reglab/housing_qa huggingface dataset:
MN Stat § 62D.107 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.107 — Equal Access To Acupuncture Services.

62D.107 EQUAL ACCESS TO ACUPUNCTURE SERVICES. Subdivision 1. Coverage. All benefits provided by a health maintenance contract relating to expenses incurred for acupuncture services that are provided by a physician must also include acupuncture treatment and services of a licensed acupuncture practitioner to the extent that the acupuncture services and treatment are within the scope of acupuncture practitioner licensure. This subdivision ensures equal access to benefits for enrollees who choose to directly obtain treatment for illness and injury from a licensed acupuncture practitioner, as long as the treatment falls within the scope of practice of the licensed acupuncture practitioner. This subdivision is not intended to change or add to the benefits provided for in these policies or contracts. Subd. 2. Denial of benefits. (a) In the payment of claims for enrollees in this state, no health maintenance organization may deny payment for acupuncture services covered by an enrollee's health maintenance contract if the services are lawfully performed by a licensed acupuncture practitioner. (b) When a health maintenance organization makes a denial of payment claim determination concerning the appropriateness, quality, or utilization of acupuncture services for enrollees in this state performed by a licensed acupuncture practitioner, the determination must be made by, under the direction of, or subject to the review of a licensed acupuncture practitioner. History:   2009 c 45 s 3
MN Stat § 62D.109 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.109 — Services Associated With Clinical Trials.

62D.109 SERVICES ASSOCIATED WITH CLINICAL TRIALS. A health maintenance organization must inform an enrollee who is a participant in a clinical trial upon inquiry by the enrollee that coverage shall be provided as required under the enrollee's health maintenance contract or under state or federal rule or statute. History:  1Sp2001 c 9 art 16 s 2; 2002 c 379 art 1 s 113
MN Stat § 62D.11 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.11 — Complaint System.

62D.11 COMPLAINT SYSTEM. Subdivision 1. Enrollee complaint system. Every health maintenance organization shall establish and maintain a complaint system, as required under sections 62Q.68 to 62Q.72 to provide reasonable procedures for the resolution of written complaints initiated by or on behalf of enrollees concerning the provision of health care services. Subd. 1a. Service coverage. Where a complaint involves a dispute about a health maintenance organization's coverage of a service, the commissioner may review the complaint and any information and testimony necessary in order to make a determination and order the appropriate remedy pursuant to sections 62D.15 to 62D.17. Subd. 1b.  [Repealed, 1999 c 239 s 43 para (a)] Subd. 2.  [Repealed, 1999 c 239 s 43 para (a)] Subd. 3. Denial of coverage. Within a reasonable time after receiving an enrollee's written or oral communication to the health maintenance organization concerning a denial of coverage or inadequacy of services, the health maintenance organization shall provide the enrollee with a written statement of the reason for the denial of coverage, and a statement approved by the commissioner of health which explains the health maintenance organization complaint procedures, and in the case of Medicare enrollees, which also explains Medicare appeal procedures. Subd. 4.  [Repealed, 1997 c 205 s 40] History:  1973 c 670 s 11; 1974 c 284 s 5; 1977 c 305 s 45; 1986 c 444; 1988 c 434 s 10; 1988 c 592 s 6,7; 1990 c 538 s 22-24; 1995 c 234 art 2 s 1; 1997 c 205 s 12-14; 1998 c 407 art 2 s 2; 1999 c 239 s 1
MN Stat § 62D.123 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.123 — Provider Contracts.

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
MN Stat § 62D.13 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.13 — Powers Of Insurers And Nonprofit Health Service Plans.

62D.13 POWERS OF INSURERS AND NONPROFIT HEALTH SERVICE PLANS. Notwithstanding any law to the contrary, an insurer or a hospital or medical service plan corporation may contract with a health maintenance organization to provide insurance or similar protection against the cost of care provided through health maintenance organizations and to provide coverage in the event of the failure of the health maintenance organization to meet its obligations. The enrollees of a health maintenance organization constitute a permissible group for group coverage under the insurance laws and the Nonprofit Health Service Plan Corporations Act. Under such contracts, the insurer or nonprofit health service plan corporation may make benefit payments to health maintenance organizations for health care services rendered, or to be rendered, by providers pursuant to the health care plan. Any insurer, or nonprofit health service plan corporation, licensed to do business in this state, is authorized to provide the types of coverages described in section 62D.05, subdivision 3. History:   1973 c 670 s 13
MN Stat § 62D.145 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.145 — Disclosure Of Information Held By Health Maintenance Organizations.

