Bill > HF4373

This bill makes several changes to Minnesota's health laws, including requiring prescription drug prior authorization requests to be exchanged electronically using the NCPDP SCRIPT Standard starting January 1, 2027, and clarifying exemptions for group purchasers not covered by HIPAA regarding health plan transaction eligibility. It also expands the definition of "manufacturer" for prescription drug price reporting to include entities that set wholesale acquisition costs and refines how drug prices are reported, particularly for international comparisons. The bill mandates that health maintenance organizations (HMOs) must publish up-to-date provider directories online and provide hard copies upon request, and that they must reprocess claims as in-network if a provider's status changes from in-network to out-of-network before the change is posted online, unless the enrollee was notified beforehand. Additionally, it requires health carriers to meet time and distance standards for all covered health services, including dental, retail pharmacy, and specialty services, and expands coverage requirements for immunizations to include recommendations from certain professional organizations beyond the CDC's Advisory Committee on Immunization Practices. The bill also allows the commissioner of health access to certain data collected by the commissioner of commerce for health insurance oversight and removes obsolete references to the Health Technology Advisory Committee and related provisions.

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https://www.revisor.mn.gov/bills/94/2026/0/HF/4373/