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Minnesota Statutes Insurance (Ch. 59A-79a) § 62M.18. Annual posting on website; prior authorizations

Current as of January 01, 2023 | Updated by FindLaw Staff

(a) By April 1, 2022, and each April 1 thereafter, a health plan company must post on the health plan company's public website the following data for the immediately preceding calendar year for each commercial product:

(1) the number of prior authorization requests for which an authorization was issued;

(2) the number of prior authorization requests for which an adverse determination was issued and sorted by: (i) health care service; (ii) whether the adverse determination was appealed; and (iii) whether the adverse determination was upheld or reversed on appeal;

(3) the number of prior authorization requests that were submitted electronically and not by facsimile or email or other method pursuant to section 62J.497; and

(4) the reasons for prior authorization denial including but not limited to:

(i) patient did not meet prior authorization criteria;

(ii) incomplete information submitted by the provider to the utilization review organization;

(iii) change in treatment program; and

(iv) the patient is no longer covered by the plan.

(b) All information posted under this section must be written in easily understandable language.

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Cite this article: FindLaw.com - Minnesota Statutes Insurance (Ch. 59A-79a) § 62M.18. Annual posting on website; prior authorizations - last updated January 01, 2023 | https://codes.findlaw.com/mn/insurance-ch-59a-79a/mn-st-sect-62m-18/

Read this complete Minnesota Statutes Insurance (Ch. 59A-79a) § 62M.18. Annual posting on website; prior authorizations on Westlaw. Westlaw subscription required.

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