2005 Minnesota Statutes

     62Q.45 Coverage for out-of-area primary care. 

    Subdivision 1.    Study.  The commissioner of health 
 shall develop methods to allow enrollees of managed care 
 organizations to obtain primary care health services outside of 
 the service area of their managed care organization, from health 
 care providers who are employed by or under contract with 
 another managed care organization.  The commissioner shall make 
 recommendations on:  (1) whether this out-of-area primary care 
 coverage should be available to students and/or other enrollees 
 without additional premium charges or cost sharing; (2) methods 
 to coordinate the services provided by different managed care 
 organizations; (3) methods to manage the quality of care 
 provided by different managed care organizations and monitor 
 health care outcomes; (4) methods to reimburse managed care 
 organizations for care provided to enrollees of other managed 
 care organizations; and (5) other issues relevant to the design 
 and administration of out-of-area primary care coverage.  The 
 commissioner shall present recommendations to the legislature by 
 January 15, 1996. 

    Subd. 2.    Definition.  For purposes of this section, 
 "managed care organization" means:  

    (1) a health maintenance organization operating under 
 chapter 62D; 

    (2) a community integrated service network as defined under 
 section 62N.02, subdivision 4a; or 

    (3) an insurance company licensed under chapter 60A, 
 nonprofit health service plan corporation operating under 
 chapter 62C, fraternal benefit society operating under chapter 
 64B, or any other health plan company, to the extent that it 
 covers health care services delivered to Minnesota residents 
 through a preferred provider organization or a network of 
 selected providers.  

    HIST: 1995 c 234 art 2 s 28; 1997 c 225 art 2 s 44