Office of the Revisor of Statutes
Minnesota Session Laws - 1997, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 205-S.F.No. 95
An act relating to health; modifying provisions
related to health maintenance organizations; modifying
lead inspection provisions; modifying vital statistics
provisions; modifying asbestos abatement provisions;
modifying provisions relating to traumatic brain
injury and spinal cord injury notification and data;
modifying provisions for hearings related to
permitting, licensing, registration, and
certification; modifying revocation and suspension
provisions for permits, licenses, registration, and
certifications; modifying provisions for testing
infants for inborn metabolic errors; modifying medical
education and research costs trust fund provisions;
requiring conformance with federal regulations;
amending Minnesota Statutes 1996, sections 62D.02,
subdivision 10; 62D.03, subdivisions 3 and 4; 62D.04,
subdivision 3; 62D.042, subdivision 3; 62D.06,
subdivision 1; 62D.07, subdivision 3; 62D.09,
subdivisions 1, 3, and 8; 62D.102; 62D.11,
subdivisions 1, 1b, and 3; 62D.12, by adding a
subdivision; 62D.20, subdivision 2; 62J.60,
subdivision 3; 62J.69, subdivision 1; 144.125;
144.215, subdivision 1; 144.218; 144.664, subdivision
3; 144.665; 144.9501, subdivision 29, and by adding a
subdivision; 144.9504, subdivision 2; 144.9506,
subdivisions 1 and 5; 144.99, subdivisions 9 and 10;
257.73; 326.71, subdivisions 4 and 6; 326.72,
subdivision 2; 326.74; 326.76; 326.78, subdivision 1;
and 326.785; repealing Minnesota Statutes 1996,
sections 62D.03, subdivision 2; and 62D.11,
subdivision 4; Laws 1988, chapter 495, section 1;
Minnesota Rules, part 4600.3900.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. Minnesota Statutes 1996, section 62D.02,
subdivision 10, is amended to read:
Subd. 10. "Consumer" means any person other than a person
(a) whose occupation involves, or before retirement involved,
the administration of health activities or the providing of
health services; (b) who is, or ever was, employed by a health
care facility, as a licensed health professional; or (c) who
has, or ever had, a direct, substantial financial or managerial
interest in the rendering of health service other than the
payment of reasonable expense reimbursement or compensation as a
member of the board of a health maintenance organization,
including an enrollee, to whom a health maintenance organization
directs marketing materials.
Sec. 2. Minnesota Statutes 1996, section 62D.03,
subdivision 3, is amended to read:
Subd. 3. The commissioner of health may require any person
providing physician and hospital services with payments made in
the manner set forth in section 62D.02, subdivision 4, to apply
for a certificate of authority under sections 62D.01 to 62D.30.
An applicant may continue to operate until the commissioner of
health acts upon the application. In the event that an
application is denied, the applicant shall henceforth be treated
as a health maintenance organization whose certificate of
authority has been revoked. Any person directed to apply for a
certificate of authority shall be subject to the provisions
of this subdivision 2.
Sec. 3. Minnesota Statutes 1996, section 62D.03,
subdivision 4, is amended to read:
Subd. 4. Each application for a certificate of authority
shall be verified by an officer or authorized representative of
the applicant, and shall be in a form prescribed by the
commissioner of health. Each application shall include the
following:
(a) a copy of the basic organizational document, if any, of
the applicant and of each major participating entity; such as
the articles of incorporation, or other applicable documents,
and all amendments thereto;
(b) a copy of the bylaws, rules and regulations, or similar
document, if any, and all amendments thereto which regulate the
conduct of the affairs of the applicant and of each major
participating entity;
(c) a list of the names, addresses, and official positions
of the following:
(1) all members of the board of directors, or governing
body of the local government unit, and the principal officers
and shareholders of the applicant organization; and
(2) all members of the board of directors, or governing
body of the local government unit, and the principal officers of
the major participating entity and each shareholder beneficially
owning more than ten percent of any voting stock of the major
participating entity;
The commissioner may by rule identify persons included in
the term "principal officers";
(d) a full disclosure of the extent and nature of any
contract or financial arrangements between the following:
(1) the health maintenance organization and the persons
listed in clause (c)(1);
(2) the health maintenance organization and the persons
listed in clause (c)(2);
(3) each major participating entity and the persons listed
in clause (c)(1) concerning any financial relationship with the
health maintenance organization; and
(4) each major participating entity and the persons listed
in clause (c)(2) concerning any financial relationship with the
health maintenance organization;
(e) the name and address of each participating entity and
the agreed upon duration of each contract or agreement;
(f) a copy of the form of each contract binding the
participating entities and the health maintenance organization.
Contractual provisions shall be consistent with the purposes of
sections 62D.01 to 62D.30, in regard to the services to be
performed under the contract, the manner in which payment for
services is determined, the nature and extent of
responsibilities to be retained by the health maintenance
organization, the nature and extent of risk sharing permissible,
and contractual termination provisions;
(g) a copy of each contract binding major participating
entities and the health maintenance organization. Contract
information filed with the commissioner shall be confidential
and subject to the provisions of section 13.37, subdivision 1,
clause (b), upon the request of the health maintenance
organization.
Upon initial filing of each contract, the health
maintenance organization shall file a separate document
detailing the projected annual expenses to the major
participating entity in performing the contract and the
projected annual revenues received by the entity from the health
maintenance organization for such performance. The commissioner
shall disapprove any contract with a major participating entity
if the contract will result in an unreasonable expense under
section 62D.19. The commissioner shall approve or disapprove a
contract within 30 days of filing.
