Minnesota Legislature
Office of the Revisor of Statutes
Minnesota Session Laws - 1997, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 228-H.F.No. 556
An act relating to health; modifying provisions for
unique identifiers for health care providers, group
purchasers, and patients; modifying birth data
provisions; limiting access to certified copies of
birth and death certificates; requiring standardized
format for birth and death certificates; extending
date of commissioner's access to fetal, infant, and
maternal death data; modifying lead inspection and
notice requirements; amending Minnesota Statutes 1996,
sections 62J.451, subdivision 6c; 62J.54; 144.212, by
adding subdivisions; 144.215, by adding subdivisions;
144.225, subdivision 2, and by adding subdivisions;
144.9504, subdivision 2; and 145.90, subdivision 2.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. Minnesota Statutes 1996, section 62J.451,
subdivision 6c, is amended to read:
Subd. 6c. [PROVIDER ORGANIZATION PERFORMANCE
MEASUREMENT.] (a) As part of the performance measurement plan
specified in subdivision 6, the health data institute shall
develop a mechanism to assess the performance of hospitals and
other provider organizations, and to disseminate this
information to consumers, purchasers, policymakers, and other
interested parties, consistent with the data policies specified
in section 62J.452. Data to be collected may include structural
characteristics including staff-mix and nurse-patient ratios.
In selecting additional data for collection, the health data
institute may consider:
(1) feasibility and statistical validity of the indicator;
(2) purchaser and public demand for the indicator;
(3) estimated expense of collecting and reporting the
indicator; and
(4) usefulness of the indicator for internal improvement
purposes.
(b) The health data institute may conduct consumer surveys
that focus on health care provider organizations. Health care
provider organizations may provide roster data, as defined in
subdivision 2, including names, addresses, and telephone numbers
of their patients, to the health data institute for purposes of
conducting the surveys. Roster data provided by health care
provider organizations under this paragraph are private data on
individuals as defined in section 13.02, subdivision 12.
Providing data under this paragraph does not constitute a
release of health records for purposes of section 144.335,
subdivision 3a.
Sec. 2. Minnesota Statutes 1996, section 62J.54, is
amended to read:
62J.54 [IDENTIFICATION AND IMPLEMENTATION OF UNIQUE
IDENTIFIERS.]
Subdivision 1. [UNIQUE IDENTIFICATION NUMBER FOR HEALTH
CARE PROVIDER ORGANIZATIONS.] (a) On and after January 1,
1998 Not later than 24 months after the date on which a unique
health identifier for health care providers is adopted or
established under sections 1171 to 1179 of Public Law Number
104-191, 110 Statutes at Large 1936, all group purchasers and
health care providers in Minnesota shall use a unique
identification number to identify health care provider
organizations, except as provided in paragraph (e) (b).
(b) Small health plans, as defined by the federal Secretary
of Health and Human Services under section 1175 of Public Law
Number 104-191, 110 Statutes at Large 1936, shall use a unique
identification number to identify health provider organizations
no later than 36 months after the date on which a unique health
identifier for health care providers is adopted or established
under sections 1171 to 1179 of Public Law Number 104-191, 110
Statutes at Large 1936.
(c) The first eight digits of the national provider
identifier maintained by the federal Health Care Financing
Administration unique health identifier for health care
providers adopted or established by the federal Secretary of
Health and Human Services under sections 1171 to 1179 of Public
Law Number 104-191, 110 Statutes at Large 1936 (1996 and
subsequent amendments), shall be used as the unique
identification number for health care provider organizations.
(c) (d) Provider organizations required to have a national
provider unique health identifier are:
(1) hospitals licensed under chapter 144;
(2) nursing homes and hospices licensed under chapter 144A;
(3) subacute care facilities;
(4) individual providers organized as a clinic or group
practice;
(5) independent laboratory, pharmacy, surgery, radiology,
or outpatient facilities;
(6) ambulance services licensed under chapter 144; and
(7) special transportation services certified under chapter
174; and
(8) other provider organizations as required by the federal
Secretary of Health and Human Services under sections 1171 to
1179 of Public Law Number 104-191, 110 Statutes at Large 1936
(1996 and subsequent amendments).
