SF 203

2nd Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 02:11am

A bill for an act
relating to health; establishing oversight for health cooperative arrangements;
establishing an application fee; appropriating money; amending Minnesota
Statutes 2008, section 13.381, by adding a subdivision; proposing coding for new
law in Minnesota Statutes, chapter 62R.

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

Section 1.

Minnesota Statutes 2008, section 13.381, is amended by adding a
subdivision to read:

new text begin Subd. 18. new text end

new text begin Rural health cooperatives. new text end

new text begin Data collected from health plan companies
and providers for purposes of approval of rural health cooperative arrangements are
classified under section 62R.09.
new text end

Sec. 2.

new text begin [62R.09] STATE OVERSIGHT AND SUPERVISION.
new text end

new text begin Subdivision 1. new text end

new text begin Review and approval; monitoring. new text end

new text begin (a) The commissioner of
health shall review and authorize contracts and business or financial arrangements under
section 62R.06, subdivision 1, and any modification, renewal, or extension of a contract
or business or financial arrangement that previously has been approved. All contracts
and business or financial arrangements, modifications, renewals, or extensions must be
submitted on an application for approval to the commissioner.
new text end

new text begin (b) Within 30 days after receiving an application, the commissioner may request
additional information that is necessary to complete the review required under this section.
The commissioner must approve or deny an application within 60 days after receiving the
application or within 60 days after receiving any additional information requested by the
commissioner, whichever is later. The commissioner must not deny an application unless
the commissioner determines, using the criteria in paragraph (g), that:
new text end

new text begin (1) the anticompetitive effects of the arrangement on the marketplace exceed the
procompetitive effects or efficiencies, or that any price agreements included in the
arrangement are not necessary to achieve the efficiencies that are expected to result from
the arrangement; or
new text end

new text begin (2) the applicant has not provided complete or sufficient information requested
by the commissioner to evaluate the impact of the proposed arrangement on the health
care marketplace.
new text end

new text begin (c) The commissioner may collect information from other persons to assist in
evaluating the impact of the proposed arrangement on the health care marketplace. The
commissioner shall collect information from health plan companies and health care
providers operating in the same geographic area as the health care cooperative. Data
collected from health plan companies and health care providers under this paragraph are
nonpublic data or private data on individuals, as defined in section 13.02.
new text end

new text begin (d) The commissioner may solicit public comment on the impact of the proposed
arrangement.
new text end

new text begin (e) The commissioner may condition approval of a proposed arrangement on a
modification of all or part of the arrangement to eliminate any restriction on competition
that is not reasonably related to the goals of improving health care access or quality. The
commissioner may also establish conditions for approval that are reasonably necessary
to protect against abuses of private economic power and to ensure that the arrangement
has oversight by the state.
new text end

new text begin (f) The commissioner shall actively monitor arrangements approved under this
section to ensure that the arrangement remains in compliance with the conditions of
approval. Upon request, the health care cooperative shall provide information to the
commissioner regarding compliance. The commissioner may revoke an approval upon
a finding that the arrangement is not in substantial compliance with the terms of the
application or the conditions of approval.
new text end

new text begin (g) In evaluating applications received under this section, the commissioner shall
consider whether:
new text end

new text begin (1) the arrangement is likely to produce significant efficiencies that benefit
consumers, such as cost savings or improvements in quality of or access to care;
new text end

new text begin (2) the arrangement is likely to have any anticompetitive effects on the marketplace;
and
new text end

new text begin (3) the potential anticompetitive effects outweigh the procompetitive efficiencies
resulting from the arrangement.
new text end

new text begin Subd. 2. new text end

new text begin Applications. new text end

new text begin (a) Applications for approval under this section must
include a detailed description of the proposed arrangement.
new text end

new text begin (b) The application must include:
new text end

new text begin (1) the identities of all the parties to the arrangement;
new text end

new text begin (2) the participation rules for the cooperative, including the terms and conditions
under which participating providers may be members of the cooperative;
new text end

new text begin (3) a description of the geographic areas served by the cooperative and the products
provided, and a list of competing providers that are not members of the cooperative;
new text end

new text begin (4) a description of any restriction on participating members of the cooperative
entering into other contracts with payers; and
new text end

new text begin (5) a description of the increased efficiency, improved health care access, improved
health care quality, or increased market competition that will result from the arrangement.
new text end

new text begin (c) Data on providers collected under this section are private data on individuals or
nonpublic data, as defined in section 13.02.
new text end

new text begin Subd. 3. new text end

new text begin Application fee. new text end

new text begin When submitting an initial application to the
commissioner, a health care cooperative shall pay a fee of $2,000 for the commissioner's
cost of reviewing and monitoring the arrangement. When submitting an application for
modification, renewal, or extension of a previously approved contract and business
or financial arrangement, the health care cooperative shall pay a fee of $500. Revenue
received by the commissioner under this section is appropriated to the commissioner for
the purpose of administering this section.
new text end