|S.F. No. 2337 - Health and Human Services Appropriations (First Engrossment)|
|Author:||Senator Linda Berglin|
|Prepared by:||David Giel, Senate Research (296-7178)
Katie Cavanor, Senate Counsel (651/296-3801)
Joan White, Senate Counsel (651/296-3814)
|Date:||May 5, 2010|
Section 1 (256.9657, subdivision 2) increases the current 1.56 percent hospital surcharge to 2.63 percent from July 1, 2010, to September 30, 2011, after which time the surcharge is reduced to 2.3 percent.
Section 2 (256.9657, subdivision 3) increases the current .6 percent health maintenance organization surcharge by an additional .85 percent and establishes a new surcharge on county-based purchasing plans of 1.45 percent, effective October 1, 2010. Collections from the increased and new surcharges are deposited in the health care access fund instead of the general fund.
Section 3 (256.969, subdivision 2b) eliminates partial rebasing of medical assistance (MA) inpatient hospital rates scheduled to begin on January 1, 2011, and delays full rebasing, now scheduled to occur on April 1, 2012, until January 1, 2013.
Section 4 (256.969, subdivision 3a) increases MA inpatient fee-for-service hospital rates by five percent from July 1, 2010, to June 30, 2011, after which time the rate increase is reduced to .63 percent.
Section 5 (256.969, subdivision 21) increases MA inpatient hospital rates for certain listed mental health diagnoses at private, nonprofit hospitals with high rates of mental health admissions. The total cost of the rate increases, including state and federal shares, may not exceed $10 million each fiscal year.
Section 6 (256.969, subdivision 26) increases MA inpatient hospital fee-for-service rates at hospitals located outside of the seven-county metropolitan area for 16 listed diagnostic-related groups (DRGs) to 100 percent of the metropolitan average rate. Currently, these DRGs are reimbursed at 90 percent.
Section 7 (256.969, subdivision 31) establishes two per-admission increases in MA inpatient hospital rates.
Section 8 (256B.04, subdivision 14a) limits the frequency of nonemergency medical transportation level of need determinations to annually, rather than semiannually, unless the individual's circumstances have changed sufficiently to necessitate a new determination.
Section 9 (256B.055, subdivision 15) extends MA coverage to persons who are over the age of 21 and under the age of 65; residing in a household without children; are not pregnant; and are not eligible for MA under any other subdivision. Beginning October 1, 2010, these recipients are not eligible for long-term care services unless they meet one of the categories described under section 1937(a)(2), subparagraph (B), of the Social Security Act.
Section 10 (256B.056, subdivision 3) states that there is no asset limit for persons eligible for MA under Minnesota Statutes, section 256B.055, subdivision 15.
Section 11 (256B.056, subdivision 4) states that the income limit for persons eligible for MA under section 256B.055, subdivision 15, is 75 percent of the federal poverty guidelines.
Section 12 (256B.0625, subdivision 13h) states that if there are no pharmacists who meet the requirements to provide medication therapy management services within a reasonable geographic distance of the patient, a pharmacist who does meet the requirements may provide the services via two-way interactive video.
Section 13 (256B.0625, subdivision 22) clarifies that a child who elects to receive hospice services does not waive coverage for services related to the treatment of the underlying condition.
Section 14 (256B.0625, subdivision 54) states that MA covers services provided by a licensed birth center if the services would otherwise be covered if provided in a hospital and the services are provided by a licensed health professional. This section also establishes payment rates for the facility based on a percentage of the rate paid to hospitals for an uncomplicated vaginal birth; payment rates for nursery services based on a percentage of the rate paid to hospitals for nursery care; and payment rates for licensed traditional midwives based on 100 percent of the rate paid to a physician performing the same service.
Section 15 (256B.0631, subdivision 1) reduces the MA co-payment for nonemergency visits to a hospital-based emergency room beginning January 1, 2011, to $3.50 per visit.
Section 16 (256B.0631, subdivision 3) specifies that the MA rate shall not be increased due to the decrease in the co-payment for nonemergency visits to a hospital-based emergency room.
Section 17 (256B.0753, subdivision 4) authorizes the commissioner to modify the care coordination payments in order to qualify for the enhanced federal match in the federal health reform bill.
