<a id="pl.1.3"></a><var>1.3</var>and transportation costs; prohibiting a broker or coordinator from dispatching <br/>
<a id="pl.1.4"></a><var>1.4</var>nonemergency medical transportation;amending Minnesota Statutes 2008, <br/>
<a id="pl.1.5"></a><var>1.5</var>sections 256B.04, subdivision 14a; 256B.0625, subdivision 17, by adding a <br/>
<a id="pl.1.6"></a><var>1.6</var>subdivision.<br/>
<a id="pl.1.7"></a><var>1.7</var>BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:<br/>
<br/>
<a id="bill.0.1.0"></a><a id="pl.1.8"></a><var>1.8</var>    Section 1. Minnesota Statutes 2008, section 256B.04, subdivision 14a, is amended to <br/>
<a id="pl.1.9"></a><var>1.9</var>read:<br/>
<a id="pl.1.10"></a><var>1.10</var>    Subd. 14a. <b>Level of need determination.</b> Nonemergency medical transportation <br/>
<a id="pl.1.11"></a><var>1.11</var>level of need determinations must be performed by a physician, a registered nurse working <br/>
<a id="pl.1.12"></a><var>1.12</var>under direct supervision of a physician, a physician's assistant, a nurse practitioner, a <br/>
<a id="pl.1.13"></a><var>1.13</var>licensed practical nurse, or a discharge planner. Nonemergency medical transportation <br/>
<a id="pl.1.14"></a><var>1.14</var>level of need determinations must not be performed more than semiannually on any <br/>
<a id="pl.1.15"></a><var>1.15</var>individual, unless the individual's circumstances have sufficiently changed so as to require <br/>
<a id="pl.1.16"></a><var>1.16</var>a new level of need determination. Nonemergency medical transportation level of need <br/>
<a id="pl.1.17"></a><var>1.17</var>determinations must not be performed more than every seven years on an individual, <br/>
<a id="pl.1.18"></a><var>1.18</var>if a physician certifies that the individual's medical condition that requires the use of <br/>
<a id="pl.1.19"></a><var>1.19</var>nonemergency medical transportation is permanent and is not likely to improve, and this <br/>
<a id="pl.1.20"></a><var>1.20</var>certification by the physician is confirmed by a level of need determination. Individuals <br/>
<a id="pl.1.21"></a><var>1.21</var>residing in licensed nursing facilities are exempt from a level of need determination and <br/>
<a id="pl.1.22"></a><var>1.22</var>are eligible for special transportation services until the individual no longer resides in a <br/>
<a id="pl.1.23"></a><var>1.23</var>licensed nursing facility. If a person authorized by this subdivision to perform a level of <br/>
<a id="pl.1.24"></a><var>1.24</var>need determination determines that an individual requires stretcher transportation, the <br/>
<a id="pl.1.25"></a><var>1.25</var>individual is presumed to maintain that level of need until otherwise determined by a <br/>
<a id="pl.2.1"></a><var>2.1</var>person authorized to perform a level of need determination, or for six months, whichever <br/>
<a id="pl.2.2"></a><var>2.2</var>is sooner.<br/>
<br/>
<a id="bill.0.2.0"></a><a id="pl.2.3"></a><var>2.3</var>    Sec. 2. Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to <br/>
<a id="pl.2.4"></a><var>2.4</var>read:<br/>
<a id="pl.2.5"></a><var>2.5</var>    Subd. 17. <b>Transportation costs.</b> (a) For purposes of this subdivision, the following <br/>
<a id="pl.2.6"></a><var>2.6</var>terms have the meanings given unless otherwise provided for in this subdivision:<br/>
<a id="pl.2.7"></a><var>2.7</var>(1) "special transportation" means nonemergency medical transportation to or from a <br/>
<a id="pl.2.8"></a><var>2.8</var>covered service that is provided to a recipient who has a physical or mental impairment <br/>
<a id="pl.2.9"></a><var>2.9</var>that prohibits the recipient from independently and safely accessing and using a bus, taxi, <br/>
<a id="pl.2.10"></a><var>2.10</var>other commercial transportation, or private automobile;<br/>
<a id="pl.2.11"></a><var>2.11</var>(2) "access transportation service" means curb-to-curb nonemergency medical <br/>
<a id="pl.2.12"></a><var>2.12</var>transportation to or from a covered service that is provided to a recipient without a <br/>
<a id="pl.2.13"></a><var>2.13</var>physical or mental impairment, but who requires transportation services to be able to <br/>
<a id="pl.2.14"></a><var>2.14</var>access a covered service, and who are unable to do so by bus or private automobile; and <br/>
