1.1 	A bill for an act
1.2 	relating to human services; modifying policy provisions governing health care; 
1.3 	specifying when a provider must furnish requested medical records; modifying 
1.4 	x-ray equipment provisions; requiring an annual unannounced inspection of medical 
1.5 	cannabis manufacturers; modifying eligibility for the reduced patient enrollment 
1.6 	fee for the medical cannabis program; permitting licensed physician assistants to 
1.7 	practice without a delegation agreement; modifying licensed traditional midwifery 
1.8 	scope of practice; modifying the request for proposal for a central drug repository; 
1.9 	authorizing pharmacists to prescribe self-administered hormonal contraceptives, 
1.10 	nicotine replacement medications, and opiate antagonists; allowing telemedicine 
1.11 	examinations to be used to prescribe medications for erectile dysfunction and for 
1.12 	the treatment of substance abuse disorders; changing the terminology and other 
1.13 	technical changes to the opiate epidemic response account and council; adding 
1.14 	advanced practice registered nurses to certain statutes; modifying definitions; 
1.15 	reclassifying certain controlled substances; modifying certain provisions related 
1.16 	to medical cannabis;amending Minnesota Statutes 2018, sections 62A.307, 
1.17 	subdivision 2; 62D.09, subdivision 1; 62E.06, subdivision 1; 62J.17, subdivision 
1.18 	4a; 62J.495, subdivision 1a; 62J.52, subdivision 2; 62J.823, subdivision 3; 62Q.43, 
1.19 	subdivisions 1, 2; 62Q.54; 62Q.57, subdivision 1; 62Q.73, subdivision 7; 62Q.733, 
1.20 	subdivision 3; 62Q.74, subdivision 1; 62S.08, subdivision 3; 62S.20, subdivision 
1.21 	5b; 62S.21, subdivision 2; 62S.268, subdivision 1; 62U.03; 62U.04, subdivision 
1.22 	11; 144.121, subdivisions 1, 2, 5, by adding subdivisions; 144.292, subdivisions 
1.23 	2, 5; 144.3345, subdivision 1; 144.3352; 144.34; 144.441, subdivisions 4, 5; 
1.24 	144.442, subdivision 1; 144.4803, subdivisions 1, 4, 10, by adding a subdivision; 
1.25 	144.4806; 144.4807, subdivisions 1, 2, 4; 144.50, subdivision 2; 144.55, subdivision 
1.26 	6; 144.6501, subdivision 7; 144.651, subdivisions 7, 8, 9, 10, 12, 14, 31, 33; 
1.27 	144.652, subdivision 2; 144.69; 144.7402, subdivision 2; 144.7406, subdivision 
1.28 	2; 144.7407, subdivision 2; 144.7414, subdivision 2; 144.7415, subdivision 2; 
1.29 	144.9502, subdivision 4; 144.966, subdivisions 3, 6; 144A.135; 144A.161, 
1.30 	subdivisions 5, 5a, 5e, 5g; 144A.75, subdivisions 3, 6; 144A.752, subdivision 1; 
1.31 	145.853, subdivision 5; 145.892, subdivision 3; 145.94, subdivision 2; 145B.13; 
1.32 	145C.02; 145C.06; 145C.07, subdivision 1; 145C.16; 147A.01, subdivisions 3, 
1.33 	21, 26, 27, by adding a subdivision; 147A.02; 147A.03, by adding a subdivision; 
1.34 	147A.05; 147A.09; 147A.13, subdivision 1; 147A.14, subdivision 4; 147A.16; 
1.35 	147A.23; 147D.03, subdivision 2; 148.6438, subdivision 1; 151.01, by adding a 
1.36 	subdivision; 151.071, subdivision 8; 151.19, subdivision 4; 151.21, subdivision 
1.37 	4a; 151.37, subdivision 2, by adding subdivisions; 152.02, subdivisions 2, 3, 4; 
1.38 	152.12, subdivision 1; 152.32, subdivision 3; 152.35; 245A.143, subdivision 8; 
2.1 	245A.1435; 245C.02, subdivision 18; 245C.04, subdivision 1; 245D.02, subdivision 
2.2 	11; 245D.11, subdivision 2; 245D.22, subdivision 7; 245D.25, subdivision 2; 
2.3 	245G.08, subdivisions 2, 5; 245G.21, subdivisions 2, 3; 246.711, subdivision 2; 
2.4 	246.715, subdivision 2; 246.716, subdivision 2; 246.721; 246.722; 251.043, 
2.5 	subdivision 1; 252A.02, subdivision 12; 252A.04, subdivision 2; 252A.20, 
2.6 	subdivision 1; 253B.03, subdivisions 4, 6d; 253B.06, subdivision 2; 253B.23, 
2.7 	subdivision 4; 254A.08, subdivision 2; 256.01, subdivision 29; 256.9685, 
2.8 	subdivisions 1a, 1b, 1c; 256.975, subdivisions 7a, 11; 256B.04, subdivision 14a; 
2.9 	256B.043, subdivision 2; 256B.055, subdivision 12; 256B.056, subdivisions 1a, 
2.10 	4, 7, 10; 256B.0561, subdivision 2; 256B.057, subdivisions 1, 10; 256B.0575, 
2.11 	subdivisions 1, 2; 256B.0622, subdivision 2b; 256B.0623, subdivision 2; 
2.12 	256B.0625, subdivisions 1, 12, 13h, 26, 27, 28, 64; 256B.0654, subdivisions 1, 
2.13 	2a, 3, 4; 256B.0659, subdivisions 2, 4, 8; 256B.0751; 256B.0753, subdivision 1; 
2.14 	256B.69, by adding a subdivision; 256B.73, subdivision 5; 256B.75; 256J.08, 
2.15 	subdivision 73a; 256L.03, subdivision 1; 256L.15, subdivision 1; 256R.54, 
2.16 	subdivisions 1, 2; 257.63, subdivision 3; 257B.01, subdivisions 3, 9, 10; 257B.06, 
2.17 	subdivision 7; 446A.081, subdivision 9; Minnesota Statutes 2019 Supplement, 
2.18 	sections 16A.151, subdivision 2; 62J.23, subdivision 2; 62Q.184, subdivision 1; 
2.19 	144.121, subdivisions 1a, 5a; 144.55, subdivision 2; 145C.05, subdivision 2; 
2.20 	147A.06; 151.01, subdivisions 23, 27; 151.065, subdivisions 1, as amended, 3, as 
2.21 	amended, 6, 7, as amended; 151.071, subdivision 2; 151.19, subdivision 3; 151.252, 
2.22 	subdivision 1; 151.555, subdivision 3; 152.29, subdivision 1; 245G.08, subdivision 
2.23 	3; 245H.11; 256.042, subdivisions 2, 4; 256.043; 256B.056, subdivision 7a; 
2.24 	256B.0625, subdivisions 13, 17, 60a; 256B.0659, subdivision 11; 256B.0913, 
2.25 	subdivision 8; 256R.44; Laws 2019, chapter 63, article 3, sections 1; 2; Laws 2019, 
2.26 	First Special Session chapter 9, article 11, section 35; Laws 2020, chapter 73, 
2.27 	section 4, subdivisions 3, 4; proposing coding for new law in Minnesota Statutes, 
2.28 	chapters 62Q; 147A; repealing Minnesota Statutes 2018, sections 62U.15, 
2.29 	subdivision 2; 144.121, subdivisions 3, 5b; 147A.01, subdivisions 4, 11, 16a, 17a, 
2.30 	24, 25; 147A.04; 147A.10; 147A.11; 147A.18, subdivisions 1, 2, 3; 147A.20; 
2.31 	256B.057, subdivision 8; 256B.0752; 256L.04, subdivision 13; Minnesota Rules, 
2.32 	parts 7380.0280; 9505.0365, subpart 3.
2.33 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.34 	ARTICLE 1
2.35 	DEPARTMENT OF HEALTH

2.36 	Section 1. Minnesota Statutes 2018, section 144.121, subdivision 1, is amended to read:
2.37 		Subdivision 1.Registration; fees. The fee for the registration for x-ray machines
2.38 	equipment and other sources of ionizing radiation required to be registered under rules 
2.39 	adopted by the state commissioner of health pursuant to section 144.12, shall be in an amount 
2.40 	as described in subdivision 1a pursuant to section 144.122. The registration shall expire and 
2.41 	be renewed as prescribed by the commissioner pursuant to section 144.122.

2.42 	Sec. 2. Minnesota Statutes 2019 Supplement, section 144.121, subdivision 1a, is amended 
2.43 	to read:
2.44 		Subd. 1a.Fees for ionizing radiation-producing equipment. (a) A facility with ionizing 
2.45 	radiation-producing equipment and other sources of ionizing radiation must pay an annual
3.1 	initial or annual renewal registration fee consisting of a base facility fee of $100 and an 
3.2 	additional fee for each radiation source x-ray tube, as follows:

3.3	(1)
	medical or veterinary equipment
	$
	100
		
3.4	(2)
	dental x-ray equipment
	$
	40
		
3.53.6	(3)
	x-ray equipment not used on 
humans or animals
	$
	100
		
3.73.8
3.9	(4)
	devices with sources of ionizing 
radiation not used on humans or 
animals
	$
	100
		
3.10	(5)
	security screening system
	$
	100
		
3.11 	(b) A facility with radiation therapy and accelerator equipment must pay an initial or 
3.12 	annual registration fee of $500. A facility with an industrial accelerator must pay an initial 
3.13 	or annual registration fee of $150.
3.14 	(c) Electron microscopy equipment is exempt from the registration fee requirements of 
3.15 	this section.
3.16 	(d) For purposes of this section, a security screening system means ionizing 
3.17 	radiation-producing equipment designed and used for security screening of humans who 
3.18 	are in the custody of a correctional or detention facility, and used by the facility to image 
3.19 	and identify contraband items concealed within or on all sides of a human body. For purposes 
3.20 	of this section, a correctional or detention facility is a facility licensed under section 241.021
3.21 	and operated by a state agency or political subdivision charged with detection, enforcement, 
3.22 	or incarceration in respect to state criminal and traffic laws.

3.23 	Sec. 3. Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to 
3.24 	read:
3.25 		Subd. 1d.Handheld dental x-ray equipment. A facility that uses handheld dental x-ray 
3.26 	equipment according to section 144.1215 must comply with this section.

3.27 	Sec. 4. Minnesota Statutes 2018, section 144.121, subdivision 2, is amended to read:
3.28 		Subd. 2.Inspections. Periodic radiation safety inspections of the x-ray equipment and 
3.29 	other sources of ionizing radiation shall be made by the state commissioner of health. The 
3.30 	frequency of safety inspections shall be prescribed by the commissioner on the basis of the 
3.31 	frequency of use of the x-ray equipment and other source of ionizing radiation;, provided 
3.32 	that each source shall be inspected at least once every four years.

4.1 	Sec. 5. Minnesota Statutes 2018, section 144.121, subdivision 5, is amended to read:
4.2 		Subd. 5.Examination for individual operating x-ray equipment systems. (a) After 
4.3 	January 1, 2008, An individual in a facility with x-ray equipment systems for use on living 
4.4 	humans that is registered under subdivision 1 may not operate, nor may the facility allow 
4.5 	the individual to operate, x-ray equipment systems unless the individual has passed a national 
4.6 	or state examination for limited x-ray machine operators that meets the requirements of 
4.7 	paragraphs (b) and (c) and is approved by the commissioner of health.
4.8 	(b) The commissioner shall establish criteria for the approval of examinations based on 
4.9 	national standards, such as the examination in radiography from the American Registry of 
4.10 	Radiologic Technologists, the examination for limited scope of practice in radiography from 
4.11 	the American Registry of Radiologic Technologists for limited x-ray machine operators, 
4.12 	and the American Registry of Chiropractic Radiography Technologists for limited 
4.13 	radiography in spines and extremities; or equivalent examinations approved by other states. 
4.14 	Equivalent examinations may be approved by the commissioner, if the examination is 
4.15 	consistent with the standards for educational and psychological testing as recommended by 
4.16 	the American Education Research Association, the American Psychological Association, 
4.17 	the National Council on Measurement in Education, or the National Commission for 
4.18 	Certifying Agencies. The organization proposing the use of an equivalent examination shall 
4.19 	submit a fee to the commissioner of $1,000 per examination to cover the cost of determining 
4.20 	the extent to which the examination meets the examining standards. The collected fee shall 
4.21 	be deposited in the state treasury and credited to the state government special revenue fund.
4.22 	(b) Individuals who may operate x-ray systems include:
4.23 	(1) an individual who has passed the American Registry of Radiologic Technologists 
4.24 	(ARRT) registry for radiography examination;
4.25 	(2) an individual who has passed the American Chiropractic Registry of Radiologic 
4.26 	Technologists (ACRRT) registry examination and is limited to radiography of spines and 
4.27 	extremities;
4.28 	(3) a registered limited scope x-ray operator and a registered bone densitometry equipment 
4.29 	operator who passed the examination requirements in paragraphs (d) and (e) and practices 
4.30 	according to subdivision 5a;
4.31 	(4) an x-ray operator who has the original certificate or the original letter of passing the 
4.32 	examination that was required before January 1, 2008, under Minnesota Statutes 2008, 
4.33 	section 144.121, subdivision 5a, paragraph (b), clause (1);
5.1 	(5) an individual who has passed the American Registry of Radiologic Technologists 
5.2 	(ARRT) registry for radiation therapy examination according to subdivision 5e;
5.3 	(6) a cardiovascular technologist according to subdivision 5c;
5.4 	(7) a nuclear medicine technologist according to subdivision 5d;
5.5 	(8) an individual who has passed the examination for a dental hygienist under section 
5.6 	150A.06 and only operates dental x-ray systems;
5.7 	(9) an individual who has passed the examination for a dental therapist under section 
5.8 	150A.06 and only operates dental x-ray systems;
5.9 	(10) an individual who has passed the examination for a dental assistant under section 
5.10 	150A.06, and only operates dental x-ray systems;
5.11 	(11) an individual who has passed the examination under Minnesota Rules, part 
5.12 	3100.8500, subpart 3, and only operates dental x-ray systems; and
5.13 	(12) a qualified practitioner who is licensed by a health-related licensing board with 
5.14 	active practice authority and is working within the practitioner's scope of practice.
5.15 	(c) Except for individuals under clauses (3) and (4), an individual who is participating 
5.16 	in a training or educational program in any of the occupations listed in paragraph (b) is 
5.17 	exempt from the examination requirement within the scope and for the duration of the 
5.18 	training or educational program.
5.19 	(c) (d) The Minnesota examination for limited scope x-ray machine operators must 
5.20 	include:
5.21 	(1) radiation protection, radiation physics and radiobiology, equipment maintenance and
5.22 	operation and quality assurance, image production acquisition and technical evaluation, and 
5.23 	patient care interactions and management; and
5.24 	(2) at least one of the following regions of the human anatomy: chest, extremities, skull 
5.25 	and sinus, spine, or ankle and foot podiatry. The examinations must include the anatomy 
5.26 	of, and positioning radiographic positions and projections for, the specific regions.
5.27 	(e) The examination for bone densitometry equipment operators must include:
5.28 	(1) osteoporosis, bone physiology, bone health and patient education, patient preparation, 
5.29 	fundamental principals, biological effects of radiation, units of measurements, radiation 
5.30 	protection in bone densitometry, fundamentals of x-ray production, quality control, measuring 
5.31 	bone mineral testing, determining quality in bone mineral testing, file and database 
5.32 	management; and
6.1 	(2) dual x-ray absorptiometry scanning of the lumbar spine, proximal femur, and forearm. 
6.2 	The examination must include the anatomy, scan acquisition, and scan analysis for these 
6.3 	three procedures.
6.4 	(d) (f) A limited scope x-ray operator, and a bone densitometry equipment operator,
6.5 	who is are required to take an examination under this subdivision must submit to the 
6.6 	commissioner an a registration application for the examination, and a $25 processing fee, 
6.7 	and the required examination fee set by the national organization offering the examination. 
6.8 	The processing fee and the examination fee shall be deposited in the state treasury and 
6.9 	credited to the state government special revenue fund. The commissioner shall submit the 
6.10 	fee to the national organization providing the examination.

6.11 	Sec. 6. Minnesota Statutes 2019 Supplement, section 144.121, subdivision 5a, is amended 
6.12 	to read:
6.13 		Subd. 5a.Limited scope x-ray machine and bone densitometry equipment operator 
6.14 	practice. (a) A registered limited scope x-ray operator and a registered bone densitometry 
6.15 	equipment operator may only practice medical radiography on limited regions of the human 
6.16 	anatomy for which the operator has successfully passed an examination identified in 
6.17 	subdivision 5, unless the operator meets one of the exemptions described in paragraph (b). 
6.18 	The operator may practice using only routine radiographic procedures, for the interpretation 
6.19 	by and under the direction of a qualified practitioner, excludingparagraphs (d) and (e) and 
6.20 	may not operate computed tomography, cone beam computed tomography, the use of contrast 
6.21 	media, and the use of fluoroscopic or mammographic equipment x-ray systems.
6.22 	(b) This subdivision does not apply to:
6.23 	(1) limited x-ray machine operators who passed the examination that was required before 
6.24 	January 1, 2008;
6.25 	(2) certified radiologic technologists, licensed dental hygienists, registered dental 
6.26 	assistants, certified registered nurse anesthetists, and registered physician assistants;
6.27 	(3) individuals who are licensed in Minnesota to practice medicine, osteopathic medicine, 
6.28 	chiropractic, podiatry, or dentistry;
6.29 	(4) individuals who are participating in a training course in any of the occupations listed 
6.30 	in clause (2), (3), or (5) for the duration and within the scope of the training course; and
6.31 	(5) cardiovascular technologists who assist with the operation of fluoroscopy equipment 
6.32 	if they:
7.1 	(i) are credentialed by Cardiovascular Credentialing International as a registered 
7.2 	cardiovascular invasive specialist or as a registered cardiac electrophysiology specialist, 
7.3 	are a graduate of an education program accredited by the Commission on Accreditation of 
7.4 	Allied Health Education Programs, which uses the standards and criteria established by the 
7.5 	Joint Review Committee on Education in Cardiovascular Technology, or are designated on 
7.6 	a variance granted by the commissioner, effective July 31, 2019; and
7.7 	(ii) are under the personal supervision and in the physical presence of a qualified 
7.8 	practitioner for diagnosing or treating a disease or condition of the cardiovascular system 
7.9 	in fluoroscopically guided interventional procedures. Cardiovascular technologists may not 
7.10 	activate the fluoroscopic system or evaluate quality control tests.

7.11 	Sec. 7. Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to 
7.12 	read:
7.13 		Subd. 5c.Cardiovascular technologist practice. (a) Cardiovascular technologists may 
7.14 	assist with the operation of fluoroscopy equipment if they:
7.15 	(1) are credentialed by Cardiovascular Credentialing International as a registered 
7.16 	cardiovascular invasive specialist or as a registered cardiac electrophysiology specialist, 
7.17 	are a graduate of an educational program accredited by the Commission on Accreditation 
7.18 	of Allied Health Education Programs, which uses the standards and criteria established by 
7.19 	the Joint Review Committee on Education in Cardiovascular Technology, or are designated 
7.20 	on a variance granted by the commissioner effective July 31, 2019; and
7.21 	(2) are under the personal supervision and in the physical presence of a qualified 
7.22 	practitioner for diagnosing or treating a disease or condition of the cardiovascular system 
7.23 	in fluoroscopically guided interventional procedures. Cardiovascular technologists may not 
7.24 	activate the fluoroscopic system or evaluate quality control tests.
7.25 	(b) A cardiovascular technologist who is participating in a training or educational program 
7.26 	in any of the occupations listed in this subdivision is exempt from the examination 
7.27 	requirement within the scope and for the duration of the training or educational program.

7.28 	Sec. 8. Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to 
7.29 	read:
7.30 		Subd. 5d.Nuclear medicine technologist practice. (a) Nuclear medicine technologists 
7.31 	who have passed the primary pathway credential in Nuclear Medicine Technology 
7.32 	Certification Board (NMTCB) for nuclear medicine or the American Registry of Radiologic 
8.1 	Technologists (ARRT) for nuclear medicine technology or the American Society of Clinical 
8.2 	Pathologists (NM) (ASCP) may operate a fusion imaging device or a dual imaging device 
8.3 	that uses radioactive material as a point source in transmission scanning and attenuation 
8.4 	correction.
8.5 	(b) A nuclear medicine technologist in paragraph (a) may only operate a stand-alone 
8.6 	computed tomography x-ray system if the technologist has passed the Nuclear Medicine 
8.7 	Technology Certification Board for computed tomography (CT) or is credentialed in 
8.8 	computed tomography (CT) from the American Registry of Radiologic Technologists 
8.9 	(ARRT).
8.10 	(c) A nuclear medicine technologist who meets the requirements under paragraph (a) 
8.11 	and who is participating in a training or educational program to obtain a credential under 
8.12 	paragraph (b) is exempt from the examination requirement within the scope and for the 
8.13 	duration of the training or educational program.

8.14 	Sec. 9. Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to 
8.15 	read:
8.16 		Subd. 5e.Radiation therapy technologist practice. (a) A radiation therapy technologist 
8.17 	who has passed the primary pathway credential in radiation therapy may operate radiation 
8.18 	therapy accelerator and simulator x-ray systems.
8.19 	(b) A radiation therapy technologist in paragraph (a) may only operate a stand-alone 
8.20 	computed tomography x-ray system if the technologist has passed and is credentialed in 
8.21 	computed tomography (CT) from the American Registry of Radiologic Technologists 
8.22 	(ARRT).
8.23 	(c) A radiation therapy technologist who meets the requirements under paragraph (a) 
8.24 	and who is participating in a training or educational program to obtain a credential under 
8.25 	paragraph (b) is exempt from the examination requirement within the scope and for the 
8.26 	duration of the training or educational program.

8.27 	Sec. 10. Minnesota Statutes 2018, section 144.292, subdivision 2, is amended to read:
8.28 		Subd. 2.Patient access. Upon request, a provider shall supply to a patient within 30 
8.29 	calendar days of receiving a written request for medical records complete and current 
8.30 	information possessed by that provider concerning any diagnosis, treatment, and prognosis 
8.31 	of the patient in terms and language the patient can reasonably be expected to understand.

9.1 	Sec. 11. Minnesota Statutes 2018, section 144.292, subdivision 5, is amended to read:
9.2 		Subd. 5.Copies of health records to patients. Except as provided in section 144.296, 
9.3 	upon a patient's written request, a provider, at a reasonable cost to the patient, shall promptly
9.4 	furnish to the patient within 30 calendar days of receiving a written request for medical 
9.5 	records:
9.6 	(1) copies of the patient's health record, including but not limited to laboratory reports, 
9.7 	x-rays, prescriptions, and other technical information used in assessing the patient's health 
9.8 	conditions; or
9.9 	(2) the pertinent portion of the record relating to a condition specified by the patient.
9.10 	With the consent of the patient, the provider may instead furnish only a summary of the 
9.11 	record. The provider may exclude from the health record written speculations about the 
9.12 	patient's health condition, except that all information necessary for the patient's informed 
9.13 	consent must be provided.

9.14 	Sec. 12. Minnesota Statutes 2019 Supplement, section 152.29, subdivision 1, is amended 
9.15 	to read:
9.16 		Subdivision 1.Manufacturer; requirements. (a) A manufacturer shall may operate 
9.17 	eight distribution facilities, which may include the manufacturer's single location for 
9.18 	cultivation, harvesting, manufacturing, packaging, and processing but is not required to 
9.19 	include that location. The commissioner shall designate the geographical service areas to 
9.20 	be served by each manufacturer based on geographical need throughout the state to improve 
9.21 	patient access. A manufacturer shall not have more than two distribution facilities in each 
9.22 	geographical service area assigned to the manufacturer by the commissioner. A manufacturer 
9.23 	shall operate only one location where all cultivation, harvesting, manufacturing, packaging, 
9.24 	and processing of medical cannabis shall be conducted. This location may be one of the 
9.25 	manufacturer's distribution facility sites. The additional distribution facilities may dispense 
9.26 	medical cannabis and medical cannabis products but may not contain any medical cannabis 
9.27 	in a form other than those forms allowed under section 152.22, subdivision 6, and the 
9.28 	manufacturer shall not conduct any cultivation, harvesting, manufacturing, packaging, or 
9.29 	processing at the other distribution facility sites. Any distribution facility operated by the 
9.30 	manufacturer is subject to all of the requirements applying to the manufacturer under sections 
9.31 	152.22 to 152.37, including, but not limited to, security and distribution requirements.
9.32 	(b) A manufacturer may acquire hemp grown in this state from a hemp grower. A 
9.33 	manufacturer may manufacture or process hemp into an allowable form of medical cannabis 
10.1 	under section 152.22, subdivision 6. Hemp acquired by a manufacturer under this paragraph 
10.2 	is subject to the same quality control program, security and testing requirements, and other 
10.3 	requirements that apply to medical cannabis under sections 152.22 to 152.37 and Minnesota 
10.4 	Rules, chapter 4770.
10.5 	(c) A medical cannabis manufacturer shall contract with a laboratory approved by the 
10.6 	commissioner, subject to any additional requirements set by the commissioner, for purposes 
10.7 	of testing medical cannabis manufactured or hemp acquired by the medical cannabis 
10.8 	manufacturer as to content, contamination, and consistency to verify the medical cannabis 
10.9 	meets the requirements of section 152.22, subdivision 6. The cost of laboratory testing shall 
10.10 	be paid by the manufacturer.
10.11 	(d) The operating documents of a manufacturer must include:
10.12 	(1) procedures for the oversight of the manufacturer and procedures to ensure accurate 
10.13 	record keeping;
10.14 	(2) procedures for the implementation of appropriate security measures to deter and 
10.15 	prevent the theft of medical cannabis and unauthorized entrance into areas containing medical 
10.16 	cannabis; and
10.17 	(3) procedures for the delivery and transportation of hemp between hemp growers and 
10.18 	manufacturers.
10.19 	(e) A manufacturer shall implement security requirements, including requirements for 
10.20 	the delivery and transportation of hemp, protection of each location by a fully operational 
10.21 	security alarm system, facility access controls, perimeter intrusion detection systems, and 
10.22 	a personnel identification system.
10.23 	(f) A manufacturer shall not share office space with, refer patients to a health care 
10.24 	practitioner, or have any financial relationship with a health care practitioner.
10.25 	(g) A manufacturer shall not permit any person to consume medical cannabis on the 
10.26 	property of the manufacturer.
10.27 	(h) A manufacturer is subject to reasonable inspection by the commissioner.
10.28 	(i) For purposes of sections 152.22 to 152.37, a medical cannabis manufacturer is not 
10.29 	subject to the Board of Pharmacy licensure or regulatory requirements under chapter 151.
10.30 	(j) A medical cannabis manufacturer may not employ any person who is under 21 years 
10.31 	of age or who has been convicted of a disqualifying felony offense. An employee of a 
10.32 	medical cannabis manufacturer must submit a completed criminal history records check 
11.1 	consent form, a full set of classifiable fingerprints, and the required fees for submission to 
11.2 	the Bureau of Criminal Apprehension before an employee may begin working with the 
11.3 	manufacturer. The bureau must conduct a Minnesota criminal history records check and 
11.4 	the superintendent is authorized to exchange the fingerprints with the Federal Bureau of 
11.5 	Investigation to obtain the applicant's national criminal history record information. The 
11.6 	bureau shall return the results of the Minnesota and federal criminal history records checks 
11.7 	to the commissioner.
11.8 	(k) A manufacturer may not operate in any location, whether for distribution or 
11.9 	cultivation, harvesting, manufacturing, packaging, or processing, within 1,000 feet of a 
11.10 	public or private school existing before the date of the manufacturer's registration with the 
11.11 	commissioner.
11.12 	(l) A manufacturer shall comply with reasonable restrictions set by the commissioner 
11.13 	relating to signage, marketing, display, and advertising of medical cannabis.
11.14 	(m) Before a manufacturer acquires hemp from a hemp grower, the manufacturer must 
11.15 	verify that the hemp grower has a valid license issued by the commissioner of agriculture 
11.16 	under chapter 18K.
11.17 	(n) Until a state-centralized, seed-to-sale system is implemented that can track a specific 
11.18 	medical cannabis plant from cultivation through testing and point of sale, the commissioner 
11.19 	shall conduct at least one unannounced inspection per year of each manufacturer that includes 
11.20 	inspection of:
11.21 	(1) business operations;
11.22 	(2) physical locations of the manufacturer's manufacturing facility and distribution 
11.23 	facilities;
11.24 	(3) financial information and inventory documentation, including laboratory testing 
11.25 	results; and
11.26 	(4) physical and electronic security alarm systems.

11.27 	Sec. 13. Minnesota Statutes 2018, section 152.35, is amended to read:
11.28 	152.35 FEES; DEPOSIT OF REVENUE.
11.29 	(a) The commissioner shall collect an enrollment fee of $200 from patients enrolled 
11.30 	under this section. If the patient attests to provides evidence of receiving Social Security 
11.31 	disability insurance (SSDI), Supplemental Security Insurance Income (SSI), veterans 
12.1 	disability, or railroad disability payments, or being enrolled in medical assistance or 
12.2 	MinnesotaCare, then the fee shall be $50. For purposes of this section:
12.3 	(1) a patient is considered to receive SSDI if the patient was receiving SSDI at the time 
12.4 	the patient was transitioned to retirement benefits by the United States Social Security 
12.5 	Administration; and
12.6 	(2) veterans disability payments include VA dependency and indemnity compensation.
12.7 	Unless a patient provides evidence of receiving payments from or participating in one of 
12.8 	the programs specifically listed in this paragraph, the commissioner of health must collect 
12.9 	the $200 enrollment fee from a patient to enroll the patient in the registry program. The fees 
12.10 	shall be payable annually and are due on the anniversary date of the patient's enrollment. 
12.11 	The fee amount shall be deposited in the state treasury and credited to the state government 
12.12 	special revenue fund.
12.13 	(b) The commissioner shall collect an application fee of $20,000 from each entity 
12.14 	submitting an application for registration as a medical cannabis manufacturer. Revenue 
12.15 	from the fee shall be deposited in the state treasury and credited to the state government 
12.16 	special revenue fund.
12.17 	(c) The commissioner shall establish and collect an annual fee from a medical cannabis 
12.18 	manufacturer equal to the cost of regulating and inspecting the manufacturer in that year. 
12.19 	Revenue from the fee amount shall be deposited in the state treasury and credited to the 
12.20 	state government special revenue fund.
12.21 	(d) A medical cannabis manufacturer may charge patients enrolled in the registry program 
12.22 	a reasonable fee for costs associated with the operations of the manufacturer. The 
12.23 	manufacturer may establish a sliding scale of patient fees based upon a patient's household 
12.24 	income and may accept private donations to reduce patient fees.

