The bill (S.F. No. 1340) aims to modify the rules surrounding utilization reviews for prescription drug coverage in health care plans in Minnesota. Here are the main points:

1. Definition of Health Benefit Plan: The bill clarifies what constitutes a health benefit plan. From January 1, 2026, these include coverage for medical, dental, or hospital services through certain state programs, but it does not include other types of insurance like disability or automobile medical payment coverage.

2. Changes in Prior Authorization Rules:

   • If the rules or clinical criteria for prior authorization for a healthcare service change during a plan year, these changes won't affect any enrollee who was already approved under the old rules until the next plan year, except in specific situations.
   • Exceptions include changes made to address drugs or devices that have been deemed unsafe or withdrawn by the FDA, or if new research or guidelines suggest changes due to safety concerns.

3. Prescription Drug Authorizations:

   • Authorizations for prescription drugs must last for the duration of an enrollee’s contract term as long as the drug continues to be prescribed for an ongoing condition.
   • Exceptions apply if the drug is found unsafe, withdrawn by the FDA, or if new warnings or recommendations for change are issued based on new research or guidelines.

Overall, the bill tries to stabilize patients' access to necessary medications and treatments by preventing sudden changes in coverage due to alterations in policy terms or clinical guidelines during the middle of a contract term, with exceptions aimed at maintaining safety based on the latest evidence or regulatory actions.