1.1                          A bill for an act 
  1.2             relating to health; modifying provisions for unique 
  1.3             identifiers for health care providers, group 
  1.4             purchasers, and patients; modifying birth data 
  1.5             provisions; limiting access to certified copies of 
  1.6             birth and death certificates; requiring standardized 
  1.7             format for birth and death certificates; extending 
  1.8             date of commissioner's access to fetal, infant, and 
  1.9             maternal death data; amending Minnesota Statutes 1996, 
  1.10            sections 62J.54; 144.215, by adding subdivisions; 
  1.11            144.225, subdivision 2, and by adding subdivisions; 
  1.12            and 145.90, subdivision 2.  
  1.13  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.14     Section 1.  Minnesota Statutes 1996, section 62J.54, is 
  1.15  amended to read: 
  1.16     62J.54 [IDENTIFICATION AND IMPLEMENTATION OF UNIQUE 
  1.17  IDENTIFIERS.] 
  1.18     Subdivision 1.  [UNIQUE IDENTIFICATION NUMBER FOR HEALTH 
  1.19  CARE PROVIDER ORGANIZATIONS.] (a) On and after January 1, 
  1.20  1998 Not later than 24 months after the date on which a unique 
  1.21  health identifier for health care providers is adopted or 
  1.22  established under sections 1171 to 1179 of Public Law Number 
  1.23  104-191, 110 Statutes at Large 1936, all group purchasers and 
  1.24  health care providers in Minnesota shall use a unique 
  1.25  identification number to identify health care provider 
  1.26  organizations, except as provided in paragraph (e) (b). 
  1.27     (b) Small health plans, as defined by the federal Secretary 
  1.28  of Health and Human Services under section 1175 of Public Law 
  1.29  Number 104-191, 110 Statutes at Large 1936, shall use a unique 
  2.1   identification number to identify health provider organizations 
  2.2   no later than 36 months after the date on which a unique health 
  2.3   identifier for health care providers is adopted or established 
  2.4   under sections 1171 to 1179 of Public Law Number 104-191, 110 
  2.5   Statutes at Large 1936. 
  2.6      (c) The first eight digits of the national provider 
  2.7   identifier maintained by the federal Health Care Financing 
  2.8   Administration unique health identifier for health care 
  2.9   providers adopted or established by the federal Secretary of 
  2.10  Health and Human Services under sections 1171 to 1179 of Public 
  2.11  Law Number 104-191, 110 Statutes at Large 1936 (1996 and 
  2.12  subsequent amendments), shall be used as the unique 
  2.13  identification number for health care provider organizations. 
  2.14     (c) (d) Provider organizations required to have a national 
  2.15  provider unique health identifier are:  
  2.16     (1) hospitals licensed under chapter 144; 
  2.17     (2) nursing homes and hospices licensed under chapter 144A; 
  2.18     (3) subacute care facilities; 
  2.19     (4) individual providers organized as a clinic or group 
  2.20  practice; 
  2.21     (5) independent laboratory, pharmacy, surgery, radiology, 
  2.22  or outpatient facilities; 
  2.23     (6) ambulance services licensed under chapter 144; and 
  2.24     (7) special transportation services certified under chapter 
  2.25  174; and 
  2.26     (8) other provider organizations as required by the federal 
  2.27  Secretary of Health and Human Services under sections 1171 to 
  2.28  1179 of Public Law Number 104-191, 110 Statutes at Large 1936 
  2.29  (1996 and subsequent amendments).  
  2.30     Provider organizations shall obtain a national provider 
  2.31  unique health identifier from the federal Health Care Financing 
  2.32  Administration Secretary of Health and Human Services using the 
  2.33  federal Health Care Financing Administration's prescribed 
  2.34  process prescribed by the Secretary. 
  2.35     (d) (e) Only the unique health care provider organization 
  2.36  identifier shall be used for purposes of submitting and 
  3.1   receiving claims, and in conjunction with other data collection 
  3.2   and reporting functions. 
