HEALTH CARE UTILIZATION REVIEW

Appeals

Consulting physicians, Minn. Statutes 2005 62M.06, 62M.09

Generally, Minn. Statutes 2005 62M.06

Prior authorization, denial, Minn. Statutes 2005 62M.07

Procedures, Minn. Statutes 2005 62M.06, 62M.07

Reporting requirements, Minn. Statutes 2005 62M.09

Utilization Review Act, Minn. Statutes 2005 62M.01

Attending health care professionals

Appeals, Minn. Statutes 2005 62M.06, 62M.07, 62M.09

Certification, see same under this topic

Clinical criteria, review, Minn. Statutes 2005 62M.09

Data, certification, Minn. Statutes 2005 62M.02

Notice received, Minn. Statutes 2005 62M.04 to 62M.06, 62M.10

On-site reviews, Minn. Statutes 2005 62M.10

Certification

Appeals, Minn. Statutes 2005 62M.06

Audit trails, Minn. Statutes 2005 62M.05

Certification numbers, Minn. Statutes 2005 62M.05

Data, Minn. Statutes 2005 62M.04

Denials

Appeals, Minn. Statutes 2005 62M.06

Attending physician, rights, Minn. Statutes 2005 62M.06

Complaints, enrollees' rights, Minn. Statutes 2005 62D.11, 62M.11

Criteria, Minn. Statutes 2005 62M.05

Financial incentives, Minn. Statutes 2005 62M.12

Grounds, Minn. Statutes 2005 62M.05

Lawsuits, compliance with regulations, effect, Minn. Statutes 2005 62M.14

Notice, Minn. Statutes 2005 62M.05

Review, Minn. Statutes 2005 62M.04

Determinations, notice, Minn. Statutes 2005 62M.05

Notice, Minn. Statutes 2005 62M.04, 62M.05

Outpatient services, Minn. Statutes 2005 62M.09

Providers' failure to supply information, procedures, Minn. Statutes 2005 62M.05

Review, Minn. Statutes 2005 62M.04, 62M.05

Claimants

Notice received, certification, denial, Minn. Statutes 2005 62M.05

Claims administrators

Contracts, utilization review certification, Minn. Statutes 2005 62M.04

Notice given, Minn. Statutes 2005 62M.05, 62M.06

Notice received, Minn. Statutes 2005 62M.05 to 62M.07

Prior authorization, Minn. Statutes 2005 62M.07

Concurrent review

Committed persons, rights, Minn. Statutes 2005 253B.03

Generally, Minn. Statutes 2005 62M.02 to 62M.05

Conduct of review, generally, Minn. Statutes 2005 62M.01, 62M.15

Contested cases

Unlicensed organizations, cease and desist orders, Minn. Statutes 2005 62M.03

Continued stay review, Minn. Statutes 2005 62M.02 to 62M.05, 253B.03

County-based purchasing, Minn. Statutes 2005 256B.692

Data, Minn. Statutes 2005 62M.04, 62M.08

Definitions, generally, Minn. Statutes 2005 62M.02

Diagnostic imaging facilities, Minn. Statutes 2005 144.565

Employees

Financial incentives for denials, Minn. Statutes 2005 62M.12

Identification, Minn. Statutes 2005 62M.10

On-site reviews, Minn. Statutes 2005 62M.10

Utilization review organizations, Minn. Statutes 2005 62M.09

Enforcement of law

County-based purchasing, Minn. Statutes 2005 256B.692

Health Department, powers, Minn. Statutes 2005 256B.77

Enrollees

Appeals by, Minn. Statutes 2005 62M.06, 62M.07, 62M.09

Certification review organizations, data sharing, Minn. Statutes 2005 62M.04

Claimants, enrollees defined as, Minn. Statutes 2005 62M.02

Complaints, rights, Minn. Statutes 2005 62D.11, 62M.11

Data, certification, Minn. Statutes 2005 62M.04

Notice given, Minn. Statutes 2005 62M.04, 62M.07

Notice received, Minn. Statutes 2005 62M.05 to 62M.07

On-site reviews, Minn. Statutes 2005 62M.10

Reports received, utilization review organizations, review criteria, Minn. Statutes 2005 62M.10