12.25 	Sec. 14. Minnesota Statutes 2018, section 446A.081, subdivision 9, is amended to read:
12.26 		Subd. 9.Other uses of fund. (a) The drinking water revolving loan fund may be used 
12.27 	as provided in the act, including the following uses:
12.28 	(1) to buy or refinance the debt obligations, at or below market rates, of public water 
12.29 	systems for drinking water systems, where the debt was incurred after the date of enactment 
12.30 	of the act, for the purposes of construction of the necessary improvements to comply with 
12.31 	the national primary drinking water regulations under the federal Safe Drinking Water Act;
13.1 	(2) to purchase or guarantee insurance for local obligations to improve credit market 
13.2 	access or reduce interest rates;
13.3 	(3) to provide a source of revenue or security for the payment of principal and interest 
13.4 	on revenue or general obligation bonds issued by the authority if the bond proceeds are 
13.5 	deposited in the fund;
13.6 	(4) to provide loans or loan guarantees for similar revolving funds established by a 
13.7 	governmental unit or state agency;
13.8 	(5) to earn interest on fund accounts;
13.9 	(6) to pay the reasonable costs incurred by the authority, the Department of Employment 
13.10 	and Economic Development, and the Department of Health for conducting activities as 
13.11 	authorized and required under the act up to the limits authorized under the act;
13.12 	(7) to develop and administer programs for water system supervision, source water 
13.13 	protection, and related programs required under the act;
13.14 	(8) notwithstanding Minnesota Rules, part 7380.0280, to provide principal forgiveness 
13.15 	or grants to the extent permitted under the federal Safe Drinking Water Act and other federal 
13.16 	law, based on the criteria and requirements established for drinking water projects under 
13.17 	the water infrastructure funding program under section 446A.072;
13.18 	(9) to provide loans, principal forgiveness or grants to the extent permitted under the 
13.19 	federal Safe Drinking Water Act and other federal law to address green infrastructure, water 
13.20 	or energy efficiency improvements, or other environmentally innovative activities; and
13.21 	(10) to provide principal forgiveness, or grants for 50 80 percent of the project cost costs
13.22 	up to a maximum of $10,000 $100,000 for projects needed to comply with national primary 
13.23 	drinking water standards for an existing nonmunicipal community or noncommunity public 
13.24 	water system.; and
13.25 	(11) to provide principal forgiveness or grants to the extent permitted under the federal 
13.26 	Safe Drinking Water Act and other federal laws for 50 percent of the project costs up to a 
13.27 	maximum of $250,000 for projects to replace the privately owned portion of drinking water 
13.28 	lead service lines.
13.29 	(b) Principal forgiveness or grants provided under paragraph (a), clause (9), may not 
13.30 	exceed 25 percent of the eligible project costs as determined by the Department of Health 
13.31 	for project components directly related to green infrastructure, water or energy efficiency 
13.32 	improvements, or other environmentally innovative activities, up to a maximum of 
13.33 	$1,000,000.

14.1 	Sec. 15. Laws 2019, First Special Session chapter 9, article 11, section 35, the effective 
14.2 	date, is amended to read:

14.3 	EFFECTIVE DATE. This section is effective August 1, 2020 January 1, 2021.

14.4 	EFFECTIVE DATE. This section is effective the day following final enactment.

14.5 	Sec. 16. AGE-RELATED MACULAR DEGENERATION; QUALIFYING MEDICAL 
14.6 	CONDITION.
 14.7 	(a) In accordance with Minnesota Statutes, section 152.27, subdivision 2, paragraph (b), 
14.8 	the commissioner of health notified the legislature that the commissioner intends to add 
14.9 	age-related macular degeneration as a qualifying medical condition to the medical cannabis 
14.10 	program under Minnesota Statutes, section 152.22, subdivision 14.
14.11 	(b) Minnesota Statutes, section 152. 27, subdivision 2, paragraph (b), specifies that the 
14.12 	proposed qualifying medical condition is added effective August 1 unless the legislature 
14.13 	by law provides otherwise.
14.14 	(c) The legislature hereby states that age-related macular degeneration shall not be added 
14.15 	as a qualifying medical condition under Minnesota Statutes, section 152.22, subdivision 
14.16 	14.

14.17 	EFFECTIVE DATE. This section is effective the day following final enactment.

14.18 	Sec. 17. REPEALER.
 14.19 	(a) Minnesota Statutes 2018, section 144.121, subdivisions 3 and 5b, are repealed.
14.20 	(b) Minnesota Rules, part 7380.0280, is repealed.

14.21 	ARTICLE 2
14.22 	HEALTH-RELATED LICENSING BOARDS

14.23 	Section 1. Minnesota Statutes 2018, section 62A.307, subdivision 2, is amended to read:
14.24 		Subd. 2.Requirement. Coverage described in subdivision 1 that covers prescription 
14.25 	drugs must provide the same coverage for a prescription written by a health care provider 
14.26 	authorized to prescribe the particular drug covered by the health coverage described in 
14.27 	subdivision 1, regardless of the type of health care provider that wrote the prescription. This 
14.28 	section is intended to prohibit denial of coverage based on the prescription having been 
14.29 	written by an advanced practice nurse under section 148.235, a physician assistant under 
15.1 	section 147A.18 147A.185, or any other nonphysician health care provider authorized to 
15.2 	prescribe the particular drug.

15.3 	Sec. 2. [62Q.529] COVERAGE FOR DRUGS PRESCRIBED AND DISPENSED BY 
15.4 	PHARMACIES.
15.5 	(a) A health plan that provides prescription coverage must provide coverage for 
15.6 	self-administered hormonal contraceptives, nicotine replacement medications, and opiate 
15.7 	antagonists for the treatment of an acute opiate overdose prescribed and dispensed by a 
15.8 	licensed pharmacist in accordance with section 151.37, subdivision 14, 15, or 16, under the 
15.9 	same terms of coverage that would apply had the prescription drug been prescribed by a 
15.10 	licensed physician, physician assistant, or advanced practice nurse practitioner.
15.11 	(b) A health plan is not required to cover the drug if dispensed by an out-of-network 
15.12 	pharmacy, unless the health plan covers prescription drugs dispensed by out-of-network 
15.13 	pharmacies.

15.14 	Sec. 3. Minnesota Statutes 2018, section 147A.01, subdivision 3, is amended to read:
15.15 		Subd. 3.Administer. "Administer" means the delivery by a physician assistant authorized 
15.16 	to prescribe legend drugs, a single dose of a legend drug, including controlled substances,
15.17 	to a patient by injection, inhalation, ingestion, or by any other immediate means, and the 
15.18 	delivery by a physician assistant ordered by a physician a single dose of a legend drug by 
15.19 	injection, inhalation, ingestion, or by any other immediate means.

15.20 	Sec. 4. Minnesota Statutes 2018, section 147A.01, is amended by adding a subdivision to 
15.21 	read:
15.22 		Subd. 6a.Collaborating physician. "Collaborating physician" means a Minnesota 
15.23 	licensed physician who oversees the performance, practice, and activities of a physician 
15.24 	assistant under a collaborative agreement as described in section 147A.02, paragraph (c).

15.25 	Sec. 5. Minnesota Statutes 2018, section 147A.01, subdivision 21, is amended to read:
15.26 		Subd. 21.Prescription. "Prescription" means a signed written order, an oral order 
15.27 	reduced to writing, or an electronic order meeting current and prevailing standards given 
15.28 	by a physician assistant authorized to prescribe drugs for patients in the course of the 
15.29 	physician assistant's practice, and issued for an individual patient and containing the 
15.30 	information required in the physician-physician assistant delegation agreement.

16.1 	Sec. 6. Minnesota Statutes 2018, section 147A.01, subdivision 26, is amended to read:
16.2 		Subd. 26.Therapeutic order. "Therapeutic order" means an a written or verbal order 
16.3 	given to another for the purpose of treating or curing a patient in the course of a physician 
16.4 	assistant's practice. Therapeutic orders may be written or verbal, but do not include the 
16.5 	prescribing of legend drugs or medical devices unless prescribing authority has been 
16.6 	delegated within the physician-physician assistant delegation agreement.

16.7 	Sec. 7. Minnesota Statutes 2018, section 147A.01, subdivision 27, is amended to read:
16.8 		Subd. 27.Verbal order. "Verbal order" means an oral order given to another for the 
16.9 	purpose of treating or curing a patient in the course of a physician assistant's practice. Verbal 
16.10 	orders do not include the prescribing of legend drugs unless prescribing authority has been 
16.11 	delegated within the physician-physician assistant delegation agreement.

16.12 	Sec. 8. Minnesota Statutes 2018, section 147A.02, is amended to read:
16.13 	147A.02 QUALIFICATIONS FOR LICENSURE.
16.14 	Except as otherwise provided in this chapter, an individual shall be licensed by the board 
16.15 	before the individual may practice as a physician assistant.
16.16 	(a) The board may grant a license as a physician assistant to an applicant who:
16.17 	(1) submits an application on forms approved by the board;
16.18 	(2) pays the appropriate fee as determined by the board;
16.19 	(3) has current certification from the National Commission on Certification of Physician 
16.20 	Assistants, or its successor agency as approved by the board;
16.21 	(4) certifies that the applicant is mentally and physically able to engage safely in practice 
16.22 	as a physician assistant;
16.23 	(5) has no licensure, certification, or registration as a physician assistant under current 
16.24 	discipline, revocation, suspension, or probation for cause resulting from the applicant's 
16.25 	practice as a physician assistant, unless the board considers the condition and agrees to 
16.26 	licensure;
16.27 	(6) submits any other information the board deems necessary to evaluate the applicant's 
16.28 	qualifications; and
16.29 	(7) has been approved by the board.
17.1 	(b) All persons registered as physician assistants as of June 30, 1995, are eligible for 
17.2 	continuing license renewal. All persons applying for licensure after that date shall be licensed 
17.3 	according to this chapter.
17.4 	(c) A physician assistant who qualifies for licensure must practice for at least 2,080 
17.5 	hours, within the context of a collaborative agreement, within a hospital or integrated clinical 
17.6 	setting where physician assistants and physicians work together to provide patient care. The 
17.7 	physician assistant shall submit written evidence to the board with the application, or upon 
17.8 	completion of the required collaborative practice experience. For purposes of this paragraph, 
17.9 	a collaborative agreement is a mutually agreed upon plan for the overall working relationship 
17.10 	and collaborative arrangement between a physician assistant, and one or more physicians 
17.11 	licensed under chapter 147, that designates the scope of services that can be provided to 
17.12 	manage the care of patients. The physician assistant and one of the collaborative physicians 
17.13 	must have experience in providing care to patients with the same or similar medical 
17.14 	conditions. The collaborating physician is not required to be physically present so long as 
17.15 	the collaborating physician and physician assistant are or can be easily in contact with each 
17.16 	other by radio, telephone, or other telecommunication device.

17.17 	Sec. 9. Minnesota Statutes 2018, section 147A.03, is amended by adding a subdivision to 
17.18 	read:
17.19 		Subd. 1a.Licensure required. Except as provided under subdivision 2, it is unlawful 
17.20 	for any person to practice as a physician assistant without being issued a valid license 
17.21 	according to this chapter.

17.22 	Sec. 10. Minnesota Statutes 2018, section 147A.05, is amended to read:
17.23 	147A.05 INACTIVE LICENSE.
17.24 	(a) Physician assistants who notify the board in writing may elect to place their license 
17.25 	on an inactive status. Physician assistants with an inactive license shall be excused from 
17.26 	payment of renewal fees and shall not practice as physician assistants. Persons who engage 
17.27 	in practice while their license is lapsed or on inactive status shall be considered to be 
17.28 	practicing without a license, which shall be grounds for discipline under section 147A.13. 
17.29 	Physician assistants who provide care under the provisions of section 147A.23 shall not be 
17.30 	considered practicing without a license or subject to disciplinary action. Physician assistants 
17.31 	who notify the board of their intent to resume active practice shall be required to pay the 
17.32 	current renewal fees and all unpaid back fees and shall be required to meet the criteria for 
17.33 	renewal specified in section 147A.07.
18.1 	(b) Notwithstanding section 147A.03, subdivision 1, a person with an inactive license 
18.2 	may continue to use the protected titles specified in section 147A.03, subdivision 1, so long 
18.3 	as the person does not practice as a physician assistant.

18.4 	Sec. 11. Minnesota Statutes 2019 Supplement, section 147A.06, is amended to read:
18.5 	147A.06 CANCELLATION OF LICENSE FOR NONRENEWAL.
18.6 		Subdivision 1.Cancellation of license. The board shall not renew, reissue, reinstate, or 
18.7 	restore a license that has lapsed on or after July 1, 1996, and has not been renewed within 
18.8 	two annual renewal cycles starting July 1, 1997. A licensee whose license is canceled for 
18.9 	nonrenewal must obtain a new license by applying for licensure and fulfilling all requirements 
18.10 	then in existence for an initial license to practice as a physician assistant.
18.11 		Subd. 2.Licensure following lapse of licensed status; transition. (a) A licensee whose 
18.12 	license has lapsed under subdivision 1 before January 1, 2020, and who seeks to regain 
18.13 	licensed status after January 1, 2020, shall be treated as a first-time licensee only for purposes 
18.14 	of establishing a license renewal schedule, and shall not be subject to the license cycle 
18.15 	conversion provisions in section 147A.29.
18.16 	(b) This subdivision expires July 1, 2022.

18.17 	Sec. 12. Minnesota Statutes 2018, section 147A.09, is amended to read:
18.18 	147A.09 SCOPE OF PRACTICE, DELEGATION.
18.19 		Subdivision 1.Scope of practice. Physician assistants shall practice medicine only with 
18.20 	physician supervision. Physician assistants may perform those duties and responsibilities 
18.21 	as delegated in the physician-physician assistant delegation agreement and delegation forms 
18.22 	maintained at the address of record by the supervising physician and physician assistant, 
18.23 	including the prescribing, administering, and dispensing of drugs, controlled substances, 
18.24 	and medical devices, excluding anesthetics, other than local anesthetics, injected in 
18.25 	connection with an operating room procedure, inhaled anesthesia and spinal anesthesia
18.26 	under an established practice agreement.
18.27 	Patient service must be limited to A physician assistant's scope of practice includes:
18.28 	(1) services within the training and experience of the physician assistant;
18.29 	(2) patient services customary to the practice of the supervising physician or alternate 
18.30 	supervising physician physician assistant and the practice agreement; and
19.1 	(3) services delegated by the supervising physician or alternate supervising physician 
19.2 	under the physician-physician assistant delegation agreement; and
19.3 	(4) services within the parameters of the laws, rules, and standards of the facilities in 
19.4 	which the physician assistant practices.
19.5 	Nothing in this chapter authorizes physician assistants to perform duties regulated by 
19.6 	the boards listed in section 214.01, subdivision 2, other than the Board of Medical Practice, 
19.7 	and except as provided in this section.
19.8 		Subd. 2.Delegation Patient services. Patient services may include, but are not limited 
19.9 	to, the following, as delegated by the supervising physician and authorized in the delegation 
19.10 	agreement:
19.11 	(1) taking patient histories and developing medical status reports;
19.12 	(2) performing physical examinations;
19.13 	(3) interpreting and evaluating patient data;
19.14 	(4) ordering or, performing, or reviewing diagnostic procedures, including the use of 
19.15 	radiographic imaging systems in compliance with Minnesota Rules 2007, chapter 4732, but 
19.16 	excluding interpreting computed tomography scans, magnetic resonance imaging scans, 
19.17 	positron emission tomography scans, nuclear scans, and mammography;
19.18 	(5) ordering or performing therapeutic procedures including the use of ionizing radiation 
19.19 	in compliance with Minnesota Rules 2007, chapter 4732;
19.20 	(6) providing instructions regarding patient care, disease prevention, and health 
19.21 	promotion;
19.22 	(7) assisting the supervising physician in providing patient care in the home and in health 
19.23 	care facilities;
19.24 	(8) creating and maintaining appropriate patient records;
19.25 	(9) transmitting or executing specific orders at the direction of the supervising physician;
19.26 	(10) prescribing, administering, and dispensing drugs, controlled substances, and medical 
19.27 	devices if this function has been delegated by the supervising physician pursuant to and 
19.28 	subject to the limitations of section 147A.18 and chapter 151. For physician assistants who 
19.29 	have been delegated the authority to prescribe controlled substances, such delegation shall 
19.30 	be included in the physician-physician assistant delegation agreement, and all schedules of 
19.31 	controlled substances the physician assistant has the authority to prescribe shall be specified, 
20.1 	including administering local anesthetics, but excluding anesthetics injected in connection 
20.2 	with an operating room procedure, inhaled anesthesia, and spinal anesthesia;
20.3 	(11) for physician assistants not delegated prescribing authority, administering legend 
20.4 	drugs and medical devices following prospective review for each patient by and upon 
20.5 	direction of the supervising physician;
20.6 	(12) functioning as an emergency medical technician with permission of the ambulance 
20.7 	service and in compliance with section 144E.127, and ambulance service rules adopted by 
20.8 	the commissioner of health;
20.9 	(13) (12) initiating evaluation and treatment procedures essential to providing an 
20.10 	appropriate response to emergency situations;
20.11 	(14) (13) certifying a patient's eligibility for a disability parking certificate under section 
20.12 	169.345, subdivision 2;
20.13 	(15) (14) assisting at surgery; and
20.14 	(16) (15) providing medical authorization for admission for emergency care and treatment 
20.15 	of a patient under section 253B.05, subdivision 2.
20.16 	Orders of physician assistants shall be considered the orders of their supervising 
20.17 	physicians in all practice-related activities, including, but not limited to, the ordering of 
20.18 	diagnostic, therapeutic, and other medical services.
20.19 		Subd. 3.Practice agreement review. A physician assistant shall have a practice 
20.20 	agreement at the practice level that describes the practice of the physician assistant. The 
20.21 	practice agreement must be reviewed on an annual basis by a licensed physician  within the 
20.22 	same clinic, hospital, health system, or other facility as the physician assistant and has 
20.23 	knowledge of the physician assistant's practice to ensure that the physician assistant's medical 
20.24 	practice is consistent with the practice agreement. A document stating that the review 
20.25 	occurred must be maintained at the practice level and made available to the board, upon 
20.26 	request.
20.27 		Subd. 4.Scope of practice limitations; spinal injections for acute and chronic 
20.28 	pain. Notwithstanding subdivision 1, a physician assistant may only perform spinal injections 
20.29 	to address acute and chronic pain symptoms upon referral and in collaboration with a 
20.30 	physician licensed under chapter 147. For purposes of performing spinal injections for acute 
20.31 	or chronic pain symptoms, the physician assistant and one or more physicians licensed under 
20.32 	chapter 147 must have a mutually agreed upon plan that designates the scope of collaboration 
20.33 	necessary for treating patients with acute and chronic pain.
21.1 		Subd. 5.Scope of practice limitations; psychiatric care for children with emotional 
21.2 	disturbance or adults with serious mental illness. Notwithstanding subdivision 1, a 
21.3 	physician assistant may only provide ongoing psychiatric treatment for children with 
21.4 	emotional disturbance, as defined in section 245.4871, subdivision 15, or adults with serious 
21.5 	mental illness in collaboration with a physician licensed under chapter 147. For purposes 
21.6 	of providing ongoing psychiatric treatment for children with emotional disturbance or adults 
21.7 	with serious mental illness, the practice agreement between the physician assistant and one 
21.8 	or more physicians licensed under chapter 147 must define the collaboration between the 
21.9 	physician assistant and the collaborating physician, including appropriate consultation or 
21.10 	referral to psychiatry.

21.11 	Sec. 13. Minnesota Statutes 2018, section 147A.13, subdivision 1, is amended to read:
21.12 		Subdivision 1.Grounds listed. The board may refuse to grant licensure or may impose 
21.13 	disciplinary action as described in this subdivision against any physician assistant. The 
21.14 	following conduct is prohibited and is grounds for disciplinary action:
21.15 	(1) failure to demonstrate the qualifications or satisfy the requirements for licensure 
21.16 	contained in this chapter or rules of the board. The burden of proof shall be upon the applicant 
21.17 	to demonstrate such qualifications or satisfaction of such requirements;
21.18 	(2) obtaining a license by fraud or cheating, or attempting to subvert the examination 
21.19 	process. Conduct which subverts or attempts to subvert the examination process includes, 
21.20 	but is not limited to:
21.21 	(i) conduct which violates the security of the examination materials, such as removing 
21.22 	examination materials from the examination room or having unauthorized possession of 
21.23 	any portion of a future, current, or previously administered licensing examination;
21.24 	(ii) conduct which violates the standard of test administration, such as communicating 
21.25 	with another examinee during administration of the examination, copying another examinee's 
21.26 	answers, permitting another examinee to copy one's answers, or possessing unauthorized 
21.27 	materials; and
21.28 	(iii) impersonating an examinee or permitting an impersonator to take the examination 
21.29 	on one's own behalf;
21.30 	(3) conviction, during the previous five years, of a felony reasonably related to the 
21.31 	practice of physician assistant. Conviction as used in this subdivision includes a conviction 
21.32 	of an offense which if committed in this state would be deemed a felony without regard to 
22.1 	its designation elsewhere, or a criminal proceeding where a finding or verdict of guilt is 
22.2 	made or returned but the adjudication of guilt is either withheld or not entered;
22.3 	(4) revocation, suspension, restriction, limitation, or other disciplinary action against 
22.4 	the person's physician assistant credentials in another state or jurisdiction, failure to report 
22.5 	to the board that charges regarding the person's credentials have been brought in another 
22.6 	state or jurisdiction, or having been refused licensure by any other state or jurisdiction;
22.7 	(5) advertising which is false or misleading, violates any rule of the board, or claims 
22.8 	without substantiation the positive cure of any disease or professional superiority to or 
22.9 	greater skill than that possessed by another physician assistant;
22.10 	(6) violating a rule adopted by the board or an order of the board, a state, or federal law 
22.11 	which relates to the practice of a physician assistant, or in part regulates the practice of a 
22.12 	physician assistant, including without limitation sections 604.201, 609.344, and 609.345, 
22.13 	or a state or federal narcotics or controlled substance law;
22.14 	(7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the 
22.15 	public, or demonstrating a willful or careless disregard for the health, welfare, or safety of 
22.16 	a patient; or practice which is professionally incompetent, in that it may create unnecessary 
22.17 	danger to any patient's life, health, or safety, in any of which cases, proof of actual injury 
22.18 	need not be established;
22.19 	(8) failure to adhere to the provisions of the physician-physician assistant delegation 
22.20 	agreement;
22.21 	(9) (8) engaging in the practice of medicine beyond that what is allowed by the 
22.22 	physician-physician assistant delegation agreement under this chapter, or aiding or abetting 
22.23 	an unlicensed person in the practice of medicine;
22.24 	(10)(9) adjudication as mentally incompetent, mentally ill or developmentally disabled, 
22.25 	or as a chemically dependent person, a person dangerous to the public, a sexually dangerous 
22.26 	person, or a person who has a sexual psychopathic personality by a court of competent 
22.27 	jurisdiction, within or without this state. Such adjudication shall automatically suspend a 
22.28 	license for its duration unless the board orders otherwise;
22.29 	(11) (10) engaging in unprofessional conduct. Unprofessional conduct includes any 
22.30 	departure from or the failure to conform to the minimal standards of acceptable and prevailing 
22.31 	practice in which proceeding actual injury to a patient need not be established;
22.32 	(12) (11) inability to practice with reasonable skill and safety to patients by reason of 
22.33 	illness, drunkenness, use of drugs, narcotics, chemicals, or any other type of material, or as 
23.1 	a result of any mental or physical condition, including deterioration through the aging 
23.2 	process or loss of motor skills;
23.3 	(13) (12) revealing a privileged communication from or relating to a patient except when 
23.4 	otherwise required or permitted by law;
23.5 	(14) (13) any identification of a physician assistant by the title "Physician," "Doctor," 
23.6 	or "Dr." in a patient care setting or in a communication directed to the general public;
23.7 	(15) (14) improper management of medical records, including failure to maintain adequate 
23.8 	medical records, to comply with a patient's request made pursuant to sections 144.291 to 
23.9 	144.298, or to furnish a medical record or report required by law;
23.10 	(16) (15) engaging in abusive or fraudulent billing practices, including violations of the 
23.11 	federal Medicare and Medicaid laws or state medical assistance laws;
23.12 	(17) (16) becoming addicted or habituated to a drug or intoxicant;
23.13 	(18) (17) prescribing a drug or device for other than medically accepted therapeutic, 
23.14 	experimental, or investigative purposes authorized by a state or federal agency or referring 
23.15 	a patient to any health care provider as defined in sections 144.291 to 144.298 for services 
23.16 	or tests not medically indicated at the time of referral;
23.17 	(19) (18) engaging in conduct with a patient which is sexual or may reasonably be 
23.18 	interpreted by the patient as sexual, or in any verbal behavior which is seductive or sexually 
23.19 	demeaning to a patient;
23.20 	(20) (19) failure to make reports as required by section 147A.14 or to cooperate with an 
23.21 	investigation of the board as required by section 147A.15, subdivision 3;
23.22 	(21) (20) knowingly providing false or misleading information that is directly related 
23.23 	to the care of that patient unless done for an accepted therapeutic purpose such as the 
23.24 	administration of a placebo;
23.25 	(22) (21) aiding suicide or aiding attempted suicide in violation of section 609.215 as 
23.26 	established by any of the following:
23.27 	(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation 
23.28 	of section 609.215, subdivision 1 or 2;
23.29 	(ii) a copy of the record of a judgment of contempt of court for violating an injunction 
23.30 	issued under section 609.215, subdivision 4;
23.31 	(iii) a copy of the record of a judgment assessing damages under section 609.215, 
23.32 	subdivision 5; or
24.1 	(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2. 
24.2 	The board shall investigate any complaint of a violation of section 609.215, subdivision 1
24.3 	or 2; or
24.4 	(23) (22)failure to maintain annually reviewed and updated physician-physician assistant 
24.5 	delegation agreements for each physician-physician assistant practice relationship, or failure 
24.6 	to provide copies of such documents upon request by the boardfailure to maintain the proof 
24.7 	of review document as required under section 147A.09, subdivision 3, or to provide a copy 
24.8 	of the document upon request of the board.

24.9 	Sec. 14. Minnesota Statutes 2018, section 147A.14, subdivision 4, is amended to read:
24.10 		Subd. 4.Licensed professionals. Licensed health professionals and persons holding 
24.11 	residency permits under section 147.0391, shall report to the board personal knowledge of 
24.12 	any conduct which the person reasonably believes constitutes grounds for disciplinary action 
24.13 	under this chapter by a physician assistant, including any conduct indicating that the person 
24.14 	may be incompetent, or may have engaged in unprofessional conduct or may be medically 
24.15 	or physically unable to engage safely in practice as a physician assistant. No report shall be 
24.16 	required if the information was obtained in the course of a physician-patient provider-patient
24.17 	relationship if the patient is a physician assistant, and the treating physician provider
24.18 	successfully counsels the person to limit or withdraw from practice to the extent required 
24.19 	by the impairment.

24.20 	Sec. 15. Minnesota Statutes 2018, section 147A.16, is amended to read:
24.21 	147A.16 FORMS OF DISCIPLINARY ACTION.
24.22 	When the board finds that a licensed physician assistant has violated a provision of this 
24.23 	chapter, it may do one or more of the following:
24.24 	(1) revoke the license;
24.25 	(2) suspend the license;
24.26 	(3) impose limitations or conditions on the physician assistant's practice, including 
24.27 	limiting the scope of practice to designated field specialties; impose imposing retraining or 
24.28 	rehabilitation requirements; require practice under additional supervision; or condition 
24.29 	continued limiting practice on until demonstration of knowledge or skills by appropriate 
24.30 	examination or other review of skill and competence;
24.31 	(4) impose a civil penalty not exceeding $10,000 for each separate violation, the amount 
24.32 	of the civil penalty to be fixed so as to deprive the physician assistant of any economic 
25.1 	advantage gained by reason of the violation charged or to reimburse the board for the cost 
25.2 	of the investigation and proceeding; or
25.3 	(5) order the physician assistant to provide unremunerated professional service under 
25.4 	supervision at a designated public hospital, clinic, or other health care institution; or
25.5 	(6) (5) censure or reprimand the licensed physician assistant.
25.6 	Upon judicial review of any board disciplinary action taken under this chapter, the 
25.7 	reviewing court shall seal the administrative record, except for the board's final decision, 
25.8 	and shall not make the administrative record available to the public.

25.9 	Sec. 16. [147A.185] PRESCRIBING DRUGS AND THERAPEUTIC DEVICES.
25.10 		Subd. 1.Diagnosis, prescribing, and ordering. A physician assistant is authorized to:
25.11 	(1) diagnose, prescribe, and institute therapy or referrals of patients to health care agencies 
25.12 	and providers;
25.13 	(2) prescribe, procure, sign for, record, administer, and dispense over-the-counter drugs, 
25.14 	legend drugs, and controlled substances, including sample drugs; and
25.15 	(3) plan and initiate a therapeutic regimen that includes ordering and prescribing durable 
25.16 	medical devices and equipment, nutrition, diagnostic services, and supportive services 
25.17 	including but not limited to home health care, hospice, physical therapy, and occupational 
25.18 	therapy.
25.19 		Subd. 2.Drug Enforcement Administration requirements. (a) A physician assistant 
25.20 	must:
25.21 	(1) comply with federal Drug Enforcement Administration (DEA) requirements related 
25.22 	to controlled substances; and
25.23 	(2) file any and all of the physician assistant's DEA registrations and numbers with the 
25.24 	board.
25.25 	(b) The board shall maintain current records of all physician assistants with DEA 
25.26 	registration and numbers.
25.27 		Subd. 3.Other requirements and restrictions. (a) Each prescription initiated by a 
25.28 	physician assistant shall indicate the following:
25.29 	(1) the date of issue;
25.30 	(2) the name and address of the patient;
26.1 	(3) the name and quantity of the drug prescribed;
26.2 	(4) directions for use; and
26.3 	(5) the name and address of the prescribing physician assistant.
26.4 	(b) In prescribing, dispensing, and administering legend drugs, controlled substances, 
26.5 	and medical devices, a physician assistant must comply with this chapter and chapters 151 
26.6 	and 152.

26.7 	Sec. 17. Minnesota Statutes 2018, section 147A.23, is amended to read:
26.8 	147A.23 RESPONDING TO DISASTER SITUATIONS.
26.9 	(a) A physician assistant duly licensed or credentialed in a United States jurisdiction or 
26.10 	by a federal employer who is responding to a need for medical care created by an emergency 
26.11 	according to section 604A.01, or a state or local disaster may render such care as the 
26.12 	physician assistant is trained to provide, under the physician assistant's license or credential, 
26.13 	without the need of a physician-physician assistant delegation agreement or a notice of 
26.14 	intent to practice as required under section 147A.20. A physician assistant may provide 
26.15 	emergency care without physician supervision or under the supervision that is available.
26.16 	(b) The physician who provides supervision to a physician assistant while the physician 
26.17 	assistant is rendering care in accordance with this section may do so without meeting the 
26.18 	requirements of section 147A.20.
26.19 	(c) The supervising physician who otherwise provides supervision to a physician assistant 
26.20 	under a physician-physician assistant delegation agreement described in section 147A.20
26.21 	shall not be held medically responsible for the care rendered by a physician assistant pursuant 
26.22 	to paragraph (a). Services provided by a physician assistant under paragraph (a) shall be 
26.23 	considered outside the scope of the relationship between the supervising physician and the 
26.24 	physician assistant.

