1.1    .................... moves to amend H. F. No. 3391, the second engrossment, as follows:
1.2Page 21, after line 9, insert

1.3    "Section 1. Minnesota Statutes 2006, section 62J.26, is amended to read:
1.462J.26 EVALUATION OF PROPOSED HEALTH COVERAGE MANDATES.
1.5    Subdivision 1. Definitions. For purposes of this section, the following terms have
1.6the meanings given unless the context otherwise requires:
1.7    (1) "commissioner" means the commissioner of commerce health;
1.8    (2) "Cost effective" means that the economic costs of using a particular service,
1.9device, or health technology to achieve improvement in a patient's health outcome are
1.10justified given the comparison to both the economic costs and the improvement in patient
1.11health outcome resulting from the use of an alternative service, device, or technology, or
1.12from not providing the service, device, or technology;
1.13    (3) "enacted mandated health benefit" means a mandated health benefit that is
1.14already enacted and contained in chapter 62A or chapter 62Q;
1.15    (2) (4) "health plan" means a health plan as defined in section 62A.011, subdivision
1.163 , but includes coverage listed in clauses (7) and (10) of that definition;
1.17    (3) (5) "mandated health benefit proposal" means a proposal that would statutorily
1.18require statutory or regulatory requirement that a health plan to do the following:
1.19    (i) provide coverage or increase the amount of coverage for the treatment of a
1.20particular disease, condition, or other health care need;
1.21    (ii) provide coverage or increase the amount of coverage of a particular type of
1.22health care treatment or service or of equipment, supplies, or drugs used in connection
1.23with a health care treatment or service; or
1.24    (iii) provide coverage for care delivered by a specific type of provider.
1.25    "Mandated health benefit proposal" does not include a health benefit proposals
1.26amending provision that solely amends the scope of practice of a licensed health care
1.27professional.;
2.1    (6) "proposed mandated health benefit" means a mandated health benefit proposed
2.2for enactment in a bill that is pending in the legislature or under consideration as a
2.3regulatory requirement by a state agency;
2.4    (7) "regulatory mandated health benefit" means a mandated health benefit that a
2.5regulatory agency of this state has in effect required through an order, action, review,
2.6policy, or approval or denial of a request for approval of a policy or other contract of health
2.7coverage, where there is not an enacted mandated health benefit that clearly supports
2.8the regulatory agency's position.
2.9    Subd. 2. Evaluation process and content. (a) The commissioner, in consultation
2.10with the commissioners of health and employee relations commissioner of commerce,
2.11must evaluate mandated health benefit proposals as provided under subdivision 3.
2.12    (b) The purpose of the evaluation is to provide the legislature with a complete
2.13and timely analysis of all ramifications of any mandated health benefit proposal. The
2.14evaluation must include, in addition to other relevant information, the following:
2.15    (1) an evidence-based scientific review of the proposed treatment, service,
2.16equipment, supply, or drug. "Evidence-based scientific review" means a review that
2.17examines reliable scientific evidence regarding safety, effectiveness, and effect on health
2.18outcomes. The standard for the review must use a preponderance of reliable evidence as
2.19described in Minnesota Rules, part 4685.0700, subpart 2, item F;
2.20    (1) (2) scientific and medical information on the proposed health benefit, on the
2.21potential for harm or benefit to the patient, and on the comparative benefit or harm from
2.22alternative forms of treatment;
2.23    (2) (3) public health, economic, and fiscal impacts of the proposed mandate
2.24mandated health benefit on persons receiving health services in Minnesota, on the relative
2.25cost-effectiveness of the benefit, and on the health care system in general;
2.26    (4) the extent to which the proposed mandated health benefit would be cost effective;
2.27    (3) (5) the extent to which the service proposed mandated health benefit is generally
2.28utilized by a significant portion of the population;
2.29    (4) (6) the extent to which insurance coverage for the proposed mandated health
2.30benefit is already generally available;
2.31    (5) (7) the extent to which the mandated coverage will increase or decrease the
2.32cost of the service; and
2.33    (6) (8) the commissioner may consider actuarial analysis done by health insurers
2.34plan companies in determining the cost of the proposed mandated benefit.
2.35    (c) The commissioner must summarize the nature and quality of available
2.36information on these issues, and, if possible, must provide preliminary information to
3.1the public. The commissioner may conduct appropriate new research on these issues or
3.2may determine that existing research is sufficient to meet the informational needs of the
3.3legislature. The commissioner must include the opinion of two or more private firms
3.4that specialize in independent evaluation of health care treatments, services, equipment,
3.5supplies, or drugs, using evidence-based scientific review as defined in this subdivision.
