SF 960

3rd Engrossment - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to health care; prohibiting contracts that 
  1.3             restrict communication between providers and their 
  1.4             patients; requiring certain disclosures; requiring 
  1.5             health plan companies to provide continuity of care 
  1.6             and access to specialty care for certain enrollees; 
  1.7             prohibiting certain exclusive arrangements; modifying 
  1.8             dispute resolution provisions; requiring 
  1.9             identification of health care providers; requiring 
  1.10            emergency services coverage; establishing a consumer 
  1.11            advisory board; amending Minnesota Statutes 1996, 
  1.12            sections 62Q.105, subdivision 1; 62Q.30; 181.932, 
  1.13            subdivision 1; and 214.16, subdivisions 1 and 3; 
  1.14            proposing coding for new law in Minnesota Statutes, 
  1.15            chapters 62J; 62Q; and 144. 
  1.16  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.17     Section 1.  [62J.695] [CITATION.] 
  1.18     Sections 62J.70 to 62J.75 may be cited as the "Patient 
  1.19  Protection Act." 
  1.20     Sec. 2.  [62J.70] [DEFINITIONS.] 
  1.21     Subdivision 1.  [APPLICABILITY.] For purposes of sections 
  1.22  62J.70 to 62J.725, the terms defined in this section have the 
  1.23  meanings given them. 
  1.24     Subd. 2.  [HEALTH CARE PROVIDER OR PROVIDER.] "Health care 
  1.25  provider" or "provider" means: 
  1.26     (1) a physician, nurse, or other provider as defined under 
  1.27  section 62J.03; 
  1.28     (2) a hospital as defined under section 144.696, 
  1.29  subdivision 3; 
  1.30     (3) an individual or entity that provides health care 
  2.1   services under the medical assistance, general assistance 
  2.2   medical care, MinnesotaCare, or state employee group insurance 
  2.3   program; and 
  2.4      (4) an association, partnership, corporation, limited 
  2.5   liability corporation, or other organization of persons or 
  2.6   entities described in clause (1) or (2) organized for the 
  2.7   purposes of providing, arranging, or administering health care 
  2.8   services or treatment.  
  2.9      This section does not apply to trade associations, 
  2.10  membership associations of health care professionals, or other 
  2.11  organizations that do not directly provide, arrange, or 
  2.12  administer health care services or treatment. 
  2.13     Subd. 3.  [HEALTH PLAN COMPANY.] "Health plan company" 
  2.14  means health plan company as defined in section 62Q.01, 
  2.15  subdivision 4. 
  2.16     Subd. 4.  [ENROLLEE.] "Enrollee" means an individual 
  2.17  covered by a health plan company or health insurance or health 
  2.18  coverage plan and includes an insured policyholder, subscriber, 
  2.19  contract holder, member, covered person, or certificate holder.  
  2.20     Sec. 3.  [62J.71] [PROHIBITED PROVIDER CONTRACTS.] 
  2.21     Subdivision 1.  [AGREEMENTS PROHIBITED.] The following 
  2.22  types of agreements are contrary to state public policy, are 
  2.23  prohibited under this section, and are null and void: 
  2.24     (1) any agreement that prohibits a health care provider 
  2.25  from communicating with a patient with respect to the patient's 
  2.26  health status, health care, or treatment options, if the health 
  2.27  care provider is acting in good faith and within the provider's 
  2.28  scope of practice as defined by law; 
  2.29     (2) any agreement that prohibits a health care provider 
  2.30  from disclosing accurate information about whether services or 
  2.31  treatment will be paid for by a patient's health plan company or 
  2.32  health insurance or health coverage plan; and 
  2.33     (3) any agreement that prohibits a health care provider 
  2.34  from informing a patient about the nature of the reimbursement 
  2.35  methodology used by a patient's health plan company, health 
  2.36  insurance, or health coverage plan to pay the provider. 
  3.1      Subd. 2.  [PERSONS AND ENTITIES AFFECTED.] The following 
  3.2   persons and entities shall not enter into any agreement that is 
  3.3   prohibited under this section: 
  3.4      (1) a health plan company; 
  3.5      (2) a health care network cooperative as defined under 
  3.6   section 62R.04, subdivision 3; or 
  3.7      (3) a health care provider as defined in section 62J.70, 
  3.8   subdivision 2. 
