HEALTH CARE UTILIZATION REVIEW

Appeals

Consulting physicians, Minn. Statutes 2012 62M.06, 62M.09

Generally, Minn. Statutes 2012 62M.06

Prior authorization, denial, Minn. Statutes 2012 62M.07

Procedures, Minn. Statutes 2012 62M.06, 62M.07

Reporting requirements, Minn. Statutes 2012 62M.09

Utilization Review Act, Minn. Statutes 2012 62M.01

Attending health care professionals

Appeals, Minn. Statutes 2012 62M.06, 62M.07, 62M.09

Certification, see same under this topic

Clinical criteria, review, Minn. Statutes 2012 62M.09

Data, certification, Minn. Statutes 2012 62M.02

Notice received, Minn. Statutes 2012 62M.04 to 62M.06, 62M.10

On-site reviews, Minn. Statutes 2012 62M.10

Certification

Appeals, Minn. Statutes 2012 62M.06

Data, Minn. Statutes 2012 62M.04

Denials

Appeals, Minn. Statutes 2012 62M.06

Attending physician, rights, Minn. Statutes 2012 62M.06

Complaints, enrollees' rights, Minn. Statutes 2012 62D.11, 62M.11

Financial incentives, Minn. Statutes 2012 62M.12

Generally, Minn. Statutes 2012 62M.05

Lawsuits, compliance with regulations, effect, Minn. Statutes 2012 62M.14

Review, Minn. Statutes 2012 62M.04

Generally, Minn. Statutes 2012 62M.05

Notice, Minn. Statutes 2012 62M.04, 62M.05

Outpatient services, Minn. Statutes 2012 62M.09

Review, Minn. Statutes 2012 62M.04, 62M.05

Claimants, notice received, certification, denial, Minn. Statutes 2012 62M.05

Claims administrators

Contracts, utilization review certification, Minn. Statutes 2012 62M.04

Notice given, Minn. Statutes 2012 62M.05, 62M.06

Notice received, Minn. Statutes 2012 62M.05 to 62M.07

Prior authorization, Minn. Statutes 2012 62M.07

Concurrent review

Committed persons, rights, Minn. Statutes 2012 253B.03

Generally, Minn. Statutes 2012 62M.02 to 62M.05

Conduct of review, generally, Minn. Statutes 2012 62M.01, 62M.15

Contested cases, unlicensed organizations, cease and desist orders, Minn. Statutes 2012 62M.03

Continued stay review, Minn. Statutes 2012 62M.02 to 62M.05, 253B.03

County-based purchasing, Minn. Statutes 2012 256B.692

Data, Minn. Statutes 2012 62M.04, 62M.08

Definitions, generally, Minn. Statutes 2012 62M.02

Diagnostic imaging facilities, Minn. Statutes 2012 144.565

Employees

Financial incentives for denials, Minn. Statutes 2012 62M.12

Identification, Minn. Statutes 2012 62M.10

On-site reviews, Minn. Statutes 2012 62M.10

Utilization review organizations, Minn. Statutes 2012 62M.09

Enforcement of law

County-based purchasing, Minn. Statutes 2012 256B.692

Health Department, powers, Minn. Statutes 2012 256B.77

Enrollees

Appeals by, Minn. Statutes 2012 62M.06, 62M.07, 62M.09

Certification review organizations, data sharing, Minn. Statutes 2012 62M.04

Claimants, enrollees defined as, Minn. Statutes 2012 62M.02

Complaints, rights, Minn. Statutes 2012 62D.11, 62M.11

Data, certification, Minn. Statutes 2012 62M.04

Notice given, Minn. Statutes 2012 62M.04, 62M.07

Notice received, Minn. Statutes 2012 62M.05 to 62M.07

On-site reviews, Minn. Statutes 2012 62M.10

Reports received, utilization review organizations, review criteria, Minn. Statutes 2012 62M.10

