HF 293

1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 02/15/2023 11:13am

A bill for an act
relating to health; requiring medical and dental practices to make available to the
public their current standard charges; authorizing the commissioner of health to
establish a price comparison tool for items and services offered by medical and
dental practices; proposing coding for new law in Minnesota Statutes, chapter 62J.

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

Section 1.

new text begin [62J.826] MEDICAL AND DENTAL PRACTICES; CURRENT
STANDARD CHARGES; COMPARISON TOOL.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) The definitions in this subdivision apply to this section.
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new text begin (b) "CDT code" means a code value drawn from the Code on Dental Procedures and
Nomenclature published by the American Dental Association.
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new text begin (c) "Chargemaster" means the list of all individual items and services maintained by a
medical or dental practice for which the medical or dental practice has established a charge.
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new text begin (d) "Commissioner" means the commissioner of health.
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new text begin (e) "CPT code" means a code value drawn from the Current Procedural Terminology
published by the American Medical Association.
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new text begin (f) "Dental service" means a service charged using a CDT code.
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new text begin (g) "Diagnostic laboratory testing" means a service charged using a CPT code within
the CPT code range of 80047 to 89398.
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new text begin (h) "Diagnostic radiology service" means a service charged using a CPT code within
the CPT code range of 70010 to 79999 and includes the provision of x-rays, computed
tomography scans, positron emission tomography scans, magnetic resonance imaging scans,
and mammographies.
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new text begin (i) "Hospital" means an acute care institution licensed under sections 144.50 to 144.58,
but does not include a health care institution conducted for those who rely primarily upon
treatment by prayer or spiritual means in accordance with the creed or tenets of any church
or denomination.
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new text begin (j) "Medical or dental practice" means a business that:
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new text begin (1) earns revenue by providing medical care or dental services to the public;
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new text begin (2) issues payment claims to health plan companies and other payers; and
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new text begin (3) may be identified by its federal tax identification number.
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new text begin (k) "Outpatient surgical center" means a health care facility other than a hospital offering
elective outpatient surgery under a license issued under sections 144.50 to 144.58.
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new text begin (l) "Standard charge" has the meaning given in Code of Federal Regulations, title 45,
section 180.20.
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new text begin Subd. 2. new text end

new text begin Requirement; current standard charges. new text end

new text begin The following medical or dental
practices must make available to the public a list of their current standard charges, as reflected
in the medical or dental practice's chargemaster, for all items and services provided by the
medical or dental practice:
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new text begin (1) hospitals;
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new text begin (2) outpatient surgical centers; and
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new text begin (3) any other medical or dental practice that has revenue of greater than $50,000,000
per year and that derives the majority of its revenue by providing one or more of the following
services:
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new text begin (i) diagnostic radiology services;
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new text begin (ii) diagnostic laboratory testing;
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new text begin (iii) orthopedic surgical procedures, including joint arthroplasty procedures within the
CPT code range of 26990 to 27899;
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new text begin (iv) ophthalmologic surgical procedures, including cataract surgery coded using CPT
code 66982 or 66984, or refractive correction surgery to improve visual acuity;
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new text begin (v) anesthesia services commonly provided as an ancillary to services provided at a
hospital, outpatient surgical center, or medical practice that provides orthopedic surgical
procedures or ophthalmologic surgical procedures;
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new text begin (vi) oncology services, including radiation oncology treatments within the CPT code
range of 77261 to 77799 and drug infusions; or
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new text begin (vii) dental services.
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new text begin Subd. 3. new text end

new text begin Required file format and content. new text end

new text begin (a) A medical or dental practice that is
subject to this section must make available to the public, and must report to the commissioner,
current standard charges using the format and data elements specified in the currently
effective version of the Hospital Price Transparency Sample Format (Tall) (CSV) and related
data dictionary recommended for hospitals by the Centers for Medicare and Medicaid
Services (CMS). If CMS modifies or replaces the specifications for this format, the form
of this file must be modified or replaced to conform with the new CMS specifications by
the date specified by CMS for compliance with its new specifications. All prices included
in the file must be expressed as dollar amounts. The data must be in the form of a comma
separated values file which can be directly imported, without further editing or remediation,
into a relational database table which has been designed to receive these files. The medical
or dental practice must make the file available to the public in a manner specified by the
commissioner and must report the file to the commissioner in a manner and frequency
specified by the commissioner.
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new text begin (b) A medical or dental practice must test its file for compliance with paragraph (a)
before making the file available to the public and reporting the file to the commissioner.
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new text begin (c) A hospital must comply with this section no later than January 1, 2024. A medical
or dental practice that meets the requirements in subdivision 2, clause (3), or an outpatient
surgical center must comply with this section no later than January 1, 2025.
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new text begin Subd. 4. new text end

new text begin Price comparison tool. new text end

new text begin The commissioner shall use the information reported
to the commissioner under subdivision 3 to develop and make available to the public a tool
for the public to use to compare charges for a specific item or service across medical and
dental practices that offer that item or service. The commissioner may contract with a third
party for the development and operation of this tool. The price comparison tool must be
made available to the public by July 1, 2024.
new text end