MN HF2796

Health plan companies, network cooperatives, and providers using value-based payments must disclose to enrollees during enrollment and annually how reimbursement methodologies create financial incentives to limit or restrict care, including volume-based payments, risk-sharing arrangements, and provider tiering systems.

Enrollees may request specific written information about their provider's payment plan, incentive arrangements, and any transfer of financial risk to providers; disclosures must be provided in English, Spanish, Vietnamese, and Hmong upon request.

Health plan companies must disclose to providers the fee schedule and any contract conditions related to reimbursement that may limit or restrict health care services before requiring contract signature.

Ombudsperson for public managed health care programs expanded to provide assistance to recipients understanding their plan's reimbursement methodology and how it may limit or restrict their care.

Health carriers are liable for patient injuries caused by delays or denials of care that result from compensation limits imposed on health care providers; reimbursement methodology information is not considered proprietary in legal proceedings.

Most provisions effective January 1, 2022; health carrier liability provision effective for causes of action accruing on or after August 1, 2021.