SF 5187

Introduction - 94th Legislature (2025 - 2026)

Posted on 04/23/2026 08:03 a.m.

A bill for an act
relating to health insurance; prohibiting the use of step therapy protocols for the
treatment of neurological conditions; 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.1842] PROHIBITION ON USE OF STEP THERAPY PROTOCOLS
FOR NEUROLOGICAL CONDITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

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

new text begin (b) "Clinical practice guideline" has the meaning given in section 62Q.184, subdivision
1, paragraph (b).
new text end

new text begin (c) "Neurological condition" means a disorder, whether resulting from accident or illness,
that causes an impairment in neurological function.
new text end

new text begin (d) "Step therapy protocol" has the meaning given in section 62Q.184, subdivision 1,
paragraph (e).
new text end

new text begin Subd. 2. new text end

new text begin Prohibition on use of step therapy protocols. new text end

new text begin A health plan that covers
treatment for neurological conditions must not limit or exclude coverage for a drug that is
approved by the United States Food and Drug Administration and included on the health
plan's prescription drug formulary by requiring an enrollee with a neurological condition
to follow a step therapy protocol if the approved drug's use is consistent with:
new text end

new text begin (1) a United States Food and Drug Administration-approved indication; and
new text end

new text begin (2) a clinical practice guideline.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027, and applies to health
plans offered, issued, or renewed on or after that date.
new text end