<a id="pl.2.15"></a><var>2.15</var>(3) "medical transportation" means the transport of a recipient to obtain a covered <br/>
<a id="pl.2.16"></a><var>2.16</var>service or the transport of a recipient after the covered service is provided.<br/>
<a id="pl.2.17"></a><var>2.17</var>(b) Medical assistance covers medical transportation costs incurred solely for <br/>
<a id="pl.2.18"></a><var>2.18</var>obtaining emergency medical care or transportation costs incurred by eligible persons in <br/>
<a id="pl.2.19"></a><var>2.19</var>obtaining emergency or nonemergency medical care when paid directly to an ambulance <br/>
<a id="pl.2.20"></a><var>2.20</var>company, common carrier, or other recognized providers of transportation services. <br/>
<a id="pl.2.21"></a><var>2.21</var>Medical transportation must be provided by:<br/>
<a id="pl.2.22"></a><var>2.22</var>(1) an ambulance, as defined in section 144E.001, subdivision 2;<br/>
<a id="pl.2.23"></a><var>2.23</var>(2) special transportation;<br/>
<a id="pl.2.24"></a><var>2.24</var>(3) access transportation; or<br/>
<a id="pl.2.25"></a><var>2.25</var>(4) other common carrier, including but not limited to, bus, taxi, other commercial <br/>
<a id="pl.2.26"></a><var>2.26</var>carrier, or private automobile.<br/>
<a id="pl.2.27"></a><var>2.27</var>(b) Medical assistance covers special transportation, as defined in Minnesota Rules, <br/>
<a id="pl.2.28"></a><var>2.28</var>part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that <br/>
<a id="pl.2.29"></a><var>2.29</var>would prohibit the recipient from safely accessing and using a bus, taxi, other commercial <br/>
<a id="pl.2.30"></a><var>2.30</var>transportation, or private automobile.<br/>
<a id="pl.2.31"></a><var>2.31</var>(c) "Rural urban commuting area" or "RUCA" means an area determined to be <br/>
<a id="pl.2.32"></a><var>2.32</var>urban, rural, or super rural by the Centers for Medicare and Medicaid Services for <br/>
<a id="pl.2.33"></a><var>2.33</var>purposes of Medicare reimbursement of ambulance services.<br/>
<a id="pl.2.34"></a><var>2.34</var>The commissioner may use an order by the recipient's attending physician to certify that <br/>
<a id="pl.2.35"></a><var>2.35</var>the recipient requires special transportation services. Special transportation includes <br/>
<a id="pl.3.1"></a><var>3.1</var>providers shall perform  driver-assisted service to services for eligible individuals. <br/>
<a id="pl.3.2"></a><var>3.2</var>Driver-assisted service includes passenger pickup at and return to the individual's <br/>
<a id="pl.3.3"></a><var>3.3</var>residence or place of business, assistance with admittance of the individual to the medical <br/>
<a id="pl.3.4"></a><var>3.4</var>facility, and assistance in passenger securement or in securing of wheelchairs or stretchers <br/>
<a id="pl.3.5"></a><var>3.5</var>in the vehicle. Special transportation providers must obtain written documentation from <br/>
<a id="pl.3.6"></a><var>3.6</var>the health care service provider who is serving the recipient being transported, identifying <br/>
<a id="pl.3.7"></a><var>3.7</var>the time that the recipient arrived. Special transportation and access transportation <br/>
<a id="pl.3.8"></a><var>3.8</var>providers may not bill for separate base rates for the continuation of a trip beyond the <br/>
<a id="pl.3.9"></a><var>3.9</var>original destination. Special transportation and access transportation providers must take <br/>
<a id="pl.3.10"></a><var>3.10</var>recipients to the nearest appropriate health care provider, using the most direct route <br/>
<a id="pl.3.11"></a><var>3.11</var>available as determined by a commercially available software program approved by the <br/>
<a id="pl.3.12"></a><var>3.12</var>commissioner and designated by the provider as the program to be used to determine the <br/>
<a id="pl.3.13"></a><var>3.13</var>route and mileage for all trips. The maximum minimum medical assistance reimbursement <br/>
<a id="pl.3.14"></a><var>3.14</var>rates for special nonemergency medical transportation services are:<br/>
<a id="pl.3.15"></a><var>3.15</var>(1) for areas defined under RUCA as urban:<br/>
<a id="pl.3.16"></a><var>3.16</var>(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to <br/>
<a id="pl.3.17"></a><var>3.17</var>eligible persons who need a wheelchair-accessible van;<br/>
