1.1    .................... moves to amend S. F. No. 2171, the second unofficial engrossment
1.2(UES2171-2), as follows:
1.3Page 331, after line 11, insert:

1.4    "Sec. 4. [62J.431] EVIDENCE-BASED HEALTH CARE GUIDELINES.
1.5    Evidence-based guidelines must meet the following criteria:
1.6    (1) the scope and application are clear;
1.7    (2) authorship is stated and any conflicts of interest disclosed;
1.8    (3) authors represent all pertinent clinical fields or other means of input have been
1.9used;
1.10    (4) the development process is explicitly stated;
1.11    (5) the guideline is grounded in evidence;
1.12    (6) the evidence is cited and grated;
1.13    (7) the document itself is clear and practical;
1.14    (8) the document is flexible in use, with exceptions noted or provided for with
1.15general statements;
1.16    (9) measures are included for use in systems improvement; and
1.17    (10) the guideline has scheduled reviews and updating.

1.18    Sec. 5. Minnesota Statutes 2006, section 62J.60, is amended by adding a subdivision to
1.19read:
1.20    Subd. 3a. Required statement. An identification card issued to an enrollee by a
1.21health plan company or other entity governed by Minnesota health coverage laws must
1.22contain the following statement: "Subject to Minnesota law."

1.23    Sec. 6. [62Q.101] EVALUATION OF PROVIDER PERFORMANCE.
1.24    Subdivision 1. Use of patient-paid charges. A health plan company, or a vendor of
1.25risk management services as defined under section 60A.23, subdivision 8, shall not, in
2.1evaluating the performance of a health care provider, include patient-paid costs or charges
2.2as a factor in the performance evaluation.
2.3    Subd. 2. Performance targets; reasonable basis and disclosure required. A
2.4health plan company, or a vendor of risk management services as defined under section
2.560A.23, subdivision 8, shall, in evaluating the performance of a health care provider:
2.6    (1) conduct the evaluation using a bona fide baseline based upon practice experience
2.7of the provider group; and
2.8    (2) disclose the baseline to the health care provider in writing and prior to the
2.9beginning of the time period used for the evaluation.

