1.1 	A bill for an act
1.2 	relating to human services; amending health care services provisions; 
1.3 	making changes to general assistance medical care, medical assistance, and 
1.4 	MinnesotaCare; modifying claims, liens, and treatment of assets; establishing 
1.5 	a statewide information exchange; modifying regulation of certain home care 
1.6 	service providers; clarifying coverage of community health worker education 
1.7 	services;amending Minnesota Statutes 2006, sections 125A.02, subdivision 
1.8 	1; 144A.45, subdivision 1, by adding a subdivision; 256.01, by adding a 
1.9 	subdivision; 256B.055, subdivision 12; 256B.056, subdivisions 2, 4a, 11, 
1.10 	by adding a subdivision; 256B.057, subdivision 1; 256B.0571, subdivisions 
1.11 	6, 8, 9, 15, by adding a subdivision; 256B.058; 256B.059, subdivisions 1, 
1.12 	1a; 256B.0594; 256B.0595, subdivisions 1, 2, 3, 4, by adding subdivisions; 
1.13 	256B.0625, subdivisions 13g, 13h; 256B.075, subdivision 2; 256B.15, 
1.14 	subdivision 4; 256B.69, subdivisions 6, 27; 524.3-803; Minnesota Statutes 2007 
1.15 	Supplement, sections 256B.055, subdivision 14; 256B.0625, subdivision 49; 
1.16 	256D.03, subdivision 3; repealing Minnesota Statutes 2006, section 256B.0571, 
1.17 	subdivision 8a; Laws 2003, First Special Session chapter 5, section 11.
1.18 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.19 	Section 1. Minnesota Statutes 2006, section 125A.02, subdivision 1, is amended to 
1.20 	read:
1.21 		Subdivision 1.Child with a disability. Every child who has a hearing impairment, 
1.22 	blindness, visual disability, speech or language impairment, physical disability, other 
1.23 	health impairment, mental disability, emotional/behavioral disorder, specific learning 
1.24 	disability, autism, traumatic brain injury, multiple disabilities, or deaf/blind disability 
1.25 	and needs special instruction and services, as determined by the standards of the 
1.26 	commissioner, is a child with a disability. A licensed physician or a licensed psychologist 
1.27 	is qualified to make a diagnosis and determination of attention deficit disorder or attention 
1.28 	deficit hyperactivity disorder for purposes of identifying a child with a disability. In 
1.29 	addition, every child under age three, and at local district discretion from age three to age 
2.1 	seven, who needs special instruction and services, as determined by the standards of the 
2.2 	commissioner, because the child has a substantial delay or has an identifiable physical or 
2.3 	mental condition known to hinder normal development is a child with a disability.

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

2.5 	Sec. 2. Minnesota Statutes 2006, section 144A.45, subdivision 1, is amended to read:
2.6 		Subdivision 1.Rules. The commissioner shall adopt rules for the regulation of 
2.7 	home care providers pursuant to sections 144A.43 to 144A.47. The rules shall include 
2.8 	the following: 
2.9 	(a) (1) provisions to assure, to the extent possible, the health, safety and well-being, 
2.10 	and appropriate treatment of persons who receive home care services;
2.11 	(b) (2) requirements that home care providers furnish the commissioner with 
2.12 	specified information necessary to implement sections 144A.43 to 144A.47; 
2.13 	(c) (3) standards of training of home care provider personnel, which may vary 
2.14 	according to the nature of the services provided or the health status of the consumer;
2.15 	(d) (4) standards for medication management which may vary according to the 
2.16 	nature of the services provided, the setting in which the services are provided, or the 
2.17 	status of the consumer. Medication management includes the central storage, handling, 
2.18 	distribution, and administration of medications;
2.19 	(e) (5) standards for supervision of home care services requiring supervision by a 
2.20 	registered nurse or other appropriate health care professional which must occur on site 
2.21 	at least every 62 days, or more frequently if indicated by a clinical assessment, and in 
2.22 	accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that, 
2.23 	notwithstanding the provisions of Minnesota Rules, part 4668.0110, subpart 5, item B, 
2.24 	supervision of a person performing home care aide tasks for a class B licensee providing 
2.25 	paraprofessional services must occur only every 180 days, or more frequently if indicated 
2.26 	by a clinical assessment; 
2.27 	(f) (6) standards for client evaluation or assessment which may vary according to the 
2.28 	nature of the services provided or the status of the consumer;
2.29 	(g) (7) requirements for the involvement of a consumer's physician, the 
2.30 	documentation of physicians' orders, if required, and the consumer's treatment plan, and 
2.31 	the maintenance of accurate, current clinical records;
2.32 	(h) (8) the establishment of different classes of licenses for different types of 
2.33 	providers and different standards and requirements for different kinds of home care 
2.34 	services; and
2.35 	(i) (9) operating procedures required to implement the home care bill of rights.

3.1 	Sec. 3. Minnesota Statutes 2006, section 144A.45, is amended by adding a subdivision 
3.2 	to read:
3.3 		Subd. 1a.Home care aide tasks. Notwithstanding the provisions of Minnesota 
3.4 	Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting 
3.5 	toileting, transfers, and ambulation if the client is ambulatory and if the client has no 
3.6 	serious acute illness or infectious disease.

3.7 	Sec. 4. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 
3.8 	to read:
3.9 		Subd. 27.Statewide health information exchange. (a) The commissioner has the 
3.10 	authority to join and participate as a member in a legal entity developing and operating a 
3.11 	statewide health information exchange that shall meet the following criteria:
3.12 	(1) the legal entity must meet all constitutional and statutory requirements to allow 
3.13 	the commissioner to participate; and 
3.14 	(2) the commissioner or the commissioner's designated representative must have 
3.15 	the right to participate in the governance of the legal entity under the same terms and 
3.16 	conditions and subject to the same requirements as any other member in the legal entity 
3.17 	and in that role shall act to advance state interests and lessen the burdens of government.
3.18 	(b) Notwithstanding chapter 16C, the commissioner may pay the state's prorated 
3.19 	share of development-related expenses of the legal entity retroactively from October 29, 
3.20 	2007, regardless of the date the commissioner joins the legal entity as a member.

3.21 	Sec. 5. Minnesota Statutes 2006, section 256B.055, subdivision 12, is amended to read:
3.22 		Subd. 12.Disabled children. (a) A person is eligible for medical assistance if the 
3.23 	person is under age 19 and qualifies as a disabled individual under United States Code, 
3.24 	title 42, section 1382c(a), and would be eligible for medical assistance under the state 
3.25 	plan if residing in a medical institution, and the child requires a level of care provided in 
3.26 	a hospital, nursing facility, or intermediate care facility for persons with developmental 
3.27 	disabilities, for whom home care is appropriate, provided that the cost to medical 
3.28 	assistance under this section is not more than the amount that medical assistance would pay 
3.29 	for if the child resides in an institution. After the child is determined to be eligible under 
3.30 	this section, the commissioner shall review the child's disability under United States Code, 
3.31 	title 42, section 1382c(a) and level of care defined under this section no more often than 
3.32 	annually and may elect, based on the recommendation of health care professionals under 
3.33 	contract with the state medical review team, to extend the review of disability and level of 
3.34 	care up to a maximum of four years. The commissioner's decision on the frequency of 
4.1 	continuing review of disability and level of care is not subject to administrative appeal 
4.2 	under section 256.045. The county agency shall send a notice of disability review to the 
4.3 	enrollee six months prior to the date the recertification of disability is due. Nothing in this 
4.4 	subdivision shall be construed as affecting other redeterminations of medical assistance 
4.5 	eligibility under this chapter and annual cost-effective reviews under this section.
4.6 	(b) For purposes of this subdivision, "hospital" means an institution as defined 
4.7 	in section 144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part 
4.8 	4640.3600, and licensed pursuant to sections 144.50 to 144.58. For purposes of this 
4.9 	subdivision, a child requires a level of care provided in a hospital if the child is determined 
4.10 	by the commissioner to need an extensive array of health services, including mental health 
4.11 	services, for an undetermined period of time, whose health condition requires frequent 
4.12 	monitoring and treatment by a health care professional or by a person supervised by a 
4.13 	health care professional, who would reside in a hospital or require frequent hospitalization 
4.14 	if these services were not provided, and the daily care needs are more complex than 
4.15 	a nursing facility level of care.
4.16 	A child with serious emotional disturbance requires a level of care provided in a 
4.17 	hospital if the commissioner determines that the individual requires 24-hour supervision 
4.18 	because the person exhibits recurrent or frequent suicidal or homicidal ideation or 
4.19 	behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that 
4.20 	may become life threatening, recurrent or frequent severe socially unacceptable behavior 
4.21 	associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing 
4.22 	and chronic developmental problems requiring continuous skilled observation, or severe 
4.23 	disabling symptoms for which office-centered outpatient treatment is not adequate, and 
4.24 	which overall severely impact the individual's ability to function.
4.25 	(c) For purposes of this subdivision, "nursing facility" means a facility which 
4.26 	provides nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to 
4.27 	sections 144A.02 to 144A.10, which is appropriate if a person is in active restorative 
4.28 	treatment; is in need of special treatments provided or supervised by a licensed nurse; or 
4.29 	has unpredictable episodes of active disease processes requiring immediate judgment 
4.30 	by a licensed nurse. For purposes of this subdivision, a child requires the level of care 
4.31 	provided in a nursing facility if the child is determined by the commissioner to meet 
4.32 	the requirements of the preadmission screening assessment document under section 
4.33 	256B.0911 and the home care independent rating document under section 256B.0655, 
4.34 	subdivision 4, clause (3), adjusted to address age-appropriate standards for children age 18 
4.35 	and under, pursuant to section 256B.0655, subdivision 3.
5.1 	(d) For purposes of this subdivision, "intermediate care facility for persons with 
5.2 	developmental disabilities" or "ICF/MR" means a program licensed to provide services to 
5.3 	persons with developmental disabilities under section 252.28, and chapter 245A, and a 
5.4 	physical plant licensed as a supervised living facility under chapter 144, which together 
5.5 	are certified by the Minnesota Department of Health as meeting the standards in Code of 
5.6 	Federal Regulations, title 42, part 483, for an intermediate care facility which provides 
5.7 	services for persons with developmental disabilities who require 24-hour supervision 
5.8 	and active treatment for medical, behavioral, or habilitation needs. For purposes of this 
5.9 	subdivision, a child requires a level of care provided in an ICF/MR if the commissioner 
5.10 	finds that the child has a developmental disability in accordance with section 256B.092, 
5.11 	is in need of a 24-hour plan of care and active treatment similar to persons with 
5.12 	developmental disabilities, and there is a reasonable indication that the child will need 
5.13 	ICF/MR services.
5.14 	(e) For purposes of this subdivision, a person requires the level of care provided 
5.15 	in a nursing facility if the person requires 24-hour monitoring or supervision and a plan 
5.16 	of mental health treatment because of specific symptoms or functional impairments 
5.17 	associated with a serious mental illness or disorder diagnosis, which meet severity criteria 
5.18 	for mental health established by the commissioner and published in March 1997 as 
5.19 	the Minnesota Mental Health Level of Care for Children and Adolescents with Severe 
5.20 	Emotional Disorders.
5.21 	(f) The determination of the level of care needed by the child shall be made by 
5.22 	the commissioner based on information supplied to the commissioner by the parent or 
5.23 	guardian, the child's physician or physicians, and other professionals as requested by the 
5.24 	commissioner. The commissioner shall establish a screening team to conduct the level of 
5.25 	care determinations according to this subdivision.
5.26 	(g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner 
5.27 	must assess the case to determine whether:
5.28 	(1) the child qualifies as a disabled individual under United States Code, title 42, 
5.29 	section 1382c(a), and would be eligible for medical assistance if residing in a medical 
5.30 	institution; and
5.31 	(2) the cost of medical assistance services for the child, if eligible under this 
5.32 	subdivision, would not be more than the cost to medical assistance if the child resides in a 
5.33 	medical institution to be determined as follows:
5.34 	(i) for a child who requires a level of care provided in an ICF/MR, the cost of 
5.35 	care for the child in an institution shall be determined using the average payment rate 
5.36 	established for the regional treatment centers that are certified as ICF's/MR;
6.1 	(ii) for a child who requires a level of care provided in an inpatient hospital setting 
6.2 	according to paragraph (b), cost-effectiveness shall be determined according to Minnesota 
6.3 	Rules, part 9505.3520, items F and G; and
6.4 	(iii) for a child who requires a level of care provided in a nursing facility according 
6.5 	to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota 
6.6 	Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to 
6.7 	reflect rates which would be paid for children under age 16. The commissioner may 
6.8 	authorize an amount up to the amount medical assistance would pay for a child referred to 
6.9 	the commissioner by the preadmission screening team under section 256B.0911.
6.10 	(h) Children eligible for medical assistance services under section 256B.055, 
6.11 	subdivision 12, as of June 30, 1995, must be screened according to the criteria in this 
6.12 	subdivision prior to January 1, 1996. Children found to be ineligible may not be removed 
6.13 	from the program until January 1, 1996.

