2006 Minnesota Statutes

62J.03 DEFINITIONS.
    Subdivision 1. Scope of definitions. For purposes of this chapter, the terms defined in this
section have the meanings given.
    Subd. 2. Clinically effective. "Clinically effective" means that the use of a particular
medical technology improves patient clinical status, as measured by medical condition, survival
rates, and other variables, and that the use of the particular technology demonstrates a clinical
advantage over alternative technologies.
    Subd. 3.[Repealed, 1997 c 225 art 2 s 63]
    Subd. 4. Commissioner. "Commissioner" means the commissioner of health.
    Subd. 5. Cost-effective. "Cost-effective" means that the economic costs of using a particular
technology to achieve improvement in a patient's health outcome are justified given a comparison
to both the economic costs and the improvement in patient health outcome resulting from the use
of alternative technologies.
    Subd. 6. Group purchaser. "Group purchaser" means a person or organization that
purchases health care services on behalf of an identified group of persons, regardless of whether
the cost of coverage or services is paid for by the purchaser or by the persons receiving coverage
or services, as further defined in rules adopted by the commissioner. "Group purchaser" includes,
but is not limited to, community integrated service networks; health insurance companies,
health maintenance organizations, nonprofit health service plan corporations, and other health
plan companies; employee health plans offered by self-insured employers; trusts established
in a collective bargaining agreement under the federal Labor-Management Relations Act of
1947, United States Code, title 29, section 141, et seq.; the Minnesota Comprehensive Health
Association; group health coverage offered by fraternal organizations, professional associations,
or other organizations; state and federal health care programs; state and local public employee
health plans; workers' compensation plans; and the medical component of automobile insurance
coverage.
    Subd. 7. Improvement in health outcome. "Improvement in health outcome" means an
improvement in patient clinical status, and an improvement in patient quality-of-life status, as
measured by ability to function, ability to return to work, and other variables.
    Subd. 8. Provider or health care provider. "Provider" or "health care provider" means
a person or organization other than a nursing home that provides health care or medical care
services within Minnesota for a fee and is eligible for reimbursement under the medical assistance
program under chapter 256B. For purposes of this subdivision, "for a fee" includes traditional
fee-for-service arrangements, capitation arrangements, and any other arrangement in which
a provider receives compensation for providing health care services or has the authority to
directly bill a group purchaser, health carrier, or individual for providing health care services. For
purposes of this subdivision, "eligible for reimbursement under the medical assistance program"
means that the provider's services would be reimbursed by the medical assistance program if the
services were provided to medical assistance enrollees and the provider sought reimbursement, or
that the services would be eligible for reimbursement under medical assistance except that those
services are characterized as experimental, cosmetic, or voluntary.
    Subd. 9. Safety. "Safety" means a judgment of the acceptability of risk of using a technology
in a specified situation.
    Subd. 10. Health plan company. "Health plan company" means a health plan company
as defined in section 62Q.01, subdivision 4.
History: 1992 c 549 art 1 s 2; 1993 c 345 art 3 s 1; art 4 s 1; art 6 s 1; 1994 c 625 art 8 s
14,15; 1997 c 225 art 2 s 62