This bill mandates that health plans in Minnesota must provide enrollees with a credit for services received from out-of-network providers if the cost is lower than that of in-network providers. Specifically, health plans are required to issue a credit equal to fifty percent of the estimated in-network cost difference when an enrollee receives care from an out-of-network provider and identifies a positive cost difference prior to the service. The bill also prohibits health plans from imposing any limitations that would restrict an enrollee's ability to utilize this out-of-network credit, ensuring that enrollees can benefit from these credits without facing increased costs or restrictions.

Additionally, the bill introduces new provisions for the disclosure of cost estimates by health plans, requiring them to provide a good faith estimate of costs for both in-network and out-of-network services upon request. It also establishes enforcement authority for the commissioner of commerce to ensure compliance with these requirements. Furthermore, the bill includes a provision that allows for the out-of-network credit balance to be treated as a subtraction for tax purposes, effective for taxable years beginning after December 31, 2025.

Statutes affected:
Introduction: 62J.81, 290.0132