Relating to the organization, operation and financing of state government, appropriating money for and modifying certain health and human services programs and services

ARTICLE 1 - LICENSING

Imposing an annual license fee on programs providing residential based habilitation services under the home and community based waiver for persons with developmental disabilities, exempting state operated programs; increasing the fee for the cost of background studies initiated by supplemental nursing services agencies and personal care provider organizations and increasing the limit on the fee for the cost of obtaining and providing requested background study data

ARTICLE 2 - STATE OPERATED SERVICES

Modifying certain provisions relating to the pilot projects for alternatives to delivery of adult mental health services, authorizing certain enterprise activities and additional Minnesota security hospital geographic locations

ARTICLE 3 - HEALTH CARE

Requiring deposit of certain provider surcharge revenues in the health care access fund and providing for the transfer of certain excess funds from the health care access fund to the general fund, limits, designating MinnesotaCare as a forecasted program for certain fiscal years and providing for the meeting of expenditures; authorizing and providing for the commissioner of human services to administer a drug rebate program and a pharmaceutical assistance program and to establish test sites for an automated eligibility system for medical assistance (MA), general assistance medical care and MinnesotaCare; authorizing county retention of certain MinnesotaCare cost recoveries; authorizing state agency hearings for adverse decisions relating to medicare part D prescription drug subsidies; eliminating the requirement for prepaid health plans to notify the ombudsman upon the filing of complaints relating to denial of services; authorizing the department of human services in lieu of local agencies to initiate administrative fraud disqualification hearings in certain cases; authorizing and providing for department withholding of delinquent and future provider surcharge payments from money owed the provider, providing for provider objections and for the resolution of disputes; reducing the payment for fee for service inpatient and outpatient hospital admissions, excluding inpatient mental health services and outpatient Indian health service facilities; eliminating the authority of the commissioner to adjust certain inpatient hospital diagnostic related group payments outside the metropolitan area; expanding the definition of third party payer under the medical assistance program to entities under contract with recipients to cover medical costs; requiring the commissioner to administer eligibility determinations for the medicare part D prescription drug subsidy and facilitate the enrollment of eligible medical assistance recipients into medicare prescription drug plans; authorizing the reduction of certain excess assets for medical assistance eligibility purposes; modifying the monthly deadline for recipient spenddown payments and clarifying the reporting requirements for recipients receiving fixed unearned, excluded or fluctuating low income; providing for the determination of the period of eligibility before application; requiring and providing for notice to the department of human services of monetary claims against persons, entities or corporations liable for medical care costs; requiring eligibility verification for continuation of medical assistance coverage for women after the end of the postpartum period; limiting reasonable expenses for medical assistance eligibility determination for institutionalized persons and clarifying the period of ineligibility for certain uncompensated transfers; providing for coverage for eligible undocumented or nonimmigrant pregnant women upon availability of certain federal and state funding; restricting medical assistance coverage for hospital emergency room services to emergency and emergency poststabilization care or urgent care; eliminating medical assistance coverage for gender or sex reassignment surgery and restricting coverage for circumcision; requiring and providing for the commissioner to establish a health services policy committee for advice on health services issues relating to the administration of state health care programs; eliminating medical assistance coverage for drugs coverable under medicare part D after a certain date; modifying certain provisions governing the drug utilization review board and the formulary committee; modifying the method for commissioner estimation of the actual acquisition costs of drugs and the basis for determining the amount of payment under medical assistance for drugs administered in outpatient settings, authorizing the commissioner to negotiate lower reimbursement rates for specialty pharmacy products and to require health care program enrollees to obtain drugs used to treat hemophilia from certain comprehensive hemophilia diagnostic treatment centers; requiring the commissioner to automatically temporarily grant prior authorization for drugs prescribed for treatment of mental illness within a certain number of days of availability of a generically equivalent drug and authorizing the commissioner to automatically require prior authorization for drugs approved by the federal food and drug administration (FDA), providing for certain formulary committee recommendations; providing medical assistance