|Senate Counsel & Research||State of Minnesota|
|S.F. No. 1837 - DHS Health Care Policy Amendments|
|Author:||Senator Becky Lourey|
|Prepared by:||Katie Cavanor, Senate Counsel (651/296-3801)
David Giel, Senate Research (651/296-7178)
|Date:||April 6, 2005|
Section 1 (256.045, subdivision 3a) eliminates the requirement that a prepaid health plan notify the ombudsman within three days of a complaint being filed.
Section 2 (256b.02, subdivision 12) clarifies that a third-party payer includes an entity under contract with the recipient to cover all or part of the recipient's medical costs.
Section 3 (256B.056, subdivision 3d) enacts into law a former rule that governed allowable methods for Medical Assistance (MA) applicants and recipients to reduce excess assets. The rule was inadvertently repealed in 2002.
Section 4 (256B.056, subdivision 5) permits recipients to pay spenddown payments to DHS through the last business day of the month.
Section 5 (256B.056, subdivision 5a) clarifies that individuals on fixed or excluded income must report and verify their income every 12 months, which begins with the month of application.
Section 6 (256b.056, subdivision 5b) clarifies that individuals with low, fluctuating income must report and verify their income every six months with the six-month eligibility period beginning the month of application.
Section 7 (256B.065, subdivision 7) separates the eligibility for the MA retroactive period from the prospective renewal period and clarifies that the 12-month period of eligibility begins with the month of application.
Section 8 (256B.056, subdivision 9) restates language from an existing statute that requires various parties (MA applicants and recipients, providers of medical services, parties to certain claims) to provide notice to DHS about monetary claims against third-parties when DHS may be entitled to the claim to reimburse DHS for medical costs paid by the state. The language is being restated because other portions of the existing statute have been struck down by the courts.
Section 9 (256B.057, subdivision 1) reinstates the language restoring the MA income standard of 275 percent of the federal poverty guidelines (FPG) and the special work expense deduction for pregnant women and infants. (Restoring this language would make it consistent with implementation.)
Section 10 (256B.0644) excludes dentists from Rule 101 requirements, which requires providers to accept a certain percentage of public assistance patients in order to be able to serve state employees.
Section 11 (256D.045) permits an exemption to the requirement that an applicant provide a Social Security number if the applicant has a well-established religious objection as described in federal law.
Section 12 (256L.04, subdivision 4) aligns the income calculation in the MinnesotaCare program to the six-month eligibility period, which went into effect last year.
Section 13 (256L.01, subdivision 5) permits the commissioner some flexibility to establish reasonable methods for calculating gross earned and unearned income for MinnesotaCare. This would supercede the rule, which prescribes only one method of calculation.
Section 14 (256L.03, subdivision 1b) aligns MinnesotaCare and MA policy regarding when eligibility for benefits as a pregnant woman begins. MinnesotaCare benefits are to begin at the date of conception instead of the date the pregnancy was diagnosed.
Section 15 (256L.04, subdivision 1a) codifies the MinnesotaCare program's Social Security number rule requirements and establishes exceptions for newborns with automatic eligibility, individuals who have applied for and are awaiting issuance of a Social Security number, or for individuals who have a well-established religious objection.
Section 16 (256L.04, subdivision 2) requires enrollees to give notice to DHS in order to allow DHS to assert and recover its claim to medical payments form liable third parties as required by state and federal law.
Section 17 (256L.04, subdivision 2a) requires enrollees to take all necessary steps to obtain other benefits described in federal regulations and requires that the enrollee apply for these benefits within 30 days of application.
Section 18 (256L.05, subdivision 3) states that the effective date of coverage for adding new members to a family is the first day of the month following the month the change is reported, and for newly adopted children the effective date is the month of placement or the month the placement is reported, whichever is later.
Section 19 (256L.05, subdivision 3a) clarifies that the six-month renewal period begins the month the renewal application is received by the commissioner.
Section 20 (256L.07, subdivision 1) aligns the income calculation and premium comparison for purposes of determining a child's continued coverage under the Minnesota Comprehensive Health Association exception with the six-month income projection and six-month renewals.
This section also changes the income limit for parents from $50,000 annual income to $25,000 six-month projection of income.
Section 21 (256L.07, subdivision 3) clarifies that cost effective insurance paid for by MA is not considered other health coverage for purposes of the four-month "no insurance" barrier, but if the insurance continued after it was no longer considered cost effective or after MA was closed, it would be considered and the four-month barrier would apply.
Section 22 (256L.07, subdivision 5) permits active duty military members and their dependents to voluntarily disenroll from MinnesotaCare and reenroll during or following the member's tour of active duty. Upon reenrollment, income and assets increases reported shall be disregarded until the next six-month renewal.
Section 23 (256L.15, subdivision 2) clarifies that the sliding fee scale references to income refer to monthly income and not annual or six-month income figures.
Section 24 (256L.15, subdivision 3) specifies that children in families with income below 150 percent of FPG pay a monthly premium of $4.
Section 25 (549.02, subdivision 3) excludes DHS, in cases where DHS is seeking third-party recovery, from the statute requiring the plaintiff in district court to pay certain amounts stated in law to a defendant if the defendant prevails.
Section 26 (549.04) excludes DHS, in cases where DHS is seeking third-party recovery, from the statute requiring the plaintiff in district court to reimburse certain expenses of a defendant if the defendant prevails.
Section 27 requires DHS to develop a planning process to implement at least one additional managed care arrangement to provide MA services to persons with disabilities.
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