MN HF2300

Beginning January 1, 2020, all health plan companies offering plans in Minnesota must establish a shared savings incentive program that provides enrollees at least 50 percent of savings when receiving covered comparable health care services from providers charging less than the plan's average allowed amount.

Comparable health care services include physical and occupational therapy, obstetrical and gynecological services, radiology and imaging, laboratory services, infusion therapy, inpatient and outpatient surgical procedures, and outpatient diagnostic tests and procedures.

Health plan companies must establish interactive mechanisms allowing enrollees to request cost information, compare provider charges, and receive good faith estimates of out-of-pocket costs for comparable health care services.

Enrollees may use out-of-network providers at prices below the plan's average allowed amount, with payments applied toward deductibles and out-of-pocket maximums as if the service were provided in-network.

The Commissioner of Health shall develop a web-based cost comparison system for consumers and collect annual reports from health plan companies on program participation, savings achieved, and incentive payments by service category.