Minnesota Session Laws - 2004, Regular Session

                            CHAPTER 268-H.F.No. 2762 
                  An act relating to health; regulating coverages; 
                  regulating the Minnesota Comprehensive Health 
                  Association; providing for the composition of the 
                  board; authorizing an enrollee incentive for 
                  participation in a disease management program; phasing 
                  out Medicare-extended basic supplement plans; 
                  providing for high deductible plans; authorizing 
                  purchasing alliances to include seasonal employees; 
                  regulating trade practices; regulating certain health 
                  occupations and professions; requiring certain 
                  pharmacy benefit disclosures; providing an effective 
                  date for a certain hospital construction moratorium 
                  exemption; requiring a study; amending Minnesota 
                  Statutes 2002, sections 62A.65, subdivision 5; 62E.10, 
                  subdivisions 2, 10; 62L.12, subdivisions 2, 3; 62Q.01, 
                  by adding a subdivision; 62T.02, by adding a 
                  subdivision; 72A.20, by adding a subdivision; 147.03, 
                  subdivision 1; Minnesota Statutes 2003 Supplement, 
                  sections 62E.12; 256B.69, subdivision 4; proposing 
                  coding for new law in Minnesota Statutes, chapters 
                  62Q; 151. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  Minnesota Statutes 2002, section 62A.65, 
        subdivision 5, is amended to read: 
           Subd. 5.  [PORTABILITY AND CONVERSION OF COVERAGE.] (a) No 
        individual health plan may be offered, sold, issued, or with 
        respect to children age 18 or under renewed, to a Minnesota 
        resident that contains a preexisting condition limitation, 
        preexisting condition exclusion, or exclusionary rider, unless 
        the limitation or exclusion is permitted under this subdivision 
        and under chapter 62L, provided that, except for children age 18 
        or under, underwriting restrictions may be retained on 
        individual contracts that are issued without evidence of 
        insurability as a replacement for prior individual coverage that 
        was sold before May 17, 1993.  The individual may be subjected 
        to an 18-month preexisting condition limitation, unless the 
        individual has maintained continuous coverage as defined in 
        section 62L.02.  The individual must not be subjected to an 
        exclusionary rider.  An individual who has maintained continuous 
        coverage may be subjected to a onetime preexisting condition 
        limitation of up to 12 months, with credit for time covered 
        under qualifying coverage as defined in section 62L.02, at the 
        time that the individual first is covered under an individual 
        health plan by any health carrier.  Credit must be given for all 
        qualifying coverage with respect to all preexisting conditions, 
        regardless of whether the conditions were preexisting with 
        respect to any previous qualifying coverage.  The individual 
        must not be subjected to an exclusionary rider.  Thereafter, the 
        individual must not be subject to any preexisting condition 
        limitation, preexisting condition exclusion, or exclusionary 
        rider under an individual health plan by any health carrier, 
        except an unexpired portion of a limitation under prior 
        coverage, so long as the individual maintains continuous 
        coverage as defined in section 62L.02. 
           (b) A health carrier must offer an individual health plan 
        to any individual previously covered under a group health plan 
        issued by that health carrier, regardless of the size of the 
        group, so long as the individual maintained continuous coverage 
        as defined in section 62L.02.  If the individual has available 
        any continuation coverage provided under sections 62A.146; 
        62A.148; 62A.17, subdivisions 1 and 2; 62A.20; 62A.21; 62C.142; 
        62D.101; or 62D.105, or continuation coverage provided under 
        federal law, the health carrier need not offer coverage under 
        this paragraph until the individual has exhausted the 
        continuation coverage.  The offer must not be subject to 
        underwriting, except as permitted under this paragraph.  A 
        health plan issued under this paragraph must be a qualified plan 
        as defined in section 62E.02 and must not contain any 
        preexisting condition limitation, preexisting condition 
        exclusion, or exclusionary rider, except for any unexpired 
        limitation or exclusion under the previous coverage.  The 
        individual health plan must cover pregnancy on the same basis as 
        any other covered illness under the individual health plan.  The 
        offer of coverage by the health carrier must inform the 
        individual that the coverage, including what is covered and the 
        health care providers from whom covered care may be obtained, 
        may not be the same as the individual's coverage under the group 
        health plan.  The offer of coverage by the health carrier must 
        also inform the individual that the individual, if a Minnesota 
        resident, may be eligible to obtain coverage from (i) other 
        private sources of health coverage, or (ii) the Minnesota 
        Comprehensive Health Association, without a preexisting 
        condition limitation, and must provide the telephone number used 
        by that association for enrollment purposes.  The initial 
        premium rate for the individual health plan must comply with 
        subdivision 3.  The premium rate upon renewal must comply with 
        subdivision 2.  In no event shall the premium rate exceed 100 
        percent of the premium charged for comparable individual 
        coverage by the Minnesota Comprehensive Health Association, and 
        the premium rate must be less than that amount if necessary to 
        otherwise comply with this section.  An individual health plan 
        offered under this paragraph to a person satisfies the health 
        carrier's obligation to offer conversion coverage under section 
        62E.16, with respect to that person.  Coverage issued under this 
        paragraph must provide that it cannot be canceled or nonrenewed 
        as a result of the health carrier's subsequent decision to leave 
        the individual, small employer, or other group market.  Section 
        72A.20, subdivision 28, applies to this paragraph. 
