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ARTICLE 1
HEALTH CARE
Section 1 (72A.201, subdivision 8) eliminates the requirement that an insurer report the number of chemical dependency reviewer evaluations performed on behalf of the insurer during the reporting period, the types of evaluations performed, the results, the number of appeals of denials based on these evaluations, the results of the appeal, and the number of complaints filed in a court.
Section 2 (256B.06, subdivision 4) reinstates coverage for dialysis services as an emergency medical condition covered under Medical Assistance (MA) for noncitizens, effective May 1, 2012.
Section 3 (256B.0625, subdivision 9) Paragraph (b) expands MA coverage to include repairs to removable prostheses, effective January 1, 2013.
Paragraph (e) expands MA dental coverage to developmentally disabled adults to include house calls or extended care facility calls; behavioral management; oral or IV conscious sedation; and prophylaxis up to four times per year.
Section 4 (256B.0625, subdivision 60) Paragraph (a) provides medical assistance coverage for services provided by community paramedics who are certified by the Board of Emergency Medical Services Regulatory Board as a EMT-CP to eligible recipients if the services are provided in accordance with this subdivision.
Paragraph (b) defines an eligible recipient as an individual who has received hospital emergency department services three or more times within four consecutive months in the past 12 months, or an individual who has been identified by their primary health care provider as benefiting from community paramedic services since the services are likely to prevent admission to or would allow discharge from a nursing facility or would likely prevent readmission to a hospital or nursing facility.
Paragraph (c) requires the services to be part of a care plan ordered by a primary health care provider in consultation with the medical director of an ambulance service and must be billed by an eligible provider that employs or contracts with the community paramedic. This paragraph also lists the community paramedic services.
Paragraph (d) requires services that are provided to a recipient who is also receiving care coordination services to be provided in consultation with the providers of the care coordination services.
Paragraph (e) requires the commissioner to seek any necessary federal approval.
Section 5 (256B.0631, subdivision 1) permits a prepaid health plan to waive the required family deductible in the Medical Assistance Program.
Section 6 (256B.0644) removes health maintenance organizations (HMOs) from the Rule 101 requirement.
Section 7 (256B.69, subdivision 5a) requires the clinical or utilization performance targets for managed care plans to consider evidence-based research and reasonable interventions when available or applicable to the population served. This section also clarifies that the health plan's emergency room utilization rate reduction for purposes of the withhold is based on the utilization in 2009. This section also requires the commissioner to consider when measuring performance the difference in health risk in a managed care or county-based purchasing plan's membership in the baseline year compared to the measurement year and work with the plan to account for differences that are significant. This section also requires the commissioner to structure the withholds to return a portion of the withheld funds in amounts that commensurate with achieved reductions in utilization loss the targeted amount.
Section 8 (256B.69, subdivision 9c), paragraph (d), requires the Legislature Auditor to contract for a financial audit of the information required under section 256B.69, subdivision 9c, paragraph (b). States that the commissioner, as part of the request for bids and the resulting contracts with managed care plans and county-based purchasing plans, shall require the plans to submit to and fully cooperate with an annual independent third-party financial audit.
Paragraph (e) requires the audit to be conducted by an independent third-party firm in accordance with generally accepted government auditing standards.
Paragraph (f) requires the plans to provide encounter and claims data at a detailed level and participate in a quality assurance program that verifies the data provided.
Paragraph (g) states that contracts awarded under section 256B.69 must provide the commissioner and the auditor with unlimited access to any and all data required to complete the audit. This paragraph also states that this access shall be enforceable through injunctive or other appropriate relief.
Paragraph (h) requires actuary or actuarial firms providing actuarial services to the commissioner in connection with this subdivision to meet professional code requirements.
Paragraph (i) states that the actuary or actuarial firm shall certify and attest to the rates paid to the managed care and county-based purchasing plans and that the certification and attestation must be auditable.
Paragraph (j) requires the independent audit to include a determination of compliance with the federal Medicaid rate certification process.
Paragraph (k) requires the contract with the auditing firm to be designed and administered so that the independent audit will be eligible for a federal subsidy if available for that purpose.
Paragraph (l) requires the legislative auditor to provide copies of the audit report to the state auditor, the attorney general, and the legislature.
