1.1.................... moves to amend H.F. No. 3056 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2008, section 62U.04, subdivision 3, is amended to read:
1.4    Subd. 3. Provider peer grouping. (a) The commissioner shall develop a peer
1.5grouping system for providers based on a combined measure that incorporates both
1.6provider risk-adjusted cost of care and quality of care, and for specific conditions as
1.7determined by the commissioner. In developing this system, the commissioner shall
1.8consult and coordinate with health care providers, health plan companies, state agencies,
1.9and organizations that work to improve health care quality in Minnesota. For purposes of
1.10the final establishment of the peer grouping system, the commissioner shall not contract
1.11with any private entity, organization, or consortium of entities that has or will have a direct
1.12financial interest in the outcome of the system.
1.13    (b) Beginning June 1 By no later than October 15, 2010, the commissioner shall
1.14disseminate information to providers on their total cost of care, total resource use, total
1.15quality of care, and the total care results of the grouping developed under this subdivision
1.16in comparison to an appropriate peer group. Any analyses or reports that identify
1.17providers may only be published after the provider has been provided the opportunity by
1.18the commissioner to review the underlying data and submit comments. Providers may be
1.19given any data for which they are the subject of the data. The provider shall have 21 30
1.20days to review the data for accuracy and initiate an appeal as specified in paragraph (d).
1.21    (c) By no later than January 1, 2011, the commissioner shall disseminate information
1.22to providers on their condition-specific cost of care, condition-specific resource use,
1.23condition-specific quality of care, and the condition-specific results of the grouping
1.24developed under this subdivision in comparison to an appropriate peer group. Any
1.25analyses or reports that identify providers may only be published after the provider has
1.26been provided the opportunity by the commissioner to review the underlying data and
1.27submit comments. Providers may be given any data for which they are the subject of the
2.1data. The provider shall have 30 days to review the data for accuracy and initiate an
2.2appeal as specified in paragraph (d).
2.3(d) The commissioner shall establish an appeals process to resolve disputes from
2.4providers regarding the accuracy of the data used to develop analyses or reports. When
2.5a provider appeals the accuracy of the data used to calculate the peer grouping system
2.6results, the provider shall:
2.7(1) clearly indicate the reason they believe the data used to calculate the peer group
2.8system results are not accurate;
2.9(2) provide evidence and documentation to support the reason that data was not
2.10accurate; and
2.11(3) cooperate with the commissioner, including allowing the commissioner access to
2.12data necessary and relevant to resolving the dispute.
2.13If a provider does not meet the requirements of this paragraph, a provider's appeal shall be
2.14considered withdrawn. The commissioner shall not publish results for a specific provider
2.15under paragraph (e) or (f) while that provider has an unresolved appeal.
2.16    (d) (e) Beginning September 1, 2010 January 1, 2011, the commissioner shall, no
2.17less than annually, publish information on providers' total cost, total resource use, total
2.18quality, and the results of the total care portion of the peer grouping process. The results
2.19that are published must be on a risk-adjusted basis.
2.20(f) Beginning March 30, 2011, the commissioner shall no less than annually
2.21publish information on providers' condition-specific cost, condition-specific resource use,
2.22condition-specific quality, and the results of the condition-specific portion of the peer
2.23grouping process. The results that are published must be on a risk-adjusted basis.
2.24(g) Prior to disseminating data to providers under paragraphs (b) or (c) or publishing
2.25information under paragraph (e) or (f), the commissioner shall assure the scientific validity
2.26and reliability of the results according to the standards described in paragraph (h). If
2.27additional time is needed to establish the scientific validity and reliability of the results,
2.28the commissioner may delay the dissemination of data to providers under paragraph (b) or
2.29(c), or the publication of information under paragraph (e) or (f). If the delay is more than
2.3060 days, the commissioner shall report in writing to the Legislative Commission on Health
2.31Care Access the following information:
2.32(1) the reason for the delay;
2.33(2) the actions being taken to resolve the delay and establish the scientific validity
2.34and reliability of the results; and
2.35(3) the new dates by which the results shall be disseminated.
3.1If there is a delay under this paragraph, the commissioner must disseminate the
3.2information to providers under paragraph (b) or (c) at least 90 days before publishing
3.3results under paragraph (e) or (f).
3.4(h) The commissioner's assurance of valid and reliable clinic and hospital peer
3.5grouping performance results shall include, at a minimum, the following:
3.6(1) use of the best available evidence, research, and methodologies;
3.7(2) a reliability threshold of no less than 0.70 for purposes of disseminating data to
3.8providers and of no less than 0.80 for purposes of public reporting.
3.9In achieving these thresholds, the commissioner shall not aggregate clinics that are
3.10not part of the same system or practice group. The commissioner shall consult with and
3.11solicit feed back from representatives of physician clinics and hospitals during the peer
3.12grouping data analysis process to obtain input on the methodological options prior to final
3.13analysis and on the design, development, and testing of provider reports.

3.14    Sec. 2. Minnesota Statutes 2008, section 62U.04, subdivision 9, is amended to read:
3.15    Subd. 9. Uses of information. (a) By January 1, 2011 no later than 12 months after
3.16the commissioner publishes the information in section 62U.04, subdivision 3, paragraph
3.18    (1) the commissioner of management and budget shall use the information and
3.19methods developed under subdivision 3 to strengthen incentives for members of the state
3.20employee group insurance program to use high-quality, low-cost providers;
3.21    (2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer
3.22health benefits to their employees must offer plans that differentiate providers on their
3.23cost and quality performance and create incentives for members to use better-performing
3.25    (3) all health plan companies shall use the information and methods developed
3.26under subdivision 3 to develop products that encourage consumers to use high-quality,
3.27low-cost providers; and
3.28    (4) health plan companies that issue health plans in the individual market or the
3.29small employer market must offer at least one health plan that uses the information
3.30developed under subdivision 3 to establish financial incentives for consumers to choose
3.31higher-quality, lower-cost providers through enrollee cost-sharing or selective provider
3.33    (b) By January 1, 2011, the commissioner of health shall report to the governor
3.34and the legislature on recommendations to encourage health plan companies to promote
3.35widespread adoption of products that encourage the use of high-quality, low-cost providers.
4.1The commissioner's recommendations may include tax incentives, public reporting of
4.2health plan performance, regulatory incentives or changes, and other strategies.

4.3    Sec. 3. Minnesota Statutes 2008, section 256B.0754, subdivision 2, is amended to read:
4.4    Subd. 2. Payment reform. By January 1, 2011 no later than 12 months after the
4.5commissioner of health publishes the information in section 62U.04, subdivision 3,
4.6paragraph (e), the commissioner of human services shall use the information and methods
4.7developed under section 62U.04 to establish a payment system that:
4.8    (1) rewards high-quality, low-cost providers;
4.9    (2) creates enrollee incentives to receive care from high-quality, low-cost providers;
4.11    (3) fosters collaboration among providers to reduce cost shifting from one part of
4.12the health continuum to another.

4.13    Sec. 4. REPEALER.
4.14Minnesota Statutes 2009 Supplement, section 256B.032, is repealed."
4.15Delete the title and insert:
4.16"A bill for an act
4.17relating to health; modifying the provider peer grouping timelines and system;
4.18amending Minnesota Statutes 2008, sections 62U.04, subdivisions 3, 9;
4.19256B.0754, subdivision 2; repealing Minnesota Statutes 2009 Supplement,
4.20section 256B.032."