  3.3      (e) The state and federal health care programs administered 
  3.4   by the department of human services shall use the unique 
  3.5   identification number assigned to health care providers for 
  3.6   implementation of the Medicaid Management Information System or 
  3.7   the national provider identifier maintained by the federal 
  3.8   Health Care Financing Administration. 
  3.9      (f) The commissioner of health may become a subscriber to 
  3.10  contract with the federal Health Care Financing Administration's 
  3.11  national provider system Secretary of Health and Human Services 
  3.12  or the Secretary's agent to implement this subdivision. 
  3.13     Subd. 2.  [UNIQUE IDENTIFICATION NUMBER FOR INDIVIDUAL 
  3.14  HEALTH CARE PROVIDERS.] (a) On and after January 1, 1998 Not 
  3.15  later than 24 months after the date on which a unique health 
  3.16  identifier for health care providers is adopted or established 
  3.17  under sections 1171 to 1179 of Public Law Number 104-191, 110 
  3.18  Statutes at Large 1936, all group purchasers and health care 
  3.19  providers in Minnesota shall use a unique identification number 
  3.20  to identify an individual health care provider, except as 
  3.21  provided in paragraph (e) (b). 
  3.22     (b) Small health plans, as defined by the federal Secretary 
  3.23  of Health and Human Services under section 1175 of Public Law 
  3.24  Number 104-191, 110 Statutes at Large 1936, shall use a unique 
  3.25  identification number to identify an individual health care 
  3.26  provider no later than 36 months after the date on which a 
  3.27  unique health identifier for health care providers is adopted or 
  3.28  established under sections 1171 to 1179 of Public Law Number 
  3.29  104-191, 110 Statutes at Large 1936. 
  3.30     (c) The first eight digits of the national provider 
  3.31  identifier maintained by the federal Health Care Financing 
  3.32  Administration's national provider system unique health 
  3.33  identifier for health care providers adopted or established by 
  3.34  the federal Secretary of Health and Human Services under 
  3.35  sections 1171 to 1179 of Public Law Number 104-191, 110 Statutes 
  3.36  at Large 1936 (1996 and subsequent amendments), shall be used as 
  4.1   the unique identification number for individual health care 
  4.2   providers.  
  4.3      (c) (d) Individual providers required to have a national 
  4.4   provider unique health identifier are:  
  4.5      (1) physicians licensed under chapter 147; 
  4.6      (2) dentists licensed under chapter 150A; 
  4.7      (3) chiropractors licensed under chapter 148; 
  4.8      (4) podiatrists licensed under chapter 153; 
  4.9      (5) physician assistants as defined under section 147A.01; 
  4.10     (6) advanced practice nurses as defined under section 
  4.11  62A.15; 
  4.12     (7) doctors of optometry licensed under section 148.57; 
  4.13     (8) individual providers who may bill Medicare for medical 
  4.14  and other health services as defined in United States Code, 
  4.15  title 42, section 1395x(s); and 
  4.16     (9) individual providers who are providers for state and 
  4.17  federal health care programs administered by the commissioner of 
  4.18  human services; and 
  4.19     (10) other individual providers as required by the federal 
  4.20  Secretary of Health and Human Services under sections 1171 to 
  4.21  1179 of Public Law Number 104-191, 110 Statutes at Large 1936 
  4.22  (1996 and subsequent amendments). 
  4.23     Providers shall obtain a national provider unique health 
  4.24  identifier from the federal Health Care Financing Administration 
  4.25  Secretary of Health and Human Services using the Health Care 
  4.26  Financing Administration's prescribed process prescribed by the 
  4.27  Secretary.  
  4.28     (d) (e) Only the unique individual health care provider 
  4.29  identifier shall be used for purposes of submitting and 
  4.30  receiving claims, and in conjunction with other data collection 
  4.31  and reporting functions. 
