HF 3073
1st Unofficial Engrossment - 88th Legislature (2013 - 2014)
Posted on 05/13/2014 02:27 p.m.
KEY: stricken = removed, old language.
underscored = added, new language.
Line numbers
1.1A bill for an act
1.2relating to insurance; modifying certain regulations to reduce the incidence of
1.3insurance fraud; providing licensing authority penalties; regulating no-fault auto
1.4benefits; modifying certain economic benefits under chapter 65B; establishing a
1.5task force on motor vehicle insurance coverage verification; amending Minnesota
1.6Statutes 2012, sections 13.7191, subdivision 16; 60A.952, subdivision 3;
1.765B.44, subdivisions 2, 3, 4, 6; 65B.525, subdivision 1; 72A.502, subdivision
1.82; proposing coding for new law in Minnesota Statutes, chapter 45; repealing
1.9Minnesota Statutes 2012, section 72A.327.
1.10BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.11 Section 1. Minnesota Statutes 2012, section 13.7191, subdivision 16, is amended to read:
1.12 Subd. 16. Regulation of trade practicesnew text begin ; insurance contract datanew text end . (a) Insurance
1.13contract data. Certain insurance contract data held by the commissioner of commerce are
1.14classified under section
72A.20, subdivision 15.
1.15(b) Health claims appeals. Documents that are part of an appeal from denial of
1.16health care coverage for experimental treatment are classified under section
.
1.17 Sec. 2. new text begin [45.0137] LICENSING AUTHORITY PENALTIES.new text end
1.18 new text begin Subdivision 1.new text end new text begin Definitions.new text end new text begin (a) As used in this section, the following terms have new text end
1.19new text begin the meaning given.new text end
1.20new text begin (b) "Appropriate licensing authority" means the state agency responsible for new text end
1.21new text begin licensing and discipline of a provider.new text end
1.22new text begin (c) "Commissioner" means the commissioner of commerce.new text end
1.23new text begin (d) "Medical services" means those services eligible for reimbursement under new text end
1.24new text begin section 65B.44, subdivision 2.new text end
2.1new text begin (e) "Provider of medical services" or "provider" means a person or entity that has new text end
2.2new text begin provided medical services.new text end
2.3 new text begin Subd. 2.new text end new text begin Authority to impose penalties.new text end new text begin In addition to any other disciplinary new text end
2.4new text begin authority available, an appropriate licensing authority upon finding, after investigation new text end
2.5new text begin as provided in subdivision 5, or referral by the commissioner, that a provider engaged in new text end
2.6new text begin prohibited activities set forth in subdivision 4, may, by order:new text end
2.7new text begin (1) remove authorization for a provider of medical services to demand or request new text end
2.8new text begin payment under chapter 65B for medical services;new text end
2.9new text begin (2) impose an administrative penalty against a provider of medical services not new text end
2.10new text begin exceeding $10,000 for each separate violation of engaging in the prohibited activities new text end
2.11new text begin set forth in subdivision 4. The amount of the administrative penalty is to be fixed as to new text end
2.12new text begin deprive the provider of medical services of any economic advantage gained by reason of new text end
2.13new text begin the violation, to reimburse the appropriate licensing authority for the cost of counsel, new text end
2.14new text begin investigation, and proceeding, and to discourage repeated violations;new text end
2.15new text begin (3) order restitution by the provider of medical services of any proceeds received new text end
2.16new text begin by the provider of medical services in engaging in the prohibited activities set forth in new text end
2.17new text begin subdivision 4.new text end
2.18 new text begin Subd. 3.new text end new text begin Factors to consider in imposing penalties.new text end new text begin (a) In determining the new text end
2.19new text begin penalties imposed under subdivision 2, the appropriate licensing authority must consider:new text end
2.20new text begin (1) the nature, circumstances, extent, gravity, and number of violations;new text end
2.21new text begin (2) the degree of culpability of the violator;new text end
2.22new text begin (3) prior offenses and repeated violations of the violator; andnew text end
2.23new text begin (4) any other matter that the appropriate licensing authority considers appropriate new text end
2.24new text begin and relevant.new text end
2.25new text begin (b) If an administrative penalty is not paid after all rights of appeal have been new text end
2.26new text begin waived or exhausted, the appropriate licensing authority may bring a civil action in a court new text end
