reglab/statecodes huggingface dataset:
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62I — Joint Underwriting Association › Section 62I.19 — Annual Statements.

62I.19 ANNUAL STATEMENTS.
Annually, the association shall file with the commissioner a report of its transactions, financial conditions, and operations during the preceding year. The report shall be in a format approved by the commissioner. The commissioner may at any time require the association to furnish additional information to assist in evaluating the scope, operation, and experience of the association.
History:
1986 c 455 s 38; 2017 c 34 s 12
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62I — Joint Underwriting Association › Section 62I.21 — Activation Of Joint Underwriting Association.

62I.21 ACTIVATION OF JOINT UNDERWRITING ASSOCIATION.
Upon submission of an application for placement of general liability insurance coverage under section 62I.13 in a class of business for which the Joint Underwriting Association is not then activated, where the applicant has been refused coverage within the meaning of section 62I.13, subdivision 2, the commissioner may by notice in the State Register activate the Joint Underwriting Association on Minnesota risks for the class of business. The association is activated for a period of 180 days from publication of the notice. At the same time the notice is published, the commissioner shall prepare a written petition requesting that a hearing be held to determine whether activation of the Joint Underwriting Association is necessary beyond the 180-day period. The hearing must be held in accordance with section 62I.22. The commissioner by order shall deactivate the Joint Underwriting Association or a class of business at any time the commissioner finds that the Joint Underwriting Association or the class of business is not necessary.
History:
1986 c 455 s 40; 1994 c 425 s 17; 2003 c 21 s 11; 2017 c 34 s 13
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62I — Joint Underwriting Association › Section 62I.22 — Hearing.

62I.22 HEARING.
Subdivision 1.
Administrative law judge.
The commissioner shall forward a copy of the petition to activate the Joint Underwriting Association with respect to a class of business to the chief administrative law judge. The chief administrative law judge shall, within three business days of receipt of the copy of the petition, set a hearing date, assign an administrative law judge to hear the matter, and notify the commissioner of the hearing date and the administrative law judge assigned to hear the matter. The hearing date must be no less than 60 days nor more than 90 days from the date of receipt of the petition by the chief administrative law judge.
Subd. 2.
Notice.
The commissioner of commerce shall publish notice of the hearing in the State Register at least 30 days before the hearing date. The notice should be that used for rulemaking under chapter 14. Approval by the administrative law judge of the notice prior to publication is not required. The notice must contain a statement that anyone wishing to oppose activation beyond 180 days for any particular class, must file a petition to intervene with the administrative law judge at least ten days before the hearing date. If no notice to intervene is filed for a class, then the class is activated beyond the 180-day period without further action.
Subd. 3.
Contested case; report.
The hearing and all matters after the hearing are a contested case under chapter 14. Within 45 days from the commencement of the hearing and within 15 days of the completion of the hearing the administrative law judge shall submit a report to the commissioner of commerce. The parties, or the administrative law judge, if the parties cannot agree, shall adjust all time requirements under the contested case procedure to conform with the 45-day requirement.
Subd. 4.
Decision.
The commissioner shall make a decision within ten days of the receipt of the administrative law judge's report.
Subd. 5.
Waiver or modification.
If all parties to the proceeding agree, any of the requirements of this section may be waived or modified.
Subd. 6.
Case presentation.
The Department of Commerce, upon request by small businesses, shall assist small businesses in any specific class requesting continuation of coverage beyond the 180-day period, in coordinating the class and presenting the case in the contested hearing.
For purposes of this subdivision, "small business" means a business entity, including farming and other agricultural operations and its affiliates, that (1) is independently owned and operated; (2) is not dominant in its field; and (3) employs fewer than 50 full-time employees or has gross annual sales of less than $4,000,000.
History:
1986 c 455 s 41; 1987 c 337 s 84,85; 1996 c 305 art 1 s 22; 2003 c 21 s 12
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.01 — Findings.

