HF 2023

1st Engrossment - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to health; assessing health maintenance 
  1.3             organizations for purposes of the insurance fraud 
  1.4             prevention account; regulating certain rates, claims, 
  1.5             filing, reporting, and information disclosure 
  1.6             practices; eliminating expanded provider network 
  1.7             requirements; amending Minnesota Statutes 2004, 
  1.8             sections 45.0135, subdivision 7; 62D.145, subdivision 
  1.9             2; 62E.05, subdivision 2; 62L.08, subdivision 8; 
  1.10            62Q.75; 72A.201, subdivision 4; 72A.502, by adding a 
  1.11            subdivision; 144.335, subdivision 3a; 256B.692, 
  1.12            subdivision 2; 295.582; repealing Minnesota Statutes 
  1.13            2004, sections 62E.035; 62Q.095; 62Q.64. 
  1.14  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.15     Section 1.  Minnesota Statutes 2004, section 45.0135, 
  1.16  subdivision 7, is amended to read: 
  1.17     Subd. 7.  [ASSESSMENT.] Each insurer authorized to sell 
  1.18  insurance in the state of Minnesota shall remit an assessment to 
  1.19  the commissioner for deposit in the insurance fraud prevention 
  1.20  account on or before June 1 of each year.  The amount of the 
  1.21  assessment shall be based on the insurer's total assets and on 
  1.22  the insurer's total written Minnesota premium, for the preceding 
  1.23  fiscal year, as reported pursuant to section 60A.13.  The 
  1.24  assessment is calculated as follows: 
  1.25            Total Assets                      Assessment
  1.26       Less than $100,000,000                   $  200
  1.27       $100,000,000 to $1,000,000,000           $  750
  1.28       Over $1,000,000,000                      $2,000
  1.29       
  2.1        Minnesota Written Premium              Assessment 
  2.2        Less than $10,000,000                    $  200
  2.3        $10,000,000 to $100,000,000              $  750
  2.4        Over $100,000,000                        $2,000
  2.5      For purposes of this subdivision, the following entities 
  2.6   are not considered to be insurers authorized to sell insurance 
  2.7   in the state of Minnesota:  risk retention groups; or township 
  2.8   mutuals organized under chapter 67A; or health maintenance 
  2.9   organizations organized under chapter 62D. 
  2.10     Sec. 2.  Minnesota Statutes 2004, section 62D.145, 
  2.11  subdivision 2, is amended to read: 
  2.12     Subd. 2.  [HEALTH DATA OR INFORMATION.] (a) A health 
  2.13  maintenance organization is prohibited from disclosing to any 
  2.14  person any individually identifiable data or information held by 
  2.15  the health maintenance organization pertaining to the diagnosis, 
  2.16  treatment, or health of any enrollee, or any application 
  2.17  obtained from any person, except: 
  2.18     (1) to the extent necessary to carry out the purposes of 
  2.19  this chapter, the commissioner and a designee shall have access 
  2.20  to the above data or information but the data removed from the 
  2.21  health maintenance organization or participating entity shall 
  2.22  not identify any particular patient or client by name or contain 
  2.23  any other unique personal identifier; 
  2.24     (2) upon the express consent of the enrollee or applicant; 
  2.25     (3) pursuant to statute or court order for the production 
  2.26  of evidence or the discovery thereof; 
  2.27     (4) in the event of claim or litigation between the person 
  2.28  and the provider or health maintenance organization wherein such 
  2.29  data or information is pertinent; 
  2.30     (5) to meet the requirements of contracts for prepaid 
  2.31  medical services with the commissioner of human services 
  2.32  authorized under chapter 256B, 256D, or 256L; 
  2.33     (6) to meet the requirements of contracts for benefit plans 
  2.34  with the commissioner of employee relations under chapter 43A; 
  2.35  or 
  2.36     (7) as otherwise authorized pursuant to statute permitted 
  3.1   or required by law. 
  3.2      No provision in a contract for a benefit plan under chapter 
  3.3   43A shall authorize dissemination of individually identifiable 
  3.4   health records, unless the dissemination of the health records 
  3.5   is required to carry out the requirements of the contract and 
  3.6   employees whose health records will be disseminated are fully 
  3.7   informed of the dissemination by the Department of Employee 
  3.8   Relations at the time the employees are enrolling for or 
  3.9   changing insurance coverage. 
