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Minnesota Legislature

Office of the Revisor of Statutes

Key: (1) language to be deleted (2) new language

                            CHAPTER 237-S.F.No. 960 
                  An act relating to health care; providing for patient 
                  protection; requiring certain disclosures; prohibiting 
                  certain provider contracts; providing for continuity 
                  of care and specialty care; prohibiting certain 
                  exclusive arrangements; modifying dispute resolution 
                  provisions; requiring identification of health care 
                  providers; requiring studies; requiring emergency 
                  services coverage; establishing a consumer advisory 
                  board; providing civil penalties; amending Minnesota 
                  Statutes 1996, sections 62Q.105, subdivision 1; 
                  62Q.30; 181.932, subdivision 1; and 214.16, 
                  subdivisions 1 and 3; proposing coding for new law in 
                  Minnesota Statutes, chapters 62J; 62Q; and 144; 
                  repealing Minnesota Statutes 1996, sections 62J.2911; 
                  62J.2912; 62J.2913; 62J.2914; 62J.2915; 62J.2916; 
                  62J.2917; 62J.2918; 62J.2919; 62J.2920; and 62J.2921. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  [62J.695] [CITATION.] 
           Sections 62J.695 to 62J.76 may be cited as the "Patient 
        Protection Act." 
           Sec. 2.  [62J.70] [DEFINITIONS.] 
           Subdivision 1.  [APPLICABILITY.] For purposes of sections 
        62J.70 to 62J.76, the terms defined in this section have the 
        meanings given them. 
           Subd. 2.  [HEALTH CARE PROVIDER OR PROVIDER.] "Health care 
        provider" or "provider" means: 
           (1) a physician, nurse, or other provider as defined under 
        section 62J.03; 
           (2) a hospital as defined under section 144.696, 
        subdivision 3; 
           (3) an individual or entity that provides health care 
        services under the medical assistance, general assistance 
        medical care, MinnesotaCare, or state employee group insurance 
        program; and 
           (4) an association, partnership, corporation, limited 
        liability corporation, or other organization of persons or 
        entities described in clause (1) or (2) organized for the 
        purposes of providing, arranging, or administering health care 
        services or treatment.  
           This section does not apply to trade associations, 
        membership associations of health care professionals, or other 
        organizations that do not directly provide, arrange, or 
        administer health care services or treatment. 
           Subd. 3.  [HEALTH PLAN COMPANY.] "Health plan company" 
        means health plan company as defined in section 62Q.01, 
        subdivision 4. 
           Subd. 4.  [ENROLLEE.] "Enrollee" means an individual 
        covered by a health plan company or health insurance or health 
        coverage plan and includes an insured policyholder, subscriber, 
        contract holder, member, covered person, or certificate holder.  
           Sec. 3.  [62J.71] [PROHIBITED PROVIDER CONTRACTS.] 
           Subdivision 1.  [PROHIBITED AGREEMENTS AND DIRECTIVES.] The 
        following types of agreements and directives are contrary to 
        state public policy, are prohibited under this section, and are 
        null and void: 
           (1) any agreement that prohibits a health care provider 
        from communicating with an enrollee with respect to the 
        enrollee's health status, health care, or treatment options, if 
        the health care provider is acting in good faith and within the 
        provider's scope of practice as defined by law; 
           (2) any agreement or directive that prohibits a health care 
        provider from making a recommendation regarding the suitability 
        or desirability of a health plan company, health insurer, or 
        health coverage plan for an enrollee, unless the provider has a 
        financial conflict of interest in the enrollee's choice of 
        health plan company, health insurer, or health coverage plan; 
           (3) any agreement or directive that prohibits a provider 
        from providing testimony, supporting or opposing legislation, or 
        making any other contact with state or federal legislators or 
        legislative staff or with state and federal executive branch 
        officers or staff; 
           (4) any agreement or directive that prohibits a health care 
        provider from disclosing accurate information about whether 
        services or treatment will be paid for by a patient's health 
        plan company or health insurer or health coverage plan; and 
           (5) any agreement or directive that prohibits a health care 
        provider from informing an enrollee about the nature of the 
        reimbursement methodology used by an enrollee's health plan 
        company, health insurer, or health coverage plan to pay the 
        provider. 
