MN HF4225

Limits charges to enrollees when a health plan company denies coverage for procedural reasons on services that are otherwise covered benefits; providers cannot charge more than the negotiated payment amount plus 20 percent

Requires any amount paid by the enrollee under this provision to count toward the enrollee's applicable deductible

Does not require health plan companies to pay for out-of-network providers or cover services not included in the enrollee's health plan

Defines "negotiated provider payment" as the contracted rate between the provider and health plan company for services to covered enrollees