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HF 1988

2nd Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:56am

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to human services; requiring managed care plans and county-based
purchasing plans to report provider payment rate data; requiring the
commissioner to analyze the plans' data; requiring a report; amending Minnesota
Statutes 2008, section 256B.69, subdivision 9b.

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

Section 1.

Minnesota Statutes 2008, section 256B.69, subdivision 9b, is amended to
read:


Subd. 9b.

Reporting provider payment rates.

(a) According to guidelines
developed by the commissioner, in consultation withnew text begin health care providers,new text end managed care
plansnew text begin,new text end and county-based purchasing plans, each managed care plan and county-based
purchasing plan mustnew text begin annuallynew text end provide to the commissionerdeleted text begin, at the commissioner's request,
detailed or aggregate
deleted text end information on reimbursement rates paid by the managed care plan
under this section or the county-based purchasing plan under section 256B.692 to deleted text beginprovider
types
deleted text endnew text begin providersnew text end and vendors for administrative services under contract with the plan.

new text begin (b) Each managed care plan and county-based purchasing plan must annually
provide to the commissioner, in the form and manner specified by the commissioner:
new text end

new text begin (1) the amount of the payment made to the plan under this section that is paid to
health care providers for patient care;
new text end

new text begin (2) aggregate provider payment data, categorized by inpatient payments and
outpatient payments, with the outpatient payments categorized by payments to primary
care providers and nonprimary care providers;
new text end

new text begin (3) the process by which increases or decreases in payments made to the plan
under this section, that are based on actuarial analysis related to provider cost increases
or decreases, or that are required by legislative action, are passed through to health care
providers, categorized by payments to primary care providers and nonprimary care
providers; and
new text end

new text begin (4) specific information on the methodology used to establish provider
reimbursement rates paid by the managed health care plan and county-based purchasing
plan.
new text end

new text begin Data provided to the commissioner under this subdivision must allow the
commissioner to conduct the analyses required under paragraph (d).
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end Data provided to the commissioner under this subdivision are nonpublic
data as defined in section 13.02.

new text begin (d) The commissioner shall analyze data provided under this subdivision to assist the
legislature in providing oversight and accountability related to expenditures under this
section. The analysis must include information on payments to physicians, physician
extenders, and hospitals, and may include other provider types as determined by the
commissioner. The commissioner shall also array aggregate provider reimbursement rates
by health plan, by primary care, and nonprimary care categories. The commissioner shall
report the analysis to the legislature annually, beginning December 15, 2010, and each
December 15 thereafter. The commissioner shall also make this information available on
the agency's Web site to managed care and county-based purchasing plans, health care
providers, and the public.
new text end