HF 1391

as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:50am

A bill for an act
relating to health care; prohibiting the use of a broker for medical transportation
services; allowing county social workers to make level-of-need determinations;
amending Minnesota Statutes 2008, sections 256.045, by adding a subdivision;
256B.04, subdivision 14a; 256B.0625, subdivisions 17, 18, by adding a
subdivision.

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

Section 1.

Minnesota Statutes 2008, section 256.045, is amended by adding a
subdivision to read:

new text begin Subd. 3d. new text end

new text begin Special requirements regarding medical assistance nonemergency
transportation services. new text end

new text begin Notwithstanding the provisions of Minnesota Rules, parts
9505.0125, subpart 1, and 9505.0130, subpart 2, a recipient of medical assistance
nonemergency medical transportation services under section 256B.0625, subdivision 17
or 18, shall be given a written notice of a denial, reduction, termination, or suspension
of those services no later than 30 days before the effective date of the action, and a
local agency shall not reduce, suspend, or terminate eligibility for those services when a
recipient appeals within 30 days of the agency's mailing of the notice, unless the recipient
requests in writing not to receive continued medical assistance nonemergency medical
transportation services while the appeal is pending.
new text end

Sec. 2.

Minnesota Statutes 2008, section 256B.04, subdivision 14a, is amended to read:

Subd. 14a.

Level of need determination.

Nonemergency medical transportation
level of need determinations must be performed by a physician, a registered nurse working
under direct supervision of a physician, a physician's assistant, a nurse practitioner, a
licensed practical nurse, new text begin a county social worker, new text end or a discharge planner. Nonemergency
medical transportation level of need determinations must not be performed more than
semiannually on any individual, unless the individual's circumstances have sufficiently
changed so as to require a new level of need determination. Individuals residing in licensed
nursing facilities are exempt from a level of need determination and are eligible for
special transportation services until the individual no longer resides in a licensed nursing
facility. If a person authorized by this subdivision to perform a level of need determination
determines that an individual requires stretcher transportation, the individual is presumed
to maintain that level of need until otherwise determined by a person authorized to
perform a level of need determination, or for six months, whichever is sooner.

Sec. 3.

Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to
read:

Subd. 17.

Transportation costs.

(a) Medical assistance covers transportation costs
incurred solely for obtaining emergency medical care or transportation costs incurred
by eligible persons in obtaining emergency or nonemergency medical care when paid
directly to an ambulance company, common carrier, or other recognized providers of
transportation services.

(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
transportation, or private automobile.

The commissioner may use an order by the recipient's attending physician to certify that
the recipient requires special transportation services. Special transportation includes
driver-assisted service to eligible individuals. Driver-assisted service includes passenger
pickup at and return to the individual's residence or place of business, assistance with
admittance of the individual to the medical facility, and assistance in passenger securement
or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers
must obtain written documentation from the health care service provider who is serving
the recipient being transported, identifying the time that the recipient arrived. Special
transportation providers may not bill for separate base rates for the continuation of a trip
beyond the original destination. Special transportation providers must take recipients
to the nearest appropriate health care provider, using the deleted text begin most direct deleted text end new text begin quickest new text end route
deleted text begin available deleted text end new text begin as determined by a commercially available software program approved by
the commissioner new text end . The maximum medical assistance reimbursement rates for special
transportation services are:

(1) $17 for the base rate and $1.35 per mile for services to eligible persons who
need a wheelchair-accessible van;

(2) $11.50 for the base rate and $1.30 per mile for services to eligible persons who
do not need a wheelchair-accessible van; and

(3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
services to eligible persons who need a stretcher-accessible vehicle.

Sec. 4.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 17b. new text end

new text begin Broker dispatching prohibition. new text end

new text begin The commissioner shall not use a
broker or coordinator for any purpose related to nonemergency medical transportation
services including, but not limited to, managing or dispatching transportation services,
verifying recipient eligibility, authorizing recipients for the appropriate level of
transportation, and monitoring provider compliance with subdivision 17.
new text end

Sec. 5.

Minnesota Statutes 2008, section 256B.0625, subdivision 18, is amended to
read:

Subd. 18.

deleted text begin Bus or taxicab deleted text end new text begin Access new text end transportation.

To the extent authorized by
rule of the state agency, medical assistance covers costs of the most appropriate and
cost-effective form of transportation incurred by any ambulatory eligible person for
obtaining nonemergency medical care new text begin , including gasoline reimbursement, volunteer
drivers, bus tokens, or common carrier transportation. The minimum medical assistance
reimbursement rates for access transportation services provided by common carrier or
for-hire vehicles are:
new text end

new text begin (1) $13 for the base rate and $1.45 per mile for each mile or portion thereof that is
in excess of five miles for services to eligible persons who need a wheelchair-accessible
van; and
new text end

new text begin (2) $10 for the base rate and $1.45 per mile for each mile or portion thereof
that is in excess of five miles for services to eligible persons who do not need a
wheelchair-accessible van new text end .