Bill > SF1739

This bill establishes a Prior Authorization Commission to review and recommend medications for exemption from prior authorization requirements in health insurance plans. The commission will consist of nine members from various state departments, healthcare organizations, and professional associations, including representatives from the Departments of Health and Commerce, the Minnesota Prescription Drug Affordability Board, medical professionals, health plans, and pharmacy benefit managers. The commission will annually review the 25 medications with the highest prior authorization denial rates and make recommendations based on criteria such as medication cost, population utilization, health plan coverage, effectiveness, potential premium impacts, medical necessity, and other significant factors. By August 1, 2026, and each subsequent year, the commission will submit a report to legislative committees detailing their analysis and recommended medications. Starting in 2027, the Commissioner of Health will be required to approve at least one medication annually for inclusion in the prior authorization prohibition, which means health insurance companies would be prohibited from requiring prior authorization for that specific medication. The bill also permits certain government entities to share data related to drug benefits and utilization to support the commission's work, with strict limitations on data sharing and usage.

Health and Social Services

https://www.revisor.mn.gov/bills/bill.php?b=Senate&f=SF1739&ssn=0&y=2025