1.1                          A bill for an act 
  1.2             relating to health; specifying who may deny access to 
  1.3             service under MinnesotaCare; providing penalties; 
  1.4             amending Minnesota Statutes 1994, section 62Q.12; 
  1.5             Minnesota Statutes 1995 Supplement, section 144.99, 
  1.6             subdivision 1. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 1994, section 62Q.12, is 
  1.9   amended to read: 
  1.10     62Q.12 [DENIAL OF ACCESS.] 
  1.11     (a) No health plan company may deny access to a covered 
  1.12  health care service unless the denial is made by, or under the 
  1.13  direction of, or subject to the review of a health care 
  1.14  professional licensed to provide the service in question.  
  1.15     (b) If a covered health care service is recommended by a 
  1.16  physician, a denial of access permitted by paragraph (a) must be 
  1.17  made by, under the direction of, or subject to review by a 
  1.18  physician.  A health plan company may contract with a physician 
  1.19  to review a denial of access as required under this paragraph.  
  1.20     (c) Denial of access that does not comply with paragraph 
  1.21  (b) and results in care that fails to conform to minimal 
  1.22  standards of acceptable and prevailing practice within the 
  1.23  specialty of the care ordered, whether or not actual injury to a 
  1.24  patient is established, is grounds for the commissioner 
  1.25  responsible for regulating the health plan company to take any 
  1.26  action authorized under section 45.027 or 144.99. 
  2.1      (d) For purposes of this section, "physician" means a 
  2.2   person licensed to practice medicine under chapter 147 or a 
  2.3   person licensed to practice osteopathy under Minnesota Statutes 
  2.4   1961, sections 148.11 to 148.16. 
  2.5      Sec. 2.  Minnesota Statutes 1995 Supplement, section 
  2.6   144.99, subdivision 1, is amended to read: 
  2.7      Subdivision 1.  [REMEDIES AVAILABLE.] The provisions of 
  2.8   chapters 103I and 157 and sections 62Q.12; 115.71 to 115.77; 
  2.9   144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), 
  2.10  (12), (13), (14), and (15); 144.121; 144.1222; 144.35; 144.381 
  2.11  to 144.385; 144.411 to 144.417; 144.491; 144.495; 144.71 to 
  2.12  144.74; 144.9501 to 144.9509; 144.992; 326.37 to 326.45; 326.57 
  2.13  to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all 
  2.14  rules, orders, stipulation agreements, settlements, compliance 
  2.15  agreements, licenses, registrations, certificates, and permits 
  2.16  adopted or issued by the department or under any other law now 
  2.17  in force or later enacted for the preservation of public health 
  2.18  may, in addition to provisions in other statutes, be enforced 
  2.19  under this section. 
  2.20     Sec. 3.  [EFFECTIVE DATE.] 
  2.21     Sections 1 and 2 are effective July 1, 1996, and apply to 
  2.22  any request for access made on or after that date.