Office of the Revisor of Statutes
Minnesota Session Laws - 2001, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 110-H.F.No. 926
An act relating to health; modifying content and
format requirements for Minnesota uniform health care
identification cards; requiring uniform prescription
drug information to be included on cards; establishing
requirements for issuance of cards; amending Minnesota
Statutes 2000, section 62J.60.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. Minnesota Statutes 2000, section 62J.60, is
amended to read:
62J.60 [STANDARDS FOR THE MINNESOTA UNIFORM HEALTH CARE
IDENTIFICATION CARD.]
Subdivision 1. [MINNESOTA UNIFORM HEALTH CARE
IDENTIFICATION CARD.] All individuals with health care coverage
shall be issued Minnesota uniform health care identification
cards by group purchasers as of January 1, 1998, unless the
requirements of section 62A.01, subdivisions 2 and 3, are
met. If a health benefit plan issued by a group purchaser
provides coverage for prescription drugs, the group purchaser
shall include uniform prescription drug information on the
uniform health care identification card issued to its enrollees
on or after July 1, 2003. Nothing in this section requires a
group purchaser to issue a separate card containing uniform
prescription drug information, provided that the Minnesota
uniform health care identification card can accommodate the
information necessary to process prescription drug claims as
required by this section. The Minnesota uniform health care
identification cards shall comply with the standards prescribed
in this section.
Subd. 1a. [DEFINITION; HEALTH BENEFIT PLAN.] For purposes
of this section, "health benefit plan" means a policy, contract,
or certificate offered, sold, issued, or renewed by a group
purchaser for the coverage of medical and hospital benefits. A
health benefit plan does not include coverage that is:
(1) limited to disability or income protection coverage;
(2) automobile or homeowners medical payment coverage;
(3) liability insurance or supplemental to liability
insurance;
(4) accident-only coverage;
(5) credit accident and health insurance issued under
chapter 62B;
(6) designed solely to provide dental or vision care;
(7) designed solely to provide coverage for a specified
disease or illness;
(8) coverage under which benefits are payable with or
without regard to fault and that is statutorily required to be
contained in any liability insurance policy or equivalent
self-insurance; or
(9) hospital income or indemnity.
Subd. 2. [GENERAL CHARACTERISTICS.] (a) The Minnesota
uniform health care identification card must be a preprinted
card constructed of plastic, paper, or any other medium that
conforms with ANSI and ISO 7810 physical characteristics
standards. The card dimensions must also conform to ANSI and
ISO 7810 physical characteristics standard. The use of a
signature panel is optional. The uniform prescription drug
information contained on the card must conform with the format
adopted by the NCPDP and, except as provided in subdivision 3,
paragraph (a), clause (2), must include all of the fields
required to submit a claim in conformance with the most recent
pharmacy identification card implementation guide produced by
the NCPDP. All information required to submit a prescription
drug claim, exclusive of information provided on a prescription
that is required by law, must be included on the card in a
clear, readable, and understandable manner. If a health benefit
plan requires a conditional or situational field, as defined by
the NCPDP, the conditional or situational field must conform to
the most recent pharmacy information card implementation guide
produced by the NCPDP.
(b) The Minnesota uniform health care identification card
must have an essential information window in on the front side
with the following data elements left justified in the following
top to bottom sequence: card issuer name, claim submission
electronic transaction routing information, card issuer
identification number, cardholder (insured) identification
number, and cardholder (insured) identification name. No
optional data may be interspersed between these data elements.
The window must be left justified.
(c) Standardized labels are required next to human readable
data elements and must come before the human readable data
elements. The card issuer may decide the location of the
standardized label relative to the data element.
Subd. 2a. [ISSUANCE.] A new Minnesota uniform health care
identification card must be issued to individuals upon
enrollment. Except for the medical assistance, general
assistance medical care, and MinnesotaCare programs, a new card
must be issued upon any change in an individual's health care
coverage that impacts the content or format of the data included
on the card or no later than 24 months after adoption of any
change in the NCPDP implementation guide or successor document
that affects the content or format of the data included on the
card. Anytime that a card is issued upon enrollment or replaced
by the medical assistance, general assistance medical care, or
MinnesotaCare program, the card must conform to the adopted
NCPDP standards in effect and to the implementation guide in use
at the time of issuance. Newly issued cards must conform to the
adopted NCPDP standards in effect at the time of issuance and to
the implementation guide in use at the time of issuance.
Stickers or other methodologies may be used to update cards
temporarily.
