HF 4046

as introduced - 93rd Legislature (2023 - 2024) Posted on 02/22/2024 02:56pm

A bill for an act
relating to state government; establishing the Minnesota Commission for Equitable
Health Care Services; requiring reports; providing appointments; appropriating
money; proposing coding for new law as Minnesota Statutes, chapter 145E.

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

Section 1.

new text begin [145E.10] COMMISSION FOR EQUITABLE HEALTH CARE SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The Minnesota Commission for Equitable Health Care
Services is established to evaluate Minnesotans' experience with and access to health care
services, regardless of coverage. The commission will evaluate the means by which care is
organized and financed, the financial and policy instruments employed by the health care
industry to limit health care spending, and how these features of the health care system
impact Minnesotans' experience with access, cost, and care. The commission will develop
and submit to the legislature recommendations to ensure that every Minnesotan has access
to meaningful care according to the goals articulated by this commission.
new text end

new text begin Subd. 2. new text end

new text begin Public membership. new text end

new text begin (a) The Minnesota Commission for Equitable Health
Care Services shall consist of nine public members appointed according to Minnesota
Statutes, section 15.0597, as follows:
new text end

new text begin (1) one member who is a resident of congressional district 1 appointed by the attorney
general;
new text end

new text begin (2) one member who is a resident of congressional district 2 appointed by the attorney
general;
new text end

new text begin (3) one member who is a resident of congressional district 3 appointed by the speaker
of the house of representatives;
new text end

new text begin (4) one member who is a resident of congressional district 4 appointed by the governor;
new text end

new text begin (5) one member who is a resident of congressional district 5 appointed by the majority
leader of the senate;
new text end

new text begin (6) one member who is a resident of congressional district 6 appointed by the minority
leader of the house of representatives;
new text end

new text begin (7) one member who is a resident of congressional district 7 appointed by the minority
leader of the senate;
new text end

new text begin (8) one member who is a resident of congressional district 8 appointed by the governor;
and
new text end

new text begin (9) one member who is a representative of Tribal governments appointed by the governor.
new text end

new text begin (b) The appointing authorities under this subdivision must consult with one another to
ensure to the extent practicable that the public membership of the commission represents
the diversity of Minnesotans with respect to gender, race, ethnicity, and geography.
new text end

new text begin (c) The appointing authorities must complete the initial appointments required under
this subdivision by August 1, 2024.
new text end

new text begin (d) The governor shall designate one public member appointed by the governor to serve
as the acting chairperson solely for the purposes of planning and convening the first meeting
of the commission.
new text end

new text begin (e) Public members may be removed as provided in Minnesota Statutes, section 15.059,
subdivision 4.
new text end

new text begin Subd. 3. new text end

new text begin Commission advisors. new text end

new text begin (a) The Minnesota Commission for Equitable Health
Care Services shall include eight nonvoting commission advisors appointed according to
Minnesota Statutes, section 15.0597, as follows:
new text end

new text begin (1) one advisor who is a registered nurse and practices nursing in a hospital setting,
appointed by the Minnesota Nurses Association;
new text end

new text begin (2) one advisor who is a licensed traditional midwife, appointed by the Birth Justice
Coalition;
new text end

new text begin (3) one advisor who is a mental health provider with rural mental health care experience,
appointed by the National Alliance on Mental Illness, Minnesota;
new text end

new text begin (4) one advisor who is living with a disability, appointed by the Minnesota Council on
Disability;
new text end

new text begin (5) one advisor who is a primary care physician with rural health care experience,
appointed by the Minnesota Medical Association;
new text end

new text begin (6) one advisor who is a licensed practical nurse and practices practical nursing in a rural
health care setting, appointed by the American Federation of State, County, and Municipal
Employees, Council 65;
new text end

new text begin (7) one advisor who is a long-term care provider, appointed by Service Employees
International Union Healthcare Minnesota and Iowa; and
new text end

new text begin (8) one advisor who is a representative of the counties, appointed by the Association of
Minnesota Counties.
new text end

new text begin (b) The appointing authorities under this subdivision must consult with one another to
ensure to the extent practicable that the commission advisor membership represents the
diversity of Minnesotans with respect to gender, race, ethnicity, and geography.
new text end

new text begin (c) The appointing authorities must complete the initial appointments required under
this subdivision by August 1, 2024.
new text end

new text begin (d) Commission advisors may be removed as provided in Minnesota Statutes, section
15.059, subdivision 4.
new text end

