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ARTICLE 1
CONTINUING CARE
Sections 1 (256.01, subdivision 24) modifies the Disability Linkage Line by adding information dissemination responsibilities. (Governor)
Section 2 (256.01, subdivision 29) makes conforming language changes related to section 5. (Governor)
Sections 3 and 4 (256B.056, subdivisions 1a and subdivision 3) disregard the assets of Medical Assistance (MA) enrollees and their spouses for eligibility purposes if: the enrollee is a disabled person who is employed, reaches age 65, and has been enrolled in MA for 24 consecutive months prior to reaching age 65. Additionally, the enrollee’s spouse’s income must also be disregarded for MA eligibility purposes. (S.F. No. 726)
Section 5 (256B.057, subdivision 9) increases the monthly premium for MA recipients that are employed persons with disabilities (MA-EPD) from $35 to $65, effective January 1, 2014 for adults age 21 or older, and October 1, 2019 for children age 16 to before child’s 21st birthday. (Governor)
Section 6 (256B.0625, subdivision 19a) strikes language that makes persons with one activity of daily living (ADL) dependency ineligible for personal care assistance (PCA) services effective July 1, 2011. (S.F. No. 348)
Section 7 (256B.0652, subdivision 6) applies the existing home care rating system to PCA services recipients with two or more ADL dependencies, and sets the home care rating for PCA services recipients with one ADL dependency or Level I behavior to no more than two units per day, effective July 1, 2011. (S.F. No. 348)
Section 8 (256B.0913, subdivision 4) allows funding for alternative care (AC) services for people with up to two ADL dependencies, and reduces the limit of the monthly AC services cost from $600 to $593, effective July 1, 2011. (Governor)
Sections 9 and 10 (256B.0915, subdivisions 3a and subdivision 3b) allows funding for Elderly Waiver (EW) services for people with up to two ADL dependencies, and limits the monthly cost for EW services to $1,750 for all new enrollees effective July 1, 2011. Also establishes how to convert the per diem nursing facility rate into an EW monthly budget for nursing facility residents applying for EW services; savings are then realized by reducing the EW monthly budget based on applicants’ maintenance needs outside of the nursing facility. (Governor)
Section 11 (256B.0915, subdivision 3e) sets the monthly payments for customized living services to 25 percent lower than the current case mix A rate for new or reassessed EW services recipients meeting specific criteria, effective July 1, 2011. (Governor)
Section 12 (256B.0915, subdivision 3h) requires new participants enrolling in 24-hour customized living services to have dependencies in at least three of the following ADLs: bathing, grooming, walking or eating (when the eating dependency score is three or above). Additionally, it prohibits a provider from charging EW participants for additional units of allowable component service beyond those approved by the lead agency. Effective July 1, 2011. (Governor)
Section 13 (256B.0915, subdivision 6) requires EW client’s provider of services to be provided a copy of the client’s written care plan. (S.F. No. 753)
Section 14 (256B.0915, subdivision 10) makes conforming language changes related to sections 8 to 13. (Governor)
Section 15 (256B.14, subdivision 3b) obliges spouses of institutionalized persons on MA to contribute to the cost of care for the institutionalized spouse, with certain exceptions, effective July 1, 2011. Payments are based on a sliding scale, as outlined in the table below, with certain limits. Notification and appeals processes are also established. (S.F. No. 645)
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Adjusted Gross Income
(AGI)
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Spousal Contribution
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>= 250% and <545% of Federal Poverty Guidelines for family of two
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Sliding scale between 7.5% and 15% of AGI, determined by the Commissioner of the Department of Human Services
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>= 545% and < 750% of Federal Poverty Guidelines for family of two
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Sliding scale between 15% and 25% of AGI, determined by the Commissioner of the Department of Human Services
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>= 750% and < 975% of Federal Poverty Guidelines for family of two
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Sliding scale between 25% and 33% of AGI, determined by the Commissioner of the Department of Human Services
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> =975% of
Federal Poverty Guidelines for family of two
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33% of AGI
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Section 16 (256B.431, subdivision 2r) eliminates payments for leave days in nursing facilities, effective July 1, 2011. (Governor modified by Senate)
Section 17 (256B.431, subdivision 32) renames the subdivision and makes the necessary language changes to reflect the current first 30-day incentive program for new nursing facility residents. (Senate)
Section 18 (256B.431, subdivision 42) eliminates the nursing facility single bed incentive, effective July 1, 2011. (Governor)
Section 19 (256B.431, subdivision 44) modifies the property rate for a nursing facility in Bloomington, effective November 1, 2010. (Senate)
Section 20 (256B.437, subdivision 6)eliminates the nursing facility planned closure rate adjustment, effective July 1, 2011. (Governor)
Section 21 (256B.441, subdivision 50a) modifies certain nursing facility operating payment rates proximity adjustments. (S.F. No. 87)
