Minnesota Session Laws - 2000, Regular Session

                            CHAPTER 349-S.F.No. 2767 
                  An act relating to health; requiring prompt payment by 
                  health plan companies and third-party administrators 
                  of clean claims for health care services; proposing 
                  coding for new law in Minnesota Statutes, chapter 62Q; 
                  repealing Minnesota Statutes 1999 Supplement, section 
                  65D.108. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  [62Q.75] [PROMPT PAYMENT REQUIRED.] 
           Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
        section, the following terms have the meanings given to them. 
           (b) "Clean claim" means a claim that has no defect or 
        impropriety, including any lack of any required substantiating 
        documentation, or particular circumstance requiring special 
        treatment that prevents timely payment from being made on a 
        claim under this section. 
           (c) "Third-party administrator" means a third-party 
        administrator or other entity subject to section 60A.23, 
        subdivision 8, and Minnesota Rules, chapter 2767. 
           Subd. 2.  [CLAIMS PAYMENTS.] (a) This section applies to 
        clean claims submitted to a health plan company or third-party 
        administrator for services provided by any: 
           (1) health care provider, except a provider licensed under 
        chapter 151; 
           (2) home health care provider, as defined in section 
        144A.43, subdivision 4; or 
           (3) health care facility. 
        All health plan companies and third-party administrators must 
        pay or deny claims that are clean claims within 30 calendar days 
        after the date upon which the health plan company or third-party 
        administrator received the claim. 
           (b) If a health plan company or third-party administrator 
        does not pay or deny a clean claim within the period provided in 
        paragraph (a), the health plan company or third-party 
        administrator must pay interest on the claim for the period 
        beginning on the day after the required payment date specified 
        in paragraph (a) and ending on the date on which the health plan 
        company or third-party administrator makes the payment or denies 
        the claim.  In any payment, the health plan company or 
        third-party administrator must itemize any interest payment 
        being made separately from other payments being made for 
        services provided.  The health plan company or third-party 
        administrator may, at its discretion, require the health care 
        provider to bill the health plan company or third-party 
        administrator for the interest required under this section 
        before any interest payment is made. 
           (c) The rate of interest paid by a health plan company or 
        third-party administrator under this subdivision shall be 1.5 
        percent per month or any part of a month. 
           (d) A health plan company or third-party administrator is 
        not required to make an interest payment on a claim for which 
        payment has been delayed for purposes of reviewing potentially 
        fraudulent or abusive billing practices. 
           (e) The commissioner may not assess a financial 
        administrative penalty against a health plan company for 
        violation of this subdivision. 
           Sec. 2.  [REPEALER.] 
           Minnesota Statutes 1999 Supplement, section 62D.108, is 
        repealed. 
           Sec. 3.  [EFFECTIVE DATE.] 
           Section 1 is effective January 1, 2001, and applies to 
        claims submitted on or after that date.  Section 2 is effective 
        January 1, 2001. 
           Presented to the governor April 6, 2000 
           Signed by the governor April 10, 2000, 2:49 p.m.