Subdivision 1. Scope of coverage.
This section applies to all health plans issued or renewed to a Minnesota resident.
Subd. 2. Definitions.
(a) For the purposes of this section, the terms defined in this subdivision have the meanings given them.
(b) "Cost-sharing" means a deductible payment, co-payment, or coinsurance amount imposed on an enrollee for a covered prescription drug in accordance with the terms and conditions of the enrollee's health plan.
(c) "Legend drug" has the same meaning as in section 151.01, subdivision 17 .
(d) "Prescription insulin drug" means a legend drug that contains insulin and is used to treat diabetes.
(e) "Net price" means the health plan company's cost for a prescription insulin drug, including any rebates or discounts received by or accrued directly or indirectly to the health plan company from a drug manufacturer or pharmacy benefit manager.
Subd. 3. Cost-sharing limits.
(a) A health plan that imposes a cost-sharing requirement on the coverage of a prescription insulin drug shall limit the total amount of cost-sharing that an enrollee is required to pay at point of sale, including deductible payments and the cost-sharing amounts charged once the deductible is met at an amount that does not exceed the net price of the prescription insulin drug.
(b) Nothing in this section shall prevent a health plan company from imposing a cost-sharing requirement that is less than the amount specified in paragraph (a).