Section 22 (256B.441, subdivision 59) eliminates the private room incentive for MA recipients in nursing facilities, effective July 1, 2011. (Governor modified by Senate)
Section 23 (256B.48, subdivision 1)phases out the rate equalization requirements for nursing facilities with both MA and private pay residents, as outlined in the table below: (S.F. No. 731)
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Effective Date
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*Rate Increase (above the sum of the MA allowable payment rate)
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October 1, 2011
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2 percent
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October 1, 2012
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4 percent
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October 1, 2013
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6 percent
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October 1, 2014
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8 percent
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October 1, 2015
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No restriction on rates
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*The Rate Increase is applied to the allowable payment rate in effect on the date before the Effective Date
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Section 24 creates a working group to develop a proposal to create a single administrative structure for providing medical nonemergency transportation services to fee-for-service MA recipients. A report is due to the Legislature on January 15, 2012. (S.F. No. 370)
Section 25 creates a nursing facility pilot project to develop a new approach to caring for certain individuals. A report is due to the Legislature on November 15, 2011. (Senate)
ARTICLE 2
CHEMICAL MENTAL HEALTH
Sections 1 and 3 (254B.03, subdivision 4, and 254B.06, subdivision 2) increase the county share from 16.14 percent to 29.76 percent, for chemical dependency treatment costs. (Governor modified by Senate)
Section 2 (254B.04, subdivision 2a) relates to eligibility for treatment in residential settings. This section requires a person to score at level 4 on assessment dimensions related to relapse, continued use, and recovery environment in order to be assigned to services with a room and board component. (Governor)
ARTICLE 3
HUMAN SERVICES
Sections 1 to 8 modify the child care chapter of law.
Section 1 (119B.011, subdivision 13) limits the time an adult family member who is not in an authorized activity may be temporarily absent from the home to 60 days. (Governor)
Sections 2 and 3 (119B.09, subdivisions 9a and 10) limit child care assistance payments (CCAP) to child care centers that provide services and receive CCAP payments for children whose parent or a person who resides with the child is employed at the center. (Governor)
Section 4 (119B.09, subdivision 13) prohibits CCAP payments for child care provided in the child’s home, unless certain conditions are met as specified in this section. (Governor)
Section 5 (119B.125, subdivision 1b) requires legal nonlicensed child care providers to complete CPR training. (Governor)
Section 6 (119B.13, subdivision 1) reduces child care rates by five percent and eliminates payments for activity fees. Sections 6 and 7 (119B.13, subdivision 1a) eliminate the rate differential for providers that care for children during nonstandard hours. (Governor modified by Senate)
Section 8 (119B.13, subdivision 7) eliminates absent day payments for legal nonlicensed child care providers and limits absent day payments to ten days per calendar year for licensed providers. (Governor)
Section 9 (256.01, subdivision 14) limits child welfare pilot programs to available appropriations. (Senate)
Section 10 (256.0145) requires the Commissioner of Human Services to reprogram MAXIS to automatically apply child support payments, and requires all prepaid health plans to accept an updated billing format for certain benefits. The commissioner is required to make necessary changes to the SSIS system to bill prepaid health plans for the claims. (S.F. No. 703)
Section 11 (256B.69, subdivision 30) permits prepaid health plans to provide medical assistance enrollees and potential enrollees with required materials in a medium other than paper. (S.F. No. 703)
Section 12 (256D.02, subdivision 12a) continues the 30-day residency requirement for general assistance medical care and strikes existing language in this subdivision related to general assistance. (S.F. No. 150)
Sections 13 and 14 (256D.44, subdivision 5; and 256D.47) amend the Minnesota supplemental aid program by eliminating allowances for special needs and special diets. (Senate)
Sections 15, 22, and 28 (256D.49, subdivision 3; 256J.38, subdivision 1; and 393.07, subdivision 10) make uniform the policy related overpayments of assistance across programs. The new language provides that the establishment of an overpayment is limited to 12 months prior to the month of discovery due to agency error and six years prior to the month of discovery due to client error or an international program violation. (S.F. No. 703)
Section 16 (256E.30, subdivision 2) strikes the reference to state money appropriated for community action agencies. (Initial Governor)
Sections 17 and 18 (256E.35, subdivision 5, and 256E.35, subdivision 6) strike references to funding for the family assets for independence program. (Governor)
Sections 19 and 20 (256J.12, subdivision 1a; 256J.12, subdivision 2) impose a 60-day residency requirement on the Minnesota Family Investment program. Current law imposes a 30-day residency requirement. Current law is stricken that allows the residency requirement to be waived for unusual hardship, as defined in this section. (S.F. No. 150)
