HF 4581

as introduced - 91st Legislature (2019 - 2020) Posted on 04/28/2020 11:02am

A bill for an act
relating to health care; requiring a health care provider to disclose to a consumer
whether services are covered by a consumer's health plan and provider's network
participation status; amending Minnesota Statutes 2018, section 62J.81, by adding
a subdivision.

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

Section 1.

Minnesota Statutes 2018, section 62J.81, is amended by adding a subdivision
to read:

new text begin Subd. 1b. new text end

new text begin Additional required disclosures by provider. new text end

new text begin (a) Before a health care provider
provides any health care services to a consumer, the provider or the provider's designee, as
agreed to by that designee, must determine whether the proposed health care services are
covered by the consumer's health plan. If any of the health care services are not covered by
the consumer's health plan, the provider or the provider's designee must provide the consumer
with a notice specifying the services not covered by the consumer's health plan and must
retain a copy of the notice signed by the consumer. If a provider fails to disclose to a
consumer that a service is not covered, the provider is prohibited from billing the consumer
for that noncovered service. If a provider complies with the disclosure and signature
requirements of this paragraph and the consumer receives the noncovered services from the
provider, the consumer must pay for the services received.
new text end

new text begin (b) In addition to the information required to be disclosed under paragraph (a), before
a health care provider provides any health care services to a consumer, the provider or the
provider's designee, as agreed to by that designee, must determine whether the provider
participates in the provider network for the consumer's health plan and must disclose the
provider's network participation status to the consumer. If the provider does not participate
in the provider network for the consumer's health plan, the provider must obtain a signed
acknowledgment from the consumer indicating that the consumer understands the provider
is out-of-network. If the provider fails to obtain the signed acknowledgment from the
consumer under this paragraph, the provider shall not bill the consumer for services provided
to the consumer for any amount that is in addition to the amount authorized for the services
in the out-of-network fee schedule of the consumer's health plan.
new text end