  3.10     (b) In any case involving a suspected violation of a law 
  3.11  applicable to health maintenance organizations in which access 
  3.12  to health data maintained by the health maintenance organization 
  3.13  or participating entity is necessary, the commissioner and 
  3.14  agents, while maintaining the privacy rights of individuals and 
  3.15  families, shall be permitted to obtain data that identifies any 
  3.16  particular patient or client by name.  A health maintenance 
  3.17  organization shall be entitled to claim any statutory privileges 
  3.18  against such disclosure which the provider who furnished the 
  3.19  information to the health maintenance organization is entitled 
  3.20  to claim. 
  3.21     Sec. 3.  Minnesota Statutes 2004, section 62E.05, 
  3.22  subdivision 2, is amended to read: 
  3.23     Subd. 2.  [ANNUAL REPORT.] (a) All health plan companies, 
  3.24  as defined in section 62Q.01, shall annually report to the 
  3.25  commissioner responsible for their regulation.  The following 
  3.26  information shall be reported to the appropriate commissioner on 
  3.27  February 1 of each year: 
  3.28     (1) the number of individuals and groups who received 
  3.29  coverage in the prior year through the qualified plans; and 
  3.30     (2) the number of individuals and groups who received 
  3.31  coverage in the prior year through each of the unqualified plans 
  3.32  sold by the company. 
  3.33     (b) The state of Minnesota or any of its departments, 
  3.34  agencies, programs, instrumentalities, or political 
  3.35  subdivisions, shall report in writing to the association and to 
  3.36  the commissioner of commerce no later than September 15 of each 
  4.1   year regarding the number of persons and the amount of premiums, 
  4.2   deductibles, co-payments, or coinsurance that it paid for on 
  4.3   behalf of enrollees in the Comprehensive Health Association.  
  4.4   This report must contain only summary information and must not 
  4.5   include any individually identifiable data.  The report must 
  4.6   cover the 12-month period ending the preceding June 30. 
  4.7      Sec. 4.  Minnesota Statutes 2004, section 62L.08, 
  4.8   subdivision 8, is amended to read: 
  4.9      Subd. 8.  [FILING REQUIREMENT.] No later than July 1, 1993, 
  4.10  and each year thereafter, A health carrier that offers, sells, 
  4.11  issues, or renews a health benefit plan for small employers 
  4.12  shall file with the commissioner the index rates and must 
  4.13  demonstrate that all rates shall be within the rating 
  4.14  restrictions defined in this chapter.  Such demonstration must 
  4.15  include the allowable range of rates from the index rates and a 
  4.16  description of how the health carrier intends to use demographic 
  4.17  factors including case characteristics in calculating the 
  4.18  premium rates.  The rates shall not be approved, unless the 
  4.19  commissioner has determined that the rates are reasonable.  In 
  4.20  determining reasonableness, the commissioner shall consider the 
  4.21  growth rates applied under section 62J.04, subdivision 1, 
  4.22  paragraph (b), to the calendar year or years that the proposed 
  4.23  premium rate would be in effect, actuarially valid changes in 
  4.24  risk associated with the enrollee population, and actuarially 
  4.25  valid changes as a result of statutory changes in Laws 1992, 
  4.26  chapter 549.  For premium rates proposed to go into effect 
  4.27  between July 1, 1993 and December 31, 1993, the pertinent growth 
  4.28  rate is the growth rate applied under section 62J.04, 
  4.29  subdivision 1, paragraph (b), to calendar year 1994.  
  4.30     Sec. 5.  Minnesota Statutes 2004, section 62Q.75, is 
  4.31  amended to read: 
  4.32     62Q.75 [PROMPT PAYMENT REQUIRED.] 
  4.33     Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
  4.34  section, the following terms have the meanings given to them. 