Section 21 (256J.37, subdivision 3c) modifies the MFIP program by reducing the MFIP grant by $150 per SSI recipient who resides in the household. (Senate)
Sections 23 to 27 (256N.10; 256N.20; 256N.22; 256N.25; and 256N.30) establish the adult assistance program by combining the general assistance, emergency general assistance, emergency supplemental aid, and Minnesota supplemental aid special needs and special diets, into one block grant to counties for low-income adults, with a 60-day residency requirement. The county is given flexibility to spend the funds on the target population. (Senate)
Sections 29 to 31 (section 402A.10, subdivisions 4 and 5; 402A.15) modify the county redesign legislation passed in 2009. (Senate)
Section 32 (518A.51) increases the child support recovery fee from one percent to two percent to be reinvested in the child support enforcement program. (Governor)
Section 33 (County Electronic Verification Procedures) requires the Commissioner of Human Services to define which public assistance program requirements may be electronically verified for purposes of eligibility, and also defines procedures for electronic verification, and report back to the Legislature by January 15, 2012. (S.F. No. 703)
Sections 34 (Alignment of Program Policy and Procedures) requires the commissioner to develop recommendations to align eligibility verification procedures for health care, assistance, food support, child support enforcement, and child care, and report back by January 15, 2012, with recommendations. (S.F. No. 703)
Section 35 (Alternative Strategies for Certain Redeterminations) requires the commissioner to develop and implement by January 15, 2012, a simplified process to redetermine eligibility for a specific population who are expected to experience minimal change in income or assets from month to month. (S.F. No. 703)
Section 36 (Request for Proposals; Combined Online Application) requires the commissioner to request proposals to implement an integrated online eligibility and application portal for food support, cash assistance, child care and health care, which must streamline eligibility determinations and case processing. The commissioner is required to enter into a contract by January 31, 2012. The contract must incorporate a performance-based vendor financing option whereby the vendor contributes the nonfederal share of the cost. The commissioner shall report back to the Legislature if an adequate vendor cannot be chosen based on the responses to the request for proposals. (S.F. No. 578)
Section 37 (Uniform Asset Limit Requirements) requires the Commissioner of Human Services to analyze the difference in asset limit requirements across programs to establish a consistent asset limit, and report to the Legislature by January 15, 2012. (S.F. No. 470)
Section 38 (Anaysis of Programs and Their Affect on Healthy Marriages) requires the Commissioner Human Services to conduct an analysis of whether current human services programs affect the motivation and capacity to form and sustain healthy marriages, and report back to the Legislature by January 1, 2012. (Senate)
Section 39 is a Revisor instruction to make conforming amendments and correct statutory cross-references as necessitated by the creation of Minnesota Statutes, chapter 256N, and related repealers. (Senate)
Section 40 repeals Minnesota Statutes, sections: 256.979, (Child Support Incentives) subdivisions 5 (Bonus incentive program), 6 (Claims for bonus incentive), 7 (Distribution), and 10 (Transferability between bonus incentive accounts and grants to county agencies); 256.9791 (Medical Support Bonus Incentives) subdivisions 1 (Bonus incentive), 2 (Definitions), 3 (Eligibility; reporting requirements), 4 (Rate of bonus incentive), 5 (Claims for bonus incentive), and 6 (Distribution); 256D.01 (Declaration of Policy; Citation) subdivisions 1 (Policy), 1a (Standards), 1b (Rules), 1e (Rules regarding emergency assistance), and 2 (Citation); 256D.03 (Responsibility to Provide General Assistance) subdivisions 1 (County administration), 2 (Assistance standards), and 2a (County agency options); 256D.05, (Eligibility for General Assistance) subdivisions 1 (Eligibility), 2 (Use of federal funds), 4 (Consent to review records), 5 (Transfers of property), 6 (Assistance for persons without a verified residence), 7 (Ineligibility for general assistance), and 8 (Citizenship); 256D.0513 (Budgeting Lump Sums); 256D.053 (Minnesota Food Assistance Program) subdivisions 1 (Program established), 2 (Eligibility requirements), and 3 (Program administration); 256D.06 (Amount of Assistance) subdivisions 1 (Eligibility; amount of assistance), 1b (Earned income savings account), 2 (Emergency need), 5 (Eligibility; requirements), 7 (SSI conversions and back claims), and 8 (Recovery of ATM errors); 256D.09 (Payment; Assessment; Overpayment) subdivisions 1 (Presumptive eligibility; payments), 2 (Voucher or vendor payments), 2a (Vendor payments for drug dependent persons), 2b (Disability verification; drug or alcohol dependency), 5 (Vendor payments to landlords), and 6 (Recovery of overpayments); 256D.10 (Administrative Hearing Prior to Adverse Action); 256D.13 (Mandamus to Compel Payment of General Assistance) subdivisions 1 (District court), and 2 (Administrative or judicial review); 256D.15 (Relative’s Responsibility); 256D.16 (General Assistance to be Allowed as Claim in Court); 256D.35 (Definitions) subdivision 8b (Emergency); and 256D.46 (Emergency Minnesota Supplemental Aid) subdivisions 1 (Eligibility), 2 (Income and resource test), and 3 (Payment amount).