Within 120 days of the anniversary of the implementation of
each contract, the health maintenance organization shall file a
document detailing the actual expenses incurred and reported by
the major participating entity in performing the contract in the
preceding year and the actual revenues received from the health
maintenance organization by the entity in payment for the
performance.;
Contracts implemented prior to April 25, 1984, shall be
filed within 90 days of April 25, 1984. These contracts are
subject to the provisions of section 62D.19, but are not subject
to the prospective review prescribed by this clause, unless or
until the terms of the contract are modified. Commencing with
the next anniversary of the implementation of each of these
contracts immediately following filing, the health maintenance
organization shall, as otherwise required by this subdivision,
file annual actual expenses and revenues;
(h) a statement generally describing the health maintenance
organization, its health maintenance contracts and separate
health service contracts, facilities, and personnel, including a
statement describing the manner in which the applicant proposes
to provide enrollees with comprehensive health maintenance
services and separate health services;
(i) a copy of the form of each evidence of coverage to be
issued to the enrollees;
(j) a copy of the form of each individual or group health
maintenance contract and each separate health service contract
which is to be issued to enrollees or their representatives;
(k) financial statements showing the applicant's assets,
liabilities, and sources of financial support. If the
applicant's financial affairs are audited by independent
certified public accountants, a copy of the applicant's most
recent certified financial statement may be deemed to satisfy
this requirement;
(l) a description of the proposed method of marketing the
plan, a schedule of proposed charges, and a financial plan which
includes a three-year projection of the expenses and income and
other sources of future capital;
(m) a statement reasonably describing the geographic area
or areas to be served and the type or types of enrollees to be
served;
(n) a description of the complaint procedures to be
utilized as required under section 62D.11;
(o) a description of the procedures and programs to be
implemented to meet the requirements of section 62D.04,
subdivision 1, clauses (b) and (c) and to monitor the quality of
health care provided to enrollees;
(p) a description of the mechanism by which enrollees will
be afforded an opportunity to participate in matters of policy
and operation under section 62D.06;
(q) a copy of any agreement between the health maintenance
organization and an insurer or nonprofit health service
corporation regarding reinsurance, stop-loss coverage,
insolvency coverage, or any other type of coverage for potential
costs of health services, as authorized in sections 62D.04,
subdivision 1, clause (f), 62D.05, subdivision 3, and 62D.13;
(r) a copy of the conflict of interest policy which applies
to all members of the board of directors and the principal
officers of the health maintenance organization, as described in
section 62D.04, subdivision 1, paragraph (g). All currently
licensed health maintenance organizations shall also file a
conflict of interest policy with the commissioner within 60 days
after August 1, 1990, or at a later date if approved by the
commissioner;
(s) a copy of the statement that describes the health
maintenance organization's prior authorization administrative
procedures;
(t) a copy of the agreement between the guaranteeing
organization and the health maintenance organization, as
described in section 62D.043, subdivision 6; and
(u) other information as the commissioner of health may
reasonably require to be provided.
Sec. 4. Minnesota Statutes 1996, section 62D.04,
subdivision 3, is amended to read:
Subd. 3. Except as provided in section 62D.03, subdivision
2, no person who has not been issued a certificate of authority
shall use the words "health maintenance organization" or the
initials "HMO" in its name, contracts or literature. Provided,
however, that persons who are operating under a contract with,
operating in association with, enrolling enrollees for, or
otherwise authorized by a health maintenance organization
licensed under sections 62D.01 to 62D.30 to act on its behalf
may use the terms "health maintenance organization" or "HMO" for
the limited purpose of denoting or explaining their association
or relationship with the authorized health maintenance
organization. No health maintenance organization which has a
minority of consumers enrollees and members elected according to
section 62D.06, subdivision 1, as members of its board of
directors shall use the words "consumer controlled" in its name
or in any way represent to the public that it is controlled by
consumers.
Sec. 5. Minnesota Statutes 1996, section 62D.042,
subdivision 3, is amended to read:
Subd. 3. [PHASE-IN FOR EXISTING ORGANIZATIONS.] (a)
Organizations that obtained a certificate of authority on or
before April 25, 1988, have until December 31, 1993, to
establish a net worth of at least 8-1/3 percent of the sum of
all expenses incurred during the previous calendar year, or
$1,000,000, whichever is greater.
(b) By December 31, 1989, organizations shall have a net
worth of at least one-fifth of 8-1/3 percent of the sum of all
expenses incurred during the previous calendar year, or
$1,000,000, whichever is greater.
(c) By December 31, 1990, organizations shall have a net
worth of at least two-fifths of 8-1/3 percent of the sum of all
expenses incurred during the previous calendar year, or
$1,000,000, whichever is greater.
(d) By December 31, 1991, organizations shall have a net
worth of at least three-fifths of 8-1/3 percent of the sum of
all expenses incurred during the previous calendar year, or
$1,000,000, whichever is greater.
(e) By December 31, 1992, organizations Each organization
shall have a net worth of at least four-fifths of 8-1/3 percent
of the sum of all expenses incurred during the previous calendar
year, or $1,000,000, whichever is greater.
Sec. 6. Minnesota Statutes 1996, section 62D.06,
subdivision 1, is amended to read:
Subdivision 1. The governing body of any health
maintenance organization which is a nonprofit corporation may
include enrollees, providers, or other individuals; provided,
however, that after a health maintenance organization which is a
nonprofit corporation has been authorized under sections 62D.01
to 62D.30 for one year, at least 40 percent of the governing
body shall be composed of consumers enrollees and members
elected by the enrollees and members from among the
enrollees and members. For purposes of this section, "member"
means a consumer who receives health care services through a
self-insured contract that is administered by the health
maintenance organization or its related third-party
administrator. The number of members elected to the governing
body shall not exceed the number of enrollees elected to the
governing body. An enrollee or member elected to the governing
board may not be a person (1) whose occupation involves, or
before retirement involved, the administration of health
activities or the provision of health services; (2) who is or
was employed by a health care facility as a licensed health
professional; or (3) who has or had a direct substantial
financial or managerial interest in the rendering of a health
service, other than the payment of a reasonable expense
reimbursement or compensation as a member of the board of a
health maintenance organization.
After a health maintenance organization which is a local
governmental unit has been authorized under sections 62D.01 to
62D.30 for one year, an enrollee advisory body shall be
established. The enrollees who make up this advisory body shall
be elected by the enrollees from among the enrollees.
