SF1806 (Legislative Session 94 (2025-2026))
Certain formulary changes during the plan year prohibition provision and medical assistance program formulary changes implementation for certain enrollees prohibition provision
Related bill: HF1652
AI Generated Summary
This Minnesota Senate bill (S.F. No. 1806) prohibits health plans from making certain formulary changes during a plan year that would negatively impact enrollees. Specifically, it prevents health plans from removing a drug from their formulary or increasing an enrollee's cost for a drug they were already prescribed during the plan year.
Exceptions to this prohibition include: 1. Instances where a drug has been deemed unsafe by the FDA. 2. Situations where the drug has been withdrawn by the FDA or the manufacturer. 3. Cases where independent clinical guidelines or research issue warnings or recommend changes due to unforeseen patient harm.
Additionally, health plans may replace a brand-name drug with a lower-cost generic or interchangeable biologic alternative if they provide at least 60 days' notice to prescribers, pharmacists, and affected enrollees.
This legislation aims to ensure prescription drug stability for enrollees while allowing for necessary safety-based adjustments.
Past committee meetings
- Commerce and Consumer Protection on: March 11, 2025 12:30
- Commerce and Consumer Protection on: March 11, 2025 12:30
- Health and Human Services on: March 25, 2025 08:30
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| February 24, 2025 | Senate | Floor | Action | Introduction and first reading | |
| February 24, 2025 | Senate | Floor | Action | Referred to | Commerce and Consumer Protection |
| March 13, 2025 | Senate | Floor | Action | Comm report: To pass as amended and re-refer to | Health and Human Services |
| March 13, 2025 | Senate | Floor | Action | Author added |
Citations
[
{
"analysis": {
"added": [],
"removed": [],
"summary": "This section provides definitions related to drugs, which are referenced for clarity in this bill.",
"modified": []
},
"citation": "151.01"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "This section provides definitions related to enrollees and health plans, which are referenced for clarity in this bill.",
"modified": []
},
"citation": "62Q.01"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "This section defines pharmacy benefit managers, which is referenced for clarity in this bill.",
"modified": []
},
"citation": "62W.02"
}
]