SF 2616

as introduced - 89th Legislature (2015 - 2016) Posted on 03/22/2016 08:48am

A bill for an act
relating to human services; allowing interactive video for targeted case
management; amending Minnesota Statutes 2014, sections 256B.0621,
subdivision 10; 256B.0924, by adding a subdivision; Minnesota Statutes 2015
Supplement, section 256B.0625, subdivision 20.

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

Section 1.

Minnesota Statutes 2014, section 256B.0621, subdivision 10, is amended to
read:

Subd. 10.

Payment rates.

The commissioner shall set payment rates for targeted
case management under this subdivision. Case managers may bill according to the
following criteria:

(1) for relocation targeted case management, case managers may bill for direct case
management activities, including face-to-face deleted text begin and deleted text end new text begin , new text end telephone contacts, new text begin and interactive
video contact in accordance with section 256B.0924, subdivision 4a, new text end in the lesser of:

(i) 180 days preceding an eligible recipient's discharge from an institution; or

(ii) the limits and conditions which apply to federal Medicaid funding for this service;

(2) for home care targeted case management, case managers may bill for direct case
management activities, including face-to-face and telephone contacts; and

(3) billings for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.

Sec. 2.

Minnesota Statutes 2015 Supplement, section 256B.0625, subdivision 20,
is amended to read:

Subd. 20.

Mental health new text begin targeted new text end case management.

(a) To the extent authorized
by rule of the state agency, medical assistance covers case management services to persons
with serious and persistent mental illness and children with severe emotional disturbance.
Services provided under this section must meet the relevant standards in sections 245.461
to 245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota
Rules, parts 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.

(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe
emotional disturbance when these services meet the program standards in Minnesota
Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.

(c) Medical assistance and MinnesotaCare payment for mental health case
management shall be made on a monthly basis. In order to receive payment for an eligible
child, the provider must document at least a face-to-face contact with the child, the child's
parents, or the child's legal representative. To receive payment for an eligible adult, the
provider must document:

(1) at least a face-to-face contact with the adult or the adult's legal representative; deleted text begin or
deleted text end

(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact with the adult or the adult's legal representative within the
preceding two months new text begin ; or
new text end

new text begin (3) at least a contact by interactive video that meets the requirements of section
256B.0924, subdivision 4a new text end .

(d) Payment for mental health case management provided by county or state staff
shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
paragraph (b), with separate rates calculated for child welfare and mental health, and
within mental health, separate rates for children and adults.

(e) Payment for mental health case management provided by Indian health services
or by agencies operated by Indian tribes may be made according to this section or other
relevant federally approved rate setting methodology.

(f) Payment for mental health case management provided by vendors who contract
with a county or Indian tribe shall be based on a monthly rate negotiated by the host county
or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the
county or tribe may negotiate a team rate with a vendor who is a member of the team. The
team shall determine how to distribute the rate among its members. No reimbursement
received by contracted vendors shall be returned to the county or tribe, except to reimburse
the county or tribe for advance funding provided by the county or tribe to the vendor.

(g) If the service is provided by a team which includes contracted vendors, tribal
staff, and county or state staff, the costs for county or state staff participation in the team
shall be included in the rate for county-provided services. In this case, the contracted
vendor, the tribal agency, and the county may each receive separate payment for services
provided by each entity in the same month. In order to prevent duplication of services,
each entity must document, in the recipient's file, the need for team case management and
a description of the roles of the team members.

(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs
for mental health case management shall be provided by the recipient's county of
responsibility, as defined in sections 256G.01 to 256G.12, from sources other than federal
funds or funds used to match other federal funds. If the service is provided by a tribal
agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this
service is paid by the state without a federal share through fee-for-service, 50 percent of
the cost shall be provided by the recipient's county of responsibility.

(i) Notwithstanding any administrative rule to the contrary, prepaid medical
assistance, general assistance medical care, and MinnesotaCare include mental health case
management. When the service is provided through prepaid capitation, the nonfederal
share is paid by the state and the county pays no share.

(j) The commissioner may suspend, reduce, or terminate the reimbursement to a
provider that does not meet the reporting or other requirements of this section. The county
of responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal
agency, is responsible for any federal disallowances. The county or tribe may share this
responsibility with its contracted vendors.

(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (o). The repayment is limited to:

(1) the costs of developing and implementing this section; and

(2) programming the information systems.

(l) Payments to counties and tribal agencies for case management expenditures
under this section shall only be made from federal earnings from services provided
under this section. When this service is paid by the state without a federal share through
fee-for-service, 50 percent of the cost shall be provided by the state. Payments to
county-contracted vendors shall include the federal earnings, the state share, and the
county share.

(m) Case management services under this subdivision do not include therapy,
treatment, legal, or outreach services.

(n) If the recipient is a resident of a nursing facility, intermediate care facility, or
hospital, and the recipient's institutional care is paid by medical assistance, payment for
case management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility and may not exceed
more than six months in a calendar year; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.

Sec. 3.

Minnesota Statutes 2014, section 256B.0924, is amended by adding a
subdivision to read:

new text begin Subd. 4a. new text end

new text begin Targeted case management through interactive video. new text end

new text begin (a) Subject to
federal approval, contact made for targeted case management by interactive video shall be
eligible for payment under subdivision 6, if:
new text end

new text begin (1) the person receiving targeted case management services is in a setting that is
staffed 24 hours per day, seven days per week;
new text end

new text begin (2) interactive video is in the best interests of the person and is deemed appropriate
by the provider;
new text end

new text begin (3) the use of interactive video is approved as part of the person's written personal
service or case plan; and
new text end

new text begin (4) interactive video is used for up to, but not more than, 50 percent of the minimum
required face-to-face contacts.
new text end

new text begin (b) The commissioner of human services shall seek any federal approval necessary
to implement paragraph (a).
new text end