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.
***The Managed Care Section (MCS) at MDH is issuing a request for proposals (RFP).*** MDH is seeking a consultant to advise MCS on quality initiatives as they relate to data collection, auditing, policies and procedures, and Healthcare Effectiveness Data and Information Set (HEDIS) data reporting. MCS has launched this Quality Consultant RFP to solicit responses from health quality experts to serve as an advisor on a part-time basis. MCS anticipates the start date to be around January 2016 and for a consultant to be available via telephone and through in-person contact at the downtown St. Paul location approximately 5 to 10 hours a week through June 30, 2016.
Check back here frequently through November 25th for any addendums and responses to questions in regards to this RFP.
Q1. Do I need to have the skills and experience to address all of the deliverables listed in the RFP or can I still apply and identify the deliverables I am in experienced in?
Yes, you may apply even if you don’t have the expertise in all the deliverables outlined within the RFP. The goal is to award the most qualified applicant which includes consideration for their expertise in each of the deliverables. MDH will review and score your application according to the expertise you outline within your application.
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.
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
For more information, or to file a complaint, contact MCS section at (651) 201-5100 or 1-800-657-3916.