SF 3716
1st Engrossment - 94th Legislature (2025 - 2026)
Posted on 03/10/2026 08:36 a.m.
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A bill for an act
relating to health insurance; requiring health plans to cover cervical cancer screening
tests and subsequent diagnostic services; requiring the commissioner of commerce
to defray the cost of coverage of cervical cancer screening tests and subsequent
diagnostic services; modifying language relating to coverage of cervical cancer
screening tests and subsequent diagnostic services in the medical assistance
program; appropriating money; amending Minnesota Statutes 2024, section
256B.0625, subdivision 14, 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.
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[62Q.505] COVERAGE OF CERVICAL CANCER SCREENING TESTS.
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new text begin Subdivision 1. new text end
new text begin Required coverage. new text end
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All health plans must cover:
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(1) cervical cancer screening tests, including all cervical cancer screening tests
recommended in the American Cancer Society Guideline for Cervical Cancer Screening at
the time the medical service is performed; and
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(2) additional diagnostic services after a cervical cancer screening test, if a health care
provider determines the additional services are medically necessary based on the test's result.
Additional diagnostic services under this clause include follow-up examinations used to
evaluate an abnormality seen or suspected from a cervical cancer screening, regardless of
whether different samples from the prior cervical cancer screening are used or the follow-up
examination is performed on a different date than the cervical cancer screening. Follow-up
examinations include, but are not limited to, human papillomavirus examinations with
typing, cytology, dual stain, or colposcopy with biopsy.
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new text begin Subd. 2. new text end
new text begin Cost-sharing requirements. new text end
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A health plan must not impose any cost-sharing
requirement on the coverage under this section including but not limited to the following
requirements:
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(1) deductible;
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(2) co-payment; or
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(3) coinsurance.
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new text begin Subd. 3. new text end
new text begin Review and referral limitations. new text end
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A health plan must not impose any review
or referral limitation on the coverage under this section including but not limited to the
following limitations:
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(1) utilization review, as defined in section 62M.02;
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(2) referral requirement; or
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(3) delay period.
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new text begin Subd. 4. new text end
new text begin Quantity limitations. new text end
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A health plan must not impose any quantity limitation
on the coverage under this section, including limitations on test frequency.
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new text begin Subd. 5. new text end
new text begin Application. new text end
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If the application of subdivision 2 before an enrollee has met the
enrollee's health plan's deductible would result in: (1) health savings account ineligibility
under United States Code, title 26, section 223; or (2) catastrophic health plan ineligibility
under United States Code, title 42, section 18022(e), then subdivision 2 applies to coverage
under this section only after the enrollee has met the enrollee's health plan's deductible.
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new text begin Subd. 6. new text end
new text begin Reimbursement. new text end
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(a) The commissioner of commerce must reimburse health
plan companies for coverage under this section, as required by Code of Federal Regulations,
title 45, section 155.170. Reimbursement is available only for coverage that would not have
been provided by the health plan without the requirements of this section. Treatments,
services, supplies, and equipment covered by the health plan as of January 1, 2026, are
ineligible for payments under this subdivision by the commissioner of commerce.
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(b) Health plan companies must report to the commissioner of commerce quantified
costs attributable to the additional benefit under this section in a format developed by the
commissioner. A health plan's coverage as of January 1, 2026, must be used by the health
plan company as the basis for determining whether coverage would not have been provided
by the health plan for purposes of this subdivision.
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(c) The commissioner of commerce must evaluate submissions and make payments to
health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.
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new text begin Subd. 7. new text end
new text begin Appropriation. new text end
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Beginning in fiscal year 2028, an amount necessary to make
payments to health plan companies to defray the cost of providing coverage under this
section is annually appropriated from the general fund to the commissioner of commerce.
The amount appropriated under this subdivision must include the administrative costs
incurred by the commissioner to make the defrayal payments.
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new text begin EFFECTIVE DATE. new text end
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This section is effective January 1, 2027, and applies to all health
plans offered, issued, or sold on or after that date.
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Sec. 2.
Minnesota Statutes 2024, section 256B.0625, subdivision 14, is amended to read:
Subd. 14.
Diagnostic, screening, and preventive services.
(a) Medical assistance covers
diagnostic, screening, and preventive services.
(b) "Preventive services" include services related to pregnancy, including:
(1) services for those conditions which may complicate a pregnancy and which may be
available to a pregnant woman determined to be at risk of poor pregnancy outcome;
(2) prenatal HIV risk assessment, education, counseling, and testing; and
(3) alcohol abuse assessment, education, and counseling on the effects of alcohol usage
while pregnant. Preventive services available to a woman at risk of poor pregnancy outcome
may differ in an amount, duration, or scope from those available to other individuals eligible
for medical assistance.
(c) "Screening services" include, but are not limited to, blood lead tests.
(d) The commissioner shall encourage, at the time of the child and teen checkup or at
an episodic care visit, the primary care health care provider to perform primary caries
preventive services. Primary caries preventive services include, at a minimum:
(1) a general visual examination of the child's mouth without using probes or other dental
equipment or taking radiographs;
(2) a risk assessment using the factors established by the American Academies of
Pediatrics and Pediatric Dentistry; and
(3) the application of a fluoride varnish beginning at age one to those children assessed
by the provider as being high risk in accordance with best practices as defined by the
Department of Human Services. The provider must obtain parental or legal guardian consent
before a fluoride varnish is applied to a minor child's teeth.
At each checkup, if primary caries preventive services are provided, the provider must
provide to the child's parent or legal guardian: information on caries etiology and prevention;
and information on the importance of finding a dental home for their child by the age of
one. The provider must also advise the parent or legal guardian to contact the child's managed
care plan or the Department of Human Services in order to secure a dental appointment
with a dentist. The provider must indicate in the child's medical record that the parent or
legal guardian was provided with this information and document any primary caries
prevention services provided to the child.
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(e) "Diagnostic services" include but are not limited to the following:
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(1) cervical cancer screening tests, including all cervical cancer screening tests
recommended in the American Cancer Society Guideline for Cervical Cancer Screening at
the time the medical service is performed; and
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(2) additional diagnostic services after a cervical cancer screening test, if a health care
provider determines the additional services are medically necessary based on the test's result.
Additional diagnostic services under this clause include follow-up examinations used to
evaluate an abnormality seen or suspected from a cervical cancer screening, regardless of
whether different samples from the prior cervical cancer screening are used or the follow-up
examination is performed on a different date than the cervical cancer screening. Follow-up
examinations include, but are not limited to, human papillomavirus examinations with
typing, cytology, dual stain, or colposcopy with biopsy.
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new text begin EFFECTIVE DATE. new text end
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This section is effective January 1, 2027, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
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Sec. 3.
Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 14a. new text end
new text begin Cervical cancer screening tests. new text end
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For the coverage of cervical cancer screening
tests and additional diagnostic services after a test, pursuant to subdivision 14, medical
assistance must meet the requirements that would otherwise apply to a health plan under
section 62Q.505, except that medical assistance is not required to comply with any provision
of section 62Q.505 if compliance with the provision would:
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(1) prevent the state from receiving federal financial participation for the coverage under
this subdivision; or
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(2) result in a lower level of coverage or reduced access to coverage for medical assistance
enrollees.
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new text begin EFFECTIVE DATE. new text end
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This section is effective January 1, 2027, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
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