and GAMC coverage for medication therapy management services for certain recipients, defining medication therapy management; increasing the maximum reimbursement rates under medical assistance for special transportation services requiring stretcher accessible vehicles; restricting medical assistance coverage to medically necessary items and services and limiting coverage of health care services for public programs, specifying certain prior authorization requirements; exempting persons providing dental services from the requirement for providers to participate in state health care programs; requiring the commissioner to develop and implement a pilot intensive care management program for medial assistance children with complex and chronic medical issues not able to participate in the metro based U special kids program due to geographic distance; limiting and providing for the recovery of medical assistance costs against life estates or joint tenancy interests in real property; restricting the exclusion from the medical assistance prepayment demonstration project of persons enrolled in individual health plans to persons enrolled in non-medicare plans; reducing the total payment made to managed care plans under the medical assistance and GAMC prepayment demonstration projects, exclusions; modifying certain GAMC eligibility requirements, eliminating coverage for gender or sex reassignment surgery and restricting GAMC and MinnesotaCare coverage to medically necessary items or services; requiring GAMC payments after a certain date to be from the health care access fund; modifying certain provisions governing the MinnesotaCare program; modifying the definition of child for individuals enrolled in post-secondary education institutions and of gross individual or gross family income and requiring the commissioner to use reasonable methods to calculate gross earned and unearned income for eligibility purposes; imposing copayment or coinsurance requirements for nonpreventive office visits and for nonemergency visits to hospital emergency rooms and modifying coverage for certain families with children; requiring individuals and families applying for MinnesotaCare coverage to provide social security numbers, exempting persons refusing due to religious objections; expanding the definition of cooperation to compliance with certain monetary claims notice requirements under medical assistance; requiring application for other benefits and verification of both earned and unearned income to be eligible for MinnesotaCare; modifying the effective date of coverage for persons added to families receiving covered health services and for eligibility upon renewal; requiring the commissioner to develop and implement procedures to adjust MinnesotaCare premiums for both increases and decreases in income; modifying MinnesotaCare eligibility for certain children and families, women with certain increased income to remain eligible through the end of the postpartum period; clarifying eligibility for persons eligible for medicare relating to the other health coverage restriction and creating an exception to the exclusion of health insurance paid for by medical assistance from the four month requirement; providing for reenrollment of members of the military voluntarily disenrolling due to active duty; reducing the total payments made to managed care plans under the program; requiring determination of the sliding fee scale for premiums payment purposes to be based on the percentage of monthly gross income and increasing the premium calculation by a certain percentage and the premium for children in certain families; providing for the recovery of state health care program long term care costs from certain trusts; extending the restriction on commissioner use of a broker or coordinator to manage special transportation services for a fee for service medical assistance enrollees residing in nursing homes; requiring the commissioner to establish an advisory committee on nonemergency transportation services to evaluate the services under medical assistance and make recommendations to the commissioner; requiring the commissioner to develop a planning process for implementing additional managed care arrangements to provide medical assistance services except continuing care services to medical assistance recipients enrolled in the fee for service program; requiring the commissioner to apply for federal waivers and approvals to retain the medial assistance income limit for pregnant women while not applying the special work expense deductions and continuing to receive federal funding under the state children's health insurance program (SCHIP) and to allow the charging of medical assistance recipients sliding scale premiums based on the sliding scale used for the MinnesotaCare program; requiring the commissioner to develop recommendations on simplifying publicly funded health care program financing and report to the legislature; exempting the commissioner, county agencies and elected officials and employees from liability for certain actions relating to the recovery of medical assistance from life estates and joint tenancy interests; repealing MinnesotaCare eligibility for single adults and households without children and the MinnesotaCare outreach grant program, the senior citizens prescription drug program, the expiration of disease management programs under medical assistance and the prohibition on non-MinnesotaCare transfers from the health care access fund

