1.1 	A bill for an act
1.2 	relating to government operations; making changes to health and human services 
1.3 	programs; modifying human service policy; modifying health policy; modifying 
1.4 	health care cost containment provisions; changing provisions for federal 
1.5 	health care compliance; changing provisions in state health care programs; 
1.6 	modifying long-term care and mental health provisions; establishing community 
1.7 	electronic health collaboratives; requiring a description of annuities for medical 
1.8 	assistance payments for long-term care; amending the assisted living bill of 
1.9 	rights; establishing the pharmacy payment reform advisory committee; requiring 
1.10 	certain abortion notification data; providing penalties; prohibiting pharmacists 
1.11 	from refusing to dispense a prescription drug; modifying provisions of the 
1.12 	Women's Right to Know Act; prohibiting the use of state funds for abortions; 
1.13 	requiring reports; appropriating money; making forecast adjustments;amending 
1.14 	Minnesota Statutes 2004, sections 13.3806, by adding a subdivision; 62A.045; 
1.15 	62D.02, subdivision 4, by adding a subdivision; 62D.03, subdivision 1; 62D.05, 
1.16 	subdivision 1; 62D.095, subdivisions 3, 4, by adding a subdivision; 62E.11, 
1.17 	subdivision 13; 62J.81, subdivision 1; 62S.05, by adding a subdivision; 62S.08, 
1.18 	subdivision 3; 62S.081, subdivision 4; 62S.10, subdivision 2; 62S.13, by 
1.19 	adding a subdivision; 62S.14, subdivision 2; 62S.15; 62S.20, subdivision 1; 
1.20 	62S.24, subdivisions 1, 3, 4, by adding subdivisions; 62S.25, subdivision 6, 
1.21 	by adding a subdivision; 62S.26; 62S.266, subdivision 2; 62S.29, subdivision 
1.22 	1; 62S.30; 72A.20, by adding a subdivision; 123A.21, subdivision 7; 144.0724, 
1.23 	subdivision 4; 144.6501, subdivision 6; 144.698, by adding a subdivision; 
1.24 	144A.071, subdivisions 4a, 4c; 144A.4605; 144D.01, by adding a subdivision; 
1.25 	144D.015; 144D.02; 144D.03, subdivision 2, by adding a subdivision; 144D.04; 
1.26 	144D.05; 144D.065; 145.4241, by adding subdivisions; 151.214, subdivision 
1.27 	1; 256.01, subdivision 18, by adding a subdivision; 256B.02, subdivision 9; 
1.28 	256B.056, subdivision 2, by adding subdivisions; 256B.0595, subdivisions 1, 
1.29 	3, 4; 256B.431, by adding a subdivision; 256B.434, by adding a subdivision; 
1.30 	256B.438, subdivision 4; 256B.69, subdivision 9, by adding a subdivision; 
1.31 	256B.692, subdivision 6; 256B.76; 256D.03, by adding a subdivision; 256L.04, 
1.32 	subdivision 10; 256L.17, subdivision 3; 295.52, by adding a subdivision; 
1.33 	Minnesota Statutes 2005 Supplement, sections 62J.052; 145.4242; 157.16, 
1.34 	subdivision 3a; 214.071; 256B.0571; 256B.0595, subdivision 2; 256B.06, 
1.35 	subdivision 4; 256B.434, subdivision 4; 256B.69, subdivision 23; 256D.03, 
1.36 	subdivision 3; 256L.05, subdivision 2;  Laws 2003, First Special Session chapter 
1.37 	14, article 12, section 93, as amended; Laws 2005, First Special Session chapter 
1.38 	4, article 8, section 84; proposing coding for new law in Minnesota Statutes, 
2.1 	chapters 62J; 62M; 62Q; 62S; 144; 144A; 144D; 145; 151; 214; 245; 256B; 
2.2 	proposing coding for new law as Minnesota Statutes, chapter 144G; repealing 
2.3 	Minnesota Statutes 2004, sections 62J.17; 62J.694; 144.395; 256B.692, 
2.4 	subdivision 10; Minnesota Statutes 2005 Supplement, sections 62Q.251; 
2.5 	256B.0571, subdivisions 2, 5, 11; Minnesota Rules, part 4668.0215.
2.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.7 	ARTICLE 1
2.8 	LONG-TERM CARE AND MENTAL HEALTH

2.9 	Section 1. Minnesota Statutes 2004, section 144.0724, subdivision 4, is amended to 
2.10 	read:
2.11 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and 
2.12 	electronically submit to the commissioner of health case mix assessments that conform 
2.13 	with the assessment schedule defined by Code of Federal Regulations, title 42, section  
2.14 	483.20, and published by the United States Department of Health and Human Services, 
2.15 	Centers for Medicare and Medicaid Services, in the Long Term Care Assessment 
2.16 	Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made 
2.17 	in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0, 
2.18 	August 1996. The commissioner of health may substitute successor manuals or question 
2.19 	and answer documents published by the United States Department of Health and Human 
2.20 	Services, Centers for Medicare and Medicaid Services, to replace or supplement the 
2.21 	current version of the manual or document. 
2.22 	(b) The assessments used to determine a case mix classification for reimbursement 
2.23 	include the following:
2.24 	(1) a new admission assessment must be completed by day 14 following admission;
2.25 	(2) an annual assessment must be completed within 366 days of the last 
2.26 	comprehensive assessment;
2.27 	(3) a significant change assessment must be completed within 14 days of the 
2.28 	identification of a significant change; and
2.29 	(4) the first, second, and third quarterly assessment following either a new admission 
2.30 	assessment, an annual assessment, or a significant change assessment. Each quarterly 
2.31 	assessment must be completed within 92 days of the previous assessment.

2.32 	EFFECTIVE DATE. This section is effective October 1, 2006.

2.33 	Sec. 2. Minnesota Statutes 2004, section 144A.071, subdivision 4a, is amended to read:
2.34 		Subd. 4a.Exceptions for replacement beds.  It is in the best interest of the state 
2.35 	to ensure that nursing homes and boarding care homes continue to meet the physical 
3.1 	plant licensing and certification requirements by permitting certain construction projects.  
3.2 	Facilities should be maintained in condition to satisfy the physical and emotional needs 
3.3 	of residents while allowing the state to maintain control over nursing home expenditure 
3.4 	growth.
3.5 	The commissioner of health in coordination with the commissioner of human 
3.6 	services, may approve the renovation, replacement, upgrading, or relocation of a nursing 
3.7 	home or boarding care home, under the following conditions:
3.8 	(a) to license or certify beds in a new facility constructed to replace a facility or to 
3.9 	make repairs in an existing facility that was destroyed or damaged after June 30, 1987, by 
3.10 	fire, lightning, or other hazard provided:
3.11 	(i) destruction was not caused by the intentional act of or at the direction of a 
3.12 	controlling person of the facility;
3.13 	(ii) at the time the facility was destroyed or damaged the controlling persons of the 
3.14 	facility maintained insurance coverage for the type of hazard that occurred in an amount 
3.15 	that a reasonable person would conclude was adequate;
3.16 	(iii) the net proceeds from an insurance settlement for the damages caused by the 
3.17 	hazard are applied to the cost of the new facility or repairs;
3.18 	(iv) the new facility is constructed on the same site as the destroyed facility or on 
3.19 	another site subject to the restrictions in section 144A.073, subdivision 5;
3.20 	(v) the number of licensed and certified beds in the new facility does not exceed the 
3.21 	number of licensed and certified beds in the destroyed facility; and
3.22 	(vi) the commissioner determines that the replacement beds are needed to prevent an 
3.23 	inadequate supply of beds.
3.24 	Project construction costs incurred for repairs authorized under this clause shall not be 
3.25 	considered in the dollar threshold amount defined in subdivision 2;
3.26 	(b) to license or certify beds that are moved from one location to another within a 
3.27 	nursing home facility, provided the total costs of remodeling performed in conjunction 
3.28 	with the relocation of beds does not exceed $1,000,000;
3.29 	(c) to license or certify beds in a project recommended for approval under section 
3.30 	144A.073;
3.31 	(d) to license or certify beds that are moved from an existing state nursing home to 
3.32 	a different state facility, provided there is no net increase in the number of state nursing 
3.33 	home beds;
3.34 	(e) to certify and license as nursing home beds boarding care beds in a certified 
3.35 	boarding care facility if the beds meet the standards for nursing home licensure, or in a 
3.36 	facility that was granted an exception to the moratorium under section 144A.073, and if 
4.1 	the cost of any remodeling of the facility does not exceed $1,000,000.  If boarding care 
4.2 	beds are licensed as nursing home beds, the number of boarding care beds in the facility 
4.3 	must not increase beyond the number remaining at the time of the upgrade in licensure.  
4.4 	The provisions contained in section 144A.073 regarding the upgrading of the facilities 
4.5 	do not apply to facilities that satisfy these requirements;
4.6 	(f) to license and certify up to 40 beds transferred from an existing facility owned and 
4.7 	operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the 
4.8 	same location as the existing facility that will serve persons with Alzheimer's disease and 
4.9 	other related disorders.  The transfer of beds may occur gradually or in stages, provided 
4.10 	the total number of beds transferred does not exceed 40.  At the time of licensure and 
4.11 	certification of a bed or beds in the new unit, the commissioner of health shall delicense 
4.12 	and decertify the same number of beds in the existing facility.  As a condition of receiving 
4.13 	a license or certification under this clause, the facility must make a written commitment 
4.14 	to the commissioner of human services that it will not seek to receive an increase in its 
4.15 	property-related payment rate as a result of the transfers allowed under this paragraph;
4.16 	(g) to license and certify nursing home beds to replace currently licensed and certified 
4.17 	boarding care beds which may be located either in a remodeled or renovated boarding care 
4.18 	or nursing home facility or in a remodeled, renovated, newly constructed, or replacement 
4.19 	nursing home facility within the identifiable complex of health care facilities in which the 
4.20 	currently licensed boarding care beds are presently located, provided that the number of 
4.21 	boarding care beds in the facility or complex are decreased by the number to be licensed 
4.22 	as nursing home beds and further provided that, if the total costs of new construction, 
4.23 	replacement, remodeling, or renovation exceed ten percent of the appraised value of 
4.24 	the facility or $200,000, whichever is less, the facility makes a written commitment to 
4.25 	the commissioner of human services that it will not seek to receive an increase in its 
4.26 	property-related payment rate by reason of the new construction, replacement, remodeling, 
4.27 	or renovation.  The provisions contained in section 144A.073 regarding the upgrading of 
4.28 	facilities do not apply to facilities that satisfy these requirements;
4.29 	(h) to license as a nursing home and certify as a nursing facility a facility that is 
4.30 	licensed as a boarding care facility but not certified under the medical assistance program, 
4.31 	but only if the commissioner of human services certifies to the commissioner of health that 
4.32 	licensing the facility as a nursing home and certifying the facility as a nursing facility will 
4.33 	result in a net annual savings to the state general fund of $200,000 or more;
4.34 	(i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing 
4.35 	home beds in a facility that was licensed and in operation prior to January 1, 1992;
5.1 	(j) to license and certify new nursing home beds to replace beds in a facility acquired 
5.2 	by the Minneapolis Community Development Agency as part of redevelopment activities 
5.3 	in a city of the first class, provided the new facility is located within three miles of the site 
5.4 	of the old facility.  Operating and property costs for the new facility must be determined 
5.5 	and allowed under section 256B.431 or 256B.434;
5.6 	(k) to license and certify up to 20 new nursing home beds in a community-operated 
5.7 	hospital and attached convalescent and nursing care facility with 40 beds on April 21, 
5.8 	1991, that suspended operation of the hospital in April 1986.  The commissioner of human 
5.9 	services shall provide the facility with the same per diem property-related payment rate 
5.10 	for each additional licensed and certified bed as it will receive for its existing 40 beds;
5.11 	(l) to license or certify beds in renovation, replacement, or upgrading projects as 
5.12 	defined in section 144A.073, subdivision 1, so long as the cumulative total costs of the 
5.13 	facility's remodeling projects do not exceed $1,000,000;
5.14 	(m) to license and certify beds that are moved from one location to another for the 
5.15 	purposes of converting up to five four-bed wards to single or double occupancy rooms 
5.16 	in a nursing home that, as of January 1, 1993, was county-owned and had a licensed 
5.17 	capacity of 115 beds;
5.18 	(n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified 
5.19 	nursing facility located in Minneapolis to layaway all of its licensed and certified nursing 
5.20 	home beds.  These beds may be relicensed and recertified in a newly constructed teaching 
5.21 	nursing home facility affiliated with a teaching hospital upon approval by the legislature.  
5.22 	The proposal must be developed in consultation with the interagency committee on 
5.23 	long-term care planning.  The beds on layaway status shall have the same status as 
5.24 	voluntarily delicensed and decertified beds, except that beds on layaway status remain 
5.25 	subject to the surcharge in section 256.9657.  This layaway provision expires July 1, 1998;
5.26 	(o) to allow a project which will be completed in conjunction with an approved 
5.27 	moratorium exception project for a nursing home in southern Cass County and which is 
5.28 	directly related to that portion of the facility that must be repaired, renovated, or replaced, 
5.29 	to correct an emergency plumbing problem for which a state correction order has been 
5.30 	issued and which must be corrected by August 31, 1993;
5.31 	(p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified 
5.32 	nursing facility located in Minneapolis to layaway, upon 30 days prior written notice to 
5.33 	the commissioner, up to 30 of the facility's licensed and certified beds by converting 
5.34 	three-bed wards to single or double occupancy.  Beds on layaway status shall have the 
5.35 	same status as voluntarily delicensed and decertified beds except that beds on layaway 
5.36 	status remain subject to the surcharge in section 256.9657, remain subject to the license 
6.1 	application and renewal fees under section 144A.07 and shall be subject to a $100 per bed 
6.2 	reactivation fee.  In addition, at any time within three years of the effective date of the 
6.3 	layaway, the beds on layaway status may be:
6.4 	(1) relicensed and recertified upon relocation and reactivation of some or all of 
6.5 	the beds to an existing licensed and certified facility or facilities located in Pine River, 
6.6 	Brainerd, or International Falls; provided that the total project construction costs related to 
6.7 	the relocation of beds from layaway status for any facility receiving relocated beds may 
6.8 	not exceed the dollar threshold provided in subdivision 2 unless the construction project 
6.9 	has been approved through the moratorium exception process under section 144A.073;
6.10 	(2) relicensed and recertified, upon reactivation of some or all of the beds within the 
6.11 	facility which placed the beds in layaway status, if the commissioner has determined a 
6.12 	need for the reactivation of the beds on layaway status.
6.13 	The property-related payment rate of a facility placing beds on layaway status 
6.14 	must be adjusted by the incremental change in its rental per diem after recalculating the 
6.15 	rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c).  The 
6.16 	property-related payment rate for a facility relicensing and recertifying beds from layaway 
6.17 	status must be adjusted by the incremental change in its rental per diem after recalculating 
6.18 	its rental per diem using the number of beds after the relicensing to establish the facility's 
6.19 	capacity day divisor, which shall be effective the first day of the month following the 
6.20 	month in which the relicensing and recertification became effective.  Any beds remaining 
6.21 	on layaway status more than three years after the date the layaway status became effective 
6.22 	must be removed from layaway status and immediately delicensed and decertified;
6.23 	(q) to license and certify beds in a renovation and remodeling project to convert 12 
6.24 	four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing 
6.25 	home that, as of January 1, 1994, met the following conditions:  the nursing home was 
6.26 	located in Ramsey County; had a licensed capacity of 154 beds; and had been ranked 
6.27 	among the top 15 applicants by the 1993 moratorium exceptions advisory review panel.  
6.28 	The total project construction cost estimate for this project must not exceed the cost 
6.29 	estimate submitted in connection with the 1993 moratorium exception process;
6.30 	(r) to license and certify up to 117 beds that are relocated from a licensed and 
6.31 	certified 138-bed nursing facility located in St. Paul to a hospital with 130 licensed 
6.32 	hospital beds located in South St. Paul, provided that the nursing facility and hospital are 
6.33 	owned by the same or a related organization and that prior to the date the relocation is 
6.34 	completed the hospital ceases operation of its inpatient hospital services at that hospital.  
6.35 	After relocation, the nursing facility's status under section 256B.431, subdivision 2j, shall 
6.36 	be the same as it was prior to relocation.  The nursing facility's property-related payment 
7.1 	rate resulting from the project authorized in this paragraph shall become effective no 
7.2 	earlier than April 1, 1996.  For purposes of calculating the incremental change in the 
7.3 	facility's rental per diem resulting from this project, the allowable appraised value of 
7.4 	the nursing facility portion of the existing health care facility physical plant prior to the 
7.5 	renovation and relocation may not exceed $2,490,000;
7.6 	(s) to license and certify two beds in a facility to replace beds that were voluntarily 
7.7 	delicensed and decertified on June 28, 1991;
7.8 	(t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed 
7.9 	nursing home and 21-bed boarding care home facility in Minneapolis, notwithstanding 
7.10 	the licensure and certification after July 1, 1995, of the Minneapolis facility as a 147-bed 
7.11 	nursing home facility after completion of a construction project approved in 1993 under 
7.12 	section 144A.073, to be laid away upon 30 days' prior written notice to the commissioner.  
7.13 	Beds on layaway status shall have the same status as voluntarily delicensed or decertified 
7.14 	beds except that they shall remain subject to the surcharge in section 256.9657.  The 
7.15 	16 beds on layaway status may be relicensed as nursing home beds and recertified at 
7.16 	any time within five years of the effective date of the layaway upon relocation of some 
7.17 	or all of the beds to a licensed and certified facility located in Watertown, provided that 
7.18 	the total project construction costs related to the relocation of beds from layaway status 
7.19 	for the Watertown facility may not exceed the dollar threshold provided in subdivision 
7.20 	2 unless the construction project has been approved through the moratorium exception 
7.21 	process under section 144A.073.
7.22 	The property-related payment rate of the facility placing beds on layaway status 
7.23 	must be adjusted by the incremental change in its rental per diem after recalculating the 
7.24 	rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c).  The 
7.25 	property-related payment rate for the facility relicensing and recertifying beds from 
7.26 	layaway status must be adjusted by the incremental change in its rental per diem after 
7.27 	recalculating its rental per diem using the number of beds after the relicensing to establish 
7.28 	the facility's capacity day divisor, which shall be effective the first day of the month 
7.29 	following the month in which the relicensing and recertification became effective.  Any 
7.30 	beds remaining on layaway status more than five years after the date the layaway status 
7.31 	became effective must be removed from layaway status and immediately delicensed 
7.32 	and decertified;
7.33 	(u) to license and certify beds that are moved within an existing area of a facility or 
7.34 	to a newly constructed addition which is built for the purpose of eliminating three- and 
7.35 	four-bed rooms and adding space for dining, lounge areas, bathing rooms, and ancillary 
8.1 	service areas in a nursing home that, as of January 1, 1995, was located in Fridley and had 
8.2 	a licensed capacity of 129 beds;
8.3 	(v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County 
8.4 	to a 160-bed facility in Crow Wing County, provided all the affected beds are under 
8.5 	common ownership;
8.6 	(w) to license and certify a total replacement project of up to 49 beds located in 
8.7 	Norman County that are relocated from a nursing home destroyed by flood and whose 
8.8 	residents were relocated to other nursing homes.  The operating cost payment rates for 
8.9 	the new nursing facility shall be determined based on the interim and settle-up payment 
8.10 	provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of 
8.11 	section 256B.431, except that subdivision 26, paragraphs (a) and (b), shall not apply until 
8.12 	the second rate year after the settle-up cost report is filed.  Property-related reimbursement 
8.13 	rates shall be determined under section 256B.431, taking into account any federal or state 
8.14 	flood-related loans or grants provided to the facility;
8.15 	(x) to license and certify a total replacement project of up to 129 beds located 
8.16 	in Polk County that are relocated from a nursing home destroyed by flood and whose 
8.17 	residents were relocated to other nursing homes.  The operating cost payment rates for 
8.18 	the new nursing facility shall be determined based on the interim and settle-up payment 
8.19 	provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of 
8.20 	section 256B.431, except that subdivision 26, paragraphs (a) and (b), shall not apply until 
8.21 	the second rate year after the settle-up cost report is filed.  Property-related reimbursement 
8.22 	rates shall be determined under section 256B.431, taking into account any federal or state 
8.23 	flood-related loans or grants provided to the facility;
8.24 	(y) to license and certify beds in a renovation and remodeling project to convert 13 
8.25 	three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and 
8.26 	add improvements in a nursing home that, as of January 1, 1994, met the following 
8.27 	conditions:  the nursing home was located in Ramsey County, was not owned by a hospital 
8.28 	corporation, had a licensed capacity of 64 beds, and had been ranked among the top 15 
8.29 	applicants by the 1993 moratorium exceptions advisory review panel.  The total project 
8.30 	construction cost estimate for this project must not exceed the cost estimate submitted in 
8.31 	connection with the 1993 moratorium exception process;
8.32 	(z) to license and certify up to 150 nursing home beds to replace an existing 285 
8.33 	bed nursing facility located in St. Paul.  The replacement project shall include both the 
8.34 	renovation of existing buildings and the construction of new facilities at the existing 
8.35 	site.  The reduction in the licensed capacity of the existing facility shall occur during the 
8.36 	construction project as beds are taken out of service due to the construction process.  Prior 
9.1 	to the start of the construction process, the facility shall provide written information to the 
9.2 	commissioner of health describing the process for bed reduction, plans for the relocation 
9.3 	of residents, and the estimated construction schedule.  The relocation of residents shall be 
9.4 	in accordance with the provisions of law and rule;
9.5 	(aa) to allow the commissioner of human services to license an additional 36 beds to 
9.6 	provide residential services for the physically handicapped under Minnesota Rules, parts 
9.7 	9570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that 
9.8 	the total number of licensed and certified beds at the facility does not increase;
9.9 	(bb) to license and certify a new facility in St. Louis county with 44 beds constructed 
9.10 	to replace an existing facility in St. Louis County with 31 beds, which has resident rooms 
9.11 	on two separate floors and an antiquated elevator that creates safety concerns for residents 
9.12 	and prevents nonambulatory residents from residing on the second floor.  The project shall 
9.13 	include the elimination of three- and four-bed rooms;
9.14 	(cc) to license and certify four beds in a 16-bed certified boarding care home in 
9.15 	Minneapolis to replace beds that were voluntarily delicensed and decertified on or 
9.16 	before March 31, 1992.  The licensure and certification is conditional upon the facility 
9.17 	periodically assessing and adjusting its resident mix and other factors which may 
9.18 	contribute to a potential institution for mental disease declaration.  The commissioner of 
9.19 	human services shall retain the authority to audit the facility at any time and shall require 
9.20 	the facility to comply with any requirements necessary to prevent an institution for mental 
9.21 	disease declaration, including delicensure and decertification of beds, if necessary;
9.22 	(dd) to license and certify 72 beds in an existing facility in Mille Lacs County with 
9.23 	80 beds as part of a renovation project.  The renovation must include construction of 
9.24 	an addition to accommodate ten residents with beginning and midstage dementia in a 
9.25 	self-contained living unit; creation of three resident households where dining, activities, 
9.26 	and support spaces are located near resident living quarters; designation of four beds 
9.27 	for rehabilitation in a self-contained area; designation of 30 private rooms; and other 
9.28 	improvements;
9.29 	(ee) to license and certify beds in a facility that has undergone replacement or 
9.30 	remodeling as part of a planned closure under section 256B.437;
9.31 	(ff) to license and certify a total replacement project of up to 124 beds located 
9.32 	in Wilkin County that are in need of relocation from a nursing home significantly 
9.33 	damaged by flood. The operating cost payment rates for the new nursing facility shall 
9.34 	be determined based on the interim and settle-up payment provisions of Minnesota 
9.35 	Rules, part 9549.0057, and the reimbursement provisions of section 256B.431, except 
9.36 	that section 256B.431, subdivision 26, paragraphs (a) and (b), shall not apply until the 
10.1 	second rate year after the settle-up cost report is filed.  Property-related reimbursement 
10.2 	rates shall be determined under section 256B.431, taking into account any federal or state 
10.3 	flood-related loans or grants provided to the facility;
10.4 	(gg) to allow the commissioner of human services to license an additional nine beds 
10.5 	to provide residential services for the physically handicapped under Minnesota Rules, 
10.6 	parts 9570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that 
10.7 	the total number of licensed and certified beds at the facility does not increase;
10.8 	(hh) to license and certify up to 120 new nursing facility beds to replace beds in a 
10.9 	facility in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the 
10.10 	new facility is located within four miles of the existing facility and is in Anoka County.  
10.11 	Operating and property rates shall be determined and allowed under section 256B.431 and 
10.12 	Minnesota Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 256B.435.  The 
10.13 	provisions of section 256B.431, subdivision 26, paragraphs (a) and (b), do not apply until 
10.14 	the second rate year following settle-up; or 
10.15 	(ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County 
10.16 	that, as of March 25, 2001, is in the active process of closing, to a 122-licensed bed 
10.17 	nonprofit nursing facility located in the city of Columbia Heights or its affiliate.  The 
10.18 	transfer is effective when the receiving facility notifies the commissioner in writing of the 
10.19 	number of beds accepted.  The commissioner shall place all transferred beds on layaway 
10.20 	status held in the name of the receiving facility.  The layaway adjustment provisions of 
10.21 	section 256B.431, subdivision 30, do not apply to this layaway. The receiving facility 
10.22 	may only remove the beds from layaway for recertification and relicensure at the receiving 
10.23 	facility's current site, or at a newly constructed facility located in Anoka County.  The 
10.24 	receiving facility must receive statutory authorization before removing these beds from 
10.25 	layaway status, or may remove these beds from layaway status if removal from layaway 
10.26 	status is part of a moratorium exception project approved by the commissioner under 
10.27 	section 144A.073.

10.28 	Sec. 3. Minnesota Statutes 2004, section 144A.071, subdivision 4c, is amended to read:
10.29 		Subd. 4c.Exceptions for replacement beds after June 30, 2003. (a) The 
10.30 	commissioner of health, in coordination with the commissioner of human services, may 
10.31 	approve the renovation, replacement, upgrading, or relocation of a nursing home or 
10.32 	boarding care home, under the following conditions:
10.33 	(1) to license and certify an 80-bed city-owned facility in Nicollet County to be 
10.34 	constructed on the site of a new city-owned hospital to replace an existing 85-bed facility 
10.35 	attached to a hospital that is also being replaced. The threshold allowed for this project 
11.1 	under section  144A.073 shall be the maximum amount available to pay the additional 
11.2 	medical assistance costs of the new facility; 
11.3 	(2) to license and certify 29 beds to be added to an existing 69-bed facility in St. 
11.4 	Louis County, provided that the 29 beds must be transferred from active or layaway status 
11.5 	at an existing facility in St. Louis County that had 235 beds on April 1, 2003.
11.6 	The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment 
11.7 	rate at that facility shall not be adjusted as a result of this transfer. The operating payment 
11.8 	rate of the facility adding beds after completion of this project shall be the same as it was 
11.9 	on the day prior to the day the beds are licensed and certified. This project shall not 
11.10 	proceed unless it is approved and financed under the provisions of section  144A.073; and
11.11 	(3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of 
11.12 	the new beds are transferred from a 45-bed facility in Austin under common ownership 
11.13 	that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea 
11.14 	under common ownership; (ii) the commissioner of human services is authorized by the 
11.15 	2004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii) 
11.16 	money is available from planned closures of facilities under common ownership to make 
11.17 	implementation of this clause budget-neutral to the state. The bed capacity of the Albert 
11.18 	Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the 
11.19 	new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's 
11.20 	disease or related dementias.; and
11.21 	(4) to license and certify up to 80 beds transferred from an existing state-owned 
11.22 	nursing facility in Cass County to a new facility located on the grounds of the 
11.23 	Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be 
11.24 	determined based on the interim and settle-up payment provisions of Minnesota Rules, 
11.25 	part 9549.0057, and the reimbursement provisions of section 256B.431. The property 
11.26 	payment rate for the first three years of operation shall be $35 per day. For subsequent 
11.27 	years, the property payment rate of $35 per day shall be adjusted for inflation as provided 
11.28 	in section 256B.434, subdivision 4, paragraph (c), as long as the facility has a contract 
11.29 	under section 256B.434.
11.30 	(b) Projects approved under this subdivision shall be treated in a manner equivalent 
11.31 	to projects approved under subdivision 4a.

11.32 	Sec. 4. [245.4682] MENTAL HEALTH SERVICE DELIVERY AND FINANCE 
11.33 	REFORM.
11.34 		Subdivision 1.Policy. The commissioner of human services shall study and report 
11.35 	on reforms to improve the underlying structural, financing, and organizational problems 
12.1 	in Minnesota's mental health system with the goal of improving the availability, quality, 
12.2 	and accountability of mental health care within the state.
12.3 		Subd. 2.General provisions. In the design and implementation of reforms to the 
12.4 	mental health system, the commissioner shall:
12.5 	(1) consult with consumers, families, counties, tribes, advocates, providers, and 
12.6 	other stakeholders;
12.7 	(2) report to the legislature and the state Mental Health Advisory Council by 
12.8 	December 15, 2006, and shall include recommendations on the following: 
12.9 	(a) updating the role of counties and health plans;
12.10 	(b) ensuring continuity of care for persons affected by these reforms including:
12.11 	(c) ensuring client choice of provider by requiring broad provider networks;
12.12 	(d) allowing clients options to maintain previously established therapeutic 
12.13 	relationships;
12.14 	(e) developing mechanisms to facilitate a smooth transition of service 
12.15 	responsibilities;
12.16 	(f) providing accountability for the efficient and effective use of public and private 
12.17 	resources in achieving positive outcomes for consumers; and
12.18 	(g) ensuring client access to applicable protections and appeals.

12.19 	Sec. 5. Minnesota Statutes 2004, section 256B.431, is amended by adding a 
12.20 	subdivision to read:
12.21 		Subd. 43.Rate increase for facilities in Stearns, Sherburne, and Benton 
12.22 	Counties. Effective July 1, 2006, operating payment rates of nursing facilities in Stearns, 
12.23 	Sherburne, and Benton Counties that are reimbursed under this section, section 256B.434, 
12.24 	or section 256B.441 shall be increased to be equal, for a RUG's rate with a weight of 1.00, 
12.25 	to the geographic group III median rate for the same RUG's weight. The percentage of 
12.26 	the operating payment rate for each facility to be case-mix adjusted shall be equal to the 
12.27 	percentage that is case-mix adjusted in that facility's June 30, 2006, operating payment 
12.28 	rate. This subdivision shall apply only if it results in a rate increase. Increases provided 
12.29 	by this subdivision shall be added to the rate determined under any new reimbursement 
12.30 	system established under section 256B.440.

12.31 	Sec. 6. Minnesota Statutes 2005 Supplement, section 256B.434, subdivision 4, is 
12.32 	amended to read:
12.33 		Subd. 4.Alternate rates for nursing facilities. (a) For nursing facilities which 
12.34 	have their payment rates determined under this section rather than section 256B.431, the 
13.1 	commissioner shall establish a rate under this subdivision. The nursing facility must enter 
13.2 	into a written contract with the commissioner.
13.3 	(b) A nursing facility's case mix payment rate for the first rate year of a facility's 
13.4 	contract under this section is the payment rate the facility would have received under 
13.5 	section 256B.431.
13.6 	(c) A nursing facility's case mix payment rates for the second and subsequent years 
13.7 	of a facility's contract under this section are the previous rate year's contract payment 
13.8 	rates plus an inflation adjustment and, for facilities reimbursed under this section or 
13.9 	section 256B.431, an adjustment to include the cost of any increase in Health Department 
13.10 	licensing fees for the facility taking effect on or after July 1, 2001. The index for the 
13.11 	inflation adjustment must be based on the change in the Consumer Price Index-All Items 
13.12 	(United States City average) (CPI-U) forecasted by the commissioner of finance's national 
13.13 	economic consultant, as forecasted in the fourth quarter of the calendar year preceding 
13.14 	the rate year. The inflation adjustment must be based on the 12-month period from the 
13.15 	midpoint of the previous rate year to the midpoint of the rate year for which the rate is 
13.16 	being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001, 
13.17 	July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, and July 
13.18 	1, 2008, this paragraph shall apply only to the property-related payment rate, except 
13.19 	that adjustments to include the cost of any increase in Health Department licensing fees 
13.20 	taking effect on or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to 
13.21 	the property payment rate under this section and section 256B.431 shall be effective on 
13.22 	October 1. In determining the amount of the property-related payment rate adjustment 
13.23 	under this paragraph, the commissioner shall determine the proportion of the facility's 
13.24 	rates that are property-related based on the facility's most recent cost report. Beginning 
13.25 	October 1, 2006, facilities reimbursed under this section shall be allowed to receive a 
13.26 	property rate adjustment for building projects under section 144A.071, subdivision 2.
13.27 	(d) The commissioner shall develop additional incentive-based payments of up to 
13.28 	five percent above a facility's operating payment rate for achieving outcomes specified 
13.29 	in a contract. The commissioner may solicit contract amendments and implement those 
13.30 	which, on a competitive basis, best meet the state's policy objectives. The commissioner 
13.31 	shall limit the amount of any incentive payment and the number of contract amendments 
13.32 	under this paragraph to operate the incentive payments within funds appropriated for this 
13.33 	purpose. The contract amendments may specify various levels of payment for various 
13.34 	levels of performance. Incentive payments to facilities under this paragraph may be in 
13.35 	the form of time-limited rate adjustments or supplemental payments. In establishing the 
14.1 	specified outcomes and related criteria, the commissioner shall consider the following 
14.2 	state policy objectives:
14.3 	(1) successful diversion or discharge of residents to the residents' prior home or 
14.4 	other community-based alternatives;
14.5 	(2) adoption of new technology to improve quality or efficiency; 
14.6 	(3) improved quality as measured in the Nursing Home Report Card; 
14.7 	(4) reduced acute care costs; and
14.8 	(5) any additional outcomes proposed by a nursing facility that the commissioner 
14.9 	finds desirable.

14.10 	Sec. 7. Minnesota Statutes 2004, section 256B.434, is amended by adding a 
14.11 	subdivision to read:
14.12 		Subd. 4f.Facility rate increase effective July 1, 2006. For the rate year beginning 
14.13 	July 1, 2006, a nursing facility in Otter Tail County that was licensed for 55 beds as of 
14.14 	January 1, 2006, shall receive a rate increase to increase its operating rate to the 60th 
14.15 	percentile of the operating rates of all other Otter Tail County skilled nursing facilities. 
14.16 	The commissioner shall determine the 60th percentile of the case mix portion of the 
14.17 	operating rates of all other Otter Tail County skilled nursing facilities and then apply the 
14.18 	case mix weights.  The 60th percentile of the other facilities operating per diem for all 
14.19 	other Otter Tail County facilities will be added to the above-determined weighted case 
14.20 	mix amount to compute the 60th percentile operating rate.  The nonoperating components 
14.21 	of the facility's rates will not be adjusted under this subdivision.

14.22 	Sec. 8. Minnesota Statutes 2004, section 256B.438, subdivision 4, is amended to read:
14.23 		Subd. 4.Resident assessment schedule. (a) Nursing facilities shall conduct and 
14.24 	submit case mix assessments according to the schedule established by the commissioner 
14.25 	of health under section  144.0724, subdivisions 4 and 5. 
14.26 	(b) The resident reimbursement classifications established under section  144.0724, 
14.27 	subdivision 3, shall be effective the day of admission for new admission assessments. The 
14.28 	effective date for significant change assessments shall be the assessment reference date. 
14.29 	The effective date for annual and second all quarterly assessments shall be the first day of 
14.30 	the month following assessment reference date. 

14.31 	EFFECTIVE DATE. This section is effective October 1, 2006.

14.32 	Sec. 9. Minnesota Statutes 2004, section 256B.69, subdivision 9, is amended to read:
15.1 		Subd. 9.Reporting. (a) Each demonstration provider shall submit information as 
15.2 	required by the commissioner, including data required for assessing client satisfaction, 
15.3 	quality of care, cost, and utilization of services for purposes of project evaluation. The 
15.4 	commissioner shall also develop methods of data reporting and collection from county 
15.5 	advocacy activities in order to provide aggregate enrollee information on encounters 
15.6 	and outcomes to determine access and quality assurance. Required information shall be 
15.7 	specified before the commissioner contracts with a demonstration provider.
15.8 	(b) Aggregate nonpersonally identifiable health plan encounter data, aggregate 
15.9 	spending data for major categories of service as reported to the commissioners of health 
15.10 	and commerce under section 62D.08, subdivision 3, paragraph (a), and criteria for 
15.11 	service authorization and service use are public data that the commissioner shall make 
15.12 	available and use in public reports. The commissioner shall require each health plan and 
15.13 	county-based purchasing plan to provide:
15.14 	(1) encounter data for each service provided, using standard codes and unit of 
15.15 	service definitions set by the commissioner, in a form that the commissioner can report by 
15.16 	age, eligibility groups, and health plan; and
15.17 	(2) criteria, written policies, and procedures required to be disclosed under section 
15.18 	62M.10, subdivision 7, and Code of Federal Regulations, title 42, part 438.210(b)(1), used 
15.19 	for each type of service for which authorization is required.

