reglab/housing_qa huggingface dataset:
MN Stat § 62N.26 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62N — Community Integrated Service Network|Section 62N.26 — Shared Services Cooperative.

62N.26 SHARED SERVICES COOPERATIVE. The commissioner of health shall establish, or assist in establishing, a shared services cooperative organized under chapter 308A to make available administrative and legal services, technical assistance, provider contracting and billing services, and other services to those community integrated service networks that choose to participate in the cooperative. The commissioner shall provide, to the extent funds are appropriated, start-up loans sufficient to maintain the shared services cooperative until its operations can be maintained by fees and contributions. The cooperative must not be staffed, administered, or supervised by the commissioner of health. The cooperative shall make use of existing resources that are already available in the community, to the extent possible. History:  1994 c 625 art 1 s 7; 1997 c 225 art 2 s 35
MN Stat § 62N.31 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62N — Community Integrated Service Network|Section 62N.31 — Standards For Accredited Capitated Provider Accreditation.

62N.31 STANDARDS FOR ACCREDITED CAPITATED PROVIDER ACCREDITATION. Subdivision 1. General. Each health care providing entity seeking initial accreditation as an accredited capitated provider shall submit to the commissioner of health sufficient information to establish that the applicant has operational capacity, facilities, personnel, and financial capability to provide the contracted covered services to the enrollees of the network for which it seeks accreditation (1) on an ongoing basis; and (2) for a period of 120 days following the insolvency of the network without receiving payment from the network. Accreditation shall continue until abandoned by the accredited capitated provider or revoked by the commissioner in accordance with subdivision 4. The applicant may establish financial capability by demonstrating that the provider amount at risk can be covered by or through any of allocated or restricted funds, a letter of credit, the taxing authority of the applicant or governmental sponsor of the applicant, an unrestricted fund balance at least two times the provider amount at risk, reinsurance, either purchased directly by the applicant or by the community network to which it will be accredited, or any other method accepted by the commissioner. Accreditation of a health care providing entity shall not in itself limit the right of the accredited capitated provider to seek payment of unpaid capitated amounts from a community network, whether the community network is solvent or insolvent; provided that, if the community network is subject to any liquidation, rehabilitation, or conservation proceedings, the accredited capitated provider shall have the status accorded creditors under section 60B.44, subdivision 10. Subd. 2. Annual reporting period. Each accredited capitated provider shall submit to the commissioner annually, no later than April 15, the following information for each network to which it is accredited: the provider amount at risk for that year, the number of enrollees for the network, both for the prior year and estimated for the current year, any material change in the provider's operational or financial capacity since its last report, and any other information reasonably requested by the commissioner. Subd. 3. Additional reporting. Each accredited capitated provider shall provide the commissioner with 60 days' advance written notice of termination of the accredited capitated provider relationship with a network. Subd. 4. Revocation of accreditation. The commissioner may revoke the accreditation of an accredited capitated provider if the accredited capitated provider's ongoing operational or financial capabilities fail to meet the requirements of this section. The revocation shall be handled in the same fashion as placing a health maintenance organization under administrative supervision. History:   1994 c 625 art 1 s 11
MN Stat § 62N.32 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62N — Community Integrated Service Network|Section 62N.32 — Deposit Requirement.

62N.32 DEPOSIT REQUIREMENT. A community network must satisfy the deposit requirement provided in section 62D.041. The deposit counts as an admitted asset and as part of the required net worth. The deposit requirement cannot be reduced by the alternative means that may be used to reduce the net worth requirement, other than through the use of a guaranteeing organization. History:   1994 c 625 art 1 s 12
MN Stat § 62N.33 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62N — Community Integrated Service Network|Section 62N.33 — Coverage For Enrollees Of Insolvent Networks.

62N.33 COVERAGE FOR ENROLLEES OF INSOLVENT NETWORKS. In the event of a community network insolvency, the commissioner shall determine whether one or more community networks or health plan companies are willing and able to provide replacement coverage to all of the failed community network's enrollees, and if so, the commissioner shall facilitate the provision of the replacement coverage. If such replacement coverage is not available, the commissioner shall randomly assign enrollees of the insolvent community network to other community networks and health plan companies in the service area, in proportion to their market share, for the remaining terms of the enrollees' contracts with the insolvent network. The other community networks and health plan companies must accept the allocated enrollees under their policy or contract most similar to the enrollees' contracts with the insolvent community network. The allocation must keep groups together. Enrollees with special continuity of care needs may, in the commissioner's discretion, be given a choice of replacement coverage rather than random assignment. Individuals and groups that are assigned randomly may choose a different community network or health plan company when their contracts expire, on the same basis as any other individual or group. The replacement health plan company must comply with any guaranteed renewal or other renewal provisions of the prior coverage, including but not limited to, provisions regarding preexisting conditions and health conditions that developed during prior coverage. History:   1994 c 625 art 1 s 13
MN Stat § 62N.35 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62N — Community Integrated Service Network|Section 62N.35 — Border Issues.

