HF 297

1st Committee Engrossment - 85th Legislature (2007 - 2008) Posted on 12/22/2009 12:37pm

A bill for an act
relating to health care; establishing uniform claims standards; requiring an
interoperable electronic health records system; extending an advisory task force
expiration date; establishing an electronic health record revolving account and
loan program; modifying hospital information reporting; establishing the Health
Care Transformation Task Force; providing subsidies to federally qualified
health centers; establishing a prescription drug discount program; requiring a
health care program outreach; establishing a primary care access initiative;
changing eligibility verification for medical assistance; modifying provisions
for medical assistance, general assistance medical care, and MinnesotaCare;
repealing the family planning base reduction; establishing the Minnesota Health
Insurance Exchange; requiring certain employers to offer a Section 125 Plan;
modifying provisions for health plans and establishing a premium discount
incentive; appropriating money; amending Minnesota Statutes 2006, sections
13.46, subdivision 2; 62E.02, subdivision 7; 62E.141; 62J.495; 62J.82; 62L.02,
subdivision 11; 62L.12, subdivision 2; 62Q.165, subdivisions 1, 2; 256B.056,
subdivision 10; 256B.0625, subdivisions 3b, 30, by adding a subdivision;
256D.03, subdivisions 3, 4; 256L.01, subdivisions 1, 4; 256L.02, subdivision 3,
by adding subdivisions; 256L.03, subdivisions 1, 3, 5; 256L.04, subdivisions 1a,
7, 10; 256L.05, subdivisions 1, 1b, 2, 3a, 3c, 5, by adding subdivisions; 256L.07,
subdivisions 1, 2, 3, 6; 256L.09, subdivision 4; 256L.12, subdivision 7; 256L.15,
subdivisions 1, 1a, 2, by adding a subdivision; 256L.17, subdivisions 2, 3, 7;
Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2;
proposing coding for new law in Minnesota Statutes, chapters 62A; 62J; 145;
256; 256B; repealing Minnesota Statutes 2006, sections 62A.301; 256B.0631;
256L.035.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

HEALTH CARE

Section 1.

new text begin [62J.536] UNIFORM CLAIM STANDARDS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For purposes of this section, the terms in this subdivision
have the meanings given them.
new text end

new text begin (1) "Uniform claims standards" means the data and codes required to complete
health care transactions.
new text end

new text begin (2) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
new text end

new text begin (3) "Health care provider" has the meaning given in section 62J.03, subdivision 8.
new text end

new text begin Subd. 2. new text end

new text begin Uniform claims forms. new text end

new text begin Beginning January 15, 2009, health care providers
shall submit HIPAA compliant uniform claims forms using HIPAA compliant uniform
claims standards to group purchasers and all group purchasers shall accept these forms.
new text end

new text begin Subd. 3. new text end

new text begin Electronic claims submission. new text end

new text begin (a) By January 15, 2009, all group
purchasers and health care providers shall use electronic claims submission and processing
systems.
new text end

new text begin (b) Electronic claims submission and processing systems shall include the capacity
to monitor and disseminate information concerning eligibility and coverage of individuals.
new text end

new text begin (c) Group purchasers may not impose any fee for use of these systems.
new text end

new text begin Subd. 4. new text end

new text begin Rules. new text end

new text begin The commissioner of commerce shall consult with the Minnesota
Administrative Uniformity Committee on development of uniform claims forms
and uniform claims standards. The commissioner shall use standards based on the
Medicare program with modifications as recommended by the Administrative Uniformity
Committee to promulgate rules. The commissioner shall issue rules, pursuant to sections
14.001 to 14.28 or section 14.389, establishing and requiring group purchasers and health
care providers to use uniform claims standards. The commissioner shall promulgate rules
by January 15, 2008, or report to the legislature on the status of rule development by
January 15, 2008.
new text end

new text begin Subd. 5. new text end

new text begin Modification prohibited. new text end

new text begin No group purchaser or health care provider may
add to or modify the requirements of this section.
new text end

Sec. 2.

Minnesota Statutes 2006, section 62E.02, subdivision 7, is amended to read:

Subd. 7.

Dependent.

"Dependent" means a spouse or unmarried child deleted text begin under the
age of 19 years, a dependent child deleted text end who is deleted text begin a student deleted text end under the age of 25 new text begin regardless of
whether the dependent child is enrolled in an educational institution new text end , or a dependent
child of any age who is disabled.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2008.
new text end

Sec. 3.

Minnesota Statutes 2006, section 62J.495, is amended to read:

62J.495 HEALTH INFORMATION TECHNOLOGY AND
INFRASTRUCTURE deleted text begin ADVISORY COMMITTEE deleted text end .

Subdivision 1.

deleted text begin Establishment; members; duties deleted text end new text begin Implementation new text end .

new text begin By January
1, 2012, all hospitals and health care providers must have in place an interoperable
electronic health records system within their hospital system or clinical practice setting.
The commissioner of health, in consultation with the Health Information Technology and
Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal,
including uniform standards to be used for the interoperable system for sharing and
synchronizing patient data across systems. The standards must be compatible with federal
efforts. The uniform standards must be developed by January 1, 2009, with a status report
on the development of these standards submitted to the legislature by January 15, 2008.
new text end

new text begin Subd. 2. new text end

new text begin Health Information Technology and Infrastructure Advisory
Committee. new text end

(a) The commissioner shall establish a Health Information Technology
and Infrastructure Advisory Committee governed by section 15.059 to advise the
commissioner on the following matters:

(1) assessment of the use of health information technology by the state, licensed
health care providers and facilities, and local public health agencies;

(2) recommendations for implementing a statewide interoperable health information
infrastructure, to include estimates of necessary resources, and for determining standards
for administrative data exchange, clinical support programs, patient privacy requirements,
and maintenance of the security and confidentiality of individual patient data; and

(3) other related issues as requested by the commissioner.

(b) The members of the Health Information Technology and Infrastructure Advisory
Committee shall include the commissioners, or commissioners' designees, of health,
human services, administration, and commerce and additional members to be appointed
by the commissioner to include persons representing Minnesota's local public health
agencies, licensed hospitals and other licensed facilities and providers, private purchasers,
the medical and nursing professions, health insurers and health plans, the state quality
improvement organization, academic and research institutions, consumer advisory
organizations with an interest and expertise in health information technology, and other
stakeholders as identified by the Health Information Technology and Infrastructure
Advisory Committee.

deleted text begin Subd. 2. deleted text end deleted text begin Annual report. deleted text end new text begin (c) new text end The commissioner shall prepare and issue an annual
report not later than January 30 of each year outlining progress to date in implementing a
statewide health information infrastructure and recommending future projects.

deleted text begin Subd. 3. deleted text end deleted text begin Expiration. deleted text end new text begin (d) new text end Notwithstanding section 15.059, this deleted text begin section deleted text end new text begin subdivision
new text end expires June 30, deleted text begin 2009 deleted text end new text begin 2012 new text end .

Sec. 4.

new text begin [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING
ACCOUNT AND LOAN PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Account establishment. new text end

new text begin The commissioner of finance shall
establish and implement a revolving account in the state government special revenue
fund to provide loans to physicians or physician group practices to assist in financing the
installation or support of an interoperable health record system. The system must provide
for the interoperable exchange of health care information between the applicant and, at a
minimum, a hospital system, pharmacy, and a health care clinic or other physician group.
new text end

new text begin Subd. 2. new text end

new text begin Eligibility. new text end

new text begin To be eligible for a loan under this section, the applicant
must submit a loan application to the commissioner of health on forms prescribed by the
commissioner. The application must include, at a minimum:
new text end

new text begin (1) the amount of the loan requested and a description of the purpose or project
for which the loan proceeds will be used;
new text end

new text begin (2) a signed contract with a vendor;
new text end

new text begin (3) a description of the health care entities and other groups participating in the
project;
new text end

new text begin (4) evidence of financial stability and a demonstrated ability to repay the loan; and
new text end

new text begin (5) a description of how the system to be financed interconnects or plans in the
future to interconnect with other health care entities and provider groups located in the
same geographical area.
new text end

new text begin Subd. 3. new text end

new text begin Loans. new text end

new text begin (a) The commissioner of health may make a no interest loan
to a provider or provider group who is eligible under subdivision 2 on a first-come,
first-served basis provided that the applicant is able to comply with this section. The total
accumulative loan principal must not exceed $....... per loan. The commissioner of health
has discretion over the size and number of loans made.
new text end

new text begin (b) The commissioner of health may prescribe forms and establish an application
process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable
application fee to cover the cost of administering the loan program.
new text end

new text begin (c) The borrower must begin repaying the principal no later than two years from the
date of the loan. Loans must be amortized no later than 15 years from the date of the loan.
new text end

new text begin (d) Repayments must be credited to the account.
new text end

Sec. 5.

Minnesota Statutes 2006, section 62J.82, is amended to read:

62J.82 HOSPITAL deleted text begin CHARGE deleted text end new text begin INFORMATION REPORTING new text end DISCLOSURE.

new text begin Subdivision 1. new text end

new text begin Required information. new text end

The Minnesota Hospital Association shall
develop a Web-based system, available to the public free of charge, for reporting deleted text begin charge
information deleted text end new text begin the following new text end , for Minnesota residents deleted text begin , deleted text end new text begin :
new text end

new text begin (1) hospital-specific performance on the measures of care developed under section
256B.072 for acute myocardial infarction, heart failure, and pneumonia;
new text end

new text begin (2) by January 1, 2009, hospital-specific performance on the public reporting
measures for hospital-acquired infections as published by the National Quality Forum
and collected by the Minnesota Hospital Association and Stratis Health in collaboration
with infection control practitioners; and
new text end

new text begin (3) charge information, new text end including, but not limited to, number of discharges, average
length of stay, average charge, average charge per day, and median charge, for each of the
50 most common inpatient diagnosis-related groups and the 25 most common outpatient
surgical procedures as specified by the Minnesota Hospital Association.

new text begin Subd. 2. new text end

new text begin Web site. new text end

The Web site must provide information that compares
hospital-specific data to hospital statewide data. The Web site must be deleted text begin established by
October 1, 2006, and must be deleted text end updated annually. new text begin The commissioner shall provide a link to
this reporting information on the department's Web site.
new text end

new text begin Subd. 3. new text end

new text begin Enforcement. new text end

new text begin The commissioner shall provide a link to this information
on the department's Web site. new text end If a hospital does not provide this information to the
Minnesota Hospital Association, the commissioner new text begin of health new text end may require the hospital to
do so new text begin in accordance with section 144.55, subdivision 6 new text end . deleted text begin The commissioner shall provide a
link to this information on the department's Web site.
deleted text end

Sec. 6.

new text begin [62J.84] HEALTH CARE TRANSFORMATION TASK FORCE.
new text end

new text begin Subdivision 1. new text end

new text begin Task force. new text end

new text begin The Health Care Transformation Task Force consists of:
new text end

new text begin (1) the Legislative Commission on Health Care Access established under section
62J.07;
new text end

new text begin (2) the commissioners of human services, health, and commerce;
new text end

new text begin (3) four persons designated by the SmartBuy alliance to represent private sector
purchasers, including one representing public employers, one representing large
employers, one representing small employers, and one representing labor unions; and
new text end

new text begin (4) six persons designated by the partnership for action to transform health care,
a multisector policy alliance of hospitals and health systems, health plan companies,
physicians, and other health care organizations.
new text end

new text begin Subd. 2. new text end

new text begin Public input. new text end

new text begin The commissioner of health shall review available research
and conduct statewide, regional, and local surveys, focus groups, and other activities to
determine Minnesotans' values, preferences, opinions, and perceptions related to health
care and to the issues confronting the task force, and shall report the findings to the task
force.
new text end

new text begin Subd. 3. new text end

new text begin Inventory and assessment of existing activities. new text end

new text begin The task force shall
complete an inventory and assessment of all public and private organized activities,
coalitions, and collaboratives working on tasks relating to health system improvement
including, but not limited to, patient safety, quality measurement and reporting,
evidence-based practice, adoption of health information technology, disease management
and chronic care coordination, medical homes, access to health care, cultural competence,
prevention and public health, consumer incentives, price and cost transparency, nonprofit
organization community benefits, education, research, and health care workforce. By
December 15, 2007, the task force shall present recommendations to the legislature, the
governor, and to those working on these activities on how these activities may be made
more effective and how coordination and communication may be improved.
new text end

new text begin Subd. 4. new text end

new text begin Action plan. new text end

new text begin By December 15, 2007, the task force shall develop and
present, to the legislature and the governor, a statewide action plan for transforming the
health care system to improve affordability, quality, and access. The plan may consist of
legislative actions, administrative actions of governmental entities, collaborative actions,
and actions of individuals and individual organizations. The plan must include specific
and measurable goals and deadlines for affordability, quality, and access. The plan must
include a method of coordination and communication among the activities identified
under subdivision 3.
new text end

new text begin Subd. 5. new text end

new text begin Local school wellness. new text end

new text begin The task force shall evaluate local school wellness
policies in order to understand the differences between policies, highlight innovation,
and encourage improvement, and shall evaluate continuing education requirements for
nutrition for school lunch program staff. The task force shall present recommendations
to the legislature and the governor by February 1, 2008.
new text end

new text begin Subd. 6. new text end

new text begin Health communities initiative. new text end

new text begin The task force shall evaluate the use of
grants and financial incentive programs to encourage communities to implement urban
and community planning designs and templates that foster healthy lifestyles. By February
1, 2008, the task force shall submit a report to the governor and the legislature containing
recommendations on the administration, funding, and requirements for the programs.
new text end

Sec. 7.

Minnesota Statutes 2006, section 62L.02, subdivision 11, is amended to read:

Subd. 11.

Dependent.

"Dependent" means an eligible employee's spouse,
unmarried child who is deleted text begin under the age of 19 years, unmarried child deleted text end under the age of 25
years deleted text begin who is a full-time student as defined in section 62A.301 deleted text end new text begin regardless of whether
the dependent child is enrolled in an educational institution new text end , dependent child of any age
who is disabled and who meets the eligibility criteria in section 62A.14, subdivision 2,
or any other person whom state or federal law requires to be treated as a dependent for
purposes of health plans. For the purpose of this definition, a child includes a child for
whom the employee or the employee's spouse has been appointed legal guardian and an
adoptive child as provided in section 62A.27.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2008.
new text end

Sec. 8.

Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:

Subdivision 1.

Definition.