15.20 	Sec. 10. Minnesota Statutes 2005 Supplement, section 256B.69, subdivision 23, 
15.21 	is amended to read:
15.22 		Subd. 23.Alternative services; elderly and disabled persons. (a) The 
15.23 	commissioner may implement demonstration projects to create alternative integrated 
15.24 	delivery systems for acute and long-term care services to elderly persons and persons 
15.25 	with disabilities as defined in section 256B.77, subdivision 7a, that provide increased 
15.26 	coordination, improve access to quality services, and mitigate future cost increases. 
15.27 	The commissioner may seek federal authority to combine Medicare and Medicaid 
15.28 	capitation payments for the purpose of such demonstrations and may contract with 
15.29 	Medicare-approved special needs plans to provide Medicaid services. Medicare funds 
15.30 	and services shall be administered according to the terms and conditions of the federal 
15.31 	waiver contract and demonstration provisions. For the purpose of administering medical 
15.32 	assistance funds, demonstrations under this subdivision are subject to subdivisions 1 to 
15.33 	22. The provisions of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these 
15.34 	demonstrations, with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, 
15.35 	subpart 1, items B and C, which do not apply to persons enrolling in demonstrations 
16.1 	under this section. An initial open enrollment period may be provided. Persons who 
16.2 	disenroll from demonstrations under this subdivision remain subject to Minnesota Rules, 
16.3 	parts 9500.1450 to 9500.1464. When a person is enrolled in a health plan under these 
16.4 	demonstrations and the health plan's participation is subsequently terminated for any 
16.5 	reason, the person shall be provided an opportunity to select a new health plan and shall 
16.6 	have the right to change health plans within the first 60 days of enrollment in the second 
16.7 	health plan. Persons required to participate in health plans under this section who fail 
16.8 	to make a choice of health plan shall not be randomly assigned to health plans under 
16.9 	these demonstrations. Notwithstanding section 256L.12, subdivision 5, and Minnesota 
16.10 	Rules, part 9505.5220, subpart 1, item A, if adopted, for the purpose of demonstrations 
16.11 	under this subdivision, the commissioner may contract with managed care organizations, 
16.12 	including counties, to serve only elderly persons eligible for medical assistance, elderly 
16.13 	and disabled persons, or disabled persons only. For persons with primary diagnoses of 
16.14 	mental retardation or a related condition, serious and persistent mental illness, or serious 
16.15 	emotional disturbance, the commissioner must ensure that the county authority has 
16.16 	approved the demonstration and contracting design. Enrollment in these projects for 
16.17 	persons with disabilities shall be voluntary. The commissioner shall not implement any 
16.18 	demonstration project under this subdivision for persons with primary diagnoses of 
16.19 	mental retardation or a related condition, serious and persistent mental illness, or serious 
16.20 	emotional disturbance, without approval of the county board of the county in which the 
16.21 	demonstration is being implemented.
16.22 	(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
16.23 	to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 
16.24 	9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement 
16.25 	under this section projects for persons with developmental disabilities. The commissioner 
16.26 	may capitate payments for ICF/MR services, waivered services for mental retardation or 
16.27 	related conditions, including case management services, day training and habilitation and 
16.28 	alternative active treatment services, and other services as approved by the state and by the 
16.29 	federal government. Case management and active treatment must be individualized and 
16.30 	developed in accordance with a person-centered plan. Costs under these projects may not 
16.31 	exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, 
16.32 	and until two years after the pilot project implementation date, subcontractor participation 
16.33 	in the long-term care developmental disability pilot is limited to a nonprofit long-term 
16.34 	care system providing ICF/MR services, home and community-based waiver services, 
16.35 	and in-home services to no more than 120 consumers with developmental disabilities in 
16.36 	Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature 
17.1 	prior to expansion of the developmental disability pilot project. This paragraph expires 
17.2 	two years after the implementation date of the pilot project.
17.3 	(c) Before implementation of a demonstration project for disabled persons, the 
17.4 	commissioner must provide information to appropriate committees of the house of 
17.5 	representatives and senate and must involve representatives of affected disability groups 
17.6 	in the design of the demonstration projects.
17.7 	(d) A nursing facility reimbursed under the alternative reimbursement methodology 
17.8 	in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity 
17.9 	provide services under paragraph (a). The commissioner shall amend the state plan and 
17.10 	seek any federal waivers necessary to implement this paragraph.
17.11 	(e) The commissioner, in consultation with the commissioners of commerce and 
17.12 	health, may approve and implement programs for all-inclusive care for the elderly (PACE) 
17.13 	according to federal laws and regulations governing that program and state laws or rules 
17.14 	applicable to participating providers. The process for approval of these programs shall 
17.15 	begin only after the commissioner receives grant money in an amount sufficient to cover 
17.16 	the state share of the administrative and actuarial costs to implement the programs during 
17.17 	state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 
17.18 	account in the special revenue fund and are appropriated to the commissioner to be used 
17.19 	solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 
17.20 	not required to be licensed or certified as a health plan company as defined in section 
17.21 	62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county 
17.22 	and found to be eligible for services under the elderly waiver or community alternatives 
17.23 	for disabled individuals or who are already eligible for Medicaid but meet level of 
17.24 	care criteria for receipt of waiver services may choose to enroll in the PACE program. 
17.25 	Medicare and Medicaid services will be provided according to this subdivision and 
17.26 	federal Medicare and Medicaid requirements governing PACE providers and programs. 
17.27 	PACE enrollees will receive Medicaid home and community-based services through the 
17.28 	PACE provider as an alternative to services for which they would otherwise be eligible 
17.29 	through home and community-based waiver programs and Medicaid State Plan Services. 
17.30 	The commissioner shall establish Medicaid rates for PACE providers that do not exceed 
17.31 	costs that would have been incurred under fee-for-service or other relevant managed care 
17.32 	programs operated by the state.
17.33 	(f) The commissioner shall seek federal approval to expand the Minnesota disability 
17.34 	health options (MnDHO) program established under this subdivision in stages, first to 
17.35 	regional population centers outside the seven-county metro area and then to all areas 
17.36 	of the state. Until January 1, 2008, expansion for MnDHO projects that include home 
18.1 	and community-based services is limited to the two projects and service areas in effect 
18.2 	on March 1, 2006.  Enrollment in integrated MnDHO programs that include home and 
18.3 	community-based services shall remain voluntary. Costs for home and community-based 
18.4 	services included under MnDHO must not exceed costs that would have been incurred 
18.5 	under the fee-for-service program. In developing program specifications for expansion of 
18.6 	integrated programs, the commissioner shall involve and consult the state-level stakeholder 
18.7 	group established in subdivision 28, paragraph (d), including consultation on whether and 
18.8 	how to include home and community-based waiver programs. Plans for further expansion 
18.9 	of MnDHO projects shall be presented to the chairs of the house and senate committees 
18.10 	with jurisdiction over health and human services policy and finance by February 1, 2007.
18.11 	(g) Notwithstanding section 256B.0261, health plans providing services under this 
18.12 	section are responsible for home care targeted case management and relocation targeted 
18.13 	case management. Services must be provided according to the terms of the waivers and 
18.14 	contracts approved by the federal government.

18.15 	EFFECTIVE DATE. This section is effective the day following final enactment. 

18.16 	Sec. 11. Minnesota Statutes 2004, section 256B.69, is amended by adding a subdivision 
18.17 	to read:
18.18 		Subd. 28.Medicare special needs plans and medical assistance basic health 
18.19 	care for persons with disabilities. (a) The commissioner may contract with qualified 
18.20 	Medicare-approved special needs plans to provide medical assistance basic health care 
18.21 	services to persons with disabilities, including those with developmental disabilities. 
18.22 	Basic health care services include:
18.23 	(1) those services covered by the medical assistance state plan except for ICF/MR 
18.24 	services, home and community-based waiver services, case management for persons with 
18.25 	developmental disabilities under section 256B.0625, subdivision 20a, and personal care 
18.26 	and certain home care services defined by the commissioner in consultation with the 
18.27 	stakeholder group established under paragraph (d);
18.28 	(2) basic health care services may also include risk for up to 100 days of nursing 
18.29 	facility services for persons who reside in a noninstitutional setting and home health 
18.30 	services related to rehabilitation as defined by the commissioner after consultation with 
18.31 	the stakeholder group; and
18.32 	(3) the commissioner may exclude other medical assistance services from the basic 
18.33 	health care benefit set. Enrollees in these plans can access any excluded services on the 
18.34 	same basis as other medical assistance recipients who have not enrolled.
19.1 	Unless a person is otherwise required to enroll in managed care, enrollment in these 
19.2 	plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic 
19.3 	enrollment with an option to opt out is not voluntary enrollment. 
19.4 	(b) Beginning January 1, 2007, the commissioner may contract with qualified 
19.5 	Medicare special needs plans to provide basic health care services under medical 
19.6 	assistance to persons who are dually eligible for both Medicare and Medicaid and those 
19.7 	Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare. 
19.8 	The commissioner shall consult with the stakeholder group under paragraph (d) in 
19.9 	developing program specifications for these services. The commissioner shall report to 
19.10 	the chairs of the house and senate committees with jurisdiction over health and human 
19.11 	services policy and finance by February 1, 2007, on implementation of these programs and 
19.12 	the need for increased funding for the ombudsman for managed care and other consumer 
19.13 	assistance and protections needed due to enrollment in managed care of persons with 
19.14 	disabilities. Payment for Medicaid services provided under this subdivision for the months 
19.15 	of May and June will be made no earlier than July 1 of the same calendar year.
19.16 	(c) Beginning January 1, 2008, the commissioner may expand contracting under this 
19.17 	subdivision to all persons with disabilities not otherwise required to enroll in managed 
19.18 	care.
19.19 	(d) The commissioner shall establish a state-level stakeholder group to provide 
19.20 	advice on managed care programs for persons with disabilities, including both MnDHO 
19.21 	and contracts with special needs plans that provide basic health care services as described 
19.22 	in paragraphs (a) and (b). The stakeholder group shall provide advice on program 
19.23 	expansions under this subdivision and subdivision 23, including:
19.24 	(1) implementation efforts; 
19.25 	(2) consumer protections; and 
19.26 	(3) program specifications such as quality assurance measures, data collection and 
19.27 	reporting, and evaluation of costs, quality, and results.
19.28 	(e) Each plan under contract to provide medical assistance basic health care services 
19.29 	shall establish a local or regional stakeholder group, including representatives of the 
19.30 	counties covered by the plan, members, consumer advocates, and providers, for advice on 
19.31 	issues that arise in the local or regional area.

19.32 	Sec. 12. STAKEHOLDER PARTICIPATION.
 19.33 	The commissioner of human services shall confer with one or more stakeholder 
19.34 	groups of interested persons, including representatives of recipients, advocacy groups, 
19.35 	counties, providers, and health plans to provide information and advice on the development 
20.1 	of any substantial proposals for changes in the medical assistance program authorized by 
20.2 	the federal Deficit Reduction Act of 2005, Public Law 109-171. In addition, for any 
20.3 	substantial Deficit Reduction Act-related medical assistance change that affects recipients 
20.4 	and that is proposed outside of the legislative or rulemaking process, the commissioner 
20.5 	shall convene a stakeholder meeting and provide a 30-day comment period before the 
20.6 	change becomes effective. If the time frame required to comply with a federal mandate 
20.7 	precludes the 30-day advance notice, notice shall be given to the stakeholder group as 
20.8 	soon as possible.

20.9 	EFFECTIVE DATE. This section is effective the day following final enactment.

20.10 	Sec. 13. ICF/MR PLAN.
 20.11 	The commissioner of human services shall consult with ICF/MR providers, 
20.12 	advocates, counties, and consumer families to develop a stakeholder plan and legislation 
20.13 	concerning the future services provided to people served in ICFs/MR. The plan shall be 
20.14 	reported to the house and senate committees with jurisdiction over health and human 
20.15 	services policy and finance issues by December 15, 2007. In preparing the plan, the 
20.16 	commissioner shall consider:
20.17 	(1) consumer choice of services;
20.18 	(2) consumers' service needs, including, but not limited to, active treatment;
20.19 	(3) the total cost of providing services in ICFs/MR and alternative delivery systems 
20.20 	for individuals currently residing in ICFs/MR;
20.21 	(4) the impact of the payment shift to counties for ICFs/MR with more than six beds;
20.22 	(5) whether it is the policy of the state to maintain an ICF/MR system and, if so, 
20.23 	the plan shall:
20.24 	(i) define the purpose, types of services, and intended recipients of ICF/MR services;
20.25 	(ii) define the capacity needed to maintain ICF/MR services for designated 
20.26 	populations;
20.27 	(iii) evaluate incentives for counties to maintain ICF/MR services;
20.28 	(iv) assure that mechanisms are provided to adequately fund the transition to the 
20.29 	defined services, maintain the designated capacity, and are adjustable to meet increased 
20.30 	service demands; and
20.31 	(v) address the extent to which there is consensus among stakeholders; and
20.32 	(6) if alternative services are recommended to support the people now receiving 
20.33 	services in an ICF/MR, the plan shall provide for transition planning and ensure adequate 
20.34 	state and federal financial resources are available to meet the needs of ICF/MR recipients.

21.1 	EFFECTIVE DATE. This section is effective the day following final enactment.

21.2 	ARTICLE 2
21.3 	STATE HEALTH CARE PROGRAMS

21.4 	Section 1. Minnesota Statutes 2004, section 256.01, subdivision 18, is amended to read:
21.5 		Subd. 18.Immigration status verifications. (a) Notwithstanding any waiver of 
21.6 	this requirement by the secretary of the United States Department of Health and Human 
21.7 	Services, effective July 1, 2001, the commissioner shall utilize the Systematic Alien 
21.8 	Verification for Entitlements (SAVE) program to conduct immigration status verifications:
21.9 	(1) as required under United States Code, title 8, section 1642;
21.10 	(2) for all applicants for food assistance benefits, whether under the federal food 
21.11 	stamp program, the MFIP or work first program, or the Minnesota food assistance program;
21.12 	(3) for all applicants for general assistance medical care, except assistance for an 
21.13 	emergency medical condition, for immunization with respect to an immunizable disease, 
21.14 	or for testing and treatment of symptoms of a communicable disease, and nonfederally 
21.15 	funded MinnesotaCare; and
21.16 	(4) for all applicants for general assistance, Minnesota supplemental aid, medical 
21.17 	assistance, federally funded MinnesotaCare, or group residential housing, when the 
21.18 	benefits provided by these programs would fall under the definition of "federal public 
21.19 	benefit" under United States Code, title 8, section 1642, if federal funds were used to 
21.20 	pay for all or part of the benefits.
21.21 	(b) The commissioner shall comply with the reporting requirements under United 
21.22 	States Code, title 42, section 611a, and any federal regulation or guidance adopted under 
21.23 	that law.

21.24 	Sec. 2. Minnesota Statutes 2004, section 256.01, is amended by adding a subdivision 
21.25 	to read:
21.26 		Subd. 18a.Reporting undocumented immigrants. The commissioner shall 
21.27 	require all employees of the state and counties to make a written report to the United States 
21.28 	Citizenship and Immigration Service (USCIS) for any violation of federal immigration law 
21.29 	by any applicant for medical assistance under chapter 256B, general assistance medical 
21.30 	care under chapter 256D, or MinnesotaCare under chapter 256L, that is discovered by the 
21.31 	employee.  Employees do not need an applicant's written authorization to contact USCIS.

21.32 	Sec. 3. Minnesota Statutes 2004, section 256B.692, subdivision 6, is amended to read:
21.33 		Subd. 6.Commissioner's authority. The commissioner may:
22.1 	(1) reject any preliminary or final proposal that substantially fails to meet the 
22.2 	requirements of this section, or that the commissioner determines would substantially 
22.3 	impair the state's ability to purchase health care services in other areas of the state, 
22.4 	or would substantially impair an enrollee's choice of care systemsmanaged care 
22.5 	organizations  when reasonable choice is possible, or would substantially impair the 
22.6 	implementation and operation of the Minnesota senior health options demonstration 
22.7 	project authorized under section  256B.69, subdivision 23; and 
22.8 	(2) assume operation of a county's purchasing of health care for enrollees in medical 
22.9 	assistance and general assistance medical care in the event that the contract with the 
22.10 	county is terminated.

22.11 	Sec. 4. Minnesota Statutes 2004, section 256B.76, is amended to read:
22.12 	256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.
22.13 	(a) Effective for services rendered on or after October 1, 1992, the commissioner 
22.14 	shall make payments for physician services as follows:
22.15 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
22.16 	procedural coding system codes titled "office and other outpatient services," "preventive 
22.17 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
22.18 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
22.19 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
22.20 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
22.21 	30, 1992. If the rate on any procedure code within these categories is different than the 
22.22 	rate that would have been paid under the methodology in section  256B.74, subdivision 2, 
22.23 	then the larger rate shall be paid; 
22.24 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
22.25 	or (ii) 15.4 percent above the rate in effect on June 30, 1992;
22.26 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
22.27 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
22.28 	except that payment rates for home health agency services shall be the rates in effect 
22.29 	on September 30, 1992;
22.30 	(4) effective for services rendered on or after January 1, 2000, payment rates for 
22.31 	physician and professional services shall be increased by three percent over the rates in 
22.32 	effect on December 31, 1999, except for home health agency and family planning agency 
22.33 	services; and
22.34 	(5) the increases in clause (4) shall be implemented January 1, 2000, for managed 
22.35 	care.
23.1 	(b) Effective for services rendered on or after October 1, 1992, the commissioner 
23.2 	shall make payments for dental services as follows:
23.3 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 
23.4 	percent above the rate in effect on June 30, 1992;
23.5 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 
23.6 	percentile of 1989, less the percent in aggregate necessary to equal the above increases;
23.7 	(3) effective for services rendered on or after January 1, 2000, payment rates for 
23.8 	dental services shall be increased by three percent over the rates in effect on December 
23.9 	31, 1999;
23.10 	(4) the commissioner shall award grants to community clinics or other nonprofit 
23.11 	community organizations, political subdivisions, professional associations, or other 
23.12 	organizations that demonstrate the ability to provide dental services effectively to public 
23.13 	program recipients. Grants may be used to fund the costs related to coordinating access for 
23.14 	recipients, developing and implementing patient care criteria, upgrading or establishing 
23.15 	new facilities, acquiring furnishings or equipment, recruiting new providers, or other 
23.16 	development costs that will improve access to dental care in a region. In awarding grants, 
23.17 	the commissioner shall give priority to applicants that plan to serve areas of the state in 
23.18 	which the number of dental providers is not currently sufficient to meet the needs of 
23.19 	recipients of public programs or uninsured individuals. The commissioner shall consider 
23.20 	the following in awarding the grants:
23.21 	(i) potential to successfully increase access to an underserved population;
23.22 	(ii) the ability to raise matching funds;
23.23 	(iii) the long-term viability of the project to improve access beyond the period 
23.24 	of initial funding;
23.25 	(iv) the efficiency in the use of the funding; and
23.26 	(v) the experience of the proposers in providing services to the target population.
23.27 	The commissioner shall monitor the grants and may terminate a grant if the grantee 
23.28 	does not increase dental access for public program recipients. The commissioner shall 
23.29 	consider grants for the following:
23.30 	(i) implementation of new programs or continued expansion of current access 
23.31 	programs that have demonstrated success in providing dental services in underserved 
23.32 	areas;
23.33 	(ii) a pilot program for utilizing hygienists outside of a traditional dental office to 
23.34 	provide dental hygiene services; and
24.1 	(iii) a program that organizes a network of volunteer dentists, establishes a system to 
24.2 	refer eligible individuals to volunteer dentists, and through that network provides donated 
24.3 	dental care services to public program recipients or uninsured individuals;
24.4 	(5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
24.5 	shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;
24.6 	(6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000, 
24.7 	for managed care; and
24.8 	(7) effective for services provided on or after January 1, 2002, payment for 
24.9 	diagnostic examinations and dental x-rays provided to children under age 21 shall be the 
24.10 	lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.
24.11 	(c) Effective for dental services rendered on or after January 1, 2002, the 
24.12 	commissioner may, within the limits of available appropriation, increase reimbursements 
24.13 	to dentists and dental clinics deemed by the commissioner to be critical access dental 
24.14 	providers. Reimbursement to a critical access dental provider may be increased by not 
24.15 	more than 50 percent above the reimbursement rate that would otherwise be paid to 
24.16 	the provider. Payments to health plan companies shall be adjusted to reflect increased 
24.17 	reimbursements to critical access dental providers as approved by the commissioner. 
24.18 	In determining which dentists and dental clinics shall be deemed critical access dental 
24.19 	providers, the commissioner shall review:
24.20 	(1) the utilization rate in the service area in which the dentist or dental clinic operates 
24.21 	for dental services to patients covered by medical assistance, general assistance medical 
24.22 	care, or MinnesotaCare as their primary source of coverage;
24.23 	(2) the level of services provided by the dentist or dental clinic to patients covered 
24.24 	by medical assistance, general assistance medical care, or MinnesotaCare as their primary 
24.25 	source of coverage; and
24.26 	(3) whether the level of services provided by the dentist or dental clinic is critical to 
24.27 	maintaining adequate levels of patient access within the service area.
24.28 	In the absence of a critical access dental provider in a service area, the commissioner may 
24.29 	designate a dentist or dental clinic as a critical access dental provider if the dentist or 
24.30 	dental clinic is willing to provide care to patients covered by medical assistance, general 
24.31 	assistance medical care, or MinnesotaCare at a level which significantly increases access 
24.32 	to dental care in the service area.
24.33 	The commissioner shall annually establish a reimbursement schedule for critical 
24.34 	access dental providers and provider-specific limits on total reimbursement received 
24.35 	under the reimbursement schedule, and shall notify each critical access dental provider 
24.36 	of the schedule and limit.
25.1 	(d) An entity that operates both a Medicare certified comprehensive outpatient 
25.2 	rehabilitation facility and a facility which was certified prior to January 1, 1993, that is 
25.3 	licensed under Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33 
25.4 	percent of the clients receiving rehabilitation services in the most recent calendar year are 
25.5 	medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation 
25.6 	services at rates that are 38 percent greater than the maximum reimbursement rate 
25.7 	allowed under paragraph (a), clause (2), when those services are (1) provided within the 
25.8 	comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing 
25.9 	facilities owned by the entity.
25.10 	(e) Effective for services rendered on or after January 1, 2007, the commissioner 
25.11 	shall make payments for physician and professional services based on the Medicare 
25.12 	relative value units (RVUs). This change shall be budget neutral and the cost of 
25.13 	implementing RVUs will be incorporated in the established conversion factor.

25.14 	Sec. 5. Minnesota Statutes 2004, section 256D.03, is amended by adding a subdivision 
25.15 	to read:
25.16 		Subd. 3c.General assistance medical care; eligibility verification. The 
25.17 	commissioner shall verify assets and income for all applicants, and for all recipients 
25.18 	upon renewal.

25.19 	EFFECTIVE DATE. This section is effective July 1, 2007, or upon the 
25.20 	implementation of HealthMatch, whichever is later.

25.21 	Sec. 6. Minnesota Statutes 2005 Supplement, section 256L.05, subdivision 2, is 
25.22 	amended to read:
25.23 		Subd. 2.Commissioner's duties. (a) The commissioner or county agency shall 
25.24 	use electronic verification as the primary method of income verification. If there is a 
25.25 	discrepancy between reported income and electronically verified income, an individual 
25.26 	may be required to submit additional verification. In addition, the commissioner shall 
25.27 	perform random audits to verify reported income and eligibility. The commissioner 
25.28 	may execute data sharing arrangements with the Department of Revenue and any other 
25.29 	governmental agency in order to perform income verification related to eligibility and 
25.30 	premium payment under the MinnesotaCare program.
25.31 	(b) In determining eligibility for MinnesotaCare, the commissioner shall require 
25.32 	applicants and enrollees seeking renewal of eligibility to verify both earned and unearned 
25.33 	income. The commissioner shall require applicants and enrollees seeking renewal of 
25.34 	eligibility to verify assets, if they are subject to the asset requirement under section 
26.1 	256L.17. The commissioner shall also require applicants and enrollees to submit the 
26.2 	names of their employers and a contact name with a telephone number for each employer 
26.3 	for purposes of verifying whether the applicant or enrollee, and any dependents, are 
26.4 	eligible for employer-subsidized coverage. Data collected is nonpublic data as defined 
26.5 	in section 13.02, subdivision 9.

26.6 	EFFECTIVE DATE. This section is effective July 1, 2007, or upon the 
26.7 	implementation of HealthMatch, whichever is later.

26.8 	Sec. 7. Minnesota Statutes 2004, section 256L.17, subdivision 3, is amended to read:
26.9 		Subd. 3.Documentation. (a) The commissioner of human services shall require 
26.10 	individuals and families, at the time of application or renewal, to indicate on a checkoff 
26.11 	form developed by the commissioner whether they satisfy the MinnesotaCare asset 
26.12 	requirement. This form must include the following or similar language: "To be eligible for 
26.13 	MinnesotaCare, individuals and families must not own net assets in excess of $30,000 
26.14 	for a household of two or more persons or $15,000 for a household of one person, not 
26.15 	including a homestead, household goods and personal effects, assets owned by children, 
26.16 	vehicles used for employment, court-ordered settlements up to $10,000, individual 
26.17 	retirement accounts, and capital and operating assets of a trade or business up to $200,000. 
26.18 	Do you and your household own net assets in excess of these limits?"
26.19 	(b) The commissioner shall require applicants and enrollees seeking renewal of 
26.20 	eligibility to verify assets. The commissioner may require individuals and families to 
26.21 	provide any information the commissioner determines necessary to verify compliance 
26.22 	with the asset requirement, if the commissioner determines that there is reason to believe 
26.23 	that an individual or family has assets that exceed the program limit.

26.24 	EFFECTIVE DATE. This section is effective July 1, 2007, or upon the 
26.25 	implementation of HealthMatch, whichever is later.

26.26 	Sec. 8. Minnesota Statutes 2004, section 295.52, is amended by adding a subdivision 
26.27 	to read:
26.28 		Subd. 8.Contingent reduction in tax rate. On September 1 of each odd-numbered 
26.29 	year, beginning September 1, 2007, the commissioner of finance shall determine the 
26.30 	projected balance of the health care access fund as of the end of the current biennium, 
26.31 	based on the most recent February forecast adjusted for any legislative session changes. 
26.32 	If the commissioner projects a surplus in the health care access fund as of the end of the 
26.33 	current biennium, the commissioner of finance, in consultation with the commissioner of 
27.1 	revenue, shall reduce the tax rates specified in subdivisions 1, 1a, 2, 3, and 4 in one-tenth 
27.2 	of one percent increments, making the largest reduction in tax rates consistent with 
27.3 	ensuring that the health care access fund retains a surplus as of the end of the current 
27.4 	biennium. The reduced tax rates shall take effect on the January 1 that immediately 
27.5 	follows the September 1 on which the commissioner determines the projected balance 
27.6 	and shall remain in effect for two tax years. The tax rates specified in subdivisions 1, 1a, 
27.7 	2, 3, and 4 shall apply for subsequent tax years, unless the commissioner, based on a 
27.8 	determination of the projected balance of the health care access fund made on September 
27.9 	1 of an odd-numbered year, reduces the tax rates. If the commissioner does not project a 
27.10 	surplus in the health care access fund as of the end of the current biennium, the tax rates 
27.11 	specified in subdivisions 1, 1a, 2, 3, and 4 shall continue to apply. The commissioner of 
27.12 	finance shall publish in the State Register by October 1 of each odd-numbered year the 
27.13 	amount of tax to be imposed for the next two calendar years.

27.14 	Sec. 9. Laws 2003, First Special Session chapter 14,  article 12, section 93, as amended 
27.15 	by Laws 2005, First Special Session chapter 4, article 8, section 80, is amended to read:
27.16 	Sec. 93.  REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY  
27.17 	CRITERIA AND POTENTIAL COST SAVINGS. 
27.18 	The commissioner of human services, in consultation with  the commissioner of 
27.19 	transportation and special transportation  service providers, shall review eligibility criteria 
27.20 	for medical  assistance special transportation services and shall evaluate  whether the level 
27.21 	of special transportation services provided  should be based on the degree of impairment of 
27.22 	the client, as  well as the medical diagnosis.  The commissioner shall also  evaluate methods 
27.23 	for reducing the cost of special transportation  services, including, but not limited to:  
27.24 	
27.25 	(1) requiring providers to maintain a daily log book  confirming delivery of clients to 
27.26 	medical facilities;  
27.27 	
27.28 	(2) requiring providers to implement commercially available  computer mapping 
27.29 	programs to calculate mileage for purposes of  reimbursement;  
27.30 	
27.31 	(3) restricting special transportation service from being  provided solely for trips 
27.32 	to pharmacies;  
27.33 	
27.34 	(4) modifying eligibility for special transportation;  
27.35 	
28.1 	(5) expanding alternatives to the use of special  transportation services;  
28.2 	
28.3 	(6) improving the process of certifying persons as eligible  for special transportation 
28.4 	services; and  
28.5 	
28.6 	(7) examining the feasibility and benefits of licensing  special transportation 
28.7 	providers.  
28.8 	
28.9 	The commissioner shall present recommendations for changes  in the eligibility 
28.10 	criteria and potential cost-savings for  special transportation services to the chairs and 
28.11 	ranking  minority members of the house and senate committees having  jurisdiction 
28.12 	over health and human services spending by January  15, 2004.  The commissioner 
28.13 	is prohibited from using a broker or  coordinator to manage special transportation 
28.14 	services until July  1,  2006, except for the purposes of checking for recipient  eligibility, 
28.15 	authorizing recipients for appropriate level of  transportation, and monitoring provider 
28.16 	compliance with  Minnesota Statutes, section 256B.0625, subdivision 17, and except 
28.17 	that the commissioner shall extend this prohibition on using a broker or coordinator to 
28.18 	manage special transportation services until July 1, 2007, if this extension can be done on 
28.19 	a budget-neutral basis. The  commissioner shall not amend the initial contract to broker or  
28.20 	manage nonemergency medical transportation to extend beyond two  consecutive years.  
28.21 	The commissioner shall not enter into a  broker or management contract for transportation 
28.22 	services which  denies a medical assistance recipient the free choice of health  service 
28.23 	provider, including a special transportation provider,  as specified in Code of Federal 
28.24 	Regulations, title 42, section  431.51.  This prohibition does not apply to the purchase or  
28.25 	management of common carrier transportation. 
28.26 	

28.27 	EFFECTIVE DATE. This section is effective July 1, 2006.

28.28 	Sec. 10. Laws 2005, First Special Session chapter 4, article 8, section 84, is amended 
28.29 	to read:
28.30 	Sec. 84.  SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE  
28.31 	CONTRACT.
28.32 	Notwithstanding Minnesota Statutes, section 256B.692,  subdivision 6, the 
28.33 	commissioner of human services shall not  reject consider a county-based purchasing 
28.34 	health plan proposal that  requires county-based purchasing on a sole-source or single-plan  
28.35 	basis if the implementation of the sole-source or single-plan  purchasing proposal does 
29.1 	not limit an enrollee's provider choice  or access to services.  The commissioner shall 
29.2 	request federal  approval, if necessary, to permit or maintain a sole-source or  single-plan 
29.3 	purchasing option even if choice is available in the  area. 

29.4 	Sec. 11. PHARMACY PAYMENT REFORM ADVISORY COMMITTEE.
 29.5 		Subdivision 1.Definitions. For purposes of this section, the following words, terms, 
29.6 	and phrases have the following meanings:
29.7 	(a) "Department" means the Department of Human Services.
29.8 	(b) "Commissioner" means the commissioner of the Department of Human Services.
29.9 	(c) "Cost of dispensing" includes, but is not limited to, operational and overhead 
29.10 	costs; professional counseling as required under the Omnibus Budget Reconciliation Act 
29.11 	of 1990, excluding medication management services under Minnesota Statutes, section 
29.12 	256B.0625, subdivision 13h; salaries; and other associated administrative costs, as well 
29.13 	as a reasonable return on investment. In addition, cost of dispensing includes expenses 
29.14 	transferred by wholesale drug distributors to pharmacies as a result of the wholesale drug 
29.15 	distributor tax under Minnesota Statutes, sections 295.52 to 295.582.
29.16 	(d) "Additional costs" include, but are not limited to, costs relating to coordination of 
29.17 	benefits, bad debt, uncollected co-pays, payment lag times, and high rate of rejected claims.
29.18 	(e) "Advisory committee" means the Pharmacy Payment Reform Advisory 
29.19 	Committee established by this section.
29.20 		Subd. 2.Advisory committee. The Pharmacy Payment Reform Advisory 
29.21 	Committee is established under the direction of the commissioner of human services. 
29.22 	The commissioner, after receiving recommendations from the Minnesota Pharmacists 
29.23 	Association, the Minnesota Retailers Association, the Minnesota Hospital Association, 
29.24 	and the Minnesota Wholesale Druggists Association, shall convene a pharmacy payment 
29.25 	reform advisory committee to advise the commissioner and make recommendations to the 
29.26 	legislature on implementation of pharmacy reforms contained in title VI, chapter IV, of 
29.27 	the Deficit Reduction Act of 2005. The committee shall be comprised of three licensed 
29.28 	pharmacists representing both independent and chain pharmacy entities, one of whom 
29.29 	must have expertise in pharmacoeconomics, two individuals representing hospitals with 
29.30 	outpatient pharmacies, and two individuals with expertise in wholesale drug distribution. 
29.31 	The committee shall be staffed by an employee of the department who shall serve as an ex 
29.32 	officio nonvoting member of the committee. The department's pharmacy program manager 
29.33 	shall also serve as an ex officio, nonvoting member of the committee. The committee is 
29.34 	governed by Minnesota Statutes, section 15.059, except that committee members do not 
30.1 	receive compensation or reimbursement for expenses. The advisory committee members 
30.2 	shall serve a two-year term and the advisory committee will expire on January 31, 2008.
30.3 		Subd. 3.Cost of dispensing study. The department shall conduct a prescription 
30.4 	drug cost of dispensing study to determine the average cost of dispensing Medicaid 
30.5 	prescriptions in Minnesota. The department shall contract with an independent third 
30.6 	party in the state that has experience conducting business cost allocation studies, such as 
30.7 	an academic institution, to conduct a prescription drug cost of dispensing study. If no 
30.8 	independent third-party entity exists in the state, the department may contract with an 
30.9 	out-of-state entity. The cost of dispensing study shall be completed by an independent 
30.10 	third party no later than October 1, 2006, and reported to the department and the advisory 
30.11 	committee upon completion.
30.12 		Subd. 4.Content of study. The study shall determine the cost of dispensing 
30.13 	the average prescription and any additional costs that might be incurred for dispensing 
30.14 	Medicaid prescriptions. The study shall include the current level of dispensing fees paid 
30.15 	to providers and an estimate of revenues required to adequately adjust reimbursement 
30.16 	to cover the cost to pharmacies.
30.17 		Subd. 5.Methodology of study and publishing requirement. The independent 
30.18 	third-party entity performing the cost of dispensing research shall submit to the advisory 
30.19 	committee the entity's proposed research methodology and shall publish the collected data 
30.20 	to allow other independent researchers to validate the study results. The data shall be 
30.21 	published in a manner that does not identify the source of the data.
30.22 		Subd. 6.Recommendations. The advisory committee shall use the information 
30.23 	from the cost of dispensing study and make recommendations to the commissioner on 
30.24 	implementation of pharmacy reforms contained in title VI, chapter IV, of the Deficit 
30.25 	Reduction Act of 2005. The commissioner shall report the findings of the study and 
30.26 	the recommendations of the advisory committee to the legislature by January 15, 2007. 
30.27 	The department shall conduct a cost of dispensing study every three years following the 
30.28 	initial report. The commissioner, in consultation with the advisory committee, shall make 
30.29 	recommendations to the legislature on how to adequately adjust reimbursement rates to 
30.30 	pharmacies to cover the costs of dispensing and additional costs to pharmacies. Reports 
30.31 	shall include the current level of dispensing fees paid to providers and an estimate of 
30.32 	revenues required to adequately adjust reimbursement to ensure that:
30.33 	(1) reimbursement is sufficient to enlist an adequate number of participating 
30.34 	pharmacy providers so that pharmacy services are as available for Medicaid recipients 
30.35 	under the program as for the state's general population;
31.1 	(2) Medicaid dispensing fees are adequate to reimburse pharmacy providers for the 
31.2 	costs of dispensing prescriptions under the Medicaid program;
31.3 	(3) Medicaid pharmacy reimbursement for multiple-source drugs included on the 
31.4 	federal upper reimbursement limit is set at the level established by the federal government 
31.5 	under United States Code, title 42, section 1396r-8(e)(5);
31.6 	(4) the combined Medicaid program reimbursement for prescription drug product 
31.7 	and the dispensing fee provides a return adequate to provide a reasonable profit for the 
31.8 	participating pharmacy; and
31.9 	(5) the new payment system does not create disincentives for pharmacists to 
31.10 	dispense generic drugs.

