Bill > SF4419

This bill makes several changes to health insurance laws in Minnesota, including updating requirements for electronic prescription drug prior authorization requests to use the NCPDP SCRIPT Standard by January 1, 2027, and clarifying exemptions for certain group purchasers from electronic transaction requirements. It also expands the definition of "manufacturer" to include entities that set wholesale acquisition costs for prescription drugs and modifies how prices are reported for prescription drugs, particularly for international comparisons. The bill introduces quarterly financial reporting for health maintenance organizations (HMOs) and requires them to allocate administrative expenses and investment income by business line or product. It also updates marketing requirements for HMOs to ensure clear disclosure of exclusions and limitations and mandates that provider directories be easily accessible and up-to-date, with provisions for reprocessing claims if network status changes are not promptly posted. Additionally, the bill expands network adequacy standards to include dental, retail pharmacy, and specialty services, and clarifies coverage for immunizations by including recommendations from certain professional organizations in addition to the CDC. Finally, the bill removes obsolete language related to the Health Technology Advisory Committee and other outdated provisions.

Business and Industry, Health and Social Services

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