HF 83

1st Engrossment - 90th Legislature (2017 - 2018) Posted on 01/13/2017 09:54am

A bill for an act
relating to health care; providing for verification of eligibility for premium
assistance; providing that certain health plan rate data are public; providing a
temporary program to help pay for health insurance premiums; amending Minnesota
Statutes 2016, section 60A.08, subdivision 15.

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

Section 1.

Minnesota Statutes 2016, section 60A.08, subdivision 15, is amended to read:

Subd. 15.

Classification of insurance filings data.

(a) All forms, rates, and related
information filed with the commissioner under section 61A.02 shall be nonpublic data until
the filing becomes effective.

(b) All forms, rates, and related information filed with the commissioner under section
62A.02 shall be nonpublic data until the filing becomes effective.

(c) All forms, rates, and related information filed with the commissioner under section
62C.14, subdivision 10, shall be nonpublic data until the filing becomes effective.

(d) All forms, rates, and related information filed with the commissioner under section
70A.06 shall be nonpublic data until the filing becomes effective.

(e) All forms, rates, and related information filed with the commissioner under section
79.56 shall be nonpublic data until the filing becomes effective.

(f) Notwithstanding paragraphs (b) and (c), for all rate increases subject to review under
section 2794 of the Public Health Services Act and any amendments to, or regulations, or
guidance issued under the act that are filed with the commissioner on or after September 1,
2011, the commissioner:

(1) may acknowledge receipt of the information;

(2) may acknowledge that the corresponding rate filing is pending review;

(3) must provide public access from the Department of Commerce's Web site to parts I
and II of the Preliminary Justifications of the rate increases subject to review; and

(4) must provide notice to the public on the Department of Commerce's Web site of the
review of the proposed rate, which must include a statement that the public has 30 calendar
days to submit written comments to the commissioner on the rate filing subject to review.

new text begin (g) Notwithstanding paragraphs (b) and (c), for all rates for individual health plans, as
defined in section 62A.011, subdivision 4, and small employer plans, as defined in section
62L.02, subdivision 28, the commissioner must provide:
new text end

new text begin (1) public access to the information described in clause (2) from the Department of
Commerce's Web site within ten days of receiving a rate filing from a health plan, as defined
in section 62A.011, subdivision 3; and
new text end

new text begin (2) compiled data of the proposed change to rates separated by health plan and geographic
rating area.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 30 days following final enactment.
new text end

Sec. 2. new text begin TRANSITION OF CARE COVERAGE FOR CALENDAR YEAR 2017;
REQUEST FOR AUTHORIZATION.
new text end

new text begin (a) The definitions in Minnesota Statutes, sections 62A.011 and 62Q.01, apply to this
section.
new text end

new text begin (b) An enrollee's health plan company may require medical records and other supporting
documentation to be submitted with a request for authorization for transition of care coverage.
If authorization is denied, the health plan company must explain the criteria used to make
its decision on the request for authorization and must explain the enrollee's right to appeal
the decision. If an enrollee chooses to appeal a denial, the enrollee must appeal the denial
within five business days of the date on which the enrollee receives the denial. If authorization
is granted, the health plan company must provide the enrollee, within five business days of
granting the authorization, with an explanation of how transition of care will be provided.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for health plans issued after December
31, 2016, and before March 2, 2017, and that are in effect for all or a portion of calendar
year 2017. This section expires June 30, 2018.
new text end

Sec. 3. new text begin VERIFYING ELIGIBILITY FOR PREMIUM ASSISTANCE; PROGRAM
INTEGRITY.
new text end

new text begin Subdivision 1. new text end

new text begin Verification of residency. new text end

new text begin The commissioner of management and budget
may access data from the Department of Employment and Economic Development and the
Department of Revenue to verify that persons applying for health care premium assistance
are residents of Minnesota.
new text end

new text begin Subd. 2. new text end

new text begin Program integrity. new text end

new text begin The commissioner of revenue shall review information
available from Minnesota Management and Budget, the Department of Human Services,
MNsure, and the most recent Minnesota tax records to identify ineligible individuals who
received health care premium assistance. The commissioner of revenue shall recover the
amount of any premium assistance paid on behalf of an ineligible individual from the
ineligible individual, in the manner provided by law for the collection of unpaid taxes or
erroneously paid refunds of taxes.
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. 4. new text begin DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin For purposes of this section and section 5, the following terms
have the meanings given, unless the context clearly indicates otherwise.
new text end

new text begin Subd. 2. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of Minnesota
Management and Budget.
new text end

new text begin Subd. 3. new text end

new text begin Eligible individual. new text end

new text begin "Eligible individual" means an individual who:
new text end

new text begin (1) is a resident of Minnesota;
new text end

new text begin (2) purchased qualified health coverage for calendar year 2017;
new text end

new text begin (3) meets the income eligibility requirements under section 3, subdivision 3;
new text end

new text begin (4) is not receiving a premium assistance credit under section 36B of the Internal Revenue
Code for calendar year 2017; and
new text end

new text begin (5) is approved by the commissioner as qualifying for premium assistance.
new text end