  4.35     (b) "Clean claim" means a claim that has no defect or 
  4.36  impropriety, including any lack of any required substantiating 
  5.1   documentation, including but not limited to, coordination of 
  5.2   benefits information, or particular circumstance requiring 
  5.3   special treatment that prevents timely payment from being made 
  5.4   on a claim under this section.  Nothing in this section alters 
  5.5   an enrollee's obligation to disclose information as required by 
  5.6   law.  
  5.7      (c) "Third-party administrator" means a third-party 
  5.8   administrator or other entity subject to section 60A.23, 
  5.9   subdivision 8, and Minnesota Rules, chapter 2767. 
  5.10     Subd. 2.  [CLAIMS PAYMENTS.] (a) This section applies to 
  5.11  clean claims submitted to a health plan company or third-party 
  5.12  administrator for services provided by any: 
  5.13     (1) health care provider, as defined in section 62Q.74, but 
  5.14  does not include a provider licensed under chapter 151; 
  5.15     (2) home health care provider, as defined in section 
  5.16  144A.43, subdivision 4; or 
  5.17     (3) health care facility. 
  5.18  All health plan companies and third-party administrators must 
  5.19  pay or deny claims that are clean claims within 30 calendar days 
  5.20  after the date upon which the health plan company or third-party 
  5.21  administrator received the claim. 
  5.22     (b) The health plan company or third-party administrator 
  5.23  shall, upon request, make available to the provider information 
  5.24  about the status of a claim submitted by the provider consistent 
  5.25  with section 62J.581. 
  5.26     (c) If a health plan company or third-party administrator 
  5.27  does not pay or deny a clean claim within the period provided in 
  5.28  paragraph (a), the health plan company or third-party 
  5.29  administrator must pay interest on the claim for the period 
  5.30  beginning on the day after the required payment date specified 
  5.31  in paragraph (a) and ending on the date on which the health plan 
  5.32  company or third-party administrator makes the payment or denies 
  5.33  the claim.  In any payment, the health plan company or 
  5.34  third-party administrator must itemize any interest payment 
  5.35  being made separately from other payments being made for 
  5.36  services provided.  The health plan company or third-party 
  6.1   administrator shall not require the health care provider to bill 
  6.2   the health plan company or third-party administrator for the 
  6.3   interest required under this section before any interest payment 
  6.4   is made.  Interest payments must be made to the health care 
  6.5   provider no less frequently than quarterly. 
  6.6      (d) The rate of interest paid by a health plan company or 
  6.7   third-party administrator under this subdivision shall be 1.5 
  6.8   percent per month or any part of a month. 
  6.9      (e) A health plan company or third-party administrator is 
  6.10  not required to make an interest payment on a claim for which 
  6.11  payment has been delayed for purposes of reviewing potentially 
  6.12  fraudulent or abusive billing practices. 
  6.13     (f) The commissioner may assess a financial administrative 
  6.14  penalty against a health plan company for violation of this 
  6.15  subdivision when there is a pattern of abuse that demonstrates a 
  6.16  lack of good faith effort and a systematic failure of the health 
  6.17  plan company to comply with this subdivision. 
  6.18     Subd. 3.  [CLAIMS FILING.] Unless otherwise provided by 
  6.19  contract, by section 16A.124, subdivision 4a, or by federal law, 
  6.20  the health care providers and facilities specified in 
  6.21  subdivision 2, must submit their charges to a health plan 
  6.22  company or third-party administrator within six months from the 
  6.23  date of service or the date the health care provider knew or was 
  6.24  informed of the correct name and address of the responsible 
  6.25  health plan company or third-party administrator, whichever is 
  6.26  later.  A health care provider or facility that does not submit 
  6.27  charges within the six-month period shall not be reimbursed for 
  6.28  the charge and may not collect the charge from the recipient of 
  6.29  the service or any other payer.  This subdivision also applies 
  6.30  to all health care providers and facilities that submit charges 
  6.31  to workers' compensation payers for treatment of a workers' 
  6.32  compensation injury compensable under chapter 176. 
