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62M.01 Citation, jurisdiction, and scope.

Subdivision 1. Popular name. Sections 62M.01 to 62M.16 may be cited as the "Minnesota Utilization Review Act of 1992."

Subd. 2. Jurisdiction. Sections 62M.01 to 62M.16 apply to any insurance company licensed under chapter 60A to offer, sell, or issue a policy of accident and sickness insurance as defined in section 62A.01; a health service plan licensed under chapter 62C; a health maintenance organization licensed under chapter 62D; a community integrated service network licensed under chapter 62N; an accountable provider network operating under chapter 62T; a fraternal benefit society operating under chapter 64B; a joint self-insurance employee health plan operating under chapter 62H; a multiple employer welfare arrangement, as defined in section 3 of the Employee Retirement Income Security Act of 1974 (ERISA), United States Code, title 29, section 1103, as amended; a third party administrator licensed under section 60A.23, subdivision 8, that provides utilization review services for the administration of benefits under a health benefit plan as defined in section 62M.02; or any entity performing utilization review on behalf of a business entity in this state pursuant to a health benefit plan covering a Minnesota resident.

Subd. 3. Scope. Nothing in sections 62M.01 to 62M.16 applies to review of claims after submission to determine eligibility for benefits under a health benefit plan. The appeal procedure described in section 62M.06 applies to any complaint as defined under section 62Q.68, subdivision 2, that requires a medical determination in its resolution.

HIST: 1992 c 574 s 1; 1999 c 239 s 3

* NOTE: The amendment to this section by Laws 1999, chapter *239, section 3, is effective April 1, 2000, and applies to *contracts issued or renewed on or after that date. Upon *request, the commissioner of health or commerce shall grant an *extension of up to three months to any health plan company or *utilization review organization that is unable to comply with *Laws 1999, chapter 239, sections 1, 3 to 42, and 43, paragraphs *(a) and (c) by April 1, 2000, due to circumstances beyond the *control of the health plan company or utilization review *organization. Laws 1999, chapter 239, section 44.