31.11 	EFFECTIVE DATE. This section is effective the day following final enactment.

31.12 	Sec. 12.  REPEALER.
 31.13 	Minnesota Statutes 2004, section 256B.692, subdivision 10, is repealed.

31.14 	ARTICLE 3
31.15 	HEALTH CARE FEDERAL COMPLIANCE

31.16 	Section 1. Minnesota Statutes 2004, section 62A.045, is amended to read:
31.17 	62A.045 PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT 
31.18 	HEALTH PROGRAMS.
31.19 	(a) As a condition of doing business in Minnesota, each health insurer shall comply 
31.20 	with the requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171, 
31.21 	including any federal regulations adopted under that act, to the extent that it imposes a 
31.22 	requirement that applies in this state and that is not also required by the laws of this state. 
31.23 	This section does not require compliance with any provision of the federal act prior to 
31.24 	the effective date provided for that provision in the federal act. The commissioner shall 
31.25 	enforce this section.
31.26 	"Health insurer" for the purpose of this section includes self-insured plans, group 
31.27 	health plans (as defined in section 607(1) of the Employee Retirement Income Security 
31.28 	Act of 1974), service benefit plans, managed care organizations, pharmacy benefit 
31.29 	managers, or other parties that are by contract legally responsible to pay a claim for a 
31.30 	healthcare item or service for an individual receiving benefits under paragraph (b).
31.31 	(b) No health plan issued or renewed to provide coverage to a Minnesota resident 
31.32 	shall contain any provision denying or reducing benefits because services are rendered to a 
31.33 	person who is eligible for or receiving medical benefits pursuant to title XIX of the Social 
32.1 	Security Act (Medicaid) in this or any other state; chapter 256; 256B; or 256D or services 
32.2 	pursuant to section  252.27;  256L.01 to  256L.10;  260B.331, subdivision 2;  260C.331, 
32.3 	subdivision 2; or  393.07, subdivision 1 or 2. No health carrier providing benefits under 
32.4 	plans covered by this section shall use eligibility for medical programs named in this 
32.5 	section as an underwriting guideline or reason for nonacceptance of the risk. 
32.6 	(b) (c) If payment for covered expenses has been made under state medical programs 
32.7 	for health care items or services provided to an individual, and a third party has a legal 
32.8 	liability to make payments, the rights of payment and appeal of an adverse coverage 
32.9 	decision for the individual, or in the case of a child their responsible relative or caretaker, 
32.10 	will be subrogated to the state agency. The state agency may assert its rights under this 
32.11 	section within three years of the date the service was rendered. For purposes of this 
32.12 	section, "state agency" includes prepaid health plans under contract with the commissioner 
32.13 	according to sections  256B.69,  256D.03, subdivision 4, paragraph (c), and  256L.12; 
32.14 	children's mental health collaboratives under section  245.493; demonstration projects for 
32.15 	persons with disabilities under section  256B.77; nursing homes under the alternative 
32.16 	payment demonstration project under section  256B.434; and county-based purchasing 
32.17 	entities under section  256B.692. 
32.18 	(c) (d) Notwithstanding any law to the contrary, when a person covered by a health 
32.19 	plan receives medical benefits according to any statute listed in this section, payment for 
32.20 	covered services or notice of denial for services billed by the provider must be issued 
32.21 	directly to the provider. If a person was receiving medical benefits through the Department 
32.22 	of Human Services at the time a service was provided, the provider must indicate this 
32.23 	benefit coverage on any claim forms submitted by the provider to the health carrier for 
32.24 	those services. If the commissioner of human services notifies the health carrier that 
32.25 	the commissioner has made payments to the provider, payment for benefits or notices 
32.26 	of denials issued by the health carrier must be issued directly to the commissioner. 
32.27 	Submission by the department to the health carrier of the claim on a Department of 
32.28 	Human Services claim form is proper notice and shall be considered proof of payment of 
32.29 	the claim to the provider and supersedes any contract requirements of the health carrier 
32.30 	relating to the form of submission. Liability to the insured for coverage is satisfied to the 
32.31 	extent that payments for those benefits are made by the health carrier to the provider or the 
32.32 	commissioner as required by this section.
32.33 	(d) (e) When a state agency has acquired the rights of an individual eligible for 
32.34 	medical programs named in this section and has health benefits coverage through a 
32.35 	health carrier, the health carrier shall not impose requirements that are different from 
32.36 	requirements applicable to an agent or assignee of any other individual covered.
33.1 	(e) (f) For the purpose of this section, health plan includes coverage offered by 
33.2 	community integrated service networks, any plan governed under the federal Employee 
33.3 	Retirement Income Security Act of 1974 (ERISA), United States Code, title 29, sections 
33.4 	1001 to 1461, and coverage offered under the exclusions listed in section  62A.011, 
33.5 	subdivision 3, clauses (2), (6), (9), (10), and (12). 

33.6 	Sec. 2. Minnesota Statutes 2004, section 62S.05, is amended by adding a subdivision 
33.7 	to read:
33.8 		Subd. 4.Extension of limitation periods. The commissioner may extend the 
33.9 	limitation periods set forth in subdivisions 1 and 2 as to specific age group categories in 
33.10 	specific policy forms upon finding that the extension is in the best interest of the public. 

33.11 	EFFECTIVE DATE. This section is effective July 1, 2006.

33.12 	Sec. 3. Minnesota Statutes 2004, section 62S.08, subdivision 3, is amended to read:
33.13 		Subd. 3.Mandatory format. The following standard format outline of coverage 
33.14 	must be used, unless otherwise specifically indicated:
33.15 	COMPANY NAME
33.16 	ADDRESS - CITY AND STATE
33.17 	TELEPHONE NUMBER
33.18 	LONG-TERM CARE INSURANCE
33.19 	OUTLINE OF COVERAGE
33.20 	Policy Number or Group Master Policy and Certificate Number
33.21 	(Except for policies or certificates which are guaranteed issue, the following caution 
33.22 	statement, or language substantially similar, must appear as follows in the outline of 
33.23 	coverage.)
33.24 	CAUTION: The issuance of this long-term care insurance (policy) (certificate) 
33.25 	is based upon your responses to the questions on your application. A copy of your 
33.26 	(application) (enrollment form) (is enclosed) (was retained by you when you applied). 
33.27 	If your answers are incorrect or untrue, the company has the right to deny benefits or 
33.28 	rescind your policy. The best time to clear up any questions is now, before a claim 
33.29 	arises. If, for any reason, any of your answers are incorrect, contact the company at this 
33.30 	address: (insert address).
33.31 	(1) This policy is (an individual policy of insurance) (a group policy) which was 
33.32 	issued in the (indicate jurisdiction in which group policy was issued).
33.33 	(2) PURPOSE OF OUTLINE OF COVERAGE. This outline of coverage provides 
33.34 	a very brief description of the important features of the policy. You should compare 
33.35 	this outline of coverage to outlines of coverage for other policies available to you. This 
34.1 	is not an insurance contract, but only a summary of coverage. Only the individual or 
34.2 	group policy contains governing contractual provisions. This means that the policy or 
34.3 	group policy sets forth in detail the rights and obligations of both you and the insurance 
34.4 	company. Therefore, if you purchase this coverage, or any other coverage, it is important 
34.5 	that you READ YOUR POLICY (OR CERTIFICATE) CAREFULLY.
34.6 	(3) THIS PLAN IS INTENDED TO BE A QUALIFIED LONG-TERM CARE 
34.7 	INSURANCE CONTRACT AS DEFINED UNDER SECTION 7702(B)(b) OF THE 
34.8 	INTERNAL REVENUE CODE OF 1986.
34.9 	(4) TERMS UNDER WHICH THE POLICY OR CERTIFICATE MAY BE 
34.10 	CONTINUED IN FORCE OR DISCONTINUED.
34.11 	(a) (For long-term care health insurance policies or certificates describe one of the 
34.12 	following permissible policy renewability provisions:
34.13 	(1) Policies and certificates that are guaranteed renewable shall contain the following 
34.14 	statement:) RENEWABILITY: THIS POLICY (CERTIFICATE) IS GUARANTEED 
34.15 	RENEWABLE. This means you have the right, subject to the terms of your policy, 
34.16 	(certificate) to continue this policy as long as you pay your premiums on time. (company 
34.17 	name) cannot change any of the terms of your policy on its own, except that, in the future, 
34.18 	IT MAY INCREASE THE PREMIUM YOU PAY.
34.19 	(2) (Policies and certificates that are noncancelable shall contain the following 
34.20 	statement:) RENEWABILITY: THIS POLICY (CERTIFICATE) IS NONCANCELABLE. 
34.21 	This means that you have the right, subject to the terms of your policy, to continue this 
34.22 	policy as long as you pay your premiums on time. (company name) cannot change any 
34.23 	of the terms of your policy on its own and cannot change the premium you currently 
34.24 	pay. However, if your policy contains an inflation protection feature where you choose 
34.25 	to increase your benefits, (company name) may increase your premium at that time for 
34.26 	those additional benefits.
34.27 	(b) (For group coverage, specifically describe continuation/conversion provisions 
34.28 	applicable to the certificate and group policy.)
34.29 	(c) (Describe waiver of premium provisions or state that there are not such 
34.30 	provisions.)
34.31 	(5) TERMS UNDER WHICH THE COMPANY MAY CHANGE PREMIUMS. 
34.32 	(In bold type larger than the maximum type required to be used for the other 
34.33 	provisions of the outline of coverage, state whether or not the company has a right to 
34.34 	change the premium and, if a right exists, describe clearly and concisely each circumstance 
34.35 	under which the premium may change.)
35.1 	(6) TERMS UNDER WHICH THE POLICY OR CERTIFICATE MAY BE 
35.2 	RETURNED AND PREMIUM REFUNDED.
35.3 	(a) (Provide a brief description of the right to return -- "free look" provision of 
35.4 	the policy.)
35.5 	(b) (Include a statement that the policy either does or does not contain provisions 
35.6 	providing for a refund or partial refund of premium upon the death of an insured or 
35.7 	surrender of the policy or certificate. If the policy contains such provisions, include a 
35.8 	description of them.)
35.9 	(5)(7) THIS IS NOT MEDICARE SUPPLEMENT COVERAGE. If you are 
35.10 	eligible for Medicare, review the Medicare Supplement Buyer's Guide available from 
35.11 	the insurance company.
35.12 	(a) (For agents) neither (insert company name) nor its agents represent Medicare, the 
35.13 	federal government, or any state government.
35.14 	(b) (For direct response) (insert company name) is not representing Medicare, the 
35.15 	federal government, or any state government.
35.16 	(6)(8) LONG-TERM CARE COVERAGE. Policies of this category are designed to 
35.17 	provide coverage for one or more necessary or medically necessary diagnostic, preventive, 
35.18 	therapeutic, rehabilitative, maintenance, or personal care services, provided in a setting 
35.19 	other than an acute care unit of a hospital, such as in a nursing home, in the community, 
35.20 	or in the home.
35.21 	This policy provides coverage in the form of a fixed dollar indemnity benefit for 
35.22 	covered long-term care expenses, subject to policy (limitations), (waiting periods), and 
35.23 	(coinsurance) requirements. (Modify this paragraph if the policy is not an indemnity 
35.24 	policy.)
35.25 	(7)(9) BENEFITS PROVIDED BY THIS POLICY.
35.26 	(a) (Covered services, related deductible(s), waiting periods, elimination periods, 
35.27 	and benefit maximums.)
35.28 	(b) (Institutional benefits, by skill level.)
35.29 	(c) (Noninstitutional benefits, by skill level.)
35.30 	(d) (Eligibility for payment of benefits.)
35.31 	(Activities of daily living and cognitive impairment shall be used to measure an 
35.32 	insured's need for long-term care and must be defined and described as part of the outline 
35.33 	of coverage.)
35.34 	(Any benefit screens must be explained in this section. If these screens differ for 
35.35 	different benefits, explanation of the screen should accompany each benefit description. If 
35.36 	an attending physician or other specified person must certify a certain level of functional 
36.1 	dependency in order to be eligible for benefits, this too must be specified. If activities of 
36.2 	daily living (ADLs) are used to measure an insured's need for long-term care, then these 
36.3 	qualifying criteria or screens must be explained.)
36.4 	(8)(10) LIMITATIONS AND EXCLUSIONS:
36.5 	Describe:
36.6 	(a) preexisting conditions;
36.7 	(b) noneligible facilities/provider;
36.8 	(c) noneligible levels of care (e.g., unlicensed providers, care or treatment provided 
36.9 	by a family member, etc.);
36.10 	(d) exclusions/exceptions; and
36.11 	(e) limitations.
36.12 	(This section should provide a brief specific description of any policy provisions 
36.13 	which limit, exclude, restrict, reduce, delay, or in any other manner operate to qualify 
36.14 	payment of the benefits described in paragraph (6) (8).)
36.15 	THIS POLICY MAY NOT COVER ALL THE EXPENSES ASSOCIATED WITH 
36.16 	YOUR LONG-TERM CARE NEEDS.
36.17 	(9)(11) RELATIONSHIP OF COST OF CARE AND BENEFITS. Because the costs 
36.18 	of long-term care services will likely increase over time, you should consider whether and 
36.19 	how the benefits of this plan may be adjusted. As applicable, indicate the following:
36.20 	(a) that the benefit level will not increase over time;
36.21 	(b) any automatic benefit adjustment provisions;
36.22 	(c) whether the insured will be guaranteed the option to buy additional benefits and 
36.23 	the basis upon which benefits will be increased over time if not by a specified amount 
36.24 	or percentage;
36.25 	(d) if there is such a guarantee, include whether additional underwriting or health 
36.26 	screening will be required, the frequency and amounts of the upgrade options, and any 
36.27 	significant restrictions or limitations; and
36.28 	(e) whether there will be any additional premium charge imposed and how that 
36.29 	is to be calculated.
36.30 	(10)(12) ALZHEIMER'S DISEASE AND OTHER ORGANIC BRAIN 
36.31 	DISORDERS. (State that the policy provides coverage for insureds clinically diagnosed as 
36.32 	having Alzheimer's disease or related degenerative and dementing illnesses. Specifically, 
36.33 	describe each benefit screen or other policy provision which provides preconditions to the 
36.34 	availability of policy benefits for such an insured.)
36.35 	(11)(13) PREMIUM.
36.36 	(a) State the total annual premium for the policy.
37.1 	(b) If the premium varies with an applicant's choice among benefit options, indicate 
37.2 	the portion of annual premium which corresponds to each benefit option.
37.3 	(12)(14) ADDITIONAL FEATURES.
37.4 	(a) Indicate if medical underwriting is used.
37.5 	(b) Describe other important features.
37.6 	(15) CONTACT THE STATE DEPARTMENT OF COMMERCE OR SENIOR 
37.7 	LINKAGE LINE IF YOU HAVE GENERAL QUESTIONS REGARDING LONG-TERM 
37.8 	CARE INSURANCE. CONTACT THE INSURANCE COMPANY IF YOU HAVE 
37.9 	SPECIFIC QUESTIONS REGARDING YOUR LONG-TERM CARE INSURANCE 
37.10 	POLICY OR CERTIFICATE.

37.11 	EFFECTIVE DATE. This section is effective July 1, 2006.

37.12 	Sec. 4. Minnesota Statutes 2004, section 62S.081, subdivision 4, is amended to read:
37.13 		Subd. 4.Forms. An insurer shall use the forms in Appendices B (Personal 
37.14 	Worksheet) and F (Potential Rate Increase Disclosure Form) of the Long-term Care 
37.15 	Insurance Model Regulation adopted by the National Association of Insurance 
37.16 	Commissioners to comply with the requirements of subdivisions 1 and 2.

37.17 	EFFECTIVE DATE. This section is effective July 1, 2006.

37.18 	Sec. 5. Minnesota Statutes 2004, section 62S.10, subdivision 2, is amended to read:
37.19 		Subd. 2.Contents. The summary must include the following information:
37.20 	(1) an explanation of how the long-term care benefit interacts with other components 
37.21 	of the policy, including deductions from death benefits;
37.22 	(2) an illustration of the amount of benefits, the length of benefits, and the guaranteed 
37.23 	lifetime benefits, if any, for each covered person; and
37.24 	(3) any exclusions, reductions, and limitations on benefits of long-term care; and
37.25 	(4) a statement that any long-term care inflation protection option required by section 
37.26 	62S.23 is not available under this policy. 

37.27 	EFFECTIVE DATE. This section is effective July 1, 2006.

37.28 	Sec. 6. Minnesota Statutes 2004, section 62S.13, is amended by adding a subdivision 
37.29 	to read:
37.30 		Subd. 6.Death of insured. In the event of the death of the insured, this section shall 
37.31 	not apply to the remaining death benefit of a life insurance policy that accelerates benefits 
37.32 	for long-term care. In this situation, the remaining death benefits under these policies shall 
38.1 	be governed by section 61A.03, subdivision 1, paragraph (c). In all other situations, this 
38.2 	section shall apply to life insurance policies that accelerate benefits for long-term care. 

38.3 	EFFECTIVE DATE. This section is effective July 1, 2006.

38.4 	Sec. 7. Minnesota Statutes 2004, section 62S.14, subdivision 2, is amended to read:
38.5 		Subd. 2.Terms. The terms "guaranteed renewable" and "noncancelable" may not 
38.6 	be used in an individual long-term care insurance policy without further explanatory 
38.7 	language that complies with the disclosure requirements of section  62S.20. The term 
38.8 	"level premium" may only be used when the insurer does not have the right to change 
38.9 	the premium. 

38.10 	EFFECTIVE DATE. This section is effective July 1, 2006

38.11 	Sec. 8. Minnesota Statutes 2004, section 62S.15, is amended to read:
38.12 	62S.15 AUTHORIZED LIMITATIONS AND EXCLUSIONS.
38.13 	No policy may be delivered or issued for delivery in this state as long-term care 
38.14 	insurance if the policy limits or excludes coverage by type of illness, treatment, medical 
38.15 	condition, or accident, except as follows:
38.16 	(1) preexisting conditions or diseases;
38.17 	(2) mental or nervous disorders; except that the exclusion or limitation of benefits on 
38.18 	the basis of Alzheimer's disease is prohibited;
38.19 	(3) alcoholism and drug addiction;
38.20 	(4) illness, treatment, or medical condition arising out of war or act of war; 
38.21 	participation in a felony, riot, or insurrection; service in the armed forces or auxiliary 
38.22 	units; suicide, attempted suicide, or intentionally self-inflicted injury; or non-fare-paying 
38.23 	aviation; and
38.24 	(5) treatment provided in a government facility unless otherwise required by 
38.25 	law, services for which benefits are available under Medicare or other government 
38.26 	program except Medicaid, state or federal workers' compensation, employer's liability 
38.27 	or occupational disease law, motor vehicle no-fault law; services provided by a member 
38.28 	of the covered person's immediate family; and services for which no charge is normally 
38.29 	made in the absence of insurance; and 
38.30 	(6) expenses for services or items available or paid under another long-term care 
38.31 	insurance or health insurance policy.
38.32 	This subdivision does not prohibit exclusions and limitations by type of provider or 
38.33 	territorial limitations.

39.1 	EFFECTIVE DATE. This section is effective July 1, 2006.

39.2 	Sec. 9. Minnesota Statutes 2004, section 62S.20, subdivision 1, is amended to read:
39.3 		Subdivision 1.Renewability. (a) Individual long-term care insurance policies 
39.4 	must contain a renewability provision that is appropriately captioned, appears on the first 
39.5 	page of the policy, and clearly states the duration, where limited, of renewability and the 
39.6 	duration of the term of coverage for which the policy is issued and for which it may be 
39.7 	renewed that the coverage is guaranteed renewable or noncancelable. This subdivision 
39.8 	does not apply to policies which are part of or combined with life insurance policies 
39.9 	which do not contain a renewability provision and under which the right to nonrenew is 
39.10 	reserved solely to the policyholder.
39.11 	(b) A long-term care insurance policy or certificate, other than one where the insurer 
39.12 	does not have the right to change the premium, shall include a statement that premium 
39.13 	rates may change. 

39.14 	EFFECTIVE DATE. This section is effective July 1, 2006.

39.15 	Sec. 10. Minnesota Statutes 2004, section 62S.24, subdivision 1, is amended to read:
39.16 		Subdivision 1.Required questions. An application form must include the following 
39.17 	questions designed to elicit information as to whether, as of the date of the application, the 
39.18 	applicant has another long-term care insurance policy or certificate in force or whether a 
39.19 	long-term care policy or certificate is intended to replace any other accident and sickness 
39.20 	or long-term care policy or certificate presently in force. A supplementary application 
39.21 	or other form to be signed by the applicant and agent, except where the coverage is sold 
39.22 	without an agent, containing the following questions may be used. If a replacement policy 
39.23 	is issued to a group as defined under section   62S.01, subdivision 15, clause (1), the 
39.24 	following questions may be modified only to the extent necessary to elicit information 
39.25 	about long-term care insurance policies other than the group policy being replaced; 
39.26 	provided, however, that the certificate holder has been notified of the replacement: 
39.27 	(1)  do you have another long-term care insurance policy or certificate in force
39.28 	(including health care service contract or health maintenance organization contract)?;
39.29 	(2) did you have another long-term care insurance policy or certificate in force 
39.30 	during the last 12 months?;
39.31 	(i) if so, with which company?; and
39.32 	(ii) if that policy lapsed, when did it lapse?; and
39.33 	(3) are you covered by Medicaid?; and 
40.1 	(4) do you intend to replace any of your medical or health insurance coverage with 
40.2 	this policy (certificate)?

40.3 	EFFECTIVE DATE. This section is effective July 1, 2006.

40.4 	Sec. 11. Minnesota Statutes 2004, section 62S.24, is amended by adding a subdivision 
40.5 	to read:
40.6 		Subd. 1a.Other health insurance policies sold by agent. Agents shall list all other 
40.7 	health insurance policies they have sold to the applicant that are still in force or were sold 
40.8 	in the past five years and are no longer in force. 

40.9 	EFFECTIVE DATE. This section is effective July 1, 2006.

40.10 	Sec. 12. Minnesota Statutes 2004, section 62S.24, subdivision 3, is amended to read:
40.11 		Subd. 3.Solicitations other than direct response. After determining that a 
40.12 	sale will involve replacement, an insurer, other than an insurer using direct response 
40.13 	solicitation methods or its agent, shall furnish the applicant, before issuance or delivery of 
40.14 	the individual long-term care insurance policy, a notice regarding replacement of accident 
40.15 	and sickness or long-term care coverage. One copy of the notice must be retained by the 
40.16 	applicant and an additional copy signed by the applicant must be retained by the insurer. 
40.17 	The required notice must be provided in the following manner:
40.18 	NOTICE TO APPLICANT REGARDING REPLACEMENT OF
40.19 	INDIVIDUAL ACCIDENT AND SICKNESS OR LONG-TERM 
40.20 	CARE INSURANCE
40.21 	(Insurance company's name and address)
40.22 	SAVE THIS NOTICE! IT MAY BE IMPORTANT TO YOU IN THE FUTURE.
40.23 	According to (your application) (information you have furnished), you intend to 
40.24 	lapse or otherwise terminate existing accident and sickness or long-term care insurance 
40.25 	and replace it with an individual long-term care insurance policy to be issued by (company 
40.26 	name) insurance company. Your new policy provides 30 days within which you may 
40.27 	decide, without cost, whether you desire to keep the policy. For your own information and 
40.28 	protection, you should be aware of and seriously consider certain factors which may affect 
40.29 	the insurance protection available to you under the new policy.
40.30 	You should review this new coverage carefully, comparing it with all accident 
40.31 	and sickness or long-term care insurance coverage you now have, and terminate your 
40.32 	present policy only if, after due consideration, you find that purchase of this long-term 
40.33 	care coverage is a wise decision.
40.34 	STATEMENT TO APPLICANT BY AGENT
41.1 	(BROKER OR OTHER REPRESENTATIVE):
41.2 	(Use additional sheets, as necessary.)
41.3 	I have reviewed your current medical health insurance coverage. I believe the 
41.4 	replacement of insurance involved in this transaction materially improves your position. 
41.5 	My conclusion has taken into account the following considerations, which I call to your 
41.6 	attention:
41.7 	(a) Health conditions which you presently have (preexisting conditions) may not 
41.8 	be immediately or fully covered under the new policy. This could result in denial or 
41.9 	delay in payment of benefits under the new policy, whereas a similar claim might have 
41.10 	been payable under your present policy.
41.11 	(b) State law provides that your replacement policy or certificate may not contain 
41.12 	new preexisting conditions or probationary periods. The insurer will waive any time 
41.13 	periods applicable to preexisting conditions or probationary periods in the new policy (or 
41.14 	coverage) for similar benefits to the extent such time was spent (depleted) under the 
41.15 	original policy.
41.16 	(c)  If you are replacing existing long-term care insurance coverage, you may wish to 
41.17 	secure the advice of your present insurer or its agent regarding the proposed replacement of 
41.18 	your present policy. This is not only your right, but it is also in your best interest to make 
41.19 	sure you understand all the relevant factors involved in replacing your present coverage.
41.20 	(d)  If, after due consideration, you still wish to terminate your present policy and 
41.21 	replace it with new coverage, be certain to truthfully and completely answer all questions 
41.22 	on the application concerning your medical health history. Failure to include all material 
41.23 	medical information on an application may provide a basis for the company to deny any 
41.24 	future claims and to refund your premium as though your policy had never been in force. 
41.25 	After the application has been completed and before you sign it, reread it carefully to be 
41.26 	certain that all information has been properly recorded.
41.27 	........
41.28 	(Signature of Agent, Broker, or Other Representative)
41.29 	(Typed Name and Address of Agency or Broker)
41.30 	The  above "Notice to Applicant" was delivered to me on:

41.31		........
	
41.32		(Date)
	
41.33		........
	
41.34		(Applicant's Signature)

41.35 	EFFECTIVE DATE. This section is effective July 1, 2006.

42.1 	Sec. 13. Minnesota Statutes 2004, section 62S.24, subdivision 4, is amended to read:
42.2 		Subd. 4.Direct response solicitations. Insurers using direct response solicitation 
42.3 	methods shall deliver a notice regarding replacement of long-term care coverage to 
42.4 	the applicant upon issuance of the policy. The required notice must be provided in the 
42.5 	following manner:
42.6 	NOTICE TO APPLICANT REGARDING REPLACEMENT OF
42.7 	ACCIDENT AND SICKNESS OR 
42.8 	LONG-TERM CARE INSURANCE
42.9 	(Insurance  company's name and address)
42.10 	SAVE THIS NOTICE! IT MAY BE
42.11 	IMPORTANT TO YOU IN THE FUTURE.
42.12 	According to (your application) (information you have furnished), you intend to 
42.13 	lapse or otherwise terminate existing accident and sickness or long-term care insurance 
42.14 	and replace it with the long-term care insurance policy delivered herewith issued by 
42.15 	(company name) insurance company.
42.16 	Your new policy provides 30 days within which you may decide, without cost, 
42.17 	whether you desire to keep the policy. For your own information and protection, you 
42.18 	should be aware of and seriously consider certain factors which may affect the insurance 
42.19 	protection available to you under the new policy.
42.20 	You should review this new coverage carefully, comparing it with all long-term care 
42.21 	insurance coverage you now have, and terminate your present policy only if, after due 
42.22 	consideration, you find that purchase of this long-term care coverage is a wise decision.
42.23 	(a) Health conditions which you presently have (preexisting conditions) may not 
42.24 	be immediately or fully covered under the new policy. This could result in denial or 
42.25 	delay in payment of benefits under the new policy, whereas a similar claim might have 
42.26 	been payable under your present policy.
42.27 	(b) State law provides that your replacement policy or certificate may not contain 
42.28 	new preexisting conditions or probationary periods. Your insurer will waive any time 
42.29 	periods applicable to preexisting conditions or probationary periods in the new policy (or 
42.30 	coverage) for similar benefits to the extent such time was spent (depleted) under the 
42.31 	original policy.
42.32 	(c) If you are replacing existing long-term care insurance coverage, you may wish to 
42.33 	secure the advice of your present insurer or its agent regarding the proposed replacement of 
42.34 	your present policy. This is not only your right, but it is also in your best interest to make 
42.35 	sure you understand all the relevant factors involved in replacing your present coverage.
42.36 	(d) (To be included only if the application is attached to the policy.)
43.1 	If,  after due consideration, you still wish to terminate your present policy and replace 
43.2 	it with new coverage, read the copy of the application attached to your new policy and be 
43.3 	sure that all questions are answered fully and correctly. Omissions or misstatements in 
43.4 	the application could cause an otherwise valid claim to be denied. Carefully check the 
43.5 	application and write to (company name and address) within 30 days if any information is 
43.6 	not correct and complete, or if any past medical history has been left out of the application.

43.7		........
	
43.8		(Company Name)

43.9 	EFFECTIVE DATE. This section is effective July 1, 2006.

43.10 	Sec. 14. Minnesota Statutes 2004, section 62S.24, is amended by adding a subdivision 
43.11 	to read:
43.12 		Subd. 7.Life insurance policies. Life insurance policies that accelerate benefits for 
43.13 	long-term care shall comply with this section if the policy being replaced is a long-term 
43.14 	care insurance policy. If the policy being replaced is a life insurance policy, the insurer 
43.15 	shall comply with the replacement requirements of sections 61A.53 to 61A.60. If a 
43.16 	life insurance policy that accelerates benefits for long-term care is replaced by another 
43.17 	such policy, the replacing insurer shall comply with both the long-term care and the life 
43.18 	insurance replacement requirements. 

43.19 	EFFECTIVE DATE. This section is effective July 1, 2006.

43.20 	Sec. 15.  Minnesota Statutes 2004, section 62S.24, is amended by adding a subdivision 
43.21 	to read:
43.22 		Subd. 8.Exchange for long-term care partnership policy; addition of policy 
43.23 	rider. (a) If federal law is amended or a federal waiver is granted with respect to the 
43.24 	long-term care partnership program referenced in section 256B.0571, issuers of long-term 
43.25 	care policies may voluntarily exchange a current long-term care insurance policy for a 
43.26 	long-term care partnership policy that meets the requirements of Public Law 109-171, 
43.27 	section 6021, after the effective date of the state plan amendment implementing the 
43.28 	partnership program in this state.
43.29 	(b) If federal law is amended or a federal waiver is granted with respect to the 
43.30 	long-term care partnership program referenced in section 256B.0571 allowing an existing 
43.31 	long-term care insurance policy to qualify as a partnership policy by addition of a policy 
43.32 	rider, the issuer of the policy is authorized to add the rider to the policy after the effective 
43.33 	date of the state plan amendment implementing the partnership program in this state.
44.1 	(c) The commissioner, in cooperation with the commissioner of human services, 
44.2 	shall pursue any federal law changes or waivers necessary to allow the implementation 
44.3 	of paragraphs (a) and (b).

44.4 	EFFECTIVE DATE. This section is effective July 1, 2006.

44.5 	Sec. 16. Minnesota Statutes 2004, section 62S.25, subdivision 6, is amended to read:
44.6 		Subd. 6.Claims denied. Each insurer shall report annually by June 30 the number 
44.7 	of claims denied for any reason during the reporting period for each class of business, 
44.8 	expressed as a percentage of claims denied, other than claims denied for failure to meet 
44.9 	the waiting period or because of any applicable preexisting condition. For purposes of 
44.10 	this subdivision, "claim" means a request for payment of benefits under an in-force policy 
44.11 	regardless of whether the benefit claimed is covered under the policy or any terms or 
44.12 	conditions of the policy have been met. 

44.13 	EFFECTIVE DATE. This section is effective July 1, 2006.

44.14 	Sec. 17. Minnesota Statutes 2004, section 62S.25, is amended by adding a subdivision 
44.15 	to read:
44.16 		Subd. 7.Reports.  Reports under this section shall be done on a statewide basis and 
44.17 	filed with the commissioner. They shall include, at a minimum, the information in the 
44.18 	format contained in Appendix E (Claim Denial Reporting Form) and in Appendix G 
44.19 	(Replacement and Lapse Reporting Form) of the Long-Term Care Model Regulation 
44.20 	adopted by the National Association of Insurance Commissioners. 

44.21 	EFFECTIVE DATE. This section is effective July 1, 2006.

44.22 	Sec. 18. Minnesota Statutes 2004, section 62S.26, is amended to read:
44.23 	62S.26 LOSS RATIO.
44.24 		Subdivision 1.Minimum loss ratio. (a) The minimum loss ratio must be at least 60 
44.25 	percent, calculated in a manner which provides for adequate reserving of the long-term 
44.26 	care insurance risk. In evaluating the expected loss ratio, the commissioner shall give 
44.27 	consideration to all relevant factors, including:
44.28 	(1) statistical credibility of incurred claims experience and earned premiums;
44.29 	(2) the period for which rates are computed to provide coverage;
44.30 	(3) experienced and projected trends;
44.31 	(4) concentration of experience within early policy duration;
45.1 	(5) expected claim fluctuation;
45.2 	(6) experience refunds, adjustments, or dividends;
45.3 	(7) renewability features;
45.4 	(8) all appropriate expense factors;
45.5 	(9) interest;
45.6 	(10) experimental nature of the coverage;
45.7 	(11) policy reserves;
45.8 	(12) mix of business by risk classification; and
45.9 	(13) product features such as long elimination periods, high deductibles, and high 
45.10 	maximum limits.
45.11 		Subd. 2.Life insurance policies. Subdivision 1 shall not apply to life insurance 
45.12 	policies that accelerate benefits for long-term care. A life insurance policy that funds 
45.13 	long-term care benefits entirely by accelerating the death benefit is considered to provide 
45.14 	reasonable benefits in relation to premiums paid, if the policy complies with all of the 
45.15 	following provisions:
45.16 	(1) the interest credited internally to determine cash value accumulations, including 
45.17 	long-term care, if any, are guaranteed not to be less than the minimum guaranteed interest 
45.18 	rate for cash value accumulations without long-term care set forth in the policy;
45.19 	(2) the portion of the policy that provides life insurance benefits meets the 
45.20 	nonforfeiture requirements of section 61A.24;
45.21 	(3) the policy meets the disclosure requirements of sections 62S.09, 62S.10, and 
45.22 	62S.11; and 
45.23 	(4) an actuarial memorandum is filed with the insurance department that includes:
45.24 	(i) a description of the basis on which the long-term care rates were determined;
45.25 	(ii) a description of the basis for the reserves;
45.26 	(iii) a summary of the type of policy, benefits, renewability, general marketing 
45.27 	method, and limits on ages of issuance;
45.28 	(iv) a description and a table of each actuarial assumption used. For expenses, 
45.29 	an insurer must include percentage of premium dollars per policy and dollars per unit 
45.30 	of benefits, if any;
45.31 	(v) a description and a table of the anticipated policy reserves and additional reserves 
45.32 	to be held in each future year for active lives;
45.33 	(vi) the estimated average annual premium per policy and the average issue age;
45.34 	(vii) a statement as to whether underwriting is performed at the time of application. 
45.35 	The statement shall indicate whether underwriting is used and, if used, the statement 
45.36 	shall include a description of the type or types of underwriting used, such as medical 
46.1 	underwriting or functional assessment underwriting. Concerning a group policy, the 
46.2 	statement shall indicate whether the enrollee or any dependent will be underwritten and 
46.3 	when underwriting occurs; and
46.4 	(viii) a description of the effect of the long-term care policy provision on the required 
46.5 	premiums, nonforfeiture values, and reserves on the underlying life insurance policy, both 
46.6 	for active lives and those in long-term care claim status. 
46.7 		Subd. 3.Nonapplication.  (b) This section does not apply to policies or certificates 
46.8 	that are subject to sections  62S.021,  62S.081, and  62S.265, and that comply with those 
46.9 	sections. 

46.10 	EFFECTIVE DATE. This section is effective July 1, 2006.

46.11 	Sec. 19. Minnesota Statutes 2004, section 62S.266, subdivision 2, is amended to read:
46.12 		Subd. 2.Requirement. (a) An insurer must offer each prospective policyholder a 
46.13 	nonforfeiture benefit in compliance with the following requirements:
46.14 	(1) a policy or certificate offered with nonforfeiture benefits must have coverage 
46.15 	elements, eligibility, benefit triggers, and benefit length that are the same as coverage to be 
46.16 	issued without nonforfeiture benefits. The nonforfeiture benefit included in the offer must 
46.17 	be the benefit described in subdivision 5; and
46.18 	(2)  the offer must be in writing if the nonforfeiture benefit is not otherwise described 
46.19 	in the outline of coverage or other materials given to the prospective policyholder.
46.20 	(b) When a group long-term care insurance policy is issued, the offer required in 
46.21 	paragraph (a) shall be made to the group policy holder. However, if the policy is issued as 
46.22 	group long-term care insurance as defined in section 62S.01, subdivision 15, clause (4), 
46.23 	other than to a continuing care retirement community or other similar entity, the offering 
46.24 	shall be made to each proposed certificate holder. 