Sec. 7. Minnesota Statutes 1996, section 62D.07,
subdivision 3, is amended to read:
Subd. 3. Contracts and evidences of coverage shall contain:
(a) No provisions or statements which are unjust, unfair,
inequitable, misleading, deceptive, or which are untrue,
misleading, or deceptive as defined in section 62D.12,
subdivision 1; and
(b) A clear, concise and complete statement of:
(1) the health care services and the insurance or other
benefits, if any, to which the enrollee is entitled under the
health maintenance contract;
(2) any exclusions or limitations on the services, kind of
services, benefits, or kind of benefits, to be provided,
including any deductible or copayment feature and requirements
for referrals, prior authorizations, and second opinions;
(3) where and in what manner information is available as to
how services, including emergency and out of area services, may
be obtained;
(4) the total amount of payment and copayment, if any, for
health care services and the indemnity or service benefits, if
any, which the enrollee is obligated to pay with respect to
individual contracts, or an indication whether the plan is
contributory or noncontributory with respect to group
certificates; and
(5) a description of the health maintenance organization's
method for resolving enrollee complaints and a statement
identifying the commissioner as an external source with whom
grievances complaints may be registered.; and
(c) On the cover page of the evidence of coverage and
contract, a clear and complete statement of enrollees' rights as
consumers. The statement must be in bold print and captioned
"Important Consumer Enrollee Information and Enrollee Bill of
Rights" and must include but not be limited to the following
provisions in the following language or in substantially similar
language approved in advance by the commissioner, except that
paragraph (8) does not apply to prepaid health plans providing
coverage for programs administered by the commissioner of human
services:
CONSUMER ENROLLEE INFORMATION
(1) COVERED SERVICES: Services provided by (name of health
maintenance organization) will be covered only if services are
provided by participating (name of health maintenance
organization) providers or authorized by (name of health
maintenance organization). Your contract fully defines what
services are covered and describes procedures you must follow to
obtain coverage.
(2) PROVIDERS: Enrolling in (name of health maintenance
organization) does not guarantee services by a particular
provider on the list of providers. When a provider is no longer
part of (name of health maintenance organization), you must
choose among remaining (name of the health maintenance
organization) providers.
(3) REFERRALS: Certain services are covered only upon
referral. See section (section number) of your contract for
referral requirements. All referrals to non-(name of health
maintenance organization) providers and certain types of health
care providers must be authorized by (name of health maintenance
organization).
(4) EMERGENCY SERVICES: Emergency services from providers
who are not affiliated with (name of health maintenance
organization) will be covered only if proper procedures are
followed. Your contract explains the procedures and benefits
associated with emergency care from (name of health maintenance
organization) and non-(name of health maintenance organization)
providers.
(5) EXCLUSIONS: Certain services or medical supplies are
not covered. You should read the contract for a detailed
explanation of all exclusions.
(6) CONTINUATION: You may convert to an individual health
maintenance organization contract or continue coverage under
certain circumstances. These continuation and conversion rights
are explained fully in your contract.
(7) CANCELLATION: Your coverage may be canceled by you or
(name of health maintenance organization) only under certain
conditions. Your contract describes all reasons for
cancellation of coverage.
(8) NEWBORN COVERAGE: If your health plan provides for
dependent coverage, a newborn infant is covered from birth, but
only if services are provided by participating (name of health
maintenance organization) providers or authorized by (name of
health maintenance organization). Certain services are covered
only upon referral. (Name of health maintenance organization)
will not automatically know of the infant's birth or that you
would like coverage under your plan. You should notify (name of
health maintenance organization) of the infant's birth and that
you would like coverage. If your contract requires an
additional premium for each dependent, (name of health
maintenance organization) is entitled to all premiums due from
the time of the infant's birth until the time you notify (name
of health maintenance organization) of the birth. (Name of
health maintenance organization) may withhold payment of any
health benefits for the newborn infant until any premiums you
owe are paid.
(9) PRESCRIPTION DRUGS AND MEDICAL EQUIPMENT: Enrolling in
(name of health maintenance organization) does not guarantee
that any particular prescription drug will be available nor that
any particular piece of medical equipment will be available,
even if the drug or equipment is available at the start of the
contract year.
ENROLLEE BILL OF RIGHTS
(1) Enrollees have the right to available and accessible
services including emergency services, as defined in your
contract, 24 hours a day and seven days a week;
(2) Enrollees have the right to be informed of health
problems, and to receive information regarding treatment
alternatives and risks which is sufficient to assure informed
choice;
(3) Enrollees have the right to refuse treatment, and the
right to privacy of medical and financial records maintained by
the health maintenance organization and its health care
providers, in accordance with existing law;
(4) Enrollees have the right to file a grievance complaint
with the health maintenance organization and the commissioner of
health and the right to initiate a legal proceeding when
experiencing a problem with the health maintenance organization
or its health care providers;
(5) Enrollees have the right to a grace period of 31 days
for the payment of each premium for an individual health
maintenance contract falling due after the first premium during
which period the contract shall continue in force;
(6) Medicare enrollees have the right to voluntarily
disenroll from the health maintenance organization and the right
not to be requested or encouraged to disenroll except in
circumstances specified in federal law; and
(7) Medicare enrollees have the right to a clear
description of nursing home and home care benefits covered by
the health maintenance organization.
Sec. 8. Minnesota Statutes 1996, section 62D.09,
subdivision 1, is amended to read:
Subdivision 1. (a) Any written marketing materials which
may be directed toward potential enrollees and which include a
detailed description of benefits provided by the health
maintenance organization shall include a statement of
consumer enrollee information and rights as described in section
62D.07, subdivision 3, paragraphs (b) and (c). Prior to any
oral marketing presentation, the agent marketing the plan must
inform the potential enrollees that any complaints concerning
the material presented should be directed to the health
maintenance organization, the commissioner of health, or, if
applicable, the employer.
(b) Detailed marketing materials must affirmatively
disclose all exclusions and limitations in the organization's
services or kinds of services offered to the contracting party,
including but not limited to the following types of exclusions
and limitations:
(1) health care services not provided;
(2) health care services requiring copayments or
deductibles paid by enrollees;
(3) the fact that access to health care services does not
guarantee access to a particular provider type; and
(4) health care services that are or may be provided only
by referral of a physician.
