Bill Text: MN SF718 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Prepaid health plans managed care vendors data classification requirement
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2011-03-10 - Referred to Health and Human Services [SF718 Detail]
Download: Minnesota-2011-SF718-Introduced.html
1.2relating to human services; specifying applicability of Data Practices Act to data
1.3provided to state by managed care vendors; amending Minnesota Statutes 2010,
1.4section 256B.69, subdivisions 9a, 9b.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2010, section 256B.69, subdivision 9a, is amended to
1.7read:
1.8 Subd. 9a. Administrative expense reporting. Within the limit of available
1.9appropriations, the commissioner shall work with the commissioner of health to identify
1.10and collect data on administrative spending for state health care programs reported to the
1.11commissioner of health by managed care plans under section62D.08 and county-based
1.12purchasing plans under section256B.692 , provided that such data are consistent
1.13with guidelines and standards for administrative spending that are developed by the
1.14commissioner of health, and reported to the legislature under Laws 2008, chapter 364,
1.15section 12. Data provided to the commissioner under this subdivision are nonpublic
1.16data as defined under section13.02 . For purposes of data referenced in this subdivision,
1.17a managed care or county-based purchasing plan is a government entity as defined in
1.18section 13.02, subdivision 7a.
1.19EFFECTIVE DATE.This section is effective July 1, 2011.
1.20 Sec. 2. Minnesota Statutes 2010, section 256B.69, subdivision 9b, is amended to read:
1.21 Subd. 9b. Reporting provider payment rates. (a) According to guidelines
1.22developed by the commissioner, in consultation with health care providers, managed care
1.23plans, and county-based purchasing plans, each managed care plan and county-based
2.1purchasing plan must annually provide to the commissioner information on reimbursement
2.2rates paid by the managed care plan under this section or the county-based purchasing
2.3plan under section256B.692 to providers and vendors for administrative services under
2.4contract with the plan.
2.5(b) Each managed care plan and county-based purchasing plan must annually
2.6provide to the commissioner, in the form and manner specified by the commissioner:
2.7(1) the amount of the payment made to the plan under this section that is paid to
2.8health care providers for patient care;
2.9(2) aggregate provider payment data, categorized by inpatient payments and
2.10outpatient payments, with the outpatient payments categorized by payments to primary
2.11care providers and nonprimary care providers;
2.12(3) the process by which increases or decreases in payments made to the plan
2.13under this section, that are based on actuarial analysis related to provider cost increases
2.14or decreases, or that are required by legislative action, are passed through to health care
2.15providers, categorized by payments to primary care providers and nonprimary care
2.16providers; and
2.17(4) specific information on the methodology used to establish provider
2.18reimbursement rates paid by the managed health care plan and county-based purchasing
2.19plan.
2.20Data provided to the commissioner under this subdivision must allow the
2.21commissioner to conduct the analyses required under paragraph (d).
2.22 (c) Data provided to the commissioner under this subdivision are nonpublic data as
2.23defined in section13.02 . For purposes of data referenced in this subdivision, a managed
2.24care or county-based purchasing plan is a government entity as defined in section 13.02,
2.25subdivision 7a.
2.26(d) The commissioner shall analyze data provided under this subdivision to assist the
2.27legislature in providing oversight and accountability related to expenditures under this
2.28section. The analysis must include information on payments to physicians, physician
2.29extenders, and hospitals, and may include other provider types as determined by the
2.30commissioner. The commissioner shall also array aggregate provider reimbursement rates
2.31by health plan, by primary care, and by nonprimary care categories. The commissioner
2.32shall report the analysis to the legislature annually, beginning December 15, 2010,
2.33and each December 15 thereafter. The commissioner shall also make this information
2.34available on the agency's Web site to managed care and county-based purchasing plans,
2.35health care providers, and the public.
2.36EFFECTIVE DATE.This section is effective July 1, 2011.
1.3provided to state by managed care vendors; amending Minnesota Statutes 2010,
1.4section 256B.69, subdivisions 9a, 9b.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2010, section 256B.69, subdivision 9a, is amended to
1.7read:
1.8 Subd. 9a. Administrative expense reporting. Within the limit of available
1.9appropriations, the commissioner shall work with the commissioner of health to identify
1.10and collect data on administrative spending for state health care programs reported to the
1.11commissioner of health by managed care plans under section
1.12purchasing plans under section
1.13with guidelines and standards for administrative spending that are developed by the
1.14commissioner of health, and reported to the legislature under Laws 2008, chapter 364,
1.15section 12. Data provided to the commissioner under this subdivision are nonpublic
1.16data as defined under section
1.17a managed care or county-based purchasing plan is a government entity as defined in
1.18section 13.02, subdivision 7a.
1.19EFFECTIVE DATE.This section is effective July 1, 2011.
1.20 Sec. 2. Minnesota Statutes 2010, section 256B.69, subdivision 9b, is amended to read:
1.21 Subd. 9b. Reporting provider payment rates. (a) According to guidelines
1.22developed by the commissioner, in consultation with health care providers, managed care
1.23plans, and county-based purchasing plans, each managed care plan and county-based
2.1purchasing plan must annually provide to the commissioner information on reimbursement
2.2rates paid by the managed care plan under this section or the county-based purchasing
2.3plan under section
2.4contract with the plan.
2.5(b) Each managed care plan and county-based purchasing plan must annually
2.6provide to the commissioner, in the form and manner specified by the commissioner:
2.7(1) the amount of the payment made to the plan under this section that is paid to
2.8health care providers for patient care;
2.9(2) aggregate provider payment data, categorized by inpatient payments and
2.10outpatient payments, with the outpatient payments categorized by payments to primary
2.11care providers and nonprimary care providers;
2.12(3) the process by which increases or decreases in payments made to the plan
2.13under this section, that are based on actuarial analysis related to provider cost increases
2.14or decreases, or that are required by legislative action, are passed through to health care
2.15providers, categorized by payments to primary care providers and nonprimary care
2.16providers; and
2.17(4) specific information on the methodology used to establish provider
2.18reimbursement rates paid by the managed health care plan and county-based purchasing
2.19plan.
2.20Data provided to the commissioner under this subdivision must allow the
2.21commissioner to conduct the analyses required under paragraph (d).
2.22 (c) Data provided to the commissioner under this subdivision are nonpublic data as
2.23defined in section
2.24care or county-based purchasing plan is a government entity as defined in section 13.02,
2.25subdivision 7a.
2.26(d) The commissioner shall analyze data provided under this subdivision to assist the
2.27legislature in providing oversight and accountability related to expenditures under this
2.28section. The analysis must include information on payments to physicians, physician
2.29extenders, and hospitals, and may include other provider types as determined by the
2.30commissioner. The commissioner shall also array aggregate provider reimbursement rates
2.31by health plan, by primary care, and by nonprimary care categories. The commissioner
2.32shall report the analysis to the legislature annually, beginning December 15, 2010,
2.33and each December 15 thereafter. The commissioner shall also make this information
2.34available on the agency's Web site to managed care and county-based purchasing plans,
2.35health care providers, and the public.
2.36EFFECTIVE DATE.This section is effective July 1, 2011.
