Prior Authorization in Minnesota
Minnesota enacted SF 278 (2019) requiring step therapy override protections. The law mandates exceptions for contraindications, prior failures, expected inefficacy, and patient stability on current therapy. Minnesota requires PA decisions within 24 hours for urgent requests.
Key Facts About PA in Minnesota
- ✓ Step therapy override law includes stability on current therapy as an exception
- ✓ Urgent PA decisions required within 24 hours
- ✓ Minnesota Department of Commerce oversees external review
- ✓ Minnesota has a strong managed care Medicaid program
Quick Stats
- Typical Appeal Filing Window: 30 days
- External Review Available: Yes
- Major Payers: 4
Top Payers in Minnesota
RxCheckUp generates payer-specific Letters of Medical Necessity for each of these Minnesota carriers:
Blue Cross Blue Shield of MinnesotaHealthPartnersMedicaUnitedHealthcare