Provider organizations shall obtain a national provider
unique health identifier from the federal Health Care Financing
Administration Secretary of Health and Human Services using the
federal Health Care Financing Administration's prescribed
process prescribed by the Secretary.
(d) (e) Only the unique health care provider organization
identifier shall be used for purposes of submitting and
receiving claims, and in conjunction with other data collection
and reporting functions.
(e) The state and federal health care programs administered
by the department of human services shall use the unique
identification number assigned to health care providers for
implementation of the Medicaid Management Information System or
the national provider identifier maintained by the federal
Health Care Financing Administration.
(f) The commissioner of health may become a subscriber to
contract with the federal Health Care Financing Administration's
national provider system Secretary of Health and Human Services
or the Secretary's agent to implement this subdivision.
Subd. 2. [UNIQUE IDENTIFICATION NUMBER FOR INDIVIDUAL
HEALTH CARE PROVIDERS.] (a) On and after January 1, 1998 Not
later than 24 months after the date on which a unique health
identifier for health care providers is adopted or established
under sections 1171 to 1179 of Public Law Number 104-191, 110
Statutes at Large 1936, all group purchasers and health care
providers in Minnesota shall use a unique identification number
to identify an individual health care provider, except as
provided in paragraph (e) (b).
(b) Small health plans, as defined by the federal Secretary
of Health and Human Services under section 1175 of Public Law
Number 104-191, 110 Statutes at Large 1936, shall use a unique
identification number to identify an individual health care
provider no later than 36 months after the date on which a
unique health identifier for health care providers is adopted or
established under sections 1171 to 1179 of Public Law Number
104-191, 110 Statutes at Large 1936.
(c) The first eight digits of the national provider
identifier maintained by the federal Health Care Financing
Administration's national provider system unique health
identifier for health care providers adopted or established by
the federal Secretary of Health and Human Services under
sections 1171 to 1179 of Public Law Number 104-191, 110 Statutes
at Large 1936 (1996 and subsequent amendments), shall be used as
the unique identification number for individual health care
providers.
(c) (d) Individual providers required to have a national
provider unique health identifier are:
(1) physicians licensed under chapter 147;
(2) dentists licensed under chapter 150A;
(3) chiropractors licensed under chapter 148;
(4) podiatrists licensed under chapter 153;
(5) physician assistants as defined under section 147A.01;
(6) advanced practice nurses as defined under section
62A.15;
(7) doctors of optometry licensed under section 148.57;
(8) pharmacists licensed under chapter 151;
(8) (9) individual providers who may bill Medicare for
medical and other health services as defined in United States
Code, title 42, section 1395x(s); and
(9) (10) individual providers who are providers for state
and federal health care programs administered by the
commissioner of human services; and
(11) other individual providers as required by the federal
Secretary of Health and Human Services under sections 1171 to
1179 of Public Law Number 104-191, 110 Statutes at Large 1936
(1996 and subsequent amendments).
Providers shall obtain a national provider unique health
identifier from the federal Health Care Financing Administration
Secretary of Health and Human Services using the Health Care
Financing Administration's prescribed process prescribed by the
Secretary.
(d) (e) Only the unique individual health care provider
identifier shall be used for purposes of submitting and
receiving claims, and in conjunction with other data collection
and reporting functions.
(e) The state and federal health care programs administered
by the department of human services shall use the unique
identification number assigned to health care providers for
implementation of the Medicaid Management Information System or
the national provider identifier maintained by the federal
Health Care Financing Administration.
(f) The commissioner of health may become a subscriber to
contract with the federal Health Care Financing Administration's
national provider system Secretary of Health and Human Services
or the Secretary's agent to implement this subdivision.
Subd. 3. [UNIQUE IDENTIFICATION NUMBER FOR GROUP
PURCHASERS.] (a) On and after January 1, 1998 Not later than 24
months after the date on which a unique health identifier for
employers and health plans is adopted or established under
sections 1171 to 1179 of Public Law Number 104-191, 110 Statutes
at Large 1936, all group purchasers and health care providers in
Minnesota shall use a unique identification number to identify
group purchasers, except as provided in paragraph (b).