2.27new text begin of competent jurisdiction to collect the administrative penalty, including expenses and new text end
2.28new text begin litigation costs, reasonable attorney fees, and interest.new text end
2.29new text begin (c) This section does not affect the right to take any independent action to seek new text end
2.30new text begin recovery against a provider who violates this section.new text end
2.31 new text begin Subd. 4.new text end new text begin Prohibited activities.new text end new text begin A provider may be subject to the penalties as set new text end
2.32new text begin forth in subdivision 2, if an appropriate licensing authority has found the provider, in new text end
2.33new text begin connection with medical services rendered, to have:new text end
2.34new text begin (1) committed unprofessional conduct;new text end
2.35new text begin (2) practiced outside the provider's professional licensure;new text end
3.1new text begin (3) been found guilty of engaging in activities, including the use of runners, in new text end
3.2new text begin violation of section 609.612;new text end
3.3new text begin (4) unlawfully refused to appear before, or to answer upon request of, a duly new text end
3.4new text begin authorized officer of an appropriate licensing authority, any legal question, or to produce new text end
3.5new text begin any relevant information concerning conduct in connection with providing medical new text end
3.6new text begin services; ornew text end
3.7new text begin (5) been found guilty of engaging in insurance fraud in violation of section 609.611.new text end
3.8 new text begin Subd. 5.new text end new text begin Investigation.new text end new text begin (a) An appropriate licensing authority may investigate any new text end
3.9new text begin reports, allegations, or other information in its possession regarding a provider of medical new text end
3.10new text begin services engaging in any of the prohibited activities set forth in subdivision 4.new text end
3.11new text begin (b) The commissioner, consistent with the powers granted under section 45.027, new text end
3.12new text begin may investigate any reports made under section 45.0135, or other information in the new text end
3.13new text begin commissioner's possession, regarding providers of medical services engaging in any of new text end
3.14new text begin the prohibited activities set forth in subdivision 4. After conducting an investigation, the new text end
3.15new text begin commissioner may refer to the appropriate licensing authority a list of any providers who new text end
3.16new text begin the commissioner believes may have engaged in any of the prohibited activities set forth in new text end
3.17new text begin subdivision 4 together with a description of the grounds for inclusion on the list. Within 60 new text end
3.18new text begin days of receipt of the list, the appropriate licensing authority must notify the commissioner new text end
3.19new text begin in writing of any action taken with respect to the provider of medical services, including new text end
3.20new text begin whether an order was made under subdivision 2. The appropriate licensing authority must new text end
3.21new text begin post on the appropriate licensing authority's Web site a list of providers for which an order new text end
3.22new text begin was issued under subdivision 2. The appropriate licensing authority must post quarterly new text end
3.23new text begin on its Web site the number of complaints filed against licensees, how many of those new text end
3.24new text begin complaints were investigated, and how many of the complaints resulted in disciplinary new text end
3.25new text begin action by the appropriate licensing authority.new text end
3.26new text begin (c) Hearings under this section must be conducted in accordance with chapter 14 and new text end
3.27new text begin any other applicable law.new text end
3.28 new text begin Subd. 6.new text end new text begin Not compensable.new text end new text begin If a provider renders medical services to an insured, new text end
3.29new text begin notwithstanding issuance of an order under subdivision 2, clause (1), those medical new text end
3.30new text begin services are not compensable under chapter 65B and may not be billed to the insured.new text end
3.31 Sec. 3. Minnesota Statutes 2012, section 60A.952, subdivision 3, is amended to read:
3.32 Subd. 3. Immunity from liability. If insurers, new text begin insurance support organizations new text end
3.33new text begin as defined in section 72A.491, subdivision 12, new text end agents acting on the insurers' behalf, or
3.34authorized persons release information in good faith under this section, whether orally
4.1or in writing, they are immune from any liability, civil or criminal, for the release or
4.2reporting of the information.
