as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am
Engrossments | ||
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Introduction | Posted on 02/28/2006 |
A bill for an act
relating to health; eliminating requirements that health plan companies,
physicians, and other health care providers to adopt best practice guidelines
and quality measurements; eliminating the performance reporting and quality
improvement system for health care providers serving certain public program
recipients; amending Laws 2005, First Special Session chapter 4, article 8,
section 82, subdivision 4; repealing Minnesota Statutes 2004, section 62J.43;
Minnesota Statutes 2005 Supplement, section 256B.072.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Laws 2005, First Special Session chapter 4, article 8, section 82, subdivision
4, is amended to read:
Subd. 4. Appeals. (a) For review of an initial determination not to certify
conducted under section 62M.06, subdivision 2 or 3, of a service that is subject to prior
authorization under this section, the health care provider conducting the review must
follow, when available, published evidence-based health care guidelines as established
by a nonprofit Minnesota quality improvement organization, a nationally recognized
guideline development organization, or by the professional association of the specialty
that typically provides the service.
(b) For appeals conducted under section 256.045, subdivision 3a, of a decision by a
prepaid health plan to deny, reduce, or terminate a health care service that is subject to
prior authorization under this section, the referee must base the decision on the application
of the publicly available evidence-based health care guidelines referred to in subdivision
1 deleted text begin or as established by the commissioner of human services provided that the guidelines
meet the criteria set forth in section 62J.43, subdivision 2deleted text end .
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This section is effective the day following final enactment.
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Minnesota Statutes 2004, section 62J.43,
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and
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Minnesota Statutes 2005 Supplement,
section 256B.072,
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are repealed effective the day following final enactment.
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