SF 2168

1st Unofficial Engrossment - 86th Legislature (2009 - 2010)

Posted on 12/26/2012 11:17 p.m.

1.1A bill for an act 1.2relating to health care; establishing mental health urgent care and consultation 1.3services; modifying the general assistance medical care program; requiring 1.4a report; appropriating money;amending Minnesota Statutes 2008, sections 1.5256.969, subdivision 27, by adding a subdivision; 256B.0625, subdivision 13f, 1.6by adding a subdivision; 256D.03, subdivisions 3a, 3b; 256D.06, subdivision 7; 1.7256L.05, subdivisions 1b, 3, 3a; 256L.07, subdivision 6; 256L.15, subdivision 4; 1.8256L.17, subdivision 7; Minnesota Statutes 2009 Supplement, sections 256.969, 1.9subdivisions 2b, 3a; 256B.196, subdivision 2; 256B.199; 256D.03, subdivision 1.103; proposing coding for new law in Minnesota Statutes, chapters 245; 256D. 1.11BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.12ARTICLE 1 1.13HEALTH CARE PROGRAM MODIFICATION 1.14    Section 1. new text begin [245.4862] MENTAL HEALTH URGENT CARE AND PSYCHIATRIC new text end 1.15 new text begin CONSULTATION. new text end 1.16     new text begin Subdivision 1. new text end new text begin Mental health urgent care and psychiatric consultation. new text end new text begin The new text end 1.17 new text begin commissioner shall include mental health urgent care and psychiatric consultation new text end 1.18 new text begin services as part of, but not limited to, the redesign of six community-based behavioral new text end 1.19 new text begin health hospitals and the Anoka-Metro Regional Treatment Center. These services must new text end 1.20 new text begin not duplicate existing services in the region, and must be implemented as specified in new text end 1.21 new text begin subdivisions 3 to 7. new text end 1.22     new text begin Subd. 2. new text end new text begin Definitions. new text end new text begin For purposes of this section: new text end 1.23 new text begin (a) Mental health urgent care includes: new text end 1.24 new text begin (1) initial mental health screening; new text end 1.25 new text begin (2) mobile crisis assessment and intervention; new text end 2.1 new text begin (3) rapid access to psychiatry, including psychiatric evaluation, initial treatment, new text end 2.2 new text begin and short-term psychiatry; new text end 2.3 new text begin (4) nonhospital crisis stabilization residential beds; and new text end 2.4 new text begin (5) health care navigator services which include, but are not limited to, assisting new text end 2.5 new text begin uninsured individuals in obtaining health care coverage. new text end 2.6 new text begin (b) Psychiatric consultation services includes psychiatric consultation to primary new text end 2.7 new text begin care practitioners. new text end 2.8     new text begin Subd. 3. new text end new text begin Rapid access to psychiatry. new text end new text begin The commissioner shall develop rapid access new text end 2.9 new text begin to psychiatric services based on the following criteria: new text end 2.10 new text begin (1) the individuals who receive the psychiatric services must be at risk of new text end 2.11 new text begin hospitalization and otherwise unable to receive timely services; new text end 2.12 new text begin (2) where clinically appropriate, the service may be provided via interactive video new text end 2.13 new text begin where the service is provided in conjunction with an emergency room, a local crisis new text end 2.14 new text begin service, or a primary care or behavioral care practitioner; and new text end 2.15 new text begin (3) the commissioner may integrate rapid access to psychiatry with the psychiatric new text end 2.16 new text begin consultation services in subdivision 4. new text end 2.17     new text begin Subd. 4. new text end new text begin Collaborative psychiatric consultation. new text end new text begin (a) The commissioner shall new text end 2.18 new text begin establish a collaborative psychiatric consultation service based on the following criteria: new text end 2.19 new text begin (1) the service may be available via telephone, interactive video, e-mail, or other new text end 2.20 new text begin means of communication to emergency rooms, local crisis services, mental health new text end 2.21 new text begin professionals, and primary care practitioners, including pediatricians; new text end 2.22 new text begin (2) the service shall be provided by a multidisciplinary team including, at a new text end 2.23 new text begin minimum, a child and adolescent psychiatrist, an adult psychiatrist, and a licensed clinical new text end 2.24 new text begin social worker; new text end 2.25 new text begin (3) the service shall include a triage-level assessment to determine the most new text end 2.26 new text begin appropriate response to each request, including appropriate referrals to other mental health new text end 2.27 new text begin professionals, as well as provision of rapid psychiatric access when other appropriate new text end 2.28 new text begin services are not available; new text end 2.29 new text begin (4) the first priority for this service is to provide the consultations required under new text end 2.30 new text begin section 256B.0625, subdivision 13j; and new text end 2.31 new text begin (5) the service must encourage use of cognitive and behavioral therapies and other new text end 2.32 new text begin evidence-based treatments in addition to or in place of medication, where appropriate. new text end 2.33 new text begin (b) The commissioner shall appoint an interdisciplinary work group to establish new text end 2.34 new text begin appropriate medication and psychotherapy protocols to guide the consultative process, new text end 2.35 new text begin including consultation with the Drug Utilization Review Board, as provided in section new text end 2.36 new text begin 256B.0625, subdivision 13j. new text end 3.1     new text begin Subd. 5. new text end new text begin Phased availability. new text end new text begin (a) The commissioner may phase in the availability new text end 3.2 new text begin of mental health urgent care services based on the limits of appropriations and the new text end 3.3 new text begin commissioner's determination of level of need and cost-effectiveness. new text end 3.4 new text begin (b) For subdivisions 3 and 4, the first phase must focus on adults in Hennepin new text end 3.5 new text begin and Ramsey Counties and children statewide who are affected by section 256B.0625, new text end 3.6 new text begin subdivision 13j, and must include tracking of costs for the services provided and new text end 3.7 new text begin associated impacts on utilization of inpatient, emergency room, and other services. new text end 3.8     new text begin Subd. 6. new text end new text begin Limited appropriations. new text end new text begin The commissioner shall maximize use new text end 3.9 new text begin of available health care coverage for the services provided under this section. The new text end 3.10 new text begin commissioner's responsibility to provide these services for individuals without health care new text end 3.11 new text begin coverage must not exceed the appropriations for this section. new text end 3.12     new text begin Subd. 7. new text end new text begin Flexible implementation. new text end new text begin To implement this section, the commissioner new text end 3.13 new text begin shall select the structure and funding method that is the most cost-effective for each county new text end 3.14 new text begin or group of counties. This may include grants, contracts, direct provision by state-operated new text end 3.15 new text begin services, and public-private partnerships. Where feasible, the commissioner shall make new text end 3.16 new text begin any grants under this section a part of the integrated adult mental health initiative grants new text end 3.17 new text begin under section 245.4661. new text end 3.18    Sec. 2. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 2b, is 3.19amended to read: 3.20    Subd. 2b. Operating payment rates. In determining operating payment rates for 3.21admissions occurring on or after the rate year beginning January 1, 1991, and every two 3.22years after, or more frequently as determined by the commissioner, the commissioner shall 3.23obtain operating data from an updated base year and establish operating payment rates 3.24per admission for each hospital based on the cost-finding methods and allowable costs of 3.25the Medicare program in effect during the base year. Rates under the general assistance 3.26medical care, medical assistance, and MinnesotaCare programs shall not be rebased to 3.27more current data on January 1, 1997, January 1, 2005, for the first 24 months of the 3.28rebased period beginning January 1, 2009. For the first three new text begin six new text end months of the rebased 3.29period beginning January 1, 2011, rates shall new text begin not new text end be rebased at 74.25 percent of the full 3.30value of the rebasing percentage change. From April new text begin July new text end 1, 2011, to March 31, 2012, 3.31rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change. 3.32Effective April 1, 2012, rates shall be rebased at full value. The base year operating 3.33payment rate per admission is standardized by the case mix index and adjusted by the 3.34hospital cost index, relative values, and disproportionate population adjustment. The 3.35cost and charge data used to establish operating rates shall only reflect inpatient services 4.1covered by medical assistance and shall not include property cost information and costs 4.2recognized in outlier payments. 4.3    Sec. 3. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is 4.4amended to read: 4.5    Subd. 3a. Payments. (a) Acute care hospital billings under the medical 4.6assistance program must not be submitted until the recipient is discharged. However, 4.7the commissioner shall establish monthly interim payments for inpatient hospitals that 4.8have individual patient lengths of stay over 30 days regardless of diagnostic category. 4.9Except as provided in section 256.9693, medical assistance reimbursement for treatment 4.10of mental illness shall be reimbursed based on diagnostic classifications. Individual 4.11hospital payments established under this section and sections 256.9685, 256.9686, and 4.12256.9695 , in addition to third party and recipient liability, for discharges occurring during 4.13the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 4.14inpatient services paid for the same period of time to the hospital. This payment limitation 4.15shall be calculated separately for medical assistance and general assistance medical 4.16care services. The limitation on general assistance medical care shall be effective for 4.17admissions occurring on or after July 1, 1991. Services that have rates established under 4.18subdivision 11 or 12, must be limited separately from other services. After consulting with 4.19the affected hospitals, the commissioner may consider related hospitals one entity and 4.20may merge the payment rates while maintaining separate provider numbers. The operating 4.21and property base rates per admission or per day shall be derived from the best Medicare 4.22and claims data available when rates are established. The commissioner shall determine 4.23the best Medicare and claims data, taking into consideration variables of recency of the 4.24data, audit disposition, settlement status, and the ability to set rates in a timely manner. 4.25The commissioner shall notify hospitals of payment rates by December 1 of the year 4.26preceding the rate year. The rate setting data must reflect the admissions data used to 4.27establish relative values. Base year changes from 1981 to the base year established for the 4.28rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 4.29to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 4.301. The commissioner may adjust base year cost, relative value, and case mix index data 4.31to exclude the costs of services that have been discontinued by the October 1 of the year 4.32preceding the rate year or that are paid separately from inpatient services. Inpatient stays 4.33that encompass portions of two or more rate years shall have payments established based 4.34on payment rates in effect at the time of admission unless the date of admission preceded 4.35the rate year in effect by six months or more. In this case, operating payment rates for 5.1services rendered during the rate year in effect and established based on the date of 5.2admission shall be adjusted to the rate year in effect by the hospital cost index. 5.3    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total 5.4payment, before third-party liability and spenddown, made to hospitals for inpatient 5.5services is reduced by .5 percent from the current statutory rates. 5.6    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 5.7admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 5.8before third-party liability and spenddown, is reduced five percent from the current 5.9statutory rates. Mental health services within diagnosis related groups 424 to 432, and 5.10facilities defined under subdivision 16 are excluded from this paragraph. 5.11    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for 5.12fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 5.13inpatient services before third-party liability and spenddown, is reduced 6.0 percent 5.14from the current statutory rates. Mental health services within diagnosis related groups 5.15424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 5.16Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 5.17assistance does not include general assistance medical care. Payments made to managed 5.18care plans shall be reduced for services provided on or after January 1, 2006, to reflect 5.19this reduction. 5.20    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 5.21fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 5.22to hospitals for inpatient services before third-party liability and spenddown, is reduced 5.233.46 percent from the current statutory rates. Mental health services with diagnosis related 5.24groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 5.25paragraph. Payments made to managed care plans shall be reduced for services provided 5.26on or after January 1, 2009, through June 30, 2009, to reflect this reduction. 5.27    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 5.28fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010 new text begin 2011 new text end , 5.29made to hospitals for inpatient services before third-party liability and spenddown, is 5.30reduced 1.9 percent from the current statutory rates. Mental health services with diagnosis 5.31related groups 424 to 432 and facilities defined under subdivision 16 are excluded from 5.32this paragraph. Payments made to managed care plans shall be reduced for services 5.33provided on or after July 1, 2009, through June 30, 2010 new text begin 2011 new text end , to reflect this reduction. 