4.3 Sec. 4. Minnesota Statutes 2012, section 65B.44, subdivision 2, is amended to read:
4.4 Subd. 2. Medical expense benefits. (a) Medical expense benefits shall reimburse
4.5all reasonable expenses for necessary:
4.6(1) medical, surgical, x-ray, optical, dental, chiropractic, and rehabilitative services,
4.7including prosthetic devices;
4.8(2) prescription drugsnew text begin , provided that:new text end
4.9new text begin (i) prescription drugs filled and dispensed outside of a licensed pharmacy shall be new text end
4.10new text begin billed at the average wholesale price (AWP), or its equivalent, for that drug on that date new text end
4.11new text begin as published in Medispan, Redbook, or Gold Standard Drug Database, as identified by new text end
4.12new text begin its National Drug Code, plus a dispensing fee of $4.18;new text end
4.13new text begin (ii) if a prescription drug has been repackaged, the average wholesale price used new text end
4.14new text begin to determine the maximum reimbursement shall be the average wholesale price for new text end
4.15new text begin the underlying drug product, as identified by its National Drug Code from the original new text end
4.16new text begin labeler; andnew text end
4.17new text begin (iii) compound drugs shall be billed by listing each drug and its National Drug Code new text end
4.18new text begin number included in the compound and calculating the charge for each drug separately. new text end
4.19new text begin Reimbursement shall be based on the sum of the fee for each ingredient for which new text end
4.20new text begin there is an assigned National Drug Code number plus a single dispensing fee of $4.18. new text end
4.21new text begin Compound drugs shall not be dispensed without first obtaining preauthorization from the new text end
4.22new text begin reparation obligornew text end ;
4.23(3) ambulance and all other transportation expenses incurred in traveling to receive
4.24other covered medical expense benefits;
4.25(4) sign interpreting and language translation services, other than such services
4.26provided by a family member of the patient, related to the receipt of medical, surgical,
4.27x-ray, optical, dental, chiropractic, hospital, extended care, nursing, and rehabilitative
4.28services; and
4.29(5) hospital, extended care, and nursing services.
4.30(b) Hospital room and board benefits may be limited, except for intensive care
4.31facilities, to the regular daily semiprivate room rates customarily charged by the institution
4.32in which the recipient of benefits is confined.
4.33(c) Such benefits shall also include necessary remedial treatment and services
4.34recognized and permitted under the laws of this state for an injured person who relies
5.1upon spiritual means through prayer alone for healing in accordance with that person's
5.2religious beliefs.
5.3(d) Medical expense loss includes medical expenses accrued prior to the death of a
5.4person notwithstanding the fact that benefits are paid or payable to the decedent's survivors.
5.5(e) Medical expense benefits for rehabilitative services shall be subject to the
5.6provisions of section
65B.45.
5.7 Sec. 5. Minnesota Statutes 2012, section 65B.44, subdivision 3, is amended to read:
5.8 Subd. 3. Disability and income loss benefits. new text begin (a) new text end Disability and income loss
5.9benefits shall provide compensation for 85 percent of the injured person's loss of present
5.10and future gross income from inability to work proximately caused by the nonfatal
5.11injury subject to a maximum of $250new text begin $500new text end per week. Loss of income includes the costs
5.12incurred by a self-employed person to hire substitute employees to perform tasks which
5.13are necessary to maintain the income of the injured person, which are normally performed
5.14by the injured person, and which cannot be performed because of the injury.
5.15new text begin (b) new text end If the injured person is unemployed at the time of injury and is receiving or is
5.16eligible to receive unemployment benefits under chapter 268, but the injured person loses
5.17eligibility for those benefits because of inability to work caused by the injury, disability
5.18and income loss benefits shall provide compensation for the lost benefits in an amount
5.19equal to the unemployment benefits which otherwise would have been payable, subject to
5.20a maximum of $250new text begin $500new text end per week.
5.21new text begin (c) new text end Compensation under this subdivision shall be reduced by any income from
5.22substitute work actually performed by the injured person or by income the injured person
5.23would have earned in available appropriate substitute work which the injured person was
5.24capable of performing but unreasonably failed to undertake.
5.25new text begin (d) new text end For the purposes of this section "inability to work" means disability which
5.26prevents the injured person from engaging in any substantial gainful occupation or
5.27employment on a regular basis, for wage or profit, for which the injured person is or may
5.28by training become reasonably qualified. If the injured person returns to employment and
5.29is unable by reason of the injury to work continuously, compensation for lost income shall
5.30be reduced by the income received while the injured person is actually able to work. The
5.31weekly maximums may not be prorated to arrive at a daily maximum, even if the injured
5.32person does not incur loss of income for a full week.
