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HF 2874

1st Engrossment - 88th Legislature (2013 - 2014) Posted on 04/09/2014 04:22pm

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - 1st Engrossment

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A bill for an act
relating to health; making technical changes; eliminating or modernizing
antiquated, unnecessary, and obsolete provisions; amending Minnesota Statutes
2012, sections 62J.50, subdivisions 1, 2; 62J.51; 62J.52, as amended; 62J.53;
62J.535; 62J.536, subdivision 2; 62J.54, subdivisions 1, 2, 3; 62J.56, subdivisions
1, 2, 3; 62J.581, subdivisions 1, 3, 4; 62J.61, subdivision 1; 122A.40, subdivision
12; 122A.41, subdivision 6; 144.12, subdivision 1; 154.25; 626.557, subdivision
12b; repealing Minnesota Statutes 2012, sections 62J.322; 62J.59; 144.011,
subdivision 2; 144.0506; 144.071; 144.072; 144.076; 144.146, subdivision 1;
144.1475; 144.443; 144.444; 144.45; 145.132; 145.97; 145.98, subdivisions 1, 3.

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

ARTICLE 1

HEALTH CARE ADMINISTRATIVE SIMPLIFICATION ACT

Section 1.

Minnesota Statutes 2012, section 62J.50, subdivision 1, is amended to read:


Subdivision 1.

Citation.

Sections 62J.50 to 62J.61 may be cited as the Minnesota
Health Care Administrative Simplification Act deleted text beginof 1994deleted text end.

Sec. 2.

Minnesota Statutes 2012, section 62J.50, subdivision 2, is amended to read:


Subd. 2.

Purpose.

The legislature finds that significant savings throughout the health
care industry can be accomplished by implementing a set of administrative standards and
simplified procedures and by setting forward a plan toward the use of electronic methods
of data interchange. The legislature finds that initial steps have been taken at the national
level by the federal Health Care Financing Administrationnew text begin, now known as the Centers for
Medicare and Medicaid Services,
new text end in its implementation of nationally accepted electronic
transaction sets for its Medicare program. The legislature further recognizes the work done
by the Workgroup for Electronic Data Interchange and the American National Standards
Institute and its accredited standards committee X12, at the national level, and the
Minnesota Administrative Uniformity Committee, a statewide, voluntary, public-private
group representing payers, hospitals, state programs, physicians, and other health care
providers in their work toward administrative simplification in the health care industry.

Sec. 3.

Minnesota Statutes 2012, section 62J.51, is amended to read:


62J.51 DEFINITIONS.

Subdivision 1.

Scope.

For purposes of sections 62J.50 to 62J.61, the following
definitions apply.

Subd. 2.

ANSI.

"ANSI" means the American National Standards Institute.

Subd. 3.

ASC X12.

"ASC X12" means the American National Standards Institute
committee X12.

Subd. 3a.

Card issuer.

"Card issuer" means the group purchaser who is responsible
for printing and distributing identification cards to members or insureds.

deleted text begin Subd. 4. deleted text end

deleted text begin Category I industry participants. deleted text end

deleted text begin "Category I industry participants"
means the following: group purchasers, providers, and other health care organizations
doing business in Minnesota including public and private payers; hospitals; claims
clearinghouses; third-party administrators; billing service bureaus; value added networks;
self-insured plans and employers with more than 100 employees; clinic laboratories;
durable medical equipment suppliers with a volume of at least 50,000 claims or encounters
per year; and group practices with 20 or more physicians.
deleted text end

deleted text begin Subd. 5. deleted text end

deleted text begin Category II industry participants. deleted text end

deleted text begin "Category II industry participants"
means all group purchasers and providers doing business in Minnesota not classified as
category I industry participants.
deleted text end

Subd. 6.

Claim payment/advice transaction set (ANSI ASC X12 835).

"Claim
payment/advice transaction set (ANSI ASC X12 835)" means the electronic transaction
format deleted text begindeveloped and approved for implementation in October 1991, anddeleted text end used for
electronic remittance advice and electronic funds transfernew text begin as adopted under Code of
Federal Regulations, title 45, part 162, subpart P, and any future revisions of the subpart
new text end.

Subd. 6a.

Claim status transaction set (ANSI ASC X12 276/277).

"Claim status
transaction set (ANSI ASC X12 276/277)" means the new text beginelectronic new text endtransaction format
deleted text begindeveloped and approved for implementation in December 1993 anddeleted text end used by providers to
request and receive information on the status of a health care claim or encounter that has
been submitted to a group purchasernew text begin as adopted under Code of Federal Regulations, title
45, part 162, subpart N, and any future revisions of the subpart
new text end.

Subd. 6b.

Claim submission address.

"Claim submission address" means the
address to which the group purchaser requires health care providers, members, or insureds
to send health care claims for processing.

Subd. 6c.

Claim submission number.

"Claim submission number" means the
unique identification number to identify group purchasers as described in section 62J.54,
with its suffix identifying the claim submission address.

Subd. 7.

Claim submission transaction set (ANSI ASC X12 837).

"Claim
submission transaction set (ANSI ASC X12 837)" means the electronic transaction format
deleted text begindeveloped and approved for implementation in October 1992, anddeleted text end used to submit all
health care claims informationnew text begin as adopted under Code of Federal Regulations, title 45, part
162, subpart K, and any future revisions of the subpart
new text end.

Subd. 8.

EDI or electronic data interchange.

"EDI" or "electronic data
interchange" means the computer application to computer application exchange of
information using nationally accepted standard formats.

Subd. 9.

Eligibility transaction set (ANSI ASC X12 270/271).

"Eligibility
transaction set (ANSI ASC X12 270/271)" means the new text beginelectronic new text endtransaction format
deleted text begindeveloped and approved for implementation in February 1993, anddeleted text end used by providers to
request and receive coverage information on the member or insurednew text begin as adopted under Code
of Federal Regulations, title 45, part 162, subpart L, and any future revisions of the subpart
new text end.

Subd. 10.

