Bill Text: MN HF1395 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Uninsured and underinsured coverages, medical benefits, arbitration, and marketing practices regulated; and automobile medical fraud reduced.
Spectrum: Partisan Bill (Republican 6-0)
Status: (Introduced - Dead) 2011-05-03 - Author added Dettmer [HF1395 Detail]
Download: Minnesota-2011-HF1395-Introduced.html
1.2relating to insurance; no-fault auto; regulating uninsured and underinsured
1.3coverages, medical benefits, arbitration, and marketing practices; reducing
1.4automobile medical fraud; amending Minnesota Statutes 2010, sections 65B.44,
1.5subdivisions 1, 2; 65B.525, by adding subdivisions; 65B.54, subdivisions 4, 6,
1.6by adding subdivisions; 609.612, subdivision 1.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.11 Section 1. Minnesota Statutes 2010, section 65B.44, subdivision 1, is amended to read:
1.12 Subdivision 1. Inclusions. (a) Basic economic loss benefits shall provide
1.13reimbursement for all loss suffered through injury arising out of the maintenance or use
1.14of a motor vehicle, subject to any applicable deductibles, exclusions, disqualifications,
1.15and other conditions, and shall provide a minimum of $40,000 for loss arising out of the
1.16injury of any one person, consisting of:
1.17(1) $20,000 for medical expense loss arising out of injury to any one person; and
1.18(2) a total of $20,000 for income loss, replacement services loss, funeral expense
1.19loss, survivor's economic loss, and survivor's replacement services loss arising out of the
1.20injury to any one person.
1.21(b) Notwithstanding any other law to the contrary, a person entitled to basic
1.22economic loss benefits under this chapter is entitled to the full medical expense benefits set
1.23forth in subdivision 2, and may not receive medical expense benefits that are in any way
1.24less than those provided for in subdivision 2, or that involve any preestablished limitations
1.25on the benefits. Medical expenses must be reasonable and must be for necessary medical
2.1care as provided in subdivision 2. This paragraph shall not be deemed to alter the
2.2obligations of an insured or the rights of a reparation obligor as set forth in section65B.56 .
2.3This paragraph does not apply to medical expense loss that is subject to paragraph (d).
2.4(c) No reparation obligor or health plan company as defined in section62Q.01,
2.5subdivision 4 , may enter into or renew any contract that provides, or has the effect of
2.6providing, managed care services to no-fault claimants. For the purposes of this section,
2.7"managed care services" is defined as any program of medical services that uses health care
2.8providers managed, owned, employed by, or under contract with a health plan company.
2.9(d) Medical expense loss for diagnosis and treatment of a soft tissue injury is
2.10covered only if provided in compliance with the codes, treatment standards, and fee
2.11schedules provided in Minnesota Rules, chapter 5221. For purposes of this section, "soft
2.12tissue injury" means an injury to the soft tissues, as opposed to the skeletal tissues or
2.13soft organs. The term soft tissue injury specifically includes, without limitation, any
2.14injury with treatment covered by the procedure codes set forth in Minnesota Rules,
2.15part 5221.4060, other than such treatment delivered by a health care provider defined
2.16in Minnesota Rules, part 5221.0100, subpart 11a, or by a medical facility described in
2.17section 176.136, subdivision 1b, paragraphs (a) and (b).
2.18 Sec. 2. Minnesota Statutes 2010, section 65B.44, subdivision 2, is amended to read:
2.19 Subd. 2. Medical expense benefits. (a) Medical expense benefits shall reimburse
2.20allreasonable usual and customary expenses incurred within seven days from the date
2.21of loss for medically necessary:
2.22(1) medical, surgical, x-ray, optical, dental, chiropractic, and rehabilitative services,
2.23including prosthetic devices;
2.24(2) prescription drugs;
2.25(3) ambulance and all other transportation expenses incurred in traveling to receive
2.26other covered medical expense benefits;
2.27(4) sign interpreting and language translation services, other than such services
2.28provided by a family member of the patient, related to the receipt of medical, surgical,
2.29x-ray, optical, dental, chiropractic, hospital, extended care, nursing, and rehabilitative
2.30services; and
2.31(5) hospital, extended care, and nursing services.
2.32(b) Hospital room and board benefits may be limited, except for intensive care
2.33facilities, to the regular daily semiprivate room rates customarily charged by the institution
2.34in which the recipient of benefits is confined.