46.25 	EFFECTIVE DATE. This section is effective July 1, 2006.

46.26 	Sec. 20. Minnesota Statutes 2004, section 62S.29, subdivision 1, is amended to read:
46.27 		Subdivision 1.Requirements. An insurer or other entity marketing long-term care 
46.28 	insurance coverage in this state, directly or through its producers, shall:
46.29 	(1) establish marketing procedures and agent training requirements to assure that a 
46.30 	any marketing activities, including any comparison of policies by its agents or other 
46.31 	producers, are fair and accurate;
46.32 	(2) establish marketing procedures to assure excessive insurance is not sold or issued;
47.1 	(3) display prominently by type, stamp, or other appropriate means, on the first page 
47.2 	of the outline of coverage and policy, the following:
47.3 	"Notice to buyer: This policy may not cover all of the costs associated with 
47.4 	long-term care incurred by the buyer during the period of coverage. The buyer is advised 
47.5 	to review carefully all policy limitations.";
47.6 	(4) provide copies of the disclosure forms required in section 62S.081, subdivision 
47.7 	4, to the applicant; 
47.8 	(5) inquire and otherwise make every reasonable effort to identify whether a 
47.9 	prospective applicant or enrollee for long-term care insurance already has long-term care 
47.10 	insurance and the types and amounts of the insurance;
47.11 	(5)(6) establish auditable procedures for verifying compliance with this subdivision; 
47.12 	and
47.13 	(6)(7) if applicable, provide written notice to the prospective policyholder and 
47.14 	certificate holder, at solicitation, that a senior insurance counseling program approved 
47.15 	by the commissioner is available and the name, address, and telephone number of the 
47.16 	program;
47.17 	(8) use the terms "noncancelable" or "level premium" only when the policy or 
47.18 	certificate conforms to section 62S.14; and 
47.19 	(9) provide an explanation of contingent benefit upon lapse provided for in section 
47.20 	62S.266.

47.21 	EFFECTIVE DATE. This section is effective July 1, 2006.

47.22 	Sec. 21. Minnesota Statutes 2004, section 62S.30, is amended to read:
47.23 	62S.30 APPROPRIATENESS OF RECOMMENDED PURCHASE
47.24 	SUITABILITY.
47.25 	In recommending the purchase or replacement of a long-term care insurance policy 
47.26 	or certificate, an agent shall comply with section  60K.46, subdivision 4. 
47.27 		Subdivision 1. Standards. Every insurer or other entity marketing long-term care 
47.28 	insurance shall:
47.29 	(1) develop and use suitability standards to determine whether the purchase or 
47.30 	replacement of long-term care insurance is appropriate for the needs of the applicant; 
47.31 	(2) train its agents in the use of its suitability standards; and 
47.32 	(3) maintain a copy of its suitability standards and make them available for 
47.33 	inspection upon request by the commissioner.
48.1 		Subd. 2.Procedures. (a) To determine whether the applicant meets the standards 
48.2 	developed by the insurer or other entity marketing long-term care insurance, the agent 
48.3 	and insurer or other entity marketing long-term care insurance shall develop procedures 
48.4 	that take the following into consideration:
48.5 	(1) the ability to pay for the proposed coverage and other pertinent financial 
48.6 	information related to the purchase of the coverage;
48.7 	(2) the applicant's goals or needs with respect to long-term care and the advantages 
48.8 	and disadvantages of insurance to meet those goals or needs; and 
48.9 	(3) the values, benefits, and costs of the applicant's existing insurance, if any, when 
48.10 	compared to the values, benefits, and costs of the recommended purchase or replacement.
48.11 	(b) The insurer or other entity marketing long-term care insurance, and where an 
48.12 	agent is involved, the agent, shall make reasonable efforts to obtain the information set 
48.13 	forth in paragraph (a). The efforts shall include presentation to the applicant, at or prior 
48.14 	to application, of the "Long-Term Care Insurance Personal Worksheet." The personal 
48.15 	worksheet used by the insurer or other entity marketing long-term care insurance shall 
48.16 	contain, at a minimum, the information in the format contained in Appendix B of the 
48.17 	Long-Term Care Model Regulation adopted by the National Association of Insurance 
48.18 	Commissioners, in not less than 12-point type. The insurer or other entity marketing 
48.19 	long-term care insurance may request the applicant to provide additional information to 
48.20 	comply with its suitability standards. The insurer or other entity marketing long-term care 
48.21 	insurance shall file a copy of its personal worksheet with the commissioner. 
48.22 	(c) A completed personal worksheet shall be returned to the insurer or other entity 
48.23 	marketing long-term care insurance prior to consideration of the applicant for coverage, 
48.24 	except the personal worksheet need not be returned for sales of employer group long-term 
48.25 	care insurance to employees and their spouses. The sale or dissemination by the insurer 
48.26 	or other entity marketing long-term care insurance, or the agent, of information obtained 
48.27 	through the personal worksheet, is prohibited. 
48.28 	(d) The insurer or other entity marketing long-term care insurance shall use the 
48.29 	suitability standards it has developed under this section in determining whether issuing 
48.30 	long-term care insurance coverage to an applicant is appropriate. Agents shall use the 
48.31 	suitability standards developed by the insurer or other entity marketing long-term care 
48.32 	insurance in marketing long-term care insurance. 
48.33 	(e) At the same time as the personal worksheet is provided to the applicant, the 
48.34 	disclosure form entitled "Things You Should Know Before You Buy Long-Term Care 
48.35 	Insurance" shall be provided. The form shall be in the format contained in Appendix C of 
49.1 	the Long-Term Care Insurance Model Regulation adopted by the National Association of 
49.2 	Insurance Commissioners in not less than 12-point type. 
49.3 	(f) If the insurer or other entity marketing long-term care insurance determines 
49.4 	that the applicant does not meet its financial suitability standards, or if the applicant has 
49.5 	declined to provide the information, the insurer or other entity marketing long-term 
49.6 	care insurance may reject the application. In the alternative, the insurer or other entity 
49.7 	marketing long-term care insurance shall send the applicant a letter similar to Appendix D 
49.8 	of the Long-Term Care Insurance Model Regulation adopted by the National Association 
49.9 	of Insurance Commissioners. However, if the applicant has declined to provide financial 
49.10 	information, the insurer or other entity marketing long-term care insurance may use some 
49.11 	other method to verify the applicant's intent. The applicant's returned letter or a record of 
49.12 	the alternative method of verification shall be made part of the applicant's file. 
49.13 		Subd. 3.Reports. The insurer or other entity marketing long-term care insurance 
49.14 	shall report annually to the commissioner the total number of applications received from 
49.15 	residents of this state, the number of those who declined to provide information on the 
49.16 	personal worksheet, the number of applicants who did not meet the suitability standards, 
49.17 	and the number of those who chose to confirm after receiving a suitability letter. 
49.18 		Subd. 4.Application. This section shall not apply to life insurance policies that 
49.19 	accelerate benefits for long-term care. 

49.20 	EFFECTIVE DATE. This section is effective July 1, 2006.

49.21 	Sec. 22. [62S.315] PRODUCER TRAINING.
49.22 	The commissioner shall approve producer training requirements in accordance with 
49.23 	the NAIC Long-Term Care Insurance Model Act provisions. The commissioner of the 
49.24 	Department of Human Services shall provide technical assistance and information to the 
49.25 	commissioner in accordance with Public Law 109-171, section 6021.

49.26 	EFFECTIVE DATE. This section is effective July 1, 2006.

49.27 	Sec. 23. Minnesota Statutes 2004, section 144.6501, subdivision 6, is amended to read:
49.28 		Subd. 6.Medical assistance payment. (a) An admission contract for a facility that 
49.29 	is certified for participation in the medical assistance program must state that neither the 
49.30 	prospective resident, nor anyone on the resident's behalf, is required to pay privately any 
49.31 	amount for which the resident's care at the facility has been approved for payment by 
49.32 	medical assistance or to make any kind of donation, voluntary or otherwise. Except as 
49.33 	permitted under section 6015 of the Deficit Reduction Act of 2005, Public Law 109-171, 
50.1 	an admission contract must state that the facility does not require as a condition of 
50.2 	admission, either in its admission contract or by oral promise before signing the admission 
50.3 	contract, that residents remain in private pay status for any period of time.
50.4 	(b) The admission contract must state that upon presentation of proof of eligibility, 
50.5 	the facility will submit a medical assistance claim for reimbursement and will return any 
50.6 	and all payments made by the resident, or by any person on the resident's behalf, for 
50.7 	services covered by medical assistance, upon receipt of medical assistance payment.
50.8 	(c) A facility that participates in the medical assistance program shall not charge for 
50.9 	the day of the resident's discharge from the facility or subsequent days.
50.10 	(d) If a facility's charges incurred by the resident are delinquent for 30 days, and 
50.11 	no person has agreed to apply for medical assistance for the resident, the facility may 
50.12 	petition the court under chapter 525 to appoint a representative for the resident in order to 
50.13 	apply for medical assistance for the resident.
50.14 	(e) The remedy provided in this subdivision does not preclude a facility from seeking 
50.15 	any other remedy available under other laws of this state.

50.16 	Sec. 24. Minnesota Statutes 2004, section 256B.02, subdivision 9, is amended to read:
50.17 		Subd. 9.Private health care coverage. "Private health care coverage" means any 
50.18 	plan regulated by chapter 62A, 62C or 64B. Private health care coverage also includes 
50.19 	any self-insuranceself-insured plan providing health care benefits, pharmacy benefit 
50.20 	manager, service benefit plan, managed care organization, and other parties that are by 
50.21 	contract legally responsible for payment of a claim for a health care item or service for an 
50.22 	individual receiving medical benefits under chapter 256B, 256D, or 256L.

50.23 	Sec. 25. Minnesota Statutes 2004, section 256B.056, subdivision 2, is amended to read:
50.24 		Subd. 2.Homestead; exclusion  and homestead equity limit for institutionalized 
50.25 	persons. (a) The homestead shall be excluded for the first six calendar months of a 
50.26 	person's stay in a long-term care facility and shall continue to be excluded for as long as 
50.27 	the recipient can be reasonably expected to return to the homestead. For purposes of 
50.28 	this subdivision, "reasonably expected to return to the homestead" means the recipient's 
50.29 	attending physician has certified that the expectation is reasonable, and the recipient can 
50.30 	show that the cost of care upon returning home will be met through medical assistance 
50.31 	or other sources. The homestead shall continue to be excluded for persons residing in 
50.32 	a long-term care facility if it is used as a primary residence by one of the following 
50.33 	individuals:
50.34 	(a) (1) the spouse;
51.1 	(b) (2) a child under age 21;
51.2 	(c) (3) a child of any age who is blind or permanently and totally disabled as defined 
51.3 	in the supplemental security income program;
51.4 	(d) (4) a sibling who has equity interest in the home and who resided in the home for 
51.5 	at least one year immediately before the date of the person's admission to the facility; or
51.6 	(e) (5) a child of any age, or, subject to federal approval, a grandchild of any age, 
51.7 	who resided in the home for at least two years immediately before the date of the person's 
51.8 	admission to the facility, and who provided care to the person that permitted the person to 
51.9 	reside at home rather than in an institution.
51.10 	(b) Effective for applications filed on or after July 1, 2006, and for renewals after 
51.11 	July 1, 2006, for persons who first applied for payment of long-term care services on 
51.12 	or after January 2, 2006, the equity interest in the homestead of an individual whose 
51.13 	eligibility for long-term care services is determined on or after January 1, 2006, shall not 
51.14 	exceed $500,000, unless it is the lawful residence of the individual's spouse or child 
51.15 	who is under age 21, blind, or disabled. The amount specified in this paragraph shall be 
51.16 	increased beginning in year 2011, from year-to-year based on the percentage increase in 
51.17 	the Consumer Price Index for all urban consumers (all items; United States city average), 
51.18 	rounded to the nearest $1,000. This provision may be waived in the case of demonstrated 
51.19 	hardship by a process to be determined by the secretary of health and human services 
51.20 	pursuant to section 6014 of the Deficit Reduction Act of 2005, Public Law 109-171.

51.21 	Sec. 26. Minnesota Statutes 2004, section 256B.056, is amended by adding a 
51.22 	subdivision to read:
51.23 		Subd. 3e.Treatment of continuing care retirement and life care community 
51.24 	entrance fees. An entrance fee paid by an individual to a continuing care retirement or 
51.25 	life care community shall be treated as an available asset to the extent that:
51.26 	(1) the individual has the ability to use the entrance fee, or the contract provides that 
51.27 	the entrance fee may be used, to pay for care should other resources or income of the 
51.28 	individual be insufficient to pay for care;
51.29 	(2) the individual is eligible for a refund of any remaining entrance fees when 
51.30 	the individual dies or terminates the continuing care retirement or life care community 
51.31 	contract and leaves the community; and
51.32 	(3) the entrance fee does not confer an ownership interest in the continuing care 
51.33 	retirement or life care community.

52.1 	Sec. 27. Minnesota Statutes 2004, section 256B.056, is amended by adding a 
52.2 	subdivision to read:
52.3 		Subd. 11.Treatment of annuities. (a) Any individual applying for or seeking 
52.4 	recertification of eligibility for medical assistance payment of long-term care services 
52.5 	shall provide a complete description of any interest either the individual or the individual's 
52.6 	spouse has in annuities. The individual and the individual's spouse shall furnish the 
52.7 	agency responsible for determining eligibility with complete current copies of their 
52.8 	annuities and related documents for review as part of the application process on disclosure 
52.9 	forms provided by the department as part of their application.
52.10 	(b) The disclosure form shall include a statement that the department becomes the 
52.11 	remainder beneficiary under the annuity or similar financial instrument by virtue of the 
52.12 	receipt of medical assistance. The disclosure form shall include a notice to the issuer of 
52.13 	the department's right under this section as a preferred remainder beneficiary under the 
52.14 	annuity or similar financial instrument for medical assistance furnished to the individual 
52.15 	or the individual's spouse, and require the issuer to provide confirmation that a remainder 
52.16 	beneficiary designation has been made and to notify the county agency when there is a 
52.17 	change in the amount of the income or principal being withdrawn from the annuity or 
52.18 	other similar financial instrument at the time of the most recent disclosure required under 
52.19 	this section. The individual and the individual's spouse shall execute separate disclosure 
52.20 	forms for each annuity or similar financial instrument that they are required to disclose 
52.21 	under this section and in which they have an interest.
52.22 	(c) An issuer of an annuity or similar financial instrument who receives notice on a 
52.23 	disclosure form as described in paragraph (b) shall provide confirmation to the requesting 
52.24 	agency that a remainder beneficiary designating the state has been made and shall notify 
52.25 	the county agency when there is a change in the amount of income or principal being 
52.26 	withdrawn from the annuity or other similar financial instrument. The county agency shall 
52.27 	provide the issuer with the name, address, and telephone number of a unit within the 
52.28 	department that the insurer can contact to comply with this paragraph.

52.29 	Sec. 28. Minnesota Statutes 2005 Supplement, section 256B.0571, is amended to read:
52.30 	256B.0571 LONG-TERM CARE PARTNERSHIP PROGRAM.
52.31 		Subdivision 1.Definitions. For purposes of this section, the following terms have 
52.32 	the meanings given them.
52.33 		Subd. 2.Home care service. "Home care service" means care described in section 
52.34 	144A.43.
53.1 		Subd. 3.Long-term care insurance. "Long-term care insurance" means a policy 
53.2 	described in section 62S.01.
53.3 		Subd. 4.Medical assistance. "Medical assistance" means the program of medical 
53.4 	assistance established under section 256B.01.
53.5 		Subd. 5.Nursing home. "Nursing home" means a nursing home as described 
53.6 	in section 144A.01.
53.7 		Subd. 6.Partnership policy. "Partnership policy" means a long-term care insurance 
53.8 	policy that meets the requirements under subdivision 10 or 11, regardless of when the 
53.9 	policy and was first issued on or after the effective date of the state plan amendment.
53.10 		Subd. 7.Partnership program. "Partnership program" means the Minnesota 
53.11 	partnership for long-term care program established under this section.
53.12 		Subd. 7a.Protected assets. "Protected assets" means assets or proceeds of assets 
53.13 	that are protected from recovery under subdivisions 13 and 15.
53.14 		Subd. 8.Program established. (a) The commissioner, in cooperation with the 
53.15 	commissioner of commerce, shall establish the Minnesota partnership for long-term care 
53.16 	program to provide for the financing of long-term care through a combination of private 
53.17 	insurance and medical assistance.
53.18 	(b) An individual who meets the requirements in this paragraph is eligible to 
53.19 	participate in the partnership program. The individual must:
53.20 	(1) be a Minnesota resident at the time coverage first became effective under the 
53.21 	partnership policy;
53.22 	(2) purchase a partnership policy that is delivered, issued for delivery, or renewed on 
53.23 	or after the effective date of Laws 2005, First Special Session chapter 4, article 7, section 
53.24 	5, and maintain the partnership policy in effect throughout the period of participation in 
53.25 	the partnership program be a beneficiary of a partnership policy that (i) is issued on or 
53.26 	after the effective date of the state plan amendment implementing the partnership program 
53.27 	in Minnesota, or (ii) qualifies as a partnership policy under the provisions of section 
53.28 	62S.24, subdivision 8; and
53.29 	(3) exhaust the minimumhave exhausted all of the benefits under the partnership 
53.30 	policy as described in this section. Benefits received under a long-term care insurance 
53.31 	policy before the effective date of Laws 2005, First Special Session chapter 4, article 7, 
53.32 	section 5 July 1, 2006, do not count toward the exhaustion of benefits required in this 
53.33 	subdivision.
53.34 		Subd. 9.Medical assistance eligibility. (a) Upon application offor medical 
53.35 	assistance program payment of long-term care services by an individual who meets the 
54.1 	requirements described in subdivision 8, the commissioner shall determine the individual's 
54.2 	eligibility for medical assistance according to paragraphs (b) and (c) to (i).
54.3 	(b) After disregarding financialdetermining assets exempted under medical 
54.4 	assistance eligibility requirements subject to the asset limit under section 256B.056, 
54.5 	subdivision 3 or 3c, or section 256B.057, subdivision 9 or 10, the commissioner shall 
54.6 	disregard an additional amount of financial assets equalallow the individual to designate 
54.7 	assets to be protected from recovery under subdivisions 13 and 15 of this section up 
54.8 	to the dollar amount of coveragethe benefits utilized under the partnership policy.
54.9 	Designated assets shall be disregarded for purposes of determining eligibility for payment 
54.10 	of long-term care services.
54.11 	(c) The commissioner shall consider the individual's income according to medical 
54.12 	assistance eligibility requirements. The individual shall identify the designated assets and 
54.13 	the full fair market value of those assets and designate them as assets to be protected at 
54.14 	the time of initial application for medical assistance. The full fair market value of real 
54.15 	property or interests in real property shall be based on the most recent full assessed value 
54.16 	for property tax purposes for the real property, unless the individual provides a complete 
54.17 	professional appraisal by a licensed appraiser to establish the full fair market value. The 
54.18 	extent of a life estate in real property shall be determined using the life estate table in the 
54.19 	health care program's manual. Ownership of any asset in joint tenancy shall be treated as 
54.20 	ownership as tenants in common for purposes of its designation as a disregarded asset. 
54.21 	The unprotected value of any protected asset is subject to estate recovery according to 
54.22 	subdivisions 13 and 15.
54.23 	(d) The right to designate assets to be protected is personal to the individual and 
54.24 	ends when the individual dies, except as otherwise provided in subdivisions 13 and 
54.25 	15. It does not include the increase in the value of the protected asset and the income, 
54.26 	dividends, or profits from the asset. It may be exercised by the individual or by anyone 
54.27 	with the legal authority to do so on the individual's behalf. It shall not be sold, assigned, 
54.28 	transferred, or given away.
54.29 	(e) If the dollar amount of the benefits utilized under a partnership policy is greater 
54.30 	than the full fair market value of all assets protected at the time of the application for 
54.31 	medical assistance long-term care services, the individual may designate additional assets 
54.32 	that become available during the individual's lifetime for protection under this section. 
54.33 	The individual must make the designation in writing to the county agency no later than 
54.34 	the last date on which the individual must report a change in circumstances to the county 
54.35 	agency, as provided for under the medical assistance program. Any excess used for this 
55.1 	purpose shall not be available to the individual's estate to protect assets in the estate from 
55.2 	recovery under section 256B.15, 524.3-1202, or otherwise.
55.3 	(f) This section applies only to estate recovery under United States Code, title 42, 
55.4 	section 1396p, subsections (a) and (b), and does not apply to recovery authorized by other 
55.5 	provisions of federal law, including, but not limited to, recovery from trusts under United 
55.6 	States Code, title 42, section 1396p, subsection (d)(4)(A) and (C), or to recovery from 
55.7 	annuities, or similar legal instruments, subject to section 6012, subsections (a) and (b), of 
55.8 	the Deficit Reduction Act of 2005, Public Law 109-171.
55.9 	(g) An individual's protected assets owned by the individual's spouse who applies 
55.10 	for payment of medical assistance long-term care services shall not be protected assets or 
55.11 	disregarded for purposes of eligibility of the individual's spouse solely because they were 
55.12 	protected assets of the individual.
55.13 	(h) Assets designated under this subdivision shall not be subject to penalty under 
55.14 	section 256B.0595.
55.15 	(i) The commissioner shall otherwise determine the individual's eligibility 
55.16 	for payment of long-term care services according to medical assistance eligibility 
55.17 	requirements.
55.18 		Subd. 10.Dollar-for-dollar asset protection policies Inflation protection. (a) A 
55.19 	dollar-for-dollar asset protection policy must meet all of the requirements in paragraphs 
55.20 	(b) to (e).
55.21 	(b) The policy must satisfy the requirements of chapter 62S.
55.22 	(c) The policy must offer an elimination period of not more than 180 days for an 
55.23 	adjusted premium.
55.24 	(d) The policy must satisfy the requirements established by the commissioner of 
55.25 	human services under subdivision 14.
55.26 	(e) Minimum daily benefits shall be $130 for nursing home care or $65 for home 
55.27 	care, with inflation protection provided in the policy as described in section 62S.23, 
55.28 	subdivision 1, clause (1). These minimum daily benefit amounts shall be adjusted by the 
55.29 	commissioner on October 1 of each year by a percentage equal to the inflation protection 
55.30 	feature described in section 62S.23, subdivision 1, clause (1), for purposes of setting 
55.31 	minimum requirements that a policy must meet in future years in order to initially qualify 
55.32 	as an approved policy under this subdivision. Adjusted minimum daily benefit amounts 
55.33 	shall be rounded to the nearest whole dollar.
55.34 	A long-term care partnership policy must provide the inflation protection described 
55.35 	in this paragraph. If the policy is sold to an individual who:
56.1 	(1) has not attained age 61 as of the date of purchase, the policy provides compound 
56.2 	annual inflation protection;
56.3 	(2) has attained age 61, but has not attained age 76 as of such date, the policy 
56.4 	provides some level of inflation protection; and 
56.5 	(3) has attained age 76 as of such date, the policy may, but is not required to, provide 
56.6 	some level of inflation protection.
56.7 		Subd. 11.Total asset protection policies. (a) A total asset protection policy must 
56.8 	meet all of the requirements in subdivision 10, paragraphs (b) to (d), and this subdivision.
56.9 	(b) Minimum coverage shall be for a period of not less than three years and for a 
56.10 	dollar amount equal to 36 months of nursing home care at the minimum daily benefit rate 
56.11 	determined and adjusted under paragraph (c).
56.12 	(c) Minimum daily benefits shall be $150 for nursing home care or $75 for home 
56.13 	care, with inflation protection provided in the policy as described in section 62S.23, 
56.14 	subdivision 1, clause (1). These minimum daily benefit amounts shall also be adjusted 
56.15 	by the commissioner on October 1 of each year by a percentage equal to the inflation 
56.16 	protection feature described in section 62S.23, subdivision 1, clause (1), for purposes of 
56.17 	setting minimum requirements that a policy must meet in future years in order to initially 
56.18 	qualify as an approved policy under this subdivision. Adjusted minimum daily benefit 
56.19 	amounts shall be rounded to the nearest whole dollar.
56.20 	(d) The policy must cover all of the following services:
56.21 	(1) nursing home stay;
56.22 	(2) home care service; and
56.23 	(3) care management.
56.24 		Subd. 12.Compliance with federal law. An issuer of a partnership policy must 
56.25 	comply with any federal law authorizing partnership policies in Minnesota Public Law 
56.26 	109-171, section 6021, including any federal regulations, as amended, adopted under that 
56.27 	law. This subdivision does not require compliance with any provision of this federal 
56.28 	law until the date upon which the law requires compliance with the provision. The 
56.29 	commissioner has authority to enforce this subdivision.
56.30 		Subd. 13.Limitations on estate recovery. (a) For an individual who exhausts the 
56.31 	minimum benefits of adollar-for-dollar asset protectionpolicy under subdivision 10, and 
56.32 	is determined eligible for medical assistance under subdivision 9, the state shall limit 
56.33 	recovery under the provisions of section 256B.15 against the estate of the individual or 
56.34 	individual's spouse for medical assistance benefits received by that individual to an amount 
56.35 	that exceeds the dollar amount of coverage utilized under the partnership policy. Protected 
56.36 	assets of the individual shall not be subject to recovery under section 256B.15 or section 
57.1 	524.3-1201 for medical assistance or alternative care paid on behalf of the individual. 
57.2 	Protected assets of the individual in the estate of the individual's surviving spouse shall 
57.3 	not be liable to pay a claim for recovery of medical assistance paid for the predeceased 
57.4 	individual that is filed in the estate of the surviving spouse under section 256B.15. 
57.5 	Protected assets of the individual shall not be protected assets in the surviving spouse's 
57.6 	estate by reason of the preceding sentence and shall be subject to recovery under section 
57.7 	256B.15 or 524.3-1201 for medical assistance paid on behalf of the surviving spouse.
57.8 	(b) For an individual who exhausts the minimum benefits of a total asset protection 
57.9 	policy under subdivision 11, and is determined eligible for medical assistance under 
57.10 	subdivision 9, the state shall not seek recovery under the provisions of section 256B.15
57.11 	against the estate of the individual or individual's spouse for medical assistance benefits 
57.12 	received by that individual. The personal representative may protect the full fair market 
57.13 	value of an individual's unprotected assets in the individual's estate in an amount equal 
57.14 	to the unused amount of asset protection the individual had on the date of death. The 
57.15 	personal representative shall apply the asset protection so that the full fair market value of 
57.16 	any unprotected asset in the estate is protected. When or if the asset protection available 
57.17 	to the personal representative is or becomes less than the full fair market value of any 
57.18 	remaining unprotected asset, it shall be applied to partially protect one unprotected asset.
57.19 	(c) The asset protection described in paragraph (a) terminates with respect to an asset 
57.20 	includable in the individual's estate under chapter 524 or section 256B.15:
57.21 	(1) when the estate distributes the asset; or
57.22 	(2) if the estate of the individual has not been probated within one year from the 
57.23 	date of death.
57.24 	(d) If an individual owns a protected asset on the date of death and the estate is 
57.25 	opened for probate more than one year after death, the state or a county agency may file 
57.26 	and collect claims in the estate under section 256B.15, and no statute of limitations in 
57.27 	chapter 524 that would otherwise limit or bar the claim shall apply.
57.28 	(e) Except as otherwise provided, nothing in this section shall limit or prevent 
57.29 	recovery of medical assistance.
57.30 		Subd. 14.Implementation. (a) If federal law is amended or a federal waiver is 
57.31 	granted to permit implementation of this section, the commissioner, in consultation with 
57.32 	the commissioner of commerce, may alter the requirements of subdivisions 10 and 11, 
57.33 	and may establish additional requirements for approved policies in order to conform with 
57.34 	federal law or waiver authority. In establishing these requirements, the commissioner shall 
57.35 	seek to maximize purchase of qualifying policies by Minnesota residents while controlling 
57.36 	medical assistance costs.
58.1 	(b) The commissioner is authorized to suspend implementation of this section 
58.2 	until the next session of the legislature if the commissioner, in consultation with the 
58.3 	commissioner of commerce, determines that the federal legislation or federal waiver 
58.4 	authorizing a partnership program in Minnesota is likely to impose substantial unforeseen 
58.5 	costs on the state budget.
58.6 	(c) The commissioner must take action under paragraph (a) or (b) within 45 days of 
58.7 	final federal action authorizing a partnership policy in Minnesota.
58.8 	(d) The commissioner must notify the appropriate legislative committees of 
58.9 	action taken under this subdivision within 50 days of final federal action authorizing a 
58.10 	partnership policy in Minnesota.
58.11 	(e) The commissioner must publish a notice in the State Register of implementation 
58.12 	decisions made under this subdivision as soon as practicable. The commissioner shall 
58.13 	submit a state plan amendment to the federal government to implement the long-term care 
58.14 	partnership program in accordance with this section.
58.15 		Subd. 15.Limitation on liens. (a) An individual's interest in real property shall not 
58.16 	be subject to a medical assistance lien or a notice of potential claim while it is protected 
58.17 	under subdivision 9, to the extent it is protected.
58.18 	(b) Medical assistance liens or liens arising under notices of potential claims against 
58.19 	an individual's interests in real property in their estate that are designated as protected 
58.20 	under subdivision 13, paragraph (b), shall be released to the extent of the dollar value 
58.21 	of the protection applied to the interest.
58.22 	(c) If an interest in real property is protected from a lien for recovery of medical 
58.23 	assistance paid on behalf of the individual under paragraph (a) or (b), no such lien for 
58.24 	recovery of medical assistance paid on behalf of that individual shall be filed against the 
58.25 	protected interest in real property after it is distributed to the individual's heirs or devisees.
58.26 		Subd. 16.Burden of proof. Any individual or the personal representative of the 
58.27 	individual's estate who asserts that an asset is a disregarded or protected asset under 
58.28 	this section in connection with any determination of eligibility for benefits under the 
58.29 	medical assistance program or any appeal, case, controversy, or other proceedings, shall 
58.30 	have the initial burden of:
58.31 	(1) documenting and proving by convincing evidence that the asset or source of 
58.32 	funds for the asset in question was designated as disregarded or protected;
58.33 	(2) tracing the asset and the proceeds of the asset from that time forward; and 
58.34 	(3) documenting that the asset or proceeds of the asset remained disregarded or 
58.35 	protected at all relevant times.

58.36 	EFFECTIVE DATE. This section is effective July 1, 2006.

59.1 	Sec. 29. [256B.0594] PAYMENT OF BENEFITS FROM AN ANNUITY.
59.2 	When payment becomes due under an annuity that names the department a 
59.3 	remainder beneficiary as described in section 256B.056, subdivision 11, the issuer shall 
59.4 	request and the department shall, within 45 days after receipt of the request, provide a 
59.5 	written statement of the total amount of the medical assistance paid. Upon timely receipt 
59.6 	of the written statement of the amount of medical assistance paid, the issuer shall pay the 
59.7 	department an amount equal to the lesser of the amount due the department under the 
59.8 	annuity or the total amount of medical assistance paid on behalf of the individual or the 
59.9 	individual's spouse. Any amounts remaining after the issuer's payment to the department 
59.10 	shall be payable according to the terms of the annuity or similar financial instrument. The 
59.11 	county agency or the department shall provide the issuer with the name, address, and 
59.12 	telephone number of a unit within the department the issuer can contact to comply with this 
59.13 	section. The requirements of section 72A.201, subdivision 4, clause (3), shall not apply to 
59.14 	payments made under this section until the issuer has received final payment information 
59.15 	from the department, if the issuer has notified the beneficiary of the requirements of this 
59.16 	section at the time it initially requests payment information from the department.

59.17 	Sec. 30. Minnesota Statutes 2004, section 256B.0595, subdivision 1, is amended to 
59.18 	read:
59.19 		Subdivision 1.Prohibited transfers. (a) For transfers of assets made on or before 
59.20 	August 10, 1993, if a person or the person's spouse has given away, sold, or disposed of, 
59.21 	for less than fair market value, any asset or interest therein, except assets other than the 
59.22 	homestead that are excluded under the supplemental security program, within 30 months 
59.23 	before or any time after the date of institutionalization if the person has been determined 
59.24 	eligible for medical assistance, or within 30 months before or any time after the date of the 
59.25 	first approved application for medical assistance if the person has not yet been determined 
59.26 	eligible for medical assistance, the person is ineligible for long-term care services for the 
59.27 	period of time determined under subdivision 2.
59.28 	(b) Effective for transfers made after August 10, 1993, a person, a person's spouse, 
59.29 	or any person, court, or administrative body with legal authority to act in place of, on 
59.30 	behalf of, at the direction of, or upon the request of the person or person's spouse, may not 
59.31 	give away, sell, or dispose of, for less than fair market value, any asset or interest therein, 
59.32 	except assets other than the homestead that are excluded under the supplemental security 
59.33 	income program, for the purpose of establishing or maintaining medical assistance 
59.34 	eligibility. This applies to all transfers, including those made by a community spouse 
59.35 	after the month in which the institutionalized spouse is determined eligible for medical 
60.1 	assistance. For purposes of determining eligibility for long-term care services, any transfer 
60.2 	of such assets within 36 months before or any time after an institutionalized person applies 
60.3 	for medical assistance, or 36 months before or any time after a medical assistance recipient 
60.4 	becomes institutionalized, for less than fair market value may be considered. Any such 
60.5 	transfer is presumed to have been made for the purpose of establishing or maintaining 
60.6 	medical assistance eligibility and the person is ineligible for long-term care services for 
60.7 	the period of time determined under subdivision 2, unless the person furnishes convincing 
60.8 	evidence to establish that the transaction was exclusively for another purpose, or unless 
60.9 	the transfer is permitted under subdivision 3 or 4. Notwithstanding the provisions of this 
60.10 	paragraph,  In the case of payments from a trust or portions of a trust that are considered 
60.11 	transfers of assets under federal law, or in the case of any other disposal of assets made on 
60.12 	or after February 8, 2006, any transfers made within 60 months before or any time after an 
60.13 	institutionalized person applies for medical assistance and within 60 months before or any 
60.14 	time after a medical assistance recipient becomes institutionalized, may be considered.
60.15 	(c) This section applies to transfers, for less than fair market value, of income 
60.16 	or assets, including assets that are considered income in the month received, such as 
60.17 	inheritances, court settlements, and retroactive benefit payments or income to which the 
60.18 	person or the person's spouse is entitled but does not receive due to action by the person, 
60.19 	the person's spouse, or any person, court, or administrative body with legal authority 
60.20 	to act in place of, on behalf of, at the direction of, or upon the request of the person or 
60.21 	the person's spouse.
60.22 	(d) This section applies to payments for care or personal services provided by a 
60.23 	relative, unless the compensation was stipulated in a notarized, written agreement which 
60.24 	was in existence when the service was performed, the care or services directly benefited 
60.25 	the person, and the payments made represented reasonable compensation for the care 
60.26 	or services provided. A notarized written agreement is not required if payment for the 
60.27 	services was made within 60 days after the service was provided.
60.28 	(e) This section applies to the portion of any asset or interest that a person, a person's 
60.29 	spouse, or any person, court, or administrative body with legal authority to act in place of, 
60.30 	on behalf of, at the direction of, or upon the request of the person or the person's spouse, 
60.31 	transfers to any annuity that exceeds the value of the benefit likely to be returned to the 
60.32 	person or spouse while alive, based on estimated life expectancy using the life expectancy 
60.33 	tables employed by the supplemental security income program to determine the value 
60.34 	of an agreement for services for life. The commissioner may adopt rules reducing life 
60.35 	expectancies based on the need for long-term care. This section applies to an annuity 
60.36 	described in this paragraph purchased on or after March 1, 2002, that:
61.1 	(1) is not purchased from an insurance company or financial institution that is 
61.2 	subject to licensing or regulation by the Minnesota Department of Commerce or a similar 
61.3 	regulatory agency of another state;
61.4 	(2) does not pay out principal and interest in equal monthly installments; or
61.5 	(3) does not begin payment at the earliest possible date after annuitization.
61.6 	(f) Effective for transactions, including the purchase of an annuity, occurring on or 
61.7 	after February 8, 2006, the purchase of an annuity by or on behalf of an individual who 
61.8 	has applied for or is receiving long-term care services or the individual's spouse shall be 
61.9 	treated as the disposal of an asset for less than fair market value unless:
61.10 	(1) the department is named as the remainder beneficiary in first position for an 
61.11 	amount equal to at least the total amount of medical assistance paid on behalf of the 
61.12 	individual or the individual's spouse; or the department is named as the remainder 
61.13 	beneficiary in second position for an amount equal to at least the total amount of medical 
61.14 	assistance paid on behalf of the individual or the individual's spouse after the individual's 
61.15 	community spouse or minor or disabled child and is named as the remainder beneficiary in 
61.16 	the first position if the community spouse or a representative of the minor or disabled child 
61.17 	disposes of the remainder for less than fair market value. Any subsequent change to the 
61.18 	designation of the department as a remainder beneficiary shall result in the annuity being 
61.19 	treated as a disposal of assets for less than fair market value. The amount of such transfer 
61.20 	shall be the maximum amount the individual or the individual's spouse could receive from 
61.21 	the annuity or similar financial instrument. Any change in the amount of the income or 
61.22 	principal being withdrawn from the annuity or other similar financial instrument at the 
61.23 	time of the most recent disclosure shall be deemed to be a transfer of assets for less than 
61.24 	fair market value unless the individual or the individual's spouse demonstrates that the 
61.25 	transaction was for fair market value; and
61.26 	(2) the purchase of an annuity by or on behalf of an individual applying for or 
61.27 	receiving long-term care services shall be treated as a disposal of assets for less than fair 
61.28 	market value unless it is:
61.29 	(i) an annuity described in subsection (b) or (q) of section 408 of the Internal 
61.30 	Revenue Code of 1986; or 
61.31 	(ii) purchased with proceeds from:
61.32 	(A) an account or trust described in subsection (a), (c), or (p) of section 408 of the 
61.33 	Internal Revenue Code;
61.34 	(B) a simplified employee pension within the meaning of section 408(k) of the 
61.35 	Internal Revenue Code; or
61.36 	(C) a Roth IRA described in section 408A of the Internal Revenue Code; or
62.1 	(iii) an annuity that is irrevocable and nonassignable; is actuarially sound as 
62.2 	determined in accordance with actuarial publications of the Office of the Chief Actuary of 
62.3 	the Social Security Administration; and provides for payments in equal amounts during 
62.4 	the term of the annuity, with no deferral and no balloon payments made.
62.5 	(f) (g) For purposes of this section, long-term care services include services in a 
62.6 	nursing facility, services that are eligible for payment according to section  256B.0625, 
62.7 	subdivision 2, because they are provided in a swing bed, intermediate care facility for 
62.8 	persons with mental retardation, and home and community-based services provided 
62.9 	pursuant to sections  256B.0915,  256B.092, and  256B.49. For purposes of this subdivision 
62.10 	and subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an 
62.11 	inpatient in a nursing facility or in a swing bed, or intermediate care facility for persons 
62.12 	with mental retardation or who is receiving home and community-based services under 
62.13 	sections  256B.0915,  256B.092, and  256B.49. 
62.14 	(h) This section applies to funds used to purchase a promissory note, loan, or 
62.15 	mortgage unless the note, loan, or mortgage:
62.16 	(1) has a repayment term that is actuarially sound;
62.17 	(2) provides for payments to be made in equal amounts during the term of the loan, 
62.18 	with no deferral and no balloon payments made; and
62.19 	(3) prohibits the cancellation of the balance upon the death of the lender.
62.20 	In the case of a promissory note, loan, or mortgage that does not meet an exception 
62.21 	in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding 
62.22 	balance due as of the date of the individual's application for long-term care services.
62.23 	(i) This section applies to the purchase of a life estate interest in another individual's 
62.24 	home unless the purchaser resides in the home for a period of at least one year after the 
62.25 	date of purchase.