5.34    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 5.35for fee-for-service admissions occurring on or after July 1, 2010 new text begin 2011 new text end , made to hospitals 5.36for inpatient services before third-party liability and spenddown, is reduced 1.79 percent 6.1from the current statutory rates. Mental health services with diagnosis related groups 6.2424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 6.3Payments made to managed care plans shall be reduced for services provided on or after 6.4July 1, 2010 new text begin 2011 new text end , to reflect this reduction. 6.5(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 6.6payment for fee-for-service admissions occurring on or after July 1, 2009, made to 6.7hospitals for inpatient services before third-party liability and spenddown, is reduced 6.8one percent from the current statutory rates. Facilities defined under subdivision 16 are 6.9excluded from this paragraph. Payments made to managed care plans shall be reduced for 6.10services provided on or after October 1, 2009, to reflect this reduction. 6.11 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 6.12    Sec. 4. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision 6.13to read: 6.14     new text begin Subd. 26a. new text end new text begin Psychiatric and burn services payment adjustment on or after July new text end 6.15 new text begin 1, 2010. new text end new text begin (a) For admissions occurring on or after July 1, 2010, the commissioner shall new text end 6.16 new text begin increase the total payment for medical assistance fee-for-service inpatient admissions for new text end 6.17 new text begin the diagnosis-related groups specified in paragraph (b) at any hospital that is a nonstate new text end 6.18 new text begin public Minnesota hospital and a Level I trauma center. The rate increases shall be new text end 6.19 new text begin established for each hospital by the commissioner at a level that uses each hospital's new text end 6.20 new text begin voluntary payments under paragraph (c) as the nonfederal share. For purposes of new text end 6.21 new text begin this subdivision, medical assistance does not include general assistance medical care. new text end 6.22 new text begin Payments to managed care health plans shall not be increased for payments under this new text end 6.23 new text begin subdivision. new text end 6.24     new text begin (b) The rate increases provided in paragraph (a) apply to the following new text end 6.25 new text begin diagnosis-related groups or subgroups, or any subsequent designations of such groups new text end 6.26 new text begin or subgroups: 424 to 431, 433, 504 to 511, 521, and 523. These increases are only new text end 6.27 new text begin available to the extent that revenue is available from the counties under paragraph (c) new text end 6.28 new text begin for the nonfederal share. new text end 6.29     new text begin (c) Effective July 15, 2010, in addition to any payment otherwise required under new text end 6.30 new text begin sections 256B.19, 256B.195, 256B.196, and 256B.199, the following government entities new text end 6.31 new text begin may make the following voluntary payments to the commissioner on an annual basis: new text end 6.32     new text begin (1) Hennepin County, $7,000,000; and new text end 6.33     new text begin (2) Ramsey County, $3,500,000. new text end 7.1 new text begin The amounts in this paragraph shall be part of the designated governmental unit's portion of new text end 7.2 new text begin the nonfederal share of medical assistance costs, including payments under subdivision 9. new text end 7.3     new text begin (d) The commissioner may adjust the intergovernmental transfers under paragraph new text end 7.4 new text begin (c) and the payments under paragraph (a) based on the commissioner's determination of new text end 7.5 new text begin Medicare upper payment limits, hospital-specific charge limits, and any limits imposed new text end 7.6 new text begin by the federal government regarding the rate increase or the restriction in the American new text end 7.7 new text begin Resource and Recovery Act, Public Law 111-5, regarding increased local share. new text end 7.8     new text begin (e) This section shall be implemented upon federal approval, retroactive to July 1, new text end 7.9 new text begin 2010, for services provided on or after that date. new text end 7.10    Sec. 5. Minnesota Statutes 2008, section 256.969, subdivision 27, is amended to read: 7.11    Subd. 27. Quarterly payment adjustment. (a) In addition to any other payment 7.12under this section, the commissioner shall make the following payments effective July 7.131, 2007: 7.14    (1) for a hospital located in Minnesota and not eligible for payments under 7.15subdivision 20, with a medical assistance inpatient utilization rate greater than 17.8 7.16percent of total patient days as of the base year in effect on July 1, 2005, a payment 7.17equal to 13 percent of the total of the operating and property payment rates new text begin , except that new text end 7.18 new text begin Hennepin County Medical Center and Regions Hospital shall not receive a payment new text end 7.19 new text begin under this subdivision new text end ; 7.20    (2) for a hospital located in Minnesota in a specified urban area outside of the 7.21seven-county metropolitan area and not eligible for payments under subdivision 20, with 7.22a medical assistance inpatient utilization rate less than or equal to 17.8 percent of total 7.23patient days as of the base year in effect on July 1, 2005, a payment equal to ten percent 7.24of the total of the operating and property payment rates. For purposes of this clause, the 7.25following cities are specified urban areas: Detroit Lakes, Rochester, Willmar, Alexandria, 7.26Austin, Cambridge, Brainerd, Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids, 7.27Wyoming, Fergus Falls, Albert Lea, Winona, Virginia, Thief River Falls, and Wadena; 7.28    (3) for a hospital located in Minnesota but not located in a specified urban area 7.29under clause (2), with a medical assistance inpatient utilization rate less than or equal to 7.3017.8 percent of total patient days as of the base year in effect on July 1, 2005, a payment 7.31equal to four percent of the total of the operating and property payment rates. A hospital 7.32located in Woodbury and not in existence during the base year shall be reimbursed under 7.33this clause; and 7.34    (4) in addition to any payments under clauses (1) to (3), for a hospital located in 7.35Minnesota and not eligible for payments under subdivision 20 with a medical assistance 8.1inpatient utilization rate of 17.9 percent of total patient days as of the base year in effect 8.2on July 1, 2005, a payment equal to eight percent of the total of the operating and property 8.3payment rates, and for a hospital located in Minnesota and not eligible for payments 8.4under subdivision 20 with a medical assistance inpatient utilization rate of 59.6 percent 8.5of total patient days as of the base year in effect on July 1, 2005, a payment equal to 8.6nine percent of the total of the operating and property payment rates. After making any 8.7ratable adjustments required under paragraph (b), the commissioner shall proportionately 8.8reduce payments under clauses (2) and (3) by an amount needed to make payments under 8.9this clause. 8.10    (b) The state share of payments under paragraph (a) shall be equal to federal 8.11reimbursements to the commissioner to reimburse expenditures reported under section 8.12256B.199 new text begin , paragraphs (a) to (d) new text end . The commissioner shall ratably reduce or increase 8.13payments under this subdivision in order to ensure that these payments equal the amount 8.14of reimbursement received by the commissioner under section 256B.199 new text begin , paragraphs (a) new text end 8.15 new text begin to (d) new text end , except that payments shall be ratably reduced by an amount equivalent to the state 8.16share of a four percent reduction in MinnesotaCare and medical assistance payments for 8.17inpatient hospital services. Effective July 1, 2009, the ratable reduction shall be equivalent 8.18to the state share of a three percent reduction in these payments. new text begin Effective for federal new text end 8.19 new text begin disproportionate share hospital funds earned on general assistance medical care payments new text end 8.20 new text begin for services rendered on or after March 1, 2010, to June 30, 2011, the amount of the three new text end 8.21 new text begin percent ratable reduction required under this paragraph shall be deposited in the account new text end 8.22 new text begin established in section 256D.032. Payments under this subdivision shall be further ratably new text end 8.23 new text begin reduced as follows: by $3,243,000 in fiscal year 2011; and by $2,495,000 in fiscal year new text end 8.24 new text begin 2012. These amounts shall be deposited in the account established in section 256D.032. new text end 8.25    (c) The payments under paragraph (a) shall be paid quarterly based on each hospital's 8.26operating and property payments from the second previous quarter, beginning on July 8.2715, 2007, or upon federal approval of federal reimbursements under section 256B.199 new text begin , new text end 8.28 new text begin paragraphs (a) to (d) new text end , whichever occurs later. 8.29    (d) The commissioner shall not adjust rates paid to a prepaid health plan under 8.30contract with the commissioner to reflect payments provided in paragraph (a). 8.31    (e) The commissioner shall maximize the use of available federal money for 8.32disproportionate share hospital payments and shall maximize payments to qualifying 8.33hospitals. In order to accomplish these purposes, the commissioner may, in consultation 8.34with the nonstate entities identified in section 256B.199 new text begin , paragraphs (a) to (d) new text end , adjust, 8.35on a pro rata basis if feasible, the amounts reported by nonstate entities under section 8.36256B.199 new text begin , paragraphs (a) to (d), new text end when application for reimbursement is made to the federal 9.1government, and otherwise adjust the provisions of this subdivision. The commissioner 9.2shall utilize a settlement process based on finalized data to maximize revenue under 9.3section 256B.199 new text begin , paragraphs (a) to (d), new text end and payments under this section. 9.4    (f) For purposes of this subdivision, medical assistance does not include general 9.5assistance medical care. 9.6 new text begin EFFECTIVE DATE. new text end new text begin This section is effective for services rendered on or after new text end 9.7 new text begin March 1, 2010. new text end 9.8    Sec. 6. Minnesota Statutes 2008, section 256B.0625, subdivision 13f, is amended to 9.9read: 9.10    Subd. 13f. Prior authorization. (a) The Formulary Committee shall review and 9.11recommend drugs which require prior authorization. The Formulary Committee shall 9.12establish general criteria to be used for the prior authorization of brand-name drugs for 9.13which generically equivalent drugs are available, but the committee is not required to 9.14review each brand-name drug for which a generically equivalent drug is available. 9.15(b) Prior authorization may be required by the commissioner before certain 9.16formulary drugs are eligible for payment. The Formulary Committee may recommend 9.17drugs for prior authorization directly to the commissioner. The commissioner may also 9.18request that the Formulary Committee review a drug for prior authorization. Before the 9.19commissioner may require prior authorization for a drug: 9.20(1) the commissioner must provide information to the Formulary Committee on the 9.21impact that placing the drug on prior authorization may have on the quality of patient care 9.22and on program costs, information regarding whether the drug is subject to clinical abuse 9.23or misuse, and relevant data from the state Medicaid program if such data is available; 9.24(2) the Formulary Committee must review the drug, taking into account medical and 9.25clinical data and the information provided by the commissioner; and 9.26(3) the Formulary Committee must hold a public forum and receive public comment 9.27for an additional 15 days. 9.28The commissioner must provide a 15-day notice period before implementing the prior 9.29authorization. 9.30(c) new text begin Except as provided in subdivision 13j, new text end prior authorization shall not be required or 9.31utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness if: 9.32(1) there is no generically equivalent drug available; and 9.33(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or 9.34(3) the drug is part of the recipient's current course of treatment. 10.1This paragraph applies to any multistate preferred drug list or supplemental drug rebate 10.2program established or administered by the commissioner. Prior authorization shall 10.3automatically be granted for 60 days for brand name drugs prescribed for treatment of 10.4mental illness within 60 days of when a generically equivalent drug becomes available, 10.5provided that the brand name drug was part of the recipient's course of treatment at the 10.6time the generically equivalent drug became available. 10.7(d) Prior authorization shall not be required or utilized for any antihemophilic factor 10.8drug prescribed for the treatment of hemophilia and blood disorders where there is no 10.9generically equivalent drug available if the prior authorization is used in conjunction with 10.10any supplemental drug rebate program or multistate preferred drug list established or 10.11administered by the commissioner. 10.12(e) The commissioner may require prior authorization for brand name drugs 10.13whenever a generically equivalent product is available, even if the prescriber specifically 10.14indicates "dispense as written-brand necessary" on the prescription as required by section 10.15151.21, subdivision 2 . 10.16(f) Notwithstanding this subdivision, the commissioner may automatically require 10.17prior authorization, for a period not to exceed 180 days, for any drug that is approved by 10.18the United States Food and Drug Administration on or after July 1, 2005. The 180-day 10.19period begins no later than the first day that a drug is available for shipment to pharmacies 10.20within the state. The Formulary Committee shall recommend to the commissioner general 10.21criteria to be used for the prior authorization of the drugs, but the committee is not 10.22required to review each individual drug. In order to continue prior authorizations for a 10.23drug after the 180-day period has expired, the commissioner must follow the provisions 10.24of this subdivision. 10.25 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 10.26    Sec. 7. