SF731

This bill, identified as SF No 731, seeks to amend existing insurance laws in Minnesota. Its main goal is to prohibit the need for prior authorization—a pre-approval from a health insurance company before a service can be provided by a medical professional—for specific health services under certain conditions. The proposed changes include:

1. Eliminating the requirement for prior authorization for emergency medical services and some types of confinement, although notification to the insurance company after such services commence would still be required.
2. Removing prior authorization requirements for outpatient mental health and substance use disorder treatments, except when medications are involved. Medications would still require prior authorization per existing statutes for initial decisions and appeals.
3. Excluding antineoplastic (cancer treatment) medications from prior authorization as long as the treatment follows the guidelines of the National Comprehensive Cancer Network.
4. Removing prior authorization for services that receive an A or B rating from the U.S. Preventive Services Task Force, recommended immunizations by the CDC's Advisory Committee on Immunization Practices, and preventive services and screenings for women as specified in federal regulations.
5. Ending prior authorization for pediatric hospice services provided by licensed hospice providers and treatments delivered through neonatal abstinence programs by certain subspecialists.
6. Prohibiting prior authorization for any service, item, or treatment where the health plan’s liability (cost) is $100 or less.

The act is set to take effect on January 1, 2026, and will apply to health benefit plans offered, sold, issued, or renewed on or after that date. This legislation aims to streamline certain healthcare processes, potentially easing barriers to accessing emergency, preventive, and critical care for patients.