This bill establishes a prior authorization commission within the Minnesota Department of Health to review and recommend medications for prohibition from prior authorization requirements. The commission will focus on the 25 medications with the highest prior authorization denial rates in the state and will consider various criteria, including cost, utilization, coverage, effectiveness, and medical necessity. The commission will consist of nine members appointed from various health and commerce sectors, and it is required to submit an annual report to legislative committees detailing its analysis and recommendations.

Additionally, the bill amends Minnesota Statutes 2024, section 62M.07, to prohibit prior authorization for certain services, including emergency services, outpatient mental health and substance use disorder treatments, antineoplastic cancer treatments, preventive services, pediatric hospice services, and treatments through neonatal abstinence programs. A new provision allows the commissioner of health to approve medications for inclusion in this prohibition, with the first approval due by August 1, 2027. The changes aim to streamline access to essential medications and services while ensuring that the recommendations are based on thorough analysis and data sharing among government entities.

Statutes affected:
Introduction: 62M.07