<a id="pl.1.3"></a><var>1.3</var>services; modifying the general assistance medical care program; requiring <br/>
<a id="pl.1.4"></a><var>1.4</var>a report; appropriating money;amending Minnesota Statutes 2008, sections <br/>
<a id="pl.1.5"></a><var>1.5</var>256.969, subdivision 27, by adding a subdivision; 256B.0625, subdivision 13f, <br/>
<a id="pl.1.6"></a><var>1.6</var>by adding a subdivision; 256D.03, subdivisions 3a, 3b; 256D.06, subdivision 7; <br/>
<a id="pl.1.7"></a><var>1.7</var>256L.05, subdivisions 1b, 3, 3a; 256L.07, subdivision 6; 256L.15, subdivision 4; <br/>
<a id="pl.1.8"></a><var>1.8</var>256L.17, subdivision 7; Minnesota Statutes 2009 Supplement, sections 256.969, <br/>
<a id="pl.1.9"></a><var>1.9</var>subdivisions 2b, 3a; 256B.196, subdivision 2; 256B.199; 256D.03, subdivision <br/>
<a id="pl.1.10"></a><var>1.10</var>3; proposing coding for new law in Minnesota Statutes, chapters 245; 256D.<br/>
<a id="pl.1.11"></a><var>1.11</var>BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:<br/>
<br/>
<a id="bill.1.0.0"></a>

<a id="bill.1.1.0"></a><a id="pl.1.14"></a><var>1.14</var>    Section 1. <b>[245.4862] MENTAL HEALTH URGENT CARE AND PSYCHIATRIC </b><br/>
<a id="pl.1.15"></a><var>1.15</var><b>CONSULTATION.</b><br/>
<a id="pl.1.16"></a><var>1.16</var>    Subdivision 1. <b>Mental health urgent care and psychiatric consultation.</b> The <br/>
<a id="pl.1.17"></a><var>1.17</var>commissioner shall include mental health urgent care and psychiatric consultation <br/>
<a id="pl.1.18"></a><var>1.18</var>services as part of, but not limited to, the redesign of six community-based behavioral <br/>
<a id="pl.1.19"></a><var>1.19</var>health hospitals and the Anoka-Metro Regional Treatment Center. These services must <br/>
<a id="pl.1.20"></a><var>1.20</var>not duplicate existing services in the region, and must be implemented as specified in <br/>
<a id="pl.1.21"></a><var>1.21</var>subdivisions 3 to 7.<br/>
<a id="pl.1.22"></a><var>1.22</var>    Subd. 2. <b>Definitions.</b> For purposes of this section:<br/>
<a id="pl.1.23"></a><var>1.23</var>(a) Mental health urgent care includes:<br/>
<a id="pl.1.24"></a><var>1.24</var>(1) initial mental health screening;<br/>
<a id="pl.1.25"></a><var>1.25</var>(2) mobile crisis assessment and intervention;<br/>
<a id="pl.2.1"></a><var>2.1</var>(3) rapid access to psychiatry, including psychiatric evaluation, initial treatment, <br/>
<a id="pl.2.2"></a><var>2.2</var>and short-term psychiatry;<br/>
<a id="pl.2.3"></a><var>2.3</var>(4) nonhospital crisis stabilization residential beds; and<br/>
<a id="pl.2.4"></a><var>2.4</var>(5) health care navigator services which include, but are not limited to, assisting <br/>
<a id="pl.2.5"></a><var>2.5</var>uninsured individuals in obtaining health care coverage.<br/>
<a id="pl.2.6"></a><var>2.6</var>(b) Psychiatric consultation services includes psychiatric consultation to primary <br/>
<a id="pl.2.7"></a><var>2.7</var>care practitioners.<br/>
<a id="pl.2.8"></a><var>2.8</var>    Subd. 3. <b>Rapid access to psychiatry.</b> The commissioner shall develop rapid access <br/>
<a id="pl.2.9"></a><var>2.9</var>to psychiatric services based on the following criteria:<br/>
<a id="pl.2.10"></a><var>2.10</var>(1) the individuals who receive the psychiatric services must be at risk of <br/>
<a id="pl.2.11"></a><var>2.11</var>hospitalization and otherwise unable to receive timely services;<br/>
<a id="pl.2.12"></a><var>2.12</var>(2) where clinically appropriate, the service may be provided via interactive video <br/>
<a id="pl.2.13"></a><var>2.13</var>where the service is provided in conjunction with an emergency room, a local crisis <br/>
<a id="pl.2.14"></a><var>2.14</var>service, or a primary care or behavioral care practitioner; and<br/>
<a id="pl.2.15"></a><var>2.15</var>(3) the commissioner may integrate rapid access to psychiatry with the psychiatric <br/>
<a id="pl.2.16"></a><var>2.16</var>consultation services in subdivision 4.<br/>
<a id="pl.2.17"></a><var>2.17</var>    Subd. 4. <b>Collaborative psychiatric consultation.</b> (a) The commissioner shall <br/>
<a id="pl.2.18"></a><var>2.18</var>establish a collaborative psychiatric consultation service based on the following criteria:<br/>
<a id="pl.2.19"></a><var>2.19</var>(1) the service may be available via telephone, interactive video, e-mail, or other <br/>
<a id="pl.2.20"></a><var>2.20</var>means of communication to emergency rooms, local crisis services, mental health <br/>
<a id="pl.2.21"></a><var>2.21</var>professionals, and primary care practitioners, including pediatricians;<br/>
<a id="pl.2.22"></a><var>2.22</var>(2) the service shall be provided by a multidisciplinary team including, at a <br/>
<a id="pl.2.23"></a><var>2.23</var>minimum, a child and adolescent psychiatrist, an adult psychiatrist, and a licensed clinical <br/>
<a id="pl.2.24"></a><var>2.24</var>social worker;<br/>
<a id="pl.2.25"></a><var>2.25</var>(3) the service shall include a triage-level assessment to determine the most <br/>
<a id="pl.2.26"></a><var>2.26</var>appropriate response to each request, including appropriate referrals to other mental health <br/>
<a id="pl.2.27"></a><var>2.27</var>professionals, as well as provision of rapid psychiatric access when other appropriate <br/>
<a id="pl.2.28"></a><var>2.28</var>services are not available;  <br/>
<a id="pl.2.29"></a><var>2.29</var>(4) the first priority for this service is to provide the consultations required under <br/>
<a id="pl.2.30"></a><var>2.30</var>section 256B.0625, subdivision 13j; and<br/>
<a id="pl.2.31"></a><var>2.31</var>(5) the service must encourage use of cognitive and behavioral therapies and other <br/>
<a id="pl.2.32"></a><var>2.32</var>evidence-based treatments in addition to or in place of medication, where appropriate.<br/>
<a id="pl.2.33"></a><var>2.33</var>(b) The commissioner shall appoint an interdisciplinary work group to establish <br/>
<a id="pl.2.34"></a><var>2.34</var>appropriate medication and psychotherapy protocols to guide the consultative process, <br/>
<a id="pl.2.35"></a><var>2.35</var>including consultation with the Drug Utilization Review Board, as provided in section <br/>
<a id="pl.2.36"></a><var>2.36</var>256B.0625, subdivision 13j. <br/>
<a id="pl.3.1"></a><var>3.1</var>    Subd. 5. <b>Phased availability.</b> (a) The commissioner may phase in the availability <br/>
<a id="pl.3.2"></a><var>3.2</var>of mental health urgent care services based on the limits of appropriations and the <br/>
<a id="pl.3.3"></a><var>3.3</var>commissioner's determination of level of need and cost-effectiveness.<br/>
<a id="pl.3.4"></a><var>3.4</var>(b) For subdivisions 3 and 4, the first phase must focus on adults in Hennepin <br/>
<a id="pl.3.5"></a><var>3.5</var>and Ramsey Counties and children statewide who are affected by section 256B.0625, <br/>
<a id="pl.3.6"></a><var>3.6</var>subdivision 13j, and must include tracking of costs for the services provided and <br/>
<a id="pl.3.7"></a><var>3.7</var>associated impacts on utilization of inpatient, emergency room, and other services.<br/>
<a id="pl.3.8"></a><var>3.8</var>    Subd. 6. <b>Limited appropriations.</b> The commissioner shall maximize use <br/>
<a id="pl.3.9"></a><var>3.9</var>of available health care coverage for the services provided under this section. The <br/>
<a id="pl.3.10"></a><var>3.10</var>commissioner's responsibility to provide these services for individuals without health care <br/>
<a id="pl.3.11"></a><var>3.11</var>coverage must not exceed the appropriations for this section.<br/>
<a id="pl.3.12"></a><var>3.12</var>    Subd. 7. <b>Flexible implementation.</b> To implement this section, the commissioner <br/>
<a id="pl.3.13"></a><var>3.13</var>shall select the structure and funding method that is the most cost-effective for each county <br/>
<a id="pl.3.14"></a><var>3.14</var>or group of counties. This may include grants, contracts, direct provision by state-operated <br/>
<a id="pl.3.15"></a><var>3.15</var>services, and public-private partnerships. Where feasible, the commissioner shall make <br/>
<a id="pl.3.16"></a><var>3.16</var>any grants under this section a part of the integrated adult mental health initiative grants <br/>
<a id="pl.3.17"></a><var>3.17</var>under section 245.4661.<br/>
<br/>
<a id="bill.1.2.0"></a><a id="pl.3.18"></a><var>3.18</var>    Sec. 2. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 2b, is <br/>
<a id="pl.3.19"></a><var>3.19</var>amended to read:<br/>
<a id="pl.3.20"></a><var>3.20</var>    Subd. 2b. <b>Operating payment rates.</b> In determining operating payment rates for <br/>
<a id="pl.3.21"></a><var>3.21</var>admissions occurring on or after the rate year beginning January 1, 1991, and every two <br/>
<a id="pl.3.22"></a><var>3.22</var>years after, or more frequently as determined by the commissioner, the commissioner shall <br/>
<a id="pl.3.23"></a><var>3.23</var>obtain operating data from an updated base year and establish operating payment rates <br/>
<a id="pl.3.24"></a><var>3.24</var>per admission for each hospital based on the cost-finding methods and allowable costs of <br/>
<a id="pl.3.25"></a><var>3.25</var>the Medicare program in effect during the base year. Rates under the general assistance <br/>
<a id="pl.3.26"></a><var>3.26</var>medical care, medical assistance, and MinnesotaCare programs shall not be rebased to <br/>
<a id="pl.3.27"></a><var>3.27</var>more current data on January 1, 1997, January 1, 2005, for the first 24 months of the <br/>
<a id="pl.3.28"></a><var>3.28</var>rebased period beginning January 1, 2009. For the first three six months of the rebased <br/>
<a id="pl.3.29"></a><var>3.29</var>period beginning January 1, 2011, rates shall not be rebased at 74.25 percent of the full <br/>
<a id="pl.3.30"></a><var>3.30</var>value of the rebasing percentage change. From April July 1, 2011, to March 31, 2012, <br/>
<a id="pl.3.31"></a><var>3.31</var>rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change. <br/>
<a id="pl.3.32"></a><var>3.32</var>Effective April 1, 2012, rates shall be rebased at full value. The base year operating <br/>
<a id="pl.3.33"></a><var>3.33</var>payment rate per admission is standardized by the case mix index and adjusted by the <br/>
<a id="pl.3.34"></a><var>3.34</var>hospital cost index, relative values, and disproportionate population adjustment. The <br/>
<a id="pl.3.35"></a><var>3.35</var>cost and charge data used to establish operating rates shall only reflect inpatient services <br/>
<a id="pl.4.1"></a><var>4.1</var>covered by medical assistance and shall not include property cost information and costs <br/>
<a id="pl.4.2"></a><var>4.2</var>recognized in outlier payments.<br/>
<br/>
<a id="bill.1.3.0"></a><a id="pl.4.3"></a><var>4.3</var>    Sec. 3. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is <br/>
<a id="pl.4.4"></a><var>4.4</var>amended to read:<br/>
<a id="pl.4.5"></a><var>4.5</var>    Subd. 3a. <b>Payments.</b> (a) Acute care hospital billings under the medical <br/>
<a id="pl.4.6"></a><var>4.6</var>assistance program must not be submitted until the recipient is discharged. However, <br/>
<a id="pl.4.7"></a><var>4.7</var>the commissioner shall establish monthly interim payments for inpatient hospitals that <br/>
<a id="pl.4.8"></a><var>4.8</var>have individual patient lengths of stay over 30 days regardless of diagnostic category. <br/>
<a id="pl.4.9"></a><var>4.9</var>Except as provided in section 
         <statute_ref>256.9693</statute_ref>, medical assistance reimbursement for treatment <br/>
<a id="pl.4.10"></a><var>4.10</var>of mental illness shall be reimbursed based on diagnostic classifications. Individual <br/>
<a id="pl.4.11"></a><var>4.11</var>hospital payments established under this section and sections 
         <statute_ref>256.9685</statute_ref>, 
         <statute_ref>256.9686</statute_ref>, and <br/>
<statute_ref><a id="pl.4.12"></a><var>4.12</var>256.9695
         </statute_ref>, in addition to third party and recipient liability, for discharges occurring during <br/>
<a id="pl.4.13"></a><var>4.13</var>the rate year shall not exceed, in aggregate, the charges for the medical assistance covered <br/>
<a id="pl.4.14"></a><var>4.14</var>inpatient services paid for the same period of time to the hospital. This payment limitation <br/>
<a id="pl.4.15"></a><var>4.15</var>shall be calculated separately for medical assistance and general assistance medical <br/>
<a id="pl.4.16"></a><var>4.16</var>care services. The limitation on general assistance medical care shall be effective for <br/>
<a id="pl.4.17"></a><var>4.17</var>admissions occurring on or after July 1, 1991. Services that have rates established under <br/>
<a id="pl.4.18"></a><var>4.18</var>subdivision 11 or 12, must be limited separately from other services. After consulting with <br/>
<a id="pl.4.19"></a><var>4.19</var>the affected hospitals, the commissioner may consider related hospitals one entity and <br/>
<a id="pl.4.20"></a><var>4.20</var>may merge the payment rates while maintaining separate provider numbers. The operating <br/>
<a id="pl.4.21"></a><var>4.21</var>and property base rates per admission or per day shall be derived from the best Medicare <br/>
<a id="pl.4.22"></a><var>4.22</var>and claims data available when rates are established. The commissioner shall determine <br/>
<a id="pl.4.23"></a><var>4.23</var>the best Medicare and claims data, taking into consideration variables of recency of the <br/>
<a id="pl.4.24"></a><var>4.24</var>data, audit disposition, settlement status, and the ability to set rates in a timely manner. <br/>
<a id="pl.4.25"></a><var>4.25</var>The commissioner shall notify hospitals of payment rates by December 1 of the year <br/>
<a id="pl.4.26"></a><var>4.26</var>preceding the rate year. The rate setting data must reflect the admissions data used to <br/>
<a id="pl.4.27"></a><var>4.27</var>establish relative values. Base year changes from 1981 to the base year established for the <br/>
<a id="pl.4.28"></a><var>4.28</var>rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited <br/>
<a id="pl.4.29"></a><var>4.29</var>to the limits ending June 30, 1987, on the maximum rate of increase under subdivision <br/>
<a id="pl.4.30"></a><var>4.30</var>1. The commissioner may adjust base year cost, relative value, and case mix index data <br/>
<a id="pl.4.31"></a><var>4.31</var>to exclude the costs of services that have been discontinued by the October 1 of the year <br/>
<a id="pl.4.32"></a><var>4.32</var>preceding the rate year or that are paid separately from inpatient services. Inpatient stays <br/>
<a id="pl.4.33"></a><var>4.33</var>that encompass portions of two or more rate years shall have payments established based <br/>
<a id="pl.4.34"></a><var>4.34</var>on payment rates in effect at the time of admission unless the date of admission preceded <br/>
<a id="pl.4.35"></a><var>4.35</var>the rate year in effect by six months or more. In this case, operating payment rates for <br/>
<a id="pl.5.1"></a><var>5.1</var>services rendered during the rate year in effect and established based on the date of <br/>
<a id="pl.5.2"></a><var>5.2</var>admission shall be adjusted to the rate year in effect by the hospital cost index.<br/>
<a id="pl.5.3"></a><var>5.3</var>    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total <br/>
<a id="pl.5.4"></a><var>5.4</var>payment, before third-party liability and spenddown, made to hospitals for inpatient <br/>
<a id="pl.5.5"></a><var>5.5</var>services is reduced by .5 percent from the current statutory rates.<br/>
<a id="pl.5.6"></a><var>5.6</var>    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service <br/>
<a id="pl.5.7"></a><var>5.7</var>admissions occurring on or after July 1, 2003, made to hospitals for inpatient services <br/>
<a id="pl.5.8"></a><var>5.8</var>before third-party liability and spenddown, is reduced five percent from the current <br/>
<a id="pl.5.9"></a><var>5.9</var>statutory rates. Mental health services within diagnosis related groups 424 to 432, and <br/>
<a id="pl.5.10"></a><var>5.10</var>facilities defined under subdivision 16 are excluded from this paragraph.<br/>
<a id="pl.5.11"></a><var>5.11</var>    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for <br/>
<a id="pl.5.12"></a><var>5.12</var>fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for <br/>
<a id="pl.5.13"></a><var>5.13</var>inpatient services before third-party liability and spenddown, is reduced 6.0 percent <br/>
<a id="pl.5.14"></a><var>5.14</var>from the current statutory rates. Mental health services within diagnosis related groups <br/>
<a id="pl.5.15"></a><var>5.15</var>424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. <br/>
<a id="pl.5.16"></a><var>5.16</var>Notwithstanding section 
         <statute_ref>256.9686, subdivision 7</statute_ref>, for purposes of this paragraph, medical <br/>
<a id="pl.5.17"></a><var>5.17</var>assistance does not include general assistance medical care. Payments made to managed <br/>
<a id="pl.5.18"></a><var>5.18</var>care plans shall be reduced for services provided on or after January 1, 2006, to reflect <br/>
<a id="pl.5.19"></a><var>5.19</var>this reduction.<br/>
<a id="pl.5.20"></a><var>5.20</var>    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for <br/>
<a id="pl.5.21"></a><var>5.21</var>fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made <br/>
<a id="pl.5.22"></a><var>5.22</var>to hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.5.23"></a><var>5.23</var>3.46 percent from the current statutory rates. Mental health services with diagnosis related <br/>
<a id="pl.5.24"></a><var>5.24</var>groups 424 to 432 and facilities defined under subdivision 16 are excluded from this <br/>
<a id="pl.5.25"></a><var>5.25</var>paragraph. Payments made to managed care plans shall be reduced for services provided <br/>
<a id="pl.5.26"></a><var>5.26</var>on or after January 1, 2009, through June 30, 2009, to reflect this reduction.<br/>
<a id="pl.5.27"></a><var>5.27</var>    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for <br/>
<a id="pl.5.28"></a><var>5.28</var>fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010 2011, <br/>
<a id="pl.5.29"></a><var>5.29</var>made to hospitals for inpatient services before third-party liability and spenddown, is <br/>
<a id="pl.5.30"></a><var>5.30</var>reduced 1.9 percent from the current statutory rates. Mental health services with diagnosis <br/>
<a id="pl.5.31"></a><var>5.31</var>related groups 424 to 432 and facilities defined under subdivision 16 are excluded from <br/>
<a id="pl.5.32"></a><var>5.32</var>this paragraph. Payments made to managed care plans shall be reduced for services <br/>
<a id="pl.5.33"></a><var>5.33</var>provided on or after July 1, 2009, through June 30, 2010 2011, to reflect this reduction.<br/>
