Chapter 62J — Minnesota Health Care Administrative Simplification Act

62J.01 Findings States the legislature's findings about the need to contain health care costs in Minnesota. 62J.015 Purpose States the purpose of Minnesota's health care cost containment law, called the MinnesotaCare Act. 62J.016 Goals of Restructuring Sets the goals for restructuring Minnesota's health care system to reduce costs and improve access. 62J.017 Implementation Timetable Sets the timeline for implementing health care cost containment measures in Minnesota. 62J.02 This section has been repealed and is no longer in effect. 62J.03 Definitions Defines key terms used throughout the health care cost containment chapter. 62J.04 Monitoring the Rate of Growth of Health Care Spending Requires monitoring the rate of growth of health care spending in Minnesota. 62J.041 Interim Health Plan Company Cost Containment Goals Sets cost containment goals that health plan companies must meet as an interim measure. 62J.0416 Identify Strategies for Reduction of Administrative Spending and Low-value Care Requires identifying strategies to reduce administrative spending and low-value care in health care. 62J.0417 Payment Mechanisms in Rural Health Care Addresses how payment systems should support rural health care delivery in Minnesota. 62J.042 This section has been repealed and is no longer in effect. 62J.045 This section has been repealed and is no longer in effect. 62J.05 This section has been repealed and is no longer in effect. 62J.051 This section has been repealed and is no longer in effect. 62J.052 Provider Cost Disclosure Requires health care providers to disclose their costs to patients. 62J.06 Immunity From Liability Protects people from lawsuits when they provide information for health care cost containment. 62J.07 Addresses enforcement and penalties for violations of health care cost containment rules. 62J.09 This section has been repealed and is no longer in effect. 62J.15 Addresses health care cost containment commission provisions. 62J.152 Addresses health care cost containment committee procedures. 62J.156 Closed Committee Hearings Allows certain health care cost committee hearings to be closed to the public. 62J.17 Expenditure Reporting Requires health care providers and insurers to report their spending to the state. 62J.19 This section has been repealed and is no longer in effect. 62J.21 This section has been repealed and is no longer in effect. 62J.212 Public Health Goals Sets public health goals as part of Minnesota's health care reform efforts. 62J.22 Participation of Federal Programs Seeks to include federal health programs like Medicare and Medicaid in state cost containment. 62J.23 Provider Conflicts of Interest Prohibits health care providers from referring patients to facilities they have a financial interest in. 62J.25 Mandatory Medicare Assignment Requires all health care providers to accept Medicare's approved payment amount as full payment. 62J.26 Evaluation of Proposed Health Coverage Mandates Requires an evaluation before the legislature can mandate new health insurance coverage benefits. 62J.29 This section has been repealed and is no longer in effect. 62J.2911 This section has been repealed and is no longer in effect. 62J.2912 This section has been repealed and is no longer in effect. 62J.2913 This section has been repealed and is no longer in effect. 62J.2914 This section has been repealed and is no longer in effect. 62J.2915 This section has been repealed and is no longer in effect. 62J.2916 This section has been repealed and is no longer in effect. 62J.2917 This section has been repealed and is no longer in effect. 62J.2918 This section has been repealed and is no longer in effect. 62J.2919 This section has been repealed and is no longer in effect. 62J.2920 This section has been repealed and is no longer in effect. 62J.2921 This section has been repealed and is no longer in effect. 62J.2930 Information Clearinghouse Creates a health information clearinghouse to share data about health care costs and quality. 62J.30 This section has been repealed and is no longer in effect. 62J.301 Research and Data Initiatives Authorizes research and data collection to support health care cost containment goals. 62J.31 This section has been repealed and is no longer in effect. 62J.311 Analysis and Use of Data Directs how health care cost data should be analyzed and used by the state. 62J.312 Center for Health Care Affordability Creates the Center for Health Care Affordability to study and improve health care costs. 62J.32 This section has been repealed and is no longer in effect. 62J.321 Data Collection and Processing Procedures Sets rules for how health care cost data is collected and processed by the state. 62J.322 This section has been repealed and is no longer in effect. 62J.33 This section has been repealed and is no longer in effect. 62J.34 This section has been repealed and is no longer in effect. 62J.35 This section has been repealed and is no longer in effect. 62J.37 This section has been repealed and is no longer in effect. 