Chapter 62Q — Minnesota Health Plan Contracting Act

15.001 Application of Laws 2005, Chapter 56, Terminology Changes Addresses application of laws 2005, chapter 56, terminology changes under Minnesota health plan regulations. 62Q.001 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.01 Definitions Defines key terms used in Minnesota's health plan regulation laws. 62Q.02 Applicability of Chapter Addresses applicability of chapter under Minnesota health plan regulations. 62Q.021 Federal Act; Compliance Required Addresses federal act; compliance required under Minnesota health plan regulations. 62Q.025 High Deductible Health Plans Regulates high deductible health plans in health plans. 62Q.03 Process for Risk Adjustment System Addresses process for risk adjustment system under Minnesota health plan regulations. 62Q.07 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.075 Local Public Accountability and Collaboration Plan This section has been repealed and is no longer in effect. 62Q.09 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.095 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.096 Credentialing of Providers Governs credentialing of providers requirements for health plans. 62Q.097 Requirements for Timely Provider Credentialing Governs requirements for timely provider credentialing requirements for health plans. 62Q.10 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.101 Evaluation of Provider Performance Governs evaluation of provider performance requirements for health plans. 62Q.105 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.1055 Chemical Dependency Addresses chemical dependency under Minnesota health plan regulations. 62Q.106 Dispute Resolution by Commissioner Addresses dispute resolution by commissioner under Minnesota health plan regulations. 62Q.107 Prohibited Provision; Judicial Review Establishes prohibited provision; judicial review procedures for health plan decisions. 62Q.11 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.12 Denial of Access Addresses denial of access in health plan coverage decisions. 62Q.121 Licensure of Medical Directors Addresses licensure of medical directors requirements for health plans. 62Q.135 Contracting for Chemical Dependency Services Addresses contracting for chemical dependency services under Minnesota health plan regulations. 62Q.137 Chemical Dependency Treatment; Coverage Addresses chemical dependency treatment; coverage coverage in health plans. 62Q.14 Restrictions on Enrollee Services Sets rules for restrictions on enrollee services in health plans. 62Q.145 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.16 Midmonth Termination Prohibited Sets rules for midmonth termination prohibited of health plan coverage. 62Q.165 Universal Coverage Addresses universal coverage under Minnesota health plan regulations. 62Q.17 Voluntary Purchasing Pools Addresses voluntary purchasing pools under Minnesota health plan regulations. 62Q.18 Portability of Coverage Addresses portability of coverage under Minnesota health plan regulations. 62Q.181 Written Certification of Coverage Addresses written certification of coverage requirements for health plans. 62Q.184 Step Therapy Override Addresses step therapy override coverage in health plans. 62Q.1841 Prohibition on Use of Step Therapy for Metastatic Cancer Addresses prohibition on use of step therapy for metastatic cancer coverage in health plans. 62Q.185 Guaranteed Renewability; Large Employer Group Sets rules for guaranteed renewability; large employer group of health plan coverage. 62Q.186 Prohibition on Rescissions of Health Plans Addresses prohibition on rescissions of health plans under Minnesota health plan regulations. 62Q.188 Flexible Benefits Plans Addresses flexible benefits plans under Minnesota health plan regulations. 62Q.19 Essential Community Providers Governs essential community providers requirements for health plans. 62Q.21 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.22 Health Care Services Prepaid Option Addresses health care services prepaid option under Minnesota health plan regulations. 62Q.23 General Services Addresses general services under Minnesota health plan regulations. 62Q.25 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.251 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.27 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.29 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.30 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.32 Local Ombudsperson Addresses local ombudsperson under Minnesota health plan regulations. 62Q.33 Local Government Public Health Functions Addresses local government public health functions under Minnesota health plan regulations. 