1.1 	A bill for an act
1.2 	relating to health; requiring implementation of
1.3 	cost-containment initiatives; modifying requirements
1.4 	for health plan companies and health plans; requiring
1.5 	disclosure of information to consumers; establishing a
1.6 	cancer drug repository program; requiring reporting of
1.7 	acquired infections; modifying requirement for
1.8 	health-related boards and health care providers;
1.9 	establishing evidence-based guideline and health
1.10 	promotion initiatives; requiring studies; amending
1.11 	Minnesota Statutes 2004, sections 13.3806, by adding a
1.12 	subdivision; 45.0135, subdivision 7, by adding a
1.13 	subdivision; 62D.145, subdivision 2; 62E.05,
1.14 	subdivision 2; 62E.08, subdivision 1; 62J.43; 62L.08,
1.15 	subdivision 8; 62Q.17; 62Q.64; 62Q.75; 72A.201,
1.16 	subdivision 4; 144.335, subdivision 3a; 145A.12, by
1.17 	adding subdivisions; 151.214, subdivision 1; 295.582;
1.18 	proposing coding for new law in Minnesota Statutes,
1.19 	chapters 62J; 62M; 62Q; 65B; 144; 144E; 145; 151; 214;
1.20 	repealing Minnesota Statutes 2004, sections 62E.035;
1.21 	62Q.095.
1.22 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.23 	ARTICLE 1
1.24 	HEALTH PLAN INNOVATION AND REGULATION

1.25 	Section 1. Minnesota Statutes 2004, section 62E.08,
1.26 	subdivision 1, is amended to read:
1.27 		Subdivision 1.Establishment.  The association shall
1.28 	establish the following maximum premiums to be charged for
1.29 	membership in the comprehensive health insurance plan:
1.30 	(a) the premium for the number one qualified plan shall
1.31 	range from a minimum of ~~101~~ 115 percent to a maximum of ~~125~~ 135 
1.32 	percent of the weighted average of rates charged by those
1.33 	insurers and health maintenance organizations with individuals
2.1 	enrolled in:
2.2 	(1) $1,000 annual deductible individual plans of insurance
2.3 	in force in Minnesota;
2.4 	(2) individual health maintenance organization contracts of
2.5 	coverage with a $1,000 annual deductible which are in force in
2.6 	Minnesota; and
2.7 	(3) other plans of coverage similar to plans offered by the
2.8 	association based on generally accepted actuarial principles;
2.9 	(b) the premium for the number two qualified plan shall
2.10 	range from a minimum of ~~101~~ 115 percent to a maximum of ~~125~~ 135 
2.11 	percent of the weighted average of rates charged by those
2.12 	insurers and health maintenance organizations with individuals
2.13 	enrolled in:
2.14 	(1) $500 annual deductible individual plans of insurance in
2.15 	force in Minnesota;
2.16 	(2) individual health maintenance organization contracts of
2.17 	coverage with a $500 annual deductible which are in force in
2.18 	Minnesota; and
2.19 	(3) other plans of coverage similar to plans offered by the
2.20 	association based on generally accepted actuarial principles;
2.21 	(c) the premiums for the plans with a $2,000, $5,000, or
2.22 	$10,000 annual deductible shall range from a minimum of ~~101~~ 115 
2.23 	percent to a maximum of ~~125~~ 135 percent of the weighted average
2.24 	of rates charged by those insurers and health maintenance
2.25 	organizations with individuals enrolled in:
2.26 	(1) $2,000, $5,000, or $10,000 annual deductible individual
2.27 	plans, respectively, in force in Minnesota; and
2.28 	(2) individual health maintenance organization contracts of
2.29 	coverage with a $2,000, $5,000, or $10,000 annual deductible,
2.30 	respectively, which are in force in Minnesota; or
2.31 	(3) other plans of coverage similar to plans offered by the
2.32 	association based on generally accepted actuarial principles;
2.33 	(d) the premium for each type of Medicare supplement plan
2.34 	required to be offered by the association pursuant to section
2.35 	62E.12 shall range from a minimum of ~~101~~ 115 percent to a
2.36 	maximum of ~~125~~ 135 percent of the weighted average of rates
3.1 	charged by those insurers and health maintenance organizations
3.2 	with individuals enrolled in:
3.3 	(1) Medicare supplement plans in force in Minnesota;
3.4 	(2) health maintenance organization Medicare supplement
3.5 	contracts of coverage which are in force in Minnesota; and
3.6 	(3) other plans of coverage similar to plans offered by the
3.7 	association based on generally accepted actuarial principles;
3.8 	and
3.9 	(e) the charge for health maintenance organization coverage
3.10 	shall be based on generally accepted actuarial principles.
3.11 	The list of insurers and health maintenance organizations
3.12 	whose rates are used to establish the premium for coverage
3.13 	offered by the association pursuant to paragraphs (a) to (d)
3.14 	shall be established by the commissioner on the basis of
3.15 	information which shall be provided to the association by all
3.16 	insurers and health maintenance organizations annually at the
3.17 	commissioner's request.  This information shall include the
3.18 	number of individuals covered by each type of plan or contract
3.19 	specified in paragraphs (a) to (d) that is sold, issued, and
3.20 	renewed by the insurers and health maintenance organizations,
3.21 	including those plans or contracts available only on a renewal
3.22 	basis.  The information shall also include the rates charged for
3.23 	each type of plan or contract.
3.24 	In establishing premiums pursuant to this section, the
3.25 	association shall utilize generally accepted actuarial
3.26 	principles, provided that the association shall not discriminate
3.27 	in charging premiums based upon sex.  In order to compute a
3.28 	weighted average for each type of plan or contract specified
3.29 	under paragraphs (a) to (d), the association shall, using the
3.30 	information collected pursuant to this subdivision, list
3.31 	insurers and health maintenance organizations in rank order of
3.32 	the total number of individuals covered by each insurer or
3.33 	health maintenance organization.  The association shall then
3.34 	compute a weighted average of the rates charged for coverage by
3.35 	all the insurers and health maintenance organizations by:
3.36 	(1) multiplying the numbers of individuals covered by each
4.1 	insurer or health maintenance organization by the rates charged
4.2 	for coverage;
4.3 	(2) separately summing both the number of individuals
4.4 	covered by all the insurers and health maintenance organizations
4.5 	and all the products computed under clause (1); and
4.6 	(3) dividing the total of the products computed under
4.7 	clause (1) by the total number of individuals covered.
4.8 	The association may elect to use a sample of information
4.9 	from the insurers and health maintenance organizations for
4.10 	purposes of computing a weighted average.  In no case, however,
4.11 	may a sample used by the association to compute a weighted
4.12 	average include information from fewer than the two insurers or
4.13 	health maintenance organizations highest in rank order.

4.14 	Sec. 2. [62M.071] SMALL CHARGES; NO PRIOR AUTHORIZATION.
4.15 	Claims for amounts payable that do not exceed $10 must not
4.16 	be subject to prior authorization.

4.17 	Sec. 3. [62M.072] HIGHER LEVEL SCRUTINY PERMITTED.
4.18 	A utilization review organization may apply greater levels
4.19 	of scrutiny in prior authorization and in determining medical
4.20 	necessity for nonemergency imaging, testing, and transport in
4.21 	order to reduce care that is not medically necessary.  A
4.22 	utilization review organization using this section must develop
4.23 	a definition of nonemergency care and make it available to
4.24 	providers.

4.25 	Sec. 4. [62Q.108] HEALTH PLAN CARD.
4.26 	An identification card issued to an enrollee by a health
4.27 	plan company must contain the following statement on the back:
4.28 	"This health plan is subject to Minnesota law." 

4.29 	Sec. 5. Minnesota Statutes 2004, section 62Q.17, is
4.30 	amended to read:
4.31 	62Q.17 VOLUNTARY PURCHASING POOLS.
4.32 		Subdivision 1.Permission to form. Notwithstanding
4.33 	section 62A.10, employers, groups, and individuals may
4.34 	voluntarily form purchasing pools, solely for the purpose of
4.35 	negotiating and purchasing health plan coverage from health plan
4.36 	companies for members of the pool.
5.1 		Subd. 2.Common factors. All participants in a
5.2 	purchasing pool must live within a common geographic region, be
5.3 	employed in a similar occupation, or share some other common
5.4 	factor as approved by the commissioner of commerce.  The
5.5 	membership criteria must not be designed to include
5.6 	disproportionately employers, groups, or individuals likely to
5.7 	have low costs of health coverage, or to exclude
5.8 	disproportionately employers, groups, or individuals likely to
5.9 	have high costs of health coverage.
5.10 		Subd. 3.Governing structure. Each pool must have a
5.11 	governing structure controlled by its members.  The governing
5.12 	structure of the pool is responsible for administration of the
5.13 	pool.  The governing structure shall review and evaluate all
5.14 	bids for coverage from health plan companies, shall determine
5.15 	criteria for joining and leaving the pool, and may design
5.16 	incentives for healthy lifestyles and health promotion programs.
5.17 	The governing structure may design uniform entrance standards
5.18 	for all employers, except small employers as defined under
5.19 	section 62L.02.  Small employers must be permitted to enter any
5.20 	pool if the small employer meets the pool's membership
5.21 	requirements.  Pools must provide as much choice in health plans
5.22 	to members as is financially possible.  The governing structure
5.23 	may charge all members a fee for administrative purposes.
5.24 		Subd. 4.Enrollment. (a) Pools must have an annual open
5.25 	enrollment period of not less than 15 days, during which all
5.26 	individuals or groups that qualify for membership may enter the
5.27 	pool without any preexisting condition limitations or exclusions
5.28 	or exclusionary riders, except those permitted under chapter 62L
5.29 	for groups or section 62A.65 for individuals.  Pools must reach
5.30 	and maintain an enrolled population of at least 1,000 members
5.31 	within ~~six months~~ one year of formation.  If a pool fails to
5.32 	reach or maintain the minimum enrollment, all coverage
5.33 	subsequently purchased through the purchasing pool must be
5.34 	regulated through existing applicable laws and forego all
5.35 	advantages under this section.
5.36 	(b) A pool must require an initial contribution to the
6.1 	pool's reserves at the time of entry, which may be based upon
6.2 	the entrant's experience.
6.3 		Subd. 5.Members. The governing structure of the pool
6.4 	shall set a minimum time period for membership, which must be no
6.5 	less than five years.  Members must stay in the purchasing pool
6.6 	for the entire minimum period to avoid paying a penalty.
6.7 	Penalties for early withdrawal from the purchasing pool shall be
6.8 	established by the governing structure. After the minimum
6.9 	period, a member may withdraw from the pool and receive a refund
6.10 	of its contributions to reserves, with interest at the average
6.11 	rate the pool received on its reserves during the member's
6.12 	enrollment in the pool.  The refund may be paid over a period of
6.13 	up to five years.
6.14 		Subd. 6.Employer-based purchasing pools. Employer-based
6.15 	purchasing pools must, with respect to small employers as
6.16 	defined in section 62L.02, meet all the requirements of chapter
6.17 	62L.  The experience of the pool must be pooled and the rates
6.18 	blended across all groups.  Pools may decide to create tiers
6.19 	within the pool, based on experience of group members.  These
6.20 	tiers must be designed within the requirements of section
6.21 	62L.08.  The governing structure may establish criteria limiting
6.22 	movement between tiers. ~~Tiers must be phased out within two~~
6.23 	~~years of the pool's creation.~~
6.24 		Subd. 7.Individual members. Purchasing pools that
6.25 	contain individual members must meet all of the underwriting and
6.26 	rate restrictions found in the individual health plan market.
6.27 		Subd. 8.Reports. Prior to the initial effective date of
6.28 	coverage, and annually on July 1 thereafter, each pool shall
6.29 	file a report with the ~~information clearinghouse and the~~ 
6.30 	commissioner of commerce. ~~The information clearinghouse must~~
6.31 	~~use the report to promote the purchasing pools.~~The annual
6.32 	report must contain the following information:
6.33 	(1) the number of lives in the pool;
6.34 	(2) the geographic area the pool intends to cover;
6.35 	(3) the number of health plans offered;
6.36 	(4) a description of the benefits under each plan;
7.1 	(5) a description of the premium structure, including any
7.2 	co-payments or deductibles, of each plan offered;
7.3 	(6) evidence of compliance with chapter 62L;
7.4 	(7) a sample of marketing information, including a phone
7.5 	number where the pool may be contacted; and
7.6 	(8) a list of all administrative fees charged.
7.7 		Subd. 9.Enforcement. Purchasing pools must register
7.8 	prior to offering coverage, and annually on July 1 thereafter,
7.9 	with the commissioner of commerce on a form prescribed by the
7.10 	commissioner.  The commissioner of commerce shall enforce this
7.11 	section and all other state laws with respect to purchasing
7.12 	pools, and has for that purpose all general rulemaking and
7.13 	enforcement powers otherwise available to the commissioner of
7.14 	commerce.  The commissioner may charge an annual registration
7.15 	fee sufficient to meet the costs of the commissioner's duties
7.16 	under this section.

