Minnesota Health Insurance Enforcement and Consumer Protections Grant Award

Cycle I Grant Application Summary

Minnesota Grantee: Minnesota Department of Commerce

Award Date: October 31, 2016

Total Award: $1,160,020.69

Baseline Award: $476,998

Selected Market Reforms Amount: $510,000

Workload Award Amount: $173,022.69

• Section 2707- The Minnesota Department of Commerce will develop standard operating procedures to assist in formulary review, checklists to ensure compliance with Essential Health Benefit requirements and monitor for nondiscrimination issues in form filings, checklists and tools to instruct health insurance issuers on important requirements. Minnesota will also develop fact sheets and frequently asked questions (FAQs) as part of its consumer outreach efforts. Finally, the Department of Commerce will develop a system to audit health insurance filings to ensure compliance with EHB and nondiscrimination requirements.

• Section 2713 - The Minnesota Department of Commerce will develop a checklist to assist staff in reviewing filings for preventive services coverage as well as a checklist and tools to instruct health insurance issuers in submitting forms and understanding the requirements for compliance through the review process. Minnesota will conduct audits to ensure that in-network use of the required preventive services were followed and compliance with zero percent cost sharing was similarly followed on those services. Minnesota will also develop and implement consumer outreach material, which will include Frequently Asked Questions and fact sheets to explain preventative health services coverage requirements as well as outreach through social media and the Departments’ websites.

• Section 2726 - The Minnesota Department of Commerce will formulate new standard operating procedures for review of the form filings for compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA). Minnesota will focus tools and checklists on non-quantitative limitations, due to the current difficulty in reviewing for compliance with those markers. The Minnesota Department of Commerce will also develop a system for auditing health insurance issuers for compliance with MHPAEA. In addition to developing fact sheets, FAQs, and presentations to improve the awareness of the protections available to consumers under MHPAEA, Minnesota will also enhance the Department’s consumer complaints registry. Finally, the Minnesota Department of Commerce will participate in legislative initiatives to ensure better compliance with MHPAEA in the form filings and practical application of those products.