Minnesota Legislature
HF 4396
1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 03/13/2024 12:17pm
Bill Text Versions
| Engrossments | ||
|---|---|---|
| Introduction | Posted on 02/28/2024 | |
| 1st Engrossment | Posted on 03/13/2024 |
Current Version - 1st Engrossment
1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16
1.17 1.18
1.19 1.20 1.21 1.22 2.1 2.2 2.3
A bill for an act
relating to health insurance; requiring health plan companies to include essential
community providers in all health plans; modifying contract payment rates;
amending Minnesota Statutes 2022, section 62Q.19, subdivisions 3, 5.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2022, section 62Q.19, subdivision 3, is amended to read:
Subd. 3.
Health plan company affiliation.
A health plan company must offer a provider
contract to deleted text begin anydeleted text end new text begin allnew text end designated essential community deleted text begin providerdeleted text end new text begin providersnew text end located within the
area served by the health plan company. new text begin A health plan company must include all essential
community providers that have accepted a contract in every health plan issued by the
company. new text end A health plan company shall not restrict enrollee access to services designated
to be provided by the essential community provider for the population that the essential
community provider is certified to serve. A health plan company may also make other
providers available for these services. A health plan company may require an essential
community provider to meet all data requirements, utilization review, and quality assurance
requirements on the same basis as other health plan providers.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to health
plans offered, issued, or renewed on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2022, section 62Q.19, subdivision 5, is amended to read:
Subd. 5.
Contract payment rates.
An essential community provider and a health plan
company may negotiate the payment rate for covered services provided by the essential
community provider. This rate must be at least the same rate per unit of service as is paid
new text begin by the health plan company under the largest product in place with that provider or, if no
product is currently in place, the rate must be at least the same rate per unit of service as is
paid new text end to other health plan providers for the same or similar services.