1.1                          A bill for an act
  1.2             relating to health; requiring prompt payment by health 
  1.3             plan companies and third-party administrators of clean 
  1.4             claims for health care services; proposing coding for 
  1.5             new law in Minnesota Statutes, chapter 62Q. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  [62Q.75] [PROMPT PAYMENT REQUIRED.] 
  1.8      Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
  1.9   section, the following terms have the meanings given to them. 
  1.10     (b) "Clean claim" means a claim that has no defect or 
  1.11  impropriety, including any lack of any required substantiating 
  1.12  documentation, or particular circumstance requiring special 
  1.13  treatment that prevents timely payment from being made on a 
  1.14  claim under this section. 
  1.15     (c) "Third-party administrator" means a third-party 
  1.16  administrator or other entity subject to section 60A.23, 
  1.17  subdivision 8, and Minnesota Rules, chapter 2767. 
  1.18     Subd. 2.  [CLAIMS PAYMENTS.] (a) This section applies to 
  1.19  clean claims submitted to a health plan company or third-party 
  1.20  administrator for services provided by any health care provider, 
  1.21  except a provider licensed under chapter 151, or health care 
  1.22  facility.  All health plan companies and third-party 
  1.23  administrators must pay or deny claims that are clean claims 
  1.24  within 30 calendar days after the date upon which the health 
  1.25  plan company or third-party administrator received the claim. 
  2.1      (b) If a health plan company or third-party administrator 
  2.2   does not pay or deny a clean claim within the period provided in 
  2.3   paragraph (a), the health plan company or third-party 
  2.4   administrator must pay interest on the claim for the period 
  2.5   beginning on the day after the required payment date specified 
  2.6   in paragraph (a) and ending on the date on which the health plan 
  2.7   company or third-party administrator makes the payment or denies 
  2.8   the claim.  In any payment, the health plan company or 
  2.9   third-party administrator must itemize any interest payment 
  2.10  being made separately from other payments being made for 
  2.11  services provided. 
  2.12     (c) The rate of interest paid by a health plan company or 
  2.13  third-party administrator under this subdivision shall be 1.5 
  2.14  percent per month or any part of a month. 
  2.15     (d) A health plan company or third-party administrator is 
  2.16  not required to make an interest payment on a claim for which 
  2.17  payment has been delayed for purposes of reviewing potentially 
  2.18  fraudulent or abusive billing practices. 
  2.19     (e) The commissioner may not assess a financial 
  2.20  administrative penalty against a health plan company for 
  2.21  violation of this subdivision. 
  2.22     Sec. 2.  [EFFECTIVE DATE.] 
  2.23     Section 1 is effective January 1, 2001, and applies to 
  2.24  claims submitted on or after that date.