SF 3897

as introduced - 90th Legislature (2017 - 2018) Posted on 04/10/2018 08:31am

A bill for an act
relating to health care; requiring a health plan company to make available a fee
schedule; amending Minnesota Statutes 2016, section 62Q.735, subdivision 1.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2016, section 62Q.735, subdivision 1, is amended to read:

Subdivision 1.

Contract disclosure.

(a) Before requiring a health care provider to sign
a contract, a health plan company shall give to the provider a complete copy of the proposed
contract, including:

(1) all attachments and exhibits;

(2) operating manuals;

(3) a general description of the health plan company's health service coding guidelines
and requirement for procedures and diagnoses with modifiers, and multiple procedures; and

(4) all guidelines and treatment parameters incorporated or referenced in the contract.

(b) The health plan company shall make available to the provider the fee schedule or a
method or process that allows the provider to determine the fee schedule for each health
care service to be provided under the contract.

(c) Notwithstanding paragraph (b), a health plan company that is a dental plan
organization, as defined in section 62Q.76, shall disclose deleted text begin information related to the individual
contracted provider's expected reimbursement deleted text end new text begin to each provider the fee schedule by procedure
code for each procedure to be performed under the contract in order for the provider to
determine the expected reimbursement new text end from the dental plan organization. Nothing in this
section requires a dental plan organization to disclose the plan's aggregate maximum
allowable fee table used to determine other providers' fees. The contracted provider must
not release this information in any way that would violate any state or federal antitrust law.