§ 62D.107 — Equal Access to Acupuncture Services
Plain-Language Summary
This section requires HMOs to cover acupuncture services from licensed acupuncture practitioners the same way they cover acupuncture from physicians. If acupuncture is a covered benefit, enrollees can choose to see a licensed acupuncture practitioner instead of a doctor. When an HMO denies an acupuncture claim, the denial must be reviewed by a licensed acupuncture practitioner.
62D.107 EQUAL ACCESS TO ACUPUNCTURE SERVICES.
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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:
History: History:
2009 c 45 s 3