SF 1023

Introduction - 94th Legislature (2025 - 2026)

Posted on 02/11/2025 09:09 a.m.

A bill for an act
relating to health insurance; requiring health plans to cover treatment of inherited
metabolic diseases; amending Minnesota Statutes 2024, section 256B.0625, by
adding a subdivision; proposing coding for new law in Minnesota Statutes, chapter
62Q.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62Q.536] COVERAGE OF INHERITED METABOLIC DISEASES.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin (a) For the purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Inherited metabolic disease" means a disease caused by an inherited abnormality
of body chemistry that affects the individual's metabolism.
new text end

new text begin (c) "Low-protein modified food product" means a food product that is (1) specially
formulated to have less than one gram of protein per serving, and (2) intended to be used
under the direction of a physician for the dietary treatment of an inherited metabolic disease.
Low-protein modified food product does not include a natural food that is naturally low in
protein.
new text end

new text begin (d) "Medical food" means a food that is (1) intended for the dietary treatment of a disease
or condition for which nutritional requirements are established by medical evaluation, and
(2) formulated to be consumed or administered enterally under direction of a physician.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage. new text end

new text begin A health plan must cover medically necessary treatment
of inherited metabolic diseases, including but not limited to the purchase of medical foods
and low-protein modified food products.
new text end

new text begin Subd. 3. new text end

new text begin Coverage limitations. new text end

new text begin A health plan must not impose on the coverage required
under this section any limitation, including but not limited to any cost-sharing, utilization
review, prior authorization, referral requirements, restrictions, or delays, that is not generally
applicable to other coverage under the plan.
new text end

Sec. 2.

Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 77. new text end

new text begin Inherited metabolic diseases. new text end

new text begin (a) Medical assistance covers medically
necessary treatment for inherited metabolic diseases, including but not limited to the purchase
of medical foods and low-protein modified food products. Medical assistance must meet
the requirements that otherwise apply to a health plan under section 62Q.536.
new text end

new text begin (b) For the purposes of this subdivision, "inherited metabolic disease," "low-protein
modified food product," and "medical food" have the meanings given in section 62Q.536.
new text end