Bill > SF1806

This bill establishes new restrictions on how health plans and the medical assistance program can change their prescription drug formularies (the list of covered medications) during a plan year. Specifically, health plans and the medical assistance program are prohibited from removing a drug from their formulary or increasing an enrollee's cost for a drug that was previously prescribed during the current plan year, with some important exceptions. Those exceptions include cases where a drug has been deemed unsafe by the FDA, withdrawn by the FDA or manufacturer, or when independent research indicates potential patient harm. Health plans can also swap a brand-name drug for a generic or therapeutically equivalent alternative, provided they give at least 60 days' notice to prescribers, pharmacists, and affected enrollees. The bill defines key terms like "drug," "enrollee," and "formulary," and applies to health plans offered, sold, issued, or renewed on or after January 1, 2026. The goal appears to be protecting patients from unexpected changes in their prescription drug coverage that could disrupt their medical treatment or create unexpected financial burdens.

Business and Industry, Health and Social Services

https://www.revisor.mn.gov/bills/bill.php?b=Senate&f=SF1806&ssn=0&y=2025