6.14 	Sec. 6. Minnesota Statutes 2007 Supplement, section 256B.055, subdivision 14, 
6.15 	is amended to read:
6.16 		Subd. 14.Persons detained by law. (a) Medical assistance may be paid for an 
6.17 	inmate of a correctional facility who is conditionally released as authorized under section 
6.18 	241.26, 244.065, or 631.425, if the individual does not require the security of a public 
6.19 	detention facility and is housed in a halfway house or community correction center, or 
6.20 	under house arrest and monitored by electronic surveillance in a residence approved 
6.21 	by the commissioner of corrections, and if the individual meets the other eligibility 
6.22 	requirements of this chapter.
6.23 	(b) An individual who is enrolled in medical assistance, and who is charged with a 
6.24 	crime and incarcerated for less than 12 months shall be suspended from eligibility at the 
6.25 	time of incarceration until the individual is released. Upon release, medical assistance 
6.26 	eligibility is reinstated without reapplication using a reinstatement process and form, if the 
6.27 	individual is otherwise eligible.
6.28 	(c) An individual, regardless of age, who is considered an inmate of a public 
6.29 	institution as defined in Code of Federal Regulations, title 42, section 435.1009 435.1010, 
6.30 	is not eligible for medical assistance.

6.31 	Sec. 7. Minnesota Statutes 2006, section 256B.056, subdivision 2, is amended to read:
6.32 		Subd. 2.Homestead exclusion and homestead equity limit for institutionalized
6.33 	persons residing in a long-term care facility. (a) The homestead shall be excluded 
6.34 	for the first six calendar months of a person's stay in a long-term care facility and shall 
7.1 	continue to be excluded for as long as the recipient can be reasonably expected to return to 
7.2 	the homestead. For purposes of this subdivision, "reasonably expected to return to the 
7.3 	homestead" means the recipient's attending physician has certified that the expectation 
7.4 	is reasonable, and the recipient can show that the cost of care upon returning home will 
7.5 	be met through medical assistance or other sources. The homestead shall continue to 
7.6 	be excluded for persons residing in a long-term care facility if it is used as a primary 
7.7 	residence by one of the following individuals:
7.8 	(1) the spouse;
7.9 	(2) a child under age 21;
7.10 	(3) a child of any age who is blind or permanently and totally disabled as defined in 
7.11 	the supplemental security income program;
7.12 	(4) a sibling who has equity interest in the home and who resided in the home for at 
7.13 	least one year immediately before the date of the person's admission to the facility; or
7.14 	(5) a child of any age, or, subject to federal approval, a grandchild of any age, who 
7.15 	resided in the home for at least two years immediately before the date of the person's 
7.16 	admission to the facility, and who provided care to the person that permitted the person to 
7.17 	reside at home rather than in an institution.
7.18 	(b) Effective for applications filed on or after July 1, 2006, and for renewals after 
7.19 	July 1, 2006, for persons who first applied for payment of long-term care services on 
7.20 	or after January 2, 2006, the equity interest in the homestead of an individual whose 
7.21 	eligibility for long-term care services is determined on or after January 1, 2006, shall not 
7.22 	exceed $500,000, unless it is the lawful residence of the individual's spouse or child 
7.23 	who is under age 21, blind, or disabled. The amount specified in this paragraph shall be 
7.24 	increased beginning in year 2011, from year to year based on the percentage increase in 
7.25 	the Consumer Price Index for all urban consumers (all items; United States city average), 
7.26 	rounded to the nearest $1,000. This provision may be waived in the case of demonstrated 
7.27 	hardship by a process to be determined by the secretary of health and human services 
7.28 	pursuant to section 6014 of the Deficit Reduction Act of 2005, Public Law 109-171.

7.29 	Sec. 8. Minnesota Statutes 2006, section 256B.056, is amended by adding a 
7.30 	subdivision to read:
7.31 		Subd. 2a.Home equity limit for medical assistance payment of long-term 
7.32 	care services. (a) Effective for requests of medical assistance payment of long-term 
7.33 	care services filed on or after July 1, 2006, and for renewals on or after July 1, 2006, 
7.34 	for persons who received payment of long-term care services under a request filed on 
7.35 	or after January 1, 2006, the equity interest in the home of a person whose eligibility 
8.1 	for long-term care services is determined on or after January 1, 2006, shall not exceed 
8.2 	$500,000, unless it is the lawful residence of the person's spouse or child who is under 
8.3 	age 21, or a child of any age who is blind or permanently and totally disabled as defined 
8.4 	in the Supplemental Security Income program. The amount specified in this paragraph 
8.5 	shall be increased beginning in year 2011, from year to year based on the percentage 
8.6 	increase in the Consumer Price Index for all urban consumers (all items; United States city 
8.7 	average), rounded to the nearest $1,000.
8.8 	(b) For purposes of this subdivision, a "home" means any real or personal property 
8.9 	interest, including an interest in an agricultural homestead as defined under section 
8.10 	273.124, subdivision 1, that, at the time of the request for medical assistance payment of 
8.11 	long-term care services, is the primary dwelling of the person or was the primary dwelling 
8.12 	of the person before receipt of long-term care services began outside of the home.
8.13 	(c) A person denied or terminated from medical assistance payment of long-term 
8.14 	care services because the person's home equity exceeds the home equity limit may seek 
8.15 	a waiver based upon a hardship by filing a written request with the county agency. 
8.16 	Hardship is an imminent threat to the person's health and well-being that is demonstrated 
8.17 	by documentation of no alternatives for payment of long-term care services. The county 
8.18 	agency shall make a decision regarding the written request to waive the home equity limit 
8.19 	within 30 days if all necessary information has been provided. The county agency shall 
8.20 	send the person and the person's representative a written notice of decision on the request 
8.21 	for a demonstrated hardship waiver that also advises the person of appeal rights under the 
8.22 	fair hearing process of section 256.045.

8.23 	Sec. 9. Minnesota Statutes 2006, section 256B.056, subdivision 4a, is amended to read:
8.24 		Subd. 4a.Asset verification. For purposes of verification, the value of an individual 
8.25 	is not required to make a good faith effort to sell a life estate that is not excluded under 
8.26 	subdivision 2 and the life estate shall be considered deemed not salable unless the owner 
8.27 	of the remainder interest intends to purchase the life estate, or the owner of the life estate 
8.28 	and the owner of the remainder sell the entire property. This subdivision applies only for 
8.29 	the purpose of determining eligibility for medical assistance, and does not apply to the 
8.30 	valuation of assets owned by either the institutional spouse or the community spouse 
8.31 	under section 256B.059, subdivision 2.

8.32 	Sec. 10. Minnesota Statutes 2006, section 256B.056, subdivision 11, is amended to 
8.33 	read:
9.1 		Subd. 11.Treatment of annuities. (a) Any individual applying for or seeking 
9.2 	recertification of eligibility for person requesting medical assistance payment of long-term 
9.3 	care services shall provide a complete description of any interest either the individual
9.4 	person or the individual'sperson's spouse has in annuities on a form designated by the 
9.5 	department. The form shall include a statement that the state becomes a preferred 
9.6 	remainder beneficiary of annuities or similar financial instruments by virtue of the receipt 
9.7 	of medical assistance payment of long-term care services. The individualperson and the 
9.8 	individual'sperson's spouse shall furnish the agency responsible for determining eligibility 
9.9 	with complete current copies of their annuities and related documents for review as part 
9.10 	of the application process on disclosure forms provided by the department as part of 
9.11 	their application and complete the form designating the state as the preferred remainder 
9.12 	beneficiary for each annuity in which the person or the person's spouse has an interest.
9.13 	(b) The disclosure form shall include a statement that the department becomes the 
9.14 	remainder beneficiary under the annuity or similar financial instrument by virtue of the 
9.15 	receipt of medical assistance. The disclosure form department shall include a provide
9.16 	notice to the issuer of the department's right under this section as a preferred remainder 
9.17 	beneficiary under the annuity or similar financial instrument for medical assistance 
9.18 	furnished to the individualperson or the individual'sperson's spouse, and require the 
9.19 	issuer to provide confirmation that a remainder beneficiary designation has been made 
9.20 	and to notify the county agency when there is a change in the amount of the income or 
9.21 	principal being withdrawn from the annuity or other similar financial instrument at the 
9.22 	time of the most recent disclosure required under this section. The individual and the 
9.23 	individual's spouse shall execute separate disclosure forms for each annuity or similar 
9.24 	financial instrument that they are required to disclose under this section and in which they 
9.25 	have an interest provide notice of the issuer's responsibilities as provided in paragraph (c).
9.26 	(c) An issuer of an annuity or similar financial instrument who receives notice 
9.27 	on a disclosure form of the state's right to be named a preferred remainder beneficiary
9.28 	as described in paragraph (b) shall provide confirmation to the requesting agency that 
9.29 	a remainder beneficiary designating the state has been made and a preferred remainder 
9.30 	beneficiary. The issuer shall also notify the county agency when there is a change in the 
9.31 	amount of income or principal being withdrawn from the annuity or other similar financial 
9.32 	instrument or a change in the state's preferred remainder beneficiary designation under 
9.33 	the annuity or other similar financial instrument occurs. The county agency shall provide 
9.34 	the issuer with the name, address, and telephone number of a unit within the department 
9.35 	that the issuer can contact to comply with this paragraph.
10.1 	(d) "Preferred remainder beneficiary" for purposes of this subdivision and sections 
10.2 	256B.0594 and 256B.0595 means the state is a remainder beneficiary in the first position in 
10.3 	an amount equal to the amount of medical assistance paid on behalf of the institutionalized 
10.4 	person, or is a remainder beneficiary in the second position if the institutionalized person 
10.5 	designates and is survived by a remainder beneficiary who is (1) a spouse who does not 
10.6 	reside in a medical institution, (2) a minor child, or (3) a child of any age who is blind or 
10.7 	permanently and totally disabled as defined in the Supplemental Security Income program. 
10.8 	Notwithstanding this paragraph, the state is the remainder beneficiary in the first position 
10.9 	if the spouse or child disposes of the remainder for less than fair market value.
10.10 	(e) For purposes of this subdivision, "institutionalized person" and "long-term care 
10.11 	services" have the meanings given in section 256B.0595, subdivision 1, paragraph (h).
10.12 	(f) For purposes of this subdivision, "medical institution" means a skilled 
10.13 	nursing facility, intermediate care facility, intermediate care facility for persons with 
10.14 	developmental disabilities, nursing facility, or inpatient hospital.