<a id="pl.5.34"></a><var>5.34</var>    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment <br/>
<a id="pl.5.35"></a><var>5.35</var>for fee-for-service admissions occurring on or after July 1, 2010 2011, made to hospitals <br/>
<a id="pl.5.36"></a><var>5.36</var>for inpatient services before third-party liability and spenddown, is reduced 1.79 percent <br/>
<a id="pl.6.1"></a><var>6.1</var>from the current statutory rates. Mental health services with diagnosis related groups <br/>
<a id="pl.6.2"></a><var>6.2</var>424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. <br/>
<a id="pl.6.3"></a><var>6.3</var>Payments made to managed care plans shall be reduced for services provided on or after <br/>
<a id="pl.6.4"></a><var>6.4</var>July 1, 2010 2011, to reflect this reduction.<br/>
<a id="pl.6.5"></a><var>6.5</var>(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total <br/>
<a id="pl.6.6"></a><var>6.6</var>payment for fee-for-service admissions occurring on or after July 1, 2009, made to <br/>
<a id="pl.6.7"></a><var>6.7</var>hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.6.8"></a><var>6.8</var>one percent from the current statutory rates. Facilities defined under subdivision 16 are <br/>
<a id="pl.6.9"></a><var>6.9</var>excluded from this paragraph. Payments made to managed care plans shall be reduced for <br/>
<a id="pl.6.10"></a><var>6.10</var>services provided on or after October 1, 2009, to reflect this reduction.<br/>
<a id="pl.6.11"></a><var>6.11</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.4.0"></a><a id="pl.6.12"></a><var>6.12</var>    Sec. 4. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision <br/>
<a id="pl.6.13"></a><var>6.13</var>to read:<br/>
<a id="pl.6.14"></a><var>6.14</var>    Subd. 26a. <b>Psychiatric and burn services payment adjustment on or after July </b><br/>
<a id="pl.6.15"></a><var>6.15</var><b>1, 2010.</b> (a) For admissions occurring on or after July 1, 2010, the commissioner shall <br/>
<a id="pl.6.16"></a><var>6.16</var>increase the total payment for medical assistance fee-for-service inpatient admissions for <br/>
<a id="pl.6.17"></a><var>6.17</var>the diagnosis-related groups specified in paragraph (b) at any hospital that is a nonstate <br/>
<a id="pl.6.18"></a><var>6.18</var>public Minnesota hospital and a Level I trauma center. The rate increases shall be <br/>
<a id="pl.6.19"></a><var>6.19</var>established for each hospital by the commissioner at a level that uses each hospital's <br/>
<a id="pl.6.20"></a><var>6.20</var>voluntary payments under paragraph (c) as the nonfederal share. For purposes of <br/>
<a id="pl.6.21"></a><var>6.21</var>this subdivision, medical assistance does not include general assistance medical care. <br/>
<a id="pl.6.22"></a><var>6.22</var>Payments to managed care health plans shall not be increased for payments under this <br/>
<a id="pl.6.23"></a><var>6.23</var>subdivision.<br/>
<a id="pl.6.24"></a><var>6.24</var>    (b) The rate increases provided in paragraph (a) apply to the following <br/>
<a id="pl.6.25"></a><var>6.25</var>diagnosis-related groups or subgroups, or any subsequent designations of such groups <br/>
<a id="pl.6.26"></a><var>6.26</var>or subgroups: 424 to 431, 433, 504 to 511, 521, and 523. These increases are only <br/>
<a id="pl.6.27"></a><var>6.27</var>available to the extent that revenue is available from the counties under paragraph (c) <br/>
<a id="pl.6.28"></a><var>6.28</var>for the nonfederal share.<br/>
<a id="pl.6.29"></a><var>6.29</var>    (c) Effective July 15, 2010, in addition to any payment otherwise required under <br/>
<a id="pl.6.30"></a><var>6.30</var>sections 256B.19, 256B.195, 256B.196, and 256B.199, the following government entities <br/>
<a id="pl.6.31"></a><var>6.31</var>may make the following voluntary payments to the commissioner on an annual basis:<br/>
<a id="pl.6.32"></a><var>6.32</var>    (1) Hennepin County, $7,000,000; and<br/>
<a id="pl.6.33"></a><var>6.33</var>    (2) Ramsey County, $3,500,000.<br/>
<a id="pl.7.1"></a><var>7.1</var>The amounts in this paragraph shall be part of the designated governmental unit's portion of <br/>
<a id="pl.7.2"></a><var>7.2</var>the nonfederal share of medical assistance costs, including payments under subdivision 9.<br/>
<a id="pl.7.3"></a><var>7.3</var>    (d) The commissioner may adjust the intergovernmental transfers under paragraph <br/>
<a id="pl.7.4"></a><var>7.4</var>(c) and the payments under paragraph (a) based on the commissioner's determination of <br/>
<a id="pl.7.5"></a><var>7.5</var>Medicare upper payment limits, hospital-specific charge limits, and any limits imposed <br/>
<a id="pl.7.6"></a><var>7.6</var>by the federal government regarding the rate increase or the restriction in the American <br/>
<a id="pl.7.7"></a><var>7.7</var>Resource and Recovery Act, Public Law 111-5, regarding increased local share.<br/>
<a id="pl.7.8"></a><var>7.8</var>    (e) This section shall be implemented upon federal approval, retroactive to July 1, <br/>
<a id="pl.7.9"></a><var>7.9</var>2010, for services provided on or after that date.<br/>
<br/>
<a id="bill.1.5.0"></a><a id="pl.7.10"></a><var>7.10</var>    Sec. 5. Minnesota Statutes 2008, section 256.969, subdivision 27, is amended to read:<br/>
<a id="pl.7.11"></a><var>7.11</var>    Subd. 27. <b>Quarterly payment adjustment.</b> (a) In addition to any other payment <br/>
<a id="pl.7.12"></a><var>7.12</var>under this section, the commissioner shall make the following payments effective July <br/>
<a id="pl.7.13"></a><var>7.13</var>1, 2007:<br/>
<a id="pl.7.14"></a><var>7.14</var>    (1) for a hospital located in Minnesota and not eligible for payments under <br/>
<a id="pl.7.15"></a><var>7.15</var>subdivision 20, with a medical assistance inpatient utilization rate greater than 17.8 <br/>
<a id="pl.7.16"></a><var>7.16</var>percent of total patient days as of the base year in effect on July 1, 2005, a payment <br/>
<a id="pl.7.17"></a><var>7.17</var>equal to 13 percent of the total of the operating and property payment rates, except that <br/>
<a id="pl.7.18"></a><var>7.18</var>Hennepin County Medical Center and Regions Hospital shall not receive a payment <br/>
<a id="pl.7.19"></a><var>7.19</var>under this subdivision;<br/>
<a id="pl.7.20"></a><var>7.20</var>    (2) for a hospital located in Minnesota in a specified urban area outside of the <br/>
<a id="pl.7.21"></a><var>7.21</var>seven-county metropolitan area and not eligible for payments under subdivision 20, with <br/>
<a id="pl.7.22"></a><var>7.22</var>a medical assistance inpatient utilization rate less than or equal to 17.8 percent of total <br/>
<a id="pl.7.23"></a><var>7.23</var>patient days as of the base year in effect on July 1, 2005, a payment equal to ten percent <br/>
<a id="pl.7.24"></a><var>7.24</var>of the total of the operating and property payment rates. For purposes of this clause, the <br/>
<a id="pl.7.25"></a><var>7.25</var>following cities are specified urban areas: Detroit Lakes, Rochester, Willmar, Alexandria, <br/>
<a id="pl.7.26"></a><var>7.26</var>Austin, Cambridge, Brainerd, Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids, <br/>
<a id="pl.7.27"></a><var>7.27</var>Wyoming, Fergus Falls, Albert Lea, Winona, Virginia, Thief River Falls, and Wadena; <br/>
<a id="pl.7.28"></a><var>7.28</var>    (3) for a hospital located in Minnesota but not located in a specified urban area <br/>
<a id="pl.7.29"></a><var>7.29</var>under clause (2), with a medical assistance inpatient utilization rate less than or equal to <br/>
<a id="pl.7.30"></a><var>7.30</var>17.8 percent of total patient days as of the base year in effect on July 1, 2005, a payment <br/>
<a id="pl.7.31"></a><var>7.31</var>equal to four percent of the total of the operating and property payment rates. A hospital <br/>
<a id="pl.7.32"></a><var>7.32</var>located in Woodbury and not in existence during the base year shall be reimbursed under <br/>
<a id="pl.7.33"></a><var>7.33</var>this clause; and<br/>
<a id="pl.7.34"></a><var>7.34</var>    (4) in addition to any payments under clauses (1) to (3), for a hospital located in <br/>
<a id="pl.7.35"></a><var>7.35</var>Minnesota and not eligible for payments under subdivision 20 with a medical assistance <br/>
<a id="pl.8.1"></a><var>8.1</var>inpatient utilization rate of 17.9 percent of total patient days as of the base year in effect <br/>
<a id="pl.8.2"></a><var>8.2</var>on July 1, 2005, a payment equal to eight percent of the total of the operating and property <br/>
<a id="pl.8.3"></a><var>8.3</var>payment rates, and for a hospital located in Minnesota and not eligible for payments <br/>
<a id="pl.8.4"></a><var>8.4</var>under subdivision 20 with a medical assistance inpatient utilization rate of 59.6 percent <br/>
<a id="pl.8.5"></a><var>8.5</var>of total patient days as of the base year in effect on July 1, 2005, a payment equal to <br/>
<a id="pl.8.6"></a><var>8.6</var>nine percent of the total of the operating and property payment rates. After making any <br/>
<a id="pl.8.7"></a><var>8.7</var>ratable adjustments required under paragraph (b), the commissioner shall proportionately <br/>
<a id="pl.8.8"></a><var>8.8</var>reduce payments under clauses (2) and (3) by an amount needed to make payments under <br/>
<a id="pl.8.9"></a><var>8.9</var>this clause.<br/>
<a id="pl.8.10"></a><var>8.10</var>    (b) The state share of payments under paragraph (a) shall be equal to federal <br/>
<a id="pl.8.11"></a><var>8.11</var>reimbursements to the commissioner to reimburse expenditures reported under section <br/>
<statute_ref><a id="pl.8.12"></a><var>8.12</var>256B.199, paragraphs (a) to (d)
</statute_ref>. The commissioner shall ratably reduce or increase <br/>
<a id="pl.8.13"></a><var>8.13</var>payments under this subdivision in order to ensure that these payments equal the amount <br/>
<a id="pl.8.14"></a><var>8.14</var>of reimbursement received by the commissioner under section 
         <statute_ref>256B.199, paragraphs (a) <br/>
<a id="pl.8.15"></a><var>8.15</var>to (d)
</statute_ref>, except that payments shall be ratably reduced by an amount equivalent to the state <br/>
<a id="pl.8.16"></a><var>8.16</var>share of a four percent reduction in MinnesotaCare and medical assistance payments for <br/>
<a id="pl.8.17"></a><var>8.17</var>inpatient hospital services. Effective July 1, 2009, the ratable reduction shall be equivalent <br/>
<a id="pl.8.18"></a><var>8.18</var>to the state share of a three percent reduction in these payments. Effective for federal <br/>
<a id="pl.8.19"></a><var>8.19</var>disproportionate share hospital funds earned on general assistance medical care payments <br/>
<a id="pl.8.20"></a><var>8.20</var>for services rendered on or after March 1, 2010, to June 30, 2011, the amount of the three <br/>
<a id="pl.8.21"></a><var>8.21</var>percent ratable reduction required under this paragraph shall be deposited in the account <br/>
<a id="pl.8.22"></a><var>8.22</var>established in section 256D.032. Payments under this subdivision shall be further ratably <br/>
<a id="pl.8.23"></a><var>8.23</var>reduced as follows: by $3,243,000 in fiscal year 2011; and by $2,495,000 in fiscal year <br/>
<a id="pl.8.24"></a><var>8.24</var>2012. These amounts shall be deposited in the account established in section 256D.032.<br/>
<a id="pl.8.25"></a><var>8.25</var>    (c) The payments under paragraph (a) shall be paid quarterly based on each hospital's <br/>
<a id="pl.8.26"></a><var>8.26</var>operating and property payments from the second previous quarter, beginning on July <br/>
<a id="pl.8.27"></a><var>8.27</var>15, 2007, or upon federal approval of federal reimbursements under section 
         <statute_ref>256B.199, <br/>
<a id="pl.8.28"></a><var>8.28</var>paragraphs (a) to (d)
</statute_ref>, whichever occurs later.<br/>
<a id="pl.8.29"></a><var>8.29</var>    (d) The commissioner shall not adjust rates paid to a prepaid health plan under <br/>
<a id="pl.8.30"></a><var>8.30</var>contract with the commissioner to reflect payments provided in paragraph (a).<br/>
<a id="pl.8.31"></a><var>8.31</var>    (e) The commissioner shall maximize the use of available federal money for <br/>
<a id="pl.8.32"></a><var>8.32</var>disproportionate share hospital payments and shall maximize payments to qualifying <br/>
<a id="pl.8.33"></a><var>8.33</var>hospitals. In order to accomplish these purposes, the commissioner may, in consultation <br/>
<a id="pl.8.34"></a><var>8.34</var>with the nonstate entities identified in section 
         <statute_ref>256B.199, paragraphs (a) to (d)</statute_ref>, adjust, <br/>
<a id="pl.8.35"></a><var>8.35</var>on a pro rata basis if feasible, the amounts reported by nonstate entities under section <br/>
<statute_ref><a id="pl.8.36"></a><var>8.36</var>256B.199, paragraphs (a) to (d),
</statute_ref> when application for reimbursement is made to the federal <br/>
<a id="pl.9.1"></a><var>9.1</var>government, and otherwise adjust the provisions of this subdivision. The commissioner <br/>
<a id="pl.9.2"></a><var>9.2</var>shall utilize a settlement process based on finalized data to maximize revenue under <br/>
<a id="pl.9.3"></a><var>9.3</var>section 
         <statute_ref>256B.199, paragraphs (a) to (d),</statute_ref> and payments under this section.<br/>
<a id="pl.9.4"></a><var>9.4</var>    (f) For purposes of this subdivision, medical assistance does not include general <br/>
<a id="pl.9.5"></a><var>9.5</var>assistance medical care.<br/>
<a id="pl.9.6"></a><var>9.6</var><b>EFFECTIVE DATE.</b>This section is effective for services rendered on or after <br/>
<a id="pl.9.7"></a><var>9.7</var>March 1, 2010.<br/>
<br/>
<a id="bill.1.6.0"></a><a id="pl.9.8"></a><var>9.8</var>    Sec. 6. Minnesota Statutes 2008, section 256B.0625, subdivision 13f, is amended to <br/>
<a id="pl.9.9"></a><var>9.9</var>read:<br/>
<a id="pl.9.10"></a><var>9.10</var>    Subd. 13f. <b>Prior authorization.</b> (a) The Formulary Committee shall review and <br/>
<a id="pl.9.11"></a><var>9.11</var>recommend drugs which require prior authorization. The Formulary Committee shall <br/>
<a id="pl.9.12"></a><var>9.12</var>establish general criteria to be used for the prior authorization of brand-name drugs for <br/>
<a id="pl.9.13"></a><var>9.13</var>which generically equivalent drugs are available, but the committee is not required to <br/>
<a id="pl.9.14"></a><var>9.14</var>review each brand-name drug for which a generically equivalent drug is available.<br/>
<a id="pl.9.15"></a><var>9.15</var>(b) Prior authorization may be required by the commissioner before certain <br/>
<a id="pl.9.16"></a><var>9.16</var>formulary drugs are eligible for payment. The Formulary Committee may recommend <br/>
<a id="pl.9.17"></a><var>9.17</var>drugs for prior authorization directly to the commissioner. The commissioner may also <br/>
<a id="pl.9.18"></a><var>9.18</var>request that the Formulary Committee review a drug for prior authorization. Before the <br/>
<a id="pl.9.19"></a><var>9.19</var>commissioner may require prior authorization for a drug:<br/>
<a id="pl.9.20"></a><var>9.20</var>(1) the commissioner must provide information to the Formulary Committee on the <br/>
<a id="pl.9.21"></a><var>9.21</var>impact that placing the drug on prior authorization may have on the quality of patient care <br/>
<a id="pl.9.22"></a><var>9.22</var>and on program costs, information regarding whether the drug is subject to clinical abuse <br/>
<a id="pl.9.23"></a><var>9.23</var>or misuse, and relevant data from the state Medicaid program if such data is available;<br/>
<a id="pl.9.24"></a><var>9.24</var>(2) the Formulary Committee must review the drug, taking into account medical and <br/>
<a id="pl.9.25"></a><var>9.25</var>clinical data and the information provided by the commissioner; and<br/>
<a id="pl.9.26"></a><var>9.26</var>(3) the Formulary Committee must hold a public forum and receive public comment <br/>
<a id="pl.9.27"></a><var>9.27</var>for an additional 15 days.<br/>
<a id="pl.9.28"></a><var>9.28</var>The commissioner must provide a 15-day notice period before implementing the prior <br/>
<a id="pl.9.29"></a><var>9.29</var>authorization.<br/>
<a id="pl.9.30"></a><var>9.30</var>(c) Except as provided in subdivision 13j, prior authorization shall not be required or <br/>
<a id="pl.9.31"></a><var>9.31</var>utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness if:<br/>
<a id="pl.9.32"></a><var>9.32</var>(1) there is no generically equivalent drug available; and<br/>
<a id="pl.9.33"></a><var>9.33</var>(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or<br/>
<a id="pl.9.34"></a><var>9.34</var>(3) the drug is part of the recipient's current course of treatment.<br/>
<a id="pl.10.1"></a><var>10.1</var>This paragraph applies to any multistate preferred drug list or supplemental drug rebate <br/>
<a id="pl.10.2"></a><var>10.2</var>program established or administered by the commissioner. Prior authorization shall <br/>
<a id="pl.10.3"></a><var>10.3</var>automatically be granted for 60 days for brand name drugs prescribed for treatment of <br/>
<a id="pl.10.4"></a><var>10.4</var>mental illness within 60 days of when a generically equivalent drug becomes available, <br/>
<a id="pl.10.5"></a><var>10.5</var>provided that the brand name drug was part of the recipient's course of treatment at the <br/>
<a id="pl.10.6"></a><var>10.6</var>time the generically equivalent drug became available.<br/>
<a id="pl.10.7"></a><var>10.7</var>(d) Prior authorization shall not be required or utilized for any antihemophilic factor <br/>
<a id="pl.10.8"></a><var>10.8</var>drug prescribed for the treatment of hemophilia and blood disorders where there is no <br/>
<a id="pl.10.9"></a><var>10.9</var>generically equivalent drug available if the prior authorization is used in conjunction with <br/>
<a id="pl.10.10"></a><var>10.10</var>any supplemental drug rebate program or multistate preferred drug list established or <br/>
<a id="pl.10.11"></a><var>10.11</var>administered by the commissioner.<br/>
<a id="pl.10.12"></a><var>10.12</var>(e) The commissioner may require prior authorization for brand name drugs <br/>
<a id="pl.10.13"></a><var>10.13</var>whenever a generically equivalent product is available, even if the prescriber specifically <br/>
<a id="pl.10.14"></a><var>10.14</var>indicates "dispense as written-brand necessary" on the prescription as required by section <br/>
<statute_ref><a id="pl.10.15"></a><var>10.15</var>151.21, subdivision 2
         </statute_ref>.<br/>
<a id="pl.10.16"></a><var>10.16</var>(f) Notwithstanding this subdivision, the commissioner may automatically require <br/>
<a id="pl.10.17"></a><var>10.17</var>prior authorization, for a period not to exceed 180 days, for any drug that is approved by <br/>
