Minnesota Session Laws - 1991, Regular Session

  

                         Laws of Minnesota 1991 

                         CHAPTER 264-H.F.No. 20 
           An act relating to insurance; regulating the 
          composition of the MCHA board and certain of its 
          meetings; requiring insurers to furnish a summary of 
          claims review findings; amending Minnesota Statutes 
          1990, sections 62E.10, subdivision 2; and 62E.11, by 
          adding a subdivision; proposing coding for new law in 
          Minnesota Statutes, chapter 72A. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
     Section 1.  Minnesota Statutes 1990, section 62E.10, 
subdivision 2, is amended to read: 
    Subd. 2.  [BOARD OF DIRECTORS; ORGANIZATION.] The board of 
directors of the association shall be made up of nine members as 
follows:  five insurer directors selected by participating 
members, subject to approval by the commissioner; four public 
directors selected by the commissioner, at least two of whom 
must be plan enrollees.  Public members may include licensed 
insurance agents.  In determining voting rights at members' 
meetings, each member shall be entitled to vote in person or 
proxy.  The vote shall be a weighted vote based upon the 
member's cost of self-insurance, accident and health insurance 
premium, subscriber contract charges, or health maintenance 
contract payment derived from or on behalf of Minnesota 
residents in the previous calendar year, as determined by the 
commissioner.  In approving directors of the board, the 
commissioner shall consider, among other things, whether all 
types of members are fairly represented.  Insurer directors may 
be reimbursed from the money of the association for expenses 
incurred by them as directors, but shall not otherwise be 
compensated by the association for their services.  The costs of 
conducting meetings of the association and its board of 
directors shall be borne by members of the association. 
    Sec. 2.  Minnesota Statutes 1990, section 62E.11, is 
amended by adding a subdivision to read: 
    Subd. 11.  [RATE INCREASE OR BENEFIT CHANGE.] The 
association must hold a public meeting to hear public comment at 
least two weeks before filing a rate increase or benefit change 
with the commissioner.  Notice of the public meeting to hear 
public comment must be mailed at least two weeks before the 
meeting to all plan enrollees. 
    Sec. 3.  [72A.285] [CLAIM FOR INSURANCE BENEFITS; RELEASE 
OF SUMMARY INFORMATION.] 
    Notwithstanding section 145.64, when a review organization, 
as defined in section 145.61, has conducted a review of health 
services given or proposed to be given to an insured or claimant 
in connection with or in anticipation of a claim for insurance 
benefits, a complete summary of the review findings must be 
furnished by the insurer to the provider who requested the 
review or to the insured or claimant, upon that person's request.
    The summary must list the qualifications of the reviewer, 
including any license, certification, or specialty designation.  
The summary must also describe the relationship between the 
insured's or claimant's diagnosis and the review criteria used 
as a basis for the claim decision, including the specific 
rationale for the reviewer's decision.  
    Nothing in this section requires the disclosure of the 
identity of the person conducting the review. 
    Presented to the governor May 29, 1991 
    Signed by the governor June 1, 1991, 3:28 p.m.