Prior Authorization Reform Included in House Omnibus Bill, but Not in Senate Version

April 18, 2024

The MMA’s chief legislative priority relating to prior authorization reform has been included in the House Health omnibus bill, HF 4571 (Liebling, DFL – Rochester), which was released on April 17.  

The MMA shared a letter of support at a committee hearing on April 18, thanking the bill’s author for including the critical provision in her omnibus bill.  

The legislation prohibits prior authorization for services in which a delay in care could lead to serious negative health outcomes. These services include treatments for substance-use disorder, outpatient mental health, cancer, and chronic conditions, among others.  

Furthermore, the bill requires health plans to submit data on prior authorization to the Minnesota Department of Health, which in turn will submit recommendations to improve the prior authorization process, including a recommendation for a prior authorization exemption process for providers. The language also requires health plans to adopt automated processes for prior authorization and prohibits retrospective denials.  

Parts of this language will need to be amended to fit the committee’s tight budget target, but its inclusion demonstrates the House leaders’ commitment to reducing the burden of prior authorization. 

The Senate omnibus bill, SF 4699 (Wiklund, DFL – Bloomington) does not include any language relating to prior authorization, despite the bill’s strong bipartisan support. 

The MMA shared its frustration and disappointment that the prior authorization reform was excluded from the Senate bill in a letter to the committee.  

In that same letter, however, the MMA thanked the committee for including another MMA legislative priority to improve physician wellbeing. This language provides additional protections for physicians who participate in the MMA’s SafeHaven program, and it provides a one-time grant of $500,000 to the MMA for a campaign to address the stigma related to physicians and other healthcare providers receiving mental healthcare when needed.  

The Senate bill also includes language designed to increases Minnesota’s vaccine rates by permitting childcare centers to require participants be fully vaccinated. Neither of these items were included in the House bill.