<a id="pl.10.18"></a><var>10.18</var>the United States Food and Drug Administration on or after July 1, 2005. The 180-day <br/>
<a id="pl.10.19"></a><var>10.19</var>period begins no later than the first day that a drug is available for shipment to pharmacies <br/>
<a id="pl.10.20"></a><var>10.20</var>within the state. The Formulary Committee shall recommend to the commissioner general <br/>
<a id="pl.10.21"></a><var>10.21</var>criteria to be used for the prior authorization of the drugs, but the committee is not <br/>
<a id="pl.10.22"></a><var>10.22</var>required to review each individual drug. In order to continue prior authorizations for a <br/>
<a id="pl.10.23"></a><var>10.23</var>drug after the 180-day period has expired, the commissioner must follow the provisions <br/>
<a id="pl.10.24"></a><var>10.24</var>of this subdivision.<br/>
<a id="pl.10.25"></a><var>10.25</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.7.0"></a><a id="pl.10.26"></a><var>10.26</var>    Sec. 7. Minnesota Statutes 2008, section 256B.0625, is amended by adding a <br/>
<a id="pl.10.27"></a><var>10.27</var>subdivision to read:<br/>
<a id="pl.10.28"></a><var>10.28</var>    Subd. 13j. <b>Antipsychotic and attention deficit disorder and attention deficit </b><br/>
<a id="pl.10.29"></a><var>10.29</var><b>hyperactivity disorder medications.</b> (a) The commissioner, in consultation with the <br/>
<a id="pl.10.30"></a><var>10.30</var>Drug Utilization Review Board established in subdivision 13i and actively practicing <br/>
<a id="pl.10.31"></a><var>10.31</var>pediatric mental health professionals, must:<br/>
<a id="pl.10.32"></a><var>10.32</var>(1) identify recommended pediatric dose ranges for atypical antipsychotic drugs <br/>
<a id="pl.10.33"></a><var>10.33</var>and drugs used for attention deficit disorder or attention deficit hyperactivity disorder <br/>
<a id="pl.10.34"></a><var>10.34</var>based on available medical, clinical, and safety data and research. The commissioner <br/>
<a id="pl.10.35"></a><var>10.35</var>shall periodically review the list of medications and pediatric dose ranges and update <br/>
<a id="pl.11.1"></a><var>11.1</var>the medications and doses listed as needed after consultation with the Drug Utilization <br/>
<a id="pl.11.2"></a><var>11.2</var>Review Board;<br/>
<a id="pl.11.3"></a><var>11.3</var>(2) identify situations where a collaborative psychiatric consultation and prior <br/>
<a id="pl.11.4"></a><var>11.4</var>authorization should be required before the initiation or continuation of drug therapy <br/>
<a id="pl.11.5"></a><var>11.5</var>in pediatric patients including, but not limited to, high-dose regimens, off-label use of <br/>
<a id="pl.11.6"></a><var>11.6</var>prescription medication, a patient's young age, and lack of coordination among multiple <br/>
<a id="pl.11.7"></a><var>11.7</var>prescribing providers; and<br/>
<a id="pl.11.8"></a><var>11.8</var>(3) track prescriptive practices and the use of psychotropic medications in children <br/>
<a id="pl.11.9"></a><var>11.9</var>with the goal of reducing the use of medication, where appropriate.<br/>
<a id="pl.11.10"></a><var>11.10</var>(b) Effective July 1, 2011, the commissioner shall require prior authorization and <br/>
<a id="pl.11.11"></a><var>11.11</var>a collaborative psychiatric consultation before an atypical antipsychotic and attention <br/>
<a id="pl.11.12"></a><var>11.12</var>deficit disorder and attention deficit hyperactivity disorder medication meeting the criteria <br/>
<a id="pl.11.13"></a><var>11.13</var>identified in paragraph (a), clause (2), is eligible for payment. A collaborative psychiatric <br/>
<a id="pl.11.14"></a><var>11.14</var>consultation must be completed before the identified medications are eligible for payment <br/>
<a id="pl.11.15"></a><var>11.15</var>unless:<br/>
<a id="pl.11.16"></a><var>11.16</var>(1) the patient has already been stabilized on the medication regimen; or<br/>
<a id="pl.11.17"></a><var>11.17</var>(2) the prescriber indicates that the child is in crisis.<br/>
<a id="pl.11.18"></a><var>11.18</var>If clause (1) or (2) applies, the collaborative psychiatric consultation must be completed <br/>
<a id="pl.11.19"></a><var>11.19</var>within 90 days for payment to continue.<br/>
<a id="pl.11.20"></a><var>11.20</var>(c) For purposes of this subdivision, a collaborative psychiatric consultation must <br/>
<a id="pl.11.21"></a><var>11.21</var>meet the criteria described in section 245.4862, subdivision 5.<br/>
<br/>
<a id="bill.1.8.0"></a><a id="pl.11.22"></a><var>11.22</var>    Sec. 8. Minnesota Statutes 2009 Supplement, section 256B.196, subdivision 2, is <br/>
<a id="pl.11.23"></a><var>11.23</var>amended to read:<br/>
<a id="pl.11.24"></a><var>11.24</var>    Subd. 2. <b>Commissioner's duties.</b> (a) For the purposes of this subdivision and <br/>
<a id="pl.11.25"></a><var>11.25</var>subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital <br/>
<a id="pl.11.26"></a><var>11.26</var>services upper payment limit for nonstate government hospitals. The commissioner shall <br/>
<a id="pl.11.27"></a><var>11.27</var>then determine the amount of a supplemental payment to Hennepin County Medical <br/>
<a id="pl.11.28"></a><var>11.28</var>Center and Regions Hospital for these services that would increase medical assistance <br/>
<a id="pl.11.29"></a><var>11.29</var>spending in this category to the aggregate upper payment limit for all nonstate government <br/>
<a id="pl.11.30"></a><var>11.30</var>hospitals in Minnesota. In making this determination, the commissioner shall allot the <br/>
<a id="pl.11.31"></a><var>11.31</var>available increases between Hennepin County Medical Center and Regions Hospital <br/>
<a id="pl.11.32"></a><var>11.32</var>based on the ratio of medical assistance fee-for-service outpatient hospital payments to <br/>
<a id="pl.11.33"></a><var>11.33</var>the two facilities. The commissioner shall adjust this allotment as necessary based on <br/>
<a id="pl.11.34"></a><var>11.34</var>federal approvals, the amount of intergovernmental transfers received from Hennepin and <br/>
<a id="pl.11.35"></a><var>11.35</var>Ramsey Counties, and other factors, in order to maximize the additional total payments. <br/>
<a id="pl.12.1"></a><var>12.1</var>The commissioner shall inform Hennepin County and Ramsey County of the periodic <br/>
<a id="pl.12.2"></a><var>12.2</var>intergovernmental transfers necessary to match federal Medicaid payments available <br/>
<a id="pl.12.3"></a><var>12.3</var>under this subdivision in order to make supplementary medical assistance payments to <br/>
<a id="pl.12.4"></a><var>12.4</var>Hennepin County Medical Center and Regions Hospital equal to an amount that when <br/>
<a id="pl.12.5"></a><var>12.5</var>combined with existing medical assistance payments to nonstate governmental hospitals <br/>
<a id="pl.12.6"></a><var>12.6</var>would increase total payments to hospitals in this category for outpatient services to <br/>
<a id="pl.12.7"></a><var>12.7</var>the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon <br/>
<a id="pl.12.8"></a><var>12.8</var>receipt of these periodic transfers, the commissioner shall make supplementary payments <br/>
<a id="pl.12.9"></a><var>12.9</var>to Hennepin County Medical Center and Regions Hospital.<br/>
<a id="pl.12.10"></a><var>12.10</var>    (b) For the purposes of this subdivision and subdivision 3, the commissioner shall <br/>
<a id="pl.12.11"></a><var>12.11</var>determine an upper payment limit for physicians affiliated with Hennepin County Medical <br/>
<a id="pl.12.12"></a><var>12.12</var>Center and with Regions Hospital. The upper payment limit shall be based on the average <br/>
<a id="pl.12.13"></a><var>12.13</var>commercial rate or be determined using another method acceptable to the Centers for <br/>
<a id="pl.12.14"></a><var>12.14</var>Medicare and Medicaid Services. The commissioner shall inform Hennepin County and <br/>
<a id="pl.12.15"></a><var>12.15</var>Ramsey County of the periodic intergovernmental transfers necessary to match the federal <br/>
<a id="pl.12.16"></a><var>12.16</var>Medicaid payments available under this subdivision in order to make supplementary <br/>
<a id="pl.12.17"></a><var>12.17</var>payments to physicians affiliated with Hennepin County Medical Center and Regions <br/>
<a id="pl.12.18"></a><var>12.18</var>Hospital equal to the difference between the established medical assistance payment for <br/>
<a id="pl.12.19"></a><var>12.19</var>physician services and the upper payment limit. Upon receipt of these periodic transfers, <br/>
<a id="pl.12.20"></a><var>12.20</var>the commissioner shall make supplementary payments to physicians of Hennepin Faculty <br/>
<a id="pl.12.21"></a><var>12.21</var>Associates and HealthPartners.<br/>
<a id="pl.12.22"></a><var>12.22</var>    (c) Beginning January 1, 2010, Hennepin County and Ramsey County shall may <br/>
<a id="pl.12.23"></a><var>12.23</var>make monthly voluntary intergovernmental transfers to the commissioner in the following <br/>
<a id="pl.12.24"></a><var>12.24</var>amounts: $133,333 by not to exceed $12,000,000 per year from Hennepin County <br/>
<a id="pl.12.25"></a><var>12.25</var>and $100,000 by $6,000,000 per year from Ramsey County. The commissioner shall <br/>
<a id="pl.12.26"></a><var>12.26</var>increase the medical assistance capitation payments to Metropolitan Health Plan and <br/>
<a id="pl.12.27"></a><var>12.27</var>HealthPartners by any licensed health plan under contract with the medical assistance <br/>
<a id="pl.12.28"></a><var>12.28</var>program that agrees to make enhanced payments to Hennepin County Medical Center or <br/>
<a id="pl.12.29"></a><var>12.29</var>Regions Hospital. The increase shall be in an amount equal to the annual value of the <br/>
<a id="pl.12.30"></a><var>12.30</var>monthly transfers plus federal financial participation., with each health plan receiving its <br/>
<a id="pl.12.31"></a><var>12.31</var>pro rata share of the increase based on the pro rata share of medical assistance admissions <br/>
<a id="pl.12.32"></a><var>12.32</var>to Hennepin County Medical Center and Regions Hospital by those plans. Upon the <br/>
<a id="pl.12.33"></a><var>12.33</var>request of the commissioner, health plans shall submit individual-level cost data for <br/>
<a id="pl.12.34"></a><var>12.34</var>verification purposes. The commissioner may ratably reduce these payments on a pro rata <br/>
<a id="pl.12.35"></a><var>12.35</var>basis in order to satisfy federal requirements for actuarial soundness. If payments are <br/>
<a id="pl.12.36"></a><var>12.36</var>reduced, transfers shall be reduced accordingly. Any licensed health plan that receives <br/>
<a id="pl.13.1"></a><var>13.1</var>increased medical assistance capitation payments under the intergovernmental transfer <br/>
<a id="pl.13.2"></a><var>13.2</var>described in this paragraph shall increase its medical assistance payments to Hennepin <br/>
<a id="pl.13.3"></a><var>13.3</var>County Medical Center and Regions Hospital by the same amount as the increased <br/>
<a id="pl.13.4"></a><var>13.4</var>payments received in the capitation payment described in this paragraph.<br/>
<a id="pl.13.5"></a><var>13.5</var>    (d) The commissioner shall inform Hennepin County and Ramsey County on an <br/>
<a id="pl.13.6"></a><var>13.6</var>ongoing basis of the need for any changes needed in the intergovernmental transfers <br/>
<a id="pl.13.7"></a><var>13.7</var>in order to continue the payments under paragraphs (a) to (c), at their maximum level, <br/>
<a id="pl.13.8"></a><var>13.8</var>including increases in upper payment limits, changes in the federal Medicaid match, and <br/>
<a id="pl.13.9"></a><var>13.9</var>other factors.<br/>
<a id="pl.13.10"></a><var>13.10</var>    (e) The payments in paragraphs (a) to (c) shall be implemented independently of <br/>
<a id="pl.13.11"></a><var>13.11</var>each other, subject to federal approval and to the receipt of transfers under subdivision 3.<br/>
<a id="pl.13.12"></a><var>13.12</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.1.9.0"></a><a id="pl.13.13"></a><var>13.13</var>    Sec. 9. Minnesota Statutes 2009 Supplement, section 256B.199, is amended to read:<br/>
<a id="pl.13.14"></a><var>13.14</var><b>256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.</b><br/>
<a id="pl.13.15"></a><var>13.15</var>    (a) Effective July 1, 2007, the commissioner shall apply for federal matching funds <br/>
<a id="pl.13.16"></a><var>13.16</var>for the expenditures in paragraphs (b) and (c).<br/>
<a id="pl.13.17"></a><var>13.17</var>    (b) The commissioner shall apply for federal matching funds for certified public <br/>
<a id="pl.13.18"></a><var>13.18</var>expenditures as follows:<br/>
<a id="pl.13.19"></a><var>13.19</var>    (1) Hennepin County, Hennepin County Medical Center, Ramsey County, and <br/>
<a id="pl.13.20"></a><var>13.20</var>Regions Hospital, the University of Minnesota, and Fairview-University Medical Center <br/>
<a id="pl.13.21"></a><var>13.21</var>shall report quarterly to the commissioner beginning June 1, 2007, payments made during <br/>
<a id="pl.13.22"></a><var>13.22</var>the second previous quarter that may qualify for reimbursement under federal law;<br/>
<a id="pl.13.23"></a><var>13.23</var>     (2) based on these reports, the commissioner shall apply for federal matching <br/>
<a id="pl.13.24"></a><var>13.24</var>funds. These funds are appropriated to the commissioner for the payments under section <br/>
<statute_ref><a id="pl.13.25"></a><var>13.25</var>256.969, subdivision 27
         </statute_ref>; and<br/>
<a id="pl.13.26"></a><var>13.26</var>     (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform <br/>
<a id="pl.13.27"></a><var>13.27</var>the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share <br/>
<a id="pl.13.28"></a><var>13.28</var>hospital payment money expected to be available in the current federal fiscal year.<br/>
<a id="pl.13.29"></a><var>13.29</var>    (c) The commissioner shall apply for federal matching funds for general assistance <br/>
<a id="pl.13.30"></a><var>13.30</var>medical care expenditures as follows:<br/>
<a id="pl.13.31"></a><var>13.31</var>    (1) for hospital services occurring on or after July 1, 2007, general assistance medical <br/>
<a id="pl.13.32"></a><var>13.32</var>care expenditures for fee-for-service inpatient and outpatient hospital payments made by <br/>
<a id="pl.13.33"></a><var>13.33</var>the department shall be used to apply for federal matching funds, except as limited below:<br/>
<a id="pl.14.1"></a><var>14.1</var>    (i) only those general assistance medical care expenditures made to an individual <br/>
<a id="pl.14.2"></a><var>14.2</var>hospital that would not cause the hospital to exceed its individual hospital limits under <br/>
<a id="pl.14.3"></a><var>14.3</var>section 1923 of the Social Security Act may be considered; and<br/>
<a id="pl.14.4"></a><var>14.4</var>    (ii) general assistance medical care expenditures may be considered only to the extent <br/>
<a id="pl.14.5"></a><var>14.5</var>of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and<br/>
<a id="pl.14.6"></a><var>14.6</var>    (2) all hospitals must provide any necessary expenditure, cost, and revenue <br/>
<a id="pl.14.7"></a><var>14.7</var>information required by the commissioner as necessary for purposes of obtaining federal <br/>
<a id="pl.14.8"></a><var>14.8</var>Medicaid matching funds for general assistance medical care expenditures.<br/>
<a id="pl.14.9"></a><var>14.9</var>    (d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall <br/>
<a id="pl.14.10"></a><var>14.10</var>apply for additional federal matching funds available as disproportionate share hospital <br/>
<a id="pl.14.11"></a><var>14.11</var>payments under the American Recovery and Reinvestment Act of 2009. These funds shall <br/>
<a id="pl.14.12"></a><var>14.12</var>be made available as the state share of payments under section 
         <statute_ref>256.969, subdivision 28</statute_ref>. <br/>
<a id="pl.14.13"></a><var>14.13</var>The entities required to report certified public expenditures under paragraph (b), clause <br/>
<a id="pl.14.14"></a><var>14.14</var>(1), shall report additional certified public expenditures as necessary under this paragraph.<br/>
<a id="pl.14.15"></a><var>14.15</var>    (e) Effective July 15, 2010, in addition to any payment otherwise required under <br/>
<a id="pl.14.16"></a><var>14.16</var>sections 256B.19, 256B.195, and 256B.196, the following government entities may make <br/>
<a id="pl.14.17"></a><var>14.17</var>the following voluntary payments to the commissioner on an annual basis:<br/>
<a id="pl.14.18"></a><var>14.18</var>    (1) Hennepin County, $6,200,000; and<br/>
<a id="pl.14.19"></a><var>14.19</var>    (2) Ramsey County, $4,000,000.<br/>
<a id="pl.14.20"></a><var>14.20</var>    (f) The sums in paragraph (e) shall be part of the designated governmental unit's <br/>
<a id="pl.14.21"></a><var>14.21</var>portion of the nonfederal share of medical assistance costs.<br/>
<a id="pl.14.22"></a><var>14.22</var>    (g) Effective July 15, 2010, the commissioner shall make the following Medicaid <br/>
<a id="pl.14.23"></a><var>14.23</var>disproportionate share hospital payments to the hospitals on a monthly basis:<br/>
<a id="pl.14.24"></a><var>14.24</var>    (1) to Hennepin County Medical Center, the amount of the transfer under paragraph <br/>
<a id="pl.14.25"></a><var>14.25</var>(e), clause (1), plus any federal matching funds available to recognize higher medical <br/>
<a id="pl.14.26"></a><var>14.26</var>assistance costs in institutions that provide high levels of charity care; and<br/>
<a id="pl.14.27"></a><var>14.27</var>    (2) to Regions Hospital, the amount of the transfer under paragraph (e), clause (2), <br/>
<a id="pl.14.28"></a><var>14.28</var>plus any federal matching funds available to recognize higher medical assistance costs in <br/>
<a id="pl.14.29"></a><var>14.29</var>institutions that provide high levels of charity care.<br/>
<a id="pl.14.30"></a><var>14.30</var>    (h) Effective July 15, 2010, after making the payments provided in paragraph <br/>
<a id="pl.14.31"></a><var>14.31</var>(g), the commissioner shall make the increased payments provided in section 256.969, <br/>
<a id="pl.14.32"></a><var>14.32</var>subdivision 26a.<br/>
<a id="pl.14.33"></a><var>14.33</var>    (i) The commissioner shall make the payments under paragraphs (g) and (h) prior <br/>
<a id="pl.14.34"></a><var>14.34</var>to making any other payments under this section, section 256.969, subdivision 27, or <br/>
<a id="pl.14.35"></a><var>14.35</var>256B.195.<br/>
<a id="pl.15.1"></a><var>15.1</var>    (j) The commissioner may adjust the intergovernmental transfers under paragraph <br/>
