HF 334

as introduced - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act
  1.2             relating to insurance; requiring coverage of 
  1.3             acupuncture services by certain group policies and 
  1.4             subscriber contracts; requiring claim determinations 
  1.5             regarding acupuncture services to be made or reviewed 
  1.6             by acupuncture practitioners; requiring reporting on 
  1.7             referrals to acupuncture practitioners and 
  1.8             reimbursement rates; amending Minnesota Statutes 2002, 
  1.9             section 62A.15, subdivision 4, by adding a 
  1.10            subdivision; proposing coding for new law in Minnesota 
  1.11            Statutes, chapter 62D. 
  1.12  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.13     Section 1.  Minnesota Statutes 2002, section 62A.15, is 
  1.14  amended by adding a subdivision to read: 
  1.15     Subd. 3b.  [ACUPUNCTURE SERVICES.] All acupuncture benefits 
  1.16  provided by a policy or contract referred to in subdivision 1 
  1.17  relating to expenses incurred for medical treatment or services 
  1.18  must also include acupuncture treatment and services of a 
  1.19  licensed acupuncture practitioner to the extent that the 
  1.20  acupuncture services and treatment are within the scope of 
  1.21  acupuncture practitioner licensure.  
  1.22     This subdivision is intended to provide equal access to 
  1.23  benefits for insureds and subscribers who choose to directly 
  1.24  obtain treatment for illness or injury from a licensed 
  1.25  acupuncture practitioner, as long as the treatment falls within 
  1.26  the scope of practice of the licensed acupuncture practitioner.  
  1.27     Sec. 2.  Minnesota Statutes 2002, section 62A.15, 
  1.28  subdivision 4, is amended to read: 
  2.1      Subd. 4.  [DENIAL OF BENEFITS.] (a) No carrier referred to 
  2.2   in subdivision 1 may, in the payment of claims to employees in 
  2.3   this state, deny benefits payable for services covered by the 
  2.4   policy or contract if the services are lawfully performed by a 
  2.5   licensed chiropractor, licensed optometrist, or a registered 
  2.6   nurse meeting the requirements of subdivision 3a, or a licensed 
  2.7   acupuncture practitioner. 
  2.8      (b) When carriers referred to in subdivision 1 make claim 
  2.9   determinations concerning the appropriateness, quality, or 
  2.10  utilization of chiropractic health care for Minnesotans, any of 
  2.11  these determinations that are made by health care professionals 
  2.12  must be made by, or under the direction of, or subject to the 
  2.13  review of licensed doctors of chiropractic.  
  2.14     (c) When a carrier referred to in subdivision 1 makes a 
  2.15  denial of payment claim determination concerning the 
  2.16  appropriateness, quality, or utilization of acupuncture services 
  2.17  for individuals in this state, a denial of payment claim 
  2.18  determination that is made by a health professional must be made 
  2.19  by, under the direction of, or subject to the review of a 
  2.20  licensed acupuncture practitioner. 
  2.21     Sec. 3.  [62D.107] [COVERAGE OF ACUPUNCTURE SERVICES.] 
  2.22     Subdivision 1.  [COVERAGE.] All benefits provided by a 
  2.23  health maintenance contract relating to expenses incurred for 
  2.24  medical treatment or physician services, must also include 
  2.25  acupuncture treatment and services of a licensed acupuncture 
  2.26  practitioner to the extent that the acupuncture services and 
  2.27  treatment are within the scope of acupuncture practitioner 
  2.28  licensure.  This subdivision ensures equal access to benefits 
  2.29  for enrollees who choose to directly obtain treatment for 
  2.30  illness and injury from a licensed acupuncture practitioner, as 
  2.31  long as the treatment falls within the scope of practice of the 
  2.32  licensed acupuncture practitioner.  
  2.33     Subd. 2.  [DENIAL OF BENEFITS.] (a) In the payment of 
  2.34  claims for enrollees in this state, no health maintenance 
  2.35  organization may deny payment for acupuncture services covered 
  2.36  by an enrollee's health maintenance contract if the services are 
  3.1   lawfully performed by a licensed acupuncture practitioner. 
  3.2      (b) When a health maintenance organization makes a denial 
  3.3   of payment claim determination concerning the appropriateness, 
  3.4   quality, or utilization of acupuncture services for enrollees in 
  3.5   this state, the determination must be made by, under the 
  3.6   direction of, or subject to the review of a licensed acupuncture 
  3.7   practitioner.