Subdivision 1. Definitions.
(a) For purposes of this section, the following terms have the meanings given.
(b) "Drug" has the meaning given in section 151.01, subdivision 5 .
(c) "Enrollee" has the meaning given in section 62Q.01, subdivision 2b .
(d) "Formulary" means a current list of covered prescription drug products that is subject to periodic review and update.
(e) "Health plan" has the meaning given in section 62Q.01, subdivision 3 .
(f) "Pharmacy benefit manager" has the meaning given in section 62W.02, subdivision 15.
(g) "Prescription" has the meaning given in section 151.01, subdivision 16a .
Subd. 2. Formulary changes.
(a) Except as provided in paragraphs (b) and (c), a health plan must not, with respect to an enrollee who was previously prescribed the drug during the plan year, remove a drug from the health plan's formulary or place a drug in a benefit category that increases the enrollee's cost for the duration of the enrollee's plan year.
(b) Paragraph (a) does not apply if a health plan changes the health plan's formulary:
(1) for a drug that has been deemed unsafe by the United States Food and Drug Administration (FDA);
(2) for a drug that has been withdrawn by the FDA or the drug manufacturer; or
(3) when an independent source of research, clinical guidelines, or evidence-based standards has issued drug-specific warnings or recommended changes with respect to a drug's use for reasons related to previously unknown and imminent patient harm.
(c) Paragraph (a) does not apply if a health plan removes a brand name drug from the health plan's formulary or places a brand name drug in a benefit category that increases the enrollee's cost if the health plan:
(1) adds to the health plan's formulary a generic or multisource brand name drug rated as therapeutically equivalent according to the FDA Orange Book, a biologic drug rated as interchangeable according to the FDA Purple Book, or a biosimilar at the same or lower cost to the enrollee; and
(2) provides at least a 60-day notice to prescribers, pharmacists, and affected enrollees.