Paragraph (m) requires the commissioner to annually assess managed care and county-based purchasing plans for agency costs to implement paragraphs (d) to (l) that have been approved as reasonable by the Commissioner of Management and Budget.
Section 9 (256B.69, subdivision 9d) requires managed care plans and county-based purchasing plans to use the savings from the elimination or modification of certain specified reporting requirements to pay the assessments required by subdivision 9c, paragraph (m).
Section 10 (256B.76, subdivision 4) provides a critical access dental clinic with the critical access dental reimbursement rate for dental services provided off-site at a private dental office if the following requirements are met:
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the clinic is located in a health professional shortage are and outside the seven metropolitan counties;
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the clinic is not able to provide the service and refers the patient to the off-site dentist;
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the service would be reimbursed at the critical access reimbursement rate if the service was provided at the clinic;
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the dental professionals providing services off-site are licensed and in good standing;
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the clinic submits the claim and receives the payment for the services provided off-site; and
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the clinic maintains dental records for each claim submitted.
Section 11 (256L.12, subdivision 9) requires the clinical or utilization performance targets for managed care plans to consider evidence-based research and reasonable interventions when available or applicable to the population served. This section also clarifies that the health plan's emergency room utilization rate reduction for purposes of the withhold is based on the utilization in 2009. This section also requires the commissioner to consider when measuring performance the difference in health risk in a managed care or county-based purchasing plan's membership in the baseline year compared to the measurement year and work with the plan to account for differences that are significant. This section also requires the commissioner to structure the withholds to return a portion of the withheld funds in amounts that commensurate with achieved reductions in utilization loss the targeted amount.
Section 12 requires the Commissioner of Human Services to develop recommendations to implement a revised cost-sharing structure for state public health care programs and report back to the legislature by January 15, 2013.
Section 13 requires the Commissioner of Human Services to contract with an independent vendor to evaluate the value of managed care for state public health care programs. The evaluation must be reported to the legislature by January 15, 2013.
Section 14 requires the Commissioner of Health to contract with an entity to study the efficiency, costs, quality, and enrollee satisfaction of for-profit health maintenance organizations relative to not-for-profit health maintenance organizations operating in Minnesota and other services. The study findings must be reported to the commissioner and the legislature by January 15, 2013.
Section 15, subdivision 1, authorizes the Commissioner of Human Services to discontinue the evidence-based childbirth program and the affiliated reporting requirements if the commissioner determines that hospitals representing at least 90 percent of births covered by Medical Assistance or MinnesotaCare have approved policies and processes in place that prohibit elective inductions prior to 39 weeks gestation.
Subdivision 2 requires the Commissioners of Health, Commerce, and Human Services to merge reporting requirements for HMOs and county-based purchasing plans related to provider network adequacy.
Section 16 specifies that managed care plans and county-based purchasing plans use the savings from the elimination or modification of specified reporting requirements to pay for the assessment for the financial audits in section 8.
Section 17 repeals: Minnesota Rules, part 4685.2000 (summary of complaints and grievances); Minnesota Statutes, sections 62M.09, subdivision 9 (medical necessity denials and appeals); 62Q.64 (salary reports); and 62D.04, subdivision 5, (mandatory HMO participation as provider in public programs.)
ARTICLE 2
DEPARTMENT OF HEALTH
Sections 1 to 3 and 15 transfer the regulatory authority for health maintenance organizations from the Commissioner of Health to the Commissioner of Commerce.
Section 4 (62Q.80) makes changes to the community-based health care coverage program by removing references to the program by removing references to the program being a demonstration project, removing references to demonstration project grants, removing the sunset date, and removing oversight by the Commissioner of Human Services.
Section 5 (62U.04, subdivision 1) strikes the January 1, 2010, date in which the Commissioner of Health is required to develop a plan to create transparency, encourage innovation, reduce administrative burdens, and provide comparative information to consumers.
Section 6 (62U.04, subdivision 2) requires that when developing a uniform method of calculating providers’ relative cost of care the commissioner shall address appropriate risk adjustment that reflects the differences in demographics and health status across provider populations using generally accepted risk adjustment methodologies and case mix adjustments and requires the commissioner to consider other factors that the advisory committee established under section 3 deems important.
