1.1 	A bill for an act
1.2 	relating to health care; establishing premium rate restrictions and expenditure 
1.3 	limits; requiring an interoperable electronic health records system; requiring a 
1.4 	plan to achieve universal health care; expanding the definition of dependent 
1.5 	coverage; establishing an electronic health record system revolving account and 
1.6 	loan program; modifying hospital information reporting disclosures; regulating 
1.7 	federally qualified health centers; establishing health care programs outreach; 
1.8 	establishing a primary care access initiative; requiring a medical assistance 
1.9 	co-payment for certain emergency room visits; changing eligibility requirements 
1.10 	for medical assistance; modifying general assistance medical care eligibility 
1.11 	requirements for the homeless; modifying application assistance; allowing 
1.12 	MinnesotaCare applicants to use a place of public accommodation as a verified 
1.13 	address; exempting workers' compensation settlements from income eligibility; 
1.14 	eliminating the modification to the MinnesotaCare application form; increasing 
1.15 	reimbursement for critical access dental providers; extending medical assistance 
1.16 	coverage to Medicare Part D co-payments; creating grants for nonprofit dental 
1.17 	providers with a high proportion of uninsured patients; eliminating co-payments 
1.18 	for medical assistance and general assistance medical care; modifying the period 
1.19 	of renewal for MinnesotaCare; modifying the definition of employer-subsidized 
1.20 	insurance; creating a prescription drug discount program; expanding the benefit 
1.21 	set for single adults; increasing the eligibility income limit for single adults; 
1.22 	increasing the cap for inpatient hospitalization benefits for adults; modifying the 
1.23 	definition of income for self-employed farmers; removing insurance barriers for 
1.24 	children in MinnesotaCare; eliminating MinnesotaCare premiums for members 
1.25 	of the military and their families; reducing premiums for MinnesotaCare; 
1.26 	restoring family planning grants; creating a patient incentive health program; 
1.27 	requiring uniform billing forms; establishing a small employer option; affirming 
1.28 	that every resident of Minnesota has the right to affordable health care; requiring 
1.29 	reports; appropriating money;amending Minnesota Statutes 2006, sections 
1.30 	62A.65, subdivision 3; 62E.02, subdivision 7; 62J.04, subdivision 3, by adding a 
1.31 	subdivision; 62J.041; 62J.07, subdivisions 1, 3; 62J.301, subdivision 3; 62J.38; 
1.32 	62J.495; 62J.82; 62L.02, subdivision 11; 62L.08, subdivision 8; 62Q.165, 
1.33 	subdivisions 1, 2; 256.01, subdivision 2b; 256B.056, subdivision 10; 256B.0625, 
1.34 	subdivision 30, by adding a subdivision; 256B.69, subdivision 2; 256B.76; 
1.35 	256D.03, subdivisions 3, 4; 256L.01, subdivisions 1, 4; 256L.03, subdivisions 
1.36 	1, 3, 5; 256L.04, subdivisions 1a, 7, 10; 256L.05, subdivisions 1, 1b, 2, 3a, 3c; 
1.37 	256L.07, subdivisions 1, 2, 3, 6; 256L.09, subdivision 4; 256L.15, subdivisions 
1.38 	1, 2, 4; 256L.17, subdivisions 2, 3, 7; Laws 2005, First Special Session chapter 4, 
1.39 	article 9, section 3, subdivision 2; proposing coding for new law in Minnesota 
2.1 	Statutes, chapters 62J; 145; 256; 256B; 256L; repealing Minnesota Statutes 
2.2 	2006, sections 62A.301; 256B.0631; 256L.035.
2.3 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.4 	Section 1. Minnesota Statutes 2006, section 62A.65, subdivision 3, is amended to read:
2.5 		Subd. 3.Premium rate restrictions. No individual health plan may be offered, 
2.6 	sold, issued, or renewed to a Minnesota resident unless the premium rate charged is 
2.7 	determined in accordance with the following requirements:
2.8 	(a) Premium rates must be no more than 25 percent above and no more than 25 
2.9 	percent below the index rate charged to individuals for the same or similar coverage, 
2.10 	adjusted pro rata for rating periods of less than one year. The premium variations 
2.11 	permitted by this paragraph must be based only upon health status, claims experience, 
2.12 	and occupation. For purposes of this paragraph, health status includes refraining from 
2.13 	tobacco use or other actuarially valid lifestyle factors associated with good health, 
2.14 	provided that the lifestyle factor and its effect upon premium rates have been determined 
2.15 	by the commissioner to be actuarially valid and have been approved by the commissioner. 
2.16 	Variations permitted under this paragraph must not be based upon age or applied 
2.17 	differently at different ages. This paragraph does not prohibit use of a constant percentage 
2.18 	adjustment for factors permitted to be used under this paragraph.
2.19 	(b) Premium rates may vary based upon the ages of covered persons only as 
2.20 	provided in this paragraph. In addition to the variation permitted under paragraph (a), 
2.21 	each health carrier may use an additional premium variation based upon age of up to 
2.22 	plus or minus 50 percent of the index rate.
2.23 	(c) A health carrier may request approval by the commissioner to establish separate 
2.24 	geographic regions determined by the health carrier and to establish separate index rates 
2.25 	for each such region. The commissioner shall grant approval if the following conditions 
2.26 	are met: 
2.27 	(1) the geographic regions must be applied uniformly by the health carrier;
2.28 	(2) each geographic region must be composed of no fewer than seven counties that 
2.29 	create a contiguous region; and
2.30 	(3) the health carrier provides actuarial justification acceptable to the commissioner 
2.31 	for the proposed geographic variations in index rates, establishing that the variations are 
2.32 	based upon differences in the cost to the health carrier of providing coverage.
2.33 	(d) Health carriers may use rate cells and must file with the commissioner the rate 
2.34 	cells they use. Rate cells must be based upon the number of adults or children covered 
2.35 	under the policy and may reflect the availability of Medicare coverage. The rates for 
3.1 	different rate cells must not in any way reflect generalized differences in expected costs 
3.2 	between principal insureds and their spouses.
3.3 	(e) In developing its index rates and premiums for a health plan, a health carrier shall 
3.4 	take into account only the following factors:
3.5 	(1) actuarially valid differences in rating factors permitted under paragraphs (a) 
3.6 	and (b); and
3.7 	(2) actuarially valid geographic variations if approved by the commissioner as 
3.8 	provided in paragraph (c).
3.9 	(f) All premium variations must be justified in initial rate filings and upon request of 
3.10 	the commissioner in rate revision filings. All rate variations are subject to approval by 
3.11 	the commissioner.
3.12 	(g) The loss ratio must comply with the section 62A.021 requirements for individual 
3.13 	health plans. 
3.14 	(h) Notwithstanding paragraphs (a) to (g), the rates must not be approved, unless the 
3.15 	commissioner has determined that the rates are reasonable. In determining reasonableness, 
3.16 	the commissioner shall consider the growth rates applied under section 62J.04, subdivision 
3.17 	1, paragraph (b) apply the premium growth limits established under section 62J.04, 
3.18 	subdivision 1b, to the calendar year or years that the proposed premium rate would be in 
3.19 	effect, and shall consider actuarially valid changes in risks associated with the enrollee 
3.20 	populations, and actuarially valid changes as a result of statutory changes in Laws 1992, 
3.21 	chapter 549. 
3.22 	(i) An insurer may, as part of a minimum lifetime loss ratio guarantee filing under 
3.23 	section 62A.02, subdivision 3a, include a rating practices guarantee as provided in this 
3.24 	paragraph. The rating practices guarantee must be in writing and must guarantee that 
3.25 	the policy form will be offered, sold, issued, and renewed only with premium rates and 
3.26 	premium rating practices that comply with subdivisions 2, 3, 4, and 5. The rating practices 
3.27 	guarantee must be accompanied by an actuarial memorandum that demonstrates that the 
3.28 	premium rates and premium rating system used in connection with the policy form will 
3.29 	satisfy the guarantee. The guarantee must guarantee refunds of any excess premiums to 
3.30 	policyholders charged premiums that exceed those permitted under subdivision 2, 3, 4, 
3.31 	or 5. An insurer that complies with this paragraph in connection with a policy form is 
3.32 	exempt from the requirement of prior approval by the commissioner under paragraphs 
3.33 	(c), (f), and (h).

3.34 	Sec. 2. Minnesota Statutes 2006, section 62E.02, subdivision 7, is amended to read:
4.1 		Subd. 7.Dependent. "Dependent" means a spouse or unmarried child under the 
4.2 	age of 19 years, a dependent child who is a student under the age of 25 regardless of 
4.3 	whether the dependent child is enrolled in an educational institution, or a dependent 
4.4 	child of any age who is disabled.

4.5 	EFFECTIVE DATE. This section is effective January 1, 2008.

4.6 	Sec. 3. Minnesota Statutes 2006, section 62J.04, is amended by adding a subdivision to 
4.7 	read:
4.8 		Subd. 1b.Premium growth limits. (a) For calendar year 2008 and each year 
4.9 	thereafter, the commissioner shall set annual premium growth limits for health plan 
4.10 	companies. The premium limits set by the commissioner for calendar years 2008 to 2013 
4.11 	shall not exceed the regional Consumer Price Index for urban consumers for the preceding 
4.12 	calendar year plus two percentage points and an additional one percentage point to be used 
4.13 	to finance the implementation of the electronic medical record system described under 
4.14 	section 62J.495. The commissioner shall ensure that the additional percentage point is 
4.15 	being used to provide financial assistance to health care providers to implement electronic 
4.16 	medical record systems either directly or through an increase in reimbursement.
4.17 	(b) For the calendar years beyond 2013, the rate of premium growth shall be 
4.18 	limited to the change in the Consumer Price Index for urban consumers for the previous 
4.19 	calendar year plus two percentage points. The commissioners of health and commerce 
4.20 	shall make a recommendation to the legislature by January 15, 2012, regarding the 
4.21 	continuation of the additional percentage point to the growth limit described in paragraph 
4.22 	(a). The recommendation shall be based on the progress made by health care providers 
4.23 	in instituting an electronic medical record system and in creating a statewide interactive 
4.24 	electronic health record system.
4.25 	(c) The commissioner may add additional percentage points as needed to the 
4.26 	premium limit for a calendar year if a major disaster, bioterrorism, or a public health 
4.27 	emergency occurs that results in higher health care costs. Any additional percentage 
4.28 	points must reflect the additional cost to the health care system directly attributed to 
4.29 	the disaster or emergency. 
4.30 	(d) The commissioner shall publish the annual premium growth limits in the State 
4.31 	Register by January 31 of the year that the limits are to be in effect.
4.32 	(e) For the purposes of this subdivision, premium growth is measured as the 
4.33 	percentage change in per member, per month premium revenue from the current year to 
4.34 	the previous year. Premium growth rates shall be calculated for the following lines of 
5.1 	business: individual, small group, and large group. Data used for premium growth rate 
5.2 	calculations shall be submitted as part of the cost containment filing under section 62J.38.
5.3 	(f) For purposes of this subdivision, "health plan company" has the meaning given 
5.4 	in section 62J.041.
5.5 	(g) A health plan company may reduce reimbursement to providers in order to meet 
5.6 	the premium growth limitations required by this section.

5.7 	Sec. 4. Minnesota Statutes 2006, section 62J.04, subdivision 3, is amended to read:
5.8 		Subd. 3.Cost containment duties. The commissioner shall:
5.9 	(1) establish statewide and regional cost containment goals for total health care 
5.10 	spending under this section and collect data as described in sections 62J.38 to 62J.41 to 
5.11 	monitor statewide achievement of the cost containment goals and premium growth limits; 
5.12 	(2) divide the state into no fewer than four regions, with one of those regions being 
5.13 	the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 
5.14 	Wright, and Sherburne Counties, for purposes of fostering the development of regional 
5.15 	health planning and coordination of health care delivery among regional health care 
5.16 	systems and working to achieve the cost containment goals;
5.17 	(3) monitor the quality of health care throughout the state and take action as 
5.18 	necessary to ensure an appropriate level of quality;
5.19 	(4) issue recommendations regarding uniform billing forms, uniform electronic 
5.20 	billing procedures and data interchanges, patient identification cards, and other uniform 
5.21 	claims and administrative procedures for health care providers and private and public 
5.22 	sector payers. In developing the recommendations, the commissioner shall review the 
5.23 	work of the work group on electronic data interchange (WEDI) and the American National 
5.24 	Standards Institute (ANSI) at the national level, and the work being done at the state and 
5.25 	local level. The commissioner may adopt rules requiring the use of the Uniform Bill 
5.26 	82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 
5.27 	version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 
5.28 	forms or procedures;
5.29 	(5) undertake health planning responsibilities;
5.30 	(6) authorize, fund, or promote research and experimentation on new technologies 
5.31 	and health care procedures;
5.32 	(7) within the limits of appropriations for these purposes, administer or contract for 
5.33 	statewide consumer education and wellness programs that will improve the health of 
5.34 	Minnesotans and increase individual responsibility relating to personal health and the 
5.35 	delivery of health care services, undertake prevention programs including initiatives to 
6.1 	improve birth outcomes, expand childhood immunization efforts, and provide start-up 
6.2 	grants for worksite wellness programs;
6.3 	(8) undertake other activities to monitor and oversee the delivery of health care 
6.4 	services in Minnesota with the goal of improving affordability, quality, and accessibility of 
6.5 	health care for all Minnesotans; and
6.6 	(9) make the cost containment goal and premium growth limit data available to 
6.7 	the public in a consumer-oriented manner.