26.25 	Sec. 18. Minnesota Statutes 2018, section 147D.03, subdivision 2, is amended to read:
26.26 		Subd. 2.Scope of practice. The practice of traditional midwifery includes, but is not 
26.27 	limited to:
26.28 	(1) initial and ongoing assessment for suitability of traditional midwifery care;
26.29 	(2) providing prenatal education and coordinating with a licensed health care provider 
26.30 	as necessary to provide comprehensive prenatal care, including the routine monitoring of 
26.31 	vital signs, indicators of fetal developments, and ordering standard prenatal laboratory tests
27.1 	and imaging, as needed, with attention to the physical, nutritional, and emotional needs of 
27.2 	the woman and her family;
27.3 	(3) attending and supporting the natural process of labor and birth;
27.4 	(4) postpartum care of the mother and an initial assessment of the newborn; and
27.5 	(5) providing information and referrals to community resources on childbirth preparation, 
27.6 	breastfeeding, exercise, nutrition, parenting, and care of the newborn.; and
27.7 	(6) ordering ultrasounds, providing point-of-care testing, and ordering laboratory tests 
27.8 	that conform to the standard prenatal protocol of the licensed traditional midwife's standard 
27.9 	of care.

27.10 	Sec. 19. Minnesota Statutes 2019 Supplement, section 151.01, subdivision 23, is amended 
27.11 	to read:
27.12 		Subd. 23.Practitioner. "Practitioner" means a licensed doctor of medicine, licensed 
27.13 	doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of 
27.14 	dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, or licensed 
27.15 	advanced practice registered nurse. For purposes of sections 151.15, subdivision 4; 151.211, 
27.16 	subdivision 3; 151.252, subdivision 3; 151.37, subdivision 2, paragraphs (b), (e), and (f); 
27.17 	and 151.461, "practitioner" also means a, or licensed physician assistant authorized to 
27.18 	prescribe, dispense, and administer under chapter 147A. For purposes of sections 151.15, 
27.19 	subdivision 4; 151.211, subdivision 3; 151.252, subdivision 3; 151.37, subdivision 2, 
27.20 	paragraph (b); and 151.461, "practitioner" also means a dental therapist authorized to dispense 
27.21 	and administer under chapter 150A. For purposes of sections 151.252, subdivision 3, and 
27.22 	151.461, "practitioner" also means a pharmacist authorized to prescribe self-administered 
27.23 	hormonal contraceptives, nicotine replacement medications, or opiate antagonists under 
27.24 	section 151.37, subdivision 14, 15, or 16.

27.25 	Sec. 20. Minnesota Statutes 2019 Supplement, section 151.01, subdivision 27, is amended 
27.26 	to read:
27.27 		Subd. 27.Practice of pharmacy. "Practice of pharmacy" means:
27.28 	(1) interpretation and evaluation of prescription drug orders;
27.29 	(2) compounding, labeling, and dispensing drugs and devices (except labeling by a 
27.30 	manufacturer or packager of nonprescription drugs or commercially packaged legend drugs 
27.31 	and devices);
28.1 	(3) participation in clinical interpretations and monitoring of drug therapy for assurance 
28.2 	of safe and effective use of drugs, including the performance of laboratory tests that are 
28.3 	waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code, 
28.4 	title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory 
28.5 	tests but may modify drug therapy only pursuant to a protocol or collaborative practice 
28.6 	agreement;
28.7 	(4) participation in drug and therapeutic device selection; drug administration for first 
28.8 	dosage and medical emergencies; intramuscular and subcutaneous administration used for 
28.9 	the treatment of alcohol or opioid dependence; drug regimen reviews; and drug or 
28.10 	drug-related research;
28.11 	(5) drug administration, through intramuscular and subcutaneous administration used 
28.12 	to treat mental illnesses as permitted under the following conditions:
28.13 	(i) upon the order of a prescriber and the prescriber is notified after administration is 
28.14 	complete; or
28.15 	(ii) pursuant to a protocol or collaborative practice agreement as defined by section 
28.16 	151.01, subdivisions 27b and 27c, and participation in the initiation, management, 
28.17 	modification, administration, and discontinuation of drug therapy is according to the protocol 
28.18 	or collaborative practice agreement between the pharmacist and a dentist, optometrist, 
28.19 	physician, podiatrist, or veterinarian, or an advanced practice registered nurse authorized 
28.20 	to prescribe, dispense, and administer under section 148.235. Any changes in drug therapy 
28.21 	or medication administration made pursuant to a protocol or collaborative practice agreement 
28.22 	must be documented by the pharmacist in the patient's medical record or reported by the 
28.23 	pharmacist to a practitioner responsible for the patient's care;
28.24 	(6) participation in administration of influenza vaccines and vaccines approved by the 
28.25 	United States Food and Drug Administration related to COVID-19 or SARS-CoV-2 to all 
28.26 	eligible individuals six years of age and older and all other vaccines to patients 13 years of 
28.27 	age and older by written protocol with a physician licensed under chapter 147, a physician 
28.28 	assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered 
28.29 	nurse authorized to prescribe drugs under section 148.235, provided that:
28.30 	(i) the protocol includes, at a minimum:
28.31 	(A) the name, dose, and route of each vaccine that may be given;
28.32 	(B) the patient population for whom the vaccine may be given;
28.33 	(C) contraindications and precautions to the vaccine;
29.1 	(D) the procedure for handling an adverse reaction;
29.2 	(E) the name, signature, and address of the physician, physician assistant, or advanced 
29.3 	practice registered nurse;
29.4 	(F) a telephone number at which the physician, physician assistant, or advanced practice 
29.5 	registered nurse can be contacted; and
29.6 	(G) the date and time period for which the protocol is valid;
29.7 	(ii) the pharmacist has successfully completed a program approved by the Accreditation 
29.8 	Council for Pharmacy Education specifically for the administration of immunizations or a 
29.9 	program approved by the board;
29.10 	(iii) the pharmacist utilizes the Minnesota Immunization Information Connection to 
29.11 	assess the immunization status of individuals prior to the administration of vaccines, except 
29.12 	when administering influenza vaccines to individuals age nine and older;
29.13 	(iv) the pharmacist reports the administration of the immunization to the Minnesota 
29.14 	Immunization Information Connection; and
29.15 	(v) the pharmacist complies with guidelines for vaccines and immunizations established 
29.16 	by the federal Advisory Committee on Immunization Practices, except that a pharmacist 
29.17 	does not need to comply with those portions of the guidelines that establish immunization 
29.18 	schedules when administering a vaccine pursuant to a valid, patient-specific order issued 
29.19 	by a physician licensed under chapter 147, a physician assistant authorized to prescribe 
29.20 	drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe 
29.21 	drugs under section 148.235, provided that the order is consistent with the United States 
29.22 	Food and Drug Administration approved labeling of the vaccine;
29.23 	(7) participation in the initiation, management, modification, and discontinuation of 
29.24 	drug therapy according to a written protocol or collaborative practice agreement between: 
29.25 	(i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists, 
29.26 	or veterinarians; or (ii) one or more pharmacists and one or more physician assistants 
29.27 	authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice 
29.28 	registered nurses authorized to prescribe, dispense, and administer under section 148.235. 
29.29 	Any changes in drug therapy made pursuant to a protocol or collaborative practice agreement 
29.30 	must be documented by the pharmacist in the patient's medical record or reported by the 
29.31 	pharmacist to a practitioner responsible for the patient's care;
29.32 	(8) participation in the storage of drugs and the maintenance of records;
30.1 	(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and 
30.2 	devices;
30.3 	(10) offering or performing those acts, services, operations, or transactions necessary 
30.4 	in the conduct, operation, management, and control of a pharmacy; and
30.5 	(11) participation in the initiation, management, modification, and discontinuation of 
30.6 	therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:
30.7 	(i) a written protocol as allowed under clause (6); or
30.8 	(ii) a written protocol with a community health board medical consultant or a practitioner 
30.9 	designated by the commissioner of health, as allowed under section 151.37, subdivision 13; 
30.10 	and
30.11 	(12) prescribing self-administered hormonal contraceptives; nicotine replacement 
30.12 	medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant 
30.13 	to section 151.37, subdivision 14, 15, or 16.

30.14 	Sec. 21. Minnesota Statutes 2018, section 151.01, is amended by adding a subdivision to 
30.15 	read:
30.16 		Subd. 42.Self-administered hormonal contraceptive. "Self-administered hormonal 
30.17 	contraceptive" means a drug composed of a combination of hormones that is approved by 
30.18 	the United States Food and Drug Administration to prevent pregnancy and is administered 
30.19 	by the user.

30.20 	Sec. 22. Minnesota Statutes 2018, section 151.37, subdivision 2, is amended to read:
30.21 		Subd. 2.Prescribing and filing. (a) A licensed practitioner in the course of professional 
30.22 	practice only, may prescribe, administer, and dispense a legend drug, and may cause the 
30.23 	same to be administered by a nurse, a physician assistant, or medical student or resident 
30.24 	under the practitioner's direction and supervision, and may cause a person who is an 
30.25 	appropriately certified, registered, or licensed health care professional to prescribe, dispense, 
30.26 	and administer the same within the expressed legal scope of the person's practice as defined 
30.27 	in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, without reference 
30.28 	to a specific patient, by directing a licensed dietitian or licensed nutritionist, pursuant to 
30.29 	section 148.634; a nurse, pursuant to section 148.235, subdivisions 8 and 9; physician 
30.30 	assistant; medical student or resident; or pharmacist according to section 151.01, subdivision 
30.31 	27, to adhere to a particular practice guideline or protocol when treating patients whose 
30.32 	condition falls within such guideline or protocol, and when such guideline or protocol 
31.1 	specifies the circumstances under which the legend drug is to be prescribed and administered. 
31.2 	An individual who verbally, electronically, or otherwise transmits a written, oral, or electronic 
31.3 	order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug. 
31.4 	This paragraph applies to a physician assistant only if the physician assistant meets the 
31.5 	requirements of section 147A.18.
31.6 	(b) The commissioner of health, if a licensed practitioner, or a person designated by the 
31.7 	commissioner who is a licensed practitioner, may prescribe a legend drug to an individual 
31.8 	or by protocol for mass dispensing purposes where the commissioner finds that the conditions 
31.9 	triggering section 144.4197 or 144.4198, subdivision 2, paragraph (b), exist. The 
31.10 	commissioner, if a licensed practitioner, or a designated licensed practitioner, may prescribe, 
31.11 	dispense, or administer a legend drug or other substance listed in subdivision 10 to control 
31.12 	tuberculosis and other communicable diseases. The commissioner may modify state drug 
31.13 	labeling requirements, and medical screening criteria and documentation, where time is 
31.14 	critical and limited labeling and screening are most likely to ensure legend drugs reach the 
31.15 	maximum number of persons in a timely fashion so as to reduce morbidity and mortality.
31.16 	(c) A licensed practitioner that dispenses for profit a legend drug that is to be administered 
31.17 	orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must file with the 
31.18 	practitioner's licensing board a statement indicating that the practitioner dispenses legend 
31.19 	drugs for profit, the general circumstances under which the practitioner dispenses for profit, 
31.20 	and the types of legend drugs generally dispensed. It is unlawful to dispense legend drugs 
31.21 	for profit after July 31, 1990, unless the statement has been filed with the appropriate 
31.22 	licensing board. For purposes of this paragraph, "profit" means (1) any amount received by 
31.23 	the practitioner in excess of the acquisition cost of a legend drug for legend drugs that are 
31.24 	purchased in prepackaged form, or (2) any amount received by the practitioner in excess 
31.25 	of the acquisition cost of a legend drug plus the cost of making the drug available if the 
31.26 	legend drug requires compounding, packaging, or other treatment. The statement filed under 
31.27 	this paragraph is public data under section 13.03. This paragraph does not apply to a licensed 
31.28 	doctor of veterinary medicine or a registered pharmacist. Any person other than a licensed 
31.29 	practitioner with the authority to prescribe, dispense, and administer a legend drug under 
31.30 	paragraph (a) shall not dispense for profit. To dispense for profit does not include dispensing 
31.31 	by a community health clinic when the profit from dispensing is used to meet operating 
31.32 	expenses.
31.33 	(d) A prescription drug order for the following drugs is not valid, unless it can be 
31.34 	established that the prescription drug order was based on a documented patient evaluation, 
32.1 	including an examination, adequate to establish a diagnosis and identify underlying conditions 
32.2 	and contraindications to treatment:
32.3 	(1) controlled substance drugs listed in section 152.02, subdivisions 3 to 5;
32.4 	(2) drugs defined by the Board of Pharmacy as controlled substances under section 
32.5 	152.02, subdivisions 7, 8, and 12;
32.6 	(3) muscle relaxants;
32.7 	(4) centrally acting analgesics with opioid activity;
32.8 	(5) drugs containing butalbital; or
32.9 	(6) phosphodiesterase type 5 inhibitors when used to treat erectile dysfunction.
32.10 	For purposes of prescribing drugs listed in clause (6), the requirement for a documented 
32.11 	patient evaluation, including an examination, may be met through the use of telemedicine, 
32.12 	as defined in section 147.033, subdivision 1.
32.13 	(e) For the purposes of paragraph (d), the requirement for an examination shall be met 
32.14 	if an in-person examination has been completed in any of the following circumstances:
32.15 	(1) the prescribing practitioner examines the patient at the time the prescription or drug 
32.16 	order is issued;
32.17 	(2) the prescribing practitioner has performed a prior examination of the patient;
32.18 	(3) another prescribing practitioner practicing within the same group or clinic as the 
32.19 	prescribing practitioner has examined the patient;
32.20 	(4) a consulting practitioner to whom the prescribing practitioner has referred the patient 
32.21 	has examined the patient; or
32.22 	(5) the referring practitioner has performed an examination in the case of a consultant 
32.23 	practitioner issuing a prescription or drug order when providing services by means of 
32.24 	telemedicine.
32.25 	(f) Nothing in paragraph (d) or (e) prohibits a licensed practitioner from prescribing a 
32.26 	drug through the use of a guideline or protocol pursuant to paragraph (a).
32.27 	(g) Nothing in this chapter prohibits a licensed practitioner from issuing a prescription 
32.28 	or dispensing a legend drug in accordance with the Expedited Partner Therapy in the 
32.29 	Management of Sexually Transmitted Diseases guidance document issued by the United 
32.30 	States Centers for Disease Control.
33.1 	(h) Nothing in paragraph (d) or (e) limits prescription, administration, or dispensing of 
33.2 	legend drugs through a public health clinic or other distribution mechanism approved by 
33.3 	the commissioner of health or a community health board in order to prevent, mitigate, or 
33.4 	treat a pandemic illness, infectious disease outbreak, or intentional or accidental release of 
33.5 	a biological, chemical, or radiological agent.
33.6 	(i) No pharmacist employed by, under contract to, or working for a pharmacy located 
33.7 	within the state and licensed under section 151.19, subdivision 1, may dispense a legend 
33.8 	drug based on a prescription that the pharmacist knows, or would reasonably be expected 
33.9 	to know, is not valid under paragraph (d).
33.10 	(j) No pharmacist employed by, under contract to, or working for a pharmacy located 
33.11 	outside the state and licensed under section 151.19, subdivision 1, may dispense a legend 
33.12 	drug to a resident of this state based on a prescription that the pharmacist knows, or would 
33.13 	reasonably be expected to know, is not valid under paragraph (d).
33.14 	(k) Nothing in this chapter prohibits the commissioner of health, if a licensed practitioner, 
33.15 	or, if not a licensed practitioner, a designee of the commissioner who is a licensed 
33.16 	practitioner, from prescribing legend drugs for field-delivered therapy in the treatment of 
33.17 	a communicable disease according to the Centers For Disease Control and Prevention Partner 
33.18 	Services Guidelines.

33.19 	Sec. 23. Minnesota Statutes 2018, section 151.37, is amended by adding a subdivision to 
33.20 	read:
33.21 		Subd. 14.Self-administered hormonal contraceptives. (a) A pharmacist is authorized 
33.22 	to prescribe self-administered hormonal contraceptives if the intended use is contraception 
33.23 	in accordance with this subdivision. By January 1, 2021, the board shall develop a 
33.24 	standardized protocol for the pharmacist to follow in prescribing self-administrated hormonal 
33.25 	contraceptives. In developing the protocol, the board shall consult with the Minnesota Board 
33.26 	of Medical Practice; the Minnesota Board of Nursing; the commissioner of health; the 
33.27 	Minnesota section of the American Congress of Obstetricians and Gynecologists; professional 
33.28 	pharmacy associations; and professional associations of physicians, physician assistants, 
33.29 	and advanced practice registered nurses. The protocol must, at a minimum, include:
33.30 	(1) requiring the patient to complete a self-screening tool to identify patient risk factors 
33.31 	for the use of self-administered hormonal contraceptives, based on the current United States 
33.32 	Medical Eligibility Criteria for Contraceptive Use developed by the federal Centers for 
33.33 	Disease Control and Prevention;
34.1 	(2) requiring the pharmacist to review the screening tool with the patient;
34.2 	(3) other assessments the pharmacist should make before prescribing self-administered 
34.3 	hormonal contraceptives;
34.4 	(4) situations when the prescribing of self-administered hormonal contraceptives by a 
34.5 	pharmacist is contraindicated;
34.6 	(5) situations when the pharmacist must refer a patient to the patient's primary care 
34.7 	provider or, if the patient does not have a primary care provider, to a nearby clinic or hospital; 
34.8 	and
34.9 	(6) any additional information concerning the requirements and prohibitions in this 
34.10 	subdivision that the board considers necessary.
34.11 	(b) Before a pharmacist is authorized to prescribe a self-administered hormonal 
34.12 	contraceptive to a patient under this subdivision, the pharmacist shall successfully complete 
34.13 	a training program on prescribing self-administered hormonal contraceptives that is offered 
34.14 	by a college of pharmacy or by a continuing education provider that is accredited by the 
34.15 	Accreditation Council for Pharmacy Education, or a program approved by the board. To 
34.16 	maintain authorization to prescribe, the pharmacist shall complete continuing education 
34.17 	requirements as specified by the board.
34.18 	(c) Before prescribing a self-administered hormonal contraceptive, the pharmacist shall 
34.19 	follow the standardized protocol developed under paragraph (a), and if appropriate, may 
34.20 	prescribe a self-administered hormonal contraceptive to a patient, if the patient is:
34.21 	(1) 18 years of age or older; or
34.22 	(2) under the age of 18 if the patient has previously been prescribed a self-administered 
34.23 	hormonal contraceptive by a licensed physician, physician assistant, or advanced practice 
34.24 	registered nurse.
34.25 	(d) The pharmacist shall provide counseling to the patient on the use of self-administered 
34.26 	hormonal contraceptives and provide the patient with a fact sheet that includes but is not 
34.27 	limited to the contraindications for use of the drug, the appropriate method for using the 
34.28 	drug, the need for medical follow-up, and any additional information listed in Minnesota 
34.29 	Rules, part 6800.0910, subpart 2, that is required to be given to a patient during the counseling 
34.30 	process. The pharmacist shall also provide the patient with a written record of the 
34.31 	self-administered hormonal contraceptive prescribed by the pharmacist.
34.32 	(e) If a pharmacist prescribes and dispenses a self-administered hormonal contraceptive 
34.33 	under this subdivision, the pharmacist shall not prescribe a refill to the patient unless the 
35.1 	patient has evidence of a clinical visit with a physician, physician assistant, or advanced 
35.2 	practice registered nurse within the preceding three years.
35.3 	(f) A pharmacist who is authorized to prescribe a self-administered hormonal 
35.4 	contraceptive is prohibited from delegating the prescribing to any other person. A pharmacist 
35.5 	intern registered pursuant to section 151.101 may prepare a prescription for a 
35.6 	self-administered hormonal contraceptive, but before the prescription is processed or 
35.7 	dispensed, a pharmacist authorized to prescribe under this subdivision must review, approve, 
35.8 	and sign the prescription.
35.9 	(g) Nothing in this subdivision prohibits a pharmacist from participating in the initiation, 
35.10 	management, modification, and discontinuation of drug therapy according to a protocol or 
35.11 	collaborative agreement as authorized in this section and in section 151.01, subdivision 27.

35.12 	Sec. 24. Minnesota Statutes 2018, section 151.37, is amended by adding a subdivision to 
35.13 	read:
35.14 		Subd. 15.Nicotine replacement medications. (a) A pharmacist is authorized to prescribe 
35.15 	nicotine replacement medications approved by the United States Food and Drug 
35.16 	Administration in accordance with this subdivision. By January 1, 2021, the board shall 
35.17 	develop a standardized protocol for the pharmacist to follow in prescribing nicotine 
35.18 	replacement medications. In developing the protocol, the board shall consult with the 
35.19 	Minnesota Board of Medical Practice; the Minnesota Board of Nursing; the commissioner 
35.20 	of health; professional pharmacy associations; and professional associations of physicians, 
35.21 	physician assistants, and advanced practice registered nurses.
35.22 	(b) Before a pharmacist is authorized to prescribe nicotine replacement medications 
35.23 	under this subdivision, the pharmacist shall successfully complete a training program 
35.24 	specifically developed for prescribing nicotine replacement medications that is offered by 
35.25 	a college of pharmacy or by a continuing education provider that is accredited by the 
35.26 	Accreditation Council for Pharmacy Education, or a program approved by the board. To 
35.27 	maintain authorization to prescribe, the pharmacist shall complete continuing education 
35.28 	requirements as specified by the board.
35.29 	(c) Before prescribing a nicotine replacement medication, the pharmacist shall follow 
35.30 	the appropriate standardized protocol developed under paragraph (a), and if appropriate, 
35.31 	may dispense to a patient a nicotine replacement medication.
35.32 	(d) The pharmacist shall provide counseling to the patient on the use of the nicotine 
35.33 	replacement medication and provide the patient with a fact sheet that includes but is not 
36.1 	limited to the indications and contraindications for use of a nicotine replacement medication, 
36.2 	the appropriate method for using the medication or product, the need for medical follow-up, 
36.3 	and any additional information listed in Minnesota Rules, part 6800.0910, subpart 2, that 
36.4 	is required to be given to a patient during the counseling process. The pharmacist shall also 
36.5 	provide the patient with a written record of the medication prescribed by the pharmacist.
36.6 	(e) A pharmacist who is authorized to prescribe a nicotine replacement medication under 
36.7 	this subdivision is prohibited from delegating the prescribing of the medication to any other 
36.8 	person. A pharmacist intern registered pursuant to section 151.101 may prepare a prescription 
36.9 	for the medication, but before the prescription is processed or dispensed, a pharmacist 
36.10 	authorized to prescribe under this subdivision must review, approve, and sign the prescription.
36.11 	(f) Nothing in this subdivision prohibits a pharmacist from participating in the initiation, 
36.12 	management, modification, and discontinuation of drug therapy according to a protocol or 
36.13 	collaborative agreement as authorized in this section and in section 151.01, subdivision 27.

36.14 	Sec. 25. Minnesota Statutes 2018, section 151.37, is amended by adding a subdivision to 
36.15 	read:
36.16 		Subd. 16.Opiate antagonists for the treatment of an acute opiate overdose. (a) A 
36.17 	pharmacist is authorized to prescribe opiate antagonists for the treatment of an acute opiate 
36.18 	overdose. By January 1, 2021, the board shall develop a standardized protocol for the 
36.19 	pharmacist to follow in prescribing an opiate antagonist. In developing the protocol, the 
36.20 	board shall consult with the Minnesota Board of Medical Practice; the Minnesota Board of 
36.21 	Nursing; the commissioner of health; professional pharmacy associations; and professional 
36.22 	associations of physicians, physician assistants, and advanced practice registered nurses.
36.23 	(b) Before a pharmacist is authorized to prescribe an opiate antagonist under this 
36.24 	subdivision, the pharmacist shall successfully complete a training program specifically 
36.25 	developed for prescribing opiate antagonists for the treatment of an acute opiate overdose 
36.26 	that is offered by a college of pharmacy or by a continuing education provider that is 
36.27 	accredited by the Accreditation Council for Pharmacy Education, or a program approved 
36.28 	by the board. To maintain authorization to prescribe, the pharmacist shall complete continuing 
36.29 	education requirements as specified by the board.
36.30 	(c) Before prescribing an opiate antagonist under this subdivision, the pharmacist shall 
36.31 	follow the appropriate standardized protocol developed under paragraph (a), and if 
36.32 	appropriate, may dispense to a patient an opiate antagonist.
37.1 	(d) The pharmacist shall provide counseling to the patient on the use of the opiate 
37.2 	antagonist and provide the patient with a fact sheet that includes but is not limited to the 
37.3 	indications and contraindications for use of the opiate antagonist, the appropriate method 
37.4 	for using the opiate antagonist, the need for medical follow-up, and any additional 
37.5 	information listed in Minnesota Rules, part 6800.0910, subpart 2, that is required to be given 
37.6 	to a patient during the counseling process. The pharmacist shall also provide the patient 
37.7 	with a written record of the opiate antagonist prescribed by the pharmacist.
37.8 	(e) A pharmacist who prescribes an opiate antagonist under this subdivision is prohibited 
37.9 	from delegating the prescribing of the medication to any other person. A pharmacist intern 
37.10 	registered pursuant to section 151.101 may prepare the prescription for the opiate antagonist, 
37.11 	but before the prescription is processed or dispensed, a pharmacist authorized to prescribe 
37.12 	under this subdivision must review, approve, and sign the prescription.
37.13 	(f) Nothing in this subdivision prohibits a pharmacist from participating in the initiation, 
37.14 	management, modification, and discontinuation of drug therapy according to a protocol as 
37.15 	authorized in this section and in section 151.01, subdivision 27.

37.16 	Sec. 26. Minnesota Statutes 2019 Supplement, section 151.555, subdivision 3, is amended 
37.17 	to read:
37.18 		Subd. 3.Central repository requirements. (a) The board shall may publish a request 
37.19 	for proposal for participants who meet the requirements of this subdivision and are interested 
37.20 	in acting as the central repository for the drug repository program. The board If the board 
37.21 	publishes a request for proposal, it shall follow all applicable state procurement procedures 
37.22 	in the selection process. The board may also work directly with the University of Minnesota 
37.23 	to establish a central repository.
37.24 	(b) To be eligible to act as the central repository, the participant must be a wholesale 
37.25 	drug distributor located in Minnesota, licensed pursuant to section 151.47, and in compliance 
37.26 	with all applicable federal and state statutes, rules, and regulations.
37.27 	(c) The central repository shall be subject to inspection by the board pursuant to section 
37.28 	151.06, subdivision 1.
37.29 	(d) The central repository shall comply with all applicable federal and state laws, rules, 
37.30 	and regulations pertaining to the drug repository program, drug storage, and dispensing. 
37.31 	The facility must maintain in good standing any state license or registration that applies to 
37.32 	the facility.

37.33 	EFFECTIVE DATE. This section is effective the day following final enactment.

38.1 	Sec. 27. Minnesota Statutes 2018, section 152.12, subdivision 1, is amended to read:
38.2 		Subdivision 1.Prescribing, dispensing, administering controlled substances in 
38.3 	Schedules II through V. A licensed doctor of medicine, a doctor of osteopathic medicine, 
38.4 	duly licensed to practice medicine, a doctor of dental surgery, a doctor of dental medicine, 
38.5 	a licensed doctor of podiatry, a licensed advanced practice registered nurse, a licensed 
38.6 	physician assistant, or a licensed doctor of optometry limited to Schedules IV and V, and 
38.7 	in the course of professional practice only, may prescribe, administer, and dispense a 
38.8 	controlled substance included in Schedules II through V of section 152.02, may cause the 
38.9 	same to be administered by a nurse, an intern or an assistant under the direction and 
38.10 	supervision of the doctor, and may cause a person who is an appropriately certified and 
38.11 	licensed health care professional to prescribe and administer the same within the expressed 
38.12 	legal scope of the person's practice as defined in Minnesota Statutes.

38.13 	Sec. 28. Minnesota Statutes 2019 Supplement, section 256B.0625, subdivision 13, is 
38.14 	amended to read:
38.15 		Subd. 13.Drugs. (a) Medical assistance covers drugs, except for fertility drugs when 
38.16 	specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed 
38.17 	by a licensed pharmacist, by a physician enrolled in the medical assistance program as a 
38.18 	dispensing physician, or by a physician, physician assistant, or a nurse practitioner employed 
38.19 	by or under contract with a community health board as defined in section 145A.02, 
38.20 	subdivision 5, for the purposes of communicable disease control.
38.21 	(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, 
38.22 	unless authorized by the commissioner.
38.23 	(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical 
38.24 	ingredient" is defined as a substance that is represented for use in a drug and when used in 
38.25 	the manufacturing, processing, or packaging of a drug becomes an active ingredient of the 
38.26 	drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle 
38.27 	for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and 
38.28 	excipients which are included in the medical assistance formulary. Medical assistance covers 
38.29 	selected active pharmaceutical ingredients and excipients used in compounded prescriptions 
38.30 	when the compounded combination is specifically approved by the commissioner or when 
38.31 	a commercially available product:
38.32 	(1) is not a therapeutic option for the patient;
39.1 	(2) does not exist in the same combination of active ingredients in the same strengths 
39.2 	as the compounded prescription; and
39.3 	(3) cannot be used in place of the active pharmaceutical ingredient in the compounded 
39.4 	prescription.
39.5 	(d) Medical assistance covers the following over-the-counter drugs when prescribed by 
39.6 	a licensed practitioner or by a licensed pharmacist who meets standards established by the 
39.7 	commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family 
39.8 	planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults 
39.9 	with documented vitamin deficiencies, vitamins for children under the age of seven and 
39.10 	pregnant or nursing women, and any other over-the-counter drug identified by the 
39.11 	commissioner, in consultation with the Formulary Committee, as necessary, appropriate, 
39.12 	and cost-effective for the treatment of certain specified chronic diseases, conditions, or 
39.13 	disorders, and this determination shall not be subject to the requirements of chapter 14. A 
39.14 	pharmacist may prescribe over-the-counter medications as provided under this paragraph 
39.15 	for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter 
39.16 	drugs under this paragraph, licensed pharmacists must consult with the recipient to determine 
39.17 	necessity, provide drug counseling, review drug therapy for potential adverse interactions, 
39.18 	and make referrals as needed to other health care professionals.
39.19 	(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable 
39.20 	under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and 
39.21 	Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible 
39.22 	for drug coverage as defined in the Medicare Prescription Drug, Improvement, and 
39.23 	Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these 
39.24 	individuals, medical assistance may cover drugs from the drug classes listed in United States 
39.25 	Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to 
39.26 	13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall 
39.27 	not be covered.
39.28 	(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing 
39.29 	Program and dispensed by 340B covered entities and ambulatory pharmacies under common 
39.30 	ownership of the 340B covered entity. Medical assistance does not cover drugs acquired 
39.31 	through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.
39.32 	(g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal 
39.33 	contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section 
39.34 	151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a 
40.1 	licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists 
40.2 	used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed 
40.3 	pharmacist in accordance with section 151.37, subdivision 16.

