SF 1589

Introduction - 94th Legislature (2025 - 2026)

Posted on 02/21/2025 09:14 a.m.

A bill for an act
relating to health care; modifying requirements for making current standard charges
available to the public; prohibiting collection actions in certain circumstances;
authorizing actions by patients and guarantors; amending Minnesota Statutes 2024,
sections 62J.826, subdivisions 1, 2; 144.588, subdivisions 1, 2; proposing coding
for new law in Minnesota Statutes, chapter 62J.

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

Section 1.

Minnesota Statutes 2024, section 62J.826, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) The definitions in this subdivision apply to this section new text begin
and section 62J.827 new text end .

(b) "CDT code" means a code value drawn from the Code on Dental Procedures and
Nomenclature published by the American Dental Association.

(c) "Chargemaster" means the list of all individual items and services maintained by a
medical or dental practice for which the medical or dental practice has established a charge.

new text begin (d) "Collection action" means:
new text end

new text begin (1) attempting to collect a debt through in-house collections or by referring the debt to
a collection agency, debt buyer, or collector, as those terms are defined in section 332.31;
or
new text end

new text begin (2) bringing an action in court to collect a debt or initiating arbitration or formal, binding
mediation to collect a debt.
new text end

deleted text begin (d) deleted text end new text begin (e) new text end "Commissioner" means the commissioner of health.

deleted text begin (e) deleted text end new text begin (f) new text end "CPT code" means a code value drawn from the Current Procedural Terminology
published by the American Medical Association.

deleted text begin (f) deleted text end new text begin (g) new text end "Dental service" means a service charged using a CDT code.

deleted text begin (g) deleted text end new text begin (h) new text end "Diagnostic laboratory testing" means a service charged using a CPT code within
the CPT code range of 80047 to 89398.

deleted text begin (h) deleted text end new text begin (i) new text end "Diagnostic radiology service" means a service charged using a CPT code within
the CPT code range of 70010 to 79999 and includes the provision of x-rays, computed
tomography scans, positron emission tomography scans, magnetic resonance imaging scans,
and mammographies.

deleted text begin (i) deleted text end new text begin (j) new text end "Hospital" means an acute care institution licensed under sections 144.50 to 144.58,
but does not include a health care institution conducted for those who rely primarily upon
treatment by prayer or spiritual means in accordance with the creed or tenets of any church
or denomination.

deleted text begin (j) deleted text end new text begin (k) new text end "Medical or dental practice" means a business that:

(1) earns revenue by providing medical care or dental services to the public;

(2) issues payment claims to health plan companies and other payers; and

(3) may be identified by its federal tax identification number.

deleted text begin (k) deleted text end new text begin (l) new text end "Outpatient surgical center" means a health care facility other than a hospital
offering elective outpatient surgery under a license issued under sections 144.50 to 144.58.

deleted text begin (l) deleted text end new text begin (m) new text end "Standard charge" means the regular rate established by the medical or dental
practice for an item or service provided to a specific group of paying patients. This includes
all of the following:

(1) the charge for an individual item or service that is reflected on a medical or dental
practice's chargemaster, absent any discounts;

(2) the charge that a medical or dental practice has negotiated with a third-party payer
for an item or service;

(3) the lowest charge that a medical or dental practice has negotiated with all third-party
payers for an item or service;

(4) the highest charge that a medical or dental practice has negotiated with all third-party
payers for an item or service; and

(5) the charge that applies to an individual who pays cash, or cash equivalent, for an
item or service.

Sec. 2.

Minnesota Statutes 2024, section 62J.826, subdivision 2, is amended to read:

Subd. 2.

Requirement; current standard charges.