Enrollment transaction set (ANSI ASC X12 834).

"Enrollment
transaction set (ANSI ASC X12 834)" means the electronic transaction format deleted text begindeveloped
and approved for implementation in February 1992, and
deleted text end used to transmit enrollment
and benefit information from the employer to the payer for the purpose of enrolling in
a benefit plannew text begin as adopted under Code of Federal Regulations, title 45, part 162, subpart
O, and any future revisions of the subpart
new text end.

Subd. 11.

Group purchaser.

"Group purchaser" has the meaning given in section
62J.03, subdivision 6.

Subd. 11a.

Health care clearinghouse.

"Health care clearinghouse" means
a public or private entity, including a billing service, repricing company, community
health management information system or community health information system, and
"value-added" networks and switches that does any of the following functions:

(1) processes or facilitates the processing of health information received from
another entity in a nonstandard format or containing nonstandard data content into
standard data elements or a standard transaction;

(2) receives a standard transaction from another entity and processes or facilitates
the processing of health information into nonstandard format or nonstandard data content
for the receiving entity;

(3) acts on behalf of a group purchaser in sending and receiving standard transactions
to assist the group purchaser in fulfilling its responsibilities under section 62J.536;

(4) acts on behalf of a health care provider in sending and receiving standard
transactions to assist the health care provider in fulfilling its responsibilities under section
62J.536; and

(5) other activities including but not limited to training, testing, editing, formatting,
or consolidation transactions.

A health care clearinghouse acts as an agent of a health care provider or group purchaser
only if it enters into an explicit, mutually agreed upon arrangement or contract with the
provider or group purchaser to perform specific clearinghouse functions.

Subd. 12.

ISO.

"ISO" means the International Standardization Organization.

Subd. 13.

NCPDP.

"NCPDP" means the National Council for Prescription Drug
Programs, Inc.

deleted text begin Subd. 14. deleted text end

deleted text begin NCPDP telecommunication standard format 3.2. deleted text end

deleted text begin "NCPDP
telecommunication standard format 3.2" means the recommended transaction sets for
claims transactions adopted by the membership of NCPDP in 1992.
deleted text end

deleted text begin Subd. 15. deleted text end

deleted text begin NCPDP tape billing and payment format 2.0. deleted text end

deleted text begin "NCPDP tape billing and
payment format 2.0" means the recommended transaction standards for batch processing
claims adopted by the membership of the NCPDP in 1993.
deleted text end

Subd. 16.

Provider.

"Provider" or "health care provider" has the meaning given
in section 62J.03, subdivision 8.

Subd. 16a.

Standard transaction.

"Standard transaction" means a transaction
that is defined in Code of Federal Regulations, title 45, part 162.103, and that meets the
requirements of the single, uniform companion guides described in section 62J.536.

Subd. 17.

Uniform billing form CMS 1450.

"Uniform billing form CMS 1450"
means the most current version of the uniform billing form known as the CMS 1450
developed by the National Uniform Billing Committee.

Subd. 18.

Uniform billing form CMS 1500.

"Uniform billing form CMS 1500"
means the most current version of the health insurance claim form, CMS 1500, developed
by the National Uniform Claim Committee.

Subd. 19.

Uniform dental billing form.

"Uniform dental billing form" means
the most current version of the uniform dental claim form developed by the American
Dental Association.

Subd. 19a.

Uniform explanation of benefits document.

"Uniform explanation of
benefits document" means the document associated with and explaining the details of a
group purchaser's claim adjudication for services rendered, which is sent to a patient.

deleted text begin Subd. 19b. deleted text end

deleted text begin Uniform remittance advice report. deleted text end

deleted text begin "Uniform remittance advice report"
means the document associated with and explaining the details of a group purchaser's
claim adjudication for services rendered, which is sent to a provider.
deleted text end

Subd. 20.

Uniform pharmacy billing form.

"Uniform pharmacy billing form"
means the National Council for Prescription Drug Programs/universal claim form
(NCPDP/UCF).

Subd. 21.

WEDI.

"WEDI" means the national Workgroup for Electronic Data
Interchange deleted text beginreport issued in October 1993deleted text end.

Sec. 4.

Minnesota Statutes 2012, section 62J.52, as amended by Laws 2013, chapter
125, article 1, section 107, is amended to read:


62J.52 ESTABLISHMENT OF UNIFORM BILLING FORMS.

Subdivision 1.

Uniform billing form CMS 1450.

(a) On and after January 1,
1996, all institutional inpatient hospital services, ancillary services, institutionally owned
or operated outpatient services rendered by providers in Minnesota, and institutional
or noninstitutional home health services that are not being billed using an equivalent
electronic billing format, must be billed using the new text beginmost current version of the new text enduniform
billing form CMS 1450deleted text begin, except as provided in subdivision 5deleted text end.

(b) The instructions and definitions for the use of the uniform billing form CMS
1450 shall be in accordance with the uniform billing form manual specified by the
commissioner. In promulgating these instructions, the commissioner may utilize the
manual developed by the National Uniform Billing Committee.

(c) Services to be billed using the uniform billing form CMS 1450 include:
institutional inpatient hospital services and distinct units in the hospital such as psychiatric
unit services, physical therapy unit services, swing bed (SNF) services, inpatient state
psychiatric hospital services, inpatient skilled nursing facility services, home health
services (Medicare part A), and hospice services; ancillary services, where benefits are
exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals,
skilled nursing facilities, ICFs/DD, and home health (Medicare part B); institutional
owned or operated outpatient services such as waivered services, hospital outpatient
services, including ambulatory surgical center services, hospital referred laboratory
services, hospital-based ambulance services, and other hospital outpatient services,
skilled nursing facilities, home health, freestanding renal dialysis centers, comprehensive
outpatient rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural
health clinics, federally qualified health centers, and community mental health centers;
home health services such as home health intravenous therapy providers and hospice; and
any other health care provider certified by the Medicare program to use this form.

(d) On and after January 1, 1996, a mother and newborn child must be billed
separately, and must not be combined on one claim form.

