reglab/housing_qa huggingface dataset:
MN Stat § 62J.535 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.535 — Uniform Billing Requirements For Claim Transactions.

62J.535 UNIFORM BILLING REQUIREMENTS FOR CLAIM TRANSACTIONS. Subdivision 1.  [Repealed, 2002 c 307 art 2 s 9; 2002 c 330 s 35] Subd. 1a. Additional information associated with a claim. Nothing in this section or other state law prohibits group purchasers not defined as covered entities under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the regulations promulgated under those sections, from requiring, as authorized by Minnesota law or rule, additional information associated with a claim submitted by a provider. Subd. 1b. Paper claim transactions. All group purchasers that accept paper claim transactions must accept, and health care providers submitting paper claim transactions must submit, these transactions with use of the applicable medical and nonmedical data code sets specified in the federal electronic claim transaction standards adopted under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the regulations promulgated under those sections. The paper claim transaction must also be conducted using the uniform billing forms as specified in section 62J.52 and the identifiers specified in section 62J.54, on and after the compliance date required by law. Notwithstanding the above, nothing in this section or other state law prohibits group purchasers not defined as covered entities under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the regulations promulgated under those sections, from requiring, as authorized by Minnesota law or rule, additional information associated with a claim submitted by a provider. Subd. 2.  [Repealed by amendment, 2014 c 192 art 1 s 6] History:  1999 c 245 art 2 s 8; 2000 c 483 s 16; 2000 c 488 art 11 s 1; 2002 c 307 art 2 s 4-6,8; 2002 c 330 s 20-22,33; 2014 c 192 art 1 s 6
MN Stat § 62J.55 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.55 — Privacy Of Unique Identifiers.

62J.55 PRIVACY OF UNIQUE IDENTIFIERS. (a) When the unique identifiers specified in section 62J.54 are used for data collection purposes, the identifiers must be encrypted, as required in section 62J.321, subdivision 1. Encryption must follow encryption standards set by the National Bureau of Standards and approved by the American National Standards Institute as ANSIX3. 92-1982/R 1987 to protect the confidentiality of the data. Social Security numbers must not be maintained in unencrypted form in the database, and the data must never be released in a form that would allow for the identification of individuals. The encryption algorithm and hardware used must not use clipper chip technology. (b) Providers and group purchasers shall treat medical records, including the Social Security number if it is used as a unique patient identifier, in accordance with sections 144.291 to 144.298. The Social Security number may be disclosed by providers and group purchasers to the commissioner as necessary to allow performance of those duties set forth in section 144.05. History:  1994 c 625 art 9 s 6; 1995 c 234 art 5 s 18; 2007 c 147 art 10 s 15
MN Stat § 62J.56 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.56 — Implementation Of Electronic Data Interchange Standards.

62J.56 IMPLEMENTATION OF ELECTRONIC DATA INTERCHANGE STANDARDS. Subdivision 1. General provisions. (a) The legislature finds that there is a need to advance the use of electronic methods of data interchange among all health care participants in the state in order to achieve significant administrative cost savings. The legislature also finds that in order to advance the use of health care electronic data interchange in a cost-effective manner, the state needs to implement electronic data interchange standards that are nationally accepted, widely recognized, and available for immediate use. The legislature intends to set forth a plan for a systematic phase in of uniform health care electronic data interchange standards in all segments of the health care industry. (b) The commissioner of health, with the advice of the Minnesota Administrative Uniformity Committee, shall administer the implementation of and monitor compliance with, electronic data interchange standards of health care participants, according to the plan provided in this section. Subd. 2. Identification of core transaction sets. The commissioner, with the advice of the Minnesota Administrative Uniformity Committee, and in coordination with federal efforts, may approve the use of new ASC X12 standards, or new versions of existing standards, as they become available, or other nationally recognized standards, where appropriate ASC X12 standards are not available for use. These alternative standards may be used during a transition period while ASC X12 standards are developed. Subd. 3. Implementation guides. (a) The commissioner, with the advice of the Minnesota Administrative Uniformity Committee, and the Minnesota Center for Health Care Electronic Data Interchange shall review and recommend the use of guides to implement the core transaction sets. Implementation guides must contain the background and technical information required to allow health care participants to implement the transaction set in the most cost-effective way. (b) The commissioner shall promote the development of implementation guides among health care participants for those business transaction types for which implementation guides are not available, to allow providers and group purchasers to implement electronic data interchange. In promoting the development of these implementation guides, the commissioner shall review the work done by the American Hospital Association through the national Uniform Billing Committee and its state representative organization; the American Medical Association through the National Uniform Claim Committee; the American Dental Association; the National Council of Prescription Drug Programs; and the Workgroup for Electronic Data Interchange. History:  1994 c 625 art 9 s 7; 1996 c 440 art 1 s 29; 2014 c 192 art 1 s 11-13
MN Stat § 62J.57 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.57 — Minnesota Center For Health Care Electronic Data Interchange.