Unconscious persons, utilization review, Minn. Statutes 2005 62M.02

Fines, unlicensed organizations, Minn. Statutes 2005 62M.03

Health Care Utilization Act, Minn. Statutes 2005 62M.01 to 62M.16

Implementation, timetable, Minn. Statutes 2005 62J.017

Lawsuits, compliance with regulations, effect, Minn. Statutes 2005 62M.14

Licenses, utilization review organizations, Minn. Statutes 2005 62M.03

On-site reviews, Minn. Statutes 2005 62M.10

Orders, unlicensed utilization review organizations

Contested cases, Minn. Statutes 2005 62M.03

Patient services, exclusions, Minn. Statutes 2005 295.50

Prior authorization, Minn. Statutes 2005 62M.02, 62M.07

Procedures, health plan companies, notice, Minn. Statutes 2005 62Q.71

Providers

Agreements, review, procedures, Minn. Statutes 2005 62M.10

Appeals, duties, Minn. Statutes 2005 62M.06, 62M.07

Attending health care professionals, see same under this topic

Certification, see same under this topic

Certification denial, inappropriate incentives, Minn. Statutes 2005 62M.12

Claimants, providers defined as, Minn. Statutes 2005 62M.02

Disciplinary action, Minn. Statutes 2005 147.091

Essential community providers, Minn. Statutes 2005 62Q.19

Failure to provide information, procedures, Minn. Statutes 2005 62M.05

Generally, Minn. Statutes 2005 62M.04

Notice received, Minn. Statutes 2005 62M.05, 62M.07, 62M.10

On-site reviews, Minn. Statutes 2005 62M.10

Prior authorization requests, Minn. Statutes 2005 62M.07

Referrals, Minn. Statutes 2005 62M.02

Reports received, utilization review organizations, review criteria, Minn. Statutes 2005 62M.10

Quality assessment program, Minn. Statutes 2005 62M.02, 62M.09

Review

Concurrent review, Minn. Statutes 2005 62M.02 to 62M.05, 253B.05

On-site review, Minn. Statutes 2005 62M.10

Scope, Minn. Statutes 2005 62M.01

Severability of law, Minn. Statutes 2005 62M.13

Standards

Compliance, Minn. Statutes 2005 62M.03

Generally, Minn. Statutes 2005 62M.04

Integrated children's mental health service system, Minn. Statutes 2005 245.494

Telephones, Minn. Statutes 2005 62M.10

Utilization review organizations

Accountability, delegated activities, clinics or health care systems, Minn. Statutes 2005 62M.02

Agreements, on-site reviews, procedures, Minn. Statutes 2005 62M.10

Annual reports, Minn. Statutes 2005 62M.09

Appeals, Minn. Statutes 2005 62M.06, 62M.07, 62M.09

Certification, see same under this topic

Clinical criteria, Minn. Statutes 2005 62M.02, 62M.09

Contracts, continuing care program, mentally ill persons, Minn. Statutes 2005 256.9693

Delegation of duties, limitations, Minn. Statutes 2005 62M.02

Employees, Minn. Statutes 2005 62M.09

Licensed utilization review organizations, Minn. Statutes 2005 62M.03

Notice given, Minn. Statutes 2005 62M.03, 62M.05, 62M.06, 62M.07, 62M.09

Notice received, Minn. Statutes 2005 62M.04

Payments by, medical records, duplication costs, Minn. Statutes 2005 62M.04

Physician consultants, Minn. Statutes 2005 62M.09

Prior authorization, Minn. Statutes 2005 62M.07

Quality assessment program, Minn. Statutes 2005 62M.02, 62M.09

Reports given, Minn. Statutes 2005 62M.09, 62M.10

Requests, Minn. Statutes 2005 62M.04

Review procedures, Minn. Statutes 2005 62M.05, 62M.09, 62M.10

Standards, Minn. Statutes 2005 62M.03, 62M.04

Unlicensed utilization review organizations, Minn. Statutes 2005 62M.03

Violations and penalties

Disciplinary action, Minn. Statutes 2005 147.091