1.1                          A bill for an act 
  1.2             relating to insurance; creating a statewide health 
  1.3             care consumer assistance program; modifying the 
  1.4             complaint process for health plan companies; requiring 
  1.5             disclosure of health care provider financial 
  1.6             incentives; appropriating money; amending Minnesota 
  1.7             Statutes 1996, sections 62Q.105; 62Q.106; and 62Q.30; 
  1.8             proposing coding for new law in Minnesota Statutes, 
  1.9             chapters 62J; and 62Q; repealing Minnesota Statutes 
  1.10            1996, section 62Q.11. 
  1.11  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.12     Section 1.  [LEGISLATIVE INTENT.] 
  1.13     It is the intent of the legislature in the Patient 
  1.14  Protection Act to establish additional state consumer 
  1.15  protections and assistance relating to the coverage for and 
  1.16  delivery of health care treatment and services that will 
  1.17  supplement and complement existing laws and regulations and 
  1.18  further ensure that no patient receiving services or treatment 
  1.19  within Minnesota will be harmed by inappropriate health care 
  1.20  practices or treatment, and to provide improved assistance to 
  1.21  consumers and patients who have questions or problems relating 
  1.22  to their health care coverage or treatment. 
  1.23     Sec. 2.  [62J.695] [CITATION.] 
  1.24     Sections 62J.70 to 62J.72 may be cited as the "Patient 
  1.25  Protection Act." 
  1.26     Sec. 3.  [62J.70] [DEFINITIONS.] 
  1.27     Subdivision 1.  [APPLICABILITY.] For purposes of sections 
  1.28  62J.70 to 62J.72, the terms defined in this subdivision have the 
  2.1   meanings given them. 
  2.2      Subd. 2.  [HEALTH CARE PROVIDER OR PROVIDER.] "Health care 
  2.3   provider" or "provider" means: 
  2.4      (1) a physician, nurse, or other provider as defined under 
  2.5   section 62J.03; 
  2.6      (2) a hospital as defined under section 144.696, 
  2.7   subdivision 3; 
  2.8      (3) an individual or entity that provides health care 
  2.9   services under the medical assistance, general assistance 
  2.10  medical care, MinnesotaCare, or state employee group insurance 
  2.11  program; and 
  2.12     (4) an association, partnership, corporation, limited 
  2.13  liability corporation, or other organization of persons or 
  2.14  entities described in clause (1) or (2) organized for the 
  2.15  purposes of providing, arranging, or administering health care 
  2.16  services or treatment.  
  2.17     This section does not apply to trade associations, 
  2.18  membership associations of health care professionals, or other 
  2.19  organizations that do not directly provide, arrange, or 
  2.20  administer health care services or treatment. 
  2.21     Subd. 3.  [HEALTH PLAN COMPANY.] "Health plan company" 
  2.22  means a health plan company as defined under section 62Q.01, 
  2.23  subdivision 4.  
  2.24     Subd. 4.  [ENROLLEE.] "Enrollee" means an individual 
  2.25  covered by a health plan company, health insurance or health 
  2.26  coverage plan and includes an insured, policyholder, subscriber, 
  2.27  contract holder, member, covered person, or certificate holder. 
  2.28     Sec. 4.  [62J.71] [DISCLOSURE OF HEALTH CARE PROVIDER 
  2.29  INFORMATION.] 
  2.30     Subdivision 1.  [WRITTEN DISCLOSURE.] A health plan 
  2.31  company, a health care network cooperative as defined under 
  2.32  section 62R.04, subdivision 3, and a health care provider as 
  2.33  defined under section 62J.70, subdivision 2, shall, upon 
  2.34  enrollment, and annually thereafter, provide enrollees with a 
  2.35  description of the general nature of the reimbursement 
  2.36  methodologies used by the health plan company, health insurance 
  3.1   or health coverage plan to pay providers.  This description may 
  3.2   be incorporated into the member handbook, subscriber contract, 
  3.3   or certificate of coverage.  Upon request, a health plan company 
  3.4   or provider must provide an enrollee or patient with specific 
  3.5   information regarding the reimbursement methodology, including, 
  3.6   but not limited to, the following information: 
  3.7      (1) a concise written description of any provider payment 
  3.8   plan, including any incentive plan applicable to the enrollee; 
  3.9      (2) a written description of any incentive available to the 
  3.10  provider relating to the provision of health care services to 
  3.11  patients, including any compensation arrangement that is 
  3.12  dependent on the amount of health coverage or health care 
  3.13  services provided to a patient, or the number of referrals to or 
  3.14  utilization of specialists; and 
  3.15     (3) a written description of any incentive plan that 
  3.16  involves the transfer of financial risk to a health care 
  3.17  provider. 