Minnesota Rules, parts, 9500.1243, subpart 3; and 3400.0130, subpart 8, effective September 3, 2012
ARTICLE 4
DEPARTMENT OF HUMAN SERVICES LICENSING
Section 1 (245A.10, subdivision 1) strikes state-operated programs from the list of programs exempt from a licensing fee. (Governor)
Section 2 (245A.10, subdivision 3) allows an applicant for a license for a private agency to provide foster care or adoption services to submit a single application to provide services statewide. (Governor)
Section 3 (245A.10, subdivision 4) modifies licensing fees and establishes new licensing fees. (Governor)
Section 4 (245A.10, subdivision 7) provides that the commissioner shall plan to fully recover direct expenditures for licensing activities over a five-year period. The commissioner may have anticipated expenditures in excess of anticipated revenues in a biennium by using surplus revenues accumulated in a previous biennium. (Governor)
Section 5 (245A.10, subdivision 8) establishes the human services licensing account in the state government special revenue fund. Fees collected must be deposited into the account and annually appropriated to the commissioner for licensing activities. (Governor)
Sections 6 and 7 (245A.11, subdivision 2b; and 245A.143, subdivision 1) allow an adult foster care license holder to also provide family adult day care for adults 18 or over, instead of 55 or over. (S.F. No. 254)
Section 8 (245C.10, subdivision 9) requires the commissioner to recover the cost of background studies for all programs licensed by the commissioner, except child foster care and family child care. (Governor)
Section 9 (256B.49, subdivision 16a) requires the commissioner to seek federal waiver approval for Medicaid reimbursement of family adult day services under all disability waivers. After the waiver is granted, the commissioner shall include family adult day services in the common services menu that is currently under development. (S.F. No. 254)
Section 10 repeals current law related to licensing fees, which is replaced by the new fees in this article. (Governor)
ARTICLE 5
HEALTH CARE
Sections 1 to 3 establish the Freedom of Choice in Health Care Act. (S.F. No. 33)
Section 1 (1.06) provides the definitions, statement of policy, and enforcement of the act. (S.F. No. 33)
Section 2 (8.31, subdivision 1) requires the Attorney General to seek injunctive and any other appropriate relief to preserve the rights and property of the residents of the state and to defend the state’s officials, employees, and agents in the event that there is a law or regulation that violates the public policy as set forth in the Freedom of Choice in Health Care Act. This section also requires the Attorney General to seek injunctive and any other appropriate relief in the event that any law or regulation that violates the public policy of the Freedom of Choice in Health Care Act is enacted without adequate federal funding to the state to ensure affordable health care coverage is available to the residents of the state. (S.F. No. 33)
Section 3 (8.31, subdivision 3a) allows a civil action for a violation of the Freedom of Choice in Health Care Act. (S.F. No. 33)
Section 4 (62E.14, subdivision 4f) specifies that a person who is eligible for the Healthy Minnesota Contribution Program under Minnesota Statutes, section 256B.695, may enroll in MCHA with a waiver of the preexisting condition limitation if the person has been denied coverage in the individual market. (Healthy MN Plan)
Section 5 (62J.692, subdivision 7) eliminates the medical education and research (MERC) payments. (Governor modified by Senate)
Section 6 (256.01, subdivision 33) implements federal program integrity audits and authorizes the commissioner to retain the contingency state share of recoveries in order to implement a contract with a vendor for the audits. (Governor)
Section 7 (256.969, subdivision 2b) delays rebasing of hospital rates under medical assistance (MA) for six months. (Governor)
Section 8 (256B.04, subdivision 18) requires the Commissioner of Human Services to modify the Minnesota health care programs application form to ask applicants if they are U.S. military veterans. (Healthy MN Plan)
Section 9 (256B.06, subdivision 4) eliminates state-funded medical assistance coverage for legal noncitizens, and eliminates ongoing coverage for treatment for chronic conditions under the emergency medical assistance program. (Senate)
Sections 10 to 14 and 16 eliminate optional services in MA and MinnesotaCare.
