HF 2748
1st Unofficial Engrossment - 85th Legislature (2007 - 2008)
Posted on 12/15/2009 12:00 a.m.
KEY: stricken = removed, old language.
underscored = added, new language.
Line numbers
1.1A bill for an act
1.2relating to health and human services; establishing oversight for rural health
1.3cooperative; revising requirements for county-based purchasing for state health
1.4care programs; appropriating money;amending Minnesota Statutes 2007
1.5Supplement, section 256B.69, subdivision 4; proposing coding for new law
1.6in Minnesota Statutes, chapter 62R.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.8 Section 1. new text begin [62R.09] RURAL HEALTH COOPERATIVE CONTRACT new text end
1.9new text begin OVERSIGHT.new text end
1.10 new text begin Subdivision 1.new text end new text begin Review and approval; monitoring.new text end new text begin (a) The commissioner shall new text end
1.11new text begin establish criteria and procedures to review and authorize contracts and business or new text end
1.12new text begin financial arrangements under section 62R.06, subdivision 1. All contracts and business new text end
1.13new text begin or financial arrangements must be submitted on an application for approval to the new text end
1.14new text begin commissioner. The commissioner shall not deny any application unless the commissioner new text end
1.15new text begin determines that the proposed arrangement is likely to result in higher health care costs new text end
1.16new text begin or diminished access to or quality of health care than would occur in the competitive new text end
1.17new text begin marketplace. The cost of developing the criteria and procedures, as determined by the new text end
1.18new text begin commissioner and notwithstanding section 16A.1283, shall be paid by health provider new text end
1.19new text begin cooperatives operating under this chapter.new text end
1.20 new text begin (b) Within 30 days after receiving an application, the commissioner may request new text end
1.21new text begin additional information that is necessary to complete the review required under this section. new text end
1.22new text begin If the commissioner does not request additional information and does not act within 60 new text end
1.23new text begin days after receipt of an application, the application shall be deemed approved if the new text end
1.24new text begin commissioner does not act within 60 days of receiving the additional information.new text end
2.1 new text begin (c) The commissioner may condition approval of a proposed arrangement on a new text end
2.2new text begin modification of all or part of the arrangement to eliminate any restriction on competition new text end
2.3new text begin that is not reasonably related to the goals of improving health care access or quality. The new text end
2.4new text begin commissioner may also establish conditions for approval that are reasonably necessary new text end
2.5new text begin to protect against abuses of private economic power and to ensure that the arrangement new text end
2.6new text begin has oversight by the state.new text end
2.7 new text begin (d) The commissioner shall monitor arrangements approved under this section new text end
2.8new text begin to ensure that the arrangement remains in compliance with the conditions of approval. new text end
2.9new text begin The commissioner may revoke an approval upon a finding that the arrangement is not in new text end
2.10new text begin substantial compliance with the terms of the application or the conditions of approval.new text end
2.11 new text begin Subd. 2.new text end new text begin Applications.new text end new text begin Applications for approval under this section must describe new text end
2.12new text begin the proposed arrangement in detail. The application must include: the identities of all the new text end
2.13new text begin parties to the arrangement; the intent of the arrangement; the expected outcome of the new text end
2.14new text begin arrangement; and an explanation of how the arrangement will improve access or quality new text end
2.15new text begin of care. Data on providers collected under this section are private data on individuals or new text end
2.16new text begin nonpublic data, as defined in section 13.02.new text end
2.17 new text begin Subd. 3.new text end new text begin Application fee.new text end new text begin When submitting an application to the commissioner, a new text end
2.18new text begin health care cooperative shall pay a fee of $2,000 for the commissioner's cost of reviewing new text end
2.19new text begin and monitoring the arrangement.new text end
2.20 new text begin Subd. 4.new text end new text begin Appropriation.new text end new text begin Money received by the commissioner under this section new text end
2.21new text begin shall be deposited into a revolving fund and is appropriated to the commissioner of health new text end
2.22new text begin for the purpose of administering this section.new text end
2.23 Sec. 2. Minnesota Statutes 2007 Supplement, section 256B.69, subdivision 4, is
2.24amended to read:
2.25 Subd. 4. Limitation of choice. (a) The commissioner shall develop criteria to
2.26determine when limitation of choice may be implemented in the experimental counties.
2.27The criteria shall ensure that all eligible individuals in the county have continuing access
2.28to the full range of medical assistance services as specified in subdivision 6.