6.8 	Sec. 5. Minnesota Statutes 2006, section 62J.041, is amended to read:
6.9 	62J.041 INTERIM HEALTH PLAN COMPANY COST CONTAINMENT 
6.10 	GOALS HEALTH CARE EXPENDITURE LIMITS.
6.11 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
6.12 	apply.
6.13 	(b) "Health plan company" has the definition provided in section 62Q.01. This 
6.14 	definition does not include the state employee health plan offered under chapter 43A or 
6.15 	the public employees insurance program offered under section 43A.316.
6.16 	(c) "Total Health care expenditures" means incurred claims or expenditures on health 
6.17 	care services, administrative expenses, charitable contributions, and all other payments
6.18 	made by health plan companies out of premium revenues.
6.19 	(d) "Net expenditures" means total expenditures minus exempted taxes and 
6.20 	assessments and payments or allocations made to establish or maintain reserves.
6.21 	(e) "Exempted taxes and assessments" means direct payments for taxes to 
6.22 	government agencies, contributions to the Minnesota Comprehensive Health Association, 
6.23 	the medical assistance provider's surcharge under section 256.9657, the MinnesotaCare 
6.24 	provider tax under section 295.52, assessments by the Health Coverage Reinsurance 
6.25 	Association, assessments by the Minnesota Life and Health Insurance Guaranty 
6.26 	Association, assessments by the Minnesota Risk Adjustment Association, and any new 
6.27 	assessments imposed by federal or state law. 
6.28 	(f) (d) "Consumer cost-sharing or subscriber liability" means enrollee coinsurance, 
6.29 	co-payment, deductible payments, and amounts in excess of benefit plan maximums.
6.30 		Subd. 2.Establishment. The commissioner of health shall establish cost 
6.31 	containment goals health care expenditure limits for the increase in net calendar year 
6.32 	2008, and each year thereafter, for health care expenditures by each health plan company 
6.33 	for calendar years 1994, 1995, 1996, and 1997. The cost containment goals must be the 
6.34 	same as the annual cost containment goals for health care spending established under 
6.35 	section 62J.04, subdivision 1, paragraph (b). Health plan companies that are affiliates may 
7.1 	elect to meet one combined cost containment goal health care expenditure limit. The 
7.2 	limits set by the commissioner shall not exceed the premium limits established in section 
7.3 	62J.04, subdivision 1b. 
7.4 		Subd. 3.Determination of expenditures. Health plan companies shall submit to 
7.5 	the commissioner of health, by April 1, 1994, for calendar year 1993; April 1, 1995, for 
7.6 	calendar year 1994; April 1, 1996, for calendar year 1995; April 1, 1997, for calendar 
7.7 	year 1996; and April 1, 1998, for calendar year 1997 of each year, beginning 2008, all 
7.8 	information the commissioner determines to be necessary to implement this section. 
7.9 	The information must be submitted in the form specified by the commissioner. The 
7.10 	information must include, but is not limited to, health care expenditures per member per 
7.11 	month or cost per employee per month, and detailed information on revenues and reserves. 
7.12 	The commissioner, to the extent possible, shall coordinate the submittal of the information 
7.13 	required under this section with the submittal of the financial data required under chapter 
7.14 	62J, to minimize the administrative burden on health plan companies. The commissioner 
7.15 	may adjust final expenditure figures for demographic changes, risk selection, changes in 
7.16 	basic benefits, and legislative initiatives that materially change health care costs, as long 
7.17 	as these adjustments are consistent with the methodology submitted by the health plan 
7.18 	company to the commissioner, and approved by the commissioner as actuarially justified. 
7.19 	The methodology to be used for adjustments and the election to meet one cost containment 
7.20 	goal for affiliated health plan companies must be submitted to the commissioner by 
7.21 	September 1, 1994. Community integrated service networks may submit the information 
7.22 	with their application for licensure. The commissioner shall also accept changes to 
7.23 	methodologies already submitted. The adjustment methodology submitted and approved 
7.24 	by the commissioner must apply to the data submitted for calendar years 1994 and 1995. 
7.25 	The commissioner may allow changes to accepted adjustment methodologies for data 
7.26 	submitted for calendar years 1996 and 1997. Changes to the adjustment methodology 
7.27 	must be received by September 1, 1996, and must be approved by the commissioner.
7.28 		Subd. 4.Monitoring of reserves. (a) The commissioners of health and commerce 
7.29 	shall monitor health plan company reserves and net worth as established under chapters 
7.30 	60A, 62C, 62D, 62H, and 64B, with respect to the health plan companies that each 
7.31 	commissioner respectively regulates to assess the degree to which savings resulting from 
7.32 	the establishment of cost containment goals are passed on to consumers in the form of 
7.33 	lower premium rates.
7.34 	(b) Health plan companies shall fully reflect in the premium rates the savings 
7.35 	generated by the cost containment goals. No premium rate, currently reviewed by the 
7.36 	Department of Health or Commerce, may be approved for those health plan companies 
8.1 	unless the health plan company establishes to the satisfaction of the commissioner of 
8.2 	commerce or the commissioner of health, as appropriate, that the proposed new rate 
8.3 	would comply with this paragraph.
8.4 	(c) Health plan companies, except those licensed under chapter 60A to sell accident 
8.5 	and sickness insurance under chapter 62A, shall annually before the end of the fourth fiscal 
8.6 	quarter provide to the commissioner of health or commerce, as applicable, a projection of 
8.7 	the level of reserves the company expects to attain during each quarter of the following 
8.8 	fiscal year. These health plan companies shall submit with required quarterly financial 
8.9 	statements a calculation of the actual reserve level attained by the company at the end 
8.10 	of each quarter including identification of the sources of any significant changes in the 
8.11 	reserve level and an updated projection of the level of reserves the health plan company 
8.12 	expects to attain by the end of the fiscal year. In cases where the health plan company has 
8.13 	been given a certificate to operate a new health maintenance organization under chapter 
8.14 	62D, or been licensed as a community integrated service network under chapter 62N, or 
8.15 	formed an affiliation with one of these organizations, the health plan company shall also 
8.16 	submit with its quarterly financial statement, total enrollment at the beginning and end of 
8.17 	the quarter and enrollment changes within each service area of the new organization. The 
8.18 	reserve calculations shall be maintained by the commissioners as trade secret information, 
8.19 	except to the extent that such information is also required to be filed by another provision 
8.20 	of state law and is not treated as trade secret information under such other provisions.
8.21 	(d) Health plan companies in paragraph (c) whose reserves are less than the required 
8.22 	minimum or more than the required maximum at the end of the fiscal year shall submit a 
8.23 	plan of corrective action to the commissioner of health or commerce under subdivision 7.
8.24 	(e) The commissioner of commerce, in consultation with the commissioner of health, 
8.25 	shall report to the legislature no later than January 15, 1995, as to whether the concept of 
8.26 	a reserve corridor or other mechanism for purposes of monitoring reserves is adaptable 
8.27 	for use with indemnity health insurers that do business in multiple states and that must 
8.28 	comply with their domiciliary state's reserves requirements.
8.29 		Subd. 5.Notice. The commissioner of health shall publish in the State Register 
8.30 	and make available to the public by July 1, 1995 2009, and each year thereafter, a list 
8.31 	of all health plan companies that exceeded their cost containment goalhealth care 
8.32 	expenditure limit for the 1994 previous calendar year. The commissioner shall publish 
8.33 	in the State Register and make available to the public by July 1, 1996, a list of all health 
8.34 	plan companies that exceeded their combined cost containment goal for calendar years 
8.35 	1994 and 1995. The commissioner shall notify each health plan company that the 
8.36 	commissioner has determined that the health plan company exceeded its cost containment 
9.1 	goal,health care expenditure limit at least 30 days before publishing the list, and shall 
9.2 	provide each health plan company with ten days to provide an explanation for exceeding 
9.3 	the cost containment goal health care expenditure limit. The commissioner shall review 
9.4 	the explanation and may change a determination if the commissioner determines the 
9.5 	explanation to be valid.
9.6 		Subd. 6.Assistance by the commissioner of commerce. The commissioner of 
9.7 	commerce shall provide assistance to the commissioner of health in monitoring health 
9.8 	plan companies regulated by the commissioner of commerce.

9.9 	Sec. 6. Minnesota Statutes 2006, section 62J.07, subdivision 1, is amended to read:
9.10 		Subdivision 1.Legislative oversight. The Legislative Commission on Health 
9.11 	Care Access reviews the activities of the commissioner of health, the Health Technology 
9.12 	Advisory Committee, and all other state agencies involved in the implementation and 
9.13 	administration of this chapter, including efforts to obtain federal approval through waivers 
9.14 	and other means shall make recommendations to the legislature on how to achieve the 
9.15 	goal of universal health coverage as described in section 62Q.165. The recommendations 
9.16 	shall include a timetable in which measurable progress must be achieved toward this goal. 
9.17 	The commission shall submit to the legislature by January 15, 2008, the recommendations 
9.18 	and corresponding timetable.

9.19 	Sec. 7. Minnesota Statutes 2006, section 62J.07, subdivision 3, is amended to read:
9.20 		Subd. 3.Reports to the commission. The commissionercommissioners of 
9.21 	health, human services, commerce, and the Health Technology Advisory Committee shall 
9.22 	report on their activities annually and at other times at the request of the Legislative 
9.23 	Commission on Health Care Access. The commissioners of health, commerce, and human 
9.24 	services shall provide periodic reports to the legislative commission on the progress of 
9.25 	rulemaking that is authorized or required under this chapter and shall notify members 
9.26 	of the commission when a draft of a proposed rule has been completed and scheduled 
9.27 	for publication in the State Register. At the request of a member of the commission, 
9.28 	a commissioner shall provide a description and a copy of a proposed rule other state 
9.29 	agencies shall provide assistance and technical support to the commission at the request 
9.30 	of the commission. The commission may convene subcommittees to provide additional 
9.31 	assistance and advice to the commission.

9.32 	Sec. 8. Minnesota Statutes 2006, section 62J.301, subdivision 3, is amended to read:
9.33 		Subd. 3.General duties. The commissioner shall:
10.1 	(1) collect and maintain data which enable population-based monitoring and trending 
10.2 	of the access, utilization, quality, and cost of health care services within Minnesota;
10.3 	(2) collect and maintain data for the purpose of estimating total Minnesota health 
10.4 	care expenditures and trends;
10.5 	(3) collect and maintain data for the purposes of setting cost containment goals and 
10.6 	premium growth limits under section 62J.04, and measuring cost containment goal and 
10.7 	premium growth limit compliance; 
10.8 	(4) conduct applied research using existing and new data and promote applications 
10.9 	based on existing research;
10.10 	(5) develop and implement data collection procedures to ensure a high level of 
10.11 	cooperation from health care providers and health plan companies, as defined in section 
10.12 	62Q.01, subdivision 4; 
10.13 	(6) work closely with health plan companies and health care providers to promote 
10.14 	improvements in health care efficiency and effectiveness; and
10.15 	(7) participate as a partner or sponsor of private sector initiatives that promote 
10.16 	publicly disseminated applied research on health care delivery, outcomes, costs, quality, 
10.17 	and management.

10.18 	Sec. 9. Minnesota Statutes 2006, section 62J.38, is amended to read:
10.19 	62J.38 COST CONTAINMENT DATA FROM GROUP PURCHASERS.
10.20 	(a) The commissioner shall require group purchasers to submit detailed data on total 
10.21 	health care spending for each calendar year. Group purchasers shall submit data for the 
10.22 	1993 calendar year by April 1, 1994, and each April 1 thereafter shall submit data for the 
10.23 	preceding calendar year.
10.24 	(b) The commissioner shall require each group purchaser to submit data on revenue, 
10.25 	expenses, and member months, as applicable. Revenue data must distinguish between 
10.26 	premium revenue and revenue from other sources and must also include information 
10.27 	on the amount of revenue in reserves and changes in reserves. Premium revenue data, 
10.28 	information on aggregate enrollment, and data on member months must be broken down 
10.29 	to distinguish between individual market, small group market, and large group market. 
10.30 	Filings under this section for calendar year 2008 must also include information broken 
10.31 	down by individual market, small group market, and large group market for calendar year 
10.32 	2007. Expenditure data must distinguish between costs incurred for patient care and 
10.33 	administrative costs. Patient care and administrative costs must include only expenses 
10.34 	incurred on behalf of health plan members and must not include the cost of providing 
10.35 	health care services for nonmembers at facilities owned by the group purchaser or affiliate. 
11.1 	Expenditure data must be provided separately for the following categories and for other 
11.2 	categories required by the commissioner: physician services, dental services, other 
11.3 	professional services, inpatient hospital services, outpatient hospital services, emergency, 
11.4 	pharmacy services and other nondurable medical goods, mental health, and chemical 
11.5 	dependency services, other expenditures, subscriber liability, and administrative costs. 
11.6 	Administrative costs must include costs for marketing; advertising; overhead; salaries 
11.7 	and benefits of central office staff who do not provide direct patient care; underwriting; 
11.8 	lobbying; claims processing; provider contracting and credentialing; detection and 
11.9 	prevention of payment for fraudulent or unjustified requests for reimbursement or 
11.10 	services; clinical quality assurance and other types of medical care quality improvement 
11.11 	efforts; concurrent or prospective utilization review as defined in section 62M.02; costs 
11.12 	incurred to acquire a hospital, clinic, or health care facility, or the assets thereof; capital 
11.13 	costs incurred on behalf of a hospital or clinic; lease payments; or any other costs incurred 
11.14 	pursuant to a partnership, joint venture, integration, or affiliation agreement with a 
11.15 	hospital, clinic, or other health care provider. Capital costs and costs incurred must be 
11.16 	recorded according to standard accounting principles. The reports of this data must also 
11.17 	separately identify expenses for local, state, and federal taxes, fees, and assessments. The 
11.18 	commissioner may require each group purchaser to submit any other data, including data 
11.19 	in unaggregated form, for the purposes of developing spending estimates, setting spending 
11.20 	limits, and monitoring actual spending and costs. In addition to reporting administrative 
11.21 	costs incurred to acquire a hospital, clinic, or health care facility, or the assets thereof; or 
11.22 	any other costs incurred pursuant to a partnership, joint venture, integration, or affiliation 
11.23 	agreement with a hospital, clinic, or other health care provider; reports submitted under 
11.24 	this section also must include the payments made during the calendar year for these 
11.25 	purposes. The commissioner shall make public, by group purchaser data collected under 
11.26 	this paragraph in accordance with section 62J.321, subdivision 5. Workers' compensation 
11.27 	insurance plans and automobile insurance plans are exempt from complying with this 
11.28 	paragraph as it relates to the submission of administrative costs. 
11.29 	(c) The commissioner may collect information on:
11.30 	(1) premiums, benefit levels, managed care procedures, and other features of health 
11.31 	plan companies;
11.32 	(2) prices, provider experience, and other information for services less commonly 
11.33 	covered by insurance or for which patients commonly face significant out-of-pocket 
11.34 	expenses; and
11.35 	(3) information on health care services not provided through health plan companies, 
11.36 	including information on prices, costs, expenditures, and utilization.
12.1 	(d) All group purchasers shall provide the required data using a uniform format and 
12.2 	uniform definitions, as prescribed by the commissioner.

12.3 	Sec. 10. Minnesota Statutes 2006, section 62J.495, is amended to read:
12.4 	62J.495 HEALTH INFORMATION TECHNOLOGY AND 
12.5 	INFRASTRUCTURE ADVISORY COMMITTEE.
12.6 		Subdivision 1.Establishment; members; duties Implementation. By January 
12.7 	1, 2015, all hospitals and health care providers must have in place an interoperable 
12.8 	electronic health records system within their hospital system or clinical practice setting. 
12.9 	The commissioner of health, in consultation with the Health Information Technology and 
12.10 	Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal, 
12.11 	including uniform standards to be used for the interoperable system for sharing and 
12.12 	synchronizing patient data across systems. The standards must be compatible with federal 
12.13 	efforts. The uniform standards must be developed by January 1, 2009, with a status report 
12.14 	on the development of these standards submitted to the legislature by January 15, 2008.
12.15 		Subd. 2. Health Information Technology and Infrastructure Advisory 
12.16 	Committee. (a) The commissioner shall establish a Health Information Technology 
12.17 	and Infrastructure Advisory Committee governed by section 15.059 to advise the 
12.18 	commissioner on the following matters:
12.19 	(1) assessment of the use of health information technology by the state, licensed 
12.20 	health care providers and facilities, and local public health agencies;
12.21 	(2) recommendations for implementing a statewide interoperable health information 
12.22 	infrastructure, to include estimates of necessary resources, and for determining standards 
12.23 	for administrative data exchange, clinical support programs, patient privacy requirements, 
12.24 	and maintenance of the security and confidentiality of individual patient data; and
12.25 	(3) other related issues as requested by the commissioner.
12.26 	(b) The members of the Health Information Technology and Infrastructure Advisory 
12.27 	Committee shall include the commissioners, or commissioners' designees, of health, 
12.28 	human services, administration, and commerce and additional members to be appointed 
12.29 	by the commissioner to include persons representing Minnesota's local public health 
12.30 	agencies, licensed hospitals and other licensed facilities and providers, private purchasers, 
12.31 	the medical and nursing professions, health insurers and health plans, the state quality 
12.32 	improvement organization, academic and research institutions, consumer advisory 
12.33 	organizations with an interest and expertise in health information technology, and other 
12.34 	stakeholders as identified by the Health Information Technology and Infrastructure 
12.35 	Advisory Committee.
13.1 		Subd. 2.Annual report. (c) The commissioner shall prepare and issue an annual 
13.2 	report not later than January 30 of each year outlining progress to date in implementing a 
13.3 	statewide health information infrastructure and recommending future projects.
13.4 		Subd. 3.Expiration. (d) Notwithstanding section 15.059, this sectionsubdivision 
13.5 	expires June 30, 2009 2015.

