HF 1269

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 03/28/2019 03:43pm

A bill for an act
relating to health; clarifying payment and denial of payment for mental health
services; modifying primary care residency expansion grants; establishing practicum
incentive payments; establishing American Indian traditional healing grants;
developing a mental health training program; appropriating money; amending
Minnesota Statutes 2018, sections 62A.15, subdivision 4, by adding a subdivision;
62J.692, subdivisions 1, 3; 144.1506, subdivision 2; 245.464, by adding a
subdivision; 245.4661, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2018, section 62A.15, is amended by adding a subdivision
to read:

new text begin Subd. 3c. new text end

new text begin Mental health services. new text end

new text begin All benefits provided by a policy or contract referred
to in subdivision 1 relating to expenses incurred for mental health treatment or services
provided by a mental health professional must also include treatment and services provided
by a clinical trainee to the extent that the services and treatment are within the scope of
practice of the clinical trainee according to Minnesota Rules, part 9505.0371, subpart 5,
item C. This subdivision is intended to provide equal payment of benefits for mental health
treatment and services provided by a mental health professional, as defined in Minnesota
Rules, part 9505.0371, subpart 5, item A, or a clinical trainee and is not intended to change
or add to the benefits provided for in those policies or contracts.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020, and applies to policies
and contracts offered, issued, or renewed on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2018, section 62A.15, subdivision 4, is amended to read:

Subd. 4.

Denial of benefits.

(a) No carrier referred to in subdivision 1 may, in the
payment of claims to employees in this state, deny benefits payable for services covered by
the policy or contract if the services are lawfully performed by a licensed chiropractor,
licensed optometrist, a registered nurse meeting the requirements of subdivision 3a, or a
licensed acupuncture practitioner.

(b) When carriers referred to in subdivision 1 make claim determinations concerning
the appropriateness, quality, or utilization of chiropractic health care for Minnesotans, any
of these determinations that are made by health care professionals must be made by, or
under the direction of, or subject to the review of licensed doctors of chiropractic.

(c) When a carrier referred to in subdivision 1 makes a denial of payment claim
determination concerning the appropriateness, quality, or utilization of acupuncture services
for individuals in this state performed by a licensed acupuncture practitioner, a denial of
payment claim determination that is made by a health professional must be made by, under
the direction of, or subject to the review of a licensed acupuncture practitioner.

new text begin (d) When a carrier referred to in subdivision 1 makes a denial of payment claim
determination concerning the appropriateness, quality, or utilization of mental health services
for individuals in this state performed by a licensed mental health professional or clinical
trainee, a denial of payment claim determination that is made by a health professional must
be made by, under the direction of, or subject to the review of a licensed mental health
professional.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020, and applies to policies
and contracts offered, issued, or renewed on or after that date.
new text end

Sec. 3.

Minnesota Statutes 2018, section 62J.692, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply:

(b) "Accredited clinical training" means the clinical training provided by a medical
education program that is accredited through an organization recognized by the Department
of Education, the Centers for Medicare and Medicaid Services, or another national body
who reviews the accrediting organizations for multiple disciplines and whose standards for
recognizing accrediting organizations are reviewed and approved by the commissioner of
health.

(c) "Commissioner" means the commissioner of health.

(d) "Clinical medical education program" means the accredited clinical training of
physicians (medical students and residents), doctor of pharmacy practitioners, doctors of
chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified registered
nurse anesthetists, nurse practitioners, and certified nurse midwives), physician assistants,
dental therapists and advanced dental therapists, psychologists, clinical social workers,
community paramedics, deleted text begin and deleted text end community health workers new text begin , marriage and family therapists,
and professional clinical counselors new text end .

(e) "Sponsoring institution" means a hospital, school, or consortium located in Minnesota
that sponsors and maintains primary organizational and financial responsibility for a clinical
medical education program in Minnesota and which is accountable to the accrediting body.

(f) "Teaching institution" means a hospital, medical center, clinic, or other organization
that conducts a clinical medical education program in Minnesota.

(g) "Trainee" means a student or resident involved in a clinical medical education
program.

(h) "Eligible trainee FTE's" means the number of trainees, as measured by full-time
equivalent counts, that are at training sites located in Minnesota with currently active medical
assistance enrollment status and a National Provider Identification (NPI) number where
training occurs in either an inpatient or ambulatory patient care setting and where the training
is funded, in part, by patient care revenues. Training that occurs in nursing facility settings
is not eligible for funding under this section.

Sec. 4.

Minnesota Statutes 2018, section 62J.692, subdivision 3, is amended to read:

Subd. 3.

Application process.

(a) A clinical medical education program conducted in
Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners,
dentists, chiropractors, physician assistants, dental therapists and advanced dental therapists,
psychologists, clinical social workers, community paramedics, deleted text begin or deleted text end community health workers new text begin ,
marriage and family therapists, or professional clinical counselors new text end is eligible for funds under
subdivision 4 if the program:

(1) is funded, in part, by patient care revenues;

(2) occurs in patient care settings that face increased financial pressure as a result of
competition with nonteaching patient care entities; and

(3) emphasizes primary care or specialties that are in undersupply in Minnesota.

(b) A clinical medical education program for advanced practice nursing is eligible for
funds under subdivision 4 if the program meets the eligibility requirements in paragraph
(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health
Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges
and Universities system or members of the Minnesota Private College Council.

