HF 3453

as introduced - 90th Legislature (2017 - 2018) Posted on 03/08/2018 02:25pm

A bill for an act
relating to health; requiring health plans to cover contraceptive methods,
sterilization, and related medical services, patient education, and counseling;
providing religious exemptions; 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.521] COVERAGE OF CONTRACEPTIVE METHODS AND
SERVICES.
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new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) The definitions in this subdivision apply to this section.
new text end

new text begin (b) "Contraceptive method" means a drug, device, or other product approved by the
Food and Drug Administration to prevent unintended pregnancy.
new text end

new text begin (c) "Contraceptive service" means consultation, examination, procedures, and medical
services related to the use of a contraceptive method, including natural family planning, to
prevent an unintended pregnancy.
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new text begin (d) "Therapeutic equivalent version" means a drug, device, or product that can be expected
to have the same clinical effect and safety profile when administered to a patient under the
condition specified in the labeling and that:
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new text begin (1) is approved as safe and effective;
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new text begin (2) is a pharmaceutical equivalent in that the drug, device, or product contains identical
amounts of the same active drug ingredient in the same dosage form and route of
administration, and the drug, device, or product meets compendial or other applicable
standards of strength, quality, purity, and identity;
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new text begin (3) is bioequivalent in that:
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new text begin (i) the drug, device, or product does not present a known or potential bioequivalence
problem and meets an acceptable in vitro standard; or
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new text begin (ii) if the drug, device, or product does present a known or potential bioequivalence
problem, it is shown to meet an appropriate bioequivalence standard;
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new text begin (4) is adequately labeled; and
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new text begin (5) is manufactured in compliance with current manufacturing practice regulations.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage; cost sharing prohibited. new text end

new text begin (a) A health plan must provide
coverage for:
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new text begin (1) all contraceptive methods, including over-the-counter contraceptives, but excluding
male condoms;
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new text begin (2) voluntary sterilization procedures;
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new text begin (3) contraceptive services, patient education, and counseling on contraception; and
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new text begin (4) follow-up services related to contraceptive methods, voluntary sterilization procedures,
and contraceptive services, including but not limited to management of side effects,
counseling for continued adherence, and device insertion and removal.
new text end

new text begin (b) A health plan company shall not require any cost-sharing requirements, including
co-pays, deductibles, and coinsurance, for the coverage required by this section.
new text end

new text begin (c) A health plan company shall not include any referral requirements or restrictions, or
require a delay for the coverage required by this section.
new text end

new text begin (d) If the Food and Drug Administration has approved more than one therapeutic
equivalent version of a contraceptive method, a health plan is not required to include more
than one therapeutic equivalent version in its formulary.
new text end

new text begin (e) If a provider recommends a specific contraceptive method to an enrollee, the health
plan company must provide coverage for the contraceptive method.
new text end

new text begin (f) If a contraceptive method is not covered by a health plan, the health plan company
must provide enrollees with an easily accessible, transparent, and expedient process, that
is not unduly burdensome to the enrollee, to request coverage of the contraceptive method
by the health plan.
new text end

new text begin (g) Nothing in this section allows for the exclusion of coverage for a contraceptive
method prescribed by a provider, acting within the provider's scope of practice, for reasons
other than contraceptive purposes, such as decreasing the risk of ovarian cancer or eliminating
symptoms of menopause, or for contraception that is necessary to preserve the life or health
of an enrollee.
new text end

new text begin Subd. 3. new text end

new text begin Religious employers; exempt. new text end

new text begin For purposes of this subdivision, a "religious
employer" means an employer that is a nonprofit entity and meets the requirements of
section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986, as amended (2018).
A religious employer is exempt from this section if the religious employer provides all
employees and prospective employees with reasonable and timely notice of the exemption
prior to their enrollment in the health plan. The notice must provide a list of the contraceptive
methods the employer refuses to cover for religious reasons.
new text end

new text begin Subd. 4. new text end

new text begin Accommodation for eligible organizations. new text end

new text begin (a) An organization is an "eligible
organization" if it:
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new text begin (1) is a nonprofit entity that holds itself as a religious organization and opposes providing
coverage for some or all contraceptive methods or services required to be covered by this
section on account of religious objections; or
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new text begin (2) is a closely held for-profit entity and the organization's highest governing body has
adopted a resolution or similar action, under the organization's applicable rules of governance
and consistent with state law, establishing that it objects to covering some or all of the
contraceptive methods or services on account of the owners' sincerely held religious beliefs;
and
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new text begin (3) submits a notice to its health plan company stating that it qualifies as an eligible
organization under this subdivision and that it has a religious objection to coverage for all,
or a subset of, contraceptive methods or services.
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new text begin (b) For purposes of paragraph (a), clause (2), a closely held for-profit entity is an entity
that has:
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new text begin (1) more than 50 percent of the value of its ownership interest owned directly or indirectly
by five or fewer individuals, or has an ownership structure that is substantially similar; and
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new text begin (2) no publicly traded ownership interest, meaning any class of common equity securities
required to be registered under United States Code, chapter 15, section 78l.
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new text begin (c) For purposes of paragraph (b), ownership interests owned by:
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new text begin (1) a corporation, partnership, estate, or trust are considered owned proportionately by
the entity's respective shareholders, partners, or beneficiaries;
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new text begin (2) an individual are considered owned, directly or indirectly, by or for the individual's
family. For purposes of this clause, "family" includes brothers and sisters, including
half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
new text end

new text begin (3) the person that holds the option to purchase an ownership interest are considered to
be the owner of those ownership interests.
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new text begin (d) A health plan company that receives the notice described in paragraph (a) must:
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new text begin (1) exclude coverage of contraceptive methods and services, as requested by the eligible
organization, from the health plan; and
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new text begin (2) provide enrollees with a separate payment for any contraceptive methods and services
that would be covered if the organization was not an eligible organization.
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new text begin (e) The requirements of subdivision 2 apply to payments made by a health plan company
under this subdivision.
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new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020, and applies to coverage
offered, sold, issued, or renewed on or after that date.
new text end