62J.57 MINNESOTA CENTER FOR HEALTH CARE ELECTRONIC DATA INTERCHANGE. (a) It is the intention of the legislature to support, to the extent of funds appropriated for that purpose, the creation of the Minnesota Center for Health Care Electronic Data Interchange as a broad-based effort of public and private organizations representing group purchasers, health care providers, and government programs to advance the use of health care electronic data interchange in the state. The center shall attempt to obtain private sector funding to supplement legislative appropriations, and shall become self-supporting by the end of the second year. (b) The Minnesota Center for Health Care Electronic Data Interchange shall facilitate the statewide implementation of electronic data interchange standards in the health care industry by: (1) coordinating and ensuring the availability of quality electronic data interchange education and training in the state; (2) developing an extensive, cohesive health care electronic data interchange education curriculum; (3) developing a communications and marketing plan to publicize electronic data interchange education activities, and the products and services available to support the implementation of electronic data interchange in the state; (4) administering a resource center that will serve as a clearinghouse for information relative to electronic data interchange, including the development and maintenance of a health care constituents database, health care directory and resource library, and a health care communications network through the use of electronic bulletin board services and other network communications applications; and (5) providing technical assistance in the development of implementation guides, and in other issues including legislative, legal, and confidentiality requirements. History:   1994 c 625 art 9 s 8
MN Stat § 62J.581 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.581 — Standards For Minnesota Uniform Health Care Reimbursement Documents.

62J.581 STANDARDS FOR MINNESOTA UNIFORM HEALTH CARE REIMBURSEMENT DOCUMENTS. Subdivision 1. Minnesota uniform remittance advice. All group purchasers shall provide a uniform claim payment/advice transaction to health care providers when a claim is adjudicated. The uniform claim payment/advice transaction shall comply with section 62J.536, subdivision 1b, and rules adopted under section 62J.536, subdivision 2. Subd. 2. Minnesota uniform explanation of benefits document. (a) All group purchasers shall provide a uniform explanation of benefits document to health care patients when an explanation of benefits document is provided as otherwise required or permitted by law. The uniform explanation of benefits document shall comply with the standards prescribed in this section. (b) Notwithstanding paragraph (a), this section does not apply to group purchasers not included as covered entities under United States Code, title 42, sections 1320d to 1320d-8, as amended from time to time, and the regulations promulgated under those sections. Subd. 3. Scope. For purposes of sections 62J.50 to 62J.61, the uniform claim payment/advice transaction and uniform explanation of benefits document format specified in subdivision 4 shall apply to all health care services delivered by a health care provider or health care provider organization in Minnesota, regardless of the location of the payer. Health care services not paid on an individual claims basis, such as capitated payments, are not included in this section. A health plan company is excluded from the requirements in subdivisions 1 and 2 if they comply with section 62A.01, subdivisions 2 and 3. Subd. 4. Specifications. The uniform explanation of benefits document shall be provided by use of a paper document conforming to the specifications in this section. The commissioner, after consulting with the Administrative Uniformity Committee, shall specify the data elements and definitions for the uniform explanation of benefits document. The commissioner and the Administrative Uniformity Committee must consult with the Minnesota Dental Association and Delta Dental Plan of Minnesota before requiring under this section the use of a paper document for the uniform explanation of benefits document or the uniform claim payment/advice transaction for dental care services. Subd. 5. Effective date. The requirements in subdivisions 1 and 2 are effective June 30, 2007. The requirements in subdivisions 1 and 2 apply regardless of when the health care service was provided to the patient. History:  2000 c 460 s 7; 2002 c 307 art 2 s 7; 2002 c 330 s 23; 2005 c 106 s 8; 2014 c 192 art 1 s 14-16
MN Stat § 62J.62 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.62 — Electronic Billing Assistance.

62J.62 ELECTRONIC BILLING ASSISTANCE. The commissioner of human services shall, out of existing resources, encourage and assist providers to adopt and use electronic billing for state programs, including but not limited to the provision of training. History:   2006 c 267 art 1 s 1
MN Stat § 62J.63 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.63 — Center For Health Care Purchasing Improvement.

