2E Providing for the organization, operation and financing of state government, appropriating money for and modifying certain health and human services programs and services

ARTICLE 1 - HEALTH DEPARTMENT

Requiring the commissioner of health to establish a 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; granting the commissioner certain license and registration denial, suspension or revocation authority, requiring the adoption of rules establishing criteria and procedures; increasing hospital and outpatient surgical center license fees and prescribing fees for plumbing examinations, registrations, licenses and inspections; expanding the definition of eligible rural hospital under the rural hospital planning and transition and capital improvement grant programs, requiring a commissioner priority to grant applications for electronic health records systems projects; 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; 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; creating an exception to the hospital construction moratorium for certain critical access hospitals and modifying certain swing bed restrictions; 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; reducing the blood lead level required for lead risk assessments of residences; increasing and expanding the fees for certification of environmental laboratories; 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; modifying the community clinic grant program; 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; requiring and providing for the licensing of master, journeyman and restricted plumbing contractors, excepting certain persons performing building sewer or water service installation or selling appliance plumbing installation service at retail, requiring and providing for commissioner regulation of inspectors; requiring and providing for the commissioner to develop a statewide integrated and comprehensive cervical cancer prevention plan, with the commissioner of commerce to convene a work group to explore health plan coverage of clinical trials, to work with local public health departments to develop a public health information network, to report to the legislature on swing bed usage and to develop a statewide plan for hospitals and physician group practices to implement interoperable electronic health records systems by a certain date; requiring the commissioner to amend a certain rule setting food manager certification fees; specifying certain reference change instructions to the revisor of statutes; repealing the rural community health center program, a certain food and beverage service pilot project and a certain plumbing license application restriction

ARTICLE 2 - HEALTH CARE-DEPARTMENT OF HUMAN SERVICES

Exempting health maintenance organizations (HMO) from certain coverage denial or limit restrictions for services provided under prepaid health programs; changing best practices guidelines to evidence based health care guidelines for health care cost containment purposes and prescribing certain criteria for the guidelines, requiring the commissioner of health to collaborate with a state nonprofit quality improvement organization specializing in producing and using guidelines for guidelines identification purposes, requiring initial determinations under utilization review not to certify services for prepaid health care programs to follow the guidelines; 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; changing the program for the purchase of continuation coverage for HIV/AIDS patients to an insurance assistance program for low income individuals living with HIV to provide access to treatment consistent with the guidelines of the federal public health service, specifying certain HIV health care access program eligibility and benefits requirements, specifying certain duties and authority of the commissioner of human services; requiring and providing for the commissioner to establish and administer a prescription drug discount and rebate program; requiring the commissioner to make inpatient hospital payments to certain hospitals ineligible for payments under medical assistance (MA); modifying certain provisions under the medical assistance program; expanding the definition of third party payer to entities under contract with recipients for coverage of 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; clarifying eligibility for medical assistance for offenders on work release; authorizing the reduction of 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; expanding medical assistance eligibility for pregnant women; eliminating the annual benefit limit for dental services to adults; eliminating the exception to the average wholesale price reduction requirement under the drug formulary and requiring the commissioner in developing the list of specialty pharmacy products subject to lower reimbursement rates to consider certain access issues; eliminating the expiration date for a certain provision exempting prescribed antihemophilic factor drugs from prior authorization requirements; requiring medical assistance coverage for medication therapy management services for certain recipients; modifying the maximum reimbursement rates for special transportation services; requiring and providing for the commissioner to establish a performance reporting and payment system for health care providers providing health care services to medical assistance, general assistance medical care and MinnesotaCare program participants, providing for bonuses to providers achieving certain levels of performance established by the commissioner; providing a transitional supports allowance for persons under home and community based waivers moving from licensed to community settings, specifying certain covered costs; requiring the commissioner to increase scholarship reimbursements to certain providers to be used for certain employee scholarship costs and training in English as a second language (ESL); requiring Hennepin and Ramsey counties, the Hennepin county medical center (HCMC), Regions hospital, the university of Minnesota and the Fairview university medical center to annually report to the commissioner payments qualifying for reimbursement under federal law; clarifying the exemption from the medical assistance prepayment demonstration project for persons enrolled in cost effective individual health plans; requiring coverage of dental services under GAMC to match the coverage under medical assistance and eliminating certain copayment requirements; providing GAMC eligibility for individuals refusing to provide social security numbers due to religious objection; modifying the definition of gross individual or gross family income under the MinnesotaCare program and requiring the commissioner to use reasonable methods to calculate gross earned and unearned income; modifying a certain provision providing covered health services under MinnesotaCare, clarifying coverage for adult dental care services and modifying the copayment or coinsurance requirement; providing coverage for pregnant women from the date of conception; requiring individuals and families applying for MinnesotaCare coverage to provide social security numbers, exemptions; expanding the cooperation requirement; requiring application for other benefits to be eligible for MinnesotaCare; expanding coverage for single adults and households without children and modifying the effective date of coverage for new members of families receiving covered health services and for eligibility upon renewal; modifying MinnesotaCare eligibility for certain children and for persons eligible for medicare; 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; requiring determination of the sliding fee scale for premiums payment purposes to be based on the percentage of monthly gross income and modifying the exception to the sliding scale requirement for certain children; providing a MinnesotaCare option for small employers; exempting the department of human services from liability for certain costs and disbursements; extending the prohibition on commissioner use of a broker or coordinator to manage special transportation services under medical assistance and authorizing the commissioner to establish an advisory committee on nonemergency transportation services to monitor and evaluate the provision of the services; requiring the commissioner to annually transmit to the legislature reports identifying the employers employing a certain number of public assistance health program recipients, specifying certain report content requirements and requiring availability on the department web site; requiring prior authorization for coverage of certain services under the medical assistance, GAMC and MinnesotaCare programs; requiring the commissioner to implement a pilot project to provide services for state program recipients through a new oral health care delivery system, prohibiting the commissioner from rejecting county based purchasing health plan proposals requiring purchasing on a sole source basis under certain conditions and requiring the commissioner to develop a planning process to implement additional managed care arrangements to provide medical assistance services to recipients enrolled in the fee for service program; repealing a certain managed care contracting requirement under the medical assistance prepayment demonstration project and medical assistance copayment requirements