(e) Services provided by Medicare Critical Access Hospitals electing Method
II billing will be allowed an exception to this provision to allow the inclusion of the
professional fees on the CMS 1450.

Subd. 2.

Uniform billing form CMS 1500.

(a) On and after January 1, 1996, all
noninstitutional health care services rendered by providers in Minnesota except dental
or pharmacy providers, that are not currently being billed using an equivalent electronic
billing format, must be billed using the new text beginmost current version of the new text endhealth insurance claim
form CMS 1500deleted text begin, except as provided in subdivision 5deleted text end.

(b) The instructions and definitions for the use of the uniform billing form CMS
1500 shall be in accordance with the manual developed by the Administrative Uniformity
Committee entitled standards for the use of the CMS 1500 form, dated February 1994,
as further defined by the commissioner.

(c) Services to be billed using the uniform billing form CMS 1500 include physician
services and supplies, durable medical equipment, noninstitutional ambulance services,
independent ancillary services including occupational therapy, physical therapy, speech
therapy and audiology, home infusion therapy, podiatry services, optometry services,
mental health licensed professional services, substance abuse licensed professional
services, nursing practitioner professional services, certified registered nurse anesthetists,
chiropractors, physician assistants, laboratories, medical suppliers, waivered services,
personal care attendants, and other health care providers such as day activity centers and
freestanding ambulatory surgical centers.

(d) Services provided by Medicare Critical Access Hospitals electing Method
II billing will be allowed an exception to this provision to allow the inclusion of the
professional fees on the CMS 1450.

Subd. 3.

Uniform dental billing form.

(a) On and after January 1, 1996, all dental
services provided by dental care providers in Minnesota, that are not currently being billed
using an equivalent electronic billing format, shall be billed using the new text beginmost current version
of the
new text endAmerican Dental Association uniform dental billing form.

(b) The instructions and definitions for the use of the uniform dental billing form
shall be in accordance with the manual developed by the Administrative Uniformity
Committee dated February 1994, and as amended or further defined by the commissioner.

Subd. 4.

Uniform pharmacy billing form.

(a) On and after January 1, 1996, all
pharmacy services provided by pharmacists in Minnesota that are not currently being
billed using an equivalent electronic billing format shall be billed using the new text beginmost current
version of the
new text endNCPDP/universal claim form.

(b) The instructions and definitions for the use of the uniform claim form shall be in
accordance with instructions specified by the commissioner of health.

Sec. 5.

Minnesota Statutes 2012, section 62J.53, is amended to read:


62J.53 ACCEPTANCE OF UNIFORM BILLING FORMS BY GROUP
PURCHASERS.

On and after January 1, 1996, all deleted text begincategory I and IIdeleted text end group purchasers in Minnesota
shall accept the uniform billing forms prescribed under section 62J.52 as the only
nonelectronic billing forms used for payment processing purposes.

Sec. 6.

Minnesota Statutes 2012, section 62J.535, is amended to read:


62J.535 UNIFORM BILLING REQUIREMENTS FOR CLAIM
TRANSACTIONS.

Subd. 1a.

deleted text beginElectronic claim transactionsdeleted text endnew text begin Additional information associated with
a claim
new text end.

deleted text beginGroup purchasers, including government programs, not defined as covered
entities under United States Code, title 42, sections 1320d to 1320d-8, as amended from
time to time, and the regulations promulgated under those sections, that voluntarily agree
with providers to accept electronic claim transactions, must accept them in the ANSI
X12N 837 standard electronic format as established by federal law. Nothing in this section
requires acceptance of electronic claim transactions by entities not covered under United
States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the
regulations promulgated under those sections. Notwithstanding the above,
deleted text end Nothing in this
section or other state law prohibits group purchasers not defined as covered entities under
United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time,
and the regulations promulgated under those sections, from requiring, as authorized by
Minnesota law or rule, additional information associated with a claim submitted by a
provider.

Subd. 1b.

Paper claim transactions.

All group purchasers that accept paper claim
transactions must accept, and health care providers submitting paper claim transactions
must submit, these transactions with use of the applicable medical and nonmedical data
code sets specified in the federal electronic claim transaction standards adopted under
United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time,
and the regulations promulgated under those sections. The paper claim transaction must
also be conducted using the uniform billing forms as specified in section 62J.52 and the
identifiers specified in section 62J.54, on and after the compliance date required by law.
Notwithstanding the above, nothing in this section or other state law prohibits group
purchasers not defined as covered entities under United States Code, title 42, sections
1320d to 1320d-8, as amended from time to time, and the regulations promulgated
under those sections, from requiring, as authorized by Minnesota law or rule, additional
information associated with a claim submitted by a provider.

deleted text begin Subd. 2. deleted text end

deleted text begin Compliance. deleted text end

deleted text begin Subdivision 1a is effective concurrent with the date of
required compliance for covered entities established under United States Code, title 42,
sections 1320d to 1320d-8, as amended from time to time.
deleted text end

Sec. 7.

Minnesota Statutes 2012, section 62J.536, subdivision 2, is amended to read:


Subd. 2.

Establishing uniform, standard companion guides.

(a) At least 12
months prior to the timelines required in subdivision 1, the commissioner of health shall
promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers
and health care providers to use the transactions and the uniform, standard companion
guides required under subdivision 1, paragraph deleted text begin(e)deleted text endnew text begin (f)new text end.

(b) The commissioner of health must consult with the Minnesota Administrative
Uniformity Committee on the development of the single, uniform companion guides
required under subdivision 1, paragraph deleted text begin(e)deleted text endnew text begin (f)new text end, for each of the transactions in subdivision
1. The single uniform companion guides required under subdivision 1, paragraph deleted text begin(e)deleted text endnew text begin (f)new text end,
must specify uniform billing and coding standards. The commissioner of health shall base
the companion guides required under subdivision 1, paragraph deleted text begin(e)deleted text endnew text begin (f)new text end, billing and coding
rules, and standards on the Medicare program, with modifications that the commissioner
deems appropriate after consulting the Minnesota Administrative Uniformity Committee.