  4.32     (e) The state and federal health care programs administered 
  4.33  by the department of human services shall use the unique 
  4.34  identification number assigned to health care providers for 
  4.35  implementation of the Medicaid Management Information System or 
  4.36  the national provider identifier maintained by the federal 
  5.1   Health Care Financing Administration. 
  5.2      (f) The commissioner of health may become a subscriber to 
  5.3   contract with the federal Health Care Financing Administration's 
  5.4   national provider system Secretary of Health and Human Services 
  5.5   or the Secretary's agent to implement this subdivision. 
  5.6      Subd. 3.  [UNIQUE IDENTIFICATION NUMBER FOR GROUP 
  5.7   PURCHASERS.] (a) On and after January 1, 1998 Not later than 24 
  5.8   months after the date on which a unique health identifier for 
  5.9   employers and health plans is adopted or established under 
  5.10  sections 1171 to 1179 of Public Law Number 104-191, 110 Statutes 
  5.11  at Large 1936, all group purchasers and health care providers in 
  5.12  Minnesota shall use a unique identification number to identify 
  5.13  group purchasers, except as provided in paragraph (b). 
  5.14     (b) Small health plans, as defined by the federal Secretary 
  5.15  of Health and Human Services under section 1175 of Public Law 
  5.16  Number 104-191, 110 Statutes at Large 1936, shall use a unique 
  5.17  identification number to identify group purchasers no later than 
  5.18  36 months after the date on which a unique health identifier for 
  5.19  employers and health plans is adopted or established under 
  5.20  sections 1171 to 1179 of Public Law Number 104-191, 110 Statutes 
  5.21  at Large 1936.  
  5.22     (c) The payer identification number assigned for the 
  5.23  federal Health Care Financing Administration's PAYERID system 
  5.24  unique health identifier for health plans and employers adopted 
  5.25  or established by the federal Secretary of Health and Human 
  5.26  Services under sections 1171 to 1179 of Public Law Number 
  5.27  104-191, 110 Statutes at Large 1936 (1996 and subsequent 
  5.28  amendments), shall be used as the unique identification number 
  5.29  for group purchasers.  
  5.30     (c) (d) Group purchasers shall obtain a payer unique health 
  5.31  identifier number from the federal Health Care Financing 
  5.32  Administration Secretary of Health and Human Services using 
  5.33  the Health Care Financing Administration's prescribed 
  5.34  process prescribed by the Secretary. 
  5.35     (d) (e) The unique group purchaser identifier, as described 
  5.36  in this section, shall be used for purposes of submitting and 
  6.1   receiving claims, and in conjunction with other data collection 
  6.2   and reporting functions. 
  6.3      (e) (f) The commissioner of health may become a registry 
  6.4   user to contract with the federal Health Care Financing 
  6.5   Administration's PAYERID system Secretary of Health and Human 
  6.6   Services or the Secretary's agent to implement this subdivision. 
  6.7      Subd. 4.  [UNIQUE PATIENT IDENTIFICATION NUMBER.] (a) On 
  6.8   and after January 1, 1998 Not later than 24 months after the 
  6.9   date on which a unique health identifier for individuals is 
  6.10  adopted or established under sections 1171 to 1179 of Public Law 
  6.11  Number 104-191, 110 Statutes at Large 1936, all group purchasers 
  6.12  and health care providers in Minnesota shall use a unique 
  6.13  identification number to identify each patient who receives 
  6.14  health care services in Minnesota, except as provided in 
  6.15  paragraph (e) (b). 
  6.16     (b) Except as provided in paragraph (d), following the 
  6.17  recommendation of the workgroup for electronic data interchange, 
  6.18  the social security number of the patient Small health plans, as 
  6.19  defined by the federal Secretary of Health and Human Services 
  6.20  under section 1175 of Public Law Number 104-191, 110 Statutes at 
  6.21  Large 1936, shall use a unique identification number to identify 
  6.22  each patient who receives health care services in Minnesota no 
  6.23  later than 36 months after the date on which a unique health 
  6.24  identifier for individuals is adopted or established under 
  6.25  sections 1171 to 1179 of Public Law Number 104-191, 110 Statutes 
  6.26  at Large 1936. 
