Mid-Year Formulary Changes
This page details the ongoing work of the MMA to limit the burden of mid-year formulary changes, otherwise known as non-medical switching laws.
New Mid-Year Formulary Change Law in 2026
Starting January 1, 2026, the following law, secured by the MMA, will limit the use of mid-year formulary changes in state-regulated health insurance products.
Please note that this law only applies to state regulated health insurance products (i.e., roughly 40% of the Minnesota market). A more detailed discussion of the limited applicability of state insurance regulations can be found in the MMA’s “Complete Guide to MN PA Law” (click here to read - coming soon).
Before January 2026
Prior to the effective date, insurance companies or pharmacy benefit managers (PBMs) may change their formularies throughout the year. This practice is sometimes called “non-medical switching,” and may force patients to change medications that are working for them. This practice can lead to pauses or stoppages in prescribed treatments and can cause delays in care, unexpected and increased expenses, and overall worse health outcomes for patients.
After January 2026
Insurers are prohibited from changing drug formularies for a medication a patient is currently using in the middle of the patient’s insurance contract year. This is only applicable to a treatment that a patient is currently using. State law requires that insurers wait until the end of the contract year, typically the calendar year, to make changes to their drug formulary.
Applicable Minnesota Statutes
62Q.83 FORMULARY CHANGES (Private Plans)
256B.0625 COVERED SERVICES, Subdiv. 3 (Public Plans)
Staff Contact
Please contact Adrian Uphoff, Manager of Health Policy and Regulatory Affairs, with questions.