(c) No group purchaser or health care provider may add to or modify the single,
uniform companion guides defined in subdivision 1, paragraph deleted text begin(e)deleted text endnew text begin (f)new text end, through additional
companion guides or other requirements.

(d) In promulgating the rules in paragraph (a), the commissioner shall not require data
content that is not essential to accomplish the purpose of the transactions in subdivision 1.

Sec. 8.

Minnesota Statutes 2012, section 62J.54, subdivision 1, is amended to read:


Subdivision 1.

Unique identification number for health care provider
organizations.

(a) deleted text beginNot later than 24 months after the date on which a national provider
identifier is made effective under United States Code, title 42, sections 1320d to 1320d-8
(1996 and subsequent amendments),
deleted text end All group purchasers and any health care provider
organization that meets the definition of a health care provider under United States Code,
title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder
shall use a national provider identifier to identify health care provider organizations in
Minnesota, according to this sectiondeleted text begin, except as provided in paragraph (b)deleted text end.

deleted text begin (b) Small health plans, as defined by the federal Secretary of Health and Human
Services under United States Code, title 42, section 1320d-4 (1996 and subsequent
amendments), shall use a national provider identifier to identify health provider
organizations no later than 36 months after the date on which a national provider identifier
is made effective under United States Code, title 42, sections 1320d to 1320d-8 (1996 and
subsequent amendments).
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end The national provider identifier for health care providers deleted text beginestablished by
the federal Secretary of Health and Human Services under United States Code, title 42,
sections 1320d to 1320d-8 (1996 and subsequent amendments),
deleted text endnew text begin as adopted and required in
Code of Federal Regulations, title 45, part 162, subpart D, and any future modifications
to the subpart
new text end shall be used as the unique identification number for health care provider
organizations in Minnesota under this section.

deleted text begin (d)deleted text endnew text begin (c)new text end All health care provider organizations in Minnesota that are eligible to obtain
a national provider identifier according to United States Code, title 42, sections 1320d to
1320d-8, as amended, and regulations adopted thereunder shall obtain a national provider
identifier deleted text beginfrom the federal Secretary of Health and Human Servicesdeleted text end using the process
prescribed deleted text beginby the Secretarydeleted text endnew text begin in Code of Federal Regulations, title 45, subpart D, and any
future modifications to the subpart
new text end.

deleted text begin (e)deleted text endnew text begin (d)new text end Only the national provider identifier shall be used to identify health care
provider organizations when submitting and receiving paper and electronic claims and
remittance advice notices, and in conjunction with other data collection and reporting
functions.

deleted text begin (f)deleted text endnew text begin (e)new text end Health care provider organizations in Minnesota shall make available their
national provider identifier to other health care providers when required to be included in
the administrative transactions regulated by United States Code, title 42, sections 1320d to
1320d-8, as amended, and regulations adopted thereunder.

deleted text begin (g)deleted text endnew text begin (f)new text end The commissioner of health may contract with the federal Secretary of Health
and Human Services or the Secretary's agent to implement this subdivision.

Sec. 9.

Minnesota Statutes 2012, section 62J.54, subdivision 2, is amended to read:


Subd. 2.

Unique identification number for individual health care providers.

(a) deleted text beginNot later than 24 months after the date on which a national provider identifier is
made effective under United States Code, title 42, sections 1320d to 1320d-8 (1996 and
subsequent amendments),
deleted text end All group purchasers in Minnesota and any individual health
care provider that meets the definition of a health care provider under United States Code,
title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder
shall use the national provider identifier to identify an individual health care provider in
Minnesota, according to this sectiondeleted text begin, except as provided in paragraph (b)deleted text end.

deleted text begin (b) Small health plans, as defined by the federal Secretary of Health and Human
Services under United States Code, title 42, section 1320d-4 (1996 and subsequent
amendments), shall use the national provider identifier to identify an individual health care
provider no later than 36 months after the date on which a national provider identifier for
health care providers is made effective under United States Code, title 42, sections 1320d
to 1320d-8 (1996 and subsequent amendments).
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end The national provider identifier for health care providers deleted text beginestablished by
the federal Secretary of Health and Human Services under United States Code, title 42,
sections 1320d to 1320d-8 (1996 and subsequent amendments),
deleted text endnew text begin adopted in Code of Federal
Regulations, title 45, part 162, subpart D, and any future modifications to the subpart
new text end shall
be used as the unique identification number for individual health care providers.

deleted text begin (d)deleted text endnew text begin (c)new text end All individual health care providers in Minnesota that are eligible to obtain a
national provider identifier according to United States Code, title 42, sections 1320d to
1320d-8, as amended, and regulations adopted thereunder shall obtain a national provider
identifier deleted text beginfrom the federal Secretary of Health and Human Servicesdeleted text end using the process
prescribed deleted text beginby the Secretarydeleted text endnew text begin in Code of Federal Regulations, title 45, part 162, subpart D,
and any future modifications to the subpart
new text end.

deleted text begin (e)deleted text endnew text begin (d)new text end Only the national provider identifier shall be used to identify individual health
care providers when submitting and receiving paper and electronic claims and remittance
advice notices, and in conjunction with other data collection and reporting functions.

deleted text begin (f)deleted text endnew text begin (e)new text end Individual health care providers in Minnesota shall make available their
national provider identifier to other health care providers when required to be included in
the administrative transactions regulated by United States Code, title 42, sections 1320d to
1320d-8, as amended, and regulations adopted thereunder.

deleted text begin (g)deleted text endnew text begin (f)new text end The commissioner of health may contract with the federal Secretary of Health
and Human Services or the Secretary's agent to implement this subdivision.

Sec. 10.

Minnesota Statutes 2012, section 62J.54, subdivision 3, is amended to read:


Subd. 3.

Unique identification number for group purchasers.