3.1(c) Such benefits shall also include necessary remedial treatment and services
3.2recognized and permitted under the laws of this state for an injured person who relies
3.3upon spiritual means through prayer alone for healing in accordance with that person's
3.4religious beliefs.
3.5(d) Medical expense loss includes medical expenses accrued prior to the death of a
3.6person notwithstanding the fact that benefits are paid or payable to the decedent's survivors.
3.7(e) Medical expense benefits for rehabilitative services shall be subject to the
3.8provisions of section65B.45 .
3.9 Sec. 3. Minnesota Statutes 2010, section 65B.525, is amended by adding a subdivision
3.10to read:
3.11 Subd. 3. Itemization; right to participate; full payment. All arbitration awards
3.12must be itemized. A partial award of medical benefits rendered by an arbitrator under this
3.13section and paid by an obligor will be considered full and final payment, and the injured
3.14party is not liable for, nor may the provider bill the injured party for, charges that are not
3.15part of the award, pursuant to section 65B.54, subdivision 8. A health care provider's
3.16participation as a party in an arbitration proceeding is limited to any issues related to the
3.17treatment or charges arising out of the claim that is the subject of the arbitration. This
3.18subdivision does not apply to charges for health care that are not related to the accident.
3.19 Sec. 4. Minnesota Statutes 2010, section 65B.525, is amended by adding a subdivision
3.20to read:
3.21 Subd. 4. Notice to providers. The itemization of medical services claims required
3.22pursuant to subdivision 3 must include the names and addresses of all health care providers
3.23whose charges are the subject of the claims. Within ten business days after receipt of the
3.24itemization, the administrator of arbitration under this section must send a copy of the
3.25petition and itemization to each health care provider whose charges are the subject of
3.26claims, together with a notice of the content of subdivision 3 and of the provider's right to
3.27participate as a party to the proceeding. The notice must explain to the provider what steps
3.28the provider must take in order to participate.
3.29 Sec. 5. Minnesota Statutes 2010, section 65B.54, is amended by adding a subdivision
3.30to read:
3.31 Subd. 7. Balance billing. (a) This subdivision applies to charges for medical
3.32expense benefits as defined in section 65B.44, subdivision 2, to the extent that a reparation
4.1obligor has rejected them on the basis that the health care was not medically necessary or
4.2on the basis that the charges exceed the usual and customary rate.
4.3(b) If a reparation obligor rejects, in whole or in part, a claim for health care
4.4provided to the claimant by a health care provider, for reasons specified in paragraph (a),
4.5the claimant is not obligated to pay the health care provider for the rejected charges.
4.6(c) The health care provider shall not bill the claimant for those charges or otherwise
4.7attempt to collect them from the claimant after they have been rejected by the insurer.
4.8(d) A health care provider whose charges are rejected, in whole or in part, under this
4.9section by a reparation obligor, is the party at interest and has standing to commence and
4.10pursue a claim for payment as a claimant against the reparation obligor in an arbitration
4.11proceeding under section 65B.525. In such a proceeding, the insured may be required
4.12to attend the arbitration proceeding by either the reparation obligor or the health care
4.13provider, subject to the conditions provided in section 65B.56, subdivision 2.
4.14(e) A health care provider shall not require an insured to waive any provision of this
4.15section, and any such attempted waiver is void and unenforceable.
4.19 Section 1. Minnesota Statutes 2010, section 65B.54, subdivision 4, is amended to read:
4.20 Subd. 4. Recovery of benefits paid due to intentional misrepresentation. A
4.21reparation obligor may bring an action to recover benefits which are not payable, but are
4.22in fact paid, because of an intentional misrepresentation of a material fact, upon which the
4.23reparation obligor relies, by the claimant or by a person providing products or services
4.24for which basic economic loss benefits are payable. The action may be brought only
4.25against the person providing the products or services, unless the claimant has intentionally
4.26misrepresented the facts or knew of the misrepresentation. A reparation obligor may
4.27recover damages under this subdivision by showing that the person or clinic providing the
4.28products or services engaged in a pattern and practice of intentional misrepresentation of
4.29material fact or fraud. A reparation obligor may offset amounts the reparation obligor is
4.30entitled to recover from the claimant under this subdivision against any basic economic
4.31loss benefits otherwise due the claimant.
