Minnesota Session Laws - 1997, Regular Session

                            CHAPTER 194-S.F.No. 302 
                  An act relating to health; allowing certain community 
                  health clinics to offer health care services on a 
                  prepaid basis; proposing coding for new law in 
                  Minnesota Statutes, chapter 62Q. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  [62Q.22] [HEALTH CARE SERVICES PREPAID OPTION.] 
           Subdivision 1.  [SCOPE.] A community health clinic that is 
        designated as an essential community provider under section 
        62Q.19 and is associated with a hospital, a governmental unit, 
        or the University of Minnesota may offer to individuals and 
        families the option of purchasing basic health care services on 
        a fixed prepaid basis without satisfying the requirements of 
        chapter 60A, 62A, 62C, or 62D, or any other law or rule that 
        applies to entities licensed under those chapters.  
           Subd. 2.  [REGISTRATION.] A community health clinic that 
        offers a prepaid option under this section must register on an 
        annual basis with the commissioner of health. 
           Subd. 3.  [PREMIUMS.] The premiums for a prepaid option 
        offered under this section must be based on a sliding fee 
        schedule based on current poverty income guidelines.  
           Subd. 4.  [HEALTH CARE SERVICES.] (a) A prepaid option 
        offered under this section must provide basic health care 
        services including: 
           (1) services for the diagnosis and treatment of injuries, 
        illnesses, or conditions; 
           (2) child health supervision services up to age 18, as 
        defined under section 62A.047; and 
           (3) preventive health services, including: 
           (i) health education; 
           (ii) health supervision, evaluation, and follow-up; 
           (iii) immunization; and 
           (iv) early disease detection. 
           (b) Inpatient hospital services shall not be offered as a 
        part of a community health clinic's prepaid option.  A clinic 
        may associate with a hospital to provide hospital services to an 
        individual or family who is enrolled in the prepaid option so 
        long as these services are not offered as part of the prepaid 
        option. 
           (c) All health care services included by the community 
        health clinic in a prepaid option must be services that are 
        offered within the scope of practice of the clinic by the 
        clinic's professional staff.  
           Subd. 5.  [GUARANTEED RENEWABILITY.] A community health 
        clinic shall not refuse to renew a prepaid option, except for 
        nonpayment of premiums, fraud, or misrepresentation, or as 
        permitted under subdivisions 8 and 9, paragraph (b).  
           Subd. 6.  [INFORMATION TO BE PROVIDED.] (a) A community 
        health clinic must provide an individual or family who purchases 
        a prepaid option a clear and concise written statement that 
        includes the following information: 
           (1) the health care services that the prepaid option 
        covers; 
           (2) any exclusions or limitations on the health care 
        services offered, including any preexisting condition 
        limitations, cost-sharing arrangements, or prior authorization 
        requirements; 
           (3) where the health care services may be obtained; 
           (4) a description of the clinic's method for resolving 
        patient complaints, including a description of how a patient can 
        file a complaint with the department of health; and 
           (5) a description of the conditions under which the prepaid 
        option may be canceled or terminated. 
           (b) The commissioner of health must approve a copy of the 
        written statement before the community health clinic may offer 
        the prepaid option described in this section.  
           Subd. 7.  [COMPLAINT PROCESS.] (a) A community health 
        clinic that offers a prepaid option under this section must 
        establish a complaint resolution process.  As an alternative to 
        establishing its own process, a community health clinic may use 
        the complaint process of another organization.  
           (b) A community health clinic must make reasonable efforts 
        to resolve complaints and to inform complainants in writing of 
        the clinic's decision within 60 days of receiving the complaint. 
           (c) A community health clinic that offers a prepaid option 
        under this section must report all complaints that are not 
        resolved within 60 days to the commissioner of health. 
           Subd. 8.  [PUBLIC ASSISTANCE PROGRAM ELIGIBILITY.] A 
        community health clinic may require an individual or family 
        enrolled in the clinic's prepaid option to apply for medical 
        assistance, general assistance medical care, or the 
        MinnesotaCare program.  The clinic must assist the individual or 
        family in filing the application for the appropriate public 
        program.  If, upon the request of the clinic, an individual or 
        family refuses to apply for these programs, the clinic may 
        disenroll the individual or family from the prepaid option at 
        any time. 
           Subd. 9.  [LIMITATIONS ON ENROLLMENT.] (a) A community 
        health clinic may limit enrollment in its prepaid option.  If 
        enrollment is limited, a waiting list must be established. 
           (b) A community health clinic may deny enrollment in its 
        prepaid option to an individual or family whose gross family 
        income is greater than 275 percent of the federal poverty 
        guidelines. 
           (c) No community health clinic may restrict or deny 
        enrollment in its prepaid option because of an individual's or a 
        family's financial limitations, except as permitted under this 
        subdivision. 
           Presented to the governor May 19, 1997 
           Signed by the governor May 20, 1997, 10:52 a.m.