The following medical or dental
practices must make available to the public a list of their current standard charges for all
items and services, as reflected in the medical or dental practice's chargemaster, provided
by the medical or dental practice:

(1) hospitals;

(2) outpatient surgical centers; and

(3) any other medical or dental practice deleted text begin that has revenue of greater than $50,000,000
per year and deleted text end that new text begin :
new text end

new text begin (i) new text end derives the majority of its revenue by providing one or more of the following services:

deleted text begin (i) deleted text end new text begin (A) new text end diagnostic radiology services;

deleted text begin (ii) deleted text end new text begin (B) new text end diagnostic laboratory testing;

deleted text begin (iii) deleted text end new text begin (C) new text end orthopedic surgical procedures, including joint arthroplasty procedures within
the CPT code range of 26990 to 27899;

deleted text begin (iv) deleted text end new text begin (D) new text end ophthalmologic surgical procedures, including cataract surgery coded using
CPT code 66982 or 66984, or refractive correction surgery to improve visual acuity;

deleted text begin (v) deleted text end new text begin (E) new text end anesthesia services commonly provided as an ancillary to services provided at a
hospital, outpatient surgical center, or medical practice that provides orthopedic surgical
procedures or ophthalmologic surgical procedures;

deleted text begin (vi) deleted text end new text begin (F) new text end oncology services, including radiation oncology treatments within the CPT code
range of 77261 to 77799 and drug infusions; or

deleted text begin (vii) deleted text end new text begin (G) new text end dental services deleted text begin . deleted text end new text begin ; and
new text end

new text begin (ii)(A) in calendar year 2024, has revenue of greater than $50,000,000;
new text end

new text begin (B) in calendar year 2025, has revenue of greater than $25,000,000;
new text end

new text begin (C) in calendar year 2026, has revenue of greater than $10,000,000; and
new text end

new text begin (D) in calendar year 2027 and each calendar year thereafter, has revenue of any amount.
new text end

Sec. 3.

new text begin [62J.827] FAILURE TO MAKE CURRENT STANDARD CHARGES
AVAILABLE.
new text end

new text begin Subdivision 1. new text end

new text begin Collection action prohibited. new text end

new text begin A medical or dental practice that is subject
to section 62J.826 and that is not in material compliance with section 62J.826 is prohibited
from initiating or pursuing a collection action against a patient or guarantor for debt owed
for any items or services the medical or dental practice provided to the patient while the
medical or dental practice was not in material compliance with section 62J.826.
new text end

new text begin Subd. 2. new text end

new text begin Action by patient or guarantor. new text end

new text begin (a) A patient or guarantor who believes that
a medical or dental practice initiated or pursued a collection action against the patient or
guarantor in violation of subdivision 1 may bring an action to determine whether the medical
or dental practice initiated or pursued a collection action in violation of subdivision 1. While
an action under this subdivision is pending between the patient or guarantor and the medical
or dental practice, the medical or dental practice is prohibited from initiating or pursuing a
collection action against the patient or guarantor.
new text end

new text begin (b) If the court determines that a medical or dental practice violated subdivision 1, the
court must order the medical or dental practice to:
new text end

new text begin (1) refund any amount paid by the patient, guarantor, or other payer for the items or
services that were the subject of the medical or dental practice's collection action that violated
subdivision 1; and
new text end

new text begin (2) pay to the patient or guarantor a penalty equal to the amount owed by the patient or
guarantor for the items or services that were the subject of the medical or dental practice's
collection action that violated subdivision 1.
new text end

new text begin (c) If a medical or dental practice initiated a court action against a patient or guarantor,
the court, when presented with evidence that a court found the action violated subdivision
1, must dismiss or cause to be dismissed with prejudice the court action against the patient
or guarantor found to violate subdivision 1 and must order the medical or dental practice
to pay all attorney fees and costs incurred by the patient or guarantor relating to the action
that was dismissed.
new text end

new text begin Subd. 3. new text end

new text begin Billing and refunds. new text end

new text begin Nothing in this section:
new text end

new text begin (1) prohibits a medical or dental practice from billing a patient, guarantor, or other payer,
including a health plan company, for items or services provided to the patient while the
medical or dental practice was not in material compliance with section 62J.826; or
new text end

new text begin (2) requires a medical or dental practice to refund any payments made to the medical or
dental practice for items or services provided to the patient while the medical or dental
practice was not in material compliance with section 62J.826, so long as the medical or
dental practice does not initiate or pursue a collection action in violation of subdivision 1.
new text end

Sec. 4.

