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SF 3032

1st Engrossment - 90th Legislature (2017 - 2018) Posted on 03/22/2018 09:06am

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
 relating to health insurance; requiring notification prior to provider network
changes; amending Minnesota Statutes 2016, section 62K.075.

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

Section 1.

Minnesota Statutes 2016, section 62K.075, is amended to read:


62K.075 PROVIDER NETWORK new text begin AND COST LEVELnew text end NOTIFICATIONS.

new text begin (a) Before a health carrier may change a provider's network status from in-network status
to out-of-network status, or any known tier or cost level change, the health carrier must
provide notification to the provider and to each enrollee who has utilized that provider at
any time within the previous 12 months from the date of the required notification. Notification
must be provided at least 60 days prior to the effective date of the network status change
and must be made either by U.S. mail or through electronic mail.
 new text end

deleted text begin (a)deleted text end new text begin (b)new text end A health carrier must update the carrier's Web site at least once a month with any
changes to the carrier's provider network, new text begin or any known tier or cost level change,new text end including
provider changes from in-network status to out-of-network statusnew text begin after notification as required
under paragraph (a) has been givennew text end .

deleted text begin (b)deleted text end new text begin (c)new text end Upon notification from an enrollee, a health carrier must reprocess any claim for
services provided by a provider whose status has changed from in-network to out-of-network
as an in-network claim if the service was provided after the network change went into effect
but before the change was posted as required under paragraph deleted text begin (a)deleted text end new text begin (b)new text end unless the health carrier
notified the enrollee of the network change prior to the service being provided. This paragraph
does not apply if the health carrier is able to verify that the health carrier's Web site displayed
the correct provider network status on the health carrier's Web site at the time the service
was provided.

deleted text begin (c)deleted text end new text begin (d)new text end The limitations of section 62Q.56, subdivision 2a, shall apply to payments required
by paragraph deleted text begin (b)deleted text end new text begin (c)new text end .