Minnesota Session Laws - 2001, Regular Session

                            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.