1.1 A bill for an act
1.2 relating to health; changing provider network adequacy provisions; amending
1.3 Minnesota Statutes 2024, section 62K.10, subdivisions 2, 5, 6; repealing Minnesota
1.4 Statutes 2024, section 62K.10, subdivision 3.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2024, section 62K.10, subdivision 2, is amended to read:
1.7 Subd. 2.Primary care; mental health services; general hospital services Time and
1.8distance standards.The maximum travel distance or time shall be the lesser of 30 miles
1.9or 30 minutes to the nearest provider of each of the following services: primary care services,
1.10mental health services, and general hospital services Health carriers must meet the time and
1.11distance standards under Code of Federal Regulations, title 45, section 155.1050.
1.12 Sec. 2. Minnesota Statutes 2024, section 62K.10, subdivision 5, is amended to read:
1.13 Subd. 5.Waiver.(a) A health carrier may apply to the commissioner of health for a
1.14waiver of the requirements in subdivision 2 or 3 if it is unable to meet the statutory
1.15requirements. A waiver application must be submitted on a form provided by the
1.16commissioner, must be accompanied by an application fee of $500 for each application to
1.17waive the requirements in subdivision 2 or 3 for one or more provider types per county, and
1.18must:
1.19 (1) demonstrate with specific data that the requirement of subdivision 2 or 3 is not
1.20feasible in a particular service area or part of a service area; and
1Sec. 2.
25-00303 as introduced12/06/24 REVISOR EB/DG
SENATE
STATE OF MINNESOTA
S.F. No. 3296NINETY-FOURTH SESSION
(SENATE AUTHORS: WIKLUND)
OFFICIAL STATUSD-PGDATE
Introduction and first reading04/07/2025
Referred to Health and Human Services 2.1 (2) include specific information as to the steps that were and will be taken to address
2.2the network inadequacy, and, for steps that will be taken prospectively to address network
2.3inadequacy, the time frame within which those steps will be taken.
2.4 (b) The commissioner shall establish guidelines for evaluating waiver applications,
2.5standards governing approval or denial of a waiver application, and standards for steps that
2.6health carriers must take to address the network inadequacy and allow the health carrier to
2.7meet network adequacy requirements within a reasonable time period. The commissioner
2.8shall review each waiver application using these guidelines and standards and shall approve
2.9a waiver application only if:
2.10 (1) the standards for approval established by the commissioner are satisfied; and
2.11 (2) the steps that were and will be taken to address the network inadequacy and the time
2.12frame for taking these steps satisfy the standards established by the commissioner.
2.13 (c) If, in its waiver application, a health carrier demonstrates to the commissioner that
2.14there are no providers of a specific type or specialty in a county, the commissioner may
2.15approve a waiver in which the health carrier is allowed to address network inadequacy in
2.16that county by providing for patient access to providers of that type or specialty via telehealth,
2.17as defined in section 62A.673, subdivision 2.
2.18 (d) The waiver shall automatically expire after one year. Upon or prior to expiration of
2.19a waiver, a health carrier unable to meet the requirements in subdivision 2 or 3 must submit
2.20a new waiver application under paragraph (a) and must also submit evidence of steps the
2.21carrier took to address the network inadequacy. When the commissioner reviews a waiver
2.22application for a network adequacy requirement which has been waived for the carrier for
2.23the most recent one-year period, the commissioner shall also examine the steps the carrier
2.24took during that one-year period to address network inadequacy, and shall only approve a
2.25subsequent waiver application that satisfies the requirements in paragraph (b), demonstrates
2.26that the carrier took the steps it proposed to address network inadequacy, and explains why
2.27the carrier continues to be unable to satisfy the requirements in subdivision 2 or 3.
2.28 (e) Application fees collected under this subdivision shall be deposited in the state
2.29government special revenue fund in the state treasury.
2.30 Sec. 3. Minnesota Statutes 2024, section 62K.10, subdivision 6, is amended to read:
2.31 Subd. 6.Referral centers.Subdivisions Subdivision 2 and 3 shall not apply if an enrollee
2.32is referred to a referral center for health care services. A referral center is a medical facility
2.33that provides highly specialized medical care, including but not limited to organ transplants.
2Sec. 3.
25-00303 as introduced12/06/24 REVISOR EB/DG 3.1A health carrier or preferred provider organization may consider the volume of services
3.2provided annually, case mix, and severity adjusted mortality and morbidity rates in
3.3designating a referral center.
3.4 Sec. 4. REPEALER.
3.5 Minnesota Statutes 2024, section 62K.10, subdivision 3, is repealed.
3Sec. 4.
25-00303 as introduced12/06/24 REVISOR EB/DG 62K.10 GEOGRAPHIC ACCESSIBILITY; PROVIDER NETWORK ADEQUACY.
Subd. 3.Other health services.The maximum travel distance or time shall be the lesser of 60
miles or 60 minutes to the nearest provider of specialty physician services, ancillary services,
specialized hospital services, and all other health services not listed in subdivision 2.
1R
APPENDIX
Repealed Minnesota Statutes: 25-00303