1.1 	A bill for an act
1.2 	relating to health; providing a statement of public policy declaring that every 
1.3 	resident of Minnesota has the freedom of choice in health care; making 
1.4 	appropriation adjustments in fiscal years 2010 and 2011;amending Minnesota 
1.5 	Statutes 2010, section 8.31, subdivision 1; Laws 2010, First Special Session 
1.6 	chapter 1, article 25, section 3, subdivisions 2, 5, 6, 7; proposing coding for 
1.7 	new law in Minnesota Statutes, chapter 1; repealing Minnesota Statutes 2010, 
1.8 	sections 256B.055, subdivision 15; 256B.0756; Laws 2010, First Special Session 
1.9 	chapter 1, article 16, sections 6; 7; 18; 46; 47.
1.10 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.11 	Section 1. [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.
1.12 		Subdivision 1.Citation. This section shall be known as and may be cited as the 
1.13 	"Freedom of Choice in Health Care Act."
1.14 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have 
1.15 	the meaning given them.
1.16 	(b) "Health care service" means any service, treatment, or provision of a product for 
1.17 	the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise 
1.18 	maintain or improve physical or mental health, subject to all laws and rules regulating 
1.19 	health service providers and products within the state of Minnesota.
1.20 	(c) "Mode of securing" means to purchase directly or on credit or by trade, or to 
1.21 	contract for third-party payment by insurance or other legal means as authorized by the 
1.22 	state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored 
1.23 	health care benefits under such conditions as may legally be required as a condition of 
1.24 	such benefits, or any combination of the same.
1.25 	(d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding, 
1.26 	surcharge, fee, or any other imposed consequence established by law or rule of a 
2.1 	government or its subdivision or agency that is used to punish or discourage the exercise 
2.2 	of rights protected under this section.
2.3 		Subd. 3.Statement of public policy. (a) The power to require or regulate a person's 
2.4 	choice in the mode of securing health care services, or to impose a penalty related to that 
2.5 	choice, is not found in the Constitution of the United States of America, and is therefore a 
2.6 	power reserved to the people pursuant to the Ninth Amendment, and to the several states 
2.7 	pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign 
2.8 	power to declare the public policy of the state of Minnesota regarding the right of all 
2.9 	persons residing in the state in choosing the mode of securing health care services.
2.10 	(b) It is hereby declared that the public policy of the state of Minnesota, consistent 
2.11 	with our constitutionally recognized and inalienable rights of liberty, is that every person 
2.12 	within the state of Minnesota is and shall be free to choose or decline to choose any mode 
2.13 	of securing health care services without penalty or threat of penalty.
2.14 	(c) The policy stated under this section shall not be applied to impair any right of 
2.15 	contract related to the provision of health care services to any person or group.
2.16 		Subd. 4.Enforcement. (a) No public official, employee, or agent of the state of 
2.17 	Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or 
2.18 	effectuate any penalty in the state of Minnesota that violates the public policy set forth 
2.19 	in this section.
2.20 	(b) The attorney general shall take any action as is provided in this section or section 
2.21 	8.31 in the defense or prosecution of rights protected under this section.

2.22 	Sec. 2. Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:
2.23 		Subdivision 1.Investigate offenses against provisions of certain designated 
2.24 	sections; assist in enforcement. (a) The attorney general shall investigate violations of the 
2.25 	law of this state respecting unfair, discriminatory, and other unlawful practices in business, 
2.26 	commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act 
2.27 	(sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition 
2.28 	(sections 325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to 
2.29 	325D.16), the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other 
2.30 	laws against false or fraudulent advertising, the antidiscrimination acts contained in 
2.31 	section 325D.67, the act against monopolization of food products (section 325D.68), 
2.32 	the act regulating telephone advertising services (section 325E.39), the Prevention of 
2.33 	Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency 
2.34 	exchanges and assist in the enforcement of those laws as in this section provided. 
3.1 	(b) The attorney general shall seek injunctive and any other appropriate relief as 
3.2 	expeditiously as possible to preserve the rights and property of the residents of Minnesota, 
3.3 	and to defend as necessary the state of Minnesota, its officials, employees, and agents in 
3.4 	the event that any law or regulation violating the public policy set forth in the Freedom 
3.5 	of Choice in Health Care Act in this section is enacted by any government, subdivision, 
3.6 	or agency thereof.
3.7 	(c) The attorney general shall seek injunctive and any other appropriate relief 
3.8 	as expeditiously as possible in the event that any law or regulation violating the public 
3.9 	policy set forth in the Freedom of Choice in Health Care Act in this section is enacted 
3.10 	without adequate federal funding to the state to ensure affordable health care coverage 
3.11 	is available to the residents of Minnesota.

