SF 4419 Minnesota Senate · 2025-2026 Regular Session

Various prescription drug transaction, coverage, and data provisions modifications

This bill modifies Minnesota's prescription drug regulations to standardize electronic transactions between healthcare providers and insurance companies, requiring all drug prior authorization requests to be submitted electronically by 2016 and mandating the use of the NCPDP SCRIPT Standard for these exchanges starting in 2027. The legislation affects healthcare providers, insurance group purchasers, and health plans by establishing specific timelines and technical standards for how prescription drug authorization data must be transmitted, while also clarifying exemptions for certain group purchasers not covered by federal HIPAA rules. Additionally, the bill updates definitions related to biosimilar and brand name drugs and removes obsolete language from existing health insurance statutes. These changes aim to improve administrative efficiency and align Minnesota's electronic data standards with national practices.

Issues: ✓ Healthcare ✓ Technology

Bill status in committee 1 of 4 stages cleared

Introduction

Mar 2026

Committee Review

Floor Vote

Governor

Introduced Mar 12, 2026 Last action Apr 7, 2026

Maddy AI version diff · 2 comparisons

What changed between versions

1st Engrossment → 2nd Engrossment · 4 edits · Apr 7, 2026

MODERATE

The bill was updated from the 1st to the 2nd engrossment, primarily removing obsolete sections related to prescription drug price transparency and immunizations that were previously included in the act's description. The substantive policy changes focus on expanding the definition of 'health plans' and 'scope' to explicitly include stand-alone dental plans, thereby bringing them under the same regulatory requirements as medical plans. Additionally, the bill modifies exemptions for group purchasers and providers regarding electronic transaction requirements, and updates the terminology used in reporting obligations from 'health plans' to 'health plan companies'.

Scope change

The bill's scope was expanded to explicitly include stand-alone dental plans within the regulatory framework previously applied only to medical health plans.

DEFINITION

The definition of 'health plan' and the scope of the chapter were amended to explicitly include stand-alone dental plans.

REQUIREMENT

Exemptions for group purchasers and providers regarding electronic eligibility transactions were broadened to apply to all exempt entities, not just group purchasers.

Terminology in reporting requirements was updated to refer to 'health plan companies' instead of 'health plans' to ensure consistency.

TECHNICAL

References to prescription drug price transparency and immunization coverage were removed from the bill's summary, indicating these topics are no longer part of this specific legislative package.

Introduction → 1st Engrossment · 8 edits · Mar 23, 2026

MODERATE

This bill updates Minnesota's health laws to improve transparency and accountability for health maintenance organizations (HMOs). Key changes include requiring HMOs to report detailed financial data, expanding price transparency requirements for prescription drugs, and clarifying rules for provider networks and marketing materials.

Scope change

The bill shifts regulatory focus from the commissioner of commerce to the commissioner of health for HMO regulation and adds new reporting requirements for HMOs regarding financial statements and provider directories.

DEFINITION

The definition of 'comprehensive health maintenance services' was updated to explicitly include 'preventive items and services' to clarify coverage expectations.

REQUIREMENT

HMOs must now submit unaudited financial statements for the first three quarters of the year and allocate administrative and investment expenses by business line or product.

Price transparency requirements for brand-name drugs were expanded to include the specific highest amount paid in foreign countries and clarified how to calculate values when package sizes differ.

HMOs must publish up-to-date provider directories online showing which providers are accepting new patients, along with contact information and specialties.

Marketing materials must now include specific bolded warnings that the plan may not cover all expenses and must clearly list exclusions, co-payments, and referral requirements.

HMOs must notify the commissioner within ten working days if they terminate a participating provider for cause, death, disability, or loss of license.

ELIGIBILITY

Exemptions for group purchasers regarding electronic transaction requirements were expanded to include providers exchanging transactions with those exempt group purchasers.

TECHNICAL

Several obsolete sections of the statute were repealed, including outdated provisions regarding HMO examinations and specific financial reporting rules.

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Full legislative history

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Committee

Apr 7, 2026

Upper · Passed

Comm report: To pass as amended and re-refer to Health and Human Services

upper

Mar 23, 2026

Upper · Passed

Comm report: To pass as amended and re-refer to Commerce and Consumer Protection

upper

Mar 12, 2026

Committee

Referred to Health and Human Services

upper

Mar 12, 2026

Introduced

Introduction and first reading

upper

1 primary · 0 co-sponsors