HF 3526

1st Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to insurance; requiring equal access to acupuncture services by certain
group policies and subscriber contracts; requiring claim determinations regarding
acupuncture services to be made or reviewed by acupuncture practitioners;
requiring reporting on referrals to acupuncture practitioners and reimbursement
rates; amending Minnesota Statutes 2006, section 62A.15, subdivision 4, by
adding a subdivision; proposing coding for new law in Minnesota Statutes,
chapter 62D.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2006, section 62A.15, is amended by adding a
subdivision to read:

new text begin Subd. 3b. new text end

new text begin Acupuncture services. new text end

new text begin All benefits provided by a policy or contract
referred to in subdivision 1 relating to expenses for acupuncture services that are provided
by a physician must also include acupuncture treatment and services of a licensed
acupuncture practitioner to the extent that the acupuncture services and treatment are
within the scope of acupuncture practitioner licensure.
new text end

new text begin This subdivision is intended to provide equal access to benefits for insureds and
subscribers who choose to directly obtain treatment for illness or injury from a licensed
acupuncture practitioner, as long as the treatment falls within the scope of practice of the
licensed acupuncture practitioner.
new text end

new text begin This subdivision is not intended to change or add to the benefits provided for in
these policies or contracts.
new text end

Sec. 2.

Minnesota Statutes 2006, section 62A.15, subdivision 4, is amended to read:

Subd. 4.

Denial of benefits.

(a) No carrier referred to in subdivision 1 may, in the
payment of claims to employees in this state, deny benefits payable for services covered
by the policy or contract if the services are lawfully performed by a licensed chiropractor,
licensed optometrist, or a registered nurse meeting the requirements of subdivision 3a new text begin , or a
licensed acupuncture practitioner new text end .

(b) When carriers referred to in subdivision 1 make claim determinations concerning
the appropriateness, quality, or utilization of chiropractic health care for Minnesotans, any
of these determinations that are made by health care professionals must be made by, or
under the direction of, or subject to the review of licensed doctors of chiropractic.

new text begin (c) When a carrier referred to in subdivision 1 makes a denial of payment claim
determination concerning the appropriateness, quality, or utilization of acupuncture
services for individuals in this state performed by a licensed acupuncture practitioner, a
denial of payment claim determination that is made by a health professional must be made
by, under the direction of, or subject to the review of a licensed acupuncture practitioner.
new text end

Sec. 3.

new text begin [62D.107] EQUAL ACCESS TO ACUPUNCTURE SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Coverage. new text end

new text begin All benefits provided by a health maintenance contract
relating to expenses incurred for acupuncture services that are provided by a physician,
must also include acupuncture treatment and services of a licensed acupuncture
practitioner to the extent that the acupuncture services and treatment are within the scope
of acupuncture practitioner licensure. This subdivision ensures equal access to benefits for
enrollees who choose to directly obtain treatment for illness and injury from a licensed
acupuncture practitioner, as long as the treatment falls within the scope of practice of the
licensed acupuncture practitioner.
new text end

new text begin This subdivision is not intended to change or add to the benefits provided for in
these policies or contracts.
new text end

new text begin Subd. 2. new text end

new text begin Denial of benefits. new text end

new text begin (a) In the payment of claims for enrollees in this state,
no health maintenance organization may deny payment for acupuncture services covered
by an enrollee's health maintenance contract if the services are lawfully performed by a
licensed acupuncture practitioner.
new text end

new text begin (b) When a health maintenance organization makes a denial of payment claim
determination concerning the appropriateness, quality, or utilization of acupuncture
services for enrollees in this state performed by a licensed acupuncture practitioner, the
determination must be made by, under the direction of, or subject to the review of a
licensed acupuncture practitioner.
new text end