  6.27     (c) The unique health identifier for individuals adopted or 
  6.28  established by the federal Secretary of Health and Human 
  6.29  Services under sections 1171 to 1179 of Public Law Number 
  6.30  104-191, 110 Statutes at Large 1936 (1996 and subsequent 
  6.31  amendments), shall be used as the unique patient identification 
  6.32  number. 
  6.33     (c) (d) The unique patient identification number shall be 
  6.34  used by group purchasers and health care providers for purposes 
  6.35  of submitting and receiving claims, and in conjunction with 
  6.36  other data collection and reporting functions. 
  7.1      (d) The commissioner shall develop an alternate numbering 
  7.2   system for patients who do not have or refuse to provide a 
  7.3   social security number.  This provision does not require that 
  7.4   patients provide their social security numbers and does not 
  7.5   require group purchasers or providers to demand that patients 
  7.6   provide their social security numbers.  Group purchasers and 
  7.7   health care providers shall establish procedures to notify 
  7.8   patients that they can elect not to have their social security 
  7.9   number used as the unique patient identification number. 
  7.10     (e) The state and federal health care programs administered 
  7.11  by the department of human services shall use the unique person 
  7.12  master index (PMI) identification number assigned to clients 
  7.13  participating in programs administered by the department of 
  7.14  human services.  The commissioner of health may contract with 
  7.15  the federal Secretary of Health and Human Services or the 
  7.16  Secretary's agent to implement this subdivision. 
  7.17     Sec. 2.  Minnesota Statutes 1996, section 144.215, is 
  7.18  amended by adding a subdivision to read: 
  7.19     Subd. 5.  [BIRTHS OCCURRING IN AN INSTITUTION.] When a 
  7.20  birth occurs in an institution or en route to an institution, 
  7.21  the person in charge of the institution or that person's 
  7.22  authorized designee shall obtain the personal data required 
  7.23  under this section and shall prepare the certificate of birth.  
  7.24  For purposes of this section, "institution" means a hospital or 
  7.25  other facility that provides childbirth services. 
  7.26     Sec. 3.  Minnesota Statutes 1996, section 144.215, is 
  7.27  amended by adding a subdivision to read: 
  7.28     Subd. 6.  [BIRTHS OCCURRING OUTSIDE AN INSTITUTION.] When a 
  7.29  birth occurs outside of an institution as defined in subdivision 
  7.30  5, the certificate of birth shall be prepared and filed by one 
  7.31  of the following persons, in the indicated order of preference: 
  7.32     (1) the physician present at the time of the birth or 
  7.33  immediately thereafter; 
  7.34     (2) in the absence of a physician, a person present at the 
  7.35  time of the birth or immediately thereafter; 
  7.36     (3) the father or mother of the child; or 
  8.1      (4) in the absence of the father and if the mother is 
  8.2   unable, the person with primary responsibility for the premises 
  8.3   where the child was born. 
  8.4      Sec. 4.  Minnesota Statutes 1996, section 144.215, is 
  8.5   amended by adding a subdivision to read: 
  8.6      Subd. 7.  [EVIDENCE REQUIRED TO REGISTER A NONINSTITUTION 
  8.7   BIRTH WITHIN THE FIRST YEAR OF BIRTH.] When a birth occurs in 
  8.8   this state outside of an institution, as defined in subdivision 
  8.9   5, and the birth certificate is filed before the first birthday, 
  8.10  evidence in support of the facts of birth shall be required when 
  8.11  neither the state nor local registrar has personal knowledge 
  8.12  regarding the facts of birth.  Evidence shall be presented by 
  8.13  the individual responsible for filing the certificate under 
  8.14  subdivision 6.  Evidence shall consist of proof that the child 
  8.15  was born alive, proof of pregnancy, or evidence of the mother's 
  8.16  presence in this state on the date of the birth.  If the 
  8.17  evidence is not acceptable, the state registrar shall advise the 
  8.18  applicant of the reason for not filing a birth certificate and 
  8.19  shall further advise the applicant of the right of appeal to a 
  8.20  court of competent jurisdiction. 
