4765.0020 Definitions


Published: 2015

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4765.0020 DEFINITIONS.


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Subpart 1.

Scope.

For purposes of this chapter, the following terms have the meanings given them in this part.


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Subp. 2.

Health care provider.

"Health care provider" has the meaning given in Minnesota Statutes, section 62U.01, subdivision 10.


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Subp. 3.

Payer.

"Payer" means a health plan company as defined in Minnesota Statutes, section 62U.01, subdivision 8, an employer, an individual, or a third-party administrator, as defined in Minnesota Statutes, section 60A.23, subdivision 13.


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Subp. 4.

State-designated basket of care; basket.

"State-designated basket of care" or "basket" means a collection of health care services identified in one of the eight appendices, A to H of the State-Designated Baskets of Care: Appendices to Minnesota Administrative Rules, Chapter 4765, in part 4765.0040, as incorporated by reference in part 4765.0040. The eight baskets of care are:

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A.

asthma care for children: ambulatory care of asthma in children ages five to 18 years;


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B.

diabetes: medically uncomplicated type 2 diabetes;


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C.

diabetes: prediabetes;


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D.

low back pain: acute episode of low back pain;


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E.

obstetric care: prenatal care;


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F.

preventive care for adults: preventive care assessment, recommendations, and referrals in adults;


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G.

preventive care for children ages two years and under; and


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H.

total knee replacement.
A collection of services and outcomes may only be identified as a state-designated basket of care if it contains all of the health care services listed in appendices A to H of the State-Designated Baskets of Care: Appendices to Minnesota Administrative Rules, Chapter 4765, in part 4765.0040. A collection of services that includes additional services or outcomes not listed in appendices A to H must not be identified as a state-designated basket of care.