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 10.27subdivision to read: 10.28     new text begin Subd. 13j. new text end new text begin Antipsychotic and attention deficit disorder and attention deficit new text end 10.29 new text begin hyperactivity disorder medications. new text end new text begin (a) The commissioner, in consultation with the new text end 10.30 new text begin Drug Utilization Review Board established in subdivision 13i and actively practicing new text end 10.31 new text begin pediatric mental health professionals, must: new text end 10.32 new text begin (1) identify recommended pediatric dose ranges for atypical antipsychotic drugs new text end 10.33 new text begin and drugs used for attention deficit disorder or attention deficit hyperactivity disorder new text end 10.34 new text begin based on available medical, clinical, and safety data and research. The commissioner new text end 10.35 new text begin shall periodically review the list of medications and pediatric dose ranges and update new text end 11.1 new text begin the medications and doses listed as needed after consultation with the Drug Utilization new text end 11.2 new text begin Review Board; new text end 11.3 new text begin (2) identify situations where a collaborative psychiatric consultation and prior new text end 11.4 new text begin authorization should be required before the initiation or continuation of drug therapy new text end 11.5 new text begin in pediatric patients including, but not limited to, high-dose regimens, off-label use of new text end 11.6 new text begin prescription medication, a patient's young age, and lack of coordination among multiple new text end 11.7 new text begin prescribing providers; and new text end 11.8 new text begin (3) track prescriptive practices and the use of psychotropic medications in children new text end 11.9 new text begin with the goal of reducing the use of medication, where appropriate. new text end 11.10 new text begin (b) Effective July 1, 2011, the commissioner shall require prior authorization and new text end 11.11 new text begin a collaborative psychiatric consultation before an atypical antipsychotic and attention new text end 11.12 new text begin deficit disorder and attention deficit hyperactivity disorder medication meeting the criteria new text end 11.13 new text begin identified in paragraph (a), clause (2), is eligible for payment. A collaborative psychiatric new text end 11.14 new text begin consultation must be completed before the identified medications are eligible for payment new text end 11.15 new text begin unless: new text end 11.16 new text begin (1) the patient has already been stabilized on the medication regimen; or new text end 11.17 new text begin (2) the prescriber indicates that the child is in crisis. new text end 11.18 new text begin If clause (1) or (2) applies, the collaborative psychiatric consultation must be completed new text end 11.19 new text begin within 90 days for payment to continue. new text end 11.20 new text begin (c) For purposes of this subdivision, a collaborative psychiatric consultation must new text end 11.21 new text begin meet the criteria described in section 245.4862, subdivision 5. new text end 11.22    Sec. 8. Minnesota Statutes 2009 Supplement, section 256B.196, subdivision 2, is 11.23amended to read: 11.24    Subd. 2. Commissioner's duties. (a) For the purposes of this subdivision and 11.25subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital 11.26services upper payment limit for nonstate government hospitals. The commissioner shall 11.27then determine the amount of a supplemental payment to Hennepin County Medical 11.28Center and Regions Hospital for these services that would increase medical assistance 11.29spending in this category to the aggregate upper payment limit for all nonstate government 11.30hospitals in Minnesota. In making this determination, the commissioner shall allot the 11.31available increases between Hennepin County Medical Center and Regions Hospital 11.32based on the ratio of medical assistance fee-for-service outpatient hospital payments to 11.33the two facilities. The commissioner shall adjust this allotment as necessary based on 11.34federal approvals, the amount of intergovernmental transfers received from Hennepin and 11.35Ramsey Counties, and other factors, in order to maximize the additional total payments. 12.1The commissioner shall inform Hennepin County and Ramsey County of the periodic 12.2intergovernmental transfers necessary to match federal Medicaid payments available 12.3under this subdivision in order to make supplementary medical assistance payments to 12.4Hennepin County Medical Center and Regions Hospital equal to an amount that when 12.5combined with existing medical assistance payments to nonstate governmental hospitals 12.6would increase total payments to hospitals in this category for outpatient services to 12.7the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon 12.8receipt of these periodic transfers, the commissioner shall make supplementary payments 12.9to Hennepin County Medical Center and Regions Hospital. 12.10    (b) For the purposes of this subdivision and subdivision 3, the commissioner shall 12.11determine an upper payment limit for physicians affiliated with Hennepin County Medical 12.12Center and with Regions Hospital. The upper payment limit shall be based on the average 12.13commercial rate or be determined using another method acceptable to the Centers for 12.14Medicare and Medicaid Services. The commissioner shall inform Hennepin County and 12.15Ramsey County of the periodic intergovernmental transfers necessary to match the federal 12.16Medicaid payments available under this subdivision in order to make supplementary 12.17payments to physicians affiliated with Hennepin County Medical Center and Regions 12.18Hospital equal to the difference between the established medical assistance payment for 12.19physician services and the upper payment limit. Upon receipt of these periodic transfers, 12.20the commissioner shall make supplementary payments to physicians of Hennepin Faculty 12.21Associates and HealthPartners. 12.22    (c) Beginning January 1, 2010, Hennepin County and Ramsey County shall new text begin may new text end 12.23make monthly new text begin voluntary new text end intergovernmental transfers to the commissioner in the following 12.24amounts: $133,333 by new text begin not to exceed $12,000,000 per year from new text end Hennepin County 12.25and $100,000 by new text begin $6,000,000 per year from new text end Ramsey County. The commissioner shall 12.26increase the medical assistance capitation payments to Metropolitan Health Plan and 12.27HealthPartners by new text begin any licensed health plan under contract with the medical assistance new text end 12.28 new text begin program that agrees to make enhanced payments to Hennepin County Medical Center or new text end 12.29 new text begin Regions Hospital. The increase shall be in new text end an amount equal to the annual value of the 12.30monthly transfers plus federal financial participation. new text begin , with each health plan receiving its new text end 12.31 new text begin pro rata share of the increase based on the pro rata share of medical assistance admissions new text end 12.32 new text begin to Hennepin County Medical Center and Regions Hospital by those plans. Upon the new text end 12.33 new text begin request of the commissioner, health plans shall submit individual-level cost data for new text end 12.34 new text begin verification purposes. The commissioner may ratably reduce these payments on a pro rata new text end 12.35 new text begin basis in order to satisfy federal requirements for actuarial soundness. If payments are new text end 12.36 new text begin reduced, transfers shall be reduced accordingly. Any licensed health plan that receives new text end 13.1 new text begin increased medical assistance capitation payments under the intergovernmental transfer new text end 13.2 new text begin described in this paragraph shall increase its medical assistance payments to Hennepin new text end 13.3 new text begin County Medical Center and Regions Hospital by the same amount as the increased new text end 13.4 new text begin payments received in the capitation payment described in this paragraph. new text end 13.5    (d) The commissioner shall inform Hennepin County and Ramsey County on an 13.6ongoing basis of the need for any changes needed in the intergovernmental transfers 13.7in order to continue the payments under paragraphs (a) to (c), at their maximum level, 13.8including increases in upper payment limits, changes in the federal Medicaid match, and 13.9other factors. 13.10    (e) The payments in paragraphs (a) to (c) shall be implemented independently of 13.11each other, subject to federal approval and to the receipt of transfers under subdivision 3. 13.12 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 13.13    Sec. 9. Minnesota Statutes 2009 Supplement, section 256B.199, is amended to read: 13.14256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES. 13.15    (a) Effective July 1, 2007, the commissioner shall apply for federal matching funds 13.16for the expenditures in paragraphs (b) and (c). 13.17    (b) The commissioner shall apply for federal matching funds for certified public 13.18expenditures as follows: 13.19    (1) Hennepin County, Hennepin County Medical Center, Ramsey County, new text begin and new text end 13.20Regions Hospital, the University of Minnesota, and Fairview-University Medical Center 13.21shall report quarterly to the commissioner beginning June 1, 2007, payments made during 13.22the second previous quarter that may qualify for reimbursement under federal law; 13.23     (2) based on these reports, the commissioner shall apply for federal matching 13.24funds. These funds are appropriated to the commissioner for the payments under section 13.25256.969, subdivision 27 ; and 13.26     (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform 13.27the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 13.28hospital payment money expected to be available in the current federal fiscal year. 13.29    (c) The commissioner shall apply for federal matching funds for general assistance 13.30medical care expenditures as follows: 13.31    (1) for hospital services occurring on or after July 1, 2007, general assistance medical 13.32care expenditures for fee-for-service inpatient and outpatient hospital payments made by 13.33the department shall be used to apply for federal matching funds, except as limited below: 14.1    (i) only those general assistance medical care expenditures made to an individual 14.2hospital that would not cause the hospital to exceed its individual hospital limits under 14.3section 1923 of the Social Security Act may be considered; and 14.4    (ii) general assistance medical care expenditures may be considered only to the extent 14.5of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and 14.6    (2) all hospitals must provide any necessary expenditure, cost, and revenue 14.7information required by the commissioner as necessary for purposes of obtaining federal 14.8Medicaid matching funds for general assistance medical care expenditures. 14.9    (d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall 14.10apply for additional federal matching funds available as disproportionate share hospital 14.11payments under the American Recovery and Reinvestment Act of 2009. These funds shall 14.12be made available as the state share of payments under section 256.969, subdivision 28. 14.13The entities required to report certified public expenditures under paragraph (b), clause 14.14(1), shall report additional certified public expenditures as necessary under this paragraph. 14.15     new text begin (e) Effective July 15, 2010, in addition to any payment otherwise required under new text end 14.16 new text begin sections 256B.19, 256B.195, and 256B.196, the following government entities may make new text end 14.17 new text begin the following voluntary payments to the commissioner on an annual basis: new text end 14.18     new text begin (1) Hennepin County, $6,200,000; and new text end 14.19     new text begin (2) Ramsey County, $4,000,000. new text end 14.20     new text begin (f) The sums in paragraph (e) shall be part of the designated governmental unit's new text end 14.21 new text begin portion of the nonfederal share of medical assistance costs. new text end 14.22     new text begin (g) Effective July 15, 2010, the commissioner shall make the following Medicaid new text end 14.23 new text begin disproportionate share hospital payments to the hospitals on a monthly basis: new text end 14.24     new text begin (1) to Hennepin County Medical Center, the amount of the transfer under paragraph new text end 14.25 new text begin (e), clause (1), plus any federal matching funds available to recognize higher medical new text end 14.26 new text begin assistance costs in institutions that provide high levels of charity care; and new text end 14.27     new text begin (2) to Regions Hospital, the amount of the transfer under paragraph (e), clause (2), new text end 14.28 new text begin plus any federal matching funds available to recognize higher medical assistance costs in new text end 14.29 new text begin institutions that provide high levels of charity care. new text end 14.30     new text begin (h) Effective July 15, 2010, after making the payments provided in paragraph new text end 14.31 new text begin (g), the commissioner shall make the increased payments provided in section 256.969, new text end 14.32 new text begin subdivision 26a. new text end 14.33     new text begin (i) The commissioner shall make the payments under paragraphs (g) and (h) prior new text end 14.34 new text begin to making any other payments under this section, section 256.969, subdivision 27, or new text end 14.35 new text begin 256B.195. new text end 15.1     new text begin (j) The commissioner may adjust the intergovernmental transfers under paragraph new text end 15.2 new text begin (e) and the payments under paragraph (g) based on the commissioner's determination new text end 15.3 new text begin of Medicare upper payment limits, hospital-specific charge limits, and any limitations new text end 15.4 new text begin imposed by the federal government regarding the rate increase or the restriction in the new text end 15.5 new text begin American Resource and Recovery Act, Public Law 111-5, regarding increased local share. new text end 15.6     new text begin (k) This section shall be implemented upon federal approval of the rate increase new text end 15.7 new text begin and a federal determination that the increased transfers do not violate the restriction in new text end 15.8 new text begin the American Resource and Recovery Act, Public Law 111-5, regarding the local share, new text end 15.9 new text begin retroactive to admissions occurring on or after July 15, 2010. new text end 15.10    Sec. 10. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, is 15.11amended to read: 15.12    Subd. 3. General assistance medical care; eligibility. (a) General assistance 15.13medical care may be paid for any person who is not eligible for medical assistance under 15.14chapter 256B, including eligibility for medical assistance based on a spenddown of excess 15.15income according to section 256B.056, subdivision 5, or MinnesotaCare for applicants 15.16and recipients defined in paragraph (c), except as provided in paragraph (d), and: 15.17    (1) who is receiving assistance under section 256D.05, except for families with 15.18children who are eligible under Minnesota family investment program (MFIP), or who is 15.19having a payment made on the person's behalf under sections 256I.01 to 256I.06; or 15.20    (2) who is a resident of Minnesota; and 15.21    (i) who has gross countable income not in excess of 75 percent of the federal poverty 15.22guidelines for the family size, using a six-month budget period and whose equity in assets 15.23is not in excess of $1,000 per assistance unit. General assistance medical care is not 15.24available for applicants or enrollees who are otherwise eligible for medical assistance but 15.25fail to verify their assets. Enrollees who become eligible for medical assistance shall be 15.26terminated and transferred to medical assistance. Exempt assets, the reduction of excess 15.27assets, and the waiver of excess assets must conform to the medical assistance program in 15.28section 256B.056, subdivisions 3 and 3d, with the following exception: the maximum 15.29amount of undistributed funds in a trust that could be distributed to or on behalf of the 15.30beneficiary by the trustee, assuming the full exercise of the trustee's discretion under the 15.31terms of the trust, must be applied toward the asset maximum; or 15.32    (ii) who has gross countable income above 75 percent of the federal poverty 15.33guidelines but not in excess of 175 percent of the federal poverty guidelines for the family 15.34size, using a six-month budget period, whose equity in assets is not in excess of the limits 15.35in section 256B.056, subdivision 3c, and who applies during an inpatient hospitalization. 16.1    (b) The commissioner shall adjust the income standards under this section each July 16.21 by the annual update of the federal poverty guidelines following publication by the 16.3United States Department of Health and Human Services. 16.4    (c) Effective for applications and renewals processed on or after September 1, 2006, 16.5general assistance medical care may not be paid for applicants or recipients who are adults 16.6with dependent children under 21 whose gross family income is equal to or less than 275 16.7percent of the federal poverty guidelines who are not described in paragraph (f). 16.8    (d) Effective for applications and renewals processed on or after September 1, 16.92006, general assistance medical care may be paid for applicants and recipients who 16.10meet all eligibility requirements of paragraph (a), clause (2), item (i), for a temporary 16.11period beginning the date of application. Immediately following approval of general 16.12assistance medical care, enrollees shall be enrolled in MinnesotaCare under section 16.13256L.04, subdivision 7 , with covered services as provided in section 256L.03 for the rest 16.14of the six-month general assistance medical care eligibility period, until their six-month 16.15renewal. new text begin This paragraph does not apply to applicants and recipients who are exempt new text end 16.16 new text begin under paragraph (f). new text end 16.17    (e) To be eligible for general assistance medical care following enrollment in 16.18MinnesotaCare as required by paragraph (d), an individual must complete a new 16.19application. 16.20    (f) Applicants and recipients eligible under paragraph (a), clause (2), item (i), are 16.21exempt from the MinnesotaCare enrollment requirements in this subdivision if they: 16.22    (1) have applied for and are awaiting a determination of blindness or disability by 16.23the state medical review team or a determination of eligibility for Supplemental Security 16.24Income or Social Security Disability Insurance by the Social Security Administration; 16.25    (2) fail to meet the requirements of section 256L.09, subdivision 2; 16.26    (3) are homeless as defined by United States Code, title 42, section 11301, et seq.; 16.27    (4) are classified as end-stage renal disease beneficiaries in the Medicare program; 16.28    (5) are enrolled in private health care coverage as defined in section 256B.02, 16.29subdivision 9; 16.30    (6) are eligible under paragraph (k); 16.31    (7) receive treatment funded pursuant to section 254B.02; or 16.32    (8) reside in the Minnesota sex offender program defined in chapter 246B. 16.33 new text begin If an enrollee meets one of the categories described in this paragraph, the new text end 16.34 new text begin commissioner shall not require the enrollee to enroll in MinnesotaCare. new text end 16.35    (g) For applications received on or after October 1, 2003, eligibility may begin no 16.36earlier than the date of application. For individuals eligible under paragraph (a), clause 17.1(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 17.2eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 17.3may reapply if there is a subsequent period of inpatient hospitalization. 17.4    (h) Beginning September 1, 2006, Minnesota health care program applications and 17.5renewals completed by recipients and applicants who are persons described in paragraph 17.6(d) and submitted to the county agency shall be determined for MinnesotaCare eligibility 17.7by the county agency. If all other eligibility requirements of this subdivision are met, 17.8eligibility for general assistance medical care shall be available in any month during which 17.9MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, 17.10notice of termination for eligibility for general assistance medical care shall be sent to 17.11an applicant or recipient. If all other eligibility requirements of this subdivision are 17.12met, eligibility for general assistance medical care shall be available until enrollment in 17.13MinnesotaCare subject to the provisions of paragraphs (d), (f), and (g). 17.14    (i) The date of an initial Minnesota health care program application necessary to 17.15begin a determination of eligibility shall be the date the applicant has provided a name, 17.16address, and Social Security number, signed and dated, to the county agency or the 17.17Department of Human Services. If the applicant is unable to provide a name, address, 17.18Social Security number, and signature when health care is delivered due to a medical 17.19condition or disability, a health care provider may act on an applicant's behalf to establish 17.20the date of an initial Minnesota health care program application by providing the county 17.21agency or Department of Human Services with provider identification and a temporary 17.22unique identifier for the applicant. The applicant must complete the remainder of the 17.23application and provide necessary verification before eligibility can be determined. The 17.24applicant must complete the application within the time periods required under the 17.25medical assistance program as specified in Minnesota Rules, parts 9505.0015, subpart 17.265, and 9505.0090, subpart 2. The county agency must assist the applicant in obtaining 17.27verification if necessary. 17.28    (j) County agencies are authorized to use all automated databases containing 17.29information regarding recipients' or applicants' income in order to determine eligibility for 17.30general assistance medical care or MinnesotaCare. Such use shall be considered sufficient 17.31in order to determine eligibility and premium payments by the county agency. 17.32    (k) General assistance medical care is not available for a person in a correctional 17.33facility unless the person is detained by law for less than one year in a county correctional 17.34or detention facility as a person accused or convicted of a crime, or admitted as an 17.35inpatient to a hospital on a criminal hold order, and the person is a recipient of general 17.36assistance medical care at the time the person is detained by law or admitted on a criminal 18.1hold order and as long as the person continues to meet other eligibility requirements 18.2of this subdivision. 18.3    (l) General assistance medical care is not available for applicants or recipients who 18.4do not cooperate with the county agency to meet the requirements of medical assistance. 18.5    (m) In determining the amount of assets of an individual eligible under paragraph 18.6(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 18.7an asset excluded under paragraph (a), that was given away, sold, or disposed of for 18.8less than fair market value within the 60 months preceding application for general 18.9assistance medical care or during the period of eligibility. Any transfer described in this 18.10paragraph shall be presumed to have been for the purpose of establishing eligibility for 18.11general assistance medical care, unless the individual furnishes convincing evidence to 18.12establish that the transaction was exclusively for another purpose. For purposes of this 18.13paragraph, the value of the asset or interest shall be the fair market value at the time it 18.14was given away, sold, or disposed of, less the amount of compensation received. For any 18.15uncompensated transfer, the number of months of ineligibility, including partial months, 18.16shall be calculated by dividing the uncompensated transfer amount by the average monthly 18.17per person payment made by the medical assistance program to skilled nursing facilities 18.18for the previous calendar year. The individual shall remain ineligible until this fixed period 18.19has expired. The period of ineligibility may exceed 30 months, and a reapplication for 18.20benefits after 30 months from the date of the transfer shall not result in eligibility unless 18.21and until the period of ineligibility has expired. The period of ineligibility begins in the 18.22month the transfer was reported to the county agency, or if the transfer was not reported, 18.23the month in which the county agency discovered the transfer, whichever comes first. For 18.24applicants, the period of ineligibility begins on the date of the first approved application. 18.25    (n) When determining eligibility for any state benefits under this subdivision, 18.26the income and resources of all noncitizens shall be deemed to include their sponsor's 18.27income and resources as defined in the Personal Responsibility and Work Opportunity 18.28Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 18.29subsequently set out in federal rules. 18.30    (o) Undocumented noncitizens and nonimmigrants are ineligible for general 18.31assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual 18.32in one or more of the classes listed in United States Code, title 8, section 1101, subsection 18.33(a), paragraph (15), and an undocumented noncitizen is an individual who resides in 18.34the United States without the approval or acquiescence of the United States Citizenship 18.35and Immigration Services. 19.1    (p) Notwithstanding any other provision of law, a noncitizen who is ineligible for 19.2medical assistance due to the deeming of a sponsor's income and resources, is ineligible 19.3for general assistance medical care. 19.4    (q) Effective July 1, 2003, general assistance medical care emergency services end. 19.5 new text begin (r) For the period beginning March 1, 2010, and ending July 1, 2011, the general new text end 19.6 new text begin assistance medical care program shall be administered according to section 256D.031, new text end 19.7 new text begin unless otherwise stated. new text end 19.8 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 19.9    Sec. 11. Minnesota Statutes 2008, section 256D.03, subdivision 3a, is amended to read: 19.10    Subd. 3a. Claims; assignment of benefits. new text begin (a) new text end Claims must be filed pursuant to 19.11section 256D.16. General assistance medical care applicants and recipients must apply or 19.12agree to apply third party health and accident benefits to the costs of medical care. They 19.13must cooperate with the state in establishing paternity and obtaining third party payments. 19.14By accepting general assistance, a person assigns to the Department of Human Services 19.15all rights to medical support or payments for medical expenses from another person or 19.16entity on their own or their dependent's behalf and agrees to cooperate with the state in 19.17establishing paternity and obtaining third party payments. The application shall contain 19.18a statement explaining the assignment. Any rights or amounts assigned shall be applied 19.19against the cost of medical care paid for under this chapter. An assignment is effective on 19.20the date general assistance medical care eligibility takes effect. 19.21 new text begin (b) Effective for general assistance medical care services rendered on or after new text end 19.22 new text begin March 1, 2010, to June 30, 2011, any medical collections, payments, or recoveries under new text end 19.23 new text begin this subdivision shall be deposited in or credited to the account established in section new text end 19.24 new text begin 256D.032. new text end 19.25 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 19.26    Sec. 12. Minnesota Statutes 2008, section 256D.03, subdivision 3b, is amended to read: 19.27    Subd. 3b. Cooperation. (a) General assistance or general assistance medical care 19.28applicants and recipients must cooperate with the state and local agency to identify 19.29potentially liable third-party payors and assist the state in obtaining third-party payments. 19.30Cooperation includes identifying any third party who may be liable for care and services 19.31provided under this chapter to the applicant, recipient, or any other family member for 19.32whom application is made and providing relevant information to assist the state in pursuing 19.33a potentially liable third party. General assistance medical care applicants and recipients 20.1must cooperate by providing information about any group health plan in which they may 20.2be eligible to enroll. They must cooperate with the state and local agency in determining 20.3if the plan is cost-effective. For purposes of this subdivision, coverage provided by the 20.4Minnesota Comprehensive Health Association under chapter 62E shall not be considered 20.5group health plan coverage or cost-effective by the state and local agency. If the plan is 20.6determined cost-effective and the premium will be paid by the state or local agency or is 20.7available at no cost to the person, they must enroll or remain enrolled in the group health 20.8plan. Cost-effective insurance premiums approved for payment by the state agency and 20.9paid by the local agency are eligible for reimbursement according to subdivision 6. 