Section 10 (256B.0625, subdivision 3g) eliminates coverage for chiropractic services. (Senate)
Section 11 (256B.0625, subdivision 3h) eliminates coverage for podiatric services. (Senate)
Section 12 (256B.0625, subdivision 8) eliminates physical therapy for adults. (Governor modified by Senate)
Section 13 (256B .0625, subdivision 8a) eliminates occupational therapy for adults. (Governor modified by Senate)
Section 14 (256B.0625, subdivision 8b) eliminates speech-language pathology for adults. (Governor)
Section 15 (256B.0625, subdivision 8c) modifies rehabilitation services for physical therapy, occupational therapy, and speech-language pathology and audiology services, by requiring prior authorization for an episode of treatment. Authorization for services shall include approval for up to six months, instead of 12 months. (Governor)
Section 16 (256B.0625, subdivision 12) eliminates eyeglasses, dentures, and prosthetic devices for adults. (Senate)
Section 17 (256B.0625, subdivision 13e) modifies the pharmacy reimbursement rate methodology to replace the use of Average Wholesale Price for pharmacy reimbursement. Effective July 1, 2011, drugs will be priced using the wholesale acquisition cost (WAC) benchmark. (Governor)
Sections 18 to 20 (256B.0625, subdivision 17; 256B.0625, subdivision 17a; and 256B.0625, subdivision 18) impose a 4.5 percent ratable reduction for transportation services, including ambulance, special transportation services (STS), and access transportation services (ATS). (Governor)
Section 21 (256B.0625, subdivision 25) requires the commissioner to implement a modernized electronic system for providers to request prior authorization. This section specifies what the system must include. The system must be completed by March 1, 2012, and all authorization requests after that date must be submitted electronically. (Governor)
Section 22 (256B.0625, subdivision 25b) requires that providers secure authorization or payment from third-party payers prior to requesting authorization for payment from Minnesota health care programs. (Governor)
Section 23 (256B.0625, subdivision 31a) changes the payment methodology for augmentative and alternative communication systems in the Minnesota health care programs, as specified in this section. (Governor)
Section 24 (256B.0625, subdivision 55) allows a provider to seek payment from the recipient for services not eligible for payment under MA when the provider reviews and considers all available covered alternatives with the recipient, and obtains a signed acknowledgement from the recipient of the potential of the recipient’s liability. (Governor)
Section 25 (256B.0625, subdivision 56) requires the commissioner to implement a program to reduce the number of elective inductions of labor prior to 39 weeks’ gestation. (Governor)
Section 26 (256B.0625, subdivision 57) limits MA payment for Medicare crossover claims to the MA payment rate. This is effective for services provided on or after January 1, 2012. (Governor)
Section 27 (256B.0625, subdivision 58) freezes rates on payments to providers for child and teen check-up screenings. (Governor)
Sections 28 to 30 (256B.0651, subdivision 1; 256B.0653, subdivision 2; and 256B.0653, subdivision 6) eliminate physical therapy, occupational therapy, respiratory therapy, and language-speech pathology therapy from home care services and home health agencies. (Senate)
Section 31 (256B.69, subdivision 4) requires persons eligible for MA due to blindness or disability be enrolled in prepaid Medical Assistance Program (PMAP), unless the person elects to opt out. The opt-out does not apply to persons who are 65 or older or reside in Itasca County or another county where the commissioner conducts a section 1115 waiver pilot. (Senate)
Sections 32, 45, 46, and 49 relate to managed care reforms.
Section 32 (256B.69, subdivision 5a) relates to PMAP payments and section 45 relates to MinnesotaCare payments. These sections withhold five percent of Minnesota health care (MCO) program capitation payments to managed care organizations, and the withheld funds are returned the next year depending on whether the MCO meets specified performance measures. (Govenor)
Section 33 (256B.695) establishes the Healthy Minnesota Contribution Program for certain medical assistance enrollees. (Section 41 is related to this section) (Healthy MN Plan
Subdivision 1, paragraph (a), requires the Commissioner of Human Services, beginning January 1, 2012, to provide certain medical assistance enrollees with family income greater than 75 percent of the federal poverty guidelines (FPG) with a monthly defined contribution in order to purchase health coverage through a health plan in the private individual market.
Paragraph (b) exempts these enrollees from the required enrollment in a managed care plan or a county-based purchasing plan.
Paragraph (c) states that the medical assistance provisions related to covered services (section 256B.0625), and cost sharing (section 256B.031), do not apply to these enrollees. This paragraph also states that the covered services, cost sharing, and disenrollment for nonpayment of premiums, are, instead, provided by the terms of the health plan purchased by the enrollee. This paragraph also states that a health plan purchased by an enrollee shall be considered a prepaid health plan for purposes of compliant process and appeals
Paragraph (d) specifies that unless otherwise provided in this section, all medical assistance requirements related to eligibility, income and asset methodology, income reporting, and program administration continue to apply. States that retroactive coverage still applies to these enrollees.
Subdivision 2 allows enrollees to use up to the monthly defined contribution as determined under subdivision 3 to pay premiums for coverage under a health plan.
Subdivision 3, paragraph (a), requires the commissioner to determine the defined contribution amount using a sliding scale, under which the per person defined contribution is a function of age and income. This paragraph specifies that the monthly per person base contribution ranges from $122.79 for persons under the age of 21 to $357.19 for persons age 60 and over. The base contribution is multiplied by a percentage inversely related to income, ranging from 110 to 80 percent, to obtain the monthly per person defined contribution amount.
Paragraph (b) requires the defined contribution amount calculated under paragraph (a) to be increased by 20 percent for enrollees who are denied coverage in the private individual market and who purchase coverage through MCHA.
Paragraph (c) states that notwithstanding paragraphs (a) and (b), the monthly defined contribution shall not exceed 90 percent of the monthly premium for the health plan purchased by the enrollee, and shall be reduced by five percent if the health plan the enrollee chooses to purchase does not include coverage for mental health and chemical dependency treatment services.