  8.21     Sec. 5.  Minnesota Statutes 1996, section 144.225, 
  8.22  subdivision 2, is amended to read: 
  8.23     Subd. 2.  [DATA ABOUT BIRTHS.] (a) Except as otherwise 
  8.24  provided in this subdivision, data pertaining to the birth of a 
  8.25  child, to a woman who was not married to the child's father when 
  8.26  the child was conceived nor when the child was born, including 
  8.27  the original certificate of birth and the certified copy, are 
  8.28  confidential data if the birth occurred before January 1, 1998, 
  8.29  and are public data if the birth occurs on or after that 
  8.30  date.  Until January 1, 1998, at the time of the birth of a 
  8.31  child to a woman who was not married to the child's father when 
  8.32  the child was conceived nor when the child was born, the mother 
  8.33  may designate on the birth registration form whether data 
  8.34  pertaining to the birth will be public data.  Notwithstanding 
  8.35  the designation of the data as confidential, it may be disclosed:
  8.36     (1) to a parent or guardian of the child,; 
  9.1      (2) to the child when the child is 18 years of age or 
  9.2   older,; 
  9.3      (3) under paragraph (b); or 
  9.4      (4) pursuant to a court order, or under paragraph (b).  For 
  9.5   purposes of this section, a subpoena does not constitute a court 
  9.6   order. 
  9.7      (b) Unless the child is adopted, data pertaining to the 
  9.8   birth of a child that are not accessible to the public become 
  9.9   public data if 100 years have elapsed since the birth of the 
  9.10  child who is the subject of the data, or as provided under 
  9.11  section 13.10, whichever occurs first. 
  9.12     (c) If a child is adopted, data pertaining to the child's 
  9.13  birth are governed by the provisions relating to adoption 
  9.14  records, including sections 13.10, subdivision 5; 144.1761; 
  9.15  144.218, subdivision 1; and 259.89.  The birth and death records 
  9.16  of the commissioner of health shall be open to inspection by the 
  9.17  commissioner of human services and it shall not be necessary for 
  9.18  the commissioner of human services to obtain an order of the 
  9.19  court in order to inspect records or to secure certified copies 
  9.20  of them.  
  9.21     (d) The name and address of a mother under paragraph (a) 
  9.22  and the child's date of birth may be disclosed to the county 
  9.23  social services or public health member of a family services 
  9.24  collaborative for purposes of providing services under section 
  9.25  121.8355. 
  9.26     Sec. 6.  Minnesota Statutes 1996, section 144.225, is 
  9.27  amended by adding a subdivision to read: 
  9.28     Subd. 7.  [CERTIFIED COPY OF BIRTH OR DEATH 
  9.29  CERTIFICATE.] The state or local registrar is authorized to 
  9.30  issue a certified copy of a birth certificate or death 
  9.31  certificate only: 
  9.32     (1) to a person who has a tangible interest in the 
  9.33  requested birth certificate or death certificate.  A person who 
  9.34  has a tangible interest is: 
  9.35     (i) the subject of the birth certificate or death 
  9.36  certificate; 
 10.1      (ii) a child of the subject; 
 10.2      (iii) the spouse of the subject; 
 10.3      (iv) a parent of the subject, unless the parent is a birth 
 10.4   parent whose parental rights have been terminated; 
 10.5      (v) the legal custodian or guardian of the subject; 
 10.6      (vi) a representative authorized by a person under clauses 
 10.7   (1) to (3); or 
 10.8      (vii) a person who demonstrates that a certified copy of 
 10.9   the birth certificate or death certificate is necessary for the 
 10.10  determination or protection of a personal or property right, 
 10.11  pursuant to rules adopted by the commissioner; 
 10.12     (2) to any local, state, or federal governmental agency 
 10.13  upon request if the certified birth certificate or death 
 10.14  certificate is necessary for the governmental agency to perform 
 10.15  its authorized duties.  An authorized governmental agency 
 10.16  includes the department of human services, the department of 
 10.17  revenue, and the United States Immigration and Naturalization 
 10.18  Service; or 
 10.19     (3) pursuant to a court order issued by a court of 
 10.20  competent jurisdiction.  For purposes of this section, a 
 10.21  subpoena does not constitute a court order. 