Section 18 (256B.0755) requires the commissioner to develop and authorize a demonstration project to test alternative and innovative health care delivery systems for providing MA services to persons eligible under section 256B.055, subdivision 15. This section also requires the commissioner to establish a separate pilot program in Hennepin or Ramsey County, or in both, to test integrated health care delivery networks. The enrollment in the pilot program would be capped for each county and would permit the county to transfer funds necessary to support the nonfederal share of payments for integrated health care delivery networks in their county, up to 15 percent of the expected expenses for enrollees.
Section 19 (256B.69, subdivision 5a) requires the commissioner to include in the performance targets that managed care plans and county-based purchasing plans are required to meet in order for the five percent capitation rate withhold to be returned, a reduction in the plan's emergency room utilization rate for the state health care program enrollees by a measurable rate of five percent from the utilization rate from the previous calendar year. The withhold shall continue until the plan's utilization rate is reduced by 25 percent of the plan's utilization rate for calendar year 2009.
Section 20 (256B.69, subdivision 5k) increases payments to managed care plans and county-based purchasing plans by 1.28 percent, effective October 1, 2010, to be paid from the health care access fund.
Section 21 (256B.76, subdivision 1), paragraph (c), implements an additional 1.5 percent payment rate reduction effective July 1, 2011, for physician and professional services.
Paragraph (d) increases payment rates by 25 percent, effective October 1, 2010, for physician and professional services delivered in clinics that are owned by a nonprofit HMO.
Section 22 (256B.76, subdivision 2) states that the MA payment rate for dental services performed on or after October 1, 2010, by a state-operated dental clinic shall be paid on a cost-based payment system. This section also establishes a supplemental payment if the new payments to state-operated dental clinics are less than $1.850 million per fiscal year, including federal and state shares. If the cost-based payment system does not receive federal approval, the state-operated dental clinics shall be designated as critical access providers.
Section 23 (256B.76, subdivision 4) modifies the qualifications for dentists and dental clinics to be designated as critical access dental providers.
Section 24 (256B.766) implements an additional payment rate reduction of 1.5 percent, effective July 1, 2011, for basic care services.
Section 25 (256L.03, subdivision 5) reduces the MinnesotaCare co-payment for nonemergency visits to a hospital-based emergency room beginning January 1, 2011, to $3.50 per visit. Specifies that the MinnesotaCare rate shall not be increased due to the decrease in the co-payment for nonemergency visits to a hospital-based emergency room.
Section 26 (256L.12, subdivision 9), paragraph (c), requires the commissioner to withhold an additional three percent of managed care plan or county-based purchasing plan payments under MinnesotaCare. The withheld amount must be returned no sooner than July 1 and no later than July 31 of the following calendar year.
Paragraph (d) requires the commissioner to include in the performance targets that managed care plans and county-based purchasing plans are required to meet in order for the five percent capitation rate withhold to be returned, a reduction in the plan's emergency room utilization rate for the state health care program enrollees by a measurable rate of five percent from the utilization rate from the previous calendar year. The withhold shall continue until the plan's utilization rate is reduced by 25 percent of the plan's utilization rate for calendar year 2009.
Section 27 (256L.12, subdivision 9c) increases MinnesotaCare payments to managed care plans and county-based purchasing plans by 1.28 percent.
Section 28 clarifies that the asthma MA demonstration project passed last session must include home environmental assessments and in-home asthma education and is limited to two visits per child. This section also increases the first home visit payment rate.
Section 29 extends the state subsidy for individuals eligible for the COBRA federal subsidy.
Section 30 modifies the 2009 appropriation for the COBRA subsidies.
Section 31 requires the Commissioner of Human Services to take into account anticipated savings from expanding MA coverage to services provided in a licensed birth center when negotiating the managed care contract rates.
Section 32 requires the Department of Human Services (DHS) to ensure, effective October 1, 2010, that contracts for nonemergency medical transportation services level of need determinations require the contractor to have no financial interest in the actual provision of the services.
Section 33 requires the Commissioner of Human Services to seek a state plan amendment or federal waiver, as necessary to receive federal funds for MA coverage for single adults without children.
Section 34 requires an annual report from DHS on: (1) the estimated room under the hospital upper payment limit (UPL) for the upcoming federal fiscal year; (2) the amount of an MA inpatient hospital rate increase that would raise MA spending to the UPL; and (3) the amount of a surcharge increase that would be needed to generate the state share for the possible increase.
Section 35 is a Revisor instruction to remove references to GAMC.
Section 36 repeals the GAMC program effective June 1, 2010.
Section 1 (144D.03, subdivision 2) expands the list of information a housing with services establishment must provide to the Minnesota Department of Health (MDH) in order to be registered to include whether services are included in the base rate to be paid by the resident.
