Bill > SF4419

This bill makes several changes to health insurance laws in Minnesota, primarily focusing on prescription drug pricing, coverage, and data transparency, as well as regulations for health maintenance organizations (HMOs) and network adequacy. Key provisions include mandating the electronic exchange of prescription drug prior authorization requests using the NCPDP SCRIPT Standard by January 1, 2027, and clarifying exemptions for certain group purchasers not covered by HIPAA regarding electronic transaction requirements. The bill also expands the definition of "manufacturer" for reporting purposes and modifies requirements for reporting prescription drug price increases, including specifying that the "price" reported for international comparisons should be the "amount" paid for a drug product. It introduces new reporting requirements for pharmacies, pharmacy benefit managers (PBMs), and wholesale drug distributors regarding prescription drug costs and rebates, particularly for drugs of substantial public interest. For HMOs, the bill clarifies the roles of the commissioners of health and commerce, updates definitions related to service areas and comprehensive health services, and enhances requirements for provider network notifications and directory accuracy, including reprocessing claims if network status changes are not promptly updated. Additionally, it expands coverage requirements for preventive services, including immunizations, and clarifies that stand-alone dental plans are considered health plans for certain purposes. Finally, the bill removes obsolete language related to the Health Technology Advisory Committee and other outdated provisions.

Health and Social Services

https://www.revisor.mn.gov/bills/94/2026/0/SF/4419/