DEFINITIONS.

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. History: 2024 c 114 art 3 s 25