Minnesota Administrative Rules
Agency 196 - Human Services Department
Chapter 9505 - HEALTH CARE PROGRAMS
HOSPITAL ADMISSIONS CERTIFICATION
Part 9505.0530 - INCORPORATION BY REFERENCE OF CRITERIA TO DETERMINE MEDICAL NECESSITY
Current through Register Vol. 49, No. 13, September 23, 2024
Subpart 1. Determinations using medical necessity criteria.
The medical review agent shall follow the medical necessity criteria specified in subparts 2 and 3 in determining the following:
Subp. 2. Criteria for inpatient hospital admission; general.
The most recent edition of the Appropriateness Evaluation Protocol of the National Institutes of Health is incorporated by reference. The book was published in 1984 by the Health Data Institute, 20 Maguire Road, Lexington, Massachusetts, 02173, and it is available through the Minitex interlibrary loan system. The book is not subject to change.
Subp. 3. Criteria for inpatient psychiatric treatment.
The Criteria for Inpatient Psychiatric Treatment, 1981 edition, revised 1991, published by Blue Cross and Blue Shield of Minnesota are incorporated by reference. The criteria are available at Blue Cross and Blue Shield of Minnesota, P.O. Box 64560, Saint Paul, Minnesota 55164, and at the State Law Library, Minnesota Judicial Center, 25 Rev. Dr. Martin Luther King Jr. Blvd., Saint Paul, Minnesota 55155. The criteria are not subject to frequent change.
Statutory Authority: MS s 256.9353; 256B.04; 256B.503; 256D.03