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HF 237

as introduced - 91st Legislature (2019 - 2020) Posted on 01/24/2019 03:49pm

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to health insurance; requiring notification prior to provider network
changes; amending Minnesota Statutes 2018, section 62K.075.

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

Section 1.

Minnesota Statutes 2018, section 62K.075, is amended to read:


62K.075 PROVIDER NETWORK 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, 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 website at least once a month with any
changes to the carrier's provider network, 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 (a) 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 website displayed
the correct provider network status on the health carrier's website 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 .