(a) deleted text beginNot later than
24 months after the date on which a unique health identifier for employers and health plans
is adopted or established under United States Code, title 42, sections 1320d to 1320d-8
(1996 and subsequent amendments),
deleted text end All group purchasers and health care providers in
Minnesota shall use a unique identification number to identify group purchasersdeleted text begin, except as
provided in paragraph (b)
deleted text end.

deleted text begin (b) Small health plans, as defined by the federal Secretary of Health and Human
Services under United States Code, title 42, section 1320d-4 (1996 and subsequent
amendments), shall use a unique identification number to identify group purchasers no
later than 36 months after the date on which a unique health identifier for employers and
health plans is adopted or established under United States Code, title 42, sections 1320d to
1320d-8 (1996 and subsequent amendments).
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end The unique health identifier for new text begingroup purchasers that are new text endhealth plans deleted text beginand
employers adopted or established by the federal Secretary of Health and Human Services
under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent
amendments), shall be used as the unique identification number for group purchasers
deleted text endnew text begin under Code of Federal Regulations, title 45, part 160, subpart A, shall be the Standard
Unique Health Identifier for Health Plans as adopted in Code of Federal Regulations,
title 45, part 162, subpart E, and any future modifications to the subpart, effective as
required by the subpart
new text end.

deleted text begin (d)deleted text endnew text begin (c)new text end Group purchasers new text beginthat are health plans under Code of Federal Regulations,
title 45, part 160, subpart A,
new text endshall obtain a unique health identifier deleted text beginfrom the federal
Secretary of Health and Human Services
deleted text end using the process prescribed deleted text beginby the Secretarydeleted text endnew text begin in
Code of Federal Regulations, title 45, part 162, subpart E, and any future modifications
to the subpart
new text end.

deleted text begin (e)deleted text endnew text begin (d)new text end The unique group purchaser identifier, as described in this section, shall be
used for purposes of submitting and receiving claims, and in conjunction with other data
collection and reporting functions.

deleted text begin (f)deleted text endnew text begin (e)new text end The commissioner of health may contract with the federal Secretary of Health
and Human Services or the Secretary's agent to implement this subdivision.

Sec. 11.

Minnesota Statutes 2012, section 62J.56, subdivision 1, is amended to read:


Subdivision 1.

General provisions.

(a) The legislature finds that there is a need to
advance the use of electronic methods of data interchange among all health care participants
in the state in order to achieve significant administrative cost savings. The legislature
also finds that in order to advance the use of health care electronic data interchange in a
cost-effective manner, the state needs to implement electronic data interchange standards
that are nationally accepted, widely recognized, and available for immediate use. The
legislature intends to set forth a plan for a systematic phase in of uniform health care
electronic data interchange standards in all segments of the health care industry.

(b) The commissioner of health, with the advice of the deleted text beginMinnesota Health Data
Institute and the
deleted text end Minnesota Administrative Uniformity Committee, shall administer the
implementation of and monitor compliance with, electronic data interchange standards of
health care participants, according to the plan provided in this section.

deleted text begin (c) The commissioner may grant exemptions to category I and II industry
participants from the requirements to implement some or all of the provisions in this
section if the commissioner determines that the cost of compliance would place the
organization in financial distress, or if the commissioner determines that appropriate
technology is not available to the organization.
deleted text end

Sec. 12.

Minnesota Statutes 2012, section 62J.56, subdivision 2, is amended to read:


Subd. 2.

Identification of core transaction sets.

deleted text begin (a) All category I and II industry
participants in Minnesota shall comply with the standards developed by the ANSI ASC
X12 for the following core transaction sets, according to the implementation plan outlined
for each transaction set.
deleted text end

deleted text begin (1) ANSI ASC X12 835 health care claim payment/advice transaction set.
deleted text end

deleted text begin (2) ANSI ASC X12 837 health care claim transaction set.
deleted text end

deleted text begin (3) ANSI ASC X12 834 health care enrollment transaction set.
deleted text end

deleted text begin (4) ANSI ASC X12 270/271 health care eligibility transaction set.
deleted text end

deleted text begin (5) ANSI ASC X12 276/277 health care claims status request/notification transaction
set.
deleted text end

deleted text begin (b)deleted text end The commissioner, with the advice of the deleted text beginMinnesota Health Data Institute and
the
deleted text end Minnesota Administrative Uniformity Committee, and in coordination with federal
efforts, may approve the use of new ASC X12 standards, or new versions of existing
standards, as they become available, or other nationally recognized standards, where
appropriate ASC X12 standards are not available for use. These alternative standards may
be used during a transition period while ASC X12 standards are developed.

Sec. 13.

Minnesota Statutes 2012, section 62J.56, subdivision 3, is amended to read:


Subd. 3.

Implementation guides.

(a) The commissioner, with the advice of the
Minnesota Administrative Uniformity Committee, and the Minnesota Center for Health
Care Electronic Data Interchange shall review and recommend the use of guides to
implement the core transaction sets. Implementation guides must contain the background
and technical information required to allow health care participants to implement the
transaction set in the most cost-effective way.

(b) The commissioner shall promote the development of implementation
guides among health care participants for those business transaction types for which
implementation guides are not available, to allow providers and group purchasers
to implement electronic data interchange. In promoting the development of these
implementation guides, the commissioner shall review the work done by the American
Hospital Association through the national Uniform Billing Committee and its state
representative organization; the American Medical Association through the new text beginNational
new text endUniform Claim deleted text beginTask Forcedeleted text endnew text begin Committeenew text end; the American Dental Association; the National
Council of Prescription Drug Programs; and the Workgroup for Electronic Data
Interchange.

Sec. 14.

Minnesota Statutes 2012, section 62J.581, subdivision 1, is amended to read:


Subdivision 1.

