Bill > SF1340

This bill modifies utilization review regulations for prescription drug coverage in Minnesota, making several key changes. First, it expands the definition of a "health benefit plan" to explicitly include prescription drug coverage, which could broaden the scope of regulated health plans. Second, the bill introduces new protections for patients regarding prior authorization and prescription drug coverage. Specifically, if a utilization review organization changes its coverage terms or clinical criteria during a plan year, those changes cannot be applied retroactively to patients who have already received prior authorization for a healthcare service, with some exceptions related to patient safety. A new provision requires that prescription drug authorizations remain valid for the entire duration of an enrollee's contract term, as long as the drug continues to be prescribed for an ongoing medical condition. The bill also maintains existing exceptions to these rules when a drug is deemed unsafe by the FDA, withdrawn from the market, or when independent research indicates potential patient harm. These changes aim to provide more stability and predictability for patients in their healthcare coverage, particularly around prescription medications, by preventing mid-year changes that could disrupt existing treatment plans.

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https://www.revisor.mn.gov/bills/bill.php?b=Senate&f=SF1340&ssn=0&y=2025