SF 1407

2nd Engrossment - 94th Legislature (2025 - 2026)

Posted on 07/15/2025 10:35 a.m.

A bill for an act
relating to health; modifying the evaluation process for mandated health benefit
proposals; amending Minnesota Statutes 2024, section 62J.26, subdivisions 1, 2,
3, by adding subdivisions.

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

Section 1.

Minnesota Statutes 2024, section 62J.26, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For purposes of this section, the following terms have
the meanings given unless the context otherwise requires:

(1) "commissioner" means the commissioner of commerce;

(2) "enrollee" has the meaning given in section 62Q.01, subdivision 2b;

(3) "health plan" means a health plan as defined in section 62A.011, subdivision 3, but
includes coverage listed in clauses (7) and (10) of that definition;

(4) "mandated health benefit proposal" or "proposal" means a proposal that would
statutorily require a health plan company to do the following:

(i) provide coverage or increase the amount of coverage for the treatment of a particular
disease, condition, or other health care need;

(ii) provide coverage or increase the amount of coverage of a particular type of health
care treatment or service or of equipment, supplies, or drugs used in connection with a health
care treatment or service; new text begin or
new text end

(iii) provide coverage for care delivered by a specific type of provider; new text begin and
new text end

deleted text begin (iv) require a particular benefit design or impose conditions on cost-sharing for:
deleted text end

deleted text begin (A) the treatment of a particular disease, condition, or other health care need;
deleted text end

deleted text begin (B) a particular type of health care treatment or service; or
deleted text end

deleted text begin (C) the provision of medical equipment, supplies, or a prescription drug used in
connection with treating a particular disease, condition, or other health care need; or
deleted text end

deleted text begin (v) impose limits or conditions on a contract between a health plan company and a health
care provider.
deleted text end

new text begin (5) "Minnesota public health care program" means a public health care program
administered by the commissioner of human services under chapters 256B and 256L.
new text end

(b) "Mandated health benefit proposal" does not include health benefit proposals:

(1) amending the scope of practice of a licensed health care professional; deleted text begin or
deleted text end

(2) that make state law consistent with federal law new text begin ; or
new text end

new text begin (3) that apply exclusively to Minnesota public health care programs new text end .

Sec. 2.

Minnesota Statutes 2024, section 62J.26, subdivision 2, is amended to read:

Subd. 2.

Evaluation process and content.

(a) The commissioner, in consultation with
the commissioners of health new text begin , human services, new text end and management and budget, must evaluate
all mandated health benefit proposals as provided under subdivision 3.

(b) The purpose of the evaluation is to provide the legislature with a complete and timely
analysis of all ramifications of any mandated health benefit proposal. The evaluation must
include, in addition to other relevant information, the following to the extent applicable:

(1) scientific and medical information on the mandated health benefit proposal, on the
potential for harm or benefit to the patient, and on the comparative benefit or harm from
alternative forms of treatment, and must include the results of at least one professionally
accepted and controlled trial comparing the medical consequences of the proposed therapy,
alternative therapy, and no therapy;

(2) public health, economic, and fiscal impacts of the mandated health benefit proposal
on persons receiving health services in Minnesota, new text begin on persons receiving health services in
a Minnesota public health care program, new text end on the relative cost-effectiveness of the proposal,
and on the health care system in general;

(3) the extent to which the treatment, service, equipment, or drug is generally utilized
by a significant portion of the population new text begin and used in the Minnesota public health care
programs new text end ;

(4) the extent to which insurance coverage for the mandated health benefit proposal is
already generally available new text begin and available in the Minnesota public health care programs new text end ;

(5) the extent to which the mandated health benefit proposal, by health plan category,
would apply to the benefits offered to the health plan's enrollees new text begin and enrollees in the
Minnesota public health care programs new text end ;

(6) the extent to which the mandated health benefit proposal will increase or decrease
the cost of the treatment, service, equipment, or drug;

(7) the extent to which the mandated health benefit proposal may increase enrollee
premiums; and

(8) if the proposal applies to a qualified health plan as defined in section 62A.011,
subdivision 7, the cost to the state to defray the cost of the mandated health benefit proposal
using commercial market reimbursement rates in accordance with Code of Federal
Regulations, title 45, section 155.170.