62J.01 FINDINGS.
The legislature finds that substantial numbers of Minnesotans have no health care coverage and that most of these residents are wage earners or their dependents. One-third of these individuals are children.
The legislature further finds that when these individuals enter the health care system they have often forgone preventive care and are in need of more expensive treatment that often exceeds their financial resources. Much of the cost for these uncompensated services to the uninsured are already in the health care system in the form of increased insurance and provider rates and property and income taxes.
The legislature further finds that these costs, spread among the already insured, represent a woefully inefficient method for providing basic preventive and acute care for the uninsured and represent an added cost to employers now providing health insurance to their employees.
The legislature further finds that it is necessary to ensure basic and affordable health care to all Minnesotans while addressing the economic pressures on the health care system as a whole in Minnesota.
History:
1989 c 327 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.015 — Purpose.

62J.015 PURPOSE.
The legislature finds that the staggering growth in health care costs is having a devastating effect on the health and cost of living of Minnesota residents. The legislature further finds that the number of uninsured and underinsured residents is growing each year and that the cost of health care coverage for our insured residents is increasing annually at a rate that far exceeds the state's overall rate of inflation.
The legislature further finds that it must enact immediate and intensive cost containment measures to limit the growth of health care expenditures, reform insurance practices, and finance a plan that offers access to affordable health care for our permanent residents by capturing dollars now lost to inefficiencies in Minnesota's health care system.
The legislature further finds that controlling costs is essential to the maintenance of the many factors contributing to the quality of life in Minnesota: our environment, education system, safe communities, affordable housing, provision of food, economic vitality, purchasing power, and stable population.
It is, therefore, the intent of the legislature to lay a new foundation for the delivery and financing of health care in Minnesota and to call this new foundation the MinnesotaCare Act.
History:
1992 c 549 art 1 s 1; 1993 c 247 art 4 s 11; 1994 c 625 art 8 s 72
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.016 — Goals Of Restructuring.

62J.016 GOALS OF RESTRUCTURING.
The state seeks to bring about changes in the health care delivery and financing system that will assure quality, affordable, and accessible health care for all Minnesotans. This goal will be accomplished by restructuring the delivery system, the financial incentives, and the regulatory environment in a way that will make health care providers and health plan companies more accountable to consumers, group purchasers, and communities for their costs and quality, their effectiveness in meeting the health care needs of all of their patients and enrollees, and their contributions to improving the health of the greater community.
History:
1994 c 625 art 1 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.017 — Implementation Timetable.

62J.017 IMPLEMENTATION TIMETABLE.
The state seeks to complete the restructuring of the health care delivery and financing system. Beginning July 1, 1994, measures will be taken to increase the public accountability of existing health plan companies, to promote the development of small, community-based integrated service networks, and to reduce administrative costs by standardizing third-party billing forms and procedures and utilization review requirements.
History:
1994 c 625 art 1 s 2; 1995 c 234 art 3 s 1; 1997 c 225 art 2 s 9
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.0416 — Identify Strategies For Reduction Of Administrative Spending And Low-value Care.

62J.0416 IDENTIFY STRATEGIES FOR REDUCTION OF ADMINISTRATIVE SPENDING AND LOW-VALUE CARE.
(a) The commissioner of health shall develop recommendations for strategies to reduce the volume and growth of administrative spending by health care organizations and group purchasers, and the magnitude of low-value care delivered to Minnesota residents. The commissioner shall:
(1) review the availability of data and identify gaps in the data infrastructure to estimate aggregated and disaggregated administrative spending and low-value care;
(2) based on available data, estimate the volume and change over time of administrative spending and low-value care in Minnesota;
(3) conduct an environmental scan and key informant interviews with experts in health care finance, health economics, health care management or administration, and the administration of health insurance benefits to determine drivers of spending growth for spending on administrative services or the provision of low-value care; and
(4) convene a clinical learning community and an employer task force to review the evidence from clauses (1) to (3) and develop a set of actionable strategies to address administrative spending volume and growth and the magnitude of the volume of low-value care.
(b) By March 31, 2025, the commissioner shall deliver the recommendations to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services finance and policy.
History:
2023 c 70 art 16 s 3
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.0417 — Payment Mechanisms In Rural Health Care.

