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4685.1950 NAIC BLANK FOR HEALTH MAINTENANCE ORGANIZATIONS, REPORT #4: ENROLLMENT AND UTILIZATION TABLE.

Subpart 1.

Additional columns.

Report #4: ENROLLMENT AND UTILIZATION TABLE is amended by adding the following columns:

A.

9a, Total Ambulatory Encounters for Period for Mental health; and

B.

9b, Total Ambulatory Encounters for Period for Chemical Dependency.

Subp. 2.

Total members at end of period.

The Report #4: ENROLLMENT AND UTILIZATION TABLE is amended by requiring the itemization of Cumulative Member Months for Period by gender and five-year age increments, and Total Members at End of Period by gender, by five-year age increments, and by county, for the health maintenance organization's Minnesota health maintenance contract enrollment, Medicare risk contract enrollment authorized by section 1876 of the Social Security Act, any other Medicare contract enrollment, and each demonstration project.

Subp. 3.

Type of service.

Report #4: ENROLLMENT AND UTILIZATION TABLE is amended by requiring the itemization of Total Patient Days Incurred, Annualized Hospital Days per 1,000 Enrollees, and Average Length of Stay by five-year age increments and by the following types of service for Minnesota health maintenance contracts, Minnesota health maintenance Medicare risk contracts, authorized by section 1876 of the Social Security Act, any other Medicare contract enrollment, and each demonstration project:

A.

medical/surgical, in a hospital;

B.

obstetrical/gynecological, in a hospital;

C.

mental health, in a hospital or other health care facility;

D.

chemical dependency, in a hospital or other health care facility; and

E.

other services provided in health care facilities other than hospitals.

Statutory Authority:

MS s 62D.08; 62D.182; 62D.20; 62D.21

History:

10 SR 2159; 14 SR 901

Published Electronically:

October 11, 2007

Official Publication of the State of Minnesota
Revisor of Statutes