  3.9      Subd. 3.  [RETALIATION PROHIBITED.] No person, health plan 
  3.10  company, or other organization may take retaliatory action 
  3.11  against a health care provider solely on the grounds that the 
  3.12  provider: 
  3.13     (1) refused to enter into an agreement or provide services 
  3.14  or information in a manner that is prohibited under this 
  3.15  section; 
  3.16     (2) disclosed accurate information about whether a health 
  3.17  care service or treatment is covered by a patient's health plan 
  3.18  company, health insurance, or health coverage plan; or 
  3.19     (3) expressed personal disagreement with a decision made by 
  3.20  a person, organization, or health care provider regarding 
  3.21  treatment or coverage provided to a patient of the provider, or 
  3.22  assisted the patient in seeking reconsideration of such a 
  3.23  decision, provided the health care provider makes it clear that 
  3.24  the provider is acting in a personal capacity and not as a 
  3.25  representative of or on behalf of the entity that made the 
  3.26  decision.  
  3.27     Subd. 4.  [EXCLUSION.] (a) Nothing in this section prevents 
  3.28  any person or organization from taking actions, which may 
  3.29  adversely affect a provider whose actions the person or 
  3.30  organization reasonably believes to be illegal, to constitute 
  3.31  medical malpractice, or to be contrary to accepted medical 
  3.32  practices. 
  3.33     (b) Nothing in this section prohibits a contract provision 
  3.34  that requires any contracting party to keep confidential or to 
  3.35  not use or disclose the specific amounts paid to a provider, 
  3.36  provider fee schedules, provider salaries, and other proprietary 
  4.1   information of a specific health plan or health plan company.  
  4.2      Sec. 4.  [62J.72] [DISCLOSURE OF HEALTH CARE PROVIDER 
  4.3   INFORMATION.] 
  4.4      Subdivision 1.  [WRITTEN DISCLOSURE.] A health plan 
  4.5   company, as defined under section 62J.70, subdivision 3, a 
  4.6   health care network cooperative as defined under section 62R.04, 
  4.7   subdivision 3, and a health care provider as defined under 
  4.8   section 62J.70, subdivision 2, shall, upon enrollment and 
  4.9   annually thereafter, provide enrollees with a description of the 
  4.10  general nature of the reimbursement methodologies used by the 
  4.11  health plan company, health insurer, or health coverage plan to 
  4.12  pay providers.  This description may be incorporated into the 
  4.13  member handbook, subscriber contract, or certificate.  Upon 
  4.14  request, a health plan company or provider must provide an 
  4.15  enrollee or patient with specific information regarding the 
  4.16  reimbursement methodology, including, but not limited to, the 
  4.17  following information:  
  4.18     (1) a concise written description of the provider payment 
  4.19  plan, including any incentive plan applicable to the enrollee; 
  4.20     (2) a written description of any incentive to the provider 
  4.21  relating to the provision of health care services to patients, 
  4.22  including any compensation arrangement that is dependent on the 
  4.23  amount of health coverage or health care services provided to 
  4.24  the patient, or the number of referrals to or utilization of 
  4.25  specialists; and 
  4.26     (3) a written description of any incentive plan that 
  4.27  involves the transfer of financial risk to the health care 
  4.28  provider. 
  4.29  This subdivision does not require disclosure of specific amounts 
  4.30  paid to a provider, provider fee schedules, provider salaries, 
  4.31  or other proprietary information of a specific health plan 
  4.32  company or health insurer or health coverage plan or provider. 
  4.33     Subd. 2.  [ADDITIONAL WRITTEN DISCLOSURE OF PROVIDER 
  4.34  INFORMATION.] In the event a health plan company prepares a 
  4.35  written disclosure as specified in subdivision 1, in a manner 
  4.36  that compares the financial incentives between the providers 
  5.1   with whom it contracts, it must describe the incentives that 
  5.2   occur at the provider level. 
  5.3      Subd. 3.  [INFORMATION ON PATIENTS' MEDICAL BILLS.] A 
  5.4   health plan company and health care provider shall provide 
  5.5   patients and enrollees with a copy of an explicit and 
  5.6   intelligible bill whenever the patient or enrollee is sent a 
  5.7   bill and is responsible for paying any portion of that bill.  
