MN HF4140

Adds new category of unauthorized provider services: care from nonparticipating providers, hospitals, or ambulatory surgical centers when an enrollee has a reasonable expectation that the provider is authorized or participating.

Services under the new category are not considered unauthorized if the enrollee's health plan company provides written notice prior to service delivery stating the provider is not participating and that costs may not be covered.

Maintains existing unauthorized provider service categories: nonparticipating providers at participating facilities due to unavailability, lack of enrollee knowledge, or unforeseen need; and specimens sent to nonparticipating labs by participating providers.

Excludes emergency services from unauthorized provider service classifications.

Allows advance written consent to exempt laboratory and pathology services from unauthorized provider designation when enrollees acknowledge potential uncovered costs.