HF3851

Purpose

The bill aims to restrict who can certify eligibility for the paid family and medical leave insurance program when the certifier is a foreign-licensed health care practitioner. It adds rules to suspend certifications by foreign providers after credible allegations of fraud and after certain criminal convictions. It also expands who is considered a health care provider to include foreign physicians, aligning certification oversight with fraud and conviction protections.

Main Provisions

• Redefines Health care provider to include:
  • Individuals licensed or authorized in Minnesota to practice health care, and
  • Individuals licensed in a foreign country to practice as a physician or other health care professional, if the governor-regulated rules allow it.
• Creates a new Subdivision 3a in the certification statute to address Certification by foreign physician suspension after credible allegations of fraud.
  • A credible allegation is defined as an allegation verified by the state from sources such as fraud hotlines, data mining, provider audits, civil false claims cases, and law enforcement investigations.
  • If the commissioner determines there is a credible allegation that a foreign-licensed physician filed a false certification or committed fraud in any program, the commissioner must suspend processing of all further certifications pending further review.
  • A foreign-licensed physician who has been convicted of any listed offenses is disqualified from filing a certification.
• Lists offenses that would disqualify a foreign-licensed physician from filing a certification, including specific sections of Minnesota statutes (and similar offenses under statutes from other jurisdictions).

Significant Changes to Existing Law

• Expands the definition of who is a health care provider for purposes of the paid family and medical leave insurance program to include foreign-licensed physicians.
• Establishes a new process for suspending and reviewing certifications by foreign providers if there are credible allegations of fraud.
• Creates a disqualification mechanism for foreign-licensed physicians based on certain criminal convictions.
• Allows the state to halt processing of all further foreign-provider certifications while investigating credible allegations of fraud.

Definitions and Key Terms (selected)

• paid family and medical leave insurance program
• foreign provider / foreign physician
• certification (for health care providers)
• credible allegation of fraud
• suspension of certifications
• disqualification
• health care provider (as expanded to foreign-licensed practitioners)
• offenses (listed statute references)

Relevant terms and context: fraud hotline, data mining, provider audits, civil false claims cases, law enforcement investigations, Minnesota Statutes 2024 sections 268B.01 and 268B.06, foreign-licensed physicians.

Relevant Terms - paid family and medical leave insurance program - foreign provider / foreign physician - certification - credible allegation of fraud - suspension of certifications - disqualification - health care provider - offenses (statutory sections like 256.98, 609.465, 609.466, 609.496, 609.497, 609.52, 609.542)