1.1 	A bill for an act
1.2 	relating to human services; requiring patient-centered decision-making process 
1.3 	before certain procedures are reimbursed under state employee health insurance 
1.4 	program and medical assistance; amending Minnesota Statutes 2008, sections 
1.5 	43A.23, subdivision 1; 256B.76, by adding a subdivision; proposing coding for 
1.6 	new law in Minnesota Statutes, chapter 62U.
1.7 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.8 	Section 1. Minnesota Statutes 2008, section 43A.23, subdivision 1, is amended to read:
1.9 		Subdivision 1.General. (a) The commissioner is authorized to request proposals 
1.10 	or to negotiate and to enter into contracts with parties which in the judgment of the 
1.11 	commissioner are best qualified to provide service to the benefit plans. Contracts entered 
1.12 	into are not subject to the requirements of sections 16C.16 to 16C.19. The commissioner 
1.13 	may negotiate premium rates and coverage. The commissioner shall consider the cost of 
1.14 	the plans, conversion options relating to the contracts, service capabilities, character, 
1.15 	financial position, and reputation of the carriers, and any other factors which the 
1.16 	commissioner deems appropriate. Each benefit contract must be for a uniform term of at 
1.17 	least one year, but may be made automatically renewable from term to term in the absence 
1.18 	of notice of termination by either party. A carrier licensed under chapter 62A is exempt 
1.19 	from the taxes imposed by chapter 297I on premiums paid to it by the state.
1.20 	(b) All self-insured hospital and medical service products must comply with coverage 
1.21 	mandates, data reporting, and consumer protection requirements applicable to the licensed 
1.22 	carrier administering the product, had the product been insured, including chapters 62J, 
1.23 	62M, and 62Q. Any self-insured products that limit coverage to a network of providers 
1.24 	or provide different levels of coverage between network and nonnetwork providers shall 
2.1 	comply with section 62D.123 and geographic access standards for health maintenance 
2.2 	organizations adopted by the commissioner of health in rule under chapter 62D.
2.3 	(c) Notwithstanding paragraph (b), a self-insured hospital and medical product 
2.4 	offered under sections 43A.22 to 43A.30 is not required to extend dependent coverage to 
2.5 	an eligible employee's unmarried child under the age of 25 to the full extent required under 
2.6 	chapters 62A and 62L. Dependent coverage must, at a minimum, extend to an eligible 
2.7 	employee's unmarried child who is under the age of 19 or an unmarried child under the 
2.8 	age of 25 who is a full-time student. The definition of "full-time student" for purposes 
2.9 	of this paragraph includes any student who by reason of illness, injury, or physical or 
2.10 	mental disability as documented by a physician is unable to carry what the educational 
2.11 	institution considers a full-time course load so long as the student's course load is at least 
2.12 	60 percent of what otherwise is considered by the institution to be a full-time course load. 
2.13 	Any notice regarding termination of coverage due to attainment of the limiting age must 
2.14 	include information about this definition of "full-time student."
2.15 	(d) Beginning January 1, 2010, the health insurance benefit plans offered in the 
2.16 	commissioner's plan under section 43A.18, subdivision 2, and the managerial plan under 
2.17 	section 43A.18, subdivision 3, must include an option for a health plan that is compatible 
2.18 	with the definition of a high-deductible health plan in section 223 of the United States 
2.19 	Internal Revenue Code.
2.20 	(e) Beginning January 1, 2010, the commissioner shall require an eligible employee 
2.21 	to participate in a patient-centered decision-making process before a referral is approved 
2.22 	or reimbursement is paid for a surgical procedure for any of the conditions identified 
2.23 	under section 62U.11. For purposes of this paragraph, "patient-centered decision-making 
2.24 	process" has the meaning given under section 62U.11.

2.25 	Sec. 2. [62U.11] PATIENT-CENTERED DECISION MAKING.
2.26 	(a) By January 1, 2010, the commissioners of human services and finance shall 
2.27 	require active participation in a patient-centered decision-making process before a referral 
2.28 	is approved or reimbursement is paid, either on a fee-for-service basis or by a health 
2.29 	plan company under contract with the commissioner of human services or finance, for 
2.30 	a surgical procedure for any of the following conditions: abnormal uterine bleeding; 
2.31 	benign prostate enlargement; chronic back pain; early stage of breast and prostate cancers; 
2.32 	gastroesophageal reflux disease; hemorrhoids; spinal stenosis; temporomandibular joint 
2.33 	dysfunction; ulcerative colitis; urinary incontinence; uterine fibroids; or varicose veins. 
2.34 	A list of these conditions shall be published in the State Register by October 1, 2009. 
3.1 	The list shall be biennially reviewed by the commissioners and any additions to the list 
3.2 	shall be published in the State Register.
3.3 	(b) For purposes of this section, "patient-centered decision-making process" means a 
3.4 	process that involves directed interaction with the patient to assist the patient in arriving 
3.5 	at an informed objective health care decision regarding the surgical procedure. The 
3.6 	interaction may be conducted by a health care provider or through the electronic use of 
3.7 	decision aids.

3.8 	Sec. 3. Minnesota Statutes 2008, section 256B.76, is amended by adding a subdivision 
3.9 	to read:
3.10 		Subd. 7.Patient-centered decision making. Beginning January 1, 2010, prior 
3.11 	authorization shall not be approved or payment reimbursement provided for a surgical 
3.12 	procedure for any condition identified under section 62U.11, either on a fee-for-service 
3.13 	basis by the commissioner or by a health plan under contract with the commissioner, until 
3.14 	the patient or the patient's parent or legal guardian has participated in a patient-centered 
3.15 	decision-making process. For purposes of this subdivision, a "patient-centered 
3.16 	decision-making process" has the meaning given in section 62U.11.