(b) Small health plans, as defined by the federal Secretary
of Health and Human Services under section 1175 of Public Law
Number 104-191, 110 Statutes at Large 1936, shall use a unique
identification number to identify group purchasers no later than
36 months after the date on which a unique health identifier for
employers and health plans is adopted or established under
sections 1171 to 1179 of Public Law Number 104-191, 110 Statutes
at Large 1936.
(c) The payer identification number assigned for the
federal Health Care Financing Administration's PAYERID system
unique health identifier for health plans and employers adopted
or established by the federal Secretary of Health and Human
Services under sections 1171 to 1179 of Public Law Number
104-191, 110 Statutes at Large 1936 (1996 and subsequent
amendments), shall be used as the unique identification number
for group purchasers.
(c) (d) Group purchasers shall obtain a payer unique health
identifier number from the federal Health Care Financing
Administration Secretary of Health and Human Services using
the Health Care Financing Administration's prescribed
process prescribed by the Secretary.
(d) (e) The unique group purchaser identifier, as described
in this section, shall be used for purposes of submitting and
receiving claims, and in conjunction with other data collection
and reporting functions.
(e) (f) The commissioner of health may become a registry
user to contract with the federal Health Care Financing
Administration's PAYERID system Secretary of Health and Human
Services or the Secretary's agent to implement this subdivision.
Subd. 4. [UNIQUE PATIENT IDENTIFICATION NUMBER.] (a) On
and after January 1, 1998 Not later than 24 months after the
date on which a unique health identifier for individuals is
adopted or established under sections 1171 to 1179 of Public Law
Number 104-191, 110 Statutes at Large 1936, all group purchasers
and health care providers in Minnesota shall use a unique
identification number to identify each patient who receives
health care services in Minnesota, except as provided in
paragraph (e) (b).
(b) Except as provided in paragraph (d), following the
recommendation of the workgroup for electronic data interchange,
the social security number of the patient Small health plans, as
defined by the federal Secretary of Health and Human Services
under section 1175 of Public Law Number 104-191, 110 Statutes at
Large 1936, shall use a unique identification number to identify
each patient who receives health care services in Minnesota no
later than 36 months after the date on which a unique health
identifier for individuals is adopted or established under
sections 1171 to 1179 of Public Law Number 104-191, 110 Statutes
at Large 1936.
(c) The unique health identifier for individuals adopted or
established by the federal Secretary of Health and Human
Services under sections 1171 to 1179 of Public Law Number
104-191, 110 Statutes at Large 1936 (1996 and subsequent
amendments), shall be used as the unique patient identification
number, except as provided in paragraphs (e) and (f).
(c) (d) The unique patient identification number shall be
used by group purchasers and health care providers for purposes
of submitting and receiving claims, and in conjunction with
other data collection and reporting functions.
(d) The commissioner shall develop an alternate numbering
system for patients who do not have or refuse to provide a
social security number. This provision does not require that
patients provide their social security numbers and does not
require group purchasers or providers to demand that patients
provide their social security numbers. Group purchasers and
health care providers shall establish procedures to notify
patients that they can elect not to have their social security
number used as the unique patient identification number.
(e) The state and federal health care programs administered
by the department of human services shall use the unique person
master index (PMI) identification number assigned to clients
participating in programs administered by the department of
human services. Within the limits of available appropriations,
the commissioner shall develop a proposal for an alternate
numbering system for patients who do not have or refuse to
provide their social security numbers, if:
(1) a unique health identifier for individuals is adopted
or established under sections 1171 to 1179 of Public Law Number
104-191, 110 Statutes at Large 1936;
(2) the unique health identifier is the social security
number of the patient;
(3) there is no federal alternate numbering system for
patients who do not have or refuse to provide their social
security numbers; and
(4) federal law or the federal Secretary of Health and
Human Services explicitly allows a state to develop an alternate
numbering system for patients who do not have or refuse to
provide their social security numbers.
(f) If an alternate numbering system is developed under
paragraph (e), patients who use numbers issued by the alternate
numbering system are not required to provide their social
security numbers and group purchasers or providers may not
demand the social security numbers of patients who provide
numbers issued by the alternate numbering system. If an
alternate numbering system is developed under paragraph (e),
group purchasers and health care providers shall establish
procedures to notify patients that they can elect not to have
their social security number used as the unique patient
identifier.
(g) The commissioner of health may contract with the
federal Secretary of Health and Human Services or the
Secretary's agent to implement this subdivision.
