Minnesota health plans must maintain drug formulary for enrollees through plan year

The Minnesota State Legislature has introduced Senate Bill 2669, aimed at reforming prescription drug coverage within health plans. Introduced on April 22, 2025, the bill seeks to protect enrollees from unexpected changes in their prescription drug coverage during the plan year.

The primary provision of Senate Bill 2669 prohibits health plans from removing a drug from their formulary or increasing the cost of a drug for enrollees who have already been prescribed that medication within the same plan year. This measure is designed to ensure that patients can continue their prescribed treatments without facing sudden financial burdens or interruptions in care. However, exceptions exist for drugs deemed unsafe by the FDA, withdrawn from the market, or subject to new clinical warnings indicating imminent patient harm.

Additionally, the bill allows health plans to replace brand-name drugs with therapeutically equivalent generic or multisource alternatives, provided that the new options are offered at the same or lower cost to the enrollee. Health plans must also notify prescribers, pharmacists, and affected enrollees at least 60 days in advance of any such changes.

The bill is set to take effect on January 1, 2026, and will apply to all health plans offered, sold, issued, or renewed after that date.

Senate Bill 2669 has sparked discussions among lawmakers, healthcare providers, and patient advocacy groups. Supporters argue that the bill addresses a critical issue in healthcare affordability and access, while opponents express concerns about potential impacts on health plan flexibility and cost management.

As the bill progresses through the legislative process, its implications for Minnesota's healthcare landscape could be significant, potentially influencing how health plans manage drug formularies and impacting the overall cost of healthcare for residents. Stakeholders are closely monitoring the developments, as the outcome may set a precedent for similar legislation in other states.