62D.145 DISCLOSURE OF INFORMATION HELD BY HEALTH MAINTENANCE ORGANIZATIONS. Subdivision 1. Personal and privileged information. The ability of a health maintenance organization to disclose personal information, as defined in section 72A.491, subdivision 17, and privileged information, as defined in section 72A.491, subdivision 19, is governed by sections 72A.497, 72A.499, and 72A.502. Subd. 2. Health data or information. (a) A health maintenance organization is prohibited from disclosing to any person any individually identifiable data or information held by the health maintenance organization pertaining to the diagnosis, treatment, or health of any enrollee, or any application obtained from any person, except: (1) to the extent necessary to carry out the purposes of this chapter, the commissioner and a designee shall have access to the above data or information but the data removed from the health maintenance organization or participating entity shall not identify any particular patient or client by name or contain any other unique personal identifier; (2) upon the express consent of the enrollee or applicant; (3) pursuant to statute or court order for the production of evidence or the discovery thereof; (4) in the event of claim or litigation between the person and the provider or health maintenance organization wherein such data or information is pertinent; (5) to meet the requirements of contracts for prepaid medical services with the commissioner of human services authorized under chapter 256B, 256D, or 256L; (6) to meet the requirements of contracts for benefit plans with the commissioner of management and budget under chapter 43A; or (7) as otherwise authorized pursuant to statute. No provision in a contract for a benefit plan under chapter 43A shall authorize dissemination of individually identifiable health records, unless the dissemination of the health records is required to carry out the requirements of the contract and employees whose health records will be disseminated are fully informed of the dissemination by the Department of Management and Budget at the time the employees are enrolling for or changing insurance coverage. (b) In any case involving a suspected violation of a law applicable to health maintenance organizations in which access to health data maintained by the health maintenance organization or participating entity is necessary, the commissioner and agents, while maintaining the privacy rights of individuals and families, shall be permitted to obtain data that identifies any particular patient or client by name. A health maintenance organization shall be entitled to claim any statutory privileges against such disclosure which the provider who furnished the information to the health maintenance organization is entitled to claim. History:  2000 c 468 s 19; 2008 c 204 s 42; 2009 c 101 art 2 s 109
MN Stat § 62D.16 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.16 — Denial, Suspension, And Revocation; Administrative Procedures.

62D.16 DENIAL, SUSPENSION, AND REVOCATION; ADMINISTRATIVE PROCEDURES. Subdivision 1. Notice and hearing. When the commissioner of health has cause to believe that grounds for the denial, suspension or revocation of a certificate of authority exists, the commissioner shall notify the health maintenance organization in writing specifically stating the grounds for denial, suspension or revocation and fixing a time of at least 20 days thereafter for a hearing on the matter, except in summary proceedings as provided in section 62D.18. Subd. 2. Written findings. After such hearing, or upon the failure of the health maintenance organization to appear at the hearing, the commissioner of health shall take action as is deemed advisable and shall issue written findings which shall be mailed to the health maintenance organization. The action of the commissioner of health shall be subject to judicial review pursuant to chapter 14. History:  1973 c 670 s 16; 1977 c 305 s 45; 1982 c 424 s 130; 1986 c 444
MN Stat § 62D.182 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.182 — Liabilities.

62D.182 LIABILITIES. Every health maintenance organization shall maintain liabilities estimated in the aggregate to be sufficient to pay all reported or unreported claims incurred that are unpaid and for which the organization is liable. Liabilities are computed under rules adopted by the commissioner. History:   1988 c 612 s 25
MN Stat § 62D.19 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.19 — Unreasonable Expenses.

62D.19 UNREASONABLE EXPENSES. No health maintenance organization shall incur or pay for any expense of any nature which is unreasonably high in relation to the value of the service or goods provided. The commissioner of health shall implement and enforce this section by rules adopted under this section. In an effort to achieve the stated purposes of sections 62D.01 to 62D.30 and to ensure that the payment of health maintenance organization money to major participating entities results in a corresponding benefit to the health maintenance organization and its enrollees, when determining whether an organization has incurred an unreasonable expense in relation to a major participating entity, due consideration shall be given to, in addition to any other appropriate factors, whether the officers and trustees of the health maintenance organization have acted with good faith and in the best interests of the health maintenance organization in entering into, and performing under, a contract under which the health maintenance organization has incurred an expense. The commissioner has standing to sue, on behalf of a health maintenance organization, officers or trustees of the health maintenance organization who have breached their fiduciary duty in entering into and performing such contracts. History:  1973 c 670 s 19; 1983 c 289 s 114 subd 1; 1984 c 464 s 41; 1984 c 655 art 1 s 92; 1Sp1985 c 10 s 62; 1987 c 384 art 2 s 1; 1988 c 612 s 26; 2017 c 2 art 2 s 8
MN Stat § 62D.20 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.20 — Rules.