<a id="pl.15.2"></a><var>15.2</var>(e) and the payments under paragraph (g) based on the commissioner's determination <br/>
<a id="pl.15.3"></a><var>15.3</var>of Medicare upper payment limits, hospital-specific charge limits, and any limitations <br/>
<a id="pl.15.4"></a><var>15.4</var>imposed by the federal government regarding the rate increase or the restriction in the <br/>
<a id="pl.15.5"></a><var>15.5</var>American Resource and Recovery Act, Public Law 111-5, regarding increased local share.<br/>
<a id="pl.15.6"></a><var>15.6</var>    (k) This section shall be implemented upon federal approval of the rate increase <br/>
<a id="pl.15.7"></a><var>15.7</var>and a federal determination that the increased transfers do not violate the restriction in <br/>
<a id="pl.15.8"></a><var>15.8</var>the American Resource and Recovery Act, Public Law 111-5, regarding the local share, <br/>
<a id="pl.15.9"></a><var>15.9</var>retroactive to admissions occurring on or after July 15, 2010.<br/>
<br/>
<a id="bill.1.10.0"></a><a id="pl.15.10"></a><var>15.10</var>    Sec. 10. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, is <br/>
<a id="pl.15.11"></a><var>15.11</var>amended to read:<br/>
<a id="pl.15.12"></a><var>15.12</var>    Subd. 3. <b>General assistance medical care; eligibility.</b> (a) General assistance <br/>
<a id="pl.15.13"></a><var>15.13</var>medical care may be paid for any person who is not eligible for medical assistance under <br/>
<a id="pl.15.14"></a><var>15.14</var>chapter 256B, including eligibility for medical assistance based on a spenddown of excess <br/>
<a id="pl.15.15"></a><var>15.15</var>income according to section 
         <statute_ref>256B.056, subdivision 5</statute_ref>, or MinnesotaCare for applicants <br/>
<a id="pl.15.16"></a><var>15.16</var>and recipients defined in paragraph (c), except as provided in paragraph (d), and:<br/>
<a id="pl.15.17"></a><var>15.17</var>    (1) who is receiving assistance under section 
         <statute_ref>256D.05</statute_ref>, except for families with <br/>
<a id="pl.15.18"></a><var>15.18</var>children who are eligible under Minnesota family investment program (MFIP), or who is <br/>
<a id="pl.15.19"></a><var>15.19</var>having a payment made on the person's behalf under sections 
         <statute_ref>256I.01</statute_ref> to 
         <statute_ref>256I.06</statute_ref>; or<br/>
<a id="pl.15.20"></a><var>15.20</var>    (2) who is a resident of Minnesota; and<br/>
<a id="pl.15.21"></a><var>15.21</var>    (i) who has gross countable income not in excess of 75 percent of the federal poverty <br/>
<a id="pl.15.22"></a><var>15.22</var>guidelines for the family size, using a six-month budget period and whose equity in assets <br/>
<a id="pl.15.23"></a><var>15.23</var>is not in excess of $1,000 per assistance unit. General assistance medical care is not <br/>
<a id="pl.15.24"></a><var>15.24</var>available for applicants or enrollees who are otherwise eligible for medical assistance but <br/>
<a id="pl.15.25"></a><var>15.25</var>fail to verify their assets. Enrollees who become eligible for medical assistance shall be <br/>
<a id="pl.15.26"></a><var>15.26</var>terminated and transferred to medical assistance. Exempt assets, the reduction of excess <br/>
<a id="pl.15.27"></a><var>15.27</var>assets, and the waiver of excess assets must conform to the medical assistance program in <br/>
<a id="pl.15.28"></a><var>15.28</var>section 
         <statute_ref>256B.056, subdivisions 3</statute_ref> and 3d, with the following exception: the maximum <br/>
<a id="pl.15.29"></a><var>15.29</var>amount of undistributed funds in a trust that could be distributed to or on behalf of the <br/>
<a id="pl.15.30"></a><var>15.30</var>beneficiary by the trustee, assuming the full exercise of the trustee's discretion under the <br/>
<a id="pl.15.31"></a><var>15.31</var>terms of the trust, must be applied toward the asset maximum; or<br/>
<a id="pl.15.32"></a><var>15.32</var>    (ii) who has gross countable income above 75 percent of the federal poverty <br/>
<a id="pl.15.33"></a><var>15.33</var>guidelines but not in excess of 175 percent of the federal poverty guidelines for the family <br/>
<a id="pl.15.34"></a><var>15.34</var>size, using a six-month budget period, whose equity in assets is not in excess of the limits <br/>
<a id="pl.15.35"></a><var>15.35</var>in section 
         <statute_ref>256B.056, subdivision 3c</statute_ref>, and who applies during an inpatient hospitalization.<br/>
<a id="pl.16.1"></a><var>16.1</var>    (b) The commissioner shall adjust the income standards under this section each July <br/>
<a id="pl.16.2"></a><var>16.2</var>1 by the annual update of the federal poverty guidelines following publication by the <br/>
<a id="pl.16.3"></a><var>16.3</var>United States Department of Health and Human Services.<br/>
<a id="pl.16.4"></a><var>16.4</var>    (c) Effective for applications and renewals processed on or after September 1, 2006, <br/>
<a id="pl.16.5"></a><var>16.5</var>general assistance medical care may not be paid for applicants or recipients who are adults <br/>
<a id="pl.16.6"></a><var>16.6</var>with dependent children under 21 whose gross family income is equal to or less than 275 <br/>
<a id="pl.16.7"></a><var>16.7</var>percent of the federal poverty guidelines who are not described in paragraph (f).<br/>
<a id="pl.16.8"></a><var>16.8</var>    (d) Effective for applications and renewals processed on or after September 1, <br/>
<a id="pl.16.9"></a><var>16.9</var>2006, general assistance medical care may be paid for applicants and recipients who <br/>
<a id="pl.16.10"></a><var>16.10</var>meet all eligibility requirements of paragraph (a), clause (2), item (i), for a temporary <br/>
<a id="pl.16.11"></a><var>16.11</var>period beginning the date of application. Immediately following approval of general <br/>
<a id="pl.16.12"></a><var>16.12</var>assistance medical care, enrollees shall be enrolled in MinnesotaCare under section <br/>
<statute_ref><a id="pl.16.13"></a><var>16.13</var>256L.04, subdivision 7
         </statute_ref>, with covered services as provided in section 
         <statute_ref>256L.03</statute_ref> for the rest <br/>
<a id="pl.16.14"></a><var>16.14</var>of the six-month general assistance medical care eligibility period, until their six-month <br/>
<a id="pl.16.15"></a><var>16.15</var>renewal. This paragraph does not apply to applicants and recipients who are exempt <br/>
<a id="pl.16.16"></a><var>16.16</var>under paragraph (f).<br/>
<a id="pl.16.17"></a><var>16.17</var>    (e) To be eligible for general assistance medical care following enrollment in <br/>
<a id="pl.16.18"></a><var>16.18</var>MinnesotaCare as required by paragraph (d), an individual must complete a new <br/>
<a id="pl.16.19"></a><var>16.19</var>application.<br/>
<a id="pl.16.20"></a><var>16.20</var>    (f) Applicants and recipients eligible under paragraph (a), clause (2), item (i), are <br/>
<a id="pl.16.21"></a><var>16.21</var>exempt from the MinnesotaCare enrollment requirements in this subdivision if they:<br/>
<a id="pl.16.22"></a><var>16.22</var>    (1) have applied for and are awaiting a determination of blindness or disability by <br/>
<a id="pl.16.23"></a><var>16.23</var>the state medical review team or a determination of eligibility for Supplemental Security <br/>
<a id="pl.16.24"></a><var>16.24</var>Income or Social Security Disability Insurance by the Social Security Administration;<br/>
<a id="pl.16.25"></a><var>16.25</var>    (2) fail to meet the requirements of section 
         <statute_ref>256L.09, subdivision 2</statute_ref>;<br/>
<a id="pl.16.26"></a><var>16.26</var>    (3) are homeless as defined by United States Code, title 42, section 11301, et seq.;<br/>
<a id="pl.16.27"></a><var>16.27</var>    (4) are classified as end-stage renal disease beneficiaries in the Medicare program;<br/>
<a id="pl.16.28"></a><var>16.28</var>    (5) are enrolled in private health care coverage as defined in section 
         <statute_ref>256B.02</statute_ref>, <br/>
<a id="pl.16.29"></a><var>16.29</var>subdivision 9;<br/>
<a id="pl.16.30"></a><var>16.30</var>    (6) are eligible under paragraph (k);<br/>
<a id="pl.16.31"></a><var>16.31</var>    (7) receive treatment funded pursuant to section 
         <statute_ref>254B.02</statute_ref>; or<br/>
<a id="pl.16.32"></a><var>16.32</var>    (8) reside in the Minnesota sex offender program defined in chapter 246B. <br/>
<a id="pl.16.33"></a><var>16.33</var>If an enrollee meets one of the categories described in this paragraph, the <br/>
<a id="pl.16.34"></a><var>16.34</var>commissioner shall not require the enrollee to enroll in MinnesotaCare.<br/>
<a id="pl.16.35"></a><var>16.35</var>    (g) For applications received on or after October 1, 2003, eligibility may begin no <br/>
<a id="pl.16.36"></a><var>16.36</var>earlier than the date of application. For individuals eligible under paragraph (a), clause <br/>
<a id="pl.17.1"></a><var>17.1</var>(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are <br/>
<a id="pl.17.2"></a><var>17.2</var>eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but <br/>
<a id="pl.17.3"></a><var>17.3</var>may reapply if there is a subsequent period of inpatient hospitalization.<br/>
<a id="pl.17.4"></a><var>17.4</var>    (h) Beginning September 1, 2006, Minnesota health care program applications and <br/>
<a id="pl.17.5"></a><var>17.5</var>renewals completed by recipients and applicants who are persons described in paragraph <br/>
<a id="pl.17.6"></a><var>17.6</var>(d) and submitted to the county agency shall be determined for MinnesotaCare eligibility <br/>
<a id="pl.17.7"></a><var>17.7</var>by the county agency. If all other eligibility requirements of this subdivision are met, <br/>
<a id="pl.17.8"></a><var>17.8</var>eligibility for general assistance medical care shall be available in any month during which <br/>
<a id="pl.17.9"></a><var>17.9</var>MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, <br/>
<a id="pl.17.10"></a><var>17.10</var>notice of termination for eligibility for general assistance medical care shall be sent to <br/>
<a id="pl.17.11"></a><var>17.11</var>an applicant or recipient. If all other eligibility requirements of this subdivision are <br/>
<a id="pl.17.12"></a><var>17.12</var>met, eligibility for general assistance medical care shall be available until enrollment in <br/>
<a id="pl.17.13"></a><var>17.13</var>MinnesotaCare subject to the provisions of paragraphs (d), (f), and (g).<br/>
<a id="pl.17.14"></a><var>17.14</var>    (i) The date of an initial Minnesota health care program application necessary to <br/>
<a id="pl.17.15"></a><var>17.15</var>begin a determination of eligibility shall be the date the applicant has provided a name, <br/>
<a id="pl.17.16"></a><var>17.16</var>address, and Social Security number, signed and dated, to the county agency or the <br/>
<a id="pl.17.17"></a><var>17.17</var>Department of Human Services. If the applicant is unable to provide a name, address, <br/>
<a id="pl.17.18"></a><var>17.18</var>Social Security number, and signature when health care is delivered due to a medical <br/>
<a id="pl.17.19"></a><var>17.19</var>condition or disability, a health care provider may act on an applicant's behalf to establish <br/>
<a id="pl.17.20"></a><var>17.20</var>the date of an initial Minnesota health care program application by providing the county <br/>
<a id="pl.17.21"></a><var>17.21</var>agency or Department of Human Services with provider identification and a temporary <br/>
<a id="pl.17.22"></a><var>17.22</var>unique identifier for the applicant. The applicant must complete the remainder of the <br/>
<a id="pl.17.23"></a><var>17.23</var>application and provide necessary verification before eligibility can be determined. The <br/>
<a id="pl.17.24"></a><var>17.24</var>applicant must complete the application within the time periods required under the <br/>
<a id="pl.17.25"></a><var>17.25</var>medical assistance program as specified in Minnesota Rules, parts 9505.0015, subpart <br/>
<a id="pl.17.26"></a><var>17.26</var>5, and 9505.0090, subpart 2. The county agency must assist the applicant in obtaining <br/>
<a id="pl.17.27"></a><var>17.27</var>verification if necessary.<br/>
<a id="pl.17.28"></a><var>17.28</var>    (j) County agencies are authorized to use all automated databases containing <br/>
<a id="pl.17.29"></a><var>17.29</var>information regarding recipients' or applicants' income in order to determine eligibility for <br/>
<a id="pl.17.30"></a><var>17.30</var>general assistance medical care or MinnesotaCare. Such use shall be considered sufficient <br/>
<a id="pl.17.31"></a><var>17.31</var>in order to determine eligibility and premium payments by the county agency.<br/>
<a id="pl.17.32"></a><var>17.32</var>    (k) General assistance medical care is not available for a person in a correctional <br/>
<a id="pl.17.33"></a><var>17.33</var>facility unless the person is detained by law for less than one year in a county correctional <br/>
<a id="pl.17.34"></a><var>17.34</var>or detention facility as a person accused or convicted of a crime, or admitted as an <br/>
<a id="pl.17.35"></a><var>17.35</var>inpatient to a hospital on a criminal hold order, and the person is a recipient of general <br/>
<a id="pl.17.36"></a><var>17.36</var>assistance medical care at the time the person is detained by law or admitted on a criminal <br/>
<a id="pl.18.1"></a><var>18.1</var>hold order and as long as the person continues to meet other eligibility requirements <br/>
<a id="pl.18.2"></a><var>18.2</var>of this subdivision.<br/>
<a id="pl.18.3"></a><var>18.3</var>    (l) General assistance medical care is not available for applicants or recipients who <br/>
<a id="pl.18.4"></a><var>18.4</var>do not cooperate with the county agency to meet the requirements of medical assistance.<br/>
<a id="pl.18.5"></a><var>18.5</var>    (m) In determining the amount of assets of an individual eligible under paragraph <br/>
<a id="pl.18.6"></a><var>18.6</var>(a), clause (2), item (i), there shall be included any asset or interest in an asset, including <br/>
<a id="pl.18.7"></a><var>18.7</var>an asset excluded under paragraph (a), that was given away, sold, or disposed of for <br/>
<a id="pl.18.8"></a><var>18.8</var>less than fair market value within the 60 months preceding application for general <br/>
<a id="pl.18.9"></a><var>18.9</var>assistance medical care or during the period of eligibility. Any transfer described in this <br/>
<a id="pl.18.10"></a><var>18.10</var>paragraph shall be presumed to have been for the purpose of establishing eligibility for <br/>
<a id="pl.18.11"></a><var>18.11</var>general assistance medical care, unless the individual furnishes convincing evidence to <br/>
<a id="pl.18.12"></a><var>18.12</var>establish that the transaction was exclusively for another purpose. For purposes of this <br/>
<a id="pl.18.13"></a><var>18.13</var>paragraph, the value of the asset or interest shall be the fair market value at the time it <br/>
<a id="pl.18.14"></a><var>18.14</var>was given away, sold, or disposed of, less the amount of compensation received. For any <br/>
<a id="pl.18.15"></a><var>18.15</var>uncompensated transfer, the number of months of ineligibility, including partial months, <br/>
<a id="pl.18.16"></a><var>18.16</var>shall be calculated by dividing the uncompensated transfer amount by the average monthly <br/>
<a id="pl.18.17"></a><var>18.17</var>per person payment made by the medical assistance program to skilled nursing facilities <br/>
<a id="pl.18.18"></a><var>18.18</var>for the previous calendar year. The individual shall remain ineligible until this fixed period <br/>
<a id="pl.18.19"></a><var>18.19</var>has expired. The period of ineligibility may exceed 30 months, and a reapplication for <br/>
<a id="pl.18.20"></a><var>18.20</var>benefits after 30 months from the date of the transfer shall not result in eligibility unless <br/>
<a id="pl.18.21"></a><var>18.21</var>and until the period of ineligibility has expired. The period of ineligibility begins in the <br/>
<a id="pl.18.22"></a><var>18.22</var>month the transfer was reported to the county agency, or if the transfer was not reported, <br/>
<a id="pl.18.23"></a><var>18.23</var>the month in which the county agency discovered the transfer, whichever comes first. For <br/>
<a id="pl.18.24"></a><var>18.24</var>applicants, the period of ineligibility begins on the date of the first approved application.<br/>
<a id="pl.18.25"></a><var>18.25</var>    (n) When determining eligibility for any state benefits under this subdivision, <br/>
<a id="pl.18.26"></a><var>18.26</var>the income and resources of all noncitizens shall be deemed to include their sponsor's <br/>
<a id="pl.18.27"></a><var>18.27</var>income and resources as defined in the Personal Responsibility and Work Opportunity <br/>
<a id="pl.18.28"></a><var>18.28</var>Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and <br/>
<a id="pl.18.29"></a><var>18.29</var>subsequently set out in federal rules.<br/>
<a id="pl.18.30"></a><var>18.30</var>    (o) Undocumented noncitizens and nonimmigrants are ineligible for general <br/>
<a id="pl.18.31"></a><var>18.31</var>assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual <br/>
<a id="pl.18.32"></a><var>18.32</var>in one or more of the classes listed in United States Code, title 8, section 1101, subsection <br/>
<a id="pl.18.33"></a><var>18.33</var>(a), paragraph (15), and an undocumented noncitizen is an individual who resides in <br/>
<a id="pl.18.34"></a><var>18.34</var>the United States without the approval or acquiescence of the United States Citizenship <br/>
<a id="pl.18.35"></a><var>18.35</var>and Immigration Services.<br/>
<a id="pl.19.1"></a><var>19.1</var>    (p) Notwithstanding any other provision of law, a noncitizen who is ineligible for <br/>
<a id="pl.19.2"></a><var>19.2</var>medical assistance due to the deeming of a sponsor's income and resources, is ineligible <br/>
<a id="pl.19.3"></a><var>19.3</var>for general assistance medical care.<br/>
<a id="pl.19.4"></a><var>19.4</var>    (q) Effective July 1, 2003, general assistance medical care emergency services end.<br/>
<a id="pl.19.5"></a><var>19.5</var>(r) For the period beginning March 1, 2010, and ending July 1, 2011, the general <br/>
<a id="pl.19.6"></a><var>19.6</var>assistance medical care program shall be administered according to section 256D.031, <br/>
<a id="pl.19.7"></a><var>19.7</var>unless otherwise stated.<br/>
<a id="pl.19.8"></a><var>19.8</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.11.0"></a><a id="pl.19.9"></a><var>19.9</var>    Sec. 11. Minnesota Statutes 2008, section 256D.03, subdivision 3a, is amended to read:<br/>
<a id="pl.19.10"></a><var>19.10</var>    Subd. 3a. <b>Claims; assignment of benefits.</b> (a) Claims must be filed pursuant to <br/>
