SF143

This legislative bill aims to update how medical assistance (Medicaid) covers prescription drugs in Minnesota. Specifically, it makes two significant changes:

1. If a medical assistance recipient uses health insurance from a commercial insurer for prescription drugs, and the state's commissioner finds this option cost-effective, then medical assistance will cover the cost-sharing (like copayments) for prescription drugs:

   • In any quantity approved by the commercial insurer, even if it's more than a 34-day supply, without needing further approval by the state.
   • For drugs approved by the commercial insurer, even if those drugs are not on the state's preferred drug list, without needing prior approval. This only applies if a recipient has a deductible.

2. The bill also states that from June 30, 1997, medical assistance will no longer cover premiums that beneficiaries need to pay if they are under a qualified or Medicare supplement plan issued by the Minnesota Comprehensive Health Association. However, for recipients who were already under such plans as of June 30, 1997, coverage will continue for six months after they receive a notice of termination, or until December 31, 1997, whichever comes later.

The purpose of these changes is to simplify and potentially expand coverage for prescription drugs under medical assistance, making it easier for those on Medicaid to obtain necessary medications without additional bureaucratic hurdles, especially when already covered by another cost-effective health insurance plan.