Minnesota Legislature
SF 2382
1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 07/05/2023 03:43pm
Current Version - 1st Engrossment
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A bill for an act
relating to commerce; establishing a Mental Health Parity and Substance Abuse
Accountability Office in the Department of Commerce; appropriating money;
amending Minnesota Statutes 2022, section 62K.10, subdivisions 2, 4, 8; proposing
coding for new law in Minnesota Statutes, chapter 62Q.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2022, section 62K.10, subdivision 2, is amended to read:
Subd. 2.
Primary care; mental health services; general hospital services.
The
maximum travel distance or time shall be the lesser of 30 miles or 30 minutes to the nearest
provider of each of the following services: primary care services, mental healthnew text begin and substance
disordernew text end services, and general hospital servicesnew text begin , provided that a health carrier only meets
this standard if the nearest provider has the availability to see an enrollee, new or existing,
within ..... daysnew text end .
Sec. 2.
Minnesota Statutes 2022, section 62K.10, subdivision 4, is amended to read:
Subd. 4.
Network adequacy.
new text begin (a) new text end Each designated provider network must include a
sufficient number and type of providers, including providers that specialize in mental health
and substance use disorder services, to ensure that covered services are available to all
enrollees without unreasonable delay. In determining network adequacy, the commissioner
of health shall consider availability of services, including the following:
(1) primary care physician services are available and accessible 24 hours per day, seven
days per week, within the network area;
(2) a sufficient number of primary care physicians have hospital admitting privileges at
one or more participating hospitals within the network area so that necessary admissions
are made on a timely basis consistent with generally accepted practice parameters;
(3) specialty physician service is available through the network or contract arrangement;
(4) mental health and substance use disorder treatment providers are available and
accessible through the network or contract arrangement;
(5) to the extent that primary care services are provided through primary care providers
other than physicians, and to the extent permitted under applicable scope of practice in state
law for a given provider, these services shall be available and accessible; and
(6) the network has available, either directly or through arrangements, appropriate and
sufficient personnel, physical resources, and equipment to meet the projected needs of
enrollees for covered health care services.
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(b) In determining whether a designated provider network described in paragraph (a)
includes a sufficient number and type of providers that specialize in mental health and
substance use disorder treatment to ensure that covered services are available to all enrollees
without unreasonable delay, and in determining whether such providers are available and
accessible through the network or contract arrangement, the commissioner shall request,
and a health carrier must submit, on an annual basis comparative data regarding access to
mental health and substance use disorder care and access to medical and surgical care, which
shall include information, reported separately for adults versus children and adolescents,
on the ability of enrollees to:
new text end
new text begin
(1) access initial appointments with physicians specializing in the treatment of mental
health conditions or substance use disorders;
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(2) access follow-up appointments with physicians specializing in the treatment of mental
health conditions or substance use disorders;
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(3) access initial appointments with physicians specializing in the treatment of medical
or surgical conditions;
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(4) access follow-up appointments with physicians specializing in the treatment of
medical or surgical conditions;
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(5) access initial appointments with mental health and licensed alcohol and drug
counselors with prescriptive authority specializing in the treatment of mental health
conditions or substance use disorders;
new text end
new text begin
(6) access follow-up appointments with mental health practitioners and licensed alcohol
and drug counselors with prescriptive authority specializing in the treatment of mental health
conditions or substance use disorders;
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(7) access initial appointments with mental health practitioners and licensed alcohol and
drug counselors with prescriptive authority specializing in the treatment of medical or
surgical conditions;
new text end
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(8) access follow-up appointments with mental health practitioners and licensed alcohol
and drug counselors with prescriptive authority specializing in the treatment of medical or
surgical conditions;
new text end
new text begin
(9) access initial appointments with mental health practitioners and licensed alcohol and
drug counselors specializing in the treatment of mental health conditions or substance use
disorders;
new text end
new text begin
(10) access follow-up appointments with mental health practitioners and licensed alcohol
and drug counselors specializing in the treatment of mental health conditions or substance
use disorders;
new text end
new text begin
(11) access initial appointments with mental health practitioners and licensed alcohol
and drug counselors specializing in the treatment of medical or surgical conditions; and
new text end
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(12) access follow-up appointments with mental health practitioners and licensed alcohol
and drug counselors specializing in the treatment of medical or surgical conditions.
new text end
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The commissioner shall prescribe the method of and format for health carriers to submit
the data required in clauses (1) to (12).