10.15 	Sec. 11. Minnesota Statutes 2006, section 256B.057, subdivision 1, is amended to read:
10.16 		Subdivision 1.Infants and pregnant women. (a)(1) An infant less than one year of 
10.17 	age or a pregnant woman who has written verification of a positive pregnancy test from a 
10.18 	physician or licensed registered nurse is eligible for medical assistance if countable family 
10.19 	income is equal to or less than 275 percent of the federal poverty guideline for the same 
10.20 	family size. A pregnant woman who has written verification of a positive pregnancy test 
10.21 	from a physician or licensed registered nurse is eligible for medical assistance if countable 
10.22 	family income is equal to or less than 200 percent of the federal poverty guideline for the 
10.23 	same family size. For purposes of this subdivision, "countable family income" means the 
10.24 	amount of income considered available using the methodology of the AFDC program 
10.25 	under the state's AFDC plan as of July 16, 1996, as required by the Personal Responsibility 
10.26 	and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193, 
10.27 	except for the earned income disregard and employment deductions.
10.28 	(2) For applications processed within one calendar month prior to the effective date, 
10.29 	eligibility shall be determined by applying the income standards and methodologies in 
10.30 	effect prior to the effective date for any months in the six-month budget period before 
10.31 	that date and the income standards and methodologies in effect on the effective date for 
10.32 	any months in the six-month budget period on or after that date. The income standards 
10.33 	for each month shall be added together and compared to the applicant's total countable 
10.34 	income for the six-month budget period to determine eligibility.
10.35 	(b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
11.1 	(2) For applications processed within one calendar month prior to July 1, 2003, 
11.2 	eligibility shall be determined by applying the income standards and methodologies in 
11.3 	effect prior to July 1, 2003, for any months in the six-month budget period before July 1, 
11.4 	2003, and the income standards and methodologies in effect on the expiration date for any 
11.5 	months in the six-month budget period on or after July 1, 2003. The income standards 
11.6 	for each month shall be added together and compared to the applicant's total countable 
11.7 	income for the six-month budget period to determine eligibility.
11.8 	(3) An amount equal to the amount of earned income exceeding 275 percent of 
11.9 	the federal poverty guideline, up to a maximum of the amount by which the combined 
11.10 	total of 185 percent of the federal poverty guideline plus the earned income disregards 
11.11 	and deductions allowed under the state's AFDC plan as of July 16, 1996, as required 
11.12 	by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public 
11.13 	Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for 
11.14 	pregnant women and infants less than one year of age.
11.15 	(c) Dependent care and child support paid under court order shall be deducted from 
11.16 	the countable income of pregnant women.
11.17 	(d) An infant born on or after January 1, 1991, to a woman who was eligible for and 
11.18 	receiving medical assistance on the date of the child's birth shall continue to be eligible for 
11.19 	medical assistance without redetermination until the child's first birthday, as long as the 
11.20 	child remains in the woman's household.

11.21 	Sec. 12. Minnesota Statutes 2006, section 256B.0571, subdivision 6, is amended to 
11.22 	read:
11.23 		Subd. 6.Partnership policy. "Partnership policy" means a long-term care insurance 
11.24 	policy that meets the requirements under subdivision 10 and was issued on or after the 
11.25 	effective date of the state plan amendment implementing the partnership program in 
11.26 	Minnesota. Policies that are exchanged or that have riders or endorsements added on or 
11.27 	after the effective date of the state plan amendment as authorized by the commissioner of 
11.28 	commerce qualify as a partnership policy.

11.29 	Sec. 13. Minnesota Statutes 2006, section 256B.0571, subdivision 8, is amended to 
11.30 	read:
11.31 		Subd. 8.Program established. (a) The commissioner, in cooperation with the 
11.32 	commissioner of commerce, shall establish the Minnesota partnership for long-term care 
11.33 	program to provide for the financing of long-term care through a combination of private 
11.34 	insurance and medical assistance.
12.1 	(b) An individual who meets the requirements in this paragraph is eligible to 
12.2 	participate in the partnership program. The individual must:
12.3 	(1) meet one of the following criteria:
12.4 	(i) be a beneficiary of, and a Minnesota resident at the time coverage first became 
12.5 	effective under the a partnership policy;
12.6 	(2) be a beneficiary of a partnership policy that (i) either  is issued on or after the 
12.7 	effective date of the state plan amendment implementing the partnership program in 
12.8 	Minnesota, or (ii) qualifies as a partnership policy under the provisions of subdivision 
12.9 	8a; and or
12.10 	(ii) be a beneficiary of a policy recognized under subdivision 17; and
12.11 	(3) (2)  have exhausted all of the benefits under the partnership policy as described 
12.12 	in this section. Benefits received under a long-term care insurance policy before July 1, 
12.13 	2006, do not count toward the exhaustion of benefits required in this subdivision.

12.14 	Sec. 14. Minnesota Statutes 2006, section 256B.0571, subdivision 9, is amended to 
12.15 	read:
12.16 		Subd. 9.Medical assistance eligibility. (a) Upon applicationrequest for medical 
12.17 	assistance program payment of long-term care services by an individual who meets the 
12.18 	requirements described in subdivision 8, the commissioner shall determine the individual's 
12.19 	eligibility for medical assistance according to paragraphs (b) to (i).
12.20 	(b) After determining assets subject to the asset limit under section 256B.056, 
12.21 	subdivision 3 or 3c, or 256B.057, subdivision 9 or 10, the commissioner shall allow 
12.22 	the individual to designate assets to be protected from recovery under subdivisions 13 
12.23 	and 15 up to the dollar amount of the benefits utilized under the partnership policy. 
12.24 	Designated assets shall be disregarded for purposes of determining eligibility for payment 
12.25 	of long-term care services.
12.26 	(c) The individual shall identify the designated assets and the full fair market value 
12.27 	of those assets and designate them as assets to be protected at the time of initial application 
12.28 	for medical assistance. The full fair market value of real property or interests in real 
12.29 	property shall be based on the most recent full assessed value for property tax purposes 
12.30 	for the real property, unless the individual provides a complete professional appraisal by 
12.31 	a licensed appraiser to establish the full fair market value. The extent of a life estate in 
12.32 	real property shall be determined using the life estate table in the health care program's 
12.33 	manual. Ownership of any asset in joint tenancy shall be treated as ownership as tenants 
12.34 	in common for purposes of its designation as a disregarded asset. The unprotected value 
12.35 	of any protected asset is subject to estate recovery according to subdivisions 13 and 15.
13.1 	(d) The right to designate assets to be protected is personal to the individual and 
13.2 	ends when the individual dies, except as otherwise provided in subdivisions 13 and 
13.3 	15. It does not include the increase in the value of the protected asset and the income, 
13.4 	dividends, or profits from the asset. It may be exercised by the individual or by anyone 
13.5 	with the legal authority to do so on the individual's behalf. It shall not be sold, assigned, 
13.6 	transferred, or given away.
13.7 	(e) If the dollar amount of the benefits utilized under a partnership policy is greater 
13.8 	than the full fair market value of all assets protected at the time of the application for 
13.9 	medical assistance long-term care services, the individual may designate additional assets 
13.10 	that become available during the individual's lifetime for protection under this section. 
13.11 	The individual must make the designation in writing to the county agency no later than 
13.12 	the last date on which the individual must report a change in circumstances to the county 
13.13 	agency, as provided for under the medical assistance program ten days from the date the 
13.14 	designation is requested by the county agency. Any excess used for this purpose shall not 
13.15 	be available to the individual's estate to protect assets in the estate from recovery under 
13.16 	section 256B.15 or 524.3-1202, or otherwise.
13.17 	(f) This section applies only to estate recovery under United States Code, title 42, 
13.18 	section 1396p, subsections (a) and (b), and does not apply to recovery authorized by other 
13.19 	provisions of federal law, including, but not limited to, recovery from trusts under United 
13.20 	States Code, title 42, section 1396p, subsection (d)(4)(A) and (C), or to recovery from 
13.21 	annuities, or similar legal instruments, subject to section 6012, subsections (a) and (b), of 
13.22 	the Deficit Reduction Act of 2005, Public Law 109-171.
13.23 	(g) An individual's protected assets owned by the individual's spouse who applies 
13.24 	for payment of medical assistance long-term care services shall not be protected assets or 
13.25 	disregarded for purposes of eligibility of the individual's spouse solely because they were 
13.26 	protected assets of the individual.
13.27 	(h) Assets designated under this subdivision shall not be subject to penalty under 
13.28 	section 256B.0595.
13.29 	(i) The commissioner shall otherwise determine the individual's eligibility 
13.30 	for payment of long-term care services according to medical assistance eligibility 
13.31 	requirements.

13.32 	Sec. 15. Minnesota Statutes 2006, section 256B.0571, subdivision 15, is amended to 
13.33 	read:
13.34 		Subd. 15.Limitation on liens. (a) An individual's interest in real property shall not 
13.35 	be subject to a medical assistance lien under sections 514.980 to 514.985 or a notice of 
14.1 	potential claim lien arising under section 256B.15 while and to the extent it is protected 
14.2 	under subdivision 9. An individual's interest in real property that exceeds the value 
14.3 	protected under subdivision 9 is subject to a lien for recovery.
14.4 	(b) Medical assistance liens under sections 514.980 to 514.985 or liens arising 
14.5 	under notices of potential claims section 256B.15 against an individual's interests in real 
14.6 	property in the individual's estate that are designated as protected under subdivision 13, 
14.7 	paragraph (b), shall be released to the extent of the dollar value of the protection applied 
14.8 	to the interest.
14.9 	(c) If an interest in real property is protected from a lien for recovery of medical 
14.10 	assistance paid on behalf of the individual under paragraph (a) or (b), no lien for recovery 
14.11 	of medical assistance paid on behalf of that individual shall be filed against the protected 
14.12 	interest in real property after it is distributed to the individual's heirs or devisees.

14.13 	Sec. 16. Minnesota Statutes 2006, section 256B.0571, is amended by adding a 
14.14 	subdivision to read:
14.15 		Subd. 17.Reciprocal agreements. The commissioner may enter into an agreement 
14.16 	with any other state with a partnership program under United States Code, title 42, 
14.17 	section 1396p(b)(1)(C), for reciprocal recognition of qualified long-term care insurance 
14.18 	policies purchased under each state's partnership program. The commissioner shall notify 
14.19 	the secretary of the United States Department of Health and Human Services if the 
14.20 	commissioner declines to enter into a national reciprocal agreement.

