MMA Board Approves 2025 Legislative Priorities; MA Payment Increase Tops List

November 21, 2024

The MMA Board of Trustees approved five legislative priorities for the upcoming legislative session at its November 16 meeting in St. Paul.  

Increasing Medical Assistance (MA, Minnesota’s Medicaid program) and MinnesotaCare payments led the list. Currently, MA reimburses at a rate of between 60 and 70% of Medicare, and only 30% of commercial payers. The MMA is proposing a way to maximize federal matching funds to pay for this increase through an assessment on managed care organizations. If it receives federal approval, it will limit the cost to the state’s general fund. 

A second priority is prohibiting formulary changes during a contract year by health plans and pharmacy benefit managers. Patients often choose their insurance based on whether the plan covers their medications. Unexpected changes in a drug formulary can not only increase out-of-pocket costs, but also compromise patient health if patients cannot access their medications. The proposal also requires payers to use a real-time benefit tool that informs prescribers what is covered and what is not. Similar to the MA payment increases, this legislative priority will have a large price tag.  

The third priority involves funding the POLST (Provider Orders for Life-Sustaining Treatment) registry that was recommended by the Minnesota Department of Health. This recommendation followed legislation promoted by the MMA two years ago directing a study of the issue. This will develop the education needed to begin the phased-in implementation of the registry.  

The fourth priority is focused on the continued effort to address physician wellness. In addition to removing administrative burdens that lead to burnout, the MMA will pursue funding for the “Breaking Barriers in Health-Seeking" campaign started through a health department grant. This campaign is designed to reduce the stigma related to seeking care and make it easier for physicians to seek help when they need it.  

The fifth priority is continuing coverage for audio-only telehealth services. When the telehealth law first passed, the Legislature put a sunset on audio-only coverage to ensure it was meeting the needs of patients. That sunset is currently scheduled for June 30, 2025. A recent state study shows that telehealth has been a useful tool for both patients and providers across Minnesota, including the use of audio-only services.  

“We have our work cut out for us,” said Dave Renner, the MMA’s director of advocacy. “These are all important priorities, but they all come with a price tag. Whether legislators will be willing to find funding sources for these topics remains to be seen.” 

The MMA advocacy team will also keep an eye on these other topics: private equity in healthcare; scope of practice; reinsurance; the public option; licensure for International Medical Graduates; and physician-aid-in-dying.  

The Legislature convenes on January 14, 2025. The MMA’s Physicians’ Day at the Capitol is February 19.