62J.823 HOSPITAL PRICING TRANSPARENCY.
Subdivision 1. Short title.
This section may be cited as the Hospital Pricing Transparency
Subd. 2. Definition.
For the purposes of this section, "estimate" means the actual price
expected to be billed to the individual or to the individual's health plan company based on the
specific diagnostic-related group code or specific procedure code or codes, reflecting any known
discounts the individual would receive.
Subd. 3. Applicability and scope.
Any hospital, as defined in section
3, and outpatient surgical center, as defined in section
, subdivision 4, shall provide a
written estimate of the cost of a specific service or stay upon the request of a patient, doctor, or the
patient's representative. The request must include:
(1) the health coverage status of the patient, including the specific health plan or other health
coverage under which the patient is enrolled, if any; and
(2) at least one of the following:
(i) the specific diagnostic-related group code;
(ii) the name of the procedure or procedures to be performed;
(iii) the type of treatment to be received; or
(iv) any other information that will allow the hospital or outpatient surgical center to
determine the specific diagnostic-related group or procedure code or codes.
Subd. 4. Estimate.
(a) An estimate provided by the hospital or outpatient surgical center
(1) the method used to calculate the estimate;
(2) the specific diagnostic-related group or procedure code or codes used to calculate the
estimate, and a description of the diagnostic-related group or procedure code or codes that is
reasonably understandable to a patient; and
(3) a statement indicating that the estimate, while accurate, may not reflect the actual
billed charges and that the final bill may be higher or lower depending on the patient's specific
(b) The estimate may be provided in any method that meets the needs of the patient and the
hospital or outpatient surgical center, including electronically; however, a paper copy must be
provided if specifically requested.
History: 2006 c 255 s 25