| 1 | 1 | | 1.1 A bill for an act |
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| 2 | 2 | | 1.2 relating to health; prohibiting facility fees for nonemergency services provided at |
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| 3 | 3 | | 1.3 provider-based clinics; prohibiting facility fees for certain health care services; |
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| 4 | 4 | | 1.4 requiring a report; proposing coding for new law in Minnesota Statutes, chapter |
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| 5 | 5 | | 1.5 62J; repealing Minnesota Statutes 2024, section 62J.824. |
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| 6 | 6 | | 1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: |
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| 7 | 7 | | 1.7 Section 1. [62J.8241] FACILITY FEES PROHIBITED. |
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| 8 | 8 | | 1.8 Subdivision 1.Definitions.(a) For purposes of this section, the definitions have the |
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| 9 | 9 | | 1.9meanings given. |
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| 10 | 10 | | 1.10 (b) "Facility fee" means any separate charge or billing by a provider-based clinic in |
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| 11 | 11 | | 1.11addition to a professional fee for physicians' services that is intended to cover building, |
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| 12 | 12 | | 1.12electronic medical records systems, billing, and other administrative and operational |
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| 13 | 13 | | 1.13expenses. |
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| 14 | 14 | | 1.14 (c) "Health care provider" has the meaning given in section 145B.02. |
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| 15 | 15 | | 1.15 (d) "Provider-based clinic" means the site of an off-campus clinic or provider office, |
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| 16 | 16 | | 1.16located at least 250 yards from the main hospital buildings or as determined by the Centers |
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| 17 | 17 | | 1.17for Medicare and Medicaid Services, that is owned by a hospital licensed under chapter 144 |
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| 18 | 18 | | 1.18or a health system that operates one or more hospitals licensed under chapter 144, and is |
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| 19 | 19 | | 1.19primarily engaged in providing diagnostic and therapeutic care, including medical history, |
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| 20 | 20 | | 1.20physical examinations, assessment of health status, and treatment monitoring. This definition |
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| 21 | 21 | | 1.21does not include clinics that are exclusively providing laboratory, x-ray, testing, therapy, |
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| 22 | 22 | | 1.22pharmacy, or educational services and does not include facilities designated as rural health |
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| 23 | 23 | | 1.23clinics. |
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| 24 | 24 | | 1Section 1. |
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| 40 | | - | 2.6health care providers are prohibited from charging, billing, or collecting a facility fee for |
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| 41 | | - | 2.7outpatient evaluation and management services. |
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| 42 | | - | 2.8 Subd. 4.Reporting.(a) By January 15, 2027, and each year thereafter, hospitals licensed |
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| 43 | | - | 2.9under chapter 144 and health systems operating one or more hospitals licensed under chapter |
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| 44 | | - | 2.10144 must submit a report to the commissioner of health identifying facility fees charged, |
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| 45 | | - | 2.11billed, and collected during the preceding calendar year. The commissioner must publish |
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| 46 | | - | 2.12the information reported on a publicly accessible website. The report shall be in the format |
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| 47 | | - | 2.13prescribed by the commissioner of health. |
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| 48 | | - | 2.14 (b) The report under this subdivision must include the following information for each |
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| 49 | | - | 2.15facility owned or operated by the hospital or health system providing services for which a |
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| 50 | | - | 2.16facility fee is charged, billed, or collected: |
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| 51 | | - | 2.17 (1) the name and full address of each facility; |
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| 52 | | - | 2.18 (2) the number of patient visits at each facility; and |
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| 53 | | - | 2.19 (3) the number, total amount, and range of allowable facility fees paid at each facility |
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| 54 | | - | 2.20by Medicare, medical assistance, MinnesotaCare, and private insurance. |
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| 55 | | - | 2.21 (c) The report under this subdivision must include the following information for the |
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| 56 | | - | 2.22entire hospital or health system: |
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| 57 | | - | 2.23 (1) the total amount charged and billed for facility fees; |
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| 58 | | - | 2.24 (2) the total amount collected from facility fees; |
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| 59 | | - | 2.25 (3) the top ten procedures or services provided by the hospital or health system that |
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| 60 | | - | 2.26generated the greatest amount of facility fee gross revenue, the volume each of these ten |
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| 61 | | - | 2.27procedures or services and gross and net revenue totals, for each such procedure or service, |
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| 62 | | - | 2.28and the total net amount of revenue received by the hospital or health system derived from |
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| 63 | | - | 2.29facility fees; |
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| 64 | | - | 2.30 (4) the top ten procedures or services, based on patient volume, provided by the hospital |
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| 65 | | - | 2.31or health system for which facility fees are charged, billed, or collected, based on patient |
