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HF 926

as introduced - 87th Legislature (2011 - 2012) Posted on 03/15/2012 03:32pm

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to health; changing provisions for evaluation of health coverage
mandates; amending Minnesota Statutes 2010, section 62J.26.


Section 1.

Minnesota Statutes 2010, section 62J.26, is amended to read:

62J.26 EVALUATION OF deleted text beginPROPOSEDdeleted text end HEALTH COVERAGE MANDATES.

Subdivision 1.


For purposes of this section, the following terms have
the meanings given unless the context otherwise requires:

(1) "commissioner" means the commissioner of commerce;

(2) "health plan" means a health plan as defined in section 62A.011, subdivision 3,
but includes coverage listed in clauses (7) and (10) of that definition;

(3) "mandated health benefit deleted text beginproposaldeleted text end" means a deleted text beginproposal that would statutorilydeleted text end
deleted text begin requiredeleted text endnew text begin requirement, proposed or currently in Minnesota statute or rule, thatnew text end a health
plan deleted text begintodeleted text end do the following:

(i) provide coverage or increase the amount of coverage for the treatment of a
particular disease, condition, or other health care need;

(ii) provide coverage or increase the amount of coverage of a particular type of
health care treatment or service or of equipment, supplies, or drugs used in connection
with a health care treatment or service; or

(iii) provide coverage for care delivered by a specific type of provider.

deleted text begin "Mandateddeleted text endnew text begin A mandatednew text end health benefit deleted text beginproposal"deleted text end does not include deleted text beginhealth benefit
proposals amending
deleted text endnew text begin an amendment tonew text end the scope of practice of a licensed health care

Subd. 2.

Evaluation process and content.

(a) The commissioner, in consultation
with the commissioners of health and management and budget, must evaluate mandated
health benefit proposals deleted text beginas provided under subdivision 3deleted text end.

(b) The purpose of the evaluation is to provide the legislature with a complete
and timely analysis of all ramifications of any mandated health benefit proposal. The
evaluation must include, in addition to other relevant information, the following:

(1) scientific and medical information on the proposed health benefit, on the
potential for harm or benefit to the patient, and on the comparative benefit or harm from
alternative forms of treatment;

(2) public health, economic, and fiscal impacts of the proposed mandate on persons
receiving health services in Minnesota, on the relative cost-effectiveness of the benefit,
and on the health care system in general;

(3) the extent to which the service is generally utilized by a significant portion
of the population;

(4) the extent to which insurance coverage for the proposed mandated benefit is
already generally available;

(5) the extent to which the mandated coverage will increase or decrease the cost
of the service; and

(6) the commissioner may consider actuarial analysis done by health insurers in
determining the cost of the proposed mandated benefit.

(c) The commissioner must summarize the nature and quality of available
information on these issues, and, if possible, must provide preliminary information to the
public. The commissioner may conduct research on these issues or may determine that
existing research is sufficient to meet the informational needs of the legislature. The
commissioner may seek the assistance and advice of researchers, community leaders, or
other persons or organizations with relevant expertise.

Subd. 3.

Requests for evaluation.

(a) Whenever deleted text begina legislative measure containingdeleted text end
a mandated health benefit deleted text beginproposaldeleted text end is deleted text beginintroduced asdeleted text endnew text begin included innew text end a bill or offered as an
amendment to a bill, deleted text beginor is likely to be introduced as a bill or offered as an amendment,deleted text end a
chair of any standing legislative committee that has jurisdiction over the subject matter
deleted text begin of the proposal maydeleted text endnew text begin mustnew text end request that the commissioner complete an evaluation of the
deleted text begin proposaldeleted text endnew text begin mandated health benefitnew text end under this section, to inform any committee of floor
action by either house of the legislature.

(b) The commissioner must conduct an evaluation described in subdivision 2 of each
mandated health benefit deleted text beginproposaldeleted text end for which an evaluation is requested under paragraph (a)deleted text begin,
unless the commissioner determines under paragraph (c) or subdivision 4 that priorities
and resources do not permit its evaluation
deleted text end.

(c) deleted text beginIf requests for evaluation of multiple proposals are received, the commissioner
must consult with the chairs of the standing legislative committees having jurisdiction
over the subject matter of the mandated health benefit proposals to prioritize the requests
and establish a reporting date for each proposal to be evaluated. The commissioner is
not required to direct an unreasonable quantity of the commissioner's resources to these
deleted text endnew text begin Following the promulgation of the interim or final regulations governing the
definition of federal essential health benefits set, the commissioner must examine all
existing state benefit mandates on health plans, either in Minnesota statute or rule, and
determine which are outside of the scope of the federally defined essential health benefits.
For each of the mandated health benefits not included, in part or in full, in the federal
essential health benefits, an evaluation must be completed
new text end.

deleted text begin Subd. 4. deleted text end

deleted text begin Sources of funding. deleted text end

deleted text begin (a) The commissioner need not use any funds for
purposes of this section other than as provided in this subdivision or as specified in an
deleted text end

deleted text begin (b) The commissioner may seek and accept funding from sources other than the state
to pay for evaluations under this section to supplement or replace state appropriations.
Any money received under this paragraph must be deposited in the state treasury, credited
to a separate account for this purpose in the special revenue fund, and is appropriated to
the commissioner for purposes of this section.
deleted text end

deleted text begin (c) If a request for an evaluation under this section has been made, the commissioner
may use for purposes of the evaluation:
deleted text end

deleted text begin (1) any funds appropriated to the commissioner specifically for purposes of this
section; or
deleted text end

deleted text begin (2) funds available under paragraph (b), if use of the funds for evaluation of that
mandated health benefit proposal is consistent with any restrictions imposed by the
source of the funds.
deleted text end

deleted text begin (d) The commissioner must ensure that the source of the funding has no influence on
the process or outcome of the evaluation.
deleted text end

Subd. 5.

Report to legislature.

The commissioner must submit a written report
on the evaluationnew text begin of any mandated health benefitsnew text end to the legislature no later than deleted text begin180deleted text endnew text begin 30new text end
days after the text begin The commissioner must submit a written report on the evaluation
of any existing state mandated health benefits to the legislature no later than 180 days after
the essential benefit set regulations are promulgated.
new text end The report must be submitted in
compliance with sections 3.195 and 3.197.