Minnesota Administrative Rules

4654.0600 USE OF QUALITY MEASURES BY HEALTH PLAN COMPANIES.

Subpart 1.

Required quality measures.

A health plan company may not require providers to use or report quality measures that are not standardized quality measures. Health plan companies and providers may voluntarily use and report quality measures that are not standardized quality measures. In addition, a health plan company may do the following:

A.

derive quality measures from any data source not submitted to the health plan company by a provider; and

B.

derive quality measures from administrative data.

Subp. 2.

Required use or report of quality measures.

For purposes of this part, requiring a provider to use or report a quality measure means contractually mandating, as a nonnegotiable condition of conducting business with a health plan company, that a provider use or report a specific quality measure.

Statutory Authority:

MS s 62U.02

History:

34 SR 905

Published Electronically:

January 13, 2010