Section 7 (62U.04 subdivision 3) modifies this subdivision relating to provider peer grouping by turning the paragraphs into new subdivisions. The substantive changes are as follows:
Subdivision 3 strikes the reference to “combined measures” in terms of the development of the peer grouping system. It also requires the commissioner to establish an advisory committee to assist the commissioner in developing and administering the peer grouping system.
Subdivision 3a requires that the data used by the commissioner to determine a provider’s total cost of care grouping must be the most recent data available. Clarifies that before publishing any analyses or reports that identify providers, the commissioner must provide a provider the opportunity to review the underlying data in order to verify the accuracy and representativeness of any analyses or reports and submit comments to the commissioner or initiate an appeal. Clarifies that upon request the provider shall be given any data for which they are the subject of the data and extends the time in which a provider has to review the data from 30 days to 60 days.
Subdivision 3b modifies the required appeals process by requiring the process to also resolve disputes involving errors in the application of standards or methodology established by the commissioner in consultation with the advisory committee. The commissioner shall cooperate with the provider during the data review period by giving the provider information necessary for the preparation of an appeal.
Subdivision 3c clarifies that the commissioner may publicly release summary data related to the peer grouping system as long as the data do not contain information or descriptions from which the identity of individual hospitals, clinics, or other providers may be discerned and establishes criteria that must be met before the commissioner may publicly release analyses or results related to the peer grouping system that identify hospitals, clinics, or other providers. This subdivision also requires the commissioner to convene a work group for the purpose of making recommendations on data to be made available to hospitals and physician clinics to allow for verification of the accuracy and representativeness of the peer grouping results.
Subdivision 3d makes conforming changes. This subdivision also strikes the requirement that the commissioner report to the legislature if there is a delay in the dissemination of the data or the publication of information.
Section 8 (62U.04, subdivision 4) specifies that the commissioner shall only use the encounter data submitted by health plan companies and third-party administrators to carry out the responsibilities in this section, including supplying the data to providers so the providers can verify the results of the peer grouping process.
Section 9 (64U.04, subdivision 5) specifies that the commissioner may provide the pricing data submitted by health plan companies and third-party administrators to providers in order for the providers to verify their results of the peer grouping process.
Section 10 (62U.04, subdivision 6) changes the word “shall” to “may” in terms of the Commissioner of Management and Budget and health plan companies using the information and methods developed under this section to strengthen incentives for members to use high-quality, low-cost providers; offer plans that differentiate providers on their costs and quality performance; and develop products that encourage consumers to use high-quality, low-cost providers.
Section 11 (144.1222, subdivision 5) creates an exception from the swimming pool regulations for a naturally treated swimming pool located in the city of Minneapolis. The pool would still have to meet drain cover and inspection requirements.
Section 12 (144.5509) Paragraph (b) creates an exception to the current moratorium to allow the relocation of a radiation therapy machine from a hospital in Maplewood to a hospital in Woodbury.
Paragraph (c) creates a modification to the radiation therapy facility construction moratorium beginning August 1, 2014. After this date, a facility may only be constructed if the entity constructing the radiation therapy facility is controlled by or under common control with a licensed hospital and the new facility is located at least seven miles from an existing radiation therapy facility.
Paragraph (d) requires any referring physician to provide each patient with a list of all radiation therapy facilities located within a 14-county area, and requires physicians with a financial interest in a radiation therapy facility to disclose to the patient the interest.
Paragraph (e) defines "controlled by" or "under common control with."
Paragraph (f) defined "financial interest in any radiation therapy facility."
Paragraph (g) creates an exception for the relocation or reconstruction of an existing facility.
Section 13 (145.906) requires the commissioner to work with the WIC program to make information about postpartum depression available at WIC sites.
Section 14 (256B.0754) changes the word “shall” to “may” in terms of the Commissioner of Human Services using the peer grouping information and other methods developed under section 62U.04 to establish a payment system for the public health care programs that rewards high-quality, low-cost providers, creates incentives for enrollees to receive care from high-quality, low-cost providers; and fosters collaboration among providers to reduce cost shifting from one part of the health continuum to another.
Section 15 eliminates the requirement that the Commissioner of Health develop a plan to implement evidence-based strategies from the statewide health improvement program (SHIP) as part of the hospital community benefit programs and the requirement that the implementation plan include an advisory board to determine priority needs and to approve hospital community benefit activities.