62.26 	Sec. 31. Minnesota Statutes 2005 Supplement, section 256B.0595, subdivision 2, 
62.27 	is amended to read:
62.28 		Subd. 2.Period of ineligibility. (a) For any uncompensated transfer occurring on or 
62.29 	before August 10, 1993, the number of months of ineligibility for long-term care services 
62.30 	shall be the lesser of 30 months, or the uncompensated transfer amount divided by the 
62.31 	average medical assistance rate for nursing facility services in the state in effect on the 
62.32 	date of application. The amount used to calculate the average medical assistance payment 
62.33 	rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year. 
62.34 	The period of ineligibility begins with the month in which the assets were transferred. 
62.35 	If the transfer was not reported to the local agency at the time of application, and the 
63.1 	applicant received long-term care services during what would have been the period of 
63.2 	ineligibility if the transfer had been reported, a cause of action exists against the transferee 
63.3 	for the cost of long-term care services provided during the period of ineligibility, or for the 
63.4 	uncompensated amount of the transfer, whichever is less. The action may be brought by 
63.5 	the state or the local agency responsible for providing medical assistance under chapter 
63.6 	256G. The uncompensated transfer amount is the fair market value of the asset at the time 
63.7 	it was given away, sold, or disposed of, less the amount of compensation received.
63.8 	(b) For uncompensated transfers made after August 10, 1993, the number of months 
63.9 	of ineligibility for long-term care services shall be the total uncompensated value of the 
63.10 	resources transferred divided by the average medical assistance rate for nursing facility 
63.11 	services in the state in effect on the date of application. The amount used to calculate the 
63.12 	average medical assistance payment rate shall be adjusted each July 1 to reflect payment 
63.13 	rates for the previous calendar year. The period of ineligibility begins with the first day 
63.14 	of the month after the month in which the assets were transferred except that if one or 
63.15 	more uncompensated transfers are made during a period of ineligibility, the total assets 
63.16 	transferred during the ineligibility period shall be combined and a penalty period calculated 
63.17 	to begin on the first day of the month after the month in which the first uncompensated 
63.18 	transfer was made. If the transfer was reported to the local agency after the date that 
63.19 	advance notice of a period of ineligibility that affects the next month could be provided to 
63.20 	the recipient and the recipient received medical assistance services or the transfer was not 
63.21 	reported to the local agency, and the applicant or recipient received medical assistance 
63.22 	services during what would have been the period of ineligibility if the transfer had been 
63.23 	reported, a cause of action exists against the transferee for the cost of medical assistance 
63.24 	services provided during the period of ineligibility, or for the uncompensated amount of 
63.25 	the transfer, whichever is less. The action may be brought by the state or the local agency 
63.26 	responsible for providing medical assistance under chapter 256G. The uncompensated 
63.27 	transfer amount is the fair market value of the asset at the time it was given away, sold, or 
63.28 	disposed of, less the amount of compensation received. Effective for transfers made on or 
63.29 	after March 1, 1996, involving persons who apply for medical assistance on or after April 
63.30 	13, 1996, no cause of action exists for a transfer unless:
63.31 	(1) the transferee knew or should have known that the transfer was being made by a 
63.32 	person who was a resident of a long-term care facility or was receiving that level of care in 
63.33 	the community at the time of the transfer;
63.34 	(2) the transferee knew or should have known that the transfer was being made to 
63.35 	assist the person to qualify for or retain medical assistance eligibility; or
64.1 	(3) the transferee actively solicited the transfer with intent to assist the person to 
64.2 	qualify for or retain eligibility for medical assistance.
64.3 	(c) For uncompensated transfers made on or after February 8, 2006, the period of 
64.4 	ineligibility begins on the first day of the month in which advance notice can be given 
64.5 	following the month in which assets have been transferred for less than fair market value, 
64.6 	or the date on which the individual is eligible for medical assistance under the Medicaid 
64.7 	state plan and would otherwise be receiving long-term care services based on an approved 
64.8 	application for such care but for the application of the penalty period, whichever is later, 
64.9 	and which does not occur during any other period of ineligibility.
64.10 	(d) If a calculation of a penalty period results in a partial month, payments for 
64.11 	long-term care services shall be reduced in an amount equal to the fraction,.except that in 
64.12 	calculating the value of uncompensated transfers, if the total value of all uncompensated 
64.13 	transfers made in a month not included in an existing penalty period does not exceed $200, 
64.14 	then such transfers shall be disregarded for each month prior to the month of application 
64.15 	for or during receipt of medical assistance.
64.16 	(e) In the case of multiple fractional transfers of assets in more than one month for 
64.17 	less than fair market value on or after February 8, 2006, the period of ineligibility is 
64.18 	calculated by treating the total, cumulative uncompensated value of all assets transferred 
64.19 	during all months on or after February 8, 2006, as one transfer.

64.20 	EFFECTIVE DATE. Amendments to this section are effective for applications on 
64.21 	or after July 1, 2006, and for renewals and reports of transfers on or after July 1, 2006.

64.22 	Sec. 32. Minnesota Statutes 2004, section 256B.0595, subdivision 3, is amended to 
64.23 	read:
64.24 		Subd. 3.Homestead exception to transfer prohibition. (a) An institutionalized 
64.25 	person is not ineligible for long-term care services due to a transfer of assets for less than 
64.26 	fair market value if the asset transferred was a homestead and:
64.27 	(1) title to the homestead was transferred to the individual's:
64.28 	(i) spouse;
64.29 	(ii) child who is under age 21;
64.30 	(iii) blind or permanently and totally disabled child as defined in the supplemental 
64.31 	security income program;
64.32 	(iv) sibling who has equity interest in the home and who was residing in the home 
64.33 	for a period of at least one year immediately before the date of the individual's admission 
64.34 	to the facility; or
65.1 	(v) son or daughter who was residing in the individual's home for a period of at least 
65.2 	two years immediately before the date of the individual's admission to the facility, and who 
65.3 	provided care to the individual that, as certified by the individual's attending physician, 
65.4 	permitted the individual to reside at home rather than in an institution or facility;
65.5 	(2) a satisfactory showing is made that the individual intended to dispose of the 
65.6 	homestead at fair market value or for other valuable consideration; or
65.7 	(3) the local agency grants a waiver of a penalty resulting from a transfer for less 
65.8 	than fair market value because denial of eligibility would cause undue hardship for the 
65.9 	individual, based on imminent threat to the individual's health and well-being. Whenever 
65.10 	an applicant or recipient is denied eligibility because of a transfer for less than fair market 
65.11 	value, the local agency shall notify the applicant or recipient that the applicant or recipient 
65.12 	may request a waiver of the penalty if the denial of eligibility will cause undue hardship. 
65.13 	With the written consent of the individual or the personal representative of the individual, 
65.14 	a long-term care facility in which an individual is residing may file an undue hardship 
65.15 	waiver request, on behalf of the individual who is denied eligibility for long-term care 
65.16 	services on or after July 1, 2006, due to a period of ineligibility resulting from a transfer on 
65.17 	or after February 8, 2006. In evaluating a waiver, the local agency shall take into account 
65.18 	whether the individual was the victim of financial exploitation, whether the individual has 
65.19 	made reasonable efforts to recover the transferred property or resource, and other factors 
65.20 	relevant to a determination of hardship. If the local agency does not approve a hardship 
65.21 	waiver, the local agency shall issue a written notice to the individual stating the reasons 
65.22 	for the denial and the process for appealing the local agency's decision.
65.23 	(b) When a waiver is granted under paragraph (a), clause (3), a cause of action exists 
65.24 	against the person to whom the homestead was transferred for that portion of long-term 
65.25 	care services granted within:
65.26 	(1) 30 months of a transfer made on or before August 10, 1993;
65.27 	(2) 60 months if the homestead was transferred after August 10, 1993, to a trust or 
65.28 	portion of a trust that is considered a transfer of assets under federal law; or
65.29 	(3) 36 months if transferred in any other manner after August 10, 1993, but prior 
65.30 	to February 8, 2006; or
65.31 	(4) 60 months if the homestead was transferred on or after February 8, 2006,
65.32 	or the amount of the uncompensated transfer, whichever is less, together with the 
65.33 	costs incurred due to the action. The action shall be brought by the state unless the 
65.34 	state delegates this responsibility to the local agency responsible for providing medical 
65.35 	assistance under chapter 256G.

66.1 	Sec. 33. Minnesota Statutes 2004, section 256B.0595, subdivision 4, is amended to 
66.2 	read:
66.3 		Subd. 4.Other exceptions to transfer prohibition. An institutionalized person 
66.4 	who has made, or whose spouse has made a transfer prohibited by subdivision 1, is not 
66.5 	ineligible for long-term care services if one of the following conditions applies:
66.6 	(1) the assets were transferred to the individual's spouse or to another for the sole 
66.7 	benefit of the spouse; or
66.8 	(2) the institutionalized spouse, prior to being institutionalized, transferred assets 
66.9 	to a spouse, provided that the spouse to whom the assets were transferred does not then 
66.10 	transfer those assets to another person for less than fair market value. (At the time when 
66.11 	one spouse is institutionalized, assets must be allocated between the spouses as provided 
66.12 	under section 256B.059); or
66.13 	(3) the assets were transferred to the individual's child who is blind or permanently 
66.14 	and totally disabled as determined in the supplemental security income program; or
66.15 	(4) a satisfactory showing is made that the individual intended to dispose of the 
66.16 	assets either at fair market value or for other valuable consideration; or
66.17 	(5) the local agency determines that denial of eligibility for long-term care services 
66.18 	would work an undue hardship and grants a waiver of a penalty resulting from a transfer 
66.19 	for less than fair market value based on an imminent threat to the individual's health 
66.20 	and well-being. Whenever an applicant or recipient is denied eligibility because of a 
66.21 	transfer for less than fair market value, the local agency shall notify the applicant or 
66.22 	recipient that the applicant or recipient may request a waiver of the penalty if the denial of 
66.23 	eligibility will cause undue hardship. With the written consent of the individual or the 
66.24 	personal representative of the individual, a long-term care facility in which an individual 
66.25 	is residing may file an undue hardship waiver request, on behalf of the individual who 
66.26 	is denied eligibility for long-term care services on or after July 1, 2006, due to a period 
66.27 	of ineligibility resulting from a transfer on or after February 8, 2006. In evaluating a 
66.28 	waiver, the local agency shall take into account whether the individual was the victim of 
66.29 	financial exploitation, whether the individual has made reasonable efforts to recover the 
66.30 	transferred property or resource, whether the individual has taken any action to prevent 
66.31 	the designation of the department as a remainder beneficiary on an annuity as described 
66.32 	in section 256B.056, subdivision 11, and other factors relevant to a determination of 
66.33 	hardship. If the local agency does not approve a hardship waiver, the local agency shall 
66.34 	issue a written notice to the individual stating the reasons for the denial and the process for 
66.35 	appealing the local agency's decision. When a waiver is granted, a cause of action exists 
67.1 	against the person to whom the assets were transferred for that portion of long-term care 
67.2 	services granted within:
67.3 	(i) 30 months of a transfer made on or before August 10, 1993;
67.4 	(ii) 60 months of a transfer if the assets were transferred after August 30, 1993, to a 
67.5 	trust or portion of a trust that is considered a transfer of assets under federal law; or
67.6 	(iii) 36 months of a transfer if transferred in any other manner after August 10, 1993,
67.7 	but prior to February 8, 2006; or
67.8 	(iv) 60 months of any transfer made on or after February 8, 2006,
67.9 	or the amount of the uncompensated transfer, whichever is less, together with the 
67.10 	costs incurred due to the action. The action shall be brought by the state unless the 
67.11 	state delegates this responsibility to the local agency responsible for providing medical 
67.12 	assistance under this chapter; or
67.13 	(6) for transfers occurring after August 10, 1993, the assets were transferred by 
67.14 	the person or person's spouse: (i) into a trust established for the sole benefit of a son or 
67.15 	daughter of any age who is blind or disabled as defined by the Supplemental Security 
67.16 	Income program; or (ii) into a trust established for the sole benefit of an individual who is 
67.17 	under 65 years of age who is disabled as defined by the Supplemental Security Income 
67.18 	program.
67.19 	"For the sole benefit of" has the meaning found in section  256B.059, subdivision 1. 

67.20 	Sec. 34. Minnesota Statutes 2005 Supplement, section 256B.06, subdivision 4, is 
67.21 	amended to read:
67.22 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited 
67.23 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
67.24 	other persons residing lawfully in the United States. Citizens or nationals of the United 
67.25 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
67.26 	nationality as required by the federal Deficit Reduction Act of 2005, Public Law 109-171.
67.27 	(b) "Qualified noncitizen" means a person who meets one of the following 
67.28 	immigration criteria:
67.29 	(1) admitted for lawful permanent residence according to United States Code, title 8;
67.30 	(2) admitted to the United States as a refugee according to United States Code, 
67.31 	title 8, section 1157;
67.32 	(3) granted asylum according to United States Code, title 8, section 1158;
67.33 	(4) granted withholding of deportation according to United States Code, title 8, 
67.34 	section 1253(h);
68.1 	(5) paroled for a period of at least one year according to United States Code, title 8, 
68.2 	section 1182(d)(5);
68.3 	(6) granted conditional entrant status according to United States Code, title 8, 
68.4 	section 1153(a)(7);
68.5 	(7) determined to be a battered noncitizen by the United States Attorney General 
68.6 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
68.7 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
68.8 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
68.9 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
68.10 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
68.11 	Public Law 104-200; or
68.12 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
68.13 	Law 96-422, the Refugee Education Assistance Act of 1980.
68.14 	(c) All qualified noncitizens who were residing in the United States before August 
68.15 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
68.16 	medical assistance with federal financial participation.
68.17 	(d) All qualified noncitizens who entered the United States on or after August 22, 
68.18 	1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 
68.19 	medical assistance with federal financial participation through November 30, 1996.
68.20 	Beginning December 1, 1996, qualified noncitizens who entered the United States 
68.21 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
68.22 	chapter are eligible for medical assistance with federal participation for five years if they 
68.23 	meet one of the following criteria:
68.24 	(i) refugees admitted to the United States according to United States Code, title 8, 
68.25 	section 1157;
68.26 	(ii) persons granted asylum according to United States Code, title 8, section 1158;
68.27 	(iii) persons granted withholding of deportation according to United States Code, 
68.28 	title 8, section 1253(h);
68.29 	(iv) veterans of the United States armed forces with an honorable discharge for 
68.30 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
68.31 	children; or
68.32 	(v) persons on active duty in the United States armed forces, other than for training, 
68.33 	their spouses and unmarried minor dependent children.
68.34 	Beginning December 1, 1996, qualified noncitizens who do not meet one of the 
68.35 	criteria in items (i) to (v) are eligible for medical assistance without federal financial 
68.36 	participation as described in paragraph (j).
69.1 	(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), 
69.2 	who are lawfully residing in the United States and who otherwise meet the eligibility 
69.3 	requirements of this chapter, are eligible for medical assistance under clauses (1) to (3). 
69.4 	These individuals must cooperate with the Immigration and Naturalization Service to 
69.5 	pursue any applicable immigration status, including citizenship, that would qualify them 
69.6 	for medical assistance with federal financial participation.
69.7 	(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 
69.8 	for medical assistance with federal financial participation through December 31, 1996.
69.9 	(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 
69.10 	medical assistance without federal financial participation as described in paragraph (j).
69.11 	(3) Beginning December 1, 1996, persons residing in the United States prior to 
69.12 	August 22, 1996, who were not receiving medical assistance and persons who arrived on 
69.13 	or after August 22, 1996, are eligible for medical assistance without federal financial 
69.14 	participation as described in paragraph (j).
69.15 	(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
69.16 	are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this 
69.17 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 
69.18 	Code, title 8, section 1101(a)(15).
69.19 	(g) Payment shall also be made for care and services that are furnished to noncitizens, 
69.20 	regardless of immigration status, who otherwise meet the eligibility requirements of 
69.21 	this chapter, if such care and services are necessary for the treatment of an emergency 
69.22 	medical condition, except for organ transplants and related care and services and routine 
69.23 	prenatal care.
69.24 	(h) For purposes of this subdivision, the term "emergency medical condition" means 
69.25 	a medical condition that meets the requirements of United States Code, title 42, section 
69.26 	1396b(v).
69.27 	(i) Pregnant noncitizens who are undocumented, nonimmigrants, or eligible for 
69.28 	medical assistance as described in paragraph (j), and who are not covered by a group 
69.29 	health plan or health insurance coverage according to Code of Federal Regulations, title 
69.30 	42, section 457.310, and who otherwise meet the eligibility requirements of this chapter, 
69.31 	are eligible for medical assistance through the period of pregnancy, including labor and 
69.32 	delivery, to the extent federal funds are available under title XXI of the Social Security 
69.33 	Act, and the state children's health insurance program, followed by 60 days postpartum 
69.34 	without federal financial participation.
69.35 	(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens 
69.36 	lawfully residing in the United States as described in paragraph (e), who are ineligible 
70.1 	for medical assistance with federal financial participation and who otherwise meet the 
70.2 	eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 
70.3 	assistance without federal financial participation. Qualified noncitizens as described 
70.4 	in paragraph (d) are only eligible for medical assistance without federal financial 
70.5 	participation for five years from their date of entry into the United States.
70.6 	(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
70.7 	services from a nonprofit center established to serve victims of torture and are otherwise 
70.8 	ineligible for medical assistance under this chapter are eligible for medical assistance 
70.9 	without federal financial participation. These individuals are eligible only for the period 
70.10 	during which they are receiving services from the center. Individuals eligible under this 
70.11 	paragraph shall not be required to participate in prepaid medical assistance.

70.12 	EFFECTIVE DATE. This section is effective July 1, 2006.

70.13 	Sec. 35. Minnesota Statutes 2005 Supplement, section 256D.03, subdivision 3, is 
70.14 	amended to read:
70.15 		Subd. 3.General assistance medical care; eligibility. (a) General assistance 
70.16 	medical care may be paid for any person who is not eligible for medical assistance under 
70.17 	chapter 256B, including eligibility for medical assistance based on a spenddown of excess 
70.18 	income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in 
70.19 	paragraph (b), except as provided in paragraph (c), and:
70.20 	(1) who is receiving assistance under section 256D.05, except for families with 
70.21 	children who are eligible under Minnesota family investment program (MFIP), or who is 
70.22 	having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
70.23 	(2) who is a resident of Minnesota; and
70.24 	(i) who has gross countable income not in excess of 75 percent of the federal poverty 
70.25 	guidelines for the family size, using a six-month budget period and whose equity in assets 
70.26 	is not in excess of $1,000 per assistance unit. Exempt assets, the reduction of excess 
70.27 	assets, and the waiver of excess assets must conform to the medical assistance program in 
70.28 	section 256B.056, subdivision 3, with the following exception: the maximum amount of 
70.29 	undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by 
70.30 	the trustee, assuming the full exercise of the trustee's discretion under the terms of the 
70.31 	trust, must be applied toward the asset maximum;
70.32 	(ii) who has gross countable income above 75 percent of the federal poverty 
70.33 	guidelines but not in excess of 175 percent of the federal poverty guidelines for the 
70.34 	family size, using a six-month budget period, whose equity in assets is not in excess 
71.1 	of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient 
71.2 	hospitalization; or
71.3 	(iii) the commissioner shall adjust the income standards under this section each July 
71.4 	1 by the annual update of the federal poverty guidelines following publication by the 
71.5 	United States Department of Health and Human Services.
71.6 	(b) Effective for applications and renewals processed on or after September 1, 2006, 
71.7 	general assistance medical care may not be paid for applicants or recipients who are adults 
71.8 	with dependent children under 21 whose gross family income is equal to or less than 275 
71.9 	percent of the federal poverty guidelines who are not described in paragraph (e).
71.10 	(c) Effective for applications and renewals processed on or after September 1, 2006, 
71.11 	general assistance medical care may be paid for applicants and recipients who meet all 
71.12 	eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period 
71.13 	beginning the date of application. Immediately following approval of general assistance 
71.14 	medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04, 
71.15 	subdivision 7, with covered services as provided in section 256L.03 for the rest of the 
71.16 	six-month eligibility period, until their six-month renewal.
71.17 	(d) To be eligible for general assistance medical care following enrollment in 
71.18 	MinnesotaCare as required by paragraph (c), an individual must complete a new 
71.19 	application.
71.20 	(e) Applicants and recipients eligible under paragraph (a), clause (1),or; who have 
71.21 	applied for and are awaiting a determination of blindness or disability by the state medical 
71.22 	review team or a determination of eligibility for Supplemental Security Income or Social 
71.23 	Security Disability Insurance by the Social Security Administration,or; who fail to meet 
71.24 	the requirements of section 256L.09, subdivision 2, are exempt from the MinnesotaCare 
71.25 	enrollment requirements of this subdivision.
71.26 	(f) For applications received on or after October 1, 2003, eligibility may begin no 
71.27 	earlier than the date of application. For individuals eligible under paragraph (a), clause 
71.28 	(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 
71.29 	eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 
71.30 	may reapply if there is a subsequent period of inpatient hospitalization.
71.31 	(g) Beginning September 1, 2006, Minnesota health care program applications and 
71.32 	renewals completed by recipients and applicants who are persons described in paragraph 
71.33 	(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility 
71.34 	by the county agency. If all other eligibility requirements of this subdivision are met, 
71.35 	eligibility for general assistance medical care shall be available in any month during which 
71.36 	MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, 
72.1 	notice of termination for eligibility for general assistance medical care shall be sent to 
72.2 	an applicant or recipient. If all other eligibility requirements of this subdivision are 
72.3 	met, eligibility for general assistance medical care shall be available until enrollment in 
72.4 	MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
72.5 	(h) The date of an initial Minnesota health care program application necessary to 
72.6 	begin a determination of eligibility shall be the date the applicant has provided a name, 
72.7 	address, and Social Security number, signed and dated, to the county agency or the 
72.8 	Department of Human Services. If the applicant is unable to provide a name, address, 
72.9 	Social Security number, and signature when health care is delivered due to a medical 
72.10 	condition or disability, a health care provider may act on an applicant's behalf to establish 
72.11 	the date of an initial Minnesota health care program application by providing the county 
72.12 	agency or Department of Human Services with provider identification and a temporary 
72.13 	unique identifier for the applicant. The applicant must complete the remainder of the 
72.14 	application and provide necessary verification before eligibility can be determined. The 
72.15 	county agency must assist the applicant in obtaining verification if necessary.
72.16 	(i) County agencies are authorized to use all automated databases containing 
72.17 	information regarding recipients' or applicants' income in order to determine eligibility 
72.18 	for general assistance medical care or MinnesotaCare. Such use shall be considered 
72.19 	sufficient in order to determine eligibility and premium payments by the county agency.
72.20 	(j) General assistance medical care is not available for a person in a correctional 
72.21 	facility unless the person is detained by law for less than one year in a county correctional 
72.22 	or detention facility as a person accused or convicted of a crime, or admitted as an 
72.23 	inpatient to a hospital on a criminal hold order, and the person is a recipient of general 
72.24 	assistance medical care at the time the person is detained by law or admitted on a criminal 
72.25 	hold order and as long as the person continues to meet other eligibility requirements 
72.26 	of this subdivision.
72.27 	(k) General assistance medical care is not available for applicants or recipients who 
72.28 	do not cooperate with the county agency to meet the requirements of medical assistance.
72.29 	(l) In determining the amount of assets of an individual eligible under paragraph 
72.30 	(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 
72.31 	an asset excluded under paragraph (a), that was given away, sold, or disposed of for 
72.32 	less than fair market value within the 60 months preceding application for general 
72.33 	assistance medical care or during the period of eligibility. Any transfer described in this 
72.34 	paragraph shall be presumed to have been for the purpose of establishing eligibility for 
72.35 	general assistance medical care, unless the individual furnishes convincing evidence to 
72.36 	establish that the transaction was exclusively for another purpose. For purposes of this 
73.1 	paragraph, the value of the asset or interest shall be the fair market value at the time it 
73.2 	was given away, sold, or disposed of, less the amount of compensation received. For any 
73.3 	uncompensated transfer, the number of months of ineligibility, including partial months, 
73.4 	shall be calculated by dividing the uncompensated transfer amount by the average monthly 
73.5 	per person payment made by the medical assistance program to skilled nursing facilities 
73.6 	for the previous calendar year. The individual shall remain ineligible until this fixed period 
73.7 	has expired. The period of ineligibility may exceed 30 months, and a reapplication for 
73.8 	benefits after 30 months from the date of the transfer shall not result in eligibility unless 
73.9 	and until the period of ineligibility has expired. The period of ineligibility begins in the 
73.10 	month the transfer was reported to the county agency, or if the transfer was not reported, 
73.11 	the month in which the county agency discovered the transfer, whichever comes first. For 
73.12 	applicants, the period of ineligibility begins on the date of the first approved application.
73.13 	(m) When determining eligibility for any state benefits under this subdivision, 
73.14 	the income and resources of all noncitizens shall be deemed to include their sponsor's 
73.15 	income and resources as defined in the Personal Responsibility and Work Opportunity 
73.16 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
73.17 	subsequently set out in federal rules.
73.18 	(n) Undocumented noncitizens and nonimmigrants are ineligible for general 
73.19 	assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual 
73.20 	in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
73.21 	an undocumented noncitizen is an individual who resides in the United States without the 
73.22 	approval or acquiescence of the Immigration and Naturalization Service.
73.23 	(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for 
73.24 	medical assistance due to the deeming of a sponsor's income and resources, is ineligible 
73.25 	for general assistance medical care.
73.26 	(p) Effective July 1, 2003, general assistance medical care emergency services end.
73.27 	(q) Citizens or nationals of the United States must cooperate in obtaining satisfactory 
73.28 	documentary evidence of citizenship or nationality as required by the federal Deficit 
73.29 	Reduction Act of 2005, Public Law 109-171. 

73.30 	EFFECTIVE DATE. This section is effective July 1, 2006.

73.31 	Sec. 36. Minnesota Statutes 2004, section 256L.04, subdivision 10, is amended to read:
73.32 		Subd. 10.Citizenship requirements. Eligibility for MinnesotaCare is limited 
73.33 	to citizens or nationals of the United States, qualified noncitizens, and other persons 
73.34 	residing lawfully in the United States as described in section  256B.06, subdivision 4, 
73.35 	paragraphs (a) to (e) and (j). Undocumented noncitizens and nonimmigrants are ineligible 
74.1 	for MinnesotaCare. For purposes of this subdivision, a nonimmigrant is an individual in 
74.2 	one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
74.3 	an undocumented noncitizen is an individual who resides in the United States without 
74.4 	the approval or acquiescence of the Immigration and Naturalization Service. Citizens 
74.5 	or nationals of the United States must cooperate in obtaining satisfactory documentary 
74.6 	evidence of citizenship or nationality as required by the federal Deficit Reduction Act of 
74.7 	2005, Public Law 109-171.

74.8 	EFFECTIVE DATE. This section is effective July 1, 2006.

74.9 	Sec. 37. DESIGNATION OF ASSETS AS CONTINGENTLY EXEMPT UNDER 
74.10 	LONG-TERM CARE PARTNERSHIP PROGRAM.
 74.11 	The commissioner of human services shall develop and present to the legislature 
74.12 	by December 15, 2006, a plan and draft legislation to allow individuals participating in 
74.13 	the long-term care partnership program established under Minnesota Statutes, section 
74.14 	256B.0571, to designate, at the time of initial application for medical assistance, assets 
74.15 	as contingently exempt.  The full fair market value of assets designated as contingently 
74.16 	exempt must not exceed a percentage, specified by the commissioner, of the full fair market 
74.17 	value of assets designated as protected under Minnesota Statutes, section 256B.0571, 
74.18 	subdivision 9.  The commissioner may specify different percentages for different categories 
74.19 	of protected assets.  Assets designated as contingently exempt shall be disregarded for 
74.20 	purposes of determining eligibility for payment of long-term care services.  If the dollar 
74.21 	amount of benefits utilized under a partnership policy is greater than the full fair market 
74.22 	value of all assets protected due to a decrease in the value of the protected assets, the plan 
74.23 	and draft legislation must allow the individual or the personal representative to designate 
74.24 	assets that are contingently exempt as protected, up to the amount of the decrease in value 
74.25 	of the protected assets.  The plan and draft legislation must provide that any contingently 
74.26 	exempt asset that is not designated as protected be subject to recovery.

74.27 	Sec. 38.  REPEALER.
 74.28 	Minnesota Statutes 2005 Supplement, section 256B.0571, subdivisions 2, 5, and 
74.29 	11, are repealed.

75.1 	ARTICLE 4
75.2 	DEPARTMENT OF HEALTH

75.3 	Section 1. Minnesota Statutes 2004, section 13.3806, is amended by adding a 
75.4 	subdivision to read:
75.5 		Subd. 21.Abortion notification data. Classification of data in abortion notification 
75.6 	reports is governed by section 144.3431.

75.7 	Sec. 2. [144.2251] COPY OF BIRTH RECORD IN EVENT OF A CHILD'S 
75.8 	DEATH.
75.9 		Subdivision 1.Definition. For the purposes of this section, "clean copy" means a 
75.10 	certified copy of a deceased child's birth record without the word DECEASED, the date of 
75.11 	death, or other similar reference appearing on the document.
75.12 		Subd. 2.Duties of state registrar. (a) Notwithstanding Minnesota Rules, part 
75.13 	4601.2525, subpart 3, the state registrar shall provide one clean copy of a birth record, if 
75.14 	requested, provided:
75.15 	(1) no other clean copy of the record has been issued;
75.16 	(2) the person requesting the clean copy of a birth record is listed as the child's 
75.17 	mother or father on the birth record;
75.18 	(3) the request is made no later than six years from the date of the child's birth; and
75.19 	(4) the child was born on or after January 1, 2002.
75.20 	(b) The state registrar shall prescribe the form of and information to be included in 
75.21 	the request and implement a process for meeting the requirements of this section. The 
75.22 	process developed and implemented under this section shall require that only the state 
75.23 	registrar, and not a local registrar, may issue a clean copy.
75.24 		Subd. 3.Information to parents. The state and local registrars shall inform parents 
75.25 	who request a certified copy of their deceased child's birth record that they may be eligible 
75.26 	to receive a clean copy of the record. The state or a local registrar shall provide parents 
75.27 	who would like to request a clean copy with information on how to obtain one from the 
75.28 	state registrar and any additional information or forms required under subdivision 2, 
75.29 	paragraph (b).

