Minn. Stat. § 62J.805

Current through 2024, c. 127

Section 62J.805 - DEFINITIONS

Subdivision 1.Application.

For purposes of sections 62J.805 to 62J.808, the following terms have the meanings given.

Subd. 2.Billing error.

"Billing error" means an error in a bill from a health care provider to a patient for health treatment or services that affects the amount owed by the patient according to that bill. Billing error includes but is not limited to (1) miscoding a health treatment or service, (2) an error in determining whether a health treatment or service is covered under the patient's health plan, or (3) an error in determining the cost-sharing owed by the patient.

Subd. 3.Group practice.

"Group practice" has the meaning given to health care provider group practice in section 145D.01, subdivision 1.

Subd. 4.Health care provider.

"Health care provider" means:

(1) a health professional who is licensed or registered by the state to provide health treatment and services within the professional's scope of practice and in accordance with state law;

(2) a group practice; or

(3) a hospital.

Subd. 5.Health plan.

"Health plan" has the meaning given in section 62A.011, subdivision 3.

Subd. 6.Hospital.

"Hospital" means a health care facility licensed as a hospital under sections 144.50 to 144.56.

Subd. 7.Medically necessary.

"Medically necessary" means:

(1) safe and effective;

(2) not experimental or investigational, except as provided in Code of Federal Regulations, title 42, section 411.15 (o);

(3) furnished in accordance with acceptable medical standards of medical practice to diagnose or treat the patient's condition, or to improve the function of a malformed body member;

(4) furnished in a setting appropriate to the patient's medical need and condition;

(5) ordered and furnished by qualified personnel;

(6) meets, but does not exceed, the patient's medical need; and

(7) is at least as beneficial as an existing and available medically appropriate alternative.

Subd. 8.Payment.

"Payment" includes co-payments and coinsurance and deductible payments made by a patient.

Minn. Stat. § 62J.805

Added by 2024 Minn. Laws, ch. 114,s 3-25, eff. 10/1/2024.