ARTICLE 4 - NURSING FACILITY REIMBURSEMENT SYSTEM AND OTHER PROVISIONS

Creating exceptions to the nursing home bed moratorium for certain facilities in the cities of Columbia Heights and Anoka and requiring the commissioner of health to extend the project approval for an exception to the moratorium approved for a certain facility in Otter Tail county; increasing total operating payment rates under medical assistance (MA) for nursing facilities, requiring use of a certain percentage of the increase for increased costs of employee salaries and benefits, providing a special rate increase for facilities in Stearns, Sherburne and Benton counties; modifying the definition of nursing facility for long term care facilities central, affiliated or corporate office costs allocation purposes, providing for the allocation of certain costs on a functional basis, authorizing nursing facilities to assign certain remaining costs to the appropriate cost category for a certain limited period of time and the inclusion of certain organization costs in allowable costs; extending the duration of contracts under the alternative payment demonstration project and modifying certain inflation adjustment requirements, authorizing property rate adjustments for certain building projects and providing for phase out of the contracts; requiring and providing for the commissioner of human services to establish a value based nursing facility reimbursement system to provide facility specific prospective rates for nursing facilities participating in the medical assistance program; requiring the commissioner of health to extend the nursing home bed moratorium project deadlines for certain projects in Aitkin and Renville counties; requiring the commissioner of human services to provide recommendations to the legislature by a certain date defining criteria and rate negotiations for nursing facilities providing specialized care or with extenuating circumstances requiring a negotiated rate and recommendations on changes to the current nursing facility property system

ARTICLE 5 - CONTINUING CARE FOR THE ELDERLY AND DISABLED

Modifying certain parental contribution requirements for the cost of services for children with mental retardation; requiring commissioner of human services reports to the legislature by certain dates identifying counties with certain pending applications for nursing facility admission under medical assistance (MA), requiring inclusion of recommendations for shorter application processing times; expanding the provision requiring commissioner reimbursement to medical assistance employed enrollees with disabilities for medicare part B premiums and excluding as income increases in benefits under title II of the social security act; requiring and providing for the commissioner in cooperation with the commissioner of commerce to establish the Minnesota partnership for long term care program to provide for the financing of long term care through a combination of private insurance and medical assistance; expanding the definition of relocation targeted case management to service coordination services, making targeted case management services specific to counties for medical assistance coverage purposes, expanding the qualification requirements for home care targeted case management and relocation service coordination providers and modifying certain services eligible for medical assistance reimbursement as targeted case management; requiring the commissioner to execute a data use agreement with the centers for medicare and medicaid services to obtain the long term care minimum data set data to assist residents of nursing facilities desiring to live in the community, requiring agreements with the centers for independent living to provide information about assistance for persons desiring a move to the community setting; requiring the commissioner to exempt facilities agreeing to provide medical assistance swing bed services from compliance with the sole community provider requirement for skilled and intermediate nursing care; restricting eligibility for alternative care services; providing a transitional supports allowance for persons under home and community based waivers moving from licensed to community settings, specifying certain covered costs; extending the quality assurance system and commission under medical assistance for persons with developmental disabilities in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, Wabasha and Winona counties, expanding team member eligibility for per diem payments and reducing the licensing process minimum random sample size requirement; modifying the division of cost requirements under medical assistance for certain placements in intermediate care facilities for persons with mental retardation or related conditions; increasing the total operating payment rate for ICF/MRs to be used for increased costs of employee salaries and benefits; authorizing and providing for the commissioner under the prepayment demonstration project to approve and implement programs for all inclusive care for the elderly (PACE) according to federal and state laws and regulations; increasing medical assistance reimbursement rates for certain home health care and waivered services; requiring the commissioner to consult with ICF/MR providers, advocates, counties and consumer families to develop recommendations and legislation relating to future services provided by ICF/MRs and report to the legislature by a certain date and to arrange for a study including recommendations for statewide development and implementation of regional or local quality assurance models for disability services for reporting to the legislature by a certain later date; requiring the commissioner to allow certain exceptions to exceed the state set budget formula for the consumer directed community supports option for home and community based waiver programs for persons with developmental disabilities under certain county of financial responsibility determination conditions, expenses allowed to include costs associated with physical activities to maintain or improve health and functioning, waiver amendment requirement, requiring the commissioner to include in the independent evaluation of the option for persons with disabilities under a certain age ongoing regular participation by stakeholder representatives, recommendations for changes to unallowable items and a review of the statewide caseload changes for disability waiver programs occurring since implementation of the state set budget methodology; requiring the commissioner to request federal approval and plan amendments to implement the transitional supports allowance and the choice of case management services coordination and to study access to dental services for persons with disabilities and present recommendations to the legislature by a certain date; requiring the commissioners of human services and housing finance (HFA) and the state council on disability to convene an interagency work group to identify barriers, strengthen coordination, recommend policy and funding changes and pursue federal financing to assist persons with disabilities in relocating from or avoiding placement in institutional settings, specifying certain required activities and requiring recommendations to state agencies and the legislature by a certain date; requiring the commissioner of human services to report to the legislature on the redesign of case management services, specifying certain consultation and draft legislation requirements