3.6Additionally, the commissioner may seek the assistance and advice of researchers,
3.7community leaders, or other persons or organizations with relevant expertise.
3.8    Subd. 3. Requests for evaluation. (a) Whenever a legislative measure containing
3.9a proposed mandated health benefit proposal is introduced as a bill or offered as an
3.10amendment to a bill, or is likely to be introduced as a bill or offered as an amendment,
3.11a the chair of any the standing legislative committee that has primary jurisdiction over
3.12the subject matter of the proposal may shall request that the commissioner complete an
3.13evaluation of the proposal under this section, to inform any committee of the legislature
3.14prior to floor action by either house of the legislature. The chair may request review of a
3.15proposed mandated health benefit proposal that is likely to be introduced as a bill or
3.16offered as an amendment. The legislature must not act on the measure on the house or
3.17senate floor until it receives the report under subdivision 5.
3.18    (b) Whenever a regulatory agency proposes to adopt any regulatory mandated health
3.19benefit, the proponent of the proposed regulatory mandated health benefit shall request the
3.20commissioner to complete an evaluation described in subdivision 2, in order to inform
3.21the proponent prior to final order, action, or contract review. The agency shall not adopt
3.22the proposed regulatory health benefit mandate until completion of the review by a
3.23report described in subdivision 5. If the proponent is the commissioner of health, the
3.24commissioner of commerce shall do the review.
3.25    (b) (c) The commissioner must conduct an evaluation described in subdivision 2
3.26of each mandated health benefit proposal for which an evaluation is requested under
3.27paragraph (a) or (b), unless the commissioner determines under paragraph (c) or
3.28subdivision 4 that priorities and resources do not permit its evaluation.
3.29    (c) (d) If requests for evaluation of multiple proposals are received, the commissioner
3.30must consult with the chairs of the standing legislative committees having primary
3.31jurisdiction over the subject matter of the mandated health benefit proposals, and the
3.32regulatory agency, in the case of a proposed regulatory mandated health benefit, to
3.33prioritize the requests and establish a reporting date for each proposal to be evaluated. The
3.34commissioner is not required to direct an unreasonable quantity of the commissioner's
3.35resources to these evaluations.
4.1    Subd. 4. Sources of funding. (a) The mandated health benefit review account is
4.2created as an account in the general fund. Money in the account does not cancel and
4.3is available until spent.
4.4    (a) (b) The commissioner need not use any funds for purposes of this section other
4.5than as provided in this subdivision or as specified in an appropriation.
4.6    (b) (c) The commissioner may seek and accept funding from sources other than the
4.7state to pay for evaluations under this section to supplement or replace state appropriations.
4.8Any money received under this paragraph must be deposited in the state treasury, credited
4.9to a separate account for this purpose in the special revenue fund, and is appropriated to
4.10the commissioner for purposes of this section.
4.11    (c) (d) If a request for an evaluation under this section has been made, the
4.12commissioner may use for purposes of the evaluation:
4.13    (1) funds in the mandated health benefit review account;
4.14    (1) (2) any other funds appropriated to the commissioner specifically for purposes
4.15of this section; or
4.16    (2) (3) funds available under paragraph (b) (c), if use of the funds for evaluation
4.17of that mandated health benefit proposal is consistent with any restrictions imposed by
4.18the source of the funds.
4.19    (d) (e) The commissioner must ensure that the source of the funding has no influence
4.20on the process or outcome of the evaluation.
4.21    Subd. 5. Report to legislature. (a) For a report under subdivision 3, paragraph
4.22(a), the commissioner must submit a written report on the evaluation to the legislature
4.23no later than 180 days after the request. The report must be submitted in compliance
4.24with sections 3.195 and 3.197.
4.25    (b) For a report under subdivision 3, paragraph (b), the commissioner must submit a
4.26written report on the evaluation to the requesting agency proponent no later than 180 days
4.27after the request and concurrently publish a notice in the State Register of the availability
4.28of the report to the public.
4.29    Subd. 6. Evaluation of enacted mandated health benefits. The commissioner
4.30of health shall contract with an unbiased reputable organization, experienced in analysis
4.31of health care services, to conduct a scientific evaluation of all enacted mandated health
4.32benefits and assess each benefit's cost effectiveness based upon the existing scientific and
4.33medical technology or knowledge. The commissioner shall determine the appropriate
4.34scope of each evaluation based upon the apparent cost and controversy of each enacted
4.35mandated health benefit."