Subdivision 4 requires the commissioner to administer the defined contributions by calculating and processing defined contributions for enrollees and paying the defined contribution to the health plan companies or MCHA, as applicable.
Subdivision 5 requires the Commissioner of Human Services, in consultation with the Commissioner of Commerce, to develop an efficient and cost-effective method to refer eligible enrollees to professional insurance agent associations.
Subdivision 6 states that beginning January 1, 2012, medical assistance enrollees who are eligible under this section, and who are denied coverage in the individual market are eligible for coverage through MCHA and may enroll in MCHA in accordance with chapter 62E. This paragraph also states that any difference between the revenue and covered losses to MCHA related to the implementation of this section shall be paid to MCHA from the health care access fund.
Subdivision 7 requires the commissioner to seek all federal approvals and waivers necessary to implement this section.
Section 34 (256B.76, subdivision 4) relates to critical access dental (CAD) providers to clarify that only clinics that are University of Minnesota or Minnesota State Colleges and Universities owned and operated may be designated as CAD providers. (Governor)
Section 35 (256B.841) Waiver Application and Process (S.F. No. 760)
Subdivision 1 provides an intent statement.
Subdivision 2 the commissioner to apply for a waiver and any necessary state plan amendments that provides program flexibility and under which Minnesota will operate its MA program. Requires the commissioner to provide the relevant legislative committees with the waiver application and related materials. If the waiver application is approved, requires the commissioner to notify legislative chairs, allow review by legislative committees, and not implement the waiver until ten legislative days have passed following notification.
Subdivision 3 upon acceptance of the waiver, requires the commissioner to adopt rules and to propose any legislative changes needed to implement the waiver.
Subdivision 4 requires the Governor to establish a joint commission on waiver implementation. Specifies membership and duties.
Section 36 (256B.842) Principles and Goals for Medical Assistance Reform (S.F. No. 760)
Subdivision 1 requires the commissioner to ensure that the reformed MA program is a person-centered, financially sustainable, and cost-effective program.
Subdivision 2 establishes criteria for the reformed program.
Subdivision 3 requires the commissioner to report annually to the Governor and the Legislature on the status of the administration and implementation of the waiver.
Section 37 (256B.843) Waiver Application Requirements (S.F. No. 760)
Subdivision 1 requires the commissioner to seek federal approval to enter into a five-year agreement with the federal government under section 1115a to waive specific provisions of Medicaid law, including but not limited to statewideness, comparability of services, and freedom of choice of providers. Also requires the commissioner to seek a waiver of Medicaid law provisions, in order to expand cost-sharing, establish health savings or power accounts, provide enrollees with a choice of appropriate private sector coverage, consolidate waivered services, and implement other specified initiatives.
Subdivision 2 requires the commissioner to establish an intraagency assessment and coordination unit.
Section 38 (256D.031, subdivision 6) reinstates the coordinated care delivery systems effective July 1, 2011, and permits a hospital or group of hospitals to contract with the commissioner if the hospital or group of hospitals agree to satisfy the requirements. (Senate)
Section 39 (256D.031, subdivision 7) establishes the payment rates for the coordinated care delivery systems. (Senate)
Section 40 (256D.031, subdivision 9) establishes the prescription drug pool effective July 1, 2011. (Senate)
Section 41 ( 256L.031) establishes the Healthy Minnesota Contribution Program. (Healthy MN Plan)
Subdivision 1, paragraph (a), requires the Commissioner of Human Services, beginning January 1, 2012, to provide MinnesotaCare enrollees who are adults without children with gross family income equal to or greater than 133 percent of FPG and families with children, upon federal approval, with gross family income equal to or greater than 133 percent of FPG with a monthly defined contribution in order to purchase health coverage through a health plan in the private individual market.
Paragraph (b) exempts these MinnesotaCare enrollees from MinnesotaCare premiums and the required enrollment in a managed care plan or a county-based purchasing plan.
Paragraph (c) states that the MinnesotaCare provisions related to covered services (Minnesota Statutes, section 256L.03), cost sharing (section 256L.03, subdivision 5), the effective date of coverage (section 256L.05, subdivision 3), and provider payments (section 256L.11) do not apply to these enrollees. This paragraph also states that the covered services, cost sharing, disenrollment for nonpayment of premiums, appeal rights and complaint procedures, and the effective date of coverage for enrollees are, instead, provided by the terms of the health plan purchased by the enrollee.
Paragraph (d) specifies that unless otherwise provided in this section, all MinnesotaCare requirements related to eligibility, income and asset methodology, income reporting, and program administration continue to apply.
Subdivision 2 allows enrollees to use up to the monthly defined contribution as determined under subdivision 3 to pay premiums for coverage under a health plan.
