Minnesota Session Laws - 2014, Regular Session

CHAPTER 192--H.F.No. 2874

An act

relating to health; making technical changes; eliminating or modernizing antiquated, unnecessary, and obsolete provisions;

amending Minnesota Statutes 2012, sections 62J.50, subdivisions 1, 2; 62J.51; 62J.52, as amended; 62J.53; 62J.535; 62J.536, subdivision 2; 62J.54, subdivisions 1, 2, 3; 62J.56, subdivisions 1, 2, 3; 62J.581, subdivisions 1, 3, 4; 62J.61, subdivision 1; 122A.40, subdivision 12; 122A.41, subdivision 6; 144.12, subdivision 1; 154.25; 626.557, subdivision 12b; repealing Minnesota Statutes 2012, sections 62J.322; 62J.59; 144.011, subdivision 2; 144.0506; 144.071; 144.072; 144.076; 144.146, subdivision 1; 144.1475; 144.443; 144.444; 144.45; 145.132; 145.97; 145.98, subdivisions 1, 3.

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

ARTICLE 1

HEALTH CARE ADMINISTRATIVE SIMPLIFICATION ACT

Section 1.

Minnesota Statutes 2012, section 62J.50, subdivision 1, is amended to read:

Subdivision 1.

Citation.

Sections 62J.50 to 62J.61 may be cited as the Minnesota Health Care Administrative Simplification Act deleted text begin of 1994 deleted text end .

Sec. 2.

Minnesota Statutes 2012, section 62J.50, subdivision 2, is amended to read:

Subd. 2.

Purpose.

The legislature finds that significant savings throughout the health care industry can be accomplished by implementing a set of administrative standards and simplified procedures and by setting forward a plan toward the use of electronic methods of data interchange. The legislature finds that initial steps have been taken at the national level by the federal Health Care Financing Administration new text begin , now known as the Centers for Medicare and Medicaid Services, new text end in its implementation of nationally accepted electronic transaction sets for its Medicare program. The legislature further recognizes the work done by the Workgroup for Electronic Data Interchange and the American National Standards Institute and its accredited standards committee X12, at the national level, and the Minnesota Administrative Uniformity Committee, a statewide, voluntary, public-private group representing payers, hospitals, state programs, physicians, and other health care providers in their work toward administrative simplification in the health care industry.

Sec. 3.

Minnesota Statutes 2012, section 62J.51, is amended to read:

62J.51 DEFINITIONS.

Subdivision 1.

Scope.

For purposes of sections 62J.50 to 62J.61, the following definitions apply.

Subd. 2.

ANSI.

"ANSI" means the American National Standards Institute.

Subd. 3.

ASC X12.

"ASC X12" means the American National Standards Institute committee X12.

Subd. 3a.

Card issuer.

"Card issuer" means the group purchaser who is responsible for printing and distributing identification cards to members or insureds.

deleted text begin Subd. 4. deleted text end

deleted text begin Category I industry participants. deleted text end

deleted text begin "Category I industry participants" means the following: group purchasers, providers, and other health care organizations doing business in Minnesota including public and private payers; hospitals; claims clearinghouses; third-party administrators; billing service bureaus; value added networks; self-insured plans and employers with more than 100 employees; clinic laboratories; durable medical equipment suppliers with a volume of at least 50,000 claims or encounters per year; and group practices with 20 or more physicians. deleted text end

deleted text begin Subd. 5. deleted text end

deleted text begin Category II industry participants. deleted text end

deleted text begin "Category II industry participants" means all group purchasers and providers doing business in Minnesota not classified as category I industry participants. deleted text end

Subd. 6.

Claim payment/advice transaction set (ANSI ASC X12 835).

"Claim payment/advice transaction set (ANSI ASC X12 835)" means the electronic transaction format deleted text begin developed and approved for implementation in October 1991, and deleted text end used for electronic remittance advice and electronic funds transfer new text begin as adopted under Code of Federal Regulations, title 45, part 162, subpart P, and any future revisions of the subpart new text end .

Subd. 6a.

Claim status transaction set (ANSI ASC X12 276/277).

"Claim status transaction set (ANSI ASC X12 276/277)" means the new text begin electronic new text end transaction format deleted text begin developed and approved for implementation in December 1993 and deleted text end used by providers to request and receive information on the status of a health care claim or encounter that has been submitted to a group purchaser new text begin as adopted under Code of Federal Regulations, title 45, part 162, subpart N, and any future revisions of the subpart new text end .

Subd. 6b.

Claim submission address.

"Claim submission address" means the address to which the group purchaser requires health care providers, members, or insureds to send health care claims for processing.

Subd. 6c.

Claim submission number.

"Claim submission number" means the unique identification number to identify group purchasers as described in section 62J.54, with its suffix identifying the claim submission address.

Subd. 7.

Claim submission transaction set (ANSI ASC X12 837).

"Claim submission transaction set (ANSI ASC X12 837)" means the electronic transaction format deleted text begin developed and approved for implementation in October 1992, and deleted text end used to submit all health care claims information new text begin as adopted under Code of Federal Regulations, title 45, part 162, subpart K, and any future revisions of the subpart new text end .

Subd. 8.

EDI or electronic data interchange.

"EDI" or "electronic data interchange" means the computer application to computer application exchange of information using nationally accepted standard formats.

Subd. 9.

Eligibility transaction set (ANSI ASC X12 270/271).

"Eligibility transaction set (ANSI ASC X12 270/271)" means the new text begin electronic new text end transaction format deleted text begin developed and approved for implementation in February 1993, and deleted text end used by providers to request and receive coverage information on the member or insured new text begin as adopted under Code of Federal Regulations, title 45, part 162, subpart L, and any future revisions of the subpart new text end .

