SF 5103
Introduction - 94th Legislature (2025 - 2026)
Posted on 04/14/2026 09:30 a.m.
1.7 1.8 1.9 1.10 1.11 1.12
1.13 1.14 1.15 1.16 1.17 1.18 1.19
2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10
2.11 2.12 2.13
2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9
3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28
A bill for an act
relating to insurance; prohibiting contractual provisions between hospitals and
health plan companies; defining terms relating to provider contracting agreements;
amending Minnesota Statutes 2024, section 62Q.733, by adding subdivisions;
proposing coding for new law in Minnesota Statutes, chapter 62Q.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Antisteering clause. new text end
new text begin
"Antisteering clause" means a provision that restricts
the ability of a health plan company to encourage an enrollee to obtain a health care item
or service from a competitor of the provider, including offering incentives to encourage
enrollees to use specific providers.
new text end
Sec. 2.
Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to
read:
new text begin Subd. 1b. new text end
new text begin Antitiering clause. new text end
new text begin
"Antitiering clause" means a provision that:
new text end
new text begin
(1) restricts the ability of a health plan company to introduce or modify a tiered network
plan or assign providers into tiers; or
new text end
new text begin
(2) requires a health plan company to place all members of a provider in the same tier
of a tiered network plan.
new text end
Sec. 3.
Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to
read:
new text begin Subd. 2a. new text end
new text begin Gag clause. new text end
new text begin
"Gag clause" means a provision that restricts the ability of a health
plan company or provider to disclose:
new text end
new text begin
(1) price or quality information, including the allowed amount, negotiated rates or
discounts, fees for services, or other claim-related financial obligations included in the
contract to a governmental entity as authorized by law or the health plan company's
contractors or agents, an enrollee, a treating provider of an enrollee, a plan sponsor, or
potential eligible enrollees and plan sponsors; or
new text end
new text begin
(2) out-of-pocket costs to an enrollee.
new text end
Sec. 4.
Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin Hospital. new text end
new text begin
"Hospital" has the meaning given in section 144.696.
new text end
Sec. 5.
Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to
read:
new text begin Subd. 7. new text end
new text begin Most favored nation clause. new text end
new text begin
"Most favored nation clause" means a provision
that:
new text end
new text begin
(1) prohibits or grants an option to prohibit:
new text end
new text begin
(i) a provider from contracting with another health plan company to provide health care
services at a lower rate; or
new text end
new text begin
(ii) a health plan company from contracting with another provider to provide health care
services at a higher rate;
new text end
new text begin
(2) requires or grants an option to require:
new text end
new text begin
(i) a provider to accept a lower rate for health care services if the provider agrees with
another health plan company to accept a lower rate for the services; or
new text end
new text begin
(ii) a health plan company to pay a higher rate for health care services if the entity agrees
with another provider to pay a higher rate for the services;
new text end
new text begin
(3) requires or grants an option to require termination or renegotiation of an existing
contract if:
new text end
new text begin
(i) a provider agrees with another health plan company to accept a lower rate for providing
health care services; or
new text end
new text begin
(ii) a health plan company agrees with a provider to pay a higher rate for health care
services; or
new text end
new text begin
(4) requires:
new text end
new text begin
(i) a provider to disclose the provider's contractual reimbursement rates with other general
contracting entities; or
new text end
new text begin
(ii) a health plan company to disclose the health plan company's contractual
reimbursement rates with other providers.
new text end
Sec. 6.
new text begin
[62Q.738] PROHIBITED HOSPITAL CONTRACTING PROVISIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Prohibited provisions. new text end
new text begin
A hospital must not:
new text end
new text begin
(1) offer to a health plan company a contract that includes an antisteering, antitiering,
gag, or most favored nation clause;
new text end
new text begin
(2) enter into a contract that includes an antisteering, antitiering, gag, or most favored
nation clause; or
new text end
new text begin
(3) amend or renew an existing contract previously entered into with a health plan
company so that the contract as amended or renewed adds or retains an antisteering,
antitiering, gag, or most favored nation clause.
new text end
new text begin Subd. 2. new text end
new text begin Provisions void and severable. new text end
new text begin
Antisteering, antitiering, gag, or most favored
nation clauses violating this section are void and unenforceable. The remaining provisions
in the contract remain in effect and are enforceable.
new text end
new text begin Subd. 3. new text end
new text begin Health plan company fiduciary duties. new text end
new text begin
A health plan company has a fiduciary
duty to the enrollee and policyholder to engage in the applicable conduct only for the primary
benefit of the enrollee or policyholder if the health plan company:
new text end
new text begin
(1) encourages an enrollee to obtain health care items or services from a particular
provider, including offering incentives to encourage enrollees to use specific providers;
new text end
new text begin
(2) introduces or modifies a tiered network plan; or
new text end
new text begin
(3) assigns providers into tiers.
new text end