Section 2 (144D.03, subdivision 3) prohibits a housing with services establishment from contracting with a prospective resident or allowing a prospective resident to move in until the establishment receives certification that the person has received a transition to housing with services consultation.
Section 3 (144D.04, subdivision 2) requires a housing with services contract to include a delineation of the portion of the base rate that constitutes rent and a delineation of charges for each service included in the base rate.
Section 4 (144D.08) requires housing with services establishments to make available to prospective and current residents information consistent with the uniform format and required components of a uniform consumer information guide adopted by MDH.
Section 5 (144D.09) requires a housing with services establishment to include with a lease termination notice information about how to contact the ombudsman for long-term care and how to request problem-solving assistance.
Section 6 (144G.06) requires the Uniform Consumer Information Guide to include information on which services may be covered by Medicare.
Section 7 (256.9657, subdivision 1) increases the nursing home license surcharge by $585, to a total of $3,400 per year. It also makes some technical changes in how beds are counted for surcharge purposes and gives nursing homes that do not participate in MA a window of opportunity to enroll in the program under certain conditions.
Section 8 (256.9657, subdivision 3a) increases the license surcharge on intermediate care facilities for persons with mental retardation (ICFs/MR) by $2,997, to a total of $4,037 per bed per year.
Section 9 (256.975, subdivision 7) requires the Senior LinkAge Line service to incorporate information about registered housing with services establishments. It requires the establishments and their home care providers to provide information to facilitate price comparisons. It requires DHS and MDH to align data elements required by the Uniform Consumer Information Guide and by the Senior LinkAge Line language to provide consumers standardized information and ease of comparison for long-term care options.
Section 10 (256B.0659, subdivision 11) reduces the maximum number of hours per month that a personal care assistant may provide and be paid for to 275 hours, down from the current 310-hour limit, effective July 1, 2011.
Section 11 (256B.0911, subdivision 3c) requires all housing with services establishments to inform prospective residents of the requirement to contact the Senior LinkAge Line for long-term care options counseling and transitional consultation. It restates the prohibition on admitting persons to establishments until provision of counseling and consultation under this subdivision to the prospective resident has been certified. This section also excludes from this provision a person moving from the community to a housing with services establishment during nonworking hours under certain conditions.
Section 12 (256B.0915, subdivision 3i) reduces service component rates and service rate limits for customized living services and 24-hour customized living services by five percent, effective July 1, 2010. To implement these rate reductions, managed care organization rates are reduced by ten percent from January 1, 2011, to June 30, 2011, and by five percent after that.
Section 13 (256B.441, subdivision 53) increases the nursing home payment rate related to the nursing home surcharge by $2 per day, to a total of $10.86 per day.
Section 14 (256B.441, subdivision 55) suspends nursing facility rebasing rate adjustments during the period from October 1, 2009, to September 30, 2013.
Section 15 (256B.49, subdivision 23) prohibits DHS from placing a limit on the number of adult waiver recipients receiving assisted living plus services or customized living services who may reside in one building.
Section 16 (256B.5012, subdivision 9) increases rates paid to ICFs/MR by $8.74 per bed per day.
Section 17 (256B.69, subdivision 23) closes down the Minnesota Disability Health Options (MnDHO) program effective December 31, 2010.
Section 18 instructs the Revisor of Statutes to delay the effective date of essential community support grants by six months, until July 1, 2011.
Sections 1 to 4, 8, and 9 (245C.27, subdivisions 1 and 2; 245C.28, subdivision 3; 256.045, subdivision 3; 626.556, subdivision 10i; and 626.557, subdivision 9d) modify provisions related to the Department of Human Services licensing act in response to a Court of Appeals decision related to due process. The sections allow for another hearing, under certain circumstances, when a person is disqualified.
Section 5 (256D.0515) modifies the Food Stamp program by eliminating the asset limit and increasing the income limit to 165 percent of the federal poverty guidelines. The current income limit is 130 percent of poverty. This section is effective November 1, 2010.
Section 6 (256J.24, subdivision 6) amends the MFIP family cap, clarifying that the law applies to pregnancies that resulted in a live birth. This section is effective September 1, 2010.
Section 7 (256J.425, subdivision 3) amends the MFIP hard-to-employ section of law, clarifying the definition of the phrase "severely limits the person's ability to obtain or maintain suitable employment."
