1.1 A bill for an act
1.2 relating to health; prohibiting prior authorization of antineoplastic cancer treatment;
1.3 amending Minnesota Statutes 2024, section 62M.07, subdivision 2.
1.4BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.5 Section 1. Minnesota Statutes 2024, section 62M.07, subdivision 2, is amended to read:
1.6 Subd. 2.Prior authorization of certain services prohibited.No utilization review
1.7organization, health plan company, or claims administrator may conduct or require prior
1.8authorization of:
1.9 (1) emergency confinement or an emergency service. The enrollee or the enrollee's
1.10authorized representative may be required to notify the health plan company, claims
1.11administrator, or utilization review organization as soon as reasonably possible after the
1.12beginning of the emergency confinement or emergency service;
1.13 (2) outpatient mental health treatment or outpatient substance use disorder treatment,
1.14except for treatment which is a medication. Prior authorizations required for medications
1.15used for outpatient mental health treatment or outpatient substance use disorder treatment
1.16must be processed according to section 62M.05, subdivision 3b, for initial determinations,
1.17and according to section 62M.06, subdivision 2, for appeals;
1.18 (3) antineoplastic cancer treatment that is consistent with guidelines of the National
1.19Comprehensive Cancer Network, except for including but not limited to treatment which
1.20that is a medication. Prior authorizations required for medications used for antineoplastic
1.21cancer treatment must be processed according to section 62M.05, subdivision 3b, for initial
1.22determinations, and according to section 62M.06, subdivision 2, for appeals;
1Section 1.
25-00578 as introduced11/18/24 REVISOR SGS/NS
SENATE
STATE OF MINNESOTA
S.F. No. 205NINETY-FOURTH SESSION
(SENATE AUTHORS: PORT, Mann, Maye Quade and Boldon)
OFFICIAL STATUSD-PGDATE
Introduction and first reading01/16/2025
Referred to Commerce and Consumer Protection 2.1 (4) services that currently have a rating of A or B from the United States Preventive
2.2Services Task Force, immunizations recommended by the Advisory Committee on
2.3Immunization Practices of the Centers for Disease Control and Prevention, or preventive
2.4services and screenings provided to women as described in Code of Federal Regulations,
2.5title 45, section 147.130;
2.6 (5) pediatric hospice services provided by a hospice provider licensed under sections
2.7144A.75 to 144A.755; and
2.8 (6) treatment delivered through a neonatal abstinence program operated by pediatric
2.9pain or palliative care subspecialists.
2.10Clauses (2) to (6) are effective January 1, 2026, and apply to health benefit plans offered,
2.11sold, issued, or renewed on or after that date.
2.12 EFFECTIVE DATE.This section is effective January 1, 2027, and applies to health
2.13benefit plans offered, sold, issued, or renewed on or after that date.
2Section 1.
25-00578 as introduced11/18/24 REVISOR SGS/NS