What does the law (Minnesota Statutes, section 62J.536) do?
• Checking a patient’s eligibility and reporting back eligibility status; • Submitting and adjudicating claims; and • Producing and receiving a remittance advice (RA). These transactions must be transmitted electronically between providers and payers, using a single, uniform, standard data content and format, beginning on three different dates in 2009. The law also requires the Minnesota Department of Health (MDH) to develop rules for the standard data content and format of the transactions. MDH must consult on the rules with a large, voluntary stakeholder group, the Minnesota Administrative Uniformity Committee (AUC). The rules are to be based on federal HIPAA transactions and code sets regulations (see Q&A below) and Medicare, although exceptions from Medicare standards are permitted in developing the rules. The rules were adopted in 2008, at least one year before having the effect of law in 2009. MDH administers the law and the related rules, including compliance and enforcement.
