Office of the Revisor of Statutes
SF 3297
Introduction - 94th Legislature (2025 - 2026)
Posted on 07/09/2025 08:43 a.m.
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A bill for an act
relating to health; allowing insurers to provide explanation of benefits electronically;
amending Minnesota Statutes 2024, sections 62J.51, subdivision 19a; 62J.581.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2024, section 62J.51, subdivision 19a, is amended to read:
Subd. 19a.
Uniform explanation of benefits deleted text begin documentdeleted text end .
"Uniform explanation of
benefits deleted text begin documentdeleted text end " means new text begin either new text end the document associated with and explaining the details
of a group purchaser's claim adjudication for services renderednew text begin or its electronic equivalent
under section 62J.581new text end , which is sent to a patient.
Sec. 2.
Minnesota Statutes 2024, section 62J.581, is amended to read:
62J.581 STANDARDS FOR MINNESOTA UNIFORM HEALTH CARE
REIMBURSEMENT DOCUMENTS.
Subdivision 1.
Minnesota uniform remittance advice.
All group purchasers shall
provide a uniform claim payment/advice transaction to health care providers when a claim
is adjudicated. The uniform claim payment/advice transaction shall comply with section
62J.536, subdivision 1, paragraph (b), and rules adopted under section 62J.536, subdivision
2.
Subd. 2.
Minnesota uniform explanation of benefits deleted text begin documentdeleted text end .
(a) All group
purchasers shall provide a uniform explanation of benefits deleted text begin documentdeleted text end to health care patients
when an explanation of benefits deleted text begin documentdeleted text end is provided as otherwise required or permitted
by law. The uniform explanation of benefits deleted text begin documentdeleted text end shall comply with the standards
prescribed in this section.
(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.
Subd. 3.
Scope.
For purposes of sections 62J.50 to 62J.61, the deleted text begin uniform claim
payment/advice transaction anddeleted text end uniform explanation of benefits deleted text begin documentdeleted text end 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
deleted text begin subdivisions 1 anddeleted text end new text begin subdivisionnew text end 2 if they comply with section 62A.01, subdivisions 2 and
3.
Subd. 4.
Specifications.
new text begin (a) new text end The uniform explanation of benefits deleted text begin documentdeleted text end shall be
provided by use of a paper document conforming to the specifications in this sectionnew text begin or its
electronic equivalent under paragraph (b)new text end .
new text begin
(b) Group purchasers may make the uniform explanation of benefits available in a version
that can be accessed by health care patients electronically if:
new text end
new text begin
(1) the group purchaser making the uniform explanation of benefits available
electronically provides health care patients the ability to choose whether to receive paper,
electronic, or both paper and electronic versions of their uniform explanation of benefits;
new text end
new text begin
(2) the group purchaser provides clear, readily accessible information and instructions
for the patient to communicate their choice; and
new text end
new text begin
(3) health care patients not responding to the opportunity to make a choice will receive
at a minimum a paper uniform explanation of benefits.
new text end
new text begin (c) new text end The commissioner, after consulting with the Administrative Uniformity Committee,
shall specify the data elements and definitions for the new text begin paper new text end uniform explanation of benefits
deleted text begin documentdeleted text end . deleted text begin 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 claim payment/advice transaction for dental care services.deleted text end new text begin Any
electronic version of the uniform explanation of benefits must use the same data elements
and definitions as the paper uniform explanation of benefits.
new text end
deleted text begin Subd. 5. deleted text end
deleted text begin Effective date. deleted text end
deleted text begin
The requirements in subdivisions 1 and 2 are effective June 30,
2007. The requirements in subdivisions 1 and 2 apply regardless of when the health care
service was provided to the patient.
deleted text end