Office of the Revisor of Statutes
HF 3056
Introduction - 94th Legislature (2025 - 2026)
Posted on 04/02/2025 11:24 a.m.
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A bill for an act
relating to health; changing provider network adequacy provisions; amending
Minnesota Statutes 2024, section 62K.10, subdivisions 2, 5, 6; repealing Minnesota
Statutes 2024, section 62K.10, subdivision 3.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2024, section 62K.10, subdivision 2, is amended to read:
Subd. 2.
deleted text begin Primary care; mental health services; general hospital servicesdeleted text end new text begin Time and
distance standardsnew text end .
deleted text begin The maximum travel distance or time shall be the lesser of 30 miles
or 30 minutes to the nearest provider of each of the following services: primary care services,
mental health services, and general hospital servicesdeleted text end new text begin Health carriers must meet the time and
distance standards under Code of Federal Regulations, title 45, section 155.1050new text end .
Sec. 2.
Minnesota Statutes 2024, section 62K.10, subdivision 5, is amended to read:
Subd. 5.
Waiver.
(a) A health carrier may apply to the commissioner of health for a
waiver of the requirements in subdivision 2 deleted text begin or 3deleted text end if it is unable to meet the statutory
requirements. A waiver application must be submitted on a form provided by the
commissioner, must be accompanied by an application fee of $500 for each application to
waive the requirements in subdivision 2 deleted text begin or 3deleted text end for one or more provider types per county, and
must:
(1) demonstrate with specific data that the requirement of subdivision 2 deleted text begin or 3deleted text end is not
feasible in a particular service area or part of a service area; and
(2) include specific information as to the steps that were and will be taken to address
the network inadequacy, and, for steps that will be taken prospectively to address network
inadequacy, the time frame within which those steps will be taken.
(b) The commissioner shall establish guidelines for evaluating waiver applications,
standards governing approval or denial of a waiver application, and standards for steps that
health carriers must take to address the network inadequacy and allow the health carrier to
meet network adequacy requirements within a reasonable time period. The commissioner
shall review each waiver application using these guidelines and standards and shall approve
a waiver application only if:
(1) the standards for approval established by the commissioner are satisfied; and
(2) the steps that were and will be taken to address the network inadequacy and the time
frame for taking these steps satisfy the standards established by the commissioner.
(c) If, in its waiver application, a health carrier demonstrates to the commissioner that
there are no providers of a specific type or specialty in a county, the commissioner may
approve a waiver in which the health carrier is allowed to address network inadequacy in
that county by providing for patient access to providers of that type or specialty via telehealth,
as defined in section 62A.673, subdivision 2.
(d) The waiver shall automatically expire after one year. Upon or prior to expiration of
a waiver, a health carrier unable to meet the requirements in subdivision 2 deleted text begin or 3deleted text end must submit
a new waiver application under paragraph (a) and must also submit evidence of steps the
carrier took to address the network inadequacy. When the commissioner reviews a waiver
application for a network adequacy requirement which has been waived for the carrier for
the most recent one-year period, the commissioner shall also examine the steps the carrier
took during that one-year period to address network inadequacy, and shall only approve a
subsequent waiver application that satisfies the requirements in paragraph (b), demonstrates
that the carrier took the steps it proposed to address network inadequacy, and explains why
the carrier continues to be unable to satisfy the requirements in subdivision 2 deleted text begin or 3deleted text end .
(e) Application fees collected under this subdivision shall be deposited in the state
government special revenue fund in the state treasury.
Sec. 3.
Minnesota Statutes 2024, section 62K.10, subdivision 6, is amended to read:
Subd. 6.
Referral centers.
deleted text begin Subdivisionsdeleted text end new text begin Subdivisionnew text end 2 deleted text begin and 3deleted text end shall not apply if an enrollee
is referred to a referral center for health care services. A referral center is a medical facility
that provides highly specialized medical care, including but not limited to organ transplants.
A health carrier or preferred provider organization may consider the volume of services
provided annually, case mix, and severity adjusted mortality and morbidity rates in
designating a referral center.
Sec. 4. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, section 62K.10, subdivision 3,
new text end
new text begin
is repealed.
new text end
APPENDIX
Repealed Minnesota Statutes: 25-00303
62K.10 GEOGRAPHIC ACCESSIBILITY; PROVIDER NETWORK ADEQUACY.
Subd. 3.
Other health services.
The maximum travel distance or time shall be the lesser of 60 miles or 60 minutes to the nearest provider of specialty physician services, ancillary services, specialized hospital services, and all other health services not listed in subdivision 2.