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Committee advances bill to prevent mid‑year formulary demotions for patients already on medicines
Summary
House File 16 52 would bar health plans from removing or increasing enrollee cost-sharing for drugs already prescribed to that enrollee during the plan year. The committee adopted the A1 amendment, heard mixed testimony from physicians, patient advocates and industry groups, and laid the bill over for possible inclusion in the omnibus bill.
Representative Elkins presented House File 16 52 and the committee adopted the A1 author’s amendment shaping the bill’s scope. The legislation would prohibit a health plan from removing a drug from an enrollee’s formulary or moving it into a more costly benefit category for the remainder of the plan year if that enrollee had previously been prescribed the drug during that plan year.
Physician witnesses and patient advocates described clinical harms when a patient must switch medications mid‑year. Dr. Laurel Reese, a family physician testifying for the Minnesota Medical Association, said the…
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