62J.0417 PAYMENT MECHANISMS IN RURAL HEALTH CARE.
(a) The commissioner shall develop a plan to assess readiness of rural communities and rural health care providers to adopt value-based, global budgeting or alternative payment systems and recommend steps needed to implement them. The commissioner may use the development of case studies and modeling of alternate payment systems to demonstrate value-based payment systems that ensure a baseline level of essential community or regional health services and address population health needs.
(b) The commissioner shall develop recommendations for pilot projects with the aim of ensuring financial viability of rural health care entities in the context of spending growth targets. The commissioner shall include the plan, recommendations, and related findings in the reports required under section 62J.312, subdivision 3.
History:
2023 c 70 art 16 s 4
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.052 — Provider Cost Disclosure.

62J.052 PROVIDER COST DISCLOSURE.
Subdivision 1.
[Repealed, 2007 c 147 art 15 s 22]
Subd. 2.
Pharmacies.
(a) Each pharmacy, as defined in section 151.01, subdivision 2, shall provide the following information to a patient upon request:
(1) the pharmacy's own usual and customary price for a prescription drug;
(2) a record, including all transactions on record with the pharmacy both past and present, of all co-payments and other cost-sharing paid to the pharmacy by the patient for up to two years; and
(3) the total amount of all co-payments and other cost-sharing paid to the pharmacy by the patient over the previous two years.
(b) The information required under paragraph (a) must be readily available at no cost to the patient.
History:
2005 c 147 art 11 s 2; 2006 c 255 s 21
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.06 — Immunity From Liability.

62J.06 IMMUNITY FROM LIABILITY.
No member of the Health Technology Advisory Committee shall be held civilly or criminally liable for an act or omission by that person if the act or omission was in good faith and within the scope of the member's responsibilities under this chapter.
History:
1993 c 247 art 1 s 7; 1995 c 234 art 5 s 3; 1997 c 225 art 2 s 10; 1999 c 245 art 2 s 3; 1Sp2003 c 14 art 7 s 88
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.156 — Closed Committee Hearings.

62J.156 CLOSED COMMITTEE HEARINGS.
Notwithstanding chapter 13D, the Health Technology Advisory Committee may meet in closed session to discuss a specific technology or procedure that involves data received that have been classified as nonpublic data, where disclosure of the data would cause harm to the competitive or economic position of the source of the data.
History:
1993 c 345 art 4 s 5; 1Sp2003 c 14 art 7 s 88
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.212 — Public Health Goals.

62J.212 PUBLIC HEALTH GOALS.
The commissioner shall establish specific public health goals including, but not limited to, increased delivery of prenatal care, improved birth outcomes, and expanded childhood immunizations. The commissioner shall consider the community public health goals and the input of the statewide advisory committee on community health in establishing the statewide goals.
History:
1993 c 345 art 5 s 9; 1995 c 234 art 5 s 4
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.22 — Participation Of Federal Programs.

62J.22 PARTICIPATION OF FEDERAL PROGRAMS.
The commissioner of health shall seek the full participation of federal health care programs under this chapter, including Medicare, medical assistance, veterans administration programs, and other federal programs. The commissioner of human services shall submit waiver requests and take other action necessary to obtain federal approval to allow participation of the medical assistance program. If federal approval is not given for one or more federal programs, data on the amount of health care spending that is collected under section 62J.04 shall be adjusted so that state and regional spending limits take into account the failure of the federal program to participate.
History:
1992 c 549 art 1 s 11; 1997 c 225 art 2 s 22
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.25 — Mandatory Medicare Assignment.

