SF 1054

1st Engrossment - 94th Legislature (2025 - 2026) Posted on 03/11/2025 09:38am

A bill for an act
relating to health insurance; requiring coverage of vasectomies by health plans;
requiring the medical assistance program and MinnesotaCare to cover vasectomies;
amending Minnesota Statutes 2024, sections 62Q.522, subdivision 1; 256B.0625,
by adding a subdivision.

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

Section 1.

Minnesota Statutes 2024, section 62Q.522, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) The definitions in this subdivision apply to this section.

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

(c) "Contraceptive service" means consultation, examination, procedures, and medical
services related to the prevention of unintended pregnancy deleted text begin , excluding vasectomies deleted text end . This
includes but is not limited to voluntary sterilization procedures, patient education, counseling
on contraceptives, and follow-up services related to contraceptive methods or services,
management of side effects, counseling for continued adherence, and device insertion or
removal.

(d) "Medical necessity" includes but is not limited to considerations such as severity of
side effects, difference in permanence and reversibility of a contraceptive method or service,
and ability to adhere to the appropriate use of the contraceptive method or service, as
determined by the attending provider.

(e) "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
conditions specified in the labeling, and that:

(1) is approved as safe and effective;

(2) is a pharmaceutical equivalent: (i) containing identical amounts of the same active
drug ingredient in the same dosage form and route of administration; and (ii) meeting
compendial or other applicable standards of strength, quality, purity, and identity;

(3) is bioequivalent in that:

(i) the drug, device, or product does not present a known or potential bioequivalence
problem and meets an acceptable in vitro standard; or

(ii) if the drug, device, or product does present a known or potential bioequivalence
problem, it is shown to meet an appropriate bioequivalence standard;

(4) is adequately labeled; and

(5) is manufactured in compliance with current manufacturing practice regulations.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, and applies to health
plans offered, issued, or renewed on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 77. new text end

new text begin Vasectomies. new text end

new text begin (a) Medical assistance covers vasectomies.
new text end

new text begin (b) Medical assistance must meet the requirements with respect to coverage of
vasectomies that would otherwise apply to a health plan under section 62Q.522, except that
medical assistance is not required to comply with any provision of section 62Q.522 if
compliance with the provision would:
new text end

new text begin (1) prevent the state from receiving federal financial participation for the coverage under
this subdivision;
new text end

new text begin (2) result in a lower level of coverage or reduced access to coverage for medical assistance
enrollees; or
new text end

new text begin (3) violate Code of Federal Regulations, title 42, part 441, subpart F.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end