Minneslate Logo

SF205 (Legislative Session 94 (2025-2026))

Antineoplastic cancer treatment prior authorization prohibition

AI Generated Summary

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.

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
January 15, 2025HouseFloorActionIntroduction and first reading
January 15, 2025SenateFloorActionIntroduction and first reading
January 15, 2025HouseFloorActionReferred toCommerce and Consumer Protection
January 15, 2025SenateFloorActionReferred toCommerce and Consumer Protection
March 09, 2025SenateFloorActionComm report: To pass as amended and re-refer toHealth and Human Services

Citations

 
[
  {
    "analysis": {
      "added": [
        "Prohibition on prior authorization for antineoplastic cancer treatments consistent with guidelines."
      ],
      "removed": [
        ""
      ],
      "summary": "This bill amends restrictions on prior authorization for certain medical services under section 62M.07.",
      "modified": [
        "Clarifies existing prohibitions on prior authorization for various treatments."
      ]
    },
    "citation": "62M.07",
    "subdivision": "subdivision 2"
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "This bill references processing rules for medication prior authorizations related to outpatient treatments.",
      "modified": [
        "Ensures consistency with guidelines for initial determinations."
      ]
    },
    "citation": "62M.05",
    "subdivision": "subdivision 3b"
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "This bill references the procedures for appeals of prior authorizations for medications.",
      "modified": [
        "Aligns appeal processes with standard guidelines for specific treatments."
      ]
    },
    "citation": "62M.06",
    "subdivision": "subdivision 2"
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "This bill mentions hospice provider licensing regulations under sections 144A.75 to 144A.755.",
      "modified": [
        "References pediatric hospice services provisions."
      ]
    },
    "citation": "144A.75",
    "subdivision": ""
  }
]

Sponsors