62J.25 MANDATORY MEDICARE ASSIGNMENT.
(a) Effective January 1, 1993, a health care provider shall not charge to or collect from a Medicare beneficiary who is a Minnesota resident any amount in excess of 115 percent of the Medicare-approved amount for any Medicare-covered service provided.
(b) Effective January 1, 1994, a health care provider shall not charge to or collect from a Medicare beneficiary who is a Minnesota resident any amount in excess of 110 percent of the Medicare-approved amount for any Medicare-covered service provided.
(c) Effective January 1, 1995, a health care provider shall not charge to or collect from a Medicare beneficiary who is a Minnesota resident any amount in excess of 105 percent of the Medicare-approved amount for any Medicare-covered service provided.
(d) Effective January 1, 1996, a health care provider shall not charge to or collect from a Medicare beneficiary who is a Minnesota resident any amount in excess of the Medicare-approved amount for any Medicare-covered service provided.
(e) This section does not apply to ambulance services as defined in section 144E.001, subdivision 3, or medical supplies and equipment. A vendor of medical supplies and equipment that does not accept assignment under the federal Medicare program with respect to a purchase or lease of Medicare-covered supplies or equipment shall notify any purchaser who is a Medicare beneficiary and Minnesota resident, prior to the purchase, or at any time upon the request of the purchaser, that the vendor charges an amount in excess of the Medicare-approved amount.
History:
1992 c 549 art 1 s 13; 1997 c 199 s 14; 1997 c 225 art 2 s 23; 1998 c 339 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.2930 — Information Clearinghouse.

62J.2930 INFORMATION CLEARINGHOUSE.
Subdivision 1.
Establishment.
The commissioner of health shall establish an information clearinghouse within the Department of Health to facilitate the ability of consumers, employers, providers, health plan companies, and others to obtain information on health reform activities in Minnesota. The commissioner shall make available through the clearinghouse updates on federal and state health reform activities, including information developed or collected by the Department of Health on cost containment or other research initiatives, the development of voluntary purchasing pools, action plans submitted by health plan companies, reports or recommendations of the Health Technology Advisory Committee and other entities on technology assessments, and reports or recommendations from other formal committees applicable to health reform activities. The clearinghouse shall also refer requestors to sources of further information or assistance. The clearinghouse is subject to chapter 13.
Subd. 2.
Information on health plan companies.
The information clearinghouse shall provide information on all health plan companies operating in a specific geographic area to consumers and purchasers who request it.
Subd. 3.
Consumer information.
(a) The information clearinghouse or another entity designated by the commissioner shall provide consumer information to health plan company enrollees to:
(1) assist enrollees in understanding their rights;
(2) explain and assist in the use of all available complaint systems, including internal complaint systems within health carriers, community integrated service networks, and the Departments of Health and Commerce;
(3) provide information on coverage options in each region of the state;
(4) provide information on the availability of purchasing pools and enrollee subsidies; and
(5) help consumers use the health care system to obtain coverage.
(b) The information clearinghouse or other entity designated by the commissioner for the purposes of this subdivision shall not:
(1) provide legal services to consumers;
(2) represent a consumer or enrollee; or
(3) serve as an advocate for consumers in disputes with health plan companies.
(c) Nothing in this subdivision shall interfere with the ombudsman program established under section 256B.6903 or other existing ombudsman programs.
Subd. 4.
Coordination.
To the extent possible, the commissioner shall coordinate the activities of the clearinghouse with the activities of the Minnesota Health Data Institute.
History:
1995 c 234 art 5 s 5; 1997 c 225 art 2 s 62; 1999 c 245 art 2 s 7; 2009 c 173 art 3 s 1; 2022 c 98 art 2 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.311 — Analysis And Use Of Data.