Section 1 (62D.08, subdivision 7) requires health maintenance organizations to allocate administrative expenses to specific lines of business or products when the information is available. Remaining expenses must be allocated based on recommendations of the advisory group established in the next section. The information must be reported on a template provided by MDH. This section also requires investment income to be allocated based on cumulative net income over time by business line or product. This section is effective January 1, 2013.
Section 2 (62D.31) establishes an advisory group on administrative expenses and outlines its membership, duties, operation, and expiration date.
Section 3 (62J.692, subdivision 4) earmarks $150,000 of the medical education funds distributed to the Academic Health Center for a program to assist foreign-trained physicians to compete for family medicine residency programs at the university.
Section 4 (144.226, subdivision 3) establishes an additional surcharge of $10 for each certified birth record.
Section 5 (144E.37) transfers responsibility for the Comprehensive Advanced Life-Support (CALS) educational program from the Emergency Medical Services Regulatory Board (EMSRB) to the Minnesota Department of Health.
Section 6 (157.16, subdivision 3) clarifies that a youth camp that pays an additional fee as a food and beverage service establishment is not required to pay an annual single fee for food and lodging.
Section 7 (327.15, subdivision 3) clarifies that manufactured home parks or recreational camping areas that are also licensed under section 157.16 (food and lodging establishments), are required to pay only one base fee, whichever fee is higher.
Section 8 authorizes health plans and county-based purchasing plans to compile and submit to MDH and DHS a list of duplicative government requirements concerning data collection, documentation, and reports. The state agencies must submit the information to appropriate legislative committees, along with their comments and recommendations.
Section 9 transfers to MDH the powers and duties of the EMSRB with respect to the CALS program.
Section 10 is a Revisor's instruction related to the changed responsibility for the CALS program.
Section 1 (256B.0644) clarifies language that was added to this section in Laws 2010, chapter 200, regarding participation by pharmacy providers in the GAMC program.
Section 2 (256B.69, subdivision 27) removes a cite to the "old" general assistance medical care (GAMC) program.
Section 3 (256B.692, subdivision 1) removes the reference to GAMC in this section.
Section 4 (256D.03, subdivision 3) clarifies that the services provided between April 1, 2010 and June 1, 2010, are the services described under section 256D.03, subdivision 4. (Section 256D.03, subdivision 4, is repealed effective June 1, 2010.) Makes an additional technical change to the cite for section 256B.0625, subdivisions 13 to 13h.
Section 5 (256L.12, subdivision 5) removes the reference to GAMC in this section that is no longer applicable.
Sections 6 to 12 amend Laws 2010, chapter 200, the new GAMC program.
Section 6 clarifies that the services described in section 256D.031, subdivision 4, are effective June 1, 2010.
Section 7 rewrites the language intended to allocate to four named hospitals 110 percent of the allocation they would otherwise receive as a coordinated care delivery system. It also establishes a schedule for the quarterly payments that span June through August each year.
Section 8 adds an effective date to Laws 2010, chapter 200, article 1, section 16.
Section 9 amends the repeal date for section 256D.03, subdivision 4, to June 1, 2010, and the repeal dates for affected sections in chapter 256L to June 1, 2010.
Section 10 transfers $410,000 in fiscal year 2010 and $412,000 in fiscal year 2011 from special revenue fund balances to the general fund.
Section 11 corrects a base adjustment rider in Laws 2010, chapter 200.
Section 12 modifies a rider from Laws 2010, chapter 200, regarding compulsive gambling administrative funds.
Section 1 (62Q.545) requires a health plan company to cover private duty nursing services under section 256B.0625, subdivision 7, for persons who are concurrently covered by both the health plan and enrolled in medical assistance. Permits cost-sharing requirements that apply under the health plan for other similar services or benefits, and permits the use of prior authorization or the use of contracted providers.
Section 2 (137.32) requests the University of Minnesota Board of Regents to implement, within the limits of available appropriations, a Minnesota Couples on the Brink project to develop, evaluate, and disseminate best practices for promoting successful reconciliation between married couples who are considering or have commenced marriage dissolution and who choose to try reconciliation. The project may be funded with federal grants, state appropriations, and in-kind services.
Section 3 (150A.106, subdivision 1) permits a dental therapy educational program to offer a combined dental therapy program if the program was in existence on April 1, 2010. States that a graduate of such a program satisfies the requirements that an applicant for certification as an advanced dental therapist must complete a dental therapy education program and graduate from a master's advanced dental therapy education program.
