§ 62Q.585 — Gender-affirming Care Coverage; Medically Necessary Care
Plain-Language Summary
Addresses gender-affirming care coverage; medically necessary care under Minnesota health plan regulations.
62Q.585 GENDER-AFFIRMING CARE COVERAGE; MEDICALLY NECESSARY CARE.
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Subdivision 1.Requirement.
No health plan that covers physical or mental health services may be offered, sold, issued, or renewed in this state that:
(1) excludes coverage for medically necessary gender-affirming care; or
(2) requires gender-affirming treatments to satisfy a definition of “medically necessary care,” “medical necessity,” or any similar term that is more restrictive than the definition provided in subdivision 2. §
Subd. 2.Minimum definition.
“Medically necessary care” means health care services appropriate in terms of type, frequency, level, setting, and duration to the enrollee’s diagnosis or condition and diagnostic testing and preventive services. Medically necessary care must be consistent with generally accepted practice parameters as determined by health care providers in the same or similar general specialty as typically manages the condition, procedure, or treatment at issue and must:
(1) help restore or maintain the enrollee’s health; or
(2) prevent deterioration of the enrollee’s condition. §
Subd. 3.Definitions.
(a) For purposes of this section, the following terms have the meanings given.
(b) “Gender-affirming care” means all medical, surgical, counseling, or referral services, including telehealth services, that an individual may receive to support and affirm the individual’s gender identity or gender expression and that are legal under the laws of this state.
(c) “Health plan” has the meaning given in section 62Q.01, subdivision 3, but includes the coverages listed in section 62A.011, subdivision 3, clauses (7) and (10).
History:
History: History:
2024 c 114 art 1 s 7