2007 Minnesota Statutes

62M.01 CITATION, JURISDICTION, AND SCOPE.
    Subdivision 1. Popular name. Sections 62M.01 to 62M.16 may be cited as the "Minnesota
Utilization Review Act of 1992."
    Subd. 2. Jurisdiction. Sections 62M.01 to 62M.16 apply to any insurance company licensed
under chapter 60A to offer, sell, or issue a policy of accident and sickness insurance as defined
in section 62A.01; a health service plan licensed under chapter 62C; a health maintenance
organization licensed under chapter 62D; the Minnesota Comprehensive Health Association
created under chapter 62E; a community integrated service network licensed under chapter 62N;
an accountable provider network operating under chapter 62T; a fraternal benefit society operating
under chapter 64B; a joint self-insurance employee health plan operating under chapter 62H; a
multiple employer welfare arrangement, as defined in section 3 of the Employee Retirement
Income Security Act of 1974 (ERISA), United States Code, title 29, section 1103, as amended; a
third party administrator licensed under section 60A.23, subdivision 8, that provides utilization
review services for the administration of benefits under a health benefit plan as defined in section
62M.02; or any entity performing utilization review on behalf of a business entity in this state
pursuant to a health benefit plan covering a Minnesota resident.
    Subd. 3. Scope. Nothing in sections 62M.01 to 62M.16 applies to review of claims
after submission to determine eligibility for benefits under a health benefit plan. The appeal
procedure described in section 62M.06 applies to any complaint as defined under section 62Q.68,
subdivision 2 , that requires a medical determination in its resolution.
History: 1992 c 574 s 1; 1999 c 239 s 3; 2006 c 255 s 31