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SF 4222

as introduced - 91st Legislature (2019 - 2020) Posted on 03/11/2020 03:38pm

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; requiring notice prior to placing a hospital patient in observation
status; permitting licensing actions against hospitals that fail to provide notice;
prohibiting billing and collections for hospital services to patients in observation
status who did not receive prior notice; amending Minnesota Statutes 2018, sections
144.55, subdivision 6; 144.586, subdivision 1.

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

Section 1.

Minnesota Statutes 2018, section 144.55, subdivision 6, is amended to read:


Subd. 6.

Suspension, revocation, and refusal to renew.

(a) The commissioner may
refuse to grant or renew, or may suspend or revoke, a license on any of the following grounds:

(1) violation of any of the provisions of sections 144.50 to 144.56 or the rules or standards
issued pursuant thereto, or Minnesota Rules, chapters 4650 and 4675;

(2) permitting, aiding, or abetting the commission of any illegal act in the institution;

(3) conduct or practices detrimental to the welfare of the patient; deleted text beginor
deleted text end

(4) obtaining or attempting to obtain a license by fraud or misrepresentation; deleted text beginor
deleted text end

(5) with respect to hospitals and outpatient surgical centers, if the commissioner
determines that there is a pattern of conduct that one or more physicians who have a "financial
or economic interest," as defined in section 144.6521, subdivision 3, in the hospital or
outpatient surgical center, have not provided the notice and disclosure of the financial or
economic interest required by section 144.6521new text begin; or
new text end

new text begin (6) with respect to hospitals, the commissioner determines that a hospital violated the
notice of observation status requirements under section 144.586, subdivision 1
new text end.

(b) The commissioner shall not renew a license for a boarding care bed in a resident
room with more than four beds.

Sec. 2.

Minnesota Statutes 2018, section 144.586, subdivision 1, is amended to read:


Subdivision 1.

deleted text beginObservation staydeleted text end Noticenew text begin of observation statusnew text end.

(a) Each hospital, as
defined under section 144.50, subdivision 2, shall provide new text beginprior new text endoral and written notice new text beginof
observation status
new text endto each patient deleted text beginthatdeleted text end the hospital places in observation status deleted text beginof such
placement not later than 24 hours after such placement
deleted text end. The oral and written notices must
include:

(1) a statement that the patient is not admitted to the hospital but is deleted text beginunderdeleted text endnew text begin innew text end observation
status;

(2) a statement that observation status may affect the patient's deleted text beginMedicaredeleted text endnew text begin health carenew text end
coverage for:

(i) hospital services, including medications and pharmaceutical supplies; or

(ii) home or community-based care or care at a skilled nursing facility upon the patient's
discharge; and

(3) a recommendation that the patient contact the patient's health insurance provider or
the Office of the Ombudsman for Long-Term Care or Office of the Ombudsman for State
Managed Health Care Programs or the Beneficiary and Family Centered Care Quality
Improvement Organization to better understand the implications of placement in observation
status.

(b) The hospital shall document deleted text beginthe datedeleted text end in the patient's record new text beginthe date new text endthat the notice
deleted text begin required in paragraph (a)deleted text endnew text begin of observation statusnew text end was provided to the patientdeleted text begin, anddeleted text endnew text begin by obtaining
the patient's signature or the patient's designated representative's signature on the notice of
observation status. The hospital shall also document in the patient's record
new text end the patient's
designated representative such as the patient's health care agent, legal guardian, conservator,
or another person acting as the patient's representative.

new text begin (c) If a hospital cannot obtain a patient's signature or the patient's designated
representative's signature on a notice of observation status because the patient cannot
communicate and the patient's designated representative is unavailable or unknown, the
hospital may not place the patient on observation status but must admit the patient if the
patient requires hospital services.
new text end

new text begin (d) If a hospital fails to meet the notice of observation status requirements under this
subdivision, the hospital shall not be paid by an insurer, self-insurer, or group self-insurer
for hospital services, including medications and pharmaceutical supplies provided while
the patient was in observation status. The hospital shall not be reimbursed or attempt to
collect reimbursement for hospital services, including medications and pharmaceutical
supplies provided while the patient was in observation status from any other source, including
the patient, another insurer, medical assistance, or MinnesotaCare. Lack of a signed notice
of observation status is an affirmative defense to any legal action for collection or
enforcement.
new text end