Minnesota Statutes 2024, section 144.588, subdivision 1, is amended to read:

Subdivision 1.

Requirement; action to collect medical debt or garnish wages or bank
accounts.

(a) In an action against a patient or guarantor for collection of medical debt owed
to a hospital or for garnishment of the patient's or guarantor's wages or bank accounts to
collect medical debt owed to a hospital, the hospital must serve on the defendant with the
summons and complaint an affidavit of expert review certifying that:

(1) unless the patient declined to participate, the hospital complied with the requirements
in section 144.587;

new text begin (2) the hospital was in material compliance with section 62J.826 when the hospital
provided the patient with the items and services for which the patient or guarantor owes the
debt;
new text end

deleted text begin (2) deleted text end new text begin (3) new text end there is a reasonable basis to believe that the patient owes the debt;

deleted text begin (3) deleted text end new text begin (4) new text end all known third-party payors have been properly billed by the hospital, such that
any remaining debt is the financial responsibility of the patient, and the hospital will not
bill the patient for any amount that an insurance company is obligated to pay;

deleted text begin (4) deleted text end new text begin (5) new text end the patient has been given a reasonable opportunity to apply for charity care, if
the facts and circumstances suggest that the patient may be eligible for charity care;

deleted text begin (5) deleted text end new text begin (6) new text end where the patient has indicated an inability to pay the full amount of the debt in
one payment and provided reasonable verification of the inability to pay the full amount of
the debt in one payment if requested by the hospital, the hospital has offered the patient a
reasonable payment plan;

deleted text begin (6) deleted text end new text begin (7) new text end there is no reasonable basis to believe that the patient's or guarantor's wages or
funds at a financial institution are likely to be exempt from garnishment; and

deleted text begin (7) deleted text end new text begin (8) new text end in the case of a default judgment proceeding, there is not a reasonable basis to
believe:

(i) that the patient may already consider that the patient has adequately answered the
complaint by calling or writing to the hospital, its debt collection agency, or its attorney;

(ii) that the patient is potentially unable to answer the complaint due to age, disability,
or medical condition; or

(iii) the patient may not have received service of the complaint.

(b) The affidavit of expert review must be completed by a designated employee of the
hospital seeking to initiate the action or garnishment.

Sec. 5.

Minnesota Statutes 2024, section 144.588, subdivision 2, is amended to read:

Subd. 2.

Requirement; referral to third-party debt collection agency.

(a) In order to
refer a patient's account to a third-party debt collection agency, a hospital must complete
an affidavit of expert review certifying that:

(1) unless the patient declined to participate, the hospital complied with the requirements
in section 144.587;

new text begin (2) the hospital was in material compliance with section 62J.826 when the hospital
provided the patient with the items and services for which the patient or guarantor owes the
debt;
new text end

deleted text begin (2) deleted text end new text begin (3) new text end there is a reasonable basis to believe that the patient owes the debt;

deleted text begin (3) deleted text end new text begin (4) new text end all known third-party payors have been properly billed by the hospital, such that
any remaining debt is the financial responsibility of the patient, and the hospital will not
bill the patient for any amount that an insurance company is obligated to pay;

deleted text begin (4) deleted text end new text begin (5) new text end the patient has been given a reasonable opportunity to apply for charity care, if
the facts and circumstances suggest that the patient may be eligible for charity care; and

deleted text begin (5) deleted text end new text begin (6) new text end where the patient has indicated an inability to pay the full amount of the debt in
one payment and provided reasonable verification of the inability to pay the full amount of
the debt in one payment if requested by the hospital, the hospital has offered the patient a
reasonable payment plan.

(b) The affidavit of expert review must be completed by a designated employee of the
hospital seeking to refer the patient's account to a third-party debt collection agency.