HF 1837 Summary

• Beginning January 1, 2022, all health plan companies offering plans in Minnesota must establish a shared savings incentive program that rewards enrollees who receive comparable health care services from providers charging less than the average allowed amount.

• Enrollees must receive at least 50 percent of the saved costs for each comparable health care service, with no payment required if savings are $25 or less; incentive payments are deposited into individual shared savings incentive accounts usable for co-payments, deductibles, coinsurance, or premiums.

• 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 nonsurgical diagnostic tests and procedures.

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

• Health plan companies must file annual reports with the commissioner by March 1 beginning in 2023, reporting total shared savings incentive payments made, service categories used, average payment amounts, total savings achieved, and percentage of enrollees who participated.