Subd. 10.

Enrollment transaction set (ANSI ASC X12 834).

"Enrollment transaction set (ANSI ASC X12 834)" means the electronic transaction format deleted text begin developed and approved for implementation in February 1992, and deleted text end used to transmit enrollment and benefit information from the employer to the payer for the purpose of enrolling in a benefit plan new text begin as adopted under Code of Federal Regulations, title 45, part 162, subpart O, and any future revisions of the subpart new text end .

Subd. 11.

Group purchaser.

"Group purchaser" has the meaning given in section 62J.03, subdivision 6.

Subd. 11a.

Health care clearinghouse.

"Health care clearinghouse" means a public or private entity, including a billing service, repricing company, community health management information system or community health information system, and "value-added" networks and switches that does any of the following functions:

(1) processes or facilitates the processing of health information received from another entity in a nonstandard format or containing nonstandard data content into standard data elements or a standard transaction;

(2) receives a standard transaction from another entity and processes or facilitates the processing of health information into nonstandard format or nonstandard data content for the receiving entity;

(3) acts on behalf of a group purchaser in sending and receiving standard transactions to assist the group purchaser in fulfilling its responsibilities under section 62J.536;

(4) acts on behalf of a health care provider in sending and receiving standard transactions to assist the health care provider in fulfilling its responsibilities under section 62J.536; and

(5) other activities including but not limited to training, testing, editing, formatting, or consolidation transactions.

A health care clearinghouse acts as an agent of a health care provider or group purchaser only if it enters into an explicit, mutually agreed upon arrangement or contract with the provider or group purchaser to perform specific clearinghouse functions.

Subd. 12.

ISO.

"ISO" means the International Standardization Organization.

Subd. 13.

NCPDP.

"NCPDP" means the National Council for Prescription Drug Programs, Inc.

deleted text begin Subd. 14. deleted text end

deleted text begin NCPDP telecommunication standard format 3.2. deleted text end

deleted text begin "NCPDP telecommunication standard format 3.2" means the recommended transaction sets for claims transactions adopted by the membership of NCPDP in 1992. deleted text end

deleted text begin Subd. 15. deleted text end

deleted text begin NCPDP tape billing and payment format 2.0. deleted text end

deleted text begin "NCPDP tape billing and payment format 2.0" means the recommended transaction standards for batch processing claims adopted by the membership of the NCPDP in 1993. deleted text end

Subd. 16.

Provider.

"Provider" or "health care provider" has the meaning given in section 62J.03, subdivision 8.

Subd. 16a.

Standard transaction.

"Standard transaction" means a transaction that is defined in Code of Federal Regulations, title 45, part 162.103, and that meets the requirements of the single, uniform companion guides described in section 62J.536.

Subd. 17.

Uniform billing form CMS 1450.

"Uniform billing form CMS 1450" means the most current version of the uniform billing form known as the CMS 1450 developed by the National Uniform Billing Committee.

Subd. 18.

Uniform billing form CMS 1500.

"Uniform billing form CMS 1500" means the most current version of the health insurance claim form, CMS 1500, developed by the National Uniform Claim Committee.

Subd. 19.

Uniform dental billing form.

"Uniform dental billing form" means the most current version of the uniform dental claim form developed by the American Dental Association.

Subd. 19a.

Uniform explanation of benefits document.

"Uniform explanation of benefits document" means the document associated with and explaining the details of a group purchaser's claim adjudication for services rendered, which is sent to a patient.

deleted text begin Subd. 19b. deleted text end

deleted text begin Uniform remittance advice report. deleted text end

deleted text begin "Uniform remittance advice report" means the document associated with and explaining the details of a group purchaser's claim adjudication for services rendered, which is sent to a provider. deleted text end

Subd. 20.

Uniform pharmacy billing form.

"Uniform pharmacy billing form" means the National Council for Prescription Drug Programs/universal claim form (NCPDP/UCF).

Subd. 21.

WEDI.

"WEDI" means the national Workgroup for Electronic Data Interchange deleted text begin report issued in October 1993 deleted text end .

Sec. 4.

Minnesota Statutes 2012, section 62J.52, as amended by Laws 2013, chapter 125, article 1, section 107, is amended to read:

62J.52 ESTABLISHMENT OF UNIFORM BILLING FORMS.

Subdivision 1.

Uniform billing form CMS 1450.

(a) On and after January 1, 1996, all institutional inpatient hospital services, ancillary services, institutionally owned or operated outpatient services rendered by providers in Minnesota, and institutional or noninstitutional home health services that are not being billed using an equivalent electronic billing format, must be billed using the new text begin most current version of the new text end uniform billing form CMS 1450 deleted text begin , except as provided in subdivision 5 deleted text end .

(b) The instructions and definitions for the use of the uniform billing form CMS 1450 shall be in accordance with the uniform billing form manual specified by the commissioner. In promulgating these instructions, the commissioner may utilize the manual developed by the National Uniform Billing Committee.

(c) Services to be billed using the uniform billing form CMS 1450 include: institutional inpatient hospital services and distinct units in the hospital such as psychiatric unit services, physical therapy unit services, swing bed (SNF) services, inpatient state psychiatric hospital services, inpatient skilled nursing facility services, home health services (Medicare part A), and hospice services; ancillary services, where benefits are exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals, skilled nursing facilities, ICFs/DD, and home health (Medicare part B); institutional owned or operated outpatient services such as waivered services, hospital outpatient services, including ambulatory surgical center services, hospital referred laboratory services, hospital-based ambulance services, and other hospital outpatient services, skilled nursing facilities, home health, freestanding renal dialysis centers, comprehensive outpatient rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural health clinics, federally qualified health centers, and community mental health centers; home health services such as home health intravenous therapy providers and hospice; and any other health care provider certified by the Medicare program to use this form.

