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HF 1863

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to health; providing for the disclosure of health care payment
information; amending Minnesota Statutes 2006, section 62J.81, subdivision 1;
repealing Minnesota Statutes 2006, section 62J.052, subdivision 1.

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

Section 1.

Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:


Subdivision 1.

Required disclosure of estimated payment.

(a) A health care
provider, as defined in section 62J.03, subdivision 8, or the provider's designee as agreed
to by that designee, shall, at the request of a consumer, provide that consumer with a good
faith estimate of the deleted text begin reimbursementdeleted text end new text begin allowable payment new text end the provider deleted text begin expects to receive
from the health plan company in which the consumer is enrolled
deleted text end new text begin has agreed to accept from
the consumer's health plan company for the services specified by the consumer, specifying
the amount of the allowable payment due from the health plan company and the amount
due from the consumer
new text end . Health plan companies must allow contracted providers, or their
designee, to release this information. deleted text begin A good faith estimate must also be made available at
the request of a consumer who is not enrolled in a health plan company.
deleted text end new text begin If a consumer has
no applicable public or private coverage, the health care provider must give the consumer
a good faith estimate of the average allowable reimbursement the provider accepts as
payment from private third-party payers for the services specified by the consumer and the
estimated amount the noncovered consumer will be required to pay.
new text end Payment information
provided by a provider, or by the provider's designee as agreed to by that designee, to a
patient pursuant to this subdivision does not constitute a legally binding estimate of the
new text begin allowable charge for or new text end cost new text begin to the consumer new text end of services.

(b) A health plan company, as defined in section 62J.03, subdivision 10, shall, at the
request of an enrollee or the enrollee's designee, provide that enrollee with a good faith
estimate of the deleted text begin reimbursementdeleted text end new text begin allowable amount new text end the health plan company deleted text begin would expect to
pay to
deleted text end new text begin has contracted for with new text end a specified provider within the network new text begin as total payment new text end for
a health care service specified by the enrolleenew text begin and the portion of the allowable amount due
from the enrollee
new text end . deleted text begin If requested by the enrollee, the health plan company shall also provide
to the enrollee a good faith estimate of the enrollee's out-of-pocket cost for the health care
service.
deleted text end An estimate provided to an enrollee under this paragraph is not a legally binding
estimate of the deleted text begin reimbursementdeleted text end new text begin allowable amount new text end or new text begin enrollee's new text end out-of-pocket cost.

Sec. 2. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2006, section 62J.052, subdivision 1, new text end new text begin is repealed.
new text end

Sec. 3. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 and 2 are effective August 1, 2007.
new text end