Minnesota 2025-2026 Regular Session

Minnesota Senate Bill SF3297 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1.1 A bill for an act
2	2	1.2 relating to health; allowing insurers to provide explanation of benefits electronically;
3	3	1.3 amending Minnesota Statutes 2024, sections 62J.51, subdivision 19a; 62J.581.
4	4	1.4BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
5	5	1.5 Section 1. Minnesota Statutes 2024, section 62J.51, subdivision 19a, is amended to read:
6	6	1.6 Subd. 19a.Uniform explanation of benefits document."Uniform explanation of
7	7	1.7benefits document" means either the document associated with and explaining the details
8	8	1.8of a group purchaser's claim adjudication for services rendered or its electronic equivalent
9	9	1.9under section 62J.581, which is sent to a patient.
10	10	1.10 Sec. 2. Minnesota Statutes 2024, section 62J.581, is amended to read:
11	11	1.11 62J.581 STANDARDS FOR MINNESOTA UNIFORM HEALTH CARE
12	12	1.12REIMBURSEMENT DOCUMENTS.
13	13	1.13 Subdivision 1.Minnesota uniform remittance advice.All group purchasers shall
14	14	1.14provide a uniform claim payment/advice transaction to health care providers when a claim
15	15	1.15is adjudicated. The uniform claim payment/advice transaction shall comply with section
16	16	1.1662J.536, subdivision 1, paragraph (b), and rules adopted under section 62J.536, subdivision
17	17	1.172.
18	18	1.18 Subd. 2.Minnesota uniform explanation of benefits document.(a) All group
19	19	1.19purchasers shall provide a uniform explanation of benefits document to health care patients
20	20	1.20when an explanation of benefits document is provided as otherwise required or permitted
21	21	1.21by law. The uniform explanation of benefits document shall comply with the standards
22	22	1.22prescribed in this section.
23	23	1Sec. 2.
24	24	25-00302 as introduced12/11/24 REVISOR EB/MI
25	25	SENATE
26	26	STATE OF MINNESOTA
27	27	S.F. No. 3297NINETY-FOURTH SESSION
28	28	(SENATE AUTHORS: WIKLUND)
29	29	OFFICIAL STATUSD-PGDATE
30	30	Introduction and first reading04/07/2025
31	31	Referred to Health and Human Services 2.1 (b) Notwithstanding paragraph (a), this section does not apply to group purchasers not
32	32	2.2included as covered entities under United States Code, title 42, sections 1320d to 1320d-8,
33	33	2.3as amended from time to time, and the regulations promulgated under those sections.
34	34	2.4 Subd. 3.Scope.For purposes of sections 62J.50 to 62J.61, the uniform claim
35	35	2.5payment/advice transaction and uniform explanation of benefits document format specified
36	36	2.6in subdivision 4 shall apply to all health care services delivered by a health care provider
37	37	2.7or health care provider organization in Minnesota, regardless of the location of the payer.
38	38	2.8Health care services not paid on an individual claims basis, such as capitated payments, are
39	39	2.9not included in this section. A health plan company is excluded from the requirements in
40	40	2.10subdivisions 1 and subdivision 2 if they comply with section 62A.01, subdivisions 2 and
41	41	2.113.
42	42	2.12 Subd. 4.Specifications.(a) The uniform explanation of benefits document shall be
43	43	2.13provided by use of a paper document conforming to the specifications in this section or its
44	44	2.14electronic equivalent under paragraph (b).
45	45	2.15 (b) Group purchasers may make the uniform explanation of benefits available in a version
46	46	2.16that can be accessed by health care patients electronically if:
47	47	2.17 (1) the group purchaser making the uniform explanation of benefits available
48	48	2.18electronically provides health care patients the ability to choose whether to receive paper,
49	49	2.19electronic, or both paper and electronic versions of their uniform explanation of benefits;
50	50	2.20 (2) the group purchaser provides clear, readily accessible information and instructions
51	51	2.21for the patient to communicate their choice; and
52	52	2.22 (3) health care patients not responding to the opportunity to make a choice will receive
53	53	2.23at a minimum a paper uniform explanation of benefits.
54	54	2.24 (c) The commissioner, after consulting with the Administrative Uniformity Committee,
55	55	2.25shall specify the data elements and definitions for the paper uniform explanation of benefits
56	56	2.26document. The commissioner and the Administrative Uniformity Committee must consult
57	57	2.27with the Minnesota Dental Association and Delta Dental Plan of Minnesota before requiring
58	58	2.28under this section the use of a paper document for the uniform explanation of benefits
59	59	2.29document or the uniform claim payment/advice transaction for dental care services. Any
60	60	2.30electronic version of the uniform explanation of benefits must use the same data elements
61	61	2.31and definitions as the paper uniform explanation of benefits.
62	62	2Sec. 2.
63	63	25-00302 as introduced12/11/24 REVISOR EB/MI 3.1 Subd. 5.Effective date.The requirements in subdivisions 1 and 2 are effective June 30,
64	64	3.22007. The requirements in subdivisions 1 and 2 apply regardless of when the health care
65	65	3.3service was provided to the patient.
66	66	3Sec. 2.
67	67	25-00302 as introduced12/11/24 REVISOR EB/MI