Sec. 3. Minnesota Statutes 1996, section 144.212, is
amended by adding a subdivision to read:
Subd. 1a. [AMENDMENT.] "Amendment" means completion or
correction of a vital record.
Sec. 4. Minnesota Statutes 1996, section 144.212, is
amended by adding a subdivision to read:
Subd. 2a. [DELAYED REGISTRATION.] "Delayed registration"
means registration of a certificate of birth or death filed one
or more years after the date established by law for filing a
certificate of birth or death.
Sec. 5. Minnesota Statutes 1996, section 144.212, is
amended by adding a subdivision to read:
Subd. 4a. [INSTITUTION.] "Institution" means a public or
private establishment that:
(1) provides inpatient or outpatient medical, surgical, or
diagnostic care or treatment; or
(2) provides nursing, custodial, or domiciliary care, or to
which persons are committed by law.
Sec. 6. Minnesota Statutes 1996, section 144.215, is
amended by adding a subdivision to read:
Subd. 5. [BIRTHS OCCURRING IN AN INSTITUTION.] When a
birth occurs in an institution or en route to an institution,
the person in charge of the institution or that person's
authorized designee shall obtain the personal data required
under this section and shall prepare the certificate of birth.
For purposes of this section, "institution" means a hospital or
other facility that provides childbirth services.
Sec. 7. Minnesota Statutes 1996, section 144.215, is
amended by adding a subdivision to read:
Subd. 6. [BIRTHS OCCURRING OUTSIDE AN INSTITUTION.] When a
birth occurs outside of an institution as defined in subdivision
5, the certificate of birth shall be prepared and filed by one
of the following persons, in the indicated order of preference:
(1) the physician present at the time of the birth or
immediately thereafter;
(2) in the absence of a physician, a person present at the
time of the birth or immediately thereafter;
(3) the father or mother of the child; or
(4) in the absence of the father and if the mother is
unable, the person with primary responsibility for the premises
where the child was born.
Sec. 8. Minnesota Statutes 1996, section 144.215, is
amended by adding a subdivision to read:
Subd. 7. [EVIDENCE REQUIRED TO REGISTER A NONINSTITUTION
BIRTH WITHIN THE FIRST YEAR OF BIRTH.] When a birth occurs in
this state outside of an institution, as defined in subdivision
5, and the birth certificate is filed before the first birthday,
evidence in support of the facts of birth shall be required when
neither the state nor local registrar has personal knowledge
regarding the facts of birth. Evidence shall be presented by
the individual responsible for filing the certificate under
subdivision 6. Evidence shall consist of proof that the child
was born alive, proof of pregnancy, or evidence of the mother's
presence in this state on the date of the birth. If the
evidence is not acceptable, the state registrar shall advise the
applicant of the reason for not filing a birth certificate and
shall further advise the applicant of the right of appeal to a
court of competent jurisdiction.
Sec. 9. Minnesota Statutes 1996, section 144.225,
subdivision 2, is amended to read:
Subd. 2. [DATA ABOUT BIRTHS.] (a) Except as otherwise
provided in this subdivision, data pertaining to the birth of a
child, to a woman who was not married to the child's father when
the child was conceived nor when the child was born, including
the original certificate of birth and the certified copy, are
confidential data. At the time of the birth of a child to a
woman who was not married to the child's father when the child
was conceived nor when the child was born, the mother may
designate on the birth registration form whether data pertaining
to the birth will be public data. Notwithstanding the
designation of the data as confidential, it may be disclosed:
(1) to a parent or guardian of the child,;
(2) to the child when the child is 18 years of age or
older,;
(3) under paragraph (b); or
(4) pursuant to a court order, or under paragraph (b). For
purposes of this section, a subpoena does not constitute a court
order.
(b) Unless the child is adopted, data pertaining to the
birth of a child that are not accessible to the public become
public data if 100 years have elapsed since the birth of the
child who is the subject of the data, or as provided under
section 13.10, whichever occurs first.
(c) If a child is adopted, data pertaining to the child's
birth are governed by the provisions relating to adoption
records, including sections 13.10, subdivision 5; 144.1761;
144.218, subdivision 1; and 259.89. The birth and death records
of the commissioner of health shall be open to inspection by the
commissioner of human services and it shall not be necessary for
the commissioner of human services to obtain an order of the
court in order to inspect records or to secure certified copies
of them.