Unconscious persons, utilization review, Minn. Statutes 2012 62M.02

Evidence-based standards, Minn. Statutes 2012 62M.072

Fines, unlicensed organizations, Minn. Statutes 2012 62M.03

Health care taxes, exclusions, Minn. Statutes 2012 295.50

Health Care Utilization Act, Minn. Statutes 2012 62M.01 to 62M.16

Implementation, timetable, Minn. Statutes 2012 62J.017

Lawsuits, compliance with regulations, effect, Minn. Statutes 2012 62M.14

Licenses, utilization review organizations, Minn. Statutes 2012 62M.03

Mental health and substance abuse reviews, psychologists, Minn. Statutes 2012 62M.09

On-site reviews, Minn. Statutes 2012 62M.10

Orders, unlicensed utilization review organizations, contested cases, Minn. Statutes 2012 62M.03

Prior authorization, Minn. Statutes 2012 62M.02, 62M.07

Procedures, health plan companies, notice, Minn. Statutes 2012 62Q.71

Providers

Agreements, review, procedures, Minn. Statutes 2012 62M.10

Appeals, duties, Minn. Statutes 2012 62M.06, 62M.07

Attending health care professionals, see same under this topic

Certification, see same under this topic

Certification denial, inappropriate incentives, Minn. Statutes 2012 62M.12

Claimants, providers defined as, Minn. Statutes 2012 62M.02

Disciplinary action, Minn. Statutes 2012 147.091

Essential community providers, Minn. Statutes 2012 62Q.19

Failure to provide information, procedures, Minn. Statutes 2012 62M.05

Generally, Minn. Statutes 2012 62M.04

Notice received, Minn. Statutes 2012 62M.05, 62M.07, 62M.10

On-site reviews, Minn. Statutes 2012 62M.10

Prior authorization requests, Minn. Statutes 2012 62M.07

Referrals, Minn. Statutes 2012 62M.02

Reports received, utilization review organizations, review criteria, Minn. Statutes 2012 62M.10

Psychologists, mental health and substance abuse reviews, Minn. Statutes 2012 62M.09

Quality assessment program, Minn. Statutes 2012 62M.02, 62M.09

Review

Concurrent review, Minn. Statutes 2012 62M.02 to 62M.05, 253B.05

On-site review, Minn. Statutes 2012 62M.10

Scope, Minn. Statutes 2012 62M.01

Severability of law, Minn. Statutes 2012 62M.13

Standards

Compliance, Minn. Statutes 2012 62M.03

Evidence-based standards, Minn. Statutes 2012 62M.072

Generally, Minn. Statutes 2012 62M.04

Integrated children's mental health service system, Minn. Statutes 2012 245.494

Telephones, Minn. Statutes 2012 62M.10

Utilization review organizations

Accountability, delegated activities, clinics or health care systems, Minn. Statutes 2012 62M.02

Agreements, on-site reviews, procedures, Minn. Statutes 2012 62M.10

Appeals, Minn. Statutes 2012 62M.06, 62M.07, 62M.09

Certification, see same under this topic

Clinical criteria, Minn. Statutes 2012 62M.02, 62M.09

Contracts, continuing care program, persons with mental illness, Minn. Statutes 2012 256.9693

Delegation of duties, limitations, Minn. Statutes 2012 62M.02

Employees, Minn. Statutes 2012 62M.09

Licensed utilization review organizations, Minn. Statutes 2012 62M.03

Notice given, Minn. Statutes 2012 62M.03, 62M.05, 62M.06, 62M.07, 62M.09

Notice received, Minn. Statutes 2012 62M.04

Payments by, medical records, duplication costs, Minn. Statutes 2012 62M.04

Physician consultants, Minn. Statutes 2012 62M.09

Prior authorization, Minn. Statutes 2012 62M.07

Quality assessment program, Minn. Statutes 2012 62M.02, 62M.09

Reports given, Minn. Statutes 2012 62M.10

Requests, Minn. Statutes 2012 62M.04

Review procedures, Minn. Statutes 2012 62M.05, 62M.09, 62M.10

Standards, Minn. Statutes 2012 62M.03, 62M.04

Unlicensed utilization review organizations, Minn. Statutes 2012 62M.03

Violations and penalties, disciplinary action, Minn. Statutes 2012 147.091