75.30 	EFFECTIVE DATE. This section is effective July 1, 2006.

75.31 	Sec. 3. [144.3431] ABORTION NOTIFICATION DATA.
76.1 		Subdivision 1.Reporting form. (a) Within 90 days of the effective date of this 
76.2 	section, the commissioner of health shall prepare a reporting form for use by physicians 
76.3 	and facilities performing abortions under the circumstances specified in paragraph (b).
76.4 	(b) The form shall require the following information:
76.5 	(1) the number of minors or women for whom a guardian has been appointed under 
76.6 	sections 524.5-301 to 524.5-317 because of a finding of incompetency for whom the 
76.7 	physician or an agent of the physician provided the notice described in section 144.343, 
76.8 	subdivision 2; of that number, the number of notices provided personally as described in 
76.9 	section 144.343, subdivision 2, paragraph (a), and the number of notices provided by 
76.10 	mail as described in section 144.343, subdivision 2, paragraph (b); and of each of those 
76.11 	numbers, the number who, to the best of the reporting physician's or reporting facility's 
76.12 	information and belief, went on to obtain the abortion from the reporting physician or 
76.13 	reporting physician's facility, or from the reporting facility;
76.14 	(2) the number of minors or women for whom a guardian has been appointed under 
76.15 	sections 524.5-301 to 524.5-317 because of a finding of incompetency upon whom 
76.16 	the physician performed an abortion without providing the notice described in section 
76.17 	144.343, subdivision 2; and of that number, the number who were emancipated minors, 
76.18 	and the number for whom section 144.343, subdivision 4, was applicable, itemized by 
76.19 	each of the limitations identified in paragraphs (a), (b), and (c) of that subdivision;
76.20 	(3) the number of abortions performed by the physician for which judicial 
76.21 	authorization was received and for which the notification described in section 144.343, 
76.22 	subdivision 2, was not provided;
76.23 	(4) the county the female resides in; the county where the abortion was performed, if 
76.24 	different from the female's residence; and, if a judicial bypass was obtained, the judicial 
76.25 	district it was obtained in;
76.26 	(5) the age of the female;
76.27 	(6) the race of the female;
76.28 	(7) the process the physician or the physician's agent used to inform the minor 
76.29 	female, or a woman for whom a guardian has been appointed under sections 524.5-301 
76.30 	to 524.5-317 because of a finding of incompetency, of the judicial bypass; whether court 
76.31 	forms were provided to her; and whether the physician or the physician's agent made 
76.32 	the court arrangement for the minor female, or a woman for whom a guardian has been 
76.33 	appointed under sections 524.5-301 to 524.5-317 because of a finding of incompetency; 
76.34 	and 
77.1 	(8) how soon after visiting the abortion facility the minor female, or a woman for 
77.2 	whom a guardian has been appointed under section 524.5-301 to 524.5-317 because of a 
77.3 	finding of incompetency, went to court to obtain a judicial bypass.
77.4 		Subd. 2.Forms to physicians and facilities. Physicians and facilities required to 
77.5 	report under subdivision 3 shall obtain reporting forms from the commissioner.
77.6 		Subd. 3.Submission. (a) The following physicians or facilities must submit the 
77.7 	forms to the commissioner no later than April 1 for abortions performed on minors or 
77.8 	women for whom a guardian has been appointed in the previous calendar year:
77.9 	(1) a physician who provides, or whose agent provides, the notice described in 
77.10 	section 144.343, subdivision 2, or the facility at which the notice is provided; and 
77.11 	(2) a physician who knowingly performs an abortion upon a minor, or a woman for 
77.12 	whom a guardian has been appointed under sections 524.5-301 to 524.5-317 because of a 
77.13 	finding of incompetency, or a facility at which such an abortion is performed.
77.14 	(b) The commissioner shall maintain as confidential data which alone or in 
77.15 	combination may constitute information that would reasonably lead, using epidemiologic 
77.16 	principles, to the identification of:
77.17 	(1) an individual who has had an abortion, who has received judicial authorization 
77.18 	for an abortion, or to whom the notice described in section 144.343, subdivision 2, has 
77.19 	been provided; or 
77.20 	(2) a physician or facility required to report under paragraph (a).
77.21 		Subd. 4.Failure to report as required. (a) Reports that are not submitted more 
77.22 	than 30 days following the due date shall be subject to a late fee of $500 for each 
77.23 	additional 30-day period or portion of a 30-day period overdue.  If a physician or facility 
77.24 	required to report under this section has not submitted a report, or has submitted only 
77.25 	an incomplete report, more than one year following the due date, the commissioner of 
77.26 	health shall bring an action in a court of competent jurisdiction for an order directing the 
77.27 	physician or facility to submit a complete report within a period stated by court order or be 
77.28 	subject to sanctions.  If the commissioner brings such an action for an order directing a 
77.29 	physician or facility to submit a complete report, the court may assess reasonable attorney 
77.30 	fees and costs against the noncomplying party.
77.31 	(b) Notwithstanding section 13.39, data related to actions taken by the commissioner 
77.32 	to enforce any provision of this section is private data if the data, alone or in combination, 
77.33 	may constitute information that would reasonably lead, using epidemiologic principles, to 
77.34 	the identification of:
78.1 	(1) an individual who has had an abortion, who has received judicial authorization 
78.2 	for an abortion, or to whom the notice described in section 144.343, subdivision 2, has 
78.3 	been provided; or 
78.4 	(2) a physician or facility required to report under subdivision 3.
78.5 		Subd. 5.Public records. (a) By September 30 of each year, the commissioner of 
78.6 	health shall issue a public report providing statistics for each item listed in subdivision 1 
78.7 	for the previous calendar year compiled from reports submitted according to this section. 
78.8 	The report shall also include statistics, which shall be obtained from court administrators, 
78.9 	that include:
78.10 	(1) the total number of petitions or motions filed under section 144.343, subdivision 
78.11 	6, paragraph (c), clause (i);
78.12 	(2) the number of cases in which the court appointed a guardian ad litem;
78.13 	(3) the number of cases in which the court appointed counsel;
78.14 	(4) the number of cases in which the judge issued an order authorizing an abortion 
78.15 	without notification, including:
78.16 	(i) the number of petitions or motions granted by the court because of a finding of 
78.17 	maturity and the basis for that finding; and 
78.18 	(ii) the number of petitions or motions granted because of a finding that the abortion 
78.19 	would be in the best interest of the minor and the basis for that finding;
78.20 	(5) the number of denials from which an appeal was filed;
78.21 	(6) the number of appeals that resulted in a denial being affirmed; and 
78.22 	(7) the number of appeals that resulted in reversal of a denial.
78.23 	(b) The report shall provide the statistics for all previous calendar years for which a 
78.24 	public report was required to be issued, adjusted to reflect any additional information from 
78.25 	late or corrected reports.
78.26 	(c) The commissioner shall ensure that all statistical information included in the 
78.27 	public reports are presented so that the data cannot reasonably lead, using epidemiologic 
78.28 	principles, to the identification of:
78.29 	(1) an individual who has had an abortion, who has received judicial authorization 
78.30 	for an abortion, or to whom the notice described in section 144.343, subdivision 2, has 
78.31 	been provided; or 
78.32 	(2) a physician or facility who has submitted a form to the commissioner under 
78.33 	subdivision 3.
78.34 		Subd. 6.Modification of requirements. The commissioner of health may, by 
78.35 	administrative rule, alter the dates established in subdivisions 3 and 5, consolidate the 
78.36 	forms created according to subdivision 1 with the reporting form created according 
79.1 	to section 145.4131, or consolidate reports to achieve administrative convenience or 
79.2 	fiscal savings, to allow physicians and facilities to submit all information collected by 
79.3 	the commissioner regarding abortions at one time, or to reduce the burden of the data 
79.4 	collection, so long as the report described in subdivision 5 is issued at least once a year.
79.5 		Subd. 7.Suit to compel statistical report. If the commissioner of health fails to 
79.6 	issue the public report required under subdivision 5, any group of ten or more citizens 
79.7 	of the state may seek an injunction in a court of competent jurisdiction against the 
79.8 	commissioner, requiring that a complete report be issued within a period stated by court 
79.9 	order.  Failure to abide by the injunction shall subject the commissioner to sanctions 
79.10 	for civil contempt.
79.11 		Subd. 8.Attorney fees. If judgment is rendered in favor of the plaintiff in any 
79.12 	action described in this section, the court shall also render judgment for a reasonable 
79.13 	attorney fee in favor of the plaintiff against the defendant.  If the judgment is rendered in 
79.14 	favor of the defendant and the court finds that plaintiff's suit was frivolous and brought 
79.15 	in bad faith, the court shall render judgment for a reasonable attorney fee in favor of 
79.16 	the defendant against the plaintiff.
79.17 		Subd. 9.Severability. If any one or more provision, section, subdivision, 
79.18 	sentence, clause, phrase, or word of this section or the application thereof to any person 
79.19 	or circumstance is found to be unconstitutional, the same is hereby declared to be 
79.20 	severable and the balance of this section shall remain effective notwithstanding such 
79.21 	unconstitutionality.  The legislature intends that it would have passed this section, and each 
79.22 	provision, section, subdivision, sentence, clause, phrase, or word thereof irrespective of 
79.23 	the fact that any one provision, section, subdivision, sentence, clause, phrase, or word be 
79.24 	declared unconstitutional.
79.25 		Subd. 10. Supreme Court jurisdiction.  The Minnesota Supreme Court has original 
79.26 	jurisdiction over an action challenging the constitutionality of this section and shall 
79.27 	expedite the resolution of the action.

79.28 	Sec. 4. [144.388] LIMITATION.
79.29 	Cross-connection control devices shall be limited in use according to the respective 
79.30 	standard, unless otherwise permitted under sections 144.381 to 144.387. The use of a hose 
79.31 	connection backflow preventer and a hose connection vacuum breaker in a continuous 
79.32 	pressure situation shall be limited to campgrounds that are not connected to a municipal 
79.33 	water system.

79.34 	Sec. 5. [144A.441] ASSISTED LIVING BILL OF RIGHTS ADDENDUM.
80.1 	Assisted living clients, as defined in section 144G.01, subdivision 3, shall be 
80.2 	provided with the home care bill of rights required by section 144A.44, except that the 
80.3 	home care bill of rights provided to these clients must include the following provision in 
80.4 	place of the provision in section 144A.44, subdivision 1, clause (16): 
80.5 	"(16) the right to reasonable, advance notice of changes in services or charges, 
80.6 	including at least 30 days' advance notice of the termination of a service by a provider, 
80.7 	except in cases where:
80.8 	(i) the recipient of services engages in conduct that alters the conditions of 
80.9 	employment as specified in the employment contract between the home care provider 
80.10 	and the individual providing home care services, or creates an abusive or unsafe work 
80.11 	environment for the individual providing home care services;
80.12 	(ii) an emergency for the informal caregiver or a significant change in the recipient's 
80.13 	condition has resulted in service needs that exceed the current service provider agreement 
80.14 	and that cannot be safely met by the home care provider; or
80.15 	(iii) the provider has not received payment for services, for which at least ten days' 
80.16 	advance notice of the termination of a service shall be provided."

80.17 	EFFECTIVE DATE. This section is effective January 1, 2007.

80.18 	Sec. 6. [144A.442] TERMINATION OF HOME CARE SERVICES FOR 
80.19 	ASSISTED LIVING CLIENTS.
80.20 	If an arranged home care provider, as defined in section 144D.01, subdivision 2a, 
80.21 	who is not also Medicare certified terminates a service agreement or service plan with 
80.22 	an assisted living client, as defined in section 144G.01, subdivision 3, the home care 
80.23 	provider shall provide the assisted living client and the legal or designated representatives 
80.24 	of the client, if any, with a written notice of termination which includes the following 
80.25 	information:
80.26 	(1) the effective date of termination;
80.27 	(2) the reason for termination;
80.28 	(3) without extending the termination notice period, an affirmative offer to meet with 
80.29 	the assisted living client or client representatives within no more than five business days of 
80.30 	the date of the termination notice to discuss the termination;
80.31 	(4) contact information for a reasonable number of other home care providers in 
80.32 	the geographic area of the assisted living client, as required by Minnesota Rules, part 
80.33 	4668.0050;
81.1 	(5) a statement that the provider will participate in a coordinated transfer of the care 
81.2 	of the client to another provider or caregiver, as required by section 144A.44, subdivision 
81.3 	1, clause (17);
81.4 	(6) the name and contact information of a representative of the home care provider 
81.5 	with whom the client may discuss the notice of termination;
81.6 	(7) a copy of the home care bill of rights; and
81.7 	(8) a statement that the notice of termination of home care services by the home care 
81.8 	provider does not constitute notice of termination of the housing with services contract 
81.9 	with a housing with services establishment.

81.10 	EFFECTIVE DATE. This section is effective January 1, 2007.

81.11 	Sec. 7. Minnesota Statutes 2004, section 144A.4605, is amended to read:
81.12 	144A.4605 ASSISTED LIVING HOME CARE CLASS F PROVIDER.
81.13 		Subdivision 1.Definitions. For purposes of this section, the term "assisted 
81.14 	living class F home care provider" means a home care provider who provides nursing 
81.15 	services, delegated nursing services, other services performed by unlicensed personnel, or 
81.16 	central storage of medications solely for residents of one or more housing with services 
81.17 	establishments registered under chapter 144D.
81.18 		Subd. 2.Assisted living Class F home care license established. A home care 
81.19 	provider license category entitled assisted living class F home care provider is hereby 
81.20 	established. A home care provider may obtain an assisted living a class F license if the 
81.21 	program meets the following requirements:
81.22 	(a) nursing services, delegated nursing services, other services performed by 
81.23 	unlicensed personnel, or central storage of medications under the assisted living class 
81.24 	F license are provided solely for residents of one or more housing with services 
81.25 	establishments registered under chapter 144D;
81.26 	(b) unlicensed personnel perform home health aide and home care aide tasks 
81.27 	identified in Minnesota Rules, parts 4668.0100, subparts 1 and 2, and 4668.0110, subpart 1. 
81.28 	Qualifications to perform these tasks shall be established in accordance with subdivision 3;
81.29 	(c) periodic supervision of unlicensed personnel is provided as required by rule;
81.30 	(d) notwithstanding Minnesota Rules, part 4668.0160, subpart 6, item D, client 
81.31 	records shall include:
81.32 	(1) daily records or a weekly summary of home care services provided;
81.33 	(2) documentation each time medications are administered to a client; and
82.1 	(3) documentation on the day of occurrence of any significant change in the client's 
82.2 	status or any significant incident, such as a fall or refusal to take medications.
82.3 	All entries must be signed by the staff providing the services and entered into the 
82.4 	record no later than two weeks after the end of the service day, except as specified in 
82.5 	clauses (2) and (3);
82.6 	(e) medication and treatment orders, if any, are included in the client record and 
82.7 	are renewed at least every 12 months, or more frequently when indicated by a clinical 
82.8 	assessment;
82.9 	(f) the central storage of medications in a housing with services establishment 
82.10 	registered under chapter 144D is managed under a system that is established by a 
82.11 	registered nurse and addresses the control of medications, handling of medications, 
82.12 	medication containers, medication records, and disposition of medications; and
82.13 	(g) in other respects meets the requirements established by rules adopted under 
82.14 	sections  144A.45 to  144A.47. 
82.15 		Subd. 3.Training or competency evaluations required. (a) Unlicensed personnel 
82.16 	must:
82.17 	(1) satisfy the training or competency requirements established by rule under 
82.18 	sections  144A.45 to  144A.47; or 
82.19 	(2) be trained or determined competent by a registered nurse in each task identified 
82.20 	under Minnesota Rules, part 4668.0100, subparts 1 and 2, when offered to clients in a 
82.21 	housing with services establishment as described in paragraphs (b) to (e).
82.22 	(b) Training for tasks identified under Minnesota Rules, part 4668.0100, subparts 
82.23 	1 and 2, shall use a curriculum which meets the requirements in Minnesota Rules, part 
82.24 	4668.0130.
82.25 	(c) Competency evaluations for tasks identified under Minnesota Rules, part 
82.26 	4668.0100, subparts 1 and 2, must be completed and documented by a registered nurse.
82.27 	(d) Unlicensed personnel performing tasks identified under Minnesota Rules, part 
82.28 	4668.0100, subparts 1 and 2, shall be trained or demonstrate competency in the following 
82.29 	topics:
82.30 	(1) an overview of sections  144A.43 to  144A.47 and rules adopted thereunder; 
82.31 	(2) recognition and handling of emergencies and use of emergency services;
82.32 	(3) reporting the maltreatment of vulnerable minors or adults under sections  626.556
82.33 	and  626.557; 
82.34 	(4) home care bill of rights;
82.35 	(5) handling of clients' complaints and reporting of complaints to the Office of 
82.36 	Health Facility Complaints;
83.1 	(6) services of the ombudsman for older Minnesotans;
83.2 	(7) observation, reporting, and documentation of client status and of the care or 
83.3 	services provided;
83.4 	(8) basic infection control;
83.5 	(9) maintenance of a clean, safe, and healthy environment;
83.6 	(10) communication skills;
83.7 	(11) basic elements of body functioning and changes in body function that must be 
83.8 	reported to an appropriate health care professional; and
83.9 	(12) physical, emotional, and developmental needs of clients, and ways to work with 
83.10 	clients who have problems in these areas, including respect for the client, the client's 
83.11 	property, and the client's family.
83.12 	(e) Unlicensed personnel who administer medications must comply with rules 
83.13 	relating to the administration of medications in Minnesota Rules, part 4668.0100, subpart 
83.14 	2, except that unlicensed personnel need not comply with the requirements of Minnesota 
83.15 	Rules, part 4668.0100, subpart 5.
83.16 		Subd. 4.License required. (a) A housing with services establishment registered 
83.17 	under chapter 144D that is required to obtain a home care license must obtain an assisted 
83.18 	living a class F home care license according to this section or a class A or class E B license 
83.19 	according to rule. A housing with services establishment that obtains a class E B license 
83.20 	under this subdivision remains subject to the payment limitations in sections  256B.0913, 
83.21 	subdivision 5f, paragraph (b), and  256B.0915, subdivision 3d. 
83.22 	(b) A board and lodging establishment registered for special services as of December 
83.23 	31, 1996, and also registered as a housing with services establishment under chapter 
83.24 	144D, must deliver home care services according to sections  144A.43 to 144A.47, and 
83.25 	may apply for a waiver from requirements under Minnesota Rules, parts 4668.0002 to 
83.26 	4668.0240, to operate a licensed agency under the standards of section  157.17. Such 
83.27 	waivers as may be granted by the department will expire upon promulgation of home care 
83.28 	rules implementing section  144A.4605. 
83.29 	(c) An adult foster care provider licensed by the Department of Human Services and 
83.30 	registered under chapter 144D may continue to provide health-related services under its 
83.31 	foster care license until the promulgation of home care rules implementing this section.
83.32 	(d) An assisted living (c) A class F home care provider licensed under this section 
83.33 	must comply with the disclosure provisions of section  325F.72 to the extent they are 
83.34 	applicable. 
83.35 		Subd. 5.License fees. The license fees for assisted living class F home care 
83.36 	providers shall be as follows:
84.1 	(1) $125 annually for those providers serving a monthly average of 15 or fewer 
84.2 	clients, and for assisted living class F providers of all sizes during the first year of 
84.3 	operation;
84.4 	(2) $200 annually for those providers serving a monthly average of 16 to 30 clients;
84.5 	(3) $375 annually for those providers serving a monthly average of 31 to 50 clients; 
84.6 	and
84.7 	(4) $625 annually for those providers serving a monthly average of 51 or more 
84.8 	clients.
84.9 		Subd. 6.Waiver. Upon request of the home care provider, the commissioner may 
84.10 	waive the provisions of this section relating to registered nurse duties.

84.11 	EFFECTIVE DATE. This section is effective January 1, 2007.

84.12 	Sec. 8. Minnesota Statutes 2004, section 144D.01, is amended by adding a subdivision 
84.13 	to read:
84.14 		Subd. 2a.Arranged home care provider. "Arranged home care provider" means a 
84.15 	home care provider licensed under Minnesota Rules, chapter 4668, that provides services 
84.16 	to some or all of the residents of a housing with services establishment and that is either 
84.17 	the establishment itself or another entity with which the establishment has an arrangement.

84.18 	EFFECTIVE DATE. This section is effective January 1, 2007.

84.19 	Sec. 9. Minnesota Statutes 2004, section 144D.015, is amended to read:
84.20 	144D.015 ASSISTED LIVING FACILITY OR ASSISTED LIVING 
84.21 	RESIDENCE DEFINITION FOR PURPOSES OF LONG-TERM CARE 
84.22 	INSURANCE.
84.23 	For purposes of consistency with terminology commonly used in long-term 
84.24 	care insurance policies and notwithstanding chapter 144G, a housing with services 
84.25 	establishment that is registered under section  144D.03 and that holds, or contracts makes 
84.26 	arrangements with an individual or entity that holds, a any type of home care license and 
84.27 	all other licenses, permits, registrations, or other governmental approvals legally required 
84.28 	for delivery of the services the establishment offers or provides to its residents, constitutes 
84.29 	an "assisted living facility" or "assisted living residence." 

84.30 	EFFECTIVE DATE. This section is effective January 1, 2007.

85.1 	Sec. 10. Minnesota Statutes 2004, section 144D.02, is amended to read:
85.2 	144D.02 REGISTRATION REQUIRED.
85.3 	No entity may establish, operate, conduct, or maintain an elderly a housing with 
85.4 	services establishment in this state without registering and operating as required in 
85.5 	sections  144D.01 to  144D.06. 

85.6 	EFFECTIVE DATE. This section is effective January 1, 2007.

85.7 	Sec. 11. Minnesota Statutes 2004, section 144D.03, is amended by adding a 
85.8 	subdivision to read:
85.9 		Subd. 1a.Surcharge for injunctive relief actions. The commissioner shall assess 
85.10 	each housing with services establishment that offers or provides assisted living under 
85.11 	chapter 144G a surcharge on the annual registration fee paid under subdivision 1, to pay 
85.12 	for the commissioner's costs related to bringing actions for injunctive relief under section 
85.13 	144G.02, subdivision 2, paragraph (b), on or after July 1, 2007. The commissioner shall 
85.14 	assess surcharges using a sliding scale under which the surcharge amount increases with 
85.15 	the client capacity of an establishment. The commissioner shall adjust the surcharge as 
85.16 	necessary to recover the projected costs of bringing actions for injunctive relief. The 
85.17 	commissioner shall adjust the surcharge in accordance with section 16A.1285.

85.18 	EFFECTIVE DATE. This section is effective for annual registrations submitted 
85.19 	on or after July 1, 2007.

85.20 	Sec. 12. Minnesota Statutes 2004, section 144D.03, subdivision 2, is amended to read:
85.21 		Subd. 2.Registration information. The establishment shall provide the following 
85.22 	information to the commissioner in order to be registered:
85.23 	(1) the business name, street address, and mailing address of the establishment;
85.24 	(2) the name and mailing address of the owner or owners of the establishment and, if 
85.25 	the owner or owners are not natural persons, identification of the type of business entity 
85.26 	of the owner or owners, and the names and addresses of the officers and members of the 
85.27 	governing body, or comparable persons for partnerships, limited liability corporations, or 
85.28 	other types of business organizations of the owner or owners;
85.29 	(3) the name and mailing address of the managing agent, whether through 
85.30 	management agreement or lease agreement, of the establishment, if different from the 
85.31 	owner or owners, and the name of the on-site manager, if any;
86.1 	(4) verification that the establishment has entered into an elderly a housing with 
86.2 	services contract, as required in section  144D.04, with each resident or resident's 
86.3 	representative; 
86.4 	(5) verification that the establishment is complying with the requirements of section  
86.5 	325F.72, if applicable; 
86.6 	(6) the name and address of at least one natural person who shall be responsible 
86.7 	for dealing with the commissioner on all matters provided for in sections  144D.01 to  
86.8 	144D.06, and on whom personal service of all notices and orders shall be made, and who 
86.9 	shall be authorized to accept service on behalf of the owner or owners and the managing 
86.10 	agent, if any; and 
86.11 	(7) the signature of the authorized representative of the owner or owners or, if 
86.12 	the owner or owners are not natural persons, signatures of at least two authorized 
86.13 	representatives of each owner, one of which shall be an officer of the owner.
86.14 	Personal service on the person identified under clause (6) by the owner or owners in 
86.15 	the registration shall be considered service on the owner or owners, and it shall not be a 
86.16 	defense to any action that personal service was not made on each individual or entity. The 
86.17 	designation of one or more individuals under this subdivision shall not affect the legal 
86.18 	responsibility of the owner or owners under sections  144D.01 to  144D.06. 

86.19 	EFFECTIVE DATE. This section is effective January 1, 2007.

86.20 	Sec. 13. Minnesota Statutes 2004, section 144D.04, is amended to read:
86.21 	144D.04 ELDERLY HOUSING WITH SERVICES CONTRACTS.
86.22 		Subdivision 1.Contract required. No elderly housing with services establishment 
86.23 	may operate in this state unless a written elderly housing with services contract, as defined 
86.24 	in subdivision 2, is executed between the establishment and each resident or resident's 
86.25 	representative and unless the establishment operates in accordance with the terms of the 
86.26 	contract. The resident or the resident's representative shall be given a complete copy of 
86.27 	the contract and all supporting documents and attachments and any changes whenever 
86.28 	changes are made.
86.29 		Subd. 2.Contents of contract. An elderly A housing with services contract, which 
86.30 	need not be entitled as such to comply with this section, shall include at least the following 
86.31 	elements in itself or through supporting documents or attachments:
86.32 	(1) the name, street address, and mailing address of the establishment;
87.1 	(2) the name and mailing address of the owner or owners of the establishment and, if 
87.2 	the owner or owners is not a natural person, identification of the type of business entity 
87.3 	of the owner or owners;
87.4 	(3) the name and mailing address of the managing agent, through management 
87.5 	agreement or lease agreement, of the establishment, if different from the owner or owners;
87.6 	(4) the name and address of at least one natural person who is authorized to accept 
87.7 	service of process on behalf of the owner or owners and managing agent;
87.8 	(5) a statement describing the registration and licensure status of the establishment 
87.9 	and any provider providing health-related or supportive services under an arrangement 
87.10 	with the establishment;
87.11 	(6) the term of the contract;
87.12 	(7) a description of the services to be provided to the resident in the base rate to 
87.13 	be paid by resident;
87.14 	(8) a description of any additional services, including home care services, available 
87.15 	for an additional fee from the establishment directly or through arrangements with the 
87.16 	establishment, and a schedule of fees charged for these services;
87.17 	(9) fee schedules outlining the cost of any additional services;
87.18 	(10) (9) (a) description of the process through which the contract may be modified, 
87.19 	amended, or terminated;
87.20 	(11) (10) a description of the establishment's complaint resolution process available 
87.21 	to residents including the toll-free complaint line for the Office of Ombudsman for Older 
87.22 	Minnesotans;
87.23 	(12) (11) the resident's designated representative, if any;
87.24 	(13) (12) the establishment's referral procedures if the contract is terminated;
87.25 	(14) criteria (13) requirements of residency used by the establishment to determine 
87.26 	who may reside or continue to reside in the elderly housing with services establishment;
87.27 	(15) (14) billing and payment procedures and requirements;
87.28 	(16) (15)a statement regarding the ability of residents to receive services from 
87.29 	service providers with whom the establishment does not have an arrangement; and
87.30 	(17) (16)a statement regarding the availability of public funds for payment for 
87.31 	residence or services in the establishment; and
87.32 	(17) a statement regarding the availability of and contact information for long- 
87.33 	term care consultation services under section 256B.0911 in the county in which the 
87.34 	establishment is located.
87.35 		Subd. 3.Contracts in permanent files. Elderly Housing with services contracts 
87.36 	and related documents executed by each resident or resident's representative shall be 
88.1 	maintained by the establishment in files from the date of execution until three years after 
88.2 	the contract is terminated. The contracts and the written disclosures required under section  
88.3 	325F.72, if applicable, shall be made available for on-site inspection by the commissioner 
88.4 	upon request at any time. 

88.5 	EFFECTIVE DATE. This section is effective January 1, 2007.

88.6 	Sec. 14. [144D.045] INFORMATION CONCERNING ARRANGED HOME 
88.7 	CARE PROVIDERS.
88.8 	If a housing with services establishment has one or more arranged home care 
88.9 	providers, the establishment shall arrange to have that arranged home care provider deliver 
88.10 	the following information in writing to a prospective resident, prior to the date on which 
88.11 	the prospective resident executes a contract with the establishment or the prospective 
88.12 	resident's move-in date, whichever is earlier:
88.13 	(1) the name, mailing address, and telephone number of the arranged home care 
88.14 	provider;
88.15 	(2) the name and mailing address of at least one natural person who is authorized to 
88.16 	accept service of process on behalf of the entity described in clause (1) ;
88.17 	(3) a description of the process through which a home care service agreement or 
88.18 	service plan between a resident and the arranged home care provider, if any, may be 
88.19 	modified, amended, or terminated;
88.20 	(4) the arranged home care provider's billing and payment procedures and 
88.21 	requirements; and
88.22 	(5) any limits to the services available from the arranged provider.

88.23 	EFFECTIVE DATE. This section is effective January 1, 2007.

88.24 	Sec. 15. Minnesota Statutes 2004, section 144D.05, is amended to read:
88.25 	144D.05 AUTHORITY OF COMMISSIONER.
88.26 	The commissioner shall, upon receipt of information which may indicate the failure 
88.27 	of the elderly housing with services establishment, a resident, a resident's representative, 
88.28 	or a service provider to comply with a legal requirement to which one or more of them 
88.29 	may be subject, make appropriate referrals to other governmental agencies and entities 
88.30 	having jurisdiction over the subject matter. The commissioner may also make referrals 
88.31 	to any public or private agency the commissioner considers available for appropriate 
88.32 	assistance to those involved.
89.1 	The commissioner shall have standing to bring an action for injunctive relief 
89.2 	in the district court in the district in which an establishment is located to compel the 
89.3 	elderly housing with services establishment to meet the requirements of this chapter or 
89.4 	other requirements of the state or of any county or local governmental unit to which the 
89.5 	establishment is otherwise subject. Proceedings for securing an injunction may be brought 
89.6 	by the commissioner through the attorney general or through the appropriate county 
89.7 	attorney. The sanctions in this section do not restrict the availability of other sanctions.

89.8 	EFFECTIVE DATE. This section is effective January 1, 2007.

89.9 	Sec. 16. Minnesota Statutes 2004, section 144D.065, is amended to read:
89.10 	144D.065 ESTABLISHMENTS THAT SERVE PERSONS WITH 
89.11 	ALZHEIMER'S DISEASE OR RELATED DISORDERS.
89.12 	(a) If a housing with services establishment registered under this chapter markets or 
89.13 	otherwise promotes services for persons with Alzheimer's disease or related disorders, 
89.14 	whether in a segregated or general unit, the facility's establishment's direct care staff and 
89.15 	their supervisors must be trained in dementia care.
89.16 	(b) Areas of required training include:
89.17 	(1) an explanation of Alzheimer's disease and related disorders;
89.18 	(2) assistance with activities of daily living;
89.19 	(3) problem solving with challenging behaviors; and
89.20 	(4) communication skills.
89.21 	(c) The establishment shall provide to consumers in written or electronic form a 
89.22 	description of the training program, the categories of employees trained, the frequency 
89.23 	of training, and the basic topics covered. This information satisfies the disclosure 
89.24 	requirements of section  325F.72, subdivision 2, clause (4). 

89.25 	EFFECTIVE DATE. This section is effective January 1, 2007.

89.26 	Sec. 17. [144G.01] DEFINITIONS.
89.27 		Subdivision 1.Scope; other definitions. For purposes of sections 144G.01 to 
89.28 	144G.05, the following definitions apply. In addition, the definitions provided in section 
89.29 	144D.01 also apply to sections 144G.01 to 144G.05.
89.30 		Subd. 2.Assisted living. "Assisted living" means a service or package of services 
89.31 	advertised, marketed, or otherwise described, offered, or promoted using the phrase 
89.32 	"assisted living" either alone or in combination with other words, whether orally or in 
89.33 	writing, and which is subject to the requirements of this chapter.
90.1 		Subd. 3.Assisted living client. "Assisted living client" or "client" means a housing 
90.2 	with services resident who receives assisted living that is subject to the requirements 
90.3 	of this chapter.
90.4 		Subd. 4.Commissioner. "Commissioner" means the commissioner of health.

90.5 	EFFECTIVE DATE. This section is effective January 1, 2007.

90.6 	Sec. 18. [144G.02] ASSISTED LIVING; PROTECTED TITLE; RESTRICTION 
90.7 	ON USE; REGULATORY FUNCTIONS.
90.8 		Subdivision 1.Protected title; restriction on use. No person or entity may use the 
90.9 	phrase "assisted living," whether alone or in combination with other words and whether 
90.10 	orally or in writing, to advertise, market, or otherwise describe, offer, or promote itself, or 
90.11 	any housing, service, service package, or program that it provides within this state, unless 
90.12 	the person or entity is a housing with services establishment that meets the requirements of 
90.13 	this chapter, or is a person or entity that provides some or all components of assisted living 
90.14 	that meet the requirements of this chapter. A person or entity entitled to use the phrase 
90.15 	"assisted living" shall use the phrase only in the context of its participation in assisted 
90.16 	living that meets the requirements of this chapter. A housing with services establishment 
90.17 	offering or providing assisted living that is not made available to residents in all of its 
90.18 	housing units shall identify the number or location of the units in which assisted living 
90.19 	is available, and may not use the term "assisted living" in the name of the establishment 
90.20 	registered with the commissioner under chapter 144D, or in the name the establishment 
90.21 	uses to identify itself to residents or the public.
90.22 		Subd. 2.Authority of commissioner. (a) The commissioner, upon receipt of 
90.23 	information that may indicate the failure of a housing with services establishment, the 
90.24 	arranged home care provider, an assisted living client, or an assisted living client's 
90.25 	representative to comply with a legal requirement to which one or more of the entities may 
90.26 	be subject, shall make appropriate referrals to other governmental agencies and entities 
90.27 	having jurisdiction over the subject matter. The commissioner may also make referrals 
90.28 	to any public or private agency the commissioner considers available for appropriate 
90.29 	assistance to those involved.
90.30 	(b) In addition to the authority with respect to licensed home care providers under 
90.31 	sections 144A.45 and 144A.46 and with respect to housing with services establishments 
90.32 	under chapter 144D, the commissioner shall have standing to bring an action for injunctive 
90.33 	relief in the district court in the district in which a housing with services establishment 
90.34 	is located to compel the housing with services establishment or the arranged home care 
90.35 	provider to meet the requirements of this chapter or other requirements of the state or of 
91.1 	any county or local governmental unit to which the establishment or arranged home care 
91.2 	provider is otherwise subject. Proceedings for securing an injunction may be brought by 
91.3 	the commissioner through the attorney general or through the appropriate county attorney. 
91.4 	The sanctions in this section do not restrict the availability of other sanctions.

91.5 	EFFECTIVE DATE. This section is effective January 1, 2007.

91.6 	Sec. 19. [144G.03] ASSISTED LIVING REQUIREMENTS.
91.7 		Subdivision 1.Verification in annual registration. A registered housing with 
91.8 	services establishment using the phrase "assisted living," pursuant to section 144G.02, 
91.9 	subdivision 1, shall verify to the commissioner in its annual registration pursuant to chapter 
91.10 	144D that the establishment is complying with sections 144G.01 to 144G.05, as applicable.
91.11 		Subd. 2.Minimum requirements for assisted living. (a) Assisted living shall 
91.12 	be provided or made available only to individuals residing in a registered housing with 
91.13 	services establishment. Except as expressly stated in this chapter, a person or entity 
91.14 	offering assisted living may define the available services and may offer assisted living to 
91.15 	all or some of the residents of a housing with services establishment. The services that 
91.16 	comprise assisted living may be provided or made available directly by a housing with 
91.17 	services establishment or by persons or entities with which the housing with services 
91.18 	establishment has made arrangements.
91.19 	(b) A person or entity entitled to use the phrase "assisted living," according to 
91.20 	section 144G.02, subdivision 1, shall do so only with respect to a housing with services 
91.21 	establishment, or a service, service package, or program available within a housing with 
91.22 	services establishment that, at a minimum:
91.23 	(1) provides or makes available health related services under a class A or class F 
91.24 	home care license. At a minimum, health related services must include:
91.25 	(i) assistance with self-administration of medication as defined in Minnesota Rules, 
91.26 	part 4668.0003, subpart 2a, or medication administration as defined in Minnesota Rules, 
91.27 	part 4668.0003, subpart 21a; and
91.28 	(ii) assistance with at least three of the following seven activities of daily living: 
91.29 	bathing, dressing, grooming, eating, transferring, continence care, and toileting. 
91.30 	All health related services shall be provided in a manner that complies with applicable 
91.31 	home care licensure requirements in chapter 144A and Minnesota Rules, chapter 4668, 
91.32 	and with sections 148.171 to 148.285;
91.33 	(2) provides necessary assessments of the physical and cognitive needs of assisted 
91.34 	living clients by a registered nurse, as required by applicable home care licensure 
92.1 	requirements in chapter 144A and Minnesota Rules, chapter 4668, and by sections 
92.2 	148.171 to 148.285;
92.3 	(3) has and maintains a system for delegation of health care activities to unlicensed 
92.4 	assistive health care personnel by a registered nurse, including supervision and evaluation 
92.5 	of the delegated activities as required by applicable home care licensure requirements in 
92.6 	chapter 144A and Minnesota Rules, chapter 4668, and by sections 148.171 to 148.285;
92.7 	(4) provides staff access to an on-call registered nurse 24 hours per day, seven 
92.8 	days per week;
92.9 	(5) has and maintains a system to check on each assisted living client at least daily;
92.10 	(6) provides a means for assisted living clients to request assistance for health and 
92.11 	safety needs 24 hours per day, seven days per week, from the establishment or a person or 
92.12 	entity with which the establishment has made arrangements;
92.13 	(7) has a person or persons available 24 hours per day, seven days per week, who 
92.14 	is responsible for responding to the requests of assisted living clients for assistance with 
92.15 	health or safety needs, who shall be:
92.16 	(i)	awake;
92.17 	(ii) located in the same building, in an attached building, or on a contiguous campus 
92.18 	with the housing with services establishment in order to respond within a reasonable 
92.19 	amount of time;
92.20 	(iii) capable of communicating with assisted living clients;
92.21 	(iv) capable of recognizing the need for assistance;
92.22 	(v) capable of providing either the assistance required or summoning the appropriate 
92.23 	assistance; and
92.24 	(vi) capable of following directions;
92.25 	(8) offers to provide or make available at least the following supportive services 
92.26 	to assisted living clients:
92.27 	(i) two meals per day;
92.28 	(ii) weekly housekeeping;
92.29 	(iii) weekly laundry service;
92.30 	(iv) upon the request of the client, reasonable assistance with arranging for 
92.31 	transportation to medical and social services appointments, and the name of or other 
92.32 	identifying information about the person or persons responsible for providing this 
92.33 	assistance;
92.34 	(v) upon the request of the client, reasonable assistance with accessing community 
92.35 	resources and social services available in the community, and the name of or other 
93.1 	identifying information about the person or persons responsible for providing this 
93.2 	assistance; and
93.3 	(vi) periodic opportunities for socialization; and
93.4 	(9) makes available to all prospective and current assisted living clients information 
93.5 	consistent with the uniform format and the required components adopted by the 
93.6 	commissioner under section 144G.06. This information must be made available beginning 
93.7 	no later than six months after the commissioner makes the uniform format and required 
93.8 	components available to providers according to section 144G.06.
93.9 		Subd. 3.Exemption from awake-staff requirement. (a) A housing with services 
93.10 	establishment that offers or provides assisted living is exempt from the requirement in 
93.11 	subdivision 2, paragraph (b), clause (7), item (i), that the person or persons available and 
93.12 	responsible for responding to requests for assistance must be awake, if the establishment 
93.13 	meets the following requirements:
93.14 	(1) the establishment has a maximum capacity to serve 12 or fewer assisted living 
93.15 	clients;
93.16 	(2) the person or persons available and responsible for responding to requests for 
93.17 	assistance are physically present within the housing with services establishment in which 
93.18 	the assisted living clients reside;
93.19 	(3) the establishment has a system in place that is compatible with the health, safety, 
93.20 	and welfare of the establishment's assisted living clients;
93.21 	(4) the establishment's housing with services contract, as required by section 
93.22 	144D.04, includes a statement disclosing the establishment's qualification for, and 
93.23 	intention to rely upon, this exemption;
93.24 	(5) the establishment files with the commissioner, for purposes of public information 
93.25 	but not review or approval by the commissioner, a statement describing how the 
93.26 	establishment meets the conditions in clauses (1) to (4), and makes a copy of this statement 
93.27 	available to actual and prospective assisted living clients; and 
93.28 	(6) the establishment indicates on its housing with services registration, under 
93.29 	section 144D.02 or 144D.03, as applicable, that it qualifies for and intends to rely upon the 
93.30 	exemption under this subdivision.
93.31 		Subd. 4.Nursing assessment. (a) A housing with services establishment offering or 
93.32 	providing assisted living shall:
93.33 	(1) offer to have the arranged home care provider conduct a nursing assessment by 
93.34 	a registered nurse of the physical and cognitive needs of the prospective resident and 
93.35 	propose a service agreement or service plan prior to the date on which a prospective 
94.1 	resident executes a contract with a housing with services establishment or the date on 
94.2 	which a prospective resident moves in, whichever is earlier; and
94.3 	(2) inform the prospective resident of the availability of and contact information for 
94.4 	long-term care consultation services under section 256B.0911, prior to the date on which a 
94.5 	prospective resident executes a contract with a housing with services establishment or the 
94.6 	date on which a prospective resident moves in, whichever is earlier.
94.7 	(b) An arranged home care provider is not obligated to conduct a nursing assessment 
94.8 	by a registered nurse when requested by a prospective resident if either the geographic 
94.9 	distance between the prospective resident and the provider, or urgent or unexpected 
94.10 	circumstances, do not permit the assessment to be conducted prior to the date on which 
94.11 	the prospective resident executes a contract or moves in, whichever is earlier. When such 
94.12 	circumstances occur, the arranged home care provider shall offer to conduct a telephone 
94.13 	conference whenever reasonably possible. 
94.14 	(c) The arranged home care provider shall comply with applicable home care 
94.15 	licensure requirements in chapter 144A and Minnesota Rules, chapter 4668, and with 
94.16 	sections 148.171 to 148.285 with respect to the provision of a nursing assessment prior 
94.17 	to the delivery of nursing services and the execution of a home care service plan or 
94.18 	service agreement.
94.19 		Subd. 5.Assistance with arranged home care provider. The housing with services 
94.20 	establishment shall provide each assisted living client with identifying information about a 
94.21 	person or persons reasonably available to assist the client with concerns the client may 
94.22 	have with respect to the services provided by the arranged home care provider. The 
94.23 	establishment shall keep each assisted living client reasonably informed of any changes in 
94.24 	the personnel referenced in this subdivision. Upon request of the assisted living client, 
94.25 	such personnel or designee shall provide reasonable assistance to the assisted living client 
94.26 	in addressing concerns regarding services provided by the arranged home care provider.
94.27 		Subd. 6.Termination of housing with services contract. If a housing with 
94.28 	services establishment terminates a housing with services contract with an assisted living 
94.29 	client, the establishment shall provide the assisted living client, and the legal or designated 
94.30 	representative of the assisted living client, if any, with a written notice of termination 
94.31 	which includes the following information:
94.32 	(1) the effective date of termination;
94.33 	(2) the section of the contract that authorizes the termination;
94.34 	(3) without extending the termination notice period, an affirmative offer to meet with 
94.35 	the assisted living client and, if applicable, client representatives, within no more than five 
94.36 	business days of the date of the termination notice to discuss the termination;
95.1 	(4) an explanation that:
95.2 	(i) the assisted living client must vacate the apartment, along with all personal 
95.3 	possessions, on or before the effective date of termination;
95.4 	(ii) failure to vacate the apartment by the date of termination may result in the filing 
95.5 	of an eviction action in court by the establishment, and that the assisted living client may 
95.6 	present a defense, if any, to the court at that time; and 
95.7 	(iii) the assisted living client may seek legal counsel in connection with the notice 
95.8 	of termination;
95.9 	(5) a statement that, with respect to the notice of termination, reasonable 
95.10 	accommodation is available for the disability of the assisted living client, if any; and
95.11 	(6) the name and contact information of the representative of the establishment 
95.12 	with whom the assisted living client or client representatives may discuss the notice of 
95.13 	termination.