14.21 	Sec. 17. Minnesota Statutes 2006, section 256B.058, is amended to read:
14.22 	256B.058 TREATMENT OF INCOME OF INSTITUTIONALIZED SPOUSE.
14.23 		Subdivision 1.Income not available. The income described in subdivisions 2 and 3 
14.24 	shall be deducted from an institutionalized spouse's monthly income and is not considered 
14.25 	available for payment of the monthly costs of an institutionalized personspouse in the 
14.26 	institution after the person has been determined eligible for medical assistance.
14.27 		Subd. 2.Monthly income allowance for community spouse. (a) For an 
14.28 	institutionalized spouse with a spouse residing in the community, monthly income may be 
14.29 	allocated to the community spouse as a monthly income allowance for the community 
14.30 	spouse. Beginning with the first full calendar month the institutionalized spouse is 
14.31 	in the institution, the monthly income allowance is not considered available to the 
14.32 	institutionalized spouse for monthly payment of costs of care in the institution as long as 
14.33 	the income is made available to the community spouse.
15.1 	(b) The monthly income allowance is the amount by which the community spouse's 
15.2 	monthly maintenance needs allowance under paragraphs (c) and (d) exceeds the amount 
15.3 	of monthly income otherwise available to the community spouse.
15.4 	(c) The community spouse's monthly maintenance needs allowance is the lesser of 
15.5 	$1,500 or 122 percent of the monthly federal poverty guideline for a family of two plus 
15.6 	an excess shelter allowance. The excess shelter allowance is for the amount of shelter 
15.7 	expenses that exceed 30 percent of 122 percent of the federal poverty guideline line for a 
15.8 	family of two. Shelter expenses are the community spouse's expenses for rent, mortgage 
15.9 	payments including principal and interest, taxes, insurance, required maintenance charges 
15.10 	for a cooperative or condominium that is the community spouse's principal residence, 
15.11 	and the standard utility allowance under section 5(e) of the federal Food Stamp Act of 
15.12 	1977. If the community spouse has a required maintenance charge for a cooperative or 
15.13 	condominium, the standard utility allowance must be reduced by the amount of utility 
15.14 	expenses included in the required maintenance charge.
15.15 	If the community or institutionalized spouse establishes that the community spouse 
15.16 	needs income greater than the monthly maintenance needs allowance determined in this 
15.17 	paragraph due to exceptional circumstances resulting in significant financial duress, the 
15.18 	monthly maintenance needs allowance may be increased to an amount that provides 
15.19 	needed additional income.
15.20 	(d) The percentage of the federal poverty guideline used to determine the monthly 
15.21 	maintenance needs allowance in paragraph (c) is increased to 133 percent on July 1, 
15.22 	1991, and to 150 percent on July 1, 1992. Adjustments in the income limits due to annual 
15.23 	changes in the federal poverty guidelines shall be implemented the first day of July 
15.24 	following publication of the annual changes. The $1,500 maximum must be adjusted 
15.25 	January 1, 1990, and every January 1 after that by the same percentage increase in the 
15.26 	Consumer Price Index for all urban consumers (all items; United States city average) 
15.27 	between the two previous Septembers.
15.28 	(e) If a court has entered an order against an institutionalized spouse for monthly 
15.29 	income for support of the community spouse, the community spouse's monthly income 
15.30 	allowance under this subdivision shall not be less than the amount of the monthly income 
15.31 	ordered.
15.32 		Subd. 3.Family allowance. (a) A family allowance determined under paragraph 
15.33 	(b) is not considered available to the institutionalized spouse for monthly payment of costs 
15.34 	of care in the institution.
16.1 	(b) The family allowance is equal to one-third of the amount by which 122 percent 
16.2 	of the monthly federal poverty guideline for a family of two exceeds the monthly income 
16.3 	for that family member.
16.4 	(c) For purposes of this subdivision, the term family member only includes a 
16.5 	minor or dependent child as defined in the Internal Revenue Code, dependent parent, or 
16.6 	dependent sibling of the institutionalized or community spouse if the sibling resides with 
16.7 	the community spouse.
16.8 	(d) The percentage of the federal poverty guideline used to determine the family 
16.9 	allowance in paragraph (b) is increased to 133 percent on July 1, 1991, and to 150 percent 
16.10 	on July 1, 1992. Adjustments in the income limits due to annual changes in the federal 
16.11 	poverty guidelines shall be implemented the first day of July following publication of 
16.12 	the annual changes.
16.13 		Subd. 4.Treatment of income. (a) No income of the community spouse will 
16.14 	be considered available to an eligible institutionalized spouse, beginning the first full 
16.15 	calendar month of institutionalization, except as provided in this subdivision.
16.16 	(b) In determining the income of an institutionalized spouse or community spouse, 
16.17 	after the institutionalized spouse has been determined eligible for medical assistance, 
16.18 	the following rules apply.
16.19 	(1) For income that is not from a trust, availability is determined according to items 
16.20 	(i) to (v), unless the instrument providing the income otherwise specifically provides:
16.21 	(i) if payment is made solely in the name of one spouse, the income is considered 
16.22 	available only to that spouse;
16.23 	(ii) if payment is made in the names of both spouses, one-half of the income is 
16.24 	considered available to each;
16.25 	(iii) if payment is made in the names of one or both spouses together with one or 
16.26 	more other persons, the income is considered available to each spouse according to the 
16.27 	spouse's interest, or one-half of the joint interest is considered available to each spouse 
16.28 	if each spouse's interest is not specified;
16.29 	(iv) if there is no instrument that establishes ownership, one-half of the income is 
16.30 	considered available to each spouse; and
16.31 	(v) either spouse may rebut the determination of availability of income by showing 
16.32 	by a preponderance of the evidence that ownership interests are different than provided 
16.33 	above.
16.34 	(2) For income from a trust, income is considered available to each spouse as 
16.35 	provided in the trust. If the trust does not specify an amount available to either or both 
16.36 	spouses, availability will be determined according to items (i) to (iii):
17.1 	(i) if payment of income is made only to one spouse, the income is considered 
17.2 	available only to that spouse;
17.3 	(ii) if payment of income is made to both spouses, one-half is considered available to 
17.4 	each; and
17.5 	(iii) if payment is made to either or both spouses and one or more other persons, 
17.6 	the income is considered available to each spouse in proportion to each spouse's interest, 
17.7 	or if no such interest is specified, one-half of the joint interest is considered available 
17.8 	to each spouse.

17.9 	Sec. 18. Minnesota Statutes 2006, section 256B.059, subdivision 1, is amended to read:
17.10 		Subdivision 1.Definitions. (a) For purposes of this section and section sections 
17.11 	256B.058 and256B.0595, the terms defined in this subdivision have the meanings given 
17.12 	them. 
17.13 	(b) "Community spouse" means the spouse of an institutionalized spouse.
17.14 	(c) "Spousal share" means one-half of the total value of all assets, to the extent that 
17.15 	either the institutionalized spouse or the community spouse had an ownership interest at 
17.16 	the time of the first continuous period of institutionalization.
17.17 	(d) "Assets otherwise available to the community spouse" means assets individually 
17.18 	or jointly owned by the community spouse, other than assets excluded by subdivision 5, 
17.19 	paragraph (c).
17.20 	(e) "Community spouse asset allowance" is the value of assets that can be transferred 
17.21 	under subdivision 3.
17.22 	(f) "Institutionalized spouse" means a person who is:
17.23 	(1) in a hospital, nursing facility, or intermediate care facility for persons with 
17.24 	developmental disabilities, or receiving home and community-based services under 
17.25 	section 256B.0915or 256B.49, and is expected to remain in the facility or institution or 
17.26 	receive the home and community-based services for at least 30 consecutive days; and 
17.27 	(2) married to a person who is not in a hospital, nursing facility, or intermediate 
17.28 	care facility for persons with developmental disabilities, and is not receiving home and 
17.29 	community-based services under section 256B.0915, 256B.092,  or 256B.49. 
17.30 	(g) "For the sole benefit of" means no other individual or entity can benefit in any 
17.31 	way from the assets or income at the time of a transfer or at any time in the future.
17.32 	(h) "Continuous period of institutionalization" means a 30-consecutive-day period 
17.33 	of time in which a person is expected to stay in a medical or long-term care facility, 
17.34 	or receive home and community-based services that would qualify for coverage under 
17.35 	the elderly waiver (EW) or alternative care (AC) programs. For a stay in a facility, the 
18.1 	30-consecutive-day period begins on the date of entry into a medical or long-term care 
18.2 	facility. For receipt of home and community-based services, the 30-consecutive-day 
18.3 	period begins on the date that the following conditions are met:
18.4 	(1) the person is receiving services that meet the nursing facility level of care 
18.5 	determined by a long-term care consultation;
18.6 	(2) the person has received the long-term care consultation within the past 60 days;
18.7 	(3) the services are paid by the EW program under section 256B.0915 or the AC 
18.8 	program under section 256B.0913 or would qualify for payment under the EW or AC 
18.9 	programs if the person were otherwise eligible for either program, and but for the receipt 
18.10 	of such services the person would have resided in a nursing facility; and
18.11 	(4) the services are provided by a licensed provider qualified to provide home and 
18.12 	community-based services.

18.13 	Sec. 19. Minnesota Statutes 2006, section 256B.059, subdivision 1a, is amended to 
18.14 	read:
18.15 		Subd. 1a.Institutionalized spouse. The provisions of this section apply only 
18.16 	when a spouse is institutionalized for abegins the first continuous period beginningof 
18.17 	institutionalization on or after October 1, 1989.

18.18 	Sec. 20. Minnesota Statutes 2006, section 256B.0594, is amended to read:
18.19 	256B.0594 PAYMENT OF BENEFITS FROM AN ANNUITY.
18.20 	When payment becomes due under an annuity that names the department a 
18.21 	remainder beneficiary as described in section 256B.056, subdivision 11, the issuer shall 
18.22 	request and the department shall, within 45 days after receipt of the request, provide 
18.23 	a written statement of the total amount of the medical assistance paid or confirmation 
18.24 	that any family member designated as a remainder beneficiary meets requirements for 
18.25 	qualification as a beneficiary in the first position. Upon timely receipt of the written 
18.26 	statement of the amount of medical assistance paid, the issuer shall pay the department an 
18.27 	amount equal to the lesser of the amount due the department under the annuity or the total 
18.28 	amount of medical assistance paid on behalf of the individual or the individual's spouse. 
18.29 	Any amounts remaining after the issuer's payment to the department shall be payable 
18.30 	according to the terms of the annuity or similar financial instrument. The county agency 
18.31 	or the department shall provide the issuer with the name, address, and telephone number 
18.32 	of a unit within the department the issuer can contact to comply with this section. The 
18.33 	requirements of section 72A.201, subdivision 4, clause (3), shall not apply to payments 
18.34 	made under this section until the issuer has received final payment information from the 
19.1 	department, if the issuer has notified the beneficiary of the requirements of this section at 
19.2 	the time it initially requests payment information from the department.