Section 16 requires the Commissioner of Health to study the current treatment capacity of existing radiation facilities; the present need for these services; and the projected need in the next ten years. Permits the commissioner to contract with a qualified entity to conduct the study.
Section 17 is a Revisor's Instruction related to the change in HMO regulatory authority.
Section 18 provides and effective date for the peer provider grouping sections, and specifies that these sections be implemented by the commissioner within available sources.
ARTICLE 3
CHILDREN AND FAMILY SERVICES
Section 1 (119B.13, subdivision 7) modifies the child care assistance ten absent days policy for reimbursement to allow more absent days for children in families where at least one parent is (1) under the age of 21; (2) does not have a high school diploma or GED; (3) is a student in a school district or similar program that provides or arranges child care, and other supportive services.
Section 2 (256.01, subdivision 18d) requires the State Court Administrator to provide to the Commissioner of Human Services a report every six months of each individual convicted of a felony under chapter 152 (controlled substances). Requires the commissioner to determine whether any of the individuals are receiving public assistance under chapter 256D or 256J, and for those individuals instruct the counties to proceed under section 256D.024 or 256J.26, whichever is applicable. Also requires the State Court Administrator to provide a onetime report for individuals with a felony drug conviction dated from July 1, 1997, until the date of transfer.
Section 3 (256.01, subdivision 18e) requires the Commissioner of Public Safety to, on a monthly basis, provide the Commissioner of Human Services with information of all applicants and holders whose drivers’ licenses and state identification cards have been canceled by the Commissioner of Public Safety. Requires the Commissioner of Human Services to compare this information with the data on recipients of all public assistance programs to determine whether any person has illegally or improperly enrolled in any public assistance programs. Requires the commissioner to provide all due process protections to the person before terminating the person from the applicable program and notifying the County Attorney.
Section 4 (256.01, subdivision 18f) requires the Commissioner of Public Safety on a monthly basis to provide the Commissioner of Human Services with information on all applicants and holders of drivers’ licenses and state identification cards whose temporary legal presence status has expired and whose license or identification card has been canceled by the Commissioner of Public Safety. Requires the commissioner to use this information to determine whether the eligibility of any recipient of public assistance programs has changed due to status change in this data. Requires the commissioner to provide all due process protections to the individual before terminating the individual from the program and notifying the County Attorney.
Section 5 (256.987, subdivision 1) makes a technical change to conform with changes made last session.
Section 6 (256D.06, subdivision 1b) modifies the general assistance program by increasing the earned income disregard from $150 to $500 per month and the maximum savings account disregard from $1,000 to $2,000.
Section 7 (626.556, subdivision 10n) modifies the Maltreatment of Minors Act, requiring that a child under age three who is involved in a substantiated case of maltreatment be referred for screening under the Individuals with Disabilities Act, Part C. Parents must be informed that the evaluation and acceptance of services are voluntary. Within available appropriations, the commissioner must monitor referral rates by the county and annually report to the Legislature, beginning March 15, 2014.
Section 8 modifies the working family credit amount claimed for TANF maintenance of effort.
Section 9 requires the Commissioner of Human Services, in consultation with the Commissioner of Public Safety, to report to the legislature on the implementation of section 256.01, subdivisions 18d, 18e, and 18f, by April 1, 2013.
ARTICLE 4
CONTINUING CARE
Section 1 (62J.496, subdivision 2) adds nursing facilities and customized living facilities to the list of eligible borrowers under the Electronic Health Record System Revolving Account and Loan Program.
Section 2 (144A.351) requires the Departments of Human Services (DHS) and Health (MDH) to submit a report to the Legislature by August 15, 2013, on balancing long-term care services and supports for the elderly, and children and adults with disabilities and mental illnesses.
Section 3 (144A.073) adds a new subdivision that allows the MDH to approve an exception to the nursing facility moratorium if the full annualized share of Medical Assistance costs does not exceed $1 million.
Section 4 (245A.03) adds a new subdivision instructing the DHS to develop an optional certification process for adult foster care homes that serve people with mental illness. The proposed certification is for licensed adult foster care homes where the license holder does not primarily reside at the licensed home.