<a id="pl.3.18"></a><var>3.18</var>(2) (ii) $11.50 for the base rate and $1.30 per mile for special transportation services <br/>
<a id="pl.3.19"></a><var>3.19</var>to eligible persons who do not need a wheelchair-accessible van; and<br/>
<a id="pl.3.20"></a><var>3.20</var>(iii) $10 for the base rate and $1.35 per mile for access transportation services to <br/>
<a id="pl.3.21"></a><var>3.21</var>eligible persons who need a wheelchair-accessible van;<br/>
<a id="pl.3.22"></a><var>3.22</var>(iv) $10 for the base rate and $1.30 per mile for access transportation services to <br/>
<a id="pl.3.23"></a><var>3.23</var>eligible persons who do not need a wheelchair-accessible van;<br/>
<a id="pl.3.24"></a><var>3.24</var>(3) (v) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, <br/>
<a id="pl.3.25"></a><var>3.25</var>for services to eligible persons who need a stretcher-accessible vehicle; and<br/>
<a id="pl.3.26"></a><var>3.26</var>(vi) for all special transportation and access transportation services for a trip equal to <br/>
<a id="pl.3.27"></a><var>3.27</var>or exceeding 51 miles, the provider shall receive mileage reimbursement for each mile <br/>
<a id="pl.3.28"></a><var>3.28</var>equal to or exceeding 51 miles at 125 percent of the respective mileage rates in this clause;<br/>
<a id="pl.3.29"></a><var>3.29</var>(2) the base rates for special transportation services and access transportation in <br/>
<a id="pl.3.30"></a><var>3.30</var>areas defined under RUCA as rural, shall be equal to the reimbursement rate established in <br/>
<a id="pl.3.31"></a><var>3.31</var>clause (1) plus one percent;<br/>
<a id="pl.3.32"></a><var>3.32</var>(3) the base rate for special transportation and access transportation services in areas <br/>
<a id="pl.3.33"></a><var>3.33</var>defined under RUCA as super rural shall be equal to the reimbursement rate established in <br/>
<a id="pl.3.34"></a><var>3.34</var>clause (1) plus 22.6 percent; and<br/>
<a id="pl.3.35"></a><var>3.35</var>(4) for special transportation and access transportation services defined under RUCA <br/>
<a id="pl.3.36"></a><var>3.36</var>as rural and super rural areas;<br/>
<a id="pl.4.1"></a><var>4.1</var>(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 150 <br/>
<a id="pl.4.2"></a><var>4.2</var>percent of the respective mileage rate in clause (1);<br/>
<a id="pl.4.3"></a><var>4.3</var>(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 100 <br/>
<a id="pl.4.4"></a><var>4.4</var>percent of the respective mileage rate in clause (1); and<br/>
<a id="pl.4.5"></a><var>4.5</var>(iii) for a trip equal to or exceeding 51 miles, mileage reimbursement shall be equal <br/>
<a id="pl.4.6"></a><var>4.6</var>to 125 percent of the respective mileage rate in clause (1), items (i) to (v).<br/>
<a id="pl.4.7"></a><var>4.7</var>(d) For purposes of reimbursement rates for special transportation and access <br/>
<a id="pl.4.8"></a><var>4.8</var>transportation services under paragraph (c), the recipient's place of residence shall <br/>
<a id="pl.4.9"></a><var>4.9</var>determine whether the urban, rural, or super rural reimbursement rate applies.<br/>
<a id="pl.4.10"></a><var>4.10</var>(e) For all special transportation and access transportation services, the transportation <br/>
<a id="pl.4.11"></a><var>4.11</var>provider must obtain delivery confirmation of the recipient by the medical provider to <br/>
<a id="pl.4.12"></a><var>4.12</var>whom the recipient is delivered.<br/>
<br/>
<a id="bill.0.3.0"></a><a id="pl.4.13"></a><var>4.13</var>    Sec. 3. Minnesota Statutes 2008, section 256B.0625, is amended by adding a <br/>
<a id="pl.4.14"></a><var>4.14</var>subdivision to read:<br/>
<a id="pl.4.15"></a><var>4.15</var>    Subd. 17b. <b>Broker dispatching prohibition.</b> The commissioner shall not use <br/>
<a id="pl.4.16"></a><var>4.16</var>a broker or coordinator to manage or dispatch nonemergency medical transportation <br/>
<a id="pl.4.17"></a><var>4.17</var>services.<br/>
<br/>
<a id="bill.0.4.0"></a><a id="pl.4.18"></a><var>4.18</var>    Sec. 4. <b>REIMBURSEMENT REFORM ACT.</b><br/>
<a id="pl.4.19"></a><var>4.19</var>This act shall be referred to as the "Nonemergency Medical Transportation Reform <br/>
<a id="pl.4.20"></a><var>4.20</var>Act of 2009."<br/>