It is the commitment of the state to achieve universal
health coverage for all Minnesotans new text begin by the year 2010 new text end . Universal coverage is achieved
when:

(1) every Minnesotan has access to a full range of quality health care services;

(2) every Minnesotan is able to obtain affordable health coverage which pays for the
full range of services, including preventive and primary care; and

(3) every Minnesotan pays into the health care system according to that person's
ability.

Sec. 9.

Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:

Subd. 2.

Goal.

It is the goal of the state to make continuous progress toward
reducing the number of Minnesotans who do not have health coverage so that by January
1, deleted text begin 2000 deleted text end new text begin 2010 new text end , deleted text begin fewer than four percent of the state's population will be without health
coverage deleted text end new text begin all Minnesota residents have access to affordable health care new text end . deleted text begin The goal will be deleted text end
deleted text begin achieved by deleted text end new text begin In achieving this goal, a number of options shall be considered, including
new text end improving access to private health coverage through insurance reforms and market
reforms, deleted text begin by deleted text end making health coverage more affordable for low-income Minnesotans through
purchasing pools and state subsidies, and deleted text begin by deleted text end reducing the cost of health coverage through
cost containment programs and methods of ensuring that all Minnesotans are paying
into the system according to their ability.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 10.

new text begin [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For purposes of this section, "federally qualified health
center" means an entity that is receiving a grant under United States Code, title 42,
section 254b, or, based on the recommendation of the Health Resources and Services
Administration within the Public Health Service, is determined by the secretary to meet
the requirements for receiving such a grant.
new text end

new text begin Subd. 2. new text end

new text begin Allocation of subsidies. new text end

new text begin The commissioner of health shall distribute
subsidies to federally qualified health centers operating in Minnesota to continue, expand,
and improve federally qualified health center services to low-income populations. The
commissioner shall distribute the funds appropriated under this section to federally
qualified health centers operating in Minnesota as of January 1, 2007. The amount of
each subsidy shall be in proportion to each federally qualified health center's amount of
discounts granted to patients during calendar year 2006 as reported on the federal Uniform
Data System report in conformance with the Bureau of Primary Health Care Program
Expectations Policy Information Notice 98-23, except that each eligible federally qualified
health center shall receive at least two percent but no more than 30 percent of the total
amount of money available under this section.
new text end

Sec. 11.

new text begin [256.9545] PRESCRIPTION DRUG DISCOUNT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; administration. new text end

new text begin The commissioner shall establish
and administer the prescription drug discount program.
new text end

new text begin Subd. 2. new text end

new text begin Commissioner's authority. new text end

new text begin The commissioner shall administer a drug
rebate program for drugs purchased according to the prescription drug discount program.
The commissioner shall execute a rebate agreement from all manufacturers that choose to
participate in the program for those drugs covered under the medical assistance program.
For each drug, the amount of the rebate shall be equal to the rebate as defined for purposes
of the federal rebate program in United States Code, title 42, section 1396r-8. The
rebate program shall utilize the terms and conditions used for the federal rebate program
established according to section 1927 of title XIX of the federal Social Security Act.
new text end

new text begin Subd. 3. new text end

new text begin Definitions. new text end

new text begin For purposes of this section, the following terms have the
meanings given them.
new text end

new text begin (a) "Commissioner" means the commissioner of human services.
new text end

new text begin (b) "Covered prescription drug" means a prescription drug as defined in section
151.44, paragraph (d), that is covered under medical assistance as described in section
256B.0625, subdivision 13, and that is provided by a participating manufacturer that has a
fully executed rebate agreement with the commissioner under this section and complies
with that agreement.
new text end

new text begin (c) "Enrolled individual" means a person who is eligible for the program under
subdivision 4 and has enrolled in the program according to subdivision 5.
new text end

new text begin (d) "Health carrier" means an insurance company licensed under chapter 60A to
offer, sell, or issue an individual or group policy of accident and sickness insurance as
defined in section 62A.01; a nonprofit health service plan corporation operating under
chapter 62C; a health maintenance organization operating under chapter 62D; a joint
self-insurance employee health plan operating under chapter 62H; a community integrated
service network licensed under chapter 62N; a fraternal benefit society operating under
chapter 64B; a city, county, school district, or other political subdivision providing
self-insured health coverage under section 471.617 or sections 471.98 to 471.982; and a
self-funded health plan under the Employee Retirement Income Security Act of 1974, as
amended.
new text end

new text begin (e) "Participating manufacturer" means a manufacturer as defined in section 151.44,
paragraph (c), that agrees to participate in the prescription drug discount program.
new text end

new text begin (f) "Participating pharmacy" means a pharmacy as defined in section 151.01,
subdivision 2, that agrees to participate in the prescription drug discount program.
new text end

new text begin Subd. 4. new text end

new text begin Eligibility. new text end

new text begin (a) To be eligible for the program, an applicant must:
new text end

new text begin (1) be a permanent resident of Minnesota as defined in section 256L.09, subdivision
4;
new text end

new text begin (2) not be enrolled in medical assistance, general assistance medical care, or
MinnesotaCare;
new text end

new text begin (3) not be enrolled in and have currently available prescription drug coverage under
a health plan offered by a health carrier or employer or under a pharmacy benefit program
offered by a pharmaceutical manufacturer; and
new text end

new text begin (4) not be enrolled in and have currently available prescription drug coverage
under a Medicare supplement policy, as defined in sections 62A.31 to 62A.44, or
policies, contracts, or certificates that supplement Medicare issued by health maintenance
organizations or those policies, contracts, or certificates governed by section 1833 or 1876
of the federal Social Security Act, United States Code, title 42, section 1395, et seq., as
amended.
new text end

new text begin (b) Notwithstanding paragraph (a), clause (3), an individual who is enrolled in a
Medicare Part D prescription drug plan or Medicare Advantage plan is eligible for the
program but only for drugs that are not covered under the Medicare Part D plan or for
drugs that are covered under the plan, but according to the conditions of the plan, the
individual is responsible for 100 percent of the cost of the prescription drug.
new text end

new text begin Subd. 5. new text end

new text begin Application procedure. new text end

new text begin (a) Applications and information on the program
must be made available at county social services agencies, health care provider offices, and
agencies and organizations serving senior citizens. Individuals shall submit applications
and any information specified by the commissioner as being necessary to verify eligibility
directly to the commissioner. The commissioner shall determine an applicant's eligibility
for the program within 30 days from the date the application is received. Upon notice of
approval, the applicant must submit to the commissioner the enrollment fee specified in
subdivision 10. Eligibility begins the month after the enrollment fee is received by the
commissioner.
new text end

new text begin (b) An enrollee's eligibility must be renewed every 12 months with the 12-month
period beginning in the month after the application is approved.
new text end

new text begin (c) The commissioner shall develop an application form that does not exceed one
page in length and requires information necessary to determine eligibility for the program.
new text end

new text begin Subd. 6. new text end

new text begin Participating pharmacy. new text end

new text begin (a) Upon implementation of the prescription
drug discount program, and until January 1, 2009, a participating pharmacy, with a
valid prescription, must sell a covered prescription drug to an enrolled individual at the
medical assistance rate.
new text end

new text begin (b) After January 1, 2009, a participating pharmacy, with a valid prescription, must
sell a covered prescription drug to an enrolled individual at the medical assistance rate,
minus an amount that is equal to the rebate amount described in subdivision 8, plus
the amount of any switch fee established by the commissioner under subdivision 10,
paragraph (b).
new text end

new text begin (c) Each participating pharmacy shall provide the commissioner with all information
necessary to administer the program, including, but not limited to, information on
prescription drug sales to enrolled individuals and usual and customary retail prices.
new text end

new text begin Subd. 7. new text end

new text begin Notification of rebate amount. new text end

new text begin The commissioner shall notify each
participating manufacturer, each calendar quarter or according to a schedule established
by the commissioner, of the amount of the rebate owed on the prescription drugs sold by
participating pharmacies to enrolled individuals.
new text end

new text begin Subd. 8. new text end

new text begin Provision of rebate. new text end

new text begin To the extent that a participating manufacturer's
prescription drugs are prescribed to a resident of this state, the manufacturer must provide
a rebate equal to the rebate provided under the medical assistance program for any
prescription drug distributed by the manufacturer that is purchased at a participating
pharmacy by an enrolled individual. The participating manufacturer must provide full
payment within 38 days of receipt of the state invoice for the rebate, or according to
a schedule to be established by the commissioner. The commissioner shall deposit all
rebates received into the Minnesota prescription drug dedicated fund established under
subdivision 11. The manufacturer must provide the commissioner with any information
necessary to verify the rebate determined per drug.
new text end

new text begin Subd. 9. new text end

new text begin Payment to pharmacies. new text end

new text begin Beginning January 1, 2009, the commissioner
shall distribute on a biweekly basis an amount that is equal to an amount collected under
subdivision 8 to each participating pharmacy based on the prescription drugs sold by that
pharmacy to enrolled individuals on or after January 1, 2009.
new text end

new text begin Subd. 10. new text end

new text begin Enrollment fee; switch fee. new text end

new text begin (a) The commissioner shall establish an
annual enrollment fee that covers the commissioner's expenses for enrollment, processing
claims, and distributing rebates under this program.
new text end

new text begin (b) The commissioner shall establish a reasonable switch fee that covers expenses
incurred by participating pharmacies in formatting for electronic submission claims for
prescription drugs sold to enrolled individuals.
new text end

new text begin Subd. 11. new text end

new text begin Dedicated fund; creation; use of fund. new text end

new text begin (a) The Minnesota prescription
drug dedicated fund is established as an account in the state treasury. The commissioner
of finance shall credit to the dedicated fund all rebates paid under subdivision 8, any
federal funds received for the program, all enrollment fees paid by the enrollees, and
any appropriations or allocations designated for the fund. The commissioner of finance
shall ensure that fund money is invested under section 11A.25. All money earned by the
fund must be credited to the fund. The fund shall earn a proportionate share of the total
state annual investment income.
new text end

new text begin (b) Money in the fund is appropriated to the commissioner to reimburse participating
pharmacies for prescription drugs provided to enrolled individuals under subdivision 6,
paragraph (b); to reimburse the commissioner for costs related to enrollment, processing
claims, distributing rebates, and for other reasonable administrative costs related to
administration of the prescription drug discount program; and to repay the appropriation
provided by law for this section. The commissioner must administer the program so that
the costs total no more than funds appropriated plus the drug rebate proceeds.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 12.

new text begin [256.962] MINNESOTA HEALTH CARE PROGRAMS OUTREACH.
new text end

new text begin Subdivision 1. new text end

new text begin Public awareness and education. new text end

new text begin (a) The commissioner shall
design and implement a statewide campaign to raise public awareness on the availability
of health coverage through medical assistance, general assistance medical care, and
MinnesotaCare and to educate the public on the importance of obtaining and maintaining
health care coverage. The campaign shall include multimedia messages directed to the
general population and messages that are culturally specific and community-based,
directed to high-uninsured population areas.
new text end

new text begin (b) The commissioner shall collaborate with public and private entities, including,
but not limited to, hospitals, providers, health plans, legal aid offices, pharmacies,
insurance agencies, and faith-based organizations to develop outreach activities and
partnerships to ensure the distribution of information and applications.
new text end

new text begin (c) The commissioner shall ensure that all outreach materials are available in
languages other than English.
new text end

new text begin Subd. 2. new text end

new text begin Outreach grants. new text end

new text begin The commissioner shall award grants to public and
private organizations to provide information, applications, and assistance in obtaining
coverage through Minnesota public health care programs. In awarding these grants, the
commissioner shall give priority to community organizations with a proven ability to
provide multilingual and cultural outreach efforts in areas of high-uninsured populations.
new text end

new text begin Subd. 3. new text end

new text begin Application and assistance. new text end

new text begin (a) The Minnesota health care programs
application must be made available at provider offices, local human services agencies,
school districts, public and private elementary schools in which 25 percent or more of
the students receive free or reduced price lunches, community health offices, Women,
Infants and Children (WIC) program sites, Head Start program sites, public housing
councils, child care centers, early childhood education and preschool program sites, legal
aid offices, and libraries. The commissioner shall ensure that applications are available in
languages other than English and that individuals and families who need assistance due to
language or cultural barriers receive the necessary services.
new text end

new text begin (b) Local human service agencies, hospitals, and health care community clinics
receiving state funds must provide direct assistance in completing the application form,
including the free use of a copy machine and a drop box for applications. Other locations
where applications are required to be available shall either provide direct assistance in
completing the application form or provide information on where an applicant can receive
application assistance.
new text end

new text begin (c) Counties must offer applications and application assistance when providing
child support collection services.
new text end

new text begin (d) Local public health agencies and counties that provide immunization clinics must
offer applications and application assistance during these clinics.
new text end

new text begin Subd. 4. new text end

new text begin Statewide toll-free telephone number. new text end

new text begin The commissioner shall provide
funds to establish a statewide toll-free telephone number to provide information on public
and private health coverage options and sources of free and low-cost health care.
new text end

new text begin Subd. 5. new text end

new text begin Incentive program. new text end

new text begin The commissioner shall establish an incentive
program for organizations that directly identify and assist potential enrollees in filling
out and submitting an application. For each applicant who is successfully enrolled in
MinnesotaCare, medical assistance, or general assistance medical care, the commissioner
shall pay the organization a $25 application assistance fee. The organization may provide
an applicant a gift certificate or other incentive upon enrollment.
new text end

new text begin Subd. 6. new text end

new text begin School districts. new text end

new text begin (a) At the beginning of each school year, a school district
shall provide information to each student on the availability of health care coverage
through the Minnesota health care programs.
new text end

new text begin (b) For each child who is determined to be eligible for a free or reduced priced lunch,
the district shall provide the child's family with an application for the Minnesota health
care programs and information on how to obtain application assistance.
new text end

new text begin (c) A district shall also ensure that applications and information on application
assistance are available at early childhood education sites and public schools located
within the district's jurisdiction.
new text end

new text begin (d) Each district shall designate an enrollment specialist to provide application
assistance and follow-up services with families who are eligible for the reduced or free
lunch program or who have indicated an interest in receiving information or an application
for the Minnesota health care program.
new text end

new text begin (e) Each school district shall provide on their Web site a link to information on how
to obtain an application and application assistance.
new text end

new text begin Subd. 7. new text end

new text begin Renewal notice. new text end

new text begin (a) The commissioner shall mail a renewal notice to
enrollees notifying the enrollee that their eligibility must be renewed. A notice shall be
sent at 90 days prior to the renewal date and at 60 days prior to the renewal date.
new text end

new text begin (b) For enrollees who are receiving services through managed care plans, the
managed care plan must provide a follow-up renewal call at least 60 days prior to the
enrollee's renewal date.
new text end

new text begin (c) The commissioner shall include the end of coverage dates on the monthly rosters
of enrollees provided to managed care organizations.
new text end

Sec. 13.

new text begin [256.963] PRIMARY CARE ACCESS INITIATIVE.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin (a) The commissioner shall award a grant to
implement in Hennepin and Ramsey Counties a Web-based primary care access pilot
project designed as a collaboration between private and public sectors to connect, where
appropriate, a patient with a primary care medical home and schedule patients into
available community-based appointments as an alternative to nonemergency use of the
hospital emergency room. The grantee must establish a program that diverts patients
presenting at an emergency room for nonemergency care to more appropriate outpatient
settings. The program must refer the patient to an appropriate health care professional
based on the patient's health care needs and situation. The program must provide the
patient with a scheduled appointment that is timely, with an appropriate provider who is
conveniently located. If the patient is uninsured and potentially eligible for a Minnesota
health care program, the program must connect the patient to a primary care provider,
community clinic, or agency that can assist the patient with the application process. The
program must also ensure that discharged patients are connected with a community-based
primary care provider and assist in scheduling any necessary follow-up visits before
the patient is discharged.
new text end

new text begin (b) The program must not require a provider to pay a fee for accepting charity care
patients or patients enrolled in a Minnesota public health care program.
new text end

new text begin Subd. 2. new text end

new text begin Evaluation. new text end

new text begin (a) The grantee must report to the commissioner on a quarterly
basis the following information:
new text end

new text begin (1) total number of appointments available for scheduling by specialty;
new text end

new text begin (2) average length of time between scheduling and actual appointment; and
new text end

new text begin (3) total number of patients referred and whether the patient was insured or
uninsured.
new text end

new text begin (b) The commissioner, in consultation with the Minnesota Hospital Association,
shall conduct an evaluation of the emergency room diversion pilot project and submit the
results to the legislature by January 15, 2009. The evaluation shall compare the number of
nonemergency visits and repeat visits to hospital emergency rooms for the period before
the commencement of the project and one year after the commencement, and an estimate
of the costs saved from any documented reductions.
new text end

Sec. 14.