62Q.37 Audits Conducted by Independent Organization Addresses audits conducted by independent organization under Minnesota health plan regulations. 62Q.41 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.43 Geographic Access Governs geographic access to health plan services. 62Q.45 Coverage for Out-of-area Primary Care Addresses coverage for out-of-area primary care under Minnesota health plan regulations. 62Q.451 Unrestricted Access to Services for the Diagnosis, Monitoring, and Treatment of Rare Diseases Governs unrestricted access to services for the diagnosis, monitoring, and treatment of rare diseases to health plan … 62Q.46 Preventive Items and Services Addresses preventive items and services under Minnesota health plan regulations. 62Q.465 Mental Health Parity and Substance Abuse Accountability Office Addresses mental health parity and substance abuse accountability office coverage requirements for health plans. 62Q.47 Alcoholism, Mental Health, and Chemical Dependency Services Addresses alcoholism, mental health, and chemical dependency services coverage requirements for health plans. 62Q.471 Exclusion for Suicide Attempts Prohibited Addresses exclusion for suicide attempts prohibited under Minnesota health plan regulations. 62Q.472 Screening and Testing for Opioids Addresses screening and testing for opioids under Minnesota health plan regulations. 62Q.473 Biomarker Testing Addresses biomarker testing under Minnesota health plan regulations. 62Q.48 Cost-sharing in Prescription Insulin Drugs Regulates cost-sharing in prescription insulin drugs in health plans. 62Q.481 Cost-sharing for Prescription Drugs and Related Medical Supplies to Treat Chronic Disease Regulates cost-sharing for prescription drugs and related medical supplies to treat chronic disease in health plans. 62Q.49 Enrollee Cost Sharing; Negotiated Provider Payments Governs enrollee cost sharing; negotiated provider payments requirements for health plans. 62Q.50 Prostate Cancer Screening Addresses prostate cancer screening under Minnesota health plan regulations. 62Q.51 Point-of-service Option Addresses point-of-service option under Minnesota health plan regulations. 62Q.52 Direct Access to Obstetric and Gynecologic Services Governs direct access to obstetric and gynecologic services to health plan services. 62Q.521 Postnatal Care Addresses postnatal care under Minnesota health plan regulations. 62Q.522 Coverage of Contraceptive Methods and Services Addresses coverage of contraceptive methods and services under Minnesota health plan regulations. 62Q.523 Coverage for Prescription Contraceptives; Supply Requirements Addresses coverage for prescription contraceptives; supply requirements for health plans in Minnesota. 62Q.524 Coverage of Abortions and Abortion-related Services Addresses coverage of abortions and abortion-related services under Minnesota health plan regulations. 62Q.525 Coverage for Off-label Drug Use Regulates coverage for off-label drug use in health plans. 62Q.526 Coverage for Participation in Approved Clinical Trials Addresses coverage for participation in approved clinical trials under Minnesota health plan regulations. 62Q.527 Nonformulary Antipsychotic Drugs; Required Coverage Addresses nonformulary antipsychotic drugs; required coverage for health plans in Minnesota. 62Q.528 Drug Coverage in Emergency Situations Sets rules for drug coverage in emergency situations coverage by health plans. 62Q.529 Coverage for Drugs Prescribed and Dispensed by Pharmacies Regulates coverage for drugs prescribed and dispensed by pharmacies in health plans. 62Q.53 Mental Health Coverage; Medically Necessary Care Addresses mental health coverage; medically necessary care coverage requirements for health plans. 62Q.531 Amino Acid-based Formula Coverage Addresses amino acid-based formula coverage under Minnesota health plan regulations. 62Q.535 Coverage for Court-ordered Mental Health Services Addresses coverage for court-ordered mental health services coverage requirements for health plans. 62Q.54 Referrals for Residents of Health Care Facilities Addresses referrals for residents of health care facilities under Minnesota health plan regulations. 62Q.545 Coverage of Home Care Nursing Addresses coverage of home care nursing under Minnesota health plan regulations. 62Q.55 Emergency Services Sets rules for emergency services coverage by health plans. 62Q.556 Consumer Protections Against Balance Billing Establishes consumer protections against balance billing protections in health plans. 62Q.56 Continuity of Care Sets rules for continuity of care of health plan coverage. 