(d) On and after January 1, 1996, a mother and newborn child must be billed separately, and must not be combined on one claim form.

(e) Services provided by Medicare Critical Access Hospitals electing Method II billing will be allowed an exception to this provision to allow the inclusion of the professional fees on the CMS 1450.

Subd. 2.

Uniform billing form CMS 1500.

(a) On and after January 1, 1996, all noninstitutional health care services rendered by providers in Minnesota except dental or pharmacy providers, that are not currently being billed using an equivalent electronic billing format, must be billed using the new text begin most current version of the new text end health insurance claim form CMS 1500 deleted text begin , except as provided in subdivision 5 deleted text end .

(b) The instructions and definitions for the use of the uniform billing form CMS 1500 shall be in accordance with the manual developed by the Administrative Uniformity Committee entitled standards for the use of the CMS 1500 form, dated February 1994, as further defined by the commissioner.

(c) Services to be billed using the uniform billing form CMS 1500 include physician services and supplies, durable medical equipment, noninstitutional ambulance services, independent ancillary services including occupational therapy, physical therapy, speech therapy and audiology, home infusion therapy, podiatry services, optometry services, mental health licensed professional services, substance abuse licensed professional services, nursing practitioner professional services, certified registered nurse anesthetists, chiropractors, physician assistants, laboratories, medical suppliers, waivered services, personal care attendants, and other health care providers such as day activity centers and freestanding ambulatory surgical centers.

(d) Services provided by Medicare Critical Access Hospitals electing Method II billing will be allowed an exception to this provision to allow the inclusion of the professional fees on the CMS 1450.

Subd. 3.

Uniform dental billing form.

(a) On and after January 1, 1996, all dental services provided by dental care providers in Minnesota, that are not currently being billed using an equivalent electronic billing format, shall be billed using the new text begin most current version of the new text end American Dental Association uniform dental billing form.

(b) The instructions and definitions for the use of the uniform dental billing form shall be in accordance with the manual developed by the Administrative Uniformity Committee dated February 1994, and as amended or further defined by the commissioner.

Subd. 4.

Uniform pharmacy billing form.

(a) On and after January 1, 1996, all pharmacy services provided by pharmacists in Minnesota that are not currently being billed using an equivalent electronic billing format shall be billed using the new text begin most current version of the new text end NCPDP/universal claim form.

(b) The instructions and definitions for the use of the uniform claim form shall be in accordance with instructions specified by the commissioner of health.

Sec. 5.

Minnesota Statutes 2012, section 62J.53, is amended to read:

62J.53 ACCEPTANCE OF UNIFORM BILLING FORMS BY GROUP PURCHASERS.

On and after January 1, 1996, all deleted text begin category I and II deleted text end group purchasers in Minnesota shall accept the uniform billing forms prescribed under section 62J.52 as the only nonelectronic billing forms used for payment processing purposes.

Sec. 6.

Minnesota Statutes 2012, section 62J.535, is amended to read:

62J.535 UNIFORM BILLING REQUIREMENTS FOR CLAIM TRANSACTIONS.

Subd. 1a.

deleted text begin Electronic claim transactions deleted text end new text begin Additional information associated with a claim new text end .

deleted text begin Group purchasers, including government programs, not defined as covered entities under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the regulations promulgated under those sections, that voluntarily agree with providers to accept electronic claim transactions, must accept them in the ANSI X12N 837 standard electronic format as established by federal law. Nothing in this section requires acceptance of electronic claim transactions by entities not covered under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the regulations promulgated under those sections. Notwithstanding the above, deleted text end Nothing in this section or other state law prohibits group purchasers not defined as covered entities under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the regulations promulgated under those sections, from requiring, as authorized by Minnesota law or rule, additional information associated with a claim submitted by a provider.

Subd. 1b.

Paper claim transactions.

All group purchasers that accept paper claim transactions must accept, and health care providers submitting paper claim transactions must submit, these transactions with use of the applicable medical and nonmedical data code sets specified in the federal electronic claim transaction standards adopted under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the regulations promulgated under those sections. The paper claim transaction must also be conducted using the uniform billing forms as specified in section 62J.52 and the identifiers specified in section 62J.54, on and after the compliance date required by law. Notwithstanding the above, nothing in this section or other state law prohibits group purchasers not defined as covered entities under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the regulations promulgated under those sections, from requiring, as authorized by Minnesota law or rule, additional information associated with a claim submitted by a provider.

deleted text begin Subd. 2. deleted text end

deleted text begin Compliance. deleted text end

deleted text begin Subdivision 1a is effective concurrent with the date of required compliance for covered entities established under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time. deleted text end

Sec. 7.

Minnesota Statutes 2012, section 62J.536, subdivision 2, is amended to read:

Subd. 2.

Establishing uniform, standard companion guides.

(a) At least 12 months prior to the timelines required in subdivision 1, the commissioner of health shall promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers and health care providers to use the transactions and the uniform, standard companion guides required under subdivision 1, paragraph deleted text begin (e) deleted text end new text begin (f) new text end .

(b) The commissioner of health must consult with the Minnesota Administrative Uniformity Committee on the development of the single, uniform companion guides required under subdivision 1, paragraph deleted text begin (e) deleted text end new text begin (f) new text end , for each of the transactions in subdivision 1. The single uniform companion guides required under subdivision 1, paragraph deleted text begin (e) deleted text end new text begin (f) new text end , must specify uniform billing and coding standards. The commissioner of health shall base the companion guides required under subdivision 1, paragraph deleted text begin (e) deleted text end new text begin (f) new text end , billing and coding rules, and standards on the Medicare program, with modifications that the commissioner deems appropriate after consulting the Minnesota Administrative Uniformity Committee.

