MN HF3831

Health plan companies, network cooperatives, and providers must disclose to enrollees during enrollment and annually thereafter the general nature of reimbursement methodologies, including any aspects that create financial incentives to limit or restrict care, with approval by the commissioner required before use.

Enrollees may request specific information about provider payment plans, incentives, compensation arrangements, and financial risk transfers, and disclosure statements must be provided in English, Spanish, Vietnamese, and Hmong upon request.

Health plan companies must provide providers with complete contract copies before signing, including fee schedules and descriptions of contract conditions that may limit or restrict health care services provided to enrollees.

Ombudsperson duties are expanded to include assisting recipients in understanding their prepaid health plan's reimbursement methodology and how it may limit or restrict health care provided to them.

Health carriers are liable for patient injuries caused in whole or part by delays or denials of care if the delay or denial resulted from compensation limits imposed by the carrier on health care providers, effective for causes of action accruing on or after August 1, 2020.