Improving Medication Access for Patients

Medication access would be easier for Minnesotans thanks to a bill heard in the Health, Human Services and Housing Committee. The bill would remove barriers confronting a patient’s access to necessary medications.

Currently, through a process known as prior authorization, health plans require subscribers to submit certain prescriptions for approval before they are covered. While a necessary process for several medications, it is increasingly used for medications that do not need to go through the process. This added level of bureaucracy takes time for physicians and can be confusing, as they are not aware of what drugs are and are not covered. Additionally, these formularies are different across all health plans, and plans can eliminate and add drugs to a formulary at any time.

This bill would make the process more standardized and less time-consuming for prescribers through several modifications to prior authorization. It shortens available to process prior authorization requests and adds a process to report which requests were approved and denied. The bill also requires health plans to release its formulary prior to the renewal period and prohibits removing drugs that increase costs for patients unless they also add a similar drug that will lower the cost. If the formulary does change, the health plan would have to establish a transition period to prevent coverage gaps.

To oversee this process, the bill would create an advisory group within the Department of Health to provide guidance in the changes and trends that occur within prescription coverage and formularies. Supporters of the legislation argue that these changes put the patient’s care first, and guarantees they get the care they deserve.

The bill was amended and re-referred to the Committee on Commerce. (S.F. 934)

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