ARTICLE 6 - MISCELLANEOUS

Requiring the commissioner of human services to authorize the method of payment to or from the department as a part of the human services programs administered by the department, to prepare annual reports on the number of eligible applicants applying in the prior calendar year for health care programs and not living in the state during the year before application and to assess county compliance with deeming the income and assets of sponsors of noncitizens under state assistance programs and report to the legislature by a certain date

ARTICLE 7 - MENTAL HEALTH SERVICES

Changing the screening requirement for children referred for treatment of severe emotional disturbance under the children's mental health act to a determination of the needed level of care and expanding the requirement to referral or admission to treatment foster care settings and the definition of examiner; providing medical assistance (MA) coverage for mental health services provided by interactive video, for psychiatric consultations by electronic means to primary care practitioners and for certain foster care treatment and transitional youth intensive rehabilitative mental health services and coverage under general assistance medical care (GAMC) and the MinnesotaCare program for mental health telemedicine and psychiatric consultations; specifying a frequency requirement for autism spectrum disorder diagnostic assessments at parental request to determine continued eligibility under the medical assistance children's therapeutic services and supports program

ARTICLE 8 - HEALTH POLICY

Requiring and providing for the commissioner of health to establish a temporary health information technology and infrastructure advisory committee for advice on certain health information technology and infrastructure issues; increasing well notification, permit, variance and disclosure certificate fees, changing exploratory borers licenses to explorers licenses and setting certain fees; increasing public water supply service connections and hospital and outpatient surgical center license fees; expanding the definition of eligible rural hospital under the rural hospital planning and transition and capital improvement grant programs and authorizing the use of program grants to establish electronic health records systems; requiring and providing for the commissioner to establish a rural pharmacy planning and transition grant program to preserve access to prescription medications and pharmacist skills; expanding the health professional education loan forgiveness program and modifying certain funds distribution requirements; increasing certain fees for processing requests for vital records, making the fees nonrefundable and requiring the establishment of a fee for electronic verification of vital events, authorizing the approval and implementation of alternative payment methods by the state or local registrars; requiring and providing for the commissioner to prepare a reporting form for use by physicians and facilities performing abortions and specifying certain reporting requirements, providing for confidentiality; creating an exception to the hospital construction moratorium for certain critical access hospitals and modifying certain swing bed restrictions; requiring hospitals to offer for viewing to parents of newborn infants and the commissioner to make available for viewing by licensed and legal nonlicensed child care providers a video presentation on the dangers associated with shaking infants and young children; requiring and providing for the commissioner to adopt certain statewide trauma system criteria for prompt transportation and treatment of severely injured people and to designate certain hospitals as trauma hospitals, regulating interhospital transfers and establishing a registry and an advisory council; requiring and providing for the board of pharmacy to establish and maintain a cancer drug repository program authorizing persons to donate cancer drugs or supplies for use by individuals meeting certain eligibility criteria, prohibiting the resale of donated drugs or supplies; reducing the blood lead level required for lead risk assessments of residences; increasing and expanding the fees for certification of environmental laboratories; prohibiting the use of family planning grant funds to subsidize abortion services, authorizing use of the funds by organizations for certain pregnancy counseling services; providing grants for positive abortion alternatives, specifying certain duties of the commissioner; enacting the "Unborn Child Pain Prevention Act", requiring physicians performing abortions on unborn children of a certain number of weeks of gestational age to inform the woman of certain anesthetics or analgesics eliminating or alleviating organic pain to the unborn child and of the associated medical risks, requiring administration of the anesthetics or analgesics with consent of the woman, imposing a criminal penalty for violation and providing for civil remedies, providing for protection of the privacy of the woman in civil or criminal proceedings; restricting the authority of the commissioner to establish suicide prevention programs to the availability of appropriated funds; requiring and providing for the commissioner to establish a postpartum depression education and information program for use by health care professionals providing prenatal care to women; prohibiting the use of AIDS prevention grants for web sites, pamphlets or other communications containing sexually explicit images or language; modifying the community clinic grant program and certain information required in the complementary and alternative health care bill of rights; transferring the responsibility for the donated dental services program from the board of dentistry to the commissioner; exempting food establishments under ownership transfer from the requirement to acquire equipment or change construction based solely on the ownership change; imposing a statewide hospitality fee to fund statewide food, beverage and lodging program development activities and increasing or imposing certain food and beverage establishment fees or penalties, clarifying certain food and beverage establishments inspection frequency requirements and providing for the inspection of school food service establishments; modifying certain fee adjustment requirements for health related licensing boards and requiring the crediting of fees to the health occupations licensing account in the special revenue fund; authorizing local government units to contract with insurance companies for the voluntary purchase of long term care insurance by employees and dependents; requiring the commissioner to amend a certain rule setting food manager certification fees, to review the leadership and advisory role of the department relating to dental health and to develop a statewide integrated and comprehensive cervical cancer prevention plan; repealing the rural community health centers grant and dentists loan forgiveness programs, the office of unlicensed complementary and alternative health care practice, the regulated food and the beverage service establishment industry pilot project and the family planning special projects grant program

