SF 203

1st Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 02:11am

A bill for an act
relating to health; establishing oversight for rural health cooperative
arrangements; establishing an application fee; appropriating money; proposing
coding for new law in Minnesota Statutes, chapter 62R.

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

Section 1.

new text begin [62R.09] ANTITRUST IMMUNITY.
new text end

new text begin Subdivision 1. new text end

new text begin Intent; purpose. new text end

new text begin The legislature finds that the goals of controlling
health care costs and improving the quality of and access to health care services in rural
areas are significantly enhanced by the development of health care cooperatives created
under this chapter. To promote health care cooperative arrangements, it is necessary for the
cooperatives to collectively negotiate on behalf of their members. Although negotiations
may raise competitive issues, the legislature finds that properly supervised health care
cooperative negotiations will enhance the delivery of health care in rural markets. The
legislature further finds that by establishing a system of review and supervision of health
care cooperative contractual negotiations competition is preserved. The purpose of this
legislation is to clarify the provisions in this chapter to ensure that health care cooperative
arrangements under section 62R.06 are not in violation of state or federal antitrust law.
new text end

new text begin Subd. 2. new text end

new text begin Review and approval; monitoring. new text end

new text begin (a) The commissioner shall review
and authorize contracts and business or financial arrangements under section 62R.06,
subdivision 1. All contracts and business or financial arrangements must be submitted on
an application for approval to the commissioner.
new text end

new text begin (b) Within 30 days after receiving an application, the commissioner may request
additional information that is necessary to complete the review required under this section.
If the commissioner does not request additional information and does not act within
60 days after receipt of an application, the application shall be deemed approved. If
the commissioner requests additional information and does not act within 60 days of
receiving additional information sufficient to evaluate the application, as determined by
the commissioner, the application shall be deemed approved. The commissioner shall not
deny any application unless the commissioner determines, using the criteria in paragraph
(g), that: (1) the anticompetitive effects of the arrangement on the marketplace exceed
the procompetitive effects or efficiencies, or that any price agreements included in the
arrangement are not necessary to achieve the efficiencies that are expected to result from
the arrangement; or (2) the applicant has not provided complete or sufficient information
requested by the commissioner to evaluate the impact of the proposed arrangement on the
health care marketplace.
new text end

new text begin (c) The commissioner may collect information from other parties, such as health
plan companies or other health care providers operating in the same geographic area as the
health care cooperative, to assist in evaluating the impact of the proposed arrangement
on the health care marketplace. Data collected from health plan companies and health
care providers under this paragraph are nonpublic data or private data on individuals, as
defined in section 13.02.
new text end

new text begin (d) The commissioner may solicit public comment on the impact of the proposed
arrangement.
new text end

new text begin (e) The commissioner may condition approval of a proposed arrangement on a
modification of all or part of the arrangement to eliminate any restriction on competition
that is not reasonably related to the goals of improving health care access or quality. The
commissioner may also establish conditions for approval that are reasonably necessary
to protect against abuses of private economic power and to ensure that the arrangement
has oversight by the state.
new text end

new text begin (f) The commissioner shall monitor arrangements approved under this section to
ensure that the arrangement remains in compliance with the conditions of approval. The
commissioner may revoke an approval upon a finding that the arrangement is not in
substantial compliance with the terms of the application or the conditions of approval.
new text end

new text begin (g) In evaluating applications received under this section, the commissioner shall
consider whether:
new text end

new text begin (1) the arrangement is likely to produce significant efficiencies that benefit
consumers, such as cost savings or improvements in quality of or access to care;
new text end

new text begin (2) the arrangement is likely to have any anticompetitive effects on the marketplace;
and
new text end

new text begin (3) the potential anticompetitive effects outweigh the procompetitive efficiencies
resulting from the arrangement.
new text end

new text begin Subd. 3. new text end

new text begin Applications. new text end

new text begin (a) Applications for approval under this section must
include a detailed description of the proposed arrangement.
new text end

new text begin (b) The application must include:
new text end

new text begin (1) the identities of all the parties to the arrangement;
new text end

new text begin (2) the participation rules for the cooperative, including the terms and conditions
under which participating providers may be members of the cooperative;
new text end

new text begin (3) a description of the geographic areas served by the cooperative and the products
provided, and a list of competing providers that are not members of the cooperative;
new text end

new text begin (4) a description of any restriction on participating members of the cooperative
entering into other contracts with payers; and
new text end

new text begin (5) a description of the increased efficiency, improved health care access, improved
health care quality, or increased market competition that will result from the arrangement.
new text end

new text begin (c) Data on providers collected under this section are private data on individuals or
nonpublic data, as defined in section 13.02.
new text end

new text begin Subd. 4. new text end

new text begin Application fee. new text end

new text begin When submitting an application to the commissioner, a
health care cooperative shall pay a fee of $2,000 for the commissioner's cost of reviewing
and monitoring the arrangement. Revenue received by the commissioner under this section
shall be appropriated to the commissioner for the purpose of administering this section.
new text end