Managed Care Regulation
The Managed Care Systems Section of the Minnesota Department of Health licenses and regulates Health Maintenance Organizations (HMOs), Community Integrated Service Networks (CISNs), County-Based Purchasers (CBPs), and Accountable Provider Networks (APNs). Regulation helps to ensure that your health plan company follows all applicable laws and rules governing financial solvency, quality of care, access to services, complaints, appeals and other consumer rights.
The Managed Care Section also reviews Networks, Service Area and ECP requirements for MNSure.
We also provide information that may assist you in making decisions
about your health insurance and your rights as a health plan company
member. Click on the links below to view frequently asked questions,
information, pamphlets and brochures that may be of interest.
HMO Complaint Category Reporting & Peer Protection Confidentiality
Pursuant to MS §62D.08 and §62D.115, MDH solicited input regarding HMO complaint categories and quality of care complaints that are subject to peer protection confidentiality. More information on HMO complaint categories and complaints subject to peer protection confidentiality may be found here:
Frequently Asked Questions and Hot Issues:
- Health Care Provider Network FAQs
- COBRA-How to continue your health care coverage
- Minnesota Health Information Clearinghouse FAQs - Portability
- Minnesota Health Information Clearinghouse FAQs - Small Employer Health Insurance
- Network Adequacy: Filing Requirements for Healthcare Providers
To find out more information about the health care provider networks and the service areas for health plans offered on MNsure in 2018, see 2018 MNsure Provider Networks and Service Areas.
For more information, or to file a complaint, contact MCS section at (651) 201-5100 or 1-800-657-3916.