new text begin Subd. 4. new text end

new text begin Legislative membership. new text end

new text begin The Minnesota Commission for Equitable Health
Care Services shall include four nonvoting legislative members, of whom two must be
members of the senate, with one appointed by the majority leader of the senate and one
appointed by the minority leader of the senate; and of whom two must be members of the
house of representatives, with one appointed by the speaker of the house of representatives
and one appointed by the minority leader of the house of representatives. The appointing
authorities must complete the initial appointments required under this subdivision by August
1, 2024.
new text end

new text begin Subd. 5. new text end

new text begin Ex officio membership. new text end

new text begin (a) The Minnesota Commission for Equitable Health
Care Services shall include four nonvoting ex officio members, three of whom must be
employees of the Department of Health appointed by the commissioner of health, and one
of whom must be an employee of the Office of the Attorney General appointed by the
attorney general.
new text end

new text begin (b) Of the commissioner of health's appointments, one must have expertise in network
adequacy for managed care plans, one must have expertise in health equity, and one must
have expertise in rural health.
new text end

new text begin (c) The appointing authorities must complete the initial appointments required under
this subdivision by August 1, 2024.
new text end

new text begin Subd. 6. new text end

new text begin Limitations on membership. new text end

new text begin (a) No member or advisor of the Minnesota
Commission for Equitable Health Care Services may be a director, manager, managing
partner, officer, or executive of any of the following:
new text end

new text begin (1) a health care entity, as defined under Minnesota Statutes, section 145D.01;
new text end

new text begin (2) an entity formed to provide a professional health care service to individuals;
new text end

new text begin (3) a utilization review organization, as defined in Minnesota Statutes, section 62M.02;
new text end

new text begin (4) an entity subject to Minnesota Statutes, section 60A.23, subdivision 8;
new text end

new text begin (5) a pharmacy benefit manager, as defined in Minnesota Statutes, section 62W.02;
new text end

new text begin (6) a manufacturer, pharmacy, retailer, wholesaler, third-party logistics provider, group
purchasing organization, distributor, or other entity engaged in supplying a drug or medical
device; or
new text end

new text begin (7) a direct or indirect affiliate of an entity listed in clauses (1) to (6).
new text end

new text begin (b) No member of the commission may have a personal interest in an entity listed in
paragraph (a), clauses (1) to (7). For the purposes of this subdivision, "personal interest"
means that:
new text end

new text begin (1) a person owns or controls, directly or indirectly, at least five percent of the voting
interest or equity interest in the entity;
new text end

new text begin (2) the equity interest in the entity owned by a person represents at least five percent of
that person's net worth; or
new text end

new text begin (3) at least five percent of a person's gross income, other than income from fixed wages
and employment benefits received from the entity, is based, through equity, contract, or
otherwise, on the entity's revenue.
new text end

new text begin Subd. 7. new text end

new text begin Chairperson; executive committee. new text end

new text begin (a) The Minnesota Commission for
Equitable Health Care Services shall elect a chairperson at its first meeting and other officers
as it deems necessary.
new text end

new text begin (b) The executive committee, or the chairperson if the commission chooses not to elect
additional officers, may appoint additional subcommittees and work groups as necessary
to fulfill the duties of the commission.
new text end

new text begin Subd. 8. new text end

new text begin Meetings. new text end

new text begin (a) The appointee of the governor designated by the governor to
serve as acting chairperson for the purposes of convening the first meeting must convene
the first meeting of the Minnesota Commission for Equitable Health Care Services by
September 1, 2024.
new text end

new text begin (b) The commission shall meet at the call of the chairperson or at the request of a majority
of commission members. Meetings of the commission are subject to Minnesota Statutes,
section 13D.01, and notice of its meetings is governed by Minnesota Statutes, section
13D.04.
new text end

new text begin Subd. 9. new text end

new text begin Executive director; staff. new text end

new text begin The Minnesota Commission for Equitable Health
Care Services shall appoint an executive director. The executive director serves as an ex
officio nonvoting member of the executive committee. The commission may delegate to
the executive director any powers and duties under this section that do not require commission
approval. The executive director serves in the unclassified service and may be removed at
any time by a majority vote of the commission. The executive director may employ and
direct staff necessary to carry out commission mandates, policies, activities, and objectives.
new text end

new text begin Subd. 10. new text end

new text begin Office space; equipment; technical assistance. new text end

new text begin (a) The commissioner of
administration shall provide to the Minnesota Commission for Equitable Health Care
Services, at a reasonable cost, administrative assistance, office space, and access to office
equipment and services. The commissioner of administration may accept outside resources
to help support its efforts.
new text end