2.29 (b) The commissioner shall exempt the following persons from participation in the
2.30project, in addition to those who do not meet the criteria for limitation of choice:
2.31 (1) persons eligible for medical assistance according to section
256B.055,
2.32subdivision 1
;
2.33 (2) persons eligible for medical assistance due to blindness or disability as
2.34determined by the Social Security Administration or the state medical review team, unless:
2.35 (i) they are 65 years of age or older; or
3.1 (ii) they reside in Itasca County or they reside in a county in which the commissioner
3.2conducts a pilot project under a waiver granted pursuant to section 1115 of the Social
3.3Security Act;
3.4 (3) recipients who currently have private coverage through a health maintenance
3.5organization;
3.6 (4) recipients who are eligible for medical assistance by spending down excess
3.7income for medical expenses other than the nursing facility per diem expense;
3.8 (5) recipients who receive benefits under the Refugee Assistance Program,
3.9established under United States Code, title 8, section 1522(e);
3.10 (6) children who are both determined to be severely emotionally disturbed and
3.11receiving case management services according to section
256B.0625, subdivision 20,
3.12except children who are eligible for and who decline enrollment in an approved preferred
3.13integrated network under section
245.4682;
3.14 (7) adults who are both determined to be seriously and persistently mentally ill and
3.15received case management services according to section
256B.0625, subdivision 20;
3.16 (8) persons eligible for medical assistance according to section
256B.057,
3.17subdivision 10
; and
3.18 (9) persons with access to cost-effective employer-sponsored private health
3.19insurance or persons enrolled in a non-Medicare individual health plan determined to be
3.20cost-effective according to section
256B.0625, subdivision 15.
3.21Children under age 21 who are in foster placement may enroll in the project on an elective
3.22basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an
3.23elective basis. The commissioner may enroll recipients in the prepaid medical assistance
3.24program for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by
3.25spending down excess income.
3.26 (c) The commissioner may allow persons with a one-month spenddown who are
3.27otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay
3.28their monthly spenddown to the state.
3.29 (d) The commissioner may require those individuals to enroll in the prepaid medical
3.30assistance program who otherwise would have been excluded under paragraph (b), clauses
3.31(1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.
3.32 (e) Before limitation of choice is implemented, eligible individuals shall be notified
3.33and after notification, shall be allowed to choose only among demonstration providers.
3.34The commissioner may assign an individual with private coverage through a health
3.35maintenance organization, to the same health maintenance organization for medical
3.36assistance coverage, if the health maintenance organization is under contract for medical
4.1assistance in the individual's county of residence. After initially choosing a provider,
4.2the recipient is allowed to change that choice only at specified times as allowed by the
4.3commissioner. If a demonstration provider ends participation in the project for any reason,
4.4a recipient enrolled with that provider must select a new provider but may change providers
4.5without cause once more within the first 60 days after enrollment with the second provider.
4.6 (f) An infant born to a woman who is eligible for and receiving medical assistance
4.7and who is enrolled in the prepaid medical assistance program shall be retroactively
4.8enrolled to the month of birth in the same managed care plan as the mother once the
4.9child is enrolled in medical assistance unless the child is determined to be excluded from
4.10enrollment in a prepaid plan under this section.
4.11 new text begin (g) For an eligible individual under the age of 65, in the absence of a specific new text end
4.12new text begin managed care plan choice by the individual, the commissioner shall assign the individual new text end
4.13new text begin to the county-based purchasing health plan in Olmsted, Winona, Houston, Fillmore, new text end
4.14new text begin and Mower Counties, if the individual resides in one of these counties. For an eligible new text end
4.15new text begin individual over the age of 65, the commissioner shall make this default assignment upon new text end
4.16new text begin the county-based purchasing plan entering into a contract with the commissioner to serve new text end
4.17new text begin this population and receiving federal approval as a special needs plan.new text end
4.18 Sec. 3. new text begin STATEMENT OF COSTS; APPROPRIATION.new text end
4.19 new text begin By June 1, 2009, the commissioner of human services shall submit to Olmsted new text end
4.20new text begin County an itemized statement of costs incurred by the Department of Human Services for new text end
4.21new text begin necessary changes to the department's computer system to implement Minnesota Statutes, new text end
4.22new text begin section 256B.69, subdivision 4, paragraph (g), along with a bill for the amount of these new text end
4.23new text begin costs, up to $18,000. By June 30, 2009, Olmsted County must remit to the commissioner new text end
4.24new text begin the amount billed. The amount received by the commissioner must be deposited in the new text end
4.25new text begin state treasury and credited to a special account and is appropriated to the commissioner as new text end
4.26new text begin reimbursement for the costs billed.new text end