(c) No group purchaser or health care provider may add to or modify the single, uniform companion guides defined in subdivision 1, paragraph deleted text begin (e) deleted text end new text begin (f) new text end , through additional companion guides or other requirements.

(d) In promulgating the rules in paragraph (a), the commissioner shall not require data content that is not essential to accomplish the purpose of the transactions in subdivision 1.

Sec. 8.

Minnesota Statutes 2012, section 62J.54, subdivision 1, is amended to read:

Subdivision 1.

Unique identification number for health care provider organizations.

(a) deleted text begin Not later than 24 months after the date on which a national provider identifier is made effective under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments), deleted text end All group purchasers and any health care provider organization that meets the definition of a health care provider under United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder shall use a national provider identifier to identify health care provider organizations in Minnesota, according to this section deleted text begin , except as provided in paragraph (b) deleted text end .

deleted text begin (b) Small health plans, as defined by the federal Secretary of Health and Human Services under United States Code, title 42, section 1320d-4 (1996 and subsequent amendments), shall use a national provider identifier to identify health provider organizations no later than 36 months after the date on which a national provider identifier is made effective under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments). deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end The national provider identifier for health care providers deleted text begin established by the federal Secretary of Health and Human Services under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments), deleted text end new text begin as adopted and required in Code of Federal Regulations, title 45, part 162, subpart D, and any future modifications to the subpart new text end shall be used as the unique identification number for health care provider organizations in Minnesota under this section.

deleted text begin (d) deleted text end new text begin (c) new text end All health care provider organizations in Minnesota that are eligible to obtain a national provider identifier according to United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder shall obtain a national provider identifier deleted text begin from the federal Secretary of Health and Human Services deleted text end using the process prescribed deleted text begin by the Secretary deleted text end new text begin in Code of Federal Regulations, title 45, subpart D, and any future modifications to the subpart new text end .

deleted text begin (e) deleted text end new text begin (d) new text end Only the national provider identifier shall be used to identify health care provider organizations when submitting and receiving paper and electronic claims and remittance advice notices, and in conjunction with other data collection and reporting functions.

deleted text begin (f) deleted text end new text begin (e) new text end Health care provider organizations in Minnesota shall make available their national provider identifier to other health care providers when required to be included in the administrative transactions regulated by United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder.

deleted text begin (g) deleted text end new text begin (f) new text end The commissioner of health may contract with the federal Secretary of Health and Human Services or the Secretary's agent to implement this subdivision.

Sec. 9.

Minnesota Statutes 2012, section 62J.54, subdivision 2, is amended to read:

Subd. 2.

Unique identification number for individual health care providers.

(a) deleted text begin Not later than 24 months after the date on which a national provider identifier is made effective under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments), deleted text end All group purchasers in Minnesota and any individual health care provider that meets the definition of a health care provider under United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder shall use the national provider identifier to identify an individual health care provider in Minnesota, according to this section deleted text begin , except as provided in paragraph (b) deleted text end .

deleted text begin (b) Small health plans, as defined by the federal Secretary of Health and Human Services under United States Code, title 42, section 1320d-4 (1996 and subsequent amendments), shall use the national provider identifier to identify an individual health care provider no later than 36 months after the date on which a national provider identifier for health care providers is made effective under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments). deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end The national provider identifier for health care providers deleted text begin established by the federal Secretary of Health and Human Services under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments), deleted text end new text begin adopted in Code of Federal Regulations, title 45, part 162, subpart D, and any future modifications to the subpart new text end shall be used as the unique identification number for individual health care providers.

deleted text begin (d) deleted text end new text begin (c) new text end All individual health care providers in Minnesota that are eligible to obtain a national provider identifier according to United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder shall obtain a national provider identifier deleted text begin from the federal Secretary of Health and Human Services deleted text end using the process prescribed deleted text begin by the Secretary deleted text end new text begin in Code of Federal Regulations, title 45, part 162, subpart D, and any future modifications to the subpart new text end .

deleted text begin (e) deleted text end new text begin (d) new text end Only the national provider identifier shall be used to identify individual health care providers when submitting and receiving paper and electronic claims and remittance advice notices, and in conjunction with other data collection and reporting functions.

deleted text begin (f) deleted text end new text begin (e) new text end Individual health care providers in Minnesota shall make available their national provider identifier to other health care providers when required to be included in the administrative transactions regulated by United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder.

deleted text begin (g) deleted text end new text begin (f) new text end The commissioner of health may contract with the federal Secretary of Health and Human Services or the Secretary's agent to implement this subdivision.

Sec. 10.

Minnesota Statutes 2012, section 62J.54, subdivision 3, is amended to read:

Subd. 3.

Unique identification number for group purchasers.

(a) deleted text begin Not later than 24 months after the date on which a unique health identifier for employers and health plans is adopted or established under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments), deleted text end All group purchasers and health care providers in Minnesota shall use a unique identification number to identify group purchasers deleted text begin , except as provided in paragraph (b) deleted text end .

deleted text begin (b) Small health plans, as defined by the federal Secretary of Health and Human Services under United States Code, title 42, section 1320d-4 (1996 and subsequent amendments), shall use a unique identification number to identify group purchasers no later than 36 months after the date on which a unique health identifier for employers and health plans is adopted or established under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments). deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end The unique health identifier for new text begin group purchasers that are new text end health plans deleted text begin and employers adopted or established by the federal Secretary of Health and Human Services under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments), shall be used as the unique identification number for group purchasers deleted text end new text begin under Code of Federal Regulations, title 45, part 160, subpart A, shall be the Standard Unique Health Identifier for Health Plans as adopted in Code of Federal Regulations, title 45, part 162, subpart E, and any future modifications to the subpart, effective as required by the subpart new text end .