new text begin Subd. 4. new text end

new text begin Health plan. new text end

new text begin "Health plan" has the meaning provided in Minnesota Statutes,
section 62A.011, subdivision 3.
new text end

new text begin Subd. 5. new text end

new text begin Health plan company. new text end

new text begin "Health plan company" means a health carrier, as
defined in Minnesota Statutes, section 62A.011, subdivision 2, that provides qualified health
coverage in the individual market through MNsure or outside of MNsure to Minnesota
resident individuals in 2017.
new text end

new text begin Subd. 6. new text end

new text begin Individual market. new text end

new text begin "Individual market" means the individual market as defined
in Minnesota Statutes, section 62A.011, subdivision 5.
new text end

new text begin Subd. 7. new text end

new text begin Internal Revenue Code. new text end

new text begin "Internal Revenue Code" means the Internal Revenue
Code as amended through December 31, 2016.
new text end

new text begin Subd. 8. new text end

new text begin Modified adjusted gross income. new text end

new text begin "Modified adjusted gross income" means
the modified adjusted gross income for taxable year 2016, as defined in section 36B(d)(2)(B)
of the Internal Revenue Code.
new text end

new text begin Subd. 9. new text end

new text begin Premium assistance. new text end

new text begin "Premium assistance," "assistance amount," or "assistance"
means the amount allowed to an eligible individual as determined by the commissioner
under section 3 as a percentage of the qualified premium.
new text end

new text begin Subd. 10. new text end

new text begin Program. new text end

new text begin "Program" means the premium assistance program established
under section 1.
new text end

new text begin Subd. 11. new text end

new text begin Qualified health coverage. new text end

new text begin "Qualified health coverage" means health coverage
provided under a qualified health plan, as defined in Minnesota Statutes, section 62V.02,
subdivision 11, or provided under a health plan that meets the standards of a qualified health
plan except that it is not purchased through MNsure, and is:
new text end

new text begin (1) offered to individuals in the individual market;
new text end

new text begin (2) not a grandfathered health plan, as defined in section 36B of the Internal Revenue
Code; and
new text end

new text begin (3) provided by a health plan company through MNsure or outside of MNsure.
new text end

new text begin Subd. 12. new text end

new text begin Qualified premium. new text end

new text begin "Qualified premium" means the premium for qualified
health coverage purchased by an eligible individual.
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. 5. new text begin PREMIUM ASSISTANCE AMOUNT.
new text end

new text begin Subdivision 1. new text end

new text begin Applications by individuals; notification of eligibility. new text end

new text begin (a) An eligible
individual may apply to the commissioner to receive premium assistance under this section
at any time after purchase of qualified health coverage, but no later than January 31, 2018.
The commissioner shall prescribe the manner and form for applications, including requiring
any information the commissioner considers necessary or useful in determining whether an
applicant is eligible and the assistance amount allowed to the individual under this section.
The application must include a Tennessen warning as provided in Minnesota Statutes,
section 13.04, subdivision 2. The commissioner shall make application forms available on
the agency's Web site.
new text end

new text begin (b) The commissioner shall notify applicants of their eligibility status under the program,
including, for applicants determined to be eligible, their premium assistance amount.
new text end

new text begin Subd. 2. new text end

new text begin Health plan companies. new text end

new text begin (a) Through June 30, 2018, each health plan company
shall provide to the commissioner, by the first of each month and any other times the
commissioner requires, an effectuated coverage list with the following information for each
individual for whom it provides qualified health coverage:
new text end

new text begin (1) the name, address, and age of each individual covered by the health plan, and any
other identifying information that the commissioner determines appropriate to administer
the program;
new text end

new text begin (2) the qualified premium for the coverage;
new text end

new text begin (3) whether the coverage is individual or family coverage; and
new text end

new text begin (4) whether the individual is receiving advance payment of the credit under section 36B
of the Internal Revenue Code.
new text end

new text begin (b) A health plan company must notify the commissioner of coverage terminations of
eligible individuals within ten business days.
new text end

new text begin (c) Each health plan company shall make the application forms developed by the
commissioner under subdivision 1 available on the company's Web site, and shall include
application forms with premium notices for individual health coverage.
new text end

new text begin Subd. 3. new text end

new text begin Contracting. new text end

new text begin The commissioner may contract with a third-party administrator
to determine eligibility for and administer premium assistance under this section.
new text end

new text begin Subd. 4. new text end

new text begin Verification. new text end

new text begin The commissioner shall verify that persons applying for premium
assistance are residents of Minnesota. The commissioner may access information from the
Department of Employment and Economic Development and the Department of Revenue
when verifying residency.
new text end

new text begin Subd. 5. new text end

new text begin Data practices. new text end

new text begin (a) Information provided to the commissioner under subdivisions
1 and 2 are private data on individuals as defined in Minnesota Statutes, section 13.02,
subdivision 12.
new text end

new text begin (b) Notwithstanding the commissioner's retention schedule, the commissioner must
destroy data provided under subdivision 2 on June 30, 2018.
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