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, it requires health plan companies to give enrollees a good faith estimate of the lowest allowable amount due for a health care service from any provider, as well as the total payment for a service from an in-network provider. The bill also introduces a new section, 62J.829, which outlines the requirements for issuing out-of-network credits, including the conditions under which credits must be provided and how they should be applied to the enrollee's payment obligations.

Additionally, the bill includes provisions for the enforcement of these requirements by the commissioner of commerce and specifies that the out-of-network credit balance paid to an enrollee will be treated as a subtraction for tax purposes. The bill also prohibits health plans from imposing limitations that would restrict an enrollee's ability to utilize these credits and mandates regular statements regarding credit balances. The effective date for the tax-related provisions is set for taxable years beginning after December 31, 2025.

Statutes affected:
Introduction: 62J.81, 290.0132