Minnesota uniform remittance advice deleted text beginreportdeleted text end.

deleted text begin(a)deleted text end All group
purchasers shall provide a uniform deleted text beginremittance advice reportdeleted text endnew text begin claim payment/advice
transaction
new text end to health care providers when a claim is adjudicated. The uniform deleted text beginremittance
advice report
deleted text endnew text begin claim payment/advice transactionnew text end shall comply with deleted text beginthe standards prescribed
in this
deleted text end sectionnew text begin 62J.536, subdivision 1b, and rules adopted under section 62J.536,
subdivision 2
new text end.

deleted text begin (b) Notwithstanding paragraph (a), this section does not apply to group purchasers not
included as covered entities under United States Code, title 42, sections 1320d to 1320d-8,
as amended from time to time, and the regulations promulgated under those sections.
deleted text end

Sec. 15.

Minnesota Statutes 2012, section 62J.581, subdivision 3, is amended to read:


Subd. 3.

Scope.

For purposes of sections 62J.50 to 62J.61, the uniform deleted text beginremittance
advice report and the
deleted text endnew text begin claim payment/advice transaction andnew text end uniform explanation of
benefits document format specified in subdivision 4 shall apply to all health care services
delivered by a health care provider or health care provider organization in Minnesota,
regardless of the location of the payer. Health care services not paid on an individual
claims basis, such as capitated payments, are not included in this section. A health plan
company is excluded from the requirements in subdivisions 1 and 2 if they comply with
section 62A.01, subdivisions 2 and 3.

Sec. 16.

Minnesota Statutes 2012, section 62J.581, subdivision 4, is amended to read:


Subd. 4.

Specifications.

The deleted text beginuniform remittance advice report and thedeleted text end uniform
explanation of benefits document shall be provided by use of a paper document
conforming to the specifications in this section deleted text beginor by use of the ANSI X12N 835 standard
electronic format as established under United States Code, title 42, sections 1320d to
1320d-8, and as amended from time to time for the remittance advice
deleted text end. The commissioner,
after consulting with the Administrative Uniformity Committee, shall specify the data
elements and definitions for the deleted text beginuniform remittance advice report and thedeleted text end uniform
explanation of benefits document. The commissioner and the Administrative Uniformity
Committee must consult with the Minnesota Dental Association and Delta Dental Plan
of Minnesota before requiring under this section the use of a paper document for the
uniform explanation of benefits document or the uniform deleted text beginremittance advice reportdeleted text endnew text begin claim
payment/advice transaction
new text end for dental care services.

Sec. 17.

Minnesota Statutes 2012, section 62J.61, subdivision 1, is amended to read:


Subdivision 1.

Exemption.

The commissioner of health is exempt from chapter
14, including section 14.386, in implementing sections 62J.50 to 62J.54, subdivision
3
, and 62J.56 to deleted text begin62J.59deleted text endnew text begin 62J.581new text end.

Sec. 18. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin The revisor shall make changes necessary to correct punctuation, grammar, and
structure of the remaining text required by the repealed section in this article.
new text end

Sec. 19. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2012, section 62J.59, new text end new text begin is repealed.
new text end

ARTICLE 2

COMBINING REPORTS ON VULNERABLE ADULTS MALTREATMENT

Section 1.

Minnesota Statutes 2012, section 626.557, subdivision 12b, is amended to
read:


Subd. 12b.

Data management.

(a) In performing any of the duties of this section as
a lead investigative agency, the county social service agency shall maintain appropriate
records. Data collected by the county social service agency under this section are welfare
data under section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a),
data under this paragraph that are inactive investigative data on an individual who is a
vendor of services are private data on individuals, as defined in section 13.02. The identity
of the reporter may only be disclosed as provided in paragraph (c).

Data maintained by the common entry point are confidential data on individuals or
protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163,
the common entry point shall maintain data for three calendar years after date of receipt
and then destroy the data unless otherwise directed by federal requirements.

(b) The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section.
County social service agencies must maintain private data on individuals but are not
required to prepare an investigation memorandum. During an investigation by the
commissioner of health or the commissioner of human services, data collected under this
section are confidential data on individuals or protected nonpublic data as defined in
section 13.02. Upon completion of the investigation, the data are classified as provided in
clauses (1) to (3) and paragraph (c).

(1) The investigation memorandum must contain the following data, which are public:

(i) the name of the facility investigated;

(ii) a statement of the nature of the alleged maltreatment;

(iii) pertinent information obtained from medical or other records reviewed;

(iv) the identity of the investigator;

(v) a summary of the investigation's findings;

(vi) statement of whether the report was found to be substantiated, inconclusive,
false, or that no determination will be made;

(vii) a statement of any action taken by the facility;

(viii) a statement of any action taken by the lead investigative agency; and

(ix) when a lead investigative agency's determination has substantiated maltreatment,
a statement of whether an individual, individuals, or a facility were responsible for the
substantiated maltreatment, if known.

The investigation memorandum must be written in a manner which protects the
identity of the reporter and of the vulnerable adult and may not contain the names or, to
the extent possible, data on individuals or private data listed in clause (2).

(2) Data on individuals collected and maintained in the investigation memorandum
are private data, including:

(i) the name of the vulnerable adult;

(ii) the identity of the individual alleged to be the perpetrator;

(iii) the identity of the individual substantiated as the perpetrator; and

(iv) the identity of all individuals interviewed as part of the investigation.

(3) Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.

(c) After the assessment or investigation is completed, the name of the reporter
must be confidential. The subject of the report may compel disclosure of the name of the
reporter only with the consent of the reporter or upon a written finding by a court that
the report was false and there is evidence that the report was made in bad faith. This
subdivision does not alter disclosure responsibilities or obligations under the Rules of
Criminal Procedure, except that where the identity of the reporter is relevant to a criminal
prosecution, the district court shall do an in-camera review prior to determining whether
to order disclosure of the identity of the reporter.

(d) Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be maintained under the following
schedule and then destroyed unless otherwise directed by federal requirements:

(1) data from reports determined to be false, maintained for three years after the
finding was made;

(2) data from reports determined to be inconclusive, maintained for four years after
the finding was made;

(3) data from reports determined to be substantiated, maintained for seven years
after the finding was made; and

(4) data from reports which were not investigated by a lead investigative agency and
for which there is no final disposition, maintained for three years from the date of the report.

