1.1                          A bill for an act 
  1.2             relating to human services; changing recovery 
  1.3             provisions; amending Minnesota Statutes 2000, sections 
  1.4             62A.095, subdivision 1; and 256B.0913, subdivisions 12 
  1.5             and 14. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Minnesota Statutes 2000, section 62A.095, 
  1.8   subdivision 1, is amended to read: 
  1.9      Subdivision 1.  [APPLICABILITY.] (a) No health plan shall 
  1.10  be offered, sold, or issued to a resident of this state, or to 
  1.11  cover a resident of this state, unless the health plan complies 
  1.12  with subdivision 2. 
  1.13     (b) Health plans providing benefits under health care 
  1.14  programs administered by the department of human services are 
  1.15  not subject to the limits described in subdivision 2.  These 
  1.16  health plans are instead subject to the right of subrogation 
  1.17  provisions under section 256B.37 and the lien provisions under 
  1.18  sections 256.015, 256B.042, 256D.03, subdivision 8, and 256L.03, 
  1.19  subdivision 6. 
  1.20     Sec. 2.  Minnesota Statutes 2000, section 256B.0913, 
  1.21  subdivision 12, is amended to read: 
  1.22     Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
  1.23  all 180-day eligible clients to help pay for the cost of 
  1.24  participating in the program.  The amount of the premium for the 
  1.25  alternative care client shall be determined as follows: 
  2.1      (1) when the alternative care client's income less 
  2.2   recurring and predictable medical expenses is greater than the 
  2.3   medical assistance income standard but less than 150 percent of 
  2.4   the federal poverty guideline, and total assets are less than 
  2.5   $10,000, the fee is zero; 
  2.6      (2) when the alternative care client's income less 
  2.7   recurring and predictable medical expenses is greater than 150 
  2.8   percent of the federal poverty guideline, and total assets are 
  2.9   less than $10,000, the fee is 25 percent of the cost of 
  2.10  alternative care services or the difference between 150 percent 
  2.11  of the federal poverty guideline and the client's income less 
  2.12  recurring and predictable medical expenses, whichever is less; 
  2.13  and 
  2.14     (3) when the alternative care client's total assets are 
  2.15  greater than $10,000, the fee is 25 percent of the cost of 
  2.16  alternative care services.  
  2.17     For married persons, total assets are defined as the total 
  2.18  marital assets less the estimated community spouse asset 
  2.19  allowance, under section 256B.059, if applicable.  For married 
  2.20  persons, total income is defined as the client's income less the 
  2.21  monthly spousal allotment, under section 256B.058. 
  2.22     All alternative care services except case management shall 
  2.23  be included in the estimated costs for the purpose of 
  2.24  determining 25 percent of the costs. 
  2.25     The monthly premium shall be calculated based on the cost 
  2.26  of the first full month of alternative care services and shall 
  2.27  continue unaltered until the next reassessment is completed or 
  2.28  at the end of 12 months, whichever comes first.  Premiums are 
  2.29  due and payable each month alternative care services are 
  2.30  received unless the actual cost of the services is less than the 
  2.31  premium. 
  2.32     (b) The fee shall be waived by the commissioner when: 
  2.33     (1) a person who is residing in a nursing facility is 
  2.34  receiving case management only; 
  2.35     (2) a person is applying for medical assistance; 
  2.36     (3) a married couple is requesting an asset assessment 
  3.1   under the spousal impoverishment provisions; 
  3.2      (4) a person is a medical assistance recipient, but has 
  3.3   been approved for alternative care-funded assisted living 
  3.4   services; 
  3.5      (5) a person is found eligible for alternative care, but is 
  3.6   not yet receiving alternative care services; or 
  3.7      (6) a person's fee under paragraph (a) is less than $25. 
  3.8      (c) The county agency must record in the state's receivable 
  3.9   system the client's assessed premium amount or the reason the 
  3.10  premium has been waived.  The commissioner will bill and collect 
  3.11  the premium from the client and forward the amounts collected to 
  3.12  the commissioner in the manner and at the times prescribed by 
  3.13  the commissioner.  Money collected must be deposited in the 
  3.14  general fund and is appropriated to the commissioner for the 
  3.15  alternative care program.  The client must supply the county 
  3.16  with the client's social security number at the time of 
  3.17  application.  If a client fails or refuses to pay the premium 
  3.18  due, The county shall supply the commissioner with the client's 
  3.19  social security number and other information the commissioner 
  3.20  requires to collect the premium from the client.  The 
  3.21  commissioner shall collect unpaid premiums using the Revenue 
  3.22  Recapture Act in chapter 270A and other methods available to the 
  3.23  commissioner.  The commissioner may require counties to inform 
  3.24  clients of the collection procedures that may be used by the 
  3.25  state if a premium is not paid.  
  3.26     (d) The commissioner shall begin to adopt emergency or 
  3.27  permanent rules governing client premiums within 30 days after 
  3.28  July 1, 1991, including criteria for determining when services 
  3.29  to a client must be terminated due to failure to pay a premium.  
  3.30     Sec. 3.  Minnesota Statutes 2000, section 256B.0913, 
  3.31  subdivision 14, is amended to read: 
  3.32     Subd. 14.  [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a) 
  3.33  Reimbursement for expenditures for the alternative care services 
  3.34  as approved by the client's case manager shall be through the 
  3.35  invoice processing procedures of the department's Medicaid 
  3.36  Management Information System (MMIS).  To receive reimbursement, 
  4.1   the county or vendor must submit invoices within 12 months 
  4.2   following the date of service.  The county agency and its 
  4.3   vendors under contract shall not be reimbursed for services 
  4.4   which exceed the county allocation. 
  4.5      (b) If a county collects less than 50 percent of the client 
  4.6   premiums due under subdivision 12, the commissioner may withhold 
  4.7   up to three percent of the county's final alternative care 
  4.8   program allocation determined under subdivisions 10 and 11. 
  4.9      (c) The county shall negotiate individual rates with 
  4.10  vendors and may be reimbursed for actual costs up to the greater 
  4.11  of the county's current approved rate or 60 percent of the 
  4.12  maximum rate in fiscal year 1994 and 65 percent of the maximum 
  4.13  rate in fiscal year 1995 for each alternative care service.  
  4.14  Notwithstanding any other rule or statutory provision to the 
  4.15  contrary, the commissioner shall not be authorized to increase 
  4.16  rates by an annual inflation factor, unless so authorized by the 
  4.17  legislature. 
  4.18     (d) (c) On July 1, 1993, the commissioner shall increase 
  4.19  the maximum rate for home delivered meals to $4.50 per meal.