  5.8   The bills must contain descriptive language sufficient to be 
  5.9   understood by the average patient or enrollee.  This subdivision 
  5.10  does not apply to a flat co-pay paid by the patient at the time 
  5.11  the service is required.  
  5.12     Subd. 4.  [NONAPPLICABILITY.] Health care providers as 
  5.13  defined in section 62J.70, subdivision 2, clause (1), and health 
  5.14  plan companies, as defined in section 62J.70, subdivision 3, 
  5.15  need not individually provide information required under this 
  5.16  section if it has been provided by another individual or entity 
  5.17  that is subject to this section. 
  5.18     Sec. 5.  [62J.725] [NOTICE; ADMINISTRATIVE COSTS.] 
  5.19     (a) Each health care policy or certificate issued by a 
  5.20  health plan company shall disclose the percentage amount of 
  5.21  premium dollar for that policy or certificate that is not 
  5.22  included as incurred health care expenses as determined for 
  5.23  purposes of calculating loss ratios under section 62A.021.  This 
  5.24  notice stating the appropriate percentage shall be prominently 
  5.25  displayed on the first page of each policy or certificate and on 
  5.26  all marketing materials in the following format: 
  5.27       Notice:  This policy or certificate spends on average 
  5.28                XX percent of your premium dollar on administrative
  5.29                costs. 
  5.30     (b) This notice may be expanded to include a complete 
  5.31  accounting of all expenses that are not included as incurred 
  5.32  health care expenses. 
  5.33     Sec. 6.  [62J.73] [PROHIBITION ON EXCLUSIVE ARRANGEMENTS.] 
  5.34     Subdivision 1.  [PROHIBITION ON EXCLUSIVE 
  5.35  RELATIONSHIPS.] No provider, group of providers, or health plan 
  5.36  company shall restrict a person's right to provide health 
  6.1   services or procedures to another provider, group of providers, 
  6.2   or health plan company, unless the person is an employee. 
  6.3      Subd. 2.  [PROHIBITION ON RESTRICTIVE CONTRACT TERMS.] No 
  6.4   provider, group of providers, or person providing goods or 
  6.5   health services to a provider shall enter into a contract or 
  6.6   subcontract with a health plan company or group of providers on 
  6.7   terms that require the provider, group of providers, or person 
  6.8   not to contract with another health plan company, unless the 
  6.9   provider or person is an employee.  
  6.10     Subd. 3.  [PROHIBITION REGARDING ESSENTIAL FACILITIES AND 
  6.11  SERVICES.] (a) No health plan company, provider, or group of 
  6.12  providers may withhold from its competitors health care 
  6.13  services, which are essential for competition between health 
  6.14  care providers within the meaning of the essential facilities 
  6.15  doctrine as interpreted by the federal courts. 
  6.16     (b) This subdivision should be construed as an instruction 
  6.17  to state court in interpreting federal law. 
  6.18     Subd. 4.  [VIOLATIONS.] Any provider or other individual 
  6.19  who believes provisions of this section may have been violated 
  6.20  may file a complaint with the attorney general's office 
  6.21  regarding a possible violation of this section. 
  6.22     Sec. 7.  [62J.74] [ENFORCEMENT.] 
  6.23     Subdivision 1.  [AUTHORITY.] The commissioners of health 
  6.24  and commerce shall each periodically review contracts and 
  6.25  arrangements among health care providing entities and health 
  6.26  plan companies they regulate to determine compliance with 
  6.27  sections 62J.70 to 62J.73.  Any person may submit a contract or 
  6.28  arrangement to the relevant commissioner for review if the 
  6.29  person believes sections 62J.70 to 62J.73 have been violated.  
  6.30  Any provision of a contract or arrangement found by the relevant 
  6.31  commissioner to violate this section is null and void, and the 
  6.32  relevant commissioner may assess civil penalties against the 
  6.33  health plan company in an amount not to exceed $2,500 for each 
  6.34  day the contract or arrangement is in effect, and may use the 
  6.35  enforcement procedures otherwise available to the commissioner. 