(e) The commissioners of health and human services shall deleted text begineachdeleted text end annually deleted text beginreport to the
legislature and the governor on
deleted text endnew text begin publish on their Web sites new text end the number and type of reports of
alleged maltreatment involving licensed facilities reported under this section, the number of
those requiring investigation under this section, and the resolution of those investigations.
deleted text beginThe report shall identify:deleted text endnew text begin On a biennial basis, the commissioners of health and human
services shall jointly report the following information to the legislature and the governor:
new text end

(1) new text beginthe number and type of reports of alleged maltreatment involving licensed
facilities reported under this section, the number of those requiring investigations under
this section, the resolution of those investigations, and which of the two lead agencies
was responsible;
new text end

new text begin (2) trends about types of substantiated maltreatment found in the reporting period;
new text end

new text begin (3) if there are upward trends for types of maltreatment substantiated,
recommendations for addressing and responding to them;
new text end

new text begin (4) efforts undertaken or recommended to improve the protection of vulnerable adults;
new text end

new text begin (5) new text endwhether and where backlogs of cases result in a failure to conform with statutory
time framesnew text begin and recommendations for reducing backlogs if applicablenew text end;

deleted text begin (2) where adequate coverage requires additional appropriations and staffing; and
deleted text end

deleted text begin (3) any other trends that affect the safety of vulnerable adults.
deleted text end

new text begin (6) recommended changes to statutes affecting the protection of vulnerable adults; and
new text end

new text begin (7) any other information that is relevant to the report trends and findings.
new text end

(f) Each lead investigative agency must have a record retention policy.

(g) Lead investigative agencies, prosecuting authorities, and law enforcement
agencies may exchange not public data, as defined in section 13.02, if the agency or
authority requesting the data determines that the data are pertinent and necessary to
the requesting agency in initiating, furthering, or completing an investigation under
this section. Data collected under this section must be made available to prosecuting
authorities and law enforcement officials, local county agencies, and licensing agencies
investigating the alleged maltreatment under this section. The lead investigative agency
shall exchange not public data with the vulnerable adult maltreatment review panel
established in section 256.021 if the data are pertinent and necessary for a review
requested under that section. Notwithstanding section 138.17, upon completion of the
review, not public data received by the review panel must be destroyed.

(h) Each lead investigative agency shall keep records of the length of time it takes to
complete its investigations.

(i) A lead investigative agency may notify other affected parties and their authorized
representative if the lead investigative agency has reason to believe maltreatment has
occurred and determines the information will safeguard the well-being of the affected
parties or dispel widespread rumor or unrest in the affected facility.

(j) Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead investigative agency may
not provide any notice unless the vulnerable adult has consented to disclosure in a manner
which conforms to federal requirements.

ARTICLE 3

TUBERCULOSIS

Section 1.

Minnesota Statutes 2012, section 122A.40, subdivision 12, is amended to
read:


Subd. 12.

Suspension and leave of absence for health reasons.

Affliction with
deleted text beginactive tuberculosis or otherdeleted text end new text begina new text endcommunicable disease, mental illness, drug or alcoholic
addiction, or other serious incapacity shall be grounds for temporary suspension and
leave of absence while the teacher is suffering from such disability. Unless the teacher
consents, such action must be taken only upon evidence that suspension is required from a
physician who has examined the teacher. The physician must be competent in the field
involved and must be selected by the teacher from a list of three provided by the school
board, and the examination must be at the expense of the school district. A copy of the
report of the physician shall be furnished the teacher upon request. If the teacher fails to
submit to the examination within the prescribed time, the board may discharge the teacher,
effective immediately. In the event of mental illness, if the teacher submits to such an
examination and the examining physician's or psychiatrist's statement is unacceptable to
the teacher or the board, a panel of three physicians or psychiatrists must be selected to
examine the teacher at the board's expense. The board and the teacher shall each select a
member of this panel, and these two members shall select a third member. The panel must
examine the teacher and submit a statement of its findings and conclusions to the board.
Upon receipt and consideration of the statement from the panel the board may suspend
the teacher. The board must notify the teacher in writing of such suspension and the
reasons therefor. During the leave of absence, the district must pay the teacher sick leave
benefits up to the amount of unused accumulated sick leave, and after it is exhausted, the
district may in its discretion pay additional benefits. The teacher must be reinstated to the
teacher's position upon evidence from such a physician of sufficient recovery to be capable
of resuming performance of duties in a proper manner. In the event that the teacher does
not qualify for reinstatement within 12 months after the date of suspension, the continuing
disability may be a ground for discharge under subdivision 13.

Sec. 2.

Minnesota Statutes 2012, section 122A.41, subdivision 6, is amended to read:


Subd. 6.

Grounds for discharge or demotion.

(a) Except as otherwise provided
in paragraph (b), causes for the discharge or demotion of a teacher either during or after
the probationary period must be:

(1) immoral character, conduct unbecoming a teacher, or insubordination;

(2) failure without justifiable cause to teach without first securing the written release
of the school board having the care, management, or control of the school in which the
teacher is employed;

(3) inefficiency in teaching or in the management of a school, consistent with
subdivision 5, paragraph (b);

(4) affliction with deleted text beginactive tuberculosis or otherdeleted text endnew text begin anew text end communicable disease must be
considered as cause for removal or suspension while the teacher is suffering from such
disability; or

(5) discontinuance of position or lack of pupils.

For purposes of this paragraph, conduct unbecoming a teacher includes an unfair
discriminatory practice described in section 363A.13.

(b) A probationary or continuing-contract teacher must be discharged immediately
upon receipt of notice under section 122A.20, subdivision 1, paragraph (b), that the
teacher's license has been revoked due to a conviction for child abuse or sexual abuse.

Sec. 3.