           Subd. 2.  [PERSONS AND ENTITIES AFFECTED.] The following 
        persons and entities shall not enter into any agreement or 
        directive that is prohibited under this section: 
           (1) a health plan company; 
           (2) a health care network cooperative as defined under 
        section 62R.04, subdivision 3; or 
           (3) a health care provider as defined in section 62J.70, 
        subdivision 2. 
           Subd. 3.  [RETALIATION PROHIBITED.] No person, health plan 
        company, or other organization may take retaliatory action 
        against a health care provider solely on the grounds that the 
        provider: 
           (1) refused to enter into an agreement or provide services 
        or information in a manner that is prohibited under this section 
        or took any of the actions listed in subdivision 1; 
           (2) disclosed accurate information about whether a health 
        care service or treatment is covered by an enrollee's health 
        plan company, health insurer, or health coverage plan; or 
           (3) expressed personal disagreement with a decision made by 
        a person, organization, or health care provider regarding 
        treatment or coverage provided to a patient of the provider, or 
        assisted the patient in seeking reconsideration of such a 
        decision, provided the health care provider makes it clear that 
        the provider is acting in a personal capacity and not as a 
        representative of or on behalf of the entity that made the 
        decision. 
           Subd. 4.  [EXCLUSION.] (a) Nothing in this section 
        prohibits a health plan from taking action against a provider if 
        the health plan has evidence that the provider's actions are 
        illegal, constitute medical malpractice, or are contrary to 
        accepted medical practices. 
           (b) Nothing in this section prohibits a contract provision 
        or directive that requires any contracting party to keep 
        confidential or to not use or disclose the specific amounts paid 
        to a provider, provider fee schedules, provider salaries, and 
        other proprietary information of a specific health plan or 
        health plan company.  
           Sec. 4.  [62J.72] [DISCLOSURE OF HEALTH CARE PROVIDER 
        INFORMATION.] 
           Subdivision 1.  [WRITTEN DISCLOSURE.] (a) A health plan 
        company, as defined under section 62J.70, subdivision 3, a 
        health care network cooperative as defined under section 62R.04, 
        subdivision 3, and a health care provider as defined under 
        section 62J.70, subdivision 2, shall, during open enrollment, 
        upon enrollment, and annually thereafter, provide enrollees with 
        a description of the general nature of the reimbursement 
        methodologies used by the health plan company, health insurer, 
        or health coverage plan to pay providers.  This description may 
        be incorporated into the member handbook, subscriber contract, 
        certificate of coverage, or other written enrollee 
        communication.  The general reimbursement methodology shall be 
        made available to employers at the time of open enrollment.  
           (b) Health plan companies and providers must, upon request, 
        provide an enrollee with specific information regarding the 
        reimbursement methodology, including, but not limited to, the 
        following information:  
           (1) a concise written description of the provider payment 
        plan, including any incentive plan applicable to the enrollee; 
           (2) a written description of any incentive to the provider 
        relating to the provision of health care services to enrollees, 
        including any compensation arrangement that is dependent on the 
        amount of health coverage or health care services provided to 
        the enrollee, or the number of referrals to or utilization of 
        specialists; and 
           (3) a written description of any incentive plan that 
        involves the transfer of financial risk to the health care 
        provider. 
           (c) The disclosure statement describing the general nature 
        of the reimbursement methodologies must comply with the 
        Readability of Insurance Policies Act in chapter 72C.  
        Notwithstanding any other law to the contrary, the disclosure 
        statement may voluntarily be filed with the commissioner for 
        approval. 
           (d) A disclosure statement that has voluntarily been filed 
        with the commissioner for approval under chapter 72C or 
        voluntarily filed with the commissioner for approval for 
        purposes other than pursuant to chapter 72C is deemed approved 
        30 days after the date of filing, unless approved or disapproved 
        by the commissioner on or before the end of that 30-day period. 
