Minn. Stat. § 62M.18

Current through 2024, c. 127
Section 62M.18 - ANNUAL POSTING ON WEBSITE; PRIOR AUTHORIZATIONS
(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.

Minn. Stat. § 62M.18

Added by 2020 Minn. Laws, ch. 114,s 1-20, eff. 1/1/2021.