Minn. Stat. § 62M.18
This is the official text of Minn. Stat. § 62M.18, part of Minnesota’s Stat — part of the compiled statutory law of Minnesota, published by the state as "Stat." Browse the sections below, each linked to its official government source.
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§ 62M.18 ANNUAL POSTING ON WEBSITE; PRIOR AUTHORIZATIONS.
Official statutory text
(a) By April 1, 2022, and each April 1 thereafter, a health plan company must post on the health plan company's public website the following data for the immediately preceding calendar year for each commercial product:
(1) the number of prior authorization requests for which an authorization was issued;
(2) the number of prior authorization requests for which an adverse determination was issued and sorted by: (i) health care service; (ii) whether the adverse determination was appealed; and (iii) whether the adverse determination was upheld or reversed on appeal;
(3) the number of prior authorization requests that were submitted electronically and not by facsimile or email or other method pursuant to section 62J.497 ; and
(4) the reasons for prior authorization denial including but not limited to:
(i) patient did not meet prior authorization criteria;
(ii) incomplete information submitted by the provider to the utilization review organization;
(iii) change in treatment program; and
(iv) the patient is no longer covered by the plan.
(b) All information posted under this section must be written in easily understandable language.
(1) the number of prior authorization requests for which an authorization was issued;
(2) the number of prior authorization requests for which an adverse determination was issued and sorted by: (i) health care service; (ii) whether the adverse determination was appealed; and (iii) whether the adverse determination was upheld or reversed on appeal;
(3) the number of prior authorization requests that were submitted electronically and not by facsimile or email or other method pursuant to section 62J.497 ; and
(4) the reasons for prior authorization denial including but not limited to:
(i) patient did not meet prior authorization criteria;
(ii) incomplete information submitted by the provider to the utilization review organization;
(iii) change in treatment program; and
(iv) the patient is no longer covered by the plan.
(b) All information posted under this section must be written in easily understandable language.
Status: in_force · Read it on the official government site
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