3.12 	Sec. 3. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 2, 
3.13 	is amended to read:

3.14	Subd. 2.Agency Management 

3.15	(a)  Financial Operations
		-0-
		103,000
	
3.16 	Base Adjustment. The general fund base is 
3.17 	decreased by $10,000 in fiscal year 2012 and 
3.18 	$10,000 in fiscal year 2013.

3.19	(b) Legal and Regulatory Operations
		-0-
		114,000
	
3.20 	Base Adjustment. The general fund base is 
3.21 	decreased by $18,000 in fiscal year 2012 and 
3.22 	$18,000 in fiscal year 2013.

3.23	(c) (b)  Management Operations
		-0-
		(114,000)
	
3.24 	Base Adjustment. The general fund base is 
3.25 	increased by $18,000 in fiscal year 2012 and 
3.26 	$18,000 in fiscal year 2013.

3.27	(d) (c) Information Technology Operations
		-0-
		(2,500,000)
	
3.28 	Base Adjustment. The general fund base is 
3.29 	decreased by $1,666,000 in fiscal year 2012 
3.30 	and $1,666,000 in fiscal year 2013.

3.31 	Sec. 4. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 5, 
3.32 	is amended to read:

4.1
4.2	Subd. 5.Children and Economic Assistance 
Management

4.3
4.4	(a) Children and Economic Assistance 
Administration
		-0-
		-0-
	
4.5 	Base Adjustment. The federal TANF fund 
4.6 	base is decreased by $700,000 in fiscal year 
4.7 	2012 and $700,000 in fiscal year 2013.

4.8
4.9	(b) Children and Economic Assistance 
Operations
		-0-
		195,000 90,000
	
4.10 	Base Adjustment. The general fund base 
4.11 	is decreased increased  by $12,000 $93,000 
4.12 	 in fiscal year 2012 and $12,000 $93,000  in 
4.13 	fiscal year 2013.

4.14 	Sec. 5. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 6, 
4.15 	is amended to read:

4.16	Subd. 6.Health Care Grants

4.17	(a) MinnesotaCare Grants
		998,000
		(13,376,000)
	
4.18 	This appropriation is from the health care 
4.19 	access fund.
4.20 	Health Care Access Fund Transfer to 
4.21 	General Fund. The commissioner of 
4.22 	management and budget shall transfer 
4.23 	the following amounts in the following 
4.24 	years from the health care access fund to 
4.25 	the general fund: $998,000 in fiscal year 
4.26 	2010; $176,704,000 in fiscal year 2011; 
4.27 	$141,041,000 in fiscal year 2012; and 
4.28 	$286,150,000 in fiscal year 2013. If at any 
4.29 	time the governor issues an executive order 
4.30 	not to participate in early medical assistance 
4.31 	expansion, no funds shall be transferred from 
4.32 	the health care access fund to the general 
4.33 	fund until early medical assistance expansion 
5.1 	takes effect. This paragraph is effective the 
5.2 	day following final enactment.
5.3 	MinnesotaCare Ratable Reduction.
5.4 	Effective for services rendered on or after 
5.5 	July 1, 2010, to December 31, 2013, 
5.6 	MinnesotaCare payments to managed care 
5.7 	plans under Minnesota Statutes, section 
5.8 	256L.12, for single adults and households 
5.9 	without children whose income is greater 
5.10 	than 75 percent of federal poverty guidelines 
5.11 	shall be reduced by 15 percent. Effective 
5.12 	for services provided from July 1, 2010, to 
5.13 	June 30, 2011, this reduction shall apply to 
5.14 	all services. Effective for services provided 
5.15 	from July 1, 2011, to December 31, 2013, this 
5.16 	reduction shall apply to all services except 
5.17 	inpatient hospital services. Notwithstanding 
5.18 	any contrary provision of this article, this 
5.19 	paragraph shall expire on December 31, 
5.20 	2013.