  6.36     Subd. 2.  [ASSISTANCE TO LICENSING BOARDS.] A 
  7.1   health-related licensing board as defined under section 214.01, 
  7.2   subdivision 2, shall submit a contract or arrangement to the 
  7.3   relevant commissioner for review if the board believes sections 
  7.4   62J.70 to 62J.73 have been violated.  If the commissioner 
  7.5   determines that any provision of a contract or arrangement 
  7.6   violates those sections, the board shall take disciplinary 
  7.7   action against any person who is licensed or regulated by the 
  7.8   board who entered into the contract arrangement. 
  7.9      Sec. 8.  [62J.75] [CONSUMER ADVISORY BOARD.] 
  7.10     (a) The consumer advisory board consists of 18 members 
  7.11  appointed in accordance with paragraph (b).  All members must be 
  7.12  public, consumer members who: 
  7.13     (1) do not have and never had a material interest in either 
  7.14  health care services, such as health insurance sales or health 
  7.15  plan administration; and 
  7.16     (2) are not registered lobbyists. 
  7.17     (b) The governor, the speaker of the house of 
  7.18  representatives, and the subcommittee on committees of the 
  7.19  committee on rules and administration of the senate shall each 
  7.20  appoint two members.  The Indian affairs council, the council on 
  7.21  affairs of Chicano/Latino people, the council on Black 
  7.22  Minnesotans, the council on Asian-Pacific Minnesotans, 
  7.23  mid-Minnesota legal assistance, and the Minnesota chamber of 
  7.24  commerce shall each appoint one member.  The member appointed by 
  7.25  the Minnesota chamber of commerce must represent small business 
  7.26  interests.  The health care campaign of Minnesota, Minnesotans 
  7.27  for affordable health care, and consortium for citizens with 
  7.28  disabilities shall each appoint two members.  Members serve 
  7.29  without compensation or reimbursement for expenses. 
  7.30     (c) The board shall advise the commissioners of health and 
  7.31  commerce on the following:  (1) the needs of health care 
  7.32  consumers and how to better serve and educate the consumers on 
  7.33  health care concerns and recommend solutions to identified 
  7.34  problems; and (2) consumer protection issues in the self-insured 
  7.35  market, including, but not limited to, public education needs. 
  7.36     The board also may make recommendations to the legislature 
  8.1   on these issues. 
  8.2      (d) The board and this section expire June 30, 2001. 
  8.3      Sec. 9.  [62J.76] [NONPREEMPTION.] 
  8.4      Nothing in the Patient Protection Act preempts or replaces 
  8.5   requirements related to patient protections that are more 
  8.6   protective of patient rights than the requirements established 
  8.7   by the Patient Protection Act. 
  8.8      Sec. 10.  Minnesota Statutes 1996, section 62Q.105, 
  8.9   subdivision 1, is amended to read: 
  8.10     Subdivision 1.  [ESTABLISHMENT.] Each health plan company 
  8.11  shall establish and make available to enrollees, by July 1, 1997 
  8.12  1998, an informal complaint resolution process that meets the 
  8.13  requirements of this section.  A health plan company must make 
  8.14  reasonable efforts to resolve enrollee complaints, and must 
  8.15  inform complainants in writing of the company's decision within 
  8.16  30 days of receiving the complaint.  The complaint resolution 
  8.17  process must treat the complaint and information related to it 
  8.18  as required under sections 72A.49 to 72A.505.  
  8.19     Sec. 11.  Minnesota Statutes 1996, section 62Q.30, is 
  8.20  amended to read: 
  8.21     62Q.30 [EXPEDITED FACT FINDING AND DISPUTE RESOLUTION 
  8.22  PROCESS.] 
  8.23     The commissioner shall establish an expedited fact finding 
  8.24  and dispute resolution process to assist enrollees of health 
  8.25  plan companies with contested treatment, coverage, and service 
  8.26  issues to be in effect July 1, 1997 1998.  The commissioner may 
  8.27  order an integrated service network or an all-payer insurer to 
  8.28  provide or pay for a service that is within the standard health 
  8.29  coverage.  If the disputed issue relates to whether a service is 
  8.30  appropriate and necessary, the commissioner shall issue an order 
  8.31  only after consulting with appropriate experts knowledgeable, 
  8.32  trained, and practicing in the area in dispute, reviewing 
  8.33  pertinent literature, and considering the availability of 
  8.34  satisfactory alternatives.  The commissioner shall take steps 
  8.35  including but not limited to fining, suspending, or revoking the 
  8.36  license of a health plan company that is the subject of repeated 
  9.1   orders by the commissioner that suggests a pattern of 
  9.2   inappropriate underutilization.  