Minnesota Statutes 2006, section 256B.056, subdivision 10, is amended to
read:

Subd. 10.

Eligibility verification.

(a) The commissioner shall require women who
are applying for the continuation of medical assistance coverage following the end of the
60-day postpartum period to update their income and asset information and to submit
any required income or asset verification.

(b) The commissioner shall determine the eligibility of private-sector health care
coverage for infants less than one year of age eligible under section 256B.055, subdivision
10, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
if this is determined to be cost-effective.

deleted text begin (c) The commissioner shall modify the application for Minnesota health care
programs to require more detailed information related to verification of assets and income,
and shall verify assets and income for all applicants, and for all recipients upon renewal.
deleted text end

deleted text begin (d) The commissioner shall require Minnesota health care program recipients to
report new or an increase in earned income within ten days of the change, and to verify new
or an increase in earned income that affects eligibility within ten days of notification by
the agency that the new or increased earned income affects eligibility. Recipients who fail
to verify new or an increase in earned income that affects eligibility shall be disenrolled.
deleted text end

Sec. 15.

Minnesota Statutes 2006, section 256B.0625, subdivision 30, is amended to
read:

Subd. 30.

Other clinic services.

(a) Medical assistance covers rural health clinic
services, federally qualified health center services, nonprofit community health clinic
services, public health clinic services, and the services of a clinic meeting the criteria
established in rule by the commissioner. Rural health clinic services and federally
qualified health center services mean services defined in United States Code, title 42,
section 1396d(a)(2)(B) and (C). Payment for rural health clinic and federally qualified
health center services shall be made according to applicable federal law and regulation.

(b) A federally qualified health center that is beginning initial operation shall submit
an estimate of budgeted costs and visits for the initial reporting period in the form and
detail required by the commissioner. A federally qualified health center that is already in
operation shall submit an initial report using actual costs and visits for the initial reporting
period. Within 90 days of the end of its reporting period, a federally qualified health
center shall submit, in the form and detail required by the commissioner, a report of
its operations, including allowable costs actually incurred for the period and the actual
number of visits for services furnished during the period, and other information required
by the commissioner. Federally qualified health centers that file Medicare cost reports
shall provide the commissioner with a copy of the most recent Medicare cost report filed
with the Medicare program intermediary for the reporting year which support the costs
claimed on their cost report to the state.

(c) deleted text begin In order to continue cost-based payment under the medical assistance program
according to paragraphs (a) and (b), a federally qualified health center or rural health clinic
must apply for designation as an essential community provider within six months of final
adoption of rules by the Department of Health according to section 62Q.19, subdivision
7. For those federally qualified health centers and rural health clinics that have applied
for essential community provider status within the six-month time prescribed, medical
assistance payments will continue to be made according to paragraphs (a) and (b) for the
first three years after application. For federally qualified health centers and rural health
clinics that either do not apply within the time specified above or who have had essential
community provider status for three years, medical assistance payments for health services
provided by these entities shall be according to the same rates and conditions applicable
to the same service provided by health care providers that are not federally qualified
health centers or rural health clinics. deleted text end

deleted text begin (d) deleted text end deleted text begin Effective July 1, 1999, the provisions of paragraph (c) requiring a federally
qualified health center or a rural health clinic to make application for an essential
community provider designation in order to have cost-based payments made according
to paragraphs (a) and (b) no longer apply.
deleted text end

deleted text begin (e) deleted text end Effective January 1, 2000, payments made according to paragraphs (a) and (b)
shall be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.

deleted text begin (f) deleted text end new text begin (d) new text end Effective January 1, 2001, each federally qualified health center and
rural health clinic may elect to be paid either under the prospective payment system
established in United States Code, title 42, section 1396a(aa), or under an alternative
payment methodology consistent with the requirements of United States Code, title 42,
section 1396a(aa), and approved by the Centers for Medicare and Medicaid Services.
The alternative payment methodology shall be 100 percent of deleted text begin cost deleted text end new text begin costs new text end as determined
deleted text begin according to deleted text end new text begin by generally accepted accounting principles and annual new text end Medicare cost
deleted text begin principles deleted text end new text begin reports, including Medicaid-eligible cost add-ons new text end .

Sec. 16.

Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 49. new text end

new text begin Community health worker. new text end

new text begin Medical assistance covers the care
coordination and patient education services of a community health worker if the
community health worker has earned a certificate from the Minnesota State Colleges
and University System approved community health worker curriculum or equivalent.
Services provided by community health workers who have at least five years of supervised
experience must be considered eligible for payment but these workers must complete the
certificate program by January 1, 2010. Community health workers must work under the
supervision of a medical assistance enrolled provider.
new text end

Sec. 17.

new text begin [256B.0632] MEDICAL ASSISTANCE CO-PAYMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Co-payment. new text end

new text begin The medical assistance benefit plan shall include a
$6 co-payment for nonemergency visits to a hospital-based emergency room, except as
provided in subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Exceptions. new text end

new text begin A co-payment shall not be charged to:
new text end

new text begin (1) children under the age of 21;
new text end

new text begin (2) pregnant women for services that relate to the pregnancy or any other medical
condition that may complicate the pregnancy;
new text end

new text begin (3) recipients expected to reside for at least 30 days in a hospital, nursing facility, or
intermediate care facility for the developmentally disabled; and
new text end

new text begin (4) recipients receiving hospice care.
new text end

Sec. 18.

Minnesota Statutes 2006, section 256D.03, subdivision 3, is amended to read:

Subd. 3.

General assistance medical care; eligibility.

(a) General assistance
medical care may be paid for any person who is not eligible for medical assistance under
chapter 256B, including eligibility for medical assistance based on a spenddown of excess
income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in
paragraph (b), except as provided in paragraph (c), and:

(1) who is receiving assistance under section 256D.05, except for families with
children who are eligible under Minnesota family investment program (MFIP), or who is
having a payment made on the person's behalf under sections 256I.01 to 256I.06; or

(2) who is a resident of Minnesota; and

(i) who has gross countable income not in excess of 75 percent of the federal poverty
guidelines for the family size, using a six-month budget period and whose equity in assets
is not in excess of $1,000 per assistance unit. General assistance medical care is not
available for applicants or enrollees who are otherwise eligible for medical assistance but
fail to verify their assets. Enrollees who become eligible for medical assistance shall be
terminated and transferred to medical assistance. Exempt assets, the reduction of excess
assets, and the waiver of excess assets must conform to the medical assistance program in
section 256B.056, subdivision 3, with the following exception: the maximum amount of
undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by
the trustee, assuming the full exercise of the trustee's discretion under the terms of the
trust, must be applied toward the asset maximum;

(ii) who has gross countable income above 75 percent of the federal poverty
guidelines but not in excess of 175 percent of the federal poverty guidelines for the
family size, using a six-month budget period, whose equity in assets is not in excess
of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient
hospitalization; or

(iii) the commissioner shall adjust the income standards under this section each July
1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.

(b) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may not be paid for applicants or recipients who are adults
with dependent children under 21 whose gross family income is equal to or less than 275
percent of the federal poverty guidelines who are not described in paragraph (e).

(c) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may be paid for applicants and recipients who meet all
eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
beginning the date of application. Immediately following approval of general assistance
medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
subdivision 7, with covered services as provided in section 256L.03 for the rest of the
deleted text begin six-month deleted text end new text begin initial new text end eligibility period, until their deleted text begin six-month deleted text end new text begin annual new text end renewal.

(d) To be eligible for general assistance medical care following enrollment in
MinnesotaCare as required by paragraph (c), an individual must complete a new
application.

(e) Applicants and recipients eligible under paragraph (a), clause (1); who have
applied for and are awaiting a determination of blindness or disability by the state medical
review team or a determination of eligibility for Supplemental Security Income or Social
Security Disability Insurance by the Social Security Administration; who fail to meet the
requirements of section 256L.09, subdivision 2; new text begin who are homeless as defined by United
States Code, title 42, section 11301, et seq.; new text end who are classified as end-stage renal disease
beneficiaries in the Medicare program; who are enrolled in private health care coverage as
defined in section 256B.02, subdivision 9; who are eligible under paragraph (j); or who
receive treatment funded pursuant to section 254B.02 are exempt from the MinnesotaCare
enrollment requirements of this subdivision.

(f) For applications received on or after October 1, 2003, eligibility may begin no
earlier than the date of application. For individuals eligible under paragraph (a), clause
(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
may reapply if there is a subsequent period of inpatient hospitalization.

(g) Beginning September 1, 2006, Minnesota health care program applications and
renewals completed by recipients and applicants who are persons described in paragraph
(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility
by the county agency. If all other eligibility requirements of this subdivision are met,
eligibility for general assistance medical care shall be available in any month during which
MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
notice of termination for eligibility for general assistance medical care shall be sent to
an applicant or recipient. If all other eligibility requirements of this subdivision are
met, eligibility for general assistance medical care shall be available until enrollment in
MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).

(h) The date of an initial Minnesota health care program application necessary to
begin a determination of eligibility shall be the date the applicant has provided a name,
address, and Social Security number, signed and dated, to the county agency or the
Department of Human Services. If the applicant is unable to provide a name, address,
Social Security number, and signature when health care is delivered due to a medical
condition or disability, a health care provider may act on an applicant's behalf to establish
the date of an initial Minnesota health care program application by providing the county
agency or Department of Human Services with provider identification and a temporary
unique identifier for the applicant. The applicant must complete the remainder of the
application and provide necessary verification before eligibility can be determined. The
county agency must assist the applicant in obtaining verification if necessary.

(i) County agencies are authorized to use all automated databases containing
information regarding recipients' or applicants' income in order to determine eligibility for
general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
in order to determine eligibility and premium payments by the county agency.

(j) General assistance medical care is not available for a person in a correctional
facility unless the person is detained by law for less than one year in a county correctional
or detention facility as a person accused or convicted of a crime, or admitted as an
inpatient to a hospital on a criminal hold order, and the person is a recipient of general
assistance medical care at the time the person is detained by law or admitted on a criminal
hold order and as long as the person continues to meet other eligibility requirements
of this subdivision.

(k) General assistance medical care is not available for applicants or recipients who
do not cooperate with the county agency to meet the requirements of medical assistance.

(l) In determining the amount of assets of an individual eligible under paragraph
(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
an asset excluded under paragraph (a), that was given away, sold, or disposed of for
less than fair market value within the 60 months preceding application for general
assistance medical care or during the period of eligibility. Any transfer described in this
paragraph shall be presumed to have been for the purpose of establishing eligibility for
general assistance medical care, unless the individual furnishes convincing evidence to
establish that the transaction was exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair market value at the time it
was given away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial months,
shall be calculated by dividing the uncompensated transfer amount by the average monthly
per person payment made by the medical assistance program to skilled nursing facilities
for the previous calendar year. The individual shall remain ineligible until this fixed period
has expired. The period of ineligibility may exceed 30 months, and a reapplication for
benefits after 30 months from the date of the transfer shall not result in eligibility unless
and until the period of ineligibility has expired. The period of ineligibility begins in the
month the transfer was reported to the county agency, or if the transfer was not reported,
the month in which the county agency discovered the transfer, whichever comes first. For
applicants, the period of ineligibility begins on the date of the first approved application.

(m) When determining eligibility for any state benefits under this subdivision,
the income and resources of all noncitizens shall be deemed to include their sponsor's
income and resources as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
subsequently set out in federal rules.

(n) Undocumented noncitizens and nonimmigrants are ineligible for general
assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and
an undocumented noncitizen is an individual who resides in the United States without the
approval or acquiescence of the Immigration and Naturalization Service.

(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for
medical assistance due to the deeming of a sponsor's income and resources, is ineligible
for general assistance medical care.

(p) Effective July 1, 2003, general assistance medical care emergency services end.

Sec. 19.

Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:

Subd. 4.

General assistance medical care; services.