19.3 	Sec. 21. Minnesota Statutes 2006, section 256B.0595, subdivision 1, is amended to 
19.4 	read:
19.5 		Subdivision 1.Prohibited transfers. (a) For transfers of assets made on or before 
19.6 	August 10, 1993, if a an institutionalized person or the institutionalized person's spouse 
19.7 	has given away, sold, or disposed of, for less than fair market value, any asset or interest 
19.8 	therein, except assets other than the homestead that are excluded under the supplemental 
19.9 	security program, within 30 months before or any time after the date of institutionalization 
19.10 	if the person has been determined eligible for medical assistance, or within 30 months 
19.11 	before or any time after the date of the first approved application for medical assistance 
19.12 	if the person has not yet been determined eligible for medical assistance, the person is 
19.13 	ineligible for long-term care services for the period of time determined under subdivision 
19.14 	2.
19.15 	(b) Effective for transfers made after August 10, 1993, a an institutionalized person, 
19.16 	a an institutionalized person's spouse, or any person, court, or administrative body with 
19.17 	legal authority to act in place of, on behalf of, at the direction of, or upon the request of the 
19.18 	institutionalized person or institutionalized person's spouse, may not give away, sell, or 
19.19 	dispose of, for less than fair market value, any asset or interest therein, except assets other 
19.20 	than the homestead that are excluded under the supplemental security income program, 
19.21 	for the purpose of establishing or maintaining medical assistance eligibility. This applies 
19.22 	to all transfers, including those made by a community spouse after the month in which 
19.23 	the institutionalized spouse is determined eligible for medical assistance. For purposes of 
19.24 	determining eligibility for long-term care services, any transfer of such assets within 36 
19.25 	months before or any time after an institutionalized person applies forrequests medical 
19.26 	assistance payment of long-term care services, or 36 months before or any time after a 
19.27 	medical assistance recipient becomes an institutionalized person, for less than fair market 
19.28 	value may be considered. Any such transfer is presumed to have been made for the purpose 
19.29 	of establishing or maintaining medical assistance eligibility and the institutionalized
19.30 	person is ineligible for long-term care services for the period of time determined under 
19.31 	subdivision 2, unless the institutionalized person furnishes convincing evidence to 
19.32 	establish that the transaction was exclusively for another purpose, or unless the transfer is 
19.33 	permitted under subdivision 3 or 4.  In the case of payments from a trust or portions of a 
19.34 	trust that are considered transfers of assets under federal law, or in the case of any other 
19.35 	disposal of assets made on or after February 8, 2006, any transfers made within 60 months 
20.1 	before or any time after an institutionalized person applies forrequests medical assistance 
20.2 	payment of long-term care services and within 60 months before or any time after a 
20.3 	medical assistance recipient becomes an institutionalized person, may be considered.
20.4 	(c) This section applies to transfers, for less than fair market value, of income 
20.5 	or assets, including assets that are considered income in the month received, such as 
20.6 	inheritances, court settlements, and retroactive benefit payments or income to which the
20.7 	institutionalized person or the institutionalized person's spouse is entitled but does not 
20.8 	receive due to action by the institutionalized person, the institutionalized person's spouse, 
20.9 	or any person, court, or administrative body with legal authority to act in place of, on 
20.10 	behalf of, at the direction of, or upon the request of the institutionalized person or the
20.11 	institutionalized person's spouse.
20.12 	(d) This section applies to payments for care or personal services provided by a 
20.13 	relative, unless the compensation was stipulated in a notarized, written agreement which 
20.14 	was in existence when the service was performed, the care or services directly benefited 
20.15 	the person, and the payments made represented reasonable compensation for the care 
20.16 	or services provided. A notarized written agreement is not required if payment for the 
20.17 	services was made within 60 days after the service was provided.
20.18 	(e) This section applies to the portion of any asset or interest that a an institutionalized
20.19 	person, a an institutionalized person's spouse, or any person, court, or administrative body 
20.20 	with legal authority to act in place of, on behalf of, at the direction of, or upon the request 
20.21 	of the institutionalized person or the institutionalized person's spouse, transfers to any 
20.22 	annuity that exceeds the value of the benefit likely to be returned to the institutionalized 
20.23 	person or institutionalized person's spouse while alive, based on estimated life expectancy 
20.24 	using the life expectancy tables employed by the supplemental security income program 
20.25 	to determine the value of an agreement for services for life as determined according to the 
20.26 	current actuarial tables published by the Office of the Chief Actuary of the Social Security 
20.27 	Administration. The commissioner may adopt rules reducing life expectancies based on 
20.28 	the need for long-term care. This section applies to an annuity described in this paragraph
20.29 	purchased on or after March 1, 2002, that:
20.30 	(1) is not purchased from an insurance company or financial institution that is 
20.31 	subject to licensing or regulation by the Minnesota Department of Commerce or a similar 
20.32 	regulatory agency of another state;
20.33 	(2) does not pay out principal and interest in equal monthly installments; or
20.34 	(3) does not begin payment at the earliest possible date after annuitization.
20.35 	(f) Effective for transactions, including the purchase of an annuity, occurring on 
20.36 	or after February 8, 2006, the purchase of an annuity by or on behalf of an individual
21.1 	institutionalized person who has applied for or is receiving long-term care services or the 
21.2 	individual's institutionalized person's spouse shall be treated as the disposal of an asset for 
21.3 	less than fair market value unless the department is named as the a preferred remainder 
21.4 	beneficiary in first position for an amount equal to at least the total amount of medical 
21.5 	assistance paid on behalf of the individual or the individual's spouse; or the department 
21.6 	is named as the remainder beneficiary in second position for an amount equal to at least 
21.7 	the total amount of medical assistance paid on behalf of the individual or the individual's 
21.8 	spouse after the individual's community spouse or minor or disabled child and is named as 
21.9 	the remainder beneficiary in the first position if the community spouse or a representative 
21.10 	of the minor or disabled child disposes of the remainder for less than fair market value  as 
21.11 	described in section 256B.056, subdivision 11. Any subsequent change to the designation 
21.12 	of the department as a preferred remainder beneficiary shall result in the annuity being 
21.13 	treated as a disposal of assets for less than fair market value. The amount of such transfer 
21.14 	shall be the maximum amount the individual institutionalized person or the individual's
21.15 	institutionalized person's spouse could receive from the annuity or similar financial 
21.16 	instrument. Any change in the amount of the income or principal being withdrawn 
21.17 	from the annuity or other similar financial instrument at the time of the most recent 
21.18 	disclosure shall be deemed to be a transfer of assets for less than fair market value unless 
21.19 	the individual institutionalized person or the individual's institutionalized person's spouse 
21.20 	demonstrates that the transaction was for fair market value. In the event a distribution 
21.21 	of income or principal has been improperly distributed or disbursed from an annuity or 
21.22 	other retirement planning instrument of an institutionalized person or the institutionalized 
21.23 	person's spouse, a cause of action exists against the individual receiving the improper 
21.24 	distribution for the cost of medical assistance services provided or the amount of the 
21.25 	improper distribution, whichever is less.
21.26 	(g) Effective for transactions, including the purchase of an annuity, occurring on 
21.27 	or after February 8, 2006, the purchase of an annuity by or on behalf of an individual
21.28 	institutionalized person applying for or receiving long-term care services shall be treated 
21.29 	as a disposal of assets for less than fair market value unless it is:
21.30 	(i) an annuity described in subsection (b) or (q) of section 408 of the Internal 
21.31 	Revenue Code of 1986; or 
21.32 	(ii) purchased with proceeds from:
21.33 	(A) an account or trust described in subsection (a), (c), or (p) of section 408 of the 
21.34 	Internal Revenue Code;
21.35 	(B) a simplified employee pension within the meaning of section 408(k) of the 
21.36 	Internal Revenue Code; or
22.1 	(C) a Roth IRA described in section 408A of the Internal Revenue Code; or
22.2 	(iii) an annuity that is irrevocable and nonassignable; is actuarially sound as 
22.3 	determined in accordance with actuarial publications of the Office of the Chief Actuary of 
22.4 	the Social Security Administration; and provides for payments in equal amounts during 
22.5 	the term of the annuity, with no deferral and no balloon payments made.
22.6 	 (h) For purposes of this section, long-term care services include services in a nursing 
22.7 	facility, services that are eligible for payment according to section 256B.0625, subdivision 
22.8 	2, because they are provided in a swing bed, intermediate care facility for persons with 
22.9 	developmental disabilities, and home and community-based services provided pursuant 
22.10 	to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and 
22.11 	subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient 
22.12 	in a nursing facility or in a swing bed, or intermediate care facility for persons with 
22.13 	developmental disabilities or who is receiving home and community-based services under 
22.14 	sections 256B.0915, 256B.092, and 256B.49. 
22.15 	(i) This section applies to funds used to purchase a promissory note, loan, or 
22.16 	mortgage unless the note, loan, or mortgage:
22.17 	(1) has a repayment term that is actuarially sound;
22.18 	(2) provides for payments to be made in equal amounts during the term of the loan, 
22.19 	with no deferral and no balloon payments made; and
22.20 	(3) prohibits the cancellation of the balance upon the death of the lender.
22.21 	In the case of a promissory note, loan, or mortgage that does not meet an exception 
22.22 	in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding 
22.23 	balance due as of the date of the individual's applicationinstitutionalized person's request 
22.24 	for medical assistance payment of long-term care services.
22.25 	(j) This section applies to the purchase of a life estate interest in another individual's
22.26 	person's home unless the purchaser resides in the home for a period of at least one year 
22.27 	after the date of purchase.

22.28 	Sec. 22. Minnesota Statutes 2006, section 256B.0595, subdivision 2, is amended to 
22.29 	read:
22.30 		Subd. 2.Period of ineligibility. (a) For any uncompensated transfer occurring on or 
22.31 	before August 10, 1993, the number of months of ineligibility for long-term care services 
22.32 	shall be the lesser of 30 months, or the uncompensated transfer amount divided by the 
22.33 	average medical assistance rate for nursing facility services in the state in effect on the 
22.34 	date of application. The amount used to calculate the average medical assistance payment 
22.35 	rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year. 
23.1 	The period of ineligibility begins with the month in which the assets were transferred. 
23.2 	If the transfer was not reported to the local agency at the time of application, and the 
23.3 	applicant received long-term care services during what would have been the period of 
23.4 	ineligibility if the transfer had been reported, a cause of action exists against the transferee 
23.5 	for the cost of long-term care services provided during the period of ineligibility, or for the 
23.6 	uncompensated amount of the transfer, whichever is less. The action may be brought by 
23.7 	the state or the local agency responsible for providing medical assistance under chapter 
23.8 	256G. The uncompensated transfer amount is the fair market value of the asset at the time 
23.9 	it was given away, sold, or disposed of, less the amount of compensation received.
23.10 	(b) For uncompensated transfers made after August 10, 1993, the number of months 
23.11 	of ineligibility for long-term care services shall be the total uncompensated value of the 
23.12 	resources transferred divided by the average medical assistance rate for nursing facility 
23.13 	services in the state in effect on the date of application. The amount used to calculate the 
23.14 	average medical assistance payment rate shall be adjusted each July 1 to reflect payment 
23.15 	rates for the previous calendar year. The period of ineligibility begins with the first day 
23.16 	of the month after the month in which the assets were transferred except that if one or 
23.17 	more uncompensated transfers are made during a period of ineligibility, the total assets 
23.18 	transferred during the ineligibility period shall be combined and a penalty period calculated 
23.19 	to begin on the first day of the month after the month in which the first uncompensated 
23.20 	transfer was made. If the transfer was reported to the local agency after the date that 
23.21 	advance notice of a period of ineligibility that affects the next month could be provided to 
23.22 	the recipient and the recipient received medical assistance services or the transfer was not 
23.23 	reported to the local agency, and the applicant or recipient received medical assistance 
23.24 	services during what would have been the period of ineligibility if the transfer had been 
23.25 	reported, a cause of action exists against the transferee for the cost of medical assistance
23.26 	that portion of long-term care services provided during the period of ineligibility, or for 
23.27 	the uncompensated amount of the transfer, whichever is less. The action may be brought 
23.28 	by the state or the local agency responsible for providing medical assistance under chapter 
23.29 	256G. The uncompensated transfer amount is the fair market value of the asset at the 
23.30 	time it was given away, sold, or disposed of, less the amount of compensation received. 
23.31 	Effective for transfers made on or after March 1, 1996, involving persons who apply for 
23.32 	medical assistance on or after April 13, 1996, no cause of action exists for a transfer unless:
23.33 	(1) the transferee knew or should have known that the transfer was being made by a 
23.34 	person who was a resident of a long-term care facility or was receiving that level of care in 
23.35 	the community at the time of the transfer;
24.1 	(2) the transferee knew or should have known that the transfer was being made to 
24.2 	assist the person to qualify for or retain medical assistance eligibility; or
24.3 	(3) the transferee actively solicited the transfer with intent to assist the person to 
24.4 	qualify for or retain eligibility for medical assistance.
24.5 	(c) For uncompensated transfers made on or after February 8, 2006, the period 
24.6 	of ineligibility:
24.7 	(1) for uncompensated transfers by or on behalf of individuals receiving medical 
24.8 	assistance payment of long-term care services, begins on the first day of the month 
24.9 	in which following advance notice can be given following of the penalty period, but no 
24.10 	later than the first day of the month in which assets have been transferred for less than 
24.11 	fair market value, that follows three full calendar months from the date of the report 
24.12 	or discovery of the transfer; or 
24.13 	(2) for uncompensated transfers by individuals requesting medical assistance 
24.14 	payment of long-term care services, begins the date on which the individual is eligible 
24.15 	for medical assistance under the Medicaid state plan and would otherwise be receiving 
24.16 	long-term care services based on an approved application for such care but for the 
24.17 	application of the penalty period, whichever is later,; and which does not occur
24.18 	(3) cannot begin during any other period of ineligibility.
24.19 	(d) If a calculation of a penalty period results in a partial month, payments for 
24.20 	long-term care services shall be reduced in an amount equal to the fraction. 
24.21 	(e) In the case of multiple fractional transfers of assets in more than one month for 
24.22 	less than fair market value on or after February 8, 2006, the period of ineligibility is 
24.23 	calculated by treating the total, cumulative, uncompensated value of all assets transferred 
24.24 	during all months on or after February 8, 2006, as one transfer.