7.17 	Sec. 6. [62Q.251] CASH PAYMENT DISCOUNT CARDS.
7.18 	(a) The commissioner of commerce shall issue to any
7.19 	Minnesota resident a cash payment discount card upon request for
7.20 	a onetime fee of $25.
7.21 	(b) The card entitles the owner of the card to receive a
7.22 	discount from a health care provider in exchange for same-day
7.23 	full payment of the provider's charge for service, supplies, and
7.24 	prescription drugs.
7.25 	(c) Participation by a provider is voluntary, and the
7.26 	provider may choose the amount of the discount, up to 25 percent
7.27 	of the charge for any service or product, which may be stated as
7.28 	a percentage or fixed dollar amount, and which may vary for
7.29 	different categories of services, supplies, and medications.

7.30 	Sec. 7. [62Q.645] DISCLOSURE RELATED TO ADMINISTRATIVE
7.31 	EFFICIENCY.
7.32 	Health plan companies shall annually report to the
7.33 	commissioner, in the form and manner specified by the
7.34 	commissioner, the following information related to
7.35 	administrative efficiency:
7.36 	(1) administrative costs, including costs related to prior
8.1 	authorization, claims processing and payment, and provider
8.2 	reviews, and all costs not included in the actual amount of
8.3 	reimbursement paid to providers;
8.4 	(2) allocation of premium revenues;
8.5 	(3) average processing time for clean claims; and 
8.6 	(4) any other measures of administrative efficiency
8.7 	identified by the commissioner.
8.8 	The commissioner shall use this information to compile
8.9 	health plan company-specific administrative efficiency report
8.10 	cards, and shall make these report cards available on state
8.11 	agency Web sites, including minnesotahealthinfo.com.

8.12 	Sec. 8. [62Q.646] DISCLOSURE OF HEALTH COVERAGE OPTIONS.
8.13 	Health plan companies, and service cooperatives established
8.14 	under chapter 123A, shall annually report to the commissioner,
8.15 	in the form and manner specified by the commissioner, the
8.16 	following information for each health plan offered:
8.17 	(1) number of covered lives;
8.18 	(2) covered services, including whether the health plan
8.19 	provides coverage for procedures and services identified by the
8.20 	commissioner to be cost-effective alternatives;
8.21 	(3) geographic availability;
8.22 	(4) current premium rates;
8.23 	(5) administrative costs, using the definition of
8.24 	administrative costs developed under section 62Q.45;
8.25 	(6) Internet links to information on the health plan, if
8.26 	available; and 
8.27 	(7) any other information about the health plan identified
8.28 	by the commissioner as being useful for consumers in evaluating
8.29 	health plan options.
8.30 	The commissioner shall make this information available on
8.31 	state agency Web sites, including minnesotahealthinfo.com.

8.32 	Sec. 9. [62Q.676] MEDICATION THERAPY MANAGEMENT CARE.
8.33 		Subdivision 1.Coverage required. A health plan that
8.34 	provides prescription drug coverage must cover medication
8.35 	therapy management services for enrollees taking four or more
8.36 	prescriptions to treat or prevent two or more chronic medical
9.1 	conditions.  For purposes of this subdivision, "medication
9.2 	therapy management" means the provision of the following
9.3 	pharmaceutical care services by a licensed pharmacist to
9.4 	optimize the therapeutic outcomes of the patient's medications:
9.5 	(1) performing or obtaining necessary assessments of the
9.6 	patient's health status;
9.7 	(2) formulating a medication treatment plan;
9.8 	(3) monitoring and evaluating the patient's response to
9.9 	therapy, including safety and effectiveness;
9.10 	(4) performing a comprehensive medication review to
9.11 	identify, resolve, and prevent medication-related problems,
9.12 	including adverse drug events;
9.13 	(5) documenting the care delivered and communicating
9.14 	essential information to the patient's other primary care
9.15 	providers;
9.16 	(6) providing verbal education and training designed to
9.17 	enhance patient understanding and appropriate use of the
9.18 	patient's medications;
9.19 	(7) providing information, support services, and resources
9.20 	designed to enhance patient adherence with the patient's
9.21 	therapeutic regimens; and 
9.22 	(8) coordinating and integrating medication therapy
9.23 	management services within the broader health care management
9.24 	services being provided to the patient.
9.25 	Nothing in this subdivision shall be construed to expand or
9.26 	modify the scope of practice of the pharmacist as defined in
9.27 	section 151.01, subdivision 27.
9.28 		Subd. 2.Pharmacist requirements. To be eligible for
9.29 	reimbursement for services under this section, a pharmacist must
9.30 	meet the following requirements:
9.31 	(1) have a valid license issued under chapter 151;
9.32 	(2) have graduated from an accredited college of pharmacy
9.33 	on or after May 1996; or completed a structured and
9.34 	comprehensive education program approved by the Board of
9.35 	Pharmacy and the American Council of Pharmaceutical Education
9.36 	for the provision and documentation of pharmaceutical care
10.1 	management services that has both clinical and didactic
10.2 	elements;
10.3 	(3) be practicing in an ambulatory care setting as part of
10.4 	a multidisciplinary team or have developed a structured patient
10.5 	care process that is offered in a private or semiprivate patient
10.6 	care area that is separate from the commercial business that
10.7 	also occurs in the setting; and 
10.8 	(4) make use of an electronic patient record system that
10.9 	meets state standards.

10.10 	Sec. 10. TRANSFER OF HMO REGULATORY RESPONSIBILITIES.
 10.11 	(a) Notwithstanding any other provision of law, regulatory
10.12 	authority over health maintenance organizations under Minnesota
10.13 	Statutes, chapter 62D, is transferred from the commissioner of
10.14 	health to the commissioner of commerce, effective July 1, 2006.
10.15 	This transfer is governed by Minnesota Statutes, section 15.039.
10.16 	(b) The revisor of statutes shall prepare legislation for
10.17 	the 2006 legislative session making the necessary statutory
10.18 	changes to comply with paragraph (a).

10.19 	ARTICLE 2
10.20 	PUBLIC HEALTH, HEALTH CARE, AND HEALTH CARE PROVIDERS

10.21 	Section 1. Minnesota Statutes 2004, section 13.3806, is
10.22 	amended by adding a subdivision to read:
10.23 		Subd. 14a.Acquired infections. Data collected by the
10.24 	commissioner of health in connection with reporting acquired
10.25 	infections in hospitals and outpatient surgical centers are
10.26 	classified under section 144.7071, subdivision 6.

10.27 	Sec. 2. Minnesota Statutes 2004, section 45.0135, is
10.28 	amended by adding a subdivision to read:
10.29 		Subd. 8.Investigations; health-related boards. (a) The
10.30 	Division of Insurance Fraud Prevention shall consult with the
10.31 	appropriate health-related board when a licensee, licensed under
10.32 	chapter 147, 148, 148B, or 150A, is suspected of insurance fraud.
10.33 	(b) In order for an investigation to proceed, the board
10.34 	shall review the evidence submitted by the Division of Insurance
10.35 	Fraud Prevention and respond to the Division of Insurance Fraud
10.36 	Prevention within 60 calendar days of sufficient evidence being
11.1 	presented to the board.  If the response of the board is in the
11.2 	affirmative, the Division of Insurance Fraud Prevention may
11.3 	proceed with the investigation.  Notwithstanding the limitations
11.4 	of chapter 13, the Department of Commerce and the health-related
11.5 	boards may freely exchange information until the investigation
11.6 	is resolved.  The decision of the board that insufficient
11.7 	grounds exist to continue an investigation does not prohibit the
11.8 	presentation of additional evidence to the board and review by
11.9 	the board at a future time.
11.10 	(c) The board may revoke, suspend, condition, limit,
11.11 	restrict, or qualify a license to practice when clear and
11.12 	convincing evidence indicates the licensee has committed
11.13 	insurance fraud or subsequent to a conviction relating to fraud.
11.14 	(d) Costs incurred by the Department of Commerce shall be
11.15 	taken from existing funds appropriated to the Division of
11.16 	Insurance Fraud Prevention.  Costs for the initial review by the
11.17 	board shall be taken from existing board funds.  Subsequent
11.18 	board investigations may be funded in part or in whole by the
11.19 	licensee in the event of a conviction relating to fraud or from
11.20 	insurance proceeds that are required to be repaid as a result of
11.21 	a conviction.

11.22 	Sec. 3. [62J.052] DISCLOSURE OF CHARGES AND PAYMENT
11.23 	RATES.
11.24 	Each health care provider, as defined in section 62J.03,
11.25 	subdivision 8, shall report annually to the commissioner, in the
11.26 	form and manner specified by the commissioner, the following:
11.27 	(1) average charges to individuals paying out-of-pocket for
11.28 	the 20 services or procedures most commonly provided or
11.29 	performed;
11.30 	(2) average payment rates for these services and procedures
11.31 	from private sector health plan companies as an aggregate group,
11.32 	and from self-insured payors, as an aggregate group; and 
11.33 	(3) average payment rates for these services and procedures
11.34 	from medical assistance.
11.35 	The commissioner may exempt specific provider types from this
11.36 	requirement, if the commissioner determines that inclusion would
12.1 	significantly increase administrative costs for those providers
12.2 	or would not provide useful information for consumers.  The
12.3 	commissioner may specify the 20 most common procedures or
12.4 	services for specific provider types, and may require providers
12.5 	to report information for specific procedures and services.  The
12.6 	commissioner shall make the information provided under this
12.7 	section available on agency Web sites, including
12.8 	minnesotahealthinfo.com.