All staff are required to meet certain training requirements, and must receive seven hours of training each year. The following are required for certification: the availability of mental health professionals and practitioners for consultation; a plan and protocol in place to address a mental health crisis; and an individual crisis prevention and management plan in each person’s Individual Placement Agreement. The new subdivision creates the certification request process and an ongoing compliance review by the county licensing agency. Certification denials are not subject to appeal, but applicants may reapply once all requirements are met.
Section 5 (245A.03, subdivision 7) allows DHS to de-license up to 128 adult foster care beds by June 30, 2013, under certain circumstances using, a needs determination process. Requires DHS to work with stakeholders in collecting data on long-term care services and supports capacity, and provide information by February 1 of each year. Exempts adult foster care homes certified for people with mental illness, along with other residential settings, from the requirement that once service recipients move out, license capacity is decreased by the same amount.
Section 6 (245A.11, subdivision 2a) exempts adult foster care homes from the four-bed license maximum, allowing a fifth bed for respite services, with certain staffing, time-restriction, and notification requirements.
Section 7 (245A.11, subdivision 7) clarifies that to receive a variance for alternate oversight supervision, the adult foster care license holder must not have had a conditional license issued or other licensing sanctions.
Section 8 (245A.11, subdivision 7a) clarifies certain requirements in order to receive an adult foster care home license where a caregiver is not present during normal sleeping hours. It outlines license application review timelines and processes, and approval or denial timelines and processes.
Section 9 (245B.07, subdivision 1) prevents a license holder from being penalized for not having an individual service plan if the case manager fails to provide one.
Section 10 (245C.04, subdivision 6) exempts providers of both licensed and unlicensed home and community-based waiver services from repeating annual background studies under certain conditions.
Section 11 (245C.05, subdivision 7) specifies that a probation officer or corrections agent must notify DHS of an individual’s conviction if the individual has been affiliated in the preceding year with: a program or facility regulated by DHS or MDH; a youth facility licensed by the Department of Corrections; or any type of home care agency or personal care assistance provider.
Section 12 (256.975, subdivision 7) requires the Senior LinkAge Line to develop processes to assist health care homes and hospitals to identify at-risk older adults, and determine when long-term care counseling is appropriate, effective July 1, 2013.
Section 13 (256B.056, subdivision 1a) adds a cross-reference for language added in section 12, effective April 1, 2012.
Section 14 (256B.056, subdivision 3) disregards, for Medical Assistance (MA) eligibility purposes, the assets and spousal income, up to certain limits, of Medical Assistance for Employed People with Disabilities (MA-EPD) participants who turn 65 years of age and have been enrolled in MA-EPD for at least 24 consecutive months.
Section 15 (256B.0625, subdivision 17) allows DHS to adjust reimbursement rates for special transportation services by one percent for every $0.10 increase or decrease in the average price of gasoline over an average of three dollars per gallon.
Section 16 (256B.0631, subdivision 2) exempts the following services from MA co-payments: DD, CADI, CAC, TBI, and elderly waiver services; nursing and home health services; personal care services and related nursing supervision services; private nursing duty services; personal care assistance services; and day training and habilitation services.
Section 17 (256B.0911, subdivision 3c) requires housing with services establishments to inform a prospective resident or their legal representative of the long-term care options counseling requirement and the opportunity to decline the counseling. Changes to the list of circumstances when consultation services are required within five working days are also made. This section is effective July 1, 2013.
Section 18 (256.0911, subdivision 3d) adds a new subdivision exempting long-term care consultation requirements under certain circumstances, effective July 1, 2013.
Section 19 (256B.092, subdivision 1b) states that changes to a consumer’s services should serve as an addendum to the consumer’s individual service plan.
Section 20 (256B.097, subdivision 3) requires the State Quality Council to identify financial and personal risk issues that prevent people with disabilities from optimizing community-based services and recommend statutory and rule changes to the Legislature by January 15, 2013.
Section 21 (256B.431, subdivision 17e) allows the replacement-costs-new per bed amount to increase under the nursing facility moratorium exception in section 3, beginning October 1, 2012.
Section 22 (256B.431, subdivision 45) adds a new subdivision allowing a rate adjustment for certain nursing facilities under the moratorium exception in section 3, effective upon federal approval.
Section 23 (256B.434, subdivision 10) removes a reference to a subdivision being repealed from the list of exemptions for nursing facilities participating in the Alternative Payment Demonstration Project.