62J.38 Cost Containment Data From Group Purchasers Requires group purchasers of health care to report cost containment data to the state. 62J.381 This section has been repealed and is no longer in effect. 62J.40 Cost Containment Data From State Agencies and Other Governmental Units Requires state agencies and local governments to report health care cost data. 62J.41 Addresses enforcement of health care data collection requirements. 62J.42 Quality, Utilization, and Outcome Data Requires collection of data on health care quality, how services are used, and patient outcomes. 62J.43 This section has been repealed and is no longer in effect. 62J.431 Evidence-based Health Care Guidelines Requires the use of evidence-based guidelines for health care treatment decisions. 62J.44 This section has been repealed and is no longer in effect. 62J.45 This section has been repealed and is no longer in effect. 62J.451 This section has been repealed and is no longer in effect. 62J.452 This section has been repealed and is no longer in effect. 62J.46 Monitoring and Reports Requires monitoring of health care cost containment efforts and regular reports to the legislature. 62J.461 340b Covered Entity Report Requires covered entities using the 340B drug discount program to report certain information. 62J.47 This section has been repealed and is no longer in effect. 62J.48 Criteria for Ambulance Services Reimbursement Sets criteria for how ambulance services are reimbursed by health plans in Minnesota. 62J.49 Ambulance Services Financial Data Requires ambulance services to report their financial data to the state. 62J.495 Electronic Health Record Technology Sets standards for electronic health record technology used by Minnesota health care providers. 62J.496 Electronic Health Record System Revolving Account and Loan Program Creates a loan program to help health care providers adopt electronic health record systems. 62J.497 Electronic Prescription Drug Program Requires health care providers to use electronic prescribing for medications. 62J.498 Health Information Exchange Sets rules for how health information is exchanged electronically between providers and organizations. 62J.4981 Certificate of Authority to Provide Health Information Exchange Services Requires organizations that exchange health information electronically to get a certificate of authority. 62J.4982 Enforcement Authority; Compliance Gives the commissioner authority to enforce rules about electronic health information exchange. 62J.50 Citation and Purpose States the purpose of Minnesota's uniform health care billing rules. 62J.51 Definitions Defines terms used in the uniform health care billing and administrative simplification sections. 62J.52 Establishment of Uniform Billing Forms Requires health care providers to use uniform billing forms for all claims. 62J.53 Acceptance of Uniform Billing Forms by Group Purchasers Requires health plans to accept the standard uniform billing forms from providers. 62J.535 Uniform Billing Requirements for Claim Transactions Sets uniform billing requirements for health care claim transactions. 62J.536 Uniform Electronic Transactions and Implementation Guide Standards Establishes standards for electronic health care transactions and data exchange. 62J.54 Identification and Implementation of Unique Identifiers Requires unique identification numbers for health care providers, patients, and payers. 62J.55 Privacy of Unique Identifiers Protects the privacy of unique identification numbers used in health care. 62J.56 Implementation of Electronic Data Interchange Standards Sets rules for implementing electronic data interchange standards in health care. 62J.57 Minnesota Center for Health Care Electronic Data Interchange Creates the Minnesota Center for Health Care Electronic Data Interchange. 62J.58 This section has been repealed and is no longer in effect. 62J.581 Standards for Minnesota Uniform Health Care Reimbursement Documents Sets standards for uniform health care reimbursement documents in Minnesota. 62J.59 This section has been repealed and is no longer in effect. 62J.60 Minnesota Uniform Health Care Identification Card Requires a standard health care identification card for all Minnesota residents. 62J.61 Rulemaking; Implementation Authorizes the commissioner to adopt rules to implement health care simplification standards. 62J.62 Electronic Billing Assistance Provides assistance to help health care providers switch to electronic billing systems. 62J.63 Center for Health Care Purchasing Improvement Creates the Center for Health Care Purchasing Improvement to help buyers get better deals. 62J.65 This section has been repealed and is no longer in effect. 62J.66 This section has been repealed and is no longer in effect. 62J.68 This section has been repealed and is no longer in effect. 62J.685 This section has been repealed and is no longer in effect. 62J.69 This section has been repealed and is no longer in effect. 62J.691 Purpose States the purpose of Minnesota's medical education funding provisions. 62J.692 Medical Education Governs how medical education is funded through Minnesota's health care system. 62J.693 This section has been repealed and is no longer in effect. 