12.9 	Sec. 4. Minnesota Statutes 2004, section 62J.43, is
12.10 	amended to read:
12.11 	62J.43  ~~BEST PRACTICES~~ EVIDENCE-BASED HEALTH CARE
12.12 	GUIDELINES AND QUALITY IMPROVEMENT.
12.13 	~~(a)~~ Subdivision 1.[ADOPTION OF ~~BEST~~
12.14 	~~PRACTICES~~ EVIDENCE-BASED HEALTH CARE GUIDELINES.] To improve
12.15 	quality and reduce health care costs, state agencies shall
12.16 	encourage the ~~adoption~~ use of ~~best practice~~ evidence-based
12.17 	health care guidelines and participation in ~~best practices~~ 
12.18 	quality of care measurement activities by ~~physicians~~ medical
12.19 	groups, hospitals, other health care providers, and health plan
12.20 	companies.  The commissioner of health shall facilitate access
12.21 	to ~~best practice~~ evidence-based health care guidelines and
12.22 	quality of care measurement information ~~to~~ for providers,
12.23 	purchasers, and consumers by:
12.24 	(1) identifying and promoting ~~local community-based,~~
12.25 	~~physician-designed best practices care~~ evidence-based health
12.26 	care guidelines across the Minnesota health care system using
12.27 	local community-based, physician-designed guidelines whenever
12.28 	they are available and meet the criteria in subdivision 2;
12.29 	(2) disseminating information available to the commissioner
12.30 	on ~~adherence to best practices care by physicians~~ the
12.31 	performance of Minnesota medical groups, hospitals,and other
12.32 	health care providers in ~~Minnesota~~ providing care in accordance
12.33 	with evidence-based health care guidelines;
12.34 	(3) educating consumers and purchasers on how to
12.35 	~~effectively~~ use this information effectively in choosing their
12.36 	providers and in making purchasing decisions; and
13.1 	(4) making ~~best practices~~ evidence-based health care
13.2 	guidelines and quality of care measurement information available
13.3 	to enrollees and program participants through the Department of
13.4 	Health's Web site.  The commissioner may convene an advisory
13.5 	committee to ensure that the Web site is ~~designed to provide~~ 
13.6 	user friendly and ~~easy accessibility~~ easily accessible.
13.7 	~~(b)~~ Subd. 2.[COLLABORATION.] The commissioner of
13.8 	health ~~shall~~ may collaborate with ~~a nonprofit Minnesota quality~~
13.9 	~~improvement organization~~ one or more health professional
13.10 	licensing boards, professional associations, institutions of
13.11 	higher education, and other organizations specializing in ~~best~~
13.12 	~~practices and~~ quality of care measurements to provide ~~best~~
13.13 	~~practices~~ evidence-based health care guidelines criteria and
13.14 	assist in the collection of the data.
13.15 	~~(c)~~ Subd. 3.[HEALTH-RELATED BOARDS; PRACTICE
13.16 	STANDARDS.] The health-related boards, under chapter 148, may
13.17 	establish practice standards for treating patients within their
13.18 	respective scopes of practice.  The boards may utilize the
13.19 	services of appropriate public or private entities to facilitate
13.20 	the development or review of practice standards and
13.21 	evidence-based guidelines.  Each board that has established or
13.22 	ratified existing standards shall report these standards to the
13.23 	legislative committees with jurisdiction over the public health
13.24 	occupations by January 15, 2006, and shall report subsequent
13.25 	changes annually thereafter.  If a board has existing standards,
13.26 	nothing in this section requires a board to establish new
13.27 	standards.
13.28 		Subd. 4.Criteria for evidence-based
13.29 	guidelines. Guidelines identified under this section must meet
13.30 	the following criteria:
13.31 	(1) the scope and application are clear;
13.32 	(2) authorship is stated and any conflicts of interest
13.33 	disclosed;
13.34 	(3) authors represent all pertinent clinical fields or
13.35 	other means of input have been used;
13.36 	(4) the development process is explicitly stated;
14.1 	(5) the guideline is grounded in evidence;
14.2 	(6) the evidence is cited and graded;
14.3 	(7) the document itself is clear and practical;
14.4 	(8) the document is flexible in use, with exceptions noted
14.5 	or provided for with general statements;
14.6 	(9) measures are included for use in systems improvement;
14.7 	and 
14.8 	(10) the guideline has scheduled reviews and updating.
14.9 		Subd. 5.Initial evidence-based health care guidelines.
 14.10 	The ~~initial best practices and quality of care measurement~~
14.11 	~~criteria developed~~ topics of the evidence-based health care
14.12 	guidelines initially identified and promoted by the commissioner 
14.13 	shall include asthma, diabetes, ~~and at least two other~~
14.14 	~~preventive health measures.  Hypertension and coronary artery~~
14.15 	~~diseases shall be included within one year following~~
14.16 	~~availability~~ hypertension, coronary artery disease, depression,
14.17 	preventive services, acute myocardial infarction, heart failure,
14.18 	pneumonia, and surgical infections.
14.19 		Subd. 6.Measurement and reporting of performance. In
14.20 	order to disseminate information on the performance of medical
14.21 	groups, hospitals, and other health care providers in providing
14.22 	care in accordance with evidence-based guidelines, the
14.23 	commissioner of health shall collaborate with Minnesota
14.24 	organizations that specialize in the development of health care
14.25 	quality measures derived from evidence-based guidelines,
14.26 	including, but not limited to, health professional licensing
14.27 	boards, professional associations, and institutions of higher
14.28 	education, in the measurement of performance by health care
14.29 	providers, and in the reporting of performance using publicly
14.30 	accessible means, including Web sites.  The commissioner shall
14.31 	not measure performance directly but shall determine whether
14.32 	performance is being measured competently and accurately and
14.33 	shall provide on the department Web site links to the Web site
14.34 	or sites of the measuring organizations.
14.35 	~~(d)~~ Subd. 7.[USE IN STATE CONTRACTS WITH HEALTH PLANS.]
14.36 	The commissioners of human services and employee relations may
15.1 	use the data to make decisions about contracts they enter into
15.2 	with health plan companies, service cooperatives, and health
15.3 	care providers, and shall develop a financial reward program
15.4 	that compensates health care practices that implement effective
15.5 	quality improvement programs or systems in their practices.
15.6 	These programs or systems may include, but are not limited to,
15.7 	clinical information systems, patient education and support,
15.8 	case and disease management, and improvement of outcomes.
15.9 	~~(e)~~ Subd. 8.[LIMITATIONS.] This section does not apply if
15.10 	the ~~best practices~~ evidence-based health care guidelines
15.11 	authorize or recommend denial of treatment, food, or fluids
15.12 	necessary to sustain life on the basis of the patient's age or
15.13 	expected length of life or the patient's present or predicted
15.14 	disability, degree of medical dependency, or quality of life.
15.15 	~~(f)~~ Subd. 9.[REPORT.] The commissioner of health, human
15.16 	services, and employee relations shall report to the legislature
15.17 	~~by~~ annually each January 15~~, 2005,~~on the status of best
15.18 	practices and quality of care initiatives, and shall present
15.19 	recommendations to the legislature on any statutory changes
15.20 	needed to increase the effectiveness of these initiatives.
15.21 	~~(g) This section expires June 30, 2006.~~

15.22 	Sec. 5. Minnesota Statutes 2004, section 62Q.64, is
15.23 	amended to read:
15.24 	62Q.64 DISCLOSURE OF EXECUTIVE COMPENSATION.
15.25 	(a) Each health plan company doing business in this state,
15.26 	and each hospital under contract with the health plan company,
15.27 	shall annually file with the ~~Consumer Advisory Board created in~~
15.28 	~~section 62J.75:~~
15.29 	~~(1) a copy of the health plan company's form 990 filed with~~
15.30 	~~the federal Internal Revenue Service; or~~ 
15.31 	~~(2) if the health plan company did not file a form 990 with~~
15.32 	~~the federal Internal Revenue Service,~~commissioner of commerce a
15.33 	list of the amount and ~~recipients~~ job classifications of the
15.34 	~~health plan company's five~~ entity's 20 highest salaries,
15.35 	including all types of compensation, in excess
15.36 	of ~~$50,000~~ $200,000.
16.1 	(b) A filing under this section is public data under
16.2 	section 13.03.
16.3 	(c) A health plan company shall require each hospital to
16.4 	comply with this section as a condition of its contract with the
16.5 	entity.

16.6 	Sec. 6. [65B.665] EXCESSIVE CLAIMS; HEALTH-RELATED
16.7 	BOARDS.
16.8 	Insurers may bring excessive claims to the attention of the
16.9 	appropriate health-related board under chapter 147, 148, 148B,
16.10 	or 150A.  The board shall respond to an insurer that brings a
16.11 	claim before the board within 60 calendar days as to whether or
16.12 	not the board agrees that a claim is excessive.  Upon a finding
16.13 	by the board that a claim is excessive, the insurer is relieved
16.14 	of its duty to pay the claim, and neither the person who was
16.15 	treated nor the person's guardian, nor the state shall be billed
16.16 	for payment.  If a pattern of excessive charges is determined by
16.17 	the board, the board may limit the right of the licensee to bill
16.18 	for payment for no-fault accident claims for a specified period
16.19 	of time, or the board may impose some other sanction it deems
16.20 	appropriate.  The insurer shall make available sufficient funds
16.21 	to provide for review of the claims that are submitted on a
16.22 	cost-based per review basis.  The cost of the review may vary
16.23 	based on the complexity of the review.  The boards shall report
16.24 	on excessive claims annually to the legislature beginning
16.25 	December 1, 2006.

16.26 	Sec. 7. [144.0506] AGENCY WEB SITES.
16.27 		Subdivision 1.Information to be posted. The
16.28 	commissioner of health shall post the following information on
16.29 	agency Web sites, including minnesotahealthinfo.com:
16.30 	(1) healthy lifestyle and preventive health care
16.31 	information, organized by gender and age, with procedures and
16.32 	treatments categorized by level of effectiveness and reliability
16.33 	of the supporting evidence on effectiveness;
16.34 	(2) health plan company administrative efficiency report
16.35 	cards, based on information collected under section 62Q.645;
16.36 	(3) health plan coverage options, based on information
17.1 	collected under section 62Q.646;
17.2 	(4) health care provider charges for common procedures,
17.3 	based on information collected under section 62J.052;
17.4 	(5) evidence-based medicine guidelines and related
17.5 	information for use as resources by health care professionals,
17.6 	and summaries of these guidelines and related information for
17.7 	use by patients and consumers;
17.8 	(6) resources and web-links related to improving efficiency
17.9 	in medical clinics and health care professional practices; and 
17.10 	(7) lists of nonprofit and charitable entities that accept
17.11 	donations of used medical equipment and supplies, such as
17.12 	crutches and walkers.
17.13 		Subd. 2.Other internet resources. The commissioner of
17.14 	health, in implementing subdivision 1, shall include relevant
17.15 	web links and materials from private sector and other government
17.16 	sources, in order to avoid duplication and reduce state
17.17 	administrative costs.
17.18 		Subd. 3.Cooperation with commissioner of commerce. The
17.19 	commissioner of health shall consult and work in cooperation
17.20 	with the commissioner of commerce, when posting on the Web site
17.21 	information collected from health plan companies regulated by
17.22 	the commissioner of commerce.