  9.3      Sec. 12.  [62Q.53] [EMERGENCY SERVICES.] 
  9.4      (a) Enrollees have the right to available and accessible 
  9.5   emergency services, 24 hours a day and seven days a week.  The 
  9.6   health plan company shall inform its enrollees how to obtain 
  9.7   emergency care and, if prior authorization for emergency 
  9.8   services is required, shall make available a toll-free number, 
  9.9   which is answered 24 hours a day, to answer questions about 
  9.10  emergency services and to receive reports and provide 
  9.11  authorizations, where appropriate, for treatment of emergency 
  9.12  medical conditions.  Emergency services shall be covered whether 
  9.13  provided by participating or nonparticipating providers and 
  9.14  whether provided within or outside the health plan company's 
  9.15  service area.  In reviewing a denial for coverage of emergency 
  9.16  services, the health plan company shall take the following 
  9.17  factors into consideration: 
  9.18     (1) a reasonable layperson's belief that the circumstances 
  9.19  required immediate medical care that could not wait until the 
  9.20  next working day or next available clinic appointment; 
  9.21     (2) the time of day and day of the week the care was 
  9.22  provided; 
  9.23     (3) the presenting symptoms, including, but not limited to, 
  9.24  severe pain, to ensure that the decision to reimburse the 
  9.25  emergency care is not made solely on the basis of the actual 
  9.26  diagnosis; 
  9.27     (4) the enrollee's efforts to follow the health plan 
  9.28  company's established procedures for obtaining emergency care; 
  9.29  and 
  9.30     (5) any circumstances that precluded use of the health plan 
  9.31  company's established procedures for obtaining emergency care. 
  9.32     (b) The health plan company may require enrollees to notify 
  9.33  the health plan company of nonreferred emergency care as soon as 
  9.34  possible, but not later than 48 hours, after the emergency care 
  9.35  is initially provided.  However, emergency care which would have 
  9.36  been covered under the contract had notice been provided within 
 10.1   the set time frame must be covered. 
 10.2      (c) Notwithstanding paragraphs (a) and (b), a health plan 
 10.3   company, health insurance, or health coverage plan that is in 
 10.4   compliance with the rules regarding accessibility of services 
 10.5   adopted under section 62D.20 is in compliance with this section. 
 10.6      Sec. 13.  [62Q.56] [CONTINUITY OF CARE.] 
 10.7      Subdivision 1.  [CHANGE IN HEALTH CARE PROVIDER.] (a) If a 
 10.8   health plan company requires an enrollee to access services 
 10.9   through selected primary care providers for coverage, the health 
 10.10  plan company shall prepare a written plan that provides for 
 10.11  continuity of care in the event of contract termination between 
 10.12  the health plan company and any of the contracted primary care 
 10.13  providers or general hospital providers.  The written plan must 
 10.14  explain: 
 10.15     (1) how the health plan company will inform affected 
 10.16  enrollees, insureds, or beneficiaries about termination at least 
 10.17  30 days before the termination is effective, if the health plan 
 10.18  company or health care network cooperative has received at least 
 10.19  120 days' prior notice; 
 10.20     (2) how the health plan company will inform the affected 
 10.21  enrollees about what other participating providers are available 
 10.22  to assume care and how it will facilitate an orderly transfer of 
 10.23  its enrollees from the terminating provider to the new provider 
 10.24  to maintain continuity of care; 
 10.25     (3) the procedures by which enrollees will be transferred 
 10.26  to other participating providers, when special medical needs, 
 10.27  special risks, or other special circumstances, such as cultural 
 10.28  or language barriers, require them to have a longer transition 
 10.29  period or be transferred to nonparticipating providers; 
 10.30     (4) who will identify enrollees with special medical needs 
 10.31  or at special risk and what criteria will be used for this 
 10.32  determination; and 
 10.33     (5) how continuity of care will be provided for enrollees 
 10.34  identified as having special needs or at special risk, and 
 10.35  whether the health plan company has assigned this responsibility 
 10.36  to its contracted primary care providers. 