           [EFFECTIVE DATE.] This section is effective January 1, 
        2005, and applies to conversion coverage offered on or after 
        that date. 
           Sec. 2.  Minnesota Statutes 2002, section 62E.10, 
        subdivision 2, is amended to read: 
           Subd. 2.  [BOARD OF DIRECTORS; ORGANIZATION.] The board of 
        directors of the association shall be made up of nine eleven 
        members as follows:  five six directors selected by contributing 
        members, subject to approval by the commissioner, one of which 
        must be a health actuary; four five public directors selected by 
        the commissioner, at least two of whom must be plan enrollees, 
        two of whom must be representatives of employers whose accident 
        and health insurance premiums are part of the association's 
        assessment base, and one of whom must be a licensed insurance 
        agent.  At least two of the public directors must reside outside 
        of the seven-county metropolitan area.  Public members may 
        include licensed insurance agents.  In determining voting rights 
        at members' meetings, each member shall be entitled to vote in 
        person or proxy.  The vote shall be a weighted vote based upon 
        the member's cost of self-insurance, accident and health 
        insurance premium, subscriber contract charges, health 
        maintenance contract payment, or community integrated service 
        network payment derived from or on behalf of Minnesota residents 
        in the previous calendar year, as determined by the 
        commissioner.  In approving directors of the board, the 
        commissioner shall consider, among other things, whether all 
        types of members are fairly represented.  Directors selected by 
        contributing members may be reimbursed from the money of the 
        association for expenses incurred by them as directors, but 
        shall not otherwise be compensated by the association for their 
        services.  The costs of conducting meetings of the association 
        and its board of directors shall be borne by members of the 
        association. 
           Sec. 3.  Minnesota Statutes 2002, section 62E.10, 
        subdivision 10, is amended to read: 
           Subd. 10.  [COST CONTAINMENT GOALS.] (a) By July 1, 2001, 
        the association shall investigate managed care delivery systems, 
        and if cost effective, enter into contracts with third-party 
        entities as provided in section 62E.101. 
           (b) By July 1, 2001, the association shall establish a 
        system to annually identify individuals insured by the Minnesota 
        Comprehensive Health Association who may be eligible for private 
        health care coverage, medical assistance, state drug programs, 
        or other state or federal programs and notify them about their 
        eligibility for these programs. 
           (c) The association shall endeavor to reduce health care 
        costs using additional methods consistent with effective patient 
        care.  At a minimum, by July 1, 2001, the association shall: 
           (1) develop a focused chronic disease management and case 
        management program; 
           (2) develop a comprehensive program of preventive care; and 
           (3) implement a total drug formulary program. 
           The association may establish an enrollee incentive based 
        on enrollee participation in the chronic disease management and 
        case management program developed under this section.  
           Sec. 4.  Minnesota Statutes 2003 Supplement, section 
        62E.12, is amended to read: 
           62E.12 [MINIMUM BENEFITS OF COMPREHENSIVE HEALTH INSURANCE 
        PLAN.] 
           (a) The association through its comprehensive health 
        insurance plan shall offer policies which provide the benefits 
        of a number one qualified plan and a number two qualified plan, 
        except that the maximum lifetime benefit on these plans shall be 
        $2,800,000; and an extended basic Medicare supplement plan and a 
        basic Medicare supplement plan as described in sections 62A.31 
        to 62A.44.  The association may also offer a plan that is 
        identical to a number one and number two qualified plan except 
        that it has a $2,000 annual deductible and a $2,800,000 maximum 
        lifetime benefit.  The association, subject to the approval of 
        the commissioner, may also offer plans that are identical to the 
        number one or number two qualified plan, except that they have 
        annual deductibles of $5,000 and $10,000, respectively; have 
        limitations on total annual out-of-pocket expenses equal to 
        those annual deductibles and therefore cover 100 percent of the 
        allowable cost of covered services in excess of those annual 
        deductibles; and have a $2,800,000 maximum lifetime benefit.  As 
        of January 1, 2006, the association shall no longer be required 
        to offer an extended basic Medicare supplement plan.  
