HF1487 (Legislative Session 94 (2025-2026))
Data on fully denied claims required to be submitted to the all-payer claims database, fee schedule for expanded access to data in the all-payer claims database established, and money appropriated.
Related bill: SF2104
AI Generated Summary
This bill proposes amendments to Minnesota Statutes 2024, section 62U.04, primarily focusing on expanding the All-Payer Claims Database (APCD) by requiring health plan companies, dental organizations, and third-party administrators to submit data on fully denied claims. Additionally, it introduces a fee schedule for organizations and individuals seeking expanded access to the data, along with guidelines for data usage.
Key Provisions:
Data Submission Requirements:
- Healthcare entities must submit fully denied claim data, including reasons for denial, adjudication status, and claim identifiers.
- Data must be de-identified per federal regulations.
- Healthcare entities must submit fully denied claim data, including reasons for denial, adjudication status, and claim identifiers.
Expanded Data Access & Use:
- Researchers and organizations can access APCD data if they aim to improve healthcare outcomes, affordability, quality, or disparities.
- Data cannot be used to gain an unfair market advantage or reidentify individuals.
- Researchers and organizations can access APCD data if they aim to improve healthcare outcomes, affordability, quality, or disparities.
Fee Schedule for Data Access:
- Standard data set: $3,500 per data file per year
- Limited-use data set: $7,000 per data file per year
- Custom data set/report: $100 per hour (up to 40 hours)
- Waivers may be granted based on financial hardship, academic affiliation, or data submitter status.
- Standard data set: $3,500 per data file per year
Appropriations:
- Allocates funds from the state’s general fund for fiscal years 2026 and 2027 to cover data collection costs.
- Allocates funds from the state’s general fund for fiscal years 2026 and 2027 to cover data collection costs.
This bill aims to increase healthcare transparency by expanding the state’s claims database, improving data quality, and facilitating research while ensuring privacy safeguards.
Bill text versions
- Introduction PDF file
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| February 23, 2025 | House | Floor | Action | Introduction and first reading, referred to | Health Finance and Policy |
Citations
[
{
"analysis": {
"added": [
"Includes specific exclusions linked to equivalent encounter information transactions."
],
"removed": [],
"summary": "This section requires that certain data exclusions are applied when submitting healthcare encounter data.",
"modified": []
},
"citation": "62J.536"
}
]