40.4 	Sec. 29. Minnesota Statutes 2018, section 256B.0625, subdivision 13h, is amended to 
40.5 	read:
40.6 		Subd. 13h.Medication therapy management services. (a) Medical assistance covers 
40.7 	medication therapy management services for a recipient taking prescriptions to treat or 
40.8 	prevent one or more chronic medical conditions. For purposes of this subdivision, 
40.9 	"medication therapy management" means the provision of the following pharmaceutical 
40.10 	care services by a licensed pharmacist to optimize the therapeutic outcomes of the patient's 
40.11 	medications:
40.12 	(1) performing or obtaining necessary assessments of the patient's health status;
40.13 	(2) formulating a medication treatment plan, which may include prescribing medications 
40.14 	or products in accordance with section 151.37, subdivision 14, 15, or 16;
40.15 	(3) monitoring and evaluating the patient's response to therapy, including safety and 
40.16 	effectiveness;
40.17 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
40.18 	medication-related problems, including adverse drug events;
40.19 	(5) documenting the care delivered and communicating essential information to the 
40.20 	patient's other primary care providers;
40.21 	(6) providing verbal education and training designed to enhance patient understanding 
40.22 	and appropriate use of the patient's medications;
40.23 	(7) providing information, support services, and resources designed to enhance patient 
40.24 	adherence with the patient's therapeutic regimens; and
40.25 	(8) coordinating and integrating medication therapy management services within the 
40.26 	broader health care management services being provided to the patient.
40.27 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
40.28 	the pharmacist as defined in section 151.01, subdivision 27.
40.29 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
40.30 	must meet the following requirements:
41.1 	(1) have a valid license issued by the Board of Pharmacy of the state in which the 
41.2 	medication therapy management service is being performed;
41.3 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
41.4 	completed a structured and comprehensive education program approved by the Board of 
41.5 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
41.6 	documentation of pharmaceutical care management services that has both clinical and 
41.7 	didactic elements;
41.8 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
41.9 	have developed a structured patient care process that is offered in a private or semiprivate 
41.10 	patient care area that is separate from the commercial business that also occurs in the setting, 
41.11 	or in home settings, including long-term care settings, group homes, and facilities providing 
41.12 	assisted living services, but excluding skilled nursing facilities; and
41.13 	(4) make use of an electronic patient record system that meets state standards.
41.14 	(c) For purposes of reimbursement for medication therapy management services, the 
41.15 	commissioner may enroll individual pharmacists as medical assistance providers. The 
41.16 	commissioner may also establish contact requirements between the pharmacist and recipient, 
41.17 	including limiting the number of reimbursable consultations per recipient.
41.18 	(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing 
41.19 	within a reasonable geographic distance of the patient, a pharmacist who meets the 
41.20 	requirements may provide the services via two-way interactive video. Reimbursement shall 
41.21 	be at the same rates and under the same conditions that would otherwise apply to the services 
41.22 	provided. To qualify for reimbursement under this paragraph, the pharmacist providing the 
41.23 	services must meet the requirements of paragraph (b), and must be located within an 
41.24 	ambulatory care setting that meets the requirements of paragraph (b), clause (3). The patient 
41.25 	must also be located within an ambulatory care setting that meets the requirements of 
41.26 	paragraph (b), clause (3). Services provided under this paragraph may not be transmitted 
41.27 	into the patient's residence.
41.28 	(e) Medication therapy management services may be delivered into a patient's residence 
41.29 	via secure interactive video if the medication therapy management services are performed 
41.30 	electronically during a covered home care visit by an enrolled provider. Reimbursement 
41.31 	shall be at the same rates and under the same conditions that would otherwise apply to the 
41.32 	services provided. To qualify for reimbursement under this paragraph, the pharmacist 
41.33 	providing the services must meet the requirements of paragraph (b) and must be located 
41.34 	within an ambulatory care setting that meets the requirements of paragraph (b), clause (3).

42.1 	Sec. 30. ISSUANCE OF PRESCRIPTIONS TO TREAT SUBSTANCE USE 
42.2 	DISORDERS.
 42.3 		Subdivision 1.Applicability during a peacetime emergency. This section applies 
42.4 	during a peacetime emergency declared by the governor under Minnesota Statutes, section 
42.5 	12.31, subdivision 2, for an outbreak of COVID-19.
42.6 		Subd. 2.Use of telemedicine allowed. For purposes of Minnesota Statutes, section 
42.7 	151.37, subdivision 2, paragraph (d), the requirement for an examination shall be met if the 
42.8 	prescribing practitioner has performed a telemedicine examination of the patient before 
42.9 	issuing a prescription drug order for the treatment of a substance use disorder.
42.10 		Subd. 3.Expiration. This section expires 60 days after the peacetime emergency specified 
42.11 	in subdivision 1 is terminated or rescinded by proper authority.

42.12 	EFFECTIVE DATE. This section is effective the day following final enactment.

42.13 	Sec. 31. LICENSE RENEWAL FOR PODIATRISTS; CONTINUING EDUCATION.
 42.14 	(a) Notwithstanding Minnesota Statutes, section 153.16, subdivision 5, for purposes of 
42.15 	obtaining the required hours of continuing education for licensure renewal, any continuing 
42.16 	education hours obtained by a licensed podiatrist through participation in an internet live 
42.17 	online continuing educational activity as defined by the Council on Podiatric Medical 
42.18 	Education from March 13, 2020, to the expiration date of this section, shall be classified 
42.19 	by the board of podiatric medicine in the same manner as if the credits were obtained through 
42.20 	in-person participation.
42.21 	(b) This section expires December 31, 2020, or the day after the peacetime emergency 
42.22 	declared by the governor under Minnesota Statutes, section 12.31, subdivision 2, for an 
42.23 	outbreak of COVID-19 is terminated or rescinded by proper authority, whichever is later.

42.24 	EFFECTIVE DATE. This section is effective the day following final enactment.

42.25 	Sec. 32. OBSERVATION OF PHYSICAL THERAPIST ASSISTANTS.
 42.26 		Subdivision 1.Applicability during a peacetime emergency. This section applies 
42.27 	during a peacetime emergency by the governor under Minnesota Statutes, section 12.31, 
42.28 	subdivision 2, for an outbreak of COVID-19.
42.29 		Subd. 2.On-site requirements. For purposes of Minnesota Statutes, section 148.706, 
42.30 	subdivision 3, the on-site observation requirement of treatment components delegated to a 
43.1 	physical therapist assistant by a physical therapist may be met through observation via 
43.2 	telemedicine.
43.3 		Subd. 3.Expiration. This section expires 60 days after the peacetime emergency specified 
43.4 	in subdivision 1 is terminated or rescinded by the proper authority.

43.5 	EFFECTIVE DATE. This section is effective the day following final enactment.

43.6 	Sec. 33. THERAPEUTIC INTERCHANGE.
 43.7 		Subdivision 1.Applicability during a peacetime emergency. This section applies 
43.8 	during a peacetime emergency declared by the governor under Minnesota Statutes, section 
43.9 	12.31, subdivision 2, for an outbreak of COVID-19.
43.10 		Subd. 2.Therapeutic interchange. Notwithstanding Minnesota Statutes, section 151.21, 
43.11 	subdivision 7a, paragraph (a), a pharmacist may dispense a therapeutically equivalent and 
43.12 	interchangeable prescribed drug or biological product, without having a protocol in place, 
43.13 	provided:
43.14 	(1) the drug prescribed is in short supply and the pharmacist is unable to obtain it from 
43.15 	the manufacturer, drug wholesalers, or other local pharmacies;
43.16 	(2) the pharmacist is unable to contact the prescriber within a reasonable period of time 
43.17 	to get authorization to dispense a drug that is available;
43.18 	(3) the pharmacist determines a therapeutically equivalent drug to the one prescribed is 
43.19 	available and is in the same American Hospital Formulary Service pharmacologic-therapeutic 
43.20 	classification;
43.21 	(4) the pharmacist informs the patient as required in Minnesota Statutes, section 151.21, 
43.22 	subdivision 7a, paragraph (b), and provides counseling to the patient, as required by the 
43.23 	Board of Pharmacy rules, about the substituted drug;
43.24 	(5) the pharmacist informs the prescriber as soon as possible that the therapeutic 
43.25 	interchange has been made; and
43.26 	(6) the therapeutic interchange pursuant to this section is allowed only until the expiration 
43.27 	date under subdivision 3.
43.28 		Subd. 3.Expiration. This section expires 60 days after the peacetime emergency specified 
43.29 	in subdivision 1 is terminated or rescinded by proper authority.

43.30 	EFFECTIVE DATE. This section is effective the day following final enactment.

44.1 	Sec. 34. REPEALER.
 44.2 	Minnesota Statutes 2018, sections 147A.01, subdivisions 4, 11, 16a, 17a, 24, and 25; 
44.3 	147A.04; 147A.10; 147A.11; 147A.18, subdivisions 1, 2, and 3; and 147A.20, are repealed.

44.4 	ARTICLE 3
44.5 	HEALTH CARE

44.6 	Section 1. Minnesota Statutes 2019 Supplement, section 16A.151, subdivision 2, is 
44.7 	amended to read:
44.8 		Subd. 2.Exceptions. (a) If a state official litigates or settles a matter on behalf of specific 
44.9 	injured persons or entities, this section does not prohibit distribution of money to the specific 
44.10 	injured persons or entities on whose behalf the litigation or settlement efforts were initiated. 
44.11 	If money recovered on behalf of injured persons or entities cannot reasonably be distributed 
44.12 	to those persons or entities because they cannot readily be located or identified or because 
44.13 	the cost of distributing the money would outweigh the benefit to the persons or entities, the 
44.14 	money must be paid into the general fund.
44.15 	(b) Money recovered on behalf of a fund in the state treasury other than the general fund 
44.16 	may be deposited in that fund.
44.17 	(c) This section does not prohibit a state official from distributing money to a person or 
44.18 	entity other than the state in litigation or potential litigation in which the state is a defendant 
44.19 	or potential defendant.
44.20 	(d) State agencies may accept funds as directed by a federal court for any restitution or 
44.21 	monetary penalty under United States Code, title 18, section 3663(a)(3), or United States 
44.22 	Code, title 18, section 3663A(a)(3). Funds received must be deposited in a special revenue 
44.23 	account and are appropriated to the commissioner of the agency for the purpose as directed 
44.24 	by the federal court.
44.25 	(e) Tobacco settlement revenues as defined in section 16A.98, subdivision 1, paragraph 
44.26 	(t), may be deposited as provided in section 16A.98, subdivision 12.
44.27 	(f) Any money received by the state resulting from a settlement agreement or an assurance 
44.28 	of discontinuance entered into by the attorney general of the state, or a court order in litigation 
44.29 	brought by the attorney general of the state, on behalf of the state or a state agency, against 
44.30 	one or more opioid manufacturers or opioid wholesale drug distributors related to alleged 
44.31 	violations of consumer fraud laws in the marketing, sale, or distribution of opioids in this 
44.32 	state or other alleged illegal actions that contributed to the excessive use of opioids, must 
45.1 	be deposited in a separate account in the state treasury and the commissioner shall notify 
45.2 	the chairs and ranking minority members of the Finance Committee in the senate and the 
45.3 	Ways and Means Committee in the house of representatives that an account has been created. 
45.4 	This paragraph does not apply to attorney fees and costs awarded to the state or the Attorney 
45.5 	General's Office, to contract attorneys hired by the state or Attorney General's Office, or to 
45.6 	other state agency attorneys. If the licensing fees under section 151.065, subdivision 1, 
45.7 	clause (16), and subdivision 3, clause (14), are reduced and the registration fee under section 
45.8 	151.066, subdivision 3, is repealed in accordance with section 256.043, subdivision 4, then 
45.9 	the commissioner shall transfer from the separate account created in this paragraph to the 
45.10 	opiate epidemic response account fund under section 256.043 an amount that ensures that 
45.11 	$20,940,000 each fiscal year is available for distribution in accordance with section 256.043, 
45.12 	subdivisions 2 and 3.

45.13 	EFFECTIVE DATE. This section is effective the day following final enactment.

45.14 	Sec. 2. Minnesota Statutes 2018, section 62U.03, is amended to read:
45.15 	62U.03 PAYMENT RESTRUCTURING; CARE COORDINATION PAYMENTS.
45.16 	(a) By January 1, 2010, health plan companies shall include health care homes in their 
45.17 	provider networks and by July 1, 2010, shall pay a care coordination fee for their members 
45.18 	who choose to enroll in health care homes certified by the commissioners of health and 
45.19 	human services commissioner under section 256B.0751. Health plan companies shall develop 
45.20 	payment conditions and terms for the care coordination fee for health care homes participating 
45.21 	in their network in a manner that is consistent with the system developed under section 
45.22 	256B.0753. Nothing in this section shall restrict the ability of health plan companies to 
45.23 	selectively contract with health care providers, including health care homes. Health plan 
45.24 	companies may reduce or reallocate payments to other providers to ensure that 
45.25 	implementation of care coordination payments is cost neutral.
45.26 	(b) By July 1, 2010, the commissioner of management and budget shall implement the 
45.27 	care coordination payments for participants in the state employee group insurance program. 
45.28 	The commissioner of management and budget may reallocate payments within the health 
45.29 	care system in order to ensure that the implementation of this section is cost neutral.

45.30 	EFFECTIVE DATE. This section is effective the day following final enactment.

46.1 	Sec. 3. Minnesota Statutes 2018, section 62U.04, subdivision 11, is amended to read:
46.2 		Subd. 11.Restricted uses of the all-payer claims data. (a) Notwithstanding subdivision 
46.3 	4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the commissioner's 
46.4 	designee shall only use the data submitted under subdivisions 4 and 5 for the following 
46.5 	purposes:
46.6 	(1) to evaluate the performance of the health care home program as authorized under 
46.7 	sections section256B.0751, subdivision 6, and 256B.0752, subdivision 2;
46.8 	(2) to study, in collaboration with the reducing avoidable readmissions effectively 
46.9 	(RARE) campaign, hospital readmission trends and rates;
46.10 	(3) to analyze variations in health care costs, quality, utilization, and illness burden based 
46.11 	on geographical areas or populations;
46.12 	(4) to evaluate the state innovation model (SIM) testing grant received by the Departments 
46.13 	of Health and Human Services, including the analysis of health care cost, quality, and 
46.14 	utilization baseline and trend information for targeted populations and communities; and
46.15 	(5) to compile one or more public use files of summary data or tables that must:
46.16 	(i) be available to the public for no or minimal cost by March 1, 2016, and available by 
46.17 	web-based electronic data download by June 30, 2019;
46.18 	(ii) not identify individual patients, payers, or providers;
46.19 	(iii) be updated by the commissioner, at least annually, with the most current data 
46.20 	available;
46.21 	(iv) contain clear and conspicuous explanations of the characteristics of the data, such 
46.22 	as the dates of the data contained in the files, the absence of costs of care for uninsured 
46.23 	patients or nonresidents, and other disclaimers that provide appropriate context; and
46.24 	(v) not lead to the collection of additional data elements beyond what is authorized under 
46.25 	this section as of June 30, 2015.
46.26 	(b) The commissioner may publish the results of the authorized uses identified in 
46.27 	paragraph (a) so long as the data released publicly do not contain information or descriptions 
46.28 	in which the identity of individual hospitals, clinics, or other providers may be discerned.
46.29 	(c) Nothing in this subdivision shall be construed to prohibit the commissioner from 
46.30 	using the data collected under subdivision 4 to complete the state-based risk adjustment 
46.31 	system assessment due to the legislature on October 1, 2015.
47.1 	(d) The commissioner or the commissioner's designee may use the data submitted under 
47.2 	subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until July 1, 
47.3 	2023.
47.4 	(e) The commissioner shall consult with the all-payer claims database work group 
47.5 	established under subdivision 12 regarding the technical considerations necessary to create 
47.6 	the public use files of summary data described in paragraph (a), clause (5).

47.7 	EFFECTIVE DATE. This section is effective the day following final enactment.

47.8 	Sec. 4. Minnesota Statutes 2019 Supplement, section 151.065, subdivision 1, as amended 
47.9 	by Laws 2020, chapter 71, article 2, section 5, is amended to read:
47.10 		Subdivision 1.Application fees. Application fees for licensure and registration are as 
47.11 	follows:
47.12 	(1) pharmacist licensed by examination, $175;
47.13 	(2) pharmacist licensed by reciprocity, $275;
47.14 	(3) pharmacy intern, $50;
47.15 	(4) pharmacy technician, $50;
47.16 	(5) pharmacy, $260;
47.17 	(6) drug wholesaler, legend drugs only, $5,260;
47.18 	(7) drug wholesaler, legend and nonlegend drugs, $5,260;
47.19 	(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,260;
47.20 	(9) drug wholesaler, medical gases, $5,260 for the first facility and $260 for each 
47.21 	additional facility;
47.22 	(10) third-party logistics provider, $260;
47.23 	(11) drug manufacturer, nonopiate legend drugs only, $5,260;
47.24 	(12) drug manufacturer, nonopiate legend and nonlegend drugs, $5,260;
47.25 	(13) drug manufacturer, nonlegend or veterinary legend drugs, $5,260;
47.26 	(14) drug manufacturer, medical gases, $5,260 for the first facility and $260 for each 
47.27 	additional facility;
47.28 	(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,260;
48.1 	(16) drug manufacturer of opiate-containing controlled substances listed in section 
48.2 	152.02, subdivisions 3 to 5, $55,000 $55,260;
48.3 	(17) medical gas distributor dispenser, $260;
48.4 	(18) controlled substance researcher, $75; and
48.5 	(19) pharmacy professional corporation, $150.

48.6 	EFFECTIVE DATE. This section is effective the day following final enactment.

48.7 	Sec. 5. Minnesota Statutes 2019 Supplement, section 151.065, subdivision 3, as amended 
48.8 	by Laws 2020, chapter 71, article 2, section 6, is amended to read:
48.9 		Subd. 3.Annual renewal fees. Annual licensure and registration renewal fees are as 
48.10 	follows:
48.11 	(1) pharmacist, $175;
48.12 	(2) pharmacy technician, $50;
48.13 	(3) pharmacy, $260;
48.14 	(4) drug wholesaler, legend drugs only, $5,260;
48.15 	(5) drug wholesaler, legend and nonlegend drugs, $5,260;
48.16 	(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,260;
48.17 	(7) drug wholesaler, medical gases, $5,260 for the first facility and $260 for each 
48.18 	additional facility;
48.19 	(8) third-party logistics provider, $260;
48.20 	(9) drug manufacturer, nonopiate legend drugs only, $5,260;
48.21 	(10) drug manufacturer, nonopiate legend and nonlegend drugs, $5,260;
48.22 	(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $5,260;
48.23 	(12) drug manufacturer, medical gases, $5,260 for the first facility and $260 for each 
48.24 	additional facility;
48.25 	(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,260;
48.26 	(14) drug manufacturer of opiate-containing controlled substances listed in section 
48.27 	152.02, subdivisions 3 to 5, $55,000 $55,260;
48.28 	(15) medical gas distributor dispenser, $260;
49.1 	(16) controlled substance researcher, $75; and
49.2 	(17) pharmacy professional corporation, $100.

49.3 	EFFECTIVE DATE. This section is effective the day following final enactment.

49.4 	Sec. 6. Minnesota Statutes 2019 Supplement, section 151.065, subdivision 6, is amended 
49.5 	to read:
49.6 		Subd. 6.Reinstatement fees. (a) A pharmacist who has allowed the pharmacist's license 
49.7 	to lapse may reinstate the license with board approval and upon payment of any fees and 
49.8 	late fees in arrears, up to a maximum of $1,000.
49.9 	(b) A pharmacy technician who has allowed the technician's registration to lapse may 
49.10 	reinstate the registration with board approval and upon payment of any fees and late fees 
49.11 	in arrears, up to a maximum of $90.
49.12 	(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, third-party logistics 
49.13 	provider, or a medical gas distributor dispenser who has allowed the license of the 
49.14 	establishment to lapse may reinstate the license with board approval and upon payment of 
49.15 	any fees and late fees in arrears.
49.16 	(d) A controlled substance researcher who has allowed the researcher's registration to 
49.17 	lapse may reinstate the registration with board approval and upon payment of any fees and 
49.18 	late fees in arrears.
49.19 	(e) A pharmacist owner of a professional corporation who has allowed the corporation's 
49.20 	registration to lapse may reinstate the registration with board approval and upon payment 
49.21 	of any fees and late fees in arrears.

49.22 	EFFECTIVE DATE. This section is effective the day following final enactment.

49.23 	Sec. 7. Minnesota Statutes 2019 Supplement, section 151.065, subdivision 7, as amended 
49.24 	by Laws 2020, chapter 71, article 2, section 7, is amended to read:
49.25 		Subd. 7.Deposit of fees. (a) The license fees collected under this section, with the 
49.26 	exception of the fees identified in paragraphs (b) and (c), shall be deposited in the state 
49.27 	government special revenue fund.
49.28 	(b) $5,000 of each fee collected under subdivision 1, clauses (6) to (9), and (11) to (15), 
49.29 	and subdivision 3, clauses (4) to (7), and (9) to (13), and the fees $55,000 of each fee
49.30 	collected under subdivision 1, clause (16), and subdivision 3, clause (14), shall be deposited 
49.31 	in the opiate epidemic response account fund established in section 256.043.
50.1 	(c) If the fees collected under subdivision 1, clause (16), or subdivision 3, clause (14), 
50.2 	are reduced under section 256.043, $5,000 of the reduced fee shall be deposited in the opiate 
50.3 	epidemic response account fund in section 256.043.

50.4 	EFFECTIVE DATE. This section is effective the day following final enactment.

50.5 	Sec. 8. Minnesota Statutes 2019 Supplement, section 151.071, subdivision 2, is amended 
50.6 	to read:
50.7 		Subd. 2.Grounds for disciplinary action. The following conduct is prohibited and is 
50.8 	grounds for disciplinary action:
50.9 	(1) failure to demonstrate the qualifications or satisfy the requirements for a license or 
50.10 	registration contained in this chapter or the rules of the board. The burden of proof is on 
50.11 	the applicant to demonstrate such qualifications or satisfaction of such requirements;
50.12 	(2) obtaining a license by fraud or by misleading the board in any way during the 
50.13 	application process or obtaining a license by cheating, or attempting to subvert the licensing 
50.14 	examination process. Conduct that subverts or attempts to subvert the licensing examination 
50.15 	process includes, but is not limited to: (i) conduct that violates the security of the examination 
50.16 	materials, such as removing examination materials from the examination room or having 
50.17 	unauthorized possession of any portion of a future, current, or previously administered 
50.18 	licensing examination; (ii) conduct that violates the standard of test administration, such as 
50.19 	communicating with another examinee during administration of the examination, copying 
50.20 	another examinee's answers, permitting another examinee to copy one's answers, or 
50.21 	possessing unauthorized materials; or (iii) impersonating an examinee or permitting an 
50.22 	impersonator to take the examination on one's own behalf;
50.23 	(3) for a pharmacist, pharmacy technician, pharmacist intern, applicant for a pharmacist 
50.24 	or pharmacy license, or applicant for a pharmacy technician or pharmacist intern registration, 
50.25 	conviction of a felony reasonably related to the practice of pharmacy. Conviction as used 
50.26 	in this subdivision includes a conviction of an offense that if committed in this state would 
50.27 	be deemed a felony without regard to its designation elsewhere, or a criminal proceeding 
50.28 	where a finding or verdict of guilt is made or returned but the adjudication of guilt is either 
50.29 	withheld or not entered thereon. The board may delay the issuance of a new license or 
50.30 	registration if the applicant has been charged with a felony until the matter has been 
50.31 	adjudicated;
50.32 	(4) for a facility, other than a pharmacy, licensed or registered by the board, if an owner 
50.33 	or applicant is convicted of a felony reasonably related to the operation of the facility. The 
51.1 	board may delay the issuance of a new license or registration if the owner or applicant has 
51.2 	been charged with a felony until the matter has been adjudicated;
51.3 	(5) for a controlled substance researcher, conviction of a felony reasonably related to 
51.4 	controlled substances or to the practice of the researcher's profession. The board may delay 
51.5 	the issuance of a registration if the applicant has been charged with a felony until the matter 
51.6 	has been adjudicated;
51.7 	(6) disciplinary action taken by another state or by one of this state's health licensing 
51.8 	agencies:
51.9 	(i) revocation, suspension, restriction, limitation, or other disciplinary action against a 
51.10 	license or registration in another state or jurisdiction, failure to report to the board that 
51.11 	charges or allegations regarding the person's license or registration have been brought in 
51.12 	another state or jurisdiction, or having been refused a license or registration by any other 
51.13 	state or jurisdiction. The board may delay the issuance of a new license or registration if an 
51.14 	investigation or disciplinary action is pending in another state or jurisdiction until the 
51.15 	investigation or action has been dismissed or otherwise resolved; and
51.16 	(ii) revocation, suspension, restriction, limitation, or other disciplinary action against a 
51.17 	license or registration issued by another of this state's health licensing agencies, failure to 
51.18 	report to the board that charges regarding the person's license or registration have been 
51.19 	brought by another of this state's health licensing agencies, or having been refused a license 
51.20 	or registration by another of this state's health licensing agencies. The board may delay the 
51.21 	issuance of a new license or registration if a disciplinary action is pending before another 
51.22 	of this state's health licensing agencies until the action has been dismissed or otherwise 
51.23 	resolved;
51.24 	(7) for a pharmacist, pharmacy, pharmacy technician, or pharmacist intern, violation of 
51.25 	any order of the board, of any of the provisions of this chapter or any rules of the board or 
51.26 	violation of any federal, state, or local law or rule reasonably pertaining to the practice of 
51.27 	pharmacy;
51.28 	(8) for a facility, other than a pharmacy, licensed by the board, violations of any order 
51.29 	of the board, of any of the provisions of this chapter or the rules of the board or violation 
51.30 	of any federal, state, or local law relating to the operation of the facility;
51.31 	(9) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the 
51.32 	public, or demonstrating a willful or careless disregard for the health, welfare, or safety of 
51.33 	a patient; or pharmacy practice that is professionally incompetent, in that it may create 
52.1 	unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of 
52.2 	actual injury need not be established;
52.3 	(10) aiding or abetting an unlicensed person in the practice of pharmacy, except that it 
52.4 	is not a violation of this clause for a pharmacist to supervise a properly registered pharmacy 
52.5 	technician or pharmacist intern if that person is performing duties allowed by this chapter 
52.6 	or the rules of the board;
52.7 	(11) for an individual licensed or registered by the board, adjudication as mentally ill 
52.8 	or developmentally disabled, or as a chemically dependent person, a person dangerous to 
52.9 	the public, a sexually dangerous person, or a person who has a sexual psychopathic 
52.10 	personality, by a court of competent jurisdiction, within or without this state. Such 
52.11 	adjudication shall automatically suspend a license for the duration thereof unless the board 
52.12 	orders otherwise;
52.13 	(12) for a pharmacist or pharmacy intern, engaging in unprofessional conduct as specified 
52.14 	in the board's rules. In the case of a pharmacy technician, engaging in conduct specified in 
52.15 	board rules that would be unprofessional if it were engaged in by a pharmacist or pharmacist 
52.16 	intern or performing duties specifically reserved for pharmacists under this chapter or the 
52.17 	rules of the board;
52.18 	(13) for a pharmacy, operation of the pharmacy without a pharmacist present and on 
52.19 	duty except as allowed by a variance approved by the board;
52.20 	(14) for a pharmacist, the inability to practice pharmacy with reasonable skill and safety 
52.21 	to patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type 
52.22 	of material or as a result of any mental or physical condition, including deterioration through 
52.23 	the aging process or loss of motor skills. In the case of registered pharmacy technicians, 
52.24 	pharmacist interns, or controlled substance researchers, the inability to carry out duties 
52.25 	allowed under this chapter or the rules of the board with reasonable skill and safety to 
52.26 	patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type 
52.27 	of material or as a result of any mental or physical condition, including deterioration through 
52.28 	the aging process or loss of motor skills;
52.29 	(15) for a pharmacist, pharmacy, pharmacist intern, pharmacy technician, medical gas 
52.30 	distributor dispenser, or controlled substance researcher, revealing a privileged 
52.31 	communication from or relating to a patient except when otherwise required or permitted 
52.32 	by law;
53.1 	(16) for a pharmacist or pharmacy, improper management of patient records, including 
53.2 	failure to maintain adequate patient records, to comply with a patient's request made pursuant 
53.3 	to sections 144.291 to 144.298, or to furnish a patient record or report required by law;
53.4 	(17) fee splitting, including without limitation:
53.5 	(i) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate, 
53.6 	kickback, or other form of remuneration, directly or indirectly, for the referral of patients;
53.7 	(ii) referring a patient to any health care provider as defined in sections 144.291 to 
53.8 	144.298 in which the licensee or registrant has a financial or economic interest as defined 
53.9 	in section 144.6521, subdivision 3, unless the licensee or registrant has disclosed the 
53.10 	licensee's or registrant's financial or economic interest in accordance with section 144.6521; 
53.11 	and
53.12 	(iii) any arrangement through which a pharmacy, in which the prescribing practitioner 
53.13 	does not have a significant ownership interest, fills a prescription drug order and the 
53.14 	prescribing practitioner is involved in any manner, directly or indirectly, in setting the price 
53.15 	for the filled prescription that is charged to the patient, the patient's insurer or pharmacy 
53.16 	benefit manager, or other person paying for the prescription or, in the case of veterinary 
53.17 	patients, the price for the filled prescription that is charged to the client or other person 
53.18 	paying for the prescription, except that a veterinarian and a pharmacy may enter into such 
53.19 	an arrangement provided that the client or other person paying for the prescription is notified, 
53.20 	in writing and with each prescription dispensed, about the arrangement, unless such 
53.21 	arrangement involves pharmacy services provided for livestock, poultry, and agricultural 
53.22 	production systems, in which case client notification would not be required;
53.23 	(18) engaging in abusive or fraudulent billing practices, including violations of the 
53.24 	federal Medicare and Medicaid laws or state medical assistance laws or rules;
53.25 	(19) engaging in conduct with a patient that is sexual or may reasonably be interpreted 
53.26 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
53.27 	to a patient;
53.28 	(20) failure to make reports as required by section 151.072 or to cooperate with an 
53.29 	investigation of the board as required by section 151.074;
53.30 	(21) knowingly providing false or misleading information that is directly related to the 
53.31 	care of a patient unless done for an accepted therapeutic purpose such as the dispensing and 
53.32 	administration of a placebo;
54.1 	(22) aiding suicide or aiding attempted suicide in violation of section 609.215 as 
54.2 	established by any of the following:
54.3 	(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation 
54.4 	of section 609.215, subdivision 1 or 2;
54.5 	(ii) a copy of the record of a judgment of contempt of court for violating an injunction 
54.6 	issued under section 609.215, subdivision 4;
54.7 	(iii) a copy of the record of a judgment assessing damages under section 609.215, 
54.8 	subdivision 5; or
54.9 	(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2. 
54.10 	The board shall must investigate any complaint of a violation of section 609.215, subdivision 
54.11 	1 or 2;
54.12 	(23) for a pharmacist, practice of pharmacy under a lapsed or nonrenewed license. For 
54.13 	a pharmacist intern, pharmacy technician, or controlled substance researcher, performing 
54.14 	duties permitted to such individuals by this chapter or the rules of the board under a lapsed 
54.15 	or nonrenewed registration. For a facility required to be licensed under this chapter, operation 
54.16 	of the facility under a lapsed or nonrenewed license or registration; and
54.17 	(24) for a pharmacist, pharmacist intern, or pharmacy technician, termination or discharge 
54.18 	from the health professionals services program for reasons other than the satisfactory 
54.19 	completion of the program.