new text begin (b) The commissioners of all departments of state government shall accommodate any
reasonable requests for technical assistance from the commission as it carries out its duties.
The commissioners shall leverage their existing vendor contracts to provide the requested
technical assistance. The commissioners shall receive expedited review and publication of
competitive procurements for additional vendor support if needed to fulfill the commission's
request.
new text end

new text begin Subd. 11. new text end

new text begin Duties. new text end

new text begin The Minnesota Commission for Equitable Health Care Services shall
develop and recommend to the legislature a plan to provide meaningful availability of health
care services to all state residents. In developing the plan, the commission shall:
new text end

new text begin (1) consult with a representative sample of Minnesota residents, through regional field
hearings and interviews, regarding their experiences and expectations with respect to
meaningfully accessing health care services for which they have coverage, including coverage
through public health care programs;
new text end

new text begin (2) consult small business owners, local employers, local government leaders, and local
health care providers, representing different regions across Minnesota, regarding their
experiences and expectations with health care costs, coverage, and access to care;
new text end

new text begin (3) develop and implement a method to estimate the contribution to the health care
market in the state attributable to federal, state, and local sources, including direct payments,
capitation payments, tax expenditures, and subsidies;
new text end

new text begin (4) develop and implement a method of investigating the financial and policy instruments
employed by corporate health care entities to advance, deny, and impair meaningful and
equitable health care for Minnesotans;
new text end

new text begin (5) develop and implement a method of investigating the geographic distribution of
resources such as hospital beds and specialty services and limited networks of service
providers, particularly for mental health services, substance use disorder services, obstetrics,
and long-term services and supports;
new text end

new text begin (6) study and make recommendations on transparency of ownership of health care
facilities and systems and of the role of private equity in the health care market in the state;
new text end

new text begin (7) develop and implement a method of investigating the extent and severity of inadequate
availability of culturally competent care;
new text end

new text begin (8) develop and implement a method of investigating incentives to provide equitable,
competent care;
new text end

new text begin (9) study and make recommendations on incentives and disincentives to ensure that
health care entities continue to provide health care services in rural and other underserved
communities; and
new text end

new text begin (10) conduct other activities the commission considers necessary to carry out the intent
of the legislature as expressed in this section.
new text end

new text begin Subd. 12. new text end

new text begin Expenses. new text end

new text begin Public members, commission advisors, and ex officio members
serve without compensation. All members and advisors may have expenses reimbursed as
provided in Minnesota Statutes, section 15.059, subdivision 3.
new text end

new text begin Subd. 13. new text end

new text begin Data classification. new text end

new text begin Data collected by the Minnesota Commission for Equitable
Health Care Services is private data on individuals as defined in Minnesota Statutes, section
13.02, subdivision 12, or nonpublic data as defined in Minnesota Statutes, section 13.02,
subdivision 9.
new text end

new text begin Subd. 14. new text end

new text begin Contract authority. new text end

new text begin The Minnesota Commission for Equitable Health Care
Services may contract with one or more third parties to perform its duties.
new text end

new text begin Subd. 15. new text end

new text begin Reports. new text end

new text begin (a) By January 15, 2025, the Minnesota Commission for Equitable
Health Care Services must submit to the chairs and ranking minority members of the
legislative committees with jurisdiction over health an initial report on its progress and other
appropriate information.
new text end

new text begin (b) By January 15, 2026, the Minnesota Commission for Equitable Health Care Services
shall submit to the chairs and ranking minority members of the legislative committees with
jurisdiction over health a final report with proposals to ensure that all Minnesotans have
meaningful access to equitable health care services, any additional recommendations, and
draft legislation.
new text end

new text begin Subd. 16. new text end

new text begin Expiration. new text end

new text begin This section expires July 1, 2027.
new text end

Sec. 2. new text begin APPROPRIATION.
new text end

new text begin Subdivision 1. new text end

new text begin Minnesota Commission for Equitable Health Care Services. new text end

new text begin $.......
in fiscal year 2025 is appropriated from the general fund to the Minnesota Commission for
Equitable Health Care Services for purposes of section 1 and is available until June 30,
2027.
new text end

new text begin Subd. 2. new text end

new text begin Commissioner of administration. new text end

new text begin $....... in fiscal year 2025 is appropriated
from the general fund to the commissioner of administration for purposes of section 1 and
is available until June 30, 2027.
new text end