Section 24 (256B.441, subdivision 63) adds a new subdivision creating a critical access designation for nursing facilities. DHS will work with the MDH and stakeholders in establishing the designation proposal process, and grant the designation on a competitive basis. The funding will be limited to a $1 million appropriation in fiscal year 2013, which will be ongoing and added to the base.
DHS will request designation proposals every two years. Facilities currently designated may apply for continued designation; if the continued designation is not granted, the benefits listed below will no longer apply.
Section 25 (256B.48, subdivision 6a) adds a new subdivision requiring nonMedicare participating nursing facilities to refer dual-eligible (Medicare and Medicaid) recipients qualifying for Medicare-covered stay to Medicare providers.
Section 26 (256B.49, subdivision 15) allows licensed adult foster care capacity to not be reduced if savings realized through the licensed bed closure reductions for foster care settings are met, as described in section 5. This reassessment process is extended by one year.
Section 27 (256B.49, subdivision 23) specifies that the definition of “community-living settings” includes the existence of a lease agreement between the service recipient and the landlord; requires the service provider to transfer the lease to the service recipient, and allows an exemption to this requirement if the landlord is not willing to transfer the lease.
Section 28 (256B.492) adds a new section establishing an adult foster care voluntary closure program, requiring DHS to seek proposals for the conversion of services for persons with developmental disabilities to other community settings and submit a report to the Legislature by February 15, 2013 on the inventory of assessed needs and total license capacity. The section outlines the process for voluntary closure of adult foster care homes if the total licensed capacity is deemed in excess of the assessed need.
Section 29 (256D.44, subdivision 5) requires service providers for those deemed shelter needy and who meet certain requirements to transfer the lease to the service recipient within two years, and allows an exemption to this requirement if the landlord is not willing to transfer the lease. Also sets the maximum number of units in a building utilized by general assistance recipients to be four units, or 25 percent, whichever is greater.
Section 30 (Laws 2011, First Special Session chapter 9, article 7, section 52) provides for federal approval of the nursing facility level of care after July 1, 2012.
Section 31 (Laws 2011, First Special Session chapter 9, article 10, section 3 subdivision 3) requires lead agencies to review with providers individual service plan and identify changes to reduce the utilization of congregate living services.
Section 32 (Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 4) designates $100,000 for administrative services and $400,000 for data collection and analysis related congregate living grants.
Section 33 requires DHS to reduce the 2011 congregate living rate reduction for individuals with lower needs under certain circumstances, and requires a report to the Legislature each February 1 on the congregate living rate reductions. This section is effective July 1, 2012, and expires June 30, 2014.
Section 34 requires the DHS commissioner, by June 1, 2012, to seek federal approval to allow individuals meeting the new MA eligibility criteria to continue MA-EPD enrollment.
Section 35 allows current MA-EPD enrollees who meet certain requirements and turn 65 years of age in 2012 to continue MA-EPD enrollment while seeking federal approval under section 34.
Section 36 requires the fiscal analysis for the changes in the MA-EPD program to include the cost to other state and federal agencies if implementation does not occur.
Section 37 describes, for people receiving home and community-based waiver services, the types and characteristics of living settings both allowed and not allowed in order to receive services. People receiving home and community-based waiver services whose living settings are not allowed under the new criteria are grandfathered in as of June 30, 2013.
Section 38 requires DHS to allow 15-minute and daily rate billing for independent living services under the Brain Injury (BI) and Community Alternatives for Disabled Individuals (CADI) waivers, and instructs DHS to submit a waiver amendment to the state plan to the federal government, if required.
Section 39 repeals: a subdivision related to DHS biennial budget request requirements for the nursing facility moratorium exception process; a subdivision regarding nursing facility Medicare certification; and the 1.67 percent contingency rate reduction for home and community-based programs and intermediate care facilities for developmental disabled individuals set to take effect July 1, 2012.
ARTICLE 5
MISCELLANEOUS
Section 1 (43A.316, subdivision 5) creates a moratorium on enrollment into the public employee insurance program (PEIP) for employees of an eligible employer that is not participating in the program as of the date of enactment, until January 1, 2015. Provides an exception to this moratorium for a city that has received a formal written bid from PEIP as of the date of enactment.
