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SF1101 (Legislative Session 94 (2025-2026))

Augmentative and alternative communication systems coverage requirement provision and appropriation

AI Generated Summary

Senate File No. 1101 is a proposed legislative bill in Minnesota that focuses on health insurance coverage for augmentative and alternative communication systems. These systems are used by individuals with severe communication disabilities to enhance or replace their speech capabilities.

Key points of the bill are:

  1. Coverage Requirement: Health insurance plans must cover the costs of augmentative and alternative communication systems, which include devices and their related software, components, and even speech therapy (referred to as habilitation services). These must be recognized as medically necessary and prescribed by a physician.

  2. No Discrimination in Coverage: Plans cannot impose additional financial burdens specifically on these communication systems or limit the number of habilitation services sessions if they are medically necessary.

  3. Prior Authorization: Insurance plans can require prior authorization for these communication systems, similar to other medical services, to ensure the appropriate use of these systems.

  4. Utilization Review Guidelines: Insurers must use the latest evidence-based guidelines for determining the coverage of these communications systems and related services.

  5. Reimbursement and Reporting: The Commissioner of Commerce will reimburse insurance companies for the additional costs of covering these systems, provided they prove these costs are over and above the existing coverage mandates. Insurers are required to submit the costs incurred due to these additional benefits.

  6. Funding: The bill includes an appropriation clause to allocate necessary funds each year to the Commissioner of Commerce for the reimbursement to healthcare plans providing these newly mandated coverages.

Overall, this bill aims to ensure that individuals with severe communication limitations have better access to necessary technologies and therapies to aid in their communication, through mandatory health insurance coverage.

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
February 05, 2025HouseFloorActionIntroduction and first reading
February 05, 2025SenateFloorActionIntroduction and first reading
February 05, 2025HouseFloorActionReferred toCommerce and Consumer Protection
February 05, 2025SenateFloorActionReferred toCommerce and Consumer Protection
February 19, 2025HouseFloorActionAuthors added
February 19, 2025SenateFloorActionAuthors added

Citations

 
[
  {
    "analysis": {
      "added": [
        "New requirements for coverage of augmentative and alternative communication systems and associated habilitation services."
      ],
      "removed": [
        ""
      ],
      "summary": "The bill mandates amendments to health insurance coverage requirements under sections 256B.0625, specifically affecting augmentative and alternative communication systems.",
      "modified": [
        "Modification of existing coverage regulations to include new benefits."
      ]
    },
    "citation": "256B.0625",
    "subdivision": "subdivisions 31, 31a"
  },
  {
    "analysis": {
      "added": [
        "Additional clauses specifying coverage determination based on medical necessity."
      ],
      "removed": [
        ""
      ],
      "summary": "This bill modifies provisions regarding health insurance coverage as outlined in section 256B.4914, pertaining to augmentative communication systems.",
      "modified": [
        "Adjustment to coverage requirements for communication systems to align with medical evaluations."
      ]
    },
    "citation": "256B.4914",
    "subdivision": "subdivision 12"
  },
  {
    "analysis": {
      "added": [
        "Reference for federal compliance in reimbursement process for health plan companies."
      ],
      "removed": [
        ""
      ],
      "summary": "The bill refers to a federal regulation guiding reimbursement processes for new health coverage requirements.",
      "modified": [
        "Incorporation of federal standards into state reimbursement evaluation."
      ]
    },
    "citation": "Code of Federal Regulations title 45 section 155.170",
    "subdivision": ""
  }
]

Sponsors