24.25 	Sec. 23. Minnesota Statutes 2006, section 256B.0595, subdivision 3, is amended to 
24.26 	read:
24.27 		Subd. 3.Homestead exception to transfer prohibition. (a) An institutionalized 
24.28 	person is not ineligible for long-term care services due to a transfer of assets for less than 
24.29 	fair market value if the asset transferred was a homestead and:
24.30 	(1) title to the homestead was transferred to the individual's:
24.31 	(i) spouse;
24.32 	(ii) child who is under age 21;
24.33 	(iii) blind or permanently and totally disabled child as defined in the supplemental 
24.34 	security income program;
25.1 	(iv) sibling who has equity interest in the home and who was residing in the home 
25.2 	for a period of at least one year immediately before the date of the individual's admission 
25.3 	to the facility; or
25.4 	(v) son or daughter who was residing in the individual's home for a period of at least 
25.5 	two years immediately before the date of the individual's admission to the facility the 
25.6 	individual became an institutionalized person, and who provided care to the individual 
25.7 	that, as certified by the individual's attending physician, permitted the individual to reside 
25.8 	at home rather than receive care in an institution or facility;
25.9 	(2) a satisfactory showing is made that the individual intended to dispose of the 
25.10 	homestead at fair market value or for other valuable consideration; or
25.11 	(3) the local agency grants a waiver of a penalty resulting from a transfer for less 
25.12 	than fair market value because denial of eligibility would cause undue hardship for the 
25.13 	individual, based on imminent threat to the individual's health and well-being. Whenever 
25.14 	an applicant or recipient is denied eligibility because of a transfer for less than fair market 
25.15 	value, the local agency shall notify the applicant or recipient that the applicant or recipient 
25.16 	may request a waiver of the penalty if the denial of eligibility will cause undue hardship. 
25.17 	With the written consent of the individual or the personal representative of the individual, 
25.18 	a long-term care facility in which an individual is residing may file an undue hardship 
25.19 	waiver request, on behalf of the individual who is denied eligibility for long-term care 
25.20 	services on or after July 1, 2006, due to a period of ineligibility resulting from a transfer on 
25.21 	or after February 8, 2006. In evaluating a waiver, the local agency shall take into account 
25.22 	whether the individual was the victim of financial exploitation, whether the individual has 
25.23 	made reasonable efforts to recover the transferred property or resource, and other factors 
25.24 	relevant to a determination of hardship. If the local agency does not approve a hardship 
25.25 	waiver, the local agency shall issue a written notice to the individual stating the reasons 
25.26 	for the denial and the process for appealing the local agency's decision.
25.27 	(b) When a waiver is granted under paragraph (a), clause (3), a cause of action exists 
25.28 	against the person to whom the homestead was transferred for that portion of long-term 
25.29 	care services granted provided  within:
25.30 	(1) 30 months of a transfer made on or before August 10, 1993;
25.31 	(2) 60 months if the homestead was transferred after August 10, 1993, to a trust or 
25.32 	portion of a trust that is considered a transfer of assets under federal law; 
25.33 	(3) 36 months if transferred in any other manner after August 10, 1993, but prior 
25.34 	to February 8, 2006; or
25.35 	(4) 60 months if the homestead was transferred on or after February 8, 2006,
26.1 	or the amount of the uncompensated transfer, whichever is less, together with the 
26.2 	costs incurred due to the action. The action shall be brought by the state unless the 
26.3 	state delegates this responsibility to the local agency responsible for providing medical 
26.4 	assistance under chapter 256G.

26.5 	Sec. 24. Minnesota Statutes 2006, section 256B.0595, subdivision 4, is amended to 
26.6 	read:
26.7 		Subd. 4.Other exceptions to transfer prohibition. An institutionalized person 
26.8 	who has made, or whose spouse has made a transfer prohibited by subdivision 1, is not 
26.9 	ineligible for long-term care services if one of the following conditions applies:
26.10 	(1) the assets were transferred to the individual's spouse or to another for the sole 
26.11 	benefit of the spouse; or
26.12 	(2) the institutionalized spouse, prior to being institutionalized, transferred assets 
26.13 	to a spouse, provided that the spouse to whom the assets were transferred does not then 
26.14 	transfer those assets to another person for less than fair market value. (At the time when 
26.15 	one spouse is institutionalized, assets must be allocated between the spouses as provided 
26.16 	under section 256B.059); or
26.17 	(3) the assets were transferred to the individual's child who is blind or permanently 
26.18 	and totally disabled as determined in the supplemental security income program; or
26.19 	(4) a satisfactory showing is made that the individual intended to dispose of the 
26.20 	assets either at fair market value or for other valuable consideration; or
26.21 	(5) the local agency determines that denial of eligibility for long-term care services 
26.22 	would work an undue hardship and grants a waiver of a penalty resulting from a transfer 
26.23 	for less than fair market value based on an imminent threat to the individual's health 
26.24 	and well-being. Whenever an applicant or recipient is denied eligibility because of a 
26.25 	transfer for less than fair market value, the local agency shall notify the applicant or 
26.26 	recipient that the applicant or recipient may request a waiver of the penalty if the denial of 
26.27 	eligibility will cause undue hardship. With the written consent of the individual or the 
26.28 	personal representative of the individual, a long-term care facility in which an individual 
26.29 	is residing may file an undue hardship waiver request, on behalf of the individual who 
26.30 	is denied eligibility for long-term care services on or after July 1, 2006, due to a period 
26.31 	of ineligibility resulting from a transfer on or after February 8, 2006. In evaluating a 
26.32 	waiver, the local agency shall take into account whether the individual was the victim of 
26.33 	financial exploitation, whether the individual has made reasonable efforts to recover the 
26.34 	transferred property or resource, whether the individual has taken any action to prevent 
26.35 	the designation of the department as a remainder beneficiary on an annuity as described 
27.1 	in section 256B.056, subdivision 11, and other factors relevant to a determination of 
27.2 	hardship. The local agency shall make a determination within 30 days of the receipt of all 
27.3 	necessary information needed to make such a determination. If the local agency does not 
27.4 	approve a hardship waiver, the local agency shall issue a written notice to the individual 
27.5 	stating the reasons for the denial and the process for appealing the local agency's decision. 
27.6 	When a waiver is granted, a cause of action exists against the person to whom the assets 
27.7 	were transferred for that portion of long-term care services granted provided  within:
27.8 	(i) 30 months of a transfer made on or before August 10, 1993;
27.9 	(ii) 60 months of a transfer if the assets were transferred after August 30, 1993, to a 
27.10 	trust or portion of a trust that is considered a transfer of assets under federal law; 
27.11 	(iii) 36 months of a transfer if transferred in any other manner after August 10, 1993, 
27.12 	but prior to February 8, 2006; or
27.13 	(iv) 60 months of any transfer made on or after February 8, 2006,
27.14 	or the amount of the uncompensated transfer, whichever is less, together with the 
27.15 	costs incurred due to the action. The action shall be brought by the state unless the 
27.16 	state delegates this responsibility to the local agency responsible for providing medical 
27.17 	assistance under this chapter; or
27.18 	(6) for transfers occurring after August 10, 1993, the assets were transferred by 
27.19 	the person or person's spouse: (i) into a trust established for the sole benefit of a son or 
27.20 	daughter of any age who is blind or disabled as defined by the Supplemental Security 
27.21 	Income program; or (ii) into a trust established for the sole benefit of an individual who is 
27.22 	under 65 years of age who is disabled as defined by the Supplemental Security Income 
27.23 	program.
27.24 	"For the sole benefit of" has the meaning found in section 256B.059, subdivision 1. 

27.25 	Sec. 25. Minnesota Statutes 2006, section 256B.0595, is amended by adding a 
27.26 	subdivision to read:
27.27 		Subd. 8.Cause of action; transfer prior to death. (a) A cause of action exists 
27.28 	against a transferee who receives assets for less than fair market value, either:
27.29 	(1) from a person who was a recipient of medical assistance and who made an 
27.30 	uncompensated transfer that was known to the county agency but a penalty period could 
27.31 	not be implemented under this section due to the death of the person; or
27.32 	(2) from a person who was a recipient of medical assistance who made an 
27.33 	uncompensated transfer that was not known to the county agency and the transfer was 
27.34 	made with the intent to hinder, delay, or defraud the state or local agency from recovering 
28.1 	as allowed under section 256B.15. In determining intent under this clause consideration 
28.2 	may be given, among other factors, to whether:
28.3 	(i) the transfer was to a family member;
28.4 	(ii) the transferor retained possession or control of the property after the transfer;
28.5 	(iii) the transfer was concealed;
28.6 	(iv) the transfer included the majority of the transferor's assets;
28.7 	(v) the value of the consideration received was not reasonably equivalent to the fair 
28.8 	market value of the property; and
28.9 	(vi) the transfer occurred shortly before the death of the transferor.
28.10 	(b) No cause of action exists under this subdivision unless:
28.11 	(1) the transferee knew or should have known that the transfer was being made by a 
28.12 	person who was receiving medical assistance as described in section 256B.15, subdivision 
28.13 	1, paragraph (b); and 
28.14 	(2) the transferee received the asset without providing a reasonable equivalent fair 
28.15 	market value in exchange for the transfer.
28.16 	(c) The cause of action is for the uncompensated amount of the transfer or the 
28.17 	amount of medical assistance paid on behalf of the person, whichever is less. The 
28.18 	uncompensated transfer amount is the fair market value of the asset at the time it was 
28.19 	given away, sold, or disposed of, less the amount of the compensation received.

28.20 	Sec. 26. Minnesota Statutes 2006, section 256B.0595, is amended by adding a 
28.21 	subdivision to read:
28.22 		Subd. 9.Filing cause of action; limitation. (a) The county of financial 
28.23 	responsibility under chapter 256G may bring a cause of action under any or all of the 
28.24 	following:
28.25 	(1) subdivision 1, paragraph (f);
28.26 	(2) subdivision 2, paragraphs (a) and (b);
28.27 	(3) subdivision 3, paragraph (b);
28.28 	(4) subdivision 4, clause (5); and
28.29 	(5) subdivision 8
28.30 	on behalf of the claimant who must be the commissioner.
28.31 	(b) Notwithstanding any other law to the contrary, a cause of action under 
28.32 	subdivision 2, paragraph (a) or (b), or subdivision 8, must be commenced within six years 
28.33 	of the date the local agency determines that a transfer was made for less than fair market 
28.34 	value. Notwithstanding any other law to the contrary, a cause of action under subdivision 
28.35 	3, paragraph (b), or subdivision 4, clause (5), must be commenced within six years of the 
29.1 	date of approval of a waiver of the penalty period for a transfer for less than fair market 
29.2 	value based on undue hardship.

