No individual who is performing utilization review may receive any financial incentive based on the number of adverse determinations made by such individual, provided that utilization review organizations may establish medically appropriate performance standards. This prohibition does not apply to financial incentives established between health plan companies and providers.
1992 c 574 s 12; 1999 c 239 s 30; 2020 c 114 art 2 s 16
Structure Minnesota Statutes
Chapters 59A - 79A — Insurance
Chapter 62M — Utilization Review Of Health Care
Section 62M.01 — Citation, Jurisdiction, And Scope.
Section 62M.03 — Compliance With Standards.
Section 62M.04 — Standards For Utilization Review Performance.
Section 62M.05 — Procedures For Review Determination.
Section 62M.06 — Appeals Of Adverse Determinations.
Section 62M.07 — Prior Authorization Of Services.
Section 62M.072 — Use Of Evidence-based Standards.
Section 62M.08 — Confidentiality.
Section 62M.09 — Staff And Program Qualifications.
Section 62M.10 — Accessibility And On-site Review Procedures.
Section 62M.11 — Complaints To Commerce Or Health.
Section 62M.12 — Prohibition Of Inappropriate Incentives.
Section 62M.13 — Severability.
Section 62M.14 — Effect Of Compliance.
Section 62M.15 — Applicability Of Other Chapter Requirements.
Section 62M.17 — Continuity Of Care; Prior Authorizations.
Section 62M.18 — Annual Posting On Website; Prior Authorizations.