17.23 	Sec. 8. [144.707] CANCER DRUG REPOSITORY PROGRAM.
17.24 		Subdivision 1.Definitions. (a) For the purposes of this
17.25 	section, the terms defined in this subdivision have the meanings
17.26 	given.
17.27 	(b) "Cancer drug" means a prescription drug that is used to
17.28 	treat:
17.29 	(1) cancer or the side effects of cancer; or 
17.30 	(2) the side effects of any prescription drug that is used
17.31 	to treat cancer or the side effects of cancer.
17.32 	(c) "Cancer drug repository" means a medical facility or
17.33 	pharmacy that has notified the commissioner of its election to
17.34 	participate in the cancer drug repository program.
17.35 	(d) "Cancer supply" or "supplies" means prescription and
17.36 	nonprescription cancer supplies needed to administer a cancer
18.1 	drug.
18.2 	(e) "Commissioner" means the commissioner of health.
18.3 	(f) "Dispense" has the meaning given in section 151.01,
18.4 	subdivision 30.
18.5 	(g) "Distribute" means to deliver, other than by
18.6 	administering or dispensing.
18.7 	(h) "Medical facility" means an institution defined in
18.8 	section 144.50, subdivision 2.
18.9 	(i) "Medical supplies" means any prescription and
18.10 	nonprescription medical supply needed to administer a cancer
18.11 	drug.
18.12 	(j) "Pharmacist" has the meaning given in section 151.01,
18.13 	subdivision 3.
18.14 	(k) "Pharmacy" means any pharmacy registered with the Board
18.15 	of Pharmacy according to section 151.19, subdivision 1.
18.16 	(l) "Practitioner" has the meaning given in section 151.01,
18.17 	subdivision 23.
18.18 	(m) "Prescription drug" means a legend drug as defined in
18.19 	section 151.01, subdivision 17.
18.20 	(n) "Side effects of cancer" means symptoms of cancer.
18.21 	(o) "Single-unit-dose packaging" means a single-unit
18.22 	container for articles intended for administration as a single
18.23 	dose, direct from the container.
18.24 	(p) "Tamper-evident unit dose packaging" means a container
18.25 	within which a drug is sealed so that the contents cannot be
18.26 	opened without obvious destruction of the seal.
18.27 		Subd. 2.Establishment. The commissioner shall establish
18.28 	and maintain a cancer drug repository program under which any
18.29 	person may donate a cancer drug or supply for use by an
18.30 	individual who meets the eligibility criteria specified under
18.31 	subdivision 4.  Under the program, donations may be made on the
18.32 	premises of a medical facility or pharmacy that elects to
18.33 	participate in the program and meets the requirements specified
18.34 	under subdivision 3.
18.35 		Subd. 3.Requirements for participation by pharmacies and
18.36 	medical facilities. (a) To be eligible for participation in the
19.1 	cancer drug repository program, a pharmacy or medical facility
19.2 	must be licensed and in compliance with all applicable federal
19.3 	and state laws and administrative rules.
19.4 	(b) Participation in the cancer drug repository program is
19.5 	voluntary.  A pharmacy or medical facility may elect to
19.6 	participate in the cancer drug repository program by submitting
19.7 	the following information to the commissioner, in a form
19.8 	provided by the commissioner:
19.9 	(1) the name, street address, and telephone number of the
19.10 	pharmacy or medical facility;
19.11 	(2) the name and telephone number of a pharmacist who is
19.12 	employed by or under contract with the pharmacy or medical
19.13 	facility, or other contact person who is familiar with the
19.14 	pharmacy's or medical facility's participation in the cancer
19.15 	drug repository program; and 
19.16 	(3) a statement indicating that the pharmacy or medical
19.17 	facility meets the eligibility requirements under paragraph (a)
19.18 	and the chosen level of participation under paragraph (c).
19.19 	(c) A pharmacy or medical facility may fully participate in
19.20 	the cancer drug repository program by accepting, storing, and
19.21 	dispensing donated drugs and supplies, or may limit its
19.22 	participation to only accepting and storing donated drugs and
19.23 	supplies.  If a pharmacy or facility chooses to limit its
19.24 	participation, the pharmacy or facility shall distribute any
19.25 	donated drugs to a fully participating cancer drug repository in
19.26 	accordance with subdivision 8.
19.27 	(d) A pharmacy or medical facility may withdraw from
19.28 	participation in the cancer drug repository program at any time
19.29 	upon notification to the commissioner.  A notice to withdraw
19.30 	from participation may be given by telephone or regular mail.
19.31 		Subd. 4.Individual eligibility requirements. Any
19.32 	Minnesota resident who is diagnosed with cancer is eligible to
19.33 	receive drugs or supplies under the cancer drug repository
19.34 	program.  Drugs and supplies shall be dispensed according to the
19.35 	priority given under subdivision 6.
19.36 		Subd. 5.Donations of cancer drugs and supplies. (a) Any
20.1 	one of the following persons may donate legally obtained cancer
20.2 	drugs or supplies to a cancer drug repository if the drugs or
20.3 	supplies meet the requirements under paragraph (b) or (c) as
20.4 	determined by a pharmacist who is employed by or under contract
20.5 	with a cancer drug repository:
20.6 	(1) an individual who is 18 years of age or older; or 
20.7 	(2) a pharmacy, medical facility, drug manufacturer, or
20.8 	wholesale drug distributor, if the donated drugs have not been
20.9 	previously dispensed.
20.10 	(b) A cancer drug is eligible for donation under the cancer
20.11 	drug repository program only if the following requirements are
20.12 	met:
20.13 	(1) the donation is accompanied by a cancer drug repository
20.14 	donor form described under paragraph (d) that is signed by the
20.15 	person making the donation or that person's authorized
20.16 	representative;
20.17 	(2) the drug's expiration date is at least six months later
20.18 	than the date that the drug was donated;
20.19 	(3) the drug is in its original, unopened, tamper-evident
20.20 	unit dose packaging that includes the drug's lot number and
20.21 	expiration date.  Single-unit dose drugs may be accepted if the
20.22 	single-unit-dose packaging is unopened; and 
20.23 	(4) the drug is not adulterated or misbranded.
20.24 	(c) Cancer supplies are eligible for donation under the
20.25 	cancer drug repository program only if the following
20.26 	requirements are met:
20.27 	(1) the supplies are not adulterated or misbranded;
20.28 	(2) the supplies are in their original, unopened, sealed
20.29 	packaging; and 
20.30 	(3) the donation is accompanied by a cancer drug repository
20.31 	donor form described under paragraph (d) that is signed by the
20.32 	person making the donation or that person's authorized
20.33 	representative.
20.34 	(d) The cancer drug repository donor form must be provided
20.35 	by the commissioner and shall state that to the best of the
20.36 	donor's knowledge the donated drug or supply has been properly
21.1 	stored and that the drug or supply has never been opened, used,
21.2 	tampered with, adulterated, or misbranded.  The commissioner
21.3 	shall make the cancer drug repository donor form available on
21.4 	the Department of Health's Web site.
21.5 	(e) Controlled substances and drugs and supplies that do
21.6 	not meet the criteria under this subdivision are not eligible
21.7 	for donation or acceptance under the cancer drug repository
21.8 	program.
21.9 	(f) Drugs and supplies may be donated on the premises of a
21.10 	cancer drug repository to a pharmacist designated by the
21.11 	repository.  A drop box may not be used to deliver or accept
21.12 	donations.
21.13 	(g) Cancer drugs and supplies donated under the cancer drug
21.14 	repository program must be stored in a secure storage area under
21.15 	environmental conditions appropriate for the drugs or supplies
21.16 	being stored.  Donated drugs and supplies may not be stored with
21.17 	nondonated inventory.
21.18 		Subd. 6.Dispensing requirements. (a) Drugs and supplies
21.19 	must be dispensed by a licensed pharmacist pursuant to a
21.20 	prescription by a practitioner and in accordance with the
21.21 	requirements of chapter 151.
21.22 	(b) Before being dispensed, cancer drugs and supplies shall
21.23 	be visually inspected by the pharmacist for adulteration,
21.24 	misbranding, and date of expiration.  Drugs or supplies that
21.25 	have expired or appear upon visual inspection to be adulterated,
21.26 	misbranded, or tampered with in any way may not be dispensed.
21.27 	(c) Before a cancer drug or supply may be dispensed to an
21.28 	individual, the individual must sign a cancer drug repository
21.29 	recipient form provided by the commissioner acknowledging that
21.30 	the individual understands the information stated on the form.
21.31 	The form shall include the following information:
21.32 	(1) that the drug or supply being dispensed has been
21.33 	donated and may have been previously dispensed;
21.34 	(2) that a visual inspection has been conducted by the
21.35 	pharmacist to ensure that the drug has not expired, has not been
21.36 	adulterated or misbranded, and is in its original, unopened
22.1 	packaging; and 
22.2 	(3) that the dispensing pharmacist, the cancer drug
22.3 	repository, the Department of Health, and any other participant
22.4 	in the cancer drug repository program cannot guarantee the
22.5 	safety of the drug or supply being dispensed and that the
22.6 	pharmacist has determined that the drug or supply is safe to
22.7 	dispense based on the accuracy of the donor's form submitted
22.8 	with the donated drug or supply and the visual inspection
22.9 	required to be performed by the pharmacist before dispensing.
22.10 	The commissioner shall make the cancer drug repository form
22.11 	available on the Department of Health's Web site.
22.12 	(d) Drugs and supplies shall only be dispensed to
22.13 	individuals who meet the eligibility requirements in subdivision
22.14 	4 and in the following order of priority:
22.15 	(1) individuals who are uninsured;
22.16 	(2) individuals who are enrolled in medical assistance,
22.17 	general assistance medical care, MinnesotaCare, Medicare, or
22.18 	other public assistance health care; and 
22.19 	(3) all other individuals who are otherwise eligible under
22.20 	subdivision 4 to receive drugs or supplies from a cancer drug
22.21 	repository.
22.22 		Subd. 7.Handling fees. A cancer drug repository may
22.23 	charge the individual receiving a drug or supply a handling fee
22.24 	of no more than 250 percent of the medical assistance program
22.25 	dispensing fee for each cancer drug or supply dispensed.
22.26 		Subd. 8.Distribution of donated cancer drugs and
22.27 	supplies. (a) Cancer drug repositories may distribute drugs and
22.28 	supplies donated under the cancer drug repository program to
22.29 	other repositories if requested by a participating repository.
22.30 	(b) A cancer drug repository that has elected not to
22.31 	dispense donated drugs or supplies shall distribute any donated
22.32 	drugs and supplies to a participating repository upon request of
22.33 	the repository.
22.34 	(c) If a cancer drug repository distributes drugs or
22.35 	supplies under paragraph (a) or (b), the repository shall
22.36 	complete a cancer drug repository donor form provided by the
23.1 	commissioner.  The completed form and a copy of the donor form
23.2 	that was completed by the original donor under subdivision 5
23.3 	shall be provided to the fully participating cancer drug
23.4 	repository at the time of distribution.
23.5 		Subd. 9.Resale of donated drugs or supplies. Donated
23.6 	drugs and supplies may not be resold.
23.7 		Subd. 10.Record-keeping requirements. (a) Cancer drug
23.8 	repository donor and recipient forms shall be maintained for at
23.9 	least five years.
23.10 	(b) A record of destruction of donated drugs and supplies
23.11 	that are not dispensed under subdivision 6 shall be maintained
23.12 	by the dispensing repository for at least five years.  For each
23.13 	drug or supply destroyed, the record shall include the following
23.14 	information:
23.15 	(1) the date of destruction;
23.16 	(2) the name, strength, and quantity of the cancer drug
23.17 	destroyed;
23.18 	(3) the name of the person or firm that destroyed the drug;
23.19 	and 
23.20 	(4) the source of the drugs or supplies destroyed.
23.21 		Subd. 11.Liability. (a) Unless a manufacturer of a drug
23.22 	or supply exercises bad faith, the manufacturer is not subject
23.23 	to criminal or civil liability for injury, death, or loss to a
23.24 	person or property for matters related to the donation,
23.25 	acceptance, or dispensing of a cancer drug or supply
23.26 	manufactured by the manufacturer that is donated by any
23.27 	individual under this section, including liability for failure
23.28 	to transfer or communicate product or consumer information or
23.29 	the expiration date of the donated cancer drug or supply.
23.30 	(b) A medical facility, pharmacy, pharmacist, practitioner,
23.31 	or donor participating in the program is immune from civil
23.32 	liability for injury to or for the death of an individual to
23.33 	whom the cancer drug or supply is dispensed and no disciplinary
23.34 	action shall be taken for unprofessional conduct for acts or
23.35 	omissions related to donating, accepting, distributing, or
23.36 	dispensing a cancer drug or supply under this section, unless
24.1 	the act or omission involves reckless, wanton, or intentional
24.2 	misconduct, or malpractice unrelated to the quality of the drug
24.3 	dispensed.

24.4 	Sec. 9. [144.7071] REPORTING OF ACQUIRED INFECTIONS.
24.5 		Subdivision 1.Citation. This section may be cited as
24.6 	the Minnesota Acquired Infections Disclosure Act.
24.7 		Subd. 2.Definitions. (a) For purposes of this section,
24.8 	the following definitions apply.
24.9 	(b) "Acquired infection" means a localized or systemic
24.10 	condition that:
24.11 	(1) results from adverse reaction to the presence of an
24.12 	infectious agent or its toxin; and 
24.13 	(2) was not present or incubating at the time of admission
24.14 	to the facility.
24.15 	(c) "Commissioner" means the commissioner of health.
24.16 	(d) "Facility" means a hospital or outpatient surgical
24.17 	center licensed under sections 144.50 to 144.56.
24.18 		Subd. 3.Data collection. (a) Individual facilities must
24.19 	collect data on acquired infection rates for specific clinical
24.20 	procedures identified by the commissioner after consultation
24.21 	with the advisory committee.
24.22 	(b) In developing the methodology for collecting and
24.23 	analyzing the infection rate data, the commissioner must consult
24.24 	with the advisory committee and must consider, but is not
24.25 	required to adopt, existing methodologies and systems for data
24.26 	collection, such as the Centers for Disease Control's National
24.27 	Nosocomial Infection Surveillance Program, or its successor.
24.28 	The commissioner must disclose to the public the data collection
24.29 	and analysis methodology adopted, prior to public disclosure of
24.30 	acquired infection rates.
24.31 	(c) The commissioner, in consultation with the advisory
24.32 	committee, must regularly evaluate the quality and accuracy of
24.33 	the information submitted by facilities and the adequacy of the
24.34 	data collection, analysis, risk-adjustment, and dissemination
24.35 	methodologies.
24.36 		Subd. 4.Reports by commissioner. (a) The commissioner
25.1 	must submit to the legislature, beginning December 1, 2006, and
25.2 	each December 1 thereafter, an annual report summarizing and
25.3 	analyzing the information received in facility quarterly
25.4 	reports.  The annual report must include the risk-adjusted
25.5 	acquired infection rates for each facility in the state, an
25.6 	analysis of the rates of acquired infections by geographic area
25.7 	and type of facility, and a comparison of rates of acquired
25.8 	infections over time.  The report may also include
25.9 	recommendations for policy and legislative changes necessary to
25.10 	reduce the rate of acquired infections or improve the process
25.11 	for reporting and analyzing rates of acquired infections.
25.12 	(b) The commissioner may submit quarterly reports to the
25.13 	legislature, summarizing the information submitted in the
25.14 	facility quarterly reports.
25.15 	(c) The commissioner must publicize the annual reports and
25.16 	quarterly reports and must provide copies of these documents to
25.17 	interested parties upon request.  The commissioner must also
25.18 	make the reports available on the agency Web site.
25.19 		Subd. 5.Privacy. (a) No facility report or disclosure
25.20 	by the commissioner may contain identifying information for any
25.21 	of the health care professionals, facility employees, or
25.22 	patients involved in connection with a specific infection
25.23 	incident.
25.24 	(b) Data collected as provided under subdivision 3,
25.25 	paragraph (e), are nonpublic and, to the extent they contain
25.26 	data on individuals, are confidential data on individuals, as
25.27 	defined in section 13.02.
25.28 		Subd. 6.Advisory committee. (a) The commissioner must
25.29 	establish an advisory committee that includes representatives of
25.30 	public and private hospitals, including staff from hospital
25.31 	infection control departments; outpatient surgical centers;
25.32 	direct care nursing staff; physicians; epidemiologists and
25.33 	academic researchers with expertise in hospital-acquired
25.34 	infections; consumer organizations; health plan companies;
25.35 	organized labor; and employers and other health care
25.36 	purchasers.  A majority of the members of the advisory committee
26.1 	must represent organizations other than hospitals and outpatient
26.2 	surgical centers.
26.3 	(b) The advisory committee must assist the commissioner in
26.4 	the development of procedures for collecting, analyzing, and
26.5 	reporting the information on acquired infection rates, in
26.6 	identifying specific clinical procedures for which infection
26.7 	rates must be reported, and in evaluating the accuracy of the
26.8 	data on acquired infection rates submitted to the commissioner.
26.9 	(c) Notwithstanding section 15.059, the advisory committee
26.10 	does not expire.
26.11 		Subd. 7.Rulemaking. The commissioner must adopt rules
26.12 	to implement this section.

