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HF 1588

as introduced - 89th Legislature (2015 - 2016) Posted on 03/09/2015 01:57pm

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to insurance; requiring health plan companies to make specified health
plan information available on public Web sites; requiring specified information
on health plans to be made available on state agency Web sites; amending
Minnesota Statutes 2014, section 256B.69, by adding a subdivision; proposing
coding for new law in Minnesota Statutes, chapter 62Q.

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

Section 1.

new text begin [62Q.671] PROVISION OF HEALTH PLAN INFORMATION.
new text end

new text begin Subdivision 1. new text end

new text begin Availability on Web site. new text end

new text begin A health plan company shall make
information describing the health plans offered and their availability, including all required
elements as specified in section 2715, subsection (b), paragraph (3), of the Public Health
Service Act, available to the public on the health plan company's Web site. A health
plan company shall also make this information available by other means to individuals
without access to the Internet.
new text end

new text begin Subd. 2. new text end

new text begin Information on individual and small group health plans. new text end

new text begin (a) Health
plan companies shall provide to the commissioner, for each health plan certified and
selected to be offered as a qualified health plan through MNsure and each individual and
small group health plan offered outside of MNsure, information regarding premiums and
cost-sharing and a summary of benefits and coverage, as required in Code of Federal
Regulations, title 45, section 155.205, subsection (b), paragraph (1), clauses (i) and (ii),
and Code of Federal Regulations, title 45, section 156.220.
new text end

new text begin (b) Health plan companies shall also provide to the commissioner, for each health
plan certified and selected to be offered as a qualified health plan through MNsure and
for each individual and small group health plan offered outside of MNsure, the following
information:
new text end

new text begin (1) any exclusions from coverage and any restrictions on the use or quantity of
covered items and services in each category of benefits, including prescription drugs and
drugs administered in a physician's office or clinic;
new text end

new text begin (2) any item or service, including a drug that has a coinsurance requirement, where
the cost-sharing required depends on the cost of the item or service;
new text end

new text begin (3) any item or service that has a co-payment and the dollar amount of the co-payment;
new text end

new text begin (4) whether a specific drug is available on formulary, whether a specific drug
is covered when furnished by a physician or clinic, and any clinical prerequisites or
authorization requirements for coverage of a drug;
new text end

new text begin (5) whether specific types of specialists are in network and whether a named
physician is in network;
new text end

new text begin (6) the process for a patient to obtain reversal of a health plan company's denial of
an item or service prescribed or ordered by the treating physician; and
new text end

new text begin (7) how medications will specifically be included in, or excluded from, the
deductible, including a description of out-of-pocket costs for a medication that may not
apply to the deductible.
new text end

new text begin (c) Health plan companies must submit the information required by this subdivision
to the commissioner at least two months prior to the start of each MNsure open enrollment
period. The commissioner shall make the information available to the public on the
agency Web site.
new text end

new text begin (d) The commissioner of commerce, in consultation with the commissioner of
health, shall develop and make available to the public a user-friendly Web tool that allows
the information provided under this section to be compared across health plan companies
and across health plans.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 2.

Minnesota Statutes 2014, section 256B.69, is amended by adding a subdivision
to read:


new text begin Subd. 36. new text end

new text begin Information on health plan coverage. new text end

new text begin The commissioner shall require
each managed care plan and county-based purchasing plan to report the information
required under section 62Q.671, subdivision 2, paragraph (b), as applicable, for health
plans offered to medical assistance and MinnesotaCare enrollees. The commissioner shall
make this information available to the public on the agency Web site.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end