ARTICLE 3 - HEALTH CARE COST CONTAINMENT

Modifying certain health insurance premium rate restrictions, requiring and providing for the commissioner of health to set annual premium growth limits for health plan companies; expanding the requirement for the commissioner to establish cost containment goals to a requirement to establish annual health care expenditure limits for health plan companies, prohibiting the limits from exceeding the premium limits and excluding the state employee health plan from the definition of health plan company; requiring health plan companies to annually provide to enrollees information on the increased personal health risks and additional costs to the health care system due to obesity and to the use of tobacco, exception, requiring the commissioner in consultation with the Minnesota medical association to develop an information sheet to be posted on the department web site; requiring the commissioner to distinguish between the individual, small group and large group markets in the collection of certain cost containment data from group purchasers; limiting recourse by providers under health plan company or public health care plan agreements for recovery of amounts above the amounts specified in the evidence of coverage or other document as copayments or coinsurance for health care services, remedies, specifying certain provider notice requirements; requiring and providing for the disclosure of certain hospital costs on a web site to be developed by the Minnesota hospital association; requiring the commissioner of human services in implementing independent audit requirements for nonprofit health service plan corporations, health maintenance organizations (HMO), community integrated service networks (CISN) and managed care organizations to avoid duplication of review activities, requiring annual reports to the legislature identifying the number of audits accepted, partially accepted or rejected with the rationale for partial acceptance or rejection and the documentation of variances between the audit standards and state requirements under certain conditions