4.32 Sec. 2. Minnesota Statutes 2010, section 65B.54, subdivision 6, is amended to read:
4.33 Subd. 6. Unethical practices. (a) A licensed health care provider shall not initiate
4.34direct contact, in person, over the telephone, or by other electronic means, with any person
5.1who has suffered an injury arising out of the maintenance or use of an automobile, for the
5.2purpose of influencing that person to receive treatment or to purchase any good or item
5.3from the licensee or anyone associated with the licensee. This subdivision prohibits such
5.4direct contact whether initiated by the licensee individually or on behalf of the licensee by
5.5any employee, independent contractor, agent, or third party, including, without limitation,
5.6a capper, runner, or steerer, as defined in section 609.612, subdivision 1, paragraph (c).
5.7This subdivision does not apply when an injured person voluntarily initiates contact with a
5.8licensee.
5.9 (b) This subdivision does not prohibit licensees, or persons acting on their behalf,
5.10from mailing advertising literature directly to such persons, so long as:
5.11 (1) the word "ADVERTISEMENT" appears clearly and conspicuously at the
5.12beginning of the written materials;
5.13 (2) the name of the individual licensee appears clearly and conspicuously within
5.14the written materials;
5.15 (3) the licensee is clearly identified as a licensed health care provider within the
5.16written materials; and
5.17 (4) the licensee does not initiate, individually or through any employee, independent
5.18contractor, agent, or third party, direct contact with the person after the written materials
5.19are sent.
5.20 (c) If undertaken directly by the health care provider only in its own legal name,
5.21this subdivision does not apply to:
5.22 (1) advertising that does not involve direct contact with specific prospective patients,
5.23in public media such as telephone directories, professional directories, ads in newspapers
5.24and other periodicals, radio or television ads, Web sites, billboards, or similar media;
5.25 (2) general marketing practices such as giving lectures; participating in special
5.26events, trade shows, or meetings of organizations; or making presentations relative to the
5.27benefits of chiropractic treatment;
5.28 (3) contact with friends or relatives, or statements made in a social setting;
5.29 (4) direct contact initiated by an ambulance service licensed under chapter 144E, a
5.30medical response unit registered under section144E.275 , or by the emergency department
5.31of a hospital licensed under chapter 144, for the purpose of rendering emergency care; or
5.32 (5) a situation in which the injured person:
5.33 (i) had a prior professional relationship with the licensee;
5.34 (ii) has selected that licensee as the licensee from whom the injured person receives
5.35health care; or
5.36 (iii) has received treatment related to the accident from the licensee.
6.1 (d) A violation of this subdivision is grounds for the licensing authority to take
6.2disciplinary action against the licensee, its professional corporation, or any direct or
6.3indirect successor in interest of the corporation, including revocation in appropriate cases.
6.4In addition, charges for any services provided by a health care provider in violation of this
6.5subdivision are not compensable and not enforceable as a matter of law.
6.6 Sec. 3. Minnesota Statutes 2010, section 65B.54, is amended by adding a subdivision
6.7to read:
6.8 Subd. 8. Media-generated referrals. (a) No health care provider shall pay, offer, or
6.9provide any compensation, fee, or anything of value to an individual, firm, corporation,
6.10or other legal entity for referring a person identified by use of the public media, such as
6.11telephone directories, professional directories, advertisements in newspapers and other
6.12periodicals, radio or television advertisements, Web sites, billboards, or similar media,
6.13for purposes of influencing or referring that person to receive treatment or purchase any
6.14good or item from the health care provider or anyone associated with the health care
6.15provider for any injury arising out of the maintenance or use of an automobile. Charges
6.16for any services provided by a health care provider in violation of this subdivision are not
6.17compensable and not enforceable as a matter of law. The prohibition in this subdivision
6.18does not apply to any advertisement or other contact permitted by subdivision 6. For
6.19purposes of this subdivision, "anything of value" includes agreements or understandings
6.20to refer patients by and between a health care provider, another health care provider, a
6.21lawyer, or any other third party.
6.22(b) An affiliate of a health care provider shall not advertise by use of the public media,
6.23such as telephone directories, professional directories, advertisements in newspapers and
6.24other periodicals, radio or television advertisements, Web sites, billboards, or similar
6.25media, as part of a scheme to refer persons injured by use of an automobile to a third party
6.26intending that such persons shall subsequently be referred to the health care provider.
