Pharmacists for Fair Reimbursement What your state's PBM laws actually mean for community pharmacies
State Tracker Updated June 15, 2026

Minnesota: what the PBM reimbursement law requires

For commercial plans, Minnesota requires MAC-pricing transparency and a MAC appeal (15-day filing window) but sets no acquisition-cost reimbursement floor. Separately, a 2025 law imposes a NADAC-or-acquisition-cost-plus-dispensing-fee floor on the Medicaid program under a single PBM beginning January 1, 2027.

Status Partially enacted
Law Minn. Stat. ch. 62W (§ 62W.08, commercial MAC); 2025 Medicaid reform amending § 256B.0625
Effective date Commercial MAC regime since January 1, 2020; Medicaid NADAC floor effective January 1, 2027 (interim $4.50 dispensing payment from July 1, 2025)
Reimbursement basis Commercial: no acquisition-cost floor (MAC transparency only). Medicaid: lesser of NADAC or actual acquisition cost, plus the Medicaid professional dispensing fee
Professional dispensing fee Commercial: not specified. Medicaid: the state professional dispensing fee (about $11.55), plus an interim $4.50 directed dispensing payment for smaller pharmacies
Appeal route Commercial (§ 62W.08): pharmacy may appeal within 15 business days; PBM must resolve within 7 business days and adjust the MAC within 1 business day if upheld

Minnesota runs two regimes. For commercial plans, chapter 62W requires MAC-pricing transparency and an appeal — a 15-business-day filing window, a 7-business-day PBM resolution, and a 1-business-day adjustment if upheld — but it sets no acquisition-cost reimbursement floor.

For Medicaid, a 2025 reform moves the program to a single PBM and sets a reimbursement floor at the lesser of NADAC or actual acquisition cost, plus the state Medicaid professional dispensing fee (about $11.55), beginning January 1, 2027, with an interim $4.50 directed dispensing payment for smaller pharmacies from July 1, 2025.

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