deleted text begin (d) deleted text end new text begin (c) new text end Group purchasers new text begin that are health plans under Code of Federal Regulations, title 45, part 160, subpart A, new text end shall obtain a unique health identifier deleted text begin from the federal Secretary of Health and Human Services deleted text end using the process prescribed deleted text begin by the Secretary deleted text end new text begin in Code of Federal Regulations, title 45, part 162, subpart E, and any future modifications to the subpart new text end .

deleted text begin (e) deleted text end new text begin (d) new text end The unique group purchaser identifier, as described in this section, shall be used for purposes of submitting and receiving claims, and in conjunction with other data collection and reporting functions.

deleted text begin (f) deleted text end new text begin (e) new text end The commissioner of health may contract with the federal Secretary of Health and Human Services or the Secretary's agent to implement this subdivision.

Sec. 11.

Minnesota Statutes 2012, section 62J.56, subdivision 1, is amended to read:

Subdivision 1.

General provisions.

(a) The legislature finds that there is a need to advance the use of electronic methods of data interchange among all health care participants in the state in order to achieve significant administrative cost savings. The legislature also finds that in order to advance the use of health care electronic data interchange in a cost-effective manner, the state needs to implement electronic data interchange standards that are nationally accepted, widely recognized, and available for immediate use. The legislature intends to set forth a plan for a systematic phase in of uniform health care electronic data interchange standards in all segments of the health care industry.

(b) The commissioner of health, with the advice of the deleted text begin Minnesota Health Data Institute and the deleted text end Minnesota Administrative Uniformity Committee, shall administer the implementation of and monitor compliance with, electronic data interchange standards of health care participants, according to the plan provided in this section.

deleted text begin (c) The commissioner may grant exemptions to category I and II industry participants from the requirements to implement some or all of the provisions in this section if the commissioner determines that the cost of compliance would place the organization in financial distress, or if the commissioner determines that appropriate technology is not available to the organization. deleted text end

Sec. 12.

Minnesota Statutes 2012, section 62J.56, subdivision 2, is amended to read:

Subd. 2.

Identification of core transaction sets.

deleted text begin (a) All category I and II industry participants in Minnesota shall comply with the standards developed by the ANSI ASC X12 for the following core transaction sets, according to the implementation plan outlined for each transaction set. deleted text end

deleted text begin (1) ANSI ASC X12 835 health care claim payment/advice transaction set. deleted text end

deleted text begin (2) ANSI ASC X12 837 health care claim transaction set. deleted text end

deleted text begin (3) ANSI ASC X12 834 health care enrollment transaction set. deleted text end

deleted text begin (4) ANSI ASC X12 270/271 health care eligibility transaction set. deleted text end

deleted text begin (5) ANSI ASC X12 276/277 health care claims status request/notification transaction set. deleted text end

deleted text begin (b) deleted text end The commissioner, with the advice of the deleted text begin Minnesota Health Data Institute and the deleted text end Minnesota Administrative Uniformity Committee, and in coordination with federal efforts, may approve the use of new ASC X12 standards, or new versions of existing standards, as they become available, or other nationally recognized standards, where appropriate ASC X12 standards are not available for use. These alternative standards may be used during a transition period while ASC X12 standards are developed.

Sec. 13.

Minnesota Statutes 2012, section 62J.56, subdivision 3, is amended to read:

Subd. 3.

Implementation guides.

(a) The commissioner, with the advice of the Minnesota Administrative Uniformity Committee, and the Minnesota Center for Health Care Electronic Data Interchange shall review and recommend the use of guides to implement the core transaction sets. Implementation guides must contain the background and technical information required to allow health care participants to implement the transaction set in the most cost-effective way.

(b) The commissioner shall promote the development of implementation guides among health care participants for those business transaction types for which implementation guides are not available, to allow providers and group purchasers to implement electronic data interchange. In promoting the development of these implementation guides, the commissioner shall review the work done by the American Hospital Association through the national Uniform Billing Committee and its state representative organization; the American Medical Association through the new text begin National new text end Uniform Claim deleted text begin Task Force deleted text end new text begin Committee new text end ; the American Dental Association; the National Council of Prescription Drug Programs; and the Workgroup for Electronic Data Interchange.

Sec. 14.

Minnesota Statutes 2012, section 62J.581, subdivision 1, is amended to read:

Subdivision 1.

Minnesota uniform remittance advice deleted text begin report deleted text end .

deleted text begin (a) deleted text end All group purchasers shall provide a uniform deleted text begin remittance advice report deleted text end new text begin claim payment/advice transaction new text end to health care providers when a claim is adjudicated. The uniform deleted text begin remittance advice report deleted text end new text begin claim payment/advice transaction new text end shall comply with deleted text begin the standards prescribed in this deleted text end section new text begin 62J.536, subdivision 1b, and rules adopted under section 62J.536, subdivision 2 new text end .

deleted text begin (b) Notwithstanding paragraph (a), this section does not apply to group purchasers not included as covered entities under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the regulations promulgated under those sections. deleted text end

Sec. 15.

Minnesota Statutes 2012, section 62J.581, subdivision 3, is amended to read:

Subd. 3.

Scope.

For purposes of sections 62J.50 to 62J.61, the uniform deleted text begin remittance advice report and the deleted text end new text begin claim payment/advice transaction and new text end uniform explanation of benefits document format specified in subdivision 4 shall apply to all health care services delivered by a health care provider or health care provider organization in Minnesota, regardless of the location of the payer. Health care services not paid on an individual claims basis, such as capitated payments, are not included in this section. A health plan company is excluded from the requirements in subdivisions 1 and 2 if they comply with section 62A.01, subdivisions 2 and 3.

