HF 1338

1st Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:48am

A bill for an act
relating to health; expanding the definition for standard reference compendia;
amending Minnesota Statutes 2008, section 62Q.525, subdivisions 2, 3.

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

Section 1.

Minnesota Statutes 2008, section 62Q.525, subdivision 2, is amended to
read:

Subd. 2.

Definitions.

(a) For purposes of this section, the terms defined in this
subdivision have the meanings given them.

(b) "Medical literature" means articles from major peer reviewed medical journals
that have recognized the drug or combination of drugs' safety and effectiveness for
treatment of the indication for which it has been prescribed. Each article shall meet the
uniform requirements for manuscripts submitted to biomedical journals established by
the International Committee of Medical Journal Editors or be published in a journal
specified by the United States Secretary of Health and Human Services pursuant to United
States Code, title 42, section 1395x, paragraph (t), clause (2), item (B), as amended, as
acceptable peer review medical literature. Each article must use generally acceptable
scientific standards and must not use case reports to satisfy this criterion.

(c) "Off-label use of drugs" means when drugs are prescribed for treatments other
than those stated in the labeling approved by the federal Food and Drug Administration.

(d) "Standard reference compendia" means new text begin any one of the following new text end :

deleted text begin (1) the United States Pharmacopeia Drug Information; or
deleted text end

deleted text begin (2) deleted text end new text begin (1) new text end the American Hospital Formulary Service Drug Information deleted text begin . deleted text end new text begin ;
new text end

new text begin (2) the National Comprehensive Cancer Network's Drugs and Biologics
Compendium;
new text end

new text begin (3) Thomson Micromedex's DrugDex;
new text end

new text begin (4) Elsevier Gold Standard's Clinical Pharmacology; or
new text end

new text begin (5) other authoritative compendia as identified from time to time by the United
States Department of Health and Human Services.
new text end

Sec. 2.

Minnesota Statutes 2008, section 62Q.525, subdivision 3, is amended to read:

Subd. 3.

Required coverage.

(a) Every type of coverage included in subdivision 1
that provides coverage for drugs may not exclude coverage of a drug for the treatment of
cancer on the ground that the drug has not been approved by the federal Food and Drug
Administration for the treatment of cancer if the drug is recognized for treatment of cancer
in deleted text begin one of deleted text end the standard reference compendia new text begin adopted by the health plan on an annual basis
new text end or in one article in the medical literature, as defined in subdivision 2.

(b) Coverage of a drug required by this subdivision includes coverage of medically
necessary services directly related to and required for appropriate administration of the
drug.

(c) Coverage required by this subdivision does not include coverage of a drug not
listed on the formulary of the coverage included in subdivision 1.

(d) Coverage of a drug required under this subdivision must not be subject to any
co-payment, coinsurance, deductible, or other enrollee cost-sharing greater than the
coverage included in subdivision 1 applies to other drugs.

(e) The commissioner of commerce or health, as appropriate, may direct a person
that issues coverage included in subdivision 1 to make payments required by this section.