26.13 	Sec. 10. [144.999] REPORTING ON UNCOMPENSATED CARE.
26.14 	(a) A health care provider shall file annually with the
26.15 	commissioner of health, no later than March 1 of each year, a
26.16 	report of the provider's uncompensated care for the preceding
26.17 	calendar year.  The report must be on a form prescribed by the
26.18 	commissioner.  The form must require the provider to report the
26.19 	dollar amount of uncompensated care in the following categories
26.20 	which must be more fully defined on the form:
26.21 	(1) charity care, meaning care that the provider had agreed
26.22 	with the patient, prior to providing the care, to provide all or
26.23 	a portion of at no charge or at a reduced charge; and 
26.24 	(2) bad debt, meaning amounts owing to the provider by the
26.25 	patient or other responsible party, which has remained unpaid
26.26 	for at least six months after the date the care was provided,
26.27 	whether reduced to judgment or not.
26.28 	(b) Uncompensated care for purposes of this section does
26.29 	not include:
26.30 	(1) reductions in charges by health plan companies based
26.31 	upon provider agreements or upon a determination that the
26.32 	charges exceed the reasonable and customary charge; or 
26.33 	(2) differences between what the provider receives under
26.34 	Medicare, medical assistance, general assistance medical care,
26.35 	or MinnesotaCare and what the provider might otherwise charge
26.36 	for that care.

27.1 	Sec. 11. [144E.20] LIABILITY LIMITS OF NONGOVERNMENT
27.2 	LICENSEES.
27.3 	A licensee that is not a unit of government is subject to
27.4 	the same liability limits under chapter 466 as a licensee that
27.5 	is a unit of government.

27.6 	Sec. 12. [145.985] HEALTH PROMOTION AND WELLNESS.
27.7 	Community health boards as defined in section 145A.02,
27.8 	subdivision 5, shall work with schools, health care providers,
27.9 	and others to coordinate health and wellness programs in their
27.10 	communities.  In order to meet the requirements of this section,
27.11 	community health boards shall:
27.12 	(1) provide instruction, technical assistance, and
27.13 	recommendations on how to evaluate project outcomes;
27.14 	(2) assist with on-site health and wellness programs
27.15 	utilizing volunteers and others addressing health and wellness
27.16 	topics including smoking, nutrition, obesity, and others; and 
27.17 	(3) encourage health and wellness programs consistent with
27.18 	the Centers for Disease Control and Prevention's Community Guide
27.19 	and goals consistent with the Centers for Disease Control and
27.20 	Prevention's Healthy People 2010 initiative.

27.21 	Sec. 13. Minnesota Statutes 2004, section 145A.12, is
27.22 	amended by adding a subdivision to read:
27.23 		Subd. 9.Health improvement grant fund. The commissioner
27.24 	shall establish a public health grant fund and program to award
27.25 	grants to statewide and local health improvement public-private
27.26 	partnerships to support collaborative actions that will reduce
27.27 	the rate of increase in health care costs through improvements
27.28 	in the health status or the prevention of illness and injury in
27.29 	the population of the state or a local community.  The
27.30 	commissioner shall fund the grants using foundation and other
27.31 	nonstate resources.  The commissioner shall require grantees to
27.32 	provide an equal match of local funding provided from public or
27.33 	private sources.  Each grant program must include a methodology
27.34 	approved by the commissioner for measuring the financial and
27.35 	health improvement impact of the grantees' actions.  The
27.36 	commissioner must submit a report to the legislature by June 30,
28.1 	2009, describing the impact of the programs funded under this
28.2 	section.
28.3 	
EFFECTIVE DATE. This section is effective July 1, 2005.

28.4 	Sec. 14. Minnesota Statutes 2004, section 151.214,
28.5 	subdivision 1, is amended to read:
28.6 		Subdivision 1.Explanation of pharmacy benefits.  A
28.7 	pharmacist licensed under this chapter must provide to a
28.8 	patient, for each prescription dispensed where part or all of
28.9 	the cost of the prescription is being paid or reimbursed by an
28.10 	employer-sponsored plan or health plan company, or its
28.11 	contracted pharmacy benefit manager, the patient's co-payment
28.12 	amount and the pharmacy's own usual and customary price of the
28.13 	prescription or the amount the pharmacy will be paid for the
28.14 	prescription drug by the patient's employer-sponsored plan or
28.15 	health plan company, or its contracted pharmacy benefit manager.

28.16 	Sec. 15. [151.215] PROVISION OF INFORMATION ON
28.17 	PHARMACEUTICAL ASSISTANCE PROGRAMS.
28.18 	A pharmacist licensed under this chapter must make
28.19 	available to patients, in a public area of the pharmacy,
28.20 	brochures on programs offered by pharmaceutical manufacturers
28.21 	that provide free or discounted drugs or provide coverage for
28.22 	prescription drugs.  This requirement applies only to brochures
28.23 	that are made available to pharmacists free of charge by
28.24 	pharmaceutical manufacturers.

28.25 	Sec. 16. [214.107] HEALTH-RELATED BOARDS; REVIEW OF
28.26 	JUDGMENTS, CLAIMS, SETTLEMENTS, AND VERDICTS.
28.27 	The health-related boards under chapters 147, 148, 148B,
28.28 	and 150A, shall be notified by the licensed provider or other
28.29 	party of all licensee malpractice judgments, claims,
28.30 	settlements, verdicts, or criminal convictions.  Conviction, as
28.31 	used in this subdivision, includes a conviction of an offense
28.32 	that if committed in this state would be considered a felony or
28.33 	gross misdemeanor without regard to its designation elsewhere,
28.34 	or a criminal proceeding where a finding or verdict of guilt is
28.35 	made or returned but the adjudication of guilt is either
28.36 	withheld or not entered.

29.1 	Sec. 17. [214.206] HEALTH-RELATED BOARDS; NO-FAULT
29.2 	AUTOMOBILE INJURIES.
29.3 	The health-related boards, under chapter 148, may establish
29.4 	practice standards for treating patients with injuries sustained
29.5 	in no-fault automobile accidents and update the standards
29.6 	periodically as appropriate.  The boards may utilize the
29.7 	services of appropriate public or private entities to facilitate
29.8 	the development or review of practice standards and
29.9 	evidence-based guidelines.  Each board that has established or
29.10 	ratified existing standards shall report these standards to the
29.11 	legislative committees with jurisdiction over the public health
29.12 	occupations by January 15, 2006, and shall report subsequent
29.13 	changes annually thereafter.  If a board has existing standards,
29.14 	nothing in this section requires a board to establish new
29.15 	standards.

29.16 	Sec. 18. HEALTH BOARDS; DIRECTORY OF LICENSEES.
 29.17 	Each health board under Minnesota Statutes, chapters 147,
29.18 	148, 148B, and 150A, shall establish a directory of licensees
29.19 	that includes biographical data and any malpractice judgments or
29.20 	other judgments or convictions related to the health license for
29.21 	each licensee.

29.22 	ARTICLE 3
29.23 	MISCELLANEOUS AND STUDIES

29.24 	Section 1. Minnesota Statutes 2004, section 145A.12, is
29.25 	amended by adding a subdivision to read:
29.26 		Subd. 8.Coordinated statewide health improvement action
29.27 	plan. The commissioner, in consultation with the state
29.28 	community health advisory committee and other interested
29.29 	parties, including employers, health plan companies, schools,
29.30 	health care professionals, and consumers, shall develop and
29.31 	implement a statewide action plan for improving the health
29.32 	status of Minnesotans and promoting primary prevention through
29.33 	the strategic and coordinated action of communities, businesses,
29.34 	health care professionals, health care organizations, health
29.35 	plans, schools, and other public and private entities.  The plan
29.36 	must identify up to three of the statewide public health
30.1 	outcomes as determined under subdivision 7 and provide for
30.2 	specific steps to be taken that will produce measurable
30.3 	improvements in health status and corresponding reductions in
30.4 	the incidence of disease or injury and related health care
30.5 	costs.  The plan must encourage and facilitate the formation of
30.6 	local public-private partnerships to take action on the
30.7 	statewide goals.

30.8 	Sec. 2. NO-FAULT INSURANCE MEDICAL COST STUDY.
 30.9 	The commissioner of commerce, the health-related boards
30.10 	under Minnesota Statutes, chapter 148, professional provider
30.11 	associations, and automobile insurance carriers that offer
30.12 	no-fault insurance under Minnesota Statutes, sections 65B.41 to
30.13 	65B.71, shall study the medical costs associated with no-fault
30.14 	automobile accidents and report to the legislative committees
30.15 	with jurisdiction over the public health boards and commerce on
30.16 	any high medical cost outliers by January 15, 2006.  For the
30.17 	purposes of this section, "high medical cost outliers" means
30.18 	health providers whose total charges for treating specific
30.19 	conditions or injuries sustained as a result of no-fault
30.20 	automobile accidents are at any time found to be above the 95th
30.21 	percentile or consistently above the 90th percentile.
30.22 	For the purposes of this study, the no-fault automobile
30.23 	insurance carriers shall provide nonproprietary data for
30.24 	determining the current usual and customary fees.  Such data
30.25 	shall include information on the data utilized, including where
30.26 	the data was derived from, the age of the data, the data
30.27 	demographics, and other pertinent criteria.  The data must be
30.28 	updated no less than annually.  The information provided must
30.29 	include reasonable customary charges on the 100 most commonly
30.30 	utilized codes by the professionals submitting billings,
30.31 	including codes for clinical diagnostic parameters, clinical
30.32 	treatment parameters, and therapeutic parameters.

30.33 	Sec. 3. INFORMATION FOR HEALTH CARE PURCHASING.
 30.34 		Subdivision 1.Purpose. It is the intent of the
30.35 	legislature to promote and support a health care purchasing
30.36 	system for public and private purchasers of health care that
31.1 	promotes individual consumer choice based on the value of health
31.2 	care services, drugs, equipment, and preventive measures.  A
31.3 	necessary component of value-based health care purchasing is
31.4 	convenient access to information about differences in quality
31.5 	and costs.
31.6 		Subd. 2.Cost information. The commissioner of health,
31.7 	in cooperation with other appropriate state agencies and in
31.8 	consultation with an advisory committee representing purchasers,
31.9 	consumers, physicians and other health care professionals,
31.10 	health plan companies, health care facilities and other health
31.11 	care organizations, and other interested persons and groups,
31.12 	shall develop a plan, no later than January 1, 2006, for the
31.13 	development of useful, reliable, and valid information on cost
31.14 	to support purchasing of health care based on value.
31.15 	
EFFECTIVE DATE. This section is effective July 1, 2005.

