1.1                          A bill for an act 
  1.2             relating to human services; adding adult restorative 
  1.3             dental services to the covered services for the 
  1.4             MinnesotaCare program; increasing the reimbursement 
  1.5             rate for dental services for the MinnesotaCare 
  1.6             program; amending Minnesota Statutes 1996, sections 
  1.7             256.9353, subdivisions 1 and 7; and 256.9362, 
  1.8             subdivision 1, and by adding a subdivision. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  Minnesota Statutes 1996, section 256.9353, 
  1.11  subdivision 1, is amended to read: 
  1.12     Subdivision 1.  [COVERED HEALTH SERVICES.] "Covered health 
  1.13  services" means the health services reimbursed under chapter 
  1.14  256B, with the exception of inpatient hospital services, special 
  1.15  education services, private duty nursing services, adult dental 
  1.16  care services other than preventive services, orthodontic 
  1.17  services, nonemergency medical transportation services, personal 
  1.18  care assistant and case management services, nursing home or 
  1.19  intermediate care facilities services, inpatient mental health 
  1.20  services, and chemical dependency services.  Outpatient mental 
  1.21  health services covered under the MinnesotaCare program are 
  1.22  limited to diagnostic assessments, psychological testing, 
  1.23  explanation of findings, medication management by a physician, 
  1.24  day treatment, partial hospitalization, and individual, family, 
  1.25  and group psychotherapy. 
  1.26     No public funds shall be used for coverage of abortion 
  1.27  under MinnesotaCare except where the life of the female would be 
  2.1   endangered or substantial and irreversible impairment of a major 
  2.2   bodily function would result if the fetus were carried to term; 
  2.3   or where the pregnancy is the result of rape or incest. 
  2.4      Covered health services shall be expanded as provided in 
  2.5   this section. 
  2.6      Sec. 2.  Minnesota Statutes 1996, section 256.9353, 
  2.7   subdivision 7, is amended to read: 
  2.8      Subd. 7.  [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 
  2.9   benefit plan shall include the following copayments and 
  2.10  coinsurance requirements:  
  2.11     (1) ten percent of the charges submitted for inpatient 
  2.12  hospital services for adult enrollees not eligible for medical 
  2.13  assistance, subject to an annual inpatient out-of-pocket maximum 
  2.14  of $1,000 per individual and $3,000 per family; 
  2.15     (2) $3 per prescription for adult enrollees; and 
  2.16     (3) $25 for eyeglasses for adult enrollees; and 
  2.17     (4) 25 percent of the charges for adult dental services, 
  2.18  except for preventive services, subject to an annual 
  2.19  out-of-pocket maximum of $200 per individual and $500 per family.
  2.20     Enrollees who are not eligible for medical assistance with 
  2.21  or without a spenddown shall be financially responsible for the 
  2.22  coinsurance amount and amounts which exceed the $10,000 benefit 
  2.23  limit.  MinnesotaCare shall be financially responsible for the 
  2.24  spenddown amount up to the $10,000 benefit limit for enrollees 
  2.25  who are eligible for medical assistance with a spenddown; 
  2.26  enrollees who are eligible for medical assistance with a 
  2.27  spenddown are financially responsible for amounts which exceed 
  2.28  the $10,000 benefit limit. 
  2.29     Sec. 3.  Minnesota Statutes 1996, section 256.9362, 
  2.30  subdivision 1, is amended to read: 
  2.31     Subdivision 1.  [MEDICAL ASSISTANCE RATE TO BE USED.] 
  2.32  Payment to providers under sections 256.9351 to 256.9362 shall 
  2.33  be at the same rates and conditions established for medical 
  2.34  assistance, except as provided in subdivisions 2 to 6 7. 
  2.35     Sec. 4.  Minnesota Statutes 1996, section 256.9362, is 
  2.36  amended by adding a subdivision to read: 
  3.1      Subd. 7.  [DENTAL SERVICES.] Effective July 1, 1997, the 
  3.2   reimbursement rates for dental services shall be increased by ...
  3.3   percent.  This increase must be reflected in the managed care 
  3.4   contract rates paid to managed care plans to provide dental 
  3.5   services to enrollees of the program. 
  3.6      Sec. 5.  [EFFECTIVE DATE.] 
  3.7      Section 4 is effective for all managed care contracts 
  3.8   entered into by the commissioner of human services for the 
  3.9   provision of covered dental services to enrollees of the 
  3.10  MinnesotaCare program on or after July 1, 1997.