1st Engrossment - 90th Legislature (2017 - 2018) Posted on 04/07/2017 04:20pm
A bill for an act
relating to human services; setting requirements for competitive bidding and
managed care procurement; amending Minnesota Statutes 2016, section 256B.69,
by adding a subdivision.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Minnesota Statutes 2016, section 256B.69, is amended by adding a subdivision
to read:
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(a) For managed care organization
contracts effective on or after January 1, 2019, the commissioner shall utilize a competitive
price bidding program on a regional basis for nonelderly adults and children, who are not
eligible on the basis of a disability and are enrolled in medical assistance and MinnesotaCare.
If the commissioner utilizes a competitive price bidding program, the commissioner shall
establish a minimum of four geographic regions in the state. The commissioner shall
implement separate competitive price bidding for each of the geographic regions. The
program shall allow a minimum of three managed care organizations to serve each
metropolitan statistical area, unless the commissioner determines the potential enrollment
in a particular county within a metropolitan statistical area can be adequately served by only
two managed care organizations. The commissioner shall allow a minimum of two managed
care organizations to serve areas of the state that are not part of a metropolitan statistical
area. For purposes of this subdivision, "managed care organization" means a demonstration
provider as defined in subdivision 2, paragraph (b).
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(b) County board resolutions identifying managed care organization preferences must
explicitly be given scoring weight in the procurement process. The commissioner shall
specify in the request for proposals the scoring weight that will be given to county board
resolutions. County boards may identify priority areas for managed care organizations to
address in the proposals. The request for proposals must list these priority areas for each
county and specify the scoring weight that will be assigned to addressing priority areas.
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(c) If a best and final offer is requested, each responding managed care organization
must be offered the opportunity to submit a best and final offer.
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(d) The commissioner, when evaluating proposals, shall consider network adequacy for
dental and other services.
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(e) Notwithstanding sections 13.591 and 13.599, after the managed care organizations
are notified about the award determination, but before contracts are signed, the commissioner
shall provide each managed care organization with its own scoring sheet and supporting
information. The scoring sheet shall not be made available to other managed care
organizations until final contracts are signed.
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(f) A managed care organization that is aggrieved by the commissioner's decision related
to the selection of managed care organizations to deliver services in a county or counties
may appeal the commissioner's decision using the contested case procedures in sections
14.57 to 14.62. A contested case proceeding must be initiated within 60 days after the date
on which the commissioner notifies the managed care organization that the managed care
organization was not awarded a contract or service area. After considering the appeal, the
administrative law judge must either uphold or modify the commissioner's selection of
managed care organizations. The decision of the administrative law judge constitutes the
final decision regarding the selection of managed care organizations to serve a county or
counties. A party aggrieved by the administrative law judge's decision may seek judicial
review of the decision as provided in chapter 14.
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(g) The commissioner shall contract for an independent evaluation of the competitive
price bidding process. The contractor must solicit recommendations from all parties
participating in the competitive price bidding process for service delivery in calendar year
2019 on how the competitive price bidding process may be improved for service delivery
in calendar year 2020 and annually thereafter. The commissioner shall make evaluation
results available to the public on the department's Web site.
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