(a)(i) For a person who is
eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
care covers, except as provided in paragraph (c):

(1) inpatient hospital services;

(2) outpatient hospital services;

(3) services provided by Medicare certified rehabilitation agencies;

(4) prescription drugs and other products recommended through the process
established in section 256B.0625, subdivision 13;

(5) equipment necessary to administer insulin and diagnostic supplies and equipment
for diabetics to monitor blood sugar level;

(6) eyeglasses and eye examinations provided by a physician or optometrist;

(7) hearing aids;

(8) prosthetic devices;

(9) laboratory and X-ray services;

(10) physician's services;

(11) medical transportation except special transportation;

(12) chiropractic services as covered under the medical assistance program;

(13) podiatric services;

(14) dental services as covered under the medical assistance program;

(15) outpatient services provided by a mental health center or clinic that is under
contract with the county board and is established under section 245.62;

(16) day treatment services for mental illness provided under contract with the
county board;

(17) prescribed medications for persons who have been diagnosed as mentally ill as
necessary to prevent more restrictive institutionalization;

(18) psychological services, medical supplies and equipment, and Medicare
premiums, coinsurance and deductible payments;

(19) medical equipment not specifically listed in this paragraph when the use of
the equipment will prevent the need for costlier services that are reimbursable under
this subdivision;

(20) services performed by a certified pediatric nurse practitioner, a certified family
nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
practitioner in independent practice, if (1) the service is otherwise covered under this
chapter as a physician service, (2) the service provided on an inpatient basis is not included
as part of the cost for inpatient services included in the operating payment rate, and (3) the
service is within the scope of practice of the nurse practitioner's license as a registered
nurse, as defined in section 148.171;

(21) services of a certified public health nurse or a registered nurse practicing in
a public health nursing clinic that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the scope of practice of the
public health nurse's license as a registered nurse, as defined in section 148.171;

(22) telemedicine consultations, to the extent they are covered under section
256B.0625, subdivision 3b; deleted text begin and
deleted text end

(23) mental health telemedicine and psychiatric consultation as covered under
section 256B.0625, subdivisions 46 and 48 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (24) care coordination and patient education services of a community health worker,
if the community health worker has earned a certificate from the Minnesota State Colleges
and University System approved community health worker curriculum or equivalent.
Services provided by community health workers who have at least five years of supervised
experience must be considered eligible for payment but these workers must complete the
certificate program by January 1, 2010. Community health workers must work under the
supervision of a medical assistance enrolled provider.
new text end

(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
to inpatient hospital services, including physician services provided during the inpatient
hospital stay. A $1,000 deductible is required for each inpatient hospitalization.

(b) Effective August 1, 2005, sex reassignment surgery is not covered under this
subdivision.

(c) In order to contain costs, the commissioner of human services shall select
vendors of medical care who can provide the most economical care consistent with high
medical standards and shall where possible contract with organizations on a prepaid
capitation basis to provide these services. The commissioner shall consider proposals by
counties and vendors for prepaid health plans, competitive bidding programs, block grants,
or other vendor payment mechanisms designed to provide services in an economical
manner or to control utilization, with safeguards to ensure that necessary services are
provided. Before implementing prepaid programs in counties with a county operated or
affiliated public teaching hospital or a hospital or clinic operated by the University of
Minnesota, the commissioner shall consider the risks the prepaid program creates for the
hospital and allow the county or hospital the opportunity to participate in the program in a
manner that reflects the risk of adverse selection and the nature of the patients served by
the hospital, provided the terms of participation in the program are competitive with the
terms of other participants considering the nature of the population served. Payment for
services provided pursuant to this subdivision shall be as provided to medical assistance
vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
payments made during fiscal year 1990 and later years, the commissioner shall consult
with an independent actuary in establishing prepayment rates, but shall retain final control
over the rate methodology.

(d) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
co-payments for services provided on or after October 1, 2003:

(1) $25 for eyeglasses;

(2) $25 for nonemergency visits to a hospital-based emergency room;

(3) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $12 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness; and

(4) 50 percent coinsurance on restorative dental services.

(e) Co-payments shall be limited to one per day per provider for nonpreventive visits,
eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of
general assistance medical care are responsible for all co-payments in this subdivision.
The general assistance medical care reimbursement to the provider shall be reduced by
the amount of the co-payment, except that reimbursement for prescription drugs shall not
be reduced once a recipient has reached the $12 per month maximum for prescription
drug co-payments. The provider collects the co-payment from the recipient. Providers
may not deny services to recipients who are unable to pay the co-payment, except as
provided in paragraph (f).

(f) If it is the routine business practice of a provider to refuse service to an individual
with uncollected debt, the provider may include uncollected co-payments under this
section. A provider must give advance notice to a recipient with uncollected debt before
services can be denied.

(g) Any county may, from its own resources, provide medical payments for which
state payments are not made.

(h) Chemical dependency services that are reimbursed under chapter 254B must not
be reimbursed under general assistance medical care.

(i) The maximum payment for new vendors enrolled in the general assistance
medical care program after the base year shall be determined from the average usual and
customary charge of the same vendor type enrolled in the base year.

(j) The conditions of payment for services under this subdivision are the same as the
conditions specified in rules adopted under chapter 256B governing the medical assistance
program, unless otherwise provided by statute or rule.

(k) Inpatient and outpatient payments shall be reduced by five percent, effective July
1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003,
and incorporated by reference in paragraph (i).

(l) Payments for all other health services except inpatient, outpatient, and pharmacy
services shall be reduced by five percent, effective July 1, 2003.

(m) Payments to managed care plans shall be reduced by five percent for services
provided on or after October 1, 2003.

(n) A hospital receiving a reduced payment as a result of this section may apply the
unpaid balance toward satisfaction of the hospital's bad debts.

(o) Fee-for-service payments for nonpreventive visits shall be reduced by $3
for services provided on or after January 1, 2006. For purposes of this subdivision, a
visit means an episode of service which is required because of a recipient's symptoms,
diagnosis, or established illness, and which is delivered in an ambulatory setting by
a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
audiologist, optician, or optometrist.

(p) Payments to managed care plans shall not be increased as a result of the removal
of the $3 nonpreventive visit co-payment effective January 1, 2006.

new text begin (q) Recipients eligible under subdivision 3, paragraph (a), shall pay a $25
co-payment for nonemergency visits to a hospital-based emergency room.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 20.

Minnesota Statutes 2006, section 256L.01, subdivision 1, is amended to read:

Subdivision 1.

Scope.

For purposes of deleted text begin sections 256L.01 to 256L.18 deleted text end new text begin this chapter new text end ,
the following terms shall have the meanings given them.

Sec. 21.

Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:

Subd. 4.

Gross individual or gross family income.

(a) "Gross individual or gross
family income" for nonfarm self-employed means income calculated for the deleted text begin six-month deleted text end
new text begin 12-month new text end period of eligibility using the net profit or loss reported on the applicant's
federal income tax form for the previous year and using the medical assistance families
with children methodology for determining allowable and nonallowable self-employment
expenses and countable income.

(b) "Gross individual or gross family income" for farm self-employed means income
calculated for the deleted text begin six-month deleted text end new text begin 12-month new text end period of eligibility using as the baseline the
adjusted gross income reported on the applicant's federal income tax form for the previous
year deleted text begin and adding back in reported depreciation amounts that apply to the business in which
the family is currently engaged deleted text end .

(c) "Gross individual or gross family income" means the total income for all family
members, calculated for the deleted text begin six-month deleted text end new text begin 12-month new text end period of eligibility.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 22.

Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:

Subdivision 1.

Covered health services.

deleted text begin For individuals under section 256L.04,
subdivision 7, with income no greater than 75 percent of the federal poverty guidelines
or for families with children under section 256L.04, subdivision 1, all subdivisions of
this section apply. deleted text end "Covered health services" means the health services reimbursed
under chapter 256B, with the exception of inpatient hospital services, special education
services, private duty nursing services, adult dental care services other than services
covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency
medical transportation services, personal care assistant and case management services,
nursing home or intermediate care facilities services, inpatient mental health services,
and chemical dependency services. Outpatient mental health services covered under the
MinnesotaCare program are limited to diagnostic assessments, psychological testing,
explanation of findings, mental health telemedicine, psychiatric consultation, medication
management by a physician, day treatment, partial hospitalization, and individual, family,
and group psychotherapy.

No public funds shall be used for coverage of abortion under MinnesotaCare
except where the life of the female would be endangered or substantial and irreversible
impairment of a major bodily function would result if the fetus were carried to term; or
where the pregnancy is the result of rape or incest.

Covered health services shall be expanded as provided in this section.

Sec. 23.

Minnesota Statutes 2006, section 256L.03, subdivision 3, is amended to read:

Subd. 3.

Inpatient hospital services.

(a) Covered health services shall include
inpatient hospital services, including inpatient hospital mental health services and inpatient
hospital and residential chemical dependency treatment, subject to those limitations
necessary to coordinate the provision of these services with eligibility under the medical
assistance spenddown. deleted text begin Prior to July 1, 1997, the inpatient hospital benefit for adult
enrollees is subject to an annual benefit limit of $10,000. deleted text end The inpatient hospital benefit for
adult enrollees who qualify under section 256L.04, subdivision 7, or who qualify under
section 256L.04, subdivisions 1 and 2, with family gross income that exceeds deleted text begin 175 deleted text end new text begin 200 new text end
percent of the federal poverty guidelines and who are not pregnant, is subject to an annual
limit of deleted text begin $10,000 deleted text end new text begin $20,000 new text end .

(b) Admissions for inpatient hospital services paid for under section 256L.11,
subdivision 3, must be certified as medically necessary in accordance with Minnesota
Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):

(1) all admissions must be certified, except those authorized under rules established
under section 254A.03, subdivision 3, or approved under Medicare; and

(2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
for admissions for which certification is requested more than 30 days after the day of
admission. The hospital may not seek payment from the enrollee for the amount of the
payment reduction under this clause.

Sec. 24.

Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:

Subd. 5.

Co-payments and coinsurance.

(a) Except as provided in paragraphs (b)
and (c), the MinnesotaCare benefit plan shall include the following co-payments and
coinsurance requirements for all enrollees:

(1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
$3,000 per family;

(2) $3 per prescription for adult enrollees;

(3) $25 for eyeglasses for adult enrollees;

(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
episode of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a physician or
physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist; and

(5) $6 for nonemergency visits to a hospital-based emergency room.

(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
children under the age of 21 deleted text begin in households with family income equal to or less than 175
percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
parents and relative caretakers of children under the age of 21 in households with family
income greater than 175 percent of the federal poverty guidelines for inpatient hospital
admissions occurring on or after January 1, 2001 deleted text end .

(c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children
under the age of 21.

(d) Adult enrollees with family gross income that exceeds deleted text begin 175 deleted text end new text begin 200 new text end percent of the
federal poverty guidelines and who are not pregnant shall be financially responsible for
the coinsurance amount, if applicable, and amounts which exceed the deleted text begin $10,000 deleted text end new text begin $20,000 new text end
inpatient hospital benefit limit.

(e) When a MinnesotaCare enrollee becomes a member of a prepaid health
plan, or changes from one prepaid health plan to another during a calendar year, any
charges submitted towards the deleted text begin $10,000 deleted text end new text begin $20,000 new text end annual inpatient benefit limit, and any
out-of-pocket expenses incurred by the enrollee for inpatient services, that were submitted
or incurred prior to enrollment, or prior to the change in health plans, shall be disregarded.

Sec. 25.

Minnesota Statutes 2006, section 256L.04, subdivision 1a, is amended to read:

Subd. 1a.

Social Security number required.

(a) Individuals and families applying
for MinnesotaCare coverage must provide a Social Security number. new text begin This requirement
does not apply to an undocumented noncitizen or nonimmigrant who is eligible for
MinnesotaCare.
new text end

(b) The commissioner shall not deny eligibility to an otherwise eligible applicant
who has applied for a Social Security number and is awaiting issuance of that Social
Security number.

(c) Newborns enrolled under section 256L.05, subdivision 3, are exempt from the
requirements of this subdivision.

(d) Individuals who refuse to provide a Social Security number because of
well-established religious objections are exempt from the requirements of this subdivision.
The term "well-established religious objections" has the meaning given in Code of Federal
Regulations, title 42, section 435.910.

Sec. 26.

Minnesota Statutes 2006, section 256L.04, subdivision 7, is amended to read:

Subd. 7.

Single adults and households with no children.

The definition of eligible
persons includes all individuals and households with no children who have gross family
incomes that are equal to or less than deleted text begin 175 deleted text end new text begin 200 new text end percent of the federal poverty guidelines.

Sec. 27.

Minnesota Statutes 2006, section 256L.04, subdivision 10, is amended to read:

Subd. 10.

Citizenship requirements.

new text begin (a) new text end Eligibility for MinnesotaCare is limited
to citizens or nationals of the United States, qualified noncitizens, and other persons
residing lawfully in the United States as described in section 256B.06, subdivision 4,
paragraphs (a) to (e) and (j). Undocumented noncitizens and nonimmigrants are ineligible
for MinnesotaCare. new text begin This paragraph does not apply to children. new text end

new text begin (b) new text end For purposes of this subdivision, a nonimmigrant is an individual in one or
more of the classes listed in United States Code, title 8, section 1101(a)(15), and an
undocumented noncitizen is an individual who resides in the United States without the
approval or acquiescence of the Immigration and Naturalization Service.

new text begin (c) new text end Families with children who are citizens or nationals of the United States must
cooperate in obtaining satisfactory documentary evidence of citizenship or nationality
according to the requirements of the federal Deficit Reduction Act of 2005, Public Law
109-171. new text begin State and county workers must assist applicants in obtaining satisfactory
documentary evidence of citizenship or nationality.
new text end

Sec. 28.

Minnesota Statutes 2006, section 256L.05, subdivision 1, is amended to read:

Subdivision 1.

Application and information availability.

Applications and deleted text begin other
information deleted text end new text begin application assistance new text end must be made available deleted text begin to deleted text end new text begin at new text end provider offices, local
human services agencies, school districts, public and private elementary schools in which
25 percent or more of the students receive free or reduced price lunches, community health
offices, deleted text begin and deleted text end Women, Infants and Children (WIC) program sites new text begin , Head Start program sites,
public housing councils, crisis nurseries, child care centers, early childhood education and
preschool program sites, legal aid offices, libraries, and other sites willing to cooperate
in program outreach new text end . These sites may accept applications and forward the forms to
the commissioner new text begin or local county human services agencies that choose to participate
as an enrollment site new text end . Otherwise, applicants may apply directly to the commissioner new text begin
or to participating local county human services agencies new text end . deleted text begin Beginning January 1, 2000,
MinnesotaCare enrollment sites will be expanded to include local county human services
agencies which choose to participate.
deleted text end

Sec. 29.

Minnesota Statutes 2006, section 256L.05, subdivision 1b, is amended to read:

Subd. 1b.

MinnesotaCare enrollment by county agencies.

Beginning September
1, 2006, county agencies shall enroll single adults and households with no children
formerly enrolled in general assistance medical care in MinnesotaCare according to
section 256D.03, subdivision 3. County agencies shall perform all duties necessary
to administer the MinnesotaCare program ongoing for these enrollees, including the
redetermination of MinnesotaCare eligibility at deleted text begin six-month deleted text end renewal.