Subdivision 3, paragraph (a), requires the commissioner to determine the defined contribution amount using a sliding scale, under which the per person defined contribution is a function of age and income. This paragraph specifies that the monthly per person base contribution ranges from $122.79 for persons under the age of 21 to $357.19 for persons age 60 and over. The base contribution is multiplied by a percentage inversely related to income, ranging from 150 to 80 percent, to obtain the monthly per person defined contribution amount.
Paragraph (b) requires the defined contribution amount calculated under paragraph (a) to be increased by 20 percent for enrollees who are denied coverage in the private individual market and who purchase coverage through MCHA.
Paragraph (c) states that notwithstanding paragraphs (a) and (b), the monthly defined contribution shall not exceed 90 percent of the monthly premium for the health plan purchased by the enrollee, and shall be reduced by five percent if the health plan the enrollee chooses to purchase does not include coverage for mental health and chemical dependency treatment services.
Subdivision 4 requires the commissioner to administer the defined contributions by calculating and processing defined contributions for enrollees and paying the defined contribution to the health plan companies or MCHA, as applicable.
Subdivision 5 requires the Commissioner of Human Services, in consultation with the Commissioner of Commerce, to develop an efficient and cost-effective method to refer eligible enrollees to professional insurance agent associations.
Subdivision 6 states that beginning January 1, 2012, MinnesotaCare enrollees who are eligible under this section, and who are denied coverage in the individual market are eligible for coverage through MCHA and may enroll in MCHA in accordance with chapter 62E. This paragraph also states that any difference between the revenue and covered losses to MCHA related to the implementation of this section shall be paid to MCHA from the health care access fund.
Subdivision 7 requires the commissioner to seek all federal approvals and waivers necessary to implement coverage for enrollees eligible as families and children with gross family incomes equal to or greater than 133 percent of FPG in order to continue to receive federal funds.
Section 42 (256L.04, subdivision 7) eliminates MinnesotaCare eligibility for single adults without children with income less than 75 percent of FPG. (Healthy MN Plan)
Section 43 (256L.05, subdivision 6) states that the commissioner is required to ensure that all MinnesotaCare applicants with gross family incomes less than 133 percent of FPG who identify themselves as a veteran are referred to a county veteran’s service office for assistance in applying to the U.S. Department of Veterans Affairs for any VA benefits for which they are eligible. (Healthy MN Plan)
Section 44 (256L.11, subdivision 7) reduces the CAD add-on payment for MinnesotaCare from 50 percent to 30 percent, which is in line with the CAD add-on payment for MA. (Governor)
Section 45 (256L.12, subdivision 9) (See section 32) (Governor)
Section 46 reduces the maximum amount of payments that MCOs can use to cover nontax administrative expenses from 6.6 percent to 5.3 percent. (Governor)
Sections 47 and 48 reinstate the general assistance medical care program and make corresponding changes to the funding. (Healthy MN Plan)
Section 49 relates to the managed care reforms. This section requires the Commissioner of Human Services to establish a competitive bidding process to select managed care organizations to deliver services under MA and MinnesotaCare for nonelderly, nondisabled adults, and children. The pilot must allow a minimum of two managed care organizations to serve the metropolitan area. The pilot expires December 31, 2013, and an evaluation of the pilot is required to determine the cost-effectiveness and impacts to provider access. (Governor)
Section 50 requires the Commissioner of Human Services to apply for a federal waiver in order to include in the Healthy Minnesota Contribution Program families with children and, in the alternative, the parents of families with children who may be eligible. (Healthy MN Plan)
Section 51 requires the Commissioner of Human Services to issue a request for proposals to prevent and detect Medicaid fraud. The Commissioner shall select a vendor by September 1, 2011. (S.F. No. 907)
Section 52 prohibits state funds to be expended in the planning or implementation of the Patient Protection and Affordable Care Act, and no provisions of the act may be implemented until the constitutionality of the act has been affirmed by the United States Supreme Court. This section is effective the day following final enactment. (S.F. No. 277)
Section 53 repeals:
Paragraph (a), sections 256B.0625, subdivision 8e (Chiropractic services); 256B.0653, subdivision 5 (Home care therapies); 256B.0756 (Hennepin and Ramsey Counties Pilot Program); and 256D.031, subdivisions 5 (Payment rates and contract modification; April 1, 2010, to May 31, 2010) and 8 (Temporary uncompensated care pool).
Paragraph (b), section 256B.055 (MA Eligibility Categories). Effective October 1, 2011.
Paragraph (c), Laws 2010, First Special Session chapter 1, article 16, sections 6, subdivision 3 (Asset limitations for individuals and families); and 7, subdivision 4 (Income). Effective October 1, 2011.
ARTICLE 6
DEPARTMENT OF HEALTH
Sections 1 and 2 relate to the reduction in the Minnesota Department of Health operating budget. (Governor)
Section 3 eliminates direct grants from the Medical Education and Research Costs fund (MERC). (Governor)
Sections 4 to 19 modify the wells and borings chapter of law by updating terms, expanding the definition of "bored geothermal heat exchanger" and imposing other requirements in an effort to protect groundwater from potential contamination from a heat exchanger installed in a boring. (Governor)
Sections 20 to 22 relate to testing infants for heritable and congenital disorders and the retention of the blood or tissue sample.