ARTICLE 4 - LONG TERM CARE AND CONTINUING CARE

Authorizing certain previously approved nursing home bed moratorium exception projects in the city of Duluth to reduce the size of the projects and extending the duration of certain project approval extensions; authorizing a new intermediate care facility for persons with mental retardation and related conditions in Brown county; expanding the definition of relocation targeted case management to service coordination services, making targeted case management services specific to counties for medical assistance (MA) coverage purposes and delaying the date for coverage of home care targeted case management services; specifying certain qualifications for relocation service coordination providers and expanding the qualification requirements for home care targeted case management providers, clarifying certain eligible services; requiring the commissioner of human services to exempt facilities agreeing to provide medical assistance swing bed services from the sole community provider requirement; specifying certain additional documentation requirements for personal care assistant services for medical assistance coverage purposes and modifying certain requirements of responsible parties with delegated personal care assistant duties, requiring the commissioner to establish an ongoing audit process for potential fraud and abuse in the provision of the services; providing a flexible use option for the scheduled use of personal care assistant hours, requiring prior authorization and specifying certain plan requirements; providing for commissioner oversight of the provision of personal care assistant services; modifying certain provisions relating to medical assistance claims against estates, excluding alternative care costs from recovery requirements and retroactively eliminating liens against life estates and joint tenancy interests in real property; providing a medical assistance rate increase for nursing facilities, ICF/MRs and certain home and community based waivered services providers, requiring use to increase wages and benefits for certain employees and to increase the number of staff, specifying certain facility or provider application and funds distribution plan requirements; providing a higher operating payment rate increase for nursing facilities with single bed rooms, prohibiting the discharge of residents to establish the rooms; providing a separate rate increase for a certain facility in Ramsey county; requiring the commissioner to continue developmental work on a new nursing home reimbursement system and present recommendations to the legislature by a certain date; stating state policy toward long term care services payments and certain trust instruments used to shield individual resources; 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 until implementation of a new community supports budget methodology, 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 and report to the legislature by a certain date; providing immunity from liability for commissioner and county agency attempts to recover certain alternative care costs, prohibiting refunds; specifying certain inspection requirements for skilled nursing facilities in Faribault county

ARTICLE 5 - MENTAL AND CHEMICAL HEALTH

Requesting clinical medical education programs training pediatricians to include curriculum in case and medication management for children suffering from mental illness; providing for community based services for certain additional criminal offenders diagnosed with mental illness and for determination of eligibility for medical assistance (MA), general assistance medical care or MinnesotaCare, specifying certain discharge plan requirements; increasing the required supply of prescriptions for discharged offenders with mental illness; expanding the supportive housing and managed care pilot project to individuals transitioning from the Anoka Metro regional treatment center, providing for funding of the services and specifying certain commissioner of human services bed closing requirements; requiring county boards referring clients under the children's mental health act to therapeutic services and supports to identify the nonchildren's therapeutic services and supports covered services components and the reimbursement sources for the requested services; changing the screening requirement for children referred for treatment of severe emotional disturbance to a determination of the needed level of care and expanding the requirement to referral or admission to treatment foster care settings; clarifying county responsibility for payment of services for treatment of amphetamine or methamphetamine abuse or dependence; clarifying the definition of intensive nonresidential rehabilitative mental health services; providing medical assistance 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 providing coverage under GAMC and MinnesotaCare for mental health telemedicine and psychiatric consultations; providing a standard of assistance under GAMC for adult intensive adult mental health rehabilitative residential treatment services; requiring a commissioner of administration to priority to supported work vendors in awarding contracts for janitorial services for the new buildings for the departments of human services and health

ARTICLE 6 - FAMILY SUPPORT

Modifying requirements for parental contributions to the cost of services for children with mental retardation for certain households; authorizing and providing for the commissioner of human services to authorize projects to test tribal delivery of child welfare services to American Indian children, parents and custodians living on reservations; modifying certain provisions under the Minnesota family investment program; prohibiting MFIP recipients from using electronic monthly cash assistance payments to purchase tobacco products or alcohol; reducing the number of hours required in unsubsidized employment for approval of job training and post-secondary education opportunities; establishing the work participation rate enhancement program (WORK PREP) under MFIP as the state TANF (temporary assistance for needy families) program to serve families failing to make significant progress within MFIP due to certain barriers to employment and to stabilize and improve the lives of families at risk of long term welfare dependency, specifying eligibility, requiring participation in family stabilization services, providing for case management, family stabilization plans and coordinated services and for a work participation bonus for participants exiting the diversionary work program (DWP) or terminating MFIP cash assistance with earnings and expanding child care assistance eligibility to program participants; increasing the allocation of MFIP consolidated performance base funds to counties and tribes, requiring additional allocations to be determined by the commissioner based on available funds; exempting certain newly arrived refugees and asylees from participating in the diversionary work program, authorizing direct enrollment into the MFIP; repealing certain provisions providing for the treatment of rental subsidies and unearned and supplemental security income (SSI) for MFIP eligibility purposes, requiring approval of the federal department of agriculture