(c) No marketing materials may lead consumers to believe
that all health care needs will be covered. All marketing
materials must alert consumers to possible uncovered expenses
with the following language in bold print: "THIS HEALTH CARE
PLAN MAY NOT COVER ALL YOUR HEALTH CARE EXPENSES; READ YOUR
CONTRACT CAREFULLY TO DETERMINE WHICH EXPENSES ARE COVERED."
Immediately following the disclosure required under paragraph
(b), clause (3), consumers must be given a telephone number to
use to contact the health maintenance organization for specific
information about access to provider types.
(d) The disclosures required in paragraphs (b) and (c) are
not required on billboards or image, and name identification
advertisement.
Sec. 9. Minnesota Statutes 1996, section 62D.09,
subdivision 3, is amended to read:
Subd. 3. Every health maintenance organization or its
representative shall annually, before June 1, provide to its
enrollees the following: (1) a summary of its most recent
annual financial statement including a balance sheet and
statement of receipts and disbursements; (2) a description of
the health maintenance organization, its health care plan or
plans, its facilities and personnel, any material changes
therein since the last report; (3) the current evidence of
coverage or contract; and (4) a statement of consumer enrollee
information and rights as described in section 62D.07,
subdivision 3, paragraph (c).
Sec. 10. Minnesota Statutes 1996, section 62D.09,
subdivision 8, is amended to read:
Subd. 8. Each health maintenance organization shall issue
a membership card to its enrollees. The membership card must:
(1) identify the health maintenance organization;
(2) include the name, address, and telephone number to call
if the enroller enrollee has a complaint;
(3) include the telephone number to call or the instruction
on how to receive authorization for emergency care; and
(4) include one of the following:
(i) the telephone number to call to appeal to or file a
complaint with the commissioner of health.; or
(ii) for persons enrolled under section 256.9363, 256B.69,
or 256D.03, the telephone number to call to file a complaint
with the ombudsperson designated by the commissioner of human
services under section 256B.69 and the address to appeal to the
commissioner of human services. The ombudsperson shall annually
provide the commissioner of health with a summary of complaints
and actions taken.
Sec. 11. Minnesota Statutes 1996, section 62D.102, is
amended to read:
62D.102 [FAMILY THERAPY.]
(a) In addition to minimum requirements established in
other sections, all group health maintenance contracts providing
benefits for mental or nervous disorder treatments in a hospital
shall also provide coverage for at least ten hours of treatment
over a 12-month period with a copayment not to exceed the
greater of $10 or 20 percent of the applicable usual and
customary charge for mental or nervous disorder consultation,
diagnosis and treatment services delivered while the enrollee is
not a bed patient in a hospital and at least 75 percent of the
cost of the usual and customary charges for any additional hours
of ambulatory mental health treatment during the same 12-month
benefit period for serious or persistent mental or nervous
disorders. Prior authorization may be required for an extension
of coverage beyond ten hours of treatment. This prior
authorization must be based upon the severity of the disorder,
the patient's risk of deterioration without ongoing treatment
and maintenance, degree of functional impairment, and a concise
treatment plan. Authorization for extended treatment may be
limited to a maximum of 30 visit hours during any 12-month
benefit period.
(b) For purposes of this section, Covered treatment for a
minor includes treatment for the family if family therapy is
recommended by a health maintenance organization provider. For
purposes of determining benefits under this section, "hours of
treatment" means treatment rendered on an individual or
single-family basis. If treatment is rendered on a group basis,
the hours of covered group treatment must be provided at a ratio
of no less than two group treatment sessions to one individual
treatment hour. For a health maintenance contract that is
offered as a companion to a health insurance subscriber
contract, the benefits for mental or nervous disorders must be
calculated in aggregate for the health maintenance contract and
the health insurance subscriber contract.
Sec. 12. Minnesota Statutes 1996, section 62D.11,
subdivision 1, is amended to read:
Subdivision 1. [ENROLLEE COMPLAINT SYSTEM.] Every health
maintenance organization shall establish and maintain a
complaint system, as required under section 62Q.105 to provide
reasonable procedures for the resolution of written complaints
initiated by or on behalf of enrollees concerning the provision
of health care services. "Provision of health services"
includes, but is not limited to, questions of the scope of
coverage, quality of care, and administrative operations. The
health maintenance organization must inform enrollees that they
may choose to use an alternative dispute resolution process to
appeal a health maintenance organization's internal appeal
decision. If an enrollee chooses to use an alternative dispute
resolution process, the health maintenance organization must
participate.
Sec. 13. Minnesota Statutes 1996, section 62D.11,
subdivision 1b, is amended to read:
Subd. 1b. [EXPEDITED RESOLUTION OF COMPLAINTS ABOUT
URGENTLY NEEDED SERVICE MEDICALLY URGENT SERVICES.] In addition
to any remedy contained in subdivision 1a, when a complaint
involves a dispute about a health maintenance organization's
coverage of an immediately and urgently needed a medically
urgent service, the commissioner may also order the health
maintenance organization to use an expedited system to process
the complaint.
Sec. 14. Minnesota Statutes 1996, section 62D.11,
subdivision 3, is amended to read:
Subd. 3. [DENIAL OF SERVICE COVERAGE.] Within a reasonable
time after receiving an enrollee's written or oral communication
to the health maintenance organization concerning a refusal
denial of service coverage or inadequacy of services, the health
maintenance organization shall provide the enrollee with a
written statement of the reason for the refusal denial of
service coverage, and a statement approved by the commissioner
of health which explains the health maintenance organization
complaint procedures, and in the case of Medicare enrollees,
which also explains Medicare appeal procedures.
Sec. 15. Minnesota Statutes 1996, section 62D.12, is
amended by adding a subdivision to read:
Subd. 19. [COVERAGE OF SERVICE.] A health maintenance
organization may not deny or limit coverage of a service which
the enrollee has already received solely on the basis of lack of
prior authorization or second opinion, to the extent that the
service would otherwise have been covered under the member's
contract by the health maintenance organization had prior
authorization or second opinion been obtained.
Sec. 16. Minnesota Statutes 1996, section 62D.20,
subdivision 2, is amended to read:
Subd. 2. [PRIOR AUTHORIZATION.] The commissioner shall
adopt rules that address the issue of appropriate prior
authorization requirements, considering consumer enrollee needs,
administrative concerns, and the nature of the benefit.
