SF 3252

as introduced - 89th Legislature (2015 - 2016) Posted on 03/30/2016 08:44am

A bill for an act
relating to commerce; eliminating the preauthorization requirement for
compound drugs under the No-Fault Automobile Insurance Act; amending
Minnesota Statutes 2014, section 65B.44, subdivision 2.

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

Section 1.

Minnesota Statutes 2014, section 65B.44, subdivision 2, is amended to read:

Subd. 2.

Medical expense benefits.

(a) Medical expense benefits shall reimburse
all reasonable expenses for necessary:

(1) medical, surgical, x-ray, optical, dental, chiropractic, and rehabilitative services,
including prosthetic devices;

(2) prescription drugs, provided that:

(i) prescription drugs filled and dispensed outside of a licensed pharmacy shall be
billed at the average wholesale price (AWP), or its equivalent, for that drug on that date
as published in Medispan, Redbook, or Gold Standard Drug Database, as identified by
its National Drug Code, plus a dispensing fee of $4.18;

(ii) if a prescription drug has been repackaged, the average wholesale price used
to determine the maximum reimbursement shall be the average wholesale price for
the underlying drug product, as identified by its National Drug Code from the original
labeler; and

(iii) compound drugs shall be billed by listing each drug and its National Drug Code
number included in the compound and calculating the charge for each drug separately.
Reimbursement shall be based on the sum of the fee for each ingredient for which
there is an assigned National Drug Code number plus a single dispensing fee of $4.18 deleted text begin .
Compound drugs shall not be dispensed without first obtaining preauthorization from the
reparation obligor deleted text end ;

(3) ambulance and all other transportation expenses incurred in traveling to receive
other covered medical expense benefits;

(4) sign interpreting and language translation services, other than such services
provided by a family member of the patient, related to the receipt of medical, surgical,
x-ray, optical, dental, chiropractic, hospital, extended care, nursing, and rehabilitative
services; and

(5) hospital, extended care, and nursing services.

(b) Hospital room and board benefits may be limited, except for intensive care
facilities, to the regular daily semiprivate room rates customarily charged by the institution
in which the recipient of benefits is confined.

(c) Such benefits shall also include necessary remedial treatment and services
recognized and permitted under the laws of this state for an injured person who relies
upon spiritual means through prayer alone for healing in accordance with that person's
religious beliefs.

(d) Medical expense loss includes medical expenses accrued prior to the death of a
person notwithstanding the fact that benefits are paid or payable to the decedent's survivors.

(e) Medical expense benefits for rehabilitative services shall be subject to the
provisions of section 65B.45.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end