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| 39 | + | 2.6health care providers are prohibited from charging, billing, or collecting a facility fee for: |
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| 40 | + | 2.7 (1) outpatient evaluation and management services; and |
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| 41 | + | 2.8 (2) any other services identified by the commissioner of health pursuant to subdivision |
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| 42 | + | 2.95, paragraph (a). |
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| 43 | + | 2.10 Subd. 4.Reporting.(a) By January 15, 2027, and each year thereafter, hospitals licensed |
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| 44 | + | 2.11under chapter 144 and health systems operating one or more hospitals licensed under chapter |
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| 45 | + | 2.12144 must submit a report to the commissioner of health identifying facility fees charged, |
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| 46 | + | 2.13billed, and collected during the preceding calendar year. The commissioner must publish |
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| 47 | + | 2.14the information reported on a publicly accessible website. The report shall be in the format |
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| 48 | + | 2.15prescribed by the commissioner of health. |
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| 49 | + | 2.16 (b) The report under this subdivision must include the following information for each |
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| 50 | + | 2.17facility owned or operated by the hospital or health system providing services for which a |
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| 51 | + | 2.18facility fee is charged, billed, or collected: |
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| 52 | + | 2.19 (1) the name and full address of each facility; |
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| 53 | + | 2.20 (2) the number of patient visits at each facility; and |
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| 54 | + | 2.21 (3) the number, total amount, and range of allowable facility fees paid at each facility |
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| 55 | + | 2.22by Medicare, medical assistance, MinnesotaCare, and private insurance. |
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| 56 | + | 2.23 (c) The report under this subdivision must include the following information for the |
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| 57 | + | 2.24entire hospital or health system: |
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| 58 | + | 2.25 (1) the total amount charged and billed for facility fees; |
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| 59 | + | 2.26 (2) the total amount collected from facility fees; |
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| 60 | + | 2.27 (3) the top ten procedures or services provided by the hospital or health system that |
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| 61 | + | 2.28generated the greatest amount of facility fee gross revenue, the volume each of these ten |
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| 62 | + | 2.29procedures or services and gross and net revenue totals, for each such procedure or service, |
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| 63 | + | 2.30and the total net amount of revenue received by the hospital or health system derived from |
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| 64 | + | 2.31facility fees; |
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| 67 | | - | S1503-2 2nd EngrossmentSF1503 REVISOR SGS 3.1volume, including the gross and net revenue totals received for each such procedure or |
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| 68 | | - | 3.2service; and |
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| 69 | | - | 3.3 (5) any other information related to facility fees that the commissioner of health may |
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| 70 | | - | 3.4require. |
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| 71 | | - | 3.5 Subd. 5.Enforcement.(a) A violation of this section is an unlawful business practice |
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| 72 | | - | 3.6for purposes of section 8.31. The attorney general may enforce this section pursuant to |
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| 73 | | - | 3.7section 8.31. |
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| 74 | | - | 3.8 (b) In addition to penalties provided in paragraph (a), the commissioner of health may, |
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| 75 | | - | 3.9pursuant to the procedures in sections 144.99 and 144.991, impose an administrative penalty |
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| 76 | | - | 3.10on a health care provider for failure to comply with subdivision 4. The penalty must not |
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| 77 | | - | 3.11exceed $1,000 per occurrence. |
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| 78 | | - | 3.12 (c) The commissioner of health or its designee may audit any health care provider for |
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| 79 | | - | 3.13compliance with the requirements of this section. A health care provider must make available, |
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| 80 | | - | 3.14upon written request of the commissioner or its designee, copies of any books, documents, |
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| 81 | | - | 3.15records, or data that are necessary for the purposes of completing the audit for four years |
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| 82 | | - | 3.16after the furnishing of any services for which a facility fee was charged, billed, or collected. |
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| 83 | | - | 3.17 Sec. 2. REPEALER. |
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| 84 | | - | 3.18 Minnesota Statutes, section 62J.824, is repealed. |
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| 66 | + | S1503-1 1st EngrossmentSF1503 REVISOR SGS 3.1 (4) the top ten procedures or services, based on patient volume, provided by the hospital |
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| 67 | + | 3.2or health system for which facility fees are charged, billed, or collected, based on patient |
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| 68 | + | 3.3volume, including the gross and net revenue totals received for each such procedure or |
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| 69 | + | 3.4service; and |
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| 70 | + | 3.5 (5) any other information related to facility fees that the commissioner of health may |