  6.33     Sec. 6.  Minnesota Statutes 2004, section 72A.201, 
  6.34  subdivision 4, is amended to read: 
  6.35     Subd. 4.  [STANDARDS FOR CLAIM FILING AND HANDLING.] The 
  6.36  following acts by an insurer, an adjuster, a self-insured, or a 
  7.1   self-insurance administrator constitute unfair settlement 
  7.2   practices:  
  7.3      (1) except for claims made under a health insurance policy 
  7.4   of accident and sickness insurance, after receiving notification 
  7.5   of claim from an insured or a claimant, failing to acknowledge 
  7.6   receipt of the notification of the claim within ten business 
  7.7   days, and failing to promptly provide all necessary claim forms 
  7.8   and instructions to process the claim, unless the claim is 
  7.9   settled within ten business days.  The acknowledgment must 
  7.10  include the telephone number of the company representative who 
  7.11  can assist the insured or the claimant in providing information 
  7.12  and assistance that is reasonable so that the insured or 
  7.13  claimant can comply with the policy conditions and the insurer's 
  7.14  reasonable requirements.  If an acknowledgment is made by means 
  7.15  other than writing, an appropriate notation of the 
  7.16  acknowledgment must be made in the claim file of the insurer and 
  7.17  dated.  An appropriate notation must include at least the 
  7.18  following information where the acknowledgment is by telephone 
  7.19  or oral contact:  
  7.20     (i) the telephone number called, if any; 
  7.21     (ii) the name of the person making the telephone call or 
  7.22  oral contact; 
  7.23     (iii) the name of the person who actually received the 
  7.24  telephone call or oral contact; 
  7.25     (iv) the time of the telephone call or oral contact; and 
  7.26     (v) the date of the telephone call or oral contact; 
  7.27     (2) failing to reply, within ten business days of receipt, 
  7.28  to all other communications about a claim from an insured or a 
  7.29  claimant that reasonably indicate a response is requested or 
  7.30  needed; 
  7.31     (3)(i) unless provided otherwise by clause (ii) or (iii), 
  7.32  other law, or in the policy, failing to complete its 
  7.33  investigation and inform the insured or claimant of acceptance 
  7.34  or denial of a claim within 30 business days after receipt of 
  7.35  notification of claim unless the investigation cannot be 
  7.36  reasonably completed within that time. In the event that the 
  8.1   investigation cannot reasonably be completed within that time, 
  8.2   the insurer shall notify the insured or claimant within the time 
  8.3   period of the reasons why the investigation is not complete and 
  8.4   the expected date the investigation will be complete.  For 
  8.5   claims made under a health policy of accident and sickness 
  8.6   insurance, the notification of claim must be in writing; 
  8.7      (ii) for claims submitted under a policy of accident and 
  8.8   sickness insurance, the insurer must comply with all of the 
  8.9   requirements of section 62Q.75.  The commissioner may not assess 
  8.10  a financial administrative penalty against a health plan company 
  8.11  for violation of that section; 
  8.12     (iii) for claims submitted under a policy of accident and 
  8.13  sickness insurance that are accepted, the insurer must notify 
  8.14  the insured or claimant no less than semiannually of the 
  8.15  disposition of claims of the insured or claimant.  For purposes 
  8.16  of this clause, acceptance of a claim means that there is no 
  8.17  additional financial liability for the insured or claimant, 
  8.18  either because there is a flat co-payment amount specified in 
  8.19  the health plan or because there is no co-payment, deductible, 
  8.20  or coinsurance owed; 
  8.21     (4) where evidence of suspected fraud is present, the 
  8.22  requirement to disclose their reasons for failure to complete 
  8.23  the investigation within the time period set forth in clause (3) 
  8.24  need not be specific.  The insurer must make this evidence 
  8.25  available to the Department of Commerce if requested; 
  8.26     (5) failing to notify an insured who has made a 
  8.27  notification of claim of all available benefits or coverages 
  8.28  which the insured may be eligible to receive under the terms of 
  8.29  a policy and of the documentation which the insured must supply 
  8.30  in order to ascertain eligibility; 
  8.31     (6) unless otherwise provided by law or in the policy, 
  8.32  requiring an insured to give written notice of loss or proof of 
