HF 1976

as introduced - 89th Legislature (2015 - 2016) Posted on 03/17/2015 11:41am

A bill for an act
relating to workers' compensation; modifying electronic transactions; authorizing
penalties; amending Minnesota Statutes 2014, sections 176.135, by adding a
subdivision; 176.221, subdivision 8.

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

Section 1.

Minnesota Statutes 2014, section 176.135, is amended by adding a
subdivision to read:

new text begin Subd. 7a. new text end

new text begin Electronic transactions. new text end

new text begin (a) For purposes of this subdivision, the
following terms have the meanings given:
new text end

new text begin (1) "workers' compensation payer" means a workers' compensation insurer and an
employer, or group of employers, that is self-insured for workers' compensation;
new text end

new text begin (2) "clearinghouse" has the meaning given in section 62J.51, subdivision 11a; and
new text end

new text begin (3) "electronic transactions" means the health care administrative transactions
described in section 62J.536.
new text end

new text begin (b) In addition to the requirements of section 62J.536, workers' compensation payers
and health care providers must comply with the requirements in paragraphs (c) to (e) and
any requirements adopted by rule under paragraph (f).
new text end

new text begin (c) No later than January 1, 2016, each workers' compensation payer must place
the following information in a prominent location on its Web site or otherwise provide
the information to health care providers:
new text end

new text begin (1) the name of each clearinghouse with which the workers' compensation payer has
an agreement to exchange or transmit electronic transactions, along with the identification
number each clearinghouse has assigned to the payer in order to route electronic
transactions through intermediaries or other clearinghouses to the payer;
new text end

new text begin (2) information about how a health care provider can obtain the claim number
assigned by the workers' compensation payer for an employee's claim and how the
provider should submit the claim number in the appropriate field on the electronic bill to
the payer; and
new text end

new text begin (3) the name, phone number, and e-mail address of contact persons who can answer
questions related to electronic transactions on behalf of the workers' compensation payer
and the clearinghouses with which the payer has agreements.
new text end

new text begin (d) No later than July 1, 2016:
new text end

new text begin (1) health care providers must electronically submit copies of medical records or
reports that substantiate the nature of the charge and its relationship to the work injury
using the most recently approved version of the ASC X12N 275 transaction ("Additional
Information to Support Health Care Claim or Encounter"), according to the requirements
in the corresponding implementation guide. The ASC X12N 275 transaction is the only
one that shall be used to electronically submit attachments unless a national standard is
adopted by federal law or rule. If a new version of the attachment transaction is approved,
it must be used one year after the approval date;
new text end

new text begin (2) workers' compensation payers and all clearinghouses receiving or transmitting
workers' compensation bills must accept attachments using the ASC X12N 275 transaction
and must respond with the most recently approved ASC X12 electronic acknowledgment
for the attachment transaction. If a new version of the acknowledgment transaction is
approved, it must be used one year after the approval date; and
new text end

new text begin (3) if a different national claims attachment or acknowledgment requirement is
adopted by federal law or rule, it will replace the ASC X12N 275 transaction, and the new
standard must be used on the date that it is required by the federal law or rule.
new text end

new text begin (e) No later than September 1, 2015, workers' compensation payers must provide
the patient's name and patient control number on or with all payments made to a provider
under this chapter, whether payment is made by check or electronic funds transfer. The
information provided on or with the payment must be sufficient to allow providers to
match the payment to specific bills. If a bulk payment is made to a provider for more than
one patient, the check or electronic funds transfer statement must also specify the amount
being paid for each patient. For purposes of this paragraph, the patient control number is
located on the electronic health care claim 837 transaction, loop 2300, segment CLM01,
and on the electronic health care claim payment/advice 835 transaction, loop 2100, CLP01.
new text end

new text begin (f) The commissioner of labor and industry may update existing workers'
compensation rules, using the rulemaking process in section 14.386, as needed to reflect
the requirements in this section, section 62J.536, and uniform companion guides adopted
by the commissioner of health.
new text end

new text begin (g) The commissioner may assess a monetary penalty of $500 for each violation
of this section or rule adopted under paragraph (f), not to exceed $25,000 for identical
violations during a calendar year. Before issuing a penalty for a first violation of this
section, the commissioner must provide written notice to the noncompliant payer,
clearinghouse, or provider that a penalty may be issued if the violation is not corrected
within 30 days. Penalties under this paragraph are payable to the commissioner for deposit
in the assigned risk safety account.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Minnesota Statutes 2014, section 176.221, subdivision 8, is amended to read:

Subd. 8.

Method and timeliness of payment.

new text begin (a) Except as otherwise provided
in paragraph (b), new text end payment of compensation under this chapter shall be by immediately
payable negotiable instrument, or if by any other method, arrangements shall be available
to provide for the immediate negotiability of the payment instrument.

All payment of compensation shall be made within 14 days of the filing of an
appropriate order by the division or a compensation judge, unless the order is appealed or
if a different time period is provided by this chapter.

new text begin (b) An employer or insurer responsible for payment of periodic monetary benefits
under this chapter must send the payments by electronic funds transfer to a bank, savings
association, or other financial institution, as defined in section 47.61, if requested by the
employee or a dependent under section 176.111.
new text end

new text begin (1) If the employer or insurer has already established an electronic funds transfer
arrangement with a bank, savings association, or other financial institution for the
employee's account, the employer or insurer must begin sending periodic monetary
benefit payments by electronic funds transfer to the bank, savings association, or other
financial institution within 30 days after the employer or insurer receives a request from
the employee or dependent containing the information in paragraph (c).
new text end

new text begin (2) If the employer or insurer does not already have an arrangement with the bank,
savings association, or other financial institution for electronic funds transfer for the
employee or dependent's account at the time of the request, the 30 days to begin sending
periodic benefit payments by electronic funds transfer does not start to run until the
arrangement has been established. The employer or insurer must make reasonable efforts
to establish the electronic funds transfer arrangement within 14 days after receiving a
request containing the information in paragraph (c).
new text end

new text begin (3) Payment of benefits is deemed to have been made on the date the payment is sent
by electronic funds transfer to the employee or dependent's account at the bank, savings
association, or other financial institution.
new text end

new text begin (c) The employee or dependent must provide the employer or insurer with the
following information:
new text end

new text begin (1) a signed and dated written request for electronic funds transfer of benefits;
new text end

new text begin (2) the name and address of the bank, savings association, or other financial
institution where the benefit payments are to be sent by electronic funds transfer;
new text end

new text begin (3) the account number to which the payments should be credited; and
new text end

new text begin (4) any other information or documentation required by the employer or insurer or
the financial institution necessary to implement electronic funds transfer.
new text end

new text begin (d) The employer or insurer must retain a copy of the request for as long as the
benefits are being paid by electronic funds transfer. The employer or insurer paying the
benefits must provide a copy of the request to the department upon request.
new text end

new text begin (e) Paragraph (b) does not apply if the employer or insurer reasonably determines
that the periodic monetary benefit payments are likely to end before the direct deposit or
electronic funds transfer can be arranged.
new text end

new text begin (f) The commissioner may assess a monetary penalty of $500 against the employer
or insurer for a violation of paragraph (b) or (d). Before issuing a penalty for a first
violation of paragraph (b) or (d), the commissioner must provide written notice to the
employer or insurer that a penalty may be issued if the violation is not corrected within
30 days. Penalties under this paragraph are payable to the commissioner for deposit in
the assigned risk safety account.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end