5.33new text begin (e) new text end For the purposes of this section, an injured person who is "unable by reason of
5.34the injury to work continuously" includes, but is not limited to, a person who misses time
5.35from work, including reasonable travel time, and loses income, vacation, or sick leave
6.1benefits, to obtain medical treatment for an injury arising out of the maintenance or use
6.2of a motor vehicle.
6.3 Sec. 6. Minnesota Statutes 2012, section 65B.44, subdivision 4, is amended to read:
6.4 Subd. 4. Funeral and burial expenses. Funeral and burial benefits shall be
6.5reasonable expenses not in excess of $2,000new text begin $5,000new text end , including expenses for cremation or
6.6delivery under the Darlene Luther Revised Uniform Anatomical Gift Act, chapter 525A.
6.7 Sec. 7. Minnesota Statutes 2012, section 65B.44, subdivision 6, is amended to read:
6.8 Subd. 6. Survivors economic loss benefits. Survivors economic loss benefits, in
6.9the event of death occurring within one year of the date of the accident, caused by and
6.10arising out of injuries received in the accident, are subject to a maximum of $200new text begin $500new text end
6.11 per week and shall cover loss accruing after decedent's death of contributions of money
6.12or tangible things of economic value, not including services, that surviving dependents
6.13would have received from the decedent for their support during their dependency had the
6.14decedent not suffered the injury causing death.
6.15For the purposes of definition under sections
65B.41 to
65B.71, the following
6.16described persons shall be presumed to be dependents of a deceased person: (a) a wife
6.17is dependent on a husband with whom she lives at the time of his death; (b) a husband
6.18is dependent on a wife with whom he lives at the time of her death; (c) any child while
6.19under the age of 18 years, or while over that age but physically or mentally incapacitated
6.20from earning, is dependent on the parent with whom the child is living or from whom the
6.21child is receiving support regularly at the time of the death of such parentnew text begin ; or (d) an actual new text end
6.22new text begin dependent who lives with the decedent at the time of the decedent's deathnew text end . Questions of
6.23the existence and the extent of dependency shall be questions of fact, considering the
6.24support regularly received from the deceased.
6.25Payments shall be made to the dependent, except that benefits to a dependent who
6.26is a child or an incapacitated person may be paid to the dependent's surviving parent or
6.27guardian. Payments shall be terminated whenever the recipient ceases to maintain a status
6.28which if the decedent were alive would be that of dependency.
6.29 Sec. 8. Minnesota Statutes 2012, section 65B.525, subdivision 1, is amended to read:
6.30 Subdivision 1. Mandatory submission to binding arbitration. Except as
6.31otherwise provided in section
, The Supreme Court and the several courts of
6.32general trial jurisdiction of this state shall by rules of court or other constitutionally
6.33allowable device, provide for the mandatory submission to binding arbitration of all cases
7.1at issue where the claim at the commencement of arbitration is in an amount of $10,000
7.2or less against any insured's reparation obligor for no-fault benefits or comprehensive or
7.3collision damage coverage.
