1.1 A bill for an act
1.2 relating to health; requiring medical and dental practices to make available to the
1.3 public their current standard charges; authorizing the commissioner of health to
1.4 establish a price comparison tool for items and services offered by medical and
1.5 dental practices; proposing coding for new law in Minnesota Statutes, chapter 62J.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. [62J.826] MEDICAL AND DENTAL PRACTICES; CURRENT
1.8STANDARD CHARGES; COMPARISON TOOL.
1.9 Subdivision 1.Definitions.(a) The definitions in this subdivision apply to this section.
1.10 (b) "CDT code" means a code value drawn from the Code on Dental Procedures and
1.11Nomenclature published by the American Dental Association.
1.12 (c) "Chargemaster" means the list of all individual items and services maintained by a
1.13medical or dental practice for which the medical or dental practice has established a charge.
1.14 (d) "Commissioner" means the commissioner of health.
1.15 (e) "CPT code" means a code value drawn from the Current Procedural Terminology
1.16published by the American Medical Association.
1.17 (f) "Dental service" means a service charged using a CDT code.
1.18 (g) "Diagnostic laboratory testing" means a service charged using a CPT code within
1.19the CPT code range of 80047 to 89398.
1.20 (h) "Diagnostic radiology service" means a service charged using a CPT code within
1.21the CPT code range of 70010 to 79999 and includes the provision of x-rays, computed
1Section 1.
REVISOR SGS H0293-1HF293 FIRST ENGROSSMENT
State of Minnesota
This Document can be made available
in alternative formats upon request
HOUSE OF REPRESENTATIVES
H. F. No. 293
NINETY-THIRD SESSION
Authored by Elkins, Bahner and Her01/11/2023
The bill was read for the first time and referred to the Committee on Health Finance and Policy
Adoption of Report: Re-referred to the Committee on Commerce Finance and Policy02/01/2023
Adoption of Report: Amended and re-referred to the Committee on Health Finance and Policy02/15/2023 2.1tomography scans, positron emission tomography scans, magnetic resonance imaging scans,
2.2and mammographies.
2.3 (i) "Hospital" means an acute care institution licensed under sections 144.50 to 144.58,
2.4but does not include a health care institution conducted for those who rely primarily upon
2.5treatment by prayer or spiritual means in accordance with the creed or tenets of any church
2.6or denomination.
2.7 (j) "Medical or dental practice" means a business that:
2.8 (1) earns revenue by providing medical care or dental services to the public;
2.9 (2) issues payment claims to health plan companies and other payers; and
2.10 (3) may be identified by its federal tax identification number.
2.11 (k) "Outpatient surgical center" means a health care facility other than a hospital offering
2.12elective outpatient surgery under a license issued under sections 144.50 to 144.58.
2.13 (l) "Standard charge" has the meaning given in Code of Federal Regulations, title 45,
2.14section 180.20.
2.15 Subd. 2.Requirement; current standard charges.The following medical or dental
2.16practices must make available to the public a list of their current standard charges, as reflected
2.17in the medical or dental practice's chargemaster, for all items and services provided by the
2.18medical or dental practice:
2.19 (1) hospitals;
2.20 (2) outpatient surgical centers; and
2.21 (3) any other medical or dental practice that has revenue of greater than $50,000,000
2.22per year and that derives the majority of its revenue by providing one or more of the following
2.23services:
2.24 (i) diagnostic radiology services;
2.25 (ii) diagnostic laboratory testing;
2.26 (iii) orthopedic surgical procedures, including joint arthroplasty procedures within the
2.27CPT code range of 26990 to 27899;
2.28 (iv) ophthalmologic surgical procedures, including cataract surgery coded using CPT
2.29code 66982 or 66984, or refractive correction surgery to improve visual acuity;
2Section 1.
REVISOR SGS H0293-1HF293 FIRST ENGROSSMENT 3.1 (v) anesthesia services commonly provided as an ancillary to services provided at a
3.2hospital, outpatient surgical center, or medical practice that provides orthopedic surgical
3.3procedures or ophthalmologic surgical procedures;
3.4 (vi) oncology services, including radiation oncology treatments within the CPT code
3.5range of 77261 to 77799 and drug infusions; or
3.6 (vii) dental services.
3.7 Subd. 3.Required file format and content.(a) A medical or dental practice that is
3.8subject to this section must make available to the public, and must report to the commissioner,
3.9current standard charges using the format and data elements specified in the currently
3.10effective version of the Hospital Price Transparency Sample Format (Tall) (CSV) and related
3.11data dictionary recommended for hospitals by the Centers for Medicare and Medicaid
3.12Services (CMS). If CMS modifies or replaces the specifications for this format, the form
3.13of this file must be modified or replaced to conform with the new CMS specifications by
3.14the date specified by CMS for compliance with its new specifications. All prices included
3.15in the file must be expressed as dollar amounts. The data must be in the form of a comma
3.16separated values file which can be directly imported, without further editing or remediation,
3.17into a relational database table which has been designed to receive these files. The medical
3.18or dental practice must make the file available to the public in a manner specified by the
3.19commissioner and must report the file to the commissioner in a manner and frequency
3.20specified by the commissioner.
3.21 (b) A medical or dental practice must test its file for compliance with paragraph (a)
3.22before making the file available to the public and reporting the file to the commissioner.
3.23 (c) A hospital must comply with this section no later than January 1, 2024. A medical
3.24or dental practice that meets the requirements in subdivision 2, clause (3), or an outpatient
3.25surgical center must comply with this section no later than January 1, 2025.
3.26 Subd. 4.Price comparison tool.The commissioner shall use the information reported
3.27to the commissioner under subdivision 3 to develop and make available to the public a tool
3.28for the public to use to compare charges for a specific item or service across medical and
3.29dental practices that offer that item or service. The commissioner may contract with a third
3.30party for the development and operation of this tool. The price comparison tool must be
3.31made available to the public by July 1, 2024.
3Section 1.
REVISOR SGS H0293-1HF293 FIRST ENGROSSMENT