HF 390

1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 03/01/2023 11:32am

A bill for an act
relating to insurance; requiring no-cost diagnostic services and testing following
a mammogram; amending Minnesota Statutes 2022, sections 62A.30, by adding
subdivisions; 256B.0631, subdivision 2; 256L.03, subdivision 5.

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

Section 1.

Minnesota Statutes 2022, section 62A.30, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Mammogram; diagnostic services and testing. new text end

new text begin If a health care provider
determines an enrollee requires additional diagnostic services or testing after a mammogram,
a health plan must provide coverage for the additional diagnostic services or testing with
no cost sharing, including co-pay, deductible, or coinsurance.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024, and applies to health
plans offered, issued, or sold on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2022, section 62A.30, is amended by adding a subdivision to
read:

new text begin Subd. 6. new text end

new text begin Application. new text end

new text begin If the application of subdivision 5 before an enrollee has met their
health plan's deductible would result in: (1) health savings account ineligibility under United
States Code, title 26, section 223; or (2) catastrophic health plan ineligibility under United
States Code, title 42, section 18022(e), then subdivision 5 shall apply to diagnostic services
or testing only after the enrollee has met their health plan's deductible.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024, and applies to health
plans offered, issued, or sold on or after that date.
new text end

Sec. 3.

Minnesota Statutes 2022, section 256B.0631, subdivision 2, is amended to read:

Subd. 2.

Exceptions.

Co-payments and deductibles shall be subject to the following
exceptions:

(1) children under the age of 21;

(2) pregnant women for services that relate to the pregnancy or any other medical
condition that may complicate the pregnancy;

(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
intermediate care facility for the developmentally disabled;

(4) recipients receiving hospice care;

(5) 100 percent federally funded services provided by an Indian health service;

(6) emergency services;

(7) family planning services;

(8) services that are paid by Medicare, resulting in the medical assistance program paying
for the coinsurance and deductible;

(9) co-payments that exceed one per day per provider for nonpreventive visits, eyeglasses,
and nonemergency visits to a hospital-based emergency room;

(10) services, fee-for-service payments subject to volume purchase through competitive
bidding;

(11) American Indians who meet the requirements in Code of Federal Regulations, title
42, sections 447.51 and 447.56;

(12) persons needing treatment for breast or cervical cancer as described under section
256B.057, subdivision 10; deleted text begin and
deleted text end

(13) services that currently have a rating of A or B from the United States Preventive
Services Task Force (USPSTF), immunizations recommended by the Advisory Committee
on Immunization Practices of the Centers for Disease Control and Prevention, and preventive
services and screenings provided to women as described in Code of Federal Regulations,
title 45, section 147.130 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (14) additional diagnostic services or testing that a health care provider determines an
enrollee requires after a mammogram, as specified under section 62A.30, subdivision 5.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024.
new text end

Sec. 4.

Minnesota Statutes 2022, section 256L.03, subdivision 5, is amended to read:

Subd. 5.

Cost-sharing.

(a) Co-payments, coinsurance, and deductibles do not apply to
children under the age of 21 and to American Indians as defined in Code of Federal
Regulations, title 42, section 600.5.

(b) The commissioner shall adjust co-payments, coinsurance, and deductibles for covered
services in a manner sufficient to maintain the actuarial value of the benefit to 94 percent.
The cost-sharing changes described in this paragraph do not apply to eligible recipients or
services exempt from cost-sharing under state law. The cost-sharing changes described in
this paragraph shall not be implemented prior to January 1, 2016.

(c) The cost-sharing changes authorized under paragraph (b) must satisfy the requirements
for cost-sharing under the Basic Health Program as set forth in Code of Federal Regulations,
title 42, sections 600.510 and 600.520.

new text begin (d) Co-payments, coinsurance, and deductibles do not apply to additional diagnostic
services or testing that a health care provider determines an enrollee requires after a
mammogram, as specified under section 62A.30, subdivision 5.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024.
new text end