Sec. 30.

Minnesota Statutes 2006, section 256L.05, subdivision 2, is amended to read:

Subd. 2.

Commissioner's duties.

deleted text begin (a) deleted text end The commissioner or county agency shall
use electronic verification as the primary method of income verification. If there is a
discrepancy between reported income and electronically verified income, an individual
may be required to submit additional verification. In addition, the commissioner shall
perform random audits to verify reported income and eligibility. The commissioner
may execute data sharing arrangements with the Department of Revenue and any other
governmental agency in order to perform income verification related to eligibility and
premium payment under the MinnesotaCare program.

deleted text begin (b) In determining eligibility for MinnesotaCare, the commissioner shall require
applicants and enrollees seeking renewal of eligibility to verify both earned and unearned
income. The commissioner shall also require applicants and enrollees to submit the names
of their employers and a contact name with a telephone number for each employer for
purposes of verifying whether the applicant or enrollee, and any dependents, are eligible
for employer-subsidized coverage. Data collected is nonpublic data as defined in section
deleted text begin 13.02, subdivision 9 deleted text end .
deleted text end

Sec. 31.

Minnesota Statutes 2006, section 256L.05, subdivision 3a, is amended to read:

Subd. 3a.

Renewal of eligibility.

(a) Beginning deleted text begin January 1, 1999 deleted text end new text begin July 1, 2007 new text end , an
enrollee's eligibility must be renewed every 12 months. The 12-month period begins in
the month after the month the application is approved.

(b) deleted text begin Beginning October 1, 2004, an enrollee's eligibility must be renewed every
six months. The first six-month period of eligibility begins the month the application is
received by the commissioner. The effective date of coverage within the first six-month
period of eligibility is as provided in subdivision 3. deleted text end Each new period of eligibility must
take into account any changes in circumstances that impact eligibility and premium
amount. An enrollee must provide all the information needed to redetermine eligibility by
the first day of the month that ends the eligibility period. The premium for the new period
of eligibility must be received as provided in section 256L.06 in order for eligibility to
continue.

(c) For single adults and households with no children formerly enrolled in general
assistance medical care and enrolled in MinnesotaCare according to section 256D.03,
subdivision 3, the first deleted text begin six-month deleted text end period of eligibility begins the month the enrollee
submitted the application or renewal for general assistance medical care.

Sec. 32.

Minnesota Statutes 2006, section 256L.05, subdivision 3c, is amended to read:

Subd. 3c.

Retroactive coverage.

Notwithstanding subdivision 3, the effective
date of coverage shall be the deleted text begin first deleted text end day deleted text begin of the month deleted text end following termination from medical
assistance or general assistance medical care for families and individuals who are eligible
for MinnesotaCare and who submitted a written request for retroactive MinnesotaCare
coverage with a completed application within 30 days of the mailing of notification of
termination from medical assistance or general assistance medical care. The applicant
must provide all required verifications within 30 days of the written request for
verification. For retroactive coverage, premiums must be paid in full for any retroactive
month, current month, and next month within 30 days of the premium billing.

Sec. 33.

Minnesota Statutes 2006, section 256L.05, is amended by adding a subdivision
to read:

new text begin Subd. 3d. new text end

new text begin Presumptive eligibility. new text end

new text begin Coverage under the program is available during
a presumptive eligibility period for children whose family income does not exceed the
applicable income standard. The presumptive eligibility period begins on the date on
which a health care provider enrolled in the program, or other entity designated by the
commissioner, determines, based on preliminary information, that the child's family
income does not exceed the applicable income standard. The presumptive eligibility period
ends the earlier of the day on which a determination is made of eligibility under this section
or the last day of the month following the month presumptive eligibility was determined.
new text end

Sec. 34.

Minnesota Statutes 2006, section 256L.05, is amended by adding a subdivision
to read:

new text begin Subd. 3e. new text end

new text begin Continuous eligibility. new text end

new text begin Children who are eligible under this section
shall be continuously eligible until the earlier of the next renewal period, or the time that
a child exceeds age 21.
new text end

Sec. 35.

Minnesota Statutes 2006, section 256L.07, subdivision 1, is amended to read:

Subdivision 1.

General requirements.

(a) deleted text begin Children enrolled in the original
children's health plan as of September 30, 1992, children who enrolled in the
MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
article 4, section 17, and children who have family gross incomes that are equal to or
less than 150 percent of the federal poverty guidelines are eligible without meeting
the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
long as they maintain continuous coverage in the MinnesotaCare program or medical
assistance. Children who apply for MinnesotaCare on or after the implementation date
of the employer-subsidized health coverage program as described in Laws 1998, chapter
407, article 5, section 45, who have family gross incomes that are equal to or less than 150
percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
be eligible for MinnesotaCare.
deleted text end

deleted text begin (b) deleted text end Families enrolled in MinnesotaCare under section 256L.04, subdivision 1,
whose income increases above 275 percent of the federal poverty guidelines, are no
longer eligible for the program and shall be disenrolled by the commissioner new text begin , subject to
the continuous eligibility requirement for children under section 256L.05, subdivision
3e new text end . Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, whose
income increases above deleted text begin 175 deleted text end new text begin 200 new text end percent of the federal poverty guidelines are no longer
eligible for the program and shall be disenrolled by the commissioner. For persons
disenrolled under this subdivision, MinnesotaCare coverage terminates the last day of
the calendar month following the month in which the commissioner determines that the
income of a family or individual exceeds program income limits.

deleted text begin (c) deleted text end new text begin (b) new text end Notwithstanding paragraph deleted text begin (b) deleted text end new text begin (a) new text end , children may remain enrolled in
MinnesotaCare if ten percent of their gross individual or gross family income as defined
in section 256L.01, subdivision 4, is less than the new text begin annual new text end premium for a deleted text begin six-month deleted text end
policy with a $500 deductible available through the Minnesota Comprehensive Health
Association. Children who are no longer eligible for MinnesotaCare under this clause shall
be given a 12-month notice period from the date that ineligibility is determined before
disenrollment. The premium for children remaining eligible under this clause shall be the
maximum premium determined under section 256L.15, subdivision 2, paragraph (b).

deleted text begin (d) deleted text end new text begin (c) new text end Notwithstanding paragraphs deleted text begin (b) deleted text end new text begin (a) new text end and deleted text begin (c) deleted text end new text begin (b) new text end , parents are not eligible for
MinnesotaCare if gross household income exceeds $25,000 for the six-month period
of eligibility.

Sec. 36.

Minnesota Statutes 2006, section 256L.07, subdivision 2, is amended to read:

Subd. 2.

Must not have access to employer-subsidized coverage.

(a) To be
eligible, deleted text begin a family or individual deleted text end new text begin an adult new text end must not have access to subsidized health coverage
through an employer and must not have had access to employer-subsidized coverage
through a current employer for 18 months prior to application or reapplication. deleted text begin A family
or individual deleted text end new text begin An adult new text end whose employer-subsidized coverage is lost due to an employer
terminating health care coverage as an employee benefit during the previous 18 months
is not eligible.

(b) This subdivision does not apply to deleted text begin a family or individual deleted text end new text begin an adult new text end who was
enrolled in MinnesotaCare within six months or less of reapplication and who no longer
has employer-subsidized coverage due to the employer terminating health care coverage
as an employee benefit.

(c) For purposes of this requirement, subsidized health coverage means health
coverage for which the employer pays at least 50 percent of the cost of coverage for
the employee or dependent, or a higher percentage as specified by the commissioner.
deleted text begin Children are eligible for employer-subsidized coverage through either parent, including
the noncustodial parent. deleted text end The commissioner must treat employer contributions to Internal
Revenue Code Section 125 plans and any other employer benefits intended to pay
health care costs as qualified employer subsidies toward the cost of health coverage for
employees for purposes of this subdivision.

new text begin (d) Notwithstanding paragraph (c), if an employer-subsidized health plan requires
the employee to pay more than eight percent of the employee's family gross income in
co-payments, deductibles, or coinsurance, the health coverage offered shall not constitute
employer-subsidized coverage for purposes of determining eligibility for MinnesotaCare.
new text end

new text begin (e) This subdivision does not apply to children.
new text end

Sec. 37.

Minnesota Statutes 2006, section 256L.07, subdivision 3, is amended to read:

Subd. 3.

Other health coverage.

(a) deleted text begin Families and individuals deleted text end new text begin Adults new text end enrolled in the
MinnesotaCare program must have no health coverage while enrolled or for at least four
months prior to application and renewal. deleted text begin Children enrolled in the original children's health
plan and children in families with income equal to or less than 150 percent of the federal
poverty guidelines, who have other health insurance, are eligible if the coverage:
deleted text end

deleted text begin (1) lacks two or more of the following:
deleted text end

deleted text begin (i) basic hospital insurance;
deleted text end

deleted text begin (ii) medical-surgical insurance;
deleted text end

deleted text begin (iii) prescription drug coverage;
deleted text end

deleted text begin (iv) dental coverage; or
deleted text end

deleted text begin (v) vision coverage;
deleted text end

deleted text begin (2) requires a deductible of $100 or more per person per year; or
deleted text end

deleted text begin (3) lacks coverage because the child has exceeded the maximum coverage for a
particular diagnosis or the policy excludes a particular diagnosis.
deleted text end

The commissioner may change this eligibility criterion for sliding scale premiums in
order to remain within the limits of available appropriations. deleted text begin The requirement of no health
coverage deleted text end new text begin This paragraph new text end does not apply to deleted text begin newborns deleted text end new text begin children new text end .

(b) Medical assistance, general assistance medical care, and the Civilian Health and
Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under
United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or
health coverage for purposes of the four-month requirement described in this subdivision.

(c) For purposes of this subdivision, an applicant or enrollee who is entitled to
Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
for MinnesotaCare.

(d) Applicants who were recipients of medical assistance or general assistance
medical care within one month of application must meet the provisions of this subdivision
and subdivision 2.

(e) Cost-effective health insurance that was paid for by medical assistance is not
considered health coverage for purposes of the four-month requirement under this
section, except if the insurance continued after medical assistance no longer considered it
cost-effective or after medical assistance closed.

Sec. 38.

Minnesota Statutes 2006, section 256L.07, subdivision 6, is amended to read:

Subd. 6.

Exception for certain adults.

Single adults and households with
no children formerly enrolled in general assistance medical care and enrolled in
MinnesotaCare according to section 256D.03, subdivision 3, are eligible without meeting
the requirements of this section until deleted text begin six-month deleted text end renewal.

Sec. 39.

Minnesota Statutes 2006, section 256L.09, subdivision 4, is amended to read:

Subd. 4.

Eligibility as Minnesota resident.

(a) For purposes of this section, a
permanent Minnesota resident is a person who has demonstrated, through persuasive and
objective evidence, that the person is domiciled in the state and intends to live in the
state permanently.

(b) To be eligible as a permanent resident, an applicant must demonstrate the
requisite intent to live in the state permanently by:

(1) showing that the applicant maintains a residence at a verified address deleted text begin other than a
place of public accommodation deleted text end , through the use of evidence of residence described in
section 256D.02, subdivision 12a, new text begin paragraph (b), new text end clause deleted text begin (1) deleted text end new text begin (2) new text end ;

(2) demonstrating that the applicant has been continuously domiciled in the state for
no less than 180 days immediately before the application; and

(3) signing an affidavit declaring that (A) the applicant currently resides in the state
and intends to reside in the state permanently; and (B) the applicant did not come to the
state for the primary purpose of obtaining medical coverage or treatment.

(c) A person who is temporarily absent from the state does not lose eligibility for
MinnesotaCare. "Temporarily absent from the state" means the person is out of the state
for a temporary purpose and intends to return when the purpose of the absence has been
accomplished. A person is not temporarily absent from the state if another state has
determined that the person is a resident for any purpose. If temporarily absent from the
state, the person must follow the requirements of the health plan in which the person is
enrolled to receive services.

Sec. 40.

Minnesota Statutes 2006, section 256L.15, subdivision 1, is amended to read:

Subdivision 1.

Premium determination.

(a) Families with children and individuals
shall pay a premium determined according to subdivision 2 new text begin , except that no premium shall
be charged to individuals under the age of 21 new text end .

(b) Pregnant women deleted text begin and children under age two deleted text end are exempt from the provisions
of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
for failure to pay premiums. For pregnant women, this exemption continues until the
first day of the month following the 60th day postpartum. Women who remain enrolled
during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
disenrolled on the first of the month following the 60th day postpartum for the penalty
period that otherwise applies under section 256L.06, unless they begin paying premiums.

new text begin (c) Members of the military and their families who meet the eligibility criteria
for MinnesotaCare upon eligibility approval made within 24 months following the end
of the member's tour of active duty shall have their premiums paid by the commissioner.
The effective date of coverage for an individual or family who meets the criteria of this
paragraph shall be the first day of the month following the month in which eligibility is
approved. This exemption shall apply for 12 months.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007, or upon federal
approval, whichever is later.
new text end

Sec. 41.

Minnesota Statutes 2006, section 256L.15, subdivision 2, is amended to read:

Subd. 2.

Sliding fee scale; monthly gross individual or family income.

(a) The
commissioner shall establish a sliding fee scale to determine the percentage of monthly
gross individual or family income that households at different income levels must pay
to obtain coverage through the MinnesotaCare program. The sliding fee scale must be
based on the enrollee's monthly gross individual or family income. The sliding fee scale
must contain separate tables based on enrollment of one, two, or three or more persons.
The sliding fee scale begins with a premium of 1.5 percent of monthly gross individual or
family income for individuals or families with incomes below the limits for the medical
assistance program for families and children in effect on January 1, 1999, and proceeds
through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent.
These percentages are matched to evenly spaced income steps ranging from the medical
assistance income limit for families and children in effect on January 1, 1999, to 275
percent of the federal poverty guidelines for the applicable family size, up to a family size
of five. The sliding fee scale for a family of five must be used for families of more than
five. deleted text begin Effective October 1, 2003, the commissioner shall increase each percentage by 0.5
percentage points for enrollees with income greater than 100 percent but not exceeding
200 percent of the federal poverty guidelines and shall increase each percentage by 1.0
percentage points for families and children with incomes greater than 200 percent of
the federal poverty guidelines. deleted text end The sliding fee scale and percentages are not subject to
the provisions of chapter 14. If a family or individual reports increased income after
enrollment, premiums shall be adjusted at the time the change in income is reported.

