Bill Text: MN SF2971 | 2013-2014 | 88th Legislature | Introduced
Bill Title: Health plan contracting requirements modification
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2014-04-24 - Referred to Health, Human Services and Housing [SF2971 Detail]
Download: Minnesota-2013-SF2971-Introduced.html
1.2relating to health care; modifying health plan contracting requirements;
1.3amending Minnesota Statutes 2012, sections 62Q.733, subdivision 3; 62Q.735,
1.4subdivisions 2, 5.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2012, section 62Q.733, subdivision 3, is amended to read:
1.7 Subd. 3. Health care provider or provider. "Health care provider" or "provider"
1.8means a physician, chiropractor, dentist, podiatrist, clinic, or other provider as defined
1.9under section62J.03 , other than hospitals, ambulatory surgical centers, or freestanding
1.10emergency rooms.
1.11EFFECTIVE DATE.This section is effective July 1, 2014, and applies to contracts
1.12entered into, renewed, or amended on or after that date.
1.13 Sec. 2. Minnesota Statutes 2012, section 62Q.735, subdivision 2, is amended to read:
1.14 Subd. 2. Proposed amendments. (a) Any amendment or change in the terms of an
1.15existing contract between a health plan company and a provider must be disclosed to the
1.16provider at least45 165 days prior to the effective date of the proposed change, with the
1.17exception of amendments required of the health plan company by law or governmental
1.18regulatory authority, when notice shall be given to the provider when the requirement is
1.19made known to the health plan company.
1.20(b) Any amendment or change in the contract that alters the fee schedule or
1.21materially alters the written contractual policies and procedures governing the relationship
1.22between the provider and the health plan company must be disclosed to the provider not
1.23less than45 165 days before the effective date of the proposed change and the provider
2.1must have the opportunity to terminate the contract before the amendment or change
2.2is deemed to be in effect.
2.3(c) By mutual consent, evidenced in writing in amendments separate from the
2.4base contract and not contingent on participation, the parties may waive the disclosure
2.5requirements under paragraphs (a) and (b).
2.6(d) Notwithstanding paragraphs (a) and (b), the effective date of contract termination
2.7shall comply with the terms of the contract when a provider terminates a contract.
2.8EFFECTIVE DATE.This section is effective July 1, 2014, and applies to contracts
2.9entered into, renewed, or amended on or after that date.
2.10 Sec. 3. Minnesota Statutes 2012, section 62Q.735, subdivision 5, is amended to read:
2.11 Subd. 5. Fee schedules. (a) A health plan company shall provide,upon request no
2.12later than 165 days before the next contract year's effective date, any additional fees or
2.13fee schedules relevant to the particular provider's practice beyond those provided with
2.14the renewal documents for the next contract year to all participating providers, excluding
2.15claims paid under the pharmacy benefit. Health plan companies may fulfill the requirements
2.16of this section by making the full fee schedules available no later than 165 days before the
2.17next contract year's effective date through a secure Web portal for contracted providers.
2.18(b) A dental organization may satisfy paragraph (a) by complying with section
2.1962Q.735, subdivision 1
, paragraph (c).
2.20EFFECTIVE DATE.This section is effective July 1, 2014, and applies to contracts
2.21entered into, renewed, or amended on or after that date.
1.3amending Minnesota Statutes 2012, sections 62Q.733, subdivision 3; 62Q.735,
1.4subdivisions 2, 5.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2012, section 62Q.733, subdivision 3, is amended to read:
1.7 Subd. 3. Health care provider or provider. "Health care provider" or "provider"
1.8means a physician, chiropractor, dentist, podiatrist, clinic, or other provider as defined
1.9under section
1.10emergency rooms.
1.11EFFECTIVE DATE.This section is effective July 1, 2014, and applies to contracts
1.12entered into, renewed, or amended on or after that date.
1.13 Sec. 2. Minnesota Statutes 2012, section 62Q.735, subdivision 2, is amended to read:
1.14 Subd. 2. Proposed amendments. (a) Any amendment or change in the terms of an
1.15existing contract between a health plan company and a provider must be disclosed to the
1.16provider at least
1.17exception of amendments required of the health plan company by law or governmental
1.18regulatory authority, when notice shall be given to the provider when the requirement is
1.19made known to the health plan company.
1.20(b) Any amendment or change in the contract that alters the fee schedule or
1.21materially alters the written contractual policies and procedures governing the relationship
1.22between the provider and the health plan company must be disclosed to the provider not
1.23less than
2.1must have the opportunity to terminate the contract before the amendment or change
2.2is deemed to be in effect.
2.3(c) By mutual consent, evidenced in writing in amendments separate from the
2.4base contract and not contingent on participation, the parties may waive the disclosure
2.5requirements under paragraphs (a) and (b).
2.6(d) Notwithstanding paragraphs (a) and (b), the effective date of contract termination
2.7shall comply with the terms of the contract when a provider terminates a contract.
2.8EFFECTIVE DATE.This section is effective July 1, 2014, and applies to contracts
2.9entered into, renewed, or amended on or after that date.
2.10 Sec. 3. Minnesota Statutes 2012, section 62Q.735, subdivision 5, is amended to read:
2.11 Subd. 5. Fee schedules. (a) A health plan company shall provide,
2.12later than 165 days before the next contract year's effective date, any additional fees or
2.13fee schedules relevant to the particular provider's practice beyond those provided with
2.14the renewal documents for the next contract year to all participating providers, excluding
2.15claims paid under the pharmacy benefit. Health plan companies may fulfill the requirements
2.16of this section by making the full fee schedules available no later than 165 days before the
2.17next contract year's effective date through a secure Web portal for contracted providers.
2.18(b) A dental organization may satisfy paragraph (a) by complying with section
2.20EFFECTIVE DATE.This section is effective July 1, 2014, and applies to contracts
2.21entered into, renewed, or amended on or after that date.