13.6 	Sec. 11. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING 
13.7 	ACCOUNT AND LOAN PROGRAM.
13.8 		Subdivision 1.Account establishment. The commissioner of finance shall 
13.9 	establish and implement a revolving account in the state government special revenue 
13.10 	fund to provide loans to physicians or physician group practices to assist in financing the 
13.11 	installation or support of an interoperable health record system. The system must provide 
13.12 	for the interoperable exchange of health care information between the applicant and, at a 
13.13 	minimum, a hospital system, pharmacy, and a health care clinic or other physician group.
13.14 		Subd. 2.Eligibility. To be eligible for a loan under this section, the applicant 
13.15 	must submit a loan application to the commissioner of health on forms prescribed by the 
13.16 	commissioner. The application must include, at a minimum:
13.17 	(1) the amount of the loan requested and a description of the purpose or project 
13.18 	for which the loan proceeds will be used;
13.19 	(2) a signed contract with a vendor;
13.20 	(3) a description of the health care entities and other groups participating in the 
13.21 	project;
13.22 	(4) evidence of financial stability and a demonstrated ability to repay the loan; and
13.23 	(5) a description of how the system to be financed interconnects or plans in the 
13.24 	future to interconnect with other health care entities and provider groups located in the 
13.25 	same geographical area.
13.26 		Subd. 3.Loans. (a) The commissioner of health may make a no interest loan 
13.27 	to a provider or provider group who is eligible under subdivision 2 on a first-come, 
13.28 	first-served basis provided that the applicant is able to comply with this section. The total 
13.29 	accumulative loan principal must not exceed $....... per loan. The commissioner of health 
13.30 	has discretion over the size and number of loans made.
13.31 	(b) The commissioner of health may prescribe forms and establish an application 
13.32 	process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable 
13.33 	application fee to cover the cost of administering the loan program.
13.34 	(c) The borrower must begin repaying the principal no later than two years from the 
13.35 	date of the loan. Loans must be amortized no later than 15 years from the date of the loan.
14.1 	(d) Repayments must be credited to the account.

14.2 	Sec. 12. Minnesota Statutes 2006, section 62J.82, is amended to read:
14.3 	62J.82 HOSPITAL CHARGEINFORMATION REPORTING DISCLOSURE.
14.4 		Subdivision 1.Required information. The Minnesota Hospital Association shall 
14.5 	develop a Web-based system, available to the public free of charge, for reporting charge 
14.6 	information the following, for Minnesota residents,:
14.7 	(1) hospital-specific performance on the measures of care developed under section 
14.8 	256B.072 for acute myocardial infarction, heart failure, and pneumonia; 
14.9 	(2) by January 1, 2009, hospital-specific performance on the public reporting 
14.10 	measures for hospital-acquired infections as published by the National Quality Forum 
14.11 	and collected by the Minnesota Hospital Association and Stratis Health in collaboration 
14.12 	with infection control practitioners; and 
14.13 	(3) charge information, including, but not limited to, number of discharges, average 
14.14 	length of stay, average charge, average charge per day, and median charge, for each of the 
14.15 	50 most common inpatient diagnosis-related groups and the 25 most common outpatient 
14.16 	surgical procedures as specified by the Minnesota Hospital Association. 
14.17 		Subd. 2.Web site. The Web site must provide information that compares 
14.18 	hospital-specific data to hospital statewide data. The Web site must be established by 
14.19 	October 1, 2006, and must be updated annually. The commissioner shall provide a link to 
14.20 	this reporting information on the department's Web site.
14.21 		Subd. 3.Enforcement. The commissioner shall provide a link to this information 
14.22 	on the department's Web site. If a hospital does not provide this information to the 
14.23 	Minnesota Hospital Association, the commissioner of health may require the hospital to 
14.24 	do so in accordance with section 144.55, subdivision 6. The commissioner shall provide a 
14.25 	link to this information on the department's Web site.

14.26 	Sec. 13. Minnesota Statutes 2006, section 62L.02, subdivision 11, is amended to read:
14.27 		Subd. 11.Dependent. "Dependent" means an eligible employee's spouse, 
14.28 	unmarried child who is under the age of 19 years, unmarried child under the age of 25 
14.29 	years who is a full-time student as defined in section 62A.301 regardless of whether 
14.30 	the dependent child is enrolled in an educational institution, dependent child of any age 
14.31 	who is disabled and who meets the eligibility criteria in section 62A.14, subdivision 2, 
14.32 	or any other person whom state or federal law requires to be treated as a dependent for 
14.33 	purposes of health plans. For the purpose of this definition, a child includes a child for 
15.1 	whom the employee or the employee's spouse has been appointed legal guardian and an 
15.2 	adoptive child as provided in section 62A.27. 

15.3 	EFFECTIVE DATE. This section is effective January 1, 2008.

15.4 	Sec. 14. Minnesota Statutes 2006, section 62L.08, subdivision 8, is amended to read:
15.5 		Subd. 8.Filing requirement. (a) A health carrier that offers, sells, issues, or renews 
15.6 	a health benefit plan for small employers shall file with the commissioner the index rates 
15.7 	and must demonstrate that all rates shall be within the rating restrictions defined in this 
15.8 	chapter. Such demonstration must include the allowable range of rates from the index rates 
15.9 	and a description of how the health carrier intends to use demographic factors including 
15.10 	case characteristics in calculating the premium rates. 
15.11 	(b) Notwithstanding paragraph (a), the rates shall not be approved, unless the 
15.12 	commissioner has determined that the rates are reasonable. In determining reasonableness, 
15.13 	the commissioner shall consider the growth rates applied under section 62J.04, subdivision 
15.14 	1, paragraph (b) apply the premium growth limits established under section 62J.04, 
15.15 	subdivision 1b, to the calendar year or years that the proposed premium rate would be 
15.16 	in effect, and shall consider actuarially valid changes in risk associated with the enrollee 
15.17 	population, and actuarially valid changes as a result of statutory changes in Laws 1992, 
15.18 	chapter 549.

15.19 	Sec. 15. Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:
15.20 		Subdivision 1.Definition. It is the commitment of the state to achieve universal 
15.21 	health coverage for all Minnesotans by the year 2010. Universal coverage is achieved 
15.22 	when:
15.23 	(1) every Minnesotan has access to a full range of quality health care services;
15.24 	(2) every Minnesotan is able to obtain affordable health coverage which pays for the 
15.25 	full range of services, including preventive and primary care; and
15.26 	(3) every Minnesotan pays into the health care system according to that person's 
15.27 	ability.

15.28 	Sec. 16. Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:
15.29 		Subd. 2.Goal. It is the goal of the state to make continuous progress toward 
15.30 	reducing the number of Minnesotans who do not have health coverage so that by January 
15.31 	1, 2000 2010, fewer than four percent of the state's population will be without health 
15.32 	coverage all Minnesota residents have access to affordable health care. The goal will be
15.33 	achieved byIn achieving this goal, a number of options shall be considered, including 
16.1 	improving access to private health coverage through insurance reforms and market 
16.2 	reforms, by making health coverage more affordable for low-income Minnesotans through 
16.3 	purchasing pools and state subsidies, and by reducing the cost of health coverage through 
16.4 	cost containment programs and methods of ensuring that all Minnesotans are paying 
16.5 	into the system according to their ability.

16.6 	EFFECTIVE DATE. This section is effective July 1, 2007.

16.7 	Sec. 17. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.
16.8 		Subdivision 1.Definitions. For purposes of this section, "federally qualified health 
16.9 	center" means an entity that is receiving a grant under United States Code, title 42, 
16.10 	section 254b, or, based on the recommendation of the Health Resources and Services 
16.11 	Administration within the Public Health Service, is determined by the secretary to meet 
16.12 	the requirements for receiving such a grant.
16.13 		Subd. 2.Allocation of subsidies. The commissioner of health shall distribute 
16.14 	subsidies to federally qualified health centers operating in Minnesota to continue, expand, 
16.15 	and improve federally qualified health center services to low-income populations. The 
16.16 	commissioner shall distribute the funds appropriated under this section to federally 
16.17 	qualified health centers operating in Minnesota as of January 1, 2007. The amount of 
16.18 	each subsidy shall be in proportion to each federally qualified health center's amount of 
16.19 	discounts granted to patients during calendar year 2006 as reported on the federal Uniform 
16.20 	Data System report in conformance with the Bureau of Primary Health Care Program 
16.21 	Expectations Policy Information Notice 98-23, except that each eligible federally qualified 
16.22 	health center shall receive at least two percent but no more than 30 percent of the total 
16.23 	amount of money available under this section.

16.24 	Sec. 18. Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:
16.25 		Subd. 2b.Performance payments. (a) The commissioner shall develop and 
16.26 	implement a pay-for-performance system to provide performance payments to medical 
16.27 	groups that demonstrate optimum care in serving individuals with chronic diseases who 
16.28 	are enrolled in health care programs administered by the commissioner under chapters 
16.29 	256B, 256D, and 256L.
16.30 	(b) The commissioner shall also develop and implement a patient incentive health 
16.31 	program to provide incentives and rewards to patients who are enrolled in health care 
16.32 	programs administered by the commissioner under chapters 256B, 256D, and 256L, and 
16.33 	who have agreed to and met personal health goals established with their primary care 
17.1 	provider to manage a chronic disease or condition, including, but not limited to, diabetes, 
17.2 	high blood pressure, and coronary artery disease.

17.3 	Sec. 19. [256.9545] PRESCRIPTION DRUG DISCOUNT PROGRAM.
17.4 		Subdivision 1.Establishment; administration. The    commissioner shall establish 
17.5 	and administer the prescription drug discount program.
17.6 		Subd. 2.Commissioner's authority. The commissioner  shall administer a drug 
17.7 	rebate program for drugs purchased  according to the prescription drug discount program. 
17.8 	The  commissioner shall execute a rebate agreement from all  manufacturers that choose to 
17.9 	participate in the program for  those drugs covered under the medical assistance program. 
17.10 	For  each drug, the amount of the rebate shall be equal to the rebate  as defined for purposes 
17.11 	of the federal rebate program in United  States Code, title 42, section 1396r-8.  The 
17.12 	rebate program  shall utilize the terms and conditions used for the federal  rebate program 
17.13 	established according to section 1927 of title  XIX of the federal Social Security Act.
17.14 		Subd. 3.Definitions. For purposes of this section,  the following terms have the 
17.15 	meanings given them.  
17.16 	(a) "Commissioner" means the commissioner of human services. 
17.17 	(b) "Covered prescription drug" means a prescription drug  as defined in section 
17.18 	151.44, paragraph (d), that is covered  under medical assistance as described in section 
17.19 	256B.0625,  subdivision 13, and that is provided by a participating  manufacturer that has a 
17.20 	fully executed rebate agreement with the  commissioner under this section and complies 
17.21 	with that agreement.
17.22 	(c) "Enrolled individual" means a person who is eligible  for the program under 
17.23 	subdivision 4 and has enrolled in the  program according to subdivision 5.
17.24 	(d) "Health carrier" means an insurance company licensed  under chapter 60A to 
17.25 	offer, sell, or issue an individual or  group policy of accident and sickness insurance as 
17.26 	defined in  section 62A.01; a nonprofit health service plan corporation  operating under 
17.27 	chapter 62C; a health maintenance organization  operating under chapter 62D; a joint 
17.28 	self-insurance employee  health plan operating under chapter 62H; a community integrated 
17.29 	service network licensed under chapter 62N; a fraternal benefit  society operating under 
17.30 	chapter 64B; a city, county, school  district, or other political subdivision providing 
17.31 	self-insured  health coverage under section 471.617 or sections 471.98 to  471.982; and a 
17.32 	self-funded health plan under the Employee  Retirement Income Security Act of 1974, as 
17.33 	amended. 
17.34 	(e) "Participating manufacturer" means a manufacturer as  defined in section 151.44, 
17.35 	paragraph (c), that agrees to  participate in the prescription drug discount program.   
18.1 	(f) "Participating pharmacy" means a pharmacy as defined in  section 151.01, 
18.2 	subdivision 2, that agrees to participate in the  prescription drug discount program.
18.3 		Subd. 4.Eligibility. (a) To be eligible for the program, an  applicant must:
18.4 	(1) be a permanent resident of Minnesota as defined in  section 256L.09, subdivision 
18.5 	4;
18.6 	(2) not be enrolled in medical assistance,  general assistance medical care, or 
18.7 	MinnesotaCare;
18.8 	(3) not be enrolled in and have currently available  prescription drug coverage under 
18.9 	a health plan offered by a  health carrier or employer or under a pharmacy benefit program 
18.10 	offered by a pharmaceutical manufacturer; and 
18.11 	(4) not be enrolled in and have currently available  prescription drug coverage 
18.12 	under a Medicare supplement policy, as  defined in sections 62A.31 to 62A.44, or 
18.13 	policies, contracts, or  certificates that supplement Medicare issued by health  maintenance 
18.14 	organizations or those policies, contracts, or  certificates governed by section 1833 or 1876 
18.15 	of the federal  Social Security Act, United States Code, title 42, section 1395,  et seq., as 
18.16 	amended.
18.17 	(b) Notwithstanding paragraph (a), clause (3), an individual who is enrolled in a 
18.18 	Medicare Part D prescription drug plan or Medicare Advantage plan is eligible for the 
18.19 	program but only for drugs that are not covered under the Medicare Part D plan or for 
18.20 	drugs that are covered under the plan, but according to the conditions of the plan, the 
18.21 	individual is responsible for 100 percent of the cost of the prescription drug. 
18.22 		Subd. 5.Application procedure. (a) Applications and  information on the program 
18.23 	must be made available at county  social services agencies, health care provider offices, and 
18.24 	agencies and organizations serving senior citizens.  Individuals  shall submit applications 
18.25 	and any information specified by the  commissioner as being necessary to verify eligibility 
18.26 	directly  to the commissioner.  The commissioner shall determine an  applicant's eligibility 
18.27 	for the program within 30 days from the  date the application is received.  Upon notice of 
18.28 	approval, the  applicant must submit to the commissioner the enrollment fee  specified in 
18.29 	subdivision 10.  Eligibility begins the month after  the enrollment fee is received by the 
18.30 	commissioner.
18.31 	(b) An enrollee's eligibility must be renewed every 12  months with the 12-month 
18.32 	period beginning in the month after the  application is approved.
18.33 	(c) The commissioner shall develop an application form that  does not exceed one 
18.34 	page in length and requires information  necessary to determine eligibility for the program.
18.35 		Subd. 6.Participating pharmacy. (a) Upon implementation  of the prescription 
18.36 	drug discount program, and until January 1,  2009, a participating pharmacy, with a 
19.1 	valid  prescription, must sell a covered prescription drug to an  enrolled individual at the 
19.2 	medical assistance rate.
19.3 	(b) After January 1, 2009, a participating pharmacy, with a valid prescription, must 
19.4 	sell a covered  prescription drug to an enrolled individual at the medical  assistance rate, 
19.5 	minus an amount that is equal to the rebate  amount described in subdivision 8, plus 
19.6 	the amount of any switch  fee established by the commissioner under subdivision 10, 
19.7 	paragraph (b).
19.8 	(c) Each participating pharmacy shall provide the  commissioner with all information 
19.9 	necessary to administer the  program, including, but not limited to, information on 
19.10 	prescription drug sales to enrolled individuals and usual and  customary retail prices.
19.11 		Subd. 7.Notification of rebate amount. The commissioner  shall notify each 
19.12 	participating manufacturer, each calendar  quarter or according to a schedule established 
19.13 	by the  commissioner, of the amount of the rebate owed on the  prescription drugs sold by 
19.14 	participating pharmacies to enrolled  individuals.
19.15 		Subd. 8.Provision of rebate. To the extent that a  participating manufacturer's 
19.16 	prescription drugs are prescribed  to a resident of this state, the manufacturer must provide 
19.17 	a  rebate equal to the rebate provided under the medical assistance  program for any 
19.18 	prescription drug distributed by the  manufacturer that is purchased at a  participating 
19.19 	pharmacy by an enrolled individual.  The participating manufacturer must  provide full 
19.20 	payment within 38 days of receipt of the state  invoice for the rebate, or according to 
19.21 	a schedule to be  established by the commissioner.  The commissioner shall deposit  all 
19.22 	rebates received into the Minnesota prescription drug  dedicated fund established under 
19.23 	subdivision 11.  The  manufacturer must provide the commissioner with any information 
19.24 	necessary to verify the rebate determined per drug.
19.25 		Subd. 9.Payment to pharmacies. Beginning January 1,  2009, the commissioner 
19.26 	shall distribute on a biweekly basis an  amount that is equal to an amount collected under 
19.27 	subdivision 8  to each participating pharmacy based on the prescription drugs  sold by that 
19.28 	pharmacy to enrolled individuals on or after  January 1, 2009.
19.29 		Subd. 10.Enrollment fee; switch fee. (a) The  commissioner shall establish an 
19.30 	annual enrollment fee that  covers the commissioner's expenses for enrollment, processing 
19.31 	claims, and distributing rebates under this program.
19.32 	(b) The commissioner shall establish a reasonable switch  fee that covers expenses 
19.33 	incurred by participating pharmacies in  formatting for electronic submission claims for 
19.34 	prescription  drugs sold to enrolled individuals.
19.35 		Subd. 11.Dedicated fund; creation; use of fund. (a) The  Minnesota prescription 
19.36 	drug dedicated fund is established as an  account in the state treasury.  The commissioner 
20.1 	of finance  shall credit to the dedicated fund all rebates paid under  subdivision 8, any 
20.2 	federal funds received for the program, all  enrollment fees paid by the enrollees, and 
20.3 	any appropriations or  allocations designated for the fund.  The commissioner of  finance 
20.4 	shall ensure that fund money is invested under section  11A.25.  All money earned by the 
20.5 	fund must be credited to the  fund.  The fund shall earn a proportionate share of the total 
20.6 	state annual investment income.
20.7 	(b) Money in the fund is appropriated to the commissioner  to reimburse participating 
20.8 	pharmacies for prescription drugs provided to enrolled individuals under  subdivision 6, 
20.9 	paragraph (b); to reimburse the commissioner for  costs related to enrollment, processing 
20.10 	claims, distributing  rebates, and for other reasonable administrative costs related to 
20.11 	administration of the prescription drug discount program; and to  repay the appropriation 
20.12 	provided by law for this section.  The  commissioner must administer the program so that 
20.13 	the costs total  no more than funds appropriated plus the drug rebate proceeds.