(b) deleted text begin Children in deleted text end Families whose gross income is above 275 percent of the federal
poverty guidelines shall pay the maximum premium. The maximum premium is defined
as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
cases paid the maximum premium, the total revenue would equal the total cost of
MinnesotaCare medical coverage and administration. In this calculation, administrative
costs shall be assumed to equal ten percent of the total. The costs of medical coverage
for pregnant women and children under age two and the enrollees in these groups shall
be excluded from the total. The maximum premium for two enrollees shall be twice the
maximum premium for one, and the maximum premium for three or more enrollees shall
be three times the maximum premium for one.

deleted text begin (c) After calculating the percentage of premium each enrollee shall pay under
paragraph (a), eight percent shall be added to the premium.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 42.

Minnesota Statutes 2006, section 256L.17, subdivision 2, is amended to read:

Subd. 2.

Limit on total assets.

(a) Effective July 1, 2002, or upon federal approval,
whichever is later, in order to be eligible for the MinnesotaCare program, a household of
two or more persons must not own more than $20,000 in total net assets, and a household
of one person must not own more than $10,000 in total net assets.

(b) For purposes of this subdivision, assets are determined according to section
256B.056, subdivision 3c new text begin , except that workers' compensation settlements received due to
a work-related injury shall not be considered new text end .

(c) State-funded MinnesotaCare is not available for applicants or enrollees who are
otherwise eligible for medical assistance but fail to verify assets. Enrollees who become
eligible for federally funded medical assistance shall be terminated from state-funded
MinnesotaCare and transferred to medical assistance.

Sec. 43.

Minnesota Statutes 2006, section 256L.17, subdivision 3, is amended to read:

Subd. 3.

Documentation.

(a) The commissioner of human services shall require
individuals and families, at the time of application or renewal, to indicate on a checkoff
form developed by the commissioner whether they satisfy the MinnesotaCare asset
requirement. deleted text begin This form must include the following or similar language: "To be eligible for
MinnesotaCare, individuals and families must not own net assets in excess of $30,000
for a household of two or more persons or $15,000 for a household of one person, not
including a homestead, household goods and personal effects, assets owned by children,
vehicles used for employment, court-ordered settlements up to $10,000, individual
retirement accounts, and capital and operating assets of a trade or business up to $200,000.
Do you and your household own net assets in excess of these limits?"
deleted text end

(b) The commissioner may require individuals and families to provide any
information the commissioner determines necessary to verify compliance with the asset
requirement, if the commissioner determines that there is reason to believe that an
individual or family has assets that exceed the program limit.

Sec. 44.

Minnesota Statutes 2006, section 256L.17, subdivision 7, is amended to read:

Subd. 7.

Exception for certain adults.

Single adults and households with
no children formerly enrolled in general assistance medical care and enrolled in
MinnesotaCare according to section 256D.03, subdivision 3, are exempt from the
requirements of this section until deleted text begin six-month deleted text end renewal.

Sec. 45.

Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2,
is amended to read:

Subd. 2. Community and Family Health Improvement

Summary by Fund
General	40,413,000	40,382,000
State Government Special Revenue	141,000	128,000
Health Care Access	3,510,000	3,516,000
Federal TANF	6,000,000	6,000,000

deleted text begin FAMILY PLANNING BASE
REDUCTION. Base level funding for
the family planning special projects grant
program is reduced by $1,877,000 each
year of the biennium beginning July 1,
2007, provided that this reduction shall
only take place upon full implementation of
the family planning project section of the
1115 waiver. Notwithstanding Minnesota
Statutes, section , the commissioner
shall give priority to community health care
clinics providing family planning services
that either serve a high number of women
who do not qualify for medical assistance
or are unable to participate in the medical
assistance program as a medical assistance
provider when allocating the remaining
appropriations. Notwithstanding section 15,
this paragraph shall not expire.
deleted text end

SHAKEN BABY VIDEO. Of the
state government special revenue fund
appropriation, $13,000 in 2006 is
appropriated to the commissioner of health
to provide a video to hospitals on shaken
baby syndrome. The commissioner of health
shall assess a fee to hospitals to cover the
cost of the approved shaken baby video and
the revenue received is to be deposited in the
state government special revenue fund.

Sec. 46. new text begin APPROPRIATION.
new text end

new text begin (a) $....... is appropriated from the health care access fund to the commissioner of
human services for the biennium beginning July 1, 2007, for the purpose of Minnesota
health care programs outreach grants and the enrollment incentive programs under
Minnesota Statutes, section 256.962.
new text end

new text begin (b) $1,156,000 is appropriated each fiscal year beginning July 1, 2007, from the
general fund to the commissioner of health for family planning grants under Minnesota
Statutes, section 145.925.
new text end

new text begin (c) $....... is appropriated for the biennium beginning July 1, 2007, from the general
fund to the commissioner of human services for the critical access dental providers
reimbursement rates under Minnesota Statutes, section 256B.76, paragraph (c).
new text end

new text begin (d) $....... is appropriated for the biennium beginning July 1, 2007, from the general
fund to the commissioner of health for the subsidies for federally qualified health centers
under Minnesota Statutes, section 145.9269.
new text end

new text begin (e) $....... is appropriated for the biennium beginning July 1, 2007, from the general
fund to the commissioner of human services for the patient incentive health program
established in Minnesota Statutes, section 256.01, subdivision 2b, paragraph (b).
new text end

Sec. 47. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2006, sections 62A.301; 256B.0631; and 256L.035, new text end new text begin are repealed.
new text end

ARTICLE 2

MINNESOTA HEALTH INSURANCE EXCHANGE; SECTION 125 PLANS

Section 1.

Minnesota Statutes 2006, section 13.46, subdivision 2, is amended to read:

Subd. 2.

General.

(a) Unless the data is summary data or a statute specifically
provides a different classification, data on individuals collected, maintained, used, or
disseminated by the welfare system is private data on individuals, and shall not be
disclosed except:

(1) according to section 13.05;

(2) according to court order;

(3) according to a statute specifically authorizing access to the private data;

(4) to an agent of the welfare system, including a law enforcement person, attorney,
or investigator acting for it in the investigation or prosecution of a criminal or civil
proceeding relating to the administration of a program;

(5) to personnel of the welfare system who require the data to verify an individual's
identity; determine eligibility, amount of assistance, and the need to provide services to
an individual or family across programs; evaluate the effectiveness of programs; and
investigate suspected fraud;

(6) to administer federal funds or programs;

(7) between personnel of the welfare system working in the same program;

(8) to the Department of Revenue to administer and evaluate tax refund or tax credit
programs and to identify individuals who may benefit from these programs. The following
information may be disclosed under this paragraph: an individual's and their dependent's
names, dates of birth, Social Security numbers, income, addresses, and other data as
required, upon request by the Department of Revenue. Disclosures by the commissioner
of revenue to the commissioner of human services for the purposes described in this clause
are governed by section 270B.14, subdivision 1. Tax refund or tax credit programs include,
but are not limited to, the dependent care credit under section 290.067, the Minnesota
working family credit under section 290.0671, the property tax refund and rental credit
under section 290A.04, and the Minnesota education credit under section 290.0674;

(9) between the Department of Human Services, the Department of Education, and
the Department of Employment and Economic Development for the purpose of monitoring
the eligibility of the data subject for unemployment benefits, for any employment or
training program administered, supervised, or certified by that agency, for the purpose of
administering any rehabilitation program or child care assistance program, whether alone
or in conjunction with the welfare system, or to monitor and evaluate the Minnesota
family investment program by exchanging data on recipients and former recipients of food
support, cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance
under chapter 119B, or medical programs under chapter 256B, 256D, or 256L;

(10) to appropriate parties in connection with an emergency if knowledge of
the information is necessary to protect the health or safety of the individual or other
individuals or persons;

(11) data maintained by residential programs as defined in section 245A.02 may
be disclosed to the protection and advocacy system established in this state according
to Part C of Public Law 98-527 to protect the legal and human rights of persons with
developmental disabilities or other related conditions who live in residential facilities for
these persons if the protection and advocacy system receives a complaint by or on behalf
of that person and the person does not have a legal guardian or the state or a designee of
the state is the legal guardian of the person;

(12) to the county medical examiner or the county coroner for identifying or locating
relatives or friends of a deceased person;

(13) data on a child support obligor who makes payments to the public agency
may be disclosed to the Minnesota Office of Higher Education to the extent necessary to
determine eligibility under section 136A.121, subdivision 2, clause (5);

(14) participant Social Security numbers and names collected by the telephone
assistance program may be disclosed to the Department of Revenue to conduct an
electronic data match with the property tax refund database to determine eligibility under
section 237.70, subdivision 4a;

(15) the current address of a Minnesota family investment program participant
may be disclosed to law enforcement officers who provide the name of the participant
and notify the agency that:

(i) the participant:

(A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after
conviction, for a crime or attempt to commit a crime that is a felony under the laws of the
jurisdiction from which the individual is fleeing; or

(B) is violating a condition of probation or parole imposed under state or federal law;

(ii) the location or apprehension of the felon is within the law enforcement officer's
official duties; and

(iii) the request is made in writing and in the proper exercise of those duties;

(16) the current address of a recipient of general assistance or general assistance
medical care may be disclosed to probation officers and corrections agents who are
supervising the recipient and to law enforcement officers who are investigating the
recipient in connection with a felony level offense;

(17) information obtained from food support applicant or recipient households may
be disclosed to local, state, or federal law enforcement officials, upon their written request,
for the purpose of investigating an alleged violation of the Food Stamp Act, according
to Code of Federal Regulations, title 7, section 272.1(c);

(18) the address, Social Security number, and, if available, photograph of any
member of a household receiving food support shall be made available, on request, to a
local, state, or federal law enforcement officer if the officer furnishes the agency with the
name of the member and notifies the agency that:

(i) the member:

(A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a
crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;

(B) is violating a condition of probation or parole imposed under state or federal
law; or

(C) has information that is necessary for the officer to conduct an official duty related
to conduct described in subitem (A) or (B);

(ii) locating or apprehending the member is within the officer's official duties; and

(iii) the request is made in writing and in the proper exercise of the officer's official
duty;

(19) the current address of a recipient of Minnesota family investment program,
general assistance, general assistance medical care, or food support may be disclosed to
law enforcement officers who, in writing, provide the name of the recipient and notify the
agency that the recipient is a person required to register under section 243.166, but is not
residing at the address at which the recipient is registered under section 243.166;

(20) certain information regarding child support obligors who are in arrears may be
made public according to section 518A.74;

(21) data on child support payments made by a child support obligor and data on
the distribution of those payments excluding identifying information on obligees may be
disclosed to all obligees to whom the obligor owes support, and data on the enforcement
actions undertaken by the public authority, the status of those actions, and data on the
income of the obligor or obligee may be disclosed to the other party;

(22) data in the work reporting system may be disclosed under section 256.998,
subdivision 7;

(23) to the Department of Education for the purpose of matching Department of
Education student data with public assistance data to determine students eligible for free
and reduced price meals, meal supplements, and free milk according to United States
Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and
state funds that are distributed based on income of the student's family; and to verify
receipt of energy assistance for the telephone assistance plan;

(24) the current address and telephone number of program recipients and emergency
contacts may be released to the commissioner of health or a local board of health as
defined in section 145A.02, subdivision 2, when the commissioner or local board of health
has reason to believe that a program recipient is a disease case, carrier, suspect case, or at
risk of illness, and the data are necessary to locate the person;

(25) to other state agencies, statewide systems, and political subdivisions of this
state, including the attorney general, and agencies of other states, interstate information
networks, federal agencies, and other entities as required by federal regulation or law for
the administration of the child support enforcement program;

(26) to personnel of public assistance programs as defined in section 256.741, for
access to the child support system database for the purpose of administration, including
monitoring and evaluation of those public assistance programs;

(27) to monitor and evaluate the Minnesota family investment program by
exchanging data between the Departments of Human Services and Education, on
recipients and former recipients of food support, cash assistance under chapter 256, 256D,
256J, or 256K, child care assistance under chapter 119B, or medical programs under
chapter 256B, 256D, or 256L;

(28) to evaluate child support program performance and to identify and prevent
fraud in the child support program by exchanging data between the Department of Human
Services, Department of Revenue under section 270B.14, subdivision 1, paragraphs (a)
and (b), without regard to the limitation of use in paragraph (c), Department of Health,
Department of Employment and Economic Development, and other state agencies as is
reasonably necessary to perform these functions; deleted text begin or
deleted text end

(29) counties operating child care assistance programs under chapter 119B may
disseminate data on program participants, applicants, and providers to the commissioner
of education deleted text begin . deleted text end new text begin ; or
new text end

new text begin (30) pursuant to section 256L.02, subdivision 6, between the welfare system and
the Minnesota Health Insurance Exchange, under section 62A.67, in order to enroll and
collect premiums from individuals in the MinnesotaCare program under chapter 256L and
to administer the individual's and their families' participation in the program.
new text end

(b) Information on persons who have been treated for drug or alcohol abuse may
only be disclosed according to the requirements of Code of Federal Regulations, title
42, sections 2.1 to 2.67.

(c) Data provided to law enforcement agencies under paragraph (a), clause (15),
(16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected
nonpublic while the investigation is active. The data are private after the investigation
becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).

(d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but is
not subject to the access provisions of subdivision 10, paragraph (b).

For the purposes of this subdivision, a request will be deemed to be made in writing
if made through a computer interface system.

