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SF 3286

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to health; changing information required for filing a complaint with
a health plan company; amending Minnesota Statutes 2006, section 62Q.69,
subdivision 2.

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

Section 1.

Minnesota Statutes 2006, section 62Q.69, subdivision 2, is amended to read:


Subd. 2.

Procedures for filing a complaint.

(a) A complainant may submit a
complaint to a health plan company either by telephone or in writing. If a complaint is
submitted orally and the resolution of the complaint, as determined by the complainant, is
partially or wholly adverse to the complainant, or the oral complaint is not resolved to the
satisfaction of the complainant, by the health plan company within ten days of receiving
the complaint, the health plan company must inform the complainant that the complaint
may be submitted in writing. The health plan company must also offer to provide the
complainant with any assistance needed to submit a written complaint, including an offer
to complete the complaint form for a complaint that was previously submitted orally and
promptly mail the completed form to the complainant for the complainant's signature. At
the complainant's request, the health plan company must provide the assistance requested
by the complainant. The complaint form must include the following information:

(1) the telephone number of the deleted text begin Office of Health Care Consumer Assistance,
Advocacy, and Information, and the
deleted text end health plan company member services or other
departments or persons equipped to advise complainants on complaint resolution;

(2) the address to which the form must be sent;

(3) a description of the health plan company's internal complaint procedure and the
applicable time limits; and

(4) the toll-free telephone number of either the commissioner of health or commerce
and notification that the complainant has the right to submit the complaint at any time to
the appropriate commissioner for investigation.

(b) Upon receipt of a written complaint, the health plan company must notify
the complainant within ten business days that the complaint was received, unless the
complaint is resolved to the satisfaction of the complainant within the ten business days.

(c) Each health plan company must provide, in the member handbook, subscriber
contract, or certification of coverage, a clear and concise description of how to submit a
complaint and a statement that, upon request, assistance in submitting a written complaint
is available from the health plan company.