SF 1094

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to commerce; reforming the Minnesota No-Fault
Automobile Insurance Act; tying medical expense
benefits to the workers' compensation fee schedule
with adjustments; increasing income loss and funeral
benefits; modifying the tort threshold; modifying the
arbitration process; amending Minnesota Statutes 2004,
sections 65B.44, subdivisions 1, 2, 3, 4; 65B.51,
subdivision 3; 65B.525, subdivision 1, by adding
subdivisions.

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

Section 1.

Minnesota Statutes 2004, section 65B.44,
subdivision 1, is amended to read:

Subdivision 1.

Inclusions.

(a) Basic economic loss
benefits shall provide reimbursement for all loss suffered
through injury arising out of the maintenance or use of a motor
vehicle, subject to any applicable deductibles, exclusions,
disqualifications, and other conditions, and shall provide a
minimum of $40,000 for loss arising out of the injury of any one
person, consisting of:

(1) $20,000 for medical expense loss arising out of injury
to any one person; and

(2) a total of $20,000 for income loss, replacement
services loss, funeral expense loss, survivor's economic loss,
and survivor's replacement services loss arising out of the
injury to any one person.

(b) deleted text begin Notwithstanding any other law to the contrary, a person
entitled to basic economic loss benefits under this chapter is
entitled to the full medical expense benefits set forth in
subdivision 2, and may not receive medical expense benefits that
are in any way less than those provided for in subdivision 2, or
that involve any preestablished limitations on the benefits.
Medical expenses must be reasonable and must be for necessary
medical care as provided in subdivision 2. This paragraph shall
not be deemed to alter the obligations of an insured or the
rights of a reparation obligor as set forth in section 65B.56.
deleted text end

deleted text begin (c) deleted text end No reparation obligor or health plan company as defined
in section 62Q.01, subdivision 4, may enter into or renew any
contract that provides, or has the effect of providing, managed
care services to no-fault claimants. For the purposes of this
section, "managed care services" is defined as any program of
medical services that uses health care providers managed, owned,
employed by, or under contract with a health plan company.

Sec. 2.

Minnesota Statutes 2004, section 65B.44,
subdivision 2, is amended to read:

Subd. 2.

Medical expense benefits.

(a) Medical expense
benefits shall reimburse deleted text begin all reasonable deleted text end expenses new text begin pursuant to
paragraph (f) new text end for necessary:

(1) medical, surgical, x-ray, optical, dental,
chiropractic, and rehabilitative services, including prosthetic
devices;

(2) prescription drugs;

(3) ambulance and all other transportation expenses
incurred in traveling to receive other covered medical expense
benefits;

(4) sign interpreting and language translation services,
other than such services provided by a family member of the
patient, related to the receipt of medical, surgical, x-ray,
optical, dental, chiropractic, hospital, extended care, nursing,
and rehabilitative services; and

(5) hospital, extended care, and nursing services.

(b) Hospital room and board benefits may be limited, except
for intensive care facilities, to the regular daily semiprivate
room rates customarily charged by the institution in which the
recipient of benefits is confined.

(c) Such benefits shall also include necessary remedial
treatment and services recognized and permitted under the laws
of this state for an injured person who relies upon spiritual
means through prayer alone for healing in accordance with that
person's religious beliefs.

(d) Medical expense loss includes medical expenses accrued
prior to the death of a person notwithstanding the fact that
benefits are paid or payable to the decedent's survivors.

(e) Medical expense benefits for rehabilitative services
shall be subject to the provisions of section 65B.45.

new text begin (f) Medical expense loss for diagnosis and treatment of
injury is covered only if provided in compliance with the codes,
treatment standards, and fee schedules provided in Minnesota
Rules, chapter 5221, except that payment rates for physical
medicine and rehabilitation procedure codes as defined in
Minnesota Rules, part 5221.4050, and chiropractic procedure
codes as defined in Minnesota Rules, part 5221.4060, must be
adjusted to eliminate application of scaling factors.
new text end

Sec. 3.

Minnesota Statutes 2004, section 65B.44,
subdivision 3, is amended to read:

Subd. 3.

Disability and income loss benefits.

Disability
and income loss benefits shall provide compensation for 85
percent of the injured person's loss of present and future gross
income from inability to work proximately caused by the nonfatal
injury subject to a maximum of deleted text begin $250 deleted text end new text begin $400 new text end per week. Loss of
income includes the costs incurred by a self-employed person to
hire substitute employees to perform tasks which are necessary
to maintain the income of the injured person, which are normally
performed by the injured person, and which cannot be performed
because of the injury.

If the injured person is unemployed at the time of injury
and is receiving or is eligible to receive unemployment benefits
under chapter 268, but the injured person loses eligibility for
those benefits because of inability to work caused by the
injury, disability and income loss benefits shall provide
compensation for the lost benefits in an amount equal to the
unemployment benefits which otherwise would have been payable,
subject to a maximum of deleted text begin $250 deleted text end new text begin $400 new text end per week.

Compensation under this subdivision shall be reduced by any
income from substitute work actually performed by the injured
person or by income the injured person would have earned in
available appropriate substitute work which the injured person
was capable of performing but unreasonably failed to undertake.