5.21
5.22	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		295,512,000
	
5.23 	Critical Access Dental. Of the general 
5.24 	fund appropriation, $731,000 in fiscal year 
5.25 	2011 is to the commissioner for critical 
5.26 	access dental provider reimbursement 
5.27 	payments under Minnesota Statutes, section 
5.28 	256B.76 subdivision 4. This is a onetime 
5.29 	appropriation.
5.30 	Nonadministrative Rate Reduction. For 
5.31 	services rendered on or after July 1, 2010, 
5.32 	to December 31, 2013, the commissioner 
5.33 	shall reduce contract rates paid to managed 
5.34 	care plans under Minnesota Statutes, 
5.35 	sections 256B.69 and 256L.12, and to 
5.36 	county-based purchasing plans under 
6.1 	Minnesota Statutes, section 256B.692, by 
6.2 	three percent of the contract rate attributable 
6.3 	to nonadministrative services in effect on 
6.4 	June 30, 2010. Notwithstanding any contrary 
6.5 	provision in this article, this rider expires on 
6.6 	December 31, 2013.

6.7
6.8	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		(30,265,000)

6.9	(d) General Assistance Medical Care Grants
		-0-
		(75,389,000)

6.10	(e) Other Health Care Grants
		-0-
		(7,000,000)
	
6.11 	Cobra Carryforward. Unexpended funds 
6.12 	appropriated in fiscal year 2010 for COBRA 
6.13 	grants under Laws 2009, chapter 79, article 
6.14 	5, section 78, do not cancel and are available 
6.15 	to the commissioner for fiscal year 2011 
6.16 	COBRA grant expenditures. Up to $111,000 
6.17 	of the fiscal year 2011 appropriation for 
6.18 	COBRA grants provided in Laws 2009, 
6.19 	chapter 79, article 13, section 3, subdivision 
6.20 	6, may be used by the commissioner for costs 
6.21 	related to administration of the COBRA 
6.22 	grants.