           (b) The requirement that a policy issued by the association 
        must be a qualified plan is satisfied if the association 
        contracts with a preferred provider network and the level of 
        benefits for services provided within the network satisfies the 
        requirements of a qualified plan.  If the association uses a 
        preferred provider network, payments to nonparticipating 
        providers must meet the minimum requirements of section 72A.20, 
        subdivision 15.  
           (c) The association shall offer health maintenance 
        organization contracts in those areas of the state where a 
        health maintenance organization has agreed to make the coverage 
        available and has been selected as a writing carrier.  
           (d) Notwithstanding the provisions of section 62E.06 and 
        unless those charges are billed by a provider that is part of 
        the association's preferred provider network, the state plan 
        shall exclude coverage of services of a private duty nurse other 
        than on an inpatient basis and any charges for treatment in a 
        hospital located outside of the state of Minnesota in which the 
        covered person is receiving treatment for a mental or nervous 
        disorder, unless similar treatment for the mental or nervous 
        disorder is medically necessary, unavailable in Minnesota and 
        provided upon referral by a licensed Minnesota medical 
        practitioner. 
           Sec. 5.  Minnesota Statutes 2002, section 62L.12, 
        subdivision 2, is amended to read: 
           Subd. 2.  [EXCEPTIONS.] (a) A health carrier may sell, 
        issue, or renew individual conversion policies to eligible 
        employees otherwise eligible for conversion coverage under 
        section 62D.104 as a result of leaving a health maintenance 
        organization's service area. 
           (b) A health carrier may sell, issue, or renew individual 
        conversion policies to eligible employees otherwise eligible for 
        conversion coverage as a result of the expiration of any 
        continuation of group coverage required under sections 62A.146, 
        62A.17, 62A.21, 62C.142, 62D.101, and 62D.105. 
           (c) A health carrier may sell, issue, or renew conversion 
        policies under section 62E.16 to eligible employees. 
           (d) A health carrier may sell, issue, or renew individual 
        continuation policies to eligible employees as required. 
           (e) A health carrier may sell, issue, or renew individual 
        health plans if the coverage is appropriate due to an unexpired 
        preexisting condition limitation or exclusion applicable to the 
        person under the employer's group health plan or due to the 
        person's need for health care services not covered under the 
        employer's group health plan. 
           (f) A health carrier may sell, issue, or renew an 
        individual health plan, if the individual has elected to buy the 
        individual health plan not as part of a general plan to 
        substitute individual health plans for a group health plan nor 
        as a result of any violation of subdivision 3 or 4. 
           (g) Nothing in this subdivision relieves a health carrier 
        of any obligation to provide continuation or conversion coverage 
        otherwise required under federal or state law. 
           (h) Nothing in this chapter restricts the offer, sale, 
        issuance, or renewal of coverage issued as a supplement to 
        Medicare under sections 62A.31 to 62A.44, or policies or 
        contracts that supplement Medicare issued by health maintenance 
        organizations, or those contracts governed by section 1833 or 
        1876 of the federal Social Security Act, United States Code, 
        title 42, section 1395 et seq., as amended. 
           (i) Nothing in this chapter restricts the offer, sale, 
        issuance, or renewal of individual health plans necessary to 
        comply with a court order. 
           (j) A health carrier may offer, issue, sell, or renew an 
        individual health plan to persons eligible for an employer group 
        health plan, if the individual health plan is a high deductible 
        health plan for use in connection with an existing health 
        savings account, in compliance with the Internal Revenue Code, 
        section 223.  In that situation, the same or a different health 
        carrier may offer, issue, sell, or renew a group health plan to 
        cover the other eligible employees in the group. 
           [EFFECTIVE DATE.] This section is effective January 1, 2004.