(c) The commissioner shall consider actuarial analysis done by health plan companies
and any other proponent or opponent of the mandated health benefit proposal in determining
the cost of the proposal.

(d) The commissioner must summarize the nature and quality of available information
on these issues, and, if possible, must provide preliminary information to the public. The
commissioner may conduct research on these issues or may determine that existing research
is sufficient to meet the informational needs of the legislature. The commissioner may seek
the assistance and advice of researchers, community leaders, or other persons or organizations
with relevant expertise. The commissioner must provide the public with at least 45 days'
notice when requesting information pursuant to this section. The commissioner must notify
the chief authors of a bill when a request for information is issued.

(e) Information submitted to the commissioner pursuant to this section that meets the
definition of trade secret information, as defined in section 13.37, subdivision 1, paragraph
(b), is nonpublic data.

new text begin (f) The commissioner must publish all evaluations conducted under this section on a
publicly available website within 30 days of the evaluation's completion.
new text end

Sec. 3.

Minnesota Statutes 2024, section 62J.26, subdivision 3, is amended to read:

Subd. 3.

Requirements for evaluation.

(a) No later than August 1 of the year preceding
the legislative session in which deleted text begin a deleted text end new text begin an incumbent new text end legislator is planning on introducing a bill
containing a mandated health benefit proposal deleted text begin , deleted text end or is planning on offering an amendment to
a bill that adds a mandated health benefit, the prospective author must notify the chair of
one of the standing legislative committees that have jurisdiction over the subject matter of
the proposal. new text begin The legislator is not required to provide the text of the mandated health benefit
proposal. new text end No later than 15 days after notification is received, the chair must notify the
commissioner that an evaluation of a mandated health benefit proposal is required to be
completed in accordance with this section in order to inform the legislature before any action
is taken on the proposal by either house of the legislature.

(b) The commissioner must conduct an evaluation described in subdivision 2 of each
mandated health benefit proposal for which an evaluation is required under paragraph (a).

(c) If the evaluation of multiple proposals are required, the commissioner must consult
with the chairs of the standing legislative committees having jurisdiction over the subject
matter of the mandated health benefit proposals to prioritize the evaluations and establish
a reporting date for each proposal to be evaluated.

new text begin (d) By December 31 of the year in which a mandated health benefit proposal, for which
an evaluation described in subdivision 2 has not been conducted, is enacted, the commissioner
must conduct an evaluation described in subdivision 2. The evaluation required by this
paragraph applies to mandated health benefit proposals:
new text end

new text begin (1) introduced or offered by a legislator who was not seated by the deadline for
notification under paragraph (a);
new text end

new text begin (2) enacted without conformity to paragraph (a); or
new text end

new text begin (3) for which an evaluation was required under paragraph (b) but was not conducted.
new text end

Sec. 4.

Minnesota Statutes 2024, section 62J.26, is amended by adding a subdivision to
read:

new text begin Subd. 6. new text end

new text begin Conformity. new text end

new text begin A mandated health benefit proposal enacted into law is effective
whether or not it is in conformity with this section.
new text end

Sec. 5.

Minnesota Statutes 2024, section 62J.26, is amended by adding a subdivision to
read:

new text begin Subd. 7. new text end

new text begin Adoption of forms. new text end

new text begin (a) The commissioner of commerce must adopt forms, by
July 1, 2026, for the following:
new text end

new text begin (1) an incumbent legislator to notify the chair of the mandated health benefit proposal
under subdivision 3, paragraph (a); and
new text end

new text begin (2) the chair to notify the commissioner of the mandated health benefit proposal under
subdivision 3, paragraph (a).
new text end

new text begin (b) The forms adopted under this subdivision must include all information needed from
the legislator introducing or offering the mandated health benefit proposal for the
commissioner to conduct the required evaluation.
new text end