2006 Minnesota Statutes

256.9691 TECHNOLOGY ASSISTANCE REVIEW PANEL.
    Subdivision 1. Establishment. The commissioner of health shall establish a technology
assistance review panel to resolve disputes over the provision of health care benefits for
technology-assisted persons who receive benefits under a policy or plan of health, medical,
hospitalization, or accident and sickness insurance regulated under chapter 62A, a subscriber
contract of a nonprofit health service plan corporation regulated under chapter 62C, or a certificate
of coverage of a health maintenance organization regulated under chapter 62D.
    Subd. 2. Definition. For purposes of this section, "technology-assisted person" means
a person who:
(1) has a chronic health condition;
(2) requires the routine use of a medical device to compensate for the loss of a life-sustaining
body function; and
(3) requires ongoing care or monitoring by trained personnel on a daily basis.
    Subd. 3. Steering committee. The commissioner shall appoint a seven-member steering
committee to appoint the review panel members, develop policies and procedures for the review
process, including the replacement of review panel members, serve as a liaison between the
regulatory agencies and the review panel, and provide the review panel with technical assistance.
The steering committee shall consist of representatives of the Departments of Health, Human
Services, and Commerce; a health maintenance organization regulated under chapter 62D;
an insurer regulated under chapter 62A or a health service plan corporation regulated under
chapter 62C; an advocacy organization representing persons who are technology assisted; and
a tertiary care center that serves technology-assisted persons. The steering committee shall not
be reimbursed for any expenses as defined under section 15.0575, subdivision 3. The steering
committee shall dissolve no later than June 30, 1992.
    Subd. 4. Composition of review panel. (a) The review panel shall be appointed by the
members of the steering committee that do not represent state agencies and must include:
(1) a medical director from an insurer regulated under chapter 62A, a health service plan
corporation regulated under chapter 62C, or a health maintenance organization regulated under
chapter 62D;
(2) a contract benefits analyst from an insurer regulated under chapter 62A, a health service
plan corporation regulated under chapter 62C, or a health maintenance organization regulated
under chapter 62D;
(3) a consumer board member of an insurer regulated under chapter 62A, a health service
plan corporation regulated under chapter 62C, or a health maintenance organization regulated
under chapter 62D;
(4) a physician with expertise in providing care for technology-assisted persons in a
nonhospital setting;
(5) a registered nurse with expertise in providing care for technology-assisted persons in
a nonhospital setting; and
(6) a consumer of health care benefits regulated under chapter 62A, 62C, or 62D who is a
technology-assisted person or the parent or guardian of a technology-assisted person.
(b) The term of service for review panel members is three years except that, for the initial
appointment, the steering committee shall establish procedures to assure that the terms of the
members are staggered. Members are eligible to serve two consecutive terms.
    Subd. 5. Authority. The review panel may review cases involving disputes over the
provision of contract benefits regarding discharge planning, home health care benefits eligibility
and coverage, or changes in the level of home health care services for technology-assisted persons.
The review may be requested by a third-party payor, a health or social service professional, or
a parent or guardian of a technology-assisted child or a technology-assisted adult. For the case
to be eligible for review by the panel, the parent or guardian of a technology-assisted child or
technology-assisted adult must consent to the review. The review panel may not review cases
involving discharge to a long-term care facility or cases involving coverage by title 18 or 19 of
the Social Security Act or other public funding sources. The review panel may seek advice
from experts outside the membership of the panel as necessary. The internal grievance process
within an insurer, health service plan corporation, or health maintenance organization, except
binding arbitration, must be exhausted before requesting a review by the review panel. The
recommendations of the review panel are not binding. If, following a review by the review panel,
a complaint is filed with the appropriate state agency regarding the same subject matter, the
findings of the review panel must be made available to the agency upon request and with the
consent of the parent or guardian of a technology-assisted child or technology-assisted adult.
The information must be maintained by the agency as nonpublic information under chapter 13.
The steering committee may establish policies for reimbursement of expenses for review panel
members consistent with the provisions of section 15.0575, subdivision 3.
    Subd. 6. Confidentiality. All proceedings of the review organization are nonpublic under
chapter 13. All data, information, and findings acquired and developed by the review panel in the
exercise of its duties or functions must be held in confidence, may not be disclosed to anyone
except to the extent necessary to carry out one or more of the purposes of the review panel or
as described in subdivision 5, and are not subject to subpoena or discovery. Members of the
review panel may not disclose what transpired at a meeting of the review panel except to the
extent necessary to carry out one or more of the purposes of the review panel. The proceedings
and record of the review panel are not subject to discovery or introduction into evidence in
any civil action against a health care professional or insurer, health service plan corporation,
or health maintenance organization, arising out of the matter or matters that are the subject of
consideration by the review panel.
    Subd. 7. Limitation on liability for members of steering committee and review panel.
A person who is a member of, or who acts in an advisory capacity to or who gives counsel or
services to, the steering committee or review panel is not liable for damages or other relief in any
action brought by a person or persons whose case has been reviewed by the panel, by reason of
the performance of any duty, function, or activity of the review panel, unless the performance of
the duty, function, or activity was motivated by malice toward the person affected. A member is
not liable for damages or other relief in any action by reason of the performance of the member
of any duty, function, or activity as a member of the steering committee or review panel or by
reason of any recommendation or action of the review committee when the member acts in
the reasonable belief that the action or recommendation is warranted by the facts known to the
member or review panel after reasonable efforts to ascertain the facts.
History: 1990 c 534 s 1