2006 Minnesota Statutes

62J.81 DISCLOSURE OF PAYMENTS FOR HEALTH CARE SERVICES.
    Subdivision 1. Required disclosure of estimated payment. (a) A health care provider, as
defined in section 62J.03, subdivision 8, or the provider's designee as agreed to by that designee,
shall, at the request of a consumer, provide that consumer with a good faith estimate of the
reimbursement the provider expects to receive from the health plan company in which the
consumer is enrolled. Health plan companies must allow contracted providers, or their designee,
to release this information. A good faith estimate must also be made available at the request of
a consumer who is not enrolled in a health plan company. Payment information provided by a
provider, or by the provider's designee as agreed to by that designee, to a patient pursuant to this
subdivision does not constitute a legally binding estimate of the cost of services.
(b) A health plan company, as defined in section 62J.03, subdivision 10, shall, at the request
of an enrollee or the enrollee's designee, provide that enrollee with a good faith estimate of the
reimbursement the health plan company would expect to pay to a specified provider within
the network for a health care service specified by the enrollee. If requested by the enrollee, the
health plan company shall also provide to the enrollee a good faith estimate of the enrollee's
out-of-pocket cost for the health care service. An estimate provided to an enrollee under this
paragraph is not a legally binding estimate of the reimbursement or out-of-pocket cost.
    Subd. 2. Applicability. For purposes of this section, "consumer" does not include a medical
assistance, MinnesotaCare, or general assistance medical care enrollee, for services covered
under those programs.
History: 2004 c 288 art 7 s 3; 2006 c 255 s 24