1.1 A bill for an act
1.2 relating to insurance; prohibiting prior authorization for services resulting in health
1.3 plan company liability of equal to or less than $100; amending Minnesota Statutes
1.4 2024, section 62M.07, subdivision 2.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2024, section 62M.07, subdivision 2, is amended to read:
1.7 Subd. 2.Prior authorization of certain services prohibited.No utilization review
1.8organization, health plan company, or claims administrator may conduct or require prior
1.9authorization of:
1.10 (1) emergency confinement or an emergency service. The enrollee or the enrollee's
1.11authorized representative may be required to notify the health plan company, claims
1.12administrator, or utilization review organization as soon as reasonably possible after the
1.13beginning of the emergency confinement or emergency service;
1.14 (2) outpatient mental health treatment or outpatient substance use disorder treatment,
1.15except for treatment which is a medication. Prior authorizations required for medications
1.16used for outpatient mental health treatment or outpatient substance use disorder treatment
1.17must be processed according to section 62M.05, subdivision 3b, for initial determinations,
1.18and according to section 62M.06, subdivision 2, for appeals;
1.19 (3) antineoplastic cancer treatment that is consistent with guidelines of the National
1.20Comprehensive Cancer Network, except for treatment which is a medication. Prior
1.21authorizations required for medications used for antineoplastic cancer treatment must be
1.22processed according to section 62M.05, subdivision 3b, for initial determinations, and
1.23according to section 62M.06, subdivision 2, for appeals;
1Section 1.
25-01651 as introduced12/20/24 REVISOR SGS/NS
SENATE
STATE OF MINNESOTA
S.F. No. 731NINETY-FOURTH SESSION
(SENATE AUTHORS: ABELER, Mann, Wiklund, Klein and Utke)
OFFICIAL STATUSD-PGDATE
Introduction and first reading01/27/2025
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.; and
2.10 (7) any service, item, or treatment for which a health plan company's liability would be
2.11equal to or less than $100 if the service, item, or treatment were approved.
2.12Clauses (2) to (6) (7) are effective January 1, 2026, and apply to health benefit plans offered,
2.13sold, issued, or renewed on or after that date.
2Section 1.
25-01651 as introduced12/20/24 REVISOR SGS/NS