Sec. 17. Minnesota Statutes 1996, section 62J.60,
subdivision 3, is amended to read:
Subd. 3. [HUMAN READABLE DATA ELEMENTS.] (a) The following
are the minimum human readable data elements that must be
present on the front side of the Minnesota health care
identification card:
(1) card issuer name or logo, which is the name or logo
that identifies the card issuer. The card issuer name or logo
may be the card's front background. No standard label is
required for this data element;
(2) claim submission number. The standardized label for
this element is "Clm Subm #";
(3) identification number, which is the unique
identification number of the individual card holder established
and defined under this section. The standardized label for the
data element is "ID";
(4) identification name, which is the name of the
individual card holder. The identification name must be
formatted as follows: first name, space, optional middle
initial, space, last name, optional space and name suffix. The
standardized label for this data element is "Name";
(5) account number(s), which is any other number, such as a
group number, if required for part of the identification or
claims process. The standardized label for this data element is
"Account";
(6) care type, which is the description of the group
purchaser's plan product under which the beneficiary is
covered. The description shall include the health plan company
name and the plan or product name. The standardized label for
this data element is "Care Type";
(7) service type, which is the description of coverage
provided such as hospital, dental, vision, prescription, or
mental health. The standard label for this data element is "Svc
Type"; and
(8) provider/clinic name, which is the name of the primary
care clinic the card holder is assigned to by the health plan
company. The standard label for this field is "PCP." This
information is mandatory only if the health plan company assigns
a specific primary care provider to the card holder.
(b) The following human readable data elements shall be
present on the back side of the Minnesota health identification
card. These elements must be left justified, and no optional
data elements may be interspersed between them:
(1) claims submission name(s) and address(es), which are
the name(s) and address(es) of the entity or entities to which
claims should be submitted. If different destinations are
required for different types of claims, this must be
labeled; and
(2) telephone number(s) and name(s); which are the
telephone number(s) and name(s) of the following contact(s) with
a standardized label describing the service function as
applicable:
(i) eligibility and benefit information;
(ii) utilization review;
(iii) precertification; or
(iv) customer services.
(c) The following human readable data elements are
mandatory on the back side of the card for health maintenance
organizations and integrated service networks:
(1) emergency care authorization telephone number or
instruction on how to receive authorization for emergency care.
There is no standard label required for this information; and
(2) one of the following:
(i) telephone number to call to appeal to or file a
complaint with the commissioner of health; or
(ii) for persons enrolled under section 256.9363, 256B.69,
or 256D.03, the telephone number to call to file a complaint
with the ombudsperson designated by the commissioner of human
services under section 256B.69 and the address to appeal to the
commissioner of human services. There is no standard label
required for this information.
(d) All human readable data elements not required under
paragraphs (a) to (c) are optional and may be used at the
issuer's discretion.
Sec. 18. Minnesota Statutes 1996, section 62J.69,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following definitions apply:
(a) "Medical education" means the accredited clinical
training of physicians (medical students and residents), doctor
of pharmacy practitioners, dentists, advanced practice nurses
(clinical nurse specialist, certified registered nurse
anesthetists, nurse practitioners, and certified nurse
midwives), and physician assistants.
(b) "Clinical training" means accredited training that is
funded and was historically funded in part by inpatient care
revenues and that occurs in both inpatient and ambulatory care
settings.
(c) "Trainee" means students involved in an accredited
clinical training program for medical education as defined in
paragraph (a).
(d) "Health care research" means approved clinical,
outcomes, and health services investigations that are funded by
patient out-of-pocket expenses or a third-party payer.
(e) "Commissioner" means the commissioner of health.
(f) "Teaching institutions" means any hospital, medical
center, clinic, or other organization that currently sponsors or
conducts accredited medical education programs or clinical
research in Minnesota.
Sec. 19. Minnesota Statutes 1996, section 144.125, is
amended to read:
144.125 [TESTS OF INFANTS FOR INBORN METABOLIC ERRORS.]
It is the duty of (1) the administrative officer or other
person in charge of each institution caring for infants 28 days
or less of age and, (2) the person required in pursuance of the
provisions of section 144.215, to register the birth of a child,
or (3) the nurse midwife or midwife in attendance at the birth,
to cause arrange to have administered to every infant or child
in its care tests for hemoglobinopathy, phenylketonuria, and
other inborn errors of metabolism in accordance with rules
prescribed by the state commissioner of health. In determining
which tests must be administered, the commissioner shall take
into consideration the adequacy of laboratory methods to detect
the inborn metabolic error, the ability to treat or prevent
medical conditions caused by the inborn metabolic error, and the
severity of the medical conditions caused by the inborn
metabolic error. Testing and the recording and reporting of the
test results of the tests shall be performed at the times and in
the manner prescribed by the commissioner of health. The
commissioner shall charge laboratory service fees for conducting
the tests of infants for inborn metabolic errors so that the
total of fees collected will approximate the costs of conducting
the tests. Costs associated with capital expenditures and the
development of new procedures may be prorated over a three-year
period when calculating the amount of the fees.
Sec. 20. Minnesota Statutes 1996, section 144.215,
subdivision 1, is amended to read:
Subdivision 1. [WHEN AND WHERE TO FILE.] A certificate of
birth for each live birth which occurs in this state shall be
filed with the state registrar or the local registrar of the
district in which the birth occurred, within five days after the
birth.
Sec. 21. Minnesota Statutes 1996, section 144.218, is
amended to read:
144.218 [NEW REPLACEMENT CERTIFICATES OF BIRTH.]
Subdivision 1. [ADOPTION.] Upon receipt of a certified
copy of an order, decree, or certificate of adoption, the state
registrar shall register a supplementary replacement certificate
in the new name of the adopted person. The original certificate
of birth and the certified copy are confidential pursuant to
section 13.02, subdivision 3, and shall not be disclosed except
pursuant to court order or section 144.1761. A certified copy
of the original birth certificate from which the registration
number has been deleted and which has been marked "Not for
Official Use," or the information contained on the original
birth certificate, except for the registration number, shall be
provided on request to a parent who is named on the original
birth certificate. Upon the receipt of a certified copy of a
court order of annulment of adoption the state registrar shall
restore the original certificate to its original place in the
file.
