HF 3073

3rd Engrossment - 88th Legislature (2013 - 2014) Posted on 04/24/2014 11:09am

A bill for an act
relating to insurance; modifying certain regulations to reduce the incidence of
insurance fraud; regulating no-fault auto benefits; regulating certain property
and casualty coverages; limiting reimbursement for certain prescription drugs;
regulating batch billing; modifying certain economic benefits under chapter
65B; establishing a task force on motor vehicle insurance coverage verification;
amending Minnesota Statutes 2012, sections 13.7191, subdivision 16; 60A.952,
subdivision 3; 65B.44, subdivisions 2, 3, 4, 6, by adding a subdivision; 65B.525,
by adding a subdivision; 65B.54, subdivision 2; 72A.502, subdivision 2; 604.18,
subdivision 4; proposing coding for new law in Minnesota Statutes, chapters
60A; 65B; repealing Minnesota Statutes 2012, section 72A.327.

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

Section 1.

Minnesota Statutes 2012, section 13.7191, subdivision 16, is amended to read:

Subd. 16.

Regulation of trade practices new text begin ; insurance contract data new text end .

deleted text begin (a) Insurance
contract data. deleted text end Certain insurance contract data held by the commissioner of commerce are
classified under section 72A.20, subdivision 15.

deleted text begin (b) Health claims appeals. Documents that are part of an appeal from denial of
health care coverage for experimental treatment are classified under section 72A.327.
deleted text end

Sec. 2.

new text begin [60A.0812] PROHIBITED EXCLUSION; CERTAIN PROPERTY AND
CASUALTY POLICIES.
new text end

new text begin An automobile insurance policy, personal excess liability policy, or personal
umbrella policy must not contain an exclusion of, or limitation on, liability for damages
for bodily injury solely because the injured person is a resident or member of the insured's
household that is related to the insured by blood or marriage.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2015, and applies to
policies issued, renewed, or continued on or after that date.
new text end

Sec. 3.

Minnesota Statutes 2012, section 60A.952, subdivision 3, is amended to read:

Subd. 3.

Immunity from liability.

If insurers, new text begin insurance support organizations
as defined in section 72A.491, subdivision 12, new text end agents acting on the insurers' behalf, or
authorized persons release information in good faith under this section, whether orally
or in writing, they are immune from any liability, civil or criminal, for the release or
reporting of the information.

Sec. 4.

Minnesota Statutes 2012, section 65B.44, subdivision 2, is amended to read:

Subd. 2.

Medical expense benefits.

(a) Medical expense benefits shall reimburse
all reasonable expenses for necessary:

(1) medical, surgical, x-ray, optical, dental, chiropractic, and rehabilitative services,
including prosthetic devices;

(2) prescription drugs new text begin , provided that:
new text end

new text begin (i) prescription drugs filled and dispensed outside of a licensed pharmacy shall be
billed at the average wholesale price (AWP), or its equivalent, for that drug on that date
as published in Medispan, Redbook, or Gold Standard Drug Database, as identified by
its National Drug Code, plus a dispensing fee of $4.18;
new text end

new text begin (ii) if a prescription drug has been repackaged, the average wholesale price used
to determine the maximum reimbursement shall be the average wholesale price for
the underlying drug product, as identified by its National Drug Code from the original
labeler; and
new text end

new text begin (iii) compound drugs shall be billed by listing each drug and its National Drug Code
number included in the compound and calculating the charge for each drug separately.
Reimbursement shall be based on the sum of the fee for each ingredient for which
there is an assigned National Drug Code number plus a single dispensing fee of $4.18.
Compound drugs shall not be dispensed without first obtaining preauthorization from the
reparation obligor new text end ;

(3) ambulance and all other transportation expenses incurred in traveling to receive
other covered medical expense benefits;

(4) sign interpreting and language translation services, other than such services
provided by a family member of the patient, related to the receipt of medical, surgical,
x-ray, optical, dental, chiropractic, hospital, extended care, nursing, and rehabilitative
services; and

(5) hospital, extended care, and nursing services.

(b) Hospital room and board benefits may be limited, except for intensive care
facilities, to the regular daily semiprivate room rates customarily charged by the institution
in which the recipient of benefits is confined.

(c) Such benefits shall also include necessary remedial treatment and services
recognized and permitted under the laws of this state for an injured person who relies
upon spiritual means through prayer alone for healing in accordance with that person's
religious beliefs.

(d) Medical expense loss includes medical expenses accrued prior to the death of a
person notwithstanding the fact that benefits are paid or payable to the decedent's survivors.

