SF 55

as introduced - 90th Legislature (2017 - 2018) Posted on 01/11/2017 08:46am

A bill for an act
relating to health care; providing for verification of eligibility for premium
assistance; providing that certain health plan rate data are public; amending
Minnesota Statutes 2016, section 60A.08, subdivision 15.

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

Section 1.

Minnesota Statutes 2016, section 60A.08, subdivision 15, is amended to read:

Subd. 15.

Classification of insurance filings data.

(a) All forms, rates, and related
information filed with the commissioner under section 61A.02 shall be nonpublic data until
the filing becomes effective.

(b) All forms, rates, and related information filed with the commissioner under section
62A.02 shall be nonpublic data until the filing becomes effective.

(c) All forms, rates, and related information filed with the commissioner under section
62C.14, subdivision 10, shall be nonpublic data until the filing becomes effective.

(d) All forms, rates, and related information filed with the commissioner under section
70A.06 shall be nonpublic data until the filing becomes effective.

(e) All forms, rates, and related information filed with the commissioner under section
79.56 shall be nonpublic data until the filing becomes effective.

(f) Notwithstanding paragraphs (b) and (c), for all rate increases subject to review under
section 2794 of the Public Health Services Act and any amendments to, or regulations, or
guidance issued under the act that are filed with the commissioner on or after September 1,
2011, the commissioner:

(1) may acknowledge receipt of the information;

(2) may acknowledge that the corresponding rate filing is pending review;

(3) must provide public access from the Department of Commerce's Web site to parts I
and II of the Preliminary Justifications of the rate increases subject to review; and

(4) must provide notice to the public on the Department of Commerce's Web site of the
review of the proposed rate, which must include a statement that the public has 30 calendar
days to submit written comments to the commissioner on the rate filing subject to review.

new text begin (g) Notwithstanding paragraphs (b) and (c), for all rates for individual health plans, as
defined in section 62A.011, subdivision 4, and small employer plans, as defined in section
62L.02, subdivision 28, the commissioner must provide:
new text end

new text begin (1) public access to the information described in clause (2) from the Department of
Commerce's Web site within ten days of receiving a rate filing from a health plan, as defined
in section 62A.011, subdivision 3; and
new text end

new text begin (2) compiled data of the proposed change to rates separated by health plan and geographic
rating area.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 30 days following final enactment.
new text end

Sec. 2. new text begin TRANSITION OF CARE COVERAGE FOR CALENDAR YEAR 2017;
REQUEST FOR AUTHORIZATION.
new text end

new text begin (a) The definitions in Minnesota Statutes, sections 62A.011 and 62Q.01, apply to this
section.
new text end

new text begin (b) An enrollee's health plan company may require medical records and other supporting
documentation to be submitted with a request for authorization for transition of care coverage.
If authorization is denied, the health plan company must explain the criteria used to make
its decision on the request for authorization and must explain the enrollee's right to appeal
the decision. If an enrollee chooses to appeal a denial, the enrollee must appeal the denial
within five business days of the date on which the enrollee receives the denial. If authorization
is granted, the health plan company must provide the enrollee, within five business days of
granting the authorization, with an explanation of how transition of care will be provided.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for health plans issued after December
31, 2016, and before March 2, 2017, and that are in effect for all or a portion of calendar
year 2017. This section expires June 30, 2018.
new text end

Sec. 3. new text begin VERIFYING ELIGIBILITY FOR PREMIUM ASSISTANCE; PROGRAM
INTEGRITY.
new text end

new text begin Subdivision 1. new text end

new text begin Verification of residency. new text end

new text begin The commissioner of management and budget
may access data from the Department of Employment and Economic Development and the
Department of Revenue to verify that persons applying for health care premium assistance
are residents of Minnesota.
new text end

new text begin Subd. 2. new text end

new text begin Program integrity. new text end

new text begin The commissioner of revenue shall review information
available from Minnesota Management and Budget, the Department of Human Services,
MNsure, and the most recent Minnesota tax records to identify ineligible individuals who
received health care premium assistance. The commissioner of revenue shall recover the
amount of any premium assistance paid on behalf of an ineligible individual from the
ineligible individual, in the manner provided by law for the collection of unpaid taxes or
erroneously paid refunds of taxes.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end