SF 5103

03/18/26  REVISOR  SGS/MI  26-08164  as introduced
  SENATE
  STATE OF MINNESOTA
  NINETY-FOURTH SESSION  S.F. No. 5103
  (SENATE AUTHORS: UTKE)
  DATE       D-PG  OFFICIAL STATUS
  04/13/2026      8001 Introduction and first reading
  Referred to Commerce and Consumer Protection
1.1A bill for an act
1.2relating to insurance; prohibiting contractual provisions between hospitals and
1.3health plan companies; defining terms relating to provider contracting agreements;
1.4amending Minnesota Statutes 2024, section 62Q.733, by adding subdivisions;
1.5proposing coding for new law in Minnesota Statutes, chapter 62Q.
1.6      BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7Section 1. Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision
1.8      to read:
1.9Subd. 1a. Antisteering clause. "Antisteering clause" means a provision that restricts
1.10     the ability of a health plan company to encourage an enrollee to obtain a health care item
1.11     or service from a competitor of the provider, including offering incentives to encourage
1.12     enrollees to use specific providers.
1.13Sec. 2. Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to
1.14     read:
1.15Subd. 1b. Antitiering clause. "Antitiering clause" means a provision that:
1.16(1) restricts the ability of a health plan company to introduce or modify a tiered network
1.17     plan or assign providers into tiers; or
1.18(2) requires a health plan company to place all members of a provider in the same tier
1.19     of a tiered network plan.
Sec. 2.  1
 03/18/26  REVISOR  SGS/MI  26-08164  as introduced
2.1    Sec. 3. Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to
2.2  read:
2.3      Subd. 2a. Gag clause. "Gag clause" means a provision that restricts the ability of a health
2.4  plan company or provider to disclose:
2.5      (1) price or quality information, including the allowed amount, negotiated rates or
2.6  discounts, fees for services, or other claim-related financial obligations included in the
2.7  contract to a governmental entity as authorized by law or the health plan company's
2.8  contractors or agents, an enrollee, a treating provider of an enrollee, a plan sponsor, or
2.9  potential eligible enrollees and plan sponsors; or
2.10     (2) out-of-pocket costs to an enrollee.
2.11   Sec. 4. Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to
2.12 read:
2.13     Subd. 6. Hospital. "Hospital" has the meaning given in section 144.696.
2.14   Sec. 5. Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to
2.15 read:
2.16     Subd. 7. Most favored nation clause. "Most favored nation clause" means a provision
2.17 that:
2.18     (1) prohibits or grants an option to prohibit:
2.19     (i) a provider from contracting with another health plan company to provide health care
2.20 services at a lower rate; or
2.21     (ii) a health plan company from contracting with another provider to provide health care
2.22 services at a higher rate;
2.23     (2) requires or grants an option to require:
2.24     (i) a provider to accept a lower rate for health care services if the provider agrees with
2.25 another health plan company to accept a lower rate for the services; or
2.26     (ii) a health plan company to pay a higher rate for health care services if the entity agrees
2.27 with another provider to pay a higher rate for the services;
2.28     (3) requires or grants an option to require termination or renegotiation of an existing
2.29 contract if:
 Sec. 5.  2
 03/18/26  REVISOR  SGS/MI  26-08164  as introduced
3.1      (i) a provider agrees with another health plan company to accept a lower rate for providing
3.2  health care services; or
3.3      (ii) a health plan company agrees with a provider to pay a higher rate for health care
3.4  services; or
3.5      (4) requires:
3.6      (i) a provider to disclose the provider's contractual reimbursement rates with other general
3.7  contracting entities; or
3.8      (ii) a health plan company to disclose the health plan company's contractual
3.9  reimbursement rates with other providers.
3.10   Sec. 6. [62Q.738] PROHIBITED HOSPITAL CONTRACTING PROVISIONS.
3.11     Subdivision 1. Prohibited provisions. A hospital must not:
3.12     (1) offer to a health plan company a contract that includes an antisteering, antitiering,
3.13 gag, or most favored nation clause;
3.14     (2) enter into a contract that includes an antisteering, antitiering, gag, or most favored
3.15 nation clause; or
3.16     (3) amend or renew an existing contract previously entered into with a health plan
3.17 company so that the contract as amended or renewed adds or retains an antisteering,
3.18 antitiering, gag, or most favored nation clause.
3.19     Subd. 2. Provisions void and severable. Antisteering, antitiering, gag, or most favored
3.20 nation clauses violating this section are void and unenforceable. The remaining provisions
3.21 in the contract remain in effect and are enforceable.
3.22     Subd. 3. Health plan company fiduciary duties. A health plan company has a fiduciary
3.23 duty to the enrollee and policyholder to engage in the applicable conduct only for the primary
3.24 benefit of the enrollee or policyholder if the health plan company:
3.25     (1) encourages an enrollee to obtain health care items or services from a particular
3.26 provider, including offering incentives to encourage enrollees to use specific providers;
3.27     (2) introduces or modifies a tiered network plan; or
3.28     (3) assigns providers into tiers.
 Sec. 6.  3