54.20 	EFFECTIVE DATE. This section is effective the day following final enactment.

54.21 	Sec. 9. Minnesota Statutes 2018, section 151.071, subdivision 8, is amended to read:
54.22 		Subd. 8.Temporary suspension of license for pharmacies, drug wholesalers, drug 
54.23 	manufacturers, medical gas manufacturers, and medical gas distributors dispensers. In 
54.24 	addition to any other remedy provided by law, the board may, without a hearing, temporarily 
54.25 	suspend the license or registration of a pharmacy, drug wholesaler, drug manufacturer, 
54.26 	medical gas manufacturer, or medical gas distributor dispenser if the board finds that the 
54.27 	licensee or registrant has violated a statute or rule that the board is empowered to enforce 
54.28 	and continued operation of the licensed facility would create a serious risk of harm to the 
54.29 	public. The suspension shall must take effect upon written notice to the licensee or registrant, 
54.30 	specifying the statute or rule violated. The suspension shall must remain in effect until the 
54.31 	board issues a final order in the matter after a hearing. At the time it issues the suspension 
54.32 	notice, the board shall must schedule a disciplinary hearing to be held pursuant to the 
54.33 	Administrative Procedure Act. The licensee or registrant shall must be provided with at 
55.1 	least 20 days' notice of any hearing held pursuant to this subdivision. The hearing shall must
55.2 	be scheduled to begin no later than 30 days after the issuance of the suspension order.

55.3 	EFFECTIVE DATE. This section is effective the day following final enactment.

55.4 	Sec. 10. Minnesota Statutes 2019 Supplement, section 151.19, subdivision 3, is amended 
55.5 	to read:
55.6 		Subd. 3.Sale of federally restricted medical gases. (a) A person or establishment not 
55.7 	licensed as a pharmacy or a practitioner shall must not engage in the retail sale or distribution
55.8 	dispensing of federally restricted medical gases without first obtaining a registration from 
55.9 	the board and paying the applicable fee specified in section 151.065. The registration shall
55.10 	must be displayed in a conspicuous place in the business for which it is issued and expires 
55.11 	on the date set by the board. It is unlawful for a person to sell or distribute dispense federally 
55.12 	restricted medical gases unless a certificate has been issued to that person by the board.
55.13 	(b) Application for a medical gas distributor dispenser registration under this section 
55.14 	shall must be made in a manner specified by the board.
55.15 	(c) No A registration shall must not be issued or renewed for a medical gas distributor
55.16 	dispenser located within the state unless the applicant agrees to operate in a manner prescribed 
55.17 	by federal and state law and according to the rules adopted by the board. No A license shall
55.18 	must not be issued for a medical gas distributor dispenser located outside of the state unless 
55.19 	the applicant agrees to operate in a manner prescribed by federal law and, when distributing
55.20 	dispensing medical gases for residents of this state, the laws of this state and Minnesota 
55.21 	Rules.
55.22 	(d) No A registration shall must not be issued or renewed for a medical gas distributor
55.23 	dispenser that is required to be licensed or registered by the state in which it is physically 
55.24 	located unless the applicant supplies the board with proof of the licensure or registration. 
55.25 	The board may, by rule, establish standards for the registration of a medical gas distributor
55.26 	dispenser that is not required to be licensed or registered by the state in which it is physically 
55.27 	located.
55.28 	(e) The board shall must require a separate registration for each medical gas distributor
55.29 	dispenser located within the state and for each facility located outside of the state from 
55.30 	which medical gases are distributed dispensed to residents of this state.
55.31 	(f) Prior to the issuance of an initial or renewed registration for a medical gas distributor
55.32 	dispenser, the board may require the medical gas distributor dispenser to pass an inspection 
55.33 	conducted by an authorized representative of the board. In the case of a medical gas 
56.1 	distributor dispenser located outside of the state, the board may require the applicant to pay 
56.2 	the cost of the inspection, in addition to the license fee in section 151.065, unless the applicant 
56.3 	furnishes the board with a report, issued by the appropriate regulatory agency of the state 
56.4 	in which the facility is located, of an inspection that has occurred within the 24 months 
56.5 	immediately preceding receipt of the license application by the board. The board may deny 
56.6 	licensure unless the applicant submits documentation satisfactory to the board that any 
56.7 	deficiencies noted in an inspection report have been corrected.

56.8 	EFFECTIVE DATE. This section is effective the day following final enactment.

56.9 	Sec. 11. Minnesota Statutes 2019 Supplement, section 151.252, subdivision 1, is amended 
56.10 	to read:
56.11 		Subdivision 1.Requirements. (a) No person shall act as a drug manufacturer without 
56.12 	first obtaining a license from the board and paying any applicable fee specified in section 
56.13 	151.065.
56.14 	(b) In addition to the license required under paragraph (a), each manufacturer required 
56.15 	to pay the registration fee under section 151.066 must pay the fee by June 1 of each year, 
56.16 	beginning June 1, 2020. In the event of a change of ownership of the manufacturer, the new 
56.17 	owner must pay the registration fee specified under section 151.066, subdivision 3, that the 
56.18 	original owner would have been assessed had the original owner retained ownership. The 
56.19 	registration fee collected under this paragraph shall be deposited in the opiate epidemic 
56.20 	response account fund established under section 256.043.
56.21 	(c) Application for a drug manufacturer license under this section shall be made in a 
56.22 	manner specified by the board.
56.23 	(d) No license shall be issued or renewed for a drug manufacturer unless the applicant 
56.24 	agrees to operate in a manner prescribed by federal and state law and according to Minnesota 
56.25 	Rules.
56.26 	(e) No license shall be issued or renewed for a drug manufacturer that is required to be 
56.27 	registered pursuant to United States Code, title 21, section 360, unless the applicant supplies 
56.28 	the board with proof of registration. The board may establish by rule the standards for 
56.29 	licensure of drug manufacturers that are not required to be registered under United States 
56.30 	Code, title 21, section 360.
56.31 	(f) No license shall be issued or renewed for a drug manufacturer that is required to be 
56.32 	licensed or registered by the state in which it is physically located unless the applicant 
56.33 	supplies the board with proof of licensure or registration. The board may establish, by rule, 
57.1 	standards for the licensure of a drug manufacturer that is not required to be licensed or 
57.2 	registered by the state in which it is physically located.
57.3 	(g) The board shall require a separate license for each facility located within the state at 
57.4 	which drug manufacturing occurs and for each facility located outside of the state at which 
57.5 	drugs that are shipped into the state are manufactured, except a manufacturer of 
57.6 	opiate-containing controlled substances shall not be required to pay the fee under section 
57.7 	151.065, subdivision 1, clause (16), or subdivision 3, clause (14), for more than one facility.
57.8 	(h) Prior to the issuance of an initial or renewed license for a drug manufacturing facility, 
57.9 	the board may require the facility to pass a current good manufacturing practices inspection 
57.10 	conducted by an authorized representative of the board. In the case of a drug manufacturing 
57.11 	facility located outside of the state, the board may require the applicant to pay the cost of 
57.12 	the inspection, in addition to the license fee in section 151.065, unless the applicant furnishes 
57.13 	the board with a report, issued by the appropriate regulatory agency of the state in which 
57.14 	the facility is located or by the United States Food and Drug Administration, of an inspection 
57.15 	that has occurred within the 24 months immediately preceding receipt of the license 
57.16 	application by the board. The board may deny licensure unless the applicant submits 
57.17 	documentation satisfactory to the board that any deficiencies noted in an inspection report 
57.18 	have been corrected.

57.19 	EFFECTIVE DATE. This section is effective the day following final enactment.

57.20 	Sec. 12. Minnesota Statutes 2018, section 256.01, subdivision 29, is amended to read:
57.21 		Subd. 29.State medical review team. (a) To ensure the timely processing of 
57.22 	determinations of disability by the commissioner's state medical review team under sections 
57.23 	256B.055, subdivisionsubdivisions 7, paragraph (b), and 12, and 256B.057, subdivision 9, 
57.24 	and 256B.055, subdivision 12, the commissioner shall review all medical evidence submitted 
57.25 	by county agencies with a referral and seek additional information from providers, applicants, 
57.26 	and enrollees to support the determination of disability where necessary. Disability shall 
57.27 	be determined according to the rules of title XVI and title XIX of the Social Security Act 
57.28 	and pertinent rules and policies of the Social Security Administration.
57.29 	(b) Prior to a denial or withdrawal of a requested determination of disability due to 
57.30 	insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary 
57.31 	and appropriate to a determination of disability, and (2) assist applicants and enrollees to 
57.32 	obtain the evidence, including, but not limited to, medical examinations and electronic 
57.33 	medical records.
58.1 	(c) The commissioner shall provide the chairs of the legislative committees with 
58.2 	jurisdiction over health and human services finance and budget the following information 
58.3 	on the activities of the state medical review team by February 1 of each year:
58.4 	(1) the number of applications to the state medical review team that were denied, 
58.5 	approved, or withdrawn;
58.6 	(2) the average length of time from receipt of the application to a decision;
58.7 	(3) the number of appeals, appeal results, and the length of time taken from the date the 
58.8 	person involved requested an appeal for a written decision to be made on each appeal;
58.9 	(4) for applicants, their age, health coverage at the time of application, hospitalization 
58.10 	history within three months of application, and whether an application for Social Security 
58.11 	or Supplemental Security Income benefits is pending; and
58.12 	(5) specific information on the medical certification, licensure, or other credentials of 
58.13 	the person or persons performing the medical review determinations and length of time in 
58.14 	that position.
58.15 	(d) Any appeal made under section 256.045, subdivision 3, of a disability determination 
58.16 	made by the state medical review team must be decided according to the timelines under 
58.17 	section 256.0451, subdivision 22, paragraph (a). If a written decision is not issued within 
58.18 	the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal must be 
58.19 	immediately reviewed by the chief human services judge.

58.20 	EFFECTIVE DATE. This section is effective the day following final enactment.

58.21 	Sec. 13. Minnesota Statutes 2019 Supplement, section 256.042, subdivision 2, is amended 
58.22 	to read:
58.23 		Subd. 2.Membership. (a) The council shall consist of the following 19 voting members, 
58.24 	appointed by the commissioner of human services except as otherwise specified, and three 
58.25 	nonvoting members:
58.26 	(1) two members of the house of representatives, appointed in the following sequence: 
58.27 	the first from the majority party appointed by the speaker of the house and the second from 
58.28 	the minority party appointed by the minority leader. Of these two members, one member 
58.29 	must represent a district outside of the seven-county metropolitan area, and one member 
58.30 	must represent a district that includes the seven-county metropolitan area. The appointment 
58.31 	by the minority leader must ensure that this requirement for geographic diversity in 
58.32 	appointments is met;
59.1 	(2) two members of the senate, appointed in the following sequence: the first from the 
59.2 	majority party appointed by the senate majority leader and the second from the minority 
59.3 	party appointed by the senate minority leader. Of these two members, one member must 
59.4 	represent a district outside of the seven-county metropolitan area and one member must 
59.5 	represent a district that includes the seven-county metropolitan area. The appointment by 
59.6 	the minority leader must ensure that this requirement for geographic diversity in appointments 
59.7 	is met;
59.8 	(3) one member appointed by the Board of Pharmacy;
59.9 	(4) one member who is a physician appointed by the Minnesota Medical Association;
59.10 	(5) one member representing opioid treatment programs, sober living programs, or 
59.11 	substance use disorder programs licensed under chapter 245G;
59.12 	(6) one member appointed by the Minnesota Society of Addiction Medicine who is an 
59.13 	addiction psychiatrist;
59.14 	(7) one member representing professionals providing alternative pain management 
59.15 	therapies, including, but not limited to, acupuncture, chiropractic, or massage therapy;
59.16 	(8) one member representing nonprofit organizations conducting initiatives to address 
59.17 	the opioid epidemic, with the commissioner's initial appointment being a member 
59.18 	representing the Steve Rummler Hope Network, and subsequent appointments representing 
59.19 	this or other organizations;
59.20 	(9) one member appointed by the Minnesota Ambulance Association who is serving 
59.21 	with an ambulance service as an emergency medical technician, advanced emergency 
59.22 	medical technician, or paramedic;
59.23 	(10) one member representing the Minnesota courts who is a judge or law enforcement 
59.24 	officer;
59.25 	(11) one public member who is a Minnesota resident and who is in opioid addiction 
59.26 	recovery;
59.27 	(12) two members representing Indian tribes, one representing the Ojibwe tribes and 
59.28 	one representing the Dakota tribes;
59.29 	(13) one public member who is a Minnesota resident and who is suffering from chronic 
59.30 	pain, intractable pain, or a rare disease or condition;
59.31 	(14) one mental health advocate representing persons with mental illness;
59.32 	(15) one member representing appointed by the Minnesota Hospital Association;
60.1 	(16) one member representing a local health department; and
60.2 	(17) the commissioners of human services, health, and corrections, or their designees, 
60.3 	who shall be ex officio nonvoting members of the council.
60.4 	(b) The commissioner of human services shall coordinate the commissioner's 
60.5 	appointments to provide geographic, racial, and gender diversity, and shall ensure that at 
60.6 	least one-half of council members appointed by the commissioner reside outside of the 
60.7 	seven-county metropolitan area. Of the members appointed by the commissioner, to the 
60.8 	extent practicable, at least one member must represent a community of color 
60.9 	disproportionately affected by the opioid epidemic.
60.10 	(c) The council is governed by section 15.059, except that members of the council shall 
60.11 	serve three-year terms and shall receive no compensation other than reimbursement for 
60.12 	expenses. Notwithstanding section 15.059, subdivision 6, the council shall not expire.
60.13 	(d) The chair shall convene the council at least quarterly, and may convene other meetings 
60.14 	as necessary. The chair shall convene meetings at different locations in the state to provide 
60.15 	geographic access, and shall ensure that at least one-half of the meetings are held at locations 
60.16 	outside of the seven-county metropolitan area.
60.17 	(e) The commissioner of human services shall provide staff and administrative services 
60.18 	for the advisory council.
60.19 	(f) The council is subject to chapter 13D.

60.20 	EFFECTIVE DATE. This section is effective the day following final enactment.

60.21 	Sec. 14. Minnesota Statutes 2019 Supplement, section 256.042, subdivision 4, is amended 
60.22 	to read:
60.23 		Subd. 4.Grants. (a) The commissioner of human services shall submit a report of the 
60.24 	grants proposed by the advisory council to be awarded for the upcoming fiscal year to the 
60.25 	chairs and ranking minority members of the legislative committees with jurisdiction over 
60.26 	health and human services policy and finance, by March 1 of each year, beginning March 
60.27 	1, 2020.
60.28 	(b) The commissioner of human services shall award grants from the opiate epidemic 
60.29 	response account fund under section 256.043. The grants shall be awarded to proposals 
60.30 	selected by the advisory council that address the priorities in subdivision 1, paragraph (a), 
60.31 	clauses (1) to (4), unless otherwise appropriated by the legislature. No more than three 
60.32 	percent of the grant amount may be used by a grantee for administration.

61.1 	EFFECTIVE DATE. This section is effective the day following final enactment.

61.2 	Sec. 15. Minnesota Statutes 2019 Supplement, section 256.043, is amended to read:
61.3 	256.043 OPIATE EPIDEMIC RESPONSE ACCOUNT FUND.
61.4 		Subdivision 1.Establishment. The opiate epidemic response account fund is established 
61.5 	in the special revenue fund in the state treasury. The registration fees assessed by the Board 
61.6 	of Pharmacy under section 151.066 and the license fees identified in section 151.065, 
61.7 	subdivision 7, paragraphs (b) and (c), shall be deposited into the account fund. Beginning 
61.8 	in fiscal year 2021, for each fiscal year, the funds in the account fund shall be administered 
61.9 	according to this section.
61.10 		Subd. 2.Transfers from account to state agencies. (a) The commissioner shall transfer 
61.11 	the following amounts to the agencies specified in this subdivision.
61.12 	(b) $126,000 to the Board of Pharmacy for the collection of the registration fees under 
61.13 	section 151.066.
61.14 	(c) $672,000 to the commissioner of public safety for the Bureau of Criminal 
61.15 	Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies and $288,000 
61.16 	is for special agent positions focused on drug interdiction and drug trafficking.
61.17 		Subd. 3.Appropriations from account fund. (a) After the transfers described in 
61.18 	subdivision 2, and the appropriations in Laws 2019, chapter 63, article 3, section 1, 
61.19 	paragraphs (e), (f), (g), and (h) are made, $249,000 is appropriated to the commissioner of 
61.20 	human services for the provision of administrative services to the Opiate Epidemic Response 
61.21 	Advisory Council and for the administration of the grants awarded under paragraph (c) (e).
61.22 	(b) $126,000 is appropriated to the Board of Pharmacy for the collection of the registration 
61.23 	fees under section 151.066.
61.24 	(c) $672,000 is appropriated to the commissioner of public safety for the Bureau of 
61.25 	Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies 
61.26 	and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
61.27 	(b) (d) After the transfers in subdivision 2 and the appropriations in paragraph paragraphs
61.28 	(a) to (c) are made, 50 percent of the remaining amount is appropriated to the commissioner 
61.29 	of human services for distribution to county social service and tribal social service agencies 
61.30 	to provide child protection services to children and families who are affected by addiction. 
61.31 	The commissioner shall distribute this money proportionally to counties and tribal social 
61.32 	service agencies based on out-of-home placement episodes where parental drug abuse is 
62.1 	the primary reason for the out-of-home placement using data from the previous calendar 
62.2 	year. County and tribal social service agencies receiving funds from the opiate epidemic 
62.3 	response account fund must annually report to the commissioner on how the funds were 
62.4 	used to provide child protection services, including measurable outcomes, as determined 
62.5 	by the commissioner. County social service agencies and tribal social service agencies must 
62.6 	not use funds received under this paragraph to supplant current state or local funding received 
62.7 	for child protection services for children and families who are affected by addiction.
62.8 	(c) (e) After making the transfers in subdivision 2 and the appropriations in paragraphs 
62.9 	(a) and (b) to (d), the remaining funds in the account are amount in the fund is appropriated 
62.10 	to the commissioner to award grants as specified by the Opiate Epidemic Response Advisory 
62.11 	Council in accordance with section 256.042, unless otherwise appropriated by the legislature.
62.12 		Subd. 4.Settlement; sunset. (a) If the state receives a total sum of $250,000,000 either 
62.13 	as a result of a settlement agreement or an assurance of discontinuance entered into by the 
62.14 	attorney general of the state, or resulting from a court order in litigation brought by the 
62.15 	attorney general of the state on behalf of the state or a state agency, against one or more 
62.16 	opioid manufacturers or opioid wholesale drug distributors related to alleged violations of 
62.17 	consumer fraud laws in the marketing, sale, or distribution of opioids in this state, or other 
62.18 	alleged illegal actions that contributed to the excessive use of opioids, or from the fees 
62.19 	collected under sections 151.065, subdivisions 1 and 3, and 151.066, that are deposited into 
62.20 	the opiate epidemic response account fund established in this section 256.043, or from a 
62.21 	combination of both, the fees specified in section 151.065, subdivisions 1, clause (16), and 
62.22 	3, clause (14), shall be reduced to $5,260, and the opiate registration fee in section 151.066, 
62.23 	subdivision 3, shall be repealed.
62.24 	(b) The commissioner of management and budget shall inform the board of pharmacy, 
62.25 	the governor, and the legislature when the amount specified in paragraph (a) has been 
62.26 	reached. The board shall apply the reduced license fee for the next licensure period.
62.27 	(c) Notwithstanding paragraph (a), the reduction of the license fee in section 151.065, 
62.28 	subdivisions 1 and 3, and the repeal of the registration fee in section 151.066 shall not occur 
62.29 	before July 1, 2024.

62.30 	EFFECTIVE DATE. This section is effective the day following final enactment.

62.31 	Sec. 16. Minnesota Statutes 2018, section 256B.056, subdivision 1a, is amended to read:
62.32 		Subd. 1a.Income and assets generally. (a)(1) Unless specifically required by state law 
62.33 	or rule or federal law or regulation, the methodologies used in counting income and assets 
63.1 	to determine eligibility for medical assistance for persons whose eligibility category is based 
63.2 	on blindness, disability, or age of 65 or more years, the methodologies for the Supplemental 
63.3 	Security Income program shall be used, except as provided under subdivision 3, paragraph 
63.4 	(a), clause (6).
63.5 	(2) Increases in benefits under title II of the Social Security Act shall not be counted as 
63.6 	income for purposes of this subdivision until July 1 of each year. Effective upon federal 
63.7 	approval, for children eligible under section 256B.055, subdivision 12, or for home and 
63.8 	community-based waiver services whose eligibility for medical assistance is determined 
63.9 	without regard to parental income, child support payments, including any payments made 
63.10 	by an obligor in satisfaction of or in addition to a temporary or permanent order for child 
63.11 	support, and Social Security payments are not counted as income.
63.12 	(b)(1) The modified adjusted gross income methodology as defined in the Affordable 
63.13 	Care Act United States Code, title 42, section 1396a(e)(14), shall be used for eligibility 
63.14 	categories based on:
63.15 	(i) children under age 19 and their parents and relative caretakers as defined in section 
63.16 	256B.055, subdivision 3a;
63.17 	(ii) children ages 19 to 20 as defined in section 256B.055, subdivision 16;
63.18 	(iii) pregnant women as defined in section 256B.055, subdivision 6;
63.19 	(iv) infants as defined in sections 256B.055, subdivision 10, and 256B.057, subdivision 
63.20 	8 1; and
63.21 	(v) adults without children as defined in section 256B.055, subdivision 15.
63.22 	For these purposes, a "methodology" does not include an asset or income standard, or 
63.23 	accounting method, or method of determining effective dates.
63.24 	(2) For individuals whose income eligibility is determined using the modified adjusted 
63.25 	gross income methodology in clause (1),:
63.26 	(i) the commissioner shall subtract from the individual's modified adjusted gross income 
63.27 	an amount equivalent to five percent of the federal poverty guidelines.; and
63.28 	(ii) the individual's current monthly income and household size is used to determine 
63.29 	eligibility for the 12-month eligibility period. If an individual's income is expected to vary 
63.30 	month to month, eligibility is determined based on the income predicted for the 12-month 
63.31 	eligibility period.

63.32 	EFFECTIVE DATE. This section is effective the day following final enactment.

64.1 	Sec. 17. Minnesota Statutes 2018, section 256B.056, subdivision 4, is amended to read:
64.2 		Subd. 4.Income. (a) To be eligible for medical assistance, a person eligible under section 
64.3 	256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of the federal 
64.4 	poverty guidelines. Effective January 1, 2000, and each successive January, recipients of 
64.5 	Supplemental Security Income may have an income up to the Supplemental Security Income 
64.6 	standard in effect on that date.
64.7 	(b) Effective January 1, 2014, To be eligible for medical assistance, under section 
64.8 	256B.055, subdivision 3a, a parent or caretaker relative may have an income up to 133 
64.9 	percent of the federal poverty guidelines for the household size.
64.10 	(c) To be eligible for medical assistance under section 256B.055, subdivision 15, a 
64.11 	person may have an income up to 133 percent of federal poverty guidelines for the household 
64.12 	size.
64.13 	(d) To be eligible for medical assistance under section 256B.055, subdivision 16, a child 
64.14 	age 19 to 20 may have an income up to 133 percent of the federal poverty guidelines for 
64.15 	the household size.
64.16 	(e) To be eligible for medical assistance under section 256B.055, subdivision 3a, a child 
64.17 	under age 19 may have income up to 275 percent of the federal poverty guidelines for the 
64.18 	household size or an equivalent standard when converted using modified adjusted gross 
64.19 	income methodology as required under the Affordable Care Act. Children who are enrolled 
64.20 	in medical assistance as of December 31, 2013, and are determined ineligible for medical 
64.21 	assistance because of the elimination of income disregards under modified adjusted gross 
64.22 	income methodology as defined in subdivision 1a remain eligible for medical assistance 
64.23 	under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law 
64.24 	111-3, until the date of their next regularly scheduled eligibility redetermination as required 
64.25 	in subdivision 7a.
64.26 	(f) In computing income to determine eligibility of persons under paragraphs (a) to (e) 
64.27 	who are not residents of long-term care facilities, the commissioner shall disregard increases 
64.28 	in income as required by Public Laws 94-566, section 503; 99-272; and 99-509. For persons 
64.29 	eligible under paragraph (a), veteran aid and attendance benefits and Veterans Administration 
64.30 	unusual medical expense payments are considered income to the recipient.

64.31 	EFFECTIVE DATE. This section is effective the day following final enactment.

65.1 	Sec. 18. Minnesota Statutes 2018, section 256B.056, subdivision 7, is amended to read:
65.2 		Subd. 7.Period of eligibility. (a) Eligibility is available for the month of application 
65.3 	and for three months prior to application if the person was eligible in those prior months. 
65.4 	A redetermination of eligibility must occur every 12 months.
65.5 	(b) For a person eligible for an insurance affordability program as defined in section 
65.6 	256B.02, subdivision 19, who reports a change that makes the person eligible for medical 
65.7 	assistance, eligibility is available for the month the change was reported and for three months 
65.8 	prior to the month the change was reported, if the person was eligible in those prior months.

65.9 	EFFECTIVE DATE. This section is effective the day following final enactment.

65.10 	Sec. 19. Minnesota Statutes 2019 Supplement, section 256B.056, subdivision 7a, is 
65.11 	amended to read:
65.12 		Subd. 7a.Periodic renewal of eligibility. (a) The commissioner shall make an annual 
65.13 	redetermination of eligibility based on information contained in the enrollee's case file and 
65.14 	other information available to the agency, including but not limited to information accessed 
65.15 	through an electronic database, without requiring the enrollee to submit any information 
65.16 	when sufficient data is available for the agency to renew eligibility.
65.17 	(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), the 
65.18 	commissioner must provide the enrollee with a prepopulated renewal form containing 
65.19 	eligibility information available to the agency and permit the enrollee to submit the form 
65.20 	with any corrections or additional information to the agency and sign the renewal form via 
65.21 	any of the modes of submission specified in section 256B.04, subdivision 18.
65.22 	(c) An enrollee who is terminated for failure to complete the renewal process may 
65.23 	subsequently submit the renewal form and required information within four months after 
65.24 	the date of termination and have coverage reinstated without a lapse, if otherwise eligible 
65.25 	under this chapter. The local agency may close the enrollee's case file if the required 
65.26 	information is not submitted within four months of termination.
65.27 	(d) Notwithstanding paragraph (a), individuals a person who is eligible under subdivision 
65.28 	5 shall be required to renew eligibility subject to a review of the person's income every six 
65.29 	months.

65.30 	EFFECTIVE DATE. This section is effective the day following final enactment.

66.1 	Sec. 20. Minnesota Statutes 2018, section 256B.056, subdivision 10, is amended to read:
66.2 		Subd. 10.Eligibility verification. (a) The commissioner shall require women who are 
66.3 	applying for the continuation of medical assistance coverage following the end of the 60-day 
66.4 	postpartum period to update their income and asset information and to submit any required 
66.5 	income or asset verification.
66.6 	(b) The commissioner shall determine the eligibility of private-sector health care coverage 
66.7 	for infants less than one year of age eligible under section 256B.055, subdivision 10, or 
66.8 	256B.057, subdivision 1, paragraph (b) (c), and shall pay for private-sector coverage if this 
66.9 	is determined to be cost-effective.
66.10 	(c) The commissioner shall verify assets and income for all applicants, and for all 
66.11 	recipients upon renewal.
66.12 	(d) The commissioner shall utilize information obtained through the electronic service 
66.13 	established by the secretary of the United States Department of Health and Human Services 
66.14 	and other available electronic data sources in Code of Federal Regulations, title 42, sections 
66.15 	435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish 
66.16 	standards to define when information obtained electronically is reasonably compatible with 
66.17 	information provided by applicants and enrollees, including use of self-attestation, to 
66.18 	accomplish real-time eligibility determinations and maintain program integrity.
66.19 	(e) Each person applying for or receiving medical assistance under section 256B.055, 
66.20 	subdivision 7, and any other person whose resources are required by law to be disclosed to 
66.21 	determine the applicant's or recipient's eligibility must authorize the commissioner to obtain 
66.22 	information from financial institutions to identify unreported accounts as required in section 
66.23 	256.01, subdivision 18f. If a person refuses or revokes the authorization, the commissioner 
66.24 	may determine that the applicant or recipient is ineligible for medical assistance. For purposes 
66.25 	of this paragraph, an authorization to identify unreported accounts meets the requirements 
66.26 	of the Right to Financial Privacy Act, United States Code, title 12, chapter 35, and need not 
66.27 	be furnished to the financial institution.
66.28 	(f) County and tribal agencies shall comply with the standards established by the 
66.29 	commissioner for appropriate use of the asset verification system specified in section 256.01, 
66.30 	subdivision 18f.

