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SF 3667

as introduced - 90th Legislature (2017 - 2018) Posted on 03/22/2018 09:50am

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

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Current Version - as introduced

A bill for an act
relating to health care; requiring health plan companies to count payments to
out-of-network providers toward an enrollee's annual deductible; proposing coding
for new law in Minnesota Statutes, chapter 62Q.

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

Section 1.

[62Q.495] DEDUCTIBLES FOR SERVICES PROVIDED BY
OUT-OF-NETWORK PROVIDERS.

(a) If a health plan imposes an annual deductible that the enrollee is responsible for
meeting, the health plan company must count any payment made by the enrollee to a provider
for a health care service covered under the enrollee's health plan toward the enrollee's
applicable deductible amount, regardless of whether the provider is in-network or
out-of-network. If the service is performed by an out-of-network provider, the amount that
may be counted toward the enrollee's deductible limit is limited to the amount the enrollee
would have been required to pay to an in-network provider for the same service if the actual
amount paid by the enrollee to the out-of-network provider is greater. Once the enrollee
meets the health plan's deductible, the health plan may require the enrollee to receive covered
services from an in-network provider or pay a higher cost-sharing amount if the service is
provided by an out-of-network provider.

(b) Nothing in this section shall require a health plan company to pay for services
provided by an out-of-network provider, unless required under the terms of the enrollee's
health plan, or require a health plan company to provide coverage for a health care service
that is not covered under the enrollee's health plan.

EFFECTIVE DATE.

This section is effective January 1, 2019, and applies to any health
plan issued or renewed on or after that date.

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2.1 2.2

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