Minnesota Session Laws - 2002, Regular Session

                            CHAPTER 307-S.F.No. 3315 
                  An act relating to insurance; making certain changes 
                  involving the joint underwriting association's 
                  procedures; providing continuation coverage for 
                  certain life insurance; modifying scope of provisions 
                  regulating credit insurance; providing for health care 
                  administrative simplification; amending Minnesota 
                  Statutes 2000, sections 61A.092, subdivision 6; 
                  62B.01; 62F.04, by adding a subdivision; 62J.51, 
                  subdivision 19; 62J.535, subdivision 2, by adding 
                  subdivisions; 62J.581; repealing Minnesota Statutes 
                  2000, sections 62F.04, subdivision 1a; 62J.535, 
                  subdivision 1. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 

                                   ARTICLE 1 
                         JOINT UNDERWRITING ASSOCIATION
           Section 1.  Minnesota Statutes 2000, section 62F.04, is 
        amended by adding a subdivision to read: 
           Subd. 3.  [AVOIDANCE OF GRAVE RISK.] Because the activities 
        of certain persons or entities present a risk that is so great, 
        the association shall not offer insurance coverage to any person 
        or entity the board of directors of the association determines 
        is outside the intended scope and purpose of the association 
        because of the gravity of the risk of offering insurance 
        coverage. 
           Sec. 2.  [REPEALER.] 
           Minnesota Statutes 2000, section 62F.04, subdivision 1a, is 
        repealed. 
           Sec. 3.  [EFFECTIVE DATE.] 
           Sections 1 and 2 are effective the day following final 
        enactment. 