20.10(b) Effective for all premiums due on or after June 30, 1997, general assistance 20.11medical care does not cover premiums that a recipient is required to pay under a qualified 20.12or Medicare supplement plan issued by the Minnesota Comprehensive Health Association. 20.13General assistance medical care shall continue to cover premiums for recipients who are 20.14covered under a plan issued by the Minnesota Comprehensive Health Association on June 20.1530, 1997, for a period of six months following receipt of the notice of termination or 20.16until December 31, 1997, whichever is later. 20.17 new text begin (c) Effective for general assistance medical care services rendered on or after new text end 20.18 new text begin March 1, 2010, to June 30, 2011, any medical collections, payments, or recoveries under new text end 20.19 new text begin this subdivision shall be deposited in or credited to the account established in section new text end 20.20 new text begin 256D.032. new text end 20.21 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 20.22    Sec. 13. new text begin [256D.031] GENERAL ASSISTANCE MEDICAL CARE. new text end 20.23     new text begin Subdivision 1. new text end new text begin Eligibility. new text end new text begin (a) Except as provided under subdivision 2, general new text end 20.24 new text begin assistance medical care may be paid for any individual who is not eligible for medical new text end 20.25 new text begin assistance under chapter 256B, including eligibility for medical assistance based on a new text end 20.26 new text begin spenddown of excess income according to section 256B.056, subdivision 5, and who: new text end 20.27 new text begin (1) is receiving assistance under section 256D.05, except for families with children new text end 20.28 new text begin who are eligible under the Minnesota family investment program (MFIP), or who is new text end 20.29 new text begin having a payment made on the person's behalf under sections 256I.01 to 256I.06; or new text end 20.30 new text begin (2) is a resident of Minnesota and has gross countable income not in excess of 75 new text end 20.31 new text begin percent of federal poverty guidelines for the family size, using a six-month budget period, new text end 20.32 new text begin and whose equity in assets is not in excess of $1,000 per assistance unit. new text end 20.33 new text begin Exempt assets, the reduction of excess assets, and the waiver of excess assets must new text end 20.34 new text begin conform to the medical assistance program in section 256B.056, subdivisions 3 and 3d, new text end 21.1 new text begin except that the maximum amount of undistributed funds in a trust that could be distributed new text end 21.2 new text begin to or on behalf of the beneficiary by the trustee, assuming the full exercise of the trustee's new text end 21.3 new text begin discretion under the terms of the trust, must be applied toward the asset maximum. new text end 21.4 new text begin (b) The commissioner shall adjust the income standards under this section each July new text end 21.5 new text begin 1 by the annual update of the federal poverty guidelines following publication by the new text end 21.6 new text begin United States Department of Health and Human Services. new text end 21.7     new text begin Subd. 2. new text end new text begin Ineligible groups. new text end new text begin (a) General assistance medical care may not be paid for new text end 21.8 new text begin an applicant or a recipient who: new text end 21.9 new text begin (1) is otherwise eligible for medical assistance but fails to verify their assets; new text end 21.10 new text begin (2) is an adult in a family with children as defined in section 256L.01, subdivision 3a; new text end 21.11 new text begin (3) is enrolled in private health coverage as defined in section 256B.02, subdivision new text end 21.12 new text begin 9; new text end 21.13 new text begin (4) is in a correctional facility, including an individual in a county correctional or new text end 21.14 new text begin detention facility as an individual accused or convicted of a crime, or admitted as an new text end 21.15 new text begin inpatient to a hospital on a criminal hold order; new text end 21.16 new text begin (5) resides in the Minnesota sex offender program defined in chapter 246B; new text end 21.17 new text begin (6) does not cooperate with the county agency to meet the requirements of medical new text end 21.18 new text begin assistance; or new text end 21.19 new text begin (7) does not cooperate with a county or state agency or the state medical review team new text end 21.20 new text begin in determining a disability or for determining eligibility for Supplemental Security Income new text end 21.21 new text begin or Social Security Disability Insurance by the Social Security Administration. new text end 21.22 new text begin (b) Undocumented noncitizens and nonimmigrants are ineligible for general new text end 21.23 new text begin assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual new text end 21.24 new text begin in one or more of the classes listed in United States Code, title 8, section 1101, subsection new text end 21.25 new text begin (a), paragraph (15), and an undocumented noncitizen is an individual who resides in the new text end 21.26 new text begin United States without approval or acquiescence of the United States Citizenship and new text end 21.27 new text begin Immigration Services. new text end 21.28 new text begin (c) Notwithstanding any other provision of law, a noncitizen who is ineligible for new text end 21.29 new text begin medical assistance due to the deeming of a sponsor's income and resources is ineligible for new text end 21.30 new text begin general assistance medical care. new text end 21.31 new text begin (d) General assistance medical care recipients who become eligible for medical new text end 21.32 new text begin assistance shall be terminated from general assistance medical care and transferred to new text end 21.33 new text begin medical assistance. new text end 21.34     new text begin Subd. 3. new text end new text begin Transitional MinnesotaCare. new text end new text begin (a) Except as provided in paragraph (c), new text end 21.35 new text begin effective March 1, 2010, all applicants and recipients who meet the eligibility requirements new text end 21.36 new text begin in subdivision 1, paragraph (a), clause (2), and who are not described in subdivision 2 new text end 22.1 new text begin shall be enrolled in MinnesotaCare under section 256L.04, subdivision 7, immediately new text end 22.2 new text begin following approval of general assistance medical care. new text end 22.3 new text begin (b) If all other eligibility requirements of this subdivision are met, general assistance new text end 22.4 new text begin medical care may be paid for individuals identified in paragraph (a) for a temporary new text end 22.5 new text begin period beginning the date of application. Eligibility for general assistance medical care new text end 22.6 new text begin shall continue until enrollment in MinnesotaCare is completed. Upon notification of new text end 22.7 new text begin eligibility for MinnesotaCare, notice of termination for eligibility for general assistance new text end 22.8 new text begin medical care shall be sent to the applicant or recipient. Once enrolled in MinnesotaCare, new text end 22.9 new text begin the MinnesotaCare-covered services as described in section 256L.03 shall apply for the new text end 22.10 new text begin remainder of the six-month general assistance medical care eligibility period until their new text end 22.11 new text begin six-month renewal. new text end 22.12 new text begin (c) This subdivision does not apply if the applicant or recipient: new text end 22.13 new text begin (1) has applied for and is awaiting a determination of blindness or disability by the new text end 22.14 new text begin state medical review team or a determination of eligibility for Supplemental Security new text end 22.15 new text begin Income or Social Security Disability Insurance by the Social Security Administration; new text end 22.16 new text begin (2) is homeless as defined by United States Code, title 42, section 11301, et seq.; new text end 22.17 new text begin (3) is classified as an end-stage renal disease beneficiary in the Medicare program; new text end 22.18 new text begin (4) receives treatment funded in section 254B.02; or new text end 22.19 new text begin (5) fails to meet the requirements of section 256L.09, subdivision 2. new text end 22.20 new text begin Applicants and recipients who meet any one of these criteria shall remain eligible for new text end 22.21 new text begin general assistance medical care and shall not be required to enroll in MinnesotaCare. new text end 22.22 new text begin (d) To be eligible for general assistance medical care following enrollment new text end 22.23 new text begin in MinnesotaCare as required in paragraph (a), an individual must complete a new new text end 22.24 new text begin application. new text end 22.25     new text begin Subd. 4. new text end new text begin Eligibility and enrollment procedures. new text end new text begin (a) Eligibility for general new text end 22.26 new text begin assistance medical care shall begin no earlier than the date of application. The date of new text end 22.27 new text begin application shall be the date the applicant has provided a name, address, and Social new text end 22.28 new text begin Security number, signed and dated, to the county agency or the Department of Human new text end 22.29 new text begin Services. If the applicant is unable to provide a name, address, Social Security number, new text end 22.30 new text begin and signature when health care is delivered due to a medical condition or disability, a new text end 22.31 new text begin health care provider may act on an applicant's behalf to establish the date of an application new text end 22.32 new text begin by providing the county agency or Department of Human Services with provider new text end 22.33 new text begin identification and a temporary unique identifier for the applicant. The applicant must new text end 22.34 new text begin complete the remainder of the application and provide necessary verification before new text end 22.35 new text begin eligibility can be determined. The applicant must complete the application within the time new text end 22.36 new text begin periods required under the medical assistance program as specified in Minnesota Rules, new text end 23.1 new text begin parts 9505.0015, subpart 5; and 9505.0090, subpart 2. The county agency must assist the new text end 23.2 new text begin applicant in obtaining verification if necessary. new text end 23.3     new text begin (b) County agencies are authorized to use all automated databases containing new text end 23.4 new text begin information regarding recipients' or applicants' income in order to determine eligibility for new text end 23.5 new text begin general assistance medical care or MinnesotaCare. Such use shall be considered sufficient new text end 23.6 new text begin in order to determine eligibility and premium payments by the county agency. new text end 23.7     new text begin (c) In determining the amount of assets of an individual eligible under subdivision 1, new text end 23.8 new text begin paragraph (a), clause (2), there shall be included any asset or interest in an asset, including new text end 23.9 new text begin an asset excluded under subdivision 1, paragraph (a), that was given away, sold, or new text end 23.10 new text begin disposed of for less than fair market value within the 60 months preceding application for new text end 23.11 new text begin general assistance medical care or during the period of eligibility. Any transfer described new text end 23.12 new text begin in this paragraph shall be presumed to have been for the purpose of establishing eligibility new text end 23.13 new text begin for general assistance medical care, unless the individual furnishes convincing evidence to new text end 23.14 new text begin establish that the transaction was exclusively for another purpose. For purposes of this new text end 23.15 new text begin paragraph, the value of the asset or interest shall be the fair market value at the time it new text end 23.16 new text begin was given away, sold, or disposed of, less the amount of compensation received. For any new text end 23.17 new text begin uncompensated transfer, the number of months of ineligibility, including partial months, new text end 23.18 new text begin shall be calculated by dividing the uncompensated transfer amount by the average monthly new text end 23.19 new text begin per person payment made by the medical assistance program to skilled nursing facilities new text end 23.20 new text begin for the previous calendar year. The individual shall remain ineligible until this fixed period new text end 23.21 new text begin has expired. The period of ineligibility may exceed 30 months, and a reapplication for new text end 23.22 new text begin benefits after 30 months from the date of the transfer shall not result in eligibility unless new text end 23.23 new text begin and until the period of ineligibility has expired. The period of ineligibility begins in the new text end 23.24 new text begin month the transfer was reported to the county agency, or if the transfer was not reported, new text end 23.25 new text begin the month in which the county agency discovered the transfer, whichever comes first. For new text end 23.26 new text begin applicants, the period of ineligibility begins on the date of the first approved application. new text end 23.27     new text begin (d) When determining eligibility for any state benefits under this subdivision, new text end 23.28 new text begin the income and resources of all noncitizens shall be deemed to include their sponsor's new text end 23.29 new text begin income and resources as defined in the Personal Responsibility and Work Opportunity new text end 23.30 new text begin Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and new text end 23.31 new text begin subsequently set out in federal rules. new text end 23.32     new text begin Subd. 5. new text end new text begin General assistance medical care; services. new text end new text begin (a) General assistance new text end 23.33 new text begin medical care covers: new text end 23.34     new text begin (1) inpatient hospital services within the limitations described in subdivision 10; new text end 23.35     new text begin (2) outpatient hospital services; new text end 23.36     new text begin (3) services provided by Medicare-certified rehabilitation agencies; new text end 24.1     new text begin (4) prescription drugs and other products recommended through the process new text end 24.2 new text begin established in section new text end new text begin 256B.0625, subdivision 13 new text end new text begin ; new text end 24.3     