2.10    Sec. 7. Minnesota Statutes 2006, section 62Q.17, is amended to read:
2.1162Q.17 VOLUNTARY PURCHASING POOLS.
2.12    Subdivision 1. Permission to form. Notwithstanding section 62A.10, employers,
2.13groups, and individuals may voluntarily form purchasing pools, solely for the purpose
2.14of negotiating and purchasing health plan coverage from health plan companies for
2.15members of the pool.
2.16    Subd. 2. Common factors. All participants in a purchasing pool must live within a
2.17common geographic region, be employed in a similar occupation, or share some other
2.18common factor as approved by the commissioner of commerce. The membership criteria
2.19must not be designed to include disproportionately employers, groups, or individuals
2.20likely to have low costs of health coverage, or to exclude disproportionately employers,
2.21groups, or individuals likely to have high costs of health coverage.
2.22    Subd. 3. Governing structure. Each pool must have a governing structure
2.23controlled by its members. The governing structure of the pool is responsible for
2.24administration of the pool. The governing structure shall review and evaluate all bids for
2.25coverage from health plan companies, shall determine criteria for joining and leaving the
2.26pool, and may design incentives for healthy lifestyles and health promotion programs.
2.27The governing structure may design uniform entrance standards for all employers, except
2.28small employers as defined under section 62L.02. Small employers must be permitted to
2.29enter any pool if the small employer meets the pool's membership requirements. Pools
2.30must provide as much choice in health plans to members as is financially possible. The
2.31governing structure may charge all members a fee for administrative purposes.
2.32    Subd. 4. Enrollment. Pools must have an annual open enrollment period of not less
2.33than 15 days, during which all individuals or groups that qualify for membership may enter
2.34the pool without any preexisting condition limitations or exclusions or exclusionary riders,
2.35except those permitted under chapter 62L for groups or section 62A.65 for individuals.
3.1Pools must reach and maintain an enrolled population of at least 1,000 members within
3.2six months one year of formation. If a pool fails to reach or maintain the minimum
3.3enrollment, all coverage subsequently purchased through the purchasing pool must be
3.4regulated through existing applicable laws and forego all advantages under this section.
3.5    Subd. 5. Members. The governing structure of the pool shall set a minimum time
3.6period for membership, which must be no less than five years. Members must stay in the
3.7purchasing pool for the entire minimum period to avoid paying a penalty. Penalties for
3.8early withdrawal from the purchasing pool shall be established by the governing structure.
3.9    Subd. 6. Employer-based purchasing pools. Employer-based purchasing
3.10pools must, with respect to small employers as defined in section 62L.02, meet all the
3.11requirements of chapter 62L. The experience of the pool must be pooled and the rates
3.12blended across all groups. Pools may decide to create tiers within the pool, based on
3.13experience of group members. These tiers must be designed within the requirements
3.14of section 62L.08. The governing structure may establish criteria limiting movement
3.15between tiers. Tiers must be phased out within two years of the pool's creation.
3.16    Subd. 7. Individual members. Purchasing pools that contain individual members
3.17must meet all of the underwriting and rate restrictions found in the individual health
3.18plan market.
3.19    Subd. 8. Reports. Prior to the initial effective date of coverage, and annually on
3.20July 1 thereafter, each pool shall file a report with the information clearinghouse and
3.21the commissioner of commerce. The information clearinghouse must use the report to
3.22promote the purchasing pools. The annual report must contain the following information:
3.23    (1) the number of lives in the pool;
3.24    (2) the geographic area the pool intends to cover;
3.25    (3) the number of health plans offered;
3.26    (4) a description of the benefits under each plan;
3.27    (5) a description of the premium structure, including any co-payments or deductibles,
3.28of each plan offered;
3.29    (6) evidence of compliance with chapter 62L;
3.30    (7) a sample of marketing information, including a phone number where the pool
3.31may be contacted; and
3.32    (8) a list of all administrative fees charged.
3.33    Subd. 9. Enforcement. Purchasing pools must register prior to offering coverage,
3.34and annually on July 1 thereafter, with the commissioner of commerce on a form
3.35prescribed by the commissioner. The commissioner of commerce shall enforce this
4.1section and all other state laws with respect to purchasing pools, and has for that purpose
4.2all general rulemaking and enforcement powers otherwise available to the commissioner
4.3of commerce. The commissioner may charge an annual registration fee sufficient to meet
4.4the costs of the commissioner's duties under this section.
4.5    Subd. 10. No effect on certain arrangements. Nothing in this section precludes
4.6groups of employers, including businesses of one, from forming a multiple employer
4.7welfare arrangement under chapter 62H or a purchasing alliance under chapter 62T, or
4.8precludes such groups from using a combination of chapters 62H and 62T for joint pooling
4.9purposes. Those types of group arrangements are not subject to this section."
4.10Page 332, after line 22, insert:

4.11    "Sec. 9. [62Q.676] MEDICATION THERAPY MANAGEMENT CARE.
4.12    A pharmacy benefit manager that provides prescription drug services must provide
4.13medication therapy management services for enrollees taking four or more prescriptions to
4.14treat or prevent two or more chronic medical conditions. For purposes of this subdivision,
4.15"medication therapy management" means the provision of the following pharmaceutical
4.16care services by a Minnesota licensed pharmacist to optimize the therapeutic outcomes of
4.17the patient's medications:
4.18    (1) performing a comprehensive medication review to identify, resolve, and prevent
4.19medication-related problems, including adverse drug events;
4.20    (2) communicating essential information to the patient's other primary care
4.21providers; and
4.22    (3) providing verbal education and training designed to enhance patient
4.23understanding and appropriate use of the patient's medications.
4.24    Nothing in this section shall be construed to expand or modify the scope of practice
4.25of the pharmacist as defined in section 151.01, subdivision 27."
4.26Page 332, after line 27, insert:

4.27    "Sec. 11. [145.985] HEALTH PROMOTION AND WELLNESS.
4.28    Community health boards as defined in section 145A.02, subdivision 5, shall work
4.29with schools, health care providers, and others to coordinate health and wellness programs
4.30in their communities. In order to meet the requirements of this section, community
4.31health boards shall:
4.32    (1) provide instruction, technical assistance, and recommendations on how to
4.33evaluate project outcomes;
4.34    (2) assist with on-site health and wellness programs utilizing volunteers and others
4.35addressing health and wellness topics including smoking, nutrition, obesity, and others; and
5.1    (3) encourage health and wellness programs consistent with the Centers for Disease
5.2Control and Prevention's Community Guide and goals consistent with the Centers for
5.3Disease Control and Prevention's Healthy People 2010 initiative."
5.4Renumber the sections in sequence and correct the internal references
5.5Amend the title accordingly