Section 2 (62A.047) clarifies that a health plan company may use a network of providers and impose cost-sharing requirements for out-of-network providers and use reasonable medical management techniques to determine frequency, method, treatment or setting for child health supervision services and prenatal care services.
Sections 3 and 4 (62A.21, subdivision 2a; 62D.101, subdivision 2a) permit insurers to calculate premiums for continuation policies for an insured's former spouse and dependent children in the same manner as provided under Section 4980 B of the Internal Revenue Code.
Section 5 (62J.26, subdivision 3) requires the Commissioner of Commerce to conduct an evaluation of any bill that is introduced or any amendment to a bill that contains a mandated health benefit proposal.
Section 6 (62J.26, subdivision 5) requires the commissioner to submit a written report on the evaluation to the legislature no later than 30 days from the request.
Section 7 (62J.26, subdivision 6) requires the Commissioner of Commerce, in consultation with the Commissioners of Health and Management and Budget to evaluate each mandated health benefit currently required under Minnesota law or rules. The commissioner is required to submit a written report on the required evaluation to the legislature by December 31, 2015.
Section 8 (148.2855) creates the Nurse Licensure Compact.
Article 1 defines terms.
Article 2 establishes the general provisions and jurisdiction of the compact.
Paragraph (a) states that a license to practice nursing issued by a home state must be recognized by states that are parties to the nurse licensure compact. It also requires the licensee to meet the home state’s requirements for licensure and license renewal and to comply with applicable state laws.
Paragraph (b) authorizes party states in accordance with due process laws to limit or revoke the multistate licensure privilege of any nurse to practice in their state, and may take any other actions under applicable state law in order to protect the health and safety of state’s citizens. If a party state takes such action, it must notify the administrator of the coordinated licensure system and the administrator must notify the home state of any action taken by remote states.
Paragraph (c) requires every nurse practicing in a party state to comply with practice laws of the state in which the patient is located at the time the care is rendered. It also states that the practice of nursing is not limited to patient care and will subject the nurse to the jurisdiction of the nurse licensure board, courts, and the laws of the party state.
Paragraph (d) states that this compact does not affect additional requirements imposed by states for advanced practice registered nursing, but a multistate licensure privilege to practice registered nursing shall be recognized as a license to practice registered nursing, if one is required by state law as a precondition for qualifying for advanced practice registered nurse authorization.
Paragraph (e) states that individuals who do not reside in a party state can continue to apply for licensure as provided under the laws of a party state. A license granted to these individuals does not automatically permit the individual to practice in any other party state unless that state specifically agrees to allow the individual the right to practice.
Article 3 establishes the applications for licensure in a party state.
Paragraph (a) requires the party state licensing board to determine if the applicant has ever held a license in any other state and whether there are any restrictions or other adverse actions taken against the applicant.
Paragraph (b) states that a nurse in a party state may only hold licensure in one party state at a time and that licensure must be issued by the home state.
Paragraph (c) permits a nurse who plans on changing primary state of residence to apply for licensure in the new home state in advance of the change, although a new license will not be issued until the nurse provides evidence of the change in residence.
Paragraph (d) establishes the conditions that apply when a nurse changes primary state of residence.
Article 4 establishes the provisions for adverse actions.
Paragraph (a) requires the licensing board of a remote state to report to the administrator of the coordinated licensure information system any remote state actions taken, and report any significant current investigative information. The administrator is required to notify the home state of any reports.
Paragraph (b) states that the party state licensing board has the authority to complete any pending investigation on a nurse who changes primary state of residence during the course of an investigation and take appropriate action. The conclusion of any such investigation must be reported to the administrator and the administrator is required to notify the new home state of the action taken.
Paragraph (c) authorizes a remote state to take adverse action affecting a multistate licensure privilege to practice within that party state, but only a home state has the power to impose adverse action against the license issued by the home state.
Paragraph (d) states that the licensing board of the home state must give the same priority and effect to reported conduct received from a remote state as it would if the conduct had occurred within the home state and shall apply its own state laws in determining appropriate action.
Paragraph (e) authorizes the home state to take adverse action based on the factual findings of the remote state, but each state must follow its own procedures for imposing adverse action.
Paragraph (f) states that this compact does not override a party state’s decision that participation in an alternative program may be used in lieu of licensure action, and that participation shall remain nonpublic if required by the party state’s laws.