66.31 	EFFECTIVE DATE. This section is effective the day following final enactment.

67.1 	Sec. 21. Minnesota Statutes 2018, section 256B.0561, subdivision 2, is amended to read:
67.2 		Subd. 2.Periodic data matching. (a) Beginning April 1, 2018, The commissioner shall 
67.3 	conduct periodic data matching to identify recipients who, based on available electronic 
67.4 	data, may not meet eligibility criteria for the public health care program in which the recipient 
67.5 	is enrolled. The commissioner shall conduct data matching for medical assistance or 
67.6 	MinnesotaCare recipients at least once during a recipient's 12-month period of eligibility.
67.7 	(b) If data matching indicates a recipient may no longer qualify for medical assistance 
67.8 	or MinnesotaCare, the commissioner must notify the recipient and allow the recipient no 
67.9 	more than 30 days to confirm the information obtained through the periodic data matching 
67.10 	or provide a reasonable explanation for the discrepancy to the state or county agency directly 
67.11 	responsible for the recipient's case. If a recipient does not respond within the advance notice 
67.12 	period or does not respond with information that demonstrates eligibility or provides a 
67.13 	reasonable explanation for the discrepancy within the 30-day time period, the commissioner 
67.14 	shall terminate the recipient's eligibility in the manner provided for by the laws and 
67.15 	regulations governing the health care program for which the recipient has been identified 
67.16 	as being ineligible.
67.17 	(c) The commissioner shall not terminate eligibility for a recipient who is cooperating 
67.18 	with the requirements of paragraph (b) and needs additional time to provide information in 
67.19 	response to the notification.
67.20 	(d) A recipient whose eligibility was terminated according to paragraph (b) may be 
67.21 	eligible for medical assistance no earlier than the first day of the month in which the recipient 
67.22 	provides information that demonstrates the recipient's eligibility.
67.23 	(d) (e) Any termination of eligibility for benefits under this section may be appealed as 
67.24 	provided for in sections 256.045 to 256.0451, and the laws governing the health care 
67.25 	programs for which eligibility is terminated.

67.26 	EFFECTIVE DATE. This section is effective the day following final enactment.

67.27 	Sec. 22. Minnesota Statutes 2018, section 256B.057, subdivision 1, is amended to read:
67.28 		Subdivision 1.Infants and pregnant women. (a) An infant less than two years of age 
67.29 	or a pregnant woman is eligible for medical assistance if the individual's infant's countable 
67.30 	household income is equal to or less than 275 283 percent of the federal poverty guideline 
67.31 	for the same household size or an equivalent standard when converted using modified 
67.32 	adjusted gross income methodology as required under the Affordable Care Act. Medical 
67.33 	assistance for an uninsured infant younger than two years of age may be paid with federal 
68.1 	funds available under title XXI of the Social Security Act and the state children's health 
68.2 	insurance program, for an infant with countable income above 275 percent and equal to or 
68.3 	less than 283 percent of the federal poverty guideline for the household size.
68.4 	(b) A pregnant woman is eligible for medical assistance if the woman's countable income 
68.5 	is equal to or less than 278 percent of the federal poverty guideline for the applicable 
68.6 	household size.
68.7 	(b) (c) An infant born to a woman who was eligible for and receiving medical assistance 
68.8 	on the date of the child's birth shall continue to be eligible for medical assistance without 
68.9 	redetermination until the child's first birthday.

68.10 	EFFECTIVE DATE. This section is effective the day following final enactment.

68.11 	Sec. 23. Minnesota Statutes 2018, section 256B.057, subdivision 10, is amended to read:
68.12 		Subd. 10.Certain persons needing treatment for breast or cervical cancer. (a) 
68.13 	Medical assistance may be paid for a person who:
68.14 	(1) has been screened for breast or cervical cancer by the Minnesota any Centers for 
68.15 	Disease Control and Prevention (CDC) National Breast and Cervical Cancer Early Detection 
68.16 	Program (NBCCEDP)-funded breast and cervical cancer control program, and program 
68.17 	funds have been used to pay for the person's screening;
68.18 	(2) according to the person's treating health professional, needs treatment, including 
68.19 	diagnostic services necessary to determine the extent and proper course of treatment, for 
68.20 	breast or cervical cancer, including precancerous conditions and early stage cancer;
68.21 	(3) meets the income eligibility guidelines for the Minnesota any CDC NBCCEDP-funded
68.22 	breast and cervical cancer control program;
68.23 	(4) is under age 65;
68.24 	(5) is not otherwise eligible for medical assistance under United States Code, title 42, 
68.25 	section 1396a(a)(10)(A)(i); and
68.26 	(6) is not otherwise covered under creditable coverage, as defined under United States 
68.27 	Code, title 42, section 1396a(aa).
68.28 	(b) Medical assistance provided for an eligible person under this subdivision shall be 
68.29 	limited to services provided during the period that the person receives treatment for breast 
68.30 	or cervical cancer.
69.1 	(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance 
69.2 	without meeting the eligibility criteria relating to income and assets in section 256B.056, 
69.3 	subdivisions 1a to 5a.

69.4 	Sec. 24. Minnesota Statutes 2018, section 256B.0575, subdivision 1, is amended to read:
69.5 		Subdivision 1.Income deductions. When an institutionalized person is determined 
69.6 	eligible for medical assistance, the income that exceeds the deductions in paragraphs (a) 
69.7 	and (b) must be applied to the cost of institutional care.
69.8 	(a) The following amounts must be deducted from the institutionalized person's income 
69.9 	in the following order:
69.10 	(1) the personal needs allowance under section 256B.35 or, for a veteran who does not 
69.11 	have a spouse or child, or a surviving spouse of a veteran having no child, the amount of 
69.12 	an improved pension received from the veteran's administration not exceeding $90 per 
69.13 	month, whichever amount is greater;
69.14 	(2) the personal allowance for disabled individuals under section 256B.36;
69.15 	(3) if the institutionalized person has a legally appointed guardian or conservator, five 
69.16 	percent of the recipient's gross monthly income up to $100 as reimbursement for guardianship 
69.17 	or conservatorship services;
69.18 	(4) a monthly income allowance determined under section 256B.058, subdivision 2, but 
69.19 	only to the extent income of the institutionalized spouse is made available to the community 
69.20 	spouse;
69.21 	(5) a monthly allowance for children under age 18 which, together with the net income 
69.22 	of the children, would provide income equal to the medical assistance standard for families 
69.23 	and children according to section 256B.056, subdivision 4, for a family size that includes 
69.24 	only the minor children. This deduction applies only if the children do not live with the 
69.25 	community spouse and only to the extent that the deduction is not included in the personal 
69.26 	needs allowance under section 256B.35, subdivision 1, as child support garnished under a 
69.27 	court order;
69.28 	(6) a monthly family allowance for other family members, equal to one-third of the 
69.29 	difference between 122 percent of the federal poverty guidelines and the monthly income 
69.30 	for that family member;
69.31 	(7) reparations payments made by the Federal Republic of Germany and reparations 
69.32 	payments made by the Netherlands for victims of Nazi persecution between 1940 and 1945;
70.1 	(8) all other exclusions from income for institutionalized persons as mandated by federal 
70.2 	law; and
70.3 	(9) amounts for reasonable expenses, as specified in subdivision 2, incurred for necessary 
70.4 	medical or remedial care for the institutionalized person that are recognized under state law, 
70.5 	not medical assistance covered expenses, and not subject to payment by a third party.
70.6 	For purposes of clause (6), "other family member" means a person who resides with the 
70.7 	community spouse and who is a minor or dependent child, dependent parent, or dependent 
70.8 	sibling of either spouse. "Dependent" means a person who could be claimed as a dependent 
70.9 	for federal income tax purposes under the Internal Revenue Code.
70.10 	(b) Income shall be allocated to an institutionalized person for a period of up to three 
70.11 	calendar months, in an amount equal to the medical assistance standard for a family size of 
70.12 	one if:
70.13 	(1) a physician or advanced practice registered nurse certifies that the person is expected 
70.14 	to reside in the long-term care facility for three calendar months or less;
70.15 	(2) if the person has expenses of maintaining a residence in the community; and
70.16 	(3) if one of the following circumstances apply:
70.17 	(i) the person was not living together with a spouse or a family member as defined in 
70.18 	paragraph (a) when the person entered a long-term care facility; or
70.19 	(ii) the person and the person's spouse become institutionalized on the same date, in 
70.20 	which case the allocation shall be applied to the income of one of the spouses.
70.21 	For purposes of this paragraph, a person is determined to be residing in a licensed nursing 
70.22 	home, regional treatment center, or medical institution if the person is expected to remain 
70.23 	for a period of one full calendar month or more.

70.24 	Sec. 25. Minnesota Statutes 2018, section 256B.0575, subdivision 2, is amended to read:
70.25 		Subd. 2.Reasonable expenses. For the purposes of subdivision 1, paragraph (a), clause 
70.26 	(9), reasonable expenses are limited to expenses that have not been previously used as a 
70.27 	deduction from income and were not:
70.28 	(1) for long-term care expenses incurred during a period of ineligibility as defined in 
70.29 	section 256B.0595, subdivision 2;
70.30 	(2) incurred more than three months before the month of application associated with the 
70.31 	current period of eligibility;
71.1 	(3) for expenses incurred by a recipient that are duplicative of services that are covered 
71.2 	under chapter 256B; or
71.3 	(4) nursing facility expenses incurred without a timely assessment as required under 
71.4 	section 256B.0911.; or
71.5 	(5) for private room fees incurred by an assisted living client as defined in section 
71.6 	144G.01, subdivision 3.

71.7 	EFFECTIVE DATE. This section is effective the day following final enactment.

71.8 	Sec. 26. Minnesota Statutes 2018, section 256B.0625, subdivision 1, is amended to read:
71.9 		Subdivision 1.Inpatient hospital services. (a) Medical assistance covers inpatient 
71.10 	hospital services performed by hospitals holding Medicare certifications for the services 
71.11 	performed. A second medical opinion is required prior to reimbursement for elective surgeries 
71.12 	requiring a second opinion. The commissioner shall publish in the State Register a list of 
71.13 	elective surgeries that require a second medical opinion prior to reimbursement, and the 
71.14 	criteria and standards for deciding whether an elective surgery should require a second 
71.15 	medical opinion. The list and the criteria and standards are not subject to the requirements 
71.16 	of sections 14.001 to 14.69. The commissioner's decision whether a second medical opinion 
71.17 	is required, made in accordance with rules governing that decision, is not subject to 
71.18 	administrative appeal.
71.19 	(b) When determining medical necessity for inpatient hospital services, the medical 
71.20 	review agent shall follow industry standard medical necessity criteria in determining the 
71.21 	following:
71.22 	(1) whether a recipient's admission is medically necessary;
71.23 	(2) whether the inpatient hospital services provided to the recipient were medically 
71.24 	necessary;
71.25 	(3) whether the recipient's continued stay was or will be medically necessary; and
71.26 	(4) whether all medically necessary inpatient hospital services were provided to the 
71.27 	recipient.
71.28 	The medical review agent will determine medical necessity of inpatient hospital services, 
71.29 	including inpatient psychiatric treatment, based on a review of the patient's medical condition 
71.30 	and records, in conjunction with industry standard evidence-based criteria to ensure consistent 
71.31 	and optimal application of medical appropriateness criteria.

71.32 	EFFECTIVE DATE. This section is effective the day following final enactment.

72.1 	Sec. 27. Minnesota Statutes 2018, section 256B.0625, subdivision 27, is amended to read:
72.2 		Subd. 27.Organ and tissue transplants. All organ transplants must be performed at 
72.3 	transplant centers meeting united network for organ sharing criteria or at Medicare-approved 
72.4 	organ transplant centers.Organ and tissue transplants are a covered service. Stem cell or 
72.5 	bone marrow transplant centers must meet the standards established by the Foundation for 
72.6 	the Accreditation of Hematopoietic Cell Therapy.

72.7 	EFFECTIVE DATE. This section is effective the day following final enactment.

72.8 	Sec. 28. Minnesota Statutes 2018, section 256B.0625, subdivision 64, is amended to read:
72.9 		Subd. 64.Investigational drugs, biological products, and devices, and clinical 
72.10 	trials. (a) Medical assistance and the early periodic screening, diagnosis, and treatment 
72.11 	(EPSDT) program do not cover the costs of any services that are incidental to, associated 
72.12 	with, or resulting from the use of investigational drugs, biological products, or devices as 
72.13 	defined in section 151.375 or any other treatment that is part of an approved clinical trial 
72.14 	as defined in section 62Q.526. Participation of an enrollee in an approved clinical trial does 
72.15 	not preclude coverage of medically necessary services covered under this chapter that are 
72.16 	not related to the approved clinical trial.
72.17 	(b) Notwithstanding paragraph (a), stiripentol may be covered by the EPSDT program 
72.18 	if all the following conditions are met:
72.19 	(1) the use of stiripentol is determined to be medically necessary;
72.20 	(2) the enrollee has a documented diagnosis of Dravet syndrome, regardless of whether 
72.21 	an SCN1A genetic mutation is found, or the enrollee is a child with malignant migrating 
72.22 	partial epilepsy in infancy due to an SCN2A genetic mutation;
72.23 	(3) all other available covered prescription medications that are medically necessary for 
72.24 	the enrollee have been tried without successful outcomes; and
72.25 	(4) the United States Food and Drug Administration has approved the treating physician's 
72.26 	individual patient investigational new drug application (IND) for the use of stiripentol for 
72.27 	treatment.
72.28 	This paragraph does not apply to MinnesotaCare coverage under chapter 256L.

73.1 	Sec. 29. Minnesota Statutes 2018, section 256B.0751, is amended to read:
73.2 	256B.0751 HEALTH CARE HOMES.
73.3 		Subdivision 1.Definitions. (a) For purposes of sections section256B.0751to 256B.0753, 
73.4 	the following definitions apply.
73.5 	(b) "Commissioner" means the commissioner of human services health.
73.6 	(c) "Commissioners" means the commissioner of human services and the commissioner 
73.7 	of health, acting jointly.
73.8 	(d) (c) "Health plan company" has the meaning provided in section 62Q.01, subdivision 
73.9 	4.
73.10 	(e) (d) "Personal clinician" means a physician licensed under chapter 147, a physician 
73.11 	assistant licensed and practicing under chapter 147A, or an advanced practice nurse licensed 
73.12 	and registered to practice under chapter 148.
73.13 	(f) "State health care program" means the medical assistance and MinnesotaCare 
73.14 	programs.
73.15 		Subd. 2.Development and implementation of standards. (a) By July 1, 2009, The 
73.16 	commissioners commissioner of health and human services shall develop and implement 
73.17 	standards of certification for health care homes for state health care programs. In developing 
73.18 	these standards, the commissioners commissioner shall consider existing standards developed 
73.19 	by national independent accrediting and medical home organizations. The standards 
73.20 	developed by the commissioners commissioner must meet the following criteria:
73.21 	(1) emphasize, enhance, and encourage the use of primary care, and include the use of 
73.22 	primary care physicians, advanced practice nurses, and physician assistants as personal 
73.23 	clinicians;
73.24 	(2) focus on delivering high-quality, efficient, and effective health care services;
73.25 	(3) encourage patient-centered care, including active participation by the patient and 
73.26 	family or a legal guardian, or a health care agent as defined in chapter 145C, as appropriate 
73.27 	in decision making and care plan development, and providing care that is appropriate to the 
73.28 	patient's race, ethnicity, and language;
73.29 	(4) provide patients with a consistent, ongoing contact with a personal clinician or team 
73.30 	of clinical professionals to ensure continuous and appropriate care for the patient's condition;
74.1 	(5) ensure that health care homes develop and maintain appropriate comprehensive care 
74.2 	plans for their patients with complex or chronic conditions, including an assessment of 
74.3 	health risks and chronic conditions;
74.4 	(6) enable and encourage utilization of a range of qualified health care professionals, 
74.5 	including dedicated care coordinators, in a manner that enables providers to practice to the 
74.6 	fullest extent of their license;
74.7 	(7) focus initially on patients who have or are at risk of developing chronic health 
74.8 	conditions;
74.9 	(8) incorporate measures of quality, resource use, cost of care, and patient experience;
74.10 	(9) ensure the use of health information technology and systematic follow-up, including 
74.11 	the use of patient registries; and
74.12 	(10) encourage the use of scientifically based health care, patient decision-making aids 
74.13 	that provide patients with information about treatment options and their associated benefits, 
74.14 	risks, costs, and comparative outcomes, and other clinical decision support tools.
74.15 	(b) In developing these standards, the commissioners commissioner shall consult with 
74.16 	national and local organizations working on health care home models, physicians, relevant 
74.17 	state agencies, health plan companies, hospitals, other providers, patients, and patient 
74.18 	advocates. The commissioners may satisfy this requirement by continuing the provider 
74.19 	directed care coordination advisory committee.
74.20 	(c) For the purposes of developing and implementing these standards, the commissioners
74.21 	commissioner may use the expedited rulemaking process under section 14.389.
74.22 		Subd. 3.Requirements for clinicians certified as health care homes. (a) A personal 
74.23 	clinician or a primary care clinic may be certified as a health care home. If a primary care 
74.24 	clinic is certified, all of the primary care clinic's clinicians must meet the criteria of a health 
74.25 	care home. In order To be certified as a health care home, a clinician or clinic must meet 
74.26 	the standards set by the commissioners commissioner in accordance with this section. 
74.27 	Certification as a health care home is voluntary. In order To maintain their status as health 
74.28 	care homes, clinicians or clinics must renew their certification every three years.
74.29 	(b) Clinicians or clinics certified as health care homes must offer their health care home 
74.30 	services to all their patients with complex or chronic health conditions who are interested 
74.31 	in participation.
74.32 	(c) Health care homes must participate in the health care home collaborative established 
74.33 	under subdivision 5.
75.1 		Subd. 4.Alternative models and waivers of requirements. (a) Nothing in this section 
75.2 	shall preclude precludes the continued development of existing medical or health care home 
75.3 	projects currently operating or under development by the commissioner of human services 
75.4 	or preclude precludes the commissioner of human services from establishing alternative 
75.5 	models and payment mechanisms for persons who are enrolled in integrated Medicare and 
75.6 	Medicaid programs under section 256B.69, subdivisions 23 and 28, are enrolled in managed 
75.7 	care long-term care programs under section 256B.69, subdivision 6b, are dually eligible for 
75.8 	Medicare and medical assistance, are in the waiting period for Medicare, or who have other 
75.9 	primary coverage.
75.10 	(b) The commissioner of health shall waive health care home certification requirements 
75.11 	if an applicant demonstrates that compliance with a certification requirement will create a 
75.12 	major financial hardship or is not feasible, and the applicant establishes an alternative way 
75.13 	to accomplish the objectives of the certification requirement.
75.14 		Subd. 5.Health care home collaborative. By July 1, 2009, The commissioners
75.15 	commissioner shall establish a health care home collaborative to provide an opportunity for 
75.16 	health care homes and state agencies to exchange information related to quality improvement 
75.17 	and best practices.
75.18 		Subd. 6.Evaluation and continued development. (a) For continued certification under 
75.19 	this section, health care homes must meet process, outcome, and quality standards as 
75.20 	developed and specified by the commissioners commissioner. The commissioners
75.21 	commissioner shall collect data from health care homes necessary for monitoring compliance 
75.22 	with certification standards and for evaluating the impact of health care homes on health 
75.23 	care quality, cost, and outcomes.
75.24 	(b) The commissioners commissioner may contract with a private entity to perform an 
75.25 	evaluation of the effectiveness of health care homes. Data collected under this subdivision 
75.26 	is classified as nonpublic data under chapter 13.
75.27 		Subd. 7.Outreach. Beginning July 1, 2009, The commissioner of human services shall 
75.28 	encourage state health care program enrollees who have a complex or chronic condition to 
75.29 	select a primary care clinic with clinicians who have been certified as health care homes.
75.30 		Subd. 8.Coordination with local services. The health care home and the county shall 
75.31 	coordinate care and services provided to patients enrolled with a health care home who have 
75.32 	complex medical needs or a disability, and who need and are eligible for additional local 
75.33 	services administered by counties, including but not limited to waivered services, mental 
75.34 	health services, social services, public health services, transportation, and housing. The 
76.1 	coordination of care and services must be as provided in the plan established by the patient 
76.2 	and the health care home.
76.3 		Subd. 9.Pediatric care coordination. The commissioner of human services shall 
76.4 	implement a pediatric care coordination service for children with high-cost medical or 
76.5 	high-cost psychiatric conditions who are at risk of recurrent hospitalization or emergency 
76.6 	room use for acute, chronic, or psychiatric illness, who receive medical assistance services. 
76.7 	Care coordination services must be targeted to children not already receiving care 
76.8 	coordination through another service and may include but are not limited to the provision 
76.9 	of health care home services to children admitted to hospitals that do not currently provide 
76.10 	care coordination. Care coordination services must be provided by care coordinators who 
76.11 	are directly linked to provider teams in the care delivery setting, but who may be part of a 
76.12 	community care team shared by multiple primary care providers or practices. For purposes 
76.13 	of this subdivision, the commissioner of human services shall, to the extent possible, use 
76.14 	the existing health care home certification and payment structure established under this 
76.15 	section and section 256B.0753.
76.16 		Subd. 10.Health care homes advisory committee. (a) The commissioners of health 
76.17 	and human services commissioner shall establish a health care homes advisory committee 
76.18 	to advise the commissioners commissioner on the ongoing statewide implementation of the 
76.19 	health care homes program authorized in this section.
76.20 	(b) The commissioners commissioner shall establish an advisory committee that includes 
76.21 	representatives of the health care professions such as primary care providers;, mental health 
76.22 	providers;, nursing and care coordinators;, certified health care home clinics with statewide 
76.23 	representation;, health plan companies;, state agencies;, employers;, academic researchers;,
76.24 	consumers;, and organizations that work to improve health care quality in Minnesota. At 
76.25 	least 25 percent of the committee members must be consumers or patients in health care 
76.26 	homes. The commissioners commissioner, in making appointments to the committee, shall 
76.27 	ensure geographic representation of all regions of the state.
76.28 	(c) The advisory committee shall advise the commissioners commissioner on ongoing 
76.29 	implementation of the health care homes program, including, but not limited to, the following 
76.30 	activities:
76.31 	(1) implementation of certified health care homes across the state on performance 
76.32 	management and implementation of benchmarking;
76.33 	(2) implementation of modifications to the health care homes program based on results 
76.34 	of the legislatively mandated health care homes evaluation;
77.1 	(3) statewide solutions for engagement of employers and commercial payers;
77.2 	(4) potential modifications of the health care homes rules or statutes;
77.3 	(5) consumer engagement, including patient and family-centered care, patient activation 
77.4 	in health care, and shared decision making;
77.5 	(6) oversight for health care homes subject matter task forces or workgroups; and
77.6 	(7) other related issues as requested by the commissioners commissioner.
77.7 	(d) The advisory committee shall have the ability to establish subcommittees on specific 
77.8 	topics. The advisory committee is governed by section 15.059. Notwithstanding section 
77.9 	15.059, the advisory committee does not expire.

77.10 	EFFECTIVE DATE. This section is effective the day following final enactment.

77.11 	Sec. 30. Minnesota Statutes 2018, section 256B.0753, subdivision 1, is amended to read:
77.12 		Subdivision 1.Development. The commissioner of human services, in coordination 
77.13 	with the commissioner of health, shall develop a payment system that provides per-person 
77.14 	care coordination payments to health care homes certified under section 256B.0751 for 
77.15 	providing care coordination services and directly managing on-site or employing care 
77.16 	coordinators. The care coordination payments under this section are in addition to the quality 
77.17 	incentive payments in section 256B.0754, subdivision 1. The care coordination payment 
77.18 	system must vary the fees paid by thresholds of care complexity, with the highest fees being 
77.19 	paid for care provided to individuals requiring the most intensive care coordination. In 
77.20 	developing the criteria for care coordination payments, the commissioner shall consider the 
77.21 	feasibility of including the additional time and resources needed by patients with limited 
77.22 	English-language skills, cultural differences, or other barriers to health care. The 
77.23 	commissioner may determine a schedule for phasing in care coordination fees such that the 
77.24 	fees will be applied first to individuals who have, or are at risk of developing, complex or 
77.25 	chronic health conditions. Development of the payment system must be completed by 
77.26 	January 1, 2010.

77.27 	EFFECTIVE DATE. This section is effective the day following final enactment.

77.28 	Sec. 31. Minnesota Statutes 2018, section 256B.69, is amended by adding a subdivision 
77.29 	to read:
77.30 		Subd. 6e.Dental services. (a) If a dental provider is providing services to an enrollee 
77.31 	of a managed care plan or county-based purchasing plan based on a treatment plan that 
78.1 	requires more than one visit, the managed care plan or county-based purchasing plan or the 
78.2 	plan's subcontractor, if the plan subcontracts with a third party to administer dental services 
78.3 	to the plan's enrollees, must not require the completion of the treatment plan as a condition 
78.4 	of payment to the dental provider for services performed as part of the treatment plan. The 
78.5 	health plan or subcontractor must reimburse the dental provider for all services performed 
78.6 	by the provider regardless of whether the treatment plan is completed, as long as the enrollee 
78.7 	was covered under the plan at the time the service was performed.
78.8 	(b) Nothing in paragraph (a) prevents a health plan or its subcontractor from paying for 
78.9 	services using a bundled payment method. If a bundled payment method is used and the 
78.10 	treatment plan covered by the payment is not completed for any reason, the health plan or 
78.11 	its subcontractor must reimburse the dental provider for the services performed, as long as 
78.12 	the enrollee was covered under the plan at the time the service was performed.

78.13 	Sec. 32. Minnesota Statutes 2018, section 256B.75, is amended to read:
78.14 	256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
78.15 	(a) For outpatient hospital facility fee payments for services rendered on or after October 
78.16 	1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, 
78.17 	or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for 
78.18 	which there is a federal maximum allowable payment. Effective for services rendered on 
78.19 	or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and 
78.20 	emergency room facility fees shall be increased by eight percent over the rates in effect on 
78.21 	December 31, 1999, except for those services for which there is a federal maximum allowable 
78.22 	payment. Services for which there is a federal maximum allowable payment shall be paid 
78.23 	at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total 
78.24 	aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare 
78.25 	upper limit. If it is determined that a provision of this section conflicts with existing or 
78.26 	future requirements of the United States government with respect to federal financial 
78.27 	participation in medical assistance, the federal requirements prevail. The commissioner 
78.28 	may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial 
78.29 	participation resulting from rates that are in excess of the Medicare upper limitations.
78.30 	(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory 
78.31 	surgery hospital facility fee services for critical access hospitals designated under section 
78.32 	144.1483, clause (9), shall be paid on a cost-based payment system that is based on the 
78.33 	cost-finding methods and allowable costs of the Medicare program. Effective for services 
78.34 	provided on or after July 1, 2015, rates established for critical access hospitals under this 
79.1 	paragraph for the applicable payment year shall be the final payment and shall not be settled 
79.2 	to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal 
79.3 	year ending in 2016 2017, the rate for outpatient hospital services shall be computed using 
79.4 	information from each hospital's Medicare cost report as filed with Medicare for the year 
79.5 	that is two years before the year that the rate is being computed. Rates shall be computed 
79.6 	using information from Worksheet C series until the department finalizes the medical 
79.7 	assistance cost reporting process for critical access hospitals. After the cost reporting process 
79.8 	is finalized, rates shall be computed using information from Title XIX Worksheet D series. 
79.9 	The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs 
79.10 	related to rural health clinics and federally qualified health clinics, divided by ancillary 
79.11 	charges plus outpatient charges, excluding charges related to rural health clinics and federally 
79.12 	qualified health clinics.
79.13 	(c) Effective for services provided on or after July 1, 2003, rates that are based on the 
79.14 	Medicare outpatient prospective payment system shall be replaced by a budget neutral 
79.15 	prospective payment system that is derived using medical assistance data. The commissioner 
79.16 	shall provide a proposal to the 2003 legislature to define and implement this provision.
79.17 	(d) For fee-for-service services provided on or after July 1, 2002, the total payment, 
79.18 	before third-party liability and spenddown, made to hospitals for outpatient hospital facility 
79.19 	services is reduced by .5 percent from the current statutory rate.
79.20 	(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 
79.21 	services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility 
79.22 	services before third-party liability and spenddown, is reduced five percent from the current 
79.23 	statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from 
79.24 	this paragraph.
79.25 	(f) In addition to the reductions in paragraphs (d) and (e), the total payment for 
79.26 	fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient 
79.27 	hospital facility services before third-party liability and spenddown, is reduced three percent 
79.28 	from the current statutory rates. Mental health services and facilities defined under section 
79.29 	256.969, subdivision 16, are excluded from this paragraph.

79.30 	EFFECTIVE DATE. This section is effective the day following final enactment.

79.31 	Sec. 33. Minnesota Statutes 2018, section 256L.03, subdivision 1, is amended to read:
79.32 		Subdivision 1.Covered health services. (a) "Covered health services" means the health 
79.33 	services reimbursed under chapter 256B, with the exception of special education services, 
80.1 	home care nursing services, adult dental care services other than services covered under 
80.2 	section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation 
80.3 	services, personal care assistance and case management services, behavioral health home 
80.4 	services under section 256B.0757, and nursing home or intermediate care facilities services.
80.5 	(b) No public funds shall be used for coverage of abortion under MinnesotaCare except 
80.6 	where the life of the female would be endangered or substantial and irreversible impairment 
80.7 	of a major bodily function would result if the fetus were carried to term; or where the 
80.8 	pregnancy is the result of rape or incest.
80.9 	(c) Covered health services shall be expanded as provided in this section.
80.10 	(d) For the purposes of covered health services under this section, "child" means an 
80.11 	individual younger than 19 years of age.

80.12 	EFFECTIVE DATE. This section is effective the day following final enactment.

80.13 	Sec. 34. Minnesota Statutes 2018, section 256L.15, subdivision 1, is amended to read:
80.14 		Subdivision 1.Premium determination for MinnesotaCare. (a) Families with children 
80.15 	and individuals shall pay a premium determined according to subdivision 2.
80.16 	(b) Members of the military and their families who meet the eligibility criteria for 
80.17 	MinnesotaCare upon eligibility approval made within 24 months following the end of the 
80.18 	member's tour of active duty shall have their premiums paid by the commissioner. The 
80.19 	effective date of coverage for an individual or family who meets the criteria of this paragraph 
80.20 	shall be the first day of the month following the month in which eligibility is approved. This 
80.21 	exemption applies for 12 months.
80.22 	(c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and their 
80.23 	families shall have their premiums waived by the commissioner in accordance with section 
80.24 	5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. An 
80.25 	individual must indicate status as an American Indian, as defined under Code of Federal 
80.26 	Regulations, title 42, section 447.50, to qualify for the waiver of premiums. The 
80.27 	commissioner shall accept attestation of an individual's status as an American Indian as 
80.28 	verification until the United States Department of Health and Human Services approves an 
80.29 	electronic data source for this purpose.
80.30 	(d) For premiums effective August 1, 2015, and after, the commissioner, after consulting 
80.31 	with the chairs and ranking minority members of the legislative committees with jurisdiction 
80.32 	over human services, shall increase premiums under subdivision 2 for recipients based on 
80.33 	June 2015 program enrollment. Premium increases shall be sufficient to increase projected 
81.1 	revenue to the fund described in section 16A.724 by at least $27,800,000 for the biennium 
81.2 	ending June 30, 2017. The commissioner shall publish the revised premium scale on the 
81.3 	Department of Human Services website and in the State Register no later than June 15, 
81.4 	2015. The revised premium scale applies to all premiums on or after August 1, 2015, in 
81.5 	place of the scale under subdivision 2.
81.6 	(e) By July 1, 2015, the commissioner shall provide the chairs and ranking minority 
81.7 	members of the legislative committees with jurisdiction over human services the revised 
81.8 	premium scale effective August 1, 2015, and statutory language to codify the revised 
81.9 	premium schedule.
81.10 	(f) Premium changes authorized under paragraph (d) must only apply to enrollees not 
81.11 	otherwise excluded from paying premiums under state or federal law. Premium changes 
81.12 	authorized under paragraph (d) must satisfy the requirements for premiums for the Basic 
81.13 	Health Program under title 42 of Code of Federal Regulations, section 600.505.