 11.1      (b) If the contract termination was not for cause, 
 11.2   enrollees can request a referral to the terminating provider for 
 11.3   up to 120 days if they have special medical needs or have other 
 11.4   special circumstances, such as cultural or language barriers.  
 11.5   The health plan company can require medical records and other 
 11.6   supporting documentation in support of the requested referral.  
 11.7   Each request for referral to a terminating provider shall be 
 11.8   considered by the health plan company on a case-by-case basis. 
 11.9      (c) If the contract termination was for cause, enrollees 
 11.10  must be notified of the change and transferred to participating 
 11.11  providers in a timely manner so that health care services remain 
 11.12  available and accessible to the affected enrollees.  The health 
 11.13  plan company is not required to refer an enrollee back to the 
 11.14  terminating provider if the termination was for cause. 
 11.15     Subd. 2.  [CHANGE IN HEALTH PLANS.] (a) The health plan 
 11.16  company shall prepare a written plan that provides a process for 
 11.17  coverage determinations for continuity of care for new enrollees 
 11.18  with special needs, special risks, or other special 
 11.19  circumstances, such as cultural or language barriers, who 
 11.20  request continuity of care with their former provider for up to 
 11.21  120 days.  The written plan must explain the criteria that will 
 11.22  be used for determining special needs cases, and how continuity 
 11.23  of care will be provided. 
 11.24     (b) This subdivision applies only to group coverage and 
 11.25  continuation and conversion coverage, and applies only to 
 11.26  changes in health plans made by the employer. 
 11.27     Subd. 3.  [DISCLOSURES.] The written plans required under 
 11.28  this section must be made available upon request to enrollees or 
 11.29  prospective enrollees. 
 11.30     Sec. 14.  [62Q.58] [ACCESS TO SPECIALTY CARE.] 
 11.31     Subdivision 1.  [STANDING REFERRAL.] A health plan company 
 11.32  shall establish a procedure by which an enrollee may apply for a 
 11.33  standing referral to a health care provider who is a specialist 
 11.34  if a referral to a specialist is required for coverage.  This 
 11.35  procedure for a standing referral must specify the necessary 
 11.36  criteria and conditions, which must be met in order for an 
 12.1   enrollee to obtain a standing referral. 
 12.2      Subd. 2.  [COORDINATION OF SERVICES.] A primary care 
 12.3   provider or primary care group shall remain responsible for 
 12.4   coordinating the care of an enrollee who has received a standing 
 12.5   referral to a specialist.  The specialist shall not make any 
 12.6   secondary referrals related to primary care services without 
 12.7   prior approval by the primary care provider or primary care 
 12.8   group.  However, an enrollee with a standing referral to a 
 12.9   specialist may request primary care services from that 
 12.10  specialist.  The specialist, in agreement with the enrollee and 
 12.11  primary care provider or primary care group, may elect to 
 12.12  provide primary care services to that enrollee according to 
 12.13  procedures established by the health plan company.  
 12.14     Subd. 3.  [DISCLOSURE.] Information regarding standing 
 12.15  referral procedures for requesting primary care services from a 
 12.16  specialist must be included in member contracts or certificates 
 12.17  of coverage and must be provided to an enrollee or prospective 
 12.18  enrollee by a health plan company upon request. 
 12.19     Sec. 15.  [144.6585] [IDENTIFICATION OF HEALTH CARE 
 12.20  PROVIDERS.] 
 12.21     Any health care provider who is licensed, credentialed, or 
 12.22  registered by a health-related licensing board as defined under 
 12.23  section 214.01, subdivision 2, must wear a name tag that 
 12.24  indicates by words, letters, abbreviations, or insignia the 
 12.25  profession or occupation of the individual.  The name tag must 
 12.26  be worn whenever the health care provider is rendering health 
 12.27  services to a patient, unless wearing the name tag would create 
 12.28  a safety or health risk to the patient.  