new text begin (5) equipment necessary to administer insulin and diagnostic supplies and equipment new text end 24.4 new text begin for diabetics to monitor blood sugar level; new text end 24.5     new text begin (6) eyeglasses and eye examinations provided by a physician or optometrist; new text end 24.6     new text begin (7) hearing aids; new text end 24.7     new text begin (8) prosthetic devices; new text end 24.8     new text begin (9) laboratory and x-ray services; new text end 24.9     new text begin (10) physicians' services; new text end 24.10     new text begin (11) medical transportation except special transportation; new text end 24.11     new text begin (12) chiropractic services as covered under the medical assistance program; new text end 24.12     new text begin (13) podiatric services; new text end 24.13     new text begin (14) dental services as covered under the medical assistance program; new text end 24.14     new text begin (15) mental health services covered under chapter 256B; new text end 24.15     new text begin (16) prescribed medications for persons who have been diagnosed as mentally ill as new text end 24.16 new text begin necessary to prevent more restrictive institutionalization; new text end 24.17     new text begin (17) medical supplies and equipment, and Medicare premiums, coinsurance, and new text end 24.18 new text begin deductible payments; new text end 24.19     new text begin (18) medical equipment not specifically listed in this paragraph when the use of new text end 24.20 new text begin the equipment will prevent the need for costlier services that are reimbursable under new text end 24.21 new text begin this subdivision; new text end 24.22     new text begin (19) services performed by a certified pediatric nurse practitioner, a certified family new text end 24.23 new text begin nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological new text end 24.24 new text begin nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse new text end 24.25 new text begin practitioner in independent practice, if (1) the service is otherwise covered under this new text end 24.26 new text begin chapter as a physician service, (2) the service provided on an inpatient basis is not included new text end 24.27 new text begin as part of the cost for inpatient services included in the operating payment rate, and (3) the new text end 24.28 new text begin service is within the scope of practice of the nurse practitioner's license as a registered new text end 24.29 new text begin nurse, as defined in section new text end new text begin ; new text end 24.30     new text begin (20) services of a certified public health nurse or a registered nurse practicing in new text end 24.31 new text begin a public health nursing clinic that is a department of, or that operates under the direct new text end 24.32 new text begin authority of, a unit of government, if the service is within the scope of practice of the new text end 24.33 new text begin public health nurse's license as a registered nurse, as defined in section new text end new text begin ; new text end 24.34     new text begin (21) telemedicine consultations, to the extent they are covered under section new text end 24.35 new text begin 256B.0625, subdivision 3b new text end new text begin ; new text end 25.1     new text begin (22) care coordination and patient education services provided by a community new text end 25.2 new text begin health worker according to section new text end new text begin 256B.0625, subdivision 49 new text end new text begin ; and new text end 25.3     new text begin (23) regardless of the number of employees that an enrolled health care provider new text end 25.4 new text begin may have, sign language interpreter services when provided by an enrolled health care new text end 25.5 new text begin provider during the course of providing a direct, person-to-person-covered health care new text end 25.6 new text begin service to an enrolled recipient who has a hearing loss and uses interpreting services. new text end 25.7 new text begin (b) Sex reassignment surgery is not covered under this section. new text end 25.8 new text begin (c) Drug coverage is covered in accordance with section 256D.03, subdivision 4, new text end 25.9 new text begin paragraph (d). new text end 25.10 new text begin (d) The following co-payments shall apply for services provided: new text end 25.11 new text begin (1) $25 for nonemergency visits to a hospital-based emergency room; and new text end 25.12 new text begin (2) $3 per brand-name drug prescription, subject to a $7 per month maximum for new text end 25.13 new text begin prescription drug co-payments. No co-payments shall apply to antipsychotic drugs when new text end 25.14 new text begin used for the treatment of mental illness. new text end 25.15 new text begin (e) Co-payments shall be limited to one per day per provider for nonemergency new text end 25.16 new text begin visits to a hospital-based emergency room. Recipients of general assistance medical care new text end 25.17 new text begin are responsible for all co-payments in this subdivision. Reimbursement for prescription new text end 25.18 new text begin drugs shall be reduced by the amount of the co-payment until the recipient has reached the new text end 25.19 new text begin $7 per month maximum for prescription drug co-payments. The provider shall collect new text end 25.20 new text begin the co-payment from the recipient. Providers may not deny services to recipients who new text end 25.21 new text begin are unable to pay the co-payment. new text end 25.22 new text begin (f) Chemical dependency services that are reimbursed under chapter 254B shall not new text end 25.23 new text begin be reimbursed under general assistance medical care. new text end 25.24 new text begin (g) Inpatient hospital services that are provided in community behavioral health new text end 25.25 new text begin hospitals operated by state-operated services shall not be reimbursed under general new text end 25.26 new text begin assistance medical care. new text end 25.27     new text begin Subd. 6. new text end new text begin Coordinated care delivery option. new text end new text begin (a) A county or group of counties may new text end 25.28 new text begin elect to provide health care services to individuals who are eligible for general assistance new text end 25.29 new text begin medical care under this section and who reside within the county or counties through new text end 25.30 new text begin a coordinated care delivery option. The health care services provided by the county new text end 25.31 new text begin must include the services described in subdivision 5 with the exception of outpatient new text end 25.32 new text begin prescription drug coverage but including drugs administered in an outpatient setting. new text end 25.33 new text begin Counties that elect to provide health care services through this option must ensure that new text end 25.34 new text begin the requirements of this subdivision are met. Upon electing to provide services through new text end 25.35 new text begin this option, the county accepts the financial risk of the delivery of the health care services new text end 25.36 new text begin described in this subdivision to general assistance medical care recipients residing in new text end 26.1 new text begin the county for the period beginning July 1, 2010, and ending July 1, 2011, for the fixed new text end 26.2 new text begin payments described in subdivision 10. new text end 26.3 new text begin (b) A county that elects to provide services through this option must provide to new text end 26.4 new text begin the commissioner the following: new text end 26.5 new text begin (1) the names of the county or counties that are electing to provide services through new text end 26.6 new text begin the county care delivery option; and new text end 26.7 new text begin (2) the geographic area to be served. new text end 26.8 new text begin (c) The county may contract with a managed care plan, an integrated delivery new text end 26.9 new text begin system, a physician-hospital organization, or an academic health center to administer new text end 26.10 new text begin the delivery of services through this option. Any county providing general assistance new text end 26.11 new text begin medical care services through a county-based purchasing plan in accordance with section new text end 26.12 new text begin 256B.692 may continue to provide services through the county-based purchasing plan. new text end 26.13 new text begin Payments to the county-based purchasing plan for the period beginning July 1, 2010, and new text end 26.14 new text begin ending July 1, 2011, shall be paid according to subdivision 10. new text end 26.15 new text begin (d) A county must demonstrate the ability to: new text end 26.16 new text begin (1) provide the covered services required under this subdivision to recipients new text end 26.17 new text begin residing within the county; new text end 26.18 new text begin (2) provide a system for advocacy, consumer protection, and complaints and appeals new text end 26.19 new text begin that is independent of care providers or other risk bearers and complies with section new text end 26.20 new text begin 256B.69; new text end 26.21 new text begin (3) establish a process to monitor enrollment and ensure the quality of care provided; new text end 26.22 new text begin and new text end 26.23 new text begin (4) coordinate the delivery of health care services with existing homeless prevention, new text end 26.24 new text begin supportive housing, and rent subsidy programs and funding administered by the Minnesota new text end 26.25 new text begin Housing Finance Agency under chapter 462A. new text end 26.26 new text begin (e) The commissioner may require the county to provide the commissioner with data new text end 26.27 new text begin necessary for assessing enrollment, quality of care, cost, and utilization of services. new text end 26.28 new text begin (f) A county that elects to provide services through this option shall be considered to new text end 26.29 new text begin be a prepaid health plan for purposes of section 256.045. new text end 26.30 new text begin (g) The state shall not be liable for the payment of any cost or obligation incurred new text end 26.31 new text begin by the county or a participating provider. new text end 26.32     new text begin Subd. 7. new text end new text begin Health care home designation. new text end new text begin The commissioner or a county may new text end 26.33 new text begin require a recipient to designate a primary care provider or a primary care clinic that is new text end 26.34 new text begin certified as a health care home under section 256B.0751. new text end 26.35     new text begin Subd. 8. new text end new text begin Payments; fee-for-service rate for the period between March 1, new text end 26.36 new text begin 2010, and July 1, 2010. new text end new text begin (a) Effective for services provided on or after March 1, 2010, new text end 27.1 new text begin and before July 1, 2010, the payment rates for all covered services provided to general new text end 27.2 new text begin assistance medical care recipients, with the exception of outpatient prescription drug new text end 27.3 new text begin coverage, shall be 50 percent of the general assistance medical care payment rate in effect new text end 27.4 new text begin on February 28, 2010. new text end 27.5 new text begin (b) Outpatient prescription drug coverage provided on or after March 1, 2010, and new text end 27.6 new text begin before July 1, 2010, shall be paid on a fee-for-service basis in accordance with section new text end 27.7 new text begin 256B.0625, subdivision 13e. new text end 27.8     new text begin Subd. 9. new text end new text begin Payments; fee-for-service rates for the period between July 1, 2010, new text end 27.9 new text begin and July 1, 2011. new text end new text begin (a) Effective for services provided on or after July 1, 2010, and before new text end 27.10 new text begin July 1, 2011, to general assistance medical care recipients residing in counties that are new text end 27.11 new text begin not served through the coordinated care delivery option, payments shall be made by the new text end 27.12 new text begin commissioner to providers at rates described in this subdivision. new text end 27.13 new text begin (b) For inpatient hospital admissions provided on or after July 1, 2010, and before new text end 27.14 new text begin July 1, 2011, the payment rate shall be: new text end 27.15 new text begin (1) 70 percent of the general assistance medical care rate in effect on February new text end 27.16 new text begin 28, 2010, if the inpatient hospital services were provided in a hospital where the new text end 27.17 new text begin fee-for-service inpatient and outpatient hospital general assistance medical care payments new text end 27.18 new text begin to the hospital for admissions provided in calendar year 2007 totaled $1,000,000 or more new text end 27.19 new text begin or the hospital's fee-for-service inpatient and outpatient hospital general assistance medical new text end 27.20 new text begin care payments received for calendar year 2007 admissions was one percent or more of the new text end 27.21 new text begin hospital's net patient revenue received for services provided in calendar year 2007; or new text end 27.22 new text begin (2) 40 percent of the general assistance medical care rate in effect on February 28, new text end 27.23 new text begin 2010, if the inpatient hospital services were provided by a hospital that does not meet the new text end 27.24 new text begin criteria described in clause (1). new text end 27.25 new text begin (c) Effective for services other than inpatient hospital services and outpatient new text end 27.26 new text begin prescription drug coverage provided on or after July 1, 2010, and before July 1, 2011, new text end 27.27 new text begin the payment rate shall begin at 50 percent of the general assistance medical care rate new text end 27.28 new text begin in effect on February 28, 2010. new text end 27.29 new text begin (d) Outpatient prescription drug coverage provided on or after July 1, 2010, and new text end 27.30 new text begin before July 1, 2011, shall be paid on a fee-for-service basis in accordance with section new text end 27.31 new text begin 256B.0625, subdivision 13e. new text end 27.32 new text begin (e) The commissioner may adjust the rates paid under paragraphs (b) and (c) on a new text end 27.33 new text begin quarterly basis to ensure that the total aggregate amount paid out for services provided new text end 27.34 new text begin on a fee-for-service basis beginning March 1, 2010, and ending June 30, 2011, does not new text end 27.35 new text begin exceed the appropriation from the general assistance medical care account established in new text end 27.36 new text begin section 256D.032 for the general