Subd. 2. [ADOPTION OF FOREIGN PERSONS.] In proceedings for
the adoption of a person who was born in a foreign country, the
court, upon evidence presented by the commissioner of human
services from information secured at the port of entry, or upon
evidence from other reliable sources, may make findings of fact
as to the date and place of birth and parentage. Upon receipt
of certified copies of the court findings and the order or
decree of adoption, the state registrar shall register a birth
certificate in the new name of the adopted person. The
certified copies of the court findings and the order or decree
of adoption are confidential, pursuant to section 13.02,
subdivision 3, and shall not be disclosed except pursuant to
court order or section 144.1761. The birth certificate shall
state the place of birth as specifically as possible, and that
the certificate is not evidence of United States citizenship.
Subd. 3. [SUBSEQUENT MARRIAGE OF BIRTH PARENTS.] If, in
cases in which a certificate of birth has been registered
pursuant to section 144.215 and the birth parents of the child
marry after the birth of the child, a new replacement
certificate of birth shall be registered upon presentation of a
certified copy of the marriage certificate of the birth parents,
and either an acknowledgment a recognition of parentage or court
adjudication of paternity. The information presented and the
original certificate of birth are confidential, pursuant to
section 13.02, subdivision 3, and shall not be disclosed except
pursuant to court order.
Subd. 4. [INCOMPLETE, INCORRECT, AND MODIFIED
CERTIFICATES.] If a court finds that a birth certificate is
incomplete, inaccurate or false, or if it is being issued
pursuant to section 259.10, subdivision 2, it may order the
registration of a new replacement certificate, and, if
necessary, set forth the correct information in the order. Upon
receipt of the order the state registrar shall register a new
replacement certificate containing the findings of the court,
and the prior certificate shall be confidential pursuant to
section 13.02, subdivision 3, and shall not be disclosed except
pursuant to court order.
Sec. 22. Minnesota Statutes 1996, section 144.664,
subdivision 3, is amended to read:
Subd. 3. [NOTIFICATION.] Within five days of receiving a
report of traumatic brain injury or spinal cord injury, the
commissioner shall notify the commissioner of economic
security. The notification shall include the person's name and
other identifying information injured person or the injured
person's family of resources and services available in
Minnesota, pursuant to section 144.662, clause (2).
Sec. 23. Minnesota Statutes 1996, section 144.665, is
amended to read:
144.665 [TRAUMATIC BRAIN INJURY AND SPINAL CORD INJURY
DATA.]
Data on individuals collected by the commissioner of health
under sections 144.662 to 144.664 or provided to the
commissioner of economic security under section 144.664 are
private data on individuals as defined in section 13.02,
subdivision 12, and may be used only for the purposes set forth
in sections 144.662 to 144.664 in accordance with the rules
adopted by the commissioner.
Sec. 24. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 6a. [CHILD.] "Child" means an individual up to 72
months of age.
Sec. 25. Minnesota Statutes 1996, section 144.9501,
subdivision 29, is amended to read:
Subd. 29. [SWAB TEAM SERVICES.] "Swab team services" means
activities that provide protection from lead hazards such as:
(1) removing lead dust by washing, vacuuming with high
efficiency particle accumulator (HEPA) or wet vacuum cleaners,
and cleaning the interior of residential property;
(2) removing loose paint and paint chips and reporting
repainting or installing guards to protect intact paint;
(3) covering or replacing bare soil that has a lead
concentration of 100 parts per million or more;
(4) health education;
(5) advice and assistance to help residents locate and move
to a temporary residence while lead hazard reduction is being
completed; or
(6) any other assistance necessary to meet the resident's
immediate needs as a result of the relocation.
Sec. 26. Minnesota Statutes 1996, section 144.9504,
subdivision 2, is amended to read:
Subd. 2. [LEAD INSPECTION.] (a) An inspecting agency shall
conduct a lead inspection of a residence according to the venous
blood lead level and time frame set forth in clauses (1)
to (4) (5) for purposes of secondary prevention:
(1) within 48 hours of a child or pregnant female in the
residence being identified to the agency as having a venous
blood lead level equal to or greater than 70 micrograms of lead
per deciliter of whole blood;
(2) within five working days of a child or pregnant female
in the residence being identified to the agency as having a
venous blood lead level equal to or greater than 45 micrograms
of lead per deciliter of whole blood;
(3) within ten working days of a child or pregnant female
in the residence being identified to the agency as having a
venous blood lead level equal to or greater than 20 micrograms
of lead per deciliter of whole blood; or
(4) within ten working days of a child or pregnant female
in the residence being identified to the agency as having a
venous blood lead level that persists in the range of 15 to 19
micrograms of lead per deciliter of whole blood for 90 days
after initial identification; or
(5) within ten working days of a pregnant female in the
residence being identified to the agency as having a venous
blood lead level equal to or greater than ten micrograms of lead
per deciliter of whole blood.
(b) Within the limits of available state and federal
appropriations, an inspecting agency may also conduct a lead
inspection for children with any elevated blood lead level.
(c) In a building with two or more dwelling units, an
inspecting agency shall inspect the individual unit in which the
conditions of this section are met and shall also inspect all
common areas. If a child visits one or more other sites such as
another residence, or a residential or commercial child care
facility, playground, or school, the inspecting agency shall
also inspect the other sites. The inspecting agency shall have
one additional day added to the time frame set forth in this
subdivision to complete the lead inspection for each additional
site.
(d) Within the limits of appropriations, the inspecting
agency shall identify the known addresses for the previous 12
months of the child or pregnant female with elevated blood lead
levels; notify the property owners, landlords, and tenants at
those addresses that an elevated blood lead level was found in a
person who resided at the property; and give them a copy of the
lead inspection guide. This information shall be classified as
private data on individuals as defined under section 13.02,
subdivision 12.
