Legislative Session number- 82

Bill Name: SF0414

E Modifying certain provisions under the Minnesota utilization review act;
eliminating the requirement for the attending health care professional to
request the utilization review organization to ensure the qualification of the
reviewing physician in cases of appeal to reverse determinations not to certify
for clinical reasons; requiring physicians conducting the review to be licensed
in the state, exception; exempting determination made in connection with
policies issued by certain health plan companies from mental health and
substance abuse review requirements; requiring physician consultants to be board
certified; requiring utilization review organizations to file reports with the
annual financial statement filed with the commissioner of commerce, specifying
report content requirements; requiring criteria used to determine medical
necessity to be provided to the commissioner; authorizing the board to
investigate allegations and impose certain disciplinary actions against
physicians performing utilization review for a pattern of failure to exercise a
certain degree of care in making determinations (ra, ja)