Prior authorization prohibition for services resulting in health plan company liability equal to or less than $100

SF 731 prohibits health insurance companies in Minnesota from requiring prior authorization for any service, item, or treatment where the insurer's liability would be $100 or less if approved. This directly affects health plan companies and their members by eliminating administrative hurdles for low-cost services like minor procedures or routine care. The bill amends Minnesota Statutes §62M.07 by adding this new exception to the list of services already exempt from prior authorization (such as emergency care, mental health treatment, and cancer care). The provision takes effect January 1, 2026, applying to health benefit plans offered or renewed on or after that date. It aims to reduce unnecessary administrative delays for affordable healthcare services.