(d) The name and address of a mother under paragraph (a)
and the child's date of birth may be disclosed to the county
social services or public health member of a family services
collaborative for purposes of providing services under section
121.8355.
Sec. 10. Minnesota Statutes 1996, section 144.225, is
amended by adding a subdivision to read:
Subd. 7. [CERTIFIED COPY OF BIRTH OR DEATH
CERTIFICATE.] The state or local registrar shall issue a
certified copy of a birth or death certificate to an individual
upon the individual's proper completion of an affidavit provided
by the commissioner:
(1) to a person who has a tangible interest in the
requested certificate. A person who has a tangible interest is:
(i) the subject of the certificate;
(ii) a child of the subject;
(iii) the spouse of the subject;
(iv) a parent of the subject, unless the parent is a birth
parent whose parental rights have been terminated;
(v) the legal custodian or guardian of the subject;
(vi) a personal representative of the estate of the subject
or a successor of the subject, as defined in section 524.1-201,
if the subject is deceased;
(vii) a representative authorized by a person under clauses
(1) to (3); or
(viii) a person who demonstrates that a certified copy of
the certificate is necessary for the determination or protection
of a personal or property right, pursuant to rules adopted by
the commissioner;
(2) to any local, state, or federal governmental agency
upon request if the certified certificate is necessary for the
governmental agency to perform its authorized duties. An
authorized governmental agency includes the department of human
services, the department of revenue, and the United States
Immigration and Naturalization Service; or
(3) pursuant to a court order issued by a court of
competent jurisdiction. For purposes of this section, a
subpoena does not constitute a court order.
Sec. 11. Minnesota Statutes 1996, section 144.225, is
amended by adding a subdivision to read:
Subd. 8. [STANDARDIZED FORMAT FOR CERTIFIED BIRTH AND
DEATH CERTIFICATES.] No later than July 1, 2000, the
commissioner shall develop a standardized format for certified
birth certificates and death certificates issued by state and
local registrars. The format shall incorporate security
features in accordance with this section. The standardized
format must be implemented on a statewide basis by July 1, 2001.
Sec. 12. Minnesota Statutes 1996, section 144.9504,
subdivision 2, is amended to read:
Subd. 2. [LEAD INSPECTION.] (a) An inspecting agency shall
conduct a lead inspection of a residence according to the venous
blood lead level and time frame set forth in clauses (1) to (4)
for purposes of secondary prevention:
(1) within 48 hours of a child or pregnant female in the
residence being identified to the agency as having a venous
blood lead level equal to or greater than 70 micrograms of lead
per deciliter of whole blood;
(2) within five working days of a child or pregnant female
in the residence being identified to the agency as having a
venous blood lead level equal to or greater than 45 micrograms
of lead per deciliter of whole blood;
(3) within ten working days of a child or pregnant female
in the residence being identified to the agency as having a
venous blood lead level equal to or greater than 20 micrograms
of lead per deciliter of whole blood; or
(4) within ten working days of a child or pregnant female
in the residence being identified to the agency as having a
venous blood lead level that persists in the range of 15 to 19
micrograms of lead per deciliter of whole blood for 90 days
after initial identification.
(b) Within the limits of available state and federal
appropriations, an inspecting agency may also conduct a lead
inspection for children with any elevated blood lead level.
(c) In a building with two or more dwelling units, an
inspecting agency shall inspect the individual unit in which the
conditions of this section are met and shall also inspect all
common areas. If a child visits one or more other sites such as
another residence, or a residential or commercial child care
facility, playground, or school, the inspecting agency shall
also inspect the other sites. The inspecting agency shall have
one additional day added to the time frame set forth in this
subdivision to complete the lead inspection for each additional
site.