62N.35 BORDER ISSUES. To the extent feasible and appropriate, community networks that also operate under the health maintenance organization or similar prepaid health care law of another state must be licensed and regulated by this state in a manner that avoids unnecessary duplication and expense for the community network. The commissioner shall communicate with regulatory authorities in neighboring states to explore the feasibility of cooperative approaches to streamline regulation of border community networks, such as joint financial audits, and shall report to the legislature on any changes to Minnesota law that may be needed to implement appropriate collaborative approaches to regulation. History:   1994 c 625 art 1 s 15
MN Stat § 62N.40 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62N — Community Integrated Service Network|Section 62N.40 — Chemical Dependency Services.

62N.40 CHEMICAL DEPENDENCY SERVICES. Each community integrated service network regulated under this chapter must ensure that chemically dependent individuals have access to cost-effective treatment options that address the specific needs of individuals. These include, but are not limited to, the need for: treatment that takes into account severity of illness and comorbidities; provision of a continuum of care, including treatment and rehabilitation programs licensed under chapter 245G; the safety of the individual's domestic and community environment; gender appropriate and culturally appropriate programs; and access to appropriate social services. History:  1995 c 234 art 1 s 28; 1997 c 225 art 2 s 36; 2016 c 158 art 1 s 20; 2018 c 182 art 2 s 1
MN Stat § 62Q.02 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.02 — Applicability Of Chapter.

62Q.02 APPLICABILITY OF CHAPTER. (a) This chapter applies only to health plans, as defined in section 62Q.01, and not to other types of insurance issued or renewed by health plan companies, unless otherwise specified. (b) This chapter applies to a health plan company only with respect to health plans, as defined in section 62Q.01, issued or renewed by the health plan company, unless otherwise specified. (c) If a health plan company issues or renews health plans in other states, this chapter applies only to health plans issued or renewed in this state for Minnesota residents, or to cover a resident of the state, unless otherwise specified. History:   1995 c 234 art 2 s 7
MN Stat § 62Q.021 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.021 — Federal Act; Compliance Required.

62Q.021 FEDERAL ACT; COMPLIANCE REQUIRED. Subdivision 1. Compliance with 1996 federal law. Each health plan company shall comply with the federal Health Insurance Portability and Accountability Act of 1996, including any federal regulations adopted under that act, to the extent that it imposes a requirement that applies in this state and that is not also required by the laws of this state. This section does not require compliance with any provision of the federal act prior to the effective date provided for that provision in the federal act. The commissioner shall enforce this subdivision. Subd. 2. Compliance with 2010 federal law. Each health plan company shall comply with the Affordable Care Act to the extent that it imposes a requirement that applies in this state but is not required under the laws of this state. This section does not require compliance with any provision of the Affordable Care Act before the effective date provided for that provision in the Affordable Care Act. The commissioner shall enforce this subdivision. History:  1997 c 175 art 4 s 2; 2013 c 84 art 1 s 68
MN Stat § 62Q.025 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.025 — Product Approvals.

62Q.025 PRODUCT APPROVALS. Subdivision 1. Qualified plan. A high deductible health plan shall be deemed a qualified plan under sections 62E.06 and 62E.12. The plan must meet all other requirements of state law except those that are inconsistent with a high deductible health plan as defined in sections 220 and 223 of the Internal Revenue Code and supporting regulations. Subd. 2. Authorization. Notwithstanding any other law of this state, any health plan company defined in section 62Q.01, subdivision 4, is permitted to offer high deductible health plans. History:   2004 c 268 s 8
MN Stat § 62Q.096 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.096 — Credentialing Of Providers.