           (e) The disclosure statement describing the general nature 
        of the reimbursement methodologies must be provided upon request 
        in English, Spanish, Vietnamese, and Hmong.  In addition, 
        reasonable efforts must be made to provide information contained 
        in the disclosure statement to other non-English-speaking 
        enrollees. 
           (f) Health plan companies and providers may enter into 
        agreements to determine how to respond to enrollee requests 
        received by either the provider or the health plan company.  
        This subdivision does not require disclosure of specific amounts 
        paid to a provider, provider fee schedules, provider salaries, 
        or other proprietary information of a specific health plan 
        company or health insurer or health coverage plan or provider. 
           Subd. 2.  [ADDITIONAL WRITTEN DISCLOSURE OF PROVIDER 
        INFORMATION.] In the event a health plan company prepares a 
        written disclosure as specified in subdivision 1, in a manner 
        that explicitly makes a comparison of the financial incentives 
        between the providers with whom it contracts, it must describe 
        the incentives that occur at the provider level. 
           Subd. 3.  [INFORMATION ON PATIENTS' MEDICAL BILLS.] A 
        health plan company and health care provider shall provide 
        patients and enrollees with a copy of an explicit and 
        intelligible bill whenever the patient or enrollee is sent a 
        bill and is responsible for paying any portion of that bill.  
        The bills must contain descriptive language sufficient to be 
        understood by the average patient or enrollee.  This subdivision 
        does not apply to a flat co-pay paid by the patient or enrollee 
        at the time the service is required. 
           Subd. 4.  [NONAPPLICABILITY.] Health care providers as 
        defined in section 62J.70, subdivision 2, clause (1), need not 
        individually provide information required under this section if 
        it has been provided by another individual or entity that is 
        subject to this section. 
           Sec. 5.  [62J.73] [PROHIBITION ON EXCLUSIVE ARRANGEMENTS.] 
           Subdivision 1.  [PROHIBITION ON EXCLUSIVE 
        RELATIONSHIPS.] No provider, group of providers, or health plan 
        company shall restrict a person's right to provide health 
        services or procedures to another provider, group of providers, 
        or health plan company, unless the person is an employee. 
           Subd. 2.  [PROHIBITION ON RESTRICTIVE CONTRACT TERMS.] No 
        provider, group of providers, or person providing goods or 
        health services to a provider shall enter into a contract or 
        subcontract with a health plan company or group of providers on 
        terms that require the provider, group of providers, or person 
        not to contract with another health plan company, unless the 
        provider or person is an employee.  
           Subd. 3.  [PROHIBITION REGARDING ESSENTIAL FACILITIES AND 
        SERVICES.] (a) No health plan company, provider, or group of 
        providers may withhold from its competitors health care 
        services, which are essential for competition between health 
        care providers within the meaning of the essential facilities 
        doctrine as interpreted by the federal courts. 
           (b) This subdivision should be construed as an instruction 
        to state court in interpreting federal law. 
           Subd. 4.  [VIOLATIONS.] Any provider or other individual 
        who believes provisions of this section may have been violated 
        may file a complaint with the attorney general's office 
        regarding a possible violation of this section. 
           Sec. 6.  [62J.74] [ENFORCEMENT.] 
           Subdivision 1.  [AUTHORITY.] The commissioners of health 
        and commerce shall each periodically review contracts and 
        arrangements among health care providing entities and health 
        plan companies they regulate to determine compliance with 
        sections 62J.70 to 62J.73.  Any person may submit a contract or 
        arrangement to the relevant commissioner for review if the 
        person believes sections 62J.70 to 62J.73 have been violated.  
        Any provision of a contract or arrangement found by the relevant 
        commissioner to violate this section is null and void, and the 
        relevant commissioner may assess civil penalties against the 
        health plan company in an amount not to exceed $2,500 for each 
        day the contract or arrangement is in effect, and may use the 
        enforcement procedures otherwise available to the commissioner.  