62J.63 CENTER FOR HEALTH CARE PURCHASING IMPROVEMENT. Subdivision 1. Support for state health care purchasing and performance measurement. The commissioner of health shall support the state in its efforts to be a more prudent and efficient purchaser of quality health care services, aid the state in developing and using more common strategies and approaches for health care performance measurement and health care purchasing, promote greater transparency of health care costs and quality and greater accountability for health care results and improvement, and identify barriers to more efficient, effective, quality health care and options for overcoming the barriers. Subd. 2.  Duties; scope. The commissioner of health may: (1) require reports or surveys to evaluate the performance of current health care purchasing or administrative simplification strategies; (2) calculate fiscal impacts, including net savings and return on investment, of health care purchasing strategies and initiatives; (3) support the Administrative Uniformity Committee under sections 62J.50 and 62J.536 and other relevant groups or activities to advance agreement on health care administrative process streamlining; (4) contact and participate with other relevant health care task forces, study activities, and similar efforts with regard to health care performance measurement and performance-based purchasing; and (5) assist in seeking external funding through appropriate grants or other funding opportunities and may administer grants and externally funded projects. Subd. 3.  MS 2020 [Repealed, 1Sp2021 c 7 art 3 s 47] History:  2006 c 282 art 14 s 10; 2007 c 148 art 2 s 83; 2009 c 157 art 1 s 17; 1Sp2021 c 7 art 3 s 6,7
MN Stat § 62J.691 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.691 — Purpose.

62J.691 PURPOSE. The legislature finds that medical education and research are important to the health and economic well being of Minnesotans. The legislature further finds that, as a result of competition in the health care marketplace, these teaching and research institutions are facing increased difficulty funding medical education and research. The purpose of section 62J.692 is to help offset lost patient care revenue for those teaching institutions affected by increased competition in the health care marketplace and to help ensure the continued excellence of health care research in Minnesota. History:  1999 c 245 art 2 s 9; 2014 c 275 art 1 s 6
MN Stat § 62J.695 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.695 — Citation.

62J.695 CITATION. Sections 62J.695 to 62J.76 may be cited as the "Patient Protection Act." History:   1997 c 237 s 1
MN Stat § 62J.70 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.70 — Definitions.

62J.70 DEFINITIONS. Subdivision 1. Applicability. For purposes of sections 62J.70 to 62J.76, the terms defined in this section have the meanings given them. Subd. 2. Health care provider or provider. "Health care provider" or "provider" means: (1) a physician, nurse, or other provider as defined under section 62J.03; (2) a hospital as defined under section 144.696, subdivision 3; (3) an individual or entity that provides health care services under the medical assistance, MinnesotaCare, or state employee group insurance program; and (4) an association, partnership, corporation, limited liability corporation, or other organization of persons or entities described in clause (1) or (2) organized for the purposes of providing, arranging, or administering health care services or treatment. This section does not apply to trade associations, membership associations of health care professionals, or other organizations that do not directly provide, arrange, or administer health care services or treatment. Subd. 3. Health plan company. "Health plan company" means health plan company as defined in section 62Q.01, subdivision 4. Subd. 4. Enrollee. "Enrollee" means an individual covered by a health plan company or health insurance or health coverage plan and includes an insured policyholder, subscriber, contract holder, member, covered person, or certificate holder. History:  1997 c 237 s 2; 2016 c 158 art 2 s 18
MN Stat § 62J.701 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.701 — Governmental Programs.

62J.701 GOVERNMENTAL PROGRAMS. (a) Beginning January 1, 1999, the provisions in paragraphs (b) to (e) apply. (b) For purposes of sections 62J.695 to 62J.80, the requirements and other provisions that apply to health plan companies also apply to governmental programs. (c) For purposes of this section, "governmental programs" means the medical assistance program, the MinnesotaCare program, the state employee group insurance program, the public employees insurance program under section 43A.316, and coverage provided by political subdivisions under section 471.617. (d) Notwithstanding paragraph (b), section 62J.72 does not apply to the fee-for-service programs under medical assistance and MinnesotaCare. (e) If a state commissioner or local unit of government contracts with a health plan company or a third-party administrator, the contract may assign any obligations under paragraph (b) to the health plan company or third-party administrator. Nothing in this paragraph shall be construed to remove or diminish any enforcement responsibilities of the commissioners of health or commerce provided in sections 62J.695 to 62J.80. History:  1998 c 407 art 2 s 9; 2016 c 158 art 2 s 19
MN Stat § 62J.73 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.73 — Prohibition On Exclusive Arrangements.

