Committee debates HF 4349 on gene‑therapy reimbursement, requests fiscal note and lays bill over

House File 4349 drew extended committee debate on March 23 as lawmakers considered how Minnesota should reimburse one‑time, high‑cost gene and cell therapies.

Representative Biermann said the bill addresses limitations in DRG (diagnostic related group) payment models for curative, one‑time therapies and would allow the Department of Human Services to use value‑based arrangements (VBAs) where feasible without making VBAs a prerequisite for unbundling.

Members asked whether a fiscal note exists and how the bill interacts with the federal 340B program, which can affect acquisition costs. Representative Liebling and others pressed whether hospitals reimbursed at 'actual acquisition cost' could see distortions if the product was obtained through 340B pricing. A fiscal note was requested. Miss Burns (committee testimony) said 340B has not yet been widely applied to these therapies but is a topic the legislature should consider.

Committee members also questioned how managed‑care‑enrolled patients would be covered under an unbundling approach; proponents noted different states have carved out high‑cost drugs into fee‑for‑service arrangements even when MCOs exist. Representative Nadeau raised concerns about rebates and implementation complexity and said the bill "might not be ready" for final action.

The bill was laid over for further work and a fiscal-note review.