  3.18     Nothing in this subdivision prohibits a contract provision 
  3.19  that requires any contracting party to keep confidential or to 
  3.20  not disclose proprietary information of a specific health plan 
  3.21  company, health insurance or health coverage plan. 
  3.22     Subd. 2.  [INFORMATION ON PATIENTS' MEDICAL BILLS.] A 
  3.23  health plan company and health care provider shall provide 
  3.24  patients and enrollees with a copy of an itemized and 
  3.25  intelligible bill whenever the patient or enrollee is sent a 
  3.26  bill and is responsible for paying any portion of that bill.  
  3.27  The bills must contain descriptive language sufficient to be 
  3.28  understood by the average patient or enrollee.  This subdivision 
  3.29  does not apply to a flat co-pay amount paid by the patient at 
  3.30  the time the service is required. 
  3.31     Subd. 3.  [NONAPPLICABILITY.] Health care providers as 
  3.32  defined in section 62J.70, subdivision 2, clause (1), need not 
  3.33  individually provide information required under this section if 
  3.34  it has been provided by another entity that is subject to this 
  3.35  section. 
  3.36     Sec. 5.  [62J.72] [HEALTH CARE CONSUMER ASSISTANCE 
  4.1   PROGRAM.] 
  4.2      Subdivision 1.  [ESTABLISHMENT.] The commissioners of 
  4.3   health and commerce, in consultation with the commissioner of 
  4.4   human services, shall establish a statewide program to provide 
  4.5   assistance to consumers, patients, or enrollees with complaints 
  4.6   or problems relating to their health care or health coverage 
  4.7   plan.  The program shall include a statewide toll-free telephone 
  4.8   number.  
  4.9      Subd. 2.  [SELECTION CRITERIA.] The commissioner of 
  4.10  administration shall contract with an agency, organization, or 
  4.11  consortium of organizations to operate the health care consumer 
  4.12  assistance program.  The commissioner shall not contract with an 
  4.13  agency, organization, or consortium that:  
  4.14     (1) has a direct involvement in the licensing, 
  4.15  certification, or accreditation of a health care facility, 
  4.16  health plan company, or health care provider; 
  4.17     (2) has a direct ownership or financial interest in a 
  4.18  health care facility, health plan company, or in providing, 
  4.19  arranging, or administering health care services or treatment; 
  4.20  or 
  4.21     (3) is employed by or is under contract to provide 
  4.22  management services to a health care facility, health plan 
  4.23  company, or an entity that provides, arranges, or administers 
  4.24  health care services or treatment.  
  4.25     Subd. 3.  [FUNCTIONS.] The health care consumer assistance 
  4.26  program shall provide assistance to all health care consumers: 
  4.27     (1) by informing consumers about their health care program 
  4.28  or health coverage plan; 
  4.29     (2) in obtaining appropriate referrals and information to 
  4.30  enable consumers to assert their rights as patients; 
  4.31     (3) in obtaining information and outcomes data on health 
  4.32  plan company and health care provider performances; 
  4.33     (4) by identifying and monitoring trends in patient 
  4.34  complaints about health care coverage and services; 
  4.35     (5) by providing patients referrals to another state 
  4.36  consumer assistance, ombudsman, or advocacy service whenever 
  5.1   possible; and 
  5.2      (6) by assisting patients in understanding their 
  5.3   contractual and legal rights, including the rights under the 
  5.4   dispute resolution process.  This assistance can include 
  5.5   advocacy for patients in administrative proceedings or other 
  5.6   formal dispute resolution processes, where appropriate.  
  5.7      Subd. 4.  [CONSUMER ADVISORY BOARD.] (a) The consumer 
  5.8   advisory board consists of 18 members appointed in accordance 
  5.9   with paragraph (b).  All members must be public, consumer 
  5.10  members who: 
  5.11     (1) do not have and never had a material interest in either 
  5.12  health care services, such as health insurance sales or health 
  5.13  plan administration; and 
  5.14     (2) are not registered lobbyists. 
