1.1                          A bill for an act 
  1.2             relating to medical assistance; removing the limit on 
  1.3             the number of nursing facilities that may participate 
  1.4             in the alternative payment demonstration project; 
  1.5             amending Minnesota Statutes 1995 Supplement, section 
  1.6             256B.434, subdivision 2. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 1995 Supplement, section 
  1.9   256B.434, subdivision 2, is amended to read: 
  1.10     Subd. 2.  [REQUESTS FOR PROPOSALS.] (a) No later than 
  1.11  August 1, 1995, the commissioner shall publish in the State 
  1.12  Register a request for proposals to provide nursing facility 
  1.13  services according to this section.  The commissioner shall 
  1.14  issue two additional requests for proposals prior to July 1, 
  1.15  1997, based upon a timetable established by the commissioner.  
  1.16  The commissioner must respond to all proposals in a timely 
  1.17  manner. 
  1.18     (b) The commissioner may reject any proposal if, in the 
  1.19  judgment of the commissioner, a contract with a particular 
  1.20  facility is not in the best interests of the residents of the 
  1.21  facility or the state of Minnesota.  The commissioner may accept 
  1.22  up to the number of proposals that can be adequately supported 
  1.23  with available state resources, as determined by the 
  1.24  commissioner, except that the commissioner shall not contract 
  1.25  with more than 40 nursing facilities as part of any request for 
  1.26  proposals.  The commissioner may accept proposals from a single 
  2.1   nursing facility or from a group of facilities through a 
  2.2   managing entity.  The commissioner shall seek to ensure that 
  2.3   nursing facilities under contract are located in all geographic 
  2.4   areas of the state.  The commissioner shall present 
  2.5   recommendations to the legislature by February 1, 1996, on the 
  2.6   number of nursing facility contracts that may be entered into by 
  2.7   the commissioner as a result of a request for proposals. 
  2.8      (c) In issuing the request for proposals, the commissioner 
  2.9   may develop reasonable requirements which, in the judgment of 
  2.10  the commissioner, are necessary to protect residents or ensure 
  2.11  that the contractual alternative payment demonstration project 
  2.12  furthers the interest of the state of Minnesota.  The request 
  2.13  for proposals may include, but need not be limited to, the 
  2.14  following: 
  2.15     (1) a requirement that a nursing facility make reasonable 
  2.16  efforts to maximize Medicare payments on behalf of eligible 
  2.17  residents; 
  2.18     (2) requirements designed to prevent inappropriate or 
  2.19  illegal discrimination against residents enrolled in the medical 
  2.20  assistance program as compared to private paying residents; 
  2.21     (3) requirements designed to ensure that admissions to a 
  2.22  nursing facility are appropriate and that reasonable efforts are 
  2.23  made to place residents in home and community-based settings 
  2.24  when appropriate; 
  2.25     (4) a requirement to agree to participate in a project to 
  2.26  develop data collection systems and outcome-based standards for 
  2.27  managed care contracting for long-term care services.  Among 
  2.28  other requirements specified by the commissioner, each facility 
  2.29  entering into a contract may be required to pay an annual fee in 
  2.30  an amount determined by the commissioner not to exceed $50 per 
  2.31  bed.  Revenue generated from the fees is appropriated to the 
  2.32  commissioner and must be used to contract with a qualified 
  2.33  consultant or contractor to develop data collection systems and 
  2.34  outcome-based contracting standards; 
  2.35     (5) a requirement that contractors agree to maintain 
  2.36  Medicare cost reports and to submit them to the commissioner 
  3.1   upon request or at times specified by the commissioner; 
  3.2      (6) a requirement for demonstrated willingness and ability 
  3.3   to develop and maintain data collection and retrieval systems to 
  3.4   be used in measuring outcomes; and 
  3.5      (7) a requirement to provide all information and assurances 
  3.6   required by the terms and conditions of the federal waiver or 
  3.7   federal approval. 
  3.8      (d) In addition to the information and assurances contained 
  3.9   in the submitted proposals, the commissioner may consider the 
  3.10  following in determining whether to accept or deny a proposal: 
  3.11     (1) the facility's history of compliance with federal and 
  3.12  state laws and rules; 
  3.13     (2) whether the facility has a record of excessive 
  3.14  licensure fines or sanctions or fraudulent cost reports; 
  3.15     (3) financial history and solvency; and 
  3.16     (4) other factors identified by the commissioner that the 
  3.17  commissioner deems relevant to a determination that a contract 
  3.18  with a particular facility is not in the best interests of the 
  3.19  residents of the facility or the state of Minnesota. 
  3.20     (e) If the commissioner rejects the proposal of a nursing 
  3.21  facility, the commissioner shall provide written notice to the 
  3.22  facility of the reason for the rejection, including the factors 
  3.23  and evidence upon which the rejection was based.