2007 Minnesota Statutes

62J.60 MINNESOTA UNIFORM HEALTH CARE IDENTIFICATION CARD.
    Subdivision 1. Requirements for identification card. All individuals with health care
coverage shall be issued Minnesota uniform health care identification cards by group purchasers
as of January 1, 1998, unless the requirements of section 62A.01, subdivisions 2 and 3, are
met. If a health benefit plan issued by a group purchaser provides coverage for prescription
drugs, the group purchaser shall include uniform prescription drug information on the uniform
health care identification card issued to its enrollees on or after July 1, 2003. Nothing in this
section requires a group purchaser to issue a separate card containing uniform prescription
drug information, provided that the Minnesota uniform health care identification card can
accommodate the information necessary to process prescription drug claims as required by this
section. The Minnesota uniform health care identification cards shall comply with the standards
prescribed in this section.
    Subd. 1a. Definition; health benefit plan. For purposes of this section, "health benefit plan"
means a policy, contract, or certificate offered, sold, issued, or renewed by a group purchaser for
the coverage of medical and hospital benefits. A health benefit plan does not include coverage
that is:
(1) limited to disability or income protection coverage;
(2) automobile or homeowners medical payment coverage;
(3) liability insurance or supplemental to liability insurance;
(4) accident-only coverage;
(5) credit accident and health insurance issued under chapter 62B;
(6) designed solely to provide dental or vision care;
(7) designed solely to provide coverage for a specified disease or illness;
(8) coverage under which benefits are payable with or without regard to fault and that is
statutorily required to be contained in any liability insurance policy or equivalent self-insurance; or
(9) hospital income or indemnity.
    Subd. 2. General characteristics. (a) The Minnesota uniform health care identification card
must be a preprinted card constructed of plastic, paper, or any other medium that conforms with
ANSI and ISO 7810 physical characteristics standards. The card dimensions must also conform to
ANSI and ISO 7810 physical characteristics standard. The use of a signature panel is optional.
The uniform prescription drug information contained on the card must conform with the format
adopted by the NCPDP and, except as provided in subdivision 3, paragraph (a), clause (2), must
include all of the fields required to submit a claim in conformance with the most recent pharmacy
identification card implementation guide produced by the NCPDP. All information required to
submit a prescription drug claim, exclusive of information provided on a prescription that is
required by law, must be included on the card in a clear, readable, and understandable manner.
If a health benefit plan requires a conditional or situational field, as defined by the NCPDP, the
conditional or situational field must conform to the most recent pharmacy information card
implementation guide produced by the NCPDP.
    (b) The Minnesota uniform health care identification card must have an essential
information window on the front side with the following data elements: card issuer name,
electronic transaction routing information, card issuer identification number, cardholder (insured)
identification number, and cardholder (insured) identification name. No optional data may be
interspersed between these data elements.
    (c) Standardized labels are required next to human readable data elements and must come
before the human data elements.
    Subd. 2a. Issuance. A new Minnesota uniform health care identification card must be issued
to individuals upon enrollment. Except for the medical assistance, general assistance medical
care, and MinnesotaCare programs, a new card must be issued upon any change in an individual's
health care coverage that impacts the content or format of the data included on the card or no later
than 24 months after adoption of any change in the NCPDP implementation guide or successor
document that affects the content or format of the data included on the card. Anytime that a card is
issued upon enrollment or replaced by the medical assistance, general assistance medical care, or
MinnesotaCare program, the card must conform to the adopted NCPDP standards in effect and to
the implementation guide in use at the time of issuance. Newly issued cards must conform to the
adopted NCPDP standards in effect at the time of issuance and to the implementation guide in use
at the time of issuance. Stickers or other methodologies may be used to update cards temporarily.