  5.15     (b) The governor, the speaker of the house of 
  5.16  representatives, and the subcommittee on committees of the 
  5.17  committee on rules and administration of the senate shall each 
  5.18  appoint two members.  The Indian affairs council, the council on 
  5.19  affairs of Chicano/Latino people, the council on Black 
  5.20  Minnesotans, the council on Asian-Pacific Minnesotans, 
  5.21  mid-Minnesota legal assistance, and the Minnesota chamber of 
  5.22  commerce shall each appoint one member.  The member appointed by 
  5.23  the Minnesota chamber of commerce must represent small business 
  5.24  interests.  The health care campaign of Minnesota, Minnesotans 
  5.25  for affordable health care, and consortium for citizens with 
  5.26  disabilities shall each appoint two members.  Members serve 
  5.27  without compensation or reimbursement for expenses. 
  5.28     (c) The board shall: 
  5.29     (1) advise the commissioner in preparing a request for 
  5.30  proposals for the contract required by subdivision 2; 
  5.31     (2) make recommendations to the commissioner and the 
  5.32  operator of the health care consumer assistance program during 
  5.33  its implementation and operation, including recommendations on 
  5.34  future funding levels and mechanisms; and 
  5.35     (3) report to the legislature by January 15 of each year on 
  5.36  the level of consumer protections contained in self-insured 
  6.1   plans and on trends in patient complaints and resolution of 
  6.2   those complaints.  The board and this subdivision expire June 
  6.3   30, 2001. 
  6.4      Subd. 5.  [IMMUNITY.] Employees of the health care consumer 
  6.5   assistance program, or persons employed by an entity contracting 
  6.6   with the health care consumer assistance program, are not liable 
  6.7   for actions taken within the scope of their authority if the 
  6.8   actions are taken in good faith and do not constitute willful or 
  6.9   reckless misconduct. 
  6.10     Sec. 6.  Minnesota Statutes 1996, section 62Q.105, is 
  6.11  amended to read: 
  6.12     62Q.105 [HEALTH PLAN COMPANY COMPLAINT PROCEDURE.] 
  6.13     Subdivision 1.  [ESTABLISHMENT.] Each health plan company 
  6.14  shall establish and make available to enrollees, by July 1, 
  6.15  1997, an informal complaint resolution process that meets the 
  6.16  requirements of this section.  A health plan company must make 
  6.17  reasonable efforts to resolve enrollee complaints, and must 
  6.18  inform complainants in writing of the company's decision and the 
  6.19  reasons for it within 30 days of receiving the complaint.  The 
  6.20  complaint resolution process must treat the complaint and 
  6.21  information related to it as required under sections 72A.49 to 
  6.22  72A.505. 
  6.23     Subd. 2.  [MEDICALLY URGENT COMPLAINTS.] A medically urgent 
  6.24  complaint involves medically necessary care which does not meet 
  6.25  the definition of emergency care but is needed as soon as 
  6.26  possible, usually within 24 hours, to protect the health of the 
  6.27  enrollee.  Health plan companies shall make reasonable efforts 
  6.28  to promptly resolve medically urgent enrollee complaints ~~within~~ 
  6.29  ~~72 hours~~ and promptly notify the enrollee and the commissioner 
  6.30  of their decisions, but in no case later than three business 
  6.31  days of receiving the complaint. 
  6.32     Subd. 3.  [APPEALS PROCESS.] Health plan companies shall 
  6.33  establish and make available to enrollees an ~~impartial~~ internal 
  6.34  appeals process.  If a decision by a health plan company 
  6.35  regarding a complaint is partially or wholly adverse to the 
  6.36  complainant, the health plan company shall advise the 
  7.1   complainant of ~~the right to~~ additional appeal ~~through the~~ 
  7.2   ~~impartial appeals process or to the commissioner.~~ mechanisms 
  7.3   under this section.  The person or persons conducting the appeal 
  7.4   must have the authority to resolve or recommend the resolution 
  7.5   of the complaint and must not be solely the person or persons 
  7.6   who decided the enrollee's original complaint.  A health plan 
  7.7   company must inform the enrollee of the outcome of an internal 
  7.8   appeal in writing, and the reasons for it, within 45 days of 
  7.9   receiving the appeal.  A health plan company must explain 
  7.10  Medicare appeal procedures to its Medicare enrollees.  For 
  7.11  persons enrolled in health care programs established under 
  7.12  section 256.9363, 256B.69, or 256D.03, a health plan company 
  7.13  must explain how to contact the managed care ombudsman at the 
  7.14  department of human services. 