Section 4 (150A.06, subdivision 1d) exempts dental therapy education programs in existence on April 1, 2010, from Board of Dentistry approval as required under this subdivision. Requires these programs to become accredited within two years after accreditation is available.
Section 5 (152.126) makes a number of minor changes to the controlled substances prescription electronic reporting system, including expanding the reporting requirements to all controlled substances. This section also adds a new subdivision that requires the administrative services unit for the health-related licensing boards to apportion between the Boards of Podiatric Medicine, Optometry, Pharmacy, Medical Practice, Nursing, and Dentistry an amount to be paid through fees by each respective board.
Section 6 (246.18, subdivision 8) establishes the state-operated services account in the special revenue fund. Revenue generated by certain state-operated services established after July 1, 2010, that are not enterprise activities must be deposited into the fund.
Sections 7 to 14 and 20 (254B.01, subdivision 2; 254B.02, subdivisions 1 and 5; 254B.03, subdivisions 4 and 4a; 254B.05, subdivision 4; 254B.06, subdivision 2; and 254B.09, subdivision 8) modify the chemical dependency treatment fund formula, requiring counties to pay a flat 16.14 percent of the cost of chemical dependency services. Currently, counties pay 15 percent of the cost of chemical dependency services, and some counties pay an additional maintenance of effort based on a complicated formula in statute. Further, the formula determines at what spending level each county must start paying 100 percent of the chemical dependency costs, and for how long. After the county pays 100 percent for the time determined by the formula, the county again begins to pay 15 percent. These sections also make other necessary conforming changes, including repealing several subdivisions that are inconsistent with the new policy.
Section 15 (517.08, subdivision 1b) increases the marriage license fee for couples who have not completed 12 hours of premarital education by $5, to $115.
Section 16 (517.08, subdivision 1c) appropriates $5 of the marriage license fee to the University of Minnesota for the Minnesota Couples on the Brink project.
Section 17 modifies a provision passed last session, requiring the Commissioner of Human Services to develop an array of community-based services for patients at the Anoka-Metro Regional Treatment Center. The planning must be completed by October 1, 2010. A report detailing the transition plan, services that will be provided and the location of the services, and the number of patients that will be served, is due to the health and human services committee chairs by November 30, 2010. The commissioner must make a genuine effort to engage stakeholders in the process.
Section 19 requires the Board of Pharmacy to study and report to the Legislature on recommendations on adding veterinarians to the prescription electronic reporting system by December 15, 2011.
Section 1 summarizes appropriations.
Section 2 outlines the appropriations format.
Section 3 includes appropriations and reductions for the Department of Human Services (DHS).
Section 4 includes appropriations and reductions for the Minnesota Department of Health.
Section 5 cancels a $50,000 appropriation made for fiscal year 2008 to the Veterans Nursing Homes Board.
Section 6 includes appropriations for the health-related boards.
Section 7 includes appropriations and reductions for the Emergency Medical Services Regulatory Board.
Section 8 appropriates $93,000 to the Univesrity of Minnesota for the Couples on the Brink program.
Section 9 reduces the fiscal year 2012-13 biennial base of appropriations to the Department of Corrections.
Section 10 appropriates money to the Department of Commerce.
Section 11 (214.40, subdivision 7) requires the medical professional liability insurance program operated by the health-related boards administrative services unit to stay within the limits of funds appropriated for the program. It also authorizes the unit to prorate payments or otherwise limit the number of participants in the program if program costs exceed the appropriation.
Section 12 amends a 2009 budget rider to expand the list of allowable expenditures for TANF maintenance of effort and to correct the amount of working family credit expenditures that may be claimed as TANF maintenance of effort spending in fiscal years 2010 to 2013.
Section 13 amends a 2009 budget rider to modify language regarding TANF emergency funds for nonrecurrent short-term benefits and to correct fraud prevention grant totals and the base adjustment numbers for other children and economic assistance grants.
Section 14 amends a 2009 budget rider to reduce certain chemical dependency service payment rates.
Section 15 amends a 2009 budget rider to allow the health-related boards administrative services unit more flexibility in the expenditure of appropriations for contested cases and other legal proceedings. It also requires boards receiving funds under this section to include these amounts when setting fees to cover their costs.
Section 16 sunsets all uncodified language in this article on June 30, 2011, unless a different expiration date is explicit.
Section 17 is an effective date.
This article adjusts appropriations from various funds for fiscal years 2010 and 2011 in order to recognize forecast adjustments.
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