Section 20 (144.125, subdivision 1) allows for testing and reporting of the test results, but strikes language allowing the recording of the results. (Senate)
Section 21 (144.125, subdivision 3) strikes language stating that the results of the testing will be retained by the Department of Health, and provides that the parent may elect to have the blood samples retained by the Department of Health for 24 months after testing, otherwise the blood samples and test results will be destroyed under section 22. (Senate)
Section 22 (144.128) requires the commissioner to destroy blood and tissue samples obtained from test results immediately after completion of the test results, unless the parent elects to retain the results, and requires the commissioner to destroy all blood or tissue samples and material and records related to stored samples that were collected and stored by the commissioner by August 1, 2011. (Senate)
Sections 23 and 24 (144.396, subdivision 5; and 144.396, subdivision 6) limit statewide tobacco prevention grants to available appropriations. (Senate)
Sections 25 (144.4221) prohibits any person or entity, whether public or private, from performing or attempting to perform human cloning; participating in an attempt to perform human cloning; shipping, importing, or receiving for any purpose an embryo produced by human cloning or any product derived from such an embryo; or shipping or receiving, in whole or in part, any oocyte, embryo, fetus, or human somatic cell for the purpose of human cloning. A knowing or reckless violation of the prohibition is punishable as a misdemeanor. Defines "human cloning" and "somatic cell." Provides that nothing in the law restricts areas of scientific research, including stem cell research, not specifically prohibited by the provision. Includes a severability provision. (S.F. No. 695)
Section 26 (145.925, subdivision 1) limits family planning grants to available appropriations. (Senate)
Sections 27 and 28 (145.928, subdivision 7; and 145.928, subdivision 8) limit grant funds for health disparities to available appropriations. (Senate)
Section 29 eliminates direct grants from MERC. (Governor)
Section 30 prohibits the Department of Health from appropriating state funds or accepting federal funds for family planning special projects or family planning services. (Senate)
Section 31 repeals sections 144.1464 (Summer Health Care Interns); 144.147 (Rural Hospital Planning and Transition Grant Program); 144.1487 (Loan Repayment Program for Health Professionals); 144.1488 (Program Administration and Eligibility); 144.1489 (Obligations of Participants); 144.1490 (Responsibilities of Loan Repayment Program); 144.1491 (Failure to Complete Obligated Service); 144.1499 (Promotion of Health Care and Long-Term Care Careers); 144.1501 (Health Professional Education Loan Forgiveness Program); 144.6062 (Comprehensive Advanced Life Support); 144.9507 (Lead-Related Funding); 145.925 (Family Planning Grants); 145A.14 (Special Grants); and 150A.22 (Donated Dental Services).
Article 7
HEALTH LICENSING BOARDS
Section 1 (148.108, subdivision 4) imposes an animal chiropractic registration fee. (Governor)
Sections 2 to 5 (148.191, subdivision 2; 148.212, subdivision 1; 148.231; 148.243) modify the Nursing Board. The sections strike obsolete language related to temporary permits for graduate nurses, allow the board to accept or expend grants or gifts and accept registration fees for the purposes of board activities, eliminate the late fee applied to registration renewal applications that are submitted within 30 days of the license’s registration expiration date, codify the fee structure, and establish a new fee for nurses from bordering states who are authorized to practice nursing without a Minnesota license. (Governor)
Section 6 (148.2855) establishes the nurse licensure compact, which includes ten articles specifying the enforcement of the compact. (Senate)
Section 7 (148.2856) relates to the application of the nurse licensure compact to existing laws. (Senate)
Section 8 (148.2857) allows the Governor to withdraw the state from the nurse licensure compact. (Senate)
Section 10 (148.2859) establishes the nurse licensure compact advisory committee. (Senate)
Sections 11 to 21 (151.065; 151.07; 151.101; 151.102, subdivision 3; 151.12; 151.13, subdivision 1; 151.19; 151.25; 151.47, subdivision 1; 151.48; and 152.12, subdivision 3) relate to modifications recommended by the Board of Pharmacy. Section 11 codifies fees in a new section of law, and increases fees to cover operating costs. Subsequent changes in sections 12 to 19 insert a cross-reference to the new section established in section 11. (Governor)
Section 22 (214.107) establishes administrative services for health-related licensing boards to perform administrative, financial, and management functions common to all the boards in a manner that streamlines services and reduces expenditures. The administrative services shall act as an agent of the boards. The funding for the services comes from an amount apportioned to each board. (Governor)
Section 23 makes the section related to the nurse licensure compact effective January 1, 2012. (Senate)
ARTICLE 8
HEALTH AND HUMAN SERIVCES APPROPRIATIONS
ARTICLE 9
DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENTS
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