Minnesota Session Laws - 1997, Regular Session

                             CHAPTER 49-H.F.No. 645 
                  An act relating to insurance; providing a uniform 
                  minimum definition of medically necessary care for 
                  mental health coverage in health plans; proposing 
                  coding for new law in Minnesota Statutes, chapter 62Q. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  [62Q.53] [MENTAL HEALTH COVERAGE; MINIMUM 
        STANDARDS FOR MEDICALLY NECESSARY CARE.] 
           Subdivision 1.  [REQUIREMENT.] No health plan that covers 
        mental health services may be offered, sold, issued, or renewed 
        in this state that requires mental health services to satisfy a 
        definition of "medically necessary care," "medical necessity," 
        or similar term that is more restrictive with respect to mental 
        health than the definition provided in subdivision 2. 
           Subd. 2.  [MINIMUM DEFINITION.] "Medically necessary care" 
        means health care services appropriate, in terms of type, 
        frequency, level, setting, and duration, to the enrollee's 
        diagnosis or condition, and diagnostic testing and preventive 
        services.  Medically necessary care must be consistent with 
        generally accepted practice parameters as determined by health 
        care providers in the same or similar general specialty as 
        typically manages the condition, procedure, or treatment at 
        issue and must: 
           (1) help restore or maintain the enrollee's health; or 
           (2) prevent deterioration of the enrollee's condition.  
           Subd. 3.  [HEALTH PLAN; DEFINITION.] For purposes of this 
        section, "health plan" has the meaning given in section 62Q.01, 
        subdivision 3, but includes the coverages listed in section 
        62A.011, subdivision 3, clauses (7) and (10). 
           Sec. 2.  [EFFECTIVE DATE.] 
           Section 1 is effective January 1, 1998, and applies to 
        health plans issued or renewed on or after that date. 
           Presented to the governor April 21, 1997 
           Signed by the governor April 23, 1997, 1:30 p.m.