Subd. 3. [HUMAN READABLE DATA ELEMENTS.] (a) The following
are the minimum human readable data elements that must be
present on the front side of the Minnesota uniform health care
identification card:
(1) card issuer name or logo, which is the name or logo
that identifies the card issuer. The card issuer name or logo
may be the card's front background be located at the top of the
card. No standard label is required for this data element;
(2) claim submission complete electronic transaction
routing information including, at a minimum, the international
identification number. The standardized label of this data
element is "RxBIN." Processor control numbers and group numbers
are required if needed to electronically process a prescription
drug claim. The standardized label for the process control
numbers data element is "RxPCN" and the standardized label for
the group numbers data element is "RxGrp," except that if the
group number data element is a universal element to be used by
all health care providers, the standardized label may be "Grp."
To conserve vertical space on the card, the international
identification number and the processor control number may be
printed on the same line;
(3) card issuer identification number. The standardized
label for this element is "Clm Subm # Issuer";
(3) (4) cardholder (insured) identification number, which
is the unique identification number of the individual card
holder established and defined under this section. The
standardized label for the data element is "ID";
(4) (5) cardholder (insured) identification name, which is
the name of the individual card holder. The identification name
must be formatted as follows: first name, space, optional
middle initial, space, last name, optional space and name
suffix. The standardized label for this data element is "Name";
(5) account number(s), which is any other number, such as a
group number, if required for part of the identification or
claims process. The standardized label for this data element is
"Account";
(6) care type, which is the description of the group
purchaser's plan product under which the beneficiary is
covered. The description shall include the health plan company
name and the plan or product name. The standardized label for
this data element is "Care Type";
(7) service type, which is the description of coverage
provided such as hospital, dental, vision, prescription, or
mental health. The standard label for this data element is "Svc
Type"; and
(8) provider/clinic name, which is the name of the primary
care clinic the card holder is assigned to by the health plan
company. The standard label for this field is "PCP." This
information is mandatory only if the health plan company assigns
a specific primary care provider to the card holder.
(b) The following human readable data elements shall be
present on the back side of the Minnesota uniform health care
identification card. These elements must be left justified, and
no optional data elements may be interspersed between them:
(1) claims submission name(s) names and
address(es) addresses, which are the name(s) names and
address(es) addresses of the entity or entities to which claims
should be submitted. If different destinations are required for
different types of claims, this must be labeled; and
(2) telephone numbers and names that pharmacies and other
health care providers may call for assistance. These telephone
numbers and names are required on the back side of the card only
if one of the contacts listed in clause (3) cannot provide
pharmacies or other providers with assistance or with the
telephone numbers and names of contacts for assistance; and
(3) telephone number(s) numbers and name(s) names; which
are the telephone number(s) numbers and name(s) names of the
following contact(s) contacts with a standardized label
describing the service function as applicable:
(i) eligibility and benefit information;
(ii) utilization review;
(iii) precertification; or
(iv) customer services.
(c) The following human readable data elements are
mandatory on the back side of the Minnesota uniform health care
identification card for health maintenance organizations:
(1) emergency care authorization telephone number or
instruction on how to receive authorization for emergency care.
There is no standard label required for this information; and
(2) one of the following:
(i) telephone number to call to appeal to or file a
complaint with the commissioner of health; or
(ii) for persons enrolled under section 256B.69, 256D.03,
or 256L.12, the telephone number to call to file a complaint
with the ombudsperson designated by the commissioner of human
services under section 256B.69 and the address to appeal to the
commissioner of human services. There is no standard label
required for this information.
(d) All human readable data elements not required under
paragraphs (a) to (c) are optional and may be used at the
issuer's discretion.
Subd. 4. [MACHINE READABLE DATA CONTENT.] The
Minnesota uniform health care identification card may be machine
readable or nonmachine readable. If the card is machine
readable, the card must contain a magnetic stripe that conforms
to ANSI and ISO standards for Tracks 1.
Subd. 5. [ANNUAL REPORTING.] As part of an annual filing
made with the commissioner of health or commerce on or after
January 1, 2003, a group purchaser shall certify compliance with
this section and shall submit to the commissioner of health or
commerce a copy of the Minnesota uniform health care
identification card used by the group purchaser.
Sec. 2. [EFFECTIVE DATE.]
Section 1 is effective January 1, 2003, and applies to
health benefit plans issued or renewed on or after that date.
Presented to the governor May 14, 2001
Signed by the governor May 17, 2001, 10:29 a.m.
Official Publication of the State of Minnesota
Revisor of Statutes