    Subd. 3. Human readable data elements. (a) The following are the minimum human
readable data elements that must be present on the front side of the Minnesota uniform health
care identification card:
    (1) card issuer name or logo, which is the name or logo that identifies the card issuer. The
card issuer name or logo may be located at the top of the card. No standard label is required
for this data element;
    (2) complete electronic transaction routing information including, at a minimum, the
international identification number. The standardized label of this data element is "RxBIN."
Processor control numbers and group numbers are required if needed to electronically process a
prescription drug claim. The standardized label for the process control numbers data element is
"RxPCN" and the standardized label for the group numbers data element is "RxGrp," except that
if the group number data element is a universal element to be used by all health care providers,
the standardized label may be "Grp." To conserve vertical space on the card, the international
identification number and the processor control number may be printed on the same line;
     (3) cardholder (insured) identification number, which is the unique identification number
of the individual card holder established and defined under this section. The standardized label
for the data element is "ID";
    (4) cardholder (insured) identification name, which is the name of the individual card holder.
The identification name must be formatted as follows: first name, space, optional middle initial,
space, last name, optional space and name suffix. The standardized label for this data element
is "Name";
    (5) care type, which is the description of the group purchaser's plan product under which the
beneficiary is covered. The description shall include the health plan company name and the plan
or product name. The standardized label for this data element is "Care Type";
    (6) service type, which is the description of coverage provided such as hospital, dental,
vision, prescription, or mental health. The standard label for this data element is "Svc Type"; and
    (7) provider/clinic name, which is the name of the primary care clinic the card holder
is assigned to by the health plan company. The standard label for this field is "PCP." This
information is mandatory only if the health plan company assigns a specific primary care provider
to the card holder.
    (b) The following human readable data elements shall be present on the back side of the
Minnesota uniform health care identification card. These elements must be left justified, and no
optional data elements may be interspersed between them:
    (1) claims submission names and addresses, which are the names and addresses of the
entity or entities to which claims should be submitted. If different destinations are required for
different types of claims, this must be labeled;
    (2) telephone numbers and names that pharmacies and other health care providers may call
for assistance. These telephone numbers and names are required on the back side of the card only
if one of the contacts listed in clause (3) cannot provide pharmacies or other providers with
assistance or with the telephone numbers and names of contacts for assistance; and
    (3) telephone numbers and names; which are the telephone numbers and names of the
following contacts with a standardized label describing the service function as applicable:
    (i) eligibility and benefit information;
    (ii) utilization review;
    (iii) precertification; or
    (iv) customer services.
    (c) The following human readable data elements are mandatory on the back side of the
Minnesota uniform health care identification card for health maintenance organizations:
    (1) emergency care authorization telephone number or instruction on how to receive
authorization for emergency care. There is no standard label required for this information; and
    (2) one of the following:
    (i) telephone number to call to appeal to or file a complaint with the commissioner of
health; or
    (ii) for persons enrolled under section 256B.69, 256D.03, or 256L.12, the telephone number
to call to file a complaint with the ombudsperson designated by the commissioner of human
services under section 256B.69 and the address to appeal to the commissioner of human services.
There is no standard label required for this information.
    (d) All human readable data elements not required under paragraphs (a) to (c) are optional
and may be used at the issuer's discretion.
    Subd. 4. Machine readable data content. The Minnesota uniform health care identification
card may be machine readable or nonmachine readable. If the card is machine readable, the card
must contain a magnetic stripe that conforms to ANSI and ISO standards for Tracks 1.
    Subd. 5. Annual reporting. As part of an annual filing made with the commissioner of
health or commerce on or after January 1, 2003, a group purchaser shall certify compliance with
this section and shall submit to the commissioner of health or commerce a copy of the Minnesota
uniform health care identification card used by the group purchaser.
History: 1994 c 625 art 9 s 11; 1996 c 440 art 1 s 31,32; 1997 c 205 s 17; 1997 c 225 art 2 s
62; 2000 c 460 s 8; 2001 c 110 s 1; 2006 c 255 s 22,23; 2007 c 147 art 9 s 8,9