MN HF2824

Authorizes health carriers to offer reference-based pricing health plans in individual and small group markets, subject to federal approval.

Requires reimbursement rates to be based on a percentage of the most recent Medicare reimbursement schedules established by the Centers for Medicare and Medicaid Services.

For services without corresponding Medicare values, health carriers must negotiate rates based on other fee schedules used in the health care market.

Plans with reimbursement rates at least 120 percent above the Medicare rate and offered in all state counties are exempt from geographic and network adequacy requirements.

Providers are not required to participate and health carriers cannot condition participation in other plans on participation in reference-based pricing plans; plans may impose cost-sharing requirements including copayments, deductibles, and coinsurance.