Minnesota SF622 allows health carriers to offer reference-based pricing health plans.

Minnesota SF622 allows health carriers to offer reference-based pricing health plans in the individual, small, and large group markets. These plans set a fixed price for each service, based on Medicare rates or other fee schedules, and are exempt from geographic and network adequacy requirements. Providers must agree to reimbursement rates and meet data, utilization review, and quality assurance requirements. The bill also allows for cost-sharing requirements and reasonable referral and prior authorization requirements.

Minnesota SF622 allows health carriers to offer reference-based pricing health plans.

Minnesota SF622 allows health carriers to offer reference-based pricing health plans in the individual, small, and large group markets. These plans set a fixed price for each service, based on Medicare rates or other fee schedules, and are exempt from geographic and network adequacy requirements. Providers must agree to reimbursement rates and meet data, utilization review, and quality assurance requirements. The bill also allows for cost-sharing requirements and reasonable referral and prior authorization requirements.