| 1 | 1 | | 1.1 A bill for an act |
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| 2 | 2 | | 1.2 relating to health insurance; requiring health plans to cover treatment of inherited |
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| 3 | 3 | | 1.3 metabolic diseases; amending Minnesota Statutes 2024, section 256B.0625, by |
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| 4 | 4 | | 1.4 adding a subdivision; proposing coding for new law in Minnesota Statutes, chapter |
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| 5 | 5 | | 1.5 62Q. |
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| 6 | 6 | | 1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: |
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| 7 | 7 | | 1.7 Section 1. [62Q.536] COVERAGE OF INHERITED METABOLIC DISEASES. |
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| 8 | 8 | | 1.8 Subdivision 1.Definition.(a) For the purposes of this section, the following terms have |
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| 9 | 9 | | 1.9the meanings given. |
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| 10 | 10 | | 1.10 (b) "Inherited metabolic disease" means a disease caused by an inherited abnormality |
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| 11 | 11 | | 1.11of body chemistry that affects the individual's metabolism. |
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| 12 | 12 | | 1.12 (c) "Low-protein modified food product" means a food product that is (1) specially |
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| 13 | 13 | | 1.13formulated to have less than one gram of protein per serving, and (2) intended to be used |
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| 14 | 14 | | 1.14under the direction of a physician for the dietary treatment of an inherited metabolic disease. |
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| 15 | 15 | | 1.15Low-protein modified food product does not include a natural food that is naturally low in |
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| 16 | 16 | | 1.16protein. |
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| 17 | 17 | | 1.17 (d) "Medical food" means a food that is (1) intended for the dietary treatment of a disease |
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| 18 | 18 | | 1.18or condition for which nutritional requirements are established by medical evaluation, and |
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| 19 | 19 | | 1.19(2) formulated to be consumed or administered enterally under direction of a physician. |
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| 20 | 20 | | 1.20 Subd. 2.Required coverage.A health plan must cover medically necessary treatment |
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| 21 | 21 | | 1.21of inherited metabolic diseases, including but not limited to the purchase of medical foods |
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| 22 | 22 | | 1.22and low-protein modified food products. |
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| 23 | 23 | | 1Section 1. |
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| 24 | 24 | | 25-02603 as introduced01/29/25 REVISOR SGS/DG |
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| 25 | 25 | | SENATE |
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| 26 | 26 | | STATE OF MINNESOTA |
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| 27 | 27 | | S.F. No. 1023NINETY-FOURTH SESSION |
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| 28 | 28 | | (SENATE AUTHORS: LIESKE, Hoffman, Draheim, Mann and Abeler) |
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| 29 | 29 | | OFFICIAL STATUSD-PGDATE |
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| 30 | 30 | | Introduction and first reading02/06/2025 |
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| 31 | 31 | | Referred to Commerce and Consumer Protection 2.1 Subd. 3.Coverage limitations.A health plan must not impose on the coverage required |
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| 32 | 32 | | 2.2under this section any limitation, including but not limited to any cost-sharing, utilization |
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| 33 | 33 | | 2.3review, prior authorization, referral requirements, restrictions, or delays, that is not generally |
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| 34 | 34 | | 2.4applicable to other coverage under the plan. |
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| 35 | 35 | | 2.5 Sec. 2. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision |
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| 36 | 36 | | 2.6to read: |
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| 37 | 37 | | 2.7 Subd. 77.Inherited metabolic diseases.(a) Medical assistance covers medically |
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| 38 | 38 | | 2.8necessary treatment for inherited metabolic diseases, including but not limited to the purchase |
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| 39 | 39 | | 2.9of medical foods and low-protein modified food products. Medical assistance must meet |
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| 40 | 40 | | 2.10the requirements that otherwise apply to a health plan under section 62Q.536. |
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| 41 | 41 | | 2.11 (b) For the purposes of this subdivision, "inherited metabolic disease," "low-protein |
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| 42 | 42 | | 2.12modified food product," and "medical food" have the meanings given in section 62Q.536. |
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| 43 | 43 | | 2Sec. 2. |
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| 44 | 44 | | 25-02603 as introduced01/29/25 REVISOR SGS/DG |
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