81.14 	EFFECTIVE DATE. This section is effective the day following final enactment.

81.15 	Sec. 35. Laws 2019, chapter 63, article 3, section 1, is amended to read:
81.16 	Section 1. APPROPRIATIONS.
 81.17 	(a) Board of Pharmacy; administration. $244,000 in fiscal year 2020 is appropriated 
81.18 	from the general fund to the Board of Pharmacy for onetime information technology and 
81.19 	operating costs for administration of licensing activities under Minnesota Statutes, section 
81.20 	151.066. This is a onetime appropriation.
81.21 	(b) Commissioner of human services; administration. $309,000 in fiscal year 2020 
81.22 	is appropriated from the general fund and $60,000 in fiscal year 2021 is appropriated from 
81.23 	the opiate epidemic response account fund to the commissioner of human services for the 
81.24 	provision of administrative services to the Opiate Epidemic Response Advisory Council 
81.25 	and for the administration of the grants awarded under paragraphs (f), (g), and (h). The 
81.26 	opiate epidemic response account fund base for this appropriation is $60,000 in fiscal year 
81.27 	2022, $60,000 in fiscal year 2023, $60,000 in fiscal year 2024, and $0 in fiscal year 2025.
81.28 	(c) Board of Pharmacy; administration. $126,000 in fiscal year 2020 is appropriated 
81.29 	from the general fund to the Board of Pharmacy for the collection of the registration fees 
81.30 	under section 151.066.
81.31 	(d) Commissioner of public safety; enforcement activities. $672,000 in fiscal year 
81.32 	2020 is appropriated from the general fund to the commissioner of public safety for the 
82.1 	Bureau of Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab 
82.2 	supplies and $288,000 is for special agent positions focused on drug interdiction and drug 
82.3 	trafficking.
82.4 	(e) Commissioner of management and budget; evaluation activities. $300,000 in 
82.5 	fiscal year 2020 is appropriated from the general fund and $300,000 in fiscal year 2021 is 
82.6 	appropriated from the opiate epidemic response account fund to the commissioner of 
82.7 	management and budget for evaluation activities under Minnesota Statutes, section 256.042, 
82.8 	subdivision 1, paragraph (c). The opiate epidemic response account fund base for this 
82.9 	appropriation is $300,000 in fiscal year 2022, $300,000 in fiscal year 2023, $300,000 in 
82.10 	fiscal year 2024, and $0 in fiscal year 2025.
82.11 	(f) Commissioner of human services; grants for Project ECHO. $400,000 in fiscal 
82.12 	year 2020 is appropriated from the general fund and $400,000 in fiscal year 2021 is 
82.13 	appropriated from the opiate epidemic response account fund to the commissioner of human 
82.14 	services for grants of $200,000 to CHI St. Gabriel's Health Family Medical Center for the 
82.15 	opioid-focused Project ECHO program and $200,000 to Hennepin Health Care for the 
82.16 	opioid-focused Project ECHO program. The opiate epidemic response account fund base 
82.17 	for this appropriation is $400,000 in fiscal year 2022, $400,000 in fiscal year 2023, $400,000 
82.18 	in fiscal year 2024, and $0 in fiscal year 2025.
82.19 	(g) Commissioner of human services; opioid overdose prevention grant. $100,000 
82.20 	in fiscal year 2020 is appropriated from the general fund and $100,000 in fiscal year 2021 
82.21 	is appropriated from the opiate epidemic response account fund to the commissioner of 
82.22 	human services for a grant to a nonprofit organization that has provided overdose prevention 
82.23 	programs to the public in at least 60 counties within the state, for at least three years, has 
82.24 	received federal funding before January 1, 2019, and is dedicated to addressing the opioid 
82.25 	epidemic. The grant must be used for opioid overdose prevention, community asset mapping, 
82.26 	education, and overdose antagonist distribution. The opiate epidemic response account fund
82.27 	base for this appropriation is $100,000 in fiscal year 2022, $100,000 in fiscal year 2023, 
82.28 	$100,000 in fiscal year 2024, and $0 in fiscal year 2025.
82.29 	(h) Commissioner of human services; traditional healing. $2,000,000 in fiscal year 
82.30 	2020 is appropriated from the general fund and $2,000,000 in fiscal year 2021 is appropriated 
82.31 	from the opiate epidemic response account fund to the commissioner of human services to 
82.32 	award grants to tribal nations and five urban Indian communities for traditional healing 
82.33 	practices to American Indians and to increase the capacity of culturally specific providers 
82.34 	in the behavioral health workforce. The opiate epidemic response account fund base for 
83.1 	this appropriation is $2,000,000 in fiscal year 2022, $2,000,000 in fiscal year 2023, 
83.2 	$2,000,000 in fiscal year 2024, and $0 in fiscal year 2025.
83.3 	(i) Board of Dentistry; continuing education. $11,000 in fiscal year 2020 is 
83.4 	appropriated from the state government special revenue fund to the Board of Dentistry to 
83.5 	implement the continuing education requirements under Minnesota Statutes, section 214.12, 
83.6 	subdivision 6.
83.7 	(j) Board of Medical Practice; continuing education. $17,000 in fiscal year 2020 is 
83.8 	appropriated from the state government special revenue fund to the Board of Medical Practice 
83.9 	to implement the continuing education requirements under Minnesota Statutes, section 
83.10 	214.12, subdivision 6.
83.11 	(k) Board of Nursing; continuing education. $17,000 in fiscal year 2020 is appropriated 
83.12 	from the state government special revenue fund to the Board of Nursing to implement the 
83.13 	continuing education requirements under Minnesota Statutes, section 214.12, subdivision 
83.14 	6.
83.15 	(l) Board of Optometry; continuing education. $5,000 in fiscal year 2020 is 
83.16 	appropriated from the state government special revenue fund to the Board of Optometry to 
83.17 	implement the continuing education requirements under Minnesota Statutes, section 214.12, 
83.18 	subdivision 6.
83.19 	(m) Board of Podiatric Medicine; continuing education. $5,000 in fiscal year 2020 
83.20 	is appropriated from the state government special revenue fund to the Board of Podiatric 
83.21 	Medicine to implement the continuing education requirements under Minnesota Statutes, 
83.22 	section 214.12, subdivision 6.
83.23 	(n) Commissioner of health; nonnarcotic pain management and wellness. $1,250,000 
83.24 	is appropriated in fiscal year 2020 from the general fund to the commissioner of health, to 
83.25 	provide funding for:
83.26 	(1) statewide mapping and assessment of community-based nonnarcotic pain management 
83.27 	and wellness resources; and
83.28 	(2) up to five demonstration projects in different geographic areas of the state to provide 
83.29 	community-based nonnarcotic pain management and wellness resources to patients and 
83.30 	consumers.
83.31 	The demonstration projects must include an evaluation component and scalability analysis. 
83.32 	The commissioner shall award the grant for the statewide mapping and assessment, and the 
83.33 	demonstration project grants, through a competitive request for proposal process. Grants 
84.1 	for statewide mapping and assessment and demonstration projects may be awarded 
84.2 	simultaneously. In awarding demonstration project grants, the commissioner shall give 
84.3 	preference to proposals that incorporate innovative community partnerships, are informed 
84.4 	and led by people in the community where the project is taking place, and are culturally 
84.5 	relevant and delivered by culturally competent providers. This is a onetime appropriation.
84.6 	(o) Commissioner of health; administration. $38,000 in fiscal year 2020 is appropriated 
84.7 	from the general fund to the commissioner of health for the administration of the grants 
84.8 	awarded in paragraph (n).

84.9 	EFFECTIVE DATE. This section is effective the day following final enactment.

84.10 	Sec. 36. Laws 2019, chapter 63, article 3, section 2, is amended to read:
84.11 	Sec. 2. TRANSFER.
 84.12 	By June 30, 2021, the commissioner of human services shall transfer $5,439,000 from 
84.13 	the opiate epidemic response account fund to the general fund. This is a onetime transfer.

84.14 	EFFECTIVE DATE. This section is effective the day following final enactment.

84.15 	Sec. 37. Laws 2020, chapter 73, section 4, subdivision 3, is amended to read:
84.16 		Subd. 3.Access to urgent-need insulin. (a) MNsure shall develop an application form 
84.17 	to be used by an individual who is in urgent need of insulin. The application must ask the 
84.18 	individual to attest to the eligibility requirements described in subdivision 2. The form shall 
84.19 	be accessible through MNsure's website. MNsure shall also make the form available to 
84.20 	pharmacies and health care providers who prescribe or dispense insulin, hospital emergency 
84.21 	departments, urgent care clinics, and community health clinics. By submitting a completed, 
84.22 	signed, and dated application to a pharmacy, the individual attests that the information 
84.23 	contained in the application is correct.
84.24 	(b) If the individual is in urgent need of insulin, the individual may present a completed, 
84.25 	signed, and dated application form to a pharmacy. The individual must also:
84.26 	(1) have a valid insulin prescription; and
84.27 	(2) present the pharmacist with identification indicating Minnesota residency in the form 
84.28 	of a valid Minnesota identification card, driver's license, or permit, or tribal identification 
84.29 	card as defined in section 171.072, paragraph (b). If the individual in urgent need of insulin 
84.30 	is under the age of 18, the individual's parent or legal guardian must provide the pharmacist 
84.31 	with proof of residency.
85.1 	(c) Upon receipt of a completed and signed application, the pharmacist shall dispense 
85.2 	the prescribed insulin in an amount that will provide the individual with a 30-day supply. 
85.3 	The pharmacy must notify the health care practitioner who issued the prescription order no 
85.4 	later than 72 hours after the insulin is dispensed.
85.5 	(d) The pharmacy may submit to the manufacturer of the dispensed insulin product or 
85.6 	to the manufacturer's vendor a claim for payment that is in accordance with the National 
85.7 	Council for Prescription Drug Program standards for electronic claims processing, unless 
85.8 	the manufacturer agrees to send to the pharmacy a replacement supply of the same insulin 
85.9 	as dispensed in the amount dispensed. If the pharmacy submits an electronic claim to the 
85.10 	manufacturer or the manufacturer's vendor, the manufacturer or vendor shall reimburse the 
85.11 	pharmacy in an amount that covers the pharmacy's acquisition cost.
85.12 	(e) The pharmacy may collect an insulin co-payment from the individual to cover the 
85.13 	pharmacy's costs of processing and dispensing in an amount not to exceed $35 for the 30-day 
85.14 	supply of insulin dispensed.
85.15 	(f) The pharmacy shall also provide each eligible individual with the information sheet 
85.16 	described in subdivision 7 and a list of trained navigators provided by the Board of Pharmacy 
85.17 	for the individual to contact if the individual is in need of accessing ongoing insulin coverage 
85.18 	options, including assistance in:
85.19 	(1) applying for medical assistance or MinnesotaCare;
85.20 	(2) applying for a qualified health plan offered through MNsure, subject to open and 
85.21 	special enrollment periods;
85.22 	(3) accessing information on providers who participate in prescription drug discount 
85.23 	programs, including providers who are authorized to participate in the 340B program under 
85.24 	section 340b of the federal Public Health Services Act, United States Code, title 42, section 
85.25 	256b; and
85.26 	(4) accessing insulin manufacturers' patient assistance programs, co-payment assistance 
85.27 	programs, and other foundation-based programs.
85.28 	(g) The pharmacist shall retain a copy of the application form submitted by the individual 
85.29 	to the pharmacy for reporting and auditing purposes.

85.30 	Sec. 38. Laws 2020, chapter 73, section 4, subdivision 4, is amended to read:
85.31 		Subd. 4.Continuing safety net program; general. (a) Each manufacturer shall make 
85.32 	a patient assistance program available to any individual who meets the requirements of this 
86.1 	subdivision. Each manufacturer's patient assistance programs must meet the requirements 
86.2 	of this section. Each manufacturer shall provide the Board of Pharmacy with information 
86.3 	regarding the manufacturer's patient assistance program, including contact information for 
86.4 	individuals to call for assistance in accessing their patient assistance program.
86.5 	(b) To be eligible to participate in a manufacturer's patient assistance program, the 
86.6 	individual must:
86.7 	(1) be a Minnesota resident with a valid Minnesota identification card that indicates 
86.8 	Minnesota residency in the form of a Minnesota identification card or, driver's license or 
86.9 	permit, or tribal identification card as defined in section 171.072, paragraph (b). If the 
86.10 	individual is under the age of 18, the individual's parent or legal guardian must provide 
86.11 	proof of residency;
86.12 	(2) have a family income that is equal to or less than 400 percent of the federal poverty 
86.13 	guidelines;
86.14 	(3) not be enrolled in medical assistance or MinnesotaCare;
86.15 	(4) not be eligible to receive health care through a federally funded program or receive 
86.16 	prescription drug benefits through the Department of Veterans Affairs; and
86.17 	(5) not be enrolled in prescription drug coverage through an individual or group health 
86.18 	plan that limits the total amount of cost-sharing that an enrollee is required to pay for a 
86.19 	30-day supply of insulin, including co-payments, deductibles, or coinsurance to $75 or less, 
86.20 	regardless of the type or amount of insulin needed.
86.21 	(c) Notwithstanding the requirement in paragraph (b), clause (4), an individual who is 
86.22 	enrolled in Medicare Part D is eligible for a manufacturer's patient assistance program if 
86.23 	the individual has spent $1,000 on prescription drugs in the current calendar year and meets 
86.24 	the eligibility requirements in paragraph (b), clauses (1) to (3).
86.25 	(d) An individual who is interested in participating in a manufacturer's patient assistance 
86.26 	program may apply directly to the manufacturer; apply through the individual's health care 
86.27 	practitioner, if the practitioner participates; or contact a trained navigator for assistance in 
86.28 	finding a long-term insulin supply solution, including assistance in applying to a 
86.29 	manufacturer's patient assistance program.

87.1 	Sec. 39. REVISOR INSTRUCTION.
 87.2 	(a) The revisor of statutes shall number the existing language in Minnesota Statutes, 
87.3 	section 62U.03, as subdivision 1 and renumber the provisions of Minnesota Statutes listed 
87.4 	in column A to the references listed in column B.

87.5	Column A
	Column B
	
87.6	256B.0751, subdivision 1
	62U.03, subdivision 2
	
87.7	256B.0751, subdivision 2
	62U.03, subdivision 3
	
87.8	256B.0751, subdivision 3
	62U.03, subdivision 4
	
87.9	256B.0751, subdivision 4
	62U.03, subdivision 5
	
87.10	256B.0751, subdivision 5
	62U.03, subdivision 6
	
87.11	256B.0751, subdivision 6
	62U.03, subdivision 7
	
87.12	256B.0751, subdivision 7
	62U.03, subdivision 8
	
87.13	256B.0751, subdivision 8
	62U.03, subdivision 9
	
87.14	256B.0751, subdivision 9
	62U.03, subdivision 10
	
87.15	256B.0751, subdivision 10
	62U.03, subdivision 11
	
87.16 	(b) The revisor of statutes shall change the applicable references to Minnesota Statutes, 
87.17 	section 256B.0751, to section 62U.03. The revisor shall make necessary cross-reference 
87.18 	changes in Minnesota Statutes consistent with the renumbering. The revisor shall also make 
87.19 	technical and other necessary changes to sentence structure to preserve the meaning of the 
87.20 	text.

87.21 	EFFECTIVE DATE. This section is effective the day following final enactment.

87.22 	Sec. 40. REPEALER.
 87.23 	Minnesota Statutes 2018, sections 62U.15, subdivision 2; 256B.057, subdivision 8; 
87.24 	256B.0752; and 256L.04, subdivision 13, are repealed.

87.25 	EFFECTIVE DATE. This section is effective the day following final enactment.

87.26 	ARTICLE 4
87.27 	ADVANCED PRACTICE REGISTERED NURSE PROVISIONS

87.28 	Section 1. Minnesota Statutes 2018, section 62D.09, subdivision 1, is amended to read:
87.29 		Subdivision 1.Marketing requirements. (a) Any written marketing materials which 
87.30 	may be directed toward potential enrollees and which include a detailed description of 
87.31 	benefits provided by the health maintenance organization shall include a statement of enrollee 
87.32 	information and rights as described in section 62D.07, subdivision 3, clauses (2) and (3). 
88.1 	Prior to any oral marketing presentation, the agent marketing the plan must inform the 
88.2 	potential enrollees that any complaints concerning the material presented should be directed 
88.3 	to the health maintenance organization, the commissioner of health, or, if applicable, the 
88.4 	employer.
88.5 	(b) Detailed marketing materials must affirmatively disclose all exclusions and limitations 
88.6 	in the organization's services or kinds of services offered to the contracting party, including 
88.7 	but not limited to the following types of exclusions and limitations:
88.8 	(1) health care services not provided;
88.9 	(2) health care services requiring co-payments or deductibles paid by enrollees;
88.10 	(3) the fact that access to health care services does not guarantee access to a particular 
88.11 	provider type; and
88.12 	(4) health care services that are or may be provided only by referral of a physician or 
88.13 	advanced practice registered nurse.
88.14 	(c) No marketing materials may lead consumers to believe that all health care needs will 
88.15 	be covered. All marketing materials must alert consumers to possible uncovered expenses 
88.16 	with the following language in bold print: "THIS HEALTH CARE PLAN MAY NOT 
88.17 	COVER ALL YOUR HEALTH CARE EXPENSES; READ YOUR CONTRACT 
88.18 	CAREFULLY TO DETERMINE WHICH EXPENSES ARE COVERED." Immediately 
88.19 	following the disclosure required under paragraph (b), clause (3), consumers must be given 
88.20 	a telephone number to use to contact the health maintenance organization for specific 
88.21 	information about access to provider types.
88.22 	(d) The disclosures required in paragraphs (b) and (c) are not required on billboards or 
88.23 	image, and name identification advertisement.

88.24 	Sec. 2. Minnesota Statutes 2018, section 62E.06, subdivision 1, is amended to read:
88.25 		Subdivision 1.Number three plan. A plan of health coverage shall be certified as a 
88.26 	number three qualified plan if it otherwise meets the requirements established by chapters 
88.27 	62A, 62C, and 62Q, and the other laws of this state, whether or not the policy is issued in 
88.28 	Minnesota, and meets or exceeds the following minimum standards:
88.29 	(a) The minimum benefits for a covered individual shall, subject to the other provisions 
88.30 	of this subdivision, be equal to at least 80 percent of the cost of covered services in excess 
88.31 	of an annual deductible which does not exceed $150 per person. The coverage shall include 
88.32 	a limitation of $3,000 per person on total annual out-of-pocket expenses for services covered 
89.1 	under this subdivision. The coverage shall not be subject to a lifetime maximum on essential 
89.2 	health benefits.
89.3 	The prohibition on lifetime maximums for essential health benefits and $3,000 limitation 
89.4 	on total annual out-of-pocket expenses shall not be subject to change or substitution by use 
89.5 	of an actuarially equivalent benefit.
89.6 	(b) Covered expenses shall be the usual and customary charges for the following services 
89.7 	and articles when prescribed by a physician or advanced practice registered nurse:
89.8 	(1) hospital services;
89.9 	(2) professional services for the diagnosis or treatment of injuries, illnesses, or conditions, 
89.10 	other than dental, which are rendered by a physician or advanced practice registered nurse
89.11 	or at the physician's or advanced practice registered nurse's direction;
89.12 	(3) drugs requiring a physician's or advanced practice registered nurse's prescription;
89.13 	(4) services of a nursing home for not more than 120 days in a year if the services would 
89.14 	qualify as reimbursable services under Medicare;
89.15 	(5) services of a home health agency if the services would qualify as reimbursable 
89.16 	services under Medicare;
89.17 	(6) use of radium or other radioactive materials;
89.18 	(7) oxygen;
89.19 	(8) anesthetics;
89.20 	(9) prostheses other than dental but including scalp hair prostheses worn for hair loss 
89.21 	suffered as a result of alopecia areata;
89.22 	(10) rental or purchase, as appropriate, of durable medical equipment other than 
89.23 	eyeglasses and hearing aids, unless coverage is required under section 62Q.675;
89.24 	(11) diagnostic x-rays and laboratory tests;
89.25 	(12) oral surgery for partially or completely unerupted impacted teeth, a tooth root 
89.26 	without the extraction of the entire tooth, or the gums and tissues of the mouth when not 
89.27 	performed in connection with the extraction or repair of teeth;
89.28 	(13) services of a physical therapist;
89.29 	(14) transportation provided by licensed ambulance service to the nearest facility qualified 
89.30 	to treat the condition; or a reasonable mileage rate for transportation to a kidney dialysis 
89.31 	center for treatment; and
90.1 	(15) services of an occupational therapist.
90.2 	(c) Covered expenses for the services and articles specified in this subdivision do not 
90.3 	include the following:
90.4 	(1) any charge for care for injury or disease either (i) arising out of an injury in the course 
90.5 	of employment and subject to a workers' compensation or similar law, (ii) for which benefits 
90.6 	are payable without regard to fault under coverage statutorily required to be contained in 
90.7 	any motor vehicle, or other liability insurance policy or equivalent self-insurance, or (iii) 
90.8 	for which benefits are payable under another policy of accident and health insurance, 
90.9 	Medicare, or any other governmental program except as otherwise provided by section 
90.10 	62A.04, subdivision 3, clause (4);
90.11 	(2) any charge for treatment for cosmetic purposes other than for reconstructive surgery 
90.12 	when such service is incidental to or follows surgery resulting from injury, sickness, or 
90.13 	other diseases of the involved part or when such service is performed on a covered dependent 
90.14 	child because of congenital disease or anomaly which has resulted in a functional defect as 
90.15 	determined by the attending physician or advanced practice registered nurse;
90.16 	(3) care which is primarily for custodial or domiciliary purposes which would not qualify 
90.17 	as eligible services under Medicare;
90.18 	(4) any charge for confinement in a private room to the extent it is in excess of the 
90.19 	institution's charge for its most common semiprivate room, unless a private room is prescribed 
90.20 	as medically necessary by a physician or advanced practice registered nurse, provided, 
90.21 	however, that if the institution does not have semiprivate rooms, its most common semiprivate 
90.22 	room charge shall be considered to be 90 percent of its lowest private room charge;
90.23 	(5) that part of any charge for services or articles rendered or prescribed by a physician,
90.24 	advanced practice registered nurse, dentist, or other health care personnel which exceeds 
90.25 	the prevailing charge in the locality where the service is provided; and
90.26 	(6) any charge for services or articles the provision of which is not within the scope of 
90.27 	authorized practice of the institution or individual rendering the services or articles.
90.28 	(d) The minimum benefits for a qualified plan shall include, in addition to those benefits 
90.29 	specified in clauses (a) and (e), benefits for well baby care, effective July 1, 1980, subject 
90.30 	to applicable deductibles, coinsurance provisions, and maximum lifetime benefit limitations.
90.31 	(e) Effective July 1, 1979, the minimum benefits of a qualified plan shall include, in 
90.32 	addition to those benefits specified in clause (a), a second opinion from a physician on all 
90.33 	surgical procedures expected to cost a total of $500 or more in physician, laboratory, and 
91.1 	hospital fees, provided that the coverage need not include the repetition of any diagnostic 
91.2 	tests.
91.3 	(f) Effective August 1, 1985, the minimum benefits of a qualified plan must include, in 
91.4 	addition to the benefits specified in clauses (a), (d), and (e), coverage for special dietary 
91.5 	treatment for phenylketonuria when recommended by a physician or advanced practice 
91.6 	registered nurse.
91.7 	(g) Outpatient mental health coverage is subject to section 62A.152, subdivision 2.

91.8 	Sec. 3. Minnesota Statutes 2018, section 62J.17, subdivision 4a, is amended to read:
91.9 		Subd. 4a.Expenditure reporting. Each hospital, outpatient surgical center, diagnostic 
91.10 	imaging center, and physician or advanced practice registered nurse clinic shall report 
91.11 	annually to the commissioner on all major spending commitments, in the form and manner 
91.12 	specified by the commissioner. The report shall include the following information:
91.13 	(1) a description of major spending commitments made during the previous year, 
91.14 	including the total dollar amount of major spending commitments and purpose of the 
91.15 	expenditures;
91.16 	(2) the cost of land acquisition, construction of new facilities, and renovation of existing 
91.17 	facilities;
91.18 	(3) the cost of purchased or leased medical equipment, by type of equipment;
91.19 	(4) expenditures by type for specialty care and new specialized services;
91.20 	(5) information on the amount and types of added capacity for diagnostic imaging 
91.21 	services, outpatient surgical services, and new specialized services; and
91.22 	(6) information on investments in electronic medical records systems.
91.23 	For hospitals and outpatient surgical centers, this information shall be included in reports 
91.24 	to the commissioner that are required under section 144.698. For diagnostic imaging centers, 
91.25 	this information shall be included in reports to the commissioner that are required under 
91.26 	section 144.565. For all other health care providers that are subject to this reporting 
91.27 	requirement, reports must be submitted to the commissioner by March 1 each year for the 
91.28 	preceding calendar year.

92.1 	Sec. 4. Minnesota Statutes 2019 Supplement, section 62J.23, subdivision 2, is amended 
92.2 	to read:
92.3 		Subd. 2.Restrictions. (a) From July 1, 1992, until rules are adopted by the commissioner 
92.4 	under this section, the restrictions in the federal Medicare antikickback statutes in section 
92.5 	1128B(b) of the Social Security Act, United States Code, title 42, section 1320a-7b(b), and 
92.6 	rules adopted under the federal statutes, apply to all persons in the state, regardless of whether 
92.7 	the person participates in any state health care program.
92.8 	(b) Nothing in paragraph (a) shall be construed to prohibit an individual from receiving 
92.9 	a discount or other reduction in price or a limited-time free supply or samples of a prescription 
92.10 	drug, medical supply, or medical equipment offered by a pharmaceutical manufacturer, 
92.11 	medical supply or device manufacturer, health plan company, or pharmacy benefit manager, 
92.12 	so long as:
92.13 	(1) the discount or reduction in price is provided to the individual in connection with 
92.14 	the purchase of a prescription drug, medical supply, or medical equipment prescribed for 
92.15 	that individual;
92.16 	(2) it otherwise complies with the requirements of state and federal law applicable to 
92.17 	enrollees of state and federal public health care programs;
92.18 	(3) the discount or reduction in price does not exceed the amount paid directly by the 
92.19 	individual for the prescription drug, medical supply, or medical equipment; and
92.20 	(4) the limited-time free supply or samples are provided by a physician, advanced practice 
92.21 	registered nurse, or pharmacist, as provided by the federal Prescription Drug Marketing 
92.22 	Act.
92.23 	For purposes of this paragraph, "prescription drug" includes prescription drugs that are 
92.24 	administered through infusion, and related services and supplies.
92.25 	(c) No benefit, reward, remuneration, or incentive for continued product use may be 
92.26 	provided to an individual or an individual's family by a pharmaceutical manufacturer, 
92.27 	medical supply or device manufacturer, or pharmacy benefit manager, except that this 
92.28 	prohibition does not apply to:
92.29 	(1) activities permitted under paragraph (b);
92.30 	(2) a pharmaceutical manufacturer, medical supply or device manufacturer, health plan 
92.31 	company, or pharmacy benefit manager providing to a patient, at a discount or reduced 
92.32 	price or free of charge, ancillary products necessary for treatment of the medical condition 
93.1 	for which the prescription drug, medical supply, or medical equipment was prescribed or 
93.2 	provided; and
93.3 	(3) a pharmaceutical manufacturer, medical supply or device manufacturer, health plan 
93.4 	company, or pharmacy benefit manager providing to a patient a trinket or memento of 
93.5 	insignificant value.
93.6 	(d) Nothing in this subdivision shall be construed to prohibit a health plan company 
93.7 	from offering a tiered formulary with different co-payment or cost-sharing amounts for 
93.8 	different drugs.

93.9 	Sec. 5. Minnesota Statutes 2018, section 62J.495, subdivision 1a, is amended to read:
93.10 		Subd. 1a.Definitions. (a) "Certified electronic health record technology" means an 
93.11 	electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH Act 
93.12 	to meet the standards and implementation specifications adopted under section 3004 as 
93.13 	applicable.
93.14 	(b) "Commissioner" means the commissioner of health.
93.15 	(c) "Pharmaceutical electronic data intermediary" means any entity that provides the 
93.16 	infrastructure to connect computer systems or other electronic devices utilized by prescribing 
93.17 	practitioners with those used by pharmacies, health plans, third-party administrators, and 
93.18 	pharmacy benefit managers in order to facilitate the secure transmission of electronic 
93.19 	prescriptions, refill authorization requests, communications, and other prescription-related 
93.20 	information between such entities.
93.21 	(d) "HITECH Act" means the Health Information Technology for Economic and Clinical 
93.22 	Health Act in division A, title XIII and division B, title IV of the American Recovery and 
93.23 	Reinvestment Act of 2009, including federal regulations adopted under that act.
93.24 	(e) "Interoperable electronic health record" means an electronic health record that securely 
93.25 	exchanges health information with another electronic health record system that meets 
93.26 	requirements specified in subdivision 3, and national requirements for certification under 
93.27 	the HITECH Act.
93.28 	(f) "Qualified electronic health record" means an electronic record of health-related 
93.29 	information on an individual that includes patient demographic and clinical health information 
93.30 	and has the capacity to:
93.31 	(1) provide clinical decision support;
93.32 	(2) support physician provider order entry;
94.1 	(3) capture and query information relevant to health care quality; and
94.2 	(4) exchange electronic health information with, and integrate such information from, 
94.3 	other sources.