20.14 	EFFECTIVE DATE. This section is effective July 1, 2007.

20.15 	Sec. 20. [256.962] MINNESOTA HEALTH CARE PROGRAMS OUTREACH.
20.16 		Subdivision 1.Public awareness and education. (a) The commissioner shall 
20.17 	design and implement a statewide campaign to raise public awareness on the availability 
20.18 	of health coverage through medical assistance, general assistance medical care, and 
20.19 	MinnesotaCare and to educate the public on the importance of obtaining and maintaining 
20.20 	health care coverage. The campaign shall include multimedia messages directed to the 
20.21 	general population and messages that are culturally specific and community-based, 
20.22 	directed to high-uninsured population areas.
20.23 	(b) The commissioner shall collaborate with public and private entities, including, 
20.24 	but not limited to, hospitals, providers, health plans, legal aid offices, pharmacies, 
20.25 	insurance agencies, and faith-based organizations to develop outreach activities and 
20.26 	partnerships to ensure the distribution of information and applications.
20.27 	(c) The commissioner shall ensure that all outreach materials are available in 
20.28 	languages other than English.
20.29 		Subd. 2.Outreach grants. The commissioner shall award grants to public and 
20.30 	private organizations to provide information, applications, and assistance in obtaining 
20.31 	coverage through Minnesota public health care programs. In awarding these grants, the 
20.32 	commissioner shall give priority to community organizations with a proven ability to 
20.33 	provide multilingual and cultural outreach efforts in areas of high-uninsured populations.
20.34 		Subd. 3. Application and assistance. (a) The Minnesota health care programs 
20.35 	application must be made available at provider offices, local human services agencies, 
21.1 	school districts, public and private elementary schools in which 25 percent or more of 
21.2 	the students receive free or reduced price lunches, community health offices, Women, 
21.3 	Infants and Children (WIC) program sites, Head Start program sites, public housing 
21.4 	councils, child care centers, early childhood education and preschool program sites, legal 
21.5 	aid offices, and libraries. The commissioner shall ensure that applications are available in 
21.6 	languages other than English and that individuals and families who need assistance due to 
21.7 	language or cultural barriers receive the necessary services.
21.8 	(b) Local human service agencies, hospitals, and health care community clinics 
21.9 	receiving state funds must provide direct assistance in completing the application form, 
21.10 	including the free use of a copy machine and a drop box for applications. Other locations 
21.11 	where applications are required to be available shall either provide direct assistance in 
21.12 	completing the application form or provide information on where an applicant can receive 
21.13 	application assistance.
21.14 	(c) Counties must offer applications and application assistance when providing 
21.15 	child support collection services.
21.16 	(d) Local public health agencies and counties that provide immunization clinics must 
21.17 	offer applications and application assistance during these clinics.
21.18 		Subd. 4.Statewide toll-free telephone number. The commissioner shall provide 
21.19 	funds to establish a statewide toll-free telephone number to provide information on public 
21.20 	and private health coverage options and sources of free and low-cost health care.
21.21 		Subd. 5.Incentive program. The commissioner shall establish an incentive 
21.22 	program for organizations that directly identify and assist potential enrollees in filling 
21.23 	out and submitting an application. For each applicant who is successfully enrolled in 
21.24 	MinnesotaCare, medical assistance, or general assistance medical care, the commissioner 
21.25 	shall pay the organization a $25 application assistance fee. The organization may provide 
21.26 	an applicant a gift certificate or other incentive upon enrollment.
21.27 		Subd. 6.School districts. (a) At the beginning of each school year, a school district 
21.28 	shall provide information to each student on the availability of health care coverage 
21.29 	through the Minnesota health care programs.
21.30 	(b) For each child who is determined to be eligible for a free or reduced priced lunch, 
21.31 	the district shall provide the child's family with an application for the Minnesota health 
21.32 	care programs and information on how to obtain application assistance.
21.33 	(c) A district shall also ensure that applications and information on application 
21.34 	assistance are available at early childhood education sites and public schools located 
21.35 	within the district's jurisdiction. 
22.1 	(d) Each district shall designate an enrollment specialist to provide application 
22.2 	assistance and follow-up services with families who are eligible for the reduced or free 
22.3 	lunch program or who have indicated an interest in receiving information or an application 
22.4 	for the Minnesota health care program.
22.5 	(e) Each school district shall provide on their Web site a link to information on how 
22.6 	to obtain an application and application assistance.
22.7 		Subd. 7.Renewal notice. (a) The commissioner shall mail a renewal notice to 
22.8 	enrollees notifying the enrollee that their eligibility must be renewed. A notice shall be 
22.9 	sent at 90 days prior to the renewal date and at 60 days prior to the renewal date.
22.10 	(b) For enrollees who are receiving services through managed care plans, the 
22.11 	managed care plan must provide a follow-up renewal call at least 60 days prior to the 
22.12 	enrollee's renewal date.
22.13 	(c) The commissioner shall include the end of coverage dates on the monthly rosters 
22.14 	of enrollees provided to managed care organizations.
22.15 		Subd. 8.MinnesotaCare small employer buy-in option. The commissioner shall 
22.16 	provide information on the small employer buy-in option for MinnesotaCare to insurance 
22.17 	agents and local chambers of commerce.

22.18 	Sec. 21. [256.963] PRIMARY CARE ACCESS INITIATIVE.
22.19 		Subdivision 1.Establishment. (a) The commissioner shall award a grant to 
22.20 	implement in Hennepin and Ramsey Counties a Web-based primary care access pilot 
22.21 	project designed as a collaboration between private and public sectors to connect, where 
22.22 	appropriate, a patient with a primary care medical home and schedule patients into 
22.23 	available community-based appointments as an alternative to nonemergency use of the 
22.24 	hospital emergency room. The grantee must establish a program that diverts patients 
22.25 	presenting at an emergency room for nonemergency care to more appropriate outpatient 
22.26 	settings. The program must refer the patient to an appropriate health care professional 
22.27 	based on the patient's health care needs and situation. The program must provide the 
22.28 	patient with a scheduled appointment that is timely, with an appropriate provider who is 
22.29 	conveniently located. If the patient is uninsured and potentially eligible for a Minnesota 
22.30 	health care program, the program must connect the patient to a primary care provider, 
22.31 	community clinic, or agency that can assist the patient with the application process. The 
22.32 	program must also ensure that discharged patients are connected with a community-based 
22.33 	primary care provider and assist in scheduling any necessary follow-up visits before 
22.34 	the patient is discharged.
23.1 	(b) The program must not require a provider to pay a fee for accepting charity care 
23.2 	patients or patients enrolled in a Minnesota public health care program.
23.3 		Subd. 2.Evaluation. (a) The grantee must report to the commissioner on a quarterly 
23.4 	basis the following information:
23.5 	(1) total number of appointments available for scheduling by specialty;
23.6 	(2) average length of time between scheduling and actual appointment; and 
23.7 	(3) total number of patients referred and whether the patient was insured or 
23.8 	uninsured.
23.9 	(b) The commissioner, in consultation with the Minnesota Hospital Association, 
23.10 	shall conduct an evaluation of the emergency room diversion pilot project and submit the 
23.11 	results to the legislature by January 15, 2009. The evaluation shall compare the number of 
23.12 	nonemergency visits and repeat visits to hospital emergency rooms for the period before 
23.13 	the commencement of the project and one year after the commencement, and an estimate 
23.14 	of the costs saved from any documented reductions.

23.15 	Sec. 22. Minnesota Statutes 2006, section 256B.056, subdivision 10, is amended to 
23.16 	read:
23.17 		Subd. 10.Eligibility verification. (a) The commissioner shall require women who 
23.18 	are applying for the continuation of medical assistance coverage following the end of the 
23.19 	60-day postpartum period to update their income and asset information and to submit 
23.20 	any required income or asset verification.
23.21 	(b) The commissioner shall determine the eligibility of private-sector health care 
23.22 	coverage for infants less than one year of age eligible under section 256B.055, subdivision 
23.23 	10, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage 
23.24 	if this is determined to be cost-effective.
23.25 	(c) The commissioner shall modify the application for Minnesota health care 
23.26 	programs to require more detailed information related to verification of assets and income, 
23.27 	and shall verify assets and income for all applicants, and for all recipients upon renewal.
23.28 	(d) The commissioner shall require Minnesota health care program recipients to 
23.29 	report new or an increase in earned income within ten days of the change, and to verify new 
23.30 	or an increase in earned income that affects eligibility within ten days of notification by 
23.31 	the agency that the new or increased earned income affects eligibility. Recipients who fail 
23.32 	to verify new or an increase in earned income that affects eligibility shall be disenrolled.

23.33 	Sec. 23. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 
23.34 	subdivision to read:
24.1 		Subd. 13i.Medicare Part D co-payments. For recipients who are enrolled in a 
24.2 	Medicare Part D prescription drug plan or Medicare Advantage plan, medical assistance 
24.3 	covers the co-payments which the recipient is responsible for under the Medicare Part D 
24.4 	prescription drug plan or Medicare Advantage plan. 

24.5 	EFFECTIVE DATE. This section is effective July 1, 2007.

24.6 	Sec. 24. Minnesota Statutes 2006, section 256B.0625, subdivision 30, is amended to 
24.7 	read:
24.8 		Subd. 30.Other clinic services. (a) Medical assistance covers rural health clinic 
24.9 	services, federally qualified health center services, nonprofit community health clinic 
24.10 	services, public health clinic services, and the services of a clinic meeting the criteria 
24.11 	established in rule by the commissioner. Rural health clinic services and federally 
24.12 	qualified health center services mean services defined in United States Code, title 42, 
24.13 	section 1396d(a)(2)(B) and (C). Payment for rural health clinic and federally qualified 
24.14 	health center services shall be made according to applicable federal law and regulation.
24.15 	(b) A federally qualified health center that is beginning initial operation shall submit 
24.16 	an estimate of budgeted costs and visits for the initial reporting period in the form and 
24.17 	detail required by the commissioner. A federally qualified health center that is already in 
24.18 	operation shall submit an initial report using actual costs and visits for the initial reporting 
24.19 	period. Within 90 days of the end of its reporting period, a federally qualified health 
24.20 	center shall submit, in the form and detail required by the commissioner, a report of 
24.21 	its operations, including allowable costs actually incurred for the period and the actual 
24.22 	number of visits for services furnished during the period, and other information required 
24.23 	by the commissioner. Federally qualified health centers that file Medicare cost reports 
24.24 	shall provide the commissioner with a copy of the most recent Medicare cost report filed 
24.25 	with the Medicare program intermediary for the reporting year which support the costs 
24.26 	claimed on their cost report to the state.
24.27 	(c) In order to continue cost-based payment under the medical assistance program 
24.28 	according to paragraphs (a) and (b), a federally qualified health center or rural health clinic 
24.29 	must apply for designation as an essential community provider within six months of final 
24.30 	adoption of rules by the Department of Health according to section 62Q.19, subdivision 
24.31 	7. For those federally qualified health centers and rural health clinics that have applied 
24.32 	for essential community provider status within the six-month time prescribed, medical 
24.33 	assistance payments will continue to be made according to paragraphs (a) and (b) for the 
24.34 	first three years after application. For federally qualified health centers and rural health 
24.35 	clinics that either do not apply within the time specified above or who have had essential 
25.1 	community provider status for three years, medical assistance payments for health services 
25.2 	provided by these entities shall be according to the same rates and conditions applicable 
25.3 	to the same service provided by health care providers that are not federally qualified 
25.4 	health centers or rural health clinics.
25.5 	(d)Effective July 1, 1999, the provisions of paragraph (c) requiring a federally 
25.6 	qualified health center or a rural health clinic to make application for an essential 
25.7 	community provider designation in order to have cost-based payments made according 
25.8 	to paragraphs (a) and (b) no longer apply.
25.9 	(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) 
25.10 	shall be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
25.11 	(f) (d) Effective January 1, 2001, each federally qualified health center and 
25.12 	rural health clinic may elect to be paid either under the prospective payment system 
25.13 	established in United States Code, title 42, section 1396a(aa), or under an alternative 
25.14 	payment methodology consistent with the requirements of United States Code, title 42, 
25.15 	section 1396a(aa), and approved by the Centers for Medicare and Medicaid Services. 
25.16 	The alternative payment methodology shall be 100 percent of costcosts as determined 
25.17 	according to by generally accepted accounting principles and annual Medicare cost 
25.18 	principles reports, including Medicaid-eligible cost add-ons.

25.19 	Sec. 25. [256B.0632] MEDICAL ASSISTANCE CO-PAYMENTS.
25.20 		Subdivision 1.Co-payment. The medical assistance benefit plan shall include a 
25.21 	$6 co-payment for nonemergency visits to a hospital-based emergency room, except as 
25.22 	provided in subdivision 2.
25.23 		Subd. 2.Exceptions. A co-payment shall not be charged to:
25.24 	(1) children under the age of 21;
25.25 	(2) pregnant women for services that relate to the pregnancy or any other medical 
25.26 	condition that may complicate the pregnancy;
25.27 	(3) recipients expected to reside for at least 30 days in a hospital, nursing facility, or 
25.28 	intermediate care facility for the developmentally disabled; and
25.29 	(4) recipients receiving hospice care.

25.30 	Sec. 26. Minnesota Statutes 2006, section 256B.69, subdivision 2, is amended to read:
25.31 		Subd. 2.Definitions. For the purposes of this section, the following terms have 
25.32 	the meanings given.
25.33 	(a) "Commissioner" means the commissioner of human services. For the 
25.34 	remainder of this section, the commissioner's responsibilities for methods and policies 
26.1 	for implementing the project will be proposed by the project advisory committees and 
26.2 	approved by the commissioner.
26.3 	(b) "Demonstration provider" means a health maintenance organization, community 
26.4 	integrated service network, or accountable provider network authorized and operating 
26.5 	under chapter 62D, 62N, or 62T that participates in the demonstration project according 
26.6 	to criteria, standards, methods, and other requirements established for the project and 
26.7 	approved by the commissioner. For purposes of this section, a county board, or group of 
26.8 	county boards operating under a joint powers agreement, is considered a demonstration 
26.9 	provider if the county or group of county boards meets the requirements of section 
26.10 	256B.692. Notwithstanding the above, Itasca County may continue to participate as a 
26.11 	demonstration provider until July 1, 2004. 
26.12 	(c) "Eligible individuals" means those persons eligible for medical assistance 
26.13 	benefits as defined in sections 256B.055, 256B.056, and 256B.06. Notwithstanding 
26.14 	sections 256B.055, 256B.056, and 256B.06, an individual who becomes ineligible for 
26.15 	the program because of failure to submit income reports or recertification forms in a 
26.16 	timely manner, shall remain enrolled in the prepaid health plan and shall remain eligible 
26.17 	to receive medical assistance coverage through the last day of the month following the 
26.18 	month in which the enrollee became ineligible for the medical assistance program.
26.19 	(d) "Limitation of choice" means suspending freedom of choice while allowing 
26.20 	eligible individuals to choose among the demonstration providers.