Sec. 16.

Minnesota Statutes 2012, section 62J.581, subdivision 4, is amended to read:

Subd. 4.

Specifications.

The deleted text begin uniform remittance advice report and the deleted text end uniform explanation of benefits document shall be provided by use of a paper document conforming to the specifications in this section deleted text begin or by use of the ANSI X12N 835 standard electronic format as established under United States Code, title 42, sections 1320d to 1320d-8, and as amended from time to time for the remittance advice deleted text end . The commissioner, after consulting with the Administrative Uniformity Committee, shall specify the data elements and definitions for the deleted text begin uniform remittance advice report and the deleted text end uniform explanation of benefits document. The commissioner and the Administrative Uniformity Committee must consult with the Minnesota Dental Association and Delta Dental Plan of Minnesota before requiring under this section the use of a paper document for the uniform explanation of benefits document or the uniform deleted text begin remittance advice report deleted text end new text begin claim payment/advice transaction new text end for dental care services.

Sec. 17.

Minnesota Statutes 2012, section 62J.61, subdivision 1, is amended to read:

Subdivision 1.

Exemption.

The commissioner of health is exempt from chapter 14, including section 14.386, in implementing sections 62J.50 to 62J.54, subdivision 3, and 62J.56 to deleted text begin 62J.59 deleted text end new text begin 62J.581 new text end .

Sec. 18.

new text begin REVISOR'S INSTRUCTION. new text end

new text begin The revisor shall make changes necessary to correct punctuation, grammar, and structure of the remaining text required by the repealed section in this article. new text end

Sec. 19.

new text begin REPEALER. new text end

new text begin Minnesota Statutes 2012, section 62J.59, new text end new text begin is repealed. new text end

ARTICLE 2

COMBINING REPORTS ON VULNERABLE ADULTS MALTREATMENT

Section 1.

Minnesota Statutes 2012, section 626.557, subdivision 12b, is amended to read:

Subd. 12b.

Data management.

(a) In performing any of the duties of this section as a lead investigative agency, the county social service agency shall maintain appropriate records. Data collected by the county social service agency under this section are welfare data under section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data under this paragraph that are inactive investigative data on an individual who is a vendor of services are private data on individuals, as defined in section 13.02. The identity of the reporter may only be disclosed as provided in paragraph (c).

Data maintained by the common entry point are confidential data on individuals or protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the common entry point shall maintain data for three calendar years after date of receipt and then destroy the data unless otherwise directed by federal requirements.

(b) The commissioners of health and human services shall prepare an investigation memorandum for each report alleging maltreatment investigated under this section. County social service agencies must maintain private data on individuals but are not required to prepare an investigation memorandum. During an investigation by the commissioner of health or the commissioner of human services, data collected under this section are confidential data on individuals or protected nonpublic data as defined in section 13.02. Upon completion of the investigation, the data are classified as provided in clauses (1) to (3) and paragraph (c).

(1) The investigation memorandum must contain the following data, which are public:

(i) the name of the facility investigated;

(ii) a statement of the nature of the alleged maltreatment;

(iii) pertinent information obtained from medical or other records reviewed;

(iv) the identity of the investigator;

(v) a summary of the investigation's findings;

(vi) statement of whether the report was found to be substantiated, inconclusive, false, or that no determination will be made;

(vii) a statement of any action taken by the facility;

(viii) a statement of any action taken by the lead investigative agency; and

(ix) when a lead investigative agency's determination has substantiated maltreatment, a statement of whether an individual, individuals, or a facility were responsible for the substantiated maltreatment, if known.

The investigation memorandum must be written in a manner which protects the identity of the reporter and of the vulnerable adult and may not contain the names or, to the extent possible, data on individuals or private data listed in clause (2).

(2) Data on individuals collected and maintained in the investigation memorandum are private data, including:

(i) the name of the vulnerable adult;

(ii) the identity of the individual alleged to be the perpetrator;

(iii) the identity of the individual substantiated as the perpetrator; and

(iv) the identity of all individuals interviewed as part of the investigation.

(3) Other data on individuals maintained as part of an investigation under this section are private data on individuals upon completion of the investigation.

(c) After the assessment or investigation is completed, the name of the reporter must be confidential. The subject of the report may compel disclosure of the name of the reporter only with the consent of the reporter or upon a written finding by a court that the report was false and there is evidence that the report was made in bad faith. This subdivision does not alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except that where the identity of the reporter is relevant to a criminal prosecution, the district court shall do an in-camera review prior to determining whether to order disclosure of the identity of the reporter.

(d) Notwithstanding section 138.163, data maintained under this section by the commissioners of health and human services must be maintained under the following schedule and then destroyed unless otherwise directed by federal requirements:

(1) data from reports determined to be false, maintained for three years after the finding was made;

(2) data from reports determined to be inconclusive, maintained for four years after the finding was made;

(3) data from reports determined to be substantiated, maintained for seven years after the finding was made; and

(4) data from reports which were not investigated by a lead investigative agency and for which there is no final disposition, maintained for three years from the date of the report.

