HF 3125

as introduced - 88th Legislature (2013 - 2014) Posted on 03/17/2014 01:59pm

A bill for an act
relating to health; requiring the Office of Health Care Complaints to investigate
complaints against a health maintenance organization; requiring a family member
of the complainant to be interviewed; amending Minnesota Statutes 2012,
section 144A.53, subdivision 3; Minnesota Statutes 2013 Supplement, section
144A.53, subdivision 2.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2013 Supplement, section 144A.53, subdivision 2,
is amended to read:

Subd. 2.

Complaints.

(a) The director may receive a complaint from any source
concerning an action of an administrative agency, a health care provider, a home care
provider, a residential care home, or a health facility. The director may require a
complainant to pursue other remedies or channels of complaint open to the complainant
before accepting or investigating the complaint. Investigators are required to interview at
least one family member of the deleted text begin vulnerable adult deleted text end new text begin individual new text end identified in the complaint.
If the deleted text begin vulnerable adult deleted text end new text begin individual new text end is directing his or her own care and does not want
the investigator to contact the family, this information must be documented in the
investigative file.

new text begin (b) The director shall receive a complaint from any source concerning an action of
a health maintenance organization, including, but not limited to, a complaint regarding
the quality of patient care. If the director receives a complaint concerning a health
maintenance organization, the director shall complete the investigation of the complaint
within the Office of Health Facility Complaints. This section does not prohibit the health
maintenance organization from continuing to operate an internal complaint system, as
required under section 62D.11.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end The director shall keep written records of all complaints and any action
upon them. After completing an investigation of a complaint, the director shall inform
the complainant, the administrative agency having jurisdiction over the subject matter,
the health care provider, the home care provider, the residential care home, new text begin the health
maintenance organization, new text end and the health facility of the action taken. new text begin Notwithstanding
section 145.64, new text end complainants new text begin , including those having made a complaint against a health
maintenance organization, new text end must be provided a copy of the public report upon completion
of the investigation.

Sec. 2.

Minnesota Statutes 2012, section 144A.53, subdivision 3, is amended to read:

Subd. 3.

Recommendations.

If, after duly considering a complaint and whatever
material the director deems pertinent, the director determines that the complaint is valid,
the director may recommend that an administrative agency, a health care provider, a
home care provider, a residential care home, new text begin a health maintenance organization, new text end or a
health facility should:

(a) Modify or cancel the actions which gave rise to the complaint;

(b) Alter the practice, rule or decision which gave rise to the complaint;

(c) Provide more information about the action under investigation; or

(d) Take any other step which the director considers appropriate.

If the director requests, the administrative agency, a health care provider, a home
care provider, residential care home, or health facility shall, within the time specified,
inform the director about the action taken on a recommendation.