Minnesota · statute · Minn. Stat. ch. 62Q · 106 active provisions
Subdivision 1. Applicability. For purposes of this chapter, the terms defined in this section have the meanings given. Subd. 1a. Affordable Care Act. "Affordable Care Act" means the Affordable Care Act as defined in section 62A.011, subdivision 1a. Subd. 1b. Bona fide association. "Bona fide association" means an assoc…
(a) This chapter applies only to health plans, as defined in section 62Q.01, and not to other types of insurance issued or renewed by health plan companies, unless otherwise specified. (b) This chapter applies to a health plan company only with respect to health plans, as defined in section 62Q.01, issued or renewed by…
Subdivision 1. Compliance with 1996 federal law. Each health plan company shall comply with the federal Health Insurance Portability and Accountability Act of 1996, including any federal regulations adopted under that act, to the extent that it imposes a requirement that applies in this state and that is not also requi…
Subdivision 1. Qualified plan. A high deductible health plan shall be deemed a qualified plan under sections 62E.06 and 62E.12. The plan must meet all other requirements of state law except those that are inconsistent with a high deductible health plan as defined in sections 220 and 223 of the Internal Revenue Code and…
Subdivision 1. Purpose. The purpose of risk adjustment is to reduce the effects of risk selection on health insurance premiums by making monetary transfers from health plan companies that insure lower risk populations to health plan companies that insure higher risk populations. Risk adjustment is needed to: achieve a…
Subdivision 1. [Repealed by amendment, 2001 c 171 s 1] Subd. 2. Requirement. Beginning October 31, 2004, all health maintenance organizations shall file a plan every four years with the commissioner of health describing the actions the health maintenance organization intends to take to contribute to achieving one or mo…
(a) If a health plan company has initially credentialed, as providers in its provider network, individual providers employed by or under contract with an entity that: (1) is authorized to bill under section 256B.0625, subdivision 5; (2) is a mental health clinic certified under section 245I.20; (3) is designated an ess…
Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section. (b) "Clean application for provider credentialing" or "clean application" means an application for provider credentialing submitted by a health care provider to a health plan company that is complete, is in the format required by…
A health plan company, or a vendor of risk management services as defined under section 60A.23, subdivision 8, shall, in evaluating the performance of a health care provider: (1) conduct the evaluation using a bona fide baseline based upon practice experience of the provider group; and (2) disclose the baseline to the…
All health plan companies shall use the assessment criteria in section 245G.05 when assessing and treating enrollees for chemical dependency treatment.
(a) A complainant may at any time submit a complaint to the appropriate commissioner to investigate. After investigating a complaint, or reviewing a company's decision, the appropriate commissioner may order a remedy as authorized under chapter 45, 60A, or 62D. (b) In investigating a complaint filed against a health ma…
Beginning January 1, 1999, no health plan, including the coverages described in section 62A.011, subdivision 3, clauses (7) and (10), may specify a standard of review upon which a court may review denial of a claim or of any other decision made by a health plan company with respect to an enrollee. This section prohibit…
No health plan company may deny access to a covered health care service unless the denial is made by, or under the direction of, or subject to the review of a health care professional licensed to provide the service in question.
(a) No health plan company may employ a person as a medical director unless the person is licensed as a physician in this state. This section does not apply to a health plan company that is assessed less than three percent of the total amount assessed by the Minnesota Comprehensive Health Association. (b) For purposes…
No health plan company shall contract with a chemical dependency treatment program, unless the program participates in the chemical dependency treatment accountability plan established by the commissioner of human services. The commissioner of human services shall make data on chemical dependency services and outcomes…
(a) Any health plan that provides coverage for chemical dependency treatment must cover chemical dependency treatment provided to an enrollee by the Department of Corrections while the enrollee is committed to the custody of the commissioner of corrections following a conviction for a first-degree driving while impaire…
No health plan company may restrict the choice of an enrollee as to where the enrollee receives services related to: (1) the voluntary planning of the conception and bearing of children; (2) the diagnosis of infertility; (3) the testing and treatment of a sexually transmitted disease; and (4) the testing for AIDS or ot…
The termination of a person's coverage under any health plan as defined in section 62A.011, subdivision 3, with the exception of individual health plans, issued or renewed on or after January 1, 1995, must provide coverage until the end of the month in which coverage was terminated.
Subdivision 1. Definition. It is the commitment of the state to achieve universal health coverage for all Minnesotans by the year 2011. Universal coverage is achieved when: (1) every Minnesotan has access to a full range of quality health care services; (2) every Minnesotan is able to obtain affordable health coverage…
Subdivision 1. Permission to form. Notwithstanding section 62A.10, employers, groups, and individuals may voluntarily form purchasing pools, solely for the purpose of negotiating and purchasing health plan coverage from health plan companies for members of the pool. Subd. 2. Common factors. All participants in a purcha…
Subdivision 1. Definition. For purposes of this section: (1) "continuous coverage" has the meaning given in section 62L.02, subdivision 9; (2) "guaranteed issue" means: (i) for individual health plans, that a health plan company shall not decline an application by an individual for any individual health plan offered by…
A health plan company shall provide the written certifications of coverage required under United States Code, title 42, sections 300gg(e) and 300gg-43. This section applies only to coverage that is subject to regulation under state law and only to the extent that the certification of coverage is required under federal…
Subdivision 1. Definitions. (a) For the purposes of this section, the terms in this subdivision have the meanings given them. (b) "Clinical practice guideline" means a systematically developed statement to assist health care providers and enrollees in making decisions about appropriate health care services for specific…
Subdivision 1. Definitions. (a) For purposes of this section, the following definitions apply. (b) "Health plan" has the meaning given in section 62Q.01, subdivision 3. Health plan includes health coverage provided by a county-based purchasing plan participating in a public program under chapter 256B or 256L or an inte…
(a) No health plan company, as defined in section 62Q.01, subdivision 4, shall refuse to renew a health benefit plan, as defined in section 62L.02, subdivision 15, but issued to a large employer, as defined in section 62Q.18, subdivision 1. (b) This section does not require renewal if: (1) the large employer has failed…