Plain English Breakdown
The plain English breakdown is still being put together. The official documents below are already here.
SF5103 • 2026
Contractual provisions prohibition between hospitals and health plan companies
Contractual provisions prohibition between hospitals and health plan companies
Healthcare
Passed Legislature
This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.
Bill History
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2026-04-13
House
Introduction and first reading
Official Summary Text
Contractual provisions prohibition between hospitals and health plan companies
Current Bill Text
Read the full stored bill text
A bill for an act relating to insurance; prohibiting contractual provisions between hospitals and health plan companies; defining terms relating to provider contracting agreements; amending Minnesota Statutes 2024, section 62Q.733, by adding subdivisions; proposing coding for new law in Minnesota Statutes, chapter 62Q. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: Section 1. Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to read: new text begin Subd. 1a. new text end new text begin Antisteering clause. new text end new text begin "Antisteering clause" means a provision that restricts the ability of a health plan company to encourage an enrollee to obtain a health care item or service from a competitor of the provider, including offering incentives to encourage enrollees to use specific providers. new text end Sec. 2. Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to read: new text begin Subd. 1b. new text end new text begin Antitiering clause. new text end new text begin "Antitiering clause" means a provision that: new text end new text begin (1) restricts the ability of a health plan company to introduce or modify a tiered network plan or assign providers into tiers; or new text end new text begin (2) requires a health plan company to place all members of a provider in the same tier of a tiered network plan. new text end Sec. 3. Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to read: new text begin Subd. 2a. new text end new text begin Gag clause. new text end new text begin "Gag clause" means a provision that restricts the ability of a health plan company or provider to disclose: new text end new text begin (1) price or quality information, including the allowed amount, negotiated rates or discounts, fees for services, or other claim-related financial obligations included in the contract to a governmental entity as authorized by law or the health plan company's contractors or agents, an enrollee, a treating provider of an enrollee, a plan sponsor, or potential eligible enrollees and plan sponsors; or new text end new text begin (2) out-of-pocket costs to an enrollee. new text end Sec. 4. Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to read: new text begin Subd. 6. new text end new text begin Hospital. new text end new text begin "Hospital" has the meaning given in section 144.696. new text end Sec. 5. Minnesota Statutes 2024, section 62Q.733, is amended by adding a subdivision to read: new text begin Subd. 7. new text end new text begin Most favored nation clause. new text end new text begin "Most favored nation clause" means a provision that: new text end new text begin (1) prohibits or grants an option to prohibit: new text end new text begin (i) a provider from contracting with another health plan company to provide health care services at a lower rate; or new text end new text begin (ii) a health plan company from contracting with another provider to provide health care services at a higher rate; new text end new text begin (2) requires or grants an option to require: new text end new text begin (i) a provider to accept a lower rate for health care services if the provider agrees with another health plan company to accept a lower rate for the services; or new text end new text begin (ii) a health plan company to pay a higher rate for health care services if the entity agrees with another provider to pay a higher rate for the services; new text end new text begin (3) requires or grants an option to require termination or renegotiation of an existing contract if: new text end new text begin (i) a provider agrees with another health plan company to accept a lower rate for providing health care services; or new text end new text begin (ii) a health plan company agrees with a provider to pay a higher rate for health care services; or new text end new text begin (4) requires: new text end new text begin (i) a provider to disclose the provider's contractual reimbursement rates with other general contracting entities; or new text end new text begin (ii) a health plan company to disclose the health plan company's contractual reimbursement rates with other providers. new text end Sec. 6. new text begin [62Q.738] PROHIBITED HOSPITAL CONTRACTING PROVISIONS. new text end new text begin Subdivision 1. new text end new text begin Prohibited provisions. new text end new text begin A hospital must not: new text end new text begin (1) offer to a health plan company a contract that includes an antisteering, antitiering, gag, or most favored nation clause; new text end new text begin (2) enter into a contract that includes an antisteering, antitiering, gag, or most favored nation clause; or new text end new text begin (3) amend or renew an existing contract previously entered into with a health plan company so that the contract as amended or renewed adds or retains an antisteering, antitiering, gag, or most favored nation clause. new text end new text begin Subd. 2. new text end new text begin Provisions void and severable. new text end new text begin Antisteering, antitiering, gag, or most favored nation clauses violating this section are void and unenforceable. The remaining provisions in the contract remain in effect and are enforceable. new text end new text begin Subd. 3. new text end new text begin Health plan company fiduciary duties. new text end new text begin A health plan company has a fiduciary duty to the enrollee and policyholder to engage in the applicable conduct only for the primary benefit of the enrollee or policyholder if the health plan company: new text end new text begin (1) encourages an enrollee to obtain health care items or services from a particular provider, including offering incentives to encourage enrollees to use specific providers; new text end new text begin (2) introduces or modifies a tiered network plan; or new text end new text begin (3) assigns providers into tiers. new text end