  8.33  loss within a specified time, and thereafter seeking to relieve 
  8.34  the insurer of its obligations if the time limit is not complied 
  8.35  with, unless the failure to comply with the time limit 
  8.36  prejudices the insurer's rights and then only if the insurer 
  9.1   gave prior notice to the insured of the potential prejudice; 
  9.2      (7) advising an insured or a claimant not to obtain the 
  9.3   services of an attorney or an adjuster, or representing that 
  9.4   payment will be delayed if an attorney or an adjuster is 
  9.5   retained by the insured or the claimant; 
  9.6      (8) failing to advise in writing an insured or claimant who 
  9.7   has filed a notification of claim known to be unresolved, and 
  9.8   who has not retained an attorney, of the expiration of a statute 
  9.9   of limitations at least 60 days prior to that expiration.  For 
  9.10  the purposes of this clause, any claim on which the insurer has 
  9.11  received no communication from the insured or claimant for a 
  9.12  period of two years preceding the expiration of the applicable 
  9.13  statute of limitations shall not be considered to be known to be 
  9.14  unresolved and notice need not be sent pursuant to this clause; 
  9.15     (9) demanding information which would not affect the 
  9.16  settlement of the claim; 
  9.17     (10) unless expressly permitted by law or the policy, 
  9.18  refusing to settle a claim of an insured on the basis that the 
  9.19  responsibility should be assumed by others; 
  9.20     (11) failing, within 60 business days after receipt of a 
  9.21  properly executed proof of loss, to advise the insured of the 
  9.22  acceptance or denial of the claim by the insurer.  No insurer 
  9.23  shall deny a claim on the grounds of a specific policy 
  9.24  provision, condition, or exclusion unless reference to the 
  9.25  provision, condition, or exclusion is included in the denial. 
  9.26  The denial must be given to the insured in writing with a copy 
  9.27  filed in the claim file; 
  9.28     (12) denying or reducing a claim on the basis of an 
  9.29  application which was altered or falsified by the agent or 
  9.30  insurer without the knowledge of the insured; 
  9.31     (13) failing to notify the insured of the existence of the 
  9.32  additional living expense coverage when an insured under a 
  9.33  homeowners policy sustains a loss by reason of a covered 
  9.34  occurrence and the damage to the dwelling is such that it is not 
  9.35  habitable; 
  9.36     (14) failing to inform an insured or a claimant that the 
 10.1   insurer will pay for an estimate of repair if the insurer 
 10.2   requested the estimate and the insured or claimant had 
 10.3   previously submitted two estimates of repair.  
 10.4      Sec. 7.  Minnesota Statutes 2004, section 72A.502, is 
 10.5   amended by adding a subdivision to read: 
 10.6      Subd. 2a.  [FEDERAL LAW.] Personal or privileged 
 10.7   information may be disclosed without a written authorization to 
 10.8   another person in the same way that protected health information 
 10.9   may be disclosed to carry out treatment, payment, or health care 
 10.10  operations of the disclosing insurer pursuant to the federal 
 10.11  Health Insurance Portability and Accountability Act's Standards 
 10.12  for Privacy, Code of Federal Regulations, title 45, parts 160 
 10.13  and 164, and any amendments, modifications, or supplemental or 
 10.14  successor provisions.  
 10.15     Sec. 8.  Minnesota Statutes 2004, section 144.335, 
 10.16  subdivision 3a, is amended to read: 
 10.17     Subd. 3a.  [PATIENT CONSENT TO RELEASE OF RECORDS; 
 10.18  LIABILITY.] (a) A provider, or a person who receives health 
 10.19  records from a provider, may not release a patient's health 
 10.20  records to a person without a signed and dated consent from the 
 10.21  patient or the patient's legally authorized representative 
 10.22  authorizing the release, unless the release is specifically 
 10.23  authorized permitted or required by law.  Except as provided in 
 10.24  paragraph (c) or (d), a consent is valid for one year or for a 
 10.25  lesser period specified in the consent or for a different period 
 10.26  provided by law.  
 10.27     (b) This subdivision does not prohibit the release of 
 10.28  health records: 
 10.29     (1) for a medical emergency when the provider is unable to 
 10.30  obtain the patient's consent due to the patient's condition or 
 10.31  the nature of the medical emergency; or 
 10.32     (2) to other providers within related health care entities 
 10.33  when necessary for the current treatment of the patient. 
