MN HF3694

Health carriers must offer at least one health plan in individual and small group markets with a provider network open to all licensed health care providers in Minnesota who accept the carrier's standard terms and conditions.

Carriers may require providers to meet reasonable referral, utilization review, and quality assurance requirements on the same basis as other network providers.

Negotiated payment rates must be at least 120 percent of the Medicare Physician Fee Schedule Scale rates, or 140 percent for primary care providers certified as health care homes.

Carriers cannot impose co-payments, fees, or other cost-sharing requirements based on provider selection, and any cost-sharing must apply uniformly to all network providers.

The bill does not require providers to contract with carriers, does not mandate coverage of uncovered services, and does not obligate carriers to offer specific payment rates.