<a id="pl.19.11"></a><var>19.11</var>section 
         <statute_ref>256D.16</statute_ref>. General assistance medical care applicants and recipients must apply or <br/>
<a id="pl.19.12"></a><var>19.12</var>agree to apply third party health and accident benefits to the costs of medical care. They <br/>
<a id="pl.19.13"></a><var>19.13</var>must cooperate with the state in establishing paternity and obtaining third party payments. <br/>
<a id="pl.19.14"></a><var>19.14</var>By accepting general assistance, a person assigns to the Department of Human Services <br/>
<a id="pl.19.15"></a><var>19.15</var>all rights to medical support or payments for medical expenses from another person or <br/>
<a id="pl.19.16"></a><var>19.16</var>entity on their own or their dependent's behalf and agrees to cooperate with the state in <br/>
<a id="pl.19.17"></a><var>19.17</var>establishing paternity and obtaining third party payments. The application shall contain <br/>
<a id="pl.19.18"></a><var>19.18</var>a statement explaining the assignment. Any rights or amounts assigned shall be applied <br/>
<a id="pl.19.19"></a><var>19.19</var>against the cost of medical care paid for under this chapter. An assignment is effective on <br/>
<a id="pl.19.20"></a><var>19.20</var>the date general assistance medical care eligibility takes effect. <br/>
<a id="pl.19.21"></a><var>19.21</var>(b) Effective for general assistance medical care services rendered on or after <br/>
<a id="pl.19.22"></a><var>19.22</var>March 1, 2010, to June 30, 2011, any medical collections, payments, or recoveries under <br/>
<a id="pl.19.23"></a><var>19.23</var>this subdivision shall be deposited in or credited to the account established in section <br/>
<a id="pl.19.24"></a><var>19.24</var>256D.032.<br/>
<a id="pl.19.25"></a><var>19.25</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.12.0"></a><a id="pl.19.26"></a><var>19.26</var>    Sec. 12. Minnesota Statutes 2008, section 256D.03, subdivision 3b, is amended to read:<br/>
<a id="pl.19.27"></a><var>19.27</var>    Subd. 3b. <b>Cooperation.</b> (a) General assistance or general assistance medical care <br/>
<a id="pl.19.28"></a><var>19.28</var>applicants and recipients must cooperate with the state and local agency to identify <br/>
<a id="pl.19.29"></a><var>19.29</var>potentially liable third-party payors and assist the state in obtaining third-party payments. <br/>
<a id="pl.19.30"></a><var>19.30</var>Cooperation includes identifying any third party who may be liable for care and services <br/>
<a id="pl.19.31"></a><var>19.31</var>provided under this chapter to the applicant, recipient, or any other family member for <br/>
<a id="pl.19.32"></a><var>19.32</var>whom application is made and providing relevant information to assist the state in pursuing <br/>
<a id="pl.19.33"></a><var>19.33</var>a potentially liable third party. General assistance medical care applicants and recipients <br/>
<a id="pl.20.1"></a><var>20.1</var>must cooperate by providing information about any group health plan in which they may <br/>
<a id="pl.20.2"></a><var>20.2</var>be eligible to enroll. They must cooperate with the state and local agency in determining <br/>
<a id="pl.20.3"></a><var>20.3</var>if the plan is cost-effective. For purposes of this subdivision, coverage provided by the <br/>
<a id="pl.20.4"></a><var>20.4</var>Minnesota Comprehensive Health Association under chapter 62E shall not be considered <br/>
<a id="pl.20.5"></a><var>20.5</var>group health plan coverage or cost-effective by the state and local agency. If the plan is <br/>
<a id="pl.20.6"></a><var>20.6</var>determined cost-effective and the premium will be paid by the state or local agency or is <br/>
<a id="pl.20.7"></a><var>20.7</var>available at no cost to the person, they must enroll or remain enrolled in the group health <br/>
<a id="pl.20.8"></a><var>20.8</var>plan. Cost-effective insurance premiums approved for payment by the state agency and <br/>
<a id="pl.20.9"></a><var>20.9</var>paid by the local agency are eligible for reimbursement according to subdivision 6.<br/>
<a id="pl.20.10"></a><var>20.10</var>(b) Effective for all premiums due on or after June 30, 1997, general assistance <br/>
<a id="pl.20.11"></a><var>20.11</var>medical care does not cover premiums that a recipient is required to pay under a qualified <br/>
<a id="pl.20.12"></a><var>20.12</var>or Medicare supplement plan issued by the Minnesota Comprehensive Health Association. <br/>
<a id="pl.20.13"></a><var>20.13</var>General assistance medical care shall continue to cover premiums for recipients who are <br/>
<a id="pl.20.14"></a><var>20.14</var>covered under a plan issued by the Minnesota Comprehensive Health Association on June <br/>
<a id="pl.20.15"></a><var>20.15</var>30, 1997, for a period of six months following receipt of the notice of termination or <br/>
<a id="pl.20.16"></a><var>20.16</var>until December 31, 1997, whichever is later.<br/>
<a id="pl.20.17"></a><var>20.17</var>(c) Effective for general assistance medical care services rendered on or after <br/>
<a id="pl.20.18"></a><var>20.18</var>March 1, 2010, to June 30, 2011, any medical collections, payments, or recoveries under <br/>
<a id="pl.20.19"></a><var>20.19</var>this subdivision shall be deposited in or credited to the account established in section <br/>
<a id="pl.20.20"></a><var>20.20</var>256D.032.<br/>
<a id="pl.20.21"></a><var>20.21</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.13.0"></a><a id="pl.20.22"></a><var>20.22</var>    Sec. 13. <b>[256D.031] GENERAL ASSISTANCE MEDICAL CARE.</b><br/>
<a id="pl.20.23"></a><var>20.23</var>    Subdivision 1. <b>Eligibility.</b> (a) Except as provided under subdivision 2, general <br/>
<a id="pl.20.24"></a><var>20.24</var>assistance medical care may be paid for any individual who is not eligible for medical <br/>
<a id="pl.20.25"></a><var>20.25</var>assistance under chapter 256B, including eligibility for medical assistance based on a <br/>
<a id="pl.20.26"></a><var>20.26</var>spenddown of excess income according to section 256B.056, subdivision 5, and who:<br/>
<a id="pl.20.27"></a><var>20.27</var>(1) is receiving assistance under section 256D.05, except for families with children <br/>
<a id="pl.20.28"></a><var>20.28</var>who are eligible under the Minnesota family investment program (MFIP), or who is <br/>
<a id="pl.20.29"></a><var>20.29</var>having a payment made on the person's behalf under sections 256I.01 to 256I.06; or<br/>
<a id="pl.20.30"></a><var>20.30</var>(2) is a resident of Minnesota and has gross countable income not in excess of 75 <br/>
<a id="pl.20.31"></a><var>20.31</var>percent of federal poverty guidelines for the family size, using a six-month budget period, <br/>
<a id="pl.20.32"></a><var>20.32</var>and whose equity in assets is not in excess of $1,000 per assistance unit.<br/>
<a id="pl.20.33"></a><var>20.33</var>Exempt assets, the reduction of excess assets, and the waiver of excess assets must <br/>
<a id="pl.20.34"></a><var>20.34</var>conform to the medical assistance program in section 256B.056, subdivisions 3 and 3d, <br/>
<a id="pl.21.1"></a><var>21.1</var>except that the maximum amount of undistributed funds in a trust that could be distributed <br/>
<a id="pl.21.2"></a><var>21.2</var>to or on behalf of the beneficiary by the trustee, assuming the full exercise of the trustee's <br/>
<a id="pl.21.3"></a><var>21.3</var>discretion under the terms of the trust, must be applied toward the asset maximum.<br/>
<a id="pl.21.4"></a><var>21.4</var>(b) The commissioner shall adjust the income standards under this section each July <br/>
<a id="pl.21.5"></a><var>21.5</var>1 by the annual update of the federal poverty guidelines following publication by the <br/>
<a id="pl.21.6"></a><var>21.6</var>United States Department of Health and Human Services.<br/>
<a id="pl.21.7"></a><var>21.7</var>    Subd. 2. <b>Ineligible groups.</b> (a) General assistance medical care may not be paid for <br/>
<a id="pl.21.8"></a><var>21.8</var>an applicant or a recipient who:<br/>
<a id="pl.21.9"></a><var>21.9</var>(1) is otherwise eligible for medical assistance but fails to verify their assets;<br/>
<a id="pl.21.10"></a><var>21.10</var>(2) is an adult in a family with children as defined in section 256L.01, subdivision 3a;<br/>
<a id="pl.21.11"></a><var>21.11</var>(3) is enrolled in private health coverage as defined in section 256B.02, subdivision <br/>
<a id="pl.21.12"></a><var>21.12</var>9;<br/>
<a id="pl.21.13"></a><var>21.13</var>(4) is in a correctional facility, including an individual in a county correctional or <br/>
<a id="pl.21.14"></a><var>21.14</var>detention facility as an individual accused or convicted of a crime, or admitted as an <br/>
<a id="pl.21.15"></a><var>21.15</var>inpatient to a hospital on a criminal hold order;<br/>
<a id="pl.21.16"></a><var>21.16</var>(5) resides in the Minnesota sex offender program defined in chapter 246B;<br/>
<a id="pl.21.17"></a><var>21.17</var>(6) does not cooperate with the county agency to meet the requirements of medical <br/>
<a id="pl.21.18"></a><var>21.18</var>assistance; or<br/>
<a id="pl.21.19"></a><var>21.19</var>(7) does not cooperate with a county or state agency or the state medical review team <br/>
<a id="pl.21.20"></a><var>21.20</var>in determining a disability or for determining eligibility for Supplemental Security Income <br/>
<a id="pl.21.21"></a><var>21.21</var>or Social Security Disability Insurance by the Social Security Administration.<br/>
<a id="pl.21.22"></a><var>21.22</var>(b) Undocumented noncitizens and nonimmigrants are ineligible for general <br/>
<a id="pl.21.23"></a><var>21.23</var>assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual <br/>
<a id="pl.21.24"></a><var>21.24</var>in one or more of the classes listed in United States Code, title 8, section 1101, subsection <br/>
<a id="pl.21.25"></a><var>21.25</var>(a), paragraph (15), and an undocumented noncitizen is an individual who resides in the <br/>
<a id="pl.21.26"></a><var>21.26</var>United States without approval or acquiescence of the United States Citizenship and <br/>
<a id="pl.21.27"></a><var>21.27</var>Immigration Services.<br/>
<a id="pl.21.28"></a><var>21.28</var>(c) Notwithstanding any other provision of law, a noncitizen who is ineligible for <br/>
<a id="pl.21.29"></a><var>21.29</var>medical assistance due to the deeming of a sponsor's income and resources is ineligible for <br/>
<a id="pl.21.30"></a><var>21.30</var>general assistance medical care.<br/>
<a id="pl.21.31"></a><var>21.31</var>(d) General assistance medical care recipients who become eligible for medical <br/>
<a id="pl.21.32"></a><var>21.32</var>assistance shall be terminated from general assistance medical care and transferred to <br/>
<a id="pl.21.33"></a><var>21.33</var>medical assistance.<br/>
<a id="pl.21.34"></a><var>21.34</var>    Subd. 3. <b>Transitional MinnesotaCare.</b> (a) Except as provided in paragraph (c), <br/>
<a id="pl.21.35"></a><var>21.35</var>effective March 1, 2010, all applicants and recipients who meet the eligibility requirements <br/>
<a id="pl.21.36"></a><var>21.36</var>in subdivision 1, paragraph (a), clause (2), and who are not described in subdivision 2 <br/>
<a id="pl.22.1"></a><var>22.1</var>shall be enrolled in MinnesotaCare under section 256L.04, subdivision 7, immediately <br/>
<a id="pl.22.2"></a><var>22.2</var>following approval of general assistance medical care. <br/>
<a id="pl.22.3"></a><var>22.3</var>(b) If all other eligibility requirements of this subdivision are met, general assistance <br/>
<a id="pl.22.4"></a><var>22.4</var>medical care may be paid for individuals identified in paragraph (a) for a temporary <br/>
<a id="pl.22.5"></a><var>22.5</var>period beginning the date of application. Eligibility for general assistance medical care <br/>
<a id="pl.22.6"></a><var>22.6</var>shall continue until enrollment in MinnesotaCare is completed. Upon notification of <br/>
<a id="pl.22.7"></a><var>22.7</var>eligibility for MinnesotaCare, notice of termination for eligibility for general assistance <br/>
<a id="pl.22.8"></a><var>22.8</var>medical care shall be sent to the applicant or recipient. Once enrolled in MinnesotaCare, <br/>
<a id="pl.22.9"></a><var>22.9</var>the MinnesotaCare-covered services as described in section 256L.03 shall apply for the <br/>
<a id="pl.22.10"></a><var>22.10</var>remainder of the six-month general assistance medical care eligibility period until their <br/>
<a id="pl.22.11"></a><var>22.11</var>six-month renewal.<br/>
<a id="pl.22.12"></a><var>22.12</var>(c) This subdivision does not apply if the applicant or recipient:<br/>
<a id="pl.22.13"></a><var>22.13</var>(1) has applied for and is awaiting a determination of blindness or disability by the <br/>
<a id="pl.22.14"></a><var>22.14</var>state medical review team or a determination of eligibility for Supplemental Security <br/>
<a id="pl.22.15"></a><var>22.15</var>Income or Social Security Disability Insurance by the Social Security Administration;<br/>
<a id="pl.22.16"></a><var>22.16</var>(2) is homeless as defined by United States Code, title 42, section 11301, et seq.;<br/>
<a id="pl.22.17"></a><var>22.17</var>(3) is classified as an end-stage renal disease beneficiary in the Medicare program; <br/>
<a id="pl.22.18"></a><var>22.18</var>(4) receives treatment funded in section 254B.02; or<br/>
<a id="pl.22.19"></a><var>22.19</var>(5) fails to meet the requirements of section 256L.09, subdivision 2.<br/>
<a id="pl.22.20"></a><var>22.20</var>Applicants and recipients who meet any one of these criteria shall remain eligible for <br/>
<a id="pl.22.21"></a><var>22.21</var>general assistance medical care and shall not be required to enroll in MinnesotaCare.<br/>
<a id="pl.22.22"></a><var>22.22</var>(d) To be eligible for general assistance medical care following enrollment <br/>
<a id="pl.22.23"></a><var>22.23</var>in MinnesotaCare as required in paragraph (a), an individual must complete a new <br/>
<a id="pl.22.24"></a><var>22.24</var>application.<br/>
<a id="pl.22.25"></a><var>22.25</var>    Subd. 4. <b>Eligibility and enrollment procedures.</b> (a) Eligibility for general <br/>
<a id="pl.22.26"></a><var>22.26</var>assistance medical care shall begin no earlier than the date of application. The date of <br/>
<a id="pl.22.27"></a><var>22.27</var>application shall be the date the applicant has provided a name, address, and Social <br/>
<a id="pl.22.28"></a><var>22.28</var>Security number, signed and dated, to the county agency or the Department of Human <br/>
<a id="pl.22.29"></a><var>22.29</var>Services. If the applicant is unable to provide a name, address, Social Security number, <br/>
<a id="pl.22.30"></a><var>22.30</var>and signature when health care is delivered due to a medical condition or disability, a <br/>
<a id="pl.22.31"></a><var>22.31</var>health care provider may act on an applicant's behalf to establish the date of an application <br/>
<a id="pl.22.32"></a><var>22.32</var>by providing the county agency or Department of Human Services with provider <br/>
<a id="pl.22.33"></a><var>22.33</var>identification and a temporary unique identifier for the applicant. The applicant must <br/>
<a id="pl.22.34"></a><var>22.34</var>complete the remainder of the application and provide necessary verification before <br/>
<a id="pl.22.35"></a><var>22.35</var>eligibility can be determined. The applicant must complete the application within the time <br/>
<a id="pl.22.36"></a><var>22.36</var>periods required under the medical assistance program as specified in Minnesota Rules, <br/>
<a id="pl.23.1"></a><var>23.1</var>parts 9505.0015, subpart 5; and 9505.0090, subpart 2. The county agency must assist the <br/>
<a id="pl.23.2"></a><var>23.2</var>applicant in obtaining verification if necessary. <br/>
<a id="pl.23.3"></a><var>23.3</var>    (b) County agencies are authorized to use all automated databases containing <br/>
<a id="pl.23.4"></a><var>23.4</var>information regarding recipients' or applicants' income in order to determine eligibility for <br/>
<a id="pl.23.5"></a><var>23.5</var>general assistance medical care or MinnesotaCare. Such use shall be considered sufficient <br/>
<a id="pl.23.6"></a><var>23.6</var>in order to determine eligibility and premium payments by the county agency.<br/>
<a id="pl.23.7"></a><var>23.7</var>    (c) In determining the amount of assets of an individual eligible under subdivision 1, <br/>
<a id="pl.23.8"></a><var>23.8</var>paragraph (a), clause (2), there shall be included any asset or interest in an asset, including <br/>
<a id="pl.23.9"></a><var>23.9</var>an asset excluded under subdivision 1, paragraph (a), that was given away, sold, or <br/>
<a id="pl.23.10"></a><var>23.10</var>disposed of for less than fair market value within the 60 months preceding application for <br/>
<a id="pl.23.11"></a><var>23.11</var>general assistance medical care or during the period of eligibility. Any transfer described <br/>
<a id="pl.23.12"></a><var>23.12</var>in this paragraph shall be presumed to have been for the purpose of establishing eligibility <br/>
<a id="pl.23.13"></a><var>23.13</var>for general assistance medical care, unless the individual furnishes convincing evidence to <br/>
<a id="pl.23.14"></a><var>23.14</var>establish that the transaction was exclusively for another purpose. For purposes of this <br/>
<a id="pl.23.15"></a><var>23.15</var>paragraph, the value of the asset or interest shall be the fair market value at the time it <br/>
<a id="pl.23.16"></a><var>23.16</var>was given away, sold, or disposed of, less the amount of compensation received. For any <br/>
<a id="pl.23.17"></a><var>23.17</var>uncompensated transfer, the number of months of ineligibility, including partial months, <br/>
<a id="pl.23.18"></a><var>23.18</var>shall be calculated by dividing the uncompensated transfer amount by the average monthly <br/>
<a id="pl.23.19"></a><var>23.19</var>per person payment made by the medical assistance program to skilled nursing facilities <br/>
<a id="pl.23.20"></a><var>23.20</var>for the previous calendar year. The individual shall remain ineligible until this fixed period <br/>
<a id="pl.23.21"></a><var>23.21</var>has expired. The period of ineligibility may exceed 30 months, and a reapplication for <br/>
<a id="pl.23.22"></a><var>23.22</var>benefits after 30 months from the date of the transfer shall not result in eligibility unless <br/>
<a id="pl.23.23"></a><var>23.23</var>and until the period of ineligibility has expired. The period of ineligibility begins in the <br/>
<a id="pl.23.24"></a><var>23.24</var>month the transfer was reported to the county agency, or if the transfer was not reported, <br/>