 10.34     (c) Notwithstanding paragraph (a), if a patient explicitly 
 10.35  gives informed consent to the release of health records for the 
 10.36  purposes and pursuant to the restrictions in clauses (1) and 
 11.1   (2), the consent does not expire after one year for: 
 11.2      (1) the release of health records to a provider who is 
 11.3   being advised or consulted with in connection with the current 
 11.4   treatment of the patient; 
 11.5      (2) the release of health records to an accident and health 
 11.6   insurer, health service plan corporation, health maintenance 
 11.7   organization, or third-party administrator for purposes of 
 11.8   payment of claims, fraud investigation, or quality of care 
 11.9   review and studies, provided that: 
 11.10     (i) the use or release of the records complies with 
 11.11  sections 72A.49 to 72A.505; 
 11.12     (ii) further use or release of the records in individually 
 11.13  identifiable form to a person other than the patient without the 
 11.14  patient's consent is prohibited; and 
 11.15     (iii) the recipient establishes adequate safeguards to 
 11.16  protect the records from unauthorized disclosure, including a 
 11.17  procedure for removal or destruction of information that 
 11.18  identifies the patient. 
 11.19     (d) Notwithstanding paragraph (a), health records may be 
 11.20  released to an external researcher solely for purposes of 
 11.21  medical or scientific research only as follows: 
 11.22     (1) health records generated before January 1, 1997, may be 
 11.23  released if the patient has not objected or does not elect to 
 11.24  object after that date; 
 11.25     (2) for health records generated on or after January 1, 
 11.26  1997, the provider must: 
 11.27     (i) disclose in writing to patients currently being treated 
 11.28  by the provider that health records, regardless of when 
 11.29  generated, may be released and that the patient may object, in 
 11.30  which case the records will not be released; and 
 11.31     (ii) use reasonable efforts to obtain the patient's written 
 11.32  general authorization that describes the release of records in 
 11.33  item (i), which does not expire but may be revoked or limited in 
 11.34  writing at any time by the patient or the patient's authorized 
 11.35  representative; 
 11.36     (3) authorization may be established if an authorization is 
 12.1   mailed at least two times to the patient's last known address 
 12.2   with a postage prepaid return envelope and a conspicuous notice 
 12.3   that the patient's medical records may be released if the 
 12.4   patient does not object, and at least 60 days have expired since 
 12.5   the second notice was sent; and the provider must advise the 
 12.6   patient of the rights specified in clause (4); and 
 12.7      (4) the provider must, at the request of the patient, 
 12.8   provide information on how the patient may contact an external 
 12.9   researcher to whom the health record was released and the date 
 12.10  it was released.  
 12.11     In making a release for research purposes the provider 
 12.12  shall make a reasonable effort to determine that: 
 12.13     (i) the use or disclosure does not violate any limitations 
 12.14  under which the record was collected; 
 12.15     (ii) the use or disclosure in individually identifiable 
 12.16  form is necessary to accomplish the research or statistical 
 12.17  purpose for which the use or disclosure is to be made; 
 12.18     (iii) the recipient has established and maintains adequate 
 12.19  safeguards to protect the records from unauthorized disclosure, 
 12.20  including a procedure for removal or destruction of information 
 12.21  that identifies the patient; and 
 12.22     (iv) further use or release of the records in individually 
 12.23  identifiable form to a person other than the patient without the 
 12.24  patient's consent is prohibited.  
 12.25     (e) A person who negligently or intentionally releases a 
 12.26  health record in violation of this subdivision, or who forges a 
 12.27  signature on a consent form, or who obtains under false 
 12.28  pretenses the consent form or health records of another person, 
 12.29  or who, without the person's consent, alters a consent form, is 
 12.30  liable to the patient for compensatory damages caused by an 
 12.31  unauthorized release, plus costs and reasonable attorney's fees. 
