This bill amends Minnesota Statutes to enhance medical assistance coverage for individuals with primary third-party payers. It requires that medical assistance covers any drug on the formulary of the recipient's primary third-party payer for which partial payment has been made, regardless of whether the drug is included in the medical assistance formulary or preferred drug list. Additionally, it stipulates that authorization for drugs covered by a primary third-party payer is not required, regardless of the payment amount. This aims to streamline access to necessary medications for recipients who have other insurance coverage.

Furthermore, the bill mandates that medical assistance must cover in-network services even if a primary third-party payer deems them out-of-network or requiring a referral, as long as the services do not require a referral under medical assistance guidelines. This provision is designed to ensure that recipients can access necessary medical services without unnecessary barriers, thereby improving the overall efficiency and effectiveness of healthcare delivery for those reliant on medical assistance.

Statutes affected:
Introduction: 256B.0625, 256B.37