62Q.096 CREDENTIALING OF PROVIDERS. If a health plan company has initially credentialed, as providers in its provider network, individual providers employed by or under contract with an entity that: (1) is authorized to bill under section 256B.0625, subdivision 5; (2) is a mental health clinic certified under section 245I.20; (3) is designated an essential community provider under section 62Q.19; and (4) is under contract with the health plan company to provide mental health services, the health plan company must continue to credential at least the same number of providers from that entity, as long as those providers meet the health plan company's credentialing standards. A health plan company shall not refuse to credential these providers on the grounds that their provider network has a sufficient number of providers of that type. History: 1998 c 407 art 8 s 4; 2021 c 30 art 17 s 3 NOTE: The amendment to this section by Laws 2021, chapter 30, article 17, section 3, is effective July 1, 2022, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. Laws 2021, chapter 30, article 17, section 114.
MN Stat § 62Q.097 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.097 — Requirements For Timely Provider Credentialing.

62Q.097 REQUIREMENTS FOR TIMELY PROVIDER CREDENTIALING. Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section. (b) "Clean application for provider credentialing" or "clean application" means an application for provider credentialing submitted by a health care provider to a health plan company that is complete, is in the format required by the health plan company, and includes all information and substantiation required by the health plan company and does not require evaluation of any identified potential quality or safety concern. (c) "Provider credentialing" means the process undertaken by a health plan company to evaluate and approve a health care provider's education, training, residency, licenses, certifications, and history of significant quality or safety concerns in order to approve the health care provider to provide health care services to patients at a clinic or facility. Subd. 2. Time limit for credentialing determination. A health plan company that receives an application for provider credentialing must: (1) if the application is determined to be a clean application for provider credentialing and if the health care provider submitting the application or the clinic or facility at which the health care provider provides services requests the information, affirm that the health care provider's application is a clean application and notify the health care provider or clinic or facility of the date by which the health plan company will make a determination on the health care provider's application; (2) if the application is determined not to be a clean application, inform the health care provider of the application's deficiencies or missing information or substantiation within three business days after the health plan company determines the application is not a clean application; and (3) make a determination on the health care provider's clean application within 45 days after receiving the clean application unless the health plan company identifies a substantive quality or safety concern in the course of provider credentialing that requires further investigation. Upon notice to the health care provider, clinic, or facility, the health plan company is allowed 30 additional days to investigate any quality or safety concerns. History:   2021 c 30 art 6 s 1
MN Stat § 62Q.101 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.101 — Evaluation Of Provider Performance.

62Q.101 EVALUATION OF PROVIDER PERFORMANCE. A health plan company, or a vendor of risk management services as defined under section 60A.23, subdivision 8, shall, in evaluating the performance of a health care provider: (1) conduct the evaluation using a bona fide baseline based upon practice experience of the provider group; and (2) disclose the baseline to the health care provider in writing and prior to the beginning of the time period used for the evaluation. History:   2007 c 147 art 15 s 10
MN Stat § 62Q.1055 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.1055 — Chemical Dependency.

62Q.1055 CHEMICAL DEPENDENCY. All health plan companies shall use the assessment criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, when assessing and placing enrollees for chemical dependency treatment. History:  1995 c 234 art 2 s 22; 2016 c 158 art 1 s 214
MN Stat § 62Q.106 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.106 — Dispute Resolution By Commissioner.

62Q.106 DISPUTE RESOLUTION BY COMMISSIONER. (a) A complainant may at any time submit a complaint to the appropriate commissioner to investigate. After investigating a complaint, or reviewing a company's decision, the appropriate commissioner may order a remedy as authorized under chapter 45, 60A, or 62D. (b) In investigating a complaint filed against a health maintenance organization regarding a vulnerable adult, upon request, the commissioner of health must interview at least one family member of the complainant or the subject of the complaint. If the complainant or the subject of the complaint does not want any family members to be interviewed, this information will be included in the investigative file. History:  1995 c 234 art 2 s 23; 1997 c 225 art 2 s 41; 1999 c 239 s 32; 2013 c 43 s 2
MN Stat § 62Q.107 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.107 — Prohibited Provision; Judicial Review.

62Q.107 PROHIBITED PROVISION; JUDICIAL REVIEW. Beginning January 1, 1999, no health plan, including the coverages described in section 62A.011, subdivision 3, clauses (7) and (10), may specify a standard of review upon which a court may review denial of a claim or of any other decision made by a health plan company with respect to an enrollee. This section prohibits limiting court review to a determination of whether the health plan company's decision is arbitrary and capricious, an abuse of discretion, or any other standard less favorable to the enrollee than a preponderance of the evidence. History:   1998 c 407 art 2 s 21
MN Stat § 62Q.12 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.12 — Denial Of Access.