26.21 	Sec. 27. Minnesota Statutes 2006, section 256B.76, is amended to read:
26.22 	256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.
26.23 	(a) Effective for services rendered on or after October 1, 1992, the commissioner 
26.24 	shall make payments for physician services as follows:
26.25 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
26.26 	procedural coding system codes titled "office and other outpatient services," "preventive 
26.27 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
26.28 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
26.29 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
26.30 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
26.31 	30, 1992. If the rate on any procedure code within these categories is different than the 
26.32 	rate that would have been paid under the methodology in section 256B.74, subdivision 2, 
26.33 	then the larger rate shall be paid; 
26.34 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
26.35 	or (ii) 15.4 percent above the rate in effect on June 30, 1992;
27.1 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
27.2 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
27.3 	except that payment rates for home health agency services shall be the rates in effect 
27.4 	on September 30, 1992;
27.5 	(4) effective for services rendered on or after January 1, 2000, payment rates for 
27.6 	physician and professional services shall be increased by three percent over the rates in 
27.7 	effect on December 31, 1999, except for home health agency and family planning agency 
27.8 	services; and
27.9 	(5) the increases in clause (4) shall be implemented January 1, 2000, for managed 
27.10 	care.
27.11 	(b) Effective for services rendered on or after October 1, 1992, the commissioner 
27.12 	shall make payments for dental services as follows:
27.13 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 
27.14 	percent above the rate in effect on June 30, 1992;
27.15 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 
27.16 	percentile of 1989, less the percent in aggregate necessary to equal the above increases;
27.17 	(3) effective for services rendered on or after January 1, 2000, payment rates for 
27.18 	dental services shall be increased by three percent over the rates in effect on December 
27.19 	31, 1999;
27.20 	(4) the commissioner shall award grants to community clinics or other nonprofit 
27.21 	community organizations, political subdivisions, professional associations, or other 
27.22 	organizations that demonstrate the ability to provide dental services effectively to public 
27.23 	program recipients. Grants may be used to fund the costs related to coordinating access for 
27.24 	recipients, developing and implementing patient care criteria, upgrading or establishing 
27.25 	new facilities, acquiring furnishings or equipment, recruiting new providers, or other 
27.26 	development costs that will improve access to dental care in a region. In awarding grants, 
27.27 	the commissioner shall give priority to applicants that plan to serve areas of the state in 
27.28 	which the number of dental providers is not currently sufficient to meet the needs of 
27.29 	recipients of public programs or uninsured individuals. The commissioner shall consider 
27.30 	the following in awarding the grants:
27.31 	(i) potential to successfully increase access to an underserved population;
27.32 	(ii) the ability to raise matching funds;
27.33 	(iii) the long-term viability of the project to improve access beyond the period 
27.34 	of initial funding;
27.35 	(iv) the efficiency in the use of the funding; and
27.36 	(v) the experience of the proposers in providing services to the target population.
28.1 	The commissioner shall monitor the grants and may terminate a grant if the grantee 
28.2 	does not increase dental access for public program recipients. The commissioner shall 
28.3 	consider grants for the following:
28.4 	(i) implementation of new programs or continued expansion of current access 
28.5 	programs that have demonstrated success in providing dental services in underserved 
28.6 	areas;
28.7 	(ii) a pilot program for utilizing hygienists outside of a traditional dental office to 
28.8 	provide dental hygiene services; and
28.9 	(iii) a program that organizes a network of volunteer dentists, establishes a system to 
28.10 	refer eligible individuals to volunteer dentists, and through that network provides donated 
28.11 	dental care services to public program recipients or uninsured individuals;
28.12 	(5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
28.13 	shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;
28.14 	(6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000, 
28.15 	for managed care; and
28.16 	(7) effective for services provided on or after January 1, 2002, payment for 
28.17 	diagnostic examinations and dental x-rays provided to children under age 21 shall be the 
28.18 	lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.
28.19 	(c) Effective for dental services rendered on or after January 1, 2002, the 
28.20 	commissioner may, within the limits of available appropriation,shall increase 
28.21 	reimbursements to dentists and dental clinics deemed by the commissioner to be critical 
28.22 	access dental providers. Reimbursement to a critical access dental provider may be 
28.23 	increased by not more than 50 percent above the reimbursement rate that would 
28.24 	otherwise be paid to the provider. Payments to health plan companies shall be adjusted to 
28.25 	reflect increased reimbursements to critical access dental providers as approved by the 
28.26 	commissioner. In determining which dentists and dental clinics shall be deemed critical 
28.27 	access dental providers, the commissioner shall review:
28.28 	(1) the utilization rate in the service area in which the dentist or dental clinic operates 
28.29 	for dental services to patients covered by medical assistance, general assistance medical 
28.30 	care, or MinnesotaCare as their primary source of coverage;
28.31 	(2) the level of services provided by the dentist or dental clinic to patients covered 
28.32 	by medical assistance, general assistance medical care, or MinnesotaCare as their primary 
28.33 	source of coverage; and
28.34 	(3) whether the level of services provided by the dentist or dental clinic is critical to 
28.35 	maintaining adequate levels of patient access within the service area.
29.1 	In the absence of a critical access dental provider in a service area, the commissioner may 
29.2 	designate a dentist or dental clinic as a critical access dental provider if the dentist or 
29.3 	dental clinic is willing to provide care to patients covered by medical assistance, general 
29.4 	assistance medical care, or MinnesotaCare at a level which significantly increases access 
29.5 	to dental care in the service area.
29.6 	The commissioner shall annually establish a reimbursement schedule for critical 
29.7 	access dental providers and provider-specific limits on total reimbursement received 
29.8 	under the reimbursement schedule, and shall notify each critical access dental provider 
29.9 	of the schedule and limit.
29.10 	(d) The commissioner shall award special hardship grants to nonprofit dental 
29.11 	providers with a high proportion of uninsured patients that equals or exceeds 15 percent 
29.12 	of the total number of patients served by that provider and the provider does not receive 
29.13 	a financial benefit comparable to other critical access dental providers under the critical 
29.14 	access dental provider formula described in paragraph (c). The commissioner shall award 
29.15 	a grant to these providers allocated in proportion to each critical access dental provider's 
29.16 	ratio of uninsured patients to the total number of patients served by all providers who 
29.17 	qualify for a grant under this paragraph.
29.18 	(e) An entity that operates both a Medicare certified comprehensive outpatient 
29.19 	rehabilitation facility and a facility which was certified prior to January 1, 1993, that is 
29.20 	licensed under Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33 
29.21 	percent of the clients receiving rehabilitation services in the most recent calendar year are 
29.22 	medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation 
29.23 	services at rates that are 38 percent greater than the maximum reimbursement rate 
29.24 	allowed under paragraph (a), clause (2), when those services are (1) provided within the 
29.25 	comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing 
29.26 	facilities owned by the entity.
29.27 	(e)(f) Effective for services rendered on or after January 1, 2007, the commissioner 
29.28 	shall make payments for physician and professional services based on the Medicare 
29.29 	relative value units (RVU's). This change shall be budget neutral and the cost of 
29.30 	implementing RVU's will be incorporated in the established conversion factor.

29.31 	Sec. 28. Minnesota Statutes 2006, section 256D.03, subdivision 3, is amended to read:
29.32 		Subd. 3.General assistance medical care; eligibility. (a) General assistance 
29.33 	medical care may be paid for any person who is not eligible for medical assistance under 
29.34 	chapter 256B, including eligibility for medical assistance based on a spenddown of excess 
30.1 	income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in 
30.2 	paragraph (b), except as provided in paragraph (c), and:
30.3 	(1) who is receiving assistance under section 256D.05, except for families with 
30.4 	children who are eligible under Minnesota family investment program (MFIP), or who is 
30.5 	having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
30.6 	(2) who is a resident of Minnesota; and
30.7 	(i) who has gross countable income not in excess of 75 percent of the federal poverty 
30.8 	guidelines for the family size, using a six-month budget period and whose equity in assets 
30.9 	is not in excess of $1,000 per assistance unit. General assistance medical care is not 
30.10 	available for applicants or enrollees who are otherwise eligible for medical assistance but 
30.11 	fail to verify their assets. Enrollees who become eligible for medical assistance shall be 
30.12 	terminated and transferred to medical assistance. Exempt assets, the reduction of excess 
30.13 	assets, and the waiver of excess assets must conform to the medical assistance program in 
30.14 	section 256B.056, subdivision 3, with the following exception: the maximum amount of 
30.15 	undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by 
30.16 	the trustee, assuming the full exercise of the trustee's discretion under the terms of the 
30.17 	trust, must be applied toward the asset maximum;
30.18 	(ii) who has gross countable income above 75 percent of the federal poverty 
30.19 	guidelines but not in excess of 175 percent of the federal poverty guidelines for the 
30.20 	family size, using a six-month budget period, whose equity in assets is not in excess 
30.21 	of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient 
30.22 	hospitalization; or
30.23 	(iii) the commissioner shall adjust the income standards under this section each July 
30.24 	1 by the annual update of the federal poverty guidelines following publication by the 
30.25 	United States Department of Health and Human Services.
30.26 	(b) Effective for applications and renewals processed on or after September 1, 2006, 
30.27 	general assistance medical care may not be paid for applicants or recipients who are adults 
30.28 	with dependent children under 21 whose gross family income is equal to or less than 275 
30.29 	percent of the federal poverty guidelines who are not described in paragraph (e).
30.30 	(c) Effective for applications and renewals processed on or after September 1, 2006, 
30.31 	general assistance medical care may be paid for applicants and recipients who meet all 
30.32 	eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period 
30.33 	beginning the date of application. Immediately following approval of general assistance 
30.34 	medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04, 
30.35 	subdivision 7, with covered services as provided in section 256L.03 for the rest of the 
30.36 	six-monthinitial eligibility period, until their six-monthannual renewal.
31.1 	(d) To be eligible for general assistance medical care following enrollment in 
31.2 	MinnesotaCare as required by paragraph (c), an individual must complete a new 
31.3 	application.
31.4 	(e) Applicants and recipients eligible under paragraph (a), clause (1); who have 
31.5 	applied for and are awaiting a determination of blindness or disability by the state medical 
31.6 	review team or a determination of eligibility for Supplemental Security Income or Social 
31.7 	Security Disability Insurance by the Social Security Administration; who fail to meet the 
31.8 	requirements of section 256L.09, subdivision 2; who are homeless as defined by United 
31.9 	States Code, title 42, section 11301, et seq.;  who are classified as end-stage renal disease 
31.10 	beneficiaries in the Medicare program; who are enrolled in private health care coverage as 
31.11 	defined in section 256B.02, subdivision 9; who are eligible under paragraph (j); or who 
31.12 	receive treatment funded pursuant to section 254B.02 are exempt from the MinnesotaCare 
31.13 	enrollment requirements of this subdivision.
31.14 	(f) For applications received on or after October 1, 2003, eligibility may begin no 
31.15 	earlier than the date of application. For individuals eligible under paragraph (a), clause 
31.16 	(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 
31.17 	eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 
31.18 	may reapply if there is a subsequent period of inpatient hospitalization.
31.19 	(g) Beginning September 1, 2006, Minnesota health care program applications and 
31.20 	renewals completed by recipients and applicants who are persons described in paragraph 
31.21 	(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility 
31.22 	by the county agency. If all other eligibility requirements of this subdivision are met, 
31.23 	eligibility for general assistance medical care shall be available in any month during which 
31.24 	MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, 
31.25 	notice of termination for eligibility for general assistance medical care shall be sent to 
31.26 	an applicant or recipient. If all other eligibility requirements of this subdivision are 
31.27 	met, eligibility for general assistance medical care shall be available until enrollment in 
31.28 	MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
31.29 	(h) The date of an initial Minnesota health care program application necessary to 
31.30 	begin a determination of eligibility shall be the date the applicant has provided a name, 
31.31 	address, and Social Security number, signed and dated, to the county agency or the 
31.32 	Department of Human Services. If the applicant is unable to provide a name, address, 
31.33 	Social Security number, and signature when health care is delivered due to a medical 
31.34 	condition or disability, a health care provider may act on an applicant's behalf to establish 
31.35 	the date of an initial Minnesota health care program application by providing the county 
31.36 	agency or Department of Human Services with provider identification and a temporary 
32.1 	unique identifier for the applicant. The applicant must complete the remainder of the 
32.2 	application and provide necessary verification before eligibility can be determined. The 
32.3 	county agency must assist the applicant in obtaining verification if necessary.
32.4 	(i) County agencies are authorized to use all automated databases containing 
32.5 	information regarding recipients' or applicants' income in order to determine eligibility for 
32.6 	general assistance medical care or MinnesotaCare. Such use shall be considered sufficient 
32.7 	in order to determine eligibility and premium payments by the county agency.
32.8 	(j) General assistance medical care is not available for a person in a correctional 
32.9 	facility unless the person is detained by law for less than one year in a county correctional 
32.10 	or detention facility as a person accused or convicted of a crime, or admitted as an 
32.11 	inpatient to a hospital on a criminal hold order, and the person is a recipient of general 
32.12 	assistance medical care at the time the person is detained by law or admitted on a criminal 
32.13 	hold order and as long as the person continues to meet other eligibility requirements 
32.14 	of this subdivision.
32.15 	(k) General assistance medical care is not available for applicants or recipients who 
32.16 	do not cooperate with the county agency to meet the requirements of medical assistance.
32.17 	(l) In determining the amount of assets of an individual eligible under paragraph 
32.18 	(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 
32.19 	an asset excluded under paragraph (a), that was given away, sold, or disposed of for 
32.20 	less than fair market value within the 60 months preceding application for general 
32.21 	assistance medical care or during the period of eligibility. Any transfer described in this 
32.22 	paragraph shall be presumed to have been for the purpose of establishing eligibility for 
32.23 	general assistance medical care, unless the individual furnishes convincing evidence to 
32.24 	establish that the transaction was exclusively for another purpose. For purposes of this 
32.25 	paragraph, the value of the asset or interest shall be the fair market value at the time it 
32.26 	was given away, sold, or disposed of, less the amount of compensation received. For any 
32.27 	uncompensated transfer, the number of months of ineligibility, including partial months, 
32.28 	shall be calculated by dividing the uncompensated transfer amount by the average monthly 
32.29 	per person payment made by the medical assistance program to skilled nursing facilities 
32.30 	for the previous calendar year. The individual shall remain ineligible until this fixed period 
32.31 	has expired. The period of ineligibility may exceed 30 months, and a reapplication for 
32.32 	benefits after 30 months from the date of the transfer shall not result in eligibility unless 
32.33 	and until the period of ineligibility has expired. The period of ineligibility begins in the 
32.34 	month the transfer was reported to the county agency, or if the transfer was not reported, 
32.35 	the month in which the county agency discovered the transfer, whichever comes first. For 
32.36 	applicants, the period of ineligibility begins on the date of the first approved application.
33.1 	(m) When determining eligibility for any state benefits under this subdivision, 
33.2 	the income and resources of all noncitizens shall be deemed to include their sponsor's 
33.3 	income and resources as defined in the Personal Responsibility and Work Opportunity 
33.4 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
33.5 	subsequently set out in federal rules.
33.6 	(n) Undocumented noncitizens and nonimmigrants are ineligible for general 
33.7 	assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual 
33.8 	in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
33.9 	an undocumented noncitizen is an individual who resides in the United States without the 
33.10 	approval or acquiescence of the Immigration and Naturalization Service.
33.11 	(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for 
33.12 	medical assistance due to the deeming of a sponsor's income and resources, is ineligible 
33.13 	for general assistance medical care.
33.14 	(p) Effective July 1, 2003, general assistance medical care emergency services end.