 12.29     Sec. 16.  Minnesota Statutes 1996, section 181.932, 
 12.30  subdivision 1, is amended to read: 
 12.31     Subdivision 1.  [PROHIBITED ACTION.] An employer shall not 
 12.32  discharge, discipline, threaten, otherwise discriminate against, 
 12.33  or penalize an employee regarding the employee's compensation, 
 12.34  terms, conditions, location, or privileges of employment because:
 12.35     (a) the employee, or a person acting on behalf of an 
 12.36  employee, in good faith, reports a violation or suspected 
 13.1   violation of any federal or state law or rule adopted pursuant 
 13.2   to law to an employer or to any governmental body or law 
 13.3   enforcement official; 
 13.4      (b) the employee is requested by a public body or office to 
 13.5   participate in an investigation, hearing, inquiry; or 
 13.6      (c) the employee refuses an employer's order to perform an 
 13.7   action that the employee has an objective basis in fact to 
 13.8   believe violates any state or federal law or rule or regulation 
 13.9   adopted pursuant to law, and the employee informs the employer 
 13.10  that the order is being refused for that reason; or 
 13.11     (d) the employee, in good faith, reports to an employer or 
 13.12  to any governmental body or law enforcement official a situation 
 13.13  in which the quality of the health care services provided by a 
 13.14  health care facility, organization, or health care provider 
 13.15  violates a standard established by federal or state law or rule 
 13.16  or nationally recognized clinical standards and places the 
 13.17  public at risk of harm.  
 13.18     Sec. 17.  Minnesota Statutes 1996, section 214.16, 
 13.19  subdivision 1, is amended to read: 
 13.20     Subdivision 1.  [DEFINITIONS.] For purposes of this 
 13.21  section, the following terms have the meanings given them. 
 13.22     (a) "Board" means the boards of medical practice, 
 13.23  chiropractic examiners, nursing, optometry, dentistry, pharmacy, 
 13.24  psychology, social work, marriage and family therapy, and 
 13.25  podiatry. 
 13.26     (b) "Regulated person" means a licensed physician, 
 13.27  chiropractor, nurse, optometrist, dentist, pharmacist, or 
 13.28  podiatrist. 
 13.29     Sec. 18.  Minnesota Statutes 1996, section 214.16, 
 13.30  subdivision 3, is amended to read: 
 13.31     Subd. 3.  [GROUNDS FOR DISCIPLINARY ACTION.] The board 
 13.32  shall take disciplinary action, which may include license 
 13.33  revocation, against a regulated person for: 
 13.34     (1) intentional failure to provide the commissioner of 
 13.35  health with the data required under chapter 62J; 
 13.36     (2) intentional failure to provide the commissioner of 
 14.1   revenue with data on gross revenue and other information 
 14.2   required for the commissioner to implement sections 295.50 to 
 14.3   295.58; and 
 14.4      (3) intentional failure to pay the health care provider tax 
 14.5   required under section 295.52; and 
 14.6      (4) entering into a contract or arrangement that is 
 14.7   prohibited under sections 62J.70 to 62J.73. 
 14.8      Sec. 19.  [CONSOLIDATION AND COORDINATION OF CONSUMER 
 14.9   ASSISTANCE AND ADVOCACY OFFICES.] 
 14.10     The commissioners of health and commerce, in consultation 
 14.11  with the commissioners of human services and employee relations, 
 14.12  shall study the feasibility and desirability of consolidating 
 14.13  and improving coordination of some or all existing state 
 14.14  consumer assistance, ombudsperson, and advocacy activities.  The 
 14.15  commissioners shall submit a report with recommendations, and 
 14.16  draft legislation to the legislature by January 15, 1998. 
 14.17     Sec. 20.  [COMPLAINT PROCESS STUDY.] 
 14.18     The commissioners of health and commerce, in consultation 
 14.19  with the consumer advisory board, shall make recommendations to 
 14.20  the legislature by January 15, 1998, on developing a complaint 
 14.21  resolution process for health plan companies to make available 
 14.22  for enrollees. 
 14.23     Sec. 21.  [EFFECTIVE DATE.] 
 14.24     Section 6 is effective the day following final enactment 
 14.25  and applies to contracts and arrangements entered into or 
 14.26  renewed on or after the effective date.  Sections 8, 10, 11, 19, 
 14.27  and 20 are effective the day following final enactment.