(d) Within the limits of appropriations, the inspecting
agency shall identify the known addresses for the previous 12
months of the child or pregnant female with elevated venous
blood lead levels of at least 20 micrograms per deciliter for
the child or at least ten micrograms per deciliter for the
pregnant female; notify the property owners, landlords, and
tenants at those addresses that an elevated blood lead level was
found in a person who resided at the property; and give them a
copy of the lead inspection guide. The inspecting agency shall
provide the notice required by this subdivision without
identifying the child or pregnant female with the elevated blood
lead level. The inspecting agency is not required to obtain the
consent of the child's parent or guardian or the consent of the
pregnant female for purposes of this subdivision. This
information shall be classified as private data on individuals
as defined under section 13.02, subdivision 12.
(e) The inspecting agency shall conduct the lead inspection
according to rules adopted by the commissioner under section
144.9508. An inspecting agency shall have lead inspections
performed by lead inspectors licensed by the commissioner
according to rules adopted under section 144.9508. If a
property owner refuses to allow an inspection, the inspecting
agency shall begin legal proceedings to gain entry to the
property and the time frame for conducting a lead inspection set
forth in this subdivision no longer applies. An inspector or
inspecting agency may observe the performance of lead hazard
reduction in progress and shall enforce the provisions of this
section under section 144.9509. Deteriorated painted surfaces,
bare soil, dust, and drinking water must be tested with
appropriate analytical equipment to determine the lead content,
except that deteriorated painted surfaces or bare soil need not
be tested if the property owner agrees to engage in lead hazard
reduction on those surfaces.
(f) A lead inspector shall notify the commissioner and the
board of health of all violations of lead standards under
section 144.9508, that are identified in a lead inspection
conducted under this section.
(g) Each inspecting agency shall establish an
administrative appeal procedure which allows a property owner to
contest the nature and conditions of any lead order issued by
the inspecting agency. Inspecting agencies must consider
appeals that propose lower cost methods that make the residence
lead safe.
(h) Sections 144.9501 to 144.9509 neither authorize nor
prohibit an inspecting agency from charging a property owner for
the cost of a lead inspection.
Sec. 13. Minnesota Statutes 1996, section 145.90,
subdivision 2, is amended to read:
Subd. 2. [ACCESS TO DATA.] (a) Until July 1, 1997 2000,
the commissioner of health has access to medical data as defined
in section 13.42, subdivision 1, paragraph (b), medical examiner
data as defined in section 13.83, subdivision 1, and health
records created, maintained, or stored by providers as defined
in section 144.335, subdivision 1, paragraph (b), without the
consent of the subject of the data, and without the consent of
the parent, spouse, other guardian, or legal representative of
the subject of the data, when the subject of the data is:
(1) a fetus that showed no signs of life at the time of
delivery, was 20 or more weeks of gestation at the time of
delivery, and was not delivered by an induced abortion;
(2) a liveborn infant that died within the first two years
of life;
(3) a woman who died during a pregnancy or within 12 months
of a fetal death, a live birth, or other termination of a
pregnancy; or
(4) the biological mother of a fetus or infant as described
in clause (1) or (2).
The commissioner only has access to medical data and health
records related to deaths or stillbirths that occur on or after
July 1, 1994. With respect to data under clause (4), the
commissioner only has access to medical data and health records
that contain information that bears upon the pregnancy and the
outcome of the pregnancy.
(b) The provider or responsible authority that creates,
maintains, or stores the data shall furnish the data upon the
request of the commissioner. The provider or responsible
authority may charge a fee for providing data, not to exceed the
actual cost of retrieving and duplicating the data.
(c) The commissioner shall make a good faith reasonable
effort to notify the subject of the data, or the parent, spouse,
other guardian, or legal representative of the subject of the
data, before collecting data on the subject. For purposes of
this paragraph, "reasonable effort" includes:
(1) one visit by a public health nurse to the last known
address of the data subject, or the parent, spouse, or guardian;
and
(2) if the public health nurse is unable to contact the
data subject, or the parent, spouse, or guardian, one notice by
certified mail to the last known address of the data subject, or
the parent, spouse, or guardian.
(d) The commissioner does not have access to coroner or
medical examiner data that are part of an active investigation
as described in section 13.83.
Sec. 14. [EFFECTIVE DATE.]
Sections 7 and 8 are effective August 1, 1998. Section 10
is effective August 1, 2000. Section 13 is effective the day
following final enactment.
Presented to the governor May 29, 1997
Signed by the governor June 2, 1997, 2:06 p.m.
Official Publication of the State of Minnesota
Revisor of Statutes