Minnesota Legislature
HF 3056
1st Engrossment - 86th Legislature (2009 - 2010) Posted on 03/11/2010 11:01am
1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 2.1 2.2 2.3
2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14
2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 3.1 3.2 3.3
3.4 3.5
A bill for an act
relating to health; establishing a quality improvement program for physician
clinics and hospitals; amending Minnesota Statutes 2008, section 62U.04,
subdivisions 3, 9, by adding a subdivision; repealing Minnesota Statutes 2009
Supplement, section 256B.032.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2008, section 62U.04, subdivision 3, is amended to read:
Subd. 3.
Provider peer grouping.
(a) The commissioner shall develop a peer
grouping system for providers based on a combined measure that incorporates both
provider risk-adjusted cost of care and quality of care, and for specific conditions as
determined by the commissioner. In developing this system, the commissioner shall
consult and coordinate with health care providers, health plan companies, state agencies,
and organizations that work to improve health care quality in Minnesota. For purposes of
the final establishment of the peer grouping system, the commissioner shall not contract
with any private entity, organization, or consortium of entities that has or will have a direct
financial interest in the outcome of the system.
(b) Beginning deleted text begin June 1deleted text end new text begin October 8new text end , 2010, the commissioner shall disseminate
information to providers on their cost of care, resource use, quality of care, and the results
of the grouping developed under this subdivision in comparison to an appropriate peer
group. Any analyses or reports that identify providers may only be published after the
provider has been provided the opportunity by the commissioner to review the underlying
data and submit comments. The provider shall have deleted text begin 21deleted text end new text begin 90new text end days to review the data for
accuracy.
(c) The commissioner shall establish an appeals process to resolve disputes from
providers regarding the accuracy of the data used to develop analyses or reports.
(d) Beginning September 1, deleted text begin 2010deleted text end new text begin 2011new text end , the commissioner shall, no less than
annually, publish information on providers' cost, quality, and the results of the peer
grouping process. The results that are published must be on a risk-adjusted basis.
Sec. 2.
Minnesota Statutes 2008, section 62U.04, is amended by adding a subdivision
to read:
new text begin Subd. 3a. new text end
new text begin Quality improvement. new text end
new text begin
Beginning June 1, 2010, the commissioner shall
contract with a private entity or consortium of entities to establish and implement a quality
improvement program for physician clinics and hospitals that utilizes the underlying
data and results generated from the provider peer grouping system. The program shall
annually provide physician clinics and hospitals with appropriate tools to understand
their performance and to improve their results. The quality improvement program shall
focus on those physician clinics and hospitals that deviate from identified thresholds of
performance. The entity or consortium shall include statewide associations representing
physicians and hospitals.
new text end
Sec. 3.
Minnesota Statutes 2008, section 62U.04, subdivision 9, is amended to read:
Subd. 9.
Uses of information.
(a) By January 1, deleted text begin 2011deleted text end new text begin 2012new text end :
(1) the commissioner of management and budget shall use the information and
methods developed under subdivision 3 to strengthen incentives for members of the state
employee group insurance program to use high-quality, low-cost providers;
(2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer
health benefits to their employees must offer plans that differentiate providers on their
cost and quality performance and create incentives for members to use better-performing
providers;
(3) all health plan companies shall use the information and methods developed
under subdivision 3 to develop products that encourage consumers to use high-quality,
low-cost providers; and
(4) health plan companies that issue health plans in the individual market or the
small employer market must offer at least one health plan that uses the information
developed under subdivision 3 to establish financial incentives for consumers to choose
higher-quality, lower-cost providers through enrollee cost-sharing or selective provider
networks.
(b) By January 1, deleted text begin 2011deleted text end new text begin 2012new text end , the commissioner of health shall report to the
governor and the legislature on recommendations to encourage health plan companies
to promote widespread adoption of products that encourage the use of high-quality,
low-cost providers. The commissioner's recommendations may include tax incentives,
public reporting of health plan performance, regulatory incentives or changes, and other
strategies.
Sec. 4. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2009 Supplement, section 256B.032,
new text end
new text begin
is repealed.
new text end