Legislative Session number- 84

Bill Name: SF2241

Relating to health

ARTICLE 1 - HEALTH PLAN INNOVATION AND
REGULATION

Increasing the minimum and maximum premium rates for membership in
the comprehensive health insurance plan of the Minnesota comprehensive health
association (MCHA); exempting certain smaller claims from prior authorization
requirements for utilization review purposes, authorizing utilization review
organizations to apply greater levels of scrutiny in prior authorization and in
determining medical necessity for nonemergency imaging, testing and transport,
requiring organization development of a definition of nonemergency care to be
available to health care providers; requiring a certain statement relating to
Minnesota law on health plan identification (ID) cards; modifying certain
requirements for the formation of voluntary health care plan purchasing pools;
requiring the commissioner of commerce to issue cash payment discount cards upon
request and payment of a fee entitling card owners to discounts from health care
providers voluntarily participating in the program in exchange for same day full
payment of charges for services, supplies and prescription drugs; requiring
health plan company annual reports to the commissioner of certain information
relating to administrative efficiency for use by the commissioner in compiling
health plan company specific administrative efficiency report cards to be
available on agency web sites; requiring health plan companies and service
cooperatives annual reporting to the commissioner of certain information
relating to health coverage options; requiring health plans providing
prescription drug coverage to cover medication therapy management services for
certain enrollees, defining medication therapy management, requiring pharmacists
to meet certain requirements for eligibility for reimbursement for the services;
transferring regulatory responsibilities for health maintenance organizations
(HMO) from the commissioner of health to the commissioner of commerce after a
certain date, requiring the revisor of statutes to prepare legislation to make
the necessary statutory changes

ARTICLE 2 - PUBLIC HEALTH, HEALTH CARE AND
HEALTH CARE PROVIDERS

Specifying certain licensee fraud investigation
requirements of the division of insurance fraud prevention in the department of
commerce and the appropriate health related licensing board; requiring annual
disclosure to the commissioner of health by health care providers of charges and
payment rates, authorizing commissioner exemption of specific providers from the
requirement under certain conditions; changing best practices guidelines and
measurement activities of health care providers and health plan companies to
evidenced based health care guidelines to improve quality and reduce health care
costs, authorizing health related licensing boards to establish practice
standards for treating patients, specifying certain guidelines criteria
requirements, providing for measurement and reporting of performance; modifying
executive compensation disclosure requirements of health plan companies and
expanding the requirements to hospitals under contract with the health plan
companies; providing for health related licensing boards involvement in
excessive automobile insurance claims; requiring the commissioner of health in
cooperation with the commissioner of commerce to post certain consumer health
information on agency web sites; requiring and providing for the commissioner of
health to establish and maintain a cancer drug repository program authorizing
persons to donate cancer drugs or supplies for use by individuals meeting
certain eligibility criteria, specifying requirements for participation by
pharmacies or medical facilities and individual eligibility requirements,
regulating donations and the dispensing or distribution of the drugs and
supplies, authorizing a handling fee, specifying certain recordkeeping
requirements, liability immunity provision; "Minnesota Acquired Infections
Disclosure Act", providing for the reporting of acquired infections by licensed
hospitals or outpatients surgical centers, specifying certain data collection
and reporting requirements, providing for the confidentiality of certain data
and requiring the commissioner to establish an advisory committee to assist in
the development of procedures for collecting, analyzing and reporting
information on acquired infection rates, requiring commissioner rules;
specifying certain uncompensated care reporting requirements of health care
providers; imposing certain liability limits on nongovernmental emergency
medical services (EMS) licensees; requiring and providing for community health
boards to coordinate health and wellness programs in respective communities;
requiring and providing for commissioner establishment of a public health grant
fund and program for grants to statewide and local health improvement public
private partnerships to reduce the rate of increase in health care costs;
requiring pharmacies to make available to patients information on pharmaceutical
assistance programs offered by manufacturers; providing for review of
malpractice judgments, claims, settlements, verdicts or criminal convictions by
the health related licensing boards, authorizing the boards to establish and
update practice standards for treating patients with injuries sustained in
no-fault automobile accidents and requiring the boards to establish a directory
of licensees including biographical data and malpractice or other judgments or
convictions

ARTICLE 3 - MISCELLANEOUS AND STUDIES

Requiring the commissioner
of health to develop and implement a statewide action plan for improving the
health status of Minnesotans and promoting primary prevention, specifying
certain plan requirements; requiring the commissioner of commerce, the health
related licensing boards, professional provider associations and automobile
insurance carriers to study the medical costs associated with no-fault
automobile accidents and report to the legislature by a certain date; stating
the intent of the legislature to promote and support a health care purchasing
system for public and private purchasers of health care promoting individual
consumer choice, specifying certain commissioner of health plan development
requirements; requiring and providing for the commissioners of health, commerce
and human services to study certain health care cost containment issues and
report to the legislature by a certain date, specifying certain report content
requirements and options; requiring and providing for the commissioner of
commerce to annually provide to the legislature a report on the status of the
market for medical malpractice insurance; requiring the commissioners of health
and commerce to study the possibility of reducing the cost of individual and
group health coverage through the creation of a state sponsored reinsurance
program available to health plan companies, self insured employers, service
cooperatives, the Minnesota comprehensive health association (MCHA) and other
sources of private sector and public employee health coverage, specifying
certain study requirements and requiring a report to the legislature by a
certain date

ARTICLE 4 - HEALTH PLAN ADMINISTRATIVE CHANGES

Eliminating the
exemption of health maintenance organizations from insurance fraud prevention
account assessments; clarifying certain health data or information disclosure
requirements of HMOs; eliminating certain health plan company annual report
content requirements relating to qualified and unqualified plans for
comprehensive health insurance purposes; clarifying the definition of clean
claim for prompt payment requirement purposes, restricting the authority of
health plan companies or third party administrators to require health care
providers to bill for interest on the payment of claims, regulating the filing
of claims by health care providers and facilities and specifying certain
additional requirements of insurers relating to claims submitted under health
policies; eliminating the requirement for third party purchasers to include with
annual certification of authority or licensure renewal documentation indicating
compliance with certain restrictions on the transfer of certain expenses for
MinnesotaCare gross earnings tax purposes; repealing certain self insurer
identification and reporting requirements and a certain provision regulating
expanded provider networks under the Minnesota comprehensive insurance plan
(MCHA)
(mk)