HF 1967

as introduced - 91st Legislature (2019 - 2020) Posted on 03/20/2019 12:58pm

A bill for an act
relating to human services; providing a rate increase for certain mental health
providers; requiring a rate-setting proposal; amending Minnesota Statutes 2018,
sections 256B.0625, subdivision 38; 256B.761.

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

Section 1.

Minnesota Statutes 2018, section 256B.0625, subdivision 38, is amended to
read:

Subd. 38.

Payments for mental health services.

deleted text begin Payments for mental health services
covered under the medical assistance program that are provided by masters-prepared mental
health professionals shall be 80 percent of the rate paid to doctoral-prepared professionals.
Payments for mental health services covered under the medical assistance program that are
provided by masters-prepared mental health professionals employed by community mental
health centers shall be 100 percent of the rate paid to doctoral-prepared professionals. deleted text end
Payments for mental health services covered under the medical assistance program that are
provided by physician assistants shall be 80.4 percent of the base rate paid to psychiatrists.

Sec. 2.

Minnesota Statutes 2018, section 256B.761, is amended to read:

256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.

(a) Effective for services rendered on or after July 1, 2001, payment for medication
management provided to psychiatric patients, outpatient mental health services, day treatment
services, home-based mental health services, and family community support services shall
be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of
1999 charges.

(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
services provided by an entity that operates: (1) a Medicare-certified comprehensive
outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993,
with at least 33 percent of the clients receiving rehabilitation services in the most recent
calendar year who are medical assistance recipients, will be increased by 38 percent, when
those services are provided within the comprehensive outpatient rehabilitation facility and
provided to residents of nursing facilities owned by the entity.

(c) The commissioner shall establish three levels of payment for mental health diagnostic
assessment, based on three levels of complexity. The aggregate payment under the tiered
rates must not exceed the projected aggregate payments for mental health diagnostic
assessment under the previous single rate. The new rate structure is effective January 1,
2011, or upon federal approval, whichever is later.

(d) In addition to rate increases otherwise provided, the commissioner may restructure
coverage policy and rates to improve access to adult rehabilitative mental health services
under section 256B.0623 and related mental health support services under section 256B.021,
subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected
state share of increased costs due to this paragraph is transferred from adult mental health
grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent
base adjustment for subsequent fiscal years. Payments made to managed care plans and
county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect
the rate changes described in this paragraph.

(e) Any ratables effective before July 1, 2015, do not apply to early intensive
developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.

new text begin (f) Effective January 1, 2020, managed care plans and county-based purchasing plans
must reimburse providers of mental health services who are employed by or under contract
with the plan an amount that is at least as much as the fee-for-service payment for the same
mental health service for outpatient therapy under section 256B.0625, subdivision 65;
psychiatry services; adult rehabilitative mental health services under section 256B.0623;
children's therapeutic support services under section 256B.0943; and in-home therapy
services. Quality measures that must be tracked in conjunction with this paragraph include
rate of access to mental health services and mental health inpatient hospitalization rates.
new text end

new text begin (g) Effective for services rendered on or after January 1, 2020, payment rates for the
following mental health services shall be increased by 25 percent from the rates in effect
on December 31, 2019: outpatient therapy under section 256B.0625, subdivision 65;
psychiatry services; adult rehabilitative mental health services under section 256B.0623;
children's therapeutic support services under section 256B.0943; and in-home therapy
services. Effective for services rendered on or after January 1, 2021, rates shall be annually
adjusted according to the Consumer Price Index for medical care services. This paragraph
does not apply to federally qualified health centers, rural health centers, Indian health
services, certified community behavioral health clinics, cost-based rates, and rates that are
negotiated with the county.
new text end

Sec. 3. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
RATE-SETTING PROPOSAL.
new text end

new text begin The commissioner of human services shall develop a comprehensive rate-setting proposal
compliant with federal criteria for outpatient, professional, and physician services that do
not have a cost-based, federally mandated, or contracted rate. The proposal must include
recommendations for changes to the existing fee schedule that utilize the resource-based
relative value system, alternate payment methodologies for services that do not have relative
values, and an alternative comprehensive payment methodology for services by a provider
that serves a disproportionate number of medical assistance recipients and is licensed or
certified under Minnesota Statutes, section 256B.0625, subdivision 5, to simplify the
fee-for-service medical assistance rate structure and to improve consistency and transparency.
In developing the proposal, the commissioner of human services shall consult with key
stakeholders, including community-based mental health providers, substance use disorder
service providers, home health care service providers, and others as identified by the
commissioner of human services. The commissioner of human services shall provide the
proposal to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services finance and policy by January 1, 2020.
new text end