29.3 	Sec. 27. Minnesota Statutes 2006, section 256B.0625, subdivision 13g, is amended to 
29.4 	read:
29.5 		Subd. 13g.Preferred drug list. (a) The commissioner shall adopt and implement a 
29.6 	preferred drug list by January 1, 2004. The commissioner may enter into a contract with 
29.7 	a vendor or one or more states for the purpose of participating in a multistate preferred 
29.8 	drug list and supplemental rebate program. The commissioner shall ensure that any 
29.9 	contract meets all federal requirements and maximizes federal financial participation. The 
29.10 	commissioner shall publish the preferred drug list annually in the State Register and shall 
29.11 	maintain an accurate and up-to-date list on the agency Web site.
29.12 	(b) The commissioner may add to, delete from, and otherwise modify the preferred 
29.13 	drug list, after consulting with the Formulary Committee and appropriate medical 
29.14 	specialists and providing public notice and the opportunity for public comment.
29.15 	(c) The commissioner shall adopt and administer the preferred drug list as part of the 
29.16 	administration of the supplemental drug rebate program. Reimbursement for prescription 
29.17 	drugs not on the preferred drug list may be subject to prior authorization, unless the drug 
29.18 	manufacturer signs a supplemental rebate contract.
29.19 	(d) For purposes of this subdivision, "preferred drug list" means a list of prescription 
29.20 	drugs within designated therapeutic classes selected by the commissioner, for which prior 
29.21 	authorization based on the identity of the drug or class is not required.
29.22 	(e) The commissioner shall seek any federal waivers or approvals necessary to 
29.23 	implement this subdivision.

29.24 	Sec. 28. Minnesota Statutes 2006, section 256B.0625, subdivision 13h, is amended to 
29.25 	read:
29.26 		Subd. 13h.Medication therapy management services. (a) Medical assistance 
29.27 	and general assistance medical care cover medication therapy management services for 
29.28 	a recipient taking four or more prescriptions to treat or prevent two or more chronic 
29.29 	medical conditions, or a recipient with a drug therapy problem that is identified or prior 
29.30 	authorized by the commissioner that has resulted or is likely to result in significant 
29.31 	nondrug program costs. The commissioner may cover medical therapy management 
29.32 	services under MinnesotaCare if the commissioner determines this is cost-effective. For 
29.33 	purposes of this subdivision, "medication therapy management" means the provision 
30.1 	of the following pharmaceutical care services by a licensed pharmacist to optimize the 
30.2 	therapeutic outcomes of the patient's medications:
30.3 	(1) performing or obtaining necessary assessments of the patient's health status;
30.4 	(2) formulating a medication treatment plan;
30.5 	(3) monitoring and evaluating the patient's response to therapy, including safety 
30.6 	and effectiveness;
30.7 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
30.8 	medication-related problems, including adverse drug events;
30.9 	(5) documenting the care delivered and communicating essential information to 
30.10 	the patient's other primary care providers;
30.11 	(6) providing verbal education and training designed to enhance patient 
30.12 	understanding and appropriate use of the patient's medications;
30.13 	(7) providing information, support services, and resources designed to enhance 
30.14 	patient adherence with the patient's therapeutic regimens; and
30.15 	(8) coordinating and integrating medication therapy management services within the 
30.16 	broader health care management services being provided to the patient.
30.17 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
30.18 	the pharmacist as defined in section 151.01, subdivision 27.
30.19 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
30.20 	must meet the following requirements:
30.21 	(1) have a valid license issued under chapter 151;
30.22 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
30.23 	completed a structured and comprehensive education program approved by the Board of 
30.24 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
30.25 	documentation of pharmaceutical care management services that has both clinical and 
30.26 	didactic elements;
30.27 	(3) be practicing in an ambulatory care or home care setting as part of a 
30.28 	multidisciplinary team or have developed a structured patient care process that is offered 
30.29 	in a patient's home or in a private or semiprivate patient care area that is separate from the 
30.30 	commercial business that also occurs in the setting; and
30.31 	(4) make use of an electronic patient record system that meets state standards.
30.32 	(c) For purposes of reimbursement for medication therapy management services, 
30.33 	the commissioner may enroll individual pharmacists as medical assistance and general 
30.34 	assistance medical care providers. The commissioner may also establish contact 
30.35 	requirements between the pharmacist and recipient, including limiting the number of 
30.36 	reimbursable consultations per recipient.
31.1 	(d) The commissioner, after receiving recommendations from professional medical 
31.2 	associations, professional pharmacy associations, and consumer groups, shall convene 
31.3 	an 11-member Medication Therapy Management Advisory Committee to advise 
31.4 	the commissioner on the implementation and administration of medication therapy 
31.5 	management services. The committee shall be comprised of: two licensed physicians; 
31.6 	two licensed pharmacists; two consumer representatives; two health plan company 
31.7 	representatives; and three members with expertise in the area of medication therapy 
31.8 	management, who may be licensed physicians or licensed pharmacists. The committee is 
31.9 	governed by section 15.059, except that committee members do not receive compensation 
31.10 	or reimbursement for expenses. The advisory committee expires on June 30, 2007.
31.11 	(e) The commissioner shall evaluate the effect of medication therapy management 
31.12 	on quality of care, patient outcomes, and program costs, and shall include a description 
31.13 	of any savings generated in the medical assistance and general assistance medical care 
31.14 	programs that can be attributable to this coverage. The evaluation shall be submitted to 
31.15 	the legislature by December 15, 2007. The commissioner may contract with a vendor 
31.16 	or an academic institution that has expertise in evaluating health care outcomes for the 
31.17 	purpose of completing the evaluation.

31.18 	Sec. 29. Minnesota Statutes 2007 Supplement, section 256B.0625, subdivision 49, 
31.19 	is amended to read:
31.20 		Subd. 49.Community health worker. (a) Medical assistance covers the care 
31.21 	coordination and patient education services provided by a community health worker if 
31.22 	the community health worker has: 
31.23 	(1) received a certificate from the Minnesota State Colleges and Universities System 
31.24 	approved community health worker curriculum; or
31.25 	(2) at least five years of supervised experience with an enrolled physician, registered 
31.26 	nurse, or advanced practice registered nurse, or at least five years of supervised experience 
31.27 	by a certified public health nurse operating under the direct authority of an enrolled unit 
31.28 	of government.
31.29 	Community health workers eligible for payment under clause (2) must complete the 
31.30 	certification program by January 1, 2010, to continue to be eligible for payment.
31.31 	(b) Community health workers must work under the supervision of a medical 
31.32 	assistance enrolled physician, registered nurse, or advanced practice registered nurse, or 
31.33 	work under the supervision of a certified public health nurse operating under the direct 
31.34 	authority of an enrolled unit of government.

32.1 	Sec. 30. Minnesota Statutes 2006, section 256B.075, subdivision 2, is amended to read:
32.2 		Subd. 2.Fee-for-service. (a) The commissioner shall develop and implement 
32.3 	a disease management program for medical assistance and general assistance medical 
32.4 	care recipients who are not enrolled in the prepaid medical assistance or prepaid general 
32.5 	assistance medical care programs and who are receiving services on a fee-for-service basis. 
32.6 	The commissioner may contract with an outside organization to provide these services.
32.7 	(b) The commissioner shall seek any federal approval necessary to implement this 
32.8 	section and to obtain federal matching funds.
32.9 	(c) The commissioner shall develop and implement a pilot intensive care 
32.10 	management program for medical assistance children with complex and chronic medical 
32.11 	issues who are not able to participate in the metro-based U Special Kids program due 
32.12 	to geographic distance.

32.13 	Sec. 31. Minnesota Statutes 2006, section 256B.15, subdivision 4, is amended to read:
32.14 		Subd. 4.Other survivors. (a) If the decedent who was single or the surviving 
32.15 	spouse of a married couple is survived by one of the following persons, a claim exists 
32.16 	against the estate payable first from the value of the nonhomestead property included in 
32.17 	the estate and the personal representative shall make, execute, and deliver to the county 
32.18 	agency a lien against the homestead property in the estate for any unpaid balance of the 
32.19 	claim to the claimant as provided under this section:
32.20 	(a) (1) a sibling who resided in the decedent medical assistance recipient's home at 
32.21 	least one year before the decedent's institutionalization and continuously since the date 
32.22 	of institutionalization; or
32.23 	(b) (2) a son or daughter or a grandchild who resided in the decedent medical 
32.24 	assistance recipient's home for at least two years immediately before the parent's or 
32.25 	grandparent's institutionalization and continuously since the date of institutionalization, 
32.26 	and who establishes by a preponderance of the evidence having provided care to the 
32.27 	parent or grandparent who received medical assistance, that the care was provided before 
32.28 	institutionalization, and that the care permitted the parent or grandparent to reside at 
32.29 	home rather than in an institution.
32.30 	(b) For purposes of this subdivision, "institutionalization" means receiving care: 
32.31 	(1) in a nursing facility or swing bed, or intermediate care facility for persons with 
32.32 	developmental disabilities; or (2) through home and community-based services under 
32.33 	section 256B.0915, 256B.092, or 256B.49.

32.34 	Sec. 32. Minnesota Statutes 2006, section 256B.69, subdivision 6, is amended to read:
33.1 		Subd. 6.Service delivery. (a) Each demonstration provider shall be responsible for 
33.2 	the health care coordination for eligible individuals. Demonstration providers:
33.3 	(1) shall authorize and arrange for the provision of all needed health services 
33.4 	including but not limited to the full range of services listed in sections 256B.02, 
33.5 	subdivision 8, and 256B.0625 in order to ensure appropriate health care is delivered 
33.6 	to enrollees; notwithstanding section 256B.0621, demonstration providers that provide 
33.7 	nursing home and community-based services under this section shall provide relocation 
33.8 	service coordination to enrolled persons age 65 and over; 
33.9 	(2) shall accept the prospective, per capita payment from the commissioner in return 
33.10 	for the provision of comprehensive and coordinated health care services for eligible 
33.11 	individuals enrolled in the program;
33.12 	(3) may contract with other health care and social service practitioners to provide 
33.13 	services to enrollees; and
33.14 	(4) shall institute recipient grievance procedures according to the method established 
33.15 	by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved 
33.16 	through this process shall be appealable to the commissioner as provided in subdivision 11.
33.17 	(b) Demonstration providers must comply with the standards for claims settlement 
33.18 	under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health 
33.19 	care and social service practitioners to provide services to enrollees. A demonstration 
33.20 	provider must pay a clean claim, as defined in Code of Federal Regulations, title 42, 
33.21 	section 447.45(b), within 30 business days of the date of acceptance of the claim. 

33.22 	Sec. 33. Minnesota Statutes 2006, section 256B.69, subdivision 27, is amended to read:
33.23 		Subd. 27.Information for persons with limited English-language proficiency.
 33.24 	Managed care contracts entered into under this section and sections 256D.03, subdivision 
33.25 	4, paragraph (c), and 256L.12 must require demonstration providers to inform enrollees 
33.26 	that upon request the enrollee can obtain a certificate of coverage in the following 
33.27 	languages: Spanish, Hmong, Laotian, Russian, Somali, Vietnamese, or Cambodian. 
33.28 	Upon request, the demonstration provider must provide the enrollee with a certificate of 
33.29 	coverage in the specified language of preference provide language assistance to enrollees 
33.30 	that ensures meaningful access to its programs and services according to Title VI of the 
33.31 	Civil Rights Act and federal regulations adopted under that law or any guidance from the 
33.32 	United States Department of Health and Human Services. 