6.27 Sec. 4. Minnesota Statutes 2010, section 65B.54, is amended by adding a subdivision
6.28to read:
6.29 Subd. 9. Inducements. No health care provider shall offer, pay, advertise, give, or
6.30provide any gift, prize, bonus, fee, or anything of value whatsoever, directly or indirectly,
6.31that is not a service, item, or good deemed a professional treatment under the standards of
6.32practice for the applicable health care provider, to any person who has suffered an injury
6.33arising out of the maintenance or use of an automobile, for the purpose of inducing or
6.34influencing that person to receive treatment or to purchase any good or item from the
7.1health care provider or anyone associated with the health care provider. Charges for
7.2any services provided by a health care provider in violation of this subdivision are not
7.3compensable and not enforceable as a matter of law.
7.4 Sec. 5. Minnesota Statutes 2010, section 65B.54, is amended by adding a subdivision
7.5to read:
7.6 Subd. 10. Dividing fees. It is unlawful for a health care provider to:
7.7(1) divide fees received for payment of medical expense benefits under section
7.865B.44, subdivision 2, with;
7.9(2) promise to pay a part of another health care provider's fee to; or
7.10(3) pay a commission to,
7.11any health care provider or other person who calls the health care provider in consultation
7.12or who sends patients to the health care provider for treatment. Nothing in this subdivision
7.13prevents licensed chiropractors from forming a bona fide partnership for the practice of
7.14chiropractic, nor to the actual employment by a licensed chiropractor of another licensed
7.15chiropractor. Charges for any services provided by a health care provider in violation of
7.16this subdivision are not compensable and not enforceable as a matter of law.
7.17 Sec. 6. Minnesota Statutes 2010, section 609.612, subdivision 1, is amended to read:
7.18 Subdivision 1. Definitions. (a) As used in this section, the following terms have
7.19the meanings given.
7.20(b) "Public media" means telephone directories, professional directories, newspapers
7.21and other periodicals, radio and television, billboards, and mailed or electronically
7.22transmitted written communications that do not involve in-person contact with a specific
7.23prospective patient or client.
7.24(c) "Runner," "capper," or "steerer" means a person whofor a pecuniary
7.25gain procures patients or clients or solicits prospective patients through telephonic
7.26communication, written communication, or in-person contact at the direction of, or in
7.27cooperation with, a health care providerwhen the person knows or has reason to know
7.28that the provider's purpose is to fraudulently perform or obtain services or benefits under
7.29or relating to a contract of motor vehicle insurance. The term "runner," "capper," or
7.30"steerer" does not include aperson licensed health care provider who directly procures
7.31clients through public media such as newspaper, radio, or television advertisements only
7.32using its own legal name.
7.33 Sec. 7. TITLE.
8.1This act may be cited as the "Reduce Auto Medical Fraud Act."
1.3coverages, medical benefits, arbitration, and marketing practices; reducing
1.4automobile medical fraud; amending Minnesota Statutes 2010, sections 65B.44,
1.5subdivisions 1, 2; 65B.525, by adding subdivisions; 65B.54, subdivisions 4, 6,
1.6by adding subdivisions; 609.612, subdivision 1.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.11 Section 1. Minnesota Statutes 2010, section 65B.44, subdivision 1, is amended to read:
1.12 Subdivision 1. Inclusions. (a) Basic economic loss benefits shall provide
1.13reimbursement for all loss suffered through injury arising out of the maintenance or use
1.14of a motor vehicle, subject to any applicable deductibles, exclusions, disqualifications,
1.15and other conditions, and shall provide a minimum of $40,000 for loss arising out of the
1.16injury of any one person, consisting of:
1.17(1) $20,000 for medical expense loss arising out of injury to any one person; and
1.18(2) a total of $20,000 for income loss, replacement services loss, funeral expense
1.19loss, survivor's economic loss, and survivor's replacement services loss arising out of the
1.20injury to any one person.
1.21(b) Notwithstanding any other law to the contrary, a person entitled to basic
1.22economic loss benefits under this chapter is entitled to the full medical expense benefits set
1.23forth in subdivision 2, and may not receive medical expense benefits that are in any way
1.24less than those provided for in subdivision 2, or that involve any preestablished limitations
1.25on the benefits. Medical expenses must be reasonable and must be for necessary medical
2.1care as provided in subdivision 2. This paragraph shall not be deemed to alter the
2.2obligations of an insured or the rights of a reparation obligor as set forth in section
2.3This paragraph does not apply to medical expense loss that is subject to paragraph (d).
