HF 1817

as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:55am

A bill for an act
relating to health care; establishing an alternative basic health plan for families
with children eligible for medical assistance; proposing coding for new law
in Minnesota Statutes, chapter 256B.

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

Section 1.

new text begin [256B.077] ALTERNATIVE BASIC HEALTH PLAN.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner shall develop a basic health
plan to be offered to families with children who are eligible for medical assistance under
section 256B.055, subdivisions 3a, 9, 10, and 10b. Individuals who, at the time of
application, are disabled, age 65 or older, pregnant, or are excluded under section 1938(b)
of the Social Security Act are not eligible for the basic health plan. Enrollment in the basic
health plan shall begin January 1, 2010.
new text end

new text begin Subd. 2. new text end

new text begin Alternative benefits. new text end

new text begin (a) The basic health plan covers the services
described in section 256B.0625 except for:
new text end

new text begin (1) skilled and intermediate nursing care;
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new text begin (2) hospice care;
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new text begin (3) intensive mental health outpatient treatment;
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new text begin (4) home health services;
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new text begin (5) private duty nursing;
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new text begin (6) bus or taxicab transportation;
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new text begin (7) personal care assistance services;
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new text begin (8) mental health case management;
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new text begin (9) day treatment services;
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new text begin (10) special education services;
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new text begin (11) organ and tissue transplants;
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new text begin (12) augmentative and alternative communication systems;
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new text begin (13) nutritional products;
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new text begin (14) child welfare targeted case management;
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new text begin (15) children's mental health crisis response services;
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new text begin (16) children's therapeutic services and supports;
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new text begin (17) individualized rehabilitation services as defined in section 245.492, subdivision
23;
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new text begin (18) residential services for children with severe emotional disturbances;
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new text begin (19) targeted case management services; and
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new text begin (20) subacute psychiatric care.
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new text begin (b) The basic health plan covers early, periodic screening, diagnostic, and treatment
services for individuals under the age of 21 years, as required under section 1905(a) of
the Social Security Act.
new text end

new text begin (c) Enrollees of the basic health plan are subject to the co-payments as described
under section 256B.0631.
new text end

new text begin Subd. 3. new text end

new text begin Primary care provider. new text end

new text begin Individuals enrolled in the basic health plan must
complete a health assessment and must designate a personal clinician or a primary care
clinic certified as a health care home according to section 256B.0751 as their primary care
provider. If services cannot be provided by the primary care clinic, the personal clinician
or clinic shall make a referral to an appropriate provider.
new text end

new text begin Subd. 4. new text end

new text begin Co-payments. new text end

new text begin The basic health plan shall include the co-payments
described under section 256B.031.
new text end

new text begin Subd. 5. new text end

new text begin Payments. new text end

new text begin The commissioner may contract with a managed care plan or
county-based purchasing plan to provide the basic health plan or may contract directly
with health care providers on a fee-for-service basis.
new text end

new text begin Subd. 6. new text end

new text begin Renewal. new text end

new text begin The commissioner shall implement a streamlined renewal
process for enrollees of the basic health plan. The process shall require renewal every
12 months.
new text end

new text begin Subd. 7. new text end

new text begin Preventive health assistance. new text end

new text begin (a) The commissioner shall establish a
preventive health assistance program for enrollees of the basic health plan who are over
five years of age. The program shall provide incentives to promote healthy behavior
and responsible use of health care services.
new text end

new text begin (b) An eligible enrollee may earn preventive health assistance credits when the
enrollee complies with recommended preventive care or otherwise demonstrates healthy
behaviors or activities as specified by the commissioner.
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new text begin (c) Preventive health assistance credits shall only be available to an enrollee during
the enrollee's period of eligibility and shall be limited to $200 per enrollee per year. If an
enrollee becomes ineligible for medical assistance, disenrolls in the basic health plan, or
opts out of the basic health plan, the enrollee's unused credits become void.
new text end

new text begin (d) Preventive health assistance credits may be used to purchase preventive health
products and services as specified by the commissioner or may be used for any applicable
co-payments.
new text end