<a id="pl.23.25"></a><var>23.25</var>the month in which the county agency discovered the transfer, whichever comes first. For <br/>
<a id="pl.23.26"></a><var>23.26</var>applicants, the period of ineligibility begins on the date of the first approved application.<br/>
<a id="pl.23.27"></a><var>23.27</var>    (d) When determining eligibility for any state benefits under this subdivision, <br/>
<a id="pl.23.28"></a><var>23.28</var>the income and resources of all noncitizens shall be deemed to include their sponsor's <br/>
<a id="pl.23.29"></a><var>23.29</var>income and resources as defined in the Personal Responsibility and Work Opportunity <br/>
<a id="pl.23.30"></a><var>23.30</var>Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and <br/>
<a id="pl.23.31"></a><var>23.31</var>subsequently set out in federal rules.<br/>
<a id="pl.23.32"></a><var>23.32</var>    Subd. 5. <b>General assistance medical care; services.</b> (a) General assistance <br/>
<a id="pl.23.33"></a><var>23.33</var>medical care covers:<br/>
<a id="pl.23.34"></a><var>23.34</var>    (1) inpatient hospital services within the limitations described in subdivision 10;<br/>
<a id="pl.23.35"></a><var>23.35</var>    (2) outpatient hospital services;<br/>
<a id="pl.23.36"></a><var>23.36</var>    (3) services provided by Medicare-certified rehabilitation agencies;<br/>
<a id="pl.24.1"></a><var>24.1</var>    (4) prescription drugs and other products recommended through the process <br/>
<a id="pl.24.2"></a><var>24.2</var>established in section 
<statute_ref>256B.0625, subdivision 13</statute_ref>;<br/>
<a id="pl.24.3"></a><var>24.3</var>    (5) equipment necessary to administer insulin and diagnostic supplies and equipment <br/>
<a id="pl.24.4"></a><var>24.4</var>for diabetics to monitor blood sugar level;<br/>
<a id="pl.24.5"></a><var>24.5</var>    (6) eyeglasses and eye examinations provided by a physician or optometrist;<br/>
<a id="pl.24.6"></a><var>24.6</var>    (7) hearing aids;<br/>
<a id="pl.24.7"></a><var>24.7</var>    (8) prosthetic devices;<br/>
<a id="pl.24.8"></a><var>24.8</var>    (9) laboratory and x-ray services;<br/>
<a id="pl.24.9"></a><var>24.9</var>    (10) physicians' services;<br/>
<a id="pl.24.10"></a><var>24.10</var>    (11) medical transportation except special transportation;<br/>
<a id="pl.24.11"></a><var>24.11</var>    (12) chiropractic services as covered under the medical assistance program;<br/>
<a id="pl.24.12"></a><var>24.12</var>    (13) podiatric services;<br/>
<a id="pl.24.13"></a><var>24.13</var>    (14) dental services as covered under the medical assistance program;<br/>
<a id="pl.24.14"></a><var>24.14</var>    (15) mental health services covered under chapter 256B;<br/>
<a id="pl.24.15"></a><var>24.15</var>    (16) prescribed medications for persons who have been diagnosed as mentally ill as <br/>
<a id="pl.24.16"></a><var>24.16</var>necessary to prevent more restrictive institutionalization;<br/>
<a id="pl.24.17"></a><var>24.17</var>    (17) medical supplies and equipment, and Medicare premiums, coinsurance, and <br/>
<a id="pl.24.18"></a><var>24.18</var>deductible payments;<br/>
<a id="pl.24.19"></a><var>24.19</var>    (18) medical equipment not specifically listed in this paragraph when the use of <br/>
<a id="pl.24.20"></a><var>24.20</var>the equipment will prevent the need for costlier services that are reimbursable under <br/>
<a id="pl.24.21"></a><var>24.21</var>this subdivision;<br/>
<a id="pl.24.22"></a><var>24.22</var>    (19) services performed by a certified pediatric nurse practitioner, a certified family <br/>
<a id="pl.24.23"></a><var>24.23</var>nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological <br/>
<a id="pl.24.24"></a><var>24.24</var>nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse <br/>
<a id="pl.24.25"></a><var>24.25</var>practitioner in independent practice, if (1) the service is otherwise covered under this <br/>
<a id="pl.24.26"></a><var>24.26</var>chapter as a physician service, (2) the service provided on an inpatient basis is not included <br/>
<a id="pl.24.27"></a><var>24.27</var>as part of the cost for inpatient services included in the operating payment rate, and (3) the <br/>
<a id="pl.24.28"></a><var>24.28</var>service is within the scope of practice of the nurse practitioner's license as a registered <br/>
<a id="pl.24.29"></a><var>24.29</var>nurse, as defined in section 
<statute_ref>148.171</statute_ref>;<br/>
<a id="pl.24.30"></a><var>24.30</var>    (20) services of a certified public health nurse or a registered nurse practicing in <br/>
<a id="pl.24.31"></a><var>24.31</var>a public health nursing clinic that is a department of, or that operates under the direct <br/>
<a id="pl.24.32"></a><var>24.32</var>authority of, a unit of government, if the service is within the scope of practice of the <br/>
<a id="pl.24.33"></a><var>24.33</var>public health nurse's license as a registered nurse, as defined in section 
<statute_ref>148.171</statute_ref>;<br/>
<a id="pl.24.34"></a><var>24.34</var>    (21) telemedicine consultations, to the extent they are covered under section <br/>
<a id="pl.24.35"></a><var>24.35</var><statute_ref>256B.0625, subdivision 3b</statute_ref>;<br/>
<a id="pl.25.1"></a><var>25.1</var>    (22) care coordination and patient education services provided by a community <br/>
<a id="pl.25.2"></a><var>25.2</var>health worker according to section 
<statute_ref>256B.0625, subdivision 49</statute_ref>; and<br/>
<a id="pl.25.3"></a><var>25.3</var>    (23) regardless of the number of employees that an enrolled health care provider <br/>
<a id="pl.25.4"></a><var>25.4</var>may have, sign language interpreter services when provided by an enrolled health care <br/>
<a id="pl.25.5"></a><var>25.5</var>provider during the course of providing a direct, person-to-person-covered health care <br/>
<a id="pl.25.6"></a><var>25.6</var>service to an enrolled recipient who has a hearing loss and uses interpreting services.<br/>
<a id="pl.25.7"></a><var>25.7</var>(b) Sex reassignment surgery is not covered under this section.<br/>
<a id="pl.25.8"></a><var>25.8</var>(c) Drug coverage is covered in accordance with section 256D.03, subdivision 4, <br/>
<a id="pl.25.9"></a><var>25.9</var>paragraph (d).<br/>
<a id="pl.25.10"></a><var>25.10</var>(d) The following co-payments shall apply for services provided:<br/>
<a id="pl.25.11"></a><var>25.11</var>(1) $25 for nonemergency visits to a hospital-based emergency room; and<br/>
<a id="pl.25.12"></a><var>25.12</var>(2) $3 per brand-name drug prescription, subject to a $7 per month maximum for <br/>
<a id="pl.25.13"></a><var>25.13</var>prescription drug co-payments. No co-payments shall apply to antipsychotic drugs when <br/>
<a id="pl.25.14"></a><var>25.14</var>used for the treatment of mental illness.<br/>
<a id="pl.25.15"></a><var>25.15</var>(e) Co-payments shall be limited to one per day per provider for nonemergency <br/>
<a id="pl.25.16"></a><var>25.16</var>visits to a hospital-based emergency room. Recipients of general assistance medical care <br/>
<a id="pl.25.17"></a><var>25.17</var>are responsible for all co-payments in this subdivision. Reimbursement for prescription <br/>
<a id="pl.25.18"></a><var>25.18</var>drugs shall be reduced by the amount of the co-payment until the recipient has reached the <br/>
<a id="pl.25.19"></a><var>25.19</var>$7 per month maximum for prescription drug co-payments. The provider shall collect <br/>
<a id="pl.25.20"></a><var>25.20</var>the co-payment from the recipient. Providers may not deny services to recipients who <br/>
<a id="pl.25.21"></a><var>25.21</var>are unable to pay the co-payment.<br/>
<a id="pl.25.22"></a><var>25.22</var>(f) Chemical dependency services that are reimbursed under chapter 254B shall not <br/>
<a id="pl.25.23"></a><var>25.23</var>be reimbursed under general assistance medical care.<br/>
<a id="pl.25.24"></a><var>25.24</var>(g) Inpatient hospital services that are provided in community behavioral health <br/>
<a id="pl.25.25"></a><var>25.25</var>hospitals operated by state-operated services shall not be reimbursed under general <br/>
<a id="pl.25.26"></a><var>25.26</var>assistance medical care.<br/>
<a id="pl.25.27"></a><var>25.27</var>    Subd. 6. <b>Coordinated care delivery option.</b> (a) A county or group of counties may <br/>
<a id="pl.25.28"></a><var>25.28</var>elect to provide health care services to individuals who are eligible for general assistance <br/>
<a id="pl.25.29"></a><var>25.29</var>medical care under this section and who reside within the county or counties through <br/>
<a id="pl.25.30"></a><var>25.30</var>a coordinated care delivery option. The health care services provided by the county <br/>
<a id="pl.25.31"></a><var>25.31</var>must include the services described in subdivision 5 with the exception of outpatient <br/>
<a id="pl.25.32"></a><var>25.32</var>prescription drug coverage but including drugs administered in an outpatient setting. <br/>
<a id="pl.25.33"></a><var>25.33</var>Counties that elect to provide health care services through this option must ensure that <br/>
<a id="pl.25.34"></a><var>25.34</var>the requirements of this subdivision are met. Upon electing to provide services through <br/>
<a id="pl.25.35"></a><var>25.35</var>this option, the county accepts the financial risk of the delivery of the health care services <br/>
<a id="pl.25.36"></a><var>25.36</var>described in this subdivision to general assistance medical care recipients residing in <br/>
<a id="pl.26.1"></a><var>26.1</var>the county for the period beginning July 1, 2010, and ending July 1, 2011, for the fixed <br/>
<a id="pl.26.2"></a><var>26.2</var>payments described in subdivision 10.<br/>
<a id="pl.26.3"></a><var>26.3</var>(b) A county that elects to provide services through this option must provide to <br/>
<a id="pl.26.4"></a><var>26.4</var>the commissioner the following:<br/>
<a id="pl.26.5"></a><var>26.5</var>(1) the names of the county or counties that are electing to provide services through <br/>
<a id="pl.26.6"></a><var>26.6</var>the county care delivery option; and<br/>
<a id="pl.26.7"></a><var>26.7</var>(2) the geographic area to be served.<br/>
<a id="pl.26.8"></a><var>26.8</var>(c) The county may contract with a managed care plan, an integrated delivery <br/>
<a id="pl.26.9"></a><var>26.9</var>system, a physician-hospital organization, or an academic health center to administer <br/>
<a id="pl.26.10"></a><var>26.10</var>the delivery of services through this option. Any county providing general assistance <br/>
<a id="pl.26.11"></a><var>26.11</var>medical care services through a county-based purchasing plan in accordance with section <br/>
<a id="pl.26.12"></a><var>26.12</var>256B.692 may continue to provide services through the county-based purchasing plan. <br/>
<a id="pl.26.13"></a><var>26.13</var>Payments to the county-based purchasing plan for the period beginning July 1, 2010, and <br/>
<a id="pl.26.14"></a><var>26.14</var>ending July 1, 2011, shall be paid according to subdivision 10.<br/>
<a id="pl.26.15"></a><var>26.15</var>(d) A county must demonstrate the ability to:<br/>
<a id="pl.26.16"></a><var>26.16</var>(1) provide the covered services required under this subdivision to recipients <br/>
<a id="pl.26.17"></a><var>26.17</var>residing within the county;<br/>
<a id="pl.26.18"></a><var>26.18</var>(2) provide a system for advocacy, consumer protection, and complaints and appeals <br/>
<a id="pl.26.19"></a><var>26.19</var>that is independent of care providers or other risk bearers and complies with section <br/>
<a id="pl.26.20"></a><var>26.20</var>256B.69;<br/>
<a id="pl.26.21"></a><var>26.21</var>(3) establish a process to monitor enrollment and ensure the quality of care provided; <br/>
<a id="pl.26.22"></a><var>26.22</var>and<br/>
<a id="pl.26.23"></a><var>26.23</var>(4) coordinate the delivery of health care services with existing homeless prevention, <br/>
<a id="pl.26.24"></a><var>26.24</var>supportive housing, and rent subsidy programs and funding administered by the Minnesota <br/>
<a id="pl.26.25"></a><var>26.25</var>Housing Finance Agency under chapter 462A.<br/>
<a id="pl.26.26"></a><var>26.26</var>(e) The commissioner may require the county to provide the commissioner with data <br/>
<a id="pl.26.27"></a><var>26.27</var>necessary for assessing enrollment, quality of care, cost, and utilization of services.<br/>
<a id="pl.26.28"></a><var>26.28</var>(f) A county that elects to provide services through this option shall be considered to <br/>
<a id="pl.26.29"></a><var>26.29</var>be a prepaid health plan for purposes of section 256.045.<br/>
<a id="pl.26.30"></a><var>26.30</var>(g) The state shall not be liable for the payment of any cost or obligation incurred <br/>
<a id="pl.26.31"></a><var>26.31</var>by the county or a participating provider.<br/>
<a id="pl.26.32"></a><var>26.32</var>    Subd. 7. <b>Health care home designation.</b> The commissioner or a county may <br/>
<a id="pl.26.33"></a><var>26.33</var>require a recipient to designate a primary care provider or a primary care clinic that is <br/>
<a id="pl.26.34"></a><var>26.34</var>certified as a health care home under section 256B.0751.<br/>
<a id="pl.26.35"></a><var>26.35</var>    Subd. 8. <b>Payments; fee-for-service rate for the period between March 1, </b><br/>
<a id="pl.26.36"></a><var>26.36</var><b>2010, and July 1, 2010.</b> (a) Effective for services provided on or after March 1, 2010, <br/>
<a id="pl.27.1"></a><var>27.1</var>and before July 1, 2010, the payment rates for all covered services provided to general <br/>
<a id="pl.27.2"></a><var>27.2</var>assistance medical care recipients, with the exception of outpatient prescription drug <br/>
<a id="pl.27.3"></a><var>27.3</var>coverage, shall be 50 percent of the general assistance medical care payment rate in effect <br/>
<a id="pl.27.4"></a><var>27.4</var>on February 28, 2010.<br/>
<a id="pl.27.5"></a><var>27.5</var>(b) Outpatient prescription drug coverage provided on or after March 1, 2010, and <br/>
<a id="pl.27.6"></a><var>27.6</var>before July 1, 2010, shall be paid on a fee-for-service basis in accordance with section <br/>
<a id="pl.27.7"></a><var>27.7</var>256B.0625, subdivision 13e.<br/>
<a id="pl.27.8"></a><var>27.8</var>    Subd. 9. <b>Payments; fee-for-service rates for the period between July 1, 2010, </b><br/>
<a id="pl.27.9"></a><var>27.9</var><b>and July 1, 2011.</b> (a) Effective for services provided on or after July 1, 2010, and before <br/>
<a id="pl.27.10"></a><var>27.10</var>July 1, 2011, to general assistance medical care recipients residing in counties that are <br/>
<a id="pl.27.11"></a><var>27.11</var>not served through the coordinated care delivery option, payments shall be made by the <br/>
<a id="pl.27.12"></a><var>27.12</var>commissioner to providers at rates described in this subdivision.<br/>
<a id="pl.27.13"></a><var>27.13</var>(b) For inpatient hospital admissions provided on or after July 1, 2010, and before <br/>
<a id="pl.27.14"></a><var>27.14</var>July 1, 2011, the payment rate shall be:<br/>
<a id="pl.27.15"></a><var>27.15</var>(1) 70 percent of the general assistance medical care rate in effect on February <br/>
<a id="pl.27.16"></a><var>27.16</var>28, 2010, if the inpatient hospital services were provided in a hospital where the <br/>
<a id="pl.27.17"></a><var>27.17</var>fee-for-service inpatient and outpatient hospital general assistance medical care payments <br/>
<a id="pl.27.18"></a><var>27.18</var>to the hospital for admissions provided in calendar year 2007 totaled $1,000,000 or more <br/>
<a id="pl.27.19"></a><var>27.19</var>or the hospital's fee-for-service inpatient and outpatient hospital general assistance medical <br/>
<a id="pl.27.20"></a><var>27.20</var>care payments received for calendar year 2007 admissions was one percent or more of the <br/>
<a id="pl.27.21"></a><var>27.21</var>hospital's net patient revenue received for services provided in calendar year 2007; or<br/>
<a id="pl.27.22"></a><var>27.22</var>(2) 40 percent of the general assistance medical care rate in effect on February 28, <br/>
<a id="pl.27.23"></a><var>27.23</var>2010, if the inpatient hospital services were provided by a hospital that does not meet the <br/>
<a id="pl.27.24"></a><var>27.24</var>criteria described in clause (1).<br/>
<a id="pl.27.25"></a><var>27.25</var>(c) Effective for services other than inpatient hospital services and outpatient <br/>
<a id="pl.27.26"></a><var>27.26</var>prescription drug coverage provided on or after July 1, 2010, and before July 1, 2011, <br/>
<a id="pl.27.27"></a><var>27.27</var>the payment rate shall begin at 50 percent of the general assistance medical care rate <br/>
<a id="pl.27.28"></a><var>27.28</var>in effect on February 28, 2010.<br/>
<a id="pl.27.29"></a><var>27.29</var>(d) Outpatient prescription drug coverage provided on or after July 1, 2010, and <br/>
<a id="pl.27.30"></a><var>27.30</var>before July 1, 2011, shall be paid on a fee-for-service basis in accordance with section <br/>
<a id="pl.27.31"></a><var>27.31</var>256B.0625, subdivision 13e.<br/>
<a id="pl.27.32"></a><var>27.32</var>(e) The commissioner may adjust the rates paid under paragraphs (b) and (c) on a <br/>
<a id="pl.27.33"></a><var>27.33</var>quarterly basis to ensure that the total aggregate amount paid out for services provided <br/>
<a id="pl.27.34"></a><var>27.34</var>on a fee-for-service basis beginning March 1, 2010, and ending June 30, 2011, does not <br/>
<a id="pl.27.35"></a><var>27.35</var>exceed the appropriation from the general assistance medical care account established in <br/>
<a id="pl.27.36"></a><var>27.36</var>section 256D.032 for the general assistance medical care program.<br/>
<a id="pl.28.1"></a><var>28.1</var>    Subd. 10. <b>Payments; rate setting for the coordinated care delivery option.</b> (a) <br/>
<a id="pl.28.2"></a><var>28.2</var>Effective for general assistance medical care services, with the exception of outpatient <br/>
<a id="pl.28.3"></a><var>28.3</var>prescription drug coverage, provided on or after July 1, 2010, and before July 1, 2011, <br/>
<a id="pl.28.4"></a><var>28.4</var>to recipients residing in counties that have elected to provide services through the <br/>
<a id="pl.28.5"></a><var>28.5</var>coordinated delivery care option, the commissioner shall establish quarterly prospective <br/>
<a id="pl.28.6"></a><var>28.6</var>fixed payments to the county. The payments must not exceed 60 percent of the county's <br/>
<a id="pl.28.7"></a><var>28.7</var>general assistance medical care county allocation amount as determined in paragraph (b). <br/>
<a id="pl.28.8"></a><var>28.8</var>These payments must not be used by the county to pay MinnesotaCare premiums for <br/>
<a id="pl.28.9"></a><var>28.9</var>general assistance medical care recipients or MinnesotaCare enrollees.<br/>