62J.311 ANALYSIS AND USE OF DATA.
Subdivision 1.
Data analysis.
The commissioner shall analyze the data collected to:
(1) assist the state in developing and refining its health policy in the areas of access, utilization, quality, and cost;
(2) assist the state in promoting efficiency and effectiveness in the financing and delivery of health services;
(3) monitor and track accessibility, utilization, quality, and cost of health care services within the state;
(4) evaluate the impact of health care reform activities;
(5) assist the state in its public health activities; and
(6) evaluate and determine the most appropriate methods for ongoing data collection.
Subd. 2.
Criteria for data and research initiatives.
(a) Data and research initiatives by the commissioner, pursuant to sections 62J.301 to 62J.42, must:
(1) serve the needs of the general public, public sector health care programs, employers and other purchasers of health care, health care providers, including providers serving large numbers of people with low-income, and health plan companies as applicable;
(2) be based on scientifically sound and statistically valid methods;
(3) be statewide in scope, to the extent feasible, in order to benefit health care purchasers and providers in all parts of Minnesota and to ensure broad and representative health care data for research comparisons and applications;
(4) emphasize data that is useful, relevant, and nonredundant of existing data. The initiatives may duplicate existing private data collection activities, if necessary to ensure that the data collected will be in the public domain;
(5) be structured to minimize the administrative burden on health plan companies, health care providers, and the health care delivery system, and minimize any privacy impact on individuals; and
(6) promote continuous improvement in the efficiency and effectiveness of health care delivery.
(b) Data and research initiatives related to public sector health care programs must:
(1) assist the state's current health care financing and delivery programs to deliver and purchase health care in a manner that promotes improvements in health care efficiency and effectiveness;
(2) assist the state in its public health activities, including the analysis of disease prevalence and trends and the development of public health responses;
(3) assist the state in developing and refining its overall health policy, including policy related to health care costs, quality, and access; and
(4) provide data that allows the evaluation of state health care financing and delivery programs.
History:
1995 c 234 art 5 s 7
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.40 — Cost Containment Data From State Agencies And Other Governmental Units.

62J.40 COST CONTAINMENT DATA FROM STATE AGENCIES AND OTHER GOVERNMENTAL UNITS.
(a) All state departments or agencies that administer one or more health care programs shall provide to the commissioner of health any additional data on the health care programs they administer that is requested by the commissioner of health, including data in unaggregated form, for purposes of developing estimates of spending, setting spending limits, and monitoring actual spending. The data must be provided at the times and in the form specified by the commissioner of health.
(b) For purposes of estimating total health care spending as provided in section 62J.301, subdivision 4, clause (c), all local governmental units shall provide expenditure data to the commissioner. The commissioner shall consult with representatives of the affected local government units in establishing definitions, reporting formats, and reporting time frames. As much as possible, the data shall be collected in a manner that ensures that the data collected is consistent with data collected from the private sector and minimizes the reporting burden to local government.
History:
1993 c 345 art 3 s 11; 1995 c 234 art 5 s 12
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.42 — Quality, Utilization, And Outcome Data.

62J.42 QUALITY, UTILIZATION, AND OUTCOME DATA.
The commissioner shall also require group purchasers and health care providers to maintain and periodically report information on quality of care, utilization, and outcomes. The information must be provided at the times and in the form specified by the commissioner.
History:
1993 c 345 art 3 s 13
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.431 — Evidence-based Health Care Guidelines.

62J.431 EVIDENCE-BASED HEALTH CARE GUIDELINES.
Evidence-based guidelines must meet the following criteria:
(1) the scope and application are clear;
(2) authorship is stated and any conflicts of interest disclosed;
(3) authors represent all pertinent clinical fields or other means of input have been used;
(4) the development process is explicitly stated;
(5) the guideline is grounded in evidence;
(6) the evidence is cited and grated;
(7) the document itself is clear and practical;
(8) the document is flexible in use, with exceptions noted or provided for with general statements;
(9) measures are included for use in systems improvement; and
(10) the guideline has scheduled reviews and updating.
History:
2007 c 147 art 15 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.46 — Monitoring And Reports.