  7.15     Subd. 4.  [ALTERNATIVE DISPUTE RESOLUTION.] Health plan 
  7.16  companies shall make available to enrollees an alternative 
  7.17  dispute resolution process according to subdivision 10 to appeal 
  7.18  health plan company internal appeal decisions, and shall 
  7.19  participate in that alternative dispute resolution at the 
  7.20  request of an enrollee~~, as required under section 62Q.11~~.  A 
  7.21  health plan company must respond within 14 days of receiving the 
  7.22  enrollee's request for alternative dispute resolution and inform 
  7.23  the enrollee of the options available.  A health plan company 
  7.24  may meet the requirements of subdivision 3 by providing an 
  7.25  alternative dispute resolution process~~.  If the health plan~~ 
  7.26  ~~company chooses to provide alternative dispute resolution to~~ 
  7.27  ~~meet the requirements of subdivision 3, the process shall be~~ 
  7.28  ~~provided~~ at no cost to the enrollee. 
  7.29     Subd. 5.  [REQUIREMENTS FOR MANAGED CARE ORGANIZATIONS.] 
  7.30  Each managed care organization shall submit all health care 
  7.31  quality related complaints to its quality review board or 
  7.32  quality review organization for evaluation and possible action.  
  7.33  The complaint resolution process for managed care organizations 
  7.34  must clearly indicate the entity responsible for resolving 
  7.35  complaints made by enrollees against hospitals, other health 
  7.36  care facilities, and health care providers, that are owned by or 
  8.1   under contract with the managed care organization. 
  8.2      Subd. 6.  [RECORDKEEPING.] Health plan companies shall 
  8.3   maintain records of all enrollee complaints and their 
  8.4   resolutions.  These records must be retained for five years, and 
  8.5   must be made available to the ~~appropriate~~ commissioner upon 
  8.6   request. 
  8.7      Subd. 7.  [REPORTING.] Each health plan company shall 
  8.8   submit to the ~~appropriate~~ commissioner, as part of the company's 
  8.9   annual filing, data on the number and type of complaints that 
  8.10  are not resolved within 30 days.  A health plan company shall 
  8.11  also make this information available to the public upon request. 
  8.12     Subd. 8.  [NOTICE TO ENROLLEES.] Health plan companies 
  8.13  shall provide a clear and complete description of their 
  8.14  complaint resolution procedures to enrollees as part of their 
  8.15  evidence of coverage or contract.  The description must 
  8.16  specifically inform enrollees: 
  8.17     (1) how to file a complaint with the health plan company; 
  8.18     (2) how to request an ~~impartial~~ internal appeal; 
  8.19     (3) how to appeal to or file a complaint with the 
  8.20  commissioner and that they have the right to request the use of 
  8.21  alternative methods of dispute resolution following an internal 
  8.22  appeal; and 
  8.23     (4) that they have the right to litigate. 
  8.24     Subd. 9.  [PROCEDURE.] (a) When an enrollee files a 
  8.25  complaint with the health plan company and receives the written 
  8.26  response to the complaint, the enrollee may appeal through the 
  8.27  health plan company's internal appeal process. 
  8.28     (b) When an enrollee files a complaint with the 
  8.29  commissioner, the commissioner shall investigate the complaint 
  8.30  and inform the enrollee and the health plan company of the 
  8.31  commissioner's decision.  An enrollee who receives the 
  8.32  commissioner's decision may appeal through the health plan 
  8.33  company's internal appeal process. 
  8.34     (c) An enrollee may appeal the result of the health plan 
  8.35  company's internal appeal process to the commissioner or to 
  8.36  alternative dispute resolution. 
  9.1      (d) Procedures under this section are stayed when an 
  9.2   enrollee files suit, including suit in conciliation court, 
  9.3   against a health plan company, or when the enrollee makes the 
  9.4   health plan company a party to the enrollee's suit against 
  9.5   another party concerning the facts giving rise to the enrollee's 
  9.6   complaint.  Upon a decision on the merits, the enrollee shall be 
  9.7   deemed to have waived the remedies under this section.  If an 
  9.8   enrollee's case is dismissed for reasons other than on the 
  9.9   merits or if the enrollee and health plan company agree, an 
  9.10  enrollee may access the procedures under this section. 
