1.1 	A bill for an act
1.2 	relating to health; requiring disclosure of certain payments made to health care 
1.3 	providers; changing a provision for all-payer claims data; requiring a report on 
1.4 	transparency of health care payments;amending Minnesota Statutes 2022, sections 
1.5 	62U.04, subdivision 11, by adding a subdivision; 62U.10, subdivision 7.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. Minnesota Statutes 2022, section 62U.04, is amended by adding a subdivision 
1.8 	to read:
1.9 		Subd. 5b.Nonclaims-based payments. (a) Beginning January 1, 2025, all health plan 
1.10 	companies and third-party administrators shall submit to a private entity designated by the 
1.11 	commissioner of health all nonclaims-based payments made to health care providers. The 
1.12 	data shall be submitted in a form, manner, and frequency specified by the commissioner. 
1.13 	Nonclaims-based payments are payments to health care providers designed to pay for value 
1.14 	of health care services over volume of health care services and include alternative payment 
1.15 	models or incentives, payments for infrastructure expenditures or investments, and payments 
1.16 	for workforce expenditures or investments. Nonclaims-based payments submitted under 
1.17 	this subdivision must, to the extent possible, be attributed to a health care provider in the 
1.18 	same manner in which claims-based data are attributed to a health care provider and, where 
1.19 	appropriate, must be combined with data collected under subdivisions 4 and 5 in analyses 
1.20 	of health care spending.
1.21 	(b) Data collected under this subdivision are nonpublic data as defined in section 13.02. 
1.22 	Notwithstanding the definition of summary data in section 13.02, subdivision 19, summary 
1.23 	data prepared under this subdivision may be derived from nonpublic data. The commissioner 
2.1 	shall establish procedures and safeguards to protect the integrity and confidentiality of any 
2.2 	data maintained by the commissioner.
2.3 	(c) The commissioner shall consult with health plan companies, hospitals, and health 
2.4 	care providers in developing the data reported under this subdivision and standardized 
2.5 	reporting forms.

2.6 	Sec. 2. Minnesota Statutes 2022, section 62U.04, subdivision 11, is amended to read:
2.7 		Subd. 11.Restricted uses of the all-payer claims data. (a) Notwithstanding subdivision 
2.8 	4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the commissioner's 
2.9 	designee shall only use the data submitted under subdivisions 4 and, 5, and 5b for the 
2.10 	following purposes:
2.11 	(1) to evaluate the performance of the health care home program as authorized under 
2.12 	section 62U.03, subdivision 7;
2.13 	(2) to study, in collaboration with the reducing avoidable readmissions effectively 
2.14 	(RARE) campaign, hospital readmission trends and rates;
2.15 	(3) to analyze variations in health care costs, quality, utilization, and illness burden based 
2.16 	on geographical areas or populations;
2.17 	(4) to evaluate the state innovation model (SIM) testing grant received by the Departments 
2.18 	of Health and Human Services, including the analysis of health care cost, quality, and 
2.19 	utilization baseline and trend information for targeted populations and communities; and
2.20 	(5) to compile one or more public use files of summary data or tables that must:
2.21 	(i) be available to the public for no or minimal cost by March 1, 2016, and available by 
2.22 	web-based electronic data download by June 30, 2019;
2.23 	(ii) not identify individual patients, payers, or providers;
2.24 	(iii) be updated by the commissioner, at least annually, with the most current data 
2.25 	available;
2.26 	(iv) contain clear and conspicuous explanations of the characteristics of the data, such 
2.27 	as the dates of the data contained in the files, the absence of costs of care for uninsured 
2.28 	patients or nonresidents, and other disclaimers that provide appropriate context; and
2.29 	(v) not lead to the collection of additional data elements beyond what is authorized under 
2.30 	this section as of June 30, 2015.
3.1 	(b) The commissioner may publish the results of the authorized uses identified in 
3.2 	paragraph (a) so long as the data released publicly do not contain information or descriptions 
3.3 	in which the identity of individual hospitals, clinics, or other providers may be discerned.
3.4 	(c) Nothing in this subdivision shall be construed to prohibit the commissioner from 
3.5 	using the data collected under subdivision 4 to complete the state-based risk adjustment 
3.6 	system assessment due to the legislature on October 1, 2015.
3.7 	(d) The commissioner or the commissioner's designee may use the data submitted under 
3.8 	subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until July 1, 
3.9 	2023.
3.10 	(e) (d) The commissioner shall consult with the all-payer claims database work group 
3.11 	established under subdivision 12 regarding the technical considerations necessary to create 
3.12 	the public use files of summary data described in paragraph (a), clause (5).