        All due process rights afforded under chapter 14 apply to this 
        section.  
           Subd. 2.  [ASSISTANCE TO LICENSING BOARDS.] A 
        health-related licensing board as defined under section 214.01, 
        subdivision 2, shall submit a contract or arrangement to the 
        relevant commissioner for review if the board believes sections 
        62J.70 to 62J.73 have been violated.  If the commissioner 
        determines that any provision of a contract or arrangement 
        violates those sections, the board may take disciplinary action 
        against any person who is licensed or regulated by the board who 
        entered into the contract arrangement. 
           Sec. 7.  [62J.75] [CONSUMER ADVISORY BOARD.] 
           (a) The consumer advisory board consists of 18 members 
        appointed in accordance with paragraph (b).  All members must be 
        public, consumer members who: 
           (1) do not have and never had a material interest in either 
        the provision of health care services or in an activity directly 
        related to the provision of health care services, such as health 
        insurance sales or health plan administration; 
           (2) are not registered lobbyists; and 
           (3) are not currently responsible for or directly involved 
        in the purchasing of health insurance for a business or 
        organization. 
           (b) The governor, the speaker of the house of 
        representatives, and the subcommittee on committees of the 
        committee on rules and administration of the senate shall each 
        appoint two members.  The Indian affairs council, the council on 
        affairs of Chicano/Latino people, the council on Black 
        Minnesotans, the council on Asian-Pacific Minnesotans, 
        mid-Minnesota legal assistance, and the Minnesota chamber of 
        commerce shall each appoint one member.  The member appointed by 
        the Minnesota chamber of commerce must represent small business 
        interests.  The health care campaign of Minnesota, Minnesotans 
        for affordable health care, and consortium for citizens with 
        disabilities shall each appoint two members.  Members serve 
        without compensation or reimbursement for expenses. 
           (c) The board shall advise the commissioners of health and 
        commerce on the following:  (1) the needs of health care 
        consumers and how to better serve and educate the consumers on 
        health care concerns and recommend solutions to identified 
        problems; and (2) consumer protection issues in the self-insured 
        market, including, but not limited to, public education needs. 
           The board also may make recommendations to the legislature 
        on these issues. 
           (d) The board and this section expire June 30, 2001. 
           Sec. 8.  [62J.76] [NONPREEMPTION.] 
           Nothing in the Patient Protection Act preempts or replaces 
        requirements related to patient protections that are more 
        protective of patient rights than the requirements established 
        by the Patient Protection Act. 
           Sec. 9.  Minnesota Statutes 1996, section 62Q.105, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [ESTABLISHMENT.] Each health plan company 
        shall establish and make available to enrollees, by July 1, 1997 
        1998, an informal complaint resolution process that meets the 
        requirements of this section.  A health plan company must make 
        reasonable efforts to resolve enrollee complaints, and must 
        inform complainants in writing of the company's decision within 
        30 days of receiving the complaint.  The complaint resolution 
        process must treat the complaint and information related to it 
        as required under sections 72A.49 to 72A.505.  
           Sec. 10.  Minnesota Statutes 1996, section 62Q.30, is 
        amended to read: 
           62Q.30 [EXPEDITED FACT FINDING AND DISPUTE RESOLUTION 
        PROCESS.] 
           The commissioner shall establish an expedited fact finding 
        and dispute resolution process to assist enrollees of health 
        plan companies with contested treatment, coverage, and service 
        issues to be in effect July 1, 1997 1998.  The commissioner may 
        order an integrated service network or an all-payer insurer to 
        provide or pay for a service that is within the standard health 
        coverage.  If the disputed issue relates to whether a service is 
        appropriate and necessary, the commissioner shall issue an order 
        only after consulting with appropriate experts knowledgeable, 
        trained, and practicing in the area in dispute, reviewing 
        pertinent literature, and considering the availability of 
        satisfactory alternatives.  The commissioner shall take steps 
        including but not limited to fining, suspending, or revoking the 
        license of a health plan company that is the subject of repeated 
        orders by the commissioner that suggests a pattern of 
        inappropriate underutilization.  
