Minnesota Legislature
SF 3606
as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am
Current Version - as introduced
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A bill for an act
relating to health; changing the evaluation process for mandated health benefit
proposals; requiring a report; amending Minnesota Statutes 2006, section 62J.26.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2006, section 62J.26, is amended to read:
62J.26 EVALUATION OF PROPOSED HEALTH COVERAGE MANDATES.
Subdivision 1.
Definitions.
For purposes of this section, the following terms have
the meanings given unless the context otherwise requires:
(1) "commissioner" means the commissioner of deleted text begin commercedeleted text end new text begin healthnew text end ;
(2) "health plan" means a health plan as defined in section 62A.011, subdivision 3,
but includes coverage listed in clauses (7) and (10) of that definition;
(3) "mandated health benefit proposal" means a proposal that would statutorily new text begin or
by adopted rules new text end require a health plan to do the following:
(i) provide coverage or increase the amount of coverage for the treatment of a
particular disease, condition, or other health care need;
(ii) provide coverage or increase the amount of coverage of a particular type of
health care treatment or service or of equipment, supplies, or drugs used in connection
with a health care treatment or service; or
(iii) provide coverage for care delivered by a specific type of provider.
"Mandated health benefit proposal" does not include health benefit proposals
deleted text begin amendingdeleted text end new text begin which solely amendnew text end the scope of practice of a licensed health care professional.
Subd. 2.
Evaluation process and content.
(a) The commissioner, in consultation
with the deleted text begin commissioners of health and employee relationsdeleted text end new text begin commissioner of commercenew text end ,
must evaluate mandated health benefit proposals as provided under subdivision 3.
(b) The purpose of the evaluation is to provide deleted text begin the legislature withdeleted text end a complete
and timely analysis of all ramifications of any mandated health benefit proposal. The
evaluation must include, in addition to other relevant information, the following:
(1) new text begin an evidence-based scientific review of the proposed treatment, service,
equipment, supply, or drug. "Evidence-based scientific review" means a comprehensive
review which examines reliable scientific evidence regarding safety, effectiveness, and
effect on health outcomes. The criteria for such a review shall utilize a preponderance of
reliable evidence as described in Minnesota Rules, part 4685.0700, subpart 4, item F.
new text end
new text begin (2) new text end scientific and medical information on deleted text begin the proposed health benefit, on the potential
for harm or benefit to the patient, and ondeleted text end the comparative benefit or harm from alternative
forms of treatment;
deleted text begin (2)deleted text end new text begin (3)new text end public health, economic, and fiscal impacts of the deleted text begin proposed mandatedeleted text end new text begin
mandated health benefit proposalnew text end on persons receiving health services in Minnesota, on
the relative cost-effectiveness of the benefit, and on the health care system in general;
deleted text begin (3)deleted text end new text begin (4)new text end the extent to which the deleted text begin servicedeleted text end new text begin mandated health benefit proposalnew text end is generally
utilized by a significant portion of the population;
deleted text begin (4)deleted text end new text begin (5)new text end the extent to which insurance coverage for the deleted text begin proposeddeleted text end mandatednew text begin healthnew text end
benefitnew text begin proposalnew text end is already generally available;
deleted text begin (5)deleted text end new text begin (6)new text end the extent to which the mandated deleted text begin coveragedeleted text end new text begin health benefit proposalnew text end will
increase or decrease the cost of the service; and
deleted text begin (6)deleted text end new text begin (7)new text end the commissioner may consider actuarial analysis done by health insurers in
determining the cost of the deleted text begin proposeddeleted text end mandatednew text begin healthnew text end benefitnew text begin proposalnew text end .
(c) The commissioner must summarize the nature and quality of available
information on these issues, and, if possible, must provide preliminary information to
the public. The commissioner may conduct new text begin appropriate new new text end research on these issues
or may determine that existing research is sufficient deleted text begin to meet the informational needs
of the legislaturedeleted text end . new text begin The commissioner must include the opinions of two or more private
firms which specialize in the independent evaluation of health care treatments, services,
equipment, supplies, or drugs using evidence-based scientific review as defined in this
subdivision. Additionally, new text end the commissioner may seek the assistance and advice of
researchers, community leaders, or other persons or organizations with relevant expertise.
Subd. 3.
Requests for evaluation.
(a) Whenever a legislative measure containing a
mandated health benefit proposal is introduced as a bill or offered as an amendment to a
bill, or is likely to be introduced as a bill or offered as an amendment, deleted text begin adeleted text end new text begin thenew text end chair of
deleted text begin anydeleted text end new text begin thenew text end standing legislative committee that has jurisdiction over the subject matter of the
proposal deleted text begin maydeleted text end new text begin shallnew text end request that the commissioner complete an evaluation of the proposal
under this section, new text begin in order new text end to inform deleted text begin anydeleted text end new text begin thenew text end committee deleted text begin ofdeleted text end new text begin prior tonew text end floor action by either
house of the legislature.
deleted text begin
(b) The commissioner must conduct an evaluation described in subdivision 2 of each
mandated health benefit proposal for which an evaluation is requested under paragraph (a),
unless the commissioner determines under paragraph (c) or subdivision 4 that priorities
and resources do not permit its evaluation.
deleted text end
deleted text begin
(c) If requests for evaluation of multiple proposals are received, the commissioner
must consult with the chairs of the standing legislative committees having jurisdiction
over the subject matter of the mandated health benefit proposals to prioritize the requests
and establish a reporting date for each proposal to be evaluated. The commissioner
is not required to direct an unreasonable quantity of the commissioner's resources to
these evaluations.
deleted text end
new text begin
(b) Whenever a regulatory agency proposes any order, action, or review or
approval of contracts of coverage which has the effect of creating a mandated health
benefit proposal, the proponent of the order, action, or contract review shall request the
commissioner of health to complete an evaluation of the proposal under this section, in
order to inform the proponent prior to final order, action, or contract review.
new text end
Subd. 4.
Sources of funding.
(a) The commissioner need not use any funds for
purposes of this section other than as provided in this subdivision or as specified in an
appropriation.
(b) The commissioner may seek and accept funding from sources other than the state
to pay for evaluations under this section to supplement or replace state appropriations.
Any money received under this paragraph must be deposited in the state treasury, credited
to a separate account for this purpose in the special revenue fund, and is appropriated to
the commissioner for purposes of this section.
(c) If a request for an evaluation under this section has been made, the commissioner
may use for purposes of the evaluation:
(1) any funds appropriated to the commissioner specifically for purposes of this
section; or
(2) funds available under paragraph (b), if use of the funds for evaluation of that
mandated health benefit proposal is consistent with any restrictions imposed by the
source of the funds.
(d) The commissioner must ensure that the source of the funding has no influence on
the process or outcome of the evaluation.
Subd. 5.
Report deleted text begin to legislaturedeleted text end .
new text begin (a) For an evaluation under subdivision 3, paragraph
(a), new text end the commissioner must submit a written report on the evaluation to the legislature
no later than deleted text begin 180deleted text end new text begin 90new text end days after the request. The report must be submitted in compliance
with sections 3.195 and 3.197.
new text begin
(b) For an evaluation under subdivision 3, paragraph (b), the commissioner must
submit a written report on the evaluation to the requesting agency proponent no later than
90 days after the request and concurrently publish a notice in the State Register to make
the report available to the public.
new text end