Minnesota Statutes 62M.18 – Annual Posting On Website; Prior Authorizations
(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:
Terms Used In Minnesota Statutes 62M.18
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
(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.