(e) Medical expense benefits for rehabilitative services shall be subject to the
provisions of section 65B.45.

Sec. 5.

Minnesota Statutes 2012, section 65B.44, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Billing. new text end

new text begin (a) Providers of goods and services for which a medical expense
benefit claim is submitted shall notify the appropriate reparation obligor of the date the
services were commenced or the goods were first provided within 30 days of determining
the identity of the reparation obligor, but in any event not later than 90 days from the date
services were commenced or goods were first provided. Once the reparation obligor
has been established, all bills must be submitted to the reparation obligor not later than
60 days from the date of service.
new text end

new text begin (b) If the provider of goods and services for which a medical expense benefit claim
is submitted fails to submit a bill and supporting documentation to a reparation obligor as
required in this subdivision, the medical expenses shall not be compensable.
new text end

Sec. 6.

Minnesota Statutes 2012, section 65B.44, subdivision 3, is amended to read:

Subd. 3.

Disability and income loss benefits.

new text begin (a) new text end Disability and income loss
benefits shall provide compensation for 85 percent of the injured person's loss of present
and future gross income from inability to work proximately caused by the nonfatal
injury subject to a maximum of deleted text begin $250 deleted text end new text begin $500 new text end per week. Loss of income includes the costs
incurred by a self-employed person to hire substitute employees to perform tasks which
are necessary to maintain the income of the injured person, which are normally performed
by the injured person, and which cannot be performed because of the injury.

new text begin (b) new text end If the injured person is unemployed at the time of injury and is receiving or is
eligible to receive unemployment benefits under chapter 268, but the injured person loses
eligibility for those benefits because of inability to work caused by the injury, disability
and income loss benefits shall provide compensation for the lost benefits in an amount
equal to the unemployment benefits which otherwise would have been payable, subject to
a maximum of deleted text begin $250 deleted text end new text begin $500 new text end per week.

new text begin (c) new text end Compensation under this subdivision shall be reduced by any income from
substitute work actually performed by the injured person or by income the injured person
would have earned in available appropriate substitute work which the injured person was
capable of performing but unreasonably failed to undertake.

new text begin (d) new text end For the purposes of this section "inability to work" means disability which
prevents the injured person from engaging in any substantial gainful occupation or
employment on a regular basis, for wage or profit, for which the injured person is or may
by training become reasonably qualified. If the injured person returns to employment and
is unable by reason of the injury to work continuously, compensation for lost income shall
be reduced by the income received while the injured person is actually able to work. The
weekly maximums may not be prorated to arrive at a daily maximum, even if the injured
person does not incur loss of income for a full week.

new text begin (e) new text end For the purposes of this section, an injured person who is "unable by reason of
the injury to work continuously" includes, but is not limited to, a person who misses time
from work, including reasonable travel time, and loses income, vacation, or sick leave
benefits, to obtain medical treatment for an injury arising out of the maintenance or use
of a motor vehicle.

Sec. 7.

Minnesota Statutes 2012, section 65B.44, subdivision 4, is amended to read:

Subd. 4.

Funeral and burial expenses.

Funeral and burial benefits shall be
reasonable expenses not in excess of deleted text begin $2,000 deleted text end new text begin $5,000 new text end , including expenses for cremation or
delivery under the Darlene Luther Revised Uniform Anatomical Gift Act, chapter 525A.

Sec. 8.

Minnesota Statutes 2012, section 65B.44, subdivision 6, is amended to read:

Subd. 6.

Survivors economic loss benefits.

Survivors economic loss benefits, in
the event of death occurring within one year of the date of the accident, caused by and
arising out of injuries received in the accident, are subject to a maximum of deleted text begin $200 deleted text end new text begin $500
new text end per week and shall cover loss accruing after decedent's death of contributions of money
or tangible things of economic value, not including services, that surviving dependents
would have received from the decedent for their support during their dependency had the
decedent not suffered the injury causing death.

For the purposes of definition under sections 65B.41 to 65B.71, the following
described persons shall be presumed to be dependents of a deceased person: (a) a wife
is dependent on a husband with whom she lives at the time of his death; (b) a husband
is dependent on a wife with whom he lives at the time of her death; (c) any child while
under the age of 18 years, or while over that age but physically or mentally incapacitated
from earning, is dependent on the parent with whom the child is living or from whom the
child is receiving support regularly at the time of the death of such parent new text begin ; or (d) an actual
dependent who lives with the decedent at the time of the decedent's death new text end . Questions of
the existence and the extent of dependency shall be questions of fact, considering the
support regularly received from the deceased.

