HF1487

HF1487 (Legislative Session 94 (2025-2026))

Data on fully denied claims required to be submitted to the all-payer claims database, fee schedule for expanded access to data in the all-payer claims database established, and money appropriated.

Related bill: SF2104

AI Generated Summary

This bill amends Minnesota Statutes §62U.04 to require health insurers, dental organizations, and third-party administrators to submit data on fully denied claims to the state’s all-payer claims database (APCD). The bill also establishes a fee schedule for accessing expanded APCD data and appropriates funds to support these initiatives.

Key Provisions:

Data Collection on Denied Claims:
- Health insurers must report fully denied claims, including:
  - Indicators of denied claim lines.
  - Reasons for denials.
  - Claim line adjudication status.
  - Claim identifiers to track claim actions.
Expanded Data Access:
- Researchers and organizations can access deidentified APCD data if their work benefits public health outcomes, quality, disparities, or healthcare spending.
- Restrictions prevent using this data for market advantage, patient reidentification, or contract disclosure.
Fee Structure for Data Access:
- Standard Data Set: $3,500 per year per file.
- Limited-Use Data Set: $7,000 per year per file.
- Custom Data Set/Report: $100 per hour (up to 40 hours).
- Fee waivers may be granted for financial hardship, academic institutions, or high-volume requesters.
Financial Provisions:
- Fees are deposited into a special revenue fund to support database maintenance and expansion.
- Appropriations are provided for fiscal years 2026 and 2027 to collect denied claim data.

This bill strengthens healthcare transparency by tracking denied claims and expanding data resources for research and policy improvements.

Bill text versions

Introduction PDF file

Actions

Date	Chamber	Where	Type	Name	Committee Name
February 23, 2025	House	Floor	Action	Introduction and first reading, referred to	Health Finance and Policy
February 23, 2025	House	Floor	Action	Introduction and first reading, referred to	Health Finance and Policy

Citations

[
  {
    "analysis": {
      "added": [
        "New requirements for data fields pertaining to fully denied claims, including indicators for denied claim lines, reasons for denial, claim line status, and claim identifiers."
      ],
      "removed": [],
      "summary": "The bill mandates submission of data on fully denied claims to the all-payer claims database under section 62U.04, subdivision 4.",
      "modified": []
    },
    "citation": "62U.04",
    "subdivision": "subdivision 4"
  },
  {
    "analysis": {
      "added": [
        "Requirements for data access applications, legally enforceable data use agreements, and an oversight process for data use."
      ],
      "removed": [],
      "summary": "This bill expands access to the all-payer claims data under section 62U.04, subdivision 13.",
      "modified": [
        "Clarifications on the conditions under which data can be accessed and used for research or transformation efforts, ensuring public benefit."
      ]
    },
    "citation": "62U.04",
    "subdivision": "subdivision 13"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "The bill maintains reference to data not included in equivalent encounter information transactions required under section 62J.536.",
      "modified": []
    },
    "citation": "62J.536",
    "subdivision": ""
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "The bill refers to data classifications under section 13.02, defining data on providers as private or nonpublic.",
      "modified": []
    },
    "citation": "13.02",
    "subdivision": ""
  }
]