S.F. No. 1145 permits third-party administrators to contract with the Commissioner of Human Services to provide services under the medical assistance and MinnesotaCare programs. It also eliminates the requirement that health maintenance organizations as a condition of licensure participate in the state public health care programs.
Section 1 (256B.0644) removes health maintenance organizations (HMOs) from the requirement that an HMO must participate in the medical assistance program and the MinnesotaCare program as a condition of participating in the State Employee Group Insurance Program (SEGIP), the Public Employees Insurance Program (PEIP), health insurance plans offered to local units of government, and the Minnesota Comprehensive Health Association (MCHA).
Section 2 (256B.69, subdivision 2) adds to the definition of “demonstration provider” for purposes of participating in the Prepaid Medical Assistance Program (PMAP), a vendor of risk management services as defined in Minnesota Statutes, section 60A.23, subdivision 8 (third-party administrators).
Section 3 (256B.69, subdivision 5) requires the commissioner to enter into contracts for the PMAP program with one or more demonstration providers on the basis of a request for proposal process. The commissioner is not required to enter into a contract with each entity that submits a bid.
Section 4 repeals section 62D.04, subdivision 5 (requires as a condition of licensure that HMOs participate as a provider in the state public health care programs).