  9.11     Subd. 10.  [ENROLLEE DISPUTE RESOLUTION.] (a) For purposes 
  9.12  of this section and chapter 62D, "alternative dispute 
  9.13  resolution" means the methods listed and defined in Minnesota 
  9.14  General Rules of Practice, rule 114. 
  9.15     (b) Alternative dispute resolution is binding, unless the 
  9.16  parties mutually agree in advance in writing that alternative 
  9.17  dispute resolution is not binding. 
  9.18     (c) Enrollee complaints regarding employer initiated 
  9.19  actions, agent misrepresentation, or premiums are not subject to 
  9.20  alternative dispute resolution.  A medical malpractice damage 
  9.21  claim is not subject to alternative dispute resolution unless 
  9.22  agreed to by all parties subsequent to the event giving rise to 
  9.23  the claim. 
  9.24     (d) A health plan company shall inform and educate its 
  9.25  enrollees about alternative dispute resolution and its benefits. 
  9.26     (e) The enrollee and the health plan company shall mutually 
  9.27  agree to the alternative dispute method to resolve the 
  9.28  enrollee's appeal within 14 days of the enrollee's receipt of 
  9.29  alternative dispute resolution options.  Mediation-arbitration 
  9.30  shall be used if the enrollee and the health plan company cannot 
  9.31  agree.  The alternative dispute resolution must be scheduled as 
  9.32  soon as possible after the parties agree to a method.  A health 
  9.33  plan company must inform the enrollee of the outcome of an 
  9.34  alternative dispute resolution in writing, and the reasons for 
  9.35  it, within ten calendar days of receiving the outcome from the 
  9.36  alternative dispute resolution provider. 
 10.1      Subd. 11.  [PROVIDER DISPUTE RESOLUTION.] When a health 
 10.2   care provider under a contract has a dispute with a health plan 
 10.3   company that is governed neither by the federal Health Care 
 10.4   Quality Improvement Act of 1986, United States Code, title 42, 
 10.5   sections 11101 to 11152, nor by a contract between the provider 
 10.6   and the health plan company, the provider may request an 
 10.7   alternative dispute resolution process.  The health plan company 
 10.8   must participate.  The health care provider and the health plan 
 10.9   company shall mutually agree to one of the alternative dispute 
 10.10  resolution methods listed in subdivision 10 within 30 calendar 
 10.11  days of the health plan company receiving the request for 
 10.12  alternative dispute resolution.  If the provider and the health 
 10.13  plan company cannot agree on the alternative dispute resolution 
 10.14  method, mediation-arbitration shall be used.  Alternative 
 10.15  dispute resolution under this subdivision is binding unless the 
 10.16  parties mutually agree in advance in writing that alternative 
 10.17  dispute resolution is not binding. 
 10.18     Sec. 7.  Minnesota Statutes 1996, section 62Q.106, is 
 10.19  amended to read: 
 10.20     62Q.106 [~~DISPUTE RESOLUTION BY COMMISSIONER~~ COMMISSIONER'S 
 10.21  RESPONSIBILITY TO INVESTIGATE ENROLLEE COMPLAINTS.] 
 10.22     A complainant may at any time prior to binding alternative 
 10.23  dispute resolution or a judicial decision on the merits, submit 
 10.24  a complaint to the ~~appropriate~~ commissioner to investigate.  The 
 10.25  commissioner may investigate an enrollee complaint or enrollee 
 10.26  appeal of the health plan company's internal appeal decision.  
 10.27  When the complaint concerns the health plan company's decision 
 10.28  to not cover a service, the appropriate commissioner may review 
 10.29  the complaint and any information, including testimony, 
 10.30  necessary to resolve the complaint.  After investigating a 
 10.31  complaint, or reviewing a company's decision, the ~~appropriate~~ 
 10.32  commissioner may order a remedy as authorized under section 
 10.33  ~~62N.04,~~ 62Q.30, chapter 45, 60A, or 62D. 
 10.34     Sec. 8.  Minnesota Statutes 1996, section 62Q.30, is 
 10.35  amended to read: 
 10.36     62Q.30 [EXPEDITED FACT FINDING AND DISPUTE RESOLUTION 
 11.1   PROCESS.] 
 11.2      (a) The commissioner shall establish an expedited fact 
 11.3   finding and dispute resolution process to assist enrollees of 
 11.4   health plan companies with contested medically urgent treatment, 
 11.5   coverage, and service issues to be in effect July 1, 
 11.6   1997.  "Medically urgent" has the meaning given in section 
 11.7   62Q.105, subdivision 2. 