33.15 	Sec. 29. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:
33.16 		Subd. 4.General assistance medical care; services. (a)(i) For a person who is 
33.17 	eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 
33.18 	care covers, except as provided in paragraph (c):
33.19 	(1) inpatient hospital services;
33.20 	(2) outpatient hospital services;
33.21 	(3) services provided by Medicare certified rehabilitation agencies;
33.22 	(4) prescription drugs and other products recommended through the process 
33.23 	established in section 256B.0625, subdivision 13;
33.24 	(5) equipment necessary to administer insulin and diagnostic supplies and equipment 
33.25 	for diabetics to monitor blood sugar level;
33.26 	(6) eyeglasses and eye examinations provided by a physician or optometrist;
33.27 	(7) hearing aids;
33.28 	(8) prosthetic devices;
33.29 	(9) laboratory and X-ray services;
33.30 	(10) physician's services;
33.31 	(11) medical transportation except special transportation;
33.32 	(12) chiropractic services as covered under the medical assistance program;
33.33 	(13) podiatric services;
33.34 	(14) dental services as covered under the medical assistance program;
34.1 	(15) outpatient services provided by a mental health center or clinic that is under 
34.2 	contract with the county board and is established under section 245.62;
34.3 	(16) day treatment services for mental illness provided under contract with the 
34.4 	county board;
34.5 	(17) prescribed medications for persons who have been diagnosed as mentally ill as 
34.6 	necessary to prevent more restrictive institutionalization;
34.7 	(18) psychological services, medical supplies and equipment, and Medicare 
34.8 	premiums, coinsurance and deductible payments;
34.9 	(19) medical equipment not specifically listed in this paragraph when the use of 
34.10 	the equipment will prevent the need for costlier services that are reimbursable under 
34.11 	this subdivision;
34.12 	(20) services performed by a certified pediatric nurse practitioner, a certified family 
34.13 	nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 
34.14 	nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 
34.15 	practitioner in independent practice, if (1) the service is otherwise covered under this 
34.16 	chapter as a physician service, (2) the service provided on an inpatient basis is not included 
34.17 	as part of the cost for inpatient services included in the operating payment rate, and (3) the 
34.18 	service is within the scope of practice of the nurse practitioner's license as a registered 
34.19 	nurse, as defined in section 148.171;
34.20 	(21) services of a certified public health nurse or a registered nurse practicing in 
34.21 	a public health nursing clinic that is a department of, or that operates under the direct 
34.22 	authority of, a unit of government, if the service is within the scope of practice of the 
34.23 	public health nurse's license as a registered nurse, as defined in section 148.171;
34.24 	(22) telemedicine consultations, to the extent they are covered under section 
34.25 	256B.0625, subdivision 3b; and
34.26 	(23) mental health telemedicine and psychiatric consultation as covered under 
34.27 	section 256B.0625, subdivisions 46 and 48.
34.28 	(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 
34.29 	paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 
34.30 	to inpatient hospital services, including physician services provided during the inpatient 
34.31 	hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
34.32 	(b) Effective August 1, 2005, sex reassignment surgery is not covered under this 
34.33 	subdivision.
34.34 	(c) In order to contain costs, the commissioner of human services shall select 
34.35 	vendors of medical care who can provide the most economical care consistent with high 
34.36 	medical standards and shall where possible contract with organizations on a prepaid 
35.1 	capitation basis to provide these services. The commissioner shall consider proposals by 
35.2 	counties and vendors for prepaid health plans, competitive bidding programs, block grants, 
35.3 	or other vendor payment mechanisms designed to provide services in an economical 
35.4 	manner or to control utilization, with safeguards to ensure that necessary services are 
35.5 	provided. Before implementing prepaid programs in counties with a county operated or 
35.6 	affiliated public teaching hospital or a hospital or clinic operated by the University of 
35.7 	Minnesota, the commissioner shall consider the risks the prepaid program creates for the 
35.8 	hospital and allow the county or hospital the opportunity to participate in the program in a 
35.9 	manner that reflects the risk of adverse selection and the nature of the patients served by 
35.10 	the hospital, provided the terms of participation in the program are competitive with the 
35.11 	terms of other participants considering the nature of the population served. Payment for 
35.12 	services provided pursuant to this subdivision shall be as provided to medical assistance 
35.13 	vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For 
35.14 	payments made during fiscal year 1990 and later years, the commissioner shall consult 
35.15 	with an independent actuary in establishing prepayment rates, but shall retain final control 
35.16 	over the rate methodology.
35.17 	(d) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 
35.18 	co-payments for services provided on or after October 1, 2003:
35.19 	(1) $25 for eyeglasses;
35.20 	(2) $25 for nonemergency visits to a hospital-based emergency room;
35.21 	(3) $3 per brand-name drug prescription and $1 per generic drug prescription, 
35.22 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
35.23 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
35.24 	(4) 50 percent coinsurance on restorative dental services.
35.25 	(e) Co-payments shall be limited to one per day per provider for nonpreventive visits, 
35.26 	eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of 
35.27 	general assistance medical care are responsible for all co-payments in this subdivision. 
35.28 	The general assistance medical care reimbursement to the provider shall be reduced by 
35.29 	the amount of the co-payment, except that reimbursement for prescription drugs shall not 
35.30 	be reduced once a recipient has reached the $12 per month maximum for prescription 
35.31 	drug co-payments. The provider collects the co-payment from the recipient. Providers 
35.32 	may not deny services to recipients who are unable to pay the co-payment, except as 
35.33 	provided in paragraph (f).
35.34 	(f) If it is the routine business practice of a provider to refuse service to an individual 
35.35 	with uncollected debt, the provider may include uncollected co-payments under this 
36.1 	section. A provider must give advance notice to a recipient with uncollected debt before 
36.2 	services can be denied.
36.3 	(g)(d) Any county may, from its own resources, provide medical payments for 
36.4 	which state payments are not made.
36.5 	(h)(e) Chemical dependency services that are reimbursed under chapter 254B must 
36.6 	not be reimbursed under general assistance medical care.
36.7 	(i)(f) The maximum payment for new vendors enrolled in the general assistance 
36.8 	medical care program after the base year shall be determined from the average usual and 
36.9 	customary charge of the same vendor type enrolled in the base year.
36.10 	(j)(g) The conditions of payment for services under this subdivision are the same 
36.11 	as the conditions specified in rules adopted under chapter 256B governing the medical 
36.12 	assistance program, unless otherwise provided by statute or rule.
36.13 	(k) (h) Inpatient and outpatient payments shall be reduced by five percent, effective 
36.14 	July 1, 2003. This reduction is in addition to the five percent reduction effective July 1, 
36.15 	2003, and incorporated by reference in paragraph (i) (f).
36.16 	(l)(i) Payments for all other health services except inpatient, outpatient, and 
36.17 	pharmacy services shall be reduced by five percent, effective July 1, 2003.
36.18 	(m)(j) Payments to managed care plans shall be reduced by five percent for services 
36.19 	provided on or after October 1, 2003.
36.20 	(n)(k) A hospital receiving a reduced payment as a result of this section may apply 
36.21 	the unpaid balance toward satisfaction of the hospital's bad debts.
36.22 	(o) Fee-for-service payments for nonpreventive visits shall be reduced by $3 
36.23 	for services provided on or after January 1, 2006. For purposes of this subdivision, a 
36.24 	visit means an episode of service which is required because of a recipient's symptoms, 
36.25 	diagnosis, or established illness, and which is delivered in an ambulatory setting by 
36.26 	a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 
36.27 	audiologist, optician, or optometrist.
36.28 	(p) Payments to managed care plans shall not be increased as a result of the removal 
36.29 	of the $3 nonpreventive visit co-payment effective January 1, 2006.
36.30 	(l) Recipients eligible under subdivision 3, paragraph (a), shall pay a $25 co-payment 
36.31 	for nonemergency visits to a hospital-based emergency room.

36.32 	EFFECTIVE DATE. This section is effective July 1, 2007.

36.33 	Sec. 30. Minnesota Statutes 2006, section 256L.01, subdivision 1, is amended to read:
36.34 		Subdivision 1.Scope. For purposes of sections 256L.01 to 256L.18 this chapter, 
36.35 	the following terms shall have the meanings given them. 

37.1 	Sec. 31. Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:
37.2 		Subd. 4.Gross individual or gross family income. (a) "Gross individual or gross 
37.3 	family income" for nonfarm self-employed means income calculated for the six-month
37.4 	12-month period of eligibility using the net profit or loss reported on the applicant's 
37.5 	federal income tax form for the previous year and using the medical assistance families 
37.6 	with children methodology for determining allowable and nonallowable self-employment 
37.7 	expenses and countable income.
37.8 	(b) "Gross individual or gross family income" for farm self-employed means income 
37.9 	calculated for the six-month12-month period of eligibility using as the baseline the 
37.10 	adjusted gross income reported on the applicant's federal income tax form for the previous 
37.11 	year and adding back in reported depreciation amounts that apply to the business in which 
37.12 	the family is currently engaged.
37.13 	(c) "Gross individual or gross family income" means the total income for all family 
37.14 	members, calculated for the six-month12-month period of eligibility.

37.15 	EFFECTIVE DATE. This section is effective July 1, 2007.

37.16 	Sec. 32. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:
37.17 		Subdivision 1.Covered health services. For individuals under section 256L.04, 
37.18 	subdivision 7, with income no greater than 75 percent of the federal poverty guidelines 
37.19 	or for families with children under section 256L.04, subdivision 1, all subdivisions of 
37.20 	this section apply. "Covered health services" means the health services reimbursed 
37.21 	under chapter 256B, with the exception of inpatient hospital services, special education 
37.22 	services, private duty nursing services, adult dental care services other than services 
37.23 	covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency 
37.24 	medical transportation services, personal care assistant and case management services, 
37.25 	nursing home or intermediate care facilities services, inpatient mental health services, 
37.26 	and chemical dependency services. Outpatient mental health services covered under the 
37.27 	MinnesotaCare program are limited to diagnostic assessments, psychological testing, 
37.28 	explanation of findings, mental health telemedicine, psychiatric consultation, medication 
37.29 	management by a physician, day treatment, partial hospitalization, and individual, family, 
37.30 	and group psychotherapy.
37.31 	No public funds shall be used for coverage of abortion under MinnesotaCare 
37.32 	except where the life of the female would be endangered or substantial and irreversible 
37.33 	impairment of a major bodily function would result if the fetus were carried to term; or 
37.34 	where the pregnancy is the result of rape or incest.
37.35 	Covered health services shall be expanded as provided in this section.

38.1 	Sec. 33. Minnesota Statutes 2006, section 256L.03, subdivision 3, is amended to read:
38.2 		Subd. 3.Inpatient hospital services. (a) Covered health services shall include 
38.3 	inpatient hospital services, including inpatient hospital mental health services and inpatient 
38.4 	hospital and residential chemical dependency treatment, subject to those limitations 
38.5 	necessary to coordinate the provision of these services with eligibility under the medical 
38.6 	assistance spenddown. Prior to July 1, 1997, the inpatient hospital benefit for adult 
38.7 	enrollees is subject to an annual benefit limit of $10,000. The inpatient hospital benefit 
38.8 	for adult enrollees who qualify under section 256L.04, subdivision 7, or who qualify 
38.9 	under section 256L.04, subdivisions 1 and 2, with family gross income that exceeds 
38.10 	175 200 percent of the federal poverty guidelines or 215 percent of the federal poverty 
38.11 	guidelines on or after July 1, 2009, and who are not pregnant, is subject to an annual 
38.12 	limit of $10,000 $20,000. 
38.13 	(b) Admissions for inpatient hospital services paid for under section 256L.11, 
38.14 	subdivision 3, must be certified as medically necessary in accordance with Minnesota 
38.15 	Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2): 
38.16 	(1) all admissions must be certified, except those authorized under rules established 
38.17 	under section 254A.03, subdivision 3, or approved under Medicare; and 
38.18 	(2) payment under section 256L.11, subdivision 3, shall be reduced by five percent 
38.19 	for admissions for which certification is requested more than 30 days after the day of 
38.20 	admission. The hospital may not seek payment from the enrollee for the amount of the 
38.21 	payment reduction under this clause. 

38.22 	Sec. 34. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
38.23 		Subd. 5.Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 
38.24 	and (c), the MinnesotaCare benefit plan shall include the following co-payments and 
38.25 	coinsurance requirements for all enrollees:
38.26 	(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 
38.27 	subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 
38.28 	$3,000 per family;
38.29 	(2) $3 per prescription for adult enrollees;
38.30 	(3) $25 for eyeglasses for adult enrollees;
38.31 	(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
38.32 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
38.33 	established illness, and which is delivered in an ambulatory setting by a physician or 
38.34 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
38.35 	audiologist, optician, or optometrist; and
39.1 	(5) $6 for nonemergency visits to a hospital-based emergency room.
39.2 	(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 
39.3 	children under the age of 21 in households with family income equal to or less than 175 
39.4 	percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to 
39.5 	parents and relative caretakers of children under the age of 21 in households with family 
39.6 	income greater than 175 percent of the federal poverty guidelines for inpatient hospital 
39.7 	admissions occurring on or after January 1, 2001.
39.8 	(c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children 
39.9 	under the age of 21.
39.10 	(d) Adult enrollees with family gross income that exceeds 175 200 percent of the 
39.11 	federal poverty guidelines or 215 percent of the federal poverty guidelines on or after July 
39.12 	1, 2009, and who are not pregnant shall be financially responsible for the coinsurance 
39.13 	amount, if applicable, and amounts which exceed the $10,000 $20,000 inpatient hospital 
39.14 	benefit limit.
39.15 	(e) When a MinnesotaCare enrollee becomes a member of a prepaid health 
39.16 	plan, or changes from one prepaid health plan to another during a calendar year, any 
39.17 	charges submitted towards the $10,000 $20,000 annual inpatient benefit limit, and any 
39.18 	out-of-pocket expenses incurred by the enrollee for inpatient services, that were submitted 
39.19 	or incurred prior to enrollment, or prior to the change in health plans, shall be disregarded.

39.20 	Sec. 35. Minnesota Statutes 2006, section 256L.04, subdivision 1a, is amended to read:
39.21 		Subd. 1a.Social Security number required. (a) Individuals and families applying 
39.22 	for MinnesotaCare coverage must provide a Social Security number. This requirement 
39.23 	does not apply to an undocumented noncitizen or nonimmigrant who is eligible for 
39.24 	MinnesotaCare.
39.25 	(b) The commissioner shall not deny eligibility to an otherwise eligible applicant 
39.26 	who has applied for a Social Security number and is awaiting issuance of that Social 
39.27 	Security number.
39.28 	(c) Newborns enrolled under section 256L.05, subdivision 3, are exempt from the 
39.29 	requirements of this subdivision.
39.30 	(d) Individuals who refuse to provide a Social Security number because of 
39.31 	well-established religious objections are exempt from the requirements of this subdivision. 
39.32 	The term "well-established religious objections" has the meaning given in Code of Federal 
39.33 	Regulations, title 42, section 435.910.

39.34 	Sec. 36. Minnesota Statutes 2006, section 256L.04, subdivision 7, is amended to read:
40.1 		Subd. 7.Single adults and households with no children. The definition of eligible 
40.2 	persons includes all individuals and households with no children who have gross family 
40.3 	incomes that are equal to or less than 175 200 percent of the federal poverty guidelines.
40.4 	Effective July 1, 2009, the definition of eligible persons includes all individuals and 
40.5 	households with no children who have gross family incomes that are equal to or less than 
40.6 	215 percent of the federal poverty guidelines.