Sec. 2.

new text begin [62A.67] MINNESOTA HEALTH INSURANCE EXCHANGE.
new text end

new text begin Subdivision 1. new text end

new text begin Title; citation. new text end

new text begin This section may be cited as the "Minnesota Health
Insurance Exchange."
new text end

new text begin Subd. 2. new text end

new text begin Creation; tax exemption. new text end

new text begin The Minnesota Health Insurance Exchange
is created for the limited purpose of providing individuals with greater access, choice,
portability, and affordability of health insurance products. The Minnesota Health
Insurance Exchange is a not-for-profit corporation under chapter 317A and section 501(c)
of the Internal Revenue Code.
new text end

new text begin Subd. 3. new text end

new text begin Definitions. new text end

new text begin The following terms have the meanings given them unless
otherwise provided in text.
new text end

new text begin (a) "Board" means the board of directors of the Minnesota Health Insurance
Exchange under subdivision 13.
new text end

new text begin (b) "Commissioner" means:
new text end

new text begin (1) the commissioner of commerce for health insurers subject to the jurisdiction
of the Department of Commerce;
new text end

new text begin (2) the commissioner of health for health insurers subject to the jurisdiction of the
Department of Health; or
new text end

new text begin (3) either commissioner's designated representative.
new text end

new text begin (c) "Exchange" means the Minnesota Health Insurance Exchange.
new text end

new text begin (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996.
new text end

new text begin (e) "Individual market health plans," unless otherwise specified, means individual
market health plans defined in section 62A.011.
new text end

new text begin (f) "Section 125 Plan" means a Premium Only Plan under section 125 of the Internal
Revenue Code.
new text end

new text begin Subd. 4. new text end

new text begin Insurer and health plan participation. new text end

new text begin All health plans as defined in
section 62A.011, subdivision 3, issued or renewed in the individual market shall participate
in the exchange. No health plans in the individual market may be issued or renewed
outside of the exchange. Group health plans as defined in section 62A.10 shall not be
offered through the exchange. Health plans offered through the Minnesota Comprehensive
Health Association as defined in section 62E.10 are offered through the exchange to
eligible enrollees as determined by the Minnesota Comprehensive Health Association.
Health plans offered through MinnesotaCare under chapter 256L are offered through the
exchange to eligible enrollees as determined by the commissioner of human services.
new text end

new text begin Subd. 5. new text end

new text begin Approval of health plans. new text end

new text begin No health plan may be offered through the
exchange unless the commissioner has first certified that:
new text end

new text begin (1) the insurer seeking to offer the health plan is licensed to issue health insurance in
the state; and
new text end

new text begin (2) the health plan meets the requirements of this section, and the health plan and the
insurer are in compliance with all other applicable health insurance laws.
new text end

new text begin Subd. 6. new text end

new text begin Individual market health plans. new text end

new text begin Individual market health plans offered
through the exchange continue to be regulated by the commissioner as specified in
chapters 62A, 62C, 62D, 62E, 62Q, and 72A, and must include the following provisions
that apply to all health plans issued or renewed through the exchange:
new text end

new text begin (1) premiums for children under the age of 19 shall not vary by age in the exchange;
and
new text end

new text begin (2) premiums for children under the age of 19 must be excluded from rating factors
requirements under section 62A.65, subdivision 3, paragraph (b).
new text end

new text begin Subd. 7. new text end

new text begin Individual participation and eligibility. new text end

new text begin Individuals are eligible to
purchase health plans directly through the exchange or through an employer Section
125 Plan under section 62A.68. Nothing in this section requires guaranteed issue of
individual market health plans offered through the exchange. Individuals are eligible to
purchase individual market health plans through the exchange by meeting one or more
of the following qualifications:
new text end

new text begin (1) the individual is a Minnesota resident, meaning the individual is physically
residing on a permanent basis in a place that is the person's principal residence and from
which the person is absent only for temporary purposes;
new text end

new text begin (2) the individual is a student attending an institution outside of Minnesota and
maintains Minnesota residency;
new text end

new text begin (3) the individual is not a Minnesota resident but is employed by an employer
physically located within the state and the individual's employer does not offer a group
health insurance plan as defined in section 62A.10, but does offer a Section 125 Plan
through the exchange under section 62A.68;
new text end

new text begin (4) the individual is not a Minnesota resident but is self-employed and the
individual's principal place of business is in the state; or
new text end

new text begin (5) the individual is a dependent, as defined in section 62L.02, of another individual
who is eligible to participate in the exchange.
new text end

new text begin Subd. 8. new text end

new text begin Continuation of coverage. new text end

new text begin Enrollment in a health plan may be canceled
for nonpayment of premiums, fraud, or changes in eligibility for MinnesotaCare under
chapter 256L. Enrollment in an individual market health plan may not be canceled or
renewed because of any change in employer or employment status, marital status, health
status, age, residence, or any other change that does not affect eligibility as defined
in this section.
new text end

new text begin Subd. 9. new text end

new text begin Responsibilities of the exchange. new text end

new text begin The exchange shall serve as the sole
entity for enrollment and collection and transfer of premium payments for health plans
offered through the exchange. The exchange shall be responsible for the following
functions:
new text end

new text begin (1) publicize the exchange, including but not limited to its functions, eligibility
rules, and enrollment procedures;
new text end

new text begin (2) provide assistance to employers to set up an employer Section 125 Plan under
section 62A.68;
new text end

new text begin (3) create a system to allow individuals to compare and enroll in health plans offered
through the exchange;
new text end

new text begin (4) create a system to collect and transmit to the applicable plans all premium
payments or contributions made by or on behalf of individuals, including developing
mechanisms to receive and process automatic payroll deductions for individuals enrolled
in employer Section 125 Plans;
new text end

new text begin (5) refer individuals interested in MinnesotaCare under chapter 256L to the
Department of Human Services to determine eligibility;
new text end

new text begin (6) establish a mechanism with the Department of Human Services to transfer
premiums and subsidies for MinnesotaCare to qualify for federal matching payments;
new text end

new text begin (7) collect and assess information for eligibility for premium incentives under
chapter 256L;
new text end

new text begin (8) upon request, issue certificates of previous coverage according to the provisions
of HIPAA and as referenced in section 62Q.181 to all such individuals who cease to be
covered by a participating health plan through the exchange;
new text end

new text begin (9) establish procedures to account for all funds received and disbursed by the
exchange for individual participants of the exchange; and
new text end

new text begin (10) make available to the public, at the end of each calendar year, a report of an
independent audit of the exchange's accounts.
new text end

new text begin Subd. 10. new text end

new text begin Powers of the exchange. new text end

new text begin The exchange shall have the power to:
new text end

new text begin (1) contract with insurance producers licensed in accident and health insurance
under chapter 60K and vendors to perform one or more of the functions specified in
subdivision 10;
new text end

new text begin (2) contract with employers to act as the plan administrator for participating
employer Section 125 Plans and to undertake the obligations required by federal law
of a plan administrator;
new text end

new text begin (3) establish and assess fees on health plan premiums of health plans purchased
through the exchange to fund the cost of administering the exchange;
new text end

new text begin (4) seek and directly receive grant funding from government agencies or private
philanthropic organizations to defray the costs of operating the exchange;
new text end

new text begin (5) establish and administer rules and procedures governing the operations of the
exchange;
new text end

new text begin (6) establish one or more service centers within Minnesota;
new text end

new text begin (7) sue or be sued or otherwise take any necessary or proper legal action;
new text end

new text begin (8) establish bank accounts and borrow money; and
new text end

new text begin (9) enter into agreements with the commissioners of commerce, health, human
services, revenue, employment and economic development, and other state agencies as
necessary for the exchange to implement the provisions of this section.
new text end

new text begin Subd. 11. new text end

new text begin Dispute resolution. new text end

new text begin The exchange shall establish procedures for
resolving disputes with respect to the eligibility of an individual to participate in the
exchange. The exchange does not have the authority or responsibility to intervene in or
resolve disputes between an individual and a health plan or health insurer. The exchange
shall refer complaints from individuals participating in the exchange to the commissioner
of human services to be resolved according to sections 62Q.68 to 62Q.73.
new text end

new text begin Subd. 12. new text end

new text begin Governance. new text end

new text begin The exchange shall be governed by a board of directors
with 11 members. The board shall convene on or before July 1, 2007, after the initial board
members have been selected. The initial board membership consists of the following:
new text end

new text begin (1) the commissioner of commerce;
new text end

new text begin (2) the commissioner of human services;
new text end

new text begin (3) the commissioner of health;
new text end

new text begin (4) four members appointed by a joint committee of the Minnesota senate and the
Minnesota house of representatives to serve three-year terms; and
new text end

new text begin (5) four members appointed by the governor to serve three-year terms.
new text end

new text begin Subd. 13. new text end

new text begin Subsequent board membership. new text end

new text begin Ongoing membership of the exchange
consists of the following effective July 1, 2010:
new text end

new text begin (1) the commissioner of commerce;
new text end

new text begin (2) the commissioner of human services;
new text end

new text begin (3) the commissioner of health;
new text end

new text begin (4) four members appointed by the governor with the approval of a joint committee
of the senate and house of representatives to serve two- or three-year terms. Appointed
members may serve more than one term; and
new text end

new text begin (5) four members elected by the membership of the exchange of which two are
elected to serve a two-year term and two are elected to serve a three-year term. Elected
members may serve more than one term.
new text end

new text begin Subd. 14. new text end

new text begin Operations of the board. new text end

new text begin Officers of the board of directors are elected by
members of the board and serve one-year terms. Six members of the board constitutes a
quorum, and the affirmative vote of six members of the board is necessary and sufficient
for any action taken by the board. Board members serve without pay, but are reimbursed
for actual expenses incurred in the performance of their duties.
new text end

new text begin Subd. 15. new text end

new text begin Operations of the exchange. new text end

new text begin The board of directors shall appoint an
exchange director who shall:
new text end

new text begin (1) be a full-time employee of the exchange;
new text end

new text begin (2) administer all of the activities and contracts of the exchange; and
new text end

new text begin (3) hire and supervise the staff of the exchange.
new text end

new text begin Subd. 16. new text end

new text begin Insurance producers. new text end

new text begin When a producer licensed in accident and health
insurance under chapter 60K enrolls an eligible individual in the exchange, the health plan
chosen by an individual may pay the producer a commission.
new text end

new text begin Subd. 17. new text end

new text begin Implementation. new text end

new text begin Health plan coverage through the exchange begins on
January 1, 2009. The exchange must be operational to assist employers and individuals
by September 1, 2008, and be prepared for enrollment by December 1, 2008. Enrollees
of individual market health plans, MinnesotaCare, and the Minnesota Comprehensive
Health Association as of December 2, 2008, are automatically enrolled in the exchange
on January 1, 2009, in the same health plan and at the same premium they were enrolled
in as of December 2, 2008, subject to the provisions of this section. As of January 1,
2009, all enrollees of individual market health plans, MinnesotaCare, and the Minnesota
Comprehensive Health Association shall make premium payments to the exchange.
new text end

new text begin Subd. 18. new text end

new text begin Study of insurer issue requirements. new text end

new text begin In consultation with
the commissioners of commerce and health, the exchange shall study and make
recommendations on rating requirements and risk adjustment mechanisms that could
be implemented to facilitate increased enrollment in the exchange by employers and
employees through employer Section 125 Plans. The exchange shall report study findings
and recommendations to the chairs of house and senate committees having jurisdiction
over commerce and health by January 15, 2011.
new text end

Sec. 3.

new text begin [62A.68] SECTION 125 PLANS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin The following terms have the meanings given unless
otherwise provided in text.
new text end

new text begin (a) "Current employee" means an employee currently on an employer's payroll other
than a retiree or disabled former employee.
new text end

new text begin (b) "Employer" means a person, firm, corporation, partnership, association, business
trust, or other entity employing one or more persons, including a political subdivision of
the state, filing payroll tax information on such employed person or persons.
new text end

new text begin (c) "Section 125 Plan" means a Premium Only Plan under section 125 of the Internal
Revenue Code.
new text end

new text begin (d) "Exchange" means the Minnesota Health Insurance Exchange under section
62A.67.
new text end

new text begin (e) "Exchange director" means the appointed director under section 62A.67,
subdivision 16.
new text end

new text begin Subd. 2. new text end

new text begin Section 125 Plan requirement. new text end

new text begin Effective January 1, 2009, all employers
with 11 or more current employees shall offer a Section 125 Plan through the exchange
to allow their employees to pay for health insurance premiums with pretax dollars. The
following employers are exempt from the Section 125 Plan requirement:
new text end

new text begin (1) employers that offer a group health insurance plan as defined in 62A.10;
new text end

new text begin (2) employers that offer group health insurance through a self-insured plan as
defined in section 62E.02; and
new text end

new text begin (3) employers with fewer than 11 current employees, except that employers under
this clause may voluntarily offer a Section 125 Plan.
new text end

new text begin Subd. 3. new text end

new text begin Tracking compliance. new text end

new text begin By July 1, 2008, the exchange, in consultation with
the commissioners of commerce, health, employment and economic development, and
revenue shall establish a method for tracking employer compliance with the Section 125
Plan requirement.
new text end

new text begin Subd. 4. new text end

new text begin Employer requirements. new text end

new text begin Employers that are required to offer or choose
to offer a Section 125 Plan through the exchange shall enter into an annual binding
agreement with the exchange, which includes the terms in paragraphs (a) to (h).
new text end

new text begin (a) The employer shall designate the exchange director to be the plan's administrator
for the employer's plan and the exchange director agrees to undertake the obligations
required of a plan administrator under federal law.
new text end

new text begin (b) Only the coverage and benefits offered by participating insurers in the exchange
constitutes the coverage and benefits of the participating employer plan.
new text end

new text begin (c) Any individual eligible to participate in the exchange may elect coverage under
any participating health plan for which they are eligible, and neither the employer nor
the exchange shall limit choice of coverage from among all the participating insurance
plans for which the individual is eligible.
new text end

new text begin (d) The employer shall deduct premium amounts on a pretax basis in an amount
not to exceed an employee's wages and make payments to the exchange as directed by
employees for health plans employees enroll in through the exchange.
new text end

new text begin (e) The employer shall not offer individuals eligible to participate in the exchange
any separate or competing group health plan under section 62A.10.
new text end

new text begin (f) The employer reserves the right to determine the terms and amounts of the
employer's contribution to the plan, if any.
new text end

new text begin (g) The employer shall make available to the exchange any of the employer's
documents, records, or information, including copies of the employer's federal and state
tax and wage reports that are necessary for the exchange to verify:
new text end

new text begin (1) that the employer is in compliance with the terms of its agreement with the
exchange governing the participating employer plan;
new text end

new text begin (2) that the participating employer plan is in compliance with applicable state and
federal laws, including those relating to nondiscrimination in coverage; and
new text end

new text begin (3) the eligibility of those individuals enrolled in the participating employer plan.
new text end

new text begin (h) The exchange shall not provide the participating employer plan with any
additional or different services or benefits not otherwise provided or offered to all other
participating employer plans.
new text end

new text begin Subd. 5. new text end

new text begin Section 125 eligible health plans. new text end

new text begin Individuals eligible to enroll in health
plans through an employer Section 125 Plan through the exchange may enroll in any
health plan offered through the exchange for which the individual is eligible including
individual market health plans, MinnesotaCare, and the Minnesota Comprehensive Health
Association.
new text end

Sec. 4.

Minnesota Statutes 2006, section 62E.141, is amended to read:

62E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN.