           Sec. 11.  [62Q.55] [EMERGENCY SERVICES.] 
           (a) Enrollees have the right to available and accessible 
        emergency services, 24 hours a day and seven days a week.  The 
        health plan company shall inform its enrollees how to obtain 
        emergency care and, if prior authorization for emergency 
        services is required, shall make available a toll-free number, 
        which is answered 24 hours a day, to answer questions about 
        emergency services and to receive reports and provide 
        authorizations, where appropriate, for treatment of emergency 
        medical conditions.  Emergency services shall be covered whether 
        provided by participating or nonparticipating providers and 
        whether provided within or outside the health plan company's 
        service area.  In reviewing a denial for coverage of emergency 
        services, the health plan company shall take the following 
        factors into consideration: 
           (1) a reasonable layperson's belief that the circumstances 
        required immediate medical care that could not wait until the 
        next working day or next available clinic appointment; 
           (2) the time of day and day of the week the care was 
        provided; 
           (3) the presenting symptoms, including, but not limited to, 
        severe pain, to ensure that the decision to reimburse the 
        emergency care is not made solely on the basis of the actual 
        diagnosis; 
           (4) the enrollee's efforts to follow the health plan 
        company's established procedures for obtaining emergency care; 
        and 
           (5) any circumstances that precluded use of the health plan 
        company's established procedures for obtaining emergency care. 
           (b) The health plan company may require enrollees to notify 
        the health plan company of nonreferred emergency care as soon as 
        possible, but not later than 48 hours, after the emergency care 
        is initially provided.  However, emergency care which would have 
        been covered under the contract had notice been provided within 
        the set time frame must be covered. 
           (c) Notwithstanding paragraphs (a) and (b), a health plan 
        company, health insurer, or health coverage plan that is in 
        compliance with the rules regarding accessibility of services 
        adopted under section 62D.20 is in compliance with this section. 
           Sec. 12.  [62Q.56] [CONTINUITY OF CARE.] 
           Subdivision 1.  [CHANGE IN HEALTH CARE PROVIDER.] (a) If 
        enrollees are required to access services through selected 
        primary care providers for coverage, the health plan company 
        shall prepare a written plan that provides for continuity of 
        care in the event of contract termination between the health 
        plan company and any of the contracted primary care providers or 
        general hospital providers.  The written plan must explain: 
           (1) how the health plan company will inform affected 
        enrollees, insureds, or beneficiaries about termination at least 
        30 days before the termination is effective, if the health plan 
        company or health care network cooperative has received at least 
        120 days' prior notice; 
           (2) how the health plan company will inform the affected 
        enrollees about what other participating providers are available 
        to assume care and how it will facilitate an orderly transfer of 
        its enrollees from the terminating provider to the new provider 
        to maintain continuity of care; 
           (3) the procedures by which enrollees will be transferred 
        to other participating providers, when special medical needs, 
        special risks, or other special circumstances, such as cultural 
        or language barriers, require them to have a longer transition 
        period or be transferred to nonparticipating providers; 
           (4) who will identify enrollees with special medical needs 
        or at special risk and what criteria will be used for this 
        determination; and 
           (5) how continuity of care will be provided for enrollees 
        identified as having special needs or at special risk, and 
        whether the health plan company has assigned this responsibility 
        to its contracted primary care providers. 
           (b) If the contract termination was not for cause, 
        enrollees can request a referral to the terminating provider for 
        up to 120 days if they have special medical needs or have other 
        special circumstances, such as cultural or language barriers.  
        The health plan company can require medical records and other 
        supporting documentation in support of the requested referral.  
        Each request for referral to a terminating provider shall be 
        considered by the health plan company on a case-by-case basis. 
