Our website no longer supports Internet Explorer. For the best browsing experience, we recommend using Chrome, Safari, Edge or Firefox.

MN Rare Disease Mandate

Effective January 1, 2024, HealthPartners will comply with the MN Rare Disease Mandate [Minn. Stat. § 62Q.451] ensuring that no health plan company may restrict the choice of an enrollee as to where the enrollee receives services from a licensed health care provider related to the diagnosis, monitoring and treatment of a rare disease or condition. Please note that the requirements of the statute do not apply to most self-insured plans.

For patients who meet the rare disease mandate conditions:

Please submit this information online to confirm eligibility, application of appropriate benefits, and payments for providers not participating in the enrollee’s plan network for covered services.

"Rare disease or condition" means a disease or condition:
  • Affecting fewer than 200,000 persons in the United States and is chronic, serious, life-altering, or life-threatening
  • Affecting more than 200,000 persons in the United States and a drug for treatment has been designated as a drug for a rare disease or condition pursuant to United States Code, title 21, section 360bb FDA Orphan Drugs List
  • labeled as a rare disease or condition on the Genetic and Rare Diseases Information Center list created by the National Institutes of Health
Or for which an enrollee:
  • has received two or more clinical consultations from a primary care provider or specialty provider that are specific to the presenting complaint
  • has documentation in the enrollee's medical record of a developmental delay through standardized assessment, developmental regression, failure to thrive, or progressive multisystemic involvement
  • had laboratory or clinical testing that failed to provide a definitive diagnosis or resulted in conflicting diagnoses


Additional resources:

Fast Facts January 2024 edition
HealthPartners MN Rare Diseases or Conditions policy
Review the MN Rare Disease Mandate
NIH list of rare diseases and conditions
Orphan Drugs|HRSA


Contact a HealthPartners Nurse Navigator with questions regarding HealthPartners members with a rare disease condition at 844-732-3544.