Minnesota Administrative Rules
Agency 144 - Health Department
Chapter 4688 - ESSENTIAL COMMUNITY PROVIDERS
Part 4688.0050 - REQUIREMENTS FOR CONTRACTS WITH HEALTH PLAN COMPANIES

Universal Citation: MN Rules 4688.0050
Current through Register Vol. 49, No. 13, September 23, 2024

A health plan company that contracts with providers shall offer a provider contract to all designated ECPs located within the health plan company's approved service area. An ECP shall agree to serve, with or without a contract, all health plan companies within whose approved service area the ECP is located. The provider contract shall be the same or substantially similar to those offered to health plan providers who provide the same type or category of services, unless the parties mutually agree to a different contract. The provider contract shall include all of the services designated by the commissioner to the extent the services are covered under any health plan company certificate of coverage. Every provider contract between a designated ECP and a health maintenance organization or community integrated service network shall contain the provisions of Minnesota Statutes, section 62D.123. Designation of an applicant as an ECP shall not directly or indirectly require a health plan company to contract with a related organization that is affiliated with the designated ECP but is neither designated nor eligible for designation as an ECP. For the purposes of parts 4688.0001 to 4688.0160, "related organization" has the meaning given in Minnesota Statutes, section 317A.011, subdivision 18.

Statutory Authority: MS s 62Q.19

Disclaimer: These regulations may not be the most recent version. Minnesota may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.