HF 2183

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

A bill for an act
relating to health care; regulating certain high deductible health plans; amending
Minnesota Statutes 2006, section 62Q.65.

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

Section 1.

Minnesota Statutes 2006, section 62Q.65, is amended to read:

62Q.65 deleted text begin ACCESS TO PROVIDER DISCOUNTS deleted text end new text begin HIGH DEDUCTIBLE
HEALTH PLAN REGULATION new text end .

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin Subdivisions 1 to 3 and 5 apply to a high deductible
health plan when used in connection with a medical savings account or health savings
account. Subdivision 4 applies to a high deductible health plan whether or not it is used in
connection with a medical savings account or health savings account.
new text end

deleted text begin Subdivision 1 deleted text end new text begin Subd. 2 new text end .

deleted text begin Requirement deleted text end new text begin Access to provider discounts new text end .

A high
deductible health plan must deleted text begin , when used in connection with a medical savings account or
health savings account, deleted text end provide the enrollee access to any discounted provider fees for
services covered by the high deductible health plan, regardless of whether the enrollee has
satisfied the deductible for the high deductible health plan.

new text begin Subd. 3. new text end

new text begin Assignment of benefits. new text end

new text begin A high deductible health plan must require the
enrollee to assign benefits from the plan to the health care provider providing health care
services to the enrollee.
new text end

new text begin Subd. 4. new text end

new text begin Estimated payments to providers. new text end

new text begin A high deductible health plan must
not prohibit or restrict a health care provider from collecting an estimated payment
for health care services provided to an enrollee before an explanation of benefits is
received by the enrollee. The estimated payment must be based on the expected allowable
reimbursement for the requested service from either or both of the following: (1) the
plan; or (2) the enrollee.
new text end

new text begin Subd. 5. new text end

new text begin Participation limits on providers. new text end

new text begin A high deductible health plan must not
prohibit or restrict a health care provider from entering into a provider agreement with the
issuer of the high deductible health plan, or an affiliate of the issuer, for use in connection
with the high deductible health plan if the health care provider:
new text end

new text begin (1) meets the issuer's credentialing standards;
new text end

new text begin (2) agrees to the terms of the provider agreement; and
new text end

new text begin (3) agrees to comply with all managed care protocols of the issuer.
new text end

Subd. deleted text begin 2. deleted text end new text begin 6. new text end

Definitions.

For purposes of this section, the following terms have
the meanings given:

(1) "high deductible health plan" has the meaning given under the Internal Revenue
Code of 1986, section 220(c)(2), with respect to a medical savings account; and the
meaning given under Internal Revenue Code of 1986, section 223(c)(2), with respect to a
health savings account;

(2) "medical savings account" has the meaning given under the Internal Revenue
Code of 1986, section 220(d)(1);

(3) "discounted provider fees" means fees contained in a provider agreement entered
into by the issuer of the high deductible health plan, or an affiliate of the issuer, for use
in connection with the high deductible health plan; and

(4) "health savings account" has the meaning given under the Internal Revenue Code
of 1986, section 223(d).

Sec. 2. new text begin EFFECTIVE DATE; APPLICATION.
new text end

new text begin Section 1 is effective August 1, 2007, and applies to high deductible health plans
offered, sold, issued, or renewed on or after that date.
new text end