HF 2673

as introduced - 92nd Legislature (2021 - 2022) Posted on 02/10/2022 03:45pm

A bill for an act
relating to health care; modifying dental benefit plan contract requirements;
permitting a third party access to a dental provider contract; amending Minnesota
Statutes 2020, sections 62Q.735, subdivisions 1, 5; 62Q.76, by adding a subdivision;
62Q.78, by adding subdivisions.

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

Section 1.

Minnesota Statutes 2020, section 62Q.735, subdivision 1, is amended to read:

Subdivision 1.

Contract disclosure.

(a) Before requiring a health care provider to sign
a contract, a health plan company shall give to the provider a complete copy of the proposed
contract, including:

(1) all attachments and exhibits;

(2) operating manuals;

(3) a general description of the health plan company's health service coding guidelines
and requirement for procedures and diagnoses with modifiers, and multiple procedures; and

(4) all guidelines and treatment parameters incorporated or referenced in the contract.

(b) The health plan company shall make available to the provider the fee schedule or a
method or process that allows the provider to determine the fee schedule for each health
care service to be provided under the contract.

deleted text begin (c) Notwithstanding paragraph (b), a health plan company that is a dental plan
organization, as defined in section 62Q.76, shall disclose information related to the individual
contracted provider's expected reimbursement from the dental plan organization. Nothing
in this section requires a dental plan organization to disclose the plan's aggregate maximum
allowable fee table used to determine other providers' fees. The contracted provider must
not release this information in any way that would violate any state or federal antitrust law.
deleted text end

Sec. 2.

Minnesota Statutes 2020, section 62Q.735, subdivision 5, is amended to read:

Subd. 5.

Fee schedules.

deleted text begin (a) deleted text end A health plan company shall provide, upon request, any
additional fees or fee schedules relevant to the particular provider's practice beyond those
provided with the renewal documents for the next contract year to all participating providers,
excluding claims paid under the pharmacy benefit. Health plan companies may fulfill the
requirements of this section by making the full fee schedules available through a secure
web portal for contracted providers.

deleted text begin (b) A dental organization may satisfy paragraph (a) by complying with section 62Q.735,
subdivision 1, paragraph (c).
deleted text end

Sec. 3.

Minnesota Statutes 2020, section 62Q.76, is amended by adding a subdivision to
read:

new text begin Subd. 9. new text end

new text begin Third party. new text end

new text begin "Third party" means a person or entity that enters into a contract
with a dental organization or with another third party to gain access to the dental care services
or contractual discounts of a dental provider contract.
new text end

Sec. 4.

Minnesota Statutes 2020, section 62Q.78, is amended by adding a subdivision to
read:

new text begin Subd. 7. new text end

new text begin Method of payments. new text end

new text begin A dental provider contract must include a method of
payment for dental care services in which no fees are incurred by the dentist or dental clinic.
Any fees that may be incurred by a dentist or dental clinic from receiving a payment for
dental care services must be disclosed to the dentist or dental clinic by the dental organization
before the dental provider contract is entered into or renewed.
new text end

Sec. 5.

Minnesota Statutes 2020, section 62Q.78, is amended by adding a subdivision to
read:

new text begin Subd. 8. new text end

new text begin Network leasing. new text end

new text begin (a) A dental organization may grant a third party access to
a dental provider contract or the dental care services or contractual discounts contained in
the dental provider contract if the requirements in paragraph (b) are met. The provision in
the dental provider contract permitting third-party access to the dental provider contract
must be clearly identified and must specifically state that if a dental organization enters into
an agreement permitting third-party access, the agreement would allow the third party to
obtain the dental organization's rights and responsibilities as if the third party were the dental
organization. A dental organization must not grant a third party access to a dental provider
contract unless the dentist or dental clinic has agreed to participate in third-party access at
the time the dental provider contract is entered into or renewed.
new text end

new text begin (b) A dental organization may grant a third party access to a dental provider contract or
the dental care services or contractual discounts contained in the dental provider contract
if the following requirements are met:
new text end

new text begin (1) the dentist or dental clinic affirmatively agrees to allow third-party access to the
dental provider contract at the time the dental provider contract is entered into or renewed;
new text end

new text begin (2) the dentist or dental clinic is provided the opportunity to opt out of allowing a third
party access to the dental provider contract at the time the dental provider contract is entered
into or renewed, without penalty to the dentist or dental clinic;
new text end

new text begin (3) the third party accessing the dental provider contract agrees to comply with all
applicable terms of the dental provider contract; and
new text end

new text begin (4) the dental organization lists all third parties granted access on its website and the list
is updated at least once every 90 days.
new text end

new text begin (c) A dentist or dental clinic is not bound by and is not required to perform dental care
services under a dental provider contract if access is granted to a third party in violation of
this section.
new text end