 11.8      (b) The commissioner may order ~~an integrated service~~ 
 11.9   ~~network or an all-payer insurer~~ a health plan company to provide 
 11.10  or pay for a service that is ~~within the standard health coverage~~ 
 11.11  either required to be provided by law or covered under the 
 11.12  enrollee's evidence of coverage.  The commissioner shall take 
 11.13  steps including, but not limited to, fining, suspending, or 
 11.14  revoking the license of a health plan company that is the 
 11.15  subject of repeated orders by the commissioner that suggest a 
 11.16  pattern of inappropriate underutilization. 
 11.17     (c) If the disputed issue relates to whether a service is 
 11.18  appropriate and necessary, the commissioner shall issue an order 
 11.19  only after consulting with appropriate experts knowledgeable, 
 11.20  trained, and practicing in the area in dispute, reviewing 
 11.21  pertinent literature, and considering the availability of 
 11.22  satisfactory alternatives.  ~~The commissioner shall take steps~~ 
 11.23  ~~including but not limited to fining, suspending, or revoking the~~ 
 11.24  ~~license of a health plan company that is the subject of repeated~~ 
 11.25  ~~orders by the commissioner that suggests a pattern of~~ 
 11.26  ~~inappropriate underutilization.~~ 
 11.27     (d) Procedures under this section are stayed when an 
 11.28  enrollee files suit, including suit in conciliation court, 
 11.29  against a health plan company or when the enrollee makes the 
 11.30  health plan company a party to the enrollee's suit against 
 11.31  another party concerning the facts giving rise to the enrollee's 
 11.32  complaint.  Upon a decision on the merits, the enrollee shall be 
 11.33  deemed to have waived the remedies under this section.  If an 
 11.34  enrollee's case is dismissed for reasons other than on the 
 11.35  merits or if the enrollee and the health plan company agree, an 
 11.36  enrollee may access the procedures under this section. 
 12.1      Sec. 9.  [62Q.53] [EMERGENCY SERVICES.] 
 12.2      (a) Enrollees have the right to available and accessible 
 12.3   services, including emergency services, 24 hours a day and seven 
 12.4   days a week.  The health plan company shall inform its enrollees 
 12.5   how to obtain emergency care and shall make available a 
 12.6   toll-free number, which is answered 24 hours a day, to answer 
 12.7   questions about emergency services and to receive reports and 
 12.8   provide authorizations, where appropriate, for treatment of 
 12.9   emergency medical conditions.  Emergency services shall be 
 12.10  covered whether provided by participating or nonparticipating 
 12.11  providers and whether provided within or outside the health plan 
 12.12  company's service area.  In determining whether care is 
 12.13  reimbursable as an emergency medical condition, the health plan 
 12.14  company shall take the following factors into consideration: 
 12.15     (1) a reasonable layperson's belief that the circumstances 
 12.16  required immediate medical care that could not wait until the 
 12.17  next working day or next available clinic appointment; 
 12.18     (2) the time of day and day of the week the care was 
 12.19  provided; 
 12.20     (3) the presenting symptoms, including, but not limited to, 
 12.21  severe pain, to ensure that the decision to reimburse the 
 12.22  emergency care is not made solely on the basis of the actual 
 12.23  diagnosis; 
 12.24     (4) the enrollee's efforts to follow the health plan 
 12.25  company's established procedures for obtaining emergency care; 
 12.26  and 
 12.27     (5) any circumstances that precluded use of the health plan 
 12.28  company's established procedures for obtaining emergency care. 
 12.29     (b) The health plan company may require enrollees to notify 
 12.30  the health plan company of nonreferred emergency care as soon as 
 12.31  possible, but not less than 48 hours, after the emergency care 
 12.32  is initially provided.  However, emergency care which would have 
 12.33  been provided under the contract had notice been provided within 
 12.34  the set time frame must be covered. 
 12.35     (c) Notwithstanding paragraphs (a) and (b), a health plan 
 12.36  company, health insurance, or health coverage plan that is in 
 13.1   compliance with the rules regarding accessibility of services 
 13.2   adopted under section 62D.20 is in compliance with this section. 
 13.3      Sec. 10.  [APPROPRIATION.] 
 13.4      $....... is appropriated from the general fund to the 
 13.5   commissioner of administration to contract for the operation of 
 13.6   the health care consumer assistance program described in section 
 13.7   5.  The appropriation is available until expended. 
 13.8      Sec. 11.  [REPEALER.] 
 13.9      Minnesota Statutes 1996, section 62Q.11, is repealed.