HF 1453

as introduced - 89th Legislature (2015 - 2016) Posted on 03/31/2016 04:55pm

A bill for an act
relating to human services; establishing an enhanced asthma care services benefit
for medical assistance; providing for medical assistance coverage of certain
products to reduce asthma triggers; amending Minnesota Statutes 2014, section
256B.0625, subdivision 31, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2014, section 256B.0625, subdivision 31, is amended to
read:

Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall
be made for wheelchairs and wheelchair accessories for recipients who are residents
of intermediate care facilities for the developmentally disabled. Reimbursement for
wheelchairs and wheelchair accessories for ICF/DD recipients shall be subject to the same
conditions and limitations as coverage for recipients who do not reside in institutions. A
wheelchair purchased outside of the facility's payment rate is the property of the recipient.
The commissioner may set reimbursement rates for specified categories of medical
supplies at levels below the Medicare payment rate.

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics,
orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
enrollment requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic,
orthotic, or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or
similar durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with
the Medicare program's supplier and quality standards and the vendor serves primarily
pediatric patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical
condition or is generally used primarily for a medical purpose.

(e) Electronic tablets may be considered durable medical equipment if the electronic
tablet will be used as an augmentative and alternative communication system as defined
under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
must be locked in order to prevent use not related to communication.

new text begin (f) Allergen-reducing products provided according to subdivision 64, paragraph (b),
clause (3), shall be considered durable medical equipment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
new text end

Sec. 2.

Minnesota Statutes 2014, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 64. new text end

new text begin Enhanced asthma care services. new text end

new text begin (a) Medical assistance covers enhanced
asthma care services and related products for children with poorly controlled asthma, to
be provided in the children's homes. To be eligible for services and products under this
subdivision, a child must be under age 21, have poorly controlled asthma, have received
health care for the child's asthma from a hospital emergency department at least one time
in the past year or have been hospitalized for the treatment of asthma at least one time in
the past year, and receive a referral for services and products under this subdivision from
a treating health care provider.
new text end

new text begin (b) Covered services and products include:
new text end

new text begin (1) a home assessment for asthma triggers provided by a healthy homes specialist
currently credentialed by the National Environmental Health Association;
new text end

new text begin (2) targeted asthma education services in the child's home by an asthma educator
certified by the National Asthma Educator Certification Board. Asthma education services
provided under this clause include education on self-management, avoiding asthma
triggers, identifying worsening asthma symptoms, and medication uses and techniques; and
new text end

new text begin (3) allergen-reducing products that are recommended for the child by the healthy
homes specialist or the certified asthma educator and proven to reduce asthma triggers
identified in the child's home assessment, including:
new text end

new text begin (i) encasements for mattresses, box springs, and pillows;
new text end

new text begin (ii) a HEPA vacuum cleaner, filters, and bags;
new text end

new text begin (iii) a dehumidifier and filters;
new text end

new text begin (iv) single-room air cleaners and filters;
new text end

new text begin (v) nontoxic pest control systems, including traps and starter packages of food
storage containers;
new text end

new text begin (vi) a damp mopping system;
new text end

new text begin (vii) if the child does not have access to a bed, a waterproof hospital-grade mattress;
and
new text end

new text begin (viii) for homeowners only, furnace filters.
new text end

new text begin (c) If a child receiving services and products under this subdivision resides in rental
housing, the healthy homes specialist who provided a home assessment for the child shall
report to the appropriate local housing authority charged with enforcing health, safety,
or building codes in rental property, any structural or cosmetic modifications needed to
reduce mold and pests that are present in the rental housing and that are asthma triggers
for the child. No person shall be subject to retaliation or discrimination of any kind due to
a report made under this paragraph.
new text end

new text begin (d) A child is limited to one home assessment and one visit by a certified asthma
educator to provide education on the use and maintenance of the products listed in
paragraph (b), clause (3), except that a child may receive an additional home assessment
if the child moves to a new home; if a new asthma trigger, including tobacco smoke,
enters the home; or if the child's health care provider identifies a new allergy for the child,
including an allergy to mold, pests, pets, or dust mites. The commissioner shall determine
the frequency with which a child may receive a product listed in paragraph (b), clause (3),
based on the reasonable expected lifetime of the product.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
new text end