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.
23-00712 as introduced12/02/22 REVISOR SGS/NS
SENATE
STATE OF MINNESOTA
S.F. No. 1675NINETY-THIRD SESSION
(SENATE AUTHORS: WIKLUND)
OFFICIAL STATUSD-PGDATE
Introduction and first reading02/16/2023
Referred to Health and Human Services 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 Subd. 2.Requirement; current standard charges.The following medical or dental
2.14practices must make available to the public a list of their current standard charges, as reflected
2.15in the medical or dental practice's chargemaster, for all items and services provided by the
2.16medical or dental practice:
2.17 (1) hospitals;
2.18 (2) outpatient surgical centers; and
2.19 (3) any other medical or dental practice that has revenue of greater than $50,000,000
2.20per year and that derives the majority of its revenue by providing one or more of the following
2.21services:
2.22 (i) diagnostic radiology services;
2.23 (ii) diagnostic laboratory testing;
2.24 (iii) orthopedic surgical procedures, including joint arthroplasty procedures within the
2.25CPT code range of 26990 to 27899;
2.26 (iv) ophthalmologic surgical procedures, including cataract surgery coded using CPT
2.27code 66982 or 66984, or refractive correction surgery to improve visual acuity;
2.28 (v) anesthesia services commonly provided as an ancillary to services provided at a
2.29hospital, outpatient surgical center, or medical practice that provides orthopedic surgical
2.30procedures or ophthalmologic surgical procedures;
2Section 1.
23-00712 as introduced12/02/22 REVISOR SGS/NS 3.1 (vi) oncology services, including radiation oncology treatments within the CPT code
3.2range of 77261 to 77799 and drug infusions; or
3.3 (vii) dental services.
3.4 Subd. 3.Required file format and content.(a) No later than January 1, 2024, a medical
3.5or dental practice that is subject to this section must make available to the public, and must
3.6report to the commissioner, current standard charges using the format and data elements
3.7specified in the currently effective version of the Hospital Price Transparency Sample
3.8Format (Tall) (CSV) and related data dictionary recommended for hospitals by the Centers
3.9for Medicare and Medicaid Services. The data must be in the form of a comma separated
3.10values file which can be directly imported, without further editing or remediation, into a
3.11relational database table which has been designed to receive these files. The medical or
3.12dental practice must make the file available to the public in a manner specified by the
3.13commissioner and must report the file to the commissioner in a manner and frequency
3.14specified by the commissioner.
3.15 (b) A medical or dental practice must test its file for compliance with paragraph (a)
3.16before making the file available to the public and reporting the file to the commissioner.
3.17 Subd. 4.Price comparison tool.The commissioner shall use the information reported
3.18to the commissioner under subdivision 3 to develop and make available to the public a tool
3.19for the public to use to compare charges for a specific item or service across medical and
3.20dental practices that offer that item or service. The commissioner may contract with a third
3.21party for the development and operation of this tool. The price comparison tool must be
3.22made available to the public by July 1, 2024.
3Section 1.
23-00712 as introduced12/02/22 REVISOR SGS/NS