(e) The inspecting agency shall conduct the lead inspection
according to rules adopted by the commissioner under section
144.9508. An inspecting agency shall have lead inspections
performed by lead inspectors licensed by the commissioner
according to rules adopted under section 144.9508. If a
property owner refuses to allow an inspection, the inspecting
agency shall begin legal proceedings to gain entry to the
property and the time frame for conducting a lead inspection set
forth in this subdivision no longer applies. An inspector or
inspecting agency may observe the performance of lead hazard
reduction in progress and shall enforce the provisions of this
section under section 144.9509. Deteriorated painted surfaces,
bare soil, dust, and drinking water must be tested with
appropriate analytical equipment to determine the lead content,
except that deteriorated painted surfaces or bare soil need not
be tested if the property owner agrees to engage in lead hazard
reduction on those surfaces.
(f) A lead inspector shall notify the commissioner and the
board of health of all violations of lead standards under
section 144.9508, that are identified in a lead inspection
conducted under this section.
(g) Each inspecting agency shall establish an
administrative appeal procedure which allows a property owner to
contest the nature and conditions of any lead order issued by
the inspecting agency. Inspecting agencies must consider
appeals that propose lower cost methods that make the residence
lead safe.
(h) Sections 144.9501 to 144.9509 neither authorize nor
prohibit an inspecting agency from charging a property owner for
the cost of a lead inspection.
Sec. 27. Minnesota Statutes 1996, section 144.9506,
subdivision 1, is amended to read:
Subdivision 1. [LICENSE REQUIRED.] (a) A lead inspector
shall obtain a license before performing lead inspections and
shall renew it annually. The commissioner shall charge a fee
and require annual training, as specified in this section. A
lead inspector shall have the inspector's license readily
available at all times at an inspection site and make it
available, on request, for inspection by the inspecting agency
with jurisdiction over the site. A license shall not be
transferred.
(b) Individuals shall not advertise or otherwise present
themselves as lead inspectors unless licensed by the
commissioner.
(c) An individual may use sodium rhodizonate to test paint
for the presence of lead without obtaining a lead inspector
license, but must not represent the test as a lead inspection.
Sec. 28. Minnesota Statutes 1996, section 144.9506,
subdivision 5, is amended to read:
Subd. 5. [APPROVAL OF LEAD INSPECTION COURSE.] Until the
commissioner adopts rules under section 144.9508 to license lead
inspectors and approve lead inspector training courses, a lead
inspection course sponsored by a training course provider in one
of the regional lead training consortia established by the
United States Environmental Protection Agency is an approved
course for the purpose of this section, providing it covers the
criteria listed in section 144.9505. The commissioner shall
evaluate for approval by permit lead inspector courses other
than those approved by the United States Environmental
Protection Agency. After adoption of rules under section
144.9508, all training courses offered for the purpose of
licensing individuals as lead inspectors must be reviewed and
approved by the commissioner.
Sec. 29. Minnesota Statutes 1996, section 144.99,
subdivision 9, is amended to read:
Subd. 9. [SUSPENSION OR REVOCATION OF PERMITS, LICENSES,
REGISTRATIONS, OR CERTIFICATES.] The commissioner may suspend,
place conditions on, or revoke a permit, license, registration,
or certificate issued under the statutes or rules cited in
subdivision 1 for:
(1) serious or repeated violations of the requirements in
the statutes, rules, or other actions listed in subdivision 1
that apply to the permit, license, registration, or certificate,
or if the applicant submitted;
(2) submitting false material information to the department
in connection with activities for which the permit, license,
registration, or certificate. is issued;
(3) allowing the alteration or use of one's own permit,
license, registration, or certificate by another; or
(4) within the previous five years, conviction of a crime
in connection with activities for which the permit, license,
registration, or certificate was issued.
Sec. 30. Minnesota Statutes 1996, section 144.99,
subdivision 10, is amended to read:
Subd. 10. [HEARINGS RELATED TO DENIAL, REFUSAL TO RENEW,
SUSPENSION, OR REVOCATION OF A PERMIT, LICENSE, REGISTRATION, OR
CERTIFICATE.] If the commissioner proposes to deny, refuses to
renew, suspends, or revokes a permit, license, registration, or
certificate under subdivision 8 or 9, the commissioner must
first notify, in writing, the person against whom the action is
proposed to be taken and provide the person an opportunity to
request a hearing under the contested case provisions of chapter
14. If the person does not request a hearing by notifying the
commissioner within 20 days after receipt of the notice of
proposed action, the commissioner may proceed with the action
without a hearing. This subdivision does not apply to:
(1) the denial of or refusal to renew a permit, license,
registration, or certificate based on the applicant's failure to
meet or maintain the minimum qualifications for holding the
permit, license, registration, or certificate; or
(2) the denial of, refusal to renew, suspension of, or
revocation of a permit, license, registration, or certificate if
the person against whom the action is proposed to be taken has
been granted a hearing under this subdivision within the
previous 12 months.
Sec. 31. Minnesota Statutes 1996, section 257.73, is
amended to read:
257.73 [BIRTH RECORDS.]
Subdivision 1. Upon compliance with the provisions of
section 257.55, subdivision 1, paragraph (e), 257.75, or upon
order of a court of this state or upon request of a court of
another state, the state or local registrar of vital statistics
shall prepare a new replacement certificate of birth consistent
with the acknowledgment or the findings of the court and shall
substitute the new replacement certificate for the original
certificate of birth.
Subd. 2. The fact that the father and child relationship
was declared after the child's birth shall not be ascertainable
from the new replacement certificate but the actual place and
date of birth shall be shown.
Subd. 3. The evidence upon which the new replacement
certificate was made and the original birth certificate shall be
kept in a sealed and confidential file and be subject to
inspection only upon consent of the court and all interested
persons, or in exceptional cases only upon an order of the court
for good cause shown.
