Minnesota SF2607 modifies the applicability of prior authorization clinical criteria changes and utilization review provisions.

Minnesota SF2607 amends the state's statutes to modify the applicability of prior authorization clinical criteria changes and utilization review provisions. Effective January 1, 2026, changes in coverage terms or clinical criteria by a utilization review organization will not apply until the next plan year or calendar year for fee-for-service providers. Exceptions include changes recommended by independent sources for patient harm, drugs or devices deemed unsafe by the FDA, or when a lower-cost therapeutically equivalent drug is added to the formulary.

Minnesota SF2607 modifies the applicability of prior authorization clinical criteria changes and utilization review provisions.

Minnesota SF2607 amends the state's statutes to modify the applicability of prior authorization clinical criteria changes and utilization review provisions. Effective January 1, 2026, changes in coverage terms or clinical criteria by a utilization review organization will not apply until the next plan year or calendar year for fee-for-service providers. Exceptions include changes recommended by independent sources for patient harm, drugs or devices deemed unsafe by the FDA, or when a lower-cost therapeutically equivalent drug is added to the formulary.