(e) The commissioners of health and human services shall deleted text begin each deleted text end annually deleted text begin report to the legislature and the governor on deleted text end new text begin publish on their Web sites new text end the number and type of reports of alleged maltreatment involving licensed facilities reported under this section, the number of those requiring investigation under this section, and the resolution of those investigations. deleted text begin The report shall identify: deleted text end new text begin On a biennial basis, the commissioners of health and human services shall jointly report the following information to the legislature and the governor: new text end

(1) new text begin the number and type of reports of alleged maltreatment involving licensed facilities reported under this section, the number of those requiring investigations under this section, the resolution of those investigations, and which of the two lead agencies was responsible; new text end

new text begin (2) trends about types of substantiated maltreatment found in the reporting period; new text end

new text begin (3) if there are upward trends for types of maltreatment substantiated, recommendations for addressing and responding to them; new text end

new text begin (4) efforts undertaken or recommended to improve the protection of vulnerable adults; new text end

new text begin (5) new text end whether and where backlogs of cases result in a failure to conform with statutory time frames new text begin and recommendations for reducing backlogs if applicable new text end ;

deleted text begin (2) where adequate coverage requires additional appropriations and staffing; and deleted text end

deleted text begin (3) any other trends that affect the safety of vulnerable adults. deleted text end

new text begin (6) recommended changes to statutes affecting the protection of vulnerable adults; and new text end

new text begin (7) any other information that is relevant to the report trends and findings. new text end

(f) Each lead investigative agency must have a record retention policy.

(g) Lead investigative agencies, prosecuting authorities, and law enforcement agencies may exchange not public data, as defined in section 13.02, if the agency or authority requesting the data determines that the data are pertinent and necessary to the requesting agency in initiating, furthering, or completing an investigation under this section. Data collected under this section must be made available to prosecuting authorities and law enforcement officials, local county agencies, and licensing agencies investigating the alleged maltreatment under this section. The lead investigative agency shall exchange not public data with the vulnerable adult maltreatment review panel established in section 256.021 if the data are pertinent and necessary for a review requested under that section. Notwithstanding section 138.17, upon completion of the review, not public data received by the review panel must be destroyed.

(h) Each lead investigative agency shall keep records of the length of time it takes to complete its investigations.

(i) A lead investigative agency may notify other affected parties and their authorized representative if the lead investigative agency has reason to believe maltreatment has occurred and determines the information will safeguard the well-being of the affected parties or dispel widespread rumor or unrest in the affected facility.

(j) Under any notification provision of this section, where federal law specifically prohibits the disclosure of patient identifying information, a lead investigative agency may not provide any notice unless the vulnerable adult has consented to disclosure in a manner which conforms to federal requirements.

ARTICLE 3

TUBERCULOSIS

Section 1.

Minnesota Statutes 2012, section 122A.40, subdivision 12, is amended to read:

Subd. 12.

Suspension and leave of absence for health reasons.

Affliction with deleted text begin active tuberculosis or other deleted text end new text begin a new text end communicable disease, mental illness, drug or alcoholic addiction, or other serious incapacity shall be grounds for temporary suspension and leave of absence while the teacher is suffering from such disability. Unless the teacher consents, such action must be taken only upon evidence that suspension is required from a physician who has examined the teacher. The physician must be competent in the field involved and must be selected by the teacher from a list of three provided by the school board, and the examination must be at the expense of the school district. A copy of the report of the physician shall be furnished the teacher upon request. If the teacher fails to submit to the examination within the prescribed time, the board may discharge the teacher, effective immediately. In the event of mental illness, if the teacher submits to such an examination and the examining physician's or psychiatrist's statement is unacceptable to the teacher or the board, a panel of three physicians or psychiatrists must be selected to examine the teacher at the board's expense. The board and the teacher shall each select a member of this panel, and these two members shall select a third member. The panel must examine the teacher and submit a statement of its findings and conclusions to the board. Upon receipt and consideration of the statement from the panel the board may suspend the teacher. The board must notify the teacher in writing of such suspension and the reasons therefor. During the leave of absence, the district must pay the teacher sick leave benefits up to the amount of unused accumulated sick leave, and after it is exhausted, the district may in its discretion pay additional benefits. The teacher must be reinstated to the teacher's position upon evidence from such a physician of sufficient recovery to be capable of resuming performance of duties in a proper manner. In the event that the teacher does not qualify for reinstatement within 12 months after the date of suspension, the continuing disability may be a ground for discharge under subdivision 13.

Sec. 2.

Minnesota Statutes 2012, section 122A.41, subdivision 6, is amended to read:

Subd. 6.

Grounds for discharge or demotion.

(a) Except as otherwise provided in paragraph (b), causes for the discharge or demotion of a teacher either during or after the probationary period must be:

(1) immoral character, conduct unbecoming a teacher, or insubordination;

(2) failure without justifiable cause to teach without first securing the written release of the school board having the care, management, or control of the school in which the teacher is employed;

(3) inefficiency in teaching or in the management of a school, consistent with subdivision 5, paragraph (b);

(4) affliction with deleted text begin active tuberculosis or other deleted text end new text begin a new text end communicable disease must be considered as cause for removal or suspension while the teacher is suffering from such disability; or

(5) discontinuance of position or lack of pupils.

For purposes of this paragraph, conduct unbecoming a teacher includes an unfair discriminatory practice described in section 363A.13.

(b) A probationary or continuing-contract teacher must be discharged immediately upon receipt of notice under section 122A.20, subdivision 1, paragraph (b), that the teacher's license has been revoked due to a conviction for child abuse or sexual abuse.

Sec. 3.

Minnesota Statutes 2012, section 154.25, is amended to read:

154.25 NOT TO SERVE CERTAIN PERSONS.

No person practicing the occupation of a barber in any barber shop, barber school, or college in this state shall knowingly serve a person afflicted, in a dangerous or infectious state of the disease, with erysipelas, eczema, impetigo, sycosis, deleted text begin tuberculosis, deleted text end or any other contagious or infectious disease. Any person so afflicted is hereby prohibited from being served in any barber shop, barber school, or college in this state. Any violation of this section shall be considered a misdemeanor as provided for in sections 154.001, 154.002, 154.003, 154.01 to 154.161, 154.19 to 154.21, and 154.24 to 154.26.

