SF 718

as introduced - 87th Legislature (2011 - 2012) Posted on 02/23/2012 09:12am

A bill for an act
relating to human services; specifying applicability of Data Practices Act to data
provided to state by managed care vendors; amending Minnesota Statutes 2010,
section 256B.69, subdivisions 9a, 9b.

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

Section 1.

Minnesota Statutes 2010, section 256B.69, subdivision 9a, is amended to
read:

Subd. 9a.

Administrative expense reporting.

Within the limit of available
appropriations, the commissioner shall work with the commissioner of health to identify
and collect data on administrative spending for state health care programs reported to the
commissioner of health by managed care plans under section 62D.08 and county-based
purchasing plans under section 256B.692, provided that such data are consistent
with guidelines and standards for administrative spending that are developed by the
commissioner of health, and reported to the legislature under Laws 2008, chapter 364,
section 12. Data provided to the commissioner under this subdivision are nonpublic
data as defined under section 13.02. new text begin For purposes of data referenced in this subdivision,
a managed care or county-based purchasing plan is a government entity as defined in
section 13.02, subdivision 7a.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2011.
new text end

Sec. 2.

Minnesota Statutes 2010, section 256B.69, subdivision 9b, is amended to read:

Subd. 9b.

Reporting provider payment rates.

(a) According to guidelines
developed by the commissioner, in consultation with health care providers, managed care
plans, and county-based purchasing plans, each managed care plan and county-based
purchasing plan must annually provide to the commissioner information on reimbursement
rates paid by the managed care plan under this section or the county-based purchasing
plan under section 256B.692 to providers and vendors for administrative services under
contract with the plan.

(b) Each managed care plan and county-based purchasing plan must annually
provide to the commissioner, in the form and manner specified by the commissioner:

(1) the amount of the payment made to the plan under this section that is paid to
health care providers for patient care;

(2) aggregate provider payment data, categorized by inpatient payments and
outpatient payments, with the outpatient payments categorized by payments to primary
care providers and nonprimary care providers;

(3) the process by which increases or decreases in payments made to the plan
under this section, that are based on actuarial analysis related to provider cost increases
or decreases, or that are required by legislative action, are passed through to health care
providers, categorized by payments to primary care providers and nonprimary care
providers; and

(4) specific information on the methodology used to establish provider
reimbursement rates paid by the managed health care plan and county-based purchasing
plan.

Data provided to the commissioner under this subdivision must allow the
commissioner to conduct the analyses required under paragraph (d).

(c) Data provided to the commissioner under this subdivision are nonpublic data as
defined in section 13.02. new text begin For purposes of data referenced in this subdivision, a managed
care or county-based purchasing plan is a government entity as defined in section 13.02,
subdivision 7a.
new text end

(d) The commissioner shall analyze data provided under this subdivision to assist the
legislature in providing oversight and accountability related to expenditures under this
section. The analysis must include information on payments to physicians, physician
extenders, and hospitals, and may include other provider types as determined by the
commissioner. The commissioner shall also array aggregate provider reimbursement rates
by health plan, by primary care, and by nonprimary care categories. The commissioner
shall report the analysis to the legislature annually, beginning December 15, 2010,
and each December 15 thereafter. The commissioner shall also make this information
available on the agency's Web site to managed care and county-based purchasing plans,
health care providers, and the public.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2011.
new text end