40.7 	Sec. 37. Minnesota Statutes 2006, section 256L.04, subdivision 10, is amended to read:
40.8 		Subd. 10.Citizenship requirements. (a) Eligibility for MinnesotaCare is limited 
40.9 	to citizens or nationals of the United States, qualified noncitizens, and other persons 
40.10 	residing lawfully in the United States as described in section 256B.06, subdivision 4, 
40.11 	paragraphs (a) to (e) and (j). Undocumented noncitizens and nonimmigrants are ineligible 
40.12 	for MinnesotaCare. This paragraph does not apply to children.
40.13 	(b) For purposes of this subdivision, a nonimmigrant is an individual in one or 
40.14 	more of the classes listed in United States Code, title 8, section 1101(a)(15), and an 
40.15 	undocumented noncitizen is an individual who resides in the United States without the 
40.16 	approval or acquiescence of the Immigration and Naturalization Service. 
40.17 	(c) Families with children who are citizens or nationals of the United States must 
40.18 	cooperate in obtaining satisfactory documentary evidence of citizenship or nationality 
40.19 	according to the requirements of the federal Deficit Reduction Act of 2005, Public Law 
40.20 	109-171. State and county workers must assist applicants in obtaining satisfactory 
40.21 	documentary evidence of citizenship or nationality.

40.22 	Sec. 38. Minnesota Statutes 2006, section 256L.05, subdivision 1, is amended to read:
40.23 		Subdivision 1.Application and information availability. Applications and other 
40.24 	information application assistance must be made available to at provider offices, local 
40.25 	human services agencies, school districts, public and private elementary schools in which 
40.26 	25 percent or more of the students receive free or reduced price lunches, community health 
40.27 	offices, and Women, Infants and Children (WIC) program sites, Head Start program sites, 
40.28 	public housing councils, crisis nurseries, child care centers, early childhood education 
40.29 	and preschool program sites, legal aid offices, and libraries. These sites may accept 
40.30 	applications and forward the forms to the commissioner or local county human services 
40.31 	agencies that choose to participate as an enrollment site. Otherwise, applicants may apply 
40.32 	directly to the commissioner or to participating local county human services agencies. 
40.33 	Beginning January 1, 2000, MinnesotaCare enrollment sites will be expanded to include 
40.34 	local county human services agencies which choose to participate.

41.1 	Sec. 39. Minnesota Statutes 2006, section 256L.05, subdivision 1b, is amended to read:
41.2 		Subd. 1b.MinnesotaCare enrollment by county agencies. Beginning September 
41.3 	1, 2006, county agencies shall enroll single adults and households with no children 
41.4 	formerly enrolled in general assistance medical care in MinnesotaCare according to 
41.5 	section 256D.03, subdivision 3. County agencies shall perform all duties necessary 
41.6 	to administer the MinnesotaCare program ongoing for these enrollees, including the 
41.7 	redetermination of MinnesotaCare eligibility at six-month renewal.

41.8 	Sec. 40. Minnesota Statutes 2006, section 256L.05, subdivision 2, is amended to read:
41.9 		Subd. 2.Commissioner's duties. (a) The commissioner or county agency shall 
41.10 	use electronic verification as the primary method of income verification. If there is a 
41.11 	discrepancy between reported income and electronically verified income, an individual 
41.12 	may be required to submit additional verification. In addition, the commissioner shall 
41.13 	perform random audits to verify reported income and eligibility. The commissioner 
41.14 	may execute data sharing arrangements with the Department of Revenue and any other 
41.15 	governmental agency in order to perform income verification related to eligibility and 
41.16 	premium payment under the MinnesotaCare program.
41.17 	(b) In determining eligibility for MinnesotaCare, the commissioner shall require 
41.18 	applicants and enrollees seeking renewal of eligibility to verify both earned and unearned 
41.19 	income. The commissioner shall also require applicants and enrollees to submit the names 
41.20 	of their employers and a contact name with a telephone number for each employer for 
41.21 	purposes of verifying whether the applicant or enrollee, and any dependents, are eligible 
41.22 	for employer-subsidized coverage. Data collected is nonpublic data as defined in section 
41.23 	13.02, subdivision 9.

41.24 	Sec. 41. Minnesota Statutes 2006, section 256L.05, subdivision 3a, is amended to read:
41.25 		Subd. 3a.Renewal of eligibility. (a) Beginning January 1, 1999 July 1, 2007, an 
41.26 	enrollee's eligibility must be renewed every 12 months. The 12-month period begins in 
41.27 	the month after the month the application is approved.
41.28 	(b) Beginning October 1, 2004, an enrollee's eligibility must be renewed every 
41.29 	six months. The first six-month period of eligibility begins the month the application is 
41.30 	received by the commissioner. The effective date of coverage within the first six-month 
41.31 	period of eligibility is as provided in subdivision 3. Each new period of eligibility must 
41.32 	take into account any changes in circumstances that impact eligibility and premium 
41.33 	amount. An enrollee must provide all the information needed to redetermine eligibility by 
41.34 	the first day of the month that ends the eligibility period. The premium for the new period 
42.1 	of eligibility must be received as provided in section 256L.06 in order for eligibility to 
42.2 	continue.
42.3 	(c) For single adults and households with no children formerly enrolled in general 
42.4 	assistance medical care and enrolled in MinnesotaCare according to section 256D.03, 
42.5 	subdivision 3, the first six-month period of eligibility begins the month the enrollee 
42.6 	submitted the application or renewal for general assistance medical care.

42.7 	Sec. 42. Minnesota Statutes 2006, section 256L.05, subdivision 3c, is amended to read:
42.8 		Subd. 3c.Retroactive coverage. Notwithstanding subdivision 3, the effective 
42.9 	date of coverage shall be the first day of the month following termination from medical 
42.10 	assistance or general assistance medical care for families and individuals who are eligible 
42.11 	for MinnesotaCare and who submitted a written request for retroactive MinnesotaCare 
42.12 	coverage with a completed application within 30 days of the mailing of notification of 
42.13 	termination from medical assistance or general assistance medical care. The applicant 
42.14 	must provide all required verifications within 30 days of the written request for 
42.15 	verification. For retroactive coverage, premiums must be paid in full for any retroactive 
42.16 	month, current month, and next month within 30 days of the premium billing.

42.17 	Sec. 43. Minnesota Statutes 2006, section 256L.07, subdivision 1, is amended to read:
42.18 		Subdivision 1.General requirements. (a) Children enrolled in the original 
42.19 	children's health plan as of September 30, 1992, children who enrolled in the 
42.20 	MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, 
42.21 	article 4, section 17, and children who have family gross incomes that are equal to or 
42.22 	less than 150 percent of the federal poverty guidelines are eligible without meeting 
42.23 	the requirements of subdivision 2 and the four-month requirement in subdivision 3, as 
42.24 	long as they maintain continuous coverage in the MinnesotaCare program or medical 
42.25 	assistance. Children who apply for MinnesotaCare on or after the implementation date 
42.26 	of the employer-subsidized health coverage program as described in Laws 1998, chapter 
42.27 	407, article 5, section 45, who have family gross incomes that are equal to or less than 150 
42.28 	percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to 
42.29 	be eligible for MinnesotaCare.
42.30 	(b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, 
42.31 	whose income increases above 275 percent of the federal poverty guidelines, are no 
42.32 	longer eligible for the program and shall be disenrolled by the commissioner. Individuals 
42.33 	enrolled in MinnesotaCare under section 256L.04, subdivision 7, whose income increases 
42.34 	above 175 200 percent of the federal poverty guidelines or 215 percent of the federal 
43.1 	poverty guidelines on or after July 1, 2009, are no longer eligible for the program and 
43.2 	shall be disenrolled by the commissioner. For persons disenrolled under this subdivision, 
43.3 	MinnesotaCare coverage terminates the last day of the calendar month following the 
43.4 	month in which the commissioner determines that the income of a family or individual 
43.5 	exceeds program income limits.
43.6 	(c) (b)  Notwithstanding paragraph (b) (a), children may remain enrolled in 
43.7 	MinnesotaCare if ten percent of their gross individual or gross family income as defined 
43.8 	in section 256L.01, subdivision 4, is less than the annual premium for a six-month
43.9 	policy with a $500 deductible available through the Minnesota Comprehensive Health 
43.10 	Association. Children who are no longer eligible for MinnesotaCare under this clause shall 
43.11 	be given a 12-month notice period from the date that ineligibility is determined before 
43.12 	disenrollment. The premium for children remaining eligible under this clause shall be the 
43.13 	maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
43.14 	(d) Notwithstanding paragraphs (b) and (c), parents are not eligible for 
43.15 	MinnesotaCare if gross household income exceeds $25,000 for the six-month period 
43.16 	of eligibility.

43.17 	Sec. 44. Minnesota Statutes 2006, section 256L.07, subdivision 2, is amended to read:
43.18 		Subd. 2.Must not have access to employer-subsidized coverage. (a) To be 
43.19 	eligible, a family or individual an adult must not have access to subsidized health coverage 
43.20 	through an employer and must not have had access to employer-subsidized coverage 
43.21 	through a current employer for 18 months prior to application or reapplication. A family 
43.22 	or individual An adult whose employer-subsidized coverage is lost due to an employer 
43.23 	terminating health care coverage as an employee benefit during the previous 18 months 
43.24 	is not eligible.
43.25 	(b) This subdivision does not apply to a family or individual an adult who was 
43.26 	enrolled in MinnesotaCare within six months or less of reapplication and who no longer 
43.27 	has employer-subsidized coverage due to the employer terminating health care coverage 
43.28 	as an employee benefit.
43.29 	(c) For purposes of this requirement, subsidized health coverage means health 
43.30 	coverage for which the employer pays at least 50 percent of the cost of coverage for 
43.31 	the employee or dependent, or a higher percentage as specified by the commissioner. 
43.32 	Children are eligible for employer-subsidized coverage through either parent, including 
43.33 	the noncustodial parent. The commissioner must treat employer contributions to Internal 
43.34 	Revenue Code Section 125 plans and any other employer benefits intended to pay 
44.1 	health care costs as qualified employer subsidies toward the cost of health coverage for 
44.2 	employees for purposes of this subdivision.
44.3 	(d) Notwithstanding paragraph (c), if an employer-subsidized health plan requires 
44.4 	the employee to pay more than eight percent of the employee's family gross income in 
44.5 	co-payments, deductibles, or coinsurance, the health coverage offered shall not constitute 
44.6 	employer-subsidized coverage for purposes of determining eligibility for MinnesotaCare.
44.7 	(e) This subdivision does not apply to children.

44.8 	Sec. 45. Minnesota Statutes 2006, section 256L.07, subdivision 3, is amended to read:
44.9 		Subd. 3.Other health coverage. (a) Families and individualsAdults enrolled in the 
44.10 	MinnesotaCare program must have no health coverage while enrolled or for at least four 
44.11 	months prior to application and renewal. Children enrolled in the original children's health 
44.12 	plan and children in families with income equal to or less than 150 percent of the federal 
44.13 	poverty guidelines, who have other health insurance, are eligible if the coverage:
44.14 	(1) lacks two or more of the following:
44.15 	(i) basic hospital insurance;
44.16 	(ii) medical-surgical insurance;
44.17 	(iii) prescription drug coverage;
44.18 	(iv) dental coverage; or
44.19 	(v) vision coverage;
44.20 	(2) requires a deductible of $100 or more per person per year; or
44.21 	(3) lacks coverage because the child has exceeded the maximum coverage for a 
44.22 	particular diagnosis or the policy excludes a particular diagnosis.
44.23 	The commissioner may change this eligibility criterion for sliding scale premiums in 
44.24 	order to remain within the limits of available appropriations. The requirement of no health 
44.25 	coverage This paragraph does not apply to newborns children.
44.26 	(b) Medical assistance, general assistance medical care, and the Civilian Health and 
44.27 	Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under 
44.28 	United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or 
44.29 	health coverage for purposes of the four-month requirement described in this subdivision.
44.30 	(c) For purposes of this subdivision, an applicant or enrollee who is entitled to 
44.31 	Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social 
44.32 	Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to 
44.33 	have health coverage. An applicant or enrollee who is entitled to premium-free Medicare 
44.34 	Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility 
44.35 	for MinnesotaCare.
45.1 	(d) Applicants who were recipients of medical assistance or general assistance 
45.2 	medical care within one month of application must meet the provisions of this subdivision 
45.3 	and subdivision 2.
45.4 	(e) Cost-effective health insurance that was paid for by medical assistance is not 
45.5 	considered health coverage for purposes of the four-month requirement under this 
45.6 	section, except if the insurance continued after medical assistance no longer considered it 
45.7 	cost-effective or after medical assistance closed.

45.8 	Sec. 46. Minnesota Statutes 2006, section 256L.07, subdivision 6, is amended to read:
45.9 		Subd. 6.Exception for certain adults. Single adults and households with 
45.10 	no children formerly enrolled in general assistance medical care and enrolled in 
45.11 	MinnesotaCare according to section 256D.03, subdivision 3, are eligible without meeting 
45.12 	the requirements of this section until six-month renewal.

45.13 	Sec. 47. Minnesota Statutes 2006, section 256L.09, subdivision 4, is amended to read:
45.14 		Subd. 4.Eligibility as Minnesota resident. (a) For purposes of this section, a 
45.15 	permanent Minnesota resident is a person who has demonstrated, through persuasive and 
45.16 	objective evidence, that the person is domiciled in the state and intends to live in the 
45.17 	state permanently.
45.18 	(b) To be eligible as a permanent resident, an applicant must demonstrate the 
45.19 	requisite intent to live in the state permanently by:
45.20 	(1) showing that the applicant maintains a residence at a verified address other than a 
45.21 	place of public accommodation, through the use of evidence of residence described in 
45.22 	section 256D.02, subdivision 12a, paragraph (b), clause (1) (2); 
45.23 	(2) demonstrating that the applicant has been continuously domiciled in the state for 
45.24 	no less than 180 days immediately before the application; and
45.25 	(3) signing an affidavit declaring that (A) the applicant currently resides in the state 
45.26 	and intends to reside in the state permanently; and (B) the applicant did not come to the 
45.27 	state for the primary purpose of obtaining medical coverage or treatment.
45.28 	(c) A person who is temporarily absent from the state does not lose eligibility for 
45.29 	MinnesotaCare. "Temporarily absent from the state" means the person is out of the state 
45.30 	for a temporary purpose and intends to return when the purpose of the absence has been 
45.31 	accomplished. A person is not temporarily absent from the state if another state has 
45.32 	determined that the person is a resident for any purpose. If temporarily absent from the 
45.33 	state, the person must follow the requirements of the health plan in which the person is 
45.34 	enrolled to receive services.

46.1 	Sec. 48. Minnesota Statutes 2006, section 256L.15, subdivision 1, is amended to read:
46.2 		Subdivision 1.Premium determination. (a) Families with children and individuals 
46.3 	shall pay a premium determined according to subdivision 2.
46.4 	(b) Pregnant women and children under age two are exempt from the provisions 
46.5 	of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment 
46.6 	for failure to pay premiums. For pregnant women, this exemption continues until the 
46.7 	first day of the month following the 60th day postpartum. Women who remain enrolled 
46.8 	during pregnancy or the postpartum period, despite nonpayment of premiums, shall be 
46.9 	disenrolled on the first of the month following the 60th day postpartum for the penalty 
46.10 	period that otherwise applies under section 256L.06, unless they begin paying premiums. 
46.11 	(c) Members of the military and their families who meet the eligibility criteria 
46.12 	for MinnesotaCare upon eligibility approval made within 24 months following the end 
46.13 	of the member's tour of active duty shall have their premiums paid by the commissioner. 
46.14 	The effective date of coverage for an individual or family who meets the criteria of this 
46.15 	paragraph shall be the first day of the month following the month in which eligibility is 
46.16 	approved. This exemption shall apply for 12 months. 

