SF 269

2nd Engrossment - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to insurance; requiring coverage for 
  1.3             prescription contraceptives; proposing coding for new 
  1.4             law in Minnesota Statutes, chapter 62Q. 
  1.5   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.6      Section 1.  [62Q.80] [COVERAGE OF PRESCRIPTION 
  1.7   CONTRACEPTIVES.] 
  1.8      Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
  1.9   section, the terms defined in this subdivision have the meanings 
  1.10  given. 
  1.11     (b) "Enrollee" has the meaning given in section 62Q.01, 
  1.12  subdivision 2a. 
  1.13     (c) "Health plan" has the meaning given in section 62Q.01, 
  1.14  subdivision 3, but includes the coverages described in section 
  1.15  62A.011, subdivision 3, clauses (7) and (10). 
  1.16     (d) "Health plan company" has the meaning given in section 
  1.17  62Q.01, subdivision 4. 
  1.18     (e) "Outpatient contraceptive services" means 
  1.19  consultations, examinations, procedures, and medical services, 
  1.20  provided on an outpatient basis and related to the use of 
  1.21  contraceptive drugs and devices to prevent pregnancy. 
  1.22     Subd. 2.  [PARITY FOR CONTRACEPTIVES.] (a) A health plan 
  1.23  that covers prescription drugs or devices must not exclude or 
  1.24  restrict coverage to enrollees of any prescription contraceptive 
  1.25  drug or device approved by the federal Food and Drug 
  2.1   Administration.  In providing the coverage for oral 
  2.2   contraceptive drugs required by this paragraph, a health plan 
  2.3   may reasonably limit coverage to oral contraceptive drugs listed 
  2.4   on a drug formulary maintained for the health plan.  Nothing in 
  2.5   this section shall be construed to require coverage for any 
  2.6   contraceptive drug or device that is available over the counter 
  2.7   and is not prescribed by a health care provider. 
  2.8      (b) A health plan that covers outpatient services provided 
  2.9   by a health care professional must not exclude or restrict 
  2.10  coverage of outpatient contraceptive services for enrollees. 
  2.11     Subd. 3.  [SPECIAL RESTRICTIONS PROHIBITED.] (a) A health 
  2.12  plan must not impose deductibles, co-payments, coinsurance, 
  2.13  other enrollee cost-sharing provisions, or waiting periods, for 
  2.14  prescription contraceptive drugs or devices that are greater 
  2.15  than those imposed for other covered prescription drugs or 
  2.16  devices. 
  2.17     (b) A health plan must not impose deductibles, co-payments, 
  2.18  coinsurance, other enrollee cost-sharing provisions, or waiting 
  2.19  periods, for outpatient contraceptive services that are greater 
  2.20  than those imposed for other covered outpatient services. 
  2.21     Subd. 4.  [CERTAIN PRACTICES PROHIBITED.] A health plan 
  2.22  company must not: 
  2.23     (1) deny eligibility, continued eligibility, enrollment, or 
  2.24  renewal of coverage to any individual because of the 
  2.25  individual's use or potential use of contraceptives; 
  2.26     (2) provide monetary payments or rebates to enrollees to 
  2.27  encourage them to accept less than the minimum protections 
  2.28  available under this section; 
  2.29     (3) penalize, or otherwise reduce or limit the 
  2.30  reimbursement of a health care professional or health care 
  2.31  provider, because the professional or provider prescribed 
  2.32  contraceptive drugs or devices, or provided contraceptive 
  2.33  services; or 
  2.34     (4) provide incentives, monetary or otherwise, to a health 
  2.35  care professional or health care provider to induce the 
  2.36  professional or provider to withhold contraceptive drugs, 
  3.1   devices, or services from enrollees. 
  3.2      Subd. 5.  [EXCLUSION FOR RELIGIOUS EMPLOYER.] A religious 
  3.3   employer may request and a health plan company shall grant an 
  3.4   exclusion under the health plan for the coverage required by 
  3.5   this section if the required coverage conflicts with the 
  3.6   religious employer's bona fide religious beliefs and practices.  
  3.7   A religious employer that obtains an exclusion under this 
  3.8   subdivision shall provide enrollees and prospective enrollees 
  3.9   written notice of the exclusion.  This subdivision may not be 
  3.10  construed as authorizing a health plan company to exclude 
  3.11  coverage for prescription drugs prescribed for reasons other 
  3.12  than contraceptive purposes or for prescription contraception 
  3.13  that is necessary to preserve the life or health of an 
  3.14  enrollee.  For the purposes of this section, "religious 
  3.15  employer" means an employer that is a church, convention or 
  3.16  association of churches, or an elementary or secondary school 
  3.17  that is controlled, operated, or principally supported by a 
  3.18  church or by a convention or association of churches as defined 
  3.19  in United States Code, title 26, section 3121(w)(3)(A), and that 
  3.20  qualifies as a tax-exempt organization under United States Code, 
  3.21  title 26, section 501(c)(3). 
  3.22     Sec. 2.  [EFFECTIVE DATE.] 
  3.23     Section 1 is effective August 1, 2003, and applies to 
  3.24  health plans issued or renewed on or after that date.