Health Care Administrative Simplification

Health care is a more than $35 billion per year enterprise in Minnesota, generating millions of administrative transactions between health care providers, payers, intermediaries, and vendors. The Health Care Administrative Simplification Act (ASA) of 1994, Minnesota Statutes, sections 62J.50 – 62J.61, was passed to bring about greater standardization of health care administrative transactions and more electronic exchange of administrative data, to reduce administrative costs and burden.

The Minnesota Department of Health (MDH) Health Policy Division, in collaboration with advisory and standards-setting organizations, is implementing the ASA as part of ongoing efforts to streamline and simplify health care administration.

Please note the status updates below regarding proposed revised Minnesota Uniform Companion Guides (MUCG). The MUCG are required pursuant to Minnesota Statutes, section 62J.536.

• MUCG for the Implementation of the ASC X12/005010X222A1 Health Care Claim: Professional (837), version 17.0 (PDF)
• MUCG for the Implementation of the ASC X12/005010X223A2 Health Care Claim: Institutional (837), version 17.0 (PDF)

The Minnesota Department of Health (MDH) published a notice in the June 12, 2023 edition of the Minnesota State Register announcing the availability of the above referenced Minnesota Uniform Companion Guide (MUCG) proposed rules and the start of a 30-day public comment period. The public comment period concluded July 12, 2023. No comments were received.

• MUCG for the Implementation of the ASC X12/005010X279A1 Health Care Eligibility Benefit Inquiry and Response (270/271), version 13.0 (PDF)

MDH published a notice in the July 17, 2023 edition of the Minnesota State Register announcing the availability of the above referenced MUCG proposed rule and the start of a 30-day public comment period. The public comment period concluded August 16, 2023. No comments were received.

MDH will be submitting copies of the proposed revised MUCGs to X12 for review pursuant to X12’s Intellectual Property (IP) Use guidelines. Following completion of the review, MDH will complete the process of adopting the proposed rules as final rules pursuant to Minnesota Statutes, section 62J.61. The final rules will be published in the Minnesota State Register at a future date to be determined. MDH will also announce the publication of the final rules in future AUC updates.

For additional background and information, please see the Health Care Administrative Simplification webpage.

The Minnesota Department of Health (MDH) published a notice in the Minnesota State Register announcing the availability of the following Minnesota Uniform Companion Guide (MUCG) proposed rule for public comment:

• MUCG for the Implementation of the ASC X12/005010X279A1 Health Care Eligibility Benefit Inquiry and Response (270/271), version 13.0 (PDF)

The proposed rule was developed in consultation with the Minnesota Administrative Uniformity Committee (AUC). More information regarding the proposed rule is available in the July 17, 2023 Minnesota State Register notice, Volume 48, No. 3.

Written comments regarding the proposed rule will be accepted during a 30-day public comment period beginning Monday, July 17, 2023 until 4:00 p.m. Wednesday, August 16, 2023. All comments must be submitted via the Minnesota Office of Administrative Hearings (OAH) Rulemaking e-comments website.

We are changing the way you receive AUC communications and updates by moving the majority of AUC and related communications to the Minnesota Department of Health (MDH) “GovDelivery” subscription feature. The change is being made to enable you to choose the types of information you would like to receive and to easily change your preferences. If you were already subscribed to AUC Update via GovDelivery you should have already received information about this transition.

Please note that if you do not subscribe with GovDelivery you will not receive updates regarding AUC Technical Advisory Group (TAG) meetings, proposed or adopted Minnesota Uniform Companion Guides (MUCG), and other related information.

If you were not already subscribed to receive AUC Update or if you want to change your preferences, go to Subscribe to AUC Updates and follow the directions for setting up an account. To modify your subscriptions choose, Subscriber Preferences and/or Add Subscriptions. You will have the ability as desired to sign up – or unsubscribe – for the following options:

General AUC Updates

• News & Information Updates News and information of general interest, including announcements regarding the AUC Operations Committee, and Minnesota Department of Health rulemaking.

Individual Technical Advisory Groups (TAG)

• AUC Claims DD TAG Updates This workgroup focuses primarily on exchange of electronic health care claims (X12 v5010 “837 Dental, 837 Institutional, 837 Professional” and NCPDP D.0 Pharmacy Claim Submission and Response and Pharmacy Reversal Submission and Response).
• AUC Eligibility TAG Updates This workgroup focuses primarily on exchange of electronic health care eligibility inquiries and responses (X12 v5010 “270-21”).
• AUC EOB/Remit TAG Updates This workgroup focuses primarily on exchange of electronic health care remittance advices (X12 v5010 “835”).
• AUC Medical Code TAG Updates This workgroup focuses primarily on medical coding issues in the context of the exchange of electronic health care claims (X12 v5010 “837 Dental, 837 Institutional, 837 Professional”).

The Minnesota Department of Health (MDH) published a notice in the Minnesota State Register announcing the availability of the following Minnesota Uniform Companion Guide (MUCG) proposed rules for public comment:

• MUCG for the Implementation of the ASC X12/005010X222A1 Health Care Claim: Professional (837), version 17.0 (PDF)
• MUCG for the Implementation of the ASC X12/005010X223A2 Health Care Claim: Institutional (837), version 17.0 (PDF)

The proposed rules were developed in consultation with the Minnesota Administrative Uniformity Committee (AUC). More information regarding the proposed rules is available in the June 12, 2023 Minnesota State Register notice, Volume 47, No. 50.

Written comments regarding the proposed rules will be accepted during a 30-day public comment period beginning Monday, June 12, 2023 until 4:00 p.m. Wednesday, July 12, 2023. All comments must be submitted via the Minnesota Office of Administrative Hearings (OAH) Rulemaking e-comments website.

The Minnesota Department of Health (MDH) published a notice in Minnesota State Register announcing a statutorily authorized limited exception from Minnesota’s requirements for the standard, electronic exchange of Eligibility (270/271) transactions for group purchasers (payers) not subject to federal HIPAA transactions and code sets regulations (PDF) is continued through June 30, 2024.

This exception applies only to exchanges of the ASCX12/005010X279A1 Health Care Eligibility Benefit Inquiry and Response (270/271) transaction with health care group purchasers (payers) that are not subject to federal HIPAA transactions and code sets regulations, and only through June 30, 2024. The exception applies to workers’ compensation, auto, and property and casualty carriers.

More information regarding the limited exception is available in the June 12, 2023 Minnesota State Register notice, Volume 47, No. 50.

The limited, one-year exception is reviewed annually. The next annual review of this exception to rules adopted pursuant to Minnesota Statutes §62J.536 is scheduled for April-May 2024, to determine whether the exception will be continued through June 2025.