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SF 1175

as introduced - 89th Legislature (2015 - 2016) Posted on 02/27/2015 09:33am

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to health care; modifying health plan contracting requirements;
amending Minnesota Statutes 2014, sections 62Q.733, subdivision 3; 62Q.735,
subdivisions 2, 5.

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

Section 1.

Minnesota Statutes 2014, section 62Q.733, subdivision 3, is amended to read:


Subd. 3.

Health care provider or provider.

"Health care provider" or "provider"
means a physician, chiropractor, dentist, podiatrist,new text begin clinic,new text end or other provider as defined
under section 62J.03, other than hospitals, ambulatory surgical centers, or freestanding
emergency rooms.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2015, and applies to contracts
entered into, renewed, or amended on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2014, section 62Q.735, subdivision 2, is amended to read:


Subd. 2.

Proposed amendments.

(a) Any amendment or change in the terms of an
existing contract between a health plan company and a provider must be disclosed to the
provider at least deleted text begin45deleted text endnew text begin 165new text end days prior to the effective date of the proposed change, with the
exception of amendments required of the health plan company by law or governmental
regulatory authority, when notice shall be given to the provider when the requirement is
made known to the health plan company.

(b) Any amendment or change in the contract that alters the fee schedule or
materially alters the written contractual policies and procedures governing the relationship
between the provider and the health plan company must be disclosed to the provider not
less than deleted text begin45deleted text endnew text begin 165new text end days before the effective date of the proposed change and the provider
must have the opportunity to terminate the contract before the amendment or change
is deemed to be in effect.

(c) By mutual consent, evidenced in writing in amendments separate from the
base contract and not contingent on participation, the parties may waive the disclosure
requirements under paragraphs (a) and (b).

(d) Notwithstanding paragraphs (a) and (b), the effective date of contract termination
shall comply with the terms of the contract when a provider terminates a contract.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2015, and applies to contracts
entered into, renewed, or amended on or after that date.
new text end

Sec. 3.

Minnesota Statutes 2014, section 62Q.735, subdivision 5, is amended to read:


Subd. 5.

Fee schedules.

(a) A health plan company shall provide, deleted text beginupon requestdeleted text endnew text begin no
later than 165 days before the next contract year's effective date
new text end, any additional fees or
fee schedules relevant to the particular provider's practice beyond those provided with
the renewal documents for the next contract year to all participating providers, excluding
claims paid under the pharmacy benefit. Health plan companies may fulfill the requirements
of this section by making the full fee schedules available new text beginno later than 165 days before the
next contract year's effective date
new text endthrough a secure Web portal for contracted providers.

(b) A dental organization may satisfy paragraph (a) by complying with section
62Q.735, subdivision 1, paragraph (c).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2015, and applies to contracts
entered into, renewed, or amended on or after that date.
new text end