Payments shall be made to the dependent, except that benefits to a dependent who
is a child or an incapacitated person may be paid to the dependent's surviving parent or
guardian. Payments shall be terminated whenever the recipient ceases to maintain a status
which if the decedent were alive would be that of dependency.

Sec. 9.

Minnesota Statutes 2012, section 65B.525, is amended by adding a subdivision
to read:

new text begin Subd. 3. new text end

new text begin Awards. new text end

new text begin The rules of court must provide that a party claiming economic
loss benefits shall appear at the arbitration proceeding to be awarded any benefits.
new text end

Sec. 10.

Minnesota Statutes 2012, section 65B.54, subdivision 2, is amended to read:

Subd. 2.

Interest on overdue payments.

Overdue payments shall bear simple
interest at the rate of 15 percent per annum. new text begin Once an obligor has denied benefits from a
specific provider, made a blanket denial of a type of benefits, or issued a general denial of
benefits, interest is due on all overdue benefits within the scope of the denial, regardless
of whether the insured or provider continues to provide ongoing proof of the fact and
amount of each additional loss incurred.
new text end

Sec. 11.

new text begin [65B.541] WHISTLEBLOWERS.
new text end

new text begin Subdivision 1. new text end

new text begin Financial resources. new text end

new text begin In any investigation or prosecution by the state,
nothing shall prohibit an insurer from providing the financial resources necessary for
conducting the investigation and prosecution.
new text end

new text begin Subd. 2. new text end

new text begin Whistleblowers. new text end

new text begin (a) Without limiting an insurer's right of full recovery of
proceeds paid for services deemed noncompensable, the court may also award those sums
deemed appropriate, but in no case more than 37 percent of proceeds to be recovered or
saved by the insurer with respect to a particular runner, capper, or steerer, to a qualified
person or entity (herein, "informant") who provides the primary specific evidence or
information in support of one or more violations under this section, taking into account
the significance of the evidence or information. For the purposes of this subdivision,
informant shall not include any person or entity bringing an action under this section or
acting on behalf of the news media.
new text end

new text begin (b) An insurer may elect to reimburse, including on a prepayment basis or otherwise,
reasonable out-of-pocket costs of an actual or potential informant which is incurred or
likely to be incurred in the course of preparing and disclosing the information. Such
out-of-pocket costs shall include without limit any applicable attorney fees associated with
the preparation and disclosure of the information by the informant.
new text end

new text begin (c) An actual or potential informant may place conditions on the use and disclosure of
the information. Such conditions may include without limit confidentiality as to the identity
of the informant, as well as the nature of any reimbursement terms, restrictions on the scope
of individuals and entities with whom the insurer may properly disclose the information,
assistance in the determination of the scope of the insurer's investigation or efforts to
prosecute, and other conditions relating to the use and disclosure of the information.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2014.
new text end

Sec. 12.

Minnesota Statutes 2012, section 72A.502, subdivision 2, is amended to read:

Subd. 2.

Prevention of fraud.

Personal or privileged information may be disclosed
without a written authorization to another person if the information is limited to that
which is reasonably necessary to detect or prevent criminal activity, fraud, material
misrepresentation, or material nondisclosure in connection with an insurance transaction,
and that person agrees not to disclose the information further without the individual
written authorization unless the further disclosure is otherwise permitted by this section
if made by an insurer, insurance agent, or insurance-support organization. new text begin Any insurer,
insurance agent, or insurance-support organization making such a disclosure is immune
from liability under section 60A.952, subdivision 3.
new text end

Sec. 13.

Minnesota Statutes 2012, section 604.18, subdivision 4, is amended to read:

Subd. 4.

Claim for taxable costs.

(a) Upon commencement of a civil action by an
insured against an insurer, the complaint must not seek a recovery under this section. After
deleted text begin filing the suit deleted text end new text begin judgment is entered or after trial of the action new text end , a party may make a motion to
amend the pleadings to claim recovery of taxable costs under this section. new text begin The moving
party must be permitted discovery on the liability issue under subdivision 2 before the
motion to amend the pleadings is made. new text end The motion must allege the applicable legal basis
under this section for awarding taxable costs under this section, and must be accompanied
by one or more affidavits showing the factual basis for the motion. The motion may be
opposed by the submission of one or more affidavits showing there is no factual basis
for the motion. At the hearing, if the court finds prima facie evidence in support of the
motion, the court may grant the moving party permission to amend the pleadings to claim
taxable costs under this section.