<a id="pl.28.10"></a><var>28.10</var>(b) For each county that elects to provide services in accordance with subdivision <br/>
<a id="pl.28.11"></a><var>28.11</var>7, the commissioner shall determine a general assistance medical care county allocation <br/>
<a id="pl.28.12"></a><var>28.12</var>amount that equals the total general assistance medical care payments made for recipients <br/>
<a id="pl.28.13"></a><var>28.13</var>residing within the county in fiscal year 2009 for all covered general assistance medical <br/>
<a id="pl.28.14"></a><var>28.14</var>care services with the exception of outpatient prescription drug coverage.<br/>
<a id="pl.28.15"></a><var>28.15</var>(c) Outpatient prescription drug coverage provided on or after July 1, 2010, <br/>
<a id="pl.28.16"></a><var>28.16</var>and before July 1, 2011, shall be paid on a fee-for-service basis according to section <br/>
<a id="pl.28.17"></a><var>28.17</var>256B.0625, subdivision 13e.<br/>
<a id="pl.28.18"></a><var>28.18</var>    Subd. 11. <b>Veterans medical review team.</b> (a) To ensure the timely processing of <br/>
<a id="pl.28.19"></a><var>28.19</var>determinations of service-connected disabilities among veterans enrolled in the temporary <br/>
<a id="pl.28.20"></a><var>28.20</var>general assistance medical care program, the commissioner shall review all medical <br/>
<a id="pl.28.21"></a><var>28.21</var>evidence submitted by enrollees with a referral and seek additional information from <br/>
<a id="pl.28.22"></a><var>28.22</var>providers, applicants, and enrollees to support the determination of a service-connected <br/>
<a id="pl.28.23"></a><var>28.23</var>disability when necessary. Service-connected disability shall be determined according to <br/>
<a id="pl.28.24"></a><var>28.24</var>the regulations and policies of the United States Department of Veterans Affairs.<br/>
<a id="pl.28.25"></a><var>28.25</var>(b) Prior to a denial or withdrawal of a requested determination of service-connected <br/>
<a id="pl.28.26"></a><var>28.26</var>disability due to insufficient evidence, the commissioner shall:<br/>
<a id="pl.28.27"></a><var>28.27</var>(1) ensure that the missing evidence is necessary and appropriate to a determination <br/>
<a id="pl.28.28"></a><var>28.28</var>of service-connected disability; and<br/>
<a id="pl.28.29"></a><var>28.29</var>(2) assist applicants and enrollees to obtain the evidence, including, but not limited <br/>
<a id="pl.28.30"></a><var>28.30</var>to, medical examinations and electronic medical records.<br/>
<a id="pl.28.31"></a><var>28.31</var>(c) The commissioner shall provide the chairs of the legislative committees with <br/>
<a id="pl.28.32"></a><var>28.32</var>jurisdiction over health and human services finance and veterans affairs finance the <br/>
<a id="pl.28.33"></a><var>28.33</var>following information on the activities of the veterans medical review team by August 1, <br/>
<a id="pl.28.34"></a><var>28.34</var>2010, and provide an update by January 1, 2011:<br/>
<a id="pl.28.35"></a><var>28.35</var>(1) the number of applications to the veterans medical review team that were denied, <br/>
<a id="pl.28.36"></a><var>28.36</var>approved, or withdrawn;<br/>
<a id="pl.29.1"></a><var>29.1</var>(2) the average length of time from receipt of the application to a decision;<br/>
<a id="pl.29.2"></a><var>29.2</var>(3) the number of appeals and appeal results;<br/>
<a id="pl.29.3"></a><var>29.3</var>(4) for applicants, their age, health coverage at the time of application, <br/>
<a id="pl.29.4"></a><var>29.4</var>hospitalization  history within three months of application, and whether an application for <br/>
<a id="pl.29.5"></a><var>29.5</var>service-connected veterans benefits is pending; and<br/>
<a id="pl.29.6"></a><var>29.6</var>(5) specific information on the medical certification, licensure, or other credentials <br/>
<a id="pl.29.7"></a><var>29.7</var>of the person or persons performing the medical review determinations and length of <br/>
<a id="pl.29.8"></a><var>29.8</var>time in that position.<br/>
<a id="pl.29.9"></a><var>29.9</var><b>EFFECTIVE DATE.</b>This section is effective for services rendered on or after <br/>
<a id="pl.29.10"></a><var>29.10</var>March 1, 2010, and before July 1, 2011.<br/>
<br/>
<a id="bill.1.14.0"></a><a id="pl.29.11"></a><var>29.11</var>    Sec. 14. <b>[256D.032] GENERAL ASSISTANCE MEDICAL CARE ACCOUNT.</b><br/>
<a id="pl.29.12"></a><var>29.12</var>The general assistance medical care account is created in the special revenue fund. <br/>
<a id="pl.29.13"></a><var>29.13</var>Money deposited into the account is subject to appropriation by the legislature.<br/>
<a id="pl.29.14"></a><var>29.14</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.15.0"></a><a id="pl.29.15"></a><var>29.15</var>    Sec. 15. Minnesota Statutes 2008, section 256D.06, subdivision 7, is amended to read:<br/>
<a id="pl.29.16"></a><var>29.16</var>    Subd. 7. <b>SSI conversions and back claims.</b> (a) The commissioner of human <br/>
<a id="pl.29.17"></a><var>29.17</var>services shall contract with agencies or organizations capable of ensuring that clients who <br/>
<a id="pl.29.18"></a><var>29.18</var>are presently receiving assistance under sections 
         <statute_ref>256D.01</statute_ref> to 
         <statute_ref>256D.21</statute_ref>, and who may be <br/>
<a id="pl.29.19"></a><var>29.19</var>eligible for benefits under the federal Supplemental Security Income program, apply and, <br/>
<a id="pl.29.20"></a><var>29.20</var>when eligible, are converted to the federal income assistance program and made eligible <br/>
<a id="pl.29.21"></a><var>29.21</var>for health care benefits under the medical assistance program. The commissioner shall <br/>
<a id="pl.29.22"></a><var>29.22</var>ensure that money owing to the state under interim assistance agreements is collected.<br/>
<a id="pl.29.23"></a><var>29.23</var>(b) The commissioner shall also directly or through contract implement procedures <br/>
<a id="pl.29.24"></a><var>29.24</var>for collecting federal Medicare and medical assistance funds for which clients converted <br/>
<a id="pl.29.25"></a><var>29.25</var>to SSI are retroactively eligible.<br/>
<a id="pl.29.26"></a><var>29.26</var>(c) The commissioner shall contract with agencies to ensure implementation of <br/>
<a id="pl.29.27"></a><var>29.27</var>this section. County contracts with providers for residential services shall include the <br/>
<a id="pl.29.28"></a><var>29.28</var>requirement that providers screen residents who may be eligible for federal benefits and <br/>
<a id="pl.29.29"></a><var>29.29</var>provide that information to the local agency. The commissioner shall modify the MAXIS <br/>
<a id="pl.29.30"></a><var>29.30</var>computer system to provide information on clients who have been on general assistance <br/>
<a id="pl.29.31"></a><var>29.31</var>for two years or longer. The list of clients shall be provided to local services for screening <br/>
<a id="pl.29.32"></a><var>29.32</var>under this section.<br/>
<a id="pl.30.1"></a><var>30.1</var>(d) Effective for general assistance medical care services rendered on or after <br/>
<a id="pl.30.2"></a><var>30.2</var>March 1, 2010, to June 30, 2011, any medical collections, payments, or recoveries under <br/>
<a id="pl.30.3"></a><var>30.3</var>this subdivision shall be deposited in or credited to the account established in section <br/>
<a id="pl.30.4"></a><var>30.4</var>256D.032.<br/>
<a id="pl.30.5"></a><var>30.5</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.16.0"></a><a id="pl.30.6"></a><var>30.6</var>    Sec. 16. Minnesota Statutes 2008, section 256L.05, subdivision 1b, is amended to read:<br/>
<a id="pl.30.7"></a><var>30.7</var>    Subd. 1b. <b>MinnesotaCare enrollment by county agencies.</b> Beginning September <br/>
<a id="pl.30.8"></a><var>30.8</var>1, 2006, county agencies shall enroll single adults and households with no children <br/>
<a id="pl.30.9"></a><var>30.9</var>formerly enrolled in general assistance medical care in MinnesotaCare according to <br/>
<a id="pl.30.10"></a><var>30.10</var>section 
         <statute_ref>256D.03, subdivision 3</statute_ref>, or 256D.031. County agencies shall perform all duties <br/>
<a id="pl.30.11"></a><var>30.11</var>necessary to administer the MinnesotaCare program ongoing for these enrollees, including <br/>
<a id="pl.30.12"></a><var>30.12</var>the redetermination of MinnesotaCare eligibility at renewal.<br/>
<a id="pl.30.13"></a><var>30.13</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.17.0"></a><a id="pl.30.14"></a><var>30.14</var>    Sec. 17. Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:<br/>
<a id="pl.30.15"></a><var>30.15</var>    Subd. 3. <b>Effective date of coverage.</b> (a) The effective date of coverage is the <br/>
<a id="pl.30.16"></a><var>30.16</var>first day of the month following the month in which eligibility is approved and the first <br/>
<a id="pl.30.17"></a><var>30.17</var>premium payment has been received. As provided in section 
         <statute_ref>256B.057</statute_ref>, coverage for <br/>
<a id="pl.30.18"></a><var>30.18</var>newborns is automatic from the date of birth and must be coordinated with other health <br/>
<a id="pl.30.19"></a><var>30.19</var>coverage. The effective date of coverage for eligible newly adoptive children added to a <br/>
<a id="pl.30.20"></a><var>30.20</var>family receiving covered health services is the month of placement. The effective date <br/>
<a id="pl.30.21"></a><var>30.21</var>of coverage for other new members added to the family is the first day of the month <br/>
<a id="pl.30.22"></a><var>30.22</var>following the month in which the change is reported. All eligibility criteria must be met <br/>
<a id="pl.30.23"></a><var>30.23</var>by the family at the time the new family member is added. The income of the new family <br/>
<a id="pl.30.24"></a><var>30.24</var>member is included with the family's gross income and the adjusted premium begins in <br/>
<a id="pl.30.25"></a><var>30.25</var>the month the new family member is added.<br/>
<a id="pl.30.26"></a><var>30.26</var>(b) The initial premium must be received by the last working day of the month for <br/>
<a id="pl.30.27"></a><var>30.27</var>coverage to begin the first day of the following month.<br/>
<a id="pl.30.28"></a><var>30.28</var>(c) Benefits are not available until the day following discharge if an enrollee is <br/>
<a id="pl.30.29"></a><var>30.29</var>hospitalized on the first day of coverage.<br/>
<a id="pl.30.30"></a><var>30.30</var>(d) Notwithstanding any other law to the contrary, benefits under sections 
         <statute_ref>256L.01</statute_ref> to <br/>
<statute_ref><a id="pl.30.31"></a><var>30.31</var>256L.18
         </statute_ref> are secondary to a plan of insurance or benefit program under which an eligible <br/>
<a id="pl.30.32"></a><var>30.32</var>person may have coverage and the commissioner shall use cost avoidance techniques to <br/>
<a id="pl.30.33"></a><var>30.33</var>ensure coordination of any other health coverage for eligible persons. The commissioner <br/>
<a id="pl.31.1"></a><var>31.1</var>shall identify eligible persons who may have coverage or benefits under other plans of <br/>
<a id="pl.31.2"></a><var>31.2</var>insurance or who become eligible for medical assistance.<br/>
<a id="pl.31.3"></a><var>31.3</var>(e) The effective date of coverage for single adults and households with no children <br/>
<a id="pl.31.4"></a><var>31.4</var>formerly enrolled in general assistance medical care and enrolled in MinnesotaCare <br/>
<a id="pl.31.5"></a><var>31.5</var>according to section 
         <statute_ref>256D.03, subdivision 3</statute_ref>, or 256D.031, is the first day of the month <br/>
<a id="pl.31.6"></a><var>31.6</var>following the last day of general assistance medical care coverage.<br/>
<a id="pl.31.7"></a><var>31.7</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.18.0"></a><a id="pl.31.8"></a><var>31.8</var>    Sec. 18. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:<br/>
<a id="pl.31.9"></a><var>31.9</var>    Subd. 3a. <b>Renewal of eligibility.</b> (a) Beginning July 1, 2007, an enrollee's eligibility <br/>
<a id="pl.31.10"></a><var>31.10</var>must be renewed every 12 months. The 12-month period begins in the month after the <br/>
<a id="pl.31.11"></a><var>31.11</var>month the application is approved.<br/>
<a id="pl.31.12"></a><var>31.12</var>    (b) Each new period of eligibility must take into account any changes in <br/>
<a id="pl.31.13"></a><var>31.13</var>circumstances that impact eligibility and premium amount. An enrollee must provide all <br/>
<a id="pl.31.14"></a><var>31.14</var>the information needed to redetermine eligibility by the first day of the month that ends <br/>
<a id="pl.31.15"></a><var>31.15</var>the eligibility period. If there is no change in circumstances, the enrollee may renew <br/>
<a id="pl.31.16"></a><var>31.16</var>eligibility at designated locations that include community clinics and health care providers' <br/>
<a id="pl.31.17"></a><var>31.17</var>offices. The designated sites shall forward the renewal forms to the commissioner. The <br/>
<a id="pl.31.18"></a><var>31.18</var>commissioner may establish criteria and timelines for sites to forward applications to the <br/>
<a id="pl.31.19"></a><var>31.19</var>commissioner or county agencies. The premium for the new period of eligibility must be <br/>
<a id="pl.31.20"></a><var>31.20</var>received as provided in section 
         <statute_ref>256L.06</statute_ref> in order for eligibility to continue.<br/>
<a id="pl.31.21"></a><var>31.21</var>    (c) For single adults and households with no children formerly enrolled in general <br/>
<a id="pl.31.22"></a><var>31.22</var>assistance medical care and enrolled in MinnesotaCare according to section 
         <statute_ref>256D.03, <br/>
<a id="pl.31.23"></a><var>31.23</var>subdivision 3
         </statute_ref>, or 256D.031, the first period of eligibility begins the month the enrollee <br/>
<a id="pl.31.24"></a><var>31.24</var>submitted the application or renewal for general assistance medical care.<br/>
<a id="pl.31.25"></a><var>31.25</var>    (d) An enrollee who fails to submit renewal forms and related documentation <br/>
<a id="pl.31.26"></a><var>31.26</var>necessary for verification of continued eligibility in a timely manner shall remain eligible <br/>
<a id="pl.31.27"></a><var>31.27</var>for one additional month beyond the end of the current eligibility period before being <br/>
<a id="pl.31.28"></a><var>31.28</var>disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the <br/>
<a id="pl.31.29"></a><var>31.29</var>additional month.<br/>
<br/>
<a id="bill.1.19.0"></a><a id="pl.31.30"></a><var>31.30</var>    Sec. 19. Minnesota Statutes 2008, section 256L.07, subdivision 6, is amended to read:<br/>
<a id="pl.31.31"></a><var>31.31</var>    Subd. 6. <b>Exception for certain adults.</b> Single adults and households with <br/>
<a id="pl.31.32"></a><var>31.32</var>no children formerly enrolled in general assistance medical care and enrolled in <br/>
<a id="pl.31.33"></a><var>31.33</var>MinnesotaCare according to section 
         <statute_ref>256D.03, subdivision 3</statute_ref>, or 256D.031, are eligible <br/>
<a id="pl.31.34"></a><var>31.34</var>without meeting the requirements of this section until renewal.<br/>
<a id="pl.32.1"></a><var>32.1</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.20.0"></a><a id="pl.32.2"></a><var>32.2</var>    Sec. 20. Minnesota Statutes 2008, section 256L.15, subdivision 4, is amended to read:<br/>
<a id="pl.32.3"></a><var>32.3</var>    Subd. 4. <b>Exception for transitioned adults.</b> County agencies shall pay premiums <br/>
<a id="pl.32.4"></a><var>32.4</var>for single adults and households with no children formerly enrolled in general assistance <br/>
<a id="pl.32.5"></a><var>32.5</var>medical care and enrolled in MinnesotaCare according to section 
         <statute_ref>256D.03, subdivision 3</statute_ref>, <br/>
<a id="pl.32.6"></a><var>32.6</var>or 256D.031, until six-month renewal. The county agency has the option of continuing to <br/>
<a id="pl.32.7"></a><var>32.7</var>pay premiums for these enrollees.<br/>
<a id="pl.32.8"></a><var>32.8</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.21.0"></a><a id="pl.32.9"></a><var>32.9</var>    Sec. 21. Minnesota Statutes 2008, section 256L.17, subdivision 7, is amended to read:<br/>
<a id="pl.32.10"></a><var>32.10</var>    Subd. 7. <b>Exception for certain adults.</b> Single adults and households with <br/>
<a id="pl.32.11"></a><var>32.11</var>no children formerly enrolled in general assistance medical care and enrolled in <br/>
<a id="pl.32.12"></a><var>32.12</var>MinnesotaCare according to section 
         <statute_ref>256D.03, subdivision 3</statute_ref>, or 256D.031, are exempt <br/>
<a id="pl.32.13"></a><var>32.13</var>from the requirements of this section until renewal.<br/>
<a id="pl.32.14"></a><var>32.14</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.22.0"></a><a id="pl.32.15"></a><var>32.15</var>    Sec. 22. <b>DRUG REBATE PROGRAM.</b><br/>
<a id="pl.32.16"></a><var>32.16</var>The commissioner of human services shall continue to administer a drug rebate <br/>
<a id="pl.32.17"></a><var>32.17</var>program for drugs purchased for persons eligible for the general assistance medical care <br/>
<a id="pl.32.18"></a><var>32.18</var>program in accordance with Minnesota Statutes, sections 256.01, subdivision 2, paragraph <br/>
<a id="pl.32.19"></a><var>32.19</var>(cc), and 256D.03. The rebate revenues collected under the drug rebate program for <br/>
<a id="pl.32.20"></a><var>32.20</var>persons eligible for the general assistance medical care program shall be deposited in the <br/>
<a id="pl.32.21"></a><var>32.21</var>general assistance medical care account in the special revenue fund established under <br/>
<a id="pl.32.22"></a><var>32.22</var>Minnesota Statutes, section 256D.032. <br/>
<a id="pl.32.23"></a><var>32.23</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010, and expires June <br/>
<a id="pl.32.24"></a><var>32.24</var>30, 2011.<br/>
<br/>
<a id="bill.1.23.0"></a><a id="pl.32.25"></a><var>32.25</var>    Sec. 23. <b>PROVIDER PARTICIPATION.</b><br/>
<a id="pl.32.26"></a><var>32.26</var>For purposes of Minnesota Statutes, section 256B.0644, the reference to the general <br/>
<a id="pl.32.27"></a><var>32.27</var>assistance medical care program shall include the temporary general assistance medical <br/>
<a id="pl.32.28"></a><var>32.28</var>care program established under Minnesota Statutes, section 256D.031. In meeting the <br/>
<a id="pl.32.29"></a><var>32.29</var>requirements of Minnesota Statutes, section 256B.0644, a provider must accept new <br/>