assistance medical care program. new text end 28.1     new text begin Subd. 10. new text end new text begin Payments; rate setting for the coordinated care delivery option. new text end new text begin (a) new text end 28.2 new text begin Effective for general assistance medical care services, with the exception of outpatient new text end 28.3 new text begin prescription drug coverage, provided on or after July 1, 2010, and before July 1, 2011, new text end 28.4 new text begin to recipients residing in counties that have elected to provide services through the new text end 28.5 new text begin coordinated delivery care option, the commissioner shall establish quarterly prospective new text end 28.6 new text begin fixed payments to the county. The payments must not exceed 60 percent of the county's new text end 28.7 new text begin general assistance medical care county allocation amount as determined in paragraph (b). new text end 28.8 new text begin These payments must not be used by the county to pay MinnesotaCare premiums for new text end 28.9 new text begin general assistance medical care recipients or MinnesotaCare enrollees. new text end 28.10 new text begin (b) For each county that elects to provide services in accordance with subdivision new text end 28.11 new text begin 7, the commissioner shall determine a general assistance medical care county allocation new text end 28.12 new text begin amount that equals the total general assistance medical care payments made for recipients new text end 28.13 new text begin residing within the county in fiscal year 2009 for all covered general assistance medical new text end 28.14 new text begin care services with the exception of outpatient prescription drug coverage. new text end 28.15 new text begin (c) Outpatient prescription drug coverage provided on or after July 1, 2010, new text end 28.16 new text begin and before July 1, 2011, shall be paid on a fee-for-service basis according to section new text end 28.17 new text begin 256B.0625, subdivision 13e. new text end 28.18     new text begin Subd. 11. new text end new text begin Veterans medical review team. new text end new text begin (a) To ensure the timely processing of new text end 28.19 new text begin determinations of service-connected disabilities among veterans enrolled in the temporary new text end 28.20 new text begin general assistance medical care program, the commissioner shall review all medical new text end 28.21 new text begin evidence submitted by enrollees with a referral and seek additional information from new text end 28.22 new text begin providers, applicants, and enrollees to support the determination of a service-connected new text end 28.23 new text begin disability when necessary. Service-connected disability shall be determined according to new text end 28.24 new text begin the regulations and policies of the United States Department of Veterans Affairs. new text end 28.25 new text begin (b) Prior to a denial or withdrawal of a requested determination of service-connected new text end 28.26 new text begin disability due to insufficient evidence, the commissioner shall: new text end 28.27 new text begin (1) ensure that the missing evidence is necessary and appropriate to a determination new text end 28.28 new text begin of service-connected disability; and new text end 28.29 new text begin (2) assist applicants and enrollees to obtain the evidence, including, but not limited new text end 28.30 new text begin to, medical examinations and electronic medical records. new text end 28.31 new text begin (c) The commissioner shall provide the chairs of the legislative committees with new text end 28.32 new text begin jurisdiction over health and human services finance and veterans affairs finance the new text end 28.33 new text begin following information on the activities of the veterans medical review team by August 1, new text end 28.34 new text begin 2010, and provide an update by January 1, 2011: new text end 28.35 new text begin (1) the number of applications to the veterans medical review team that were denied, new text end 28.36 new text begin approved, or withdrawn; new text end 29.1 new text begin (2) the average length of time from receipt of the application to a decision; new text end 29.2 new text begin (3) the number of appeals and appeal results; new text end 29.3 new text begin (4) for applicants, their age, health coverage at the time of application, new text end 29.4 new text begin hospitalization history within three months of application, and whether an application for new text end 29.5 new text begin service-connected veterans benefits is pending; and new text end 29.6 new text begin (5) specific information on the medical certification, licensure, or other credentials new text end 29.7 new text begin of the person or persons performing the medical review determinations and length of new text end 29.8 new text begin time in that position. new text end 29.9 new text begin EFFECTIVE DATE. new text end new text begin This section is effective for services rendered on or after new text end 29.10 new text begin March 1, 2010, and before July 1, 2011. new text end 29.11    Sec. 14. new text begin [256D.032] GENERAL ASSISTANCE MEDICAL CARE ACCOUNT. new text end 29.12 new text begin The general assistance medical care account is created in the special revenue fund. new text end 29.13 new text begin Money deposited into the account is subject to appropriation by the legislature. new text end 29.14 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 29.15    Sec. 15. Minnesota Statutes 2008, section 256D.06, subdivision 7, is amended to read: 29.16    Subd. 7. SSI conversions and back claims. (a) The commissioner of human 29.17services shall contract with agencies or organizations capable of ensuring that clients who 29.18are presently receiving assistance under sections 256D.01 to 256D.21, and who may be 29.19eligible for benefits under the federal Supplemental Security Income program, apply and, 29.20when eligible, are converted to the federal income assistance program and made eligible 29.21for health care benefits under the medical assistance program. The commissioner shall 29.22ensure that money owing to the state under interim assistance agreements is collected. 29.23(b) The commissioner shall also directly or through contract implement procedures 29.24for collecting federal Medicare and medical assistance funds for which clients converted 29.25to SSI are retroactively eligible. 29.26(c) The commissioner shall contract with agencies to ensure implementation of 29.27this section. County contracts with providers for residential services shall include the 29.28requirement that providers screen residents who may be eligible for federal benefits and 29.29provide that information to the local agency. The commissioner shall modify the MAXIS 29.30computer system to provide information on clients who have been on general assistance 29.31for two years or longer. The list of clients shall be provided to local services for screening 29.32under this section. 30.1 new text begin (d) Effective for general assistance medical care services rendered on or after new text end 30.2 new text begin March 1, 2010, to June 30, 2011, any medical collections, payments, or recoveries under new text end 30.3 new text begin this subdivision shall be deposited in or credited to the account established in section new text end 30.4 new text begin 256D.032. new text end 30.5 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 30.6    Sec. 16. Minnesota Statutes 2008, section 256L.05, subdivision 1b, is amended to read: 30.7    Subd. 1b. MinnesotaCare enrollment by county agencies. Beginning September 30.81, 2006, county agencies shall enroll single adults and households with no children 30.9formerly enrolled in general assistance medical care in MinnesotaCare according to 30.10section 256D.03, subdivision 3 new text begin , or 256D.031 new text end . County agencies shall perform all duties 30.11necessary to administer the MinnesotaCare program ongoing for these enrollees, including 30.12the redetermination of MinnesotaCare eligibility at renewal. 30.13 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 30.14    Sec. 17. Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read: 30.15    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the 30.16first day of the month following the month in which eligibility is approved and the first 30.17premium payment has been received. As provided in section 256B.057, coverage for 30.18newborns is automatic from the date of birth and must be coordinated with other health 30.19coverage. The effective date of coverage for eligible newly adoptive children added to a 30.20family receiving covered health services is the month of placement. The effective date 30.21of coverage for other new members added to the family is the first day of the month 30.22following the month in which the change is reported. All eligibility criteria must be met 30.23by the family at the time the new family member is added. The income of the new family 30.24member is included with the family's gross income and the adjusted premium begins in 30.25the month the new family member is added. 30.26(b) The initial premium must be received by the last working day of the month for 30.27coverage to begin the first day of the following month. 30.28(c) Benefits are not available until the day following discharge if an enrollee is 30.29hospitalized on the first day of coverage. 30.30(d) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to 30.31256L.18 are secondary to a plan of insurance or benefit program under which an eligible 30.32person may have coverage and the commissioner shall use cost avoidance techniques to 30.33ensure coordination of any other health coverage for eligible persons. The commissioner 31.1shall identify eligible persons who may have coverage or benefits under other plans of 31.2insurance or who become eligible for medical assistance. 31.3(e) The effective date of coverage for single adults and households with no children 31.4formerly enrolled in general assistance medical care and enrolled in MinnesotaCare 31.5according to section 256D.03, subdivision 3, new text begin or 256D.031, new text end is the first day of the month 31.6following the last day of general assistance medical care coverage. 31.7 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 31.8    Sec. 18. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read: 31.9    Subd. 3a. Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility 31.10must be renewed every 12 months. The 12-month period begins in the month after the 31.11month the application is approved. 31.12    (b) Each new period of eligibility must take into account any changes in 31.13circumstances that impact eligibility and premium amount. An enrollee must provide all 31.14the information needed to redetermine eligibility by the first day of the month that ends 31.15the eligibility period. If there is no change in circumstances, the enrollee may renew 31.16eligibility at designated locations that include community clinics and health care providers' 31.17offices. The designated sites shall forward the renewal forms to the commissioner. The 31.18commissioner may establish criteria and timelines for sites to forward applications to the 31.19commissioner or county agencies. The premium for the new period of eligibility must be 31.20received as provided in section 256L.06 in order for eligibility to continue. 31.21    (c) For single adults and households with no children formerly enrolled in general 31.22assistance medical care and enrolled in MinnesotaCare according to section 256D.03, 31.23subdivision 3 , new text begin or 256D.031, new text end the first period of eligibility begins the month the enrollee 31.24submitted the application or renewal for general assistance medical care. 31.25    (d) An enrollee who fails to submit renewal forms and related documentation 31.26necessary for verification of continued eligibility in a timely manner shall remain eligible 31.27for one additional month beyond the end of the current eligibility period before being 31.28disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the 31.29additional month. 31.30    Sec. 19. Minnesota Statutes 2008, section 256L.07, subdivision 6, is amended to read: 31.31    Subd. 6. Exception for certain adults. Single adults and households with 31.32no children formerly enrolled in general assistance medical care and enrolled in 31.33MinnesotaCare according to section 256D.03, subdivision 3, new text begin or 256D.031, new text end are eligible 31.34without meeting the requirements of this section until renewal. 32.1 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 32.2    Sec. 20. Minnesota Statutes 2008, section 256L.15, subdivision 4, is amended to read: 32.3    Subd. 4. Exception for transitioned adults. County agencies shall pay premiums 32.4for single adults and households with no children formerly enrolled in general assistance 32.5medical care and enrolled in MinnesotaCare according to section 256D.03, subdivision 3, 32.6 new text begin or 256D.031, new text end until six-month renewal. The county agency has the option of continuing to 32.7pay premiums for these enrollees. 32.8 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 32.9    Sec. 21. Minnesota Statutes 2008, section 256L.17, subdivision 7, is amended to read: 32.10    Subd. 7. Exception for certain adults. Single adults and households with 32.11no children formerly enrolled in general assistance medical care and enrolled in 32.12MinnesotaCare according to section 256D.03, subdivision 3, new text begin or 256D.031, new text end are exempt 32.13from the requirements of this section until renewal. 