SF 1812

as introduced - 89th Legislature (2015 - 2016) Posted on 03/17/2015 09:25am

A bill for an act
relating to state government; creating a three-year price transparency pilot project
in certain areas of the state within the state employee group insurance program;
appropriating money.

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

Section 1. new text begin PRICE TRANSPARENCY PILOT PROGRAM.
new text end

new text begin (a) The commissioner of management and budget shall establish a three-year pilot
project to reward value-based pricing for certain diagnostic and surgical procedures within
the state employee group insurance program (SEGIP). The goal of the pilot project is to
reward value-based pricing decisions by publishing the prices of certain diagnostic and
surgical procedures, permitting enrollees to choose among providers, and sharing with the
enrollees any savings generated by the enrollee's choice of providers.
new text end

new text begin (b) For purposes of implementing the pilot project, the commissioner shall designate
at least one and no more than three geographical areas in the state where a substantial
percentage of SEGIP enrollees reside and there is more than one provider in the area that
performs the specific procedure. The SEGIP enrollees residing in the designated area or
areas may participate in the pilot project beginning January 1, 2016. Enrollee participation
in the project is voluntary.
new text end

new text begin (c) By October 1, 2015, the commissioner shall designate between 20 and 50
diagnostic or surgical procedures that are commonly utilized by SEGIP enrollees. By
November 1, 2015, and each November 1 for the next three years, health plan companies
that contract with the state to provide services for SEGIP enrollees shall provide the
commissioner with the contracted price for the following calendar year, by provider, for
each designated procedure. The commissioner shall post the prices on its Web site and
shall designate one price per procedure as the benchmark price using a mean or other
method of comparing prices.
new text end

new text begin (d) An enrollee participating in the project may choose the provider to perform the
designated procedure. If the enrollee selects a provider that performs the designated
procedure at a price below the benchmark price for that procedure, the enrollee shall
receive from the state 50 percent of the difference between the price of the procedure by
the selected provider and the benchmark price.
new text end

new text begin (e) On or before March 1, 2017, March 1, 2018, and March 1, 2019, the
commissioner shall submit an annual report to the legislature on the implementation of
the pilot project, including the participation level in the project, the amounts paid to
enrollees, and the cost-savings to both the enrollees and the state resulting from the price
transparency pilot project for the previous calendar year.
new text end

Sec. 2. new text begin APPROPRIATION.
new text end

new text begin $....... is appropriated in fiscal year 2016 from the general fund to the commissioner
of management and budget to implement the price transparency pilot program. This is
a onetime appropriation.
new text end