Provider Cooperative Contract Review
The 2009 Minnesota Legislature passed a law establishing a review, approval, and monitoring process for contract, business or financial arrangements of health provider cooperatives (Minnesota Statutes Chapter 62R.09). Under this process, a health provider cooperative must submit an application for any modifications, renewals, or extensions of all contract, business or financial arrangements to the Minnesota Department of Health (MDH). MDH is required to review the application and issue a finding based on the impact of the proposed arrangement on the health care marketplace and to actively monitor the arrangement.
In conducting its review, the MDH is required to consider certain issues, including:
- Whether the arrangement is likely to produce significant efficiencies that benefit consumers, such as cost savings or improvements in quality of or access to care;
- If the arrangement is likely to have any anticompetitive effects on the marketplace; and
- Provided that the potential anticompetitive effects outweigh the pro-competitive efficiencies resulting from the arrangement.
Under the statute, MDH may request additional information 30 days after receiving an application and must approve or deny an application within 60 days after receiving the application or 60 days after receiving additional information requested.
Application Guidance for Health Provider Cooperative Review Process (PDF: 1.46MB/20 pgs)
Health Provider Cooperative Reviews
Contract with Sanford Health Plan of Minnesota
Submission filed: May 27, 2011
- Submission from the Minnesota Rural Health Cooperative (PDF: 1.46MB/20 pgs)
- Appendix B Sanford Health Plan Contact Information (PDF: 17KB/1 pg)
- Appendix D MHRC Membership Information (PDF: 836KB/13 pgs)
- Appendix I MRHC Indicated Competitors (PDF: 925KB/7 pgs)
Note: Appendices A, C, E, F, G, and H are marked trade secret.
- MDH Request for Additional Information on June 24, 2011 (PDF: 169KB/4 pgs)
- Additional Information Request Submission Cover Letter from MRHC on August 26, 2011 (PDF: 287 KB/10 pgs)
- Appendix 1, MRHC Primary Service Area (PDF: 35KB/1 pg)
- Appendix 2, MRHC Internal Referral Volume (PDF: 33KB/1 pg)
- Appendix 3, MRHC Provider Specialties (PDF: 12KB/1 pg)
- Appendix 4, MRHC Sample Survey Reports (PDF: 3.17MB/79 pgs)
- Appendix 5, MRHC Quality Management Plan (PDF: 30KB/5 pgs)
- Appendix 6, MRHC Member Non-MRHC Contracts (PDF: 60KB/1 pg)
- Appendix 7, MRHC Indicated Market Share (PDF: 273KB/9 pgs)
Submission filed: July 8, 2011
- Submission from the Minnesota Rural Health Cooperative (PDF: 1.47MB/21 pgs)
- Appendix B, PreferredOne Health Plan Contact Information (PDF: 16KB/1 pg)
- Appendix D, MRHC Membership Information (PDF: 812KB/13 pgs)
- Appendix I, MRHC Indicated Competitors (PDF: 915KB/7 pgs)
Note: Appendices A, C, E, F, G, and H are marked trade secret.
- MDH Request for Additional Information on August 9, 2011 (PDF: 51KB/1 pg)
- MDH Request for Additional Information on September 22, 2011 (PDF: 76KB/2 pgs)
Submission filed: September 12, 2011
- Submission from the Minnesota Rural Health Cooperative (PDF: 165MB/22 pgs)
- Appendix C, Humana Health Plan Contact Information (PDF: 241KB/2 pgs)
- Appendix D, MRHC Membership Information (Excel: 16KB)
- Appendix F, MRHC Provider Specialties (Excel: 15KB)
- Appendix G, MRHC Indicated Primary Service Area (Excel: 12KB)
- Appendix L, MRHC Internal Referral Volume (Excel: 11KB)
- Appendix M, MRHC Sample Survey Reports (PDF: 3.5MB/79 pgs)
- Appendix N, MRHC Quality Management Plan (PDF: 278KB/5 pgs)
- Appendix O, Health Plan Contact Information (PDF: 240KB/1 pg)
- Appendix P, MRHC Indicated Competitors (PDF: 572KB/7 pgs)
- Appendix Q, MRHC Indicated Market Share (Excel: 211KB)
Note: Appendices A, B, E, H, I, J, K are marked trade secret.
- MDH Request for Additional Information on September 23, 2011 (PDF: 52KB/1 pg)
- Additional Information Request Submission Cover Letter from MRHC on October 7, 2011 (PDF: 156 KB/3 pgs)
- Attachment A - Appendix G MRHC 2011 MDH Humana Contract Application (Excel: 13KB)
- Attachment B - 2009 Heart Failure in Adults Quality Improvement Project (PDF: 710KB/12 pgs)
- Attachment C - MRHC Trade Secret Response Letter (PDF: 62KB/5 pgs)
- MRHC Report to Federal Trade Commission (PDF: 150KB/6 pgs)
Public Comment
If you would like to make a comment on any provider cooperative review, please contact:
Stefan Gildemeister
MDH-Health Economics Program
P.O. Box 64882
St Paul, MN 55164-0882
Email: stefan.gildemeister@state.mn.us