31.16 	Sec. 4. HEALTH CARE COST CONTAINMENT STUDIES.
 31.17 		Subdivision 1.General requirements for studies. (a) The
31.18 	commissioners of health, commerce, and human services shall
31.19 	study the health care cost containment issues listed in this
31.20 	section, and shall present a combined report on these issues to
31.21 	the legislature by January 15, 2006.  The commissioners shall
31.22 	consult with the commissioner of employee relations and other
31.23 	agency commissioners as needed.  The combined report must:
31.24 	(1) examine the feasibility and benefits of each initiative
31.25 	being proposed;
31.26 	(2) provide recommendations for addressing each issue and
31.27 	any draft legislation necessary to implement these
31.28 	recommendations;
31.29 	(3) present for each separate issue, an estimate of the
31.30 	savings to the state, other payors, and consumers that would
31.31 	result from implementation of the recommendations; and 
31.32 	(4) provide, where applicable, a unified strategy that
31.33 	addresses cost containment across separate issue areas and
31.34 	provides a timetable for staged implementation of various
31.35 	recommendations across different issue areas.
31.36 	(b) The report may contain preliminary recommendations for
32.1 	specific issues, if the commissioners determine that additional
32.2 	time is necessary to fully analyze the issues and develop final
32.3 	recommendations.  The commissioners shall present to the
32.4 	legislature by December 15, 2006, final recommendations and
32.5 	draft legislation for these issue areas.
32.6 	(c) In conducting the studies, the commissioners shall
32.7 	regularly consult with relevant parties, including, but not
32.8 	limited to, health care consumers, representatives of health
32.9 	plan companies and other payors, health care providers,
32.10 	health-related licensing boards, professional associations, and
32.11 	medical and health policy researchers.
32.12 	(d) The commissioners shall post completed studies,
32.13 	summaries of study findings, best practices, and evidence-based
32.14 	medicine on state Web sites, including minnesotahealthinfo.com.
32.15 	(e) For purposes of this section, "commissioners" means the
32.16 	commissioners of health, commerce, and human services, unless
32.17 	otherwise indicated.
32.18 		Subd. 2.Staff support. (a) The commissioners shall
32.19 	provide staff necessary to conduct the studies.  The
32.20 	commissioners shall pay for staff and administrative costs using
32.21 	existing financial resources.
32.22 	(b) The commissioners shall seek staff support from health
32.23 	plan companies, health care provider organizations, consumer
32.24 	groups, health-related licensing boards, professional
32.25 	associations, and health policy and medical researchers, in
32.26 	order to make use of private sector expertise and minimize state
32.27 	costs.
32.28 		Subd. 3.Studies related to quality of care. (a) The
32.29 	commissioners shall study approaches to obtaining more rapid
32.30 	health plan company and payor approval of new or underutilized
32.31 	cost-saving procedures that improve quality of care, including,
32.32 	but not limited to, new procedures for wound care, when these
32.33 	procedures are supported by findings of evidence-based
32.34 	medicine.  The study must also examine methods to encourage
32.35 	health plan companies and payors to disallow reimbursement for
32.36 	procedures that evidence-based medicine findings indicate are
33.1 	ineffective.
33.2 	(b) The commissioners shall study the potential for
33.3 	improving quality and obtaining cost savings through greater use
33.4 	of treatment methods performed by alternative and complementary
33.5 	health care providers that are supported by the findings of
33.6 	evidence-based medicine.
33.7 	(c) The commissioners shall study methods to encourage the
33.8 	use of evidence-based medicine and electronic medical records,
33.9 	and improving provider access to evidence-based medicine
33.10 	findings, including recommendations for uniform standards for
33.11 	electronic data.
33.12 	(d) The commissioners shall study methods to encourage
33.13 	small providers to adopt and use electronic billing, including,
33.14 	but not limited to, the use of grants and financial incentives.
33.15 		Subd. 4.Studies related to universal participation and
33.16 	access to care. The commissioners shall study the adequacy of
33.17 	the current system of community health care clinics and centers
33.18 	both statewide, and in urban areas with significant disparities
33.19 	in health status and access to services across racial and ethnic
33.20 	groups.  The commissioners shall evaluate:
33.21 	(1) methods to provide 24-hour availability of care through
33.22 	community clinics and centers;
33.23 	(2) methods to expand the availability of free or
33.24 	subsidized care through the clinics and centers;
33.25 	(3) the use of health care access fund grants to expand the
33.26 	number of clinics and centers, the services provided, and the
33.27 	availability of free or subsidized care; and 
33.28 	(4) the extent to which increased use of physician
33.29 	assistants, nurse practitioners, medical residents and interns,
33.30 	and other allied health professionals in clinics and centers
33.31 	would increase the availability of services.
33.32 		Subd. 5.Studies related to reducing administrative
33.33 	costs. (a) The commissioners shall study the following:
33.34 	(1) whether any changes are needed to Minnesota Statutes,
33.35 	sections 62J.50 to 62J.61, the Health Care Administrative
33.36 	Simplification Act of 1994; and 
34.1 	(2) methods of providing universal access to online
34.2 	verification of health coverage, including allowing health care
34.3 	providers controlled access to health plan company information
34.4 	systems.
34.5 	(b) The commissioners shall study and make recommendations
34.6 	on providing language interpreter services to
34.7 	limited-English-speaking patients in order to facilitate the
34.8 	provision of health care services by health care providers and
34.9 	health care facilities.  The recommendations shall include:
34.10 	(1) ways to achieve the needed availability of professional
34.11 	interpreter services and an accreditation system for language
34.12 	interpreters, which includes appropriate standards for
34.13 	education, training, and credentialing; and 
34.14 	(2) criteria for determining financial responsibility for
34.15 	providing interpreter services to enrollees of health plans,
34.16 	including the responsible party for arranging interpreter
34.17 	services and for reimbursement for these services.

34.18 	Sec. 5. MEDICAL MALPRACTICE INSURANCE REPORT.
 34.19 	(a) The commissioner of commerce shall provide to the
34.20 	legislature, no later than March 1 of each year, a brief written
34.21 	report on the status of the market for medical malpractice
34.22 	insurance in Minnesota.  The report must summarize, interpret,
34.23 	explain, and analyze information on that subject available to
34.24 	the commissioner, through annual statements filed by insurance
34.25 	companies, information obtained under paragraph (c), and other
34.26 	sources.
34.27 	(b) The annual report must consider, to the extent
34.28 	possible, Minnesota-specific data on market shares; premiums
34.29 	received; amounts paid to settle claims that were not litigated,
34.30 	claims that were settled after litigation began, and claims that
34.31 	were litigated to court judgment; amounts spent on processing,
34.32 	investigation, litigation, and otherwise handling claims; other
34.33 	sales and administrative costs; and the loss ratios of the
34.34 	insurers.
34.35 	(c) Each insurance company that provides medical
34.36 	malpractice insurance in this state shall, no later than
35.1 	February 1 of each year, file with the commissioner of commerce,
35.2 	on a form prescribed by the commissioner, the Minnesota-specifc
35.3 	data referenced in paragraph (b), other than market share, for
35.4 	the previous calendar year for that insurance company, shown
35.5 	separately for the categories of coverage provided to hospitals,
35.6 	medical clinics, nursing homes, emergency medicine physicians,
35.7 	and obstetrician-gynecologists.  An insurance company need not
35.8 	comply with this paragraph if its direct premium written in the
35.9 	state for the previous calendar year is less than $2,000,000.

35.10 	Sec. 6. HEALTH COVERAGE REINSURANCE; STUDY.
 35.11 	(a) The commissioners of health and commerce shall study
35.12 	the possibility of reducing the cost of individual and group
35.13 	health coverage in this state through the creation of a
35.14 	state-sponsored reinsurance program available to health plan
35.15 	companies, self-insured employers, service cooperatives, the
35.16 	Minnesota Comprehensive Health Association, and other sources of
35.17 	private sector and public employee health coverage.  The study
35.18 	must include:
35.19 	(1) an evaluation of the current market for reinsurance and
35.20 	stop-loss insurance for health coverage in this state;
35.21 	(2) analysis of whether a state-sponsored reinsurance
35.22 	arrangement could reduce the cost of that reinsurance and
35.23 	stop-loss coverage, through the creation of a large pool to
35.24 	provide the coverage, possibly subsidized by the state;
35.25 	(3) a comparison of such a reinsurance pool with the
35.26 	Workers' Compensation Reinsurance Association and with health
35.27 	reinsurance programs in other states;
35.28 	(4) an exploration of organizational issues, including
35.29 	operating the pool jointly with the Workers' Compensation
35.30 	Reinsurance Association; reactivating the Health Coverage
35.31 	Reinsurance Association established in Minnesota Statutes,
35.32 	sections 62L.13 to 62L.23, with an expansion of it to include
35.33 	coverage provided by insured and self-insured employers of any
35.34 	size; operating the pool jointly with a pool to provide
35.35 	reinsurance for medical malpractice insurance; whether the
35.36 	coverage should be offered to self-insured employers on a
36.1 	voluntary basis in exchange for voluntarily complying with state
36.2 	laws regulating health coverage; and issues involving the 
36.3 	
36.4 	building of necessary financial reserves.
36.5 	(b) The commissioners shall provide a short written report
36.6 	to the legislature by January 15, 2006, providing the
36.7 	conclusions of the study and identifying any related issues that
36.8 	need further study.

36.9 	ARTICLE 4
36.10 	HEALTH PLAN ADMINISTRATIVE CHANGES

36.11 	Section 1. Minnesota Statutes 2004, section 45.0135,
36.12 	subdivision 7, is amended to read:
36.13 		Subd. 7.Assessment.  Each insurer authorized to sell
36.14 	insurance in the state of Minnesota shall remit an assessment to
36.15 	the commissioner for deposit in the insurance fraud prevention
36.16 	account on or before June 1 of each year.  The amount of the
36.17 	assessment shall be based on the insurer's total assets and on
36.18 	the insurer's total written Minnesota premium, for the preceding
36.19 	fiscal year, as reported pursuant to section 60A.13.  The
36.20 	assessment is calculated as follows:
36.21 	Total Assets                      Assessment
36.22 	     Less than $100,000,000                   $  200
36.23 	     $100,000,000 to $1,000,000,000           $  750
36.24 	     Over $1,000,000,000                      $2,000
36.25 	
36.26 	     Minnesota Written Premium              Assessment
36.27 	     Less than $10,000,000                    $  200
36.28 	     $10,000,000 to $100,000,000              $  750
36.29 	     Over $100,000,000                        $2,000
36.30 	For purposes of this subdivision, the following entities
36.31 	are not considered to be insurers authorized to sell insurance
36.32 	in the state of Minnesota:  risk retention groups; or township
36.33 	mutuals organized under chapter 67A~~; or health maintenance~~
36.34 	~~organizations organized under chapter 62D~~.

36.35 	Sec. 2. Minnesota Statutes 2004, section 62D.145,
36.36 	subdivision 2, is amended to read:
36.37 		Subd. 2.Health data or information.  (a) A health
37.1 	maintenance organization is prohibited from disclosing to any
37.2 	person any individually identifiable data or information held by
37.3 	the health maintenance organization pertaining to the diagnosis,
37.4 	treatment, or health of any enrollee, or any application
37.5 	obtained from any person, except:
37.6 	(1) to the extent necessary to carry out the purposes of
37.7 	this chapter, the commissioner and a designee shall have access
37.8 	to the above data or information but the data removed from the
37.9 	health maintenance organization or participating entity shall
37.10 	not identify any particular patient or client by name or contain
37.11 	any other unique personal identifier;
37.12 	(2) upon the express consent of the enrollee or applicant;
37.13 	(3) pursuant to statute or court order for the production
37.14 	of evidence or the discovery thereof;
37.15 	(4) in the event of claim or litigation between the person
37.16 	and the provider or health maintenance organization wherein such
37.17 	data or information is pertinent;
37.18 	(5) to meet the requirements of contracts for prepaid
37.19 	medical services with the commissioner of human services
37.20 	authorized under chapter 256B, 256D, or 256L;
37.21 	(6) to meet the requirements of contracts for benefit plans
37.22 	with the commissioner of employee relations under chapter 43A;
37.23 	or
37.24 	(7) as otherwise ~~authorized pursuant to statute~~ permitted
37.25 	or required by law.
37.26 	No provision in a contract for a benefit plan under chapter
37.27 	43A shall authorize dissemination of individually identifiable
37.28 	health records, unless the dissemination of the health records
37.29 	is required to carry out the requirements of the contract and
37.30 	employees whose health records will be disseminated are fully
37.31 	informed of the dissemination by the Department of Employee
37.32 	Relations at the time the employees are enrolling for or
37.33 	changing insurance coverage.
37.34 	(b) In any case involving a suspected violation of a law
37.35 	applicable to health maintenance organizations in which access
37.36 	to health data maintained by the health maintenance organization
38.1 	or participating entity is necessary, the commissioner and
38.2 	agents, while maintaining the privacy rights of individuals and
38.3 	families, shall be permitted to obtain data that identifies any
38.4 	particular patient or client by name.  A health maintenance
38.5 	organization shall be entitled to claim any statutory privileges
38.6 	against such disclosure which the provider who furnished the
38.7 	information to the health maintenance organization is entitled
38.8 	to claim.

