Legislation aimed at ensuring a patient’s needed medication would continue to be covered under their existing insurance policy was given its first committee hearing last week. The bill, authored by Sen. Carla Nelson (R-Rochester), would prevent insurance companies from making mid-year changes to drug formularies.

“This bill puts patients first,” said Sen. Nelson. “In many cases, consumers select a health plan based on medication coverage. Yet, there is nothing in law that prohibits an insurer from changing which drugs may be covered midway through a contract year and often during a course of treatment. Simply put, patients need certainty that they will have uninterrupted access to the medications they need.”

Senate File 593 would prohibit health plans from discontinuing coverage of a medication, during the length of the contract, if the consumer is undergoing a treatment of that drug. Providers spend an estimated $80,000 per year, per physician, on the administrative work of prior authorization; this legislation would ensure providers and patients are aware, upfront, of which medications would be covered under a given health plan.

“In many cases, the slightest change in a patient’s drug therapy can have a significant impact on their health and treatment.” Sen. Nelson continued. “Switching medication mid-treatment can be very dangerous and these decisions should be made by the physician, whose best interest is the health of patient, and not an insurance company. Health plans have an obligation to honor the same contract terms that patients must honor.”

The legislation has the support of several prominent medical advocacy groups, including the National Alliance on Mental Illness (NAMI) and the American Heart Association. It received bipartisan support from the Senate Health and Human Services Finance and Policy Committee, where it was laid over for possible inclusion in its larger, forthcoming budget bill. Its House companion, House File 747, has not yet had a hearing.

“There is broad, bipartisan support for this bill. I am hopeful that we can work together to make this common sense, patient-centered proposal law,” Sen. Nelson concluded.

Sen. Nelson is in her third term representing Senate District 26, which includes communities in Olmsted County. She also serves as chairwoman of the Senate E-12 Finance Committee.