3.13 	Sec. 3. Minnesota Statutes 2022, section 62U.10, subdivision 7, is amended to read:
3.14 		Subd. 7.Outcomes reporting; savings determination. (a) Beginning November 1, 
3.15 	2016, and Each November 1 thereafter, the commissioner of health shall determine the 
3.16 	actual total private and public health care and long-term care spending for Minnesota 
3.17 	residents related to each health indicator projected in subdivision 6 for the most recent 
3.18 	calendar year available. The commissioner shall determine the difference between the 
3.19 	projected and actual spending for each health indicator and for each year, and determine 
3.20 	the savings attributable to changes in these health indicators. The assumptions and research 
3.21 	methods used to calculate actual spending must be determined to be appropriate by an 
3.22 	independent actuarial consultant. If the actual spending is less than the projected spending, 
3.23 	the commissioner, in consultation with the commissioners of human services and management 
3.24 	and budget, shall use the proportion of spending for state-administered health care programs 
3.25 	to total private and public health care spending for each health indicator for the calendar 
3.26 	year two years before the current calendar year to determine the percentage of the calculated 
3.27 	aggregate savings amount accruing to state-administered health care programs.
3.28 	(b) The commissioner may use the data submitted under section 62U.04, subdivisions 
3.29 	4 and, 5, and 5b, to complete the activities required under this section, but may only report 
3.30 	publicly on regional data aggregated to granularity of 25,000 lives or greater for this purpose.

3.31 	Sec. 4. REPORT ON TRANSPARENCY OF HEALTH CARE PAYMENTS.
 3.32 		Subdivision 1.Definitions. (a) The terms defined in this subdivision apply to this section.
4.1 	(b) "Commissioner" means the commissioner of health.
4.2 	(c) "Nonclaims-based payments" means payments to health care providers designed to 
4.3 	support and reward value of health care services over volume of health care services and 
4.4 	includes alternative payment models or incentives, payments for infrastructure expenditures 
4.5 	or investments, and payments for workforce expenditures or investments.
4.6 	(d) "Nonpublic data" has the meaning given in Minnesota Statutes, section 13.02, 
4.7 	subdivision 9.
4.8 	(e) "Primary care services" means integrated, accessible health care services provided 
4.9 	by clinicians who are accountable for addressing a large majority of personal health care 
4.10 	needs, developing a sustained partnership with patients, and practicing in the context of 
4.11 	family and community. Primary care services include but are not limited to preventive 
4.12 	services, office visits, administration of vaccines, annual physicals, pre-operative physicals, 
4.13 	assessments, care coordination, development of treatment plans, management of chronic 
4.14 	conditions, and diagnostic tests.
4.15 		Subd. 2.Report. (a) To provide the legislature with information needed to meet the 
4.16 	evolving health care needs of Minnesotans, the commissioner shall report to the legislature 
4.17 	by February 15, 2024, on the volume and distribution of health care spending across payment 
4.18 	models used by health plan companies and third-party administrators, with a particular focus 
4.19 	on value-based care models and primary care spending.
4.20 	(b) The report must include specific health plan and third-party administrator estimates 
4.21 	of health care spending for claims-based payments and nonclaims-based payments for the 
4.22 	most recent available year, reported separately for Minnesotans enrolled in state health care 
4.23 	programs, Medicare Advantage, and commercial health insurance. The report must also 
4.24 	include recommendations on changes needed to gather better data from health plan companies 
4.25 	and third-party administrators on the use of value-based payments that pay for value of 
4.26 	health care services provided over volume of services provided, promote the health of all 
4.27 	Minnesotans, reduce health disparities, and support the provision of primary care services 
4.28 	and preventive services.
4.29 	(c) In preparing the report, the commissioner shall:
4.30 	(1) describe the form, manner, and timeline for submission of data by health plan 
4.31 	companies and third-party administrators to produce estimates as specified in paragraph 
4.32 	(b);
4.33 	(2) collect summary data that permits the computation of:
5.1 	(i) the percentage of total payments that are nonclaims-based payments; and
5.2 	(ii) the percentage of payments in item (i) that are for primary care services;
5.3 	(3) where data was not directly derived, specify the methods used to estimate data 
5.4 	elements;
5.5 	(4) notwithstanding Minnesota Statutes, section 62U.04, subdivision 11, conduct analyses 
5.6 	of the magnitude of primary care payments using data collected by the commissioner under 
5.7 	Minnesota Statutes, section 62U.04; and
5.8 	(5) conduct interviews with health plan companies and third-party administrators to 
5.9 	better understand the types of nonclaims-based payments and models in use, the purposes 
5.10 	or goals of each, the criteria for health care providers to qualify for these payments, and the 
5.11 	timing and structure of health plan companies or third-party administrators making these 
5.12 	payments to health care provider organizations.
5.13 	(d) Health plan companies and third-party administrators must comply with data requests 
5.14 	from the commissioner under this section within 60 days after receiving the request.
5.15 	(e) Data collected under this section is nonpublic data. Notwithstanding the definition 
5.16 	of summary data in Minnesota Statutes, section 13.02, subdivision 19, summary data prepared 
5.17 	under this section may be derived from nonpublic data. The commissioner shall establish 
5.18 	procedures and safeguards to protect the integrity and confidentiality of any data maintained 
5.19 	by the commissioner.