2.4(c) No reparation obligor or health plan company as defined in section
2.5subdivision 4
2.6providing, managed care services to no-fault claimants. For the purposes of this section,
2.7"managed care services" is defined as any program of medical services that uses health care
2.8providers managed, owned, employed by, or under contract with a health plan company.
2.9(d) Medical expense loss for diagnosis and treatment of a soft tissue injury is
2.10covered only if provided in compliance with the codes, treatment standards, and fee
2.11schedules provided in Minnesota Rules, chapter 5221. For purposes of this section, "soft
2.12tissue injury" means an injury to the soft tissues, as opposed to the skeletal tissues or
2.13soft organs. The term soft tissue injury specifically includes, without limitation, any
2.14injury with treatment covered by the procedure codes set forth in Minnesota Rules,
2.15part 5221.4060, other than such treatment delivered by a health care provider defined
2.16in Minnesota Rules, part 5221.0100, subpart 11a, or by a medical facility described in
2.17section 176.136, subdivision 1b, paragraphs (a) and (b).
2.18 Sec. 2. Minnesota Statutes 2010, section 65B.44, subdivision 2, is amended to read:
2.19 Subd. 2. Medical expense benefits. (a) Medical expense benefits shall reimburse
2.20all
2.21of loss for medically necessary:
2.22(1) medical, surgical, x-ray, optical, dental, chiropractic, and rehabilitative services,
2.23including prosthetic devices;
2.24(2) prescription drugs;
2.25(3) ambulance and all other transportation expenses incurred in traveling to receive
2.26other covered medical expense benefits;
2.27(4) sign interpreting and language translation services, other than such services
2.28provided by a family member of the patient, related to the receipt of medical, surgical,
2.29x-ray, optical, dental, chiropractic, hospital, extended care, nursing, and rehabilitative
2.30services; and
2.31(5) hospital, extended care, and nursing services.
2.32(b) Hospital room and board benefits may be limited, except for intensive care
2.33facilities, to the regular daily semiprivate room rates customarily charged by the institution
2.34in which the recipient of benefits is confined.
3.1(c) Such benefits shall also include necessary remedial treatment and services
3.2recognized and permitted under the laws of this state for an injured person who relies
3.3upon spiritual means through prayer alone for healing in accordance with that person's
3.4religious beliefs.
3.5(d) Medical expense loss includes medical expenses accrued prior to the death of a
3.6person notwithstanding the fact that benefits are paid or payable to the decedent's survivors.
3.7(e) Medical expense benefits for rehabilitative services shall be subject to the
3.8provisions of section
3.9 Sec. 3. Minnesota Statutes 2010, section 65B.525, is amended by adding a subdivision
3.10to read:
3.11 Subd. 3. Itemization; right to participate; full payment. All arbitration awards
3.12must be itemized. A partial award of medical benefits rendered by an arbitrator under this
3.13section and paid by an obligor will be considered full and final payment, and the injured
3.14party is not liable for, nor may the provider bill the injured party for, charges that are not
3.15part of the award, pursuant to section 65B.54, subdivision 8. A health care provider's
3.16participation as a party in an arbitration proceeding is limited to any issues related to the
3.17treatment or charges arising out of the claim that is the subject of the arbitration. This
3.18subdivision does not apply to charges for health care that are not related to the accident.
3.19 Sec. 4. Minnesota Statutes 2010, section 65B.525, is amended by adding a subdivision
3.20to read:
3.21 Subd. 4. Notice to providers. The itemization of medical services claims required
3.22pursuant to subdivision 3 must include the names and addresses of all health care providers
3.23whose charges are the subject of the claims. Within ten business days after receipt of the
3.24itemization, the administrator of arbitration under this section must send a copy of the
3.25petition and itemization to each health care provider whose charges are the subject of
3.26claims, together with a notice of the content of subdivision 3 and of the provider's right to
3.27participate as a party to the proceeding. The notice must explain to the provider what steps
3.28the provider must take in order to participate.
3.29 Sec. 5. Minnesota Statutes 2010, section 65B.54, is amended by adding a subdivision
3.30to read:
3.31 Subd. 7. Balance billing. (a) This subdivision applies to charges for medical
3.32expense benefits as defined in section 65B.44, subdivision 2, to the extent that a reparation
4.1obligor has rejected them on the basis that the health care was not medically necessary or
4.2on the basis that the charges exceed the usual and customary rate.