62D.20 RULES. Subdivision 1. Rulemaking. The commissioner of health may, pursuant to chapter 14, promulgate such reasonable rules as are necessary or proper to carry out the provisions of sections 62D.01 to 62D.30. Included among such rules shall be those which provide minimum requirements for the provision of comprehensive health maintenance services, as defined in section 62D.02, subdivision 7, and reasonable exclusions therefrom. Nothing in such rules shall force or require a health maintenance organization to provide elective, induced abortions, except as medically necessary to prevent the death of the mother, whether performed in a hospital, other abortion facility, or the office of a physician; the rules shall provide every health maintenance organization the option of excluding or including elective, induced abortions, except as medically necessary to prevent the death of the mother, as part of its comprehensive health maintenance services. Subd. 2. Prior authorization. The commissioner shall adopt rules that address the issue of appropriate prior authorization requirements, considering enrollee needs, administrative concerns, and the nature of the benefit. History:  1973 c 670 s 20; 1977 c 305 s 45; 1981 c 122 s 2; 1982 c 424 s 130; 1985 c 248 s 70; 1987 c 384 art 2 s 1; 1988 c 434 s 16; 1988 c 592 s 10; 1997 c 205 s 16
MN Stat § 62D.21 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.21 — Fees.

62D.21 FEES. Every health maintenance organization subject to sections 62D.01 to 62D.30 shall pay to the commissioner of health fees as prescribed by the commissioner of health pursuant to section 144.122 for the following: (1) filing an application for a certificate of authority; (2) filing an amendment to a certificate of authority; (3) filing each annual report; and (4) other filings, as specified by rule. History:  1973 c 670 s 21; 1975 c 310 s 1; 1977 c 305 s 45; 1985 c 248 s 70; 1987 c 384 art 2 s 1
MN Stat § 62D.211 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.211 — Renewal Fee.

62D.211 RENEWAL FEE. Each health maintenance organization subject to sections 62D.01 to 62D.30 shall submit to the commissioner of health each year before June 15 a certificate of authority renewal fee in the amount of $10,000 each plus 20 cents per person enrolled in the health maintenance organization on December 31 of the preceding year. The commissioner may adjust the renewal fee in rule under the provisions of chapter 14. History:  1987 c 384 art 2 s 1; 1987 c 403 art 2 s 2; 1990 c 538 s 30
MN Stat § 62D.23 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.23 — Filings And Reports As Public Documents.

62D.23 FILINGS AND REPORTS AS PUBLIC DOCUMENTS. All applications, filings, and reports required under sections 62D.01 to 62D.30 shall be treated as public documents. History:  1973 c 670 s 23; 1987 c 384 art 2 s 1
MN Stat § 62D.24 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.24 — Commissioner Of Health's Authority To Contract.

62D.24 COMMISSIONER OF HEALTH'S AUTHORITY TO CONTRACT. The commissioner of health, in carrying out the obligations under sections 62D.01 to 62D.30, may contract with the commissioner of commerce or other qualified persons to make recommendations concerning the determinations required to be made. Such recommendations may be accepted in full or in part by the commissioner of health. History:  1973 c 670 s 24; 1977 c 305 s 45; 1983 c 289 s 114 subd 1; 1984 c 655 art 1 s 92; 1986 c 444; 1987 c 384 art 2 s 1
MN Stat § 62E.01 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62E — Comprehensive Health Insurance|Section 62E.01 — Citation.

62E.01 CITATION. Sections 62E.01 to 62E.17 may be cited as the "Minnesota Comprehensive Health Insurance Act of 1976." History:   1976 c 296 art 1 s 1
MN Stat § 62E.05 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62E — Comprehensive Health Insurance|Section 62E.05 — Information On Qualified Plans.

