Minnesota Session Laws - 1988, Regular Session

  

                         Laws of Minnesota 1988 

                        CHAPTER 656-S.F.No. 1646 
           An act relating to insurance; accident and health; 
          clarifying certain coverages for newborn infants; 
          requiring coverage for services provided to a 
          ventilator-dependent person; modifying coverage for 
          adopted children; providing certain payment and 
          subrogation rights for medical care and services 
          provided to inmates; amending Minnesota Statutes 1986, 
          sections 62A.042; and 62A.044; Minnesota Statutes 1987 
          Supplement, section 62A.27; proposing coding for new 
          law in Minnesota Statutes, chapters 62A and 243. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1986, section 62A.042, is 
amended to read: 
    62A.042 [FAMILY COVERAGE; COVERAGE OF NEWBORN INFANTS.] 
    Subdivision 1.  [INDIVIDUAL FAMILY POLICIES; RENEWALS.] (a) 
No policy of individual accident and sickness insurance which 
provides for insurance for more than one person under section 
62A.03, subdivision 1, clause (3), and no individual health 
maintenance contract which provides for coverage for more than 
one person under chapter 62D, shall be renewed to insure or 
cover any person in this state or be delivered or issued for 
delivery to any person in this state unless such the policy or 
contract includes as insured or covered members of the family 
any newborn infants immediately from the moment of birth and 
thereafter which insurance or contract shall provide coverage 
for illness, injury, congenital malformation or premature birth. 
    (b) The coverage under paragraph (a) includes benefits for 
inpatient or outpatient expenses arising from medical and dental 
treatment up to age 18, including orthodontic and oral surgery 
treatment, involved in the management of birth defects known as 
cleft lip and cleft palate.  If orthodontic services are 
eligible for coverage under a dental insurance plan and another 
policy or contract, the dental plan shall be primary and the 
other policy or contract shall be secondary in regard to the 
coverage required under paragraph (a).  Payment for dental or 
orthodontic treatment not related to the management of the 
congenital condition of cleft lip and cleft palate shall not be 
covered under this provision.  
    Subd. 2.  [GROUP POLICIES; RENEWALS.] (a) No group accident 
and sickness insurance policy and no group health maintenance 
contract which provide for coverage of family members or other 
dependents of an employee or other member of the covered group 
shall be renewed to cover members of a group located in this 
state or delivered or issued for delivery to any person in this 
state unless such the policy or contract includes as insured or 
covered family members or dependents any newborn infants 
immediately from the moment of birth and thereafter which 
insurance or contract shall provide coverage for illness, 
injury, congenital malformation or premature birth.  
    (b) The coverage under paragraph (a) includes benefits for 
inpatient or outpatient expenses arising from medical and dental 
treatment up to age 18, including orthodontic and oral surgery 
treatment, involved in the management of birth defects known as 
cleft lip and cleft palate.  If orthodontic services are 
eligible for coverage under a dental insurance plan and another 
policy or contract, the dental plan shall be primary and the 
other policy or contract shall be secondary in regard to the 
coverage required under paragraph (a).  Payment for dental or 
orthodontic treatment not related to the management of the 
congenital condition of cleft lip and cleft palate shall not be 
covered under this provision. 
    Sec. 2.  Minnesota Statutes 1986, section 62A.044, is 
amended to read:  
    62A.044 [PAYMENTS TO GOVERNMENTAL INSTITUTIONS.] 
    No group or individual policy of accident and sickness 
insurance issued or renewed after May 22, 1973 pursuant to this 
chapter, no group or individual service plan or subscriber 
contract issued or renewed after May 22, 1973 pursuant to 
chapter 62C, and no group or individual health maintenance 
contract issued or renewed after August 1, 1984, pursuant to 
chapter 62D, shall contain any provision excluding, denying, or 
prohibiting payments for covered and authorized services 
rendered or paid by a hospital or medical institution owned or 
operated by the federal, state, or local government, including 
correctional facilities, or practitioners therein in any 