4.3(b) If a reparation obligor rejects, in whole or in part, a claim for health care
4.4provided to the claimant by a health care provider, for reasons specified in paragraph (a),
4.5the claimant is not obligated to pay the health care provider for the rejected charges.
4.6(c) The health care provider shall not bill the claimant for those charges or otherwise
4.7attempt to collect them from the claimant after they have been rejected by the insurer.
4.8(d) A health care provider whose charges are rejected, in whole or in part, under this
4.9section by a reparation obligor, is the party at interest and has standing to commence and
4.10pursue a claim for payment as a claimant against the reparation obligor in an arbitration
4.11proceeding under section 65B.525. In such a proceeding, the insured may be required
4.12to attend the arbitration proceeding by either the reparation obligor or the health care
4.13provider, subject to the conditions provided in section 65B.56, subdivision 2.
4.14(e) A health care provider shall not require an insured to waive any provision of this
4.15section, and any such attempted waiver is void and unenforceable.
4.19 Section 1. Minnesota Statutes 2010, section 65B.54, subdivision 4, is amended to read:
4.20 Subd. 4. Recovery of benefits paid due to intentional misrepresentation. A
4.21reparation obligor may bring an action to recover benefits which are not payable, but are
4.22in fact paid, because of an intentional misrepresentation of a material fact, upon which the
4.23reparation obligor relies, by the claimant or by a person providing products or services
4.24for which basic economic loss benefits are payable. The action may be brought only
4.25against the person providing the products or services, unless the claimant has intentionally
4.26misrepresented the facts or knew of the misrepresentation. A reparation obligor may
4.27recover damages under this subdivision by showing that the person or clinic providing the
4.28products or services engaged in a pattern and practice of intentional misrepresentation of
4.29material fact or fraud. A reparation obligor may offset amounts the reparation obligor is
4.30entitled to recover from the claimant under this subdivision against any basic economic
4.31loss benefits otherwise due the claimant.
4.32 Sec. 2. Minnesota Statutes 2010, section 65B.54, subdivision 6, is amended to read:
4.33 Subd. 6. Unethical practices. (a) A licensed health care provider shall not initiate
4.34direct contact, in person, over the telephone, or by other electronic means, with any person
5.1who has suffered an injury arising out of the maintenance or use of an automobile, for the
5.2purpose of influencing that person to receive treatment or to purchase any good or item
5.3from the licensee or anyone associated with the licensee. This subdivision prohibits such
5.4direct contact whether initiated by the licensee individually or on behalf of the licensee by
5.5any employee, independent contractor, agent, or third party, including, without limitation,
5.6a capper, runner, or steerer, as defined in section 609.612, subdivision 1, paragraph (c).
5.7This subdivision does not apply when an injured person voluntarily initiates contact with a
5.8licensee.
5.9 (b) This subdivision does not prohibit licensees
5.10from mailing advertising literature directly to such persons, so long as:
5.11 (1) the word "ADVERTISEMENT" appears clearly and conspicuously at the
5.12beginning of the written materials;
5.13 (2) the name of the individual licensee appears clearly and conspicuously within
5.14the written materials;
5.15 (3) the licensee is clearly identified as a licensed health care provider within the
5.16written materials; and
5.17 (4) the licensee does not initiate, individually or through any employee, independent
5.18contractor, agent, or third party, direct contact with the person after the written materials
5.19are sent.
5.20 (c) If undertaken directly by the health care provider only in its own legal name,
5.21this subdivision does not apply to:
5.22 (1) advertising that does not involve direct contact with specific prospective patients,
5.23in public media such as telephone directories, professional directories, ads in newspapers
5.24and other periodicals, radio or television ads, Web sites, billboards, or similar media;
5.25 (2) general marketing practices such as giving lectures; participating in special
5.26events, trade shows, or meetings of organizations; or making presentations relative to the
5.27benefits of chiropractic treatment;
5.28 (3) contact with friends or relatives, or statements made in a social setting;
5.29 (4) direct contact initiated by an ambulance service licensed under chapter 144E, a
5.30medical response unit registered under section
5.31of a hospital licensed under chapter 144, for the purpose of rendering emergency care; or
5.32 (5) a situation in which the injured person:
5.33 (i) had a prior professional relationship with the licensee;
5.34 (ii) has selected that licensee as the licensee from whom the injured person receives
5.35health care; or
5.36 (iii) has received treatment related to the accident from the licensee.