46.17 	EFFECTIVE DATE. This section is effective July 1, 2007, or upon federal 
46.18 	approval, whichever is later.

46.19 	Sec. 49. Minnesota Statutes 2006, section 256L.15, subdivision 2, is amended to read:
46.20 		Subd. 2.Sliding fee scale; monthly gross individual or family income. (a) The 
46.21 	commissioner shall establish a sliding fee scale to determine the percentage of monthly 
46.22 	gross individual or family income that households at different income levels must pay 
46.23 	to obtain coverage through the MinnesotaCare program. The sliding fee scale must be 
46.24 	based on the enrollee's monthly gross individual or family income. The sliding fee scale 
46.25 	must contain separate tables based on enrollment of one, two, or three or more persons. 
46.26 	The sliding fee scale begins with a premium of 1.5 percent of monthly gross individual or 
46.27 	family income for individuals or families with incomes below the limits for the medical 
46.28 	assistance program for families and children in effect on January 1, 1999, and proceeds 
46.29 	through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. 
46.30 	These percentages are matched to evenly spaced income steps ranging from the medical 
46.31 	assistance income limit for families and children in effect on January 1, 1999, to 275 
46.32 	percent of the federal poverty guidelines for the applicable family size, up to a family size 
46.33 	of five. The sliding fee scale for a family of five must be used for families of more than 
46.34 	five. Effective October 1, 2003, the commissioner shall increase each percentage by 0.5 
46.35 	percentage points for enrollees with income greater than 100 percent but not exceeding 
47.1 	200 percent of the federal poverty guidelines and shall increase each percentage by 1.0 
47.2 	percentage points for families and children with incomes greater than 200 percent of 
47.3 	the federal poverty guidelines. The sliding fee scale and percentages are not subject to 
47.4 	the provisions of chapter 14. If a family or individual reports increased income after 
47.5 	enrollment, premiums shall be adjusted at the time the change in income is reported.
47.6 	(b) Children in Families whose gross income is above 275 percent of the federal 
47.7 	poverty guidelines shall pay the maximum premium. The maximum premium is defined 
47.8 	as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare 
47.9 	cases paid the maximum premium, the total revenue would equal the total cost of 
47.10 	MinnesotaCare medical coverage and administration. In this calculation, administrative 
47.11 	costs shall be assumed to equal ten percent of the total. The costs of medical coverage 
47.12 	for pregnant women and children under age two and the enrollees in these groups shall 
47.13 	be excluded from the total. The maximum premium for two enrollees shall be twice the 
47.14 	maximum premium for one, and the maximum premium for three or more enrollees shall 
47.15 	be three times the maximum premium for one.
47.16 	(c) After calculating the percentage of premium each enrollee shall pay under 
47.17 	paragraph (a), eight percent shall be added to the premium.

47.18 	EFFECTIVE DATE. This section is effective July 1, 2007.

47.19 	Sec. 50. Minnesota Statutes 2006, section 256L.15, subdivision 4, is amended to read:
47.20 		Subd. 4.Exception for transitioned adults. County agencies shall pay premiums 
47.21 	for single adults and households with no children formerly enrolled in general assistance 
47.22 	medical care and enrolled in MinnesotaCare according to section 256D.03, subdivision 3, 
47.23 	until six-month renewal for six months. The county agency has the option of continuing to 
47.24 	pay premiums for these enrollees past the first six-monthsix months until the 12-month 
47.25 	renewal period.

47.26 	Sec. 51. Minnesota Statutes 2006, section 256L.17, subdivision 2, is amended to read:
47.27 		Subd. 2.Limit on total assets. (a) Effective July 1, 2002, or upon federal approval, 
47.28 	whichever is later, in order to be eligible for the MinnesotaCare program, a household of 
47.29 	two or more persons must not own more than $20,000 in total net assets, and a household 
47.30 	of one person must not own more than $10,000 in total net assets.
47.31 	(b) For purposes of this subdivision, assets are determined according to section 
47.32 	256B.056, subdivision 3c, except that workers' compensation settlements received due to 
47.33 	a work-related injury shall not be considered. 
48.1 	(c) State-funded MinnesotaCare is not available for applicants or enrollees who are 
48.2 	otherwise eligible for medical assistance but fail to verify assets. Enrollees who become 
48.3 	eligible for federally funded medical assistance shall be terminated from state-funded 
48.4 	MinnesotaCare and transferred to medical assistance.

48.5 	Sec. 52. Minnesota Statutes 2006, section 256L.17, subdivision 3, is amended to read:
48.6 		Subd. 3.Documentation. (a) The commissioner of human services shall require 
48.7 	individuals and families, at the time of application or renewal, to indicate on a checkoff 
48.8 	form developed by the commissioner whether they satisfy the MinnesotaCare asset 
48.9 	requirement. This form must include the following or similar language: "To be eligible for 
48.10 	MinnesotaCare, individuals and families must not own net assets in excess of $30,000 
48.11 	for a household of two or more persons or $15,000 for a household of one person, not 
48.12 	including a homestead, household goods and personal effects, assets owned by children, 
48.13 	vehicles used for employment, court-ordered settlements up to $10,000, individual 
48.14 	retirement accounts, and capital and operating assets of a trade or business up to $200,000. 
48.15 	Do you and your household own net assets in excess of these limits?"
48.16 	(b) The commissioner may require individuals and families to provide any 
48.17 	information the commissioner determines necessary to verify compliance with the asset 
48.18 	requirement, if the commissioner determines that there is reason to believe that an 
48.19 	individual or family has assets that exceed the program limit.

48.20 	Sec. 53. Minnesota Statutes 2006, section 256L.17, subdivision 7, is amended to read:
48.21 		Subd. 7.Exception for certain adults. Single adults and households with 
48.22 	no children formerly enrolled in general assistance medical care and enrolled in 
48.23 	MinnesotaCare according to section 256D.03, subdivision 3, are exempt from the 
48.24 	requirements of this section until six-month renewal.

48.25 	Sec. 54. [256L.20] MINNESOTACARE OPTION FOR SMALL EMPLOYERS.
48.26 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms 
48.27 	have the meanings given them.
48.28 	(b) "Dependent" means an unmarried child who is under the age of 21 and who is 
48.29 	not eligible for employer-subsidized health coverage. 
48.30 	(c) "Eligible employee" means an employee who works at least 20 hours per week 
48.31 	for an eligible employer. Eligible employee does not include an employee who works 
48.32 	on a temporary or substitute basis or who does not work more than 26 weeks annually. 
49.1 	Coverage of an eligible employee includes the employee's spouse if the spouse does not 
49.2 	have access to employer-subsidized health coverage. 
49.3 	(d) "Eligible employer" means a business that employs at least two, but not more 
49.4 	than 50, eligible employees, the majority of whom are employed in the state, and includes 
49.5 	a municipality that has 50 or fewer employees. 
49.6 	(e) "Employer-subsidized health coverage" has the meaning given under section 
49.7 	256L.07, subdivision 2, paragraph (c).
49.8 	(f) "Maximum premium" has the meaning given under section 256L.15, subdivision 
49.9 	2, paragraph (b), except that the cost of medical coverage for single adults and households 
49.10 	without children formerly enrolled in general assistance medical care and enrolled in 
49.11 	MinnesotaCare in accordance with section 256D.03, subdivision 3, paragraph (c), are 
49.12 	excluded from the total cost when determining the maximum premium.
49.13 	(g) "Participating employer" means an eligible employer who meets the requirements 
49.14 	in subdivision 3 and applies to the commissioner to enroll its eligible employees and their 
49.15 	dependents in the MinnesotaCare program.
49.16 	(h) "Program" means the MinnesotaCare program. 
49.17 		Subd. 2.Application and renewal procedures. (a) Eligible employees and their 
49.18 	dependents may enroll in MinnesotaCare through their employer if their employer meets 
49.19 	the requirements of subdivision 3. The commissioner shall establish procedures for an 
49.20 	eligible employer to participate in the program. The commissioner shall provide an 
49.21 	employer with applications for each eligible employee. The employee must fill out the 
49.22 	application and submit it to the employer. The employer must submit the completed 
49.23 	applications to the commissioner. The commissioner shall determine eligibility for the 
49.24 	program and determine the premiums owed by the employer for each eligible employee. 
49.25 	The commissioner may require eligible employees to provide income verification to 
49.26 	determine premiums.
49.27 	(b) The effective date of coverage is in accordance with section 256L.05, subdivision 
49.28 	3.
49.29 	(c) An employer's eligibility must be renewed every 12 months. At that time, all 
49.30 	eligible employees enrolled in the program regardless of their enrollment date must 
49.31 	reapply.
49.32 	(d) A participating employer must inform the commissioner of any changes in its 
49.33 	employees and premiums must be adjusted accordingly beginning the first day of the 
49.34 	month following the month in which the change is reported. An employer's premiums 
49.35 	shall not be adjusted due to a change in an employee's income until the next renewal 
49.36 	period. Eligible employees hired after enrollment must fill out an application and submit 
50.1 	the application to the commissioner. Employees who terminate their employment with 
50.2 	the participating employer shall remain enrolled in the program until the last day of the 
50.3 	month in which employment is terminated. A terminating employee may remain in the 
50.4 	MinnesotaCare program if the employee meets the eligibility requirements of enrollment 
50.5 	described in sections 256L.01 to 256L.18.
50.6 		Subd. 3.Employer requirements.  In order to participate, an eligible employer 
50.7 	must meet the following requirements:
50.8 	(1) agree to contribute toward the cost of the premium for the employee, the 
50.9 	employee's spouse, and the employee's dependents according to subdivision 4; 
50.10 	(2) certify that each eligible employee was informed of the availability of coverage 
50.11 	through the program and that at least 75 percent of its eligible employees are planning to 
50.12 	or are enrolled in the program; and
50.13 	(3) have not provided employer-subsidized health coverage as an employee benefit 
50.14 	during the previous 12 months, as defined in section 256L.07, subdivision 2, paragraph (c). 
50.15 		Subd. 4.Premiums. (a) The premium for coverage provided under this section is 
50.16 	equal to the maximum premium as defined in subdivision 1 regardless of the income 
50.17 	of the eligible employee.
50.18 	(b) For eligible employees without dependents with a gross family income equal to 
50.19 	or less than 200 percent of the federal poverty guidelines or 215 percent of the federal 
50.20 	poverty guidelines on or after July 1, 2009, and for eligible employees with dependents 
50.21 	whose gross family income is equal to or less than 275 percent of the federal poverty 
50.22 	guidelines, the participating employer shall pay 50 percent of the premium established 
50.23 	under paragraph (a) for the eligible employee, the employee's spouse, and any dependents, 
50.24 	if applicable. 
50.25 	(c) For eligible employees without dependents with a gross family income over 200 
50.26 	percent of the federal poverty guidelines or 215 percent of the federal poverty guidelines 
50.27 	on or after July 1, 2009, and for eligible employees with dependents with a gross family 
50.28 	income over 275 percent of the federal poverty guidelines, the participating employer shall 
50.29 	pay the full cost of the premium established under paragraph (a) for the eligible employee, 
50.30 	the employee's spouse, and any dependents, if applicable. The participating employer may 
50.31 	require the employee to pay a portion of the cost of the premium so long as the employer 
50.32 	pays at least 50 percent. If the employer requires the employee to pay a portion of the 
50.33 	premium, the employee shall pay the portion of the cost to the employer. 
50.34 	(d) The commissioner shall collect premium payments from participating employers 
50.35 	for eligible employees, spouses, and dependents who are covered by the program as 
51.1 	provided under this section. All premiums collected shall be deposited in the health care 
51.2 	access fund. 
51.3 	(e) Nonpayment of premiums by a participating employer will result in the 
51.4 	disenrollment of all eligible employees, spouses, and dependents from the program 
51.5 	effective the end of the month in which the premium was due.
51.6 		Subd. 5.Coverage. The coverage offered to those enrolled in the program under 
51.7 	this section shall include all health services described under section 256L.03 and all 
51.8 	co-payments and coinsurance requirements under section 256L.03 shall apply.
51.9 		Subd. 6.Enrollment. For purposes of enrollment under this section, income 
51.10 	eligibility limits established under sections 256L.04 and 256L.07, asset limits established 
51.11 	under section 256L.17, and the barriers established under section 256L.07, subdivision 2 
51.12 	or 3, do not apply to applicants eligible for this program unless specified in this section. 
51.13 	The residency requirement under section 256L.09 shall apply.
51.14 		Subd. 7.Outreach. The commissioner shall provide information on the availability 
51.15 	of this buy-in option for small employers and application forms to entities that provide 
51.16 	insurance information to small employers, including, but not limited to, insurance agents 
51.17 	and chambers of commerce. The commissioner shall establish an assistance fee of $25 per 
51.18 	enrolled employee for such entities that assist eligible employers and their employees in 
51.19 	applying to the program.

51.20 	Sec. 55. Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2, 
51.21 	is amended to read:

51.22
51.23	Subd. 2.Community and Family Health 
Improvement

51.24	Summary by Fund
	
51.25	General
	40,413,000
	40,382,000
	
51.26
51.27	State Government 
Special Revenue
	141,000
	128,000
	
51.28	Health Care Access
	3,510,000
	3,516,000
	
51.29	Federal TANF
	6,000,000
	6,000,000
	
51.30 	FAMILY PLANNING BASE 
51.31 	REDUCTION. Base level funding for 
51.32 	the family planning special projects grant 
51.33 	program is reduced by $1,877,000 each 
51.34 	year of the biennium beginning July 1, 
51.35 	2007, provided that this reduction shall 
51.36 	only take place upon full implementation of 
52.1 	the family planning project section of the 
52.2 	1115 waiver. Notwithstanding Minnesota 
52.3 	Statutes, section 145.925, the commissioner 
52.4 	shall give priority to community health care 
52.5 	clinics providing family planning services 
52.6 	that either serve a high number of women 
52.7 	who do not qualify for medical assistance 
52.8 	or are unable to participate in the medical 
52.9 	assistance program as a medical assistance 
52.10 	provider when allocating the remaining 
52.11 	appropriations. Notwithstanding section 15, 
52.12 	this paragraph shall not expire.
52.13 	SHAKEN BABY VIDEO. Of the 
52.14 	state government special revenue fund 
52.15 	appropriation, $13,000 in 2006 is 
52.16 	appropriated to the commissioner of health 
52.17 	to provide a video to hospitals on shaken 
52.18 	baby syndrome. The commissioner of health 
52.19 	shall assess a fee to hospitals to cover the 
52.20 	cost of the approved shaken baby video and 
52.21 	the revenue received is to be deposited in the 
52.22 	state government special revenue fund.

52.23 	Sec. 56. ADMINISTRATIVE SIMPLIFICATION.
 52.24 	All health care providers and health plans that contract with the state of Minnesota 
52.25 	to provide health care services either through the health care programs administered 
52.26 	under Minnesota Statutes, chapters 256B, 256D, and 256L, or through the state employee 
52.27 	group insurance program administered under Minnesota Statutes, chapter 43A, must 
52.28 	use and accept the uniform billing forms and coding requirements established by the 
52.29 	Administrative Uniformity Committee by January 1, 2009.

52.30 	Sec. 57. APPROPRIATION.
 52.31 	(a) $....... is appropriated from the health care access fund to the commissioner of 
52.32 	human services for the biennium beginning July 1, 2007, for the purpose of Minnesota 
52.33 	health care programs outreach grants and the enrollment incentive programs under 
52.34 	Minnesota Statutes, section 256.962
53.1 	(b) $1,156,000 is appropriated each fiscal year beginning July 1, 2007, from the 
53.2 	general fund to the commissioner of health for family planning grants under Minnesota 
53.3 	Statutes, section 145.925.
53.4 	(c) $....... is appropriated for the biennium beginning July 1, 2007, from the general 
53.5 	fund to the commissioner of health subsidies to federally qualified health centers described 
53.6 	in Minnesota Statutes, section 145.9269.
53.7 	(d) $....... is appropriated for the biennium beginning July 1, 2007, from the general 
53.8 	fund to the commissioner of human services for the critical access dental providers 
53.9 	reimbursement rates under Minnesota Statutes, section 256B.76, paragraph (c).
53.10 	(e) $....... is appropriated for the biennium beginning July 1, 2007, from the general 
53.11 	fund to the commissioner of health for the subsidies for federally qualified health centers 
53.12 	under Minnesota Statutes, section 145.9269.
53.13 	(f) $....... is appropriated for the biennium beginning July 1, 2007, from the general 
53.14 	fund to the commissioner of human services for the patient incentive health program 
53.15 	established in Minnesota Statutes, section 256.01, subdivision 2b, paragraph (b).

53.16 	Sec. 58.  REPEALER.
 53.17 	Minnesota Statutes 2006, sections 62A.301; 256B.0631; and 256L.035, are repealed.