ARTICLE 7 - MISCELLANEOUS

Requiring wholesale drug manufacturers to periodically report by the national drug code certain pharmaceutical pricing criteria to the commissioner of human services, classifying information reported, granting access to the attorney general or other law enforcement agencies for law enforcement purposes; 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; authorizing the commissioner of corrections to contract for the purchase of prescription drugs for persons confined in state correctional institutions, authorizing local government participation in the purchasing pool for the benefit of persons confined in local correctional facilities and providing for the establishment of a drug formulary; requiring the commissioner of human services to authorize the method of payment to or from the department as part of the human services programs administered by the department; requiring the deposit of certain child support collections in the general fund, eliminating the child support collection account in the special revenue fund; establishing a health care quality improvement account in the general fund; prohibiting contracting agreements between health plan companies or contracted pharmacy benefits managers and pharmacies from prohibiting certain transactions relating to the transfer of certain MinnesotaCare gross earnings tax expenses to the health plan company or the pharmacy benefits manager; expanding the limit on Anoka county board payments for medical services to prisoners in the county jail to Dakota county; modifying a certain prior requirement for the commissioner of human services to increase the fee for service payments under medical assistance (MA), general assistance medical care (GAMC) and MinnesotaCare; requiring the commissioner of commerce in consultation with the commissioners of health, human services and employee relations (DOER) and certain representatives to study and make recommendations on providing language interpreter services to limited English speaking patients to facilitate the provision of health care services by health care providers and facilities and report to the legislature by a certain date; requiring money received by the state from drug manufacturers due to errors in the pharmaceutical pricing used in determining the prescription drug rebate to be deposited in the health care quality improvement account

ARTICLE 8 - APPROPRIATIONS

Appropriating money to the commissioner of human services for financial, legal and regulation and information technology operations, for the Minnesota family investment program (MFIP), for children and community services, Minnesota supplemental aid (MSA), group residential housing (GRH), economic assistance, basic health care, MinnesotaCare and general assistance medical care grants, for health care administration and operations, for continuing care, mental health, deaf and hard of hearing service and chemical dependency entitlement grants, for continuing care management and for state operated services, to the commissioner of health for community and family health improvement, for development of a statewide trauma system and for family planning grants and to the veterans nursing homes and health related licensing boards including the board of dentistry for an oral health care system pilot project, the board of nursing to establish a Minnesota center of nursing, the board of pharmacy for the rural pharmacy planning and transition, health professional education loan and cancer drug repository programs and the board of social work for the office of mental health practice; reducing certain administrative appropriations to the commissioner of human services and requiring a commissioner reduction in TANF (temporary assistance for needy families) funds used to refinance the state share of the child support passthrough, providing for transfer to the federal child care and development fund; prohibiting medical assistance (MA) and GAMC provider rate increases due to the repeal of recipient copayments; authorizing the commissioner of health to approve certain nursing home bed moratorium projects; providing for the allocation of funds under the community alternatives for disabled individuals (CADI) and traumatic brain injury waivers and requiring the commissioner of human services to limit the new diversion caseload growth in the mental retardation and related conditions waiver; requiring the commissioner with the commissioner of education to create a task force to discuss collaboration between schools and mental health providers to promote certain integrated services and identify barriers to collaboration, requiring a report to the legislature by a certain date; requiring development of evidence based practices for treatment of methamphetamine abuse at the state operated services chemical dependency program in Willmar; requiring certain commissioner of health fee increases; requiring the commissioner to convene an interagency work group to make recommendations on reducing the rate of obesity among children to the legislature by a certain date; providing funding for an aids prevention program for African born residents; requiring certain base level funding adjustments; sunsetting uncodified language
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