6.1 (d) A violation of this subdivision is grounds for the licensing authority to take
6.2disciplinary action against the licensee, its professional corporation, or any direct or
6.3indirect successor in interest of the corporation, including revocation in appropriate cases.
6.4In addition, charges for any services provided by a health care provider in violation of this
6.5subdivision are not compensable and not enforceable as a matter of law.
6.6 Sec. 3. Minnesota Statutes 2010, section 65B.54, is amended by adding a subdivision
6.7to read:
6.8 Subd. 8. Media-generated referrals. (a) No health care provider shall pay, offer, or
6.9provide any compensation, fee, or anything of value to an individual, firm, corporation,
6.10or other legal entity for referring a person identified by use of the public media, such as
6.11telephone directories, professional directories, advertisements in newspapers and other
6.12periodicals, radio or television advertisements, Web sites, billboards, or similar media,
6.13for purposes of influencing or referring that person to receive treatment or purchase any
6.14good or item from the health care provider or anyone associated with the health care
6.15provider for any injury arising out of the maintenance or use of an automobile. Charges
6.16for any services provided by a health care provider in violation of this subdivision are not
6.17compensable and not enforceable as a matter of law. The prohibition in this subdivision
6.18does not apply to any advertisement or other contact permitted by subdivision 6. For
6.19purposes of this subdivision, "anything of value" includes agreements or understandings
6.20to refer patients by and between a health care provider, another health care provider, a
6.21lawyer, or any other third party.
6.22(b) An affiliate of a health care provider shall not advertise by use of the public media,
6.23such as telephone directories, professional directories, advertisements in newspapers and
6.24other periodicals, radio or television advertisements, Web sites, billboards, or similar
6.25media, as part of a scheme to refer persons injured by use of an automobile to a third party
6.26intending that such persons shall subsequently be referred to the health care provider.
6.27 Sec. 4. Minnesota Statutes 2010, section 65B.54, is amended by adding a subdivision
6.28to read:
6.29 Subd. 9. Inducements. No health care provider shall offer, pay, advertise, give, or
6.30provide any gift, prize, bonus, fee, or anything of value whatsoever, directly or indirectly,
6.31that is not a service, item, or good deemed a professional treatment under the standards of
6.32practice for the applicable health care provider, to any person who has suffered an injury
6.33arising out of the maintenance or use of an automobile, for the purpose of inducing or
6.34influencing that person to receive treatment or to purchase any good or item from the
7.1health care provider or anyone associated with the health care provider. Charges for
7.2any services provided by a health care provider in violation of this subdivision are not
7.3compensable and not enforceable as a matter of law.
7.4 Sec. 5. Minnesota Statutes 2010, section 65B.54, is amended by adding a subdivision
7.5to read:
7.6 Subd. 10. Dividing fees. It is unlawful for a health care provider to:
7.7(1) divide fees received for payment of medical expense benefits under section
7.865B.44, subdivision 2, with;
7.9(2) promise to pay a part of another health care provider's fee to; or
7.10(3) pay a commission to,
7.11any health care provider or other person who calls the health care provider in consultation
7.12or who sends patients to the health care provider for treatment. Nothing in this subdivision
7.13prevents licensed chiropractors from forming a bona fide partnership for the practice of
7.14chiropractic, nor to the actual employment by a licensed chiropractor of another licensed
7.15chiropractor. Charges for any services provided by a health care provider in violation of
7.16this subdivision are not compensable and not enforceable as a matter of law.
7.17 Sec. 6. Minnesota Statutes 2010, section 609.612, subdivision 1, is amended to read:
7.18 Subdivision 1. Definitions. (a) As used in this section, the following terms have
7.19the meanings given.
7.20(b) "Public media" means telephone directories, professional directories, newspapers
7.21and other periodicals, radio and television, billboards, and mailed or electronically
7.22transmitted written communications that do not involve in-person contact with a specific
7.23prospective patient or client.
7.24(c) "Runner," "capper," or "steerer" means a person who
7.25
7.26communication, written communication, or in-person contact at the direction of, or in
7.27cooperation with, a health care provider
7.28
7.29
7.30"steerer" does not include a
7.31clients through public media such as newspaper, radio, or television advertisements only
7.32using its own legal name.
7.33 Sec. 7. TITLE.
8.1This act may be cited as the "Reduce Auto Medical Fraud Act."