           (c) If the contract termination was for cause, enrollees 
        must be notified of the change and transferred to participating 
        providers in a timely manner so that health care services remain 
        available and accessible to the affected enrollees.  The health 
        plan company is not required to refer an enrollee back to the 
        terminating provider if the termination was for cause. 
           Subd. 2.  [CHANGE IN HEALTH PLANS.] (a) The health plan 
        company shall prepare a written plan that provides a process for 
        coverage determinations for continuity of care for new enrollees 
        with special needs, special risks, or other special 
        circumstances, such as cultural or language barriers, who 
        request continuity of care with their former provider for up to 
        120 days.  The written plan must explain the criteria that will 
        be used for determining special needs cases, and how continuity 
        of care will be provided. 
           (b) This subdivision applies only to group coverage and 
        continuation and conversion coverage, and applies only to 
        changes in health plans made by the employer. 
           Subd. 3.  [DISCLOSURES.] The written plans required under 
        this section must be made available upon request to enrollees or 
        prospective enrollees. 
           Sec. 13.  [62Q.58] [ACCESS TO SPECIALTY CARE.] 
           Subdivision 1.  [STANDING REFERRAL.] A health plan company 
        shall establish a procedure by which an enrollee may apply for a 
        standing referral to a health care provider who is a specialist 
        if a referral to a specialist is required for coverage.  This 
        procedure for a standing referral must specify the necessary 
        criteria and conditions, which must be met in order for an 
        enrollee to obtain a standing referral. 
           Subd. 2.  [COORDINATION OF SERVICES.] A primary care 
        provider or primary care group shall remain responsible for 
        coordinating the care of an enrollee who has received a standing 
        referral to a specialist.  The specialist shall not make any 
        secondary referrals related to primary care services without 
        prior approval by the primary care provider or primary care 
        group.  However, an enrollee with a standing referral to a 
        specialist may request primary care services from that 
        specialist.  The specialist, in agreement with the enrollee and 
        primary care provider or primary care group, may elect to 
        provide primary care services to that enrollee according to 
        procedures established by the health plan company.  
           Subd. 3.  [DISCLOSURE.] Information regarding referral 
        procedures must be included in member contracts or certificates 
        of coverage and must be provided to an enrollee or prospective 
        enrollee by a health plan company upon request. 
           Sec. 14.  [62Q.64] [DISCLOSURE OF EXECUTIVE COMPENSATION.] 
           (a) Each health plan company doing business in this state 
        shall annually file with the consumer advisory board created in 
        section 62J.75: 
           (1) a copy of the health plan company's form 990 filed with 
        the federal Internal Revenue Service; or 
           (2) if the health plan company did not file a form 990 with 
        the federal Internal Revenue Service, a list of the amount and 
        recipients of the health plan company's five highest salaries, 
        including all types of compensation, in excess of $50,000. 
           (b) A filing under this section is public data under 
        section 13.03. 
           Sec. 15.  [144.6585] [IDENTIFICATION OF HEALTH CARE 
        PROVIDERS.] 
           Any health care provider who is licensed, credentialed, or 
        registered by a health-related licensing board as defined under 
        section 214.01, subdivision 2, must wear a name tag that 
        indicates by words, letters, abbreviations, or insignia the 
        profession or occupation of the individual.  The name tag must 
        be worn whenever the health care provider is rendering health 
        services to a patient, unless wearing the name tag would create 
        a safety or health risk to the patient.  The failure to wear a 
        name tag is not reportable under chapter 214.  
           Sec. 16.  Minnesota Statutes 1996, section 181.932, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [PROHIBITED ACTION.] An employer shall not 
        discharge, discipline, threaten, otherwise discriminate against, 
        or penalize an employee regarding the employee's compensation, 
        terms, conditions, location, or privileges of employment because:
           (a) the employee, or a person acting on behalf of an 
        employee, in good faith, reports a violation or suspected 
        violation of any federal or state law or rule adopted pursuant 
        to law to an employer or to any governmental body or law 
        enforcement official; 
           (b) the employee is requested by a public body or office to 
        participate in an investigation, hearing, inquiry; or 
           (c) the employee refuses an employer's order to perform an 
        action that the employee has an objective basis in fact to 
        believe violates any state or federal law or rule or regulation 
        adopted pursuant to law, and the employee informs the employer 
        that the order is being refused for that reason; or 
           (d) the employee, in good faith, reports a situation in 
        which the quality of health care services provided by a health 
        care facility, organization, or health care provider violates a 
        standard established by federal or state law or a professionally 
        recognized national clinical or ethical standard and potentially 
        places the public at risk of harm. 
