1st Engrossment - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to health; establishing a minimum definition 1.3 of durable medical equipment; requiring disclosure of 1.4 covered medical equipment and supplies; proposing 1.5 coding for new law in Minnesota Statutes, chapter 62Q. 1.6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.7 Section 1. [62Q.66] [DURABLE MEDICAL EQUIPMENT COVERAGE.] 1.8 Subdivision 1. [REQUIREMENT.] No health plan company that 1.9 covers durable medical equipment may utilize a definition of 1.10 durable medical equipment more restrictive than that in 1.11 subdivision 2 and may not limit durable medical equipment 1.12 coverage to equipment used in the home. 1.13 Subd. 2. [MINIMUM DEFINITION.] "Durable medical equipment" 1.14 means a medically necessary personal item, piece of equipment, 1.15 or product system, whether modified or not, including necessary 1.16 repairs, that is suitable for repeated use and is: 1.17 (1) used to increase, maintain, or improve the functional 1.18 capabilities of a person; 1.19 (2) used to correct or accommodate a physiological 1.20 disability or physical condition of a person; 1.21 (3) is not more expensive than an appropriate alternative 1.22 which serves the same purpose; and 1.23 (4) is not primarily for educational, vocational, comfort, 1.24 convenience, or recreational purposes. 1.25 Sec. 2. [62Q.67] [DISCLOSURE OF COVERED MEDICAL EQUIPMENT 2.1 AND SUPPLIES.] 2.2 Subdivision 1. [DISCLOSURE.] A health plan company that 2.3 covers durable medical equipment or nondurable medical supplies 2.4 must include the following in the member contract or certificate 2.5 of coverage: 2.6 (1) a general description of the nature and level of 2.7 coverage available and the procedure for any required prior 2.8 authorizations; 2.9 (2) a summary of criteria used in making determinations as 2.10 to whether specific durable medical equipment or nondurable 2.11 medical supplies will be covered for individual enrollees; and 2.12 (3) the address and telephone number of a representative 2.13 whom an enrollee may contact to obtain a listing of commonly 2.14 covered durable medical equipment and nondurable medical 2.15 supplies, along with a detailed description of any limitations 2.16 or exclusions. The listing must be provided to the enrollee 2.17 within 14 days of a request. The information must also be 2.18 available prior to enrollment upon request. 2.19 Subd. 2. [CERTAIN COVERAGE CHANGES PROHIBITED.] During a 2.20 contract period, a health plan company may not remove durable 2.21 medical equipment or nondurable medical supplies from coverage 2.22 or implement more restrictive criteria for coverage 2.23 determination. 2.24 Sec. 3. [EFFECTIVE DATE; APPLICATION.] 2.25 Sections 1 and 2 are effective August 1, 1998, and apply to 2.26 health plans issued, renewed, or continued as defined in 2.27 Minnesota Statutes, section 60A.02, subdivision 2a, to provide 2.28 coverage to a Minnesota resident on or after that date.