Minnesota Statutes 2012, section 154.25, is amended to read:


154.25 NOT TO SERVE CERTAIN PERSONS.

No person practicing the occupation of a barber in any barber shop, barber school, or
college in this state shall knowingly serve a person afflicted, in a dangerous or infectious
state of the disease, with erysipelas, eczema, impetigo, sycosis, deleted text begintuberculosis,deleted text end or any other
contagious or infectious disease. Any person so afflicted is hereby prohibited from being
served in any barber shop, barber school, or college in this state. Any violation of this
section shall be considered a misdemeanor as provided for in sections 154.001, 154.002,
154.003, 154.01 to 154.161, 154.19 to 154.21, and 154.24 to 154.26.

Sec. 4. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin The revisor shall make changes necessary to correct punctuation, grammar, and
structure of the remaining text required by the repealed sections in this article.
new text end

Sec. 5. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2012, sections 144.443; 144.444; and 144.45, new text end new text begin are repealed.
new text end

ARTICLE 4

MISCELLANEOUS

Section 1.

Minnesota Statutes 2012, section 144.12, subdivision 1, is amended to read:


Subdivision 1.

Rules.

The commissioner may adopt reasonable rules pursuant to
chapter 14 for the preservation of the public health. The rules shall not conflict with the
charter or ordinance of a city of the first class upon the same subject. The commissioner
may control, by rule, by requiring the taking out of licenses or permits, or by other
appropriate means, any of the following matters:

(1) the manufacture into articles of commerce, other than food, of diseased, tainted,
or decayed animal or vegetable matter;

(2) the business of scavengering and the disposal of sewage;

(3) the location of mortuaries and cemeteries and the removal and burial of the dead;

(4) the management of boarding places for infants and the treatment of infants
in them;

(5) the pollution of streams and other waters and the distribution of water by persons
for drinking or domestic use;

(6) the construction and equipment, in respect to sanitary conditions, of schools,
hospitals, almshouses, prisons, and other public institutions, and of lodging houses and
other public sleeping places kept for gain;

(7) the treatment, in hospitals and elsewhere, of persons suffering from
communicable diseases, including all manner of venereal disease and infection, the
disinfection and quarantine of persons and places in case of those diseases, and the
reporting of sicknesses and deaths from them;

Neither the commissioner nor any new text begincommunity health new text endboard deleted text beginof healthdeleted text end as defined in
section 145A.02, subdivision deleted text begin2deleted text endnew text begin 5new text end, nor director of public health may adopt any rule or
regulation for the treatment in any penal or correctional institution of any person suffering
from any communicable disease or venereal disease or infection, which requires the
involuntary detention of any person after the expiration of the period of sentence to
the penal or correctional institution, or after the expiration of the period to which the
sentence may be reduced by good time allowance or by the lawful order of any judge or
the Department of Corrections;

(8) the prevention of infant blindness and infection of the eyes of the newly born
by the designation, from time to time, of one or more prophylactics to be used in those
cases and in the manner that the commissioner directs, unless specifically objected to
by a parent of the infant;

deleted text begin (9) The furnishing of vaccine matter; the assembling, during epidemics of smallpox,
with other persons not vaccinated, but no rule of the board or of any public board or officer
shall at any time compel the vaccination of a child, or exclude, except during epidemics
of smallpox and when approved by the local board of education, a child from the public
schools for the reason that the child has not been vaccinated; any person required to be
vaccinated may select for that purpose any licensed physician and no rule shall require the
vaccination of any child whose physician certifies that by reason of the child's physical
condition vaccination would be dangerous;
deleted text end

deleted text begin (10)deleted text endnew text begin (9)new text end the accumulation of filthy and unwholesome matter to the injury of the
public health and its removal;

deleted text begin (11)deleted text endnew text begin (10)new text end the collection, recording, and reporting of vital statistics by public officers
and the furnishing of information to them by physicians, undertakers, and others of births,
deaths, causes of death, and other pertinent facts;

deleted text begin (12)deleted text endnew text begin (11)new text end the construction, equipment, and maintenance, in respect to sanitary
conditions, of lumber camps, migratory or migrant labor camps, and other industrial camps;

deleted text begin (13)deleted text endnew text begin (12)new text end the general sanitation of tourist camps, summer hotels, and resorts in
respect to water supplies, disposal of sewage, garbage, and other wastes and the prevention
and control of communicable diseases; and, to that end, may prescribe the respective duties
of agents of a board of health as authorized under section 145A.04; and all boards of health
shall make such investigations and reports and obey such directions as the commissioner
may require or give and, under the supervision of the commissioner, enforce the rules;

deleted text begin (14)deleted text endnew text begin (13)new text end atmospheric pollution which may be injurious or detrimental to public
health;

deleted text begin (15)deleted text endnew text begin (14)new text end sources of radiation, and the handling, storage, transportation, use and
disposal of radioactive isotopes and fissionable materials; and

deleted text begin (16)deleted text endnew text begin (15)new text end the establishment, operation and maintenance of all clinical laboratories
not owned, or functioning as a component of a licensed hospital. These laboratories shall
not include laboratories owned or operated by five or less licensed practitioners of the
healing arts, unless otherwise provided by federal law or regulation, and in which these
practitioners perform tests or procedures solely in connection with the treatment of their
patients. Rules promulgated under the authority of this clause, which shall not take effect
until federal legislation relating to the regulation and improvement of clinical laboratories
has been enacted, may relate at least to minimum requirements for external and internal
quality control, equipment, facility environment, personnel, administration and records.
These rules may include the establishment of a fee schedule for clinical laboratory
inspections. The provisions of this clause shall expire 30 days after the conclusion of any
fiscal year in which the federal government pays for less than 45 percent of the cost of
regulating clinical laboratories.

Sec. 2. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin The revisor shall make changes necessary to correct punctuation, grammar, and
structure of the remaining text required by the repealed sections in this article.
new text end

Sec. 3. new text begin REPEALER.
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new text begin Minnesota Statutes 2012, sections 62J.322; 144.011, subdivision 2; 144.0506;
144.071; 144.072; 144.076; 144.146, subdivision 1; 144.1475; 145.132; 145.97; and
145.98, subdivisions 1 and 3,
new text end new text begin are repealed.
new text end