 12.32     (f) Upon the written request of a spouse, parent, child, or 
 12.33  sibling of a patient being evaluated for or diagnosed with 
 12.34  mental illness, a provider shall inquire of a patient whether 
 12.35  the patient wishes to authorize a specific individual to receive 
 12.36  information regarding the patient's current and proposed course 
 13.1   of treatment.  If the patient so authorizes, the provider shall 
 13.2   communicate to the designated individual the patient's current 
 13.3   and proposed course of treatment.  Paragraph (a) applies to 
 13.4   consents given under this paragraph. 
 13.5      (g) Notwithstanding paragraph (a), a provider must disclose 
 13.6   health records relating to a patient's mental health to a law 
 13.7   enforcement agency if the law enforcement agency provides the 
 13.8   name of the patient and communicates that the: 
 13.9      (1) patient is currently involved in an emergency 
 13.10  interaction with the law enforcement agency; and 
 13.11     (2) disclosure of the records is necessary to protect the 
 13.12  health or safety of the patient or of another person.  
 13.13     The scope of disclosure under this paragraph is limited to 
 13.14  the minimum necessary for law enforcement to respond to the 
 13.15  emergency.  A law enforcement agency that obtains health records 
 13.16  under this paragraph shall maintain a record of the requestor, 
 13.17  the provider of the information, and the patient's name.  Health 
 13.18  records obtained by a law enforcement agency under this 
 13.19  paragraph are private data on individuals as defined in section 
 13.20  13.02 and must not be used by law enforcement for any other 
 13.21  purpose.  
 13.22     (h) In cases where a provider releases health records 
 13.23  without patient consent as authorized by law, the release must 
 13.24  be documented in the patient's health record.  In the case of a 
 13.25  release under paragraph (g), the documentation must include the 
 13.26  date and circumstances under which the release was made, the 
 13.27  person or agency to whom the release was made, and the records 
 13.28  that were released. 
 13.29     Sec. 9.  Minnesota Statutes 2004, section 256B.692, 
 13.30  subdivision 2, is amended to read: 
 13.31     Subd. 2.  [DUTIES OF THE COMMISSIONER OF HEALTH.] (a) 
 13.32  Notwithstanding chapters 62D and 62N, a county that elects to 
 13.33  purchase medical assistance and general assistance medical care 
 13.34  in return for a fixed sum without regard to the frequency or 
 13.35  extent of services furnished to any particular enrollee is not 
 13.36  required to obtain a certificate of authority under chapter 62D 
 14.1   or 62N.  The county board of commissioners is the governing body 
 14.2   of a county-based purchasing program.  In a multicounty 
 14.3   arrangement, the governing body is a joint powers board 
 14.4   established under section 471.59.  
 14.5      (b) A county that elects to purchase medical assistance and 
 14.6   general assistance medical care services under this section must 
 14.7   satisfy the commissioner of health that the requirements for 
 14.8   assurance of consumer protection, provider protection, and 
 14.9   fiscal solvency of chapter 62D, applicable to health maintenance 
 14.10  organizations, or chapter 62N, applicable to community 
 14.11  integrated service networks, will be met.  
 14.12     (c) A county must also assure the commissioner of health 
 14.13  that the requirements of sections 62J.041; 62J.48; 62J.71 to 
 14.14  62J.73; 62M.01 to 62M.16; all applicable provisions of chapter 
 14.15  62Q, including sections 62Q.075; 62Q.1055; 62Q.106; 62Q.12; 
 14.16  62Q.135; 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.43; 
 14.17  62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; 62Q.68 to 
 14.18  62Q.72; and 72A.201 will be met.  
 14.19     (d) All enforcement and rulemaking powers available under 
 14.20  chapters 62D, 62J, 62M, 62N, and 62Q are hereby granted to the 
 14.21  commissioner of health with respect to counties that purchase 
 14.22  medical assistance and general assistance medical care services 
 14.23  under this section.  
 14.24     (e) The commissioner, in consultation with county 
 14.25  government, shall develop administrative and financial reporting 
 14.26  requirements for county-based purchasing programs relating to 
 14.27  sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 
 14.28  62N.31, and other sections as necessary, that are specific to 
 14.29  county administrative, accounting, and reporting systems and 
 14.30  consistent with other statutory requirements of counties.  
