1.1                          A bill for an act 
  1.2             relating to health; modifying enrollee cost sharing 
  1.3             provisions for health maintenance organizations; 
  1.4             amending Minnesota Statutes 2002, section 62D.095, 
  1.5             subdivision 2, by adding a subdivision. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Minnesota Statutes 2002, section 62D.095, 
  1.8   subdivision 2, is amended to read: 
  1.9      Subd. 2.  [CO-PAYMENTS.] (a) A health maintenance contract 
  1.10  may impose a co-payment as authorized under Minnesota Rules, 
  1.11  part 4685.0801, or under this section.  
  1.12     (b) A health maintenance organization may impose a flat fee 
  1.13  co-payment on outpatient office visits not to exceed 40 percent 
  1.14  of the median provider's charges for similar services or goods 
  1.15  received by the enrollees as calculated under Minnesota Rules, 
  1.16  part 4685.0801.  A health maintenance organization may impose a 
  1.17  flat fee co-payment on outpatient prescription drugs not to 
  1.18  exceed 50 percent of the median provider's charges for similar 
  1.19  services or goods received by the enrollees as calculated under 
  1.20  Minnesota Rules, part 4685.0801.  
  1.21     (c) If a health maintenance contract is permitted to impose 
  1.22  a co-payment for preexisting health status under sections 62D.01 
  1.23  to 62D.30, these provisions may vary with respect to length of 
  1.24  enrollment in the health plan.  
  1.25     Sec. 2.  Minnesota Statutes 2002, section 62D.095, is 
  2.1   amended by adding a subdivision to read: 
  2.2      Subd. 6.  [PUBLIC PROGRAMS.] This section does not apply to 
  2.3   the prepaid medical assistance program, the MinnesotaCare 
  2.4   program, the prepaid general assistance program, the federal 
  2.5   Medicare program, or the health plans provided through any of 
  2.6   those programs.