SF 542

Introduction - 87th Legislature (2011 - 2012)

Posted on 06/06/2012 11:04 a.m.

A bill for an act
relating to human services; requiring patient-centered decision-making process
before certain procedures are reimbursed under medical assistance; proposing
coding for new law in Minnesota Statutes, chapter 256B.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [256B.768] PATIENT-CENTERED DECISION MAKING.
new text end

new text begin (a) Effective January 1, 2012, the commissioner shall require active participation in
a patient-centered decision-making process before authorization is approved or payment
reimbursement is provided for the following:
new text end

new text begin (1) a surgical procedure for the following conditions: abnormal uterine bleeding,
benign prostate enlargement, chronic back pain, early stage breast and prostate cancers,
gastroesophageal reflux disease, hemorrhoids, spinal stenosis, temporomandibular joint
dysfunction, ulcerative colitis, urinary incontinence, uterine fibroids, or varicose veins; or
new text end

new text begin (2) bypass surgery for coronary disease, angioplasty for stable coronary artery
disease, and total hip replacement.
new text end

new text begin (b) A list of these procedures shall be published in the State Register by October
1, 2011. The list shall be reviewed no less than every two years by the commissioner, in
consultation with the commissioner of health. The commissioner, in consultation with the
Health Services Policy Committee under section 256B.0625, subdivision 3c, may include
additional preference-sensitive procedures for which the clinical evidence does not clearly
support one treatment option over another and the appropriate course of treatment depends
on the values and preferences of the patient. The commissioner shall hold a public forum
and receive public comment prior to any changes to the list provided in paragraph (a).
Any changes made shall be published in the State Register.
new text end

new text begin (c) Prior to receiving authorization or reimbursement for the procedures identified
under this section, a health care provider must certify that the patient has participated in
a patient-centered decision-making process. The format for this certification and the
process for coordination between providers shall be developed by the Health Services
Policy Committee.
new text end

new text begin (d) For purposes of this section, "patient-centered decision making" means a process
that involves directed interaction between a health care professional and the patient or
the patient's legal representative to assist the patient in understanding the patient's health
condition, available treatment options, and the benefits and harms of each option, and in
deciding what treatment is best for the patient based on the patient's circumstances, values,
and preferences. The interaction may be conducted by a health care provider or through
the use of patient decision aids, or both.
new text end

new text begin (e) For purposes of this section, "patient decision aid" means a written, audiovisual,
or online tool that provides a balanced presentation of the condition or treatment options,
benefits, and harms, and is certified by one or more national certifying organizations
or meets the certification requirements established under the Patient Protection and
Affordable Care Act, Public Law 111-148, section 3506.
new text end

new text begin (f) This section does not apply if any of the procedures identified in this section are
performed under an emergency situation.
new text end

Sec. 2. new text begin SHARED DECISION-MAKING RESOURCE CENTER.
new text end

new text begin (a) The commissioner of human services shall pursue a grant under the Patient
Protection and Affordable Care Act, Public Law 111-148, for the establishment and
support of a shared decision-making resource center to provide technical assistance to
providers and to develop and disseminate best practices and the information to support
and accelerate to adoption of patient decision aids and shared decision making.
new text end

new text begin (b) If a shared decision-making resource center is established, the resource center
shall review the procedures listed in Minnesota Statutes, section 256B.768, and make
recommendations to the commissioner on procedures that should be included in the list.
new text end