instance wherein charges for such services are imposed against 
the policy holder, subscriber, or enrollee.  The unit of 
government operating the institution may maintain an action for 
recovery of such charges. 
    Sec. 3.  [62A.155] [COVERAGE FOR SERVICES PROVIDED TO A 
VENTILATOR-DEPENDENT PERSON.] 
    Subdivision 1.  [SCOPE OF COVERAGE.] This section applies 
to all policies of accident and health insurance, group 
subscriber contracts offered by nonprofit health service plan 
corporations regulated under chapter 62C, health maintenance 
contracts regulated under chapter 62D, and health benefit 
certificates offered through a fraternal beneficiary association 
regulated under chapter 64B.  This section does not apply to 
policies designed primarily to provide coverage payable on a per 
diem, fixed indemnity or nonexpense incurred basis, or policies 
that provide only accident coverage. 
    Subd. 2.  [REQUIRED COVERAGE.] If a policy, plan, 
certificate, or contract referred to in subdivision 1 issued or 
renewed after August 1, 1988, provides coverage for services 
provided by a private duty nurse or personal care assistant to a 
ventilator-dependent person in the person's home, it must 
provide coverage for up to 120 hours of services provided by a 
private duty nurse or personal care assistant to the 
ventilator-dependent person during the time the 
ventilator-dependent person is in a hospital licensed under 
chapter 144.  The personal care assistant or private duty nurse 
shall perform only the services of communicator or interpreter 
for the ventilator-dependent patient during a transition period 
of up to 120 hours to assure adequate training of the hospital 
staff to communicate with the patient and to understand the 
unique comfort, safety and personal care needs of the patient.  
    Sec. 4.  Minnesota Statutes 1987 Supplement, section 
62A.27, is amended to read:  
    62A.27 [COVERAGE FOR ADOPTED CHILDREN.] 
    No An individual or group policy or plan of health and 
accident insurance regulated under this chapter or chapter 64B, 
subscriber contract regulated under chapter 62C, or health 
maintenance contract regulated under chapter 62D, providing 
coverage for more than one person may be issued or renewed in 
this state after August 1, 1983, unless the policy, plan, or 
contract covers that provides coverage to a Minnesota resident 
must cover adopted children of the insured, subscriber, or 
enrollee on the same basis as other dependents.  Consequently, 
the policy or plan shall not contain any provision concerning 
preexisting condition limitations, insurability, eligibility, or 
health underwriting approval concerning adopted children.  
    The coverage required by this section is effective from the 
date of placement for the purpose of adoption and continues 
unless the placement is disrupted prior to legal adoption and 
the child is removed from placement. 
    Sec. 5.  [243.255] [PRIVATE INSURANCE POLICIES; 
SUBROGATION.] 
    Subdivision 1.  [DEFINITIONS.] As used in this section: 
    (a) "Commissioner" means the commissioner of corrections; 
    (b) "Inmate" means a person who has been sentenced to 
incarceration in a state or local correctional facility, 
including persons committed in accordance with section 631.425 
or released for employment under section 241.26; and 
    (c) "Private insurance coverage" means coverage for medical 
care or services under any insurance plan regulated by chapter 
62A, 62C, 62D, 64B, or 65B.  Private insurance coverage also 
includes any self-insurance plan providing medical care or 
services. 
    Subd. 2.  [SUBROGATION RIGHTS.] When the commissioner or a 
county agency provides medical care or services pursuant to 
section 241.021, subdivision 4, or any rule adopted under it to 
any inmate having private insurance coverage, the commissioner 
or county agency shall be subrogated, to the extent of the cost 
of services provided, to any rights the inmate may have under 
the terms of any private insurance coverage.  This provision 
supersedes any inconsistent policy provision. 
    Subd. 3.  [CIVIL ACTION.] The county attorney may institute 
a civil action against the carrier of the private insurance 
coverage to recover under this section on behalf of the county 
agency. 
    Subd. 4.  [POLICY EXCLUSIONS PROHIBITED.] The provisions of 
section 62A.044 apply to this section. 
    Sec. 6.  [EFFECTIVE DATES.] 
    Sections 1 and 3 are effective August 1, 1988, and apply to 
policies issued or renewed on or after that date.  Section 4 is 
effective the day following final enactment. 
    Approved April 26, 1988