 10.22     Sec. 7.  Minnesota Statutes 1996, section 144.225, is 
 10.23  amended by adding a subdivision to read: 
 10.24     Subd. 8.  [STANDARDIZED FORMAT FOR CERTIFIED BIRTH AND 
 10.25  DEATH CERTIFICATES.] No later than July 1, 1998, the 
 10.26  commissioner shall develop a standardized format for certified 
 10.27  birth certificates and death certificates issued by state and 
 10.28  local registrars.  The format shall incorporate security 
 10.29  features in accordance with this section.  The standardized 
 10.30  format must be implemented on a statewide basis by July 1, 2001. 
 10.31     Sec. 8.  Minnesota Statutes 1996, section 145.90, 
 10.32  subdivision 2, is amended to read: 
 10.33     Subd. 2.  [ACCESS TO DATA.] (a) Until July 1, 1997 2000, 
 10.34  the commissioner of health has access to medical data as defined 
 10.35  in section 13.42, subdivision 1, paragraph (b), medical examiner 
 10.36  data as defined in section 13.83, subdivision 1, and health 
 11.1   records created, maintained, or stored by providers as defined 
 11.2   in section 144.335, subdivision 1, paragraph (b), without the 
 11.3   consent of the subject of the data, and without the consent of 
 11.4   the parent, spouse, other guardian, or legal representative of 
 11.5   the subject of the data, when the subject of the data is: 
 11.6      (1) a fetus that showed no signs of life at the time of 
 11.7   delivery, was 20 or more weeks of gestation at the time of 
 11.8   delivery, and was not delivered by an induced abortion; 
 11.9      (2) a liveborn infant that died within the first two years 
 11.10  of life; 
 11.11     (3) a woman who died during a pregnancy or within 12 months 
 11.12  of a fetal death, a live birth, or other termination of a 
 11.13  pregnancy; or 
 11.14     (4) the biological mother of a fetus or infant as described 
 11.15  in clause (1) or (2). 
 11.16     The commissioner only has access to medical data and health 
 11.17  records related to deaths or stillbirths that occur on or after 
 11.18  July 1, 1994.  With respect to data under clause (4), the 
 11.19  commissioner only has access to medical data and health records 
 11.20  that contain information that bears upon the pregnancy and the 
 11.21  outcome of the pregnancy. 
 11.22     (b) The provider or responsible authority that creates, 
 11.23  maintains, or stores the data shall furnish the data upon the 
 11.24  request of the commissioner.  The provider or responsible 
 11.25  authority may charge a fee for providing data, not to exceed the 
 11.26  actual cost of retrieving and duplicating the data. 
 11.27     (c) The commissioner shall make a good faith reasonable 
 11.28  effort to notify the subject of the data, or the parent, spouse, 
 11.29  other guardian, or legal representative of the subject of the 
 11.30  data, before collecting data on the subject.  For purposes of 
 11.31  this paragraph, "reasonable effort" includes: 
 11.32     (1) one visit by a public health nurse to the last known 
 11.33  address of the data subject, or the parent, spouse, or guardian; 
 11.34  and 
 11.35     (2) if the public health nurse is unable to contact the 
 11.36  data subject, or the parent, spouse, or guardian, one notice by 
 12.1   certified mail to the last known address of the data subject, or 
 12.2   the parent, spouse, or guardian. 
 12.3      (d) The commissioner does not have access to coroner or 
 12.4   medical examiner data that are part of an active investigation 
 12.5   as described in section 13.83. 
 12.6      Sec. 9.  [EFFECTIVE DATE.] 
 12.7      Section 8 is effective the day following final enactment.