This bill modifies the utilization review process for prescription drug coverage in Minnesota. It amends Minnesota Statutes 2024, specifically section 62M.02, subdivision 12, to include "prescription drug" in the definition of a health benefit plan. Additionally, it introduces a new subdivision in section 62M.17 that mandates any authorization for a prescription drug to remain valid for the duration of an enrollee's contract term, as long as the drug continues to be prescribed for a condition requiring ongoing medication therapy.

The bill also outlines exceptions to this rule, stating that the authorization may be invalidated if the drug is deemed unsafe by the FDA, withdrawn by the FDA or the manufacturer, or if there are warnings or recommended changes from independent research or clinical guidelines. Furthermore, it clarifies that changes in coverage terms or clinical criteria for health care services will not apply until the next plan year for enrollees who have already received prior authorization, with specific exceptions for drugs or services related to patient safety. The bill aims to enhance patient access to necessary medications while ensuring safety and adherence to clinical guidelines.

Statutes affected:
Introduction: 62M.02, 62M.17