Sec. 4.

new text begin REVISOR'S INSTRUCTION. new text end

new text begin The revisor shall make changes necessary to correct punctuation, grammar, and structure of the remaining text required by the repealed sections in this article. new text end

Sec. 5.

new text begin REPEALER. new text end

new text begin Minnesota Statutes 2012, sections 144.443; 144.444; and 144.45, new text end new text begin are repealed. new text end

ARTICLE 4

MISCELLANEOUS

Section 1.

Minnesota Statutes 2012, section 144.12, subdivision 1, is amended to read:

Subdivision 1.

Rules.

The commissioner may adopt reasonable rules pursuant to chapter 14 for the preservation of the public health. The rules shall not conflict with the charter or ordinance of a city of the first class upon the same subject. The commissioner may control, by rule, by requiring the taking out of licenses or permits, or by other appropriate means, any of the following matters:

(1) the manufacture into articles of commerce, other than food, of diseased, tainted, or decayed animal or vegetable matter;

(2) the business of scavengering and the disposal of sewage;

(3) the location of mortuaries and cemeteries and the removal and burial of the dead;

(4) the management of boarding places for infants and the treatment of infants in them;

(5) the pollution of streams and other waters and the distribution of water by persons for drinking or domestic use;

(6) the construction and equipment, in respect to sanitary conditions, of schools, hospitals, almshouses, prisons, and other public institutions, and of lodging houses and other public sleeping places kept for gain;

(7) the treatment, in hospitals and elsewhere, of persons suffering from communicable diseases, including all manner of venereal disease and infection, the disinfection and quarantine of persons and places in case of those diseases, and the reporting of sicknesses and deaths from them;

Neither the commissioner nor any new text begin community health new text end board deleted text begin of health deleted text end as defined in section 145A.02, subdivision deleted text begin 2 deleted text end new text begin 5 new text end , nor director of public health may adopt any rule or regulation for the treatment in any penal or correctional institution of any person suffering from any communicable disease or venereal disease or infection, which requires the involuntary detention of any person after the expiration of the period of sentence to the penal or correctional institution, or after the expiration of the period to which the sentence may be reduced by good time allowance or by the lawful order of any judge or the Department of Corrections;

(8) the prevention of infant blindness and infection of the eyes of the newly born by the designation, from time to time, of one or more prophylactics to be used in those cases and in the manner that the commissioner directs, unless specifically objected to by a parent of the infant;

deleted text begin (9) The furnishing of vaccine matter; the assembling, during epidemics of smallpox, with other persons not vaccinated, but no rule of the board or of any public board or officer shall at any time compel the vaccination of a child, or exclude, except during epidemics of smallpox and when approved by the local board of education, a child from the public schools for the reason that the child has not been vaccinated; any person required to be vaccinated may select for that purpose any licensed physician and no rule shall require the vaccination of any child whose physician certifies that by reason of the child's physical condition vaccination would be dangerous; deleted text end

deleted text begin (10) deleted text end new text begin (9) new text end the accumulation of filthy and unwholesome matter to the injury of the public health and its removal;

deleted text begin (11) deleted text end new text begin (10) new text end the collection, recording, and reporting of vital statistics by public officers and the furnishing of information to them by physicians, undertakers, and others of births, deaths, causes of death, and other pertinent facts;

deleted text begin (12) deleted text end new text begin (11) new text end the construction, equipment, and maintenance, in respect to sanitary conditions, of lumber camps, migratory or migrant labor camps, and other industrial camps;

deleted text begin (13) deleted text end new text begin (12) new text end the general sanitation of tourist camps, summer hotels, and resorts in respect to water supplies, disposal of sewage, garbage, and other wastes and the prevention and control of communicable diseases; and, to that end, may prescribe the respective duties of agents of a board of health as authorized under section 145A.04; and all boards of health shall make such investigations and reports and obey such directions as the commissioner may require or give and, under the supervision of the commissioner, enforce the rules;

deleted text begin (14) deleted text end new text begin (13) new text end atmospheric pollution which may be injurious or detrimental to public health;

deleted text begin (15) deleted text end new text begin (14) new text end sources of radiation, and the handling, storage, transportation, use and disposal of radioactive isotopes and fissionable materials; and

deleted text begin (16) deleted text end new text begin (15) new text end the establishment, operation and maintenance of all clinical laboratories not owned, or functioning as a component of a licensed hospital. These laboratories shall not include laboratories owned or operated by five or less licensed practitioners of the healing arts, unless otherwise provided by federal law or regulation, and in which these practitioners perform tests or procedures solely in connection with the treatment of their patients. Rules promulgated under the authority of this clause, which shall not take effect until federal legislation relating to the regulation and improvement of clinical laboratories has been enacted, may relate at least to minimum requirements for external and internal quality control, equipment, facility environment, personnel, administration and records. These rules may include the establishment of a fee schedule for clinical laboratory inspections. The provisions of this clause shall expire 30 days after the conclusion of any fiscal year in which the federal government pays for less than 45 percent of the cost of regulating clinical laboratories.

Sec. 2.

new text begin REVISOR'S INSTRUCTION. new text end

new text begin The revisor shall make changes necessary to correct punctuation, grammar, and structure of the remaining text required by the repealed sections in this article. new text end

Sec. 3.

new text begin REPEALER. new text end

new text begin Minnesota Statutes 2012, sections 62J.322; 144.011, subdivision 2; 144.0506; 144.071; 144.072; 144.076; 144.146, subdivision 1; 144.1475; 145.132; 145.97; and 145.98, subdivisions 1 and 3, new text end new text begin are repealed. new text end

Presented to the governor April 30, 2014

Signed by the governor May 1, 2014, 9:40 a.m.