Sec. 32. Minnesota Statutes 1996, section 326.71,
subdivision 4, is amended to read:
Subd. 4. [ASBESTOS-RELATED WORK.] "Asbestos-related work"
means the enclosure, removal, or encapsulation of
asbestos-containing material in a quantity that meets or exceeds
260 lineal feet of friable asbestos-containing material on
pipes, 160 square feet of friable asbestos-containing material
on other facility components, or, if linear feet or square feet
cannot be measured, a total of 35 cubic feet of friable
asbestos-containing material on or off all facility components
in one facility. In the case of single or multifamily
residences, "asbestos-related work" also means the enclosure,
removal, or encapsulation of greater than ten but less than 260
lineal linear feet of friable asbestos-containing material on
pipes or ducts or, greater than six but less than 160 square
feet of friable asbestos-containing material on other facility
components, or, if linear feet or square feet cannot be
measured, greater than one cubic foot but less than 35 cubic
feet of friable asbestos-containing material on or off all
facility components in one facility. This provision excludes
asbestos-containing floor tiles and sheeting, roofing materials,
siding, and all ceilings with asbestos-containing material in
single family residences and buildings with no more than four
dwelling units. Asbestos-related work includes asbestos
abatement area preparation; enclosure, removal, or encapsulation
operations; and an air quality monitoring specified in rule to
assure that the abatement and adjacent areas are not
contaminated with asbestos fibers during the project and after
completion.
For purposes of this subdivision, the quantity of asbestos
containing material applies separately for every project.
Sec. 33. Minnesota Statutes 1996, section 326.71,
subdivision 6, is amended to read:
Subd. 6. [CONTRACTING ENTITY.] "Contracting entity" means
a public or private body, board, natural person, corporation,
partnership, proprietorship, joint venture, fund, authority, or
similar entity that contracts with a person to do
asbestos-related work or asbestos management activity for the
benefit of the contracting entity.
Sec. 34. Minnesota Statutes 1996, section 326.72,
subdivision 2, is amended to read:
Subd. 2. [DISPLAY OF LICENSE.] Licensees shall post a
project permit, obtained from the commissioner after compliance
with the provisions of section 326.74 and rules promulgated
under section 326.78, in a conspicuous place outside of the
asbestos abatement work area. The actual license or a copy
shall be readily available at the work site for inspection by
the commissioner, other public officials charged with the
health, safety, and welfare of the state's citizens, and the
contracting entity.
Sec. 35. Minnesota Statutes 1996, section 326.74, is
amended to read:
326.74 [REPORTING ASBESTOS WORK.]
At least five calendar days before beginning any
asbestos-related work, Written notice shall be given to the
commissioner of the an asbestos-related work project by the
person holding the license issued under section 326.72,
subdivision 1. Unless the project is an emergency project, the
notice shall be given to the commissioner at least five calendar
days before the project begins. The notice shall contain the
following information:
(1) a brief description of the work to be performed;
(2) the name of the contracting entity;
(3) the location and address of the project work site;
(4) the approximate duration of the project;
(5) the approximate amount of the asbestos involved in the
project;
(6) the name of any project manager; and
(7) other information required by the commissioner.
Sec. 36. Minnesota Statutes 1996, section 326.76, is
amended to read:
326.76 [DUTIES OF CONTRACTING ENTITIES.]
A contracting entity intending to have asbestos-related
work or asbestos management activity performed for its benefit
shall include in the specifications and contracts for the work a
requirement that the work be performed by contractors and
subcontractors licensed or certified by the commissioner under
sections 326.70 to 326.81 and in accordance with rules
prescribed by the commissioner related to asbestos
abatement asbestos-related work and asbestos management
activity. No contracting entity shall allow asbestos-related
work or asbestos management activity to be performed for its
benefit unless it has seen that the person has a valid license
or certificate. A contracting entity's failure to comply with
this section does not relieve a person from any responsibilities
under sections 326.70 to 326.81.
Sec. 37. Minnesota Statutes 1996, section 326.78,
subdivision 1, is amended to read:
Subdivision 1. [RULEMAKING.] The commissioner shall adopt
and begin enforcement of rules necessary to implement sections
326.70 to 326.81. The rules adopted shall not be duplicative of
rules adopted by the commissioner of the department of labor and
industry. The rules shall include rules in the following areas:
(1) application, enclosure, removal, and encapsulation
procedures;
(2) license and certificate qualification requirements;
(3) examinations for obtaining a license and certificate;
(4) training necessary for individual certification;
(5) qualifications for managers of asbestos
abatement asbestos-related work projects;
(6) abatement asbestos-related work and asbestos management
activity specifications;
(7) any contractor bonding and insurance requirements
deemed necessary by the commissioner;
(8) license and certificate issuance and revocation
procedures;
(9) suspension or revocation of licenses or certificates;
(10) license and certificate suspension and revocation
criteria;
(11) cleanup standards;
(12) continuing education requirements; and
(13) other rules necessary to implement sections 326.70 to
326.81.
Sec. 38. Minnesota Statutes 1996, section 326.785, is
amended to read:
326.785 [ASBESTOS CONTAINMENT BARRIERS.]
Notwithstanding Minnesota Rules, part 4620.3500, subpart 4,
item B, subitem (5) 4620.3568, subparts 1 to 4, containment
barriers, in the case of tunnel abatement enclosures, are
limited to double critical barriers.
Sec. 39. [CONFORMANCE WITH FEDERAL REGULATIONS.]
The commissioner of health shall amend Minnesota Rules,
chapter 4761, as needed to conform with federal regulations, and
shall perform any procedural steps necessary to obtain
authorization to administer the regulations in Code of Federal
Regulations, title 40, part 745 (1996), adopted by the United
States Environmental Protection Agency to implement the
requirements of title X of the federal Residential Lead-Based
Paint Hazard Reduction Act of 1992, Public Law Number 102-550,
106 Statutes at Large 3897.
Sec. 40. [REPEALER.]
(a) Minnesota Statutes 1996, sections 62D.03, subdivision
2; and 62D.11, subdivision 4, are repealed.
(b) Minnesota Rules, part 4600.3900, is repealed.
(c) Laws 1988, chapter 495, section 1, is repealed.
Sec. 41. [EFFECTIVE DATE.]
Section 19 is effective the day following final enactment.
Presented to the governor May 20, 1997
Signed by the governor May 22, 1997, 12:02 p.m.
Official Publication of the State of Minnesota
Revisor of Statutes