MN SF4262

Health plan companies cannot restrict where enrollees receive services for diagnosis and treatment of rare diseases or conditions.

Rare disease or condition is defined as affecting fewer than 200,000 persons in the United States, or affecting more than 200,000 persons where a drug for treatment has been designated under federal law (21 U.S.C. § 360bb).

Cost-sharing requirements and benefit or service limitations for rare disease diagnosis and treatment must not be more restrictive or place greater financial burden on enrollees than in-network medical treatment requirements.

This requirement does not apply to coverage provided through public health care programs under Minnesota Statutes chapters 256B or 256L.

Effective July 1, 2020, for health plans offered, issued, or renewed on or after that date.