SF2104

This bill proposes amendments to Minnesota Statutes 2024, section 62U.04, to enhance data collection and access related to healthcare claims. The key provisions of the bill include:

1. Collection of Fully Denied Claims Data:

   • Health plan companies, dental organizations, and third-party administrators will be required to submit data on fully denied claims to the state’s all-payer claims database (APCD).
   • Submitted data must include details such as:
     • An indicator of denied claim lines.
     • Reasons for denial.
     • Claim line adjudication status.
     • A claim identifier to track subsequent actions on the claim.

2. Expanded Access to All-Payer Claims Data:

   • The bill establishes guidelines for individuals and organizations engaged in health research and transformation efforts to access APCD data.
   • Data cannot be used to:
     • Create unfair market advantages.
     • Reidentify individuals.
     • Publicly disclose contract details between health plan companies and providers.
   • A research advisory group will review data access applications.
   • The Department of Health will publish approved projects annually.

3. Fee Structure for Data Access:

   • The bill introduces a fee schedule for accessing different types of data:
     • Standard data set: $3,500 per file per year.
     • Limited-use data set: $7,000 per file per year.
     • Custom data set or report: $100 per hour of staff time (up to 40 hours).
   • Fee waivers may be granted for financial hardship, academic researchers, self-insured data submitters, or those requesting a high volume of data.
   • Collected fees will go into a special revenue fund for maintaining and providing access to the APCD.

4. Funding for Data Collection:

   • Appropriations from the general fund will fund the collection of fully denied claims data in fiscal years 2026 and 2027.

The bill aims to improve transparency and data accessibility for healthcare research while maintaining patient confidentiality and ensuring appropriate use of data.