No employee of an employer that offers a new text begin group new text end health plan, under which the
employee is eligible for coverage, is eligible to enroll, or continue to be enrolled, in
the comprehensive health association, except for enrollment or continued enrollment
necessary to cover conditions that are subject to an unexpired preexisting condition
limitation, preexisting condition exclusion, or exclusionary rider under the employer's
health plan. This section does not apply to persons enrolled in the Comprehensive Health
Association as of June 30, 1993. With respect to persons eligible to enroll in the health
plan of an employer that has more than 29 current employees, as defined in section
62L.02, this section does not apply to persons enrolled in the Comprehensive Health
Association as of December 31, 1994.

Sec. 5.

Minnesota Statutes 2006, section 62L.12, subdivision 2, is amended to read:

Subd. 2.

Exceptions.

(a) A health carrier may sell, issue, or renew individual
conversion policies to eligible employees otherwise eligible for conversion coverage under
section 62D.104 as a result of leaving a health maintenance organization's service area.

(b) A health carrier may sell, issue, or renew individual conversion policies to
eligible employees otherwise eligible for conversion coverage as a result of the expiration
of any continuation of group coverage required under sections 62A.146, 62A.17, 62A.21,
62C.142, 62D.101, and 62D.105.

(c) A health carrier may sell, issue, or renew conversion policies under section
62E.16 to eligible employees.

(d) A health carrier may sell, issue, or renew individual continuation policies to
eligible employees as required.

(e) A health carrier may sell, issue, or renew individual health plans if the coverage
is appropriate due to an unexpired preexisting condition limitation or exclusion applicable
to the person under the employer's group health plan or due to the person's need for health
care services not covered under the employer's group health plan.

(f) A health carrier may sell, issue, or renew an individual health plan, if the
individual has elected to buy the individual health plan not as part of a general plan to
substitute individual health plans for a group health plan nor as a result of any violation of
subdivision 3 or 4.

(g) Nothing in this subdivision relieves a health carrier of any obligation to provide
continuation or conversion coverage otherwise required under federal or state law.

(h) Nothing in this chapter restricts the offer, sale, issuance, or renewal of coverage
issued as a supplement to Medicare under sections 62A.3099 to 62A.44, or policies or
contracts that supplement Medicare issued by health maintenance organizations, or those
contracts governed by sections 1833, 1851 to 1859, 1860D, or 1876 of the federal Social
Security Act, United States Code, title 42, section 1395 et seq., as amended.

(i) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual
health plans necessary to comply with a court order.

(j) A health carrier may offer, issue, sell, or renew an individual health plan to
persons eligible for an employer group health plan, if the individual health plan is a high
deductible health plan for use in connection with an existing health savings account, in
compliance with the Internal Revenue Code, section 223. In that situation, the same or
a different health carrier may offer, issue, sell, or renew a group health plan to cover
the other eligible employees in the group.

(k) A health carrier may offer, sell, issue, or renew an individual health plan to one
or more employees of a small employer if the individual health plan is marketed directly to
all employees of the small employer and the small employer does not contribute directly
or indirectly to the premiums or facilitate the administration of the individual health plan.
The requirement to market an individual health plan to all employees does not require the
health carrier to offer or issue an individual health plan to any employee. For purposes
of this paragraph, an employer is not contributing to the premiums or facilitating the
administration of the individual health plan if the employer does not contribute to the
premium and merely collects the premiums from an employee's wages or salary through
payroll deductions and submits payment for the premiums of one or more employees in a
lump sum to the health carrier. Except for coverage under section 62A.65, subdivision 5,
paragraph (b), or 62E.16, at the request of an employee, the health carrier may bill the
employer for the premiums payable by the employee, provided that the employer is not
liable for payment except from payroll deductions for that purpose. If an employer is
submitting payments under this paragraph, the health carrier shall provide a cancellation
notice directly to the primary insured at least ten days prior to termination of coverage for
nonpayment of premium. Individual coverage under this paragraph may be offered only
if the small employer has not provided coverage under section 62L.03 to the employees
within the past 12 months.

The employer must provide a written and signed statement to the health carrier that
the employer is not contributing directly or indirectly to the employee's premiums. The
health carrier may rely on the employer's statement and is not required to guarantee-issue
individual health plans to the employer's other current or future employees.

new text begin (l) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual
health plans through the Minnesota Health Insurance Exchange under section 62A.67
or 62A.68.
new text end

Sec. 6.

Minnesota Statutes 2006, section 256L.02, subdivision 3, is amended to read:

Subd. 3.

Financial management.

(a) The commissioner shall manage spending
for the MinnesotaCare program in a manner that maintains a minimum reserve. As
part of each state revenue and expenditure forecast, the commissioner must make an
assessment of the expected expenditures for the covered services for the remainder of the
current biennium and for the following biennium. The estimated expenditure, including
the reserve, shall be compared to an estimate of the revenues that will be available in
the health care access fund. Based on this comparison, and after consulting with the
chairs of the house Ways and Means Committee and the senate Finance Committee,
and the Legislative Commission on Health Care Access, the commissioner shall, as
necessary, make the adjustments specified in paragraph (b) to ensure that expenditures
remain within the limits of available revenues for the remainder of the current biennium
and for the following biennium. The commissioner shall not hire additional staff using
appropriations from the health care access fund until the commissioner of finance makes
a determination that the adjustments implemented under paragraph (b) are sufficient to
allow MinnesotaCare expenditures to remain within the limits of available revenues for
the remainder of the current biennium and for the following biennium.

(b) The adjustments the commissioner shall use must be implemented in this order:
first, stop enrollment of single adults and households without children; second, upon 45
days' notice, stop coverage of single adults and households without children already
enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium
subsidy amounts by ten percent for families with gross annual income above 200 percent
of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium
subsidy amounts by ten percent for families with gross annual income at or below 200
percent; and fifth, require applicants to be uninsured for at least six months prior to
eligibility in the MinnesotaCare program. If these measures are insufficient to limit the
expenditures to the estimated amount of revenue, the commissioner shall further limit
enrollment or decrease premium subsidies.

new text begin (c) The commissioner shall work in cooperation with the Minnesota Health
Insurance Exchange under section 62A.67 to make adjustments under paragraph (b) as
required under this subdivision.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2009.
new text end

Sec. 7.

Minnesota Statutes 2006, section 256L.02, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Enrollment responsibilities. new text end

new text begin According to section 256L.05, subdivision 6,
effective January 1, 2009, the Minnesota Health Insurance Exchange under section 62A.67
shall assume responsibility for enrolling eligible applicants and enrollees in a health
plan for MinnesotaCare coverage. The commissioner shall maintain responsibility for
determining eligibility for MinnesotaCare.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2009.
new text end

Sec. 8.

Minnesota Statutes 2006, section 256L.02, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Exchange of data. new text end

new text begin An entity that is part of the welfare system as defined
in section 13.46, subdivision 1, paragraph (c), and the Minnesota Health Insurance
Exchange under section 62A.67 may exchange private data about individuals without
the individual's consent in order to enroll and collect premiums from individuals in the
MinnesotaCare program under chapter 256L and to administer the individual's and the
individual's family's participation in the program. This subdivision only applies if the
entity that is part of the welfare system and the Minnesota Health Insurance Exchange
have entered into an agreement that complies with the requirements in Code of Federal
Regulations, title 45, section 164.314.
new text end

Sec. 9.

Minnesota Statutes 2006, section 256L.05, subdivision 5, is amended to read:

Subd. 5.

Availability of private insurance.

new text begin (a) new text end The commissioner deleted text begin , in consultation
with the commissioners of health and commerce, deleted text end shall provide information regarding the
availability of private health insurance coverage and the deleted text begin possibility of disenrollment under
section 256L.07, subdivision 1, paragraphs (b) and (c), to all: (1) families enrolled in the
MinnesotaCare program whose gross family income is equal to or more than 225 percent
of the federal poverty guidelines; and (2) single adults and households without children
enrolled in the MinnesotaCare program whose gross family income is equal to or more
than 165 percent of the federal poverty guidelines. This information must be provided deleted text end new text begin
Minnesota Health Insurance Exchange under section 62A.67 new text end upon initial enrollment
and annually thereafter. deleted text begin The commissioner shall also include information regarding the
availability of private health insurance coverage in
deleted text end

new text begin (b) new text end The notice of ineligibility provided to persons subject to disenrollment under
section 256L.07, subdivision 1, paragraphs (b) and (c) new text begin , must include information about
assistance with identifying and selecting private health insurance coverage provided by
the Minnesota Health Insurance Exchange under section 62A.67 new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2009.
new text end

Sec. 10.

Minnesota Statutes 2006, section 256L.05, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Minnesota Health Insurance Exchange. new text end

new text begin The commissioner shall refer
all MinnesotaCare applicants and enrollees to the Minnesota Health Insurance Exchange
under section 62A.67. The Minnesota Health Insurance Exchange shall provide those
referred with assistance in selecting a managed care plan through which to receive
MinnesotaCare covered services and in analyzing health plans available through the
private market. MinnesotaCare applicants and enrollees shall effect enrollment in a
managed care plan or a private market health plan through the Minnesota Health Insurance
Exchange.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2009.
new text end

Sec. 11.

Minnesota Statutes 2006, section 256L.12, subdivision 7, is amended to read:

Subd. 7.

Managed care plan vendor requirements.

The following requirements
apply to all counties or vendors who contract with the Department of Human Services to
serve MinnesotaCare recipients. Managed care plan contractors:

(1) shall authorize and arrange for the provision of the full range of services listed in
section 256L.03 in order to ensure appropriate health care is delivered to enrollees;

(2) shall accept the prospective, per capita payment or other contractually defined
payment from the commissioner in return for the provision and coordination of covered
health care services for eligible individuals enrolled in the program;

(3) may contract with other health care and social service practitioners to provide
services to enrollees;

(4) shall provide for an enrollee grievance process as required by the commissioner
and set forth in the contract with the department;

(5) shall retain all revenue from enrollee co-payments;

(6) shall accept all eligible MinnesotaCare enrollees, without regard to health status
or previous utilization of health services;

(7) shall demonstrate capacity to accept financial risk according to requirements
specified in the contract with the department. A health maintenance organization licensed
under chapter 62D, or a nonprofit health plan licensed under chapter 62C, is not required
to demonstrate financial risk capacity, beyond that which is required to comply with
chapters 62C and 62D; deleted text begin and
deleted text end

(8) shall submit information as required by the commissioner, including data required
for assessing enrollee satisfaction, quality of care, cost, and utilization of services deleted text begin . deleted text end new text begin ; and
new text end

new text begin (9) shall participate in the Minnesota Health Insurance Exchange under section
62A.67 for the purpose of enrolling individuals under this chapter.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2009.
new text end

Sec. 12.

Minnesota Statutes 2006, section 256L.15, subdivision 1a, is amended to read:

Subd. 1a.

Payment options.

new text begin (a) new text end The commissioner may offer the following
payment options to an enrollee:

(1) payment by check;

(2) payment by credit card;

(3) payment by recurring automatic checking withdrawal;

(4) payment by onetime electronic transfer of funds;

(5) payment by wage withholding with the consent of the employer and the
employee; or

(6) payment by using state tax refund payments.

At application or reapplication, a MinnesotaCare applicant or enrollee may authorize
the commissioner to use the Revenue Recapture Act in chapter 270A to collect funds
from the applicant's or enrollee's refund for the purposes of meeting all or part of the
applicant's or enrollee's MinnesotaCare premium obligation. The applicant or enrollee
may authorize the commissioner to apply for the state working family tax credit on behalf
of the applicant or enrollee. The setoff due under this subdivision shall not be subject to
the $10 fee under section 270A.07, subdivision 1.

new text begin (b) Effective January 1, 2009, the Minnesota Health Insurance Exchange under
section 62A.67 is responsible for collecting MinnesotaCare premiums.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2009.
new text end

Sec. 13.

Minnesota Statutes 2006, section 256L.15, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Premium discount incentive. new text end

new text begin Adults and families with children are
eligible for a premium reduction of $3 per month for each child who met goals for
preventive care or an adult who met goals for cardiac or diabetes care in the previous
calendar year. The maximum premium reduction may not exceed $15 per month per
family. The commissioner, in consultation with the Minnesota Health Insurance Exchange,
shall establish specific goals for preventive care, including cardiac and diabetes care, that
make an enrollee eligible for the premium reduction. The premium discount incentive is
administered by the Minnesota Health Insurance Exchange under section 62A.67.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2009.
new text end

ARTICLE 3

HEALTH INFORMATION

Section 1.

Minnesota Statutes 2006, section 256B.0625, subdivision 3b, is amended to
read:

Subd. 3b.

Telemedicine consultations.

Medical assistance covers telemedicine
consultations. Telemedicine consultations must be made via two-way, interactive video
or store-and-forward technology. Store-and-forward technology includes telemedicine
consultations that do not occur in real time via synchronous transmissions, and that
do not require a face-to-face encounter with the patient for all or any part of any such
telemedicine consultation. The patient record must include a written opinion from the
consulting physician providing the telemedicine consultation. deleted text begin A communication between
two physicians that consists solely of a telephone conversation is not a telemedicine
consultation. deleted text end Coverage is limited to three telemedicine consultations per recipient per
calendar week. Telemedicine consultations shall be paid at the full allowable rate. new text begin
The commissioner shall develop policies for coverage of and payment for additional
telemedicine services including patient communications by e-mail, teleconferencing,
telephone consultations, and other virtual visits or consultations.
new text end

Sec. 2. new text begin STATEWIDE INFORMATION EXCHANGE.
new text end

new text begin The Minnesota health care connection is authorized to build a statewide information
exchange, help organizers of local and regional data exchange efforts, and ensure that
Minnesota's data exchange projects are consistent with national technology platforms
and networks.
new text end

Sec. 3. new text begin PAY-FOR-USE PROGRAMS.
new text end

new text begin The commissioner of human services shall adopt pay-for-use programs that offer
financial incentives to providers for the implementation and use of health care information
technology in clinical practice. To be eligible for payments under this section, the
information technology must meet national standards for interoperability, functionality,
and security and provide clinicians with data upon which to improve the quality and
safety of patient care.
new text end

Sec. 4. new text begin APPROPRIATION.
new text end

new text begin (a) $....... is appropriated from the health care access fund to the commissioner of
health for the fiscal year ending June 30, 2008, to provide grants under Minnesota Statutes,
section 144.3345, to health care providers in rural and underserved communities for
interoperable and transferable health information technologies.
new text end

new text begin (b) $....... for the fiscal year ending June 30, 2008, and $....... for the fiscal year
ending June 30, 2009, are appropriated from the general fund to the commissioner of
human services for electronic health information pay-for-use programs.
new text end