Minnesota Administrative Rules

4654.0300 PROVIDER SUBMISSION REQUIREMENTS.

Subpart 1.

Physician clinics.

A.

Each physician clinic, except ambulatory surgical centers, must register annually with the commissioner or commissioner's designee beginning January 1, 2010, as specified in Appendix E.

B.

Each physician clinic, except ambulatory surgical centers, must submit to the commissioner or commissioner's designee data required to calculate the applicable quality measures, including the data necessary to perform risk adjustment for each applicable quality measure in Appendix A, which is incorporated by reference in part 4654.0800, according to the schedule for each measure in Appendix A for all health care services provided by the physician clinic. The physician clinic must submit the data using the standardized electronic format and procedures specified in Appendix E, which is incorporated by reference in part 4654.0800.

C.

Each physician clinic with an electronic medical record in place for an entire measurement period must report on a full population basis in the subsequent reporting cycle.

D.

If less than ten percent of a physician clinic's population is age 18 or older, that physician clinic is exempt from reporting on quality measures in Appendix A applicable to patients age 18 or older.

Subp. 2.

Hospitals.

A.

Each hospital must submit to the commissioner or commissioner's designee data required to calculate the applicable quality measures, including the data necessary to perform risk adjustment for each applicable quality measure in Appendix B, which is incorporated by reference in part 4654.0800, according to the schedule for each measure in Appendix B for all relevant health care services provided by the hospital. The hospital must submit the data using the standardized electronic format and procedures specified in Appendix E, which is incorporated by reference in part 4654.0800.

B.

If less than ten percent of a hospital's patient population is age 18 or older, that hospital is exempt from reporting on quality measures in Appendix B applicable to patients age 18 or older.

Subp. 3.

Ambulatory surgical centers.

Each ambulatory surgical center must register annually with the commissioner or commissioner's designee as specified in Appendix E. Each ambulatory surgical center must submit to the commissioner or commissioner's designee data required to calculate the applicable quality measures, including the data necessary to perform risk adjustment for each applicable quality measure in Appendix C, which is incorporated by reference in part 4654.0800, according to the schedule for each measure in Appendix C for all health care services provided by the ambulatory surgical center. The ambulatory surgical center must submit the data using the standardized electronic format and procedures specified in Appendix E, which is incorporated by reference in part 4654.0800.

Subp. 4.

Provider subcontractors.

The commissioner or commissioner's designee will accept data submitted on behalf of a provider by a single subcontractor.

Statutory Authority:

MS s 62U.02; 62U.06

History:

34 SR 905; 35 SR 802; 38 SR 848

Published Electronically:

December 16, 2013