62J.694 This section has been repealed and is no longer in effect. 62J.695 Citation Provides the citation for the health care provider contract provisions. 62J.70 Definitions Defines terms used in the health care provider contract regulation sections. 62J.701 Governmental Programs Addresses how government health programs interact with provider contract rules. 62J.71 Prohibited Provider Contracts Prohibits certain unfair terms in contracts between health care providers and health plans. 62J.72 Disclosure of Health Care Provider Information Requires disclosure of health care provider information to patients and the public. 62J.73 Prohibition on Exclusive Arrangements Prohibits exclusive arrangements that limit patient access to health care providers. 62J.74 Enforcement Sets enforcement rules and penalties for violations of provider contract regulations. 62J.75 This section has been repealed and is no longer in effect. 62J.76 Nonpreemption States that federal law does not preempt these state health care regulations. 62J.77 This section has been repealed and is no longer in effect. 62J.78 This section has been repealed and is no longer in effect. 62J.79 This section has been repealed and is no longer in effect. 62J.80 Retaliation Prohibits retaliation against anyone who reports health care billing or pricing violations. 62J.805 Definitions Defines terms used in the medical debt and billing protections sections. 62J.806 Policy for Collection of Medical Debt Sets rules for how health care providers can collect medical debt from patients. 62J.807 Denial of Health Treatment or Services Due to Outstanding Medical Debt Prohibits denying health care to patients because they have unpaid medical bills. 62J.808 Billing Errors; Health Treatment or Services Sets rules for handling billing errors in health care services. 62J.81 Disclosure of Payments for Health Care Services Requires health care providers to disclose their payments for services to patients. 62J.811 Provider Balance Billing Requirements Sets rules about balance billing, where providers charge patients above what insurance pays. 62J.812 Primary Care Price Transparency Requires primary care providers to share their prices with patients before treatment. 62J.82 Hospital Information Reporting Disclosure Requires hospitals to report pricing and other information to the public. 62J.823 Hospital Pricing Transparency Requires hospitals to publicly share their pricing information. 62J.824 Facility Fee Disclosure Requires health care facilities to disclose any facility fees charged to patients. 62J.826 Medical and Dental Practices; Current Standard Charges Requires medical and dental practices to post their standard charges for services. 62J.83 Reduced Payment Amounts Permitted Allows providers to accept reduced payments from patients who cannot afford full charges. 62J.84 Prescription Drug Price Transparency Requires drug manufacturers to report detailed pricing information to the state. 62J.841 Definitions Defines terms used in the prescription drug price increase sections. 62J.842 Excessive Price Increases Prohibited Prohibits drug manufacturers from making excessive price increases on prescription drugs. 62J.843 Registered Agent and Office Within the State Requires drug manufacturers to have a registered agent and office in Minnesota. 62J.844 Enforcement Sets enforcement rules and penalties for excessive prescription drug price increases. 62J.845 Prohibition on Withdrawal of Generic or Off-patent Drugs for Sale Prohibits drug companies from pulling generic or off-patent drugs from the market to avoid price rules. 62J.846 Severability States that if any part of the drug price provisions is struck down, the rest still applies. 62J.85 Citation Provides the citation for the Prescription Drug Affordability Act. 62J.86 Definitions Defines terms used in the Prescription Drug Affordability Act. 62J.87 Prescription Drug Affordability Board Creates the Prescription Drug Affordability Board to review and control drug prices. 62J.88 Prescription Drug Affordability Advisory Council Creates an advisory council to help the Prescription Drug Affordability Board do its work. 62J.89 Conflicts of Interest Sets conflict of interest rules for the Prescription Drug Affordability Board members. 62J.90 Prescription Drug Price Information; Decision to Conduct Cost Review Describes how the board gets drug price information and decides which drugs to review. 62J.91 Prescription Drug Product Reviews Sets the process for how the board reviews the cost of prescription drug products. 62J.92 Determinations; Compliance; Remedies Sets the rules for board determinations, compliance, and remedies for drug price violations. 62J.93 Reports Requires the Prescription Drug Affordability Board to submit regular reports. 62J.94 Erisa Plans and Medicare Drug Plans Clarifies how the drug affordability rules apply to ERISA plans and Medicare drug plans. 62J.95 Severability States that if any part of the drug affordability law is struck down, the rest still applies. 62J.96 Access to 340b Drugs Ensures access to drugs purchased through the federal 340B discount program.