MN HF4372

Health carriers cannot deny in-network provider contracts to health care providers located in the same geographic area as their primary practice, though carriers may require standard referral, utilization review, and quality assurance requirements.

Contract amendment notices to providers must be provided 90 days (increased from 45 days) before effective date when changes alter fee schedules or material contractual policies, with opportunity for provider termination.

Health plan companies must pay or deny clean claims within 30 calendar days and pay interest at 1.5 percent per month on late payments, with interest payments made at least quarterly and liability for legal costs if interest is not paid.

Claims filing deadline extended from 6 months to 12 months from date of service, with possible extension to 18 months for significant operational disruptions, and claims cannot be audited after 12 months.

Effective January 1, 2021, managed care plans and county-based purchasing plans must reimburse employed or contracted providers at least the fee-for-service payment rate and follow the same claims submission and payment requirements as the commissioner's fee-for-service system.