Subdivision 1. Unique identification number for health care provider organizations. (a) All group purchasers and any health care provider organization that meets the definition of a health care provider under United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder shall use a national provider identifier to identify health care provider organizations in Minnesota, according to this section.
(b) The national provider identifier for health care providers as adopted and required in Code of Federal Regulations, title 45, part 162, subpart D, and any future modifications to the subpart shall be used as the unique identification number for health care provider organizations in Minnesota under this section.
(c) All health care provider organizations in Minnesota that are eligible to obtain a national provider identifier according to United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder shall obtain a national provider identifier using the process prescribed in Code of Federal Regulations, title 45, part 162, subpart D, and any future modifications to the subpart.
(d) Only the national provider identifier shall be used to identify health care provider organizations when submitting and receiving paper and electronic claims and remittance advice notices, and in conjunction with other data collection and reporting functions.
(e) Health care provider organizations in Minnesota shall make available their national provider identifier to other health care providers when required to be included in the administrative transactions regulated by United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder.
(f) The commissioner of health may contract with the federal Secretary of Health and Human Services or the Secretary's agent to implement this subdivision.
Subd. 2. Unique identification number for individual health care providers. (a) All group purchasers in Minnesota and any individual health care provider that meets the definition of a health care provider under United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder shall use the national provider identifier to identify an individual health care provider in Minnesota, according to this section.
(b) The national provider identifier for health care providers adopted in Code of Federal Regulations, title 45, part 162, subpart D, and any future modifications to the subpart shall be used as the unique identification number for individual health care providers.
(c) All individual health care providers in Minnesota that are eligible to obtain a national provider identifier according to United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder shall obtain a national provider identifier using the process prescribed in Code of Federal Regulations, title 45, part 162, subpart D, and any future modifications to the subpart.
(d) Only the national provider identifier shall be used to identify individual health care providers when submitting and receiving paper and electronic claims and remittance advice notices, and in conjunction with other data collection and reporting functions.
(e) Individual health care providers in Minnesota shall make available their national provider identifier to other health care providers when required to be included in the administrative transactions regulated by United States Code, title 42, sections 1320d to 1320d-8, as amended, and regulations adopted thereunder.
(f) The commissioner of health may contract with the federal Secretary of Health and Human Services or the Secretary's agent to implement this subdivision.
Subd. 3. Unique identification number for group purchasers. (a) All group purchasers and health care providers in Minnesota shall use a unique identification number to identify group purchasers.
(b) The unique health identifier for group purchasers that are health plans under Code of Federal Regulations, title 45, part 160, subpart A, shall be the Standard Unique Health Identifier for Health Plans as adopted in Code of Federal Regulations, title 45, part 162, subpart E, and any future modifications to the subpart, effective as required by the subpart.
(c) Group purchasers that are health plans under Code of Federal Regulations, title 45, part 160, subpart A, shall obtain a unique health identifier using the process prescribed in Code of Federal Regulations, title 45, part 162, subpart E, and any future modifications to the subpart.
(d) The unique group purchaser identifier, as described in this section, shall be used for purposes of submitting and receiving claims, and in conjunction with other data collection and reporting functions.
(e) The commissioner of health may contract with the federal Secretary of Health and Human Services or the Secretary's agent to implement this subdivision.
Subd. 4. Unique patient identification number. (a) Not later than 24 months after the date on which a unique health identifier for individuals is adopted or established under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments), all group purchasers and health care providers in Minnesota shall use a unique identification number to identify each patient who receives health care services in Minnesota, except as provided in paragraph (b).
(b) Small health plans, as defined by the federal Secretary of Health and Human Services under United States Code, title 42, section 1320d-4 (1996 and subsequent amendments), shall use a unique identification number to identify each patient who receives health care services in Minnesota no later than 36 months after the date on which a unique health identifier for individuals is adopted or established under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments).
(c) The unique health identifier for individuals adopted or established by the federal Secretary of Health and Human Services under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments), shall be used as the unique patient identification number, except as provided in paragraphs (e) and (f).
(d) The unique patient identification number shall be used by group purchasers and health care providers for purposes of submitting and receiving claims, and in conjunction with other data collection and reporting functions.
(e) Within the limits of available appropriations, the commissioner shall develop a proposal for an alternate numbering system for patients who do not have or refuse to provide their Social Security numbers, if:
(1) a unique health identifier for individuals is adopted or established under United States Code, title 42, sections 1320d to 1320d-8 (1996 and subsequent amendments);
(2) the unique health identifier is the Social Security number of the patient;
(3) there is no federal alternate numbering system for patients who do not have or refuse to provide their Social Security numbers; and
(4) federal law or the federal Secretary of Health and Human Services explicitly allows a state to develop an alternate numbering system for patients who do not have or refuse to provide their Social Security numbers.
