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SF 1522 Senate Long Description

E Modifying certain review and complaint procedures for health plan companies; requiring and providing for an expedited initial review determination under utilization review procedures under certain conditions; specifying a time limit for certification notice to attending physicians after expedited appeals; providing for written reconsideration or hearing of initial determinations not reversed in the first level of appeal; modifying the health plan company complaint procedure; including accountable provider networks under the procedure and exempting the Minnesota comprehensive health association (MCHA), government programs and certain health plans from the process; specifying the procedures for filing a complaint and decision notice requirements of health plans; changing the appeals process to a written reconsideration or hearing process and the alternative dispute resolution process to arbitration; modifying certain reporting and notice requirements of health plans; providing for a stay of the procedures upon complainant filing of a suit against the health plan; repealing the health maintenance organization (HMO) enrollee complaint system, certain provisions providing for the handling of medically urgent complaints by health plan companies and requiring the commissioners of health and commerce to make dispute resolution processes available to encourage early settlement of disputes and certain rules (ra, ja)