SF 159

as introduced - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to health; requiring health plan company 
  1.3             acceptance of qualified willing providers; eliminating 
  1.4             the expanded network and point-of-service options; 
  1.5             amending Minnesota Statutes 1996, section 62Q.095, 
  1.6             subdivision 1; repealing Minnesota Statutes 1996, 
  1.7             sections 62Q.095, subdivisions 3 and 4; and 62Q.51. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 1996, section 62Q.095, 
  1.10  subdivision 1, is amended to read: 
  1.11     Subdivision 1.  [PROVIDER ACCEPTANCE REQUIRED.] Each health 
  1.12  plan company, with the exception of any health plan company with 
  1.13  50,000 or fewer enrollees and health plan companies that are 
  1.14  exempt under subdivision 6, shall establish an expanded network 
  1.15  of allied independent health providers, in addition to a 
  1.16  preferred network.  A health plan company shall accept as a 
  1.17  provider in the expanded its provider network any allied 
  1.18  independent health care provider who:  (1) meets the health plan 
  1.19  company's credentialing standards; (2) agrees to the terms of 
  1.20  the health plan company's provider contract; and (3) agrees to 
  1.21  comply with all managed care protocols of the health plan 
  1.22  company.  A preferred network shall be considered an expanded 
  1.23  network if all allied independent health providers who meet the 
  1.24  requirements of clauses (1), (2), and (3) are accepted into the 
  1.25  preferred network.  A community integrated service network may 
  1.26  offer to its enrollees an expanded network of allied independent 
  2.1   health providers as described under this section.  
  2.2      Sec. 2.  [REPEALER.] 
  2.3      Minnesota Statutes 1996, sections 62Q.095, subdivisions 3 
  2.4   and 4; and 62Q.51, are repealed. 
  2.5      Sec. 3.  [EFFECTIVE DATE.] 
  2.6      Sections 1 and 2 are effective January 1, 1998.