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Office of the Revisor of Statutes

SF 414 Senate Long Description

E Modifying certain provisions under the Minnesota utilization review act; eliminating the requirement for the attending health care professional to request the utilization review organization to ensure the qualification of the reviewing physician in cases of appeal to reverse determinations not to certify for clinical reasons; requiring physicians conducting the review to be licensed in the state, exception; exempting determination made in connection with policies issued by certain health plan companies from mental health and substance abuse review requirements; requiring physician consultants to be board certified; requiring utilization review organizations to file reports with the annual financial statement filed with the commissioner of commerce, specifying report content requirements; requiring criteria used to determine medical necessity to be provided to the commissioner; authorizing the board to investigate allegations and impose certain disciplinary actions against physicians performing utilization review for a pattern of failure to exercise a certain degree of care in making determinations (ra, ja)