SF1023 (Legislative Session 94 (2025-2026))

Inherited metabolic diseases coverage by health plans requirement provision

AI Generated Summary

Senate Bill S.F. No. 1023 is a proposal that mandates health insurance plans in Minnesota to cover treatments for inherited metabolic diseases. These diseases are caused by genetic abnormalities that affect a person's metabolism. The bill specifically requires health insurance to include coverage for medical foods and specially formulated low-protein food products that are necessary for managing these conditions. Under this bill, these food products must be used under the direction of a physician and are not to include naturally low-protein regular foods.

The proposed legislation also stipulates that health plans should not apply any coverage limitations or requirements—like cost sharing or prior authorization—that are not imposed on other types of medical coverage within the same plan. Furthermore, the bill amends existing statutes to ensure that medical assistance programs also cover the necessary treatment for inherited metabolic diseases, aligning their coverage requirements with those mandated for private insurance plans under this new bill.

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
February 05, 2025SenateFloorActionIntroduction and first reading
February 05, 2025SenateFloorActionReferred toCommerce and Consumer Protection

Citations

 
[
  {
    "analysis": {
      "added": [
        "A new subdivision covering inherited metabolic diseases, including medical foods and low-protein modified food products."
      ],
      "removed": [],
      "summary": "This bill modifies medical assistance coverage for inherited metabolic diseases under section 256B.0625.",
      "modified": [
        "Clarifies medical assistance requirements to align with health plan standards under section 62Q.536."
      ]
    },
    "citation": "256B.0625"
  }
]