           Sec. 6.  Minnesota Statutes 2002, section 62L.12, 
        subdivision 3, is amended to read: 
           Subd. 3.  [AGENT'S LICENSURE.] An agent licensed under 
        chapter 60K or section 62C.17 who knowingly and willfully breaks 
        apart a small group for the purpose of selling individual health 
        plans to eligible employees and dependents of a small employer 
        that meets the participation and contribution requirements of 
        section 62L.03, subdivision 3, is guilty of an unfair trade 
        practice and subject to disciplinary action, including the 
        revocation or suspension of license, under section 60K.43 or 
        62C.17.  The action must be by order and subject to the notice, 
        hearing, and appeal procedures specified in section 60K.43.  The 
        action of the commissioner is subject to judicial review as 
        provided under chapter 14.  This section does not apply to any 
        action performed by an agent that would be permitted for a 
        health carrier under subdivision 2. 
           [EFFECTIVE DATE.] This section is effective January 1, 2004.
           Sec. 7.  Minnesota Statutes 2002, section 62Q.01, is 
        amended by adding a subdivision to read: 
           Subd. 4a.  [HIGH DEDUCTIBLE HEALTH PLANS.] "High deductible 
        health plans" means those health coverage plans issued by a 
        health plan company as defined under the provisions of sections 
        220 and 223 of the Internal Revenue Code of 1986, and 
        implementing regulations. 
           [EFFECTIVE DATE.] This section is effective January 1, 2004.
           Sec. 8.  [62Q.025] [PRODUCT APPROVALS.] 
           Subdivision 1.  [QUALIFIED PLAN.] A high deductible health 
        plan shall be deemed a qualified plan under sections 62E.06 and 
        62E.12.  The plan must meet all other requirements of state law 
        except those that are inconsistent with a high deductible health 
        plan as defined in sections 220 and 223 of the Internal Revenue 
        Code and supporting regulations. 
           Subd. 2.  [AUTHORIZATION.] Notwithstanding any other law of 
        this state, any health plan company defined in section 62Q.01, 
        subdivision 4, is permitted to offer high deductible health 
        plans. 
           [EFFECTIVE DATE.] This section is effective January 1, 2004.
           Sec. 9.  [62A.65] [Subd. 7a.] [SHORT-TERM COVERAGE; APPLICABILITY.] 
           Notwithstanding section 62A.65, subdivision 3, paragraph 
        (g), and subdivision 7, paragraph (c), short-term coverage is 
        not subject to section 62A.021. 
           Sec. 10.  Minnesota Statutes 2002, section 62T.02, is 
        amended by adding a subdivision to read: 
           Subd. 3.  [SEASONAL EMPLOYEES.] A purchasing alliance may 
        define eligible employees to include seasonal employees.  For 
        purposes of this chapter, "seasonal employee" means an employee 
        who is employed on a full-time basis for at least six months 
        during the calendar year and is unemployed for no longer than 
        four months during the calendar year.  If seasonal employees are 
        included: 
           (1) the alliance must not show bias in the selection of 
        members based on the percentage of seasonal employees employed 
        by an employer member; 
           (2) prior to issuance or renewal, the employer must inform 
        the alliance that it will include seasonal employees; 
           (3) the employer must cover seasonal employees for the 
        entire term of its plan year; and 
           (4) the purchasing alliance may require an employer-member 
        contribution of at least 50 percent of the cost of employee 
        coverage during the months the seasonal employee is unemployed. 
           Sec. 11.  Minnesota Statutes 2002, section 72A.20, is 
        amended by adding a subdivision to read: 
           Subd. 37.  [ELECTRONIC TRANSMISSION OF REQUIRED 
        INFORMATION.] A health carrier, as defined in section 62A.011, 
        subdivision 2, is not in violation of this chapter for 
        electronically transmitting or electronically making available 
        information otherwise required to be delivered in writing under 
        chapters 62A to 62Q and 72A to an enrollee as defined in section 
        62Q.01, subdivision 2a, and with the requirements of those 
        chapters if the following conditions are met: 
           (1) the health carrier informs the enrollee that electronic 
        transmission or access is available and, at the discretion of 
        the health carrier, the enrollee is given one of the following 
        options: 
           (i) electronic transmission or access will occur only if 
        the enrollee affirmatively requests to the health carrier that 
        the required information be electronically transmitted or 
        available and a record of that request is retained by the health 
        carrier; or 
           (ii) electronic transmission or access will automatically 
        occur if the enrollee has not opted out of that manner of 
        transmission by request to the health carrier and requested that 
        the information be provided in writing.  If the enrollee opts 
        out of electronic transmission, a record of that request must be 
        retained by the health carrier; 
           (2) the enrollee is allowed to withdraw the request at any 
        time; 
           (3) if the information transmitted electronically contains 
        individually identifiable data, it must be transmitted to a 
        secured mailbox.  If the information made available 
        electronically contains individually identifiable data, it must 
        be made available at a password-protected secured Web site; 
           (4) the enrollee is provided a customer service number on 
        the enrollee's member card that may be called to request a 
        written copy of the document; and 
           (5) the electronic transmission or electronic availability 
        meets all other requirements of this chapter including, but not 
        limited to, size of the typeface and any required time frames 
        for distribution. 