38.9 	Sec. 3. Minnesota Statutes 2004, section 62E.05,
38.10 	subdivision 2, is amended to read:
38.11 		Subd. 2.Annual report. ~~(a) All health plan companies,~~
38.12 	~~as defined in section 62Q.01, shall annually report to the~~
38.13 	~~commissioner responsible for their regulation.  The following~~
38.14 	~~information shall be reported to the appropriate commissioner on~~
38.15 	~~February 1 of each year:~~
38.16 	~~(1) the number of individuals and groups who received~~
38.17 	~~coverage in the prior year through the qualified plans; and~~ 
38.18 	~~(2) the number of individuals and groups who received~~
38.19 	~~coverage in the prior year through each of the unqualified plans~~
38.20 	~~sold by the company.~~
38.21 	~~(b)~~ The state of Minnesota or any of its departments,
38.22 	agencies, programs, instrumentalities, or political
38.23 	subdivisions, shall report in writing to the association and to
38.24 	the commissioner of commerce no later than September 15 of each
38.25 	year regarding the number of persons and the amount of premiums,
38.26 	deductibles, co-payments, or coinsurance that it paid for on
38.27 	behalf of enrollees in the Comprehensive Health Association.
38.28 	This report must contain only summary information and must not
38.29 	include any individually identifiable data.  The report must
38.30 	cover the 12-month period ending the preceding June 30.

38.31 	Sec. 4. Minnesota Statutes 2004, section 62L.08,
38.32 	subdivision 8, is amended to read:
38.33 		Subd. 8.Filing requirement. ~~No later than July 1, 1993,~~
38.34 	~~and each year thereafter,~~A health carrier that offers, sells,
38.35 	issues, or renews a health benefit plan for small employers
38.36 	shall file with the commissioner the index rates and must
39.1 	demonstrate that all rates shall be within the rating
39.2 	restrictions defined in this chapter.  Such demonstration must
39.3 	include the allowable range of rates from the index rates and a
39.4 	description of how the health carrier intends to use demographic
39.5 	factors including case characteristics in calculating the
39.6 	premium rates.  The rates shall not be approved, unless the
39.7 	commissioner has determined that the rates are reasonable.  In
39.8 	determining reasonableness, the commissioner shall consider the
39.9 	growth rates applied under section 62J.04, subdivision 1,
39.10 	paragraph (b), to the calendar year or years that the proposed
39.11 	premium rate would be in effect, actuarially valid changes in
39.12 	risk associated with the enrollee population, and actuarially
39.13 	valid changes as a result of statutory changes in Laws 1992,
39.14 	chapter 549. ~~For premium rates proposed to go into effect~~
39.15 	~~between July 1, 1993 and December 31, 1993, the pertinent growth~~
39.16 	~~rate is the growth rate applied under section 62J.04,~~
39.17 	~~subdivision 1, paragraph (b), to calendar year 1994.~~

39.18 	Sec. 5. Minnesota Statutes 2004, section 62Q.64, is
39.19 	amended to read:
39.20 	62Q.64 DISCLOSURE OF EXECUTIVE COMPENSATION.
39.21 	(a) Each health plan company doing business in this state
39.22 	shall annually file with the ~~Consumer Advisory Board created in~~
39.23 	~~section 62J.75:~~
39.24 	~~(1) a copy of the health plan company's form 990 filed with~~
39.25 	~~the federal Internal Revenue Service; or~~ 
39.26 	~~(2) if the health plan company did not file a form 990 with~~
39.27 	~~the federal Internal Revenue Service,~~commissioner of commerce a
39.28 	list of the amount and recipients of the health plan company's
39.29 	five highest salaries, including all types of compensation, in
39.30 	excess of $50,000.
39.31 	(b) A filing under this section is public data under
39.32 	section 13.03.

39.33 	Sec. 6. Minnesota Statutes 2004, section 62Q.75, is
39.34 	amended to read:
39.35 	62Q.75 PROMPT PAYMENT REQUIRED.
39.36 		Subdivision 1.Definitions. (a) For purposes of this
40.1 	section, the following terms have the meanings given to them.
40.2 	(b) "Clean claim" means a claim that has no defect or
40.3 	impropriety, including any lack of any required substantiating
40.4 	documentation, including coordination of benefits information,
40.5 	or particular circumstance requiring special treatment that
40.6 	prevents timely payment from being made on a claim under this
40.7 	section. Nothing in this section alters an enrollee's
40.8 	obligation to disclose information as required by law.
40.9 	(c) "Third-party administrator" means a third-party
40.10 	administrator or other entity subject to section 60A.23,
40.11 	subdivision 8, and Minnesota Rules, chapter 2767.
40.12 		Subd. 2.Claims payments. (a) This section applies to
40.13 	clean claims submitted to a health plan company or third-party
40.14 	administrator for services provided by any:
40.15 	(1) health care provider, as defined in section 62Q.74, but
40.16 	does not include a provider licensed under chapter 151;
40.17 	(2) home health care provider, as defined in section
40.18 	144A.43, subdivision 4; or
40.19 	(3) health care facility.
40.20 	All health plan companies and third-party administrators must
40.21 	pay or deny claims that are clean claims within 30 calendar days
40.22 	after the date upon which the health plan company or third-party
40.23 	administrator received the claim.
40.24 	(b) The health plan company or third-party administrator
40.25 	shall, upon request, make available to the provider information
40.26 	about the status of a claim submitted by the provider consistent
40.27 	with section 62J.581.
40.28 	(c) If a health plan company or third-party administrator
40.29 	does not pay or deny a clean claim within the period provided in
40.30 	paragraph (a), the health plan company or third-party
40.31 	administrator must pay interest on the claim for the period
40.32 	beginning on the day after the required payment date specified
40.33 	in paragraph (a) and ending on the date on which the health plan
40.34 	company or third-party administrator makes the payment or denies
40.35 	the claim.  In any payment, the health plan company or
40.36 	third-party administrator must itemize any interest payment
41.1 	being made separately from other payments being made for
41.2 	services provided. The health plan company or third-party
41.3 	administrator shall not require the health care provider to bill
41.4 	the health plan company or third-party administrator for the
41.5 	interest required under this section before any interest payment
41.6 	is made.Interest payments must be made to the health care
41.7 	provider no less frequently than quarterly.
41.8 	(d) The rate of interest paid by a health plan company or
41.9 	third-party administrator under this subdivision shall be 1.5
41.10 	percent per month or any part of a month.
41.11 	(e) A health plan company or third-party administrator is
41.12 	not required to make an interest payment on a claim for which
41.13 	payment has been delayed for purposes of reviewing potentially
41.14 	fraudulent or abusive billing practices.
41.15 	(f) The commissioner may assess a financial administrative
41.16 	penalty against a health plan company for violation of this
41.17 	subdivision when there is a pattern of abuse that demonstrates a
41.18 	lack of good faith effort and a systematic failure of the health
41.19 	plan company to comply with this subdivision.
41.20 		Subd. 3.Claims filing. Unless otherwise provided by
41.21 	contract, by section 16A.124, subdivision 4a, or by federal law,
41.22 	the health care providers and facilities specified in
41.23 	subdivision 2 must submit their charges to a health plan company
41.24 	or third-party administrator within six months from the date of
41.25 	service or the date the health care provider knew or was
41.26 	informed of the correct name and address of the responsible
41.27 	health plan company or third-party administrator, whichever is
41.28 	later.  A health care provider or facility that does not submit
41.29 	charges within the six-month period shall not be reimbursed for
41.30 	the charge and may not collect the charge from the recipient of
41.31 	the service or any other payer.  This subdivision also applies
41.32 	to all health care providers and facilities that submit charges
41.33 	to workers' compensation payers for treatment of a workers'
41.34 	compensation injury compensable under chapter 176.

41.35 	Sec. 7. Minnesota Statutes 2004, section 72A.201,
41.36 	subdivision 4, is amended to read:
42.1 		Subd. 4.Standards for claim filing and handling.  The
42.2 	following acts by an insurer, an adjuster, a self-insured, or a
42.3 	self-insurance administrator constitute unfair settlement
42.4 	practices:
42.5 	(1) except for claims made under a health insurance policy,
42.6 	after receiving notification of claim from an insured or a
42.7 	claimant, failing to acknowledge receipt of the notification of
42.8 	the claim within ten business days, and failing to promptly
42.9 	provide all necessary claim forms and instructions to process
42.10 	the claim, unless the claim is settled within ten business
42.11 	days.  The acknowledgment must include the telephone number of
42.12 	the company representative who can assist the insured or the
42.13 	claimant in providing information and assistance that is
42.14 	reasonable so that the insured or claimant can comply with the
42.15 	policy conditions and the insurer's reasonable requirements.  If
42.16 	an acknowledgment is made by means other than writing, an
42.17 	appropriate notation of the acknowledgment must be made in the
42.18 	claim file of the insurer and dated.  An appropriate notation
42.19 	must include at least the following information where the
42.20 	acknowledgment is by telephone or oral contact:
42.21 	(i) the telephone number called, if any;
42.22 	(ii) the name of the person making the telephone call or
42.23 	oral contact;
42.24 	(iii) the name of the person who actually received the
42.25 	telephone call or oral contact;
42.26 	(iv) the time of the telephone call or oral contact; and
42.27 	(v) the date of the telephone call or oral contact;
42.28 	(2) failing to reply, within ten business days of receipt,
42.29 	to all other communications about a claim from an insured or a
42.30 	claimant that reasonably indicate a response is requested or
42.31 	needed;
42.32 	(3) (i) unless provided otherwise by clause (ii) or (iii),
42.33 	other law,or in the policy, failing to complete its
42.34 	investigation and inform the insured or claimant of acceptance
42.35 	or denial of a claim within 30 business days after receipt of
42.36 	notification of claim unless the investigation cannot be
43.1 	reasonably completed within that time. In the event that the
43.2 	investigation cannot reasonably be completed within that time,
43.3 	the insurer shall notify the insured or claimant within the time
43.4 	period of the reasons why the investigation is not complete and
43.5 	the expected date the investigation will be complete.  For
43.6 	claims made under a health policy the notification of claim must
43.7 	be in writing;
43.8 	(ii) for claims submitted under a health policy, the
43.9 	insurer must comply with all of the requirements of section
43.10 	62Q.75;
43.11 	(iii) for claims submitted under a health policy that are
43.12 	accepted, the insurer must notify the insured or claimant no
43.13 	less than semiannually of the disposition of claims of the
43.14 	insured or claimant.  For purposes of this clause, acceptance of
43.15 	a claim means that there is no additional financial liability
43.16 	for the insured or claimant, either because there is a flat
43.17 	co-payment amount specified in the health plan or because there
43.18 	is no co-payment, deductible, or coinsurance owed;
43.19 	(4) where evidence of suspected fraud is present, the
43.20 	requirement to disclose their reasons for failure to complete
43.21 	the investigation within the time period set forth in clause (3)
43.22 	need not be specific.  The insurer must make this evidence
43.23 	available to the Department of Commerce if requested;
43.24 	(5) failing to notify an insured who has made a
43.25 	notification of claim of all available benefits or coverages
43.26 	which the insured may be eligible to receive under the terms of
43.27 	a policy and of the documentation which the insured must supply
43.28 	in order to ascertain eligibility;
43.29 	(6) unless otherwise provided by law or in the policy,
43.30 	requiring an insured to give written notice of loss or proof of
43.31 	loss within a specified time, and thereafter seeking to relieve
43.32 	the insurer of its obligations if the time limit is not complied
43.33 	with, unless the failure to comply with the time limit
43.34 	prejudices the insurer's rights and then only if the insurer
43.35 	gave prior notice to the insured of the potential prejudice;
43.36 	(7) advising an insured or a claimant not to obtain the
44.1 	services of an attorney or an adjuster, or representing that
44.2 	payment will be delayed if an attorney or an adjuster is
44.3 	retained by the insured or the claimant;
44.4 	(8) failing to advise in writing an insured or claimant who
44.5 	has filed a notification of claim known to be unresolved, and
44.6 	who has not retained an attorney, of the expiration of a statute
44.7 	of limitations at least 60 days prior to that expiration.  For
44.8 	the purposes of this clause, any claim on which the insurer has
44.9 	received no communication from the insured or claimant for a
44.10 	period of two years preceding the expiration of the applicable
44.11 	statute of limitations shall not be considered to be known to be
44.12 	unresolved and notice need not be sent pursuant to this clause;
44.13 	(9) demanding information which would not affect the
44.14 	settlement of the claim;
44.15 	(10) unless expressly permitted by law or the policy,
44.16 	refusing to settle a claim of an insured on the basis that the
44.17 	responsibility should be assumed by others;
44.18 	(11) failing, within 60 business days after receipt of a
44.19 	properly executed proof of loss, to advise the insured of the
44.20 	acceptance or denial of the claim by the insurer.  No insurer
44.21 	shall deny a claim on the grounds of a specific policy
44.22 	provision, condition, or exclusion unless reference to the
44.23 	provision, condition, or exclusion is included in the denial.
44.24 	The denial must be given to the insured in writing with a copy
44.25 	filed in the claim file;
44.26 	(12) denying or reducing a claim on the basis of an
44.27 	application which was altered or falsified by the agent or
44.28 	insurer without the knowledge of the insured;
44.29 	(13) failing to notify the insured of the existence of the
44.30 	additional living expense coverage when an insured under a
44.31 	homeowners policy sustains a loss by reason of a covered
44.32 	occurrence and the damage to the dwelling is such that it is not
44.33 	habitable;
44.34 	(14) failing to inform an insured or a claimant that the
44.35 	insurer will pay for an estimate of repair if the insurer
44.36 	requested the estimate and the insured or claimant had
45.1 	previously submitted two estimates of repair.

