Skip to main content Skip to office menu Skip to footer
Capital IconMinnesota Legislature

SF 3418

as introduced - 91st Legislature (2019 - 2020) Posted on 02/20/2020 03:28pm

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

Current Version - as introduced

Line numbers 1.1 1.2 1.3 1.4 1.5
1.6 1.7 1.8
1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13
2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21
3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12
4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20
4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 5.1 5.2 5.3 5.4 5.5 5.6
5.7 5.8 5.9 5.10 5.11 5.12 5.13

A bill for an act
relating to health care; modifying the evaluation process for mandated health
benefit proposals; amending Minnesota Statutes 2018, sections 62J.03, subdivision
4; 62J.26, subdivisions 1, 2, 3, 4, 5, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2018, section 62J.03, subdivision 4, is amended to read:


Subd. 4.

Commissioner.

"Commissioner" means the commissioner of healthnew text begin, unless
another commissioner is specified
new text end.

Sec. 2.

Minnesota Statutes 2018, section 62J.26, subdivision 1, is amended to read:


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 commerce;

new text begin (2) "enrollee" has the meaning given in section 62Q.01, subdivision 2b;
new text end

deleted text begin (2)deleted text endnew text begin (3)new text end "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;

deleted text begin (3)deleted text endnew text begin (4)new text end "mandated health benefit proposal" new text beginor "proposal" new text endmeans a proposal that would
statutorily require a health plan new text begincompany new text endto 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; deleted text beginor
deleted text end

(iii) provide coverage for care delivered by a specific type of providerdeleted text begin.deleted text endnew text begin;
new text end

new text begin (iv) require a particular benefit design or impose conditions on cost-sharing for:
new text end

new text begin (A) the treatment of a particular disease, condition, or other health care need;
new text end

new text begin (B) a particular type of health care treatment or service; or
new text end

new text begin (C) the provision of medical equipment, supplies, or a prescription drug used in
connection with treating a particular disease, condition, or other health care need; or
new text end

new text begin (v) impose limits or conditions on a contract between a health plan company and a health
care provider.
new text end

"Mandated health benefit proposal" does not include health benefit proposals amending
the scope of practice of a licensed health care professional.

Sec. 3.

Minnesota Statutes 2018, section 62J.26, subdivision 2, is amended to read:


Subd. 2.

Evaluation process and content.

(a) The commissioner, in consultation with
the commissioners of health and management and budget, must evaluate new text beginall new text endmandated health
benefit proposals as provided under subdivision 3.

(b) The purpose of the evaluation is to provide the legislature with 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 followingnew text begin to the extent applicablenew text end:

(1) scientific and medical information on the deleted text beginproposed health benefitdeleted text endnew text begin mandated health
benefit proposal
new text end, on the potential for harm or benefit to the patient, and on the comparative
benefit or harm from alternative forms of treatmentnew text begin, and must include the results of at least
one professionally accepted and controlled trial comparing the medical consequences of
the proposed therapy, alternative therapy, and no therapy
new text end;

(2) public health, economic, and fiscal impacts of the deleted text beginproposed mandatedeleted text endnew text begin mandated health
benefit proposal
new text end on persons receiving health services in Minnesota, on the relative
cost-effectiveness of the deleted text beginbenefitdeleted text endnew text begin proposalnew text end, and on the health care system in general;

(3) the extent to which the new text begintreatment, new text endservicenew text begin, equipment, or drugnew text end is generally utilized
by a significant portion of the population;

(4) the extent to which insurance coverage for the deleted text beginproposed mandated benefitdeleted text endnew text begin mandated
health benefit proposal
new text end is already generally available;

new text begin (5) the extent to which the mandated health benefit proposal, by payer category, would
apply to the benefits offered to the payer's enrollees;
new text end

deleted text begin (5)deleted text endnew text begin (6)new text end the extent to which the deleted text beginmandated coveragedeleted text endnew text begin mandated health benefit proposalnew text end will
increase or decrease the cost of the new text begintreatment, new text endservicenew text begin, equipment, or drugnew text end; deleted text beginand
deleted text end

new text begin (7) the extent to which the mandated health benefit proposal may increase administrative
costs to the health plan company and enrollee premiums; and
new text end

new text begin (8) if the proposal applies to a qualified health plan as defined in section 62A.011,
subdivision 7, the cost to the state to defray the cost of the mandated health benefit proposal
using commercial market reimbursement rates in accordance with Code of Federal
Regulations, title 45, section 155.70.
new text end

deleted text begin (6)deleted text endnew text begin (c)new text end The commissioner deleted text beginmaydeleted text endnew text begin shallnew text end consider actuarial analysis done by health deleted text begininsurersdeleted text endnew text begin
plan companies and any other proponent or opponent of the mandated health benefit proposal
new text end
in determining the cost of the deleted text beginproposed mandated benefitdeleted text endnew text begin proposalnew text end.