95.14 	EFFECTIVE DATE. This section is effective January 1, 2007.

95.15 	Sec. 20. [144G.04] RESERVATION OF RIGHTS.
95.16 		Subdivision 1.Use of services. Nothing in this chapter requires an assisted living 
95.17 	client to utilize any service provided or made available in assisted living.
95.18 		Subd. 2.Housing with services contracts. Nothing in this chapter requires a 
95.19 	housing with services establishment to execute or refrain from terminating a housing with 
95.20 	services contract with a prospective or current resident who is unable or unwilling to meet 
95.21 	the requirements of residency, with or without assistance. 
95.22 		Subd. 3.Provision of services. Nothing in this chapter requires the arranged home 
95.23 	care provider to offer or continue to provide services under a service agreement or service 
95.24 	plan to a prospective or current resident of the establishment whose needs cannot be 
95.25 	met by the arranged home care provider.
95.26 		Subd. 4.Altering operations; service packages. Nothing in this chapter requires 
95.27 	a housing with services establishment or arranged home care provider offering assisted 
95.28 	living to fundamentally alter the nature of the operations of the establishment or the 
95.29 	provider in order to accommodate the request or need for facilities or services by any 
95.30 	assisted living client, or to refrain from requiring, as a condition of residency, that an 
95.31 	assisted living client pay for a package of assisted living services even if the client does 
95.32 	not choose to utilize all or some of the services in the package.

95.33 	EFFECTIVE DATE. This section is effective January 1, 2007.

96.1 	Sec. 21. [144G.05] REIMBURSEMENT UNDER ASSISTED LIVING SERVICE 
96.2 	PACKAGES.
96.3 	Notwithstanding the provisions of this chapter, the requirements for the Elderly 
96.4 	Waiver program's assisted living payment rates under section 256B.0915, subdivision 
96.5 	3e, shall continue to be effective and providers who do not meet the requirements of 
96.6 	this chapter may continue to receive payment under section 256B.0915, subdivision 3e, 
96.7 	as long as they continue to meet the definitions and standards for assisted living and 
96.8 	assisted living plus set forth in the federally approved Elderly Home and Community 
96.9 	Based Services Waiver Program (Control Number 0025.91). Providers of assisted living 
96.10 	for the Community Alternatives for Disabled Individuals (CADI) and Traumatic Brain 
96.11 	Injury (TBI) waivers shall continue to receive payment as long as they continue to meet 
96.12 	the definitions and standards for assisted living and assisted living plus set forth in the 
96.13 	federally approved CADI and TBI waiver plans.

96.14 	EFFECTIVE DATE. This section is effective January 1, 2007.

96.15 	Sec. 22. [144G.06] UNIFORM CONSUMER INFORMATION GUIDE.
96.16 	(a) The commissioner of health shall establish an advisory committee consisting 
96.17 	of representatives of consumers, providers, county and state officials, and other 
96.18 	groups the commissioner considers appropriate. The advisory committee shall present 
96.19 	recommendations to the commissioner on:
96.20 	(1) a format for a guide to be used by individual providers of assisted living, as 
96.21 	defined in Minnesota Statutes, section 144G.01, that includes information about services 
96.22 	offered by that provider, service costs, and other relevant provider-specific information, as 
96.23 	well as a statement of philosophy and values associated with assisted living, presented in 
96.24 	uniform categories that facilitate comparison with guides issued by other providers; and
96.25 	(2) requirements for informing assisted living clients, as defined in Minnesota 
96.26 	Statutes, section 144G.01, of their applicable legal rights.
96.27 	(b) The commissioner, after reviewing the recommendations of the advisory 
96.28 	committee, shall adopt a uniform format for the guide to be used by individual providers, 
96.29 	and the required components of materials to be used by providers to inform assisted 
96.30 	living clients of their legal rights, and shall make the uniform format and the required 
96.31 	components available to assisted living providers.

96.32 	Sec. 23. [145.4122] NON-HOSPITAL-PERFORMED ABORTIONS; 
96.33 	REQUIREMENT; MISDEMEANOR.
97.1 		Subdivision 1.Physician requirement. A physician performing or inducing an 
97.2 	abortion who does not have clinical privileges at a hospital which offers obstetrical or 
97.3 	gynecological care within the state and within 20 miles of the location where the abortion 
97.4 	is performed or induced is guilty of a misdemeanor and is subject to the criminal penalties 
97.5 	provided by law. For purposes of this section, abortion has the meaning given in section 
97.6 	144.343, subdivision 3. 
97.7 		Subd. 2.Severability. If any one or more provision, section, subdivision, 
97.8 	sentence, clause, phrase, or word of this section or the application thereof to any person 
97.9 	or circumstance is found to be unconstitutional, the same is hereby declared to be 
97.10 	severable and the balance of this section shall remain effective notwithstanding such 
97.11 	unconstitutionality.  The legislature intends that it would have passed this section, and each 
97.12 	provision, section, subdivision, sentence, clause, phrase, or word thereof irrespective of 
97.13 	the fact that any one provision, section, subdivision, sentence, clause, phrase, or word be 
97.14 	declared unconstitutional. 
97.15 		Subd. 3. Supreme Court jurisdiction.  The Minnesota Supreme Court has original 
97.16 	jurisdiction over an action challenging the constitutionality of this section and shall 
97.17 	expedite the resolution of the action.

97.18 	Sec. 24. Minnesota Statutes 2004, section 145.4241, is amended by adding a 
97.19 	subdivision to read:
97.20 		Subd. 3a.Fetal anomaly incompatible with life. "Fetal anomaly incompatible with 
97.21 	life" means an untreatable fetal anomaly diagnosed before birth that will with reasonable 
97.22 	certainty result in fetal or neonatal death. These conditions include anencephaly, trisomy 
97.23 	13 or 18, acardia, renal agenesis, and thanatophoric dwarfism.

97.24 	Sec. 25. Minnesota Statutes 2004, section 145.4241, is amended by adding a 
97.25 	subdivision to read:
97.26 		Subd. 4a.Perinatal hospice. (a) "Perinatal hospice" means comprehensive support 
97.27 	to the female and her family that includes support from the time of diagnosis through the 
97.28 	time of birth and death of the infant and through the postpartum period. Supportive care 
97.29 	may include maternal-fetal medical specialists, obstetricians, neonatologists, anesthesia 
97.30 	specialists, family physicians, nurse midwives, clergy, social workers, and specialty nurses.
97.31 	(b) The availability of perinatal hospice provides an alternative to families for whom 
97.32 	elective pregnancy termination is not chosen.

98.1 	Sec. 26. Minnesota Statutes 2005 Supplement, section 145.4242, is amended to read:
98.2 	145.4242 INFORMED CONSENT.
98.3 	(a) No abortion shall be performed in this state except with the voluntary and 
98.4 	informed consent of the female upon whom the abortion is to be performed. Except in 
98.5 	the case of a medical emergency or if the fetus has an anomaly incompatible with life, 
98.6 	and the female has declined perinatal hospice care, consent to an abortion is voluntary 
98.7 	and informed only if:
98.8 	(1) the female is told the following, by telephone or in person, by the physician who 
98.9 	is to perform the abortion or by a referring physician, at least 24 hours before the abortion:
98.10 	(i) the particular medical risks associated with the particular abortion procedure to be 
98.11 	employed including, when medically accurate, the risks of infection, hemorrhage, breast 
98.12 	cancer, danger to subsequent pregnancies, and infertility;
98.13 	(ii) the probable gestational age of the unborn child at the time the abortion is to 
98.14 	be performed;
98.15 	(iii) the medical risks associated with carrying her child to term; and
98.16 	(iv) for abortions after 20 weeks gestational, whether or not an anesthetic or 
98.17 	analgesic would eliminate or alleviate organic pain to the unborn child caused by the 
98.18 	particular method of abortion to be employed and the particular medical benefits and risks 
98.19 	associated with the particular anesthetic or analgesic.
98.20 	The information required by this clause may be provided by telephone without 
98.21 	conducting a physical examination or tests of the patient, in which case the information 
98.22 	required to be provided may be based on facts supplied to the physician by the female and 
98.23 	whatever other relevant information is reasonably available to the physician. It may not be 
98.24 	provided by a tape recording, but must be provided during a consultation in which the 
98.25 	physician is able to ask questions of the female and the female is able to ask questions 
98.26 	of the physician. If a physical examination, tests, or the availability of other information 
98.27 	to the physician subsequently indicate, in the medical judgment of the physician, a 
98.28 	revision of the information previously supplied to the patient, that revised information 
98.29 	may be communicated to the patient at any time prior to the performance of the abortion. 
98.30 	Nothing in this section may be construed to preclude provision of required information in 
98.31 	a language understood by the patient through a translator;
98.32 	(2) the female is informed, by telephone or in person, by the physician who is to 
98.33 	perform the abortion, by a referring physician, or by an agent of either physician at least 
98.34 	24 hours before the abortion:
98.35 	(i) that medical assistance benefits may be available for prenatal care, childbirth, 
98.36 	and neonatal care;
99.1 	(ii) that the father is liable to assist in the support of her child, even in instances 
99.2 	when the father has offered to pay for the abortion; and
99.3 	(iii) that she has the right to review the printed materials described in section 
99.4 	145.4243, that these materials are available on a state-sponsored Web site, and what the 
99.5 	Web site address is. The physician or the physician's agent shall orally inform the female 
99.6 	that the materials have been provided by the state of Minnesota and that they describe the 
99.7 	unborn child, list agencies that offer alternatives to abortion, and contain information on 
99.8 	fetal pain. If the female chooses to view the materials other than on the Web site, they 
99.9 	shall either be given to her at least 24 hours before the abortion or mailed to her at least 72 
99.10 	hours before the abortion by certified mail, restricted delivery to addressee, which means 
99.11 	the postal employee can only deliver the mail to the addressee.
99.12 	The information required by this clause may be provided by a tape recording if 
99.13 	provision is made to record or otherwise register specifically whether the female does or 
99.14 	does not choose to have the printed materials given or mailed to her;
99.15 	(3) the female certifies in writing, prior to the abortion, that the information 
99.16 	described in clauses (1) and (2) has been furnished to her and that she has been informed 
99.17 	of her opportunity to review the information referred to in clause (2), subclause (iii); and
99.18 	(4) prior to the performance of the abortion, the physician who is to perform the 
99.19 	abortion or the physician's agent obtains a copy of the written certification prescribed by 
99.20 	clause (3) and retains it on file with the female's medical record for at least three years 
99.21 	following the date of receipt.
99.22 	(b) Prior to administering the anesthetic or analgesic as described in paragraph (a), 
99.23 	clause (1), item (iv), the physician must disclose to the woman any additional cost of the 
99.24 	procedure for the administration of the anesthetic or analgesic. If the woman consents 
99.25 	to the administration of the anesthetic or analgesic, the physician shall administer the 
99.26 	anesthetic or analgesic or arrange to have the anesthetic or analgesic administered.
99.27 	(c) A female seeking an abortion of her unborn child diagnosed with a fetal anomaly 
99.28 	incompatible with life must be informed of available perinatal hospice services and offered 
99.29 	this care as an alternative to abortion. If perinatal hospice services are declined, voluntary 
99.30 	and informed consent by the female seeking an abortion is given if the female receives the 
99.31 	information required in paragraphs (a), clause (1) and (b). The female and the physician or 
99.32 	physician's agent must comply with the requirements in paragraph (a), clauses (3) and 
99.33 	(4), as they relate to paragraphs (a), clause (1), and (b).

99.34 	Sec. 27. [151.415] PROHIBITION AGAINST REFUSING TO DISPENSE A 
99.35 	LEGEND DRUG OR DEVICE.
100.1 		Subdivision 1.Intent. It is the intent of the legislature that pharmacists dispense 
100.2 	legend drugs and devices in a timely way or provide appropriate referrals for patients to 
100.3 	obtain the necessary legend drugs and devices, despite the pharmacist's objection to 
100.4 	dispensing the drugs or devices on ethical, moral, or religious grounds.
100.5 		Subd. 2.Prohibition. (a) No pharmacist shall obstruct a patient in obtaining a 
100.6 	legend drug or device that has been legally prescribed or ordered for that patient. A 
100.7 	violation of this section constitutes unprofessional conduct by the pharmacist and shall 
100.8 	subject the pharmacist to disciplinary or administrative action by the Board of Pharmacy.
100.9 	(b) Notwithstanding any other provision of law, a pharmacist shall dispense drugs 
100.10 	and devices, as described in section 151.01, subdivision 30, pursuant to a lawful order or 
100.11 	prescription unless one of the following circumstances exists:
100.12 	(1) based solely on the pharmacist's professional training and judgment dispensing 
100.13 	pursuant to the order or the prescription is contrary to law, or the pharmacist determines 
100.14 	that the prescribed drug or device would cause a harmful drug interaction or would 
100.15 	otherwise adversely affect the patient's medical condition;
100.16 	(2) the legend drug or device is not in stock. If an order or prescription cannot be 
100.17 	dispensed because the drug or device is not in stock, the pharmacist shall take one of the 
100.18 	following actions:
100.19 	(i) immediately notify the patient and arrange for the drug or device to be delivered 
100.20 	to the site or directly to the patient in a timely manner;
100.21 	(ii) promptly transfer the prescription to another pharmacy known to stock the 
100.22 	legend drug or device  to ensure the patient has timely access to the drug or device; or
100.23 	(iii) return the prescription to the patient and refer the patient; or
100.24 	(3) the pharmacist refuses on ethical, moral, or religious grounds to dispense a drug 
100.25 	or device pursuant to an order or prescription. A pharmacist may decline to dispense a 
100.26 	prescription drug or device on this basis  if the employer has previously been notified by 
100.27 	the pharmacist, in writing, of the drug or class of drugs to which the pharmacist objects. 
100.28 	The pharmacist's  employer shall establish protocols that ensure that the patient has timely 
100.29 	access to the prescribed drug or device despite the pharmacist's refusal to dispense the 
100.30 	prescription or order.
100.31 	(c) For the purposes of this section, "legend drug or device" has the same meaning as 
100.32 	the definition in section 151.01, subdivision 17.
100.33 	(d) Nothing in this section requires a pharmacy to stock any legend drug or device.
100.34 	(e) This section imposes no duty on a pharmacist to dispense a drug or device 
100.35 	pursuant to a prescription or order without payment for the drug or device, including 
101.1 	payment directly by the patient or through a third-party payer accepted by the pharmacist 
101.2 	or payment of any required co-payment by the patient.

101.3 	Sec. 28. Minnesota Statutes 2005 Supplement, section 157.16, subdivision 3a, is 
101.4 	amended to read:
101.5 		Subd. 3a.Statewide hospitality fee. Every person, firm, or corporation that operates 
101.6 	a licensed boarding establishment, food and beverage service establishment, seasonal 
101.7 	temporary or permanent food stand, special event food stand, mobile food unit, food cart, 
101.8 	resort, hotel, motel, or lodging establishment in Minnesota, except for a school, as defined 
101.9 	in section 120A.05, subdivisions 9, 11, and 13, must submit to the commissioner a $35 
101.10 	annual statewide hospitality fee for each licensed activity. The fee for establishments 
101.11 	licensed by the Department of Health is required at the same time the licensure fee is due. 
101.12 	For establishments licensed by local governments, the fee is due by July 1 of each year.

101.13 	EFFECTIVE DATE. This section is effective July 1, 2006.

101.14 	Sec. 29. PROHIBITION ON USE OF STATE FUNDS.
 101.15 		Subdivision 1.Use of funds. Funding for state-sponsored health programs shall not 
101.16 	be used for funding abortions, except to the extent necessary for continued participation 
101.17 	in a federal program. For purposes of this section, abortion has the meaning given in 
101.18 	Minnesota Statutes, section 144.343, subdivision 3.
101.19 		Subd. 2.Severability. If any one or more provision, section, subdivision, 
101.20 	sentence, clause, phrase, or word of this section or the application thereof to any person 
101.21 	or circumstance is found to be unconstitutional, the same is hereby declared to be 
101.22 	severable and the balance of this section shall remain effective notwithstanding such 
101.23 	unconstitutionality.  The legislature intends that it would have passed this section, and each 
101.24 	provision, section, subdivision, sentence, clause, phrase, or word thereof irrespective of 
101.25 	the fact that any one provision, section, subdivision, sentence, clause, phrase, or word be 
101.26 	declared unconstitutional. 
101.27 		Subd. 3. Supreme Court jurisdiction.  The Minnesota Supreme Court has original 
101.28 	jurisdiction over an action challenging the constitutionality of this section and shall 
101.29 	expedite the resolution of the action.

101.30 	Sec. 30. REVISOR'S INSTRUCTION.
 101.31 		(a) The revisor of statutes shall strike all references to the "Class E assisted living 
101.32 	home care programs license, "Class E license," and similar terms in Minnesota Rules, 
101.33 	chapters 4668 and 4669. In sections affected by this instruction, the revisor may make 
102.1 	changes necessary to correct the punctuation, grammar, or structure of the remaining text 
102.2 	and preserve its meaning.
102.3 		(b) The revisor of statutes shall change the term "assisted living home care provider," 
102.4 	"assisted living license," and similar terms to "Class F home care provider," "Class F 
102.5 	license," and similar terms to "Class F home care provider," "Class F license," and similar 
102.6 	terms, in Minnesota Rules, chapter 4668. In sections affected by this instruction, the 
102.7 	revisor may make changes necessary to correct the punctuation, grammar, or structure of 
102.8 	the remaining text and preserve its meaning.

102.9 	EFFECTIVE DATE. This section is effective January 1, 2007.

102.10 	Sec. 31.  REPEALER.
 102.11 	Minnesota Rules, part 4668.0215, is repealed effective January 1, 2007.

102.12 	ARTICLE 5
102.13 	HEALTH CARE COST-CONTAINMENT

102.14 	Section 1. Minnesota Statutes 2004, section 62D.02, is amended by adding a 
102.15 	subdivision to read:
102.16 		Subd. 1a.Authorized entity. "Authorized entity" means a corporation organized 
102.17 	under chapter 302A, 317A, or the similar laws of another state; a limited liability company 
102.18 	organized under chapter 322B or the similar laws of another state; or a local government 
102.19 	unit as defined in subdivision 11.

102.20 	Sec. 2. Minnesota Statutes 2004, section 62D.02, subdivision 4, is amended to read:
102.21 		Subd. 4.Health maintenance organization. (a) "Health maintenance organization" 
102.22 	means a nonprofit corporation organized under chapter 317A, or a local governmental unit 
102.23 	as defined in subdivision 11 an authorized entity, controlled and operated as provided in 
102.24 	sections  62D.01 to  62D.30, which provides, either directly or through arrangements with 
102.25 	providers or other persons, comprehensive health maintenance services, or arranges for 
102.26 	the provision of these services, to enrollees on the basis of a fixed prepaid sum without 
102.27 	regard to the frequency or extent of services furnished to any particular enrollee. 
102.28 	(b) (Expired)

102.29 	Sec. 3. Minnesota Statutes 2004, section 62D.03, subdivision 1, is amended to read:
102.30 		Subdivision 1.Certificate of authority required. Notwithstanding any law of this 
102.31 	state to the contrary, any nonprofit corporation organized to do so or a local governmental 
103.1 	unit an authorized entity may apply to the commissioner of health for a certificate of 
103.2 	authority to establish and operate a health maintenance organization in compliance with 
103.3 	sections  62D.01 to  62D.30. No person shall establish or operate a health maintenance 
103.4 	organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive 
103.5 	advance or periodic consideration in conjunction with a health maintenance organization 
103.6 	or health maintenance contract unless the organization has a certificate of authority under 
103.7 	sections  62D.01 to  62D.30. An out-of-state corporation or out-of-state limited liability 
103.8 	company may qualify to apply for a certificate of authority under this chapter, subject to 
103.9 	obtaining a certificate of authority to do business in this state under section 303.08 or 
103.10 	322B.915, as appropriate, and compliance with this chapter and other applicable state laws.

103.11 	Sec. 4. Minnesota Statutes 2004, section 62D.05, subdivision 1, is amended to read:
103.12 		Subdivision 1.Authority granted. Any nonprofit corporation or local governmental 
103.13 	unitauthorized entity may, upon obtaining a certificate of authority as required in sections  
103.14 	62D.01 to  62D.30, operate as a health maintenance organization. 

103.15 	Sec. 5. Minnesota Statutes 2004, section 62D.095, subdivision 3, is amended to read:
103.16 		Subd. 3.Deductibles. (a) A health maintenance contract issued by a health 
103.17 	maintenance organization that is assessed less than three percent of the total annual amount 
103.18 	assessed by the Minnesota comprehensive health association may impose deductibles not 
103.19 	to exceed $3,000 $5,000 per person, per year and $6,000 $10,000 per family, per year. For 
103.20 	purposes of the percentage calculation, a health maintenance organization's assessments 
103.21 	include those of its affiliates.
103.22 	(b) All other health maintenance contracts may impose deductibles not to exceed 
103.23 	$2,250 per person, per year and $4,500 per family, per year.

103.24 	Sec. 6. Minnesota Statutes 2004, section 62D.095, subdivision 4, is amended to read:
103.25 		Subd. 4.Annual out-of-pocket maximums. (a) A health maintenance contract 
103.26 	issued by a health maintenance organization that is assessed less than three percent of the 
103.27 	total annual amount assessed by the Minnesota comprehensive health association must 
103.28 	include a limitation not to exceed $4,500 $5,000 per person and $7,500 $10,000 per 
103.29 	family on total annual out-of-pocket enrollee cost-sharing expenses. For purposes of the 
103.30 	percentage calculation, a health maintenance organization's assessments include those 
103.31 	of its affiliates.
104.1 	(b) All other health maintenance contracts must include a limitation not to 
104.2 	exceed $3,000 per person and $6,000 per family on total annual out-of-pocket enrollee 
104.3 	cost-sharing expenses.

104.4 	Sec. 7. Minnesota Statutes 2004, section 62D.095, is amended by adding a subdivision 
104.5 	to read:
104.6 		Subd. 5a. Lifetime maximum benefit. (a) A health maintenance contract issued 
104.7 	by a health maintenance organization may impose a lifetime maximum benefit no less 
104.8 	than $3,000,000. At no time shall a health maintenance organization impose a lifetime 
104.9 	maximum lower than the required lifetime maximum of the comprehensive health 
104.10 	insurance plan under section 62E.12.
104.11 	(b) The comprehensive health insurance plan is available under section 62E.14, 
104.12 	subdivision 4c, paragraph (a), to those meeting the lifetime maximum benefit, without 
104.13 	providing evidence of rejection.

104.14 	Sec. 8. Minnesota Statutes 2004, section 62E.11, subdivision 13, is amended to read:
104.15 		Subd. 13.State funding; effect on premium rates of members. (a) In approving 
104.16 	the premium rates as required in sections  62A.65, subdivision 3; and  62L.08, subdivision 
104.17 	8, the commissioners of health and commerce shall ensure that any appropriation to 
104.18 	reduce the annual assessment made on the contributing members to cover the costs of the 
104.19 	Minnesota comprehensive health insurance plan as required under this section is reflected 
104.20 	in the premium rates charged by each contributing member. 
104.21 	(b) In any fiscal year, a positive balance in the health care access fund, not to 
104.22 	exceed $40,000,000, is appropriated to the commissioner of commerce for disbursement 
104.23 	to the Minnesota Comprehensive Health Association for the purpose of reducing or 
104.24 	eliminating its annual assessments on its contributing members, under subdivision 6. The 
104.25 	amount appropriated and disbursed must not exceed the total amount that the association 
104.26 	would otherwise assess on its contributing members for the calendar year in which the 
104.27 	disbursement is made.
104.28 	(c) Notwithstanding the appropriation in paragraph (b), $87,500,000 in fiscal year 
104.29 	2007, $20,000,000 in fiscal year 2008, and $40,000,000 in fiscal year 2009 is appropriated 
104.30 	from the health care access fund to the commissioner of commerce for the purpose 
104.31 	stated in paragraph (b).
104.32 	(d) The appropriations in this section are available only after the state prevails in 
104.33 	the appeal of the decision, filed December 20, 2005, by the Minnesota District Court, 
104.34 	Second Judicial District v. Philip Morris, Inc.

105.1 	Sec. 9.  Minnesota Statutes 2005 Supplement, section 62J.052, is amended to read:
105.2 	62J.052 PROVIDER COST DISCLOSURE.
105.3 		Subdivision 1.Health care providers. (a) Each health care provider, as defined by 
105.4 	section 62J.03, subdivision 8, except hospitals and outpatient surgical centers subject to 
105.5 	the requirements of section 62J.823, shall provide the following information:
105.6 	(1) the average allowable payment from private third-party payers for the 20 services 
105.7 	or procedures most commonly performed;
105.8 	(2) the average payment rates for those services and procedures for medical 
105.9 	assistance;
105.10 	(3) the average charge for those services and procedures for individuals who have no 
105.11 	applicable private or public coverage; and
105.12 	(4) the average charge for those services and procedures, including all patients.
105.13 	(b) This information shall be updated annually and be readily available at no cost to 
105.14 	the public on site.
105.15 		Subd. 2.Pharmacies. (a) Each pharmacy, as defined in section 151.01, subdivision 
105.16 	2, shall provide the following information to a patient, upon request:
105.17 	(1) the pharmacy's own usual and customary price for a prescription drug;
105.18 	(2) a historical record, including all transactions on record with the pharmacy both 
105.19 	past and present, of all co-payments and other cost-sharing paid to the pharmacy by the 
105.20 	patient; and
105.21 	(3) the total amount of all co-payments and other cost-sharing paid to the pharmacy 
105.22 	by the patient over the entire historical record.

105.23 	Sec. 10. [62J.431] EVIDENCE-BASED PRACTICE STANDARDS AND 
105.24 	GUIDELINES.
105.25 		Subdivision 1.Health-related boards and provider organizations; practice 
105.26 	standards. The health-related boards, under chapter 148, or professional provider 
105.27 	organizations may establish practice standards for treating patients within their respective 
105.28 	scopes of practice. The boards or provider organizations may utilize the services of 
105.29 	appropriate public or private entities to facilitate the development or review of practice 
105.30 	standards and evidence-based guidelines. Each board or provider organization that has 
105.31 	established or ratified existing standards shall report these standards to the legislative 
105.32 	committees with jurisdiction over the public health occupations by January 15, 2007, and 
105.33 	shall report subsequent changes annually thereafter. If a board or provider organization 
105.34 	has existing standards, nothing in this section requires a board or provider organization to 
106.1 	establish new standards. Nothing in this section shall require a health plan company to 
106.2 	cover treatments, testing, or imaging, based on standards developed under this section.
106.3 		Subd. 2.Criteria for evidence-based guidelines. Guidelines identified under this 
106.4 	section must meet the following criteria:
106.5 	(1) the scope and application are clear;
106.6 	(2) authorship is stated and any conflicts of interest disclosed;
106.7 	(3) authors represent all pertinent clinical fields or other means of input have been 
106.8 	used;
106.9 	(4) the development process is explicitly stated;
106.10 	(5) the guideline is grounded in evidence;
106.11 	(6) the evidence is cited and graded;
106.12 	(7) the document itself is clear and practical;
106.13 	(8) the document is flexible in use, with exceptions noted or provided for with 
106.14 	general statements;
106.15 	(9) measures are included for use in systems improvement; and
106.16 	(10) the guideline has scheduled reviews and updating.

106.17 	Sec. 11. [62J.62] ELECTRONIC BILLING ASSISTANCE.
106.18 	The commissioner of human services shall, out of existing resources, encourage and 
106.19 	assist providers to adopt and use electronic billing for state programs, including but not 
106.20 	limited to the provision of training.

106.21 	Sec. 12. Minnesota Statutes 2004, section 62J.81, subdivision 1, is amended to read:
106.22 		Subdivision 1.Required disclosure of estimated payment. (a) A health care 
106.23 	provider, as defined in section  62J.03, subdivision 8, or the provider's designee as agreed 
106.24 	to by that designee, shall, at the request of a consumer, provide that consumer with a good 
106.25 	faith estimate of the reimbursement the provider expects to receive from the health plan 
106.26 	company in which the consumer is enrolled. Health plan companies must allow contracted 
106.27 	providers, or their designee, to release this information. A good faith estimate must also be 
106.28 	made available at the request of a consumer who is not enrolled in a health plan company. 
106.29 	Payment information provided by a provider, or by the provider's designee as agreed to 
106.30 	by that designee, to a patient pursuant to this subdivision does not constitute a legally 
106.31 	binding estimate of the cost of services. 
106.32 	(b) A health plan company, as defined in section 62J.03, subdivision 10, shall, 
106.33 	at the request of an enrollee, provide that enrollee with a good faith estimate of the 
106.34 	reimbursement the health plan company would expect to pay to a specified provider within 
107.1 	the network for a health care service specified by the enrollee. An estimate provided to an 
107.2 	enrollee under this paragraph is not a legally binding estimate of the reimbursement.

107.3 	EFFECTIVE DATE. Paragraph (a) is effective the day following final enactment. 
107.4 	Paragraph (b) is effective January 1, 2007.

107.5 	Sec. 13. [62J.823] HOSPITAL PRICING TRANSPARENCY.
107.6 		Subdivision 1.Short title. This section may be cited as the Hospital Pricing 
107.7 	Transparency Act.
107.8 		Subd. 2.Definition. For the purposes of this section, "estimate" means any of 
107.9 	the following: 
107.10 	(1) the actual price expected to be charged to the individual based on the specific 
107.11 	diagnostic related group code or specific procedure code or codes reflecting any discounts 
107.12 	the individual would receive; 
107.13 	(2) the actual price expected to be charged to the individual based on the specific 
107.14 	diagnostic related group code or specific procedure code or codes to be performed without 
107.15 	taking into account any discounts the individual may receive; 
107.16 	(3) the average billed rate of all of the specific diagnostic related group code or 
107.17 	procedure code performed in the last six months; 
107.18 	(4) the average billed rate of the most recently performed services of the same 
107.19 	diagnostic related group code or procedure code; or 
107.20 	(5) any other estimate that will provide a patient with an accurate view of their 
107.21 	potential financial obligations if the services are performed by the hospital.
107.22 		Subd. 3.Applicability and scope. Any hospital, as defined in section 144.696, 
107.23 	subdivision 3, and outpatient surgical center, as defined in section 144.696, subdivision 4, 
107.24 	shall provide a written estimate of the cost of a specific service or stay upon the request of 
107.25 	a patient, doctor, or the patient??A???a?sA???a?zA?s representative. The request must include: 
107.26 	(1) the specific diagnostic related group code; 
107.27 	(2) the name of the procedure or procedures to be performed; 
107.28 	(3) the type of treatment to be received; or
107.29 	(4) any other information that will allow the hospital or outpatient surgical center to 
107.30 	determine the specific diagnostic related group or procedure code or codes.
107.31 		Subd. 4.Estimate. (a) An estimate provided by the hospital or outpatient surgical 
107.32 	center must contain: 
107.33 	(1) the method used to calculate the estimate; 
107.34 	(2) the specific diagnostic related group or procedure code or codes used to calculate 
107.35 	the estimate; 
108.1 	(3) the name of any network or program that resulted in a discounted rate; and 
108.2 	(4) a statement indicating that the estimate, while accurate, may not reflect the 
108.3 	actual billed charges and that the final bill may be higher or lower depending on the 
108.4 	patient??A???a?sA???a?zA?s specific circumstances. 
108.5 	(b) The estimate may be provided in any method that meets the needs of the patient 
108.6 	and the hospital or outpatient surgical center, including electronically; however, a paper 
108.7 	copy must be provided if specifically requested.

108.8 	EFFECTIVE DATE. This section is effective January 1, 2007.

108.9 	Sec. 14. [62J.83] REDUCED PAYMENT AMOUNTS PERMITTED.
108.10 	(a) Notwithstanding any provision of chapter 148 or any other provision of law to 
108.11 	the contrary, a health care provider may provide care to a patient at a discounted payment 
108.12 	amount, including care provided for free.
108.13 	(b) This section does not apply in a situation in which the discounted payment 
108.14 	amount is not permitted under federal law.

108.15 	Sec. 15. [62J.85] PROVISION OF INFORMATION ON PHARMACEUTICAL 
108.16 	ASSISTANCE PROGRAMS.
108.17 	A medical clinic must make available to patients, in a public area of the clinic, 
108.18 	brochures on programs offered by pharmaceutical manufacturers that provide free or 
108.19 	discounted drugs or provide coverage for prescription drugs. This requirement applies 
108.20 	only to brochures that are made available to clinics free of charge by pharmaceutical 
108.21 	manufacturers. If a Web site is developed that provides this information, a public posting 
108.22 	describing the Web site complies with this requirement.