32.14 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 32.15    Sec. 22. new text begin DRUG REBATE PROGRAM. new text end 32.16 new text begin The commissioner of human services shall continue to administer a drug rebate new text end 32.17 new text begin program for drugs purchased for persons eligible for the general assistance medical care new text end 32.18 new text begin program in accordance with Minnesota Statutes, sections 256.01, subdivision 2, paragraph new text end 32.19 new text begin (cc), and 256D.03. The rebate revenues collected under the drug rebate program for new text end 32.20 new text begin persons eligible for the general assistance medical care program shall be deposited in the new text end 32.21 new text begin general assistance medical care account in the special revenue fund established under new text end 32.22 new text begin Minnesota Statutes, section 256D.032. new text end 32.23 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010, and expires June new text end 32.24 new text begin 30, 2011. new text end 32.25    Sec. 23. new text begin PROVIDER PARTICIPATION. new text end 32.26 new text begin For purposes of Minnesota Statutes, section 256B.0644, the reference to the general new text end 32.27 new text begin assistance medical care program shall include the temporary general assistance medical new text end 32.28 new text begin care program established under Minnesota Statutes, section 256D.031. In meeting the new text end 32.29 new text begin requirements of Minnesota Statutes, section 256B.0644, a provider must accept new new text end 32.30 new text begin patients regardless of the Minnesota health care program the patient is enrolled in and may new text end 33.1 new text begin not refuse to accept patients enrolled in one Minnesota health care program and continue new text end 33.2 new text begin to accept patients enrolled in other Minnesota health care programs. new text end 33.3 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 33.4    Sec. 24. new text begin TEMPORARY SUSPENSION. new text end 33.5 new text begin (a) For the period beginning March 1, 2010, to June 30, 2011, the commissioner new text end 33.6 new text begin of human services shall not implement or administer Minnesota Statutes 2008, section new text end 33.7 new text begin 256D.03, subdivisions 6 and 9; Minnesota Statutes 2009 Supplement, section 256D.03, new text end 33.8 new text begin subdivision 4; or Minnesota Statutes 2008, section 256B.692; and Minnesota Statutes new text end 33.9 new text begin 2009 Supplement, section 256B.69, as they apply to the general assistance medical care new text end 33.10 new text begin program unless specifically continued in Minnesota Statutes, section 256D.031. new text end 33.11 new text begin (b) Notwithstanding paragraph (a), outpatient prescription drug coverage shall new text end 33.12 new text begin continue to be provided under Minnesota Statutes, section 256D.03. new text end 33.13 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010, and expires July 1, new text end 33.14 new text begin 2011. new text end 33.15    Sec. 25. new text begin COORDINATED CARE DELIVERY ORGANIZATION new text end 33.16 new text begin DEMONSTRATION PROJECT. new text end 33.17 new text begin The commissioner of human services shall develop, and present to the legislature new text end 33.18 new text begin by December 15, 2010, a plan to establish a demonstration project to deliver inpatient new text end 33.19 new text begin hospital, primary care, and specialist services to general assistance medical care enrollees new text end 33.20 new text begin through coordinated care delivery organizations, beginning January 1, 2012. Each new text end 33.21 new text begin coordinated care delivery organization must deliver coordinated care through at least one new text end 33.22 new text begin hospital and one physician group practice, and may include counties and other health care new text end 33.23 new text begin providers. The coordinated care delivery organization must provide inpatient hospital, new text end 33.24 new text begin primary care, and specialist services to general assistance medical care enrollees eligible new text end 33.25 new text begin for the program under Minnesota Statutes, section 256D.03 or 256D.031. The coordinated new text end 33.26 new text begin care delivery organization must accept responsibility for the quality of care and must new text end 33.27 new text begin assume financial risk for the services provided. The plan must include: new text end 33.28 new text begin (1) financial incentives for coordinated care delivery organizations to reduce the new text end 33.29 new text begin growth in the volume and cost of services provided, while maintaining or improving new text end 33.30 new text begin the quality of care; new text end 33.31 new text begin (2) recommendations for the delivery of services not provided through a coordinated new text end 33.32 new text begin care delivery organization and coordination of outpatient and inpatient health care services; new text end 34.1 new text begin (3) recommendations as to the size and scope of the demonstration project and new text end 34.2 new text begin whether participation would be mandatory or voluntary for general assistance medical new text end 34.3 new text begin care enrollees; and new text end 34.4 new text begin (4) recommendations for managing financial risk within a coordinated care delivery new text end 34.5 new text begin organization. new text end 34.6ARTICLE 2 34.7APPROPRIATIONS 34.8 Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATION. new text end 34.9 new text begin The sums shown in the columns marked "Appropriations" are added to or, if shown new text end 34.10 new text begin in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, as amended new text end 34.11 new text begin by Laws 2009, chapter 173, or other law to the agencies and for the purposes specified in new text end 34.12 new text begin this article. The appropriations are from the general fund, or another named fund, and are new text end 34.13 new text begin available for the fiscal years indicated for each purpose. The figures "2010" and "2011" new text end 34.14 new text begin used in this article mean that the addition to or subtraction from appropriations listed under new text end 34.15 new text begin them are available for the fiscal year ending June 30, 2010, or June 30, 2011, respectively. new text end 34.16 new text begin "The first year" is fiscal year 2010. "The second year" is fiscal year 2011. "The biennium" new text end 34.17 new text begin is fiscal years 2010 and 2011. Supplemental appropriations and reductions for the fiscal new text end 34.18 new text begin year ending June 30, 2010, are effective the day following final enactment. new text end 34.19 new text begin APPROPRIATIONS new text end 34.20 new text begin Available for the Year new text end 34.21 new text begin Ending June 30 new text end 34.22 new text begin 2010 new text end new text begin 2011 new text end 34.23 Sec. 2. new text begin HUMAN SERVICES new text end 34.24 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin (88,580,000) new text end new text begin $ new text end new text begin 27,041,000 new text end 34.25 new text begin Appropriations by Fund new text end 34.26 new text begin 2010 new text end new text begin 2011 new text end 34.27 new text begin General new text end new text begin (62,256,000) new text end new text begin (34,866,000) new text end 34.28 new text begin Health Care Access new text end new text begin (68,568,000) new text end new text begin (185,157,000) new text end 34.29 new text begin Special Revenue new text end new text begin 42,244,000 new text end new text begin 247,064,000 new text end 34.30 new text begin The amounts that may be spent for each new text end 34.31 new text begin purpose are specified in the following new text end 34.32 new text begin subdivisions. new text end 34.33 34.34 new text begin Subd. 2. new text end new text begin Children and Economic Assistance new text end new text begin Grants new text end new text begin -0- new text end new text begin (9,939,000) new text end 35.1 new text begin The general fund appropriation to the new text end 35.2 new text begin commissioner of human services for children new text end 35.3 new text begin and community services grants in Laws new text end 35.4 new text begin 2009, chapter 79, article 13, section 3, new text end 35.5 new text begin subdivision 4, as amended by Laws 2009, new text end 35.6 new text begin chapter 173, article 2, section 1, subdivision new text end 35.7 new text begin 4, is reduced by $9,938,000 in fiscal year new text end 35.8 new text begin 2011. The general fund base for children new text end 35.9 new text begin and community service grants is increased new text end 35.10 new text begin by $9,938,000 per year for fiscal years 2012 new text end 35.11 new text begin and 2013. new text end 35.12 35.13 new text begin Subd. 3. new text end new text begin Children and Economic Assistance new text end new text begin Management new text end 35.14 new text begin Children and Economic Assistance Operations new text end 35.15 new text begin Appropriations by Fund new text end 35.16 new text begin Special Revenue new text end new text begin 29,000 new text end new text begin -0- new text end 35.17 new text begin Subd. 4. new text end new text begin Basic Health Care Grants new text end 35.18 new text begin The amounts that may be spent from this new text end 35.19 new text begin appropriation for each purpose are as follows: new text end 35.20 new text begin (a) MinnesotaCare Grants new text end new text begin (68,569,000) new text end new text begin (185,157,000) new text end 35.21 35.22 new text begin (b) Medical Assistance Basic Health Care new text end new text begin Grants - Families and Children new text end new text begin -0- new text end new text begin (4,070,000) new text end 35.23 35.24 new text begin (c) Medical Assistance Basic Health Care new text end new text begin Grants - Elderly and Disabled new text end new text begin -0- new text end new text begin (6,470,000) new text end 35.25 new text begin (d) General Assistance Medical Care Grants new text end 35.26 new text begin Appropriations by Fund new text end 35.27 new text begin General new text end new text begin (60,406,000) new text end new text begin -0- new text end 35.28 new text begin Special Revenue new text end new text begin 40,323,000 new text end new text begin 241,308,000 new text end 35.29 new text begin For general assistance medical care grants new text end 35.30 new text begin under Minnesota Statutes, section 256D.031. new text end 35.31 new text begin The commissioner shall transfer $60,406,000 new text end 35.32 new text begin on March 1, 2010, from the general fund to new text end 35.33 new text begin the fund established in Minnesota Statutes, new text end 35.34 new text begin section 256D.032. Any unexpended amount new text end 36.1 new text begin not used for general assistance medical care new text end 36.2 new text begin expenditures incurred before March 1, 2010, new text end 36.3 new text begin does not cancel and shall be transferred to new text end 36.4 new text begin the fund established in Minnesota Statutes, new text end 36.5 new text begin section 256D.032, by January 1, 2011. new text end 36.6 new text begin Subd. 5. new text end new text begin Health Care Management new text end 36.7 new text begin The amounts that may be spent from the new text end 36.8 new text begin appropriation for each purpose are as follows: new text end 36.9 new text begin (a) Health Care Administration new text end 36.10 new text begin Appropriations by Fund new text end 36.11 new text begin General new text end new text begin (825,000) new text end new text begin (2,425,000) new text end 36.12 new text begin Special Revenue new text end new text begin 825,000 new text end new text begin 2,681,000 new text end 36.13 new text begin $825,000 in fiscal year 2010 and $2,475,000 new text end 36.14 new text begin in fiscal year 2011 from the special revenue new text end 36.15 new text begin fund are for administration of the general new text end 36.16 new text begin assistance medical care program under new text end 36.17 new text begin Minnesota Statutes, section 256D.031. For new text end 36.18 new text begin purposes of consistent cost allocation and new text end 36.19 new text begin accounting, the commissioner may transfer new text end 36.20 new text begin these amounts to the general fund. The new text end 36.21 new text begin commissioner shall transfer $825,000 in new text end 36.22 new text begin fiscal year 2010 and $2,475,000 in fiscal new text end 36.23 new text begin year 2011 from the general fund to the fund new text end 36.24 new text begin established in Minnesota Statutes, section new text end 36.25 new text begin 256D.032. new text end 36.26 new text begin (b) Health Care Operations new text end 36.27 new text begin Appropriations by Fund new text end 36.28 new text begin General new text end new text begin (1,025,000) new text end new text begin (3,075,000) new text end 36.29 new text begin Special Revenue new text end new text begin 1,067,000 new text end new text begin 3,075,000 new text end 36.30 new text begin $1,025,000 in fiscal year 2010 and new text end 36.31 new text begin $3,075,000 in fiscal year 2011 from the new text end 36.32 new text begin special revenue fund are for operations of new text end 36.33 new text begin the general assistance medical care program new text end 36.34 new text begin under Minnesota Statutes, section 256D.031. new text end 36.35 new text begin For purposes of consistent cost allocation new text end 37.1 new text begin and accounting, the commissioner may new text end 37.2 new text begin transfer these amounts to the general fund. new text end 37.3 new text begin The commissioner shall transfer $1,025,000 new text end 37.4 new text begin in fiscal year 2010 and $3,075,000 in fiscal new text end 37.5 new text begin year 2011 from the general fund to the fund new text end 37.6 new text begin established in Minnesota Statutes, section new text end 37.7 new text begin 256D.032. new text end 37.8 new text begin Subd. 6. new text end new text begin Continuing Care Grants new text end 37.9 new text begin Mental Health Grants new text end new text begin -0- new text end new text begin (9,938,000) new text end 37.10 new text begin The general fund appropriation to the new text end 37.11 new text begin commissioner of human services for adult new text end 37.12 new text begin mental health grants in Laws 2009, chapter new text end 37.13 new text begin 79, article 13, section 3, subdivision 8, as new text end 37.14 new text begin amended by Laws 2009, chapter 173, article new text end 37.15 new text begin 2, section 1, subdivision 8, is reduced by new text end 37.16 new text begin $9,939,000 in fiscal year 2011. The general new text end 37.17 new text begin fund base for adult mental health grants is new text end 37.18 new text begin increased by $9,939,000 per year in fiscal new text end 37.19 new text begin years 2012 and 2013. new text end 37.20 new text begin Subd. 7. new text end new text begin Continuing Care Management new text end new text begin -0- new text end new text begin 1,051,000 new text end 37.21 new text begin Subd. 8. new text end new text begin Transfers new text end 37.22 new text begin (a) The commissioner of management and new text end 37.23 new text begin budget shall transfer $168,733,000 in fiscal new text end 37.24 new text begin year 2011 and $12,979,000 in fiscal year new text end 37.25 new text begin 2012, from the general fund to the fund new text end 37.26 new text begin established in Minnesota Statutes, section new text end 37.27 new text begin 256D.032. new text end 37.28 new text begin (b) $19,877,000 shall be transferred in new text end 37.29 new text begin fiscal year 2011 from the general fund to new text end 37.30 new text begin the general assistance medical care account new text end 37.31 new text begin established in Minnesota Statutes, section new text end 37.32 new text begin 256D.032. new text end 37.33 new text begin EFFECTIVE DATE. new text end new text begin This article is effective March 1, 2010. new text end