This bill amends Minnesota Statutes 2024, specifically section 256B.0625, to clarify medical assistance coverage for prescription drugs in instances where individuals have cost-effective health insurance. The amendments include provisions that require medical assistance to cover cost-sharing for prescription drugs approved by a commercial insurer, even if the quantity exceeds a 34-day supply, and without the need for prior approval when the enrollee is subject to a deductible. Additionally, the bill specifies that authorization is not required for certain cases of cost-effective prescription drug coverage, further streamlining the process for individuals with commercial insurance.

The bill also establishes an effective date of January 1, 2026, for these changes. It aims to enhance access to necessary medications for individuals enrolled in medical assistance while ensuring that the coverage aligns with their existing health insurance plans. By removing barriers to coverage and authorization, the bill seeks to improve the overall efficiency of the medical assistance program in relation to prescription drug costs.

Statutes affected:
Introduction: 256B.0625