                                   ARTICLE 2 
                            OTHER INSURANCE CHANGES 
           Section 1.  Minnesota Statutes 2000, section 61A.092, 
        subdivision 6, is amended to read: 
           Subd. 6.  [APPLICATION.] This section applies to a policy, 
        certificate of insurance, or similar evidence of coverage issued 
        to a Minnesota resident or issued to provide coverage to a 
        Minnesota resident.  This section does not apply to:  (1) a 
        certificate of insurance or similar evidence of coverage that 
        meets the conditions of section 61A.093, subdivision 2; or (2) a 
        group life insurance policy that contains a provision permitting 
        the certificate holder, upon termination or layoff from 
        employment, to retain the coverage provided under the group 
        policy by paying premiums directly to the insurer, provided that 
        the employer shall give the employee notice of the employee's 
        and each related certificate holder's right to continue the 
        insurance by paying premiums directly to the insurer.  The 
        insurer may reserve the right to increase premium rates after 
        the first 18 months of continued coverage provided for under 
        clause (2).  A related certificate holder is an insured spouse 
        or dependent child of the employee.  Upon termination of this 
        group policy or at the option of the insured who has continued 
        coverage under clause (2), each covered employee, spouse, and 
        dependent child is entitled to have issued to them a life 
        conversion policy as prescribed in section 61A.09, subdivision 
        1, paragraph (h). 
           Sec. 2.  Minnesota Statutes 2000, section 62B.01, is 
        amended to read: 
           62B.01 [SCOPE.] 
           All life insurance, accident and health insurance, and 
        involuntary unemployment insurance in connection with loan or 
        other credit transactions are subject to sections 62B.01 to 
        62B.14, except mortgage life, mortgage accidental death, and 
        mortgage disability insurance written in connection with first 
        real estate mortgage loans.  Insurance is not subject to 
        sections 62B.01 to 62B.14 where its issuance is an isolated 
        transaction on the part of the insurer not related to an 
        agreement or a plan for insuring debtors of the creditor.  
        Credit life, credit accident and health, and credit involuntary 
        unemployment insurance provided at no additional cost to the 
        borrower are not subject to sections 62B.01 to 62B.14. 
           Sec. 3.  Minnesota Statutes 2000, section 62J.51, 
        subdivision 19, is amended to read: 
           Subd. 19.  [UNIFORM DENTAL BILLING FORM.] "Uniform dental 
        billing form" means the 1990 most current version uniform dental 
        claim form developed by the American Dental Association. 
           Sec. 4.  Minnesota Statutes 2000, section 62J.535, is 
        amended by adding a subdivision to read: 
           Subd. 1a.  [ELECTRONIC CLAIM TRANSACTIONS.] Group 
        purchasers, including government programs, not defined as 
        covered entities under United States Code, title 42, sections 
        1320d to 1320d-8, as amended from time to time, and the rules 
        promulgated under those sections, that voluntarily agree with 
        providers to accept electronic claim transactions, must accept 
        them in the ANSI X12N 837 standard electronic format as 
        established by federal law.  Nothing in this section requires 
        acceptance of electronic claim transactions by entities not 
        covered under United States Code, title 42, sections 1320d to 
        1320d-8, as amended from time to time, and the rules promulgated 
        under those sections.  Notwithstanding the above, nothing in 
        this section or other state law prohibits group purchasers not 
        defined as covered entities under United States Code, title 42, 
        sections 1320d to 1320d-8, as amended from time to time, and the 
        rules promulgated under those sections, from requiring, as 
        authorized by Minnesota law or rule, additional information 
        associated with a claim submitted by a provider. 
           Sec. 5.  Minnesota Statutes 2000, section 62J.535, is 
        amended by adding a subdivision to read: 
           Subd. 1b.  [PAPER CLAIM TRANSACTIONS.] All group purchasers 
        that accept paper claim transactions must accept, and health 
        care providers submitting paper claim transactions must submit, 
        such transactions with use of the applicable medical and 
        nonmedical data code sets specified in the federal electronic 
        claim transaction standards adopted under United States Code, 
        title 42, sections 1320d to 1320d-8, as amended from time to 
        time, and the rules promulgated under those sections.  The paper 
        claim transaction must also be conducted using the uniform 
        billing forms as specified in section 62J.52 and the identifiers 
        specified in section 62J.54, on and after the compliance date 
        required by law.  Notwithstanding the above, nothing in this 
        section or other state law prohibits group purchasers not 
        defined as covered entities under United States Code, title 42, 
        sections 1320d to 1320d-8, as amended from time to time, and the 
        rules promulgated under those sections, from requiring, as 
        authorized by Minnesota law or rule, additional information 
        associated with a claim submitted by a provider. 
           Sec. 6.  Minnesota Statutes 2000, section 62J.535, 
        subdivision 2, is amended to read: 
           Subd. 2.  [COMPLIANCE.] (a) Subdivision 1a is effective 
        concurrent with the date of required compliance for covered 
        entities established under United States Code, title 42, 
        sections 1320d to 1320d-8, as amended from time to time, for 
        uniform electronic billing standards, all health care providers 
        must conform to the uniform billing standards developed under 
        subdivision 1. 
           (b) Notwithstanding paragraph (a), the requirements for the 
        uniform remittance advice report shall be effective 12 months 
        after the date of the required compliance of the standards for 
        the electronic remittance advice transaction are effective under 
        United States Code, title 42, sections 1320d to 1320d-8, as 
        amended from time to time. 
           Sec. 7.  Minnesota Statutes 2000, section 62J.581, is 
        amended to read: 
           62J.581 [STANDARDS FOR MINNESOTA UNIFORM HEALTH CARE 
        REIMBURSEMENT DOCUMENTS.] 
           Subdivision 1.  [MINNESOTA UNIFORM REMITTANCE ADVICE 
        REPORT.] All group purchasers and payers shall provide a uniform 
        remittance advice report to health care providers when a claim 
        is adjudicated.  The uniform remittance advice report shall 
        comply with the standards prescribed in this section.  
        Notwithstanding the above, this section does not apply to group 
        purchasers not included as covered entities under United States 
        Code, title 42, sections 1320d to 1320d-8, as amended from time 
        to time, and the rules promulgated under those sections. 
           Subd. 2.  [MINNESOTA UNIFORM EXPLANATION OF BENEFITS 
        DOCUMENT.] All group purchasers and payers shall provide a 
        uniform explanation of benefits document to health care patients 
        when a claim is adjudicated an explanation of benefits document 
        is provided as otherwise required or permitted by law.  The 
        uniform explanation of benefits document shall comply with the 
        standards prescribed in this section.  Notwithstanding the 
        above, this section does not apply to group purchasers not 
        included as covered entities under United States Code, title 42, 
        sections 1320d to 1320d-8, as amended from time to time, and the 
        rules promulgated under those sections. 
           Subd. 3.  [SCOPE.] For purposes of sections 62J.50 to 
        62J.61, the uniform remittance advice report and the uniform 
        explanation of benefits document format specified in subdivision 
        4 shall apply to all health care services delivered by a health 
        care provider or health care provider organization in Minnesota, 
        regardless of the location of the payer.  Health care services 
        not paid on an individual claims basis, such as capitated 
        payments, are not included in this section.  A health plan 
        company is excluded from the requirements in subdivisions 1 and 
        2 if they comply with section 62A.01, subdivisions 2 and 3. 
           Subd. 4.  [SPECIFICATIONS.] The uniform remittance advice 
        report and the uniform explanation of benefits document shall be 
        provided by use of a paper document conforming to the 
        specifications in this section or by use of the ANSI X12N 835 
        standard electronic format as established under United States 
        Code, title 42, sections 1320d to 1320d-8, and as amended from 
        time to time for the remittance advice.  The commissioner, after 
        consulting with the administrative uniformity committee, shall 
        specify the data elements and definitions for the uniform 
        remittance advice report and the uniform explanation of benefits 
        document.  The commissioner and the administrative uniformity 
        committee must consult with the Minnesota Dental Association and 
        Delta Dental Plan of Minnesota before requiring under this 
        section the use of a paper document for the uniform explanation 
        of benefits document or the uniform remittance advice report for 
        dental care services.  
           Subd. 5.  [EFFECTIVE DATE.] The requirements in 
        subdivisions 1 and 2 are effective 12 months after the date of 
        required compliance with the standards for the electronic 
        remittance advice transaction under United States Code, title 
        42, sections 1320d to 1320d-8, and as amended from time to 
        time October 16, 2004.  The requirements in subdivisions 1 and 2 
        apply regardless of when the health care service was provided to 
        the patient. 
           Sec. 8.  [REVISOR INSTRUCTION.] 
           The revisor of statutes is instructed to amend the headnote 
        of Minnesota Statutes, section 62J.535, to read "Uniform Billing 
        Requirements for Claim Transactions." 
           Sec. 9.  [REPEALER.] 
           Minnesota Statutes 2000, section 62J.535, subdivision 1, is 
        repealed. 
           Sec. 10.  [EFFECTIVE DATE.] 
           Sections 1 and 2 are effective the day following final 
        enactment. 
           Presented to the governor March 28, 2002 
           Signed by the governor April 1, 2002, 9:07 a.m.