(c) Applications must be submitted to the commissioner by a sponsoring institution on
behalf of an eligible clinical medical education program and must be received by October
31 of each year for distribution in the following year. An application for funds must contain
the following information:

(1) the official name and address of the sponsoring institution and the official name and
site address of the clinical medical education programs on whose behalf the sponsoring
institution is applying;

(2) the name, title, and business address of those persons responsible for administering
the funds;

(3) for each clinical medical education program for which funds are being sought; the
type and specialty orientation of trainees in the program; the name, site address, and medical
assistance provider number and national provider identification number of each training
site used in the program; the federal tax identification number of each training site used in
the program, where available; the total number of trainees at each training site; and the total
number of eligible trainee FTEs at each site; and

(4) other supporting information the commissioner deems necessary to determine program
eligibility based on the criteria in paragraphs (a) and (b) and to ensure the equitable
distribution of funds.

(d) An application must include the information specified in clauses (1) to (3) for each
clinical medical education program on an annual basis for three consecutive years. After
that time, an application must include the information specified in clauses (1) to (3) when
requested, at the discretion of the commissioner:

(1) audited clinical training costs per trainee for each clinical medical education program
when available or estimates of clinical training costs based on audited financial data;

(2) a description of current sources of funding for clinical medical education costs,
including a description and dollar amount of all state and federal financial support, including
Medicare direct and indirect payments; and

(3) other revenue received for the purposes of clinical training.

(e) An applicant that does not provide information requested by the commissioner shall
not be eligible for funds for the current funding cycle.

Sec. 5.

Minnesota Statutes 2018, section 144.1506, subdivision 2, is amended to read:

Subd. 2.

Expansion grant program.

(a) The commissioner of health shall award primary
care residency expansion grants to eligible primary care residency programs to plan and
implement new residency slots. A planning grant shall not exceed $75,000, and a training
grant shall not exceed $150,000 per new residency slot for the first year, $100,000 for the
second year, and $50,000 for the third year of the new residency slot. new text begin For eligible residency
programs longer than three years, training grants may be awarded for the duration of the
residency, not exceeding an average of $100,000 per residency slot per year.
new text end

(b) Funds may be spent to cover the costs of:

(1) planning related to establishing an accredited primary care residency program;

(2) obtaining accreditation by the Accreditation Council for Graduate Medical Education
or another national body that accredits residency programs;

(3) establishing new residency programs or new resident training slots;

(4) recruitment, training, and retention of new residents and faculty;

(5) travel and lodging for new residents;

(6) faculty, new resident, and preceptor salaries related to new residency slots;

(7) training site improvements, fees, equipment, and supplies required for new primary
care resident training slots; and

(8) supporting clinical education in which trainees are part of a primary care team model.

Sec. 6.

Minnesota Statutes 2018, section 245.464, is amended by adding a subdivision to
read:

new text begin Subd. 4. new text end

new text begin Practicum incentive payments. new text end

new text begin (a) The commissioner shall, in consultation
with stakeholders, establish a payment mechanism and criteria for payment to mental health
service providers who demonstrate a commitment to providing students with practicum
opportunities focused on evidence-based treatment interventions.
new text end

new text begin (b) For the purposes of this section:
new text end

new text begin (1) "practicum" means formal experience gained by a student and supervised by a person
licensed under chapter 147, 148B, 148D, or 148F, or sections 148.88 to 148.98 as part of
an accredited school or educational program in counseling, psychology, or a related mental
health field; and
new text end

new text begin (2) "student" means an individual who is enrolled in an accredited educational institution
in counseling, psychology, or a related mental health field that requires practicum experience
for credit.
new text end

Sec. 7.

Minnesota Statutes 2018, section 245.4661, is amended by adding a subdivision
to read:

new text begin Subd. 9a. new text end

new text begin Traditional healing grants. new text end

new text begin The commissioner shall establish a grant program
to improve access, coordination, and referral processes for traditional healing in American
Indian communities across Minnesota. Grants shall be distributed equally to each tribal
nation and to urban American Indian communities located in Minnesota.
new text end

Sec. 8. new text begin MENTAL HEALTH TRAINING PROGRAM FOR PEDIATRIC
RESIDENTS.
new text end

new text begin The Board of Regents of the University of Minnesota is requested to develop a clinical
mental health training program located in outpatient child psychiatric care clinics for pediatric
residents. The training program shall:
new text end

new text begin (1) place pediatric residents in multidisciplinary mental health teams;
new text end

new text begin (2) provide education on conducting comprehensive clinical mental health assessments;
new text end

new text begin (3) provide psychiatric consultation to pediatric residents in their primary care community
clinic rotation;
new text end

new text begin (4) emphasize longitudinal care for patients with behavioral health needs; and
new text end

new text begin (5) develop partnerships with community resources.
new text end

Sec. 9. new text begin APPROPRIATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Mental health training program. new text end

new text begin $540,000 in fiscal year 2020 is
appropriated from the general fund to the Board of Regents of the University of Minnesota
for the planning, design, and implementation of the clinical mental health training program
for pediatric residents in section 8.
new text end

new text begin Subd. 2. new text end

new text begin Health professional education loan forgiveness program. new text end

new text begin (a) $3,000,000 in
fiscal year 2020 and $3,000,000 in fiscal year 2021 are appropriated from the general fund
to the commissioner of health for the health professional education loan forgiveness program
under Minnesota Statutes, section 144.1501.
new text end

new text begin (b) Notwithstanding the priorities and distribution requirements for loan forgiveness in
Minnesota Statutes, section 144.1501, subdivision 4, $300,000 of this appropriation is for
loan forgiveness to mental health professionals, as defined in Minnesota Statutes, section
144.1501, subdivision 1, paragraph (g), who are practicing in an underserved urban
community, as defined in Minnesota Statutes, section 144.1501, subdivision 1, paragraph
(r), and practicing at a clinical location where at least 50 percent of the clients served are
covered by medical assistance.
new text end

new text begin Subd. 3. new text end

new text begin Adult mental health grants. new text end

new text begin $....... is appropriated in fiscal years 2020 and
2021 for adult mental health grants under section 245.4661, subdivision 9a.
new text end