deleted text begin (c)deleted text endnew text begin (d)new text end 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 research on these issues or may determine that existing research
is sufficient to meet the informational needs of the legislature. The commissioner may seek
the assistance and advice of researchers, community leaders, or other persons or organizations
with relevant expertise.

Sec. 4.

Minnesota Statutes 2018, section 62J.26, subdivision 3, is amended to read:


Subd. 3.

deleted text beginRequestsdeleted text endnew text begin Requirementsnew text end for evaluation.

(a) deleted text beginWhenever 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, a
deleted text endnew text begin
No later than August 1 of the year preceding the legislative session in which a legislator is
planning on introducing a bill or an amendment containing a mandated health benefit
proposal, the prospective author must notify the chair of one of the standing legislative
committees that have jurisdiction over the subject matter of the proposal. Once notification
is received, the
new text end chair deleted text beginof any standing legislative committee that has jurisdiction over the
subject matter of the proposal may request that
deleted text endnew text begin must notifynew text end the commissioner deleted text begincompletedeleted text endnew text begin thatnew text end
an evaluation of deleted text beginthedeleted text endnew text begin a mandated health benefitnew text end proposal deleted text beginunder this section, todeleted text endnew text begin is required to
be completed in accordance with this section in order to
new text end inform deleted text beginany committee of floordeleted text endnew text begin the
legislature before any
new text end action new text beginis taken on the proposal new text endby either house of the legislature.

(b) The commissioner must conduct an evaluation described in subdivision 2 of each
mandated health benefit proposal for which an evaluation is deleted text beginrequesteddeleted text endnew text begin requirednew text end under
paragraph (a)deleted text begin, unless the commissioner determines under paragraph (c) or subdivision 4
that priorities and resources do not permit its evaluation
deleted text end.

(c) If deleted text beginrequests fordeleted text endnew text begin thenew text end evaluation of multiple proposals are deleted text beginreceiveddeleted text endnew text begin requirednew text end, 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 deleted text beginrequestsdeleted text endnew text begin evaluationsnew text end and establish a reporting date for each proposal to be evaluated.
deleted text begin The commissioner is not required to direct an unreasonable quantity of the commissioner's
resources to these evaluations.
deleted text end

Sec. 5.

Minnesota Statutes 2018, section 62J.26, is amended by adding a subdivision to
read:


new text begin Subd. 3a. new text end

new text begin Applicability. new text end

new text begin (a) No mandated health benefit proposal may receive a hearing
or be voted on by either house or by a standing legislative committee before the commissioner
completes and delivers the evaluation specified in this section.
new text end

new text begin (b) If all the requirements of this section are satisfied and the mandated health benefit
proposal is enacted into law, the effective date of the mandated health benefit shall be the
first day of the plan year following final enactment.
new text end

Sec. 6.

Minnesota Statutes 2018, section 62J.26, subdivision 4, is amended to read:


Subd. 4.

Sources of funding.

(a) The commissioner deleted text beginneeddeleted text endnew text begin shallnew text end 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 deleted text begina request fordeleted text end an evaluation new text beginis required new text endunder this section deleted text beginhas been madedeleted text end, 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.

Sec. 7.

Minnesota Statutes 2018, section 62J.26, subdivision 5, is amended to read:


Subd. 5.

Report to legislature.

The commissioner must submit a written report on the
evaluation to the deleted text beginlegislaturedeleted text endnew text begin author of the proposal and to the chairs and ranking minority
members of the legislative committees with jurisdiction over health insurance policy and
finance
new text end no later than 180 days after the deleted text beginrequest. The report must be submitted in compliance
with sections 3.195 and 3.197
deleted text endnew text begin commissioner receives notification from a chair as required
under subdivision 3
new text end.