| 1 | 1 | | 1.1 A bill for an act |
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| 2 | 2 | | 1.2 relating to health; prohibiting prior authorization of antineoplastic cancer treatment; |
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| 3 | 3 | | 1.3 amending Minnesota Statutes 2024, section 62M.07, subdivision 2. |
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| 4 | 4 | | 1.4BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: |
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| 5 | 5 | | 1.5 Section 1. Minnesota Statutes 2024, section 62M.07, subdivision 2, is amended to read: |
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| 6 | 6 | | 1.6 Subd. 2.Prior authorization of certain services prohibited.No utilization review |
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| 7 | 7 | | 1.7organization, health plan company, or claims administrator may conduct or require prior |
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| 8 | 8 | | 1.8authorization of: |
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| 9 | 9 | | 1.9 (1) emergency confinement or an emergency service. The enrollee or the enrollee's |
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| 10 | 10 | | 1.10authorized representative may be required to notify the health plan company, claims |
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| 11 | 11 | | 1.11administrator, or utilization review organization as soon as reasonably possible after the |
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| 12 | 12 | | 1.12beginning of the emergency confinement or emergency service; |
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| 13 | 13 | | 1.13 (2) outpatient mental health treatment or outpatient substance use disorder treatment, |
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| 14 | 14 | | 1.14except for treatment which is a medication. Prior authorizations required for medications |
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| 15 | 15 | | 1.15used for outpatient mental health treatment or outpatient substance use disorder treatment |
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| 16 | 16 | | 1.16must be processed according to section 62M.05, subdivision 3b, for initial determinations, |
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| 17 | 17 | | 1.17and according to section 62M.06, subdivision 2, for appeals; |
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| 18 | 18 | | 1.18 (3) antineoplastic cancer treatment that is consistent with guidelines of the National |
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| 19 | | - | 1.19Comprehensive Cancer Network or nationally and internationally accepted standards of |
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| 20 | | - | 1.20care, except for including but not limited to treatment which that is a medication. Prior |
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| 21 | | - | 1.21authorizations required for medications used for antineoplastic cancer treatment must be |
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| 19 | + | 1.19Comprehensive Cancer Network, except for including but not limited to treatment which |
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| 20 | + | 1.20that is a medication. Prior authorizations required for medications used for antineoplastic |
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| 21 | + | 1.21cancer treatment must be processed according to section 62M.05, subdivision 3b, for initial |
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| 22 | + | 1.22determinations, and according to section 62M.06, subdivision 2, for appeals; |
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| 29 | | - | Introduction and first reading9201/16/2025 |
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| 30 | | - | Referred to Commerce and Consumer Protection |
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| 31 | | - | Comm report: To pass as amended and re-refer to Health and Human Services03/10/2025 2.1processed according to section 62M.05, subdivision 3b, for initial determinations, and |
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| 32 | | - | 2.2according to section 62M.06, subdivision 2, for appeals; |
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| 33 | | - | 2.3 (4) services that currently have a rating of A or B from the United States Preventive |
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| 34 | | - | 2.4Services Task Force, immunizations recommended by the Advisory Committee on |
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| 35 | | - | 2.5Immunization Practices of the Centers for Disease Control and Prevention, or preventive |
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| 36 | | - | 2.6services and screenings provided to women as described in Code of Federal Regulations, |
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| 37 | | - | 2.7title 45, section 147.130; |
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| 38 | | - | 2.8 (5) pediatric hospice services provided by a hospice provider licensed under sections |
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| 39 | | - | 2.9144A.75 to 144A.755; and |
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| 40 | | - | 2.10 (6) treatment delivered through a neonatal abstinence program operated by pediatric |
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| 41 | | - | 2.11pain or palliative care subspecialists. |
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| 42 | | - | 2.12Clauses (2) to (6) are effective January 1, 2026, and apply to health benefit plans offered, |
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| 43 | | - | 2.13sold, issued, or renewed on or after that date. |
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| 44 | | - | 2.14 EFFECTIVE DATE.This section is effective January 1, 2027, and applies to health |
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| 45 | | - | 2.15benefit plans offered, sold, issued, or renewed on or after that date. |
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| 30 | + | Introduction and first reading01/16/2025 |
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| 31 | + | Referred to Commerce and Consumer Protection 2.1 (4) services that currently have a rating of A or B from the United States Preventive |
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| 32 | + | 2.2Services Task Force, immunizations recommended by the Advisory Committee on |
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| 33 | + | 2.3Immunization Practices of the Centers for Disease Control and Prevention, or preventive |
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| 34 | + | 2.4services and screenings provided to women as described in Code of Federal Regulations, |
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| 35 | + | 2.5title 45, section 147.130; |
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| 36 | + | 2.6 (5) pediatric hospice services provided by a hospice provider licensed under sections |
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| 37 | + | 2.7144A.75 to 144A.755; and |
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| 38 | + | 2.8 (6) treatment delivered through a neonatal abstinence program operated by pediatric |
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| 39 | + | 2.9pain or palliative care subspecialists. |
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| 40 | + | 2.10Clauses (2) to (6) are effective January 1, 2026, and apply to health benefit plans offered, |
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| 41 | + | 2.11sold, issued, or renewed on or after that date. |
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| 42 | + | 2.12 EFFECTIVE DATE.This section is effective January 1, 2027, and applies to health |
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| 43 | + | 2.13benefit plans offered, sold, issued, or renewed on or after that date. |
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