62J.46 MONITORING AND REPORTS.
Subdivision 1.
Long-term care costs.
The commissioner shall use existing state data resources to monitor trends in public and private spending on long-term care costs and spending in Minnesota. The commissioner shall recommend to the legislature any additional data collection activities needed to monitor these trends. State agencies collecting information on long-term care spending and costs shall coordinate with the Interagency Long-Term Care Planning Committee and the commissioner to facilitate the monitoring of long-term care expenditures in the state.
Subd. 2.
Cost shifting.
The commissioner shall monitor the extent to which reimbursement rates for government health care programs lead to the shifting of costs to private payers. By January 1, 1995, the commissioner shall report any evidence of cost shifting to the legislature and make recommendations on adjustments to the cost containment plan that should be made due to cost shifting.
History:
1993 c 345 art 3 s 16; 2001 c 161 s 13
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.48 — Criteria For Ambulance Services Reimbursement.

62J.48 CRITERIA FOR AMBULANCE SERVICES REIMBURSEMENT.
All ambulance services licensed under section 144E.10 are eligible for reimbursement under health plan companies. The commissioner shall require health plan companies to adopt the following reimbursement policies.
(1) All scheduled or prearranged air and ground ambulance transports must be reimbursed if requested by an attending physician, nurse, or physician assistant, and, if the person is an enrollee in a health plan company, if approved by a designated representative of a health plan company who is immediately available on a 24-hour basis. The designated representative must be a registered nurse or a physician assistant with at least three years of critical care or trauma experience, or a licensed physician.
(2) Reimbursement must be provided for all emergency ambulance calls in which a patient is transported or medical treatment rendered.
(3) Special transportation services must not be billed or reimbursed if the patient needs medical attention immediately before transportation.
History:
1994 c 625 art 4 s 1; 1995 c 234 art 8 s 11; 1997 c 199 s 14; 2022 c 58 s 9
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.49 — Ambulance Services Financial Data.

62J.49 AMBULANCE SERVICES FINANCIAL DATA.
Subdivision 1.
Establishment.
The Emergency Medical Services Regulatory Board established under chapter 144 shall establish a financial data collection system for all ambulance services licensed in this state. To establish the financial database, the Emergency Medical Services Regulatory Board may contract with an entity that has experience in ambulance service financial data collection.
Subd. 2.
Data classification.
All financial data collected by the Emergency Medical Services Regulatory Board shall be classified as nonpublic data under section 13.02, subdivision 9.
History:
1997 c 203 art 2 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.50 — Citation And Purpose.

62J.50 CITATION AND PURPOSE.
Subdivision 1.
Citation.
Sections 62J.50 to 62J.61 may be cited as the "Minnesota Health Care Administrative Simplification Act."
Subd. 2.
Purpose.
The legislature finds that significant savings throughout the health care industry can be accomplished by implementing a set of administrative standards and simplified procedures and by setting forward a plan toward the use of electronic methods of data interchange. The legislature finds that initial steps have been taken at the national level by the federal Health Care Financing Administration, now known as the Centers for Medicare and Medicaid Services, in its implementation of nationally accepted electronic transaction sets for its Medicare program. The legislature further recognizes the work done by the Workgroup for Electronic Data Interchange and the American National Standards Institute and its accredited standards committee X12, at the national level, and the Minnesota Administrative Uniformity Committee, a statewide, voluntary, public-private group representing payers, hospitals, state programs, physicians, and other health care providers in their work toward administrative simplification in the health care industry.
History:
1994 c 625 art 9 s 1; 2014 c 192 art 1 s 1,2
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62J — Health Care Cost Containment › Section 62J.53 — Acceptance Of Uniform Billing Forms By Group Purchasers.

62J.53 ACCEPTANCE OF UNIFORM BILLING FORMS BY GROUP PURCHASERS.
On and after January 1, 1996, all group purchasers in Minnesota shall accept the uniform billing forms prescribed under section 62J.52 as the only nonelectronic billing forms used for payment processing purposes.
History:
1994 c 625 art 9 s 4; 2014 c 192 art 1 s 5
2023 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
2023 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
2023 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
2023 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
2023 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 1, paragraph (b), 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; 2023 c 25 s 7
2023 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
2023 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
2023 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
2023 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
2023 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