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4765.0020 DEFINITIONS.

Subpart 1.

Scope.

For purposes of this chapter, the following terms have the meanings given them in this part.

Subp. 2.

Health care provider.

"Health care provider" has the meaning given in Minnesota Statutes, section 62U.01, subdivision 10.

Subp. 3.

Payer.

"Payer" means a health plan company as defined in Minnesota Statutes, section 62U.01, subdivision 8, an employer, an individual, or a third-party administrator, as defined in Minnesota Statutes, section 60A.23, subdivision 13.

Subp. 4.

State-designated basket of care; basket.

"State-designated basket of care" or "basket" means a collection of health care services identified in one of the eight appendices, A to H of the State-Designated Baskets of Care: Appendices to Minnesota Administrative Rules, Chapter 4765, in part 4765.0040, as incorporated by reference in part 4765.0040. The eight baskets of care are:

A.

asthma care for children: ambulatory care of asthma in children ages five to 18 years;

B.

diabetes: medically uncomplicated type 2 diabetes;

C.

diabetes: prediabetes;

D.

low back pain: acute episode of low back pain;

E.

obstetric care: prenatal care;

F.

preventive care for adults: preventive care assessment, recommendations, and referrals in adults;

G.

preventive care for children ages two years and under; and

H.

total knee replacement.

A collection of services and outcomes may only be identified as a state-designated basket of care if it contains all of the health care services listed in appendices A to H of the State-Designated Baskets of Care: Appendices to Minnesota Administrative Rules, Chapter 4765, in part 4765.0040. A collection of services that includes additional services or outcomes not listed in appendices A to H must not be identified as a state-designated basket of care.

Statutory Authority:

MS s 62U.05; 62U.06

History:

34 SR 1259

Published Electronically:

March 26, 2010