login to your account to see these updates.
Minnesota is helping lead the charge nationally for prescription drug price transparency.
Click below to learn about their several ongoing initiatives!
January 30, 2025 | John (Owner & Pharmacist) shows MN state Representatives de-identified examples of underwater claims processed (unknown by the patients) through GoodRx
The 2025 MN Legislative Session has officially begun.
Members of our pharmacy are actively working with other MNIndys (Minnesota Independent Pharmacists) members, lobbyists, and legislators to pass critical PBM reform this session.
Bills of interest
Bills not yet introduced…
Minnesota Community Pharmacy Access and Fair Reimbursement Act
This bill—which we’re working on as a part of the MNIndys Legislative Working Group!—seeks to establish a fair floor for pharmacy reimbursement using a NADAC++ model:
National Average Drug Acquisition Cost + CODS dispensing fee + 2% or $25 (whichever is lower) to cover the cost of the myriad of services provided by pharmacists that aren’t currently covered by insurance, such as triaging walk-in’s, providing guidance on over-the-counter products, and providing health screenings (see graphics below for a visual representation)
If passed, this bill would also ban PBM tactics that restrict patient access (e.g., patient steering, spread pricing); require PBMs to maintain geographically accessible pharmacy networks so that patients in both urban and rural areas aren’t left without local pharmacy care; and impose penalties for unfair reimbursement and establishes a process for pharmacies to challenge low payments from PBMs, ensuring patients aren’t left without care due to unjust practices.
2. 62W revisions & updates
Unfortunately, the original PBM Transparency Act (62W) introduced in 2019 has proven insufficient at curbing PBMs’ abusive conduct in the State of Minnesota. This bill includes a number of provisions that would enhance this legislation and provide an additional level of regulation and appropriate accountability for unlawful behavior.
3. Medicaid coverage for health services by pharmacists
This legislation aims to ensure that pharmacists are financially compensated for providing healthcare services to Medicaid and MNSure patients, including chronic disease management, medication and vaccine administration, prescribing hormonal contraception, and conducting health screenings. Currently, Minnesota Medicaid and MNSure are not reimbursing pharmacies for these kinds of services provided to patients and authorized within their scope of practice (MN-151). For other providers in Minnesota—including RNs, APRNs, PAs, and chiropractors—Medicaid and MNSure reimbursement is tied to the healthcare services covered for physicians under MN-62D, 62A, and MN-256B.0625 and MN-256L.03. By adding pharmacists to the list of covered providers under Medicaid and MNSure, we can ensure that Minnesota pharmacists are compensated for the critical services they provide to patients. This bill mirrors consensus legislation that was passed for commercially insured patients during the 2024 Legislation Session.
Transition to a single PBM model for Medicaid
HF2242 & SF1574
Why it’s important
Minnesota Medicaid currently uses the Managed Care model to provide coverage to approximately 85% of beneficiaries. There are presently 8 different Managed Care Organizations (MCOs; listed below), each of which sub-contracts with a for-profit Pharmacy Benefit Manager (PBM) to pay pharmacies for prescriptions covered by Medicaid. For seven of the eight, the PBM is owned and operated outside of Minnesota.
UCare (MCO) | Navitus (PBM) | 368,804 (MN Medical Assistance (MA) enrollment as of February 2025)
Blue Plus | Prime Therapeutics | 310,221
HealthPartners | MedImpact | 148,484
Medica | Express Scripts | 50,390
PrimeWest Health | MedImpact | 46,295
Hennepin Health | Navitus | 24,254
South Country Health Alliance | PerformRx | 19,513
Itasca Medical Care | CVS Caremark | 6,861
These PBMs each separately control their payment rates to pharmacies and exert their market power to pay pharmacies as little as possible. It is not uncommon for the total payment to pharmacies to be less than $1 for a prescription, including the drug product, packaging, and—most importantly—the services provided by the pharmacy staff.
