HF 1943

as introduced - 89th Legislature (2015 - 2016) Posted on 03/17/2015 11:35am

A bill for an act
relating to health; amending the quality of care complaint process; proposing
coding for new law in Minnesota Statutes, chapter 62D.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62D.115] QUALITY OF CARE COMPLAINTS.
new text end

new text begin Subdivision 1. new text end

new text begin Quality of care complaint. new text end

new text begin For purposes of this section, "quality of
care complaint" means any grievance regarding a provider within the network and services
rendered by that provider to enrollees with potential or actual adverse outcomes to the
enrollee. Quality of care complaints may include but are not limited to provider and staff
competence, appropriateness, communications, behavior, or facility and environmental
considerations including but not limited to cleanliness, lack of areas for confidential
communications, or unsafe conditions for patients.
new text end

new text begin Subd. 2. new text end

new text begin Quality of care complaint investigation. new text end

new text begin (a) Each health maintenance
organization shall develop and implement policies and procedures for ongoing monitoring
of quality of care complaints and take appropriate action when it identifies occurrences of
poor quality. This includes collecting and reviewing complaints, collecting and reviewing
information from identified adverse events, and implementing appropriate interventions
when it identifies patterns of poor quality.
new text end

new text begin (b) The commissioner of health shall advise a complainant of the process followed
by the health maintenance organization in reviewing a quality of care complaint. The
process shall include a written notice indicating which items were reviewed by the
commissioner. Nothing in this section shall be construed to allow the commissioner to
share private or protected data as defined in chapter 13 or 145.
new text end

new text begin (c) To enforce the requirements of this section, the commissioner of health may
access the information, documents, or records acquired by a review organization as
permitted by law, and the final determination of the quality of care complaint.
new text end