HF 3880

as introduced - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act
  1.2             relating to insurance; prohibiting insurers from using 
  1.3             capitation and similar methods to reimburse health 
  1.4             care providers; proposing coding for new law in 
  1.5             Minnesota Statutes, chapter 62Q. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  [62Q.66] [PROHIBITION ON CAPITATION AND SIMILAR 
  1.8   PAYMENT METHODS.] 
  1.9      (a) No health plan company shall reimburse a health care 
  1.10  provider through the use of capitation, withholding, or any 
  1.11  other reimbursement method under which:  (1) the health care 
  1.12  provider is provided a direct financial incentive to reduce 
  1.13  patient utilization of health care services or reduce 
  1.14  expenditures on patient care; (2) reimbursement to the health 
  1.15  care provider is reduced as a direct result of increases in 
  1.16  patient utilization of health care services or increases in 
  1.17  expenditures on patient care; or (3) reimbursement to the health 
  1.18  care provider is increased as a direct result of decreases in 
  1.19  patient utilization of health care services or decreases in 
  1.20  expenditures on patient care. 
  1.21     (b) This section applies to payment of health care 
  1.22  providers employed by or under contract with the health plan 
  1.23  company. 
  1.24     (c) For purposes of this section, "health plan company" 
  1.25  includes any entity under contract with the health plan company 
  2.1   to provide or arrange for the provision of health care services 
  2.2   to enrollees. 
  2.3      Sec. 2.  [EFFECTIVE DATE.] 
  2.4      Section 1 is effective January 1, 2000.