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SF2104 (Legislative Session 94 (2025-2026))

Data on fully denied claims requirement to be submitted to the all-payer claims database

Related bill: HF1487

AI Generated Summary

This bill (S.F. No. 2104) amends Minnesota Statutes §62U.04 to enhance data collection and access within the state's all-payer claims database (APCD). The key provisions include:

  1. Collection of Denied Claims Data:

    • Requires health plan companies, dental organizations, and third-party administrators to submit data on fully denied claims, including reasons for denial and claim identifiers.
    • Ensures the data remains de-identified and mandates safeguards to protect patient confidentiality.

  2. Expanded Access to APCD Data:

    • Allows individuals and organizations conducting research or working on healthcare transformation (e.g., improving outcomes, access, quality, disparities, or spending) to access data.
    • Prohibits the use of data to create unfair market advantages, re-identify individuals, or disclose health plan-provider contract details.

  3. Fee Schedule for Data Access:

    • Establishes fees for accessing APCD data:
      • $3,500 per year for standard data sets.
      • $7,000 per year for limited-use data sets.
      • $100 per hour (up to 40 hours) for custom data sets.
    • Permits fee waivers for financial hardship, academic institutions, self-insured data submitters, or high-volume users.

  4. Funding and Implementation:

    • Requires fees to be paid in full before data access.
    • Directs collected fees into a special revenue fund to support APCD operations.
    • Appropriates funds for fiscal years 2026 and 2027 to support data collection on fully denied claims.

The bill aims to improve healthcare transparency and policy research while maintaining strong data privacy protections.

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
March 02, 2025HouseFloorActionIntroduction and first reading
March 02, 2025SenateFloorActionIntroduction and first reading
March 02, 2025HouseFloorActionReferred toHealth and Human Services
March 02, 2025SenateFloorActionReferred toHealth and Human Services
March 02, 2025SenateFloorActionReferred toHealth and Human Services

Citations

 
[
  {
    "analysis": {
      "added": [
        "Requirements for including fully denied claims and reasons for denial."
      ],
      "removed": [],
      "summary": "This bill modifies data reporting requirements for health plan companies related to encounter data under section 62U.04.",
      "modified": [
        "Clarifies data fields required for encounter submission."
      ]
    },
    "citation": "62U.04",
    "subdivision": "subdivision 4"
  },
  {
    "analysis": {
      "added": [
        "Provisions for expanded access to data for research with a public benefit."
      ],
      "removed": [],
      "summary": "This section expands access guidelines for the all-payer claims database data.",
      "modified": [
        "Outlines data access requirements and privacy considerations."
      ]
    },
    "citation": "62U.04",
    "subdivision": "subdivision 13"
  }
]

Sponsors