The State of Minnesota regularly conducts a Cost of Dispensing Survey (CODS), collecting data from pharmacies to determine how much it costs the pharmacy itself to operate and provide necessary medical infrastructure to Minnesota citizens. The most recent survey, endorsed by the State, shows that it costs a pharmacy an average of $11.55 per prescription, separate from the cost of the drug product itself, to break even and be able to continue operations.
Thus, every time a PBM from the above list forces payment to pharmacies for a Medicaid prescription that is less than $11.55 above the pharmacy’s acquisition cost, it results an operational loss for the pharmacy. Currently, as many as 50-70% of all Medicaid prescriptions paid for by PBMs representing MCOs result in an operational loss to the pharmacy. Long-term, pharmacies chronically operating at a loss are forced to close, leading to the continued spread of pharmacy deserts across Minnesota.
A thoughtful, bipartisan group of legislators has investigated a different model, already used by multiple other States, for Minnesota Medicaid to pay pharmacies; a model in which the State has direct control over how each prescription is paid for, using a payment algorithm the State already uses for Medicaid Fee-For-Service (FFS) beneficiaries. Unlike for-profit PBMs, who are driven by profit and have no reason to care whether a pharmacy remains in operation or not, the State has a responsibility to its citizens to care about pharmacy infrastructure and at least attempt to minimize the number of pharmacy deserts in Minnesota.
The model proposed in this bill would require that Medicaid MCOs contract with a single PBM chosen by the State, giving the State direct control over Medicaid payments to pharmacies and much more power and flexibility to ensure that as few Minnesotans as possible, both urban and rural, have difficulty accessing prescription medication because of local pharmacy closures.
Status as of March 27th, 2025
HF2242 was introduced by Representative Nadeau (R—34A) on 3/12/25 and immediately referred to the Health Finance and Policy Committee.
It has since added the following co-sponsors and is officially bipartisan: Youakim (DFL—46B), Davids (R—26B), Her (DFL—64A), Franson (R—12B), Hicks (DFL—25A), Schomacker (R—21A), Elkins (DFL—50B), Dotseth (R—11A), Burkel (R—1A), Warwas (R—7B), Pursell (DFL—58A), and Norris (DFL—32B).
SF1574 was introduced by Senator Mann (DFL—50) on 3/3/25 and was immediately referred to the Health and Human Services Committee. Click here to see members of our staff testify in support!
It has since added the following co-sponsors and is officially bipartisan: Wiklund (DFL—51), Abeler (R—35), Gruenhagen (R—17), and Boldon (DFL—25).
Click on the following links to view the current status of these bills—including any additional authors that have been added since the date listed above—on the MN Legislature’s official website: HF2242 | SF1574
What you can do
Contact your MN Representative and Senator! Bills in the MN House and Senate can have 35 and 5 total sponsors, respectively. However, even if a bill already has the maximum number of cosponsors, your legislator will eventually need to vote on the bill in order for it to pass, so it’s good to ask for their support either way. Specifically, we’re hoping to get a hearing scheduled for the house version (HF2242), so this is something to ask your Representative to help us get done!
For detailed instructions on how to contact your legislators and helpful tips and tricks, check out our How to Advocate page.
Directed pharmacy dispensing payment program
HF1100 & SF2152
Why it’s important
After decades of chronically low or complete lack of reimbursement from insurance companies (really, the PBMs that represent them) for the service of dispensing prescription medications, independent pharmacies like us are, unsurprisingly, in a financially dire place. Unfortunately, our state has seen some of the worst pharmacy closures in the nation recently: 40 have closed their doors since the beginning of 2023 and we’ve already lost 7 in 2025. This proposed legislation would create a directed pharmacy dispensing program that would give the pharmacies that are struggling the hardest and serve our most vulnerable community members—mainly those in rural and underserved urban areas—a flat-rate addition to the measly dispensing fee paid out by prepaid health plans (PMAPs, or the private health plans like HealthPartners and UCare that manage coverage for approximately 85% of Minnesota residents on Medicaid). It’s a lifeline that many pharmacies will go bankrupt without and has proved successful in other states.