<a id="pl.32.30"></a><var>32.30</var>patients regardless of the Minnesota health care program the patient is enrolled in and may <br/>
<a id="pl.33.1"></a><var>33.1</var>not refuse to accept patients enrolled in one Minnesota health care program and continue <br/>
<a id="pl.33.2"></a><var>33.2</var>to accept patients enrolled in other Minnesota health care programs.<br/>
<a id="pl.33.3"></a><var>33.3</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.1.24.0"></a><a id="pl.33.4"></a><var>33.4</var>    Sec. 24. <b>TEMPORARY SUSPENSION.</b><br/>
<a id="pl.33.5"></a><var>33.5</var>(a) For the period beginning March 1, 2010, to June 30, 2011, the commissioner <br/>
<a id="pl.33.6"></a><var>33.6</var>of human services shall not implement or administer Minnesota Statutes 2008, section <br/>
<a id="pl.33.7"></a><var>33.7</var>256D.03, subdivisions 6 and 9; Minnesota Statutes 2009 Supplement, section 256D.03, <br/>
<a id="pl.33.8"></a><var>33.8</var>subdivision 4; or Minnesota Statutes 2008, section 256B.692; and Minnesota Statutes <br/>
<a id="pl.33.9"></a><var>33.9</var>2009 Supplement, section 256B.69, as they apply to the general assistance medical care <br/>
<a id="pl.33.10"></a><var>33.10</var>program unless specifically continued in Minnesota Statutes, section 256D.031.<br/>
<a id="pl.33.11"></a><var>33.11</var>(b) Notwithstanding paragraph (a), outpatient prescription drug coverage shall <br/>
<a id="pl.33.12"></a><var>33.12</var>continue to be provided under Minnesota Statutes, section 256D.03.<br/>
<a id="pl.33.13"></a><var>33.13</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010, and expires July 1, <br/>
<a id="pl.33.14"></a><var>33.14</var>2011.<br/>
<br/>
<a id="bill.1.25.0"></a><a id="pl.33.15"></a><var>33.15</var>    Sec. 25. <b>COORDINATED CARE DELIVERY ORGANIZATION </b><br/>
<a id="pl.33.16"></a><var>33.16</var><b>DEMONSTRATION PROJECT.</b><br/>
<a id="pl.33.17"></a><var>33.17</var>The commissioner of human services shall develop, and present to the legislature <br/>
<a id="pl.33.18"></a><var>33.18</var>by December 15, 2010, a plan to establish a demonstration project to deliver inpatient <br/>
<a id="pl.33.19"></a><var>33.19</var>hospital, primary care, and specialist services to general assistance medical care enrollees <br/>
<a id="pl.33.20"></a><var>33.20</var>through coordinated care delivery organizations, beginning January 1, 2012. Each <br/>
<a id="pl.33.21"></a><var>33.21</var>coordinated care delivery organization must deliver coordinated care through at least one <br/>
<a id="pl.33.22"></a><var>33.22</var>hospital and one physician group practice, and may include counties and other health care <br/>
<a id="pl.33.23"></a><var>33.23</var>providers. The coordinated care delivery organization must provide inpatient hospital, <br/>
<a id="pl.33.24"></a><var>33.24</var>primary care, and specialist services to general assistance medical care enrollees eligible <br/>
<a id="pl.33.25"></a><var>33.25</var>for the program under Minnesota Statutes, section 256D.03 or 256D.031. The coordinated <br/>
<a id="pl.33.26"></a><var>33.26</var>care delivery organization must accept responsibility for the quality of care and must <br/>
<a id="pl.33.27"></a><var>33.27</var>assume financial risk for the services provided. The plan must include:<br/>
<a id="pl.33.28"></a><var>33.28</var>(1) financial incentives for coordinated care delivery organizations to reduce the <br/>
<a id="pl.33.29"></a><var>33.29</var>growth in the volume and cost of services provided, while maintaining or improving <br/>
<a id="pl.33.30"></a><var>33.30</var>the quality of care;<br/>
<a id="pl.33.31"></a><var>33.31</var>(2) recommendations for the delivery of services not provided through a coordinated <br/>
<a id="pl.33.32"></a><var>33.32</var>care delivery organization and coordination of outpatient and inpatient health care services;<br/>
<a id="pl.34.1"></a><var>34.1</var>(3) recommendations as to the size and scope of the demonstration project and <br/>
<a id="pl.34.2"></a><var>34.2</var>whether participation would be mandatory or voluntary for general assistance medical <br/>
<a id="pl.34.3"></a><var>34.3</var>care enrollees; and<br/>
<a id="pl.34.4"></a><var>34.4</var>(4) recommendations for managing financial risk within a coordinated care delivery <br/>
<a id="pl.34.5"></a><var>34.5</var>organization.<br/>
<br/>
<a id="bill.2.0.0"></a>

<a id="bill.2.1.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.34.8"></a><var>34.8</var><br/>
</td>
<td colspan="7">Section 1. <b>HEALTH AND HUMAN SERVICES APPROPRIATION.</b><br/>
</td>
</tr>
</table><a id="pl.34.9"></a><var>34.9</var>The sums shown in the columns marked "Appropriations" are added to or, if shown <br/>
<a id="pl.34.10"></a><var>34.10</var>in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, as amended <br/>
<a id="pl.34.11"></a><var>34.11</var>by Laws 2009, chapter 173, or other law to the agencies and for the purposes specified in <br/>
<a id="pl.34.12"></a><var>34.12</var>this article. The appropriations are from the general fund, or another named fund, and are <br/>
<a id="pl.34.13"></a><var>34.13</var>available for the fiscal years indicated for each purpose. The figures "2010" and "2011" <br/>
<a id="pl.34.14"></a><var>34.14</var>used in this article mean that the addition to or subtraction from appropriations listed under <br/>
<a id="pl.34.15"></a><var>34.15</var>them are available for the fiscal year ending June 30, 2010, or June 30, 2011, respectively. <br/>
<a id="pl.34.16"></a><var>34.16</var>"The first year" is fiscal year 2010. "The second year" is fiscal year 2011. "The biennium" <br/>
<a id="pl.34.17"></a><var>34.17</var>is fiscal years 2010 and 2011. Supplemental appropriations and reductions for the fiscal <br/>
<a id="pl.34.18"></a><var>34.18</var>year ending June 30, 2010, are effective the day following final enactment.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.34.19"></a><var>34.19</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>APPROPRIATIONS</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.34.20"></a><var>34.20</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>Available for the Year</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.34.21"></a><var>34.21</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>Ending June 30</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.34.22"></a><var>34.22</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td align="center"><b>2010</b><br/>
</td>
<td></td>
<td align="center"><b>2011</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.2.2.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.34.23"></a><var>34.23</var><br/>
</td>
<td align="left" colspan="3">Sec. 2. <b>HUMAN SERVICES</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.34.24"></a><var>34.24</var><br/>
</td>
<td align="left" colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(88,580,000)</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>27,041,000</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.34.25"></a><var>34.25</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.34.26"></a><var>34.26</var><br/>
</td>
<td align="left"></td>
<td align="center">2010<br/>
</td>
<td align="center">2011<br/>
</td>
</tr>
<tr>
<td><a id="pl.34.27"></a><var>34.27</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">(62,256,000)<br/>
</td>
<td align="right">(34,866,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.34.28"></a><var>34.28</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">(68,568,000)<br/>
</td>
<td align="right">(185,157,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.34.29"></a><var>34.29</var><br/>
</td>
<td align="left">Special Revenue <br/>
</td>
<td align="right">42,244,000<br/>
</td>
<td align="right">247,064,000<br/>
</td>
</tr>
</table><a id="pl.34.30"></a><var>34.30</var>The amounts that may be spent for each <br/>
<a id="pl.34.31"></a><var>34.31</var>purpose are specified in the following <br/>
<a id="pl.34.32"></a><var>34.32</var>subdivisions.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.34.33"></a><var>34.33</var><br/>
<a id="pl.34.34"></a><var>34.34</var><br/>
</td>
<td align="left" colspan="3">Subd. 2.<b>Children and Economic Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(9,939,000)<br/>
</td>
</tr>
</table><a id="pl.35.1"></a><var>35.1</var>The general fund appropriation to the <br/>
<a id="pl.35.2"></a><var>35.2</var>commissioner of human services for children <br/>
<a id="pl.35.3"></a><var>35.3</var>and community services grants in Laws <br/>
<a id="pl.35.4"></a><var>35.4</var>2009, chapter 79, article 13, section 3, <br/>
<a id="pl.35.5"></a><var>35.5</var>subdivision 4, as amended by Laws 2009, <br/>
<a id="pl.35.6"></a><var>35.6</var>chapter 173, article 2, section 1, subdivision <br/>
<a id="pl.35.7"></a><var>35.7</var>4, is reduced by $9,938,000 in fiscal year <br/>
<a id="pl.35.8"></a><var>35.8</var>2011. The general fund base for children <br/>
<a id="pl.35.9"></a><var>35.9</var>and community service grants is increased <br/>
<a id="pl.35.10"></a><var>35.10</var>by $9,938,000 per year for fiscal years 2012 <br/>
<a id="pl.35.11"></a><var>35.11</var>and 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.35.12"></a><var>35.12</var><br/>
<a id="pl.35.13"></a><var>35.13</var><br/>
</td>
<td align="left" colspan="3">Subd. 3.<b>Children and Economic Assistance </b><br/>
<b>Management</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.35.14"></a><var>35.14</var><br/>
</td>
<td align="left" colspan="3"><b>Children and Economic Assistance Operations</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.35.15"></a><var>35.15</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.35.16"></a><var>35.16</var><br/>
</td>
<td align="left">Special Revenue <br/>
</td>
<td align="right">29,000<br/>
</td>
<td align="right">-0-<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.35.17"></a><var>35.17</var><br/>
</td>
<td align="left" colspan="3">Subd. 4.<b>Basic Health Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.35.18"></a><var>35.18</var>The amounts that may be spent from this <br/>
<a id="pl.35.19"></a><var>35.19</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.35.20"></a><var>35.20</var><br/>
</td>
<td align="left" colspan="3"><b>(a) MinnesotaCare Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(68,569,000)<br/>
</td>
<td align="center"></td>
<td align="right">(185,157,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.35.21"></a><var>35.21</var><br/>
<a id="pl.35.22"></a><var>35.22</var><br/>
</td>
<td align="left" colspan="3"><b>(b) Medical Assistance Basic Health Care </b><br/>
<b>Grants - Families and Children</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(4,070,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.35.23"></a><var>35.23</var><br/>
<a id="pl.35.24"></a><var>35.24</var><br/>
</td>
<td align="left" colspan="3"><b>(c) Medical Assistance Basic Health Care </b><br/>
<b>Grants - Elderly and Disabled</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(6,470,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.35.25"></a><var>35.25</var><br/>
</td>
<td align="left" colspan="3"><b>(d) General Assistance Medical Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.35.26"></a><var>35.26</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.35.27"></a><var>35.27</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">(60,406,000)<br/>
</td>
<td align="right">-0-<br/>
</td>
</tr>
<tr>
<td><a id="pl.35.28"></a><var>35.28</var><br/>
</td>
<td align="left">Special Revenue<br/>
</td>
<td align="right">40,323,000<br/>
</td>
<td align="right">241,308,000<br/>
</td>
</tr>
</table><a id="pl.35.29"></a><var>35.29</var>For general assistance medical care grants <br/>
<a id="pl.35.30"></a><var>35.30</var>under Minnesota Statutes, section 256D.031. <br/>
<a id="pl.35.31"></a><var>35.31</var>The commissioner shall transfer $60,406,000 <br/>
<a id="pl.35.32"></a><var>35.32</var>on March 1, 2010, from the general fund to <br/>
<a id="pl.35.33"></a><var>35.33</var>the fund established in Minnesota Statutes, <br/>
<a id="pl.35.34"></a><var>35.34</var>section 256D.032. Any unexpended amount <br/>
<a id="pl.36.1"></a><var>36.1</var>not used for general assistance medical care <br/>
<a id="pl.36.2"></a><var>36.2</var>expenditures incurred before March 1, 2010, <br/>
<a id="pl.36.3"></a><var>36.3</var>does not cancel and shall be transferred to <br/>
<a id="pl.36.4"></a><var>36.4</var>the fund established in Minnesota Statutes, <br/>
<a id="pl.36.5"></a><var>36.5</var>section 256D.032, by January 1, 2011.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.36.6"></a><var>36.6</var><br/>
</td>
<td align="left" colspan="3">Subd. 5.<b>Health Care Management</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.36.7"></a><var>36.7</var>The amounts that may be spent from the <br/>
<a id="pl.36.8"></a><var>36.8</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.36.9"></a><var>36.9</var><br/>
</td>
<td align="left" colspan="3"><b>(a) Health Care Administration</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.36.10"></a><var>36.10</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.36.11"></a><var>36.11</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">(825,000)<br/>
</td>
<td align="right">(2,425,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.36.12"></a><var>36.12</var><br/>
</td>
<td align="left">Special Revenue<br/>
</td>
<td align="right">825,000<br/>
</td>
<td align="right">2,681,000<br/>
</td>
</tr>
</table><a id="pl.36.13"></a><var>36.13</var>$825,000 in fiscal year 2010 and $2,475,000 <br/>
<a id="pl.36.14"></a><var>36.14</var>in fiscal year 2011 from the special revenue <br/>
<a id="pl.36.15"></a><var>36.15</var>fund are for administration of the general <br/>
<a id="pl.36.16"></a><var>36.16</var>assistance medical care program under <br/>
<a id="pl.36.17"></a><var>36.17</var>Minnesota Statutes, section 256D.031. For <br/>
<a id="pl.36.18"></a><var>36.18</var>purposes of consistent cost allocation and <br/>
<a id="pl.36.19"></a><var>36.19</var>accounting, the commissioner may transfer <br/>
<a id="pl.36.20"></a><var>36.20</var>these amounts to the general fund. The <br/>
<a id="pl.36.21"></a><var>36.21</var>commissioner shall transfer $825,000 in <br/>
<a id="pl.36.22"></a><var>36.22</var>fiscal year 2010 and $2,475,000 in fiscal <br/>
<a id="pl.36.23"></a><var>36.23</var>year 2011 from the general fund to the fund <br/>
<a id="pl.36.24"></a><var>36.24</var>established in Minnesota Statutes, section <br/>
<a id="pl.36.25"></a><var>36.25</var>256D.032.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.36.26"></a><var>36.26</var><br/>
</td>
<td align="left" colspan="3"><b>(b) Health Care Operations</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.36.27"></a><var>36.27</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.36.28"></a><var>36.28</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">(1,025,000)<br/>
</td>
<td align="right">(3,075,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.36.29"></a><var>36.29</var><br/>
</td>
<td align="left">Special Revenue<br/>
</td>
<td align="right">1,067,000<br/>
</td>
<td align="right">3,075,000<br/>
</td>
</tr>
</table><a id="pl.36.30"></a><var>36.30</var>$1,025,000 in fiscal year 2010 and <br/>
<a id="pl.36.31"></a><var>36.31</var>$3,075,000 in fiscal year 2011 from the <br/>
<a id="pl.36.32"></a><var>36.32</var>special revenue fund are for operations of <br/>
<a id="pl.36.33"></a><var>36.33</var>the general assistance medical care program <br/>
<a id="pl.36.34"></a><var>36.34</var>under Minnesota Statutes, section 256D.031. <br/>
<a id="pl.36.35"></a><var>36.35</var>For purposes of consistent cost allocation <br/>
<a id="pl.37.1"></a><var>37.1</var>and accounting, the commissioner may <br/>
<a id="pl.37.2"></a><var>37.2</var>transfer these amounts to the general fund. <br/>
<a id="pl.37.3"></a><var>37.3</var>The commissioner shall transfer $1,025,000 <br/>
<a id="pl.37.4"></a><var>37.4</var>in fiscal year 2010 and $3,075,000 in fiscal <br/>
<a id="pl.37.5"></a><var>37.5</var>year 2011 from the general fund to the fund <br/>
<a id="pl.37.6"></a><var>37.6</var>established in Minnesota Statutes, section <br/>
<a id="pl.37.7"></a><var>37.7</var>256D.032.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.37.8"></a><var>37.8</var><br/>
</td>
<td align="left" colspan="3">Subd. 6.<b>Continuing Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.37.9"></a><var>37.9</var><br/>
</td>
<td align="left" colspan="3"><b>Mental Health Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(9,938,000)<br/>
</td>
</tr>
</table><a id="pl.37.10"></a><var>37.10</var>The general fund appropriation to the <br/>
<a id="pl.37.11"></a><var>37.11</var>commissioner of human services for adult <br/>
<a id="pl.37.12"></a><var>37.12</var>mental health grants in Laws 2009, chapter <br/>
<a id="pl.37.13"></a><var>37.13</var>79, article 13, section 3, subdivision 8, as <br/>
<a id="pl.37.14"></a><var>37.14</var>amended by Laws 2009, chapter 173, article <br/>
<a id="pl.37.15"></a><var>37.15</var>2, section 1, subdivision 8, is reduced by <br/>
<a id="pl.37.16"></a><var>37.16</var>$9,939,000 in fiscal year 2011. The general <br/>
<a id="pl.37.17"></a><var>37.17</var>fund base for adult mental health grants is <br/>
<a id="pl.37.18"></a><var>37.18</var>increased by $9,939,000 per year in fiscal <br/>
<a id="pl.37.19"></a><var>37.19</var>years 2012 and 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.37.20"></a><var>37.20</var><br/>
</td>
<td align="left" colspan="3">Subd. 7.<b>Continuing Care Management</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">1,051,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.37.21"></a><var>37.21</var><br/>
</td>
<td align="left" colspan="3">Subd. 8.<b>Transfers</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.37.22"></a><var>37.22</var>(a) The commissioner of management and <br/>
<a id="pl.37.23"></a><var>37.23</var>budget shall transfer $168,733,000 in fiscal <br/>
<a id="pl.37.24"></a><var>37.24</var>year 2011 and $12,979,000 in fiscal year <br/>
<a id="pl.37.25"></a><var>37.25</var>2012, from the general fund to the fund <br/>
<a id="pl.37.26"></a><var>37.26</var>established in Minnesota Statutes, section <br/>
<a id="pl.37.27"></a><var>37.27</var>256D.032.<br/>
<a id="pl.37.28"></a><var>37.28</var>(b) $19,877,000 shall be transferred in <br/>
<a id="pl.37.29"></a><var>37.29</var>fiscal year 2011 from the general fund to <br/>
<a id="pl.37.30"></a><var>37.30</var>the general assistance medical care account <br/>
<a id="pl.37.31"></a><var>37.31</var>established in Minnesota Statutes, section <br/>
<a id="pl.37.32"></a><var>37.32</var>256D.032.<br/>
<a id="pl.37.33"></a><var>37.33</var><b>EFFECTIVE DATE.</b>This article is effective March 1, 2010.<br/>