For the purposes of this section "inability to work" means
disability which prevents the injured person from engaging in
any substantial gainful occupation or employment on a regular
basis, for wage or profit, for which the injured person is or
may by training become reasonably qualified. If the injured
person returns to employment and is unable by reason of the
injury to work continuously, compensation for lost income shall
be reduced by the income received while the injured person is
actually able to work. The weekly maximums may not be prorated
to arrive at a daily maximum, even if the injured person does
not incur loss of income for a full week.

For the purposes of this section, an injured person who is
"unable by reason of the injury to work continuously" includes,
but is not limited to, a person who misses time from work,
including reasonable travel time, and loses income, vacation, or
sick leave benefits, to obtain medical treatment for an injury
arising out of the maintenance or use of a motor vehicle.

Sec. 4.

Minnesota Statutes 2004, section 65B.44,
subdivision 4, is amended to read:

Subd. 4.

Funeral and burial expenses.

Funeral and burial
benefits shall be reasonable expenses not in excess of
deleted text begin $2,000 deleted text end new text begin $5,000 new text end , including expenses for cremation or delivery
under the Uniform Anatomical Gift Act (1987), sections 525.921
to 525.9224.

Sec. 5.

Minnesota Statutes 2004, section 65B.51,
subdivision 3, is amended to read:

Subd. 3.

Limitation of damages for noneconomic
detriment.

In an action described in subdivision 1, no person
shall recover damages for noneconomic detriment unless deleted text begin :
deleted text end

deleted text begin (a) The sum of the following exceeds $4,000:
deleted text end

deleted text begin (1) reasonable medical expense benefits paid, payable or
payable but for any applicable deductible, plus
deleted text end

deleted text begin (2) the value of free medical or surgical care or ordinary
and necessary nursing services performed by a relative of the
injured person or a member of the injured person's household,
plus
deleted text end

deleted text begin (3) the amount by which the value of reimbursable medical
services or products exceeds the amount of benefit paid,
payable, or payable but for an applicable deductible for those
services or products if the injured person was charged less than
the average reasonable amount charged in this state for similar
services or products, minus
deleted text end

deleted text begin (4) the amount of medical expense benefits paid, payable,
or payable but for an applicable deductible for diagnostic
X-rays and for a procedure or treatment for rehabilitation and
not for remedial purposes or a course of rehabilitative
occupational training; or
deleted text end

deleted text begin (b) deleted text end the injury results in:

(1) deleted text begin permanent disfigurement deleted text end new text begin serious permanent impairment of
an important bodily function new text end ; new text begin or
new text end

(2) deleted text begin permanent injury;
deleted text end

deleted text begin (3) deleted text end death deleted text begin ; or
deleted text end

deleted text begin (4) disability for 60 days or more deleted text end .

deleted text begin (c) For the purposes of clause (a) evidence of the
reasonable value of medical services and products shall be
admissible in any action brought in this state.
deleted text end

deleted text begin For the purposes of this subdivision disability means the
inability to engage in substantially all of the injured person's
usual and customary daily activities.
deleted text end

Sec. 6.

Minnesota Statutes 2004, section 65B.525,
subdivision 1, is amended to read:

Subdivision 1.

Mandatory submission to binding
arbitration.

Except as otherwise provided in section 72A.327,
the Supreme Court and the several courts of general trial
jurisdiction of this state shall by rules of court or other
constitutionally allowable device, provide for the mandatory
submission to binding arbitration new text begin at the request of either party
new text end of deleted text begin all deleted text end cases at issue where the claim at the deleted text begin commencement of
arbitration deleted text end new text begin time of hearing new text end is in deleted text begin an deleted text end new text begin the total new text end amount of $10,000
or less against any insured's reparation obligor for no-fault
benefits deleted text begin or comprehensive or collision damage coverage deleted text end .

Sec. 7.

Minnesota Statutes 2004, section 65B.525, is
amended by adding a subdivision to read:

new text begin Subd. 3. new text end

new text begin Itemization; full payment. new text end

new text begin All arbitration
awards must be itemized. A partial award of medical benefits
rendered by an arbitrator under this section and paid by an
obligor will be considered full and final payment, and the
injured party is not liable for, nor may the provider bill the
injured party for, charges that are not part of the award. This
subdivision does not apply to charges for health care that are
not related to the accident.
new text end

Sec. 8.

Minnesota Statutes 2004, section 65B.525, is
amended by adding a subdivision to read:

new text begin Subd. 4. new text end

new text begin Notice to providers. new text end

new text begin The itemization of medical
services claims required under the rules promulgated by the
Supreme Court must include the names and addresses of all health
care providers whose charges are the subject of the claims.
Within ten business days after receipt of the itemization, the
administrator of arbitration under this section must send a copy
of the petition and itemization to each health care provider
whose charges are the subject of claims, together with a notice
of the content of subdivision 3 and of the provider's right to
participate as a party to the proceeding. The notice must
explain to the provider what steps the provider must take in
order to participate.
new text end

Sec. 9. new text begin EFFECTIVE DATES.
new text end

new text begin (a) Sections 1 and 2 are effective January 1, 2006, and
apply to medical expenses incurred on or after that date.
new text end

new text begin (b) Sections 3 to 8 are effective January 1, 2006, and
apply to coverage issued or renewed on or after that date.
new text end