1998 Minnesota Statutes

     62A.15 Coverage of certain licensed health professional 
  services. 

    Subdivision 1.    Applicability.  The provisions of this 
 section apply to all group policies or subscriber contracts 
 providing payment for care in this state, which are issued by 
 accident and health insurance companies regulated under this 
 chapter and nonprofit health service plan corporations regulated 
 under chapter 62C. 

    Subd. 2.    Chiropractic services.  All benefits 
 provided by any policy or contract referred to in subdivision 1, 
 relating to expenses incurred for medical treatment or services 
 of a physician must also include chiropractic treatment and 
 services of a chiropractor to the extent that the chiropractic 
 services and treatment are within the scope of chiropractic 
 licensure. 

    This subdivision is intended to provide equal access to 
 benefits for insureds and subscribers who choose to obtain 
 treatment for illness or injury from a doctor of chiropractic, 
 as long as the treatment falls within the chiropractor's scope 
 of practice.  This subdivision is not intended to change or add 
 to the benefits provided for in these policies or contracts. 

    Subd. 3.    Optometric services.  All benefits provided 
 by any policy or contract referred to in subdivision 1, relating 
 to expenses incurred for medical treatment or services of a 
 physician must also include optometric treatment and services of 
 an optometrist to the extent that the optometric services and 
 treatment are within the scope of optometric licensure. 

    This subdivision is intended to provide equal payment of 
 benefits for optometric treatment and services and is not 
 intended to change or add to the benefits provided for in those 
 policies or contracts. 

    Subd. 3a.    Nursing services.  All benefits provided by 
 a policy or contract referred to in subdivision 1, relating to 
 expenses incurred for medical treatment or services of a duly 
 licensed physician must include services provided by a 
 registered nurse who is licensed pursuant to section 148.171 and 
 who is certified by the profession to engage in advanced nursing 
 practice.  "Advanced nursing practice" means the performance of 
 health services by professional nurses who have gained 
 additional knowledge and skills through an organized program of 
 study and clinical experience preparing nurses for advanced 
 practice roles as nurse anesthetists, nurse midwives, nurse 
 practitioners, or clinical specialists in psychiatric or mental 
 health nursing.  The program of study must be beyond the 
 education required for registered nurse licensure and must meet 
 criteria established by the professional nursing organization 
 having authority to certify the registered nurse in advanced 
 nursing practice.  For the purposes of this subdivision, the 
 board of nursing shall, by rule, adopt a list of professional 
 nursing organizations which have the authority to certify nurses 
 in advanced nursing practice.  

    This subdivision is intended to provide payment of benefits 
 for treatment and services by a licensed registered nurse 
 certified in advanced nursing practice as defined in this 
 subdivision and is not intended to add to the benefits provided 
 for in these policies or contracts. 

    Subd. 4.    Denial of benefits.  (a) No carrier referred 
 to in subdivision 1 may, in the payment of claims to employees 
 in this state, deny benefits payable for services covered by the 
 policy or contract if the services are lawfully performed by a 
 licensed chiropractor, licensed optometrist, or a registered 
 nurse meeting the requirements of subdivision 3a. 

    (b) When carriers referred to in subdivision 1 make claim 
 determinations concerning the appropriateness, quality, or 
 utilization of chiropractic health care for Minnesotans, any of 
 these determinations that are made by health care professionals 
 must be made by, or under the direction of, or subject to the 
 review of licensed doctors of chiropractic.  

    HIST: 1973 c 252 s 1; 1976 c 192 s 1,2; 1976 c 242 s 1; 1983 c 
 221 s 2; 1988 c 441 s 1; 1988 c 642 s 2-4; 1989 c 330 s 13,14