This is the law that I have always wanted, but hoped someone else would take the trouble to pass. I need to do some research.
I want an amendment to help with managing the 9 RX’s listed here. Allergy only has 1 RX. Asthma has 1 RX. We have 9 listed. For example, there’s 2 RX’s for a pen.
I love this law.
It’s practical, Midwestern.
It doesn’t put any burden on patients to explain anything about the money flow on the backend. I think “Cost-sharing” doesn’t give a ■■■■ about how the money flows on the backend. It just says, “You are allotted $50, Medical System.”
But at the same time, asthma only has to wrestle with one script.
Allergy only has to wrestle with one script.
Couldn’t we bundle scripts so there aren’t so many?
My practical problem is that the insurer can call up anytime and use one of the scripts as ransom to force me to do stuff - like, schedule a Doc appointment. That makes me mad. I don’t get any notice. It’s disruptive to my schedule and we all know that I have never allowed the Doc to make dosing decisions and they don’t even try. They know better. I would like to limit the insurers opportunities to hold me at ransom for life sustaining treatment because I don’t believe they use it responsibly. I believe they use leverage to extract money from me on a whim.
Things that every insulin dependent diabetic (regardless of type 1 or type 2) needs, until they cure diabetes include:
Could I add 4.) Syringes?
Is there any reason why, if someone gets a diabetes diagnosis, we can’t just eliminate prescriptions for these or grant a prescription that never expires? Like, if you get a script for an Accucheck glucometer, is there ANY potential harm that could come from me having access to that for a lifetime? Maybe the device ages out and I need to go get a new script for a new model. That’s OK. But I feel like the threat to the public and myself, from me having unrestricted access to a blood glucose machine and test strips, is limited. One could argue that I am a larger public safety threat and potential danger to myself ANYTIME access to these items is restricted. People used to make the argument that insulin could be used as a weapon, to murder people, without detection. That’s maybe kinda true, but they sell it over the counter w/o a script now, and have for years.
What is the legal purpose of a prescription?
It’s kinda an agreement between the Doc, the pharmacist, and the insurer that a medication or device is to be administered to a patient.
Maybe I cycle all the money I save on hardware into an out of network Doc that I can work with. Maybe if I use an out of network Doc, they aren’t so beholden to the insurance company.
I don’t want to be bothered with appointments every 3 months like I’m some teenage girl who has never used a pump before. That’s absurd to me. I want one-year scripts and one endo appointment per year. I don’t get the impression old diabetic dudes from the neighborhoods in saint paul attend 4 appointments per year. I believe they would tell the insurer to “f off.” They have told me so.
I think I could do it.
Maybe I could have two Doctors (one in network and one outside of network). When one of them said or did something I didn’t like, I’d have the other one write the script. Could both of them write scripts so if one failed, the other might succeed?
Why does state law address diabetics, asthmatics, and anaphylactic shock?
Because there’s been a ■■■■ ton of predatory practice against users of medical devices. That’s why.
One of my diabetic friends in MN says she might be able to retire because of this new law, @DrBB. This law might be amazing. No one knows about it. I wouldn’t have known, except that someone on the forum found it - @spdif found it.
I’m confused–is this legally in effect or just a proposal?
ITS IN EFFECT as of Jan 1st!!!
I love how the bill is written. It’s sort of saying, “Go ahead and price gouge on the backend. We don’t care. But that behavior is going to contribute to higher premiums because you aren’t gonna price gouge any particular patient, or group of patients, without that spreading across EVERYONES premiums.”
It preserves the fundamental function of insurance, no matter what they do. It spreads risk. It distributes the risk of them price gouging.
Thus far, this year, I have only spent $90. It’s crazy.
I also love that it targets the medical device companies. I didn’t think something like this would be possible yet.
It isn’t clear to me, but does this MN law apply to Medicare and Medicare Advantage insurance? Federal rules, passed under the Biden administration capped insulin at $35/vial. This law appears to state that I should only pay $25/vial.
I’m 50.1% sure the law does not apply to Medicare Part B copays. In statute 62A.011 the definition of health plan excludes supplement plans too. Let us know if you figure out if MA or Part D plans fall under that definition.
Good question. This is Mn state legislation. Are you in MN? If you are in MN, then you should DEFINITLY NOT be paying more than $25 any given month for up to 3 vials.
On a private policy, I pay $25 for a three month supply on insulin. No idea why. I usually get months of vials - maybe 9 vials. It’s a free for all on insulin.
We have another separate cap that came out of a state lawsuit with the manufacturers - that settlement might state that they can’t charge us more than $35 for insulin per month whenever we pick it up (for the next 5 years). January 27, 2025 Press Release This applies to everyone, I think.
"Today’s settlement requires Novo Nordisk to provide insulin products—including Novolog, Tresiba, Fiasp, and Novolin, at any formulation and via any delivery method—at $35 per monthly prescription (3 vials or 2 packs of pens) for customers paying with cash. Even Minnesotans with insurance can choose to not use their insurance and pay no more than $35 per month. "
For the record, things aren’t totally clear to me either. I’m gonna ask some questions. If anyone has any to add to my list of questions, I will ask.
The Medicare $35 copay cap is a Federal law that extends to everyone, nationally.
I spoke with a member of the house today and he didn’t think that it works for Medicare. He said that there are some limits on what the state can regulate, for example they don’t have any legal control over high deductible plans. He said they can’t impact “self insured” plans (typically used by large businesses. Those are employer created plans that the state doesn’t have any control over. He says the Feds would have to manage those.
Overall, he thought the law impacted about 2/3 of people in my state.
Maybe because Medicare and Medicare are Federal law, they can’t be regulated at a state level, only federal.
