SF205

Senate File No. 205 is a Minnesota legislative bill introduced to prevent health plans and other similar organizations from requiring prior authorization for certain medical treatments and services. Specifically, the bill would make it illegal to require prior authorization for:

1. Emergency medical confinement or services, although the policyholder or their representative must notify the health insurer as soon after the incident as possible.

2. Outpatient mental health and substance use disorder treatments, avoiding prior authorizations unless medication is involved (specific processes outlined for authorizations related to medications).

3. Antineoplastic (cancer) treatments that adhere to the National Comprehensive Cancer Network guidelines, with exceptions related to medications (specific processes are also outlined).

4. Medical services that have top preventive ratings by the United States Preventive Services Task Force, recommended immunizations by the CDC, and specific preventive services for women.

5. Pediatric hospice services provided by licensed hospice providers.

6. Treatments delivered by neonatal abstinence programs headed by pediatric pain or palliative care specialists.

The prohibitions on prior authorization are set to take effect from January 1, 2026, and would apply to all health plans offered, sold, issued, or renewed from that date forward. This legislation aims to streamline access to crucial medical services and reduce the administrative burdens and delays often associated with prior authorization in healthcare.