 14.31     Sec. 10.  Minnesota Statutes 2004, section 295.582, is 
 14.32  amended to read: 
 14.33     295.582 [AUTHORITY.] 
 14.34     (a) A hospital, surgical center, or health care provider 
 14.35  that is subject to a tax under section 295.52, or a pharmacy 
 14.36  that has paid additional expense transferred under this section 
 15.1   by a wholesale drug distributor, may transfer additional expense 
 15.2   generated by section 295.52 obligations on to all third-party 
 15.3   contracts for the purchase of health care services on behalf of 
 15.4   a patient or consumer.  The additional expense transferred to 
 15.5   the third-party purchaser must not exceed the tax percentage 
 15.6   specified in section 295.52 multiplied against the gross 
 15.7   revenues received under the third-party contract, and the tax 
 15.8   percentage specified in section 295.52 multiplied against 
 15.9   co-payments and deductibles paid by the individual patient or 
 15.10  consumer.  The expense must not be generated on revenues derived 
 15.11  from payments that are excluded from the tax under section 
 15.12  295.53.  All third-party purchasers of health care services 
 15.13  including, but not limited to, third-party purchasers regulated 
 15.14  under chapter 60A, 62A, 62C, 62D, 62H, 62N, 64B, 65A, 65B, 79, 
 15.15  or 79A, or under section 471.61 or 471.617, must pay the 
 15.16  transferred expense in addition to any payments due under 
 15.17  existing contracts with the hospital, surgical center, pharmacy, 
 15.18  or health care provider, to the extent allowed under federal 
 15.19  law.  A third-party purchaser of health care services includes, 
 15.20  but is not limited to, a health carrier or community integrated 
 15.21  service network that pays for health care services on behalf of 
 15.22  patients or that reimburses, indemnifies, compensates, or 
 15.23  otherwise insures patients for health care services.  A 
 15.24  third-party purchaser shall comply with this section regardless 
 15.25  of whether the third-party purchaser is a for-profit, 
 15.26  not-for-profit, or nonprofit entity.  A wholesale drug 
 15.27  distributor may transfer additional expense generated by section 
 15.28  295.52 obligations to entities that purchase from the 
 15.29  wholesaler, and the entities must pay the additional expense.  
 15.30  Nothing in this section limits the ability of a hospital, 
 15.31  surgical center, pharmacy, wholesale drug distributor, or health 
 15.32  care provider to recover all or part of the section 295.52 
 15.33  obligation by other methods, including increasing fees or 
 15.34  charges. 
 15.35     (b) Each third-party purchaser regulated under any chapter 
 15.36  cited in paragraph (a) shall include with its annual renewal for 
 16.1   certification of authority or licensure documentation indicating 
 16.2   compliance with paragraph (a).  
 16.3      (c) Any hospital, surgical center, or health care provider 
 16.4   subject to a tax under section 295.52 or a pharmacy that has 
 16.5   paid additional expense transferred under this section by a 
 16.6   wholesale drug distributor may file a complaint with the 
 16.7   commissioner responsible for regulating the third-party 
 16.8   purchaser if at any time the third-party purchaser fails to 
 16.9   comply with paragraph (a).  
 16.10     (d) (c) If the commissioner responsible for regulating the 
 16.11  third-party purchaser finds at any time that the third-party 
 16.12  purchaser has not complied with paragraph (a), the commissioner 
 16.13  may take enforcement action against a third-party purchaser 
 16.14  which is subject to the commissioner's regulatory jurisdiction 
 16.15  and which does not allow a hospital, surgical center, pharmacy, 
 16.16  or provider to pass-through the tax.  The commissioner may by 
 16.17  order fine or censure the third-party purchaser or revoke or 
 16.18  suspend the certificate of authority or license of the 
 16.19  third-party purchaser to do business in this state if the 
 16.20  commissioner finds that the third-party purchaser has not 
 16.21  complied with this section.  The third-party purchaser may 
 16.22  appeal the commissioner's order through a contested case hearing 
 16.23  in accordance with chapter 14. 
 16.24     Sec. 11.  [REPEALER.] 
 16.25     Minnesota Statutes 2004, sections 62E.035; 62Q.095; and 
 16.26  62Q.64, are repealed.