           Sec. 17.  Minnesota Statutes 1996, section 214.16, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [DEFINITIONS.] For purposes of this 
        section, the following terms have the meanings given them. 
           (a) "Board" means the boards of medical practice, 
        chiropractic examiners, nursing, optometry, dentistry, pharmacy, 
        psychology, social work, marriage and family therapy, and 
        podiatry. 
           (b) "Regulated person" means a licensed physician, 
        chiropractor, nurse, optometrist, dentist, 
        pharmacist, psychologist, social worker, marriage and family 
        therapist, or podiatrist. 
           Sec. 18.  Minnesota Statutes 1996, section 214.16, 
        subdivision 3, is amended to read: 
           Subd. 3.  [GROUNDS FOR DISCIPLINARY ACTION.] The board 
        shall take disciplinary action, which may include license 
        revocation, against a regulated person for: 
           (1) intentional failure to provide the commissioner of 
        health with the data required under chapter 62J; 
           (2) intentional failure to provide the commissioner of 
        revenue with data on gross revenue and other information 
        required for the commissioner to implement sections 295.50 to 
        295.58; and 
           (3) intentional failure to pay the health care provider tax 
        required under section 295.52; and 
           (4) entering into a contract or arrangement that is 
        prohibited under sections 62J.70 to 62J.73. 
           Sec. 19.  [CONSOLIDATION AND COORDINATION OF CONSUMER 
        ASSISTANCE AND ADVOCACY OFFICES.] 
           The commissioners of health and commerce, in consultation 
        with the commissioners of human services and employee relations, 
        shall study the feasibility and desirability of consolidating 
        and improving coordination of some or all existing state 
        consumer assistance, ombudsperson, and advocacy activities.  The 
        commissioners shall submit a report with recommendations, and 
        draft legislation to the legislature by January 15, 1998. 
           Sec. 20.  [COMPLAINT PROCESS STUDY.] 
           The commissioners of health and commerce, in consultation 
        with the consumer advisory board and other affected parties, 
        shall make recommendations to the legislature by January 15, 
        1998, on developing a complaint resolution process for health 
        plan companies to make available for enrollees. 
           Sec. 21.  [CONSIDERATION.] 
           The consumer advisory board shall consider the use of 
        physicians by utilization review organizations, including 
        whether only Minnesota licensed physicians should be used for 
        utilization review, whether appropriate types of medical 
        practitioners are being used for utilization review, and whether 
        Minnesota's utilization review statutes afford adequate consumer 
        protection.  The consumer advisory board may report findings to 
        the legislature prior to the 1998 legislative session. 
           Sec. 22.  [REPEALER; ANTITRUST EXEMPTION PROCESS.] 
           Minnesota Statutes 1996, sections 62J.2911, 62J.2912, 
        62J.2913, 62J.2914, 62J.2915, 62J.2916, 62J.2917, 62J.2918, 
        62J.2919, 62J.2920, and 62J.2921 are repealed. 
           Sec. 23.  [EFFECTIVE DATE.] 
           Sections 3, 17, and 18 are effective January 1, 1998, and 
        apply to contracts entered into or renewed on or after the 
        effective date.  Sections 1, 7 to 10, 16, 20, and 22 are 
        effective the day following final enactment.  Sections 4, 11, 
        12, and 13 are effective January 1, 1998, and apply to contracts 
        or coverage issued or renewed on or after the effective date. 
           Presented to the governor May 29, 1997 
           Signed by the governor June 2, 1997, 2:22 p.m.