108.23 	Sec. 16. [62M.071] PRIOR AUTHORIZATION.
108.24 	Health plan companies, in cooperation with health care providers, shall review prior 
108.25 	authorization procedures administered by utilization review organizations and health plan 
108.26 	companies, to ensure the cost-effective use of prior authorization and minimization of 
108.27 	provider, clinic, and central office administrative burden.

108.28 	Sec. 17. [62M.072] USE OF EVIDENCE-BASED STANDARDS.
108.29 	If no independently developed evidence-based standards exist for a particular 
108.30 	treatment, testing, or imaging procedure, then an insurer or utilization review organization 
108.31 	shall not deny coverage of the treatment, testing, or imaging based solely on the grounds 
108.32 	that the treatment, testing, or imaging does not meet an evidence-based standard.

109.1 	Sec. 18. [62Q.645] DISTRIBUTION OF INFORMATION; ADMINISTRATIVE 
109.2 	EFFICIENCY AND COVERAGE OPTIONS.
109.3 	(a) The commissioner may use reports submitted by health  plan companies, service 
109.4 	cooperatives, and the public employee  insurance program created in section 43A.316 
109.5 	to compile  entity specific administrative efficiency reports; may make  these reports 
109.6 	available on state agency Web sites,  including minnesotahealthinfo.com; and may include 
109.7 	information  on: 
109.8 	(1) number of covered lives;  
109.9 	(2) covered services;  
109.10 	(3) geographic availability;  
109.11 	(4) whom to contact to obtain current premium rates;  
109.12 	(5) administrative costs, using the definition of  administrative costs developed under 
109.13 	section 62J.38;  
109.14 	(6) Internet links to information on the health plan, if  available; and  
109.15 	(7) any other information about the health plan identified  by the commissioner 
109.16 	as being useful for employers, consumers,  providers, and others in evaluating health 
109.17 	plan options. 
109.18 	(b) This section does not apply to a health plan company  unless its annual Minnesota 
109.19 	premiums exceed $50,000,000 based on the most recent assessment base of the Minnesota 
109.20 	Comprehensive Health Association. For purposes of this  determination, the premiums of a 
109.21 	health plan company include  those of its affiliates. 

109.22 	Sec. 19. [62Q.80] SMALL HEALTH PLAN PURCHASING POOL.
109.23 	(a) Health plan companies whose premium volume is less than ten percent of 
109.24 	total premiums in the Minnesota health plan market may create a purchasing pool for 
109.25 	group contracting for health care from health care providers for purposes of this section. 
109.26 	Membership by a health plan company is voluntary. For purposes of the ten percent 
109.27 	calculation, a health plan company's premiums include those of its affiliates.
109.28 	(b) Members of the pool may use the contracted health care for purposes of meeting 
109.29 	their obligations to their enrollees under health plans.
109.30 	(c) The pool or its members may offer and sell health care discount cards to persons 
109.31 	who have no public sector or private sector health coverage. The discount cards must 
109.32 	entitle the purchasers to discounted charges from health care providers that participate 
109.33 	in the program. The discount cards need not provide their purchasers with the same 
109.34 	discounted prices used under paragraph (b). The discount cards, and advertisements 
109.35 	regarding them, must clearly indicate that the discount card program is not insurance 
110.1 	or health maintenance coverage, and that the purchaser must check with a provider to 
110.2 	determine whether the provider accepts the card. 
110.3 	(d) The commissioner of commerce shall oversee and supervise this purchasing pool 
110.4 	to ensure that it promotes competition in the market for health plan coverage in this state 
110.5 	by enabling its members to participate in the health plan market in this state on a more 
110.6 	equal footing with their larger competitors.

110.7 	Sec. 20. Minnesota Statutes 2004, section 72A.20, is amended by adding a subdivision 
110.8 	to read:
110.9 		Subd. 39.Discounted payments by health care providers; effect on use of 
110.10 	usual and customary payments. An insurer, including, but not limited to, a health plan 
110.11 	company as defined in section 62Q.01, subdivision 4; a reparation obligor as defined in 
110.12 	section 65B.43, subdivision 9; and a workers' compensation insurer shall not consider in 
110.13 	determining a health care provider's usual and customary payment, standard payment, or 
110.14 	allowable payment used as a basis for determining the provider's payment by the insurer, 
110.15 	the following discounted payment situations:
110.16 	(1) care provided to relatives of the provider;
110.17 	(2) care for which a discount or free care is given in hardship situations; and
110.18 	(3) care for which a discount is given in exchange for cash payment.
110.19 	For purposes of this subdivision, "health care provider" and "provider" have the 
110.20 	meaning given in section 62J.03, subdivision 8.

110.21 	EFFECTIVE DATE. This section is effective the day following final enactment.

110.22 	Sec. 21. Minnesota Statutes 2004, section 123A.21, subdivision 7, is amended to read:
110.23 		Subd. 7.Educational programs and services. (a) The board of directors of each 
110.24 	SC shall submit annually a plan to the members. The plan shall identify the programs and 
110.25 	services which are suggested for implementation by the SC during the following year and 
110.26 	shall contain components of long-range planning determined by the SC. These programs 
110.27 	and services may include, but are not limited to, the following areas:
110.28 	(1) administrative services;
110.29 	(2) curriculum development;
110.30 	(3) data processing;
110.31 	(4) distance learning and other telecommunication services;
110.32 	(5) evaluation and research;
110.33 	(6) staff development;
110.34 	(7) media and technology centers;
111.1 	(8) publication and dissemination of materials;
111.2 	(9) pupil personnel services;
111.3 	(10) planning;
111.4 	(11) secondary, postsecondary, community, adult, and adult vocational education;
111.5 	(12) teaching and learning services, including services for students with special 
111.6 	talents and special needs;
111.7 	(13) employee personnel services;
111.8 	(14) vocational rehabilitation;
111.9 	(15) health, diagnostic, and child development services and centers;
111.10 	(16) leadership or direction in early childhood and family education;
111.11 	(17) community services;
111.12 	(18) shared time programs;
111.13 	(19) fiscal services and risk management programs;
111.14 	(20) technology planning, training, and support services;
111.15 	(21) health and safety services;
111.16 	(22) student academic challenges; and
111.17 	(23) cooperative purchasing services.
111.18 	(b) A health coverage program provided by one or more service cooperatives:
111.19 	(1) may provide coverage to nursing homes licensed under chapter 144A and 
111.20 	boarding care homes licensed under sections 144.50 to 144.56 and certified for 
111.21 	participation in the medical assistance program located in this state;
111.22 	(2) must rebid contracts for insurance and third-party administration at least every 
111.23 	four years. The contracts may be regional or statewide in the discretion of the service 
111.24 	cooperative;
111.25 	(3) must comply with section 72.20, subdivision 26, notwithstanding section 13.203, 
111.26 	and must also provide that same information to exclusive representatives of the employees 
111.27 	upon request. A service cooperative shall not terminate coverage, exclude an employer 
111.28 	from future coverage, or otherwise penalize an employer for seeking bids from other 
111.29 	sources of health coverage; and
111.30 	(4) may determine premiums for its health coverage individually for specific 
111.31 	employers or may determine them on a pooled or other basis established by the service 
111.32 	cooperative.

111.33 	EFFECTIVE DATE. This section is effective the day following final enactment.

111.34 	Sec. 22. [144.0506] AGENCY WEB SITES.
112.1 		Subdivision 1.Information to be posted. The commissioner of health may post the 
112.2 	following information on agency Web sites, including minnesotahealthinfo.com: 
112.3 	(1) healthy lifestyle and preventive health care information, organized by sex and 
112.4 	age, with procedures and treatments categorized by level of effectiveness and reliability of 
112.5 	the supporting evidence on effectiveness;  
112.6 	(2) health plan company administrative efficiency report cards;
112.7 	(3) health care provider charges for common procedures, based on information 
112.8 	available under section 62J.052;  
112.9 	(4) evidence-based medicine guidelines and related information for use as resources 
112.10 	by health care professionals, and summaries of the guidelines and related information for 
112.11 	use by patients and consumers;  
112.12 	(5) resources and Web links related to improving efficiency in medical clinics and 
112.13 	health care professional practices; and 
112.14 	(6) lists of nonprofit and charitable entities that accept donations of used medical 
112.15 	equipment and supplies, such as crutches and walkers.
112.16 		Subd. 2.Other Internet resources. The commissioner of health, in implementing 
112.17 	subdivision 1, shall include relevant Web links and materials from private sector and other 
112.18 	government sources, in order to avoid duplication and reduce state administrative costs.
112.19 		Subd. 3.Cooperation with commissioner of commerce. The commissioner of 
112.20 	health shall consult and work in cooperation with the commissioner of commerce when 
112.21 	posting on the Web site information collected from health plan companies regulated by 
112.22 	the commissioner of commerce.

112.23 	Sec. 23. Minnesota Statutes 2004, section 144.698, is amended by adding a subdivision 
112.24 	to read:
112.25 		Subd. 6.Reporting on uncompensated care. (a) A report on the services provided 
112.26 	to benefit the community, as required under subdivision 1, clause (5), must report charity 
112.27 	care in compliance with the following requirements:
112.28 	(1) For a facility to report amounts as charity care adjustments, the facility must: 
112.29 	(i) generate and record a charge; 
112.30 	(ii) have a policy on the provision of charity care that contains specific eligibility 
112.31 	criteria and is communicated or made available to patients; 
112.32 	(iii) have made a reasonable effort to identify a third-party payer, encourage the 
112.33 	patient to enroll in public programs, and, to the extent possible, aid the patient in the 
112.34 	enrollment process; and 
112.35 	(iv) ensure that the patient meets the charity care criteria of this subdivision. 
113.1 	(2) In determining whether to classify care as charity care, the facility must consider 
113.2 	the following: 
113.3 	(i) charity care may include services that the provider is obligated to render 
113.4 	independently of the ability to collect; 
113.5 	(ii) charity care may include care provided to patients who meet the facility's charity 
113.6 	care guidelines and have partial coverage, but who are unable to pay the remainder of their 
113.7 	medical bills, but this does not apply to that portion of the bill that has been determined to 
113.8 	be the patient's responsibility after a partial charity care classification by the facility; 
113.9 	(iii) charity care may include care provided to low-income patients who may qualify 
113.10 	for a public health insurance program and meet the facility's eligibility criteria for charity 
113.11 	care, but who do not complete the application process for public insurance despite the 
113.12 	facility's reasonable efforts; 
113.13 	(iv) charity care may include care to individuals whose eligibility for charity care 
113.14 	was determined through third-party services for information gathering purposes only; 
113.15 	(v) charity care does not include contractual allowances, which is the difference 
113.16 	between gross charges and payments received under contractual arrangements with 
113.17 	insurance companies and payers; 
113.18 	(vi) charity care does not include bad debt; 
113.19 	(vii) charity care does not include what may be perceived as underpayments for 
113.20 	operating public programs; 
113.21 	(viii) charity care does not include unreimbursed costs of basic or clinical research 
113.22 	or professional education and training; 
113.23 	(ix) charity care does not include professional courtesy discounts; 
113.24 	(x) charity care does not include community service or outreach activities; and 
113.25 	(xi) charity care does not include services for patients against whom collection 
113.26 	actions were taken that resulted in a financial obligation documented on a patient's credit 
113.27 	report with credit bureaus.
113.28 	(3) When reporting charity care adjustments, the facility must report total dollar 
113.29 	amounts and the number of contacts between a patient and a health care provider during 
113.30 	which a service is provided for the following categories: 
113.31 	(i) care to patients with family incomes at or below 275 percent of the federal 
113.32 	poverty guideline; 
113.33 	(ii) care to patients with family incomes above 275 percent of the federal poverty 
113.34 	guideline; and 
113.35 	(iii) care to patients when the facility, with reasonable effort, is unable to determine 
113.36 	family incomes.
114.1 	(b) For the report required under subdivision 1, clause (5), the facility must, in 
114.2 	determining whether to classify care as a bad debt expense:
114.3 	(1) presume that a patient is able and willing to pay until and unless the facility has 
114.4 	reason to consider the care as a charity care case under its charity care policy and the 
114.5 	facility classifies the care as a charity care case; and
114.6 	(2) include as a bad debt expense any unpaid deductibles, coinsurance, co-payments, 
114.7 	noncovered services, and other unpaid patient responsibilities.

114.8 	EFFECTIVE DATE. This section is effective for facility fiscal years ending on or 
114.9 	after December 31, 2006.

114.10 	Sec. 24. Minnesota Statutes 2004, section 151.214, subdivision 1, is amended to read:
114.11 		Subdivision 1.Explanation of pharmacy benefits. A pharmacist licensed under 
114.12 	this chapter must provide to a patient, for each prescription dispensed where part or all 
114.13 	of the cost of the prescription is being paid or reimbursed by an employer-sponsored 
114.14 	plan or health plan company, or its contracted pharmacy benefit manager, the patient's 
114.15 	co-payment amount and the pharmacy's own usual and customary price of the prescription 
114.16 	or the amount the pharmacy will be paid for the prescription drug by the patient's 
114.17 	employer-sponsored plan or health plan company, or its contracted pharmacy benefit 
114.18 	manager.

114.19 	Sec. 25. Minnesota Statutes 2005 Supplement, section 214.071, is amended to read:
114.20 	214.071 HEALTH BOARDS; DIRECTORY OF LICENSEES.
114.21 	By July 1, 2009, each health health-related licensing board under chapters 147, 148, 
114.22 	148B, and 150A, as defined in section 214.01, subdivision 2, shall establish a directory of 
114.23 	licensees that includes biographical data for each licensee.

114.24 	Sec. 26. [214.121] PRICE DISCLOSURE REMINDER.
114.25 	Each health-related licensing board shall at least annually inform and remind its 
114.26 	licensees of the price disclosure requirements of section 62J.052 or 151.214, as applicable, 
114.27 	through the board's regular means of communicating with its licensees.

114.28 	Sec. 27. REPORTING OF ACQUIRED INFECTIONS.
 114.29 	(a) The commissioner of health may consult with infection control specialists, 
114.30 	health care facility representatives, and consumers, for the purpose of obtaining 
114.31 	recommendations regarding a determination of the need for action to implement health 
115.1 	care associated infection control reporting in hospitals and nursing homes. If the outcome 
115.2 	of the determination warrants, the commissioner shall consult with the group regarding: 
115.3 	(1) the selection of reporting measures relating to health care associated infections;  
115.4 	(2) design, implementation, validation, and ongoing evaluation of the reporting 
115.5 	system; and  
115.6 	(3) ensuring that the reporting measures remain flexible and adaptable to changing 
115.7 	national standards.  
115.8 	(b) If the commissioner determines that there is a need for the action described in 
115.9 	paragraph (a), the commissioner shall make written  recommendations to the legislature. 

115.10 	Sec. 28. COST-CONTAINMENT STUDIES.
 115.11 		Subdivision 1.Alternative and complementary health care. The commissioner of 
115.12 	human services, through the medical director and in consultation with the health services 
115.13 	policy committee established under Minnesota Statutes, section 256B.0625, subdivision 
115.14 	3c, shall study the potential for improving quality and obtaining cost savings through 
115.15 	greater use of alternative and complementary treatment methods that are supported by the 
115.16 	findings of evidence-based research, and shall incorporate these methods into the medical 
115.17 	assistance, MinnesotaCare, and general assistance medical care programs as appropriate.
115.18 		Subd. 2.Study related to access to care. The commissioners of human services 
115.19 	and health shall study the adequacy of the current system of community health care clinics 
115.20 	and centers both statewide, and in urban areas with significant disparities in health status 
115.21 	and access to services across racial and ethnic groups. The commissioners shall evaluate:
115.22 	(1) methods to provide 24-hour availability of care through the clinics and centers;
115.23 	(2) methods to expand the availability of care through the clinics and centers;
115.24 	(3) the use of health care access fund grants to expand the number of clinics and 
115.25 	centers, the services provided, and the availability of care; and
115.26 	(4) the extent to which increased use of physician assistants, nurse practitioners, 
115.27 	medical residents and interns, and other allied health professionals in clinics and centers 
115.28 	would increase the availability of services.

115.29 	Sec. 29. MEDICAL MALPRACTICE INSURANCE REPORT.
 115.30 	(a) The commissioner of commerce shall provide to the legislature annually a brief 
115.31 	written report on the status of the market for medical malpractice insurance in Minnesota. 
115.32 	The report must summarize, interpret, explain, and analyze information on that subject 
115.33 	available to the commissioner, through annual statements filed by insurance companies, 
115.34 	information obtained under paragraph (c), and other sources. 
116.1 	(b) The annual report must consider, to the extent possible, using definitions 
116.2 	developed by the commissioner, Minnesota-specific data on market shares; premiums 
116.3 	received; amounts paid to settle claims that were not litigated, claims that were settled 
116.4 	after litigation began, and claims that were litigated to court judgment; amounts spent 
116.5 	on processing, investigation, litigation, and otherwise handling claims; other sales and 
116.6 	administrative costs; and the loss ratios of the insurers. 
116.7 	(c) Each insurance company that provides medical malpractice insurance in this state 
116.8 	shall, no later than June 1 each year, file with the commissioner of commerce, on a form 
116.9 	prescribed by the commissioner and using definitions developed by the commissioner, 
116.10 	the Minnesota-specific data referenced in paragraph (b), other than market share, for the 
116.11 	previous calendar year for that insurance company, shown separately for various categories 
116.12 	of coverages including, if possible, hospitals, medical clinics, nursing homes, physicians 
116.13 	who provide emergency medical care, obstetrician gynecologists, and ambulance services. 
116.14 	An insurance company need not comply with this paragraph if its direct premium that is 
116.15 	written in this state for the previous calendar year is less than $2,000,000.

116.16 	Sec. 30. STUDY; PROVIDER PRICING FAIRNESS.
 116.17 		Subdivision 1.Proposal to be studied. The commissioners of commerce and health 
116.18 	shall jointly study the proposal that state law prohibit health care providers from varying 
116.19 	the amount that they accept as full payment for a health care service based upon the 
116.20 	identity of the payer, upon a contracted arrangement with a payer, upon the identity of the 
116.21 	patient, or upon whether the patient has coverage through a group purchaser, as defined 
116.22 	in Minnesota Statutes, section 62J.03, subdivision 6. The commissioners shall submit a 
116.23 	report to the legislature that includes the results of the study by July 1, 2007. The proposal 
116.24 	does not apply if the payer is a government entity, and the proposal does not prevent care 
116.25 	for a reduced price based upon financial hardship if otherwise permitted by law.
116.26 		Subd. 2.Focus of study. The study described in subdivision 1 must focus primarily 
116.27 	upon how best to implement the proposal, taking into account its effects upon the health 
116.28 	care and health coverage markets, including any necessary related changes.

116.29 	Sec. 31.  REPEALER.
 116.30 	Minnesota Statutes 2004, section 62J.17, and Minnesota Statutes 2005 Supplement, 
116.31 	section 62Q.251, are repealed.

116.32 	EFFECTIVE DATE. This section is effective the day following final enactment.

117.1 	ARTICLE 6
117.2 	HUMAN SERVICES FORECAST ADJUSTMENTS

117.3	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT
 	
117.4 	The dollar amounts shown are added to or, if shown in parentheses, are subtracted 
117.5 	from the appropriations in Laws 2005, First Special Session chapter 4, article 9, and 
117.6 	are appropriated from the general fund, or any other fund named, to the Department of 
117.7 	Human Services for the purposes specified in this article, to be available for the fiscal year 
117.8 	indicated for each purpose. The figures "2006" and "2007" used in this article means 
117.9 	that the appropriation or appropriations listed are available for the respective fiscal year 
117.10 	ending June 30, 2006 or June 30, 2007.

117.11	SUMMARY BY FUND
	
117.12					2006
		2007
	
117.13	General Fund
			$
	(58,333,000)
	$
	(17,589,000)
	
117.14	Health Care Access
				(44,511,000)
		(62,360,000)
	
117.15	TANF
				(13,807,000)
		(3,866,000)
	
117.16	TOTAL
			$
	(116,651,000)
	$
	(83,815,000)

117.17
117.18	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

117.19	Subdivision 1.Total Appropriation
 	$
	(116,651,000)
	$
	(83,815,000)

117.20	Summary by Fund
	
117.21	General
	(58,333,000)
	(17,589,000)
	
117.22	Health Care Access
	(44,511,000)
	(62,360,000)
	
117.23	TANF
	(13,807,000)
	(3,866,000)

117.24	Subd.  2.Revenue and Pass-Through

117.25	TANF
		(1,446,000)
		(1,177,000)

117.26
117.27	Subd.  3.Children and Economic Assistance 
Grants

118.1	General
		(4,469,000)
		1,785,000
	
118.2	TANF
				(12,361,000)
		(2,689,000)
	
118.3 	The amount that may be spent from this 
118.4 	appropriation for each purpose is as follows:

118.5	(a) Minnesota Family Investment Program

118.6	General
		6,048,000
		(393,000)
	
118.7	TANF
				(12,361,000)
		(2,689,000)

118.8	(b) MFIP Child Care Assistance Grants
					
118.9	General Fund
		(5,090,000)
		2,751,000

118.10	(c) General Assistance
		2,540,000
		3,947,000

118.11	(d) Minnesota Supplemental Aid
		(285,000)
		551,000
	
118.12
118.13	(e) Group Residential 
Housing
				(7,682,000)
		(5,071,000)

118.14	Subd.  4.Basic Health Care Grants

118.15	General
		(19,022,000)
		10,499,000
	
118.16	Health Care Access
				(44,511,000)
		(62,360,000)
	
118.17 	The amount that may be spent from this 
118.18 	appropriation for each purpose is as follows:

118.19	(a) MinnesotaCare

118.20	Health Care Access
		(44,511,000)
		(62,360,000)

118.21
118.22	(b) MA Basic Health Care - Families and 
Children

118.23	General
		(29,882,000)
		(54,401,000)

118.24
118.25	(c) MA Basic Health Care - Elderly and 
Disabled

119.1	General
		(2,857,000)
		33,179,000

119.2	(d) General Assistance Medical Care

119.3	General
		13,717,000
		 31,721,000

119.4	Subd.  5.Continuing Care Grants

119.5	General
		(34,842,000)
		(29,873,000)
	
119.6 	The amount that may be spent from this 
119.7 	appropriation for each purpose is as follows:

119.8	(a) MA Long-Term Care Waivers

119.9	General
		(23,368,000)
		(35,953,000)

119.10	(b) MA Long-Term Care Facilities

119.11	General
		(16,251,000)
		(5,202,000)

119.12	(c) Chemical Dependency Entitlement Grants

119.13	General
		4,777,000
		11,282,000

119.14 	EFFECTIVE DATE. This section is effective the day following final enactment.

119.15 	ARTICLE 7
119.16 	APPROPRIATIONS

119.17	Section 1. SUPPLEMENTAL APPROPRIATIONS.
 	
119.18 	The appropriations in this article are added to or, if shown in parentheses, subtracted 
119.19 	from the appropriations enacted into law by the legislature in 2005, or other specified law, 
119.20 	to the named agencies and for the specified programs or activities. The sums shown are 
119.21 	appropriated from the general fund, or another named fund, to be available for the fiscal 
119.22 	years indicated: 2006 is the fiscal year ending June 30, 2006; 2007 is the fiscal year 
119.23 	ending June 30, 2007; and the biennium is fiscal years 2006 and 2007. Supplementary 
119.24 	appropriations and reductions to appropriations for the fiscal year ending June 30, 2006, 
119.25 	are effective the day following final enactment.

120.1	SUMMARY BY FUND
	
120.2
120.3			2006
		2007
		BIENNIAL 
TOTAL
	
120.4	General
	$
	35,250,000
	$
	53,402,000
	$
	88,652,000
	
120.5
120.6	State Government Special 
Revenue Fund
		514,000
		679,000
		1,193,000
	
120.7	Health Care Access Fund
		-0-
		1,689,000
		1,689,000
	
120.8	TOTAL
	$
	35,764,000
	$
	55,770,000
	$
	91,534,000

120.9				APPROPRIATIONS
	
120.10				Available for the Year
	
120.11				Ending June 30
	
120.12					2006
		2007

120.13
120.14	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

120.15	Subdivision 1.Total Appropriation
 	$
	35,250,000
	$
	53,256,000

120.16	Summary by Fund
	
120.17	General
	35,250,000
	51,527,000
	
120.18	Health Care Access 
	-0-
	1,729,000

120.19
120.20	Subd.  2.Children and Economic Assistance 
Management

120.21	Summary by Fund
	
120.22	General
	-0-
	8,000
	
120.23
120.24	(a) Children and Economic 
Assistance Operations
	-0-
	8,000
	
120.25 	CHILDREN AND ECONOMIC 
120.26 	ASSISTANCE OPERATIONS BASE 
120.27 	ADJUSTMENT. The general fund base for 
120.28 	children and economic assistance operations 
120.29 	shall be decreased by $8,000 in fiscal year 
120.30 	2008 and $8,000 in fiscal year 2009.

121.1	Subd.  3.Health Care Grants

121.2	Summary by Fund
	
121.3	General
	-0-
	(2,950,000)
	
121.4	Health Care Access
	-0-
	-0-

121.5
121.6	(a) MinnesotaCare Grants 
Health Care Access
	-0-
	-0-

121.7	(b) Medical Assistance Basic Health Care - Families and Children
	
121.8	General
	-0-
	(2,625,000)

121.9	(c) Medical Assistance Basic Health Care - Elderly and Disabled
	
121.10	General
	-0-
	(325,000)

121.11	(d) General Assistance Medical Care
	
121.12	General
	-0-
	-0-

121.13	Subd.  4.Health Care Management

121.14	Summary by Fund
	
121.15	General
	-0-
	2,120,000
	
121.16	Health Care Access
	-0-
	1,729,000

121.17	(a) Health Care Administration
	
121.18	General
	-0-
	2,015,000
	
121.19 	HEALTH CARE ADMINISTRATION 
121.20 	BASE ADJUSTMENT. The general fund 
121.21 	base for health care administration shall be 
121.22 	decreased by $312,000 in fiscal year 2008 
121.23 	and decreased by $859,000 in fiscal year 
121.24 	2009.
121.25 	INCREASED STAFF FOR ENROLLING 
121.26 	PERSONS WITH DISABILITIES 
121.27 	IN MANAGED CARE. $124,000 is 
121.28 	appropriated from the general fund to 
122.1 	the commissioner of human services in 
122.2 	fiscal year 2007 to increase staff for the 
122.3 	development and management of contract 
122.4 	requirements associated with enrolling 
122.5 	persons with disabilities in managed care.

122.6	(b) Health Care Operations
	
122.7	General
	-0-
	105,000
	
122.8	Health Care Access
	-0-
	1,729,000
	
122.9 	HEALTH CARE OPERATIONS BASE 
122.10 	ADJUSTMENT. The general fund base for 
122.11 	health care operations shall be decreased by 
122.12 	$81,000 in fiscal year 2008 and increased by 
122.13 	$7,000 in fiscal year 2009.
122.14 	HEALTH CARE OPERATIONS BASE 
122.15 	ADJUSTMENT. The health care access 
122.16 	fund base for health care operations shall be 
122.17 	decreased by $1,094,000 in fiscal year 2008 
122.18 	and $1,094,000 in fiscal year 2009.

122.19	Subd.  5. Continuing Care Grants

122.20	Summary by Fund
	
122.21	General
	250,000
	(573,000)

122.22	(a) Medical Assistance Long-term Care Facilities
	
122.23	General
	-0-
	(1,409,000)

122.24	(b) Medical Assistance Long-term Care Waivers
	
122.25	General
	-0-
	(414,000)
	
122.26 	ADDITIONAL WAIVER 
122.27 	ALLOCATIONS.  Notwithstanding 
122.28 	the waiver growth limits in Laws 2005, 
122.29 	First Special Session chapter 4, article 9, 
122.30 	section 2, paragraph (d), the commissioner 
122.31 	may allocate an additional waiver allocation 
123.1 	under Minnesota Statutes, section 256B.49, 
123.2 	for a recipient of personal care assistant 
123.3 	services who is eligible for and chooses 
123.4 	waivered services and received personal care 
123.5 	assistant services from a provider who was 
123.6 	billing for a service delivery model for that 
123.7 	recipient other than individual or shared care 
123.8 	on March 1, 2006.

123.9	(c) Adult and Aging Services Grants
	
123.10	General
	250,000
	1,250,000
	
123.11 	AGING AND ADULT SERVICES 
123.12 	GRANTS FOR MEDICARE PART D.
123.13 	$250,000 in fiscal year 2006 and $1,250,000 
123.14 	in fiscal year 2007 is appropriated from 
123.15 	the general fund to the commissioner of 
123.16 	human services for grants awarded through 
123.17 	the Minnesota Board on Aging to area 
123.18 	Agencies on Aging to provide information 
123.19 	and enrollment assistance for the Medicare 
123.20 	Part D program. 
123.21 	MEDICARE PART D INFORMATION 
123.22 	AND ASSISTANCE REIMBURSEMENT.
123.23 	Federal administrative reimbursement 
123.24 	obtained from information and assistance 
123.25 	services provided by the Senior Linkage or 
123.26 	Disability Linkage lines to people who are 
123.27 	identified as eligible for medical assistance 
123.28 	shall be appropriated to the commissioner 
123.29 	for this activity.
123.30 	AGING AND ADULT SERVICES 
123.31 	GRANTS BASE ADJUSTMENT. The 
123.32 	general fund base for aging and adult services 
123.33 	grants is decreased by $250,000 in fiscal 
123.34 	year 2008 and $250,000 in fiscal year 2009 
123.35 	for information and assistance grants to 
124.1 	area agencies on aging for assisting with 
124.2 	Medicare Part D.

124.3	Subd.  6.Continuing Care Management

124.4	General
	-0-
	113,000
	
124.5 	CONTINUING CARE MANAGEMENT 
124.6 	BASE ADJUSTMENT. The general fund 
124.7 	base for continuing care management shall 
124.8 	be decreased by  $30,000 in fiscal year 2009.

124.9	Subd.  7.State-Operated Services

124.10	General
	35,508,000
	53,909,000
	
124.11 	MINNESOTA SECURITY HOSPITAL.
124.12 	For the purposes of enhancing the safety 
124.13 	of the public, improving supervision, and 
124.14 	enhancing community-based mental health 
124.15 	treatment, state-operated services may 
124.16 	establish additional community capacity 
124.17 	for providing treatment and supervision 
124.18 	of clients who have been ordered into a 
124.19 	less restrictive alternative of care from the 
124.20 	state-operated services transition services 
124.21 	program consistent with Minnesota Statutes, 
124.22 	section 246.014.
124.23 	STATE-OPERATED SERVICES BASE 
124.24 	ADJUSTMENT. The general fund base 
124.25 	for state-operated services is increased by 
124.26 	$11,403,000 in fiscal year 2008 and increased 
124.27 	by $1,779,000 in fiscal year 2009.

124.28	Sec. 3. COMMISSIONER OF HEALTH

124.29	Subdivision 1.Total Appropriation
 		-0-
		1,133,000

125.1	Summary by Fund
	
125.2	General
	-0-
	1,116,000
	
125.3
125.4	State Government Special 
Revenue
	-0-
	57,000
	
125.5	Health Care Access
	-0-
	(40,000)

125.6	Subd. 2.Policy Quality and Compliance

125.7	Summary by Fund
	
125.8	General
	-0-
	116,000
	
125.9125.10
	State Government Special 
Revenue
	-0-
	140,000
	
125.11	Health Care Access
	-0-
	(40,000)
	
125.12 	POLICY QUALITY AND 
125.13 	COMPLIANCE BASE ADJUSTMENT.
125.14 	The general fund base for Policy Quality 
125.15 	and Compliance is decreased by $20,000 
125.16 	in fiscal year 2009.
125.17 	ASSISTED LIVING. (a) $140,000 is 
125.18 	appropriated from the state government 
125.19 	special revenue fund to the commissioner 
125.20 	of health for the biennium ending June 30, 
125.21 	2007, for costs related to bringing actions for 
125.22 	injunctive relief under Minnesota Statutes, 
125.23 	section 144G.02, subdivision 2, paragraph 
125.24 	(b).
125.25 	(b) The state government special revenue 
125.26 	base is increased by $140,000 in fiscal year 
125.27 	2008 and $140,000 in fiscal year 2009.

125.28	Subd. 3.Health Protection

126.1	Summary by Fund
	
126.2	General
	-0-
	1,000,000
	
126.3
126.4	State Government Special 
Revenue
	-0-
	(83,000)
	
126.5 	PANDEMIC INFLUENZA 
126.6 	PREPAREDNESS. $1,000,000 
126.7 	from the general fund is for preparation, 
126.8 	planning, and response to an outbreak of 
126.9 	influenza. The base for this is $1,000,000 in 
126.10 	fiscal years 2008 and 2009 and $0 in 2010 
126.11 	and thereafter.

126.12
126.13	Sec. 4. VETERANS NURSING HOMES 
BOARD

126.14	General
	-0-
	759,000
	
126.15 	This appropriation is added to appropriations 
126.16 	in Laws 2005, First Special Session chapter 
126.17 	4, article 9, section 4.
126.18 	BASE ADJUSTMENT. The general fund 
126.19 	base is increased by $3,945,000 in fiscal year 
126.20 	2008 and $3,945,000 in fiscal year 2009 for 
126.21 	the Veterans Homes Board.

126.22	Sec. 5. HEALTH-RELATED BOARDS

126.23
126.24	State Government Special 
Revenue
	514,000
	572,000

126.25
126.26	Subdivision  1.Board of Chiropractic 
Examiners
 		5,000
		5,000
	
126.27 	BOARD OF CHIROPRACTIC 
126.28 	EXAMINERS APPROPRIATION 
126.29 	INCREASE. (a) This appropriation is 
126.30 	added to appropriations in Laws 2005, 
127.1 	First Special Session chapter 4, article 9, 
127.2 	section 5, subdivision 3. This is a onetime 
127.3 	appropriation. 
127.4 	(b) This increase is to correct programming 
127.5 	difficulties incurred during implementation 
127.6 	of payment processing changes. 

127.7	Subd.  2.Board of Dentistry
 		-0-
		67,000
	
127.8 	BOARD OF DENTISTRY 
127.9 	APPROPRIATION INCREASE.
127.10 	(a) This appropriation is added to 
127.11 	appropriations in Laws 2005, First Special 
127.12 	Session chapter 4, article 9, section 5, 
127.13 	subdivision 4.
127.14 	(b) This increase is to retain a legal analyst 
127.15 	as part of the board staff.

127.16	Subd.  3.Board of Medical Practice
 		500,000
		500,000
	
127.17 	BOARD OF MEDICAL PRACTICE 
127.18 	INCREASE. (a) This appropriation is 
127.19 	added to appropriations in Laws 2005, 
127.20 	First Special Session chapter 4, article 9, 
127.21 	section 5, subdivision 7. This is a onetime 
127.22 	appropriation. 
127.23 	(b)  This increase is to cover higher than 
127.24 	expected costs of investigation and legal 
127.25 	action.

127.26	Subd.  4.Board of Physical Therapy
 		9,000
		-0-
	
127.27 	BOARD OF PHYSICAL THERAPY 
127.28 	APPROPRIATION INCREASE. (a) This 
127.29 	appropriation is added to appropriations in 
127.30 	Laws 2005, First Special Session chapter 4, 
127.31 	article 9, section 5, subdivision 12. This is a 
127.32 	onetime appropriation.
128.1 	(b) This increase is to correct programming 
128.2 	difficulties incurred during implementation 
128.3 	of payment processing changes.

128.4
128.5	Sec. 6. EMERGENCY MEDICAL 
SERVICES BOARD

128.6
128.7	State Government Special 
Revenue
	-0-
	50,000
	
128.8 	EMERGENCY MEDICAL SERVICES 
128.9 	BOARD APPROPRIATION INCREASE.
128.10 	(a) This appropriation is added to 
128.11 	appropriations in Laws 2005, First Special 
128.12 	Session chapter 4, article 9, section 5, 
128.13 	subdivision 12.
128.14 	(b) This increase is to be spent by the health 
128.15 	professional service program from the state 
128.16 	government special revenue fund.

128.17 	Sec. 7. TRANSFER.
 128.18 	On June 30, 2006, the commissioner of finance shall transfer the balances in the 
128.19 	tobacco use prevention and local public health endowment fund and the medical education 
128.20 	endowment fund to the general fund. These balances result from investment income 
128.21 	credited to the funds after the transfer of balances on July 1, 2003. The amount transferred 
128.22 	under this section is estimated to be $2,933,000.

128.23 	Sec. 8. REVISOR'S INSTRUCTION.
 128.24 	The revisor of statutes shall correct internal cross-references to sections that are 
128.25 	affected by section 9, the repealer section of this article. The revisor may make changes 
128.26 	necessary to correct the punctuation, grammar, or structure of the remaining text and 
128.27 	preserve its meaning.

128.28 	Sec. 9.  REPEALER.
 128.29 	Minnesota Statutes 2004, sections 62J.694; and 144.395, are repealed.