62E.05 INFORMATION ON QUALIFIED PLANS. Subdivision 1. Certification. Upon application by an insurer, fraternal, or employer for certification of a plan of health coverage as a qualified plan or a qualified Medicare supplement plan for the purposes of sections 62E.01 to 62E.19, the commissioner shall make a determination within 90 days as to whether the plan is qualified. All plans of health coverage, except Medicare supplement policies, shall be labeled as "qualified" or "nonqualified" on the front of the policy or contract, or on the schedule page. All qualified plans shall indicate whether they are number one, two, or three coverage plans. For any policy of accident and health insurance subject to the requirements of the Affordable Care Act, as defined under section 62A.011, subdivision 1a, that is offered, sold, issued, or renewed on or after January 1, 2018, the requirements of this section do not apply. Subd. 2. Annual report. The state of Minnesota or any of its departments, agencies, programs, instrumentalities, or political subdivisions, shall report in writing to the association and to the commissioner of commerce no later than September 15 of each year regarding the number of persons and the amount of premiums, deductibles, co-payments, or coinsurance that it paid for on behalf of enrollees in the Comprehensive Health Association. This report must contain only summary information and must not include any individually identifiable data. The report must cover the 12-month period ending the preceding June 30. History:  1976 c 296 art 1 s 5; 1987 c 384 art 2 s 1; 1994 c 485 s 34; 1995 c 234 art 7 s 8; 1996 c 446 art 1 s 41; 1999 c 177 s 45; 2000 c 398 s 1; 2005 c 77 s 2; 1Sp2017 c 6 art 5 s 6
MN Stat § 62E.07 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62E — Comprehensive Health Insurance|Section 62E.07 — Qualified Medicare Supplement Plan.

62E.07 QUALIFIED MEDICARE SUPPLEMENT PLAN. (a) Any plan which provides benefits may be certified as a qualified Medicare supplement plan if the plan is designed to supplement Medicare and provides coverage of 100 percent of the deductibles required under Medicare, with exclusion under paragraph (b) for any part of the Medicare Part B deductible, and 80 percent of the charges for covered services described in section 62E.06, subdivision 1, which charges are not paid by Medicare. The coverage shall include a limitation of $1,000 per person on total annual out-of-pocket expenses for the covered services. (b) Any plan sold or issued to a newly eligible individual, as defined in section 62A.3099, subdivision 18a, that provides benefits may be certified as a qualified Medicare supplemental plan if the plan is designed to supplement Medicare and provides coverage of 100 percent of the deductibles, with the exception of coverage of: (1) 100 percent or any portion of the Medicare Part B deductible; and (2) 80 percent of the charges for covered services, as provided under section 62E.06, subdivision 6, that are charges not paid by Medicare. The coverage must include a $1,000 per person limitation on total annual out-of-pocket expenses for the covered services. History:  1976 c 296 art 1 s 7; 1989 c 258 s 12; 1992 c 554 art 1 s 14; 2019 c 26 art 5 s 12,13
MN Stat § 62E.09 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62E — Comprehensive Health Insurance|Section 62E.09 — Duties Of Commissioner.

62E.09 DUTIES OF COMMISSIONER. The commissioner may: (a) formulate general policies to advance the purposes of sections 62E.01 to 62E.19; (b) supervise the creation of the Minnesota Comprehensive Health Association within the limits described in section 62E.10; (c) approve the selection of the writing carrier by the association, approve the association's contract with the writing carrier, and approve the state plan coverage; (d) appoint advisory committees; (e) conduct periodic audits to assure the general accuracy of the financial data submitted by the writing carrier and the association; (f) contract with the federal government or any other unit of government to ensure coordination of the state plan with other governmental assistance programs; (g) undertake directly or through contracts with other persons studies or demonstration programs to develop awareness of the benefits of sections 62E.01 to 62E.15, so that the residents of this state may best avail themselves of the health care benefits provided by these sections; (h) contract with insurers and others for administrative services; and (i) adopt, amend, suspend and repeal rules as reasonably necessary to carry out and make effective the provisions and purposes of sections 62E.01 to 62E.19. History:  1976 c 296 art 1 s 9; 1977 c 409 s 13; 1987 c 384 art 2 s 1; 1993 c 324 s 2; 1996 c 305 art 2 s 7; 1999 c 177 s 46; 2013 c 84 art 1 s 41
MN Stat § 62E.101 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62E — Comprehensive Health Insurance|Section 62E.101 — Managed Care Delivery Method.

62E.101 MANAGED CARE DELIVERY METHOD. The association may form a preferred provider network or contract with an existing provider network, health maintenance organization, or nonprofit health service plan corporation to deliver the services and benefits provided for in the plans of health coverage offered. If the association does not contract with an existing provider network, health maintenance organization, or nonprofit health service plan corporation, the association may adopt a provider payment schedule and negotiate provider payment rates subject to the approval of the commissioner. History:  1991 c 165 s 5; 2000 c 398 s 4