62J.73 PROHIBITION ON EXCLUSIVE ARRANGEMENTS. Subdivision 1. Prohibition on exclusive relationships. No provider, group of providers, or health plan company shall restrict a person's right to provide health services or procedures to another provider, group of providers, or health plan company, unless the person is an employee. Subd. 2. Prohibition on restrictive contract terms. No provider, group of providers, or person providing goods or health services to a provider shall enter into a contract or subcontract with a health plan company or group of providers on terms that require the provider, group of providers, or person not to contract with another health plan company, unless the provider or person is an employee. Subd. 3. Prohibition regarding essential facilities and services. (a) No health plan company, provider, or group of providers may withhold from its competitors health care services, which are essential for competition between health care providers within the meaning of the essential facilities doctrine as interpreted by the federal courts. (b) This subdivision should be construed as an instruction to state court in interpreting federal law. Subd. 4. Violations. Any provider or other individual who believes provisions of this section may have been violated may file a complaint with the attorney general's office regarding a possible violation of this section. History:   1997 c 237 s 5
MN Stat § 62J.74 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.74 — Enforcement.

62J.74 ENFORCEMENT. Subdivision 1. Authority. The commissioners of health and commerce shall each periodically review contracts and arrangements among health care providing entities and health plan companies they regulate to determine compliance with sections 62J.70 to 62J.73. Any person may submit a contract or arrangement to the relevant commissioner for review if the person believes sections 62J.70 to 62J.73 have been violated. Any provision of a contract or arrangement found by the relevant commissioner to violate this section is null and void, and the relevant commissioner may assess civil penalties against the health plan company in an amount not to exceed $2,500 for each day the contract or arrangement is in effect, and may use the enforcement procedures otherwise available to the commissioner. All due process rights afforded under chapter 14 apply to this section. Subd. 2. Assistance to licensing boards. A health-related licensing board as defined under section 214.01, subdivision 2, shall submit a contract or arrangement to the relevant commissioner for review if the board believes sections 62J.70 to 62J.73 have been violated. If the commissioner determines that any provision of a contract or arrangement violates those sections, the board may take disciplinary action against any person who is licensed or regulated by the board who entered into the contract arrangement. History:   1997 c 237 s 6
MN Stat § 62J.76 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.76 — Nonpreemption.

62J.76 NONPREEMPTION. Nothing in the Patient Protection Act preempts or replaces requirements related to patient protections that are more protective of patient rights than the requirements established by the Patient Protection Act. History:   1997 c 237 s 8
MN Stat § 62J.80 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.80 — Retaliation.

62J.80 RETALIATION. A health plan company or health care provider shall not retaliate or take adverse action against an enrollee or patient who, in good faith, makes a complaint against a health plan company or health care provider. If retaliation is suspected, the executive director may report it to the appropriate regulatory authority. History:   1998 c 407 art 2 s 18
MN Stat § 62J.812 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62J — Health Care Cost Containment|Section 62J.812 — Primary Care Price Transparency.

62J.812 PRIMARY CARE PRICE TRANSPARENCY. (a) Each provider shall maintain a list of the services over $25 that correspond with the provider's 25 most frequently billed current procedural terminology (CPT) codes, including the provider's ten most commonly billed evaluation and management codes, and of the ten most frequently billed CPT codes for preventive services. If the provider is associated with a health care system, the health care system may develop the list of services required under this paragraph for the providers within the health care system. (b) For each service listed in paragraph (a), the provider shall disclose the provider's charge, the average reimbursement rate received for the service from the provider's health plan payers in the commercial insurance market, and, if applicable, the Medicare allowable payment rate and the medical assistance fee-for-service payment rate. For purposes of this paragraph, "provider's charge" means the dollar amount the provider charges to a patient who has received the service and who is not covered by private or public health care coverage. (c) The list described in this subdivision must be updated annually and must be posted in the provider's reception area of the clinic or office and made available on the provider's website, if the provider maintains a website. (d) For purposes of this section, "provider" means a primary care provider or clinic that specializes in family medicine, general internal medicine, gynecology, or general pediatrics. (e) No contract between a health plan company and a provider shall prohibit a provider from disclosing the pricing information required under this section. History:  2018 c 168 s 2; 2020 c 83 art 1 s 10