MN SF3480

Providers must give consumers good faith estimates of allowable payments at no cost within ten business days of receiving a complete request, and must include information about other fees such as facility charges.

Health plan companies must provide enrollees with good faith estimates of allowable amounts, enrollee cost-sharing, and out-of-pocket costs within ten business days of a complete request.

No contract between health plan companies and providers may prohibit providers from disclosing pricing information required under these provisions.

Primary care providers and clinics in family medicine, general internal medicine, gynecology, or general pediatrics must maintain and annually update a list of services over $25 corresponding with their 25 most frequently billed CPT codes, including evaluation and management and preventive service codes.

Primary care providers must disclose for each listed service the provider's charge, average reimbursement rates from commercial insurance payers, Medicare allowable rates, and medical assistance fee-for-service rates, posted in reception areas and on provider websites.

All provisions become effective July 1, 2019.