7.4 Sec. 9. Minnesota Statutes 2012, section 72A.502, subdivision 2, is amended to read:
7.5 Subd. 2. Prevention of fraud. Personal or privileged information may be disclosed
7.6without a written authorization to another person if the information is limited to that
7.7which is reasonably necessary to detect or prevent criminal activity, fraud, material
7.8misrepresentation, or material nondisclosure in connection with an insurance transaction,
7.9and that person agrees not to disclose the information further without the individual
7.10written authorization unless the further disclosure is otherwise permitted by this section
7.11if made by an insurer, insurance agent, or insurance-support organization.new text begin Any insurer, new text end
7.12new text begin insurance agent, or insurance-support organization making such a disclosure is immune new text end
7.13new text begin from liability under section 60A.952, subdivision 3.new text end
7.14 Sec. 10. new text begin TASK FORCE ON MOTOR VEHICLE INSURANCE COVERAGE new text end
7.15new text begin VERIFICATION.new text end
7.16 new text begin Subdivision 1.new text end new text begin Establishment.new text end new text begin The task force on motor vehicle insurance coverage new text end
7.17new text begin verification is established to review and evaluate approaches to insurance coverage new text end
7.18new text begin verification and recommend legislation to create and fund a program in this state.new text end
7.19 new text begin Subd. 2.new text end new text begin Membership; meetings; staff.new text end new text begin (a) The task force shall be composed of new text end
7.20new text begin 13 members, who must be appointed by July 1, 2014, and who serve at the pleasure of new text end
7.21new text begin their appointing authorities:new text end
7.22new text begin (1) the commissioner of public safety or a designee;new text end
7.23new text begin (2) the commissioner of commerce or a designee;new text end
7.24new text begin (3) two members of the house of representatives, one appointed by the speaker of the new text end
7.25new text begin house and one appointed by the minority leader;new text end
7.26new text begin (4) two members of the senate, one appointed by the Subcommittee on Committees new text end
7.27new text begin of the Committee on Rules and Administration and one appointed by the minority leader;new text end
7.28new text begin (5) a representative of Minnesota Deputy Registrars Association;new text end
7.29new text begin (6) a representative of AAA Minnesota;new text end
7.30new text begin (7) a representative of AARP Minnesota;new text end
7.31new text begin (8) a representative of the Insurance Federation of Minnesota;new text end
7.32new text begin (9) a representative of the Minnesota Bankers Association;new text end
7.33new text begin (10) a representative of the Minnesota Association for Justice; new text end
7.34new text begin (11) a representative of the Minnesota Police and Peace Officers Association; andnew text end
8.1new text begin (12) a representative of the Minnesota chapter of the International Association of new text end
8.2new text begin Special Investigation Units.new text end
8.3new text begin (b) Compensation and expense reimbursement must be as provided under Minnesota new text end
8.4new text begin Statutes, section 15.059, subdivision 3, to members of the task force.new text end
8.5new text begin (c) The commissioner of public safety shall convene the task force by August new text end
8.6new text begin 1, 2014, and shall appoint a chair from the membership of the task force. Staffing and new text end
8.7new text begin technical assistance must be provided by the Department of Public Safety.new text end
8.8 new text begin Subd. 3.new text end new text begin Duties.new text end new text begin The task force shall review and evaluate programs established in new text end
8.9new text begin other states as well as programs proposed by third parties, identify one or more programs new text end
8.10new text begin recommended for implementation in this state, and, as to the recommended programs, new text end
8.11new text begin adopt findings concerning:new text end
8.12new text begin (1) comparative costs of programs;new text end
8.13new text begin (2) implementation considerations, and in particular, identifying the appropriate new text end
8.14new text begin supervising agency and assessing compatibility with existing and planned computer new text end
8.15new text begin systems;new text end
8.16new text begin (3) effectiveness in verifying existence of motor vehicle insurance coverage;new text end
8.17new text begin (4) identification of categories of authorized users;new text end
8.18new text begin (5) simplicity of access and use for authorized users;new text end
8.19new text begin (6) data privacy considerations;new text end
8.20new text begin (7) data retention policies; andnew text end
8.21new text begin (8) statutory changes necessary for implementation.new text end
8.22 new text begin Subd. 4.new text end new text begin Report.new text end new text begin By February 1, 2015, the task force must submit to the new text end
8.23new text begin chairs and ranking minority members of the house of representatives and senate new text end
8.24new text begin committees and divisions with primary jurisdiction over commerce and transportation its new text end
8.25new text begin written recommendations, including any draft legislation necessary to implement the new text end
8.26new text begin recommendations.new text end
8.27 new text begin Subd. 5.new text end new text begin Sunset.new text end new text begin The task force shall sunset the day after submitting the report new text end
8.28new text begin under subdivision 4, or February 2, 2015, whichever is earlier.new text end
8.29new text begin EFFECTIVE DATE.new text end new text begin This section is effective the day following final enactment.new text end
8.30 Sec. 11. new text begin REPEALER.new text end
8.31new text begin Minnesota Statutes 2012, section 72A.327,new text end new text begin is repealed.new text end