           Sec. 12.  Minnesota Statutes 2002, section 147.03, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [ENDORSEMENT; RECIPROCITY.] (a) The board 
        may issue a license to practice medicine to any person who 
        satisfies the requirements in paragraphs (b) to (f).  
           (b) The applicant shall satisfy all the requirements 
        established in section 147.02, subdivision 1, paragraphs (a), 
        (b), (d), (e), and (f).  
           (c) The applicant shall: 
           (1) have passed an examination prepared and graded by the 
        Federation of State Medical Boards, the National Board of 
        Medical Examiners, or the United States Medical Licensing 
        Examination program in accordance with section 147.02, 
        subdivision 1, paragraph (c), clause (2); the National Board of 
        Osteopathic Examiners; or the Medical Council of Canada; and 
           (2) have a current license from the equivalent licensing 
        agency in another state or Canada and, if the examination in 
        clause (1) was passed more than ten years ago, either: 
           (i) pass the Special Purpose Examination of the Federation 
        of State Medical Boards with a score of 75 or better within 
        three attempts; or 
           (ii) have a current certification by a specialty board of 
        the American Board of Medical Specialties, of the American 
        Osteopathic Association Bureau of Professional Education, or of 
        the Royal College of Physicians and Surgeons of Canada. 
           (d) The applicant shall pay a fee established by the board 
        by rule.  The fee may not be refunded.  
           (e) The applicant must not be under license suspension or 
        revocation by the licensing board of the state or jurisdiction 
        in which the conduct that caused the suspension or revocation 
        occurred. 
           (f) The applicant must not have engaged in conduct 
        warranting disciplinary action against a licensee, or have been 
        subject to disciplinary action other than as specified in 
        paragraph (e).  If an applicant does not satisfy the 
        requirements stated in this paragraph, the board may issue a 
        license only on the applicant's showing that the public will be 
        protected through issuance of a license with conditions or 
        limitations the board considers appropriate. 
           (g) Upon the request of an applicant, the board may conduct 
        the final interview of the applicant by teleconference. 
           Sec. 13.  [151.214] [PAYMENT DISCLOSURE.] 
           Subdivision 1.  [EXPLANATION OF PHARMACY BENEFITS.] A 
        pharmacist licensed under this chapter must provide to a 
        patient, for each prescription dispensed where part or all of 
        the cost of the prescription is being paid or reimbursed by an 
        employer-sponsored plan or health plan company, or its 
        contracted pharmacy benefit manager, the patient's co-payment 
        amount and the usual and customary price of the prescription or 
        the amount the pharmacy will be paid for the prescription drug 
        by the patient's employer-sponsored plan or health plan company, 
        or its contracted pharmacy benefit manager. 
           Subd. 2.  [NO PROHIBITION ON DISCLOSURE.] No contracting 
        agreement between an employer-sponsored health plan or health 
        plan company, or its contracted pharmacy benefit manager, and a 
        resident or nonresident pharmacy registered under this chapter, 
        may prohibit the pharmacy from disclosing to patients 
        information a pharmacy is required or given the option to 
        provide under subdivision 1. 
           Sec. 14.  Minnesota Statutes 2003 Supplement, section 
        256B.69, subdivision 4, is amended to read: 
           Subd. 4.  [LIMITATION OF CHOICE.] (a) The commissioner 
        shall develop criteria to determine when limitation of choice 
        may be implemented in the experimental counties.  The criteria 
        shall ensure that all eligible individuals in the county have 
        continuing access to the full range of medical assistance 
        services as specified in subdivision 6.  