Article 5 establishes additional party state licensing board authority.
This article gives party state licensing boards the authority to recover costs of investigation and disposition of complaints from the affected nurse, issue subpoenas, issue cease and desist orders, or revoke a nurse’s authority to practice in the party state, and adopt uniform rules as provided in article 7.
Article 6 establishes the coordinated licensure information system
Paragraph (a) requires all party states to participate in a cooperative effort to create a coordinated database of all licensed registered nurses and licensed practical/vocational nurses.
Paragraph (b) requires all party states’ licensing boards to report all adverse actions, actions against privileges, current investigative information yet to result in an adverse action, denials of applications, and the reasons for the denials to the coordinated licensure information system.
Paragraph (c) states that current investigative information is to be transmitted through the system only to party state licensing boards.
Paragraph (d) permits party states’ licensing boards contributing information to the system to designate information that may not be shared with nonparty states or disclosed to other entities or individuals without express permission of the contributing state.
Paragraph (e) states that personally identifiable information obtained by a party state’s licensing board through the system may not be shared with nonparty states or disclosed to other entities or individuals, except to the extent permitted under the laws of the party state contributing the information.
Paragraph (f) requires any information that is contributed to the coordinated licensure system that is subsequently required to be expunged by the laws of the party state contributing the information to be expunged from the information system.
Paragraph (g) requires the compact administrators to formulate procedures for the identification, collection, and exchange of information under this compact.
Article 7 establishes the compact administration and interchange of information.
Paragraph (a) states that the head or designee of each party state nurse licensing board shall be the administrator of the compact for the state.
Paragraph (b) requires the administrator of each party state to furnish to the compact administrator of each other party state any information and documents to facilitate the administration of this compact.
Paragraph (c) states that compact administrators have the authority to develop uniform rules to facilitate and coordinate implementation of this compact. These rules must be adopted by the party states under the authority included article 5.
Article 8 establishes immunity.
This article grants immunity to the party state or the officers, employees, or agents of the state’s licensing board for actions taken in good faith according to the provisions of the compact while engaged in the performance of their duties under the compact. This immunity does not apply if the action taken was willful misconduct, gross negligence, or recklessness.
Article 9 provides enactment, withdrawal, and amendment information.
Paragraph (a) states that the compact shall become effective for each state when it is enacted by that state, and the state may withdraw from the compact upon repeal of the nurse licensing compact. Withdrawal will not become effective until six months after notice has been given to the executive heads of all other party states.
Paragraph (b) states that a withdrawal does not affect the validity or applicability of any adverse action report taken by a licensing board of a party state if the report occurred prior to the withdrawal.
Paragraph (c) states that this compact does not invalidate or prevent any nurse license agreement or other arrangement between a party state and a nonparty state that is made according to other provisions of this compact.
Paragraph (d) permits the compact to be amended by the party states. An amendment does not become binding upon the party states until it is enacted into law of all party states.
Article 10 establishes construction and severability.
Paragraph (a) states that the compact shall be liberally construed and that the provisions shall be severable.
Paragraph (b) permits arbitration to settle any disputes and states that the decision of the arbitrator shall be final and binding.
Section 9 (148.2856) clarifies the applicability of the nurse licensure compact to existing nurse licensure law, including licensing requirements, labor laws, date privacy, reporting requirements, disciplinary actions, immunity provisions, cooperation requirements, data sharing, direct patient requirements, and criminal background check requirements.
Section 10 (148.2857) permits the Governor to withdraw the state from the compact upon notification by the Board of Nursing that a party state has changed that state’s requirements to be substantially lower than Minnesota’s requirements.
Section 11 (148.2858) states that for purposes of the compact, “head of the nurse licensing board”means the executive director of the Board of Nursing. This section also authorizes the Board of Nursing to recover the costs of investigating allegations against multistate licensees and to implement a system to identify multistate practitioners in Minnesota.
Section 12 (148.2859) creates the Nurse Licensure Compact Advisory Committee and establishes membership, duties of the members, and the organization of the committee.
Section 13 corrects a subtracting error from last session to the base adjustment for the administrative services unit.
Section 14 encourages the Board of Regents of the University of Minnesota to include a request for funding as part of the biennial budget request to the Department of Management and Budget for rural primary care training delivered by family practice residence programs.
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