256B.71 SOCIAL HEALTH MAINTENANCE ORGANIZATION DEMONSTRATION.
Subdivision 1. Purpose.
The commissioner of human services may participate in social
health maintenance organization demonstration projects to determine if prepayment combined
with the delivery of alternative services is an effective method of delivering services while
Subd. 2. Case management.
Each participating provider approved by the commissioner
shall serve as case manager for recipients enrolled in its plan. The participating provider shall
authorize and arrange for the provision of all needed health services including but not limited
to the full range of services listed in sections
256B.02, subdivision 8
to ensure that appropriate health care is delivered to enrollees.
Subd. 3. Enrollment of medical assistance recipients.
Medical assistance recipients may
voluntarily enroll in the social health maintenance organization projects. However, once enrolled
in a project, the recipient must remain enrolled for a period of six months.
Subd. 4. Payment for services.
and this chapter, the
method of payment utilized for the social health maintenance organization projects shall be the
method developed by the commissioner of human services in consultation with local project staff
and the federal Department of Health and Human Services, Centers for Medicare and Medicaid
Services, Office of Demonstrations. This subdivision applies only to the payment method for the
social health maintenance organization projects.
Subd. 5.[Repealed, 1991 c 292 art 7 s 26
History: 1983 c 295 s 1; 1984 c 654 art 5 s 58; 1986 c 444; 1988 c 689 art 2 s 268; 2002
c 277 s 32