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(c) The commissioner shall calculate the average number of days an enrollee must wait
before accessing the respective provider and appointment types identified in paragraph (b),
clauses (1) to (12), and a health carrier shall provide the commissioner with any requested
data or information needed for the commissioner to perform such calculations. The
commissioner, in collaboration with each health carrier, shall use reasonable assumptions
related to statistics and research methods to identify representative samples for analysis to
complete the calculations described in this paragraph and other such methods as the
commissioner determines appropriate.
new text end
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(d) The average number of days calculated in paragraph (c), based on the provider and
appointment types identified in paragraph (b), shall be compared as follows:
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(1) the average day wait result identified for paragraph (b), clause (3), shall be divided
by the average day wait result identified for paragraph (b), clause (1);
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(2) the average day wait result identified for paragraph (b), clause (4), shall be divided
by the average day wait result identified for paragraph (b), clause (2);
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(3) the average day wait result identified for paragraph (b), clause (7), shall be divided
by the average day wait result identified for paragraph (b), clause (5);
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(4) the average day wait result identified for paragraph (b), clause (8), shall be divided
by the average day wait result identified for paragraph (b), clause (6);
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(5) the average day wait result identified for paragraph (b), clause (11), shall be divided
by the average day wait result identified for paragraph (b), clause (9); and
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(6) the average day wait result identified for paragraph (b), clause (12), shall be divided
by the average day wait result identified for paragraph (b), clause (10).
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(e) The ratios established under paragraph (d) for 2023 shall establish a baseline for
potential improvement for a health carrier in subsequent years. For years subsequent to
2023, a health carrier shall:
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(1) not be required to take any action to improve any ratio that is 1.0 or higher;
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(2) improve any ratio that is lower than 0.9 but higher than 0.6 so that in the succeeding
year the ratio is at least 0.9;
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(3) improve any ratio that is lower than 0.6 but higher than 0.3 so that in the immediate
succeeding year the ratio is at least 0.6 and in the next subsequent year the ratio is at least
0.9; and
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(4) improve any ratio that is lower than 0.3 so that in the immediate succeeding year the
ratio is at least 0.3 and in the next subsequent year the ratio is at least 0.6 and in the next
following year the ratio is at least 0.9.
new text end
Sec. 3.
Minnesota Statutes 2022, section 62K.10, subdivision 8, is amended to read:
Subd. 8.
Enforcement.
new text begin (a) new text end The commissioner of health shall enforce this section.
new text begin
(b) With respect to subdivision 4, paragraph (e), the commissioner may impose a civil
penalty not to exceed $10,000 per violation for each day the violation continues.
new text end
Sec. 4.
new text begin
[62Q.465] MENTAL HEALTH PARITY AND SUBSTANCE ABUSE
ACCOUNTABILITY OFFICE.
new text end
new text begin
(a) The Mental Health Parity and Substance Abuse Accountability Office is established
within the Department of Commerce to create and execute effective strategies for
implementing the requirements under:
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(1) Minnesota Statutes, section 62Q.47;
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(2) the federal Mental Health Parity Act of 1996, Public Law 104-204;
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(3) the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction
Equity Act of 2008, Public Law 110-343, division C, sections 511 and 512;
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(4) the Affordable Care Act, as defined under section 62A.011, subdivision 1a; and
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(5) amendments made to, and federal guidance or regulations issued or adopted under,
the acts listed under clauses (2) to (4).
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(b) The office may oversee compliance reviews, conduct and lead stakeholder
engagement, review consumer and provider complaints, and serve as a resource for ensuring
health plan compliance with mental health and substance abuse requirements.
new text end
Sec. 5. new text begin APPROPRIATION.
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$500,000 in fiscal year 2024 and $500,000 in fiscal year 2025 are appropriated from the
general fund to the commissioner of commerce to create and operate the Mental Health
Parity and Substance Abuse Accountability Office.
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