33.33 	Sec. 34. Minnesota Statutes 2007 Supplement, section 256D.03, subdivision 3, is 
33.34 	amended to read:
34.1 		Subd. 3.General assistance medical care; eligibility. (a) General assistance 
34.2 	medical care may be paid for any person who is not eligible for medical assistance under 
34.3 	chapter 256B, including eligibility for medical assistance based on a spenddown of excess 
34.4 	income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in 
34.5 	paragraph (b), except as provided in paragraph (c), and:
34.6 	(1) who is receiving assistance under section 256D.05, except for families with 
34.7 	children who are eligible under Minnesota family investment program (MFIP), or who is 
34.8 	having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
34.9 	(2) who is a resident of Minnesota; and
34.10 	(i) who has gross countable income not in excess of 75 percent of the federal poverty 
34.11 	guidelines for the family size, using a six-month budget period and whose equity in assets 
34.12 	is not in excess of $1,000 per assistance unit. General assistance medical care is not 
34.13 	available for applicants or enrollees who are otherwise eligible for medical assistance but 
34.14 	fail to verify their assets. Enrollees who become eligible for medical assistance shall be 
34.15 	terminated and transferred to medical assistance. Exempt assets, the reduction of excess 
34.16 	assets, and the waiver of excess assets must conform to the medical assistance program in 
34.17 	section 256B.056, subdivision 3, with the following exception: the maximum amount of 
34.18 	undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by 
34.19 	the trustee, assuming the full exercise of the trustee's discretion under the terms of the 
34.20 	trust, must be applied toward the asset maximum;
34.21 	(ii) who has gross countable income above 75 percent of the federal poverty 
34.22 	guidelines but not in excess of 175 percent of the federal poverty guidelines for the 
34.23 	family size, using a six-month budget period, whose equity in assets is not in excess 
34.24 	of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient 
34.25 	hospitalization; or
34.26 	(iii) the commissioner shall adjust the income standards under this section each July 
34.27 	1 by the annual update of the federal poverty guidelines following publication by the 
34.28 	United States Department of Health and Human Services.
34.29 	(b) Effective for applications and renewals processed on or after September 1, 2006, 
34.30 	general assistance medical care may not be paid for applicants or recipients who are adults 
34.31 	with dependent children under 21 whose gross family income is equal to or less than 275 
34.32 	percent of the federal poverty guidelines who are not described in paragraph (e).
34.33 	(c) Effective for applications and renewals processed on or after September 1, 2006, 
34.34 	general assistance medical care may be paid for applicants and recipients who meet all 
34.35 	eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period 
34.36 	beginning the date of application. Immediately following approval of general assistance 
35.1 	medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04, 
35.2 	subdivision 7, with covered services as provided in section 256L.03 for the rest of the 
35.3 	six-month general assistance medical care eligibility period, until their six-month renewal. 
35.4 	(d) To be eligible for general assistance medical care following enrollment in 
35.5 	MinnesotaCare as required by paragraph (c), an individual must complete a new 
35.6 	application.
35.7 	(e) Applicants and recipients eligible under paragraph (a), clause (1); who, are 
35.8 	exempt from the MinnesotaCare enrollment requirements in this subdivision if they:
35.9 	(1) have applied for and are awaiting a determination of blindness or disability by 
35.10 	the state medical review team or a determination of eligibility for Supplemental Security 
35.11 	Income or Social Security Disability Insurance by the Social Security Administration; who
35.12 	(2) fail to meet the requirements of section 256L.09, subdivision 2; who
35.13 	(3) are homeless as defined by United States Code, title 42, section 11301, et seq.; 
35.14 	who
35.15 	(4)  are classified as end-stage renal disease beneficiaries in the Medicare program; 
35.16 	who
35.17 	(5) are enrolled in private health care coverage as defined in section 256B.02, 
35.18 	subdivision 9; who
35.19 	(6) are eligible under paragraph (j); or who
35.20 	(7) receive treatment funded pursuant to section 254B.02are exempt from the 
35.21 	MinnesotaCare enrollment requirements of this subdivision; or
35.22 	(8) reside in the Minnesota sex offender program defined in chapter 246B.
35.23 	(f) For applications received on or after October 1, 2003, eligibility may begin no 
35.24 	earlier than the date of application. For individuals eligible under paragraph (a), clause 
35.25 	(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 
35.26 	eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 
35.27 	may reapply if there is a subsequent period of inpatient hospitalization.
35.28 	(g) Beginning September 1, 2006, Minnesota health care program applications and 
35.29 	renewals completed by recipients and applicants who are persons described in paragraph 
35.30 	(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility 
35.31 	by the county agency. If all other eligibility requirements of this subdivision are met, 
35.32 	eligibility for general assistance medical care shall be available in any month during which 
35.33 	MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, 
35.34 	notice of termination for eligibility for general assistance medical care shall be sent to 
35.35 	an applicant or recipient. If all other eligibility requirements of this subdivision are 
36.1 	met, eligibility for general assistance medical care shall be available until enrollment in 
36.2 	MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
36.3 	(h) The date of an initial Minnesota health care program application necessary to 
36.4 	begin a determination of eligibility shall be the date the applicant has provided a name, 
36.5 	address, and Social Security number, signed and dated, to the county agency or the 
36.6 	Department of Human Services. If the applicant is unable to provide a name, address, 
36.7 	Social Security number, and signature when health care is delivered due to a medical 
36.8 	condition or disability, a health care provider may act on an applicant's behalf to establish 
36.9 	the date of an initial Minnesota health care program application by providing the county 
36.10 	agency or Department of Human Services with provider identification and a temporary 
36.11 	unique identifier for the applicant. The applicant must complete the remainder of the 
36.12 	application and provide necessary verification before eligibility can be determined. The 
36.13 	county agency must assist the applicant in obtaining verification if necessary.
36.14 	(i) County agencies are authorized to use all automated databases containing 
36.15 	information regarding recipients' or applicants' income in order to determine eligibility for 
36.16 	general assistance medical care or MinnesotaCare. Such use shall be considered sufficient 
36.17 	in order to determine eligibility and premium payments by the county agency.
36.18 	(j) General assistance medical care is not available for a person in a correctional 
36.19 	facility unless the person is detained by law for less than one year in a county correctional 
36.20 	or detention facility as a person accused or convicted of a crime, or admitted as an 
36.21 	inpatient to a hospital on a criminal hold order, and the person is a recipient of general 
36.22 	assistance medical care at the time the person is detained by law or admitted on a criminal 
36.23 	hold order and as long as the person continues to meet other eligibility requirements 
36.24 	of this subdivision.
36.25 	(k) General assistance medical care is not available for applicants or recipients who 
36.26 	do not cooperate with the county agency to meet the requirements of medical assistance.
36.27 	(l) In determining the amount of assets of an individual eligible under paragraph 
36.28 	(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 
36.29 	an asset excluded under paragraph (a), that was given away, sold, or disposed of for 
36.30 	less than fair market value within the 60 months preceding application for general 
36.31 	assistance medical care or during the period of eligibility. Any transfer described in this 
36.32 	paragraph shall be presumed to have been for the purpose of establishing eligibility for 
36.33 	general assistance medical care, unless the individual furnishes convincing evidence to 
36.34 	establish that the transaction was exclusively for another purpose. For purposes of this 
36.35 	paragraph, the value of the asset or interest shall be the fair market value at the time it 
36.36 	was given away, sold, or disposed of, less the amount of compensation received. For any 
37.1 	uncompensated transfer, the number of months of ineligibility, including partial months, 
37.2 	shall be calculated by dividing the uncompensated transfer amount by the average monthly 
37.3 	per person payment made by the medical assistance program to skilled nursing facilities 
37.4 	for the previous calendar year. The individual shall remain ineligible until this fixed period 
37.5 	has expired. The period of ineligibility may exceed 30 months, and a reapplication for 
37.6 	benefits after 30 months from the date of the transfer shall not result in eligibility unless 
37.7 	and until the period of ineligibility has expired. The period of ineligibility begins in the 
37.8 	month the transfer was reported to the county agency, or if the transfer was not reported, 
37.9 	the month in which the county agency discovered the transfer, whichever comes first. For 
37.10 	applicants, the period of ineligibility begins on the date of the first approved application.
37.11 	(m) When determining eligibility for any state benefits under this subdivision, 
37.12 	the income and resources of all noncitizens shall be deemed to include their sponsor's 
37.13 	income and resources as defined in the Personal Responsibility and Work Opportunity 
37.14 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
37.15 	subsequently set out in federal rules.
37.16 	(n) Undocumented noncitizens and nonimmigrants are ineligible for general 
37.17 	assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual 
37.18 	in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
37.19 	an undocumented noncitizen is an individual who resides in the United States without the 
37.20 	approval or acquiescence of the United States Citizenship and Immigration Services.
37.21 	(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for 
37.22 	medical assistance due to the deeming of a sponsor's income and resources, is ineligible 
37.23 	for general assistance medical care.
37.24 	(p) Effective July 1, 2003, general assistance medical care emergency services end.

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

37.26 	Sec. 35. Minnesota Statutes 2006, section 524.3-803, is amended to read:
37.27 	524.3-803 LIMITATIONS ON PRESENTATION OF CLAIMS.
37.28 	(a) All claims as defined in section 524.1-201(6), against a decedent's estate which 
37.29 	arose before the death of the decedent, including claims of the state and any subdivision 
37.30 	thereof, whether due or to become due, absolute or contingent, liquidated or unliquidated, 
37.31 	if not barred earlier by other statute of limitations, are barred against the estate, the personal 
37.32 	representative, and the heirs and devisees of the decedent, unless presented as follows: 
37.33 	(1) in the case of a creditor who is only entitled, under the United States Constitution 
37.34 	and under the Minnesota Constitution, to notice by publication under section 524.3-801, 
38.1 	within four months after the date of the court administrator's notice to creditors which 
38.2 	is subsequently published pursuant to section 524.3-801; 
38.3 	(2) in the case of a creditor who was served with notice under section 524.3-801(c), 
38.4 	within the later to expire of four months after the date of the first publication of notice to 
38.5 	creditors or one month after the service; 
38.6 	(3) within the later to expire of one year after the decedent's death, or one year after 
38.7 	June 16, 1989, whether or not notice to creditors has been published or served under 
38.8 	section 524.3-801, provided, however, that in the case of a decedent who died before June 
38.9 	16, 1989, no claim which was then barred by any provision of law may be deemed to have 
38.10 	been revived by the amendment of this section. Claims authorized by section 246.53, 
38.11 	256B.15, or 256D.16 must not be barred after one year as provided in this clause.
38.12 	(b) All claims against a decedent's estate which arise at or after the death of the 
38.13 	decedent, including claims of the state and any subdivision thereof, whether due or to 
38.14 	become due, absolute or contingent, liquidated or unliquidated, are barred against the 
38.15 	estate, the personal representative, and the heirs and devisees of the decedent, unless 
38.16 	presented as follows:
38.17 	(1) a claim based on a contract with the personal representative, within four months 
38.18 	after performance by the personal representative is due;
38.19 	(2) any other claim, within four months after it arises.
38.20 	(c) Nothing in this section affects or prevents:
38.21 	(1) any proceeding to enforce any mortgage, pledge, or other lien upon property 
38.22 	of the estate;
38.23 	(2) any proceeding to establish liability of the decedent or the personal representative 
38.24 	for which there is protection by liability insurance, to the limits of the insurance protection 
38.25 	only;
38.26 	(3) the presentment and payment at any time within one year after the decedent's 
38.27 	death of any claim arising before the death of the decedent that is referred to in section 
38.28 	524.3-715, clause (18), although the same may be otherwise barred under this section; or 
38.29 	(4) the presentment and payment at any time before a petition is filed in compliance 
38.30 	with section 524.3-1001 or 524.3-1002 or a closing statement is filed under section 
38.31 	524.3-1003, of: 
38.32 	(i) any claim arising after the death of the decedent that is referred to in section 
38.33 	524.3-715, clause (18), although the same may be otherwise barred hereunder; 
38.34 	(ii) any other claim, including claims subject to clause (3), which would otherwise be 
38.35 	barred hereunder, upon allowance by the court upon petition of the personal representative 
38.36 	or the claimant for cause shown on notice and hearing as the court may direct.

39.1 	Sec. 36.  REPEALER.
 39.2 	(a) Minnesota Statutes 2006, section 256B.0571, subdivision 8a, is repealed.
39.3 	(b) Laws 2003, First Special Session chapter 5, section 11, is repealed.