March 13, 2025
Legislation to limit mid-year formularies, an MMA priority, was heard in the Senate Commerce and Consumer Protection Committee on March 11.
Currently, insurance companies and pharmacy benefit managers (PBMs) can change a patient’s drug coverage at any point in the insurance contract year. The MMA has opposed this practice because many patients choose their health insurance plan based on whether the plan covers needed medications. Changes can lead to delays in care, unexpected and increased expenses, and overall worse health outcomes for patients. SF 1806 (Mann – DFL, Edina), would limit when mid-year formulary changes can occur.
The legislation would not prohibit all mid-year formulary changes, but would only limit them for patients currently using a medication. Nothing in the bill would prohibit PBMs and insurers from changing formularies for all other enrollees. The legislation also allows a change if the health plan offers a generic drug rated as therapeutically equivalent to the drug subject to the formulary change.
“Senate File 1806 says health plans can change their formulary whenever they want, as often as their heart desires, but if a patient is on a medication, they can stay on that one medication until the end of the year,” said Sen. Alice Mann, MD, the bill’s author. “It is a patient protection issue. We cannot pull the rug out from under patients anymore and expect good patient health outcomes.”
The Minnesota Council of Health Plans opposes the legislation, arguing that even limiting formulary changes for individuals will lead to an increase in premiums.
The bill was referred to the Senate Health and Human Services Committee. The bill’s House companion, HF 1652 (Elkins, DFL – Bloomington) has yet to receive a committee hearing.
May 29, 2025
As the Legislature works to complete its work on the state’s two-year budget, another deadline is looming. Legislators are required to pass a balanced budget before the end of the fiscal year—June 30, 2025. If they don’t meet that deadline, the state will begin a partial shutdown.
May 29, 2025
Registration has opened for the Empowering Physicians: A Night of Reflection and Engagement event, featuring best-selling author Elisabeth Rosenthal, MD.
May 29, 2025
The AMA is encouraging physicians to contact their U.S. senators and urge them to revise the reconciliation bill passed recently by the U.S. House of Representatives. While the bill includes language that would stabilize Medicare physician payments, it also threatens to cripple Medicaid and CHIP.