45.2 	Sec. 8. Minnesota Statutes 2004, section 144.335,
45.3 	subdivision 3a, is amended to read:
45.4 		Subd. 3a.Patient consent to release of records;
45.5 	liability.  (a) A provider, or a person who receives health
45.6 	records from a provider, may not release a patient's health
45.7 	records to a person without a signed and dated consent from the
45.8 	patient or the patient's legally authorized representative
45.9 	authorizing the release, unless the release is ~~specifically~~
45.10 	~~authorized~~ permitted or required by law.  Except as provided in
45.11 	paragraph (c) or (d), a consent is valid for one year or for a
45.12 	lesser period specified in the consent or for a different period
45.13 	provided by law.
45.14 	(b) This subdivision does not prohibit the release of
45.15 	health records:
45.16 	(1) for a medical emergency when the provider is unable to
45.17 	obtain the patient's consent due to the patient's condition or
45.18 	the nature of the medical emergency; or
45.19 	(2) to other providers within related health care entities
45.20 	when necessary for the current treatment of the patient.
45.21 	(c) Notwithstanding paragraph (a), if a patient explicitly
45.22 	gives informed consent to the release of health records for the
45.23 	purposes and pursuant to the restrictions in clauses (1) and
45.24 	(2), the consent does not expire after one year for:
45.25 	(1) the release of health records to a provider who is
45.26 	being advised or consulted with in connection with the current
45.27 	treatment of the patient;
45.28 	(2) the release of health records to an accident and health
45.29 	insurer, health service plan corporation, health maintenance
45.30 	organization, or third-party administrator for purposes of
45.31 	payment of claims, fraud investigation, or quality of care
45.32 	review and studies, provided that:
45.33 	(i) the use or release of the records complies with
45.34 	sections 72A.49 to 72A.505;
45.35 	(ii) further use or release of the records in individually
45.36 	identifiable form to a person other than the patient without the
46.1 	patient's consent is prohibited; and
46.2 	(iii) the recipient establishes adequate safeguards to
46.3 	protect the records from unauthorized disclosure, including a
46.4 	procedure for removal or destruction of information that
46.5 	identifies the patient.
46.6 	(d) Notwithstanding paragraph (a), health records may be
46.7 	released to an external researcher solely for purposes of
46.8 	medical or scientific research only as follows:
46.9 	(1) health records generated before January 1, 1997, may be
46.10 	released if the patient has not objected or does not elect to
46.11 	object after that date;
46.12 	(2) for health records generated on or after January 1,
46.13 	1997, the provider must:
46.14 	(i) disclose in writing to patients currently being treated
46.15 	by the provider that health records, regardless of when
46.16 	generated, may be released and that the patient may object, in
46.17 	which case the records will not be released; and
46.18 	(ii) use reasonable efforts to obtain the patient's written
46.19 	general authorization that describes the release of records in
46.20 	item (i), which does not expire but may be revoked or limited in
46.21 	writing at any time by the patient or the patient's authorized
46.22 	representative;
46.23 	(3) authorization may be established if an authorization is
46.24 	mailed at least two times to the patient's last known address
46.25 	with a postage prepaid return envelope and a conspicuous notice
46.26 	that the patient's medical records may be released if the
46.27 	patient does not object, and at least 60 days have expired since
46.28 	the second notice was sent; and the provider must advise the
46.29 	patient of the rights specified in clause (4); and
46.30 	(4) the provider must, at the request of the patient,
46.31 	provide information on how the patient may contact an external
46.32 	researcher to whom the health record was released and the date
46.33 	it was released.
46.34 	In making a release for research purposes the provider
46.35 	shall make a reasonable effort to determine that:
46.36 	(i) the use or disclosure does not violate any limitations
47.1 	under which the record was collected;
47.2 	(ii) the use or disclosure in individually identifiable
47.3 	form is necessary to accomplish the research or statistical
47.4 	purpose for which the use or disclosure is to be made;
47.5 	(iii) the recipient has established and maintains adequate
47.6 	safeguards to protect the records from unauthorized disclosure,
47.7 	including a procedure for removal or destruction of information
47.8 	that identifies the patient; and
47.9 	(iv) further use or release of the records in individually
47.10 	identifiable form to a person other than the patient without the
47.11 	patient's consent is prohibited.
47.12 	(e) A person who negligently or intentionally releases a
47.13 	health record in violation of this subdivision, or who forges a
47.14 	signature on a consent form, or who obtains under false
47.15 	pretenses the consent form or health records of another person,
47.16 	or who, without the person's consent, alters a consent form, is
47.17 	liable to the patient for compensatory damages caused by an
47.18 	unauthorized release, plus costs and reasonable attorney's fees.
47.19 	(f) Upon the written request of a spouse, parent, child, or
47.20 	sibling of a patient being evaluated for or diagnosed with
47.21 	mental illness, a provider shall inquire of a patient whether
47.22 	the patient wishes to authorize a specific individual to receive
47.23 	information regarding the patient's current and proposed course
47.24 	of treatment.  If the patient so authorizes, the provider shall
47.25 	communicate to the designated individual the patient's current
47.26 	and proposed course of treatment.  Paragraph (a) applies to
47.27 	consents given under this paragraph.
47.28 	(g) Notwithstanding paragraph (a), a provider must disclose
47.29 	health records relating to a patient's mental health to a law
47.30 	enforcement agency if the law enforcement agency provides the
47.31 	name of the patient and communicates that the:
47.32 	(1) patient is currently involved in an emergency
47.33 	interaction with the law enforcement agency; and
47.34 	(2) disclosure of the records is necessary to protect the
47.35 	health or safety of the patient or of another person.
47.36 	The scope of disclosure under this paragraph is limited to
48.1 	the minimum necessary for law enforcement to respond to the
48.2 	emergency.  A law enforcement agency that obtains health records
48.3 	under this paragraph shall maintain a record of the requestor,
48.4 	the provider of the information, and the patient's name.  Health
48.5 	records obtained by a law enforcement agency under this
48.6 	paragraph are private data on individuals as defined in section
48.7 	13.02 and must not be used by law enforcement for any other
48.8 	purpose.
48.9 	(h) In cases where a provider releases health records
48.10 	without patient consent as authorized by law, the release must
48.11 	be documented in the patient's health record.  In the case of a
48.12 	release under paragraph (g), the documentation must include the
48.13 	date and circumstances under which the release was made, the
48.14 	person or agency to whom the release was made, and the records
48.15 	that were released.

48.16 	Sec. 9. Minnesota Statutes 2004, section 295.582, is
48.17 	amended to read:
48.18 	295.582 AUTHORITY.
48.19 	(a) A hospital, surgical center, or health care provider
48.20 	that is subject to a tax under section 295.52, or a pharmacy
48.21 	that has paid additional expense transferred under this section
48.22 	by a wholesale drug distributor, may transfer additional expense
48.23 	generated by section 295.52 obligations on to all third-party
48.24 	contracts for the purchase of health care services on behalf of
48.25 	a patient or consumer.  The additional expense transferred to
48.26 	the third-party purchaser must not exceed the tax percentage
48.27 	specified in section 295.52 multiplied against the gross
48.28 	revenues received under the third-party contract, and the tax
48.29 	percentage specified in section 295.52 multiplied against
48.30 	co-payments and deductibles paid by the individual patient or
48.31 	consumer.  The expense must not be generated on revenues derived
48.32 	from payments that are excluded from the tax under section
48.33 	295.53.  All third-party purchasers of health care services
48.34 	including, but not limited to, third-party purchasers regulated
48.35 	under chapter 60A, 62A, 62C, 62D, 62H, 62N, 64B, 65A, 65B, 79,
48.36 	or 79A, or under section 471.61 or 471.617, must pay the
49.1 	transferred expense in addition to any payments due under
49.2 	existing contracts with the hospital, surgical center, pharmacy,
49.3 	or health care provider, to the extent allowed under federal
49.4 	law.  A third-party purchaser of health care services includes,
49.5 	but is not limited to, a health carrier or community integrated
49.6 	service network that pays for health care services on behalf of
49.7 	patients or that reimburses, indemnifies, compensates, or
49.8 	otherwise insures patients for health care services.  A
49.9 	third-party purchaser shall comply with this section regardless
49.10 	of whether the third-party purchaser is a for-profit,
49.11 	not-for-profit, or nonprofit entity.  A wholesale drug
49.12 	distributor may transfer additional expense generated by section
49.13 	295.52 obligations to entities that purchase from the
49.14 	wholesaler, and the entities must pay the additional expense.
49.15 	Nothing in this section limits the ability of a hospital,
49.16 	surgical center, pharmacy, wholesale drug distributor, or health
49.17 	care provider to recover all or part of the section 295.52
49.18 	obligation by other methods, including increasing fees or
49.19 	charges.
49.20 	(b) ~~Each third-party purchaser regulated under any chapter~~
49.21 	~~cited in paragraph (a) shall include with its annual renewal for~~
49.22 	~~certification of authority or licensure documentation indicating~~
49.23 	~~compliance with paragraph (a).~~
49.24 	~~(c)~~ Any hospital, surgical center, or health care provider
49.25 	subject to a tax under section 295.52 or a pharmacy that has
49.26 	paid additional expense transferred under this section by a
49.27 	wholesale drug distributor may file a complaint with the
49.28 	commissioner responsible for regulating the third-party
49.29 	purchaser if at any time the third-party purchaser fails to
49.30 	comply with paragraph (a).
49.31 	~~(d)~~ (c) If the commissioner responsible for regulating the
49.32 	third-party purchaser finds at any time that the third-party
49.33 	purchaser has not complied with paragraph (a), the commissioner
49.34 	may take enforcement action against a third-party purchaser
49.35 	which is subject to the commissioner's regulatory jurisdiction
49.36 	and which does not allow a hospital, surgical center, pharmacy,
50.1 	or provider to pass-through the tax.  The commissioner may by
50.2 	order fine or censure the third-party purchaser or revoke or
50.3 	suspend the certificate of authority or license of the
50.4 	third-party purchaser to do business in this state if the
50.5 	commissioner finds that the third-party purchaser has not
50.6 	complied with this section.  The third-party purchaser may
50.7 	appeal the commissioner's order through a contested case hearing
50.8 	in accordance with chapter 14.

50.9 	Sec. 10. REPEALER.
 50.10 	Minnesota Statutes 2004, sections 62E.035; and 62Q.095, are
50.11 	repealed.