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| 71 | + | 3.6require. |
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| 72 | + | 3.7 Subd. 5.Regulatory authority.(a) The commissioner of health may adopt rules to |
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| 73 | + | 3.8include additional outpatient, diagnostic, imaging, or other services in the prohibition on |
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| 74 | + | 3.9facility fees set forth in subdivision 3. The commissioner may only include in the prohibition |
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| 75 | + | 3.10services that the commissioner determines are reliably provided safely and effectively in |
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| 76 | + | 3.11settings other than hospitals. |
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| 77 | + | 3.12 (b) The commissioner of health may adopt rules to carry out the provisions of this section. |
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| 78 | + | 3.13 Subd. 6.Enforcement.(a) A violation of this section is an unlawful business practice |
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| 79 | + | 3.14for purposes of section 8.31. The attorney general may enforce this section pursuant to |
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| 80 | + | 3.15section 8.31. |
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| 81 | + | 3.16 (b) The commissioner of health and health-related licensing boards may impose penalties |
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| 82 | + | 3.17for noncompliance consistent with their authority to regulate health care providers. |
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| 83 | + | 3.18 (c) In addition to penalties provided in paragraphs (a) and (b), the commissioner of health |
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| 84 | + | 3.19may impose an administrative penalty on a health care provider that violates this section. |
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| 85 | + | 3.20The penalty must not exceed $1,000 per occurrence. |
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| 86 | + | 3.21 (d) The commissioner of health or its designee may audit any health care provider for |
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| 87 | + | 3.22compliance with the requirements of this section. A health care provider must make available, |
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| 88 | + | 3.23upon written request of the commissioner or its designee, copies of any books, documents, |
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| 89 | + | 3.24records, or data that are necessary for the purposes of completing the audit for four years |
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| 90 | + | 3.25after the furnishing of any services for which a facility fee was charged, billed, or collected. |
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| 91 | + | 3.26 Sec. 2. REPEALER. |
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| 92 | + | 3.27 Minnesota Statutes, section 62J.824, is repealed. |
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| 87 | 95 | | (a) Prior to the delivery of nonemergency services, a provider-based clinic that charges a facility |
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| 88 | 96 | | fee shall provide notice to any patient, including patients served by telehealth as defined in section |
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| 89 | 97 | | 62A.673, subdivision 2, paragraph (h), stating that the clinic is part of a hospital and the patient |
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| 90 | 98 | | may receive a separate charge or billing for the facility component, which may result in a higher |
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| 91 | 99 | | out-of-pocket expense. |
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| 92 | 100 | | (b) Each health care facility must post prominently in locations easily accessible to and visible |
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| 93 | 101 | | by patients, including on its website, a statement that the provider-based clinic is part of a hospital |
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| 94 | 102 | | and the patient may receive a separate charge or billing for the facility, which may result in a higher |
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| 95 | 103 | | out-of-pocket expense. |
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| 96 | 104 | | (c) This section does not apply to laboratory services, imaging services, or other ancillary health |
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| 97 | 105 | | services that are provided by staff who are not employed by the health care facility or clinic. |
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| 98 | 106 | | (d) For purposes of this section: |
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| 99 | 107 | | (1) "facility fee" means any separate charge or billing by a provider-based clinic in addition to |
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| 100 | 108 | | a professional fee for physicians' services that is intended to cover building, electronic medical |
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| 101 | 109 | | records systems, billing, and other administrative and operational expenses; and |
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| 102 | 110 | | (2) "provider-based clinic" means the site of an off-campus clinic or provider office, located at |
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| 103 | 111 | | least 250 yards from the main hospital buildings or as determined by the Centers for Medicare and |
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| 104 | 112 | | Medicaid Services, that is owned by a hospital licensed under chapter 144 or a health system that |
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| 105 | 113 | | operates one or more hospitals licensed under chapter 144, and is primarily engaged in providing |
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| 106 | 114 | | diagnostic and therapeutic care, including medical history, physical examinations, assessment of |
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| 107 | 115 | | health status, and treatment monitoring. This definition does not include clinics that are exclusively |
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| 108 | 116 | | providing laboratory, x-ray, testing, therapy, pharmacy, or educational services and does not include |
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| 109 | 117 | | facilities designated as rural health clinics. |
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| 110 | 118 | | 1R |
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| 111 | 119 | | APPENDIX |
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