Worksheet P - Minnesotacare Pharmacy Refund - 2013

Worksheet P

2013 MinnesotaCare Pharmacy Refund

For Minnesota pharmacies only

Minnesota tax ID number

Tax type

Pharmacy Refund

Round amounts to the

nearest whole dollar.

1 Total paid to wholesale drug distributors for the purchase of legend drugs. Include only those drugs that

were purchased from wholesalers subject to the MinnesotaCare tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Of the amount on line 1, enter the amount paid for legend drugs you delivered outside Minnesota . . . . . . . . . . . . 2

3 Of the amount on line 2, enter the amount paid for legend drugs that were returned to you . . . . . . . . . . . . . . . . . . 3

4 Subtract line 3 from line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

5 MinnesotaCare Pharmacy Refund. Multiply line 4 by 2% (.02) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Instructions

Who is Eligible

File Your Return Electronically

Be sure to keep all supporting documenta-

tion for your refund claim, including:

Minnesota pharmacies that purchase

Go to our website at

legend drugs from drug wholesalers who

mn.us and log into e-Services. You will

• legend drug purchase invoices;

are subject to the MinnesotaCare wholesale

need to enter the amounts from lines 1

• records verifying drugs delivered or

drug distributor tax are eligible to receive a

through 3 above. Your refund will be calcu-

shipped outside Minnesota;

refund if they later deliver or ship them to

lated for you based on the information you

locations outside Minnesota. The refund is

• records verifying any drugs returned to

enter.

equal to 2 percent of the amount paid to the

the pharmacy after they were delivered or

When you have successfully filed your

wholesaler for the drugs.

shipped outside Minnesota.

return, you will be given a confirmation

All documentation must be made available

If you don’t know if the wholesaler is subject

number. Print and keep the confirmation

to the tax, check your invoice (which may

to the department upon request.

page with your records.

show the MinnesotaCare tax) or verify it

Due Date

Information and Assistance

with the wholesaler. If you still cannot de-

Your 2013 pharmacy refund return is due

If you need help or additional information

termine if the wholesaler is required to pay

March 17, 2014.

to complete this form, please contact us.

the tax, please contact us.

All refunds must be claimed within

• Email: MinnesotaCare.tax@state.mn.us

The pharmacy refund cannot be claimed on

18 months from the date the drugs are de-

legend drugs purchased from a wholesaler

• Phone: 651-282-5533

livered or shipped outside Minnesota.

who is not subject to MinnesotaCare tax.

You can also not claim the refund on drugs

on which you paid legend drug use tax.

Keep this worksheet for your records. Do not mail.

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