(b) An award of taxable costs under this section shall be determined by the court in a
proceeding subsequent to any determination by a fact finder of the amount an insured is
entitled to under the insurance policy, and shall be governed by the procedures set forth
in Minnesota General Rules of Practice, Rule 119. new text begin The verdict in the action brought
pursuant to this section must be considered by the court in awarding taxable costs under
this subdivision.
new text end

(c) An award of taxable costs under this section is not available in any claim that is
resolved or confirmed by arbitration or appraisal.

(d) The following are not admissible in any proceeding that seeks taxable costs
under this section:

(1) findings or determinations made in arbitration proceedings conducted under
section 65B.525 or rules adopted under that section;

(2) allegations involving, or results of, investigations, examinations, or
administrative proceedings conducted by the Department of Commerce;

(3) administrative bulletins or other informal guidance published or disseminated by
the Department of Commerce; and

(4) provisions under chapters 59A to 79A and rules adopted under those sections
are not admissible as standards of conduct.

(e) A claim for taxable costs under this section may not be assigned. This paragraph
does not affect the assignment of rights not established in this section.

new text begin EFFECTIVE DATE; APPLICATION. new text end

new text begin This section is effective the day following
final enactment and applies to awards of taxable costs made on or after that date.
new text end

Sec. 14. new text begin TASK FORCE ON MOTOR VEHICLE INSURANCE COVERAGE
VERIFICATION.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The task force on motor vehicle insurance coverage
verification is established to review and evaluate approaches to insurance coverage
verification and recommend legislation to create and fund a program in this state.
new text end

new text begin Subd. 2. new text end

new text begin Membership; meetings; staff. new text end

new text begin (a) The task force shall be composed of
13 members, who must be appointed by July 1, 2014, and who serve at the pleasure of
their appointing authorities:
new text end

new text begin (1) the commissioner of public safety or a designee;
new text end

new text begin (2) the commissioner of commerce or a designee;
new text end

new text begin (3) two members of the house of representatives, one appointed by the speaker of the
house and one appointed by the minority leader;
new text end

new text begin (4) two members of the senate, one appointed by the Subcommittee on Committees
of the Committee on Rules and Administration and one appointed by the minority leader;
new text end

new text begin (5) a representative of Minnesota Deputy Registrars Association;
new text end

new text begin (6) a representative of AAA Minnesota;
new text end

new text begin (7) a representative of AARP Minnesota;
new text end

new text begin (8) a representative of the Insurance Federation;
new text end

new text begin (9) a representative of the Minnesota Bankers Association;
new text end

new text begin (10) a representative of the Minnesota Bar Association; and
new text end

new text begin (11) a representative of the Minnesota Police and Peace Officers Association.
new text end

new text begin (b) Compensation and expense reimbursement must be as provided under Minnesota
Statutes, section 15.059, subdivision 3, to members of the task force.
new text end

new text begin (c) The commissioner of public safety shall convene the task force by August
1, 2014, and shall appoint a chair from the membership of the task force. Staffing and
technical assistance must be provided by the Department of Public Safety.
new text end

new text begin Subd. 3. new text end

new text begin Duties. new text end

new text begin The task force shall review and evaluate programs established in
other states as well as programs proposed by third parties, identify one or more programs
recommended for implementation in this state, and, as to the recommended programs,
adopt findings concerning:
new text end

new text begin (1) comparative costs of programs;
new text end

new text begin (2) implementation considerations, and in particular, identifying the appropriate
supervising agency and assessing compatibility with existing and planned computer
systems;
new text end

new text begin (3) effectiveness in verifying existence of motor vehicle insurance coverage;
new text end

new text begin (4) identification of categories of authorized users;
new text end

new text begin (5) simplicity of access and use for authorized users;
new text end

new text begin (6) data privacy considerations;
new text end

new text begin (7) data retention policies; and
new text end

new text begin (8) statutory changes necessary for implementation.
new text end

new text begin Subd. 4. new text end

new text begin Report. new text end

new text begin By February 1, 2015, the task force must submit to the
chairs and ranking minority members of the house of representatives and senate
committees and divisions with primary jurisdiction over commerce and transportation its
written recommendations, including any draft legislation necessary to implement the
recommendations.
new text end

new text begin Subd. 5. new text end

new text begin Sunset. new text end

new text begin The task force shall sunset the day after submitting the report
under subdivision 4, or February 2, 2015, whichever is earlier.
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. 15. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2012, section 72A.327, new text end new text begin is repealed.
new text end