The passing of this legislation would add an additional flat-rate fee (the amount of which is currently being investigated) for the filling of each prescription for the majority of Medicaid patients. Eligible pharmacies must (1) NOT be owned by a PBM and (2) be a non-chain or a chain of 12 or less pharmacies. Chains of 13+ pharmacies must be located in a HRSA-eligible area in order to qualify (i.e., caring for underserved patients per criteria set by the Health Resources & Services Administration (HRSA).
Status as of March 27th, 2025
HF1100 was introduced by Representative Bahner (DFL—37B) on 2/19/25 and immediately referred to the Health Finance and Policy Committee. Click here to see members of our staff testify in support!
It has since added the following co-sponsors and is officially bipartisan: Backer (R—9A), Bierman (DFL—56A), Nadeau (34A), Reyer (DFL—52A), Wolgamott (DFL—14B), Norris (DFL—32B), Pursell (DFL—58A), Franson (R—12B), Elkins (DFL—50B), and Rehrauer (DFL—35B).
SF2152 was introduced by Senator Mann (DFL—50) on 3/3/25 and was immediately referred to the Health and Human Services Committee. Click here to see members of our staff testify in support!
It has since added the following co-sponsors: Boldon (DFL—25).
Click on the following links to view the current status of these bills—including any additional authors that have been added since the date listed above—on the MN Legislature’s official website: HF1100 | SF2152
What you can do
Contact your MN Representative and Senator! Bills in the MN House and Senate can have 35 and 5 total sponsors, respectively. However, even if a bill already has the maximum number of cosponsors, your legislator will eventually need to vote on the bill in order for it to pass, so it’s good to ask for their support either way.
For detailed instructions on how to contact your legislators and helpful tips and tricks, check out our How to Advocate page.
Establish reimbursement rate requirement for Prepaid Medical Assistance Program (PMAP)
HF464 & SF52
Why it’s important
Managed Care Organizations (MCOs)—such as HealthPartners and UCare—are currently responsible for managing the care of the 85% of Minnesotan Medicaid patients on a Prepaid Health Plan (i.e., who are part of PMAP instead of having “straight Medical Assistance,” where the state covers the cost of their care directly). Operating independently on our state’s behalf, these entities have taken the opportunity to increase their profit margins by chronically underpaying healthcare providers, including pharmacies (a big reason why more and more providers literally cannot afford to take care of Medicaid patients). Recently introduced in the MN Senate, this bill would build upon the proposed “band-aid” solution of a directed pharmacy dispensing payment program (HF4916 | SF5123; see below) by establishing a permanent requirement that MCOs reimburse pharmacies like us at the state-determined dispensing fee rate.
The passing of this legislation would require that MCOs reimburse pharmacies at the dispensing fee rate determined by the Cost of Dispensing Survey (CODS) that is now required by law to be completed every 3 years. It would replace the proposed directed pharmacy dispensing payment program (HF4916 | SF5123), which, if passed, will function as a temporary solution to keep struggling pharmacies open until then.
Status as of March 28th, 2025
HF464 was introduced by Representative Harder (R—17B) on 2/13/25 (originally as HF5028 on 3/18/24) and immediately referred to the Health Finance and Policy Committee. It currently has no additional authors and a hearing has yet to be scheduled.
SF52 was introduced by Senator Gruenhagen (R—17) on 1/16/25 (originally as SF4843 on 3/11/24) and was immediately referred to the Health and Human Services Committee. It currently has no additional authors and a hearing has yet to be scheduled.
Click on the following links to view the current status of these bills—including any additional authors that have been added since the date listed above—on the MN Legislature’s official website: HF464 | SF52
What you can do
Contact your MN Representative and Senator! Bills in the MN House and Senate can have 35 and 5 total sponsors, respectively. However, even if a bill already has the maximum number of cosponsors, your legislator will eventually need to vote on the bill in order for it to pass, so it’s good to ask for their support either way.
For detailed instructions on how to contact your legislators and helpful tips and tricks, check out our How to Advocate page.