PUTT Blog | MNindys: From Google Group to a Force of State Advocacy

Author: Deborah Keaveny, PUTT President, MNindys Founder

In June of 2020 the Minnesota Independent Pharmacists (MNIndys) was created as a Google discussion group email, similar to one I was inspired by in Illinois. Our state association, like so many others, serves a variety of pharmacy groups including students, academia, health systems, hospitals, and chains in addition to independents.  Being one of many, independent pharmacies did not have a strong voice.

My first task was to find all of our state’s independents. Initially, I reached out to the  Minnesota Pharmacy Association and the Minnesota Board of Pharmacy to find a list of pharmacies in our state, but neither was able to provide one, so I began researching. I was able to find an old database of MN pharmacies and began identifying the independent pharmacies, eliminating the ones that had closed, and adding ones that had opened since the list was published. I called every pharmacy on the list of independents that we created to explain what I wanted to do and ask if they would like to participate. There were two comments I heard the most: I have no money to spend, and I am too busy to help. Fortunately, as we were creating a free Google discussion group, a number of pharmacies agreed to join.

In the beginning it was a little frustrating. I would post an email in the group and either very few would respond or none. I came to realize that even though not everyone responded, they were all reading, listening and learning; and the group’s participation continued to grow. Initially we were focused on the pandemic. We shared information on how to bill COVID and asked each other questions about best practices. Over the course of a year or two we were able to add almost 100% of the state’s independent pharmacies into our Google Group.

Minnesota had already passed the Pharmacy Benefit Manager Licensure and regulation Act of 2019 (MN Law Chapter 62W). It became law effective 1/1/2020. The rulemaking process continued until December 2021. At that time most of the rulemaking meetings were held virtually because of the pandemic. Not being able to meet in person put us as “legislative newbies” at a disadvantage. Many of us still didn’t have a solid understanding of the legislative process and subsequently there were provisions of 62W that were weakened and a few concessions made that provided loopholes PBMs needed to skirt around the law. 

As a developing group, we figured out that state law is a complaint driven system. No complaints = no investigation = no enforcement.  Together we started pushing each other to submit complaints.  A step by step roadmap was posted in our Google group that explained what activity was in violation of 62W, how to fill out the complaint form, who to call in the Department of Commerce, and how to appeal a decision. We encouraged everyone to ask their patients to complain as well. MNIndys complaints from 3 stores and a MNIndy patient resulted in Minnesota seeking a $1.25M fine against CVS Caremark.  Unfortunately the fine was reduced to $500,000 and CVS did not admit any guilt - Caremark continued to steer patients (the reason for the initial fine) and the MNIndys continued to submit complaints and push the Department of Commerce to do their job.

We formalized the MNIndys in 2024 as a 501(c)4 non profit organization which brought structure to our organization. We now have a board of 9 pharmacy owners from across the state.  This legislative session we hired our own lobby firm and public relations company by raising money from individuals, finding grants, and holding fundraisers. We were successful in getting 2 bills through and signed this year:  A single PBM bill, and a Directed Pharmacy Payment program, very similar to the Illinois CAP funds.  

As a group we coordinated together to get both pieces of legislation done using precise, consistent talking points coming from all MNIndys - bringing the same message to all legislatures across the state. We engaged local news stations and local newspapers, and a couple of MNIndys assisted with and were quoted in national publications. We invited legislators to our stores, visited their offices frequently, and engaged our patients to help. As a result, legislators all agreed it was past time to act.

By working together we found talent within the group in areas like writing, marketing and social media. We learned from each other and discovered that many MNIndys already had strong relationships with the Governor’s office, the AGs office, and in the Minnesota legislature. We leaned on that to achieve our goals.

None of this could have been accomplished without the MNIndys organizing and working together, leaning on each other’s strengths, and taking the initiative to plow forward regardless of the political climate.

Reform in any state is a long game. Don’t be afraid to start small. With even the humble beginnings of a Google discussion group, you can ultimately organize and accomplish anything.