62Q.57 Designation of Primary Care Provider Governs designation of primary care provider requirements for health plans. 62Q.58 Access to Specialty Care Governs access to specialty care to health plan services. 62Q.585 Gender-affirming Care Coverage; Medically Necessary Care Addresses gender-affirming care coverage; medically necessary care under Minnesota health plan regulations. 62Q.64 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.645 Efficiency Reports and Distribution of Information Requires efficiency reports and distribution of information from health plans to consumers. 62Q.65 Access to Provider Discounts Governs access to provider discounts requirements for health plans. 62Q.66 Durable Medical Equipment Coverage Addresses durable medical equipment coverage under Minnesota health plan regulations. 62Q.665 Coverage for Orthotic and Prosthetic Devices Addresses coverage for orthotic and prosthetic devices under Minnesota health plan regulations. 62Q.6651 Medical Necessity and Nondiscrimination Standards for Coverage of Prosthetics or Orthotics Sets medical necessity and nondiscrimination standards for coverage of prosthetics or orthotics requirements for health … 62Q.666 Intermittent Catheters Addresses intermittent catheters under Minnesota health plan regulations. 62Q.67 Disclosure of Covered Durable Medical Equipment Requires disclosure of covered durable medical equipment from health plans to consumers. 62Q.675 Hearing Aids Addresses hearing aids under Minnesota health plan regulations. 62Q.676 Medication Therapy Management Addresses medication therapy management coverage in health plans. 62Q.677 Lifetime and Annual Limits Addresses lifetime and annual limits under Minnesota health plan regulations. 62Q.678 Dependent Child Notice Requires dependent child notice from health plans to consumers. 62Q.679 Religious Objections Addresses religious objections under Minnesota health plan regulations. 62Q.68 Definitions Defines key terms used in Minnesota's health plan regulation laws. 62Q.69 Complaint Resolution Sets rules for complaint resolution under health plan regulations. 62Q.70 Appeal of the Complaint Decision Sets rules for appeal of the complaint decision under health plan regulations. 62Q.71 Notice to Enrollees Sets rules for notice to enrollees in health plans. 62Q.72 Record Keeping; Reporting Requires record keeping; reporting from health plans to regulators. 62Q.73 External Review of Adverse Determinations Establishes external review of adverse determinations procedures for health plan decisions. 62Q.731 Appeal From Adverse Determination Sets rules for appeal from adverse determination under health plan regulations. 62Q.732 Citation Addresses citation under Minnesota health plan regulations. 62Q.733 Definitions Defines key terms used in Minnesota's health plan regulation laws. 62Q.734 Exemption Sets exemption from certain health plan requirements. 62Q.735 Provider Contracting Procedures Governs provider contracting procedures requirements for health plans. 62Q.736 Payment Rates Regulates payment rates for health plans in Minnesota. 62Q.737 Service Code Changes Addresses service code changes under Minnesota health plan regulations. 62Q.739 Unilateral Terms Prohibited Addresses unilateral terms prohibited under Minnesota health plan regulations. 62Q.74 Network Shadow Contracting Governs network shadow contracting requirements for health plans. 62Q.745 This section is reserved or has been repealed in the health plan regulation chapter. 62Q.746 Access to Certain Information Regarding Providers Governs access to certain information regarding providers requirements for health plans. 62Q.75 Prompt Payment Required Addresses prompt payment required under Minnesota health plan regulations. 62Q.751 Collecting Deductibles and Coinsurance Regulates collecting deductibles and coinsurance in health plans. 62Q.76 Definitions Defines key terms used in Minnesota's health plan regulation laws. 62Q.77 Terms of Coverage Disclosure Requires terms of coverage disclosure from health plans to consumers. 62Q.78 Dental Benefit Plan Requirements Addresses dental benefit plan requirements coverage in health plans. 62Q.79 Limitations Addresses limitations under Minnesota health plan regulations. 62Q.80 Community-based Health Care Coverage Program Addresses community-based health care coverage program under Minnesota health plan regulations. 62Q.81 Essential Health Benefit Package Requirements Addresses essential health benefit package requirements under Minnesota health plan regulations. 62Q.82 Benefits and Coverage Explanation Addresses benefits and coverage explanation under Minnesota health plan regulations. 62Q.83 Formulary Changes Regulates formulary changes in health plans.