62Q.12 DENIAL OF ACCESS. No health plan company may deny access to a covered health care service unless the denial is made by, or under the direction of, or subject to the review of a health care professional licensed to provide the service in question. History:   1994 c 625 art 2 s 20
MN Stat § 62Q.121 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.121 — Licensure Of Medical Directors.

62Q.121 LICENSURE OF MEDICAL DIRECTORS. (a) No health plan company may employ a person as a medical director unless the person is licensed as a physician in this state. This section does not apply to a health plan company that is assessed less than three percent of the total amount assessed by the Minnesota Comprehensive Health Association. (b) For purposes of this section, "medical director" means a physician employed by a health plan company who has direct decision-making authority, based upon medical training and knowledge, regarding the health plan company's medical protocols, medical policies, or coverage of treatment of a particular enrollee, regardless of the physician's title. (c) This section applies only to medical directors who make recommendations or decisions that involve or affect enrollees who live in this state. (d) Each health plan company that is subject to this section shall provide the commissioner with the names and licensure information of its medical directors and shall provide updates no later than 30 days after any changes. History:  1Sp2001 c 9 art 16 s 6; 2002 c 379 art 1 s 113
MN Stat § 62Q.135 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.135 — Contracting For Chemical Dependency Services.

62Q.135 CONTRACTING FOR CHEMICAL DEPENDENCY SERVICES. No health plan company shall contract with a chemical dependency treatment program, unless the program participates in the chemical dependency treatment accountability plan established by the commissioner of human services. The commissioner of human services shall make data on chemical dependency services and outcomes collected through this program available to health plan companies. History:   1994 c 625 art 2 s 21
MN Stat § 62Q.137 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.137 — Chemical Dependency Treatment; Coverage.

62Q.137 CHEMICAL DEPENDENCY TREATMENT; COVERAGE. (a) Any health plan that provides coverage for chemical dependency treatment must cover chemical dependency treatment provided to an enrollee by the Department of Corrections while the enrollee is committed to the custody of the commissioner of corrections following a conviction for a first-degree driving while impaired offense under section 169A.24 if: (1) a court of competent jurisdiction makes a preliminary determination based on a chemical use assessment conducted under section 169A.70 that treatment may be appropriate and includes this determination as part of the sentencing order; and (2) the Department of Corrections makes a determination based on a chemical assessment conducted while the individual is in the custody of the department that treatment is appropriate. Treatment provided by the Department of Corrections that meets the requirements of this section shall not be subject to a separate medical necessity determination under the health plan company's utilization review procedures. (b) The health plan company must be given a copy of the court's preliminary determination and supporting documents and the assessment conducted by the Department of Corrections. (c) Payment rates for treatment provided by the Department of Corrections shall not exceed the lowest rate for outpatient chemical dependency treatment paid by the health plan company to a participating provider of the health plan company. (d) For purposes of this section, chemical dependency treatment means all covered services that are intended to treat chemical dependency and that are covered by the enrollee's health plan or by law. History:  1Sp2001 c 9 art 19 s 1; 2002 c 379 art 1 s 113
MN Stat § 62Q.14 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.14 — Restrictions On Enrollee Services.

62Q.14 RESTRICTIONS ON ENROLLEE SERVICES. No health plan company may restrict the choice of an enrollee as to where the enrollee receives services related to: (1) the voluntary planning of the conception and bearing of children, provided that this clause does not refer to abortion services; (2) the diagnosis of infertility; (3) the testing and treatment of a sexually transmitted disease; and (4) the testing for AIDS or other HIV-related conditions. History:   1994 c 625 art 2 s 22
MN Stat § 62Q.145 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.145 — Abortion And Scope Of Practice.

62Q.145 ABORTION AND SCOPE OF PRACTICE. Health plan company policies related to scope of practice for allied independent health providers, midlevel practitioners as defined in section 144.1501, subdivision 1, and other nonphysician health care professionals must comply with the requirements governing the performance of abortions in section 145.412, subdivision 1. History:  1995 c 234 art 2 s 25; 1997 c 183 art 2 s 20; 1Sp2003 c 14 art 7 s 88; 2018 c 182 art 1 s 108
MN Stat § 62Q.16 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62Q — Health Plan Companies|Section 62Q.16 — Midmonth Termination Prohibited.

62Q.16 MIDMONTH TERMINATION PROHIBITED. The termination of a person's coverage under any health plan as defined in section 62A.011, subdivision 3, with the exception of individual health plans, issued or renewed on or after January 1, 1995, must provide coverage until the end of the month in which coverage was terminated. History:   1994 c 625 art 2 s 23