SF 2402

as introduced - 90th Legislature (2017 - 2018) Posted on 05/19/2017 09:05am

A bill for an act
relating to health care; modifying health plan contracting requirements; amending
Minnesota Statutes 2016, 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 2016, 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, 2017, and applies to contracts
entered into, renewed, or amended on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2016, 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 45 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. new text begin If a health plan company fails to provide an amendment or
change in terms at least 45 days prior to the effective date of the proposed change, as required
by this paragraph, the proposed amendment or change in terms shall not be effective until
the next contract year.
new text end

(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
45 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. new text begin If a health plan company fails to provide an amendment or change in the contract
that alters the fee schedule or materially alters the written contractual policies and procedures,
at least 45 days prior to the effective date of the proposed change, as required by this
paragraph, the proposed change in terms shall not be effective until the next contract year.
new text end

(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, 2017, and applies to contracts
entered into, renewed, or amended on or after that date.
new text end

Sec. 3.

Minnesota Statutes 2016, section 62Q.735, subdivision 5, is amended to read:

Subd. 5.

Fee schedules.

(a) A health plan company shall provide, deleted text begin upon request deleted text end new text begin no later
than 45 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 begin no later than 45 days before the next
contract year's effective date new text end through a secure Web portal for contracted providers. new text begin If a
health plan company fails to provide any additional fees or fee schedules at least 45 days
before the next contract year's effective date, as required by this paragraph, the fees on the
existing fee schedules are effective for the next contract year, as increased by the most
recently published rates in the Consumer Price Index for All Urban Consumers for Medical
Care Services for the Minneapolis region.
new text end

(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, 2017, and applies to contracts
entered into, renewed, or amended on or after that date.
new text end