SF 1714

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to insurance; requiring uniform processing of health plan claims;
proposing coding for new law in Minnesota Statutes, chapter 62A.

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

Section 1.

new text begin [62A.67] UNIFORM CLAIMS PROCESSING.
new text end

new text begin (a) The commissioner may seek recommendations on standards to establish a
uniform claim form and uniform billing and claim codes from a council of representatives
from the health care industry. Based upon the recommendations of such a council, the
commissioner may issue rules pursuant to section 14.389 requiring the use by all health
plans, health carriers, licensed insurers or third-party administrators, collectively "payers,"
and health care providers, collectively "providers," of a uniform claim form, uniform
billing, or uniform claim codes.
new text end

new text begin (b) To the extent that the commissioner does not issue rules establishing a uniform
claim form, uniform billing, and uniform claim codes, beginning January 15, 2008,
the commissioner shall adopt rules pursuant to section 14.389 requiring all payers and
providers to use a uniform claim form and uniform billing and claim codes. Before
adopting such rules, the commissioner shall seek recommendations from a council of
representatives from the health care industry. The commissioner may base the rules
required by this paragraph, in whole or in part, on standards identical to those required by
the Medicare program, or on such alternative standard as the commissioner finds will be
most effective in fulfilling the mandate for uniformity articulated in this section.
new text end

new text begin (c) Beginning January 15, 2009, all payers shall offer, and all providers shall
use, compatible systems of electronic billing approved by the commissioner through
rulemaking under section 14.389. The systems approved by the commissioner may
include monitoring and disseminating information concerning eligibility and coverage of
individuals. The systems must be capable of accepting all permissible data elements on a
claim form in order to ensure the most accurate payment and claim determination.
new text end

new text begin No payer or provider shall add to or modify these requirements and no payer shall
impose any fee for use of this system.
new text end

new text begin (d) For purposes of this section, "health carrier" and "health plan" have the meanings
given in section 62A.011, and "third-party administrator" and "licensed insurer" have the
meanings given in section 62H.10.
new text end

Sec. 2. new text begin EFFECTIVE DATE.
new text end

new text begin Section 1 is effective the day following final enactment.
new text end