This bill, S.F. No. 2441, proposes changes to Minnesota’s health care laws, particularly regarding provider payments, prompt payment requirements, and non-discrimination in health plan contracts. Here is a summary of its key provisions:

1. Non-Discrimination Against Health Care Providers Based on Geographic Location (Sec. 1)

• Mandates that health carriers cannot refuse to contract with a provider as an in-network provider if the provider's primary practice is within the same geographic area as the health plan’s coverage.
• Health plans may still enforce reasonable referral, utilization review, and quality assurance requirements for providers.
• Applies to managed care organizations and county-based purchasing plans under Medicaid.

2. Changes to Health Plan Provider Contracts (Sec. 2-3)

• Requires at least 90 days' notice for amendments that modify a provider's fee schedule or key contractual policies (increased from 45 days).
• Prohibits health plan companies from refusing to negotiate with providers’ designated contract negotiators.
• Ensures health plans follow Minnesota’s fair payment rate statutes.

3. Prompt Payment Requirements for Claims (Sec. 4-6)

• Health plans and third-party administrators must process and pay clean claims within 30 days.
• Interest at 1.5% per month must be paid on late claims, and legal fees may be charged to health plans that fail to pay required interest.
• Extends the deadline for providers to submit claims from 6 months to 12 months, with exceptions allowing up to 18 months in cases of disruptions.
• Limits adjustments and recoupments to within 12 months after payment (certain fraud and subrogation cases excluded).

4. Changes to Medical Assistance (Medicaid) Coverage (Sec. 7)

• Clarifies that wheelchairs for residents of intermediate care facilities for the disabled (ICF/DD) are recipient property.
• Vendors of durable medical equipment must enroll as Medicare providers (with exceptions to ensure access).
• Defines durable medical equipment (DME) and expands coverage for seizure detection devices.
• Managed care and county-based purchasing must follow the same limits for DME as the state’s fee-for-service system.

5. Provider Payment Requirements for Medicaid Managed Care (Sec. 8)

• Starting January 1, 2026, Medicaid managed care plans must follow the same payment rules as the fee-for-service (FFS) system for claim submission and payment.
• Reimbursement rates must be at least equal to Medicaid FFS rates.
• Quality measures must be tracked to ensure service access.

Overall Impact

This bill strengthens health care provider protections, ensures faster and fairer claims processing, and establishes consistent payment standards for Medicaid managed care organizations. The goal is to enhance provider participation, reduce administrative burdens, and promote timely payment for health care services in Minnesota.