1999 Minnesota Statutes

     256B.02 Definitions. 

    Subdivision 1. Repealed, 1987 c 363 s 14 

    Subd. 2. Repealed, 1987 c 363 s 14 

    Subd. 3. Repealed, 1987 c 363 s 14 

    Subd. 4.  "Medical institution" means any licensed medical 
 facility that receives a license from the Minnesota health 
 department or department of human services or appropriate 
 licensing authority of this state, any other state, or a 
 Canadian province. 

    Subd. 5.  "State agency" means the commissioner of human 
 services. 

    Subd. 6.  "County agency" means a local social service 
 agency operating under and pursuant to the provisions of chapter 
 393. 

    Subd. 7.  "Vendor of medical care" means any person or 
 persons furnishing, within the scope of the vendor's respective 
 license, any or all of the following goods or services:  
 medical, surgical, hospital, optical, visual, dental and nursing 
 services; drugs and medical supplies; appliances; laboratory, 
 diagnostic, and therapeutic services; nursing home and 
 convalescent care; screening and health assessment services 
 provided by public health nurses as defined in section 145A.02, 
 subdivision 18; health care services provided at the residence 
 of the patient if the services are performed by a public health 
 nurse and the nurse indicates in a statement submitted under 
 oath that the services were actually provided; and such other 
 medical services or supplies provided or prescribed by persons 
 authorized by state law to give such services and supplies.  The 
 term includes, but is not limited to, directors and officers of 
 corporations or members of partnerships who, either individually 
 or jointly with another or others, have the legal control, 
 supervision, or responsibility of submitting claims for 
 reimbursement to the medical assistance program.  The term only 
 includes directors and officers of corporations who personally 
 receive a portion of the distributed assets upon liquidation or 
 dissolution, and their liability is limited to the portion of 
 the claim that bears the same proportion to the total claim as 
 their share of the distributed assets bears to the total 
 distributed assets. 

    Subd. 8.    Medical assistance; medical care.  "Medical 
 assistance" or "medical care" means payment of part or all of 
 the cost of the care and services identified in section 
 256B.0625, for eligible individuals whose income and resources 
 are insufficient to meet all of this cost.  

    Subd. 8a. Renumbered 256B.0625 subdivision 1 

    Subd. 8b. Renumbered 256B.0625 subd 2 

    Subd. 8c. Renumbered 256B.0625 subd 3 

    Subd. 8d. Renumbered 256B.0625 subd 4 

    Subd. 8e. Renumbered 256B.0625 subd 5 

    Subd. 8f. Renumbered 256B.0625 subd 6 

    Subd. 8g. Renumbered 256B.0625 subd 7 

    Subd. 8h. Renumbered 256B.0625 subd 8 

    Subd. 8i. Renumbered 256B.0625 subd 9 

    Subd. 8j. Renumbered 256B.0625 subd 10 

    Subd. 8k. Renumbered 256B.0625 subd 11 

    Subd. 8l. Renumbered 256B.0625 subd 12 

    Subd. 8m. Renumbered 256B.0625 subd 13 

    Subd. 8n. Renumbered 256B.0625 subd 14 

    Subd. 8o. Renumbered 256B.0625 subd 15 

    Subd. 8p. Renumbered 256B.0625 subd 16 

    Subd. 8q. Renumbered 256B.0625 subd 17 

    Subd. 8r. Renumbered 256B.0625 subd 18 

    Subd. 8s. Renumbered 256B.0625 subd 19 

    Subd. 8t. Renumbered 256B.0625 subd 20 

    Subd. 8u. Renumbered 256B.0625 subd 21 

    Subd. 8v. Renumbered 256B.0625 subd 22 

    Subd. 8w. Renumbered 256B.0625 subd 23 

    Subd. 8x. Renumbered 256B.0625 subd 24 

    Subd. 8y. Renumbered 256B.0625 subd 25 

    Subd. 9.  "Private health care coverage" means any plan 
 regulated by chapter 62A, 62C or 64B.  Private health care 
 coverage also includes any self-insurance plan providing health 
 care benefits. 

    Subd. 10.  "Automobile accident coverage" means any plan, 
 or that portion of a plan, regulated under chapter 65B, which 
 provides benefits for medical expenses incurred in an automobile 
 accident. 

    Subd. 11.  "Related condition" means that condition defined 
 in section 252.27, subdivision 1a. 

    Subd. 12.  "Third party payer" means a person, entity, or 
 agency or government program that has a probable obligation to 
 pay all or part of the costs of a medical assistance recipient's 
 health services. 

    Subd. 13.    Prepaid health plan.  "Prepaid health plan" 
 means a vendor who receives a capitation payment and assumes 
 financial risk for the provision of medical assistance services 
 under a contract with the commissioner. 

    Subd. 14.    Group health plan.  "Group health plan" 
 means any plan of, or contributed to by, an employer, including 
 a self-insured plan, to provide health care directly or 
 otherwise to the employer's employees, former employees, or the 
 families of the employees or former employees, and includes 
 continuation coverage pursuant to title XXII of the Public 
 Health Service Act, section 4980B of the Internal Revenue Code 
 of 1986, or title VI of the Employee Retirement Income Security 
 Act of 1974. 

    Subd. 15.    Cost-effective.  "Cost-effective" means 
 that the amount paid by the state for premiums, coinsurance, 
 deductibles, other cost-sharing obligations under a health 
 insurance plan, and other administrative costs is likely to be 
 less than the amount paid for an equivalent set of services paid 
 by medical assistance. 

    HIST: Ex1967 c 16 s 2; 1969 c 395 s 1; 1973 c 717 s 17; 1975 c 
 247 s 9; 1975 c 384 s 1; 1975 c 437 art 2 s 3; 1976 c 173 s 56; 
 1976 c 236 s 1; 1976 c 312 s 1; 1978 c 508 s 2; 1978 c 560 s 10; 
 1981 c 360 art 2 s 26,54; 1Sp1981 c 2 s 12; 1Sp1981 c 4 art 4 s 
 22; 3Sp1981 c 2 art 1 s 31; 1982 c 562 s 2; 1983 c 151 s 1,2; 
 1983 c 312 art 1 s 27; art 5 s 10; art 9 s 4; 1984 c 654 art 5 s 
 58; 1985 c 21 s 52-54; 1985 c 49 s 41; 1985 c 252 s 19,20; 
 1Sp1985 c 3 s 19; 1986 c 394 s 17; 1986 c 444; 1987 c 370 art 1 
 s 3; art 2 s 4; 1987 c 374 s 1; 1987 c 309 s 24; 1987 c 403 art 
 2 s 73,74; art 5 s 16; 1988 c 689 art 2 s 141,268; 1992 c 464 
 art 1 s 55; 1992 c 513 art 7 s 31,32; 1994 c 631 s 31