Minnesota § 62Q.731 APPEAL FROM ADVERSE DETERMINATION

Minnesota Statutes

§ 62Q.731 — APPEAL FROM ADVERSE DETERMINATION

Minnesota § 62Q.731

PartINSURANCE

Ch. 62QHEALTH PLAN COMPANIES

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Bluebook

Minn. Stat. § 62Q.731 (2026).

Text

Subdivision 1.Definitions.

(a)For purposes of this section, the terms defined in this subdivision have the meanings given.

(b)"Enrollee" means an eligible person as defined in section62E.02, subdivision 13, and who meets the eligibility criteria established in section62E.14.

(c)"Board" means the board of directors of the Comprehensive Health Association, as described in section62E.10, subdivision 2. Subd. 2.Appeal to external review entity. If an enrollee receives an adverse determination as a result of the Comprehensive Health Association's internal appeal process, by which an established enrollee appeal committee renders an adverse determination, the enrollee then has the option of:

(1)appealing the adverse determination to the external review entity under section62Q.73, which shal

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Subdivision 1.Definitions.
(a) For purposes of this section, the terms defined in this subdivision have the meanings given.
(b) "Enrollee" means an eligible person as defined in section62E.02, subdivision 13, and who meets the eligibility criteria established in section62E.14.
(c) "Board" means the board of directors of the Comprehensive Health Association, as described in section62E.10, subdivision 2.

Subd. 2.Appeal to external review entity.
If an enrollee receives an adverse determination as a result of the Comprehensive Health Association's internal appeal process, by which an established enrollee appeal committee renders an adverse determination, the enrollee then has the option of:
(1) appealing the adverse determination to the external review entity under section62Q.73, which shall constitute a final determination subject to the conditions specified in section62Q.73; or
(2) appealing to the commissioner of commerce from an adverse determination as provided by the operating rules of the Comprehensive Health Association, in which case the commissioner has the option of making a determination regarding the appeal, or submitting the appeal to the external review entity retained under section62Q.73.