6.23 	Sec. 6. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 7, 
6.24 	is amended to read:

6.25	Subd. 7.Health Care Management

6.26	(a) Health Care Administration
		-0-
		391,000 224,000
	
6.27 	Fiscal Note Report. Of this appropriation, 
6.28 	$50,000 in fiscal year 2011 is for a transfer to 
6.29 	the commissioner of Minnesota Management 
6.30 	and Budget for the completion of the human 
6.31 	services fiscal note report in article 5.
6.32 	PACE Implementation Funding. For fiscal 
6.33 	year 2011, $145,000 is appropriated from 
7.1 	the general fund to the commissioner of 
7.2 	human services to complete the actuarial and 
7.3 	administrative work necessary to begin the 
7.4 	operation of PACE under Minnesota Statutes, 
7.5 	section 256B.69, subdivision 23, paragraph 
7.6 	(e). Base level funding for this activity shall 
7.7 	be $130,000 in fiscal year 2012 and $0 in 
7.8 	fiscal year 2013.
7.9 	Minnesota Senior Health Options 
7.10 	Reimbursement. Effective July 1, 2011, 
7.11 	federal administrative reimbursement 
7.12 	resulting from the Minnesota senior 
7.13 	health options project is appropriated 
7.14 	to the commissioner for this activity. 
7.15 	Notwithstanding any contrary provision, this 
7.16 	provision expires June 30, 2013.
7.17 	Utilization Review. Effective July 1, 
7.18 	2011, federal administrative reimbursement 
7.19 	resulting from prior authorization and 
7.20 	inpatient admission certification by a 
7.21 	professional review organization shall be 
7.22 	dedicated to, and is appropriated to, the 
7.23 	commissioner for these activities. A portion 
7.24 	of these funds must be used for activities 
7.25 	to decrease unnecessary pharmaceutical 
7.26 	costs in medical assistance. Notwithstanding 
7.27 	any contrary provision of this article, this 
7.28 	paragraph expires June 30, 2013.
7.29 	Certified Public Expenditures. (1) The 
7.30 	entities named in Minnesota Statutes, section 
7.31 	256B.199, paragraph (b), clause (1), shall 
7.32 	comply with the requirements of that statute 
7.33 	by promptly reporting on a quarterly basis 
7.34 	certified public expenditures that may qualify 
7.35 	for federal matching funds. Reporting under 
8.1 	this paragraph shall be voluntary from July 1, 
8.2 	2010, to December 31, 2010. Upon federal 
8.3 	enactment of an extension to June 30, 2011, 
8.4 	of the enhanced federal medical assistance 
8.5 	percentage (FMAP) originally provided 
8.6 	under Public Law 111-5, reporting under 
8.7 	this paragraph shall also be voluntary from 
8.8 	January 1, 2011, to June 30, 2011.
8.9 	(2) To the extent that certified public 
8.10 	expenditures reported in compliance 
8.11 	with paragraph (1) earn federal matching 
8.12 	payments that exceed $8,079,000 in fiscal 
8.13 	year 2012 and $18,316,000 in fiscal year 
8.14 	2013, the excess amount shall be deposited 
8.15 	in the health care access fund. For each fiscal 
8.16 	year after fiscal year 2013, the commissioner 
8.17 	shall forecast in November the amount 
8.18 	of federal payments anticipated to match 
8.19 	certified public expenditures reported in 
8.20 	compliance with paragraph (a). Any federal 
8.21 	match earned in a fiscal year in excess of 
8.22 	the amount forecasted in November shall be 
8.23 	deposited to the health care access fund.
8.24 	(3) Notwithstanding any contrary provision 
8.25 	of this article, this rider shall not expire.
8.26 	Poverty Guidelines. Notwithstanding 
8.27 	Minnesota Statutes, sections 256B.56, 
8.28 	subdivision 1c; 256D.03, subdivision 3; 
8.29 	or 256L.04, subdivision 7b, the poverty 
8.30 	guidelines for medical assistance, general 
8.31 	assistance medical care, and MinnesotaCare 
8.32 	from July 1, 2010, through June 30, 2011, 
8.33 	shall not be lower than the poverty guidelines 
8.34 	issued by the Secretary of Health and Human 
8.35 	Services on January 23, 2009. This section 
9.1 	shall have no effect on the revision of poverty 
9.2 	guidelines for the Minnesota health care 
9.3 	programs that would be in effect starting on 
9.4 	July 1, 2011. This paragraph is effective the 
9.5 	day following final enactment.
9.6 	Base Adjustment. The general fund base 
9.7 	is decreased by $222,000 $55,000  in fiscal 
9.8 	year 2012 and $352,000 $185,000  in fiscal 
9.9 	year 2013.

9.10	(b) Health Care Operations

9.11	Appropriations by Fund
	
9.12
9.13	General
	-0-
	186,000
27,000
	
9.14
9.15	Health Care Access
	-0-
	218,000
 291,000
	
9.16 	The general fund appropriation is a onetime 
9.17 	appropriation in fiscal year 2011.
9.18 	Base Adjustment. The health care access 
9.19 	fund base for health care operations is 
9.20 	decreased by $812,000 $280,000  in fiscal 
9.21 	year 2012 and $944,000 $274,000  in fiscal 
9.22 	year 2013.

9.23 	Sec. 7.  REPEALER.
 9.24 	(a) Minnesota Statutes 2010, sections 256B.055, subdivision 15; and 256B.0756, are 
9.25 	repealed.
9.26 	(b) Laws 2010, First Special Session chapter 1, article 16, sections 6; 7; 18; 46; 
9.27 	and 47, are repealed.

9.28 	EFFECTIVE DATE. This section is effective February 28, 2011.