Minnesota Legislature
Office of the Revisor of Statutes
2007 Minnesota Statutes
This is an historical version of this statute chapter. Also view the most recent published version.
62D.123 PROVIDER CONTRACTS.
Subdivision 1. Provider agreement. Except for an employment agreement between a
provider and health maintenance organization, an agreement to provide health care services
between a provider and a health maintenance organization entered into or renewed after April 25,
1988, must contain the following provision:
PROVIDER AGREES NOT TO BILL, CHARGE, COLLECT A DEPOSIT FROM,
SEEK REMUNERATION FROM, OR HAVE ANY RECOURSE AGAINST AN ENROLLEE
OR PERSONS ACTING ON THEIR BEHALF FOR SERVICES PROVIDED UNDER
THIS AGREEMENT. THIS PROVISION APPLIES TO BUT IS NOT LIMITED TO THE
FOLLOWING EVENTS: (1) NONPAYMENT BY THE HEALTH MAINTENANCE
ORGANIZATION OR (2) BREACH OF THIS AGREEMENT. THIS PROVISION DOES
NOT PROHIBIT THE PROVIDER FROM COLLECTING CO-PAYMENTS OR FEES FOR
UNCOVERED SERVICES.
THIS PROVISION SURVIVES THE TERMINATION OF THIS AGREEMENT FOR
AUTHORIZED SERVICES PROVIDED BEFORE THIS AGREEMENT TERMINATES,
REGARDLESS OF THE REASON FOR TERMINATION. THIS PROVISION IS FOR THE
BENEFIT OF THE HEALTH MAINTENANCE ORGANIZATION ENROLLEES. THIS
PROVISION DOES NOT APPLY TO SERVICES PROVIDED AFTER THIS AGREEMENT
TERMINATES.
THIS PROVISION SUPERSEDES ANY CONTRARY ORAL OR WRITTEN
AGREEMENT EXISTING NOW OR ENTERED INTO IN THE FUTURE BETWEEN
THE PROVIDER AND THE ENROLLEE OR PERSONS ACTING ON THEIR BEHALF
REGARDING LIABILITY FOR PAYMENT FOR SERVICES PROVIDED UNDER THIS
AGREEMENT.
Subd. 2. Cooperation required. An agreement to provide health care services between a
provider and a health maintenance organization must require the provider to cooperate with and
participate in the health maintenance organization's quality assurance program, dispute resolution
procedure, and utilization review program.
Subd. 3. Notice of termination. An agreement to provide health care services between a
provider and a health maintenance organization must require that if the provider terminates the
agreement, without cause, the provider shall give the organization 120 days' advance notice
of termination.
Subd. 4. Late payments. If a health maintenance organization's payments to a provider are
delayed beyond the payment date in the contract, the provider may notify the commissioner who
shall consider that information in assessing the financial solvency of the health maintenance
organization.
History: 1988 c 612 s 21
Subdivision 1. Provider agreement. Except for an employment agreement between a
provider and health maintenance organization, an agreement to provide health care services
between a provider and a health maintenance organization entered into or renewed after April 25,
1988, must contain the following provision:
PROVIDER AGREES NOT TO BILL, CHARGE, COLLECT A DEPOSIT FROM,
SEEK REMUNERATION FROM, OR HAVE ANY RECOURSE AGAINST AN ENROLLEE
OR PERSONS ACTING ON THEIR BEHALF FOR SERVICES PROVIDED UNDER
THIS AGREEMENT. THIS PROVISION APPLIES TO BUT IS NOT LIMITED TO THE
FOLLOWING EVENTS: (1) NONPAYMENT BY THE HEALTH MAINTENANCE
ORGANIZATION OR (2) BREACH OF THIS AGREEMENT. THIS PROVISION DOES
NOT PROHIBIT THE PROVIDER FROM COLLECTING CO-PAYMENTS OR FEES FOR
UNCOVERED SERVICES.
THIS PROVISION SURVIVES THE TERMINATION OF THIS AGREEMENT FOR
AUTHORIZED SERVICES PROVIDED BEFORE THIS AGREEMENT TERMINATES,
REGARDLESS OF THE REASON FOR TERMINATION. THIS PROVISION IS FOR THE
BENEFIT OF THE HEALTH MAINTENANCE ORGANIZATION ENROLLEES. THIS
PROVISION DOES NOT APPLY TO SERVICES PROVIDED AFTER THIS AGREEMENT
TERMINATES.
THIS PROVISION SUPERSEDES ANY CONTRARY ORAL OR WRITTEN
AGREEMENT EXISTING NOW OR ENTERED INTO IN THE FUTURE BETWEEN
THE PROVIDER AND THE ENROLLEE OR PERSONS ACTING ON THEIR BEHALF
REGARDING LIABILITY FOR PAYMENT FOR SERVICES PROVIDED UNDER THIS
AGREEMENT.
Subd. 2. Cooperation required. An agreement to provide health care services between a
provider and a health maintenance organization must require the provider to cooperate with and
participate in the health maintenance organization's quality assurance program, dispute resolution
procedure, and utilization review program.
Subd. 3. Notice of termination. An agreement to provide health care services between a
provider and a health maintenance organization must require that if the provider terminates the
agreement, without cause, the provider shall give the organization 120 days' advance notice
of termination.
Subd. 4. Late payments. If a health maintenance organization's payments to a provider are
delayed beyond the payment date in the contract, the provider may notify the commissioner who
shall consider that information in assessing the financial solvency of the health maintenance
organization.
History: 1988 c 612 s 21
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Revisor of Statutes