           (b) The commissioner shall exempt the following persons 
        from participation in the project, in addition to those who do 
        not meet the criteria for limitation of choice:  
           (1) persons eligible for medical assistance according to 
        section 256B.055, subdivision 1; 
           (2) persons eligible for medical assistance due to 
        blindness or disability as determined by the Social Security 
        Administration or the state medical review team, unless:  
           (i) they are 65 years of age or older; or 
           (ii) they reside in Itasca County or they reside in a 
        county in which the commissioner conducts a pilot project under 
        a waiver granted pursuant to section 1115 of the Social Security 
        Act; 
           (3) recipients who currently have private coverage through 
        a health maintenance organization; 
           (4) recipients who are eligible for medical assistance by 
        spending down excess income for medical expenses other than the 
        nursing facility per diem expense; 
           (5) recipients who receive benefits under the Refugee 
        Assistance Program, established under United States Code, title 
        8, section 1522(e); 
           (6) children who are both determined to be severely 
        emotionally disturbed and receiving case management services 
        according to section 256B.0625, subdivision 20; 
           (7) adults who are both determined to be seriously and 
        persistently mentally ill and received case management services 
        according to section 256B.0625, subdivision 20; 
           (8) persons eligible for medical assistance according to 
        section 256B.057, subdivision 10; and 
           (9) persons with access to cost-effective 
        employer-sponsored private health insurance or persons enrolled 
        in an individual health plan determined to be cost-effective 
        according to section 256B.0625, subdivision 15.  
        Children under age 21 who are in foster placement may enroll in 
        the project on an elective basis.  Individuals excluded under 
        clauses (1), (6), and (7) may choose to enroll on an elective 
        basis.  The commissioner may enroll recipients in the prepaid 
        medical assistance program for seniors who are (1) age 65 and 
        over, and (2) eligible for medical assistance by spending down 
        excess income. 
           (c) The commissioner may allow persons with a one-month 
        spenddown who are otherwise eligible to enroll to voluntarily 
        enroll or remain enrolled, if they elect to prepay their monthly 
        spenddown to the state.  
           (d) The commissioner may require those individuals to 
        enroll in the prepaid medical assistance program who otherwise 
        would have been excluded under paragraph (b), clauses (1), (3), 
        and (8), and under Minnesota Rules, part 9500.1452, subpart 2, 
        items H, K, and L.  
           (e) Before limitation of choice is implemented, eligible 
        individuals shall be notified and after notification, shall be 
        allowed to choose only among demonstration providers.  The 
        commissioner may assign an individual with private coverage 
        through a health maintenance organization, to the same health 
        maintenance organization for medical assistance coverage, if the 
        health maintenance organization is under contract for medical 
        assistance in the individual's county of residence.  After 
        initially choosing a provider, the recipient is allowed to 
        change that choice only at specified times as allowed by the 
        commissioner.  If a demonstration provider ends participation in 
        the project for any reason, a recipient enrolled with that 
        provider must select a new provider but may change providers 
        without cause once more within the first 60 days after 
        enrollment with the second provider. 
           (f) An infant born to a woman who is eligible for and 
        receiving medical assistance and who is enrolled in the prepaid 
        medical assistance program shall be retroactively enrolled to 
        the month of birth in the same managed care plan as the mother 
        once the child is enrolled in medical assistance unless the 
        child is determined to be excluded from enrollment in a prepaid 
        plan under this section.  
           [EFFECTIVE DATE.] This section is effective July 1, 2004, 
        or upon federal approval, whichever is later. 
           Sec. 15.  [HOSPITAL CONSTRUCTION MORATORIUM EXEMPTION; 
        EFFECTIVE DATE.] 
           Laws 2004, chapter 187, is effective July 1, 2004.  
           [EFFECTIVE DATE.] This section is effective July 1, 2004. 
           Sec. 16.  [PRESUMPTIVE CONDITIONS STUDY.] 
           The commissioner of commerce, in consultation with the 
        Minnesota Comprehensive Health Association, shall contract with 
        an independent entity to conduct an analysis of the eligibility 
        standards used for enrollment for coverage under the Minnesota 
        Comprehensive Health Association in terms of the use of 
        presumptive conditions for automatic eligibility and the 
        underwriting practices for the individual market regarding the 
        denial or limitations of coverage due to preexisting 
        conditions.  The analysis must compare the Minnesota 
        Comprehensive Health Association's practices with that of other 
        states' high-risk pools and examine the basis for denials within 
        the individual market.  The analysis must also determine whether 
        there should be additional guidelines or standards in place 
        before the existence of a specific condition or diagnosis is 
        denied coverage in the individual market or deemed automatically 
        eligible for coverage under the Minnesota Comprehensive Health 
        Association.  
           The commissioner of commerce shall submit the results of 
        the study and any recommendations to the legislature by January 
        15, 2005. 
           Presented to the governor May 18, 2004 
           Signed by the governor May 29, 2004, 2:25 p.m.