(f) If an alternate numbering system is developed under paragraph (e), patients who use numbers issued by the alternate numbering system are not required to provide their Social Security numbers and group purchasers or providers may not demand the Social Security numbers of patients who provide numbers issued by the alternate numbering system. If an alternate numbering system is developed under paragraph (e), group purchasers and health care providers shall establish procedures to notify patients that they can elect not to have their Social Security number used as the unique patient identifier.
(g) The commissioner of health may contract with the federal Secretary of Health and Human Services or the Secretary's agent to implement this subdivision.
1994 c 625 art 9 s 5; 1995 c 234 art 5 s 17; 1996 c 440 art 1 s 26-28; 1997 c 228 s 2; 1Sp1997 c 5 s 16; 2005 c 106 s 6,7; 2014 c 192 art 1 s 8-10
Structure Minnesota Statutes
Chapters 59A - 79A — Insurance
Chapter 62J — Health Care Cost Containment
Section 62J.016 — Goals Of Restructuring.
Section 62J.017 — Implementation Timetable.
Section 62J.04 — Monitoring The Rate Of Growth Of Health Care Spending.
Section 62J.041 — Interim Health Plan Company Cost Containment Goals.
Section 62J.052 — Provider Cost Disclosure.
Section 62J.06 — Immunity From Liability.
Section 62J.156 — Closed Committee Hearings.
Section 62J.17 — Expenditure Reporting.
Section 62J.212 — Public Health Goals.
Section 62J.22 — Participation Of Federal Programs.
Section 62J.23 — Provider Conflicts Of Interest.
Section 62J.25 — Mandatory Medicare Assignment.
Section 62J.26 — Evaluation Of Proposed Health Coverage Mandates.
Section 62J.2930 — Information Clearinghouse.
Section 62J.301 — Research And Data Initiatives.
Section 62J.311 — Analysis And Use Of Data.
Section 62J.321 — Data Collection And Processing Procedures.
Section 62J.38 — Cost Containment Data From Group Purchasers.
Section 62J.40 — Cost Containment Data From State Agencies And Other Governmental Units.
Section 62J.42 — Quality, Utilization, And Outcome Data.
Section 62J.431 — Evidence-based Health Care Guidelines.
Section 62J.46 — Monitoring And Reports.
Section 62J.48 — Criteria For Ambulance Services Reimbursement.
Section 62J.49 — Ambulance Services Financial Data.
Section 62J.495 — Electronic Health Record Technology.
Section 62J.496 — Electronic Health Record System Revolving Account And Loan Program.
Section 62J.497 — Electronic Prescription Drug Program.
Section 62J.498 — Health Information Exchange.
Section 62J.4981 — Certificate Of Authority To Provide Health Information Exchange Services.
Section 62J.4982 — Enforcement Authority; Compliance.
Section 62J.50 — Citation And Purpose.
Section 62J.52 — Establishment Of Uniform Billing Forms.
Section 62J.53 — Acceptance Of Uniform Billing Forms By Group Purchasers.
Section 62J.535 — Uniform Billing Requirements For Claim Transactions.
Section 62J.536 — Uniform Electronic Transactions And Implementation Guide Standards.
Section 62J.54 — Identification And Implementation Of Unique Identifiers.
Section 62J.55 — Privacy Of Unique Identifiers.
Section 62J.56 — Implementation Of Electronic Data Interchange Standards.
Section 62J.57 — Minnesota Center For Health Care Electronic Data Interchange.
Section 62J.581 — Standards For Minnesota Uniform Health Care Reimbursement Documents.
Section 62J.60 — Minnesota Uniform Health Care Identification Card.
Section 62J.61 — Rulemaking; Implementation.
Section 62J.62 — Electronic Billing Assistance.
Section 62J.63 — Center For Health Care Purchasing Improvement.
Section 62J.692 — Medical Education.
Section 62J.701 — Governmental Programs.
Section 62J.71 — Prohibited Provider Contracts.
Section 62J.72 — Disclosure Of Health Care Provider Information.
Section 62J.73 — Prohibition On Exclusive Arrangements.
Section 62J.76 — Nonpreemption.
Section 62J.81 — Disclosure Of Payments For Health Care Services.
Section 62J.812 — Primary Care Price Transparency.
Section 62J.82 — Hospital Information Reporting Disclosure.
Section 62J.823 — Hospital Pricing Transparency.
Section 62J.824 — Facility Fee Disclosure.