ARTICLE 9 - DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT

Making forecast adjustments to certain prior appropriations to the commissioner of human services for certain health care grants, waivers and facilities

ARTICLE 10 - APPROPRIATIONS

Appropriating money to the commissioner of human services for financial, legal and regulation and information technology operations, for children's and community services, economic assistance and basic health care grants, for health care policy administration, for continuing care, aging and adult services, mental health, deaf and hard of hearing and chemical dependency nonentitlement grants, for the quality assurance commission and for development of evidence based practices for the treatment of methamphetamine abuse at the state operated services chemical dependency program in Willmar, to the commissioner of health for certain home visiting and nutritional services, for a reduction in racial and ethnic disparities in infant mortality rates, for the rural pharmacy planning and transition grant program, for the shaken baby video, for implementation of positive abortion alternatives, for policy quality and compliance, for health protection and for administrative support services, to the veterans nursing homes, emergency medical services (EMS) regulatory and health related licensing boards, to the council on disability and to the ombudsmen for mental health and mental retardation and for families; regulating commissioner of human services TANF (temporary assistance for needy families) fund expenditures; providing full funding for the diagnosis related groups for outstate hospitals; requiring certain long term care provider rate increases in certain future years; limiting the growth in certain waivers; suspending the authority of the commissioner of health to collect the license renewal fee from occupational therapy practitioners; authorizing the boards of dietetic and nutrition practice and nursing to reduce fees and temporarily reducing certain occupational license fees; increasing certain base level funding; authorizing certain fund transfers and carryforwards; prohibiting the transfer of certain grant money without legislative approval and the commissioners of health and human services from using indirect cost allocations to pay for program operational costs; sunsetting uncodified language

ARTICLE 11 - OPTION B SPENDING

Basing certain policies and appropriations on passage of racino legislation, superseding amendments or repealers in article 3; modifying certain general assistance medical care eligibility requirements; reinstating certain eligibility and copayment requirements under MinnesotaCare; increasing the GAMC spenddown standard and the income standard for parents under MinnesotaCare; negating the repeal of MinnesotaCare outreach grants; providing additional increases in medical assistance (MA) reimbursement rates for home health services (ra)