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62J.79 Duties and powers of the office of health care consumer assistance, advocacy, and information.

Subdivision 1. Duties. (a) The office of health care consumer assistance, advocacy, and information shall provide information and assistance to all health care consumers by:

(1) assisting patients and enrollees in understanding and asserting their contractual and legal rights, including the rights under an alternative dispute resolution process. This assistance may include advocacy for enrollees in administrative proceedings or other formal or informal dispute resolution processes;

(2) assisting enrollees in obtaining health care referrals under their health plan company, health insurance, or health coverage plan;

(3) assisting patients and enrollees in accessing the services of governmental agencies, regulatory boards, and other state consumer assistance programs, ombudsman, or advocacy services whenever appropriate so that the patient or enrollee can take full advantage of existing mechanisms for resolving complaints;

(4) referring patients and enrollees to governmental agencies and regulatory boards for the investigation of health care complaints and for enforcement action;

(5) educating and training enrollees about their health plan company, health insurance, or health coverage plan in order to enable them to assert their rights and to understand their responsibilities;

(6) assisting enrollees in receiving a timely resolution of their complaints;

(7) monitoring health care complaints addressed by the office to identify specific complaint patterns or areas of potential improvement;

(8) recommending to health plan companies ways to identify and remove any barriers that might delay or impede the health plan company's effort to resolve consumer complaints; and

(9) in performing the duties specified in clauses (1) to (8), taking into consideration the special situations of patients and enrollees who have unique culturally defined needs.

(b) The executive director shall prioritize the duties listed in this subdivision within the appropriations allocated.

Subd. 2. Communication. (a) The executive director shall meet at least six times per year with the consumer advisory board. The executive director shall share all public information obtained by the office of health care consumer assistance, advocacy, and information with the consumer advisory board in order to assist the consumer advisory board in its role of advising the commissioners of health and commerce and the legislature in accordance with section 62J.75.

(b) The executive director shall have the authority to make recommendations to the legislature on any issue related to the needs and interests of health care consumers.

Subd. 3. Reports. Beginning July 1, 1999, the executive director, on at least a quarterly basis, shall provide data from the health care complaints addressed by the office to the commissioners of health and commerce, the consumer advisory board, the Minnesota council of health plans, and the Insurance Federation of Minnesota. Beginning January 15, 2000, the executive director must make an annual written report to the legislature regarding activities of the office, including recommendations on improving health care consumer assistance and complaint resolution processes.

Subd. 4. Data privacy. (a) Consumer complaint data, including medical records and other documentation, provided by a patient or enrollee to the office of health care consumer assistance, advocacy, and information shall be classified as private data on individuals under section 13.02, subdivision 12.

(b) Except as provided in paragraph (a), all data collected or maintained by the office in the course of assisting a patient or enrollee in resolving a complaint, including data collected or maintained for the purpose of assistance during a formal or informal dispute resolution process, shall be classified as investigative data under section 13.39, except that inactive investigative data shall be classified as private data on individuals under section 13.02, subdivision 12.

HIST: 1998 c 407 art 2 s 17

Official Publication of the State of Minnesota
Revisor of Statutes