Purpose of the Bill

This bill aims to modify the rules regarding how close healthcare providers need to be to patients in Minnesota. It seeks to ensure people have better access to essential healthcare services, such as primary care, mental health care, and hospital services, within a reasonable distance and time.

Main Provisions

• Provider Accessibility Standards: The bill sets a requirement for healthcare providers to be within 30 miles or 30 minutes' travel for services like primary care, mental health, and general hospital services. This standard aligns with federal regulations.

• Waiver Applications: Health carriers who cannot meet these standards can apply for a waiver. They must provide specific data showing why they can't meet the requirements and outline steps they will take to improve. A waiver costs $500 per application for each provider type and county.

• Telehealth Solutions: If no providers are available in a certain area, the bill allows for the use of telehealth to ensure access to specialty services.

• Waiver Expiration and Renewal: Waivers last for one year. Carriers must apply for a new waiver before the old one expires and demonstrate their ongoing efforts to improve network adequacy.

• Referral Centers: The rules about provider distance don’t apply if a patient is referred to a specialized medical facility, known as a referral center, which provides complex care, such as organ transplants.

Significant Changes

• The bill repeals the existing requirement for a wider range of health services previously set at a maximum travel distance of 60 miles or 60 minutes. This move emphasizes access to primary, mental, and general hospital care within the more stringent 30-minute or 30-mile parameters.

• Clarifies how waiver applications should be evaluated and the steps required from health carriers to address gaps in network adequacy.

Relevant Terms

• Provider Network Adequacy
• Primary Care
• Mental Health Services
• Waiver Application
• Telehealth
• Referral Centers