94.4 	Sec. 6. Minnesota Statutes 2018, section 62J.52, subdivision 2, is amended to read:
94.5 		Subd. 2.Uniform billing form CMS 1500. (a) On and after January 1, 1996, all 
94.6 	noninstitutional health care services rendered by providers in Minnesota except dental or 
94.7 	pharmacy providers, that are not currently being billed using an equivalent electronic billing 
94.8 	format, must be billed using the most current version of the health insurance claim form 
94.9 	CMS 1500.
94.10 	(b) The instructions and definitions for the use of the uniform billing form CMS 1500 
94.11 	shall be in accordance with the manual developed by the Administrative Uniformity 
94.12 	Committee entitled standards for the use of the CMS 1500 form, dated February 1994, as 
94.13 	further defined by the commissioner.
94.14 	(c) Services to be billed using the uniform billing form CMS 1500 include physician 
94.15 	services and supplies, durable medical equipment, noninstitutional ambulance services, 
94.16 	independent ancillary services including occupational therapy, physical therapy, speech 
94.17 	therapy and audiology, home infusion therapy, podiatry services, optometry services, mental 
94.18 	health licensed professional services, substance abuse licensed professional services, nursing 
94.19 	practitioner professional services, certified registered nurse anesthetists advanced practice 
94.20 	registered nurse services, chiropractors, physician assistants, laboratories, medical suppliers, 
94.21 	waivered services, personal care attendants, and other health care providers such as day 
94.22 	activity centers and freestanding ambulatory surgical centers.
94.23 	(d) Services provided by Medicare Critical Access Hospitals electing Method II billing 
94.24 	will be allowed an exception to this provision to allow the inclusion of the professional fees 
94.25 	on the CMS 1450.

94.26 	Sec. 7. Minnesota Statutes 2018, section 62J.823, subdivision 3, is amended to read:
94.27 		Subd. 3.Applicability and scope. Any hospital, as defined in section 144.696, 
94.28 	subdivision 3, and outpatient surgical center, as defined in section 144.696, subdivision 4, 
94.29 	shall provide a written estimate of the cost of a specific service or stay upon the request of 
94.30 	a patient, doctor, advanced practice registered nurse, or the patient's representative. The 
94.31 	request must include:
95.1 	(1) the health coverage status of the patient, including the specific health plan or other 
95.2 	health coverage under which the patient is enrolled, if any; and
95.3 	(2) at least one of the following:
95.4 	(i) the specific diagnostic-related group code;
95.5 	(ii) the name of the procedure or procedures to be performed;
95.6 	(iii) the type of treatment to be received; or
95.7 	(iv) any other information that will allow the hospital or outpatient surgical center to 
95.8 	determine the specific diagnostic-related group or procedure code or codes.

95.9 	Sec. 8. Minnesota Statutes 2019 Supplement, section 62Q.184, subdivision 1, is amended 
95.10 	to read:
95.11 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms in this 
95.12 	subdivision have the meanings given them.
95.13 	(b) "Clinical practice guideline" means a systematically developed statement to assist 
95.14 	health care providers and enrollees in making decisions about appropriate health care services 
95.15 	for specific clinical circumstances and conditions developed independently of a health plan 
95.16 	company, pharmaceutical manufacturer, or any entity with a conflict of interest. A clinical 
95.17 	practice guideline also includes a preferred drug list developed in accordance with section 
95.18 	256B.0625.
95.19 	(c) "Clinical review criteria" means the written screening procedures, decision abstracts, 
95.20 	clinical protocols, and clinical practice guidelines used by a health plan company to determine 
95.21 	the medical necessity and appropriateness of health care services.
95.22 	(d) "Health plan company" has the meaning given in section 62Q.01, subdivision 4, but 
95.23 	also includes a county-based purchasing plan participating in a public program under chapter 
95.24 	256B or 256L and an integrated health partnership under section 256B.0755.
95.25 	(e) "Step therapy protocol" means a protocol or program that establishes the specific 
95.26 	sequence in which prescription drugs for a specified medical condition, including 
95.27 	self-administered and physician-administered drugs and drugs that are administered by a 
95.28 	physician or advanced practice nurse practitioner, are medically appropriate for a particular 
95.29 	enrollee and are covered under a health plan.
95.30 	(f) "Step therapy override" means that the step therapy protocol is overridden in favor 
95.31 	of coverage of the selected prescription drug of the prescribing health care provider because 
95.32 	at least one of the conditions of subdivision 3, paragraph (a), exists.

96.1 	Sec. 9. Minnesota Statutes 2018, section 62Q.43, subdivision 1, is amended to read:
96.2 		Subdivision 1.Closed-panel health plan. For purposes of this section, "closed-panel 
96.3 	health plan" means a health plan as defined in section 62Q.01 that requires an enrollee to 
96.4 	receive all or a majority of primary care services from a specific clinic or physician primary 
96.5 	care provider designated by the enrollee that is within the health plan company's clinic or 
96.6 	physician provider network.

96.7 	Sec. 10. Minnesota Statutes 2018, section 62Q.43, subdivision 2, is amended to read:
96.8 		Subd. 2.Access requirement. Every closed-panel health plan must allow enrollees 
96.9 	under the age of 26 years to change their designated clinic or physician primary care provider
96.10 	at least once per month, as long as the clinic or physician provider is part of the health plan 
96.11 	company's statewide clinic or physician provider network. A health plan company shall not 
96.12 	charge enrollees who choose this option higher premiums or cost sharing than would 
96.13 	otherwise apply to enrollees who do not choose this option. A health plan company may 
96.14 	require enrollees to provide 15 days' written notice of intent to change their designated clinic 
96.15 	or physician primary care provider.

96.16 	Sec. 11. Minnesota Statutes 2018, section 62Q.54, is amended to read:
96.17 	62Q.54 REFERRALS FOR RESIDENTS OF HEALTH CARE FACILITIES.
96.18 	If an enrollee is a resident of a health care facility licensed under chapter 144A or a 
96.19 	housing with services establishment registered under chapter 144D, the enrollee's primary 
96.20 	care physician provider must refer the enrollee to that facility's skilled nursing unit or that 
96.21 	facility's appropriate care setting, provided that the health plan company and the provider 
96.22 	can best meet the patient's needs in that setting, if the following conditions are met:
96.23 	(1) the facility agrees to be reimbursed at that health plan company's contract rate 
96.24 	negotiated with similar providers for the same services and supplies; and
96.25 	(2) the facility meets all guidelines established by the health plan company related to 
96.26 	quality of care, utilization, referral authorization, risk assumption, use of health plan company 
96.27 	network, and other criteria applicable to providers under contract for the same services and 
96.28 	supplies.

96.29 	Sec. 12. Minnesota Statutes 2018, section 62Q.57, subdivision 1, is amended to read:
96.30 		Subdivision 1.Choice of primary care provider. (a) If a health plan company offering 
96.31 	a group health plan, or an individual health plan that is not a grandfathered plan, requires 
97.1 	or provides for the designation by an enrollee of a participating primary care provider, the 
97.2 	health plan company shall permit each enrollee to:
97.3 	(1) designate any participating primary care provider available to accept the enrollee; 
97.4 	and
97.5 	(2) for a child, designate any participating physician or advanced practice registered 
97.6 	nurse who specializes in pediatrics as the child's primary care provider and is available to 
97.7 	accept the child.
97.8 	(b) This section does not waive any exclusions of coverage under the terms and conditions 
97.9 	of the health plan with respect to coverage of pediatric care.

97.10 	Sec. 13. Minnesota Statutes 2018, section 62Q.73, subdivision 7, is amended to read:
97.11 		Subd. 7.Standards of review. (a) For an external review of any issue in an adverse 
97.12 	determination that does not require a medical necessity determination, the external review 
97.13 	must be based on whether the adverse determination was in compliance with the enrollee's 
97.14 	health benefit plan.
97.15 	(b) For an external review of any issue in an adverse determination by a health plan 
97.16 	company licensed under chapter 62D that requires a medical necessity determination, the 
97.17 	external review must determine whether the adverse determination was consistent with the 
97.18 	definition of medically necessary care in Minnesota Rules, part 4685.0100, subpart 9b.
97.19 	(c) For an external review of any issue in an adverse determination by a health plan 
97.20 	company, other than a health plan company licensed under chapter 62D, that requires a 
97.21 	medical necessity determination, the external review must determine whether the adverse 
97.22 	determination was consistent with the definition of medically necessary care in section 
97.23 	62Q.53, subdivision 2.
97.24 	(d) For an external review of an adverse determination involving experimental or 
97.25 	investigational treatment, the external review entity must base its decision on all documents 
97.26 	submitted by the health plan company and enrollee, including medical records, the attending 
97.27 	physician, advanced practice registered nurse, or health care professional's recommendation, 
97.28 	consulting reports from health care professionals, the terms of coverage, federal Food and 
97.29 	Drug Administration approval, and medical or scientific evidence or evidence-based 
97.30 	standards.

98.1 	Sec. 14. Minnesota Statutes 2018, section 62Q.733, subdivision 3, is amended to read:
98.2 		Subd. 3.Health care provider or provider. "Health care provider" or "provider" means 
98.3 	a physician, advanced practice registered nurse, chiropractor, dentist, podiatrist, or other 
98.4 	provider as defined under section 62J.03, other than hospitals, ambulatory surgical centers, 
98.5 	or freestanding emergency rooms.

98.6 	Sec. 15. Minnesota Statutes 2018, section 62Q.74, subdivision 1, is amended to read:
98.7 		Subdivision 1.Definitions. (a) For purposes of this section, "category of coverage" 
98.8 	means one of the following types of health-related coverage:
98.9 	(1) health;
98.10 	(2) no-fault automobile medical benefits; or
98.11 	(3) workers' compensation medical benefits.
98.12 	(b) "Health care provider" or "provider" means a physician, advanced practice registered 
98.13 	nurse, chiropractor, dentist, podiatrist, hospital, ambulatory surgical center, freestanding 
98.14 	emergency room, or other provider, as defined in section 62J.03.

98.15 	Sec. 16. Minnesota Statutes 2018, section 62S.08, subdivision 3, is amended to read:
98.16 		Subd. 3.Mandatory format. The following standard format outline of coverage must 
98.17 	be used, unless otherwise specifically indicated:
98.18 	COMPANY NAME
98.19 	ADDRESS - CITY AND STATE
98.20 	TELEPHONE NUMBER
98.21 	LONG-TERM CARE INSURANCE
98.22 	OUTLINE OF COVERAGE
98.23 	Policy Number or Group Master Policy and Certificate Number
98.24 	(Except for policies or certificates which are guaranteed issue, the following caution 
98.25 	statement, or language substantially similar, must appear as follows in the outline of 
98.26 	coverage.)
98.27 	CAUTION: The issuance of this long-term care insurance (policy) (certificate) is based 
98.28 	upon your responses to the questions on your application. A copy of your (application) 
98.29 	(enrollment form) (is enclosed) (was retained by you when you applied). If your answers 
98.30 	are incorrect or untrue, the company has the right to deny benefits or rescind your policy. 
99.1 	The best time to clear up any questions is now, before a claim arises. If, for any reason, any 
99.2 	of your answers are incorrect, contact the company at this address: (insert address).
99.3 	(1) This policy is (an individual policy of insurance) (a group policy) which was issued 
99.4 	in the (indicate jurisdiction in which group policy was issued).
99.5 	(2) PURPOSE OF OUTLINE OF COVERAGE. This outline of coverage provides a 
99.6 	very brief description of the important features of the policy. You should compare this 
99.7 	outline of coverage to outlines of coverage for other policies available to you. This is not 
99.8 	an insurance contract, but only a summary of coverage. Only the individual or group policy 
99.9 	contains governing contractual provisions. This means that the policy or group policy sets 
99.10 	forth in detail the rights and obligations of both you and the insurance company. Therefore, 
99.11 	if you purchase this coverage, or any other coverage, it is important that you READ YOUR 
99.12 	POLICY (OR CERTIFICATE) CAREFULLY.
99.13 	(3) THIS PLAN IS INTENDED TO BE A QUALIFIED LONG-TERM CARE 
99.14 	INSURANCE CONTRACT AS DEFINED UNDER SECTION 7702(B)(b) OF THE 
99.15 	INTERNAL REVENUE CODE OF 1986.
99.16 	(4) TERMS UNDER WHICH THE POLICY OR CERTIFICATE MAY BE 
99.17 	CONTINUED IN FORCE OR DISCONTINUED.
99.18 	(a) (For long-term care health insurance policies or certificates describe one of the 
99.19 	following permissible policy renewability provisions:)
99.20 	(1) (Policies and certificates that are guaranteed renewable shall contain the following 
99.21 	statement:) RENEWABILITY: THIS POLICY (CERTIFICATE) IS GUARANTEED 
99.22 	RENEWABLE. This means you have the right, subject to the terms of your policy, 
99.23 	(certificate) to continue this policy as long as you pay your premiums on time. (Company 
99.24 	name) cannot change any of the terms of your policy on its own, except that, in the future, 
99.25 	IT MAY INCREASE THE PREMIUM YOU PAY.
99.26 	(2) (Policies and certificates that are noncancelable shall contain the following statement:) 
99.27 	RENEWABILITY: THIS POLICY (CERTIFICATE) IS NONCANCELABLE. This means 
99.28 	that you have the right, subject to the terms of your policy, to continue this policy as long 
99.29 	as you pay your premiums on time. (Company name) cannot change any of the terms of 
99.30 	your policy on its own and cannot change the premium you currently pay. However, if your 
99.31 	policy contains an inflation protection feature where you choose to increase your benefits, 
99.32 	(company name) may increase your premium at that time for those additional benefits.
100.1 	(b) (For group coverage, specifically describe continuation/conversion provisions 
100.2 	applicable to the certificate and group policy.)
100.3 	(c) (Describe waiver of premium provisions or state that there are not such provisions.)
100.4 	(5) TERMS UNDER WHICH THE COMPANY MAY CHANGE PREMIUMS.
100.5 	(In bold type larger than the maximum type required to be used for the other provisions 
100.6 	of the outline of coverage, state whether or not the company has a right to change the 
100.7 	premium and, if a right exists, describe clearly and concisely each circumstance under which 
100.8 	the premium may change.)
100.9 	(6) TERMS UNDER WHICH THE POLICY OR CERTIFICATE MAY BE RETURNED 
100.10 	AND PREMIUM REFUNDED.
100.11 	(a) (Provide a brief description of the right to return -- "free look" provision of the policy.)
100.12 	(b) (Include a statement that the policy either does or does not contain provisions 
100.13 	providing for a refund or partial refund of premium upon the death of an insured or surrender 
100.14 	of the policy or certificate. If the policy contains such provisions, include a description of 
100.15 	them.)
100.16 	(7) THIS IS NOT MEDICARE SUPPLEMENT COVERAGE. If you are eligible for 
100.17 	Medicare, review the Medicare Supplement Buyer's Guide available from the insurance 
100.18 	company.
100.19 	(a) (For agents) neither (insert company name) nor its agents represent Medicare, the 
100.20 	federal government, or any state government.
100.21 	(b) (For direct response) (insert company name) is not representing Medicare, the federal 
100.22 	government, or any state government.
100.23 	(8) LONG-TERM CARE COVERAGE. Policies of this category are designed to provide 
100.24 	coverage for one or more necessary or medically necessary diagnostic, preventive, 
100.25 	therapeutic, rehabilitative, maintenance, or personal care services, provided in a setting 
100.26 	other than an acute care unit of a hospital, such as in a nursing home, in the community, or 
100.27 	in the home.
100.28 	This policy provides coverage in the form of a fixed dollar indemnity benefit for covered 
100.29 	long-term care expenses, subject to policy (limitations), (waiting periods), and (coinsurance) 
100.30 	requirements. (Modify this paragraph if the policy is not an indemnity policy.)
100.31 	(9) BENEFITS PROVIDED BY THIS POLICY.
101.1 	(a) (Covered services, related deductible(s), waiting periods, elimination periods, and 
101.2 	benefit maximums.)
101.3 	(b) (Institutional benefits, by skill level.)
101.4 	(c) (Noninstitutional benefits, by skill level.)
101.5 	(d) (Eligibility for payment of benefits.)
101.6 	(Activities of daily living and cognitive impairment shall be used to measure an insured's 
101.7 	need for long-term care and must be defined and described as part of the outline of coverage.)
101.8 	(Any benefit screens must be explained in this section. If these screens differ for different 
101.9 	benefits, explanation of the screen should accompany each benefit description. If an attending 
101.10 	physician, advanced practice registered nurse, or other specified person must certify a certain 
101.11 	level of functional dependency in order to be eligible for benefits, this too must be specified. 
101.12 	If activities of daily living (ADLs) are used to measure an insured's need for long-term care, 
101.13 	then these qualifying criteria or screens must be explained.)
101.14 	(10) LIMITATIONS AND EXCLUSIONS:
101.15 	Describe:
101.16 	(a) preexisting conditions;
101.17 	(b) noneligible facilities/provider;
101.18 	(c) noneligible levels of care (e.g., unlicensed providers, care or treatment provided by 
101.19 	a family member, etc.);
101.20 	(d) exclusions/exceptions; and
101.21 	(e) limitations.
101.22 	(This section should provide a brief specific description of any policy provisions which 
101.23 	limit, exclude, restrict, reduce, delay, or in any other manner operate to qualify payment of 
101.24 	the benefits described in paragraph (8).)
101.25 	THIS POLICY MAY NOT COVER ALL THE EXPENSES ASSOCIATED WITH 
101.26 	YOUR LONG-TERM CARE NEEDS.
101.27 	(11) RELATIONSHIP OF COST OF CARE AND BENEFITS. Because the costs of 
101.28 	long-term care services will likely increase over time, you should consider whether and 
101.29 	how the benefits of this plan may be adjusted. As applicable, indicate the following:
101.30 	(a) that the benefit level will not increase over time;
102.1 	(b) any automatic benefit adjustment provisions;
102.2 	(c) whether the insured will be guaranteed the option to buy additional benefits and the 
102.3 	basis upon which benefits will be increased over time if not by a specified amount or 
102.4 	percentage;
102.5 	(d) if there is such a guarantee, include whether additional underwriting or health 
102.6 	screening will be required, the frequency and amounts of the upgrade options, and any 
102.7 	significant restrictions or limitations; and
102.8 	(e) whether there will be any additional premium charge imposed and how that is to be 
102.9 	calculated.
102.10 	(12) ALZHEIMER'S DISEASE AND OTHER ORGANIC BRAIN DISORDERS. (State 
102.11 	that the policy provides coverage for insureds clinically diagnosed as having Alzheimer's 
102.12 	disease or related degenerative and dementing illnesses. Specifically, describe each benefit 
102.13 	screen or other policy provision which provides preconditions to the availability of policy 
102.14 	benefits for such an insured.)
102.15 	(13) PREMIUM.
102.16 	(a) State the total annual premium for the policy.
102.17 	(b) If the premium varies with an applicant's choice among benefit options, indicate the 
102.18 	portion of annual premium which corresponds to each benefit option.
102.19 	(14) ADDITIONAL FEATURES.
102.20 	(a) Indicate if medical underwriting is used.
102.21 	(b) Describe other important features.
102.22 	(15) CONTACT THE STATE DEPARTMENT OF COMMERCE OR SENIOR 
102.23 	LINKAGE LINE IF YOU HAVE GENERAL QUESTIONS REGARDING LONG-TERM 
102.24 	CARE INSURANCE. CONTACT THE INSURANCE COMPANY IF YOU HAVE 
102.25 	SPECIFIC QUESTIONS REGARDING YOUR LONG-TERM CARE INSURANCE 
102.26 	POLICY OR CERTIFICATE.

102.27 	Sec. 17. Minnesota Statutes 2018, section 62S.20, subdivision 5b, is amended to read:
102.28 		Subd. 5b.Benefit triggers. Activities of daily living and cognitive impairment must be 
102.29 	used to measure an insured's need for long-term care and must be described in the policy 
102.30 	or certificate in a separate paragraph and must be labeled "Eligibility for the Payment of 
102.31 	Benefits." Any additional benefit triggers must also be explained in this section. If these 
103.1 	triggers differ for different benefits, explanation of the trigger must accompany each benefit 
103.2 	description. If an attending physician, advanced practice registered nurse, or other specified 
103.3 	person must certify a certain level of functional dependency in order to be eligible for 
103.4 	benefits, this too shall be specified.

103.5 	Sec. 18. Minnesota Statutes 2018, section 62S.21, subdivision 2, is amended to read:
103.6 		Subd. 2.Medication information required. If an application for long-term care 
103.7 	insurance contains a question which asks whether the applicant has had medication prescribed 
103.8 	by a physician or advanced practice registered nurse, it must also ask the applicant to list 
103.9 	the medication that has been prescribed. If the medications listed in the application were 
103.10 	known by the insurer, or should have been known at the time of application, to be directly 
103.11 	related to a medical condition for which coverage would otherwise be denied, then the 
103.12 	policy or certificate shall not be rescinded for that condition.

103.13 	Sec. 19. Minnesota Statutes 2018, section 62S.268, subdivision 1, is amended to read:
103.14 		Subdivision 1.Definitions. For purposes of this section, the following terms have the 
103.15 	meanings given them:
103.16 	(a) "Qualified long-term care services" means services that meet the requirements of 
103.17 	section 7702(c)(1) of the Internal Revenue Code of 1986, as amended, as follows: necessary 
103.18 	diagnostic, preventive, therapeutic, curative, treatment, mitigation, and rehabilitative services, 
103.19 	and maintenance or personal care services which are required by a chronically ill individual, 
103.20 	and are provided pursuant to a plan of care prescribed by a licensed health care practitioner.
103.21 	(b) "Chronically ill individual" has the meaning prescribed for this term by section 
103.22 	7702B(c)(2) of the Internal Revenue Code of 1986, as amended. Under this provision, a 
103.23 	chronically ill individual means any individual who has been certified by a licensed health 
103.24 	care practitioner as being unable to perform, without substantial assistance from another 
103.25 	individual, at least two activities of daily living for a period of at least 90 days due to a loss 
103.26 	of functional capacity, or requiring substantial supervision to protect the individual from 
103.27 	threats to health and safety due to severe cognitive impairment.
103.28 	The term "chronically ill individual" does not include an individual otherwise meeting 
103.29 	these requirements unless within the preceding 12-month period a licensed health care 
103.30 	practitioner has certified that the individual meets these requirements.
103.31 	(c) "Licensed health care practitioner" means a physician, as defined in section 1861(r)(1) 
103.32 	of the Social Security Act, an advanced practice registered nurse, a registered professional 
104.1 	nurse, licensed social worker, or other individual who meets requirements prescribed by 
104.2 	the Secretary of the Treasury.
104.3 	(d) "Maintenance or personal care services" means any care the primary purpose of 
104.4 	which is the provision of needed assistance with any of the disabilities as a result of which 
104.5 	the individual is a chronically ill individual, including the protection from threats to health 
104.6 	and safety due to severe cognitive impairment.

104.7 	Sec. 20. Minnesota Statutes 2018, section 144.3345, subdivision 1, is amended to read:
104.8 		Subdivision 1.Definitions. (a) The following definitions are used for the purposes of 
104.9 	this section.
104.10 	(b) "Eligible community e-health collaborative" means an existing or newly established 
104.11 	collaborative to support the adoption and use of interoperable electronic health records. A 
104.12 	collaborative must consist of at least two or more eligible health care entities in at least two 
104.13 	of the categories listed in paragraph (c) and have a focus on interconnecting the members 
104.14 	of the collaborative for secure and interoperable exchange of health care information.
104.15 	(c) "Eligible health care entity" means one of the following:
104.16 	(1) community clinics, as defined under section 145.9268;
104.17 	(2) hospitals eligible for rural hospital capital improvement grants, as defined in section 
104.18 	144.148;
104.19 	(3) physician or advanced practice registered nurse clinics located in a community with 
104.20 	a population of less than 50,000 according to United States Census Bureau statistics and 
104.21 	outside the seven-county metropolitan area;
104.22 	(4) nursing facilities licensed under sections 144A.01 to 144A.27;
104.23 	(5) community health boards as established under chapter 145A;
104.24 	(6) nonprofit entities with a purpose to provide health information exchange coordination 
104.25 	governed by a representative, multi-stakeholder board of directors; and
104.26 	(7) other providers of health or health care services approved by the commissioner for 
104.27 	which interoperable electronic health record capability would improve quality of care, 
104.28 	patient safety, or community health.

105.1 	Sec. 21. Minnesota Statutes 2018, section 144.3352, is amended to read:
105.2 	144.3352 HEPATITIS B MATERNAL CARRIER DATA; INFANT 
105.3 	IMMUNIZATION.
105.4 	The commissioner of health or a community health board may inform the physician or 
105.5 	advanced practice registered nurse attending a newborn of the hepatitis B infection status 
105.6 	of the biological mother.

105.7 	Sec. 22. Minnesota Statutes 2018, section 144.34, is amended to read:
105.8 	144.34 INVESTIGATION AND CONTROL OF OCCUPATIONAL DISEASES.
105.9 	Any physician or advanced practice registered nurse having under professional care any 
105.10 	person whom the physician or advanced practice registered nurse believes to be suffering 
105.11 	from poisoning from lead, phosphorus, arsenic, brass, silica dust, carbon monoxide gas, 
105.12 	wood alcohol, or mercury, or their compounds, or from anthrax or from compressed-air 
105.13 	illness or any other disease contracted as a result of the nature of the employment of such 
105.14 	person shall within five days mail to the Department of Health a report stating the name, 
105.15 	address, and occupation of such patient, the name, address, and business of the patient's 
105.16 	employer, the nature of the disease, and such other information as may reasonably be required 
105.17 	by the department. The department shall prepare and furnish the physicians and advanced 
105.18 	practice registered nurses of this state suitable blanks for the reports herein required. No 
105.19 	report made pursuant to the provisions of this section shall be admissible as evidence of the 
105.20 	facts therein stated in any action at law or in any action under the Workers' Compensation 
105.21 	Act against any employer of such diseased person. The Department of Health is authorized 
105.22 	to investigate and to make recommendations for the elimination or prevention of occupational 
105.23 	diseases which have been reported to it, or which shall be reported to it, in accordance with 
105.24 	the provisions of this section. The department is also authorized to study and provide advice 
105.25 	in regard to conditions that may be suspected of causing occupational diseases. Information 
105.26 	obtained upon investigations made in accordance with the provisions of this section shall 
105.27 	not be admissible as evidence in any action at law to recover damages for personal injury 
105.28 	or in any action under the Workers' Compensation Act. Nothing herein contained shall be 
105.29 	construed to interfere with or limit the powers of the Department of Labor and Industry to 
105.30 	make inspections of places of employment or issue orders for the protection of the health 
105.31 	of the persons therein employed. When upon investigation the commissioner of health 
105.32 	reaches a conclusion that a condition exists which is dangerous to the life and health of the 
105.33 	workers in any industry or factory or other industrial institutions the commissioner shall 
105.34 	file a report thereon with the Department of Labor and Industry.

106.1 	Sec. 23. Minnesota Statutes 2018, section 144.441, subdivision 4, is amended to read:
106.2 		Subd. 4.Screening of employees. As determined by the commissioner under subdivision 
106.3 	2, a person employed by the designated school or school district shall submit to the 
106.4 	administrator or other person having general control and supervision of the school one of 
106.5 	the following:
106.6 	(1) a statement from a physician, advanced practice registered nurse, or public clinic 
106.7 	stating that the person has had a negative Mantoux test reaction within the past year, provided 
106.8 	that the person has no symptoms suggestive of tuberculosis or evidence of a new exposure 
106.9 	to active tuberculosis;
106.10 	(2) a statement from a physician, advanced practice registered nurse, or public clinic 
106.11 	stating that a person who has a positive Mantoux test reaction has had a negative chest 
106.12 	roentgenogram (X-ray) for tuberculosis within the past year, provided that the person has 
106.13 	no symptoms suggestive of tuberculosis or evidence of a new exposure to active tuberculosis;
106.14 	(3) a statement from a physician, advanced practice registered nurse, or public health 
106.15 	clinic stating that the person (i) has a history of adequately treated active tuberculosis; (ii) 
106.16 	is currently receiving tuberculosis preventive therapy; (iii) is currently undergoing therapy 
106.17 	for active tuberculosis and the person's presence in a school building will not endanger the 
106.18 	health of other people; or (iv) has completed a course of preventive therapy or was intolerant 
106.19 	to preventive therapy, provided the person has no symptoms suggestive of tuberculosis or 
106.20 	evidence of a new exposure to active tuberculosis; or
106.21 	(4) a notarized statement signed by the person stating that the person has not submitted 
106.22 	the proof of tuberculosis screening as required by this subdivision because of conscientiously 
106.23 	held beliefs. This statement must be forwarded to the commissioner of health.

106.24 	Sec. 24. Minnesota Statutes 2018, section 144.441, subdivision 5, is amended to read:
106.25 		Subd. 5.Exceptions. Subdivisions 3 and 4 do not apply to:
106.26 	(1) a person with a history of either a past positive Mantoux test reaction or active 
106.27 	tuberculosis who has a documented history of completing a course of tuberculosis therapy 
106.28 	or preventive therapy when the school or school district holds a statement from a physician, 
106.29 	advanced practice registered nurse, or public health clinic indicating that such therapy was 
106.30 	provided to the person and that the person has no symptoms suggestive of tuberculosis or 
106.31 	evidence of a new exposure to active tuberculosis; and
107.1 	(2) a person with a history of a past positive Mantoux test reaction who has not completed 
107.2 	a course of preventive therapy. This determination shall be made by the commissioner based 
107.3 	on currently accepted public health standards and the person's health status.

107.4 	Sec. 25. Minnesota Statutes 2018, section 144.442, subdivision 1, is amended to read:
107.5 		Subdivision 1.Administration; notification. In the event that the commissioner 
107.6 	designates a school or school district under section 144.441, subdivision 2, the school or 
107.7 	school district or community health board may administer Mantoux screening tests to some 
107.8 	or all persons enrolled in or employed by the designated school or school district. Any 
107.9 	Mantoux screening provided under this section shall be under the direction of a licensed 
107.10 	physician or advanced practice registered nurse.
107.11 	Prior to administering the Mantoux test to such persons, the school or school district or 
107.12 	community health board shall inform in writing such persons and parents or guardians of 
107.13 	minor children to whom the test may be administered, of the following:
107.14 	(1) that there has been an occurrence of active tuberculosis or evidence of a higher than 
107.15 	expected prevalence of tuberculosis infection in that school or school district;
107.16 	(2) that screening is necessary to avoid the spread of tuberculosis;
107.17 	(3) the manner by which tuberculosis is transmitted;
107.18 	(4) the risks and possible side effects of the Mantoux test;
107.19 	(5) the risks from untreated tuberculosis to the infected person and others;
107.20 	(6) the ordinary course of further diagnosis and treatment if the Mantoux test is positive;
107.21 	(7) that screening has been scheduled; and
107.22 	(8) that no person will be required to submit to the screening if the person submits a 
107.23 	statement of objection due to the conscientiously held beliefs of the person employed or of 
107.24 	the parent or guardian of a minor child.

107.25 	Sec. 26. Minnesota Statutes 2018, section 144.4803, subdivision 1, is amended to read:
107.26 		Subdivision 1.Active tuberculosis. "Active tuberculosis" includes infectious and 
107.27 	noninfectious tuberculosis and means:
107.28 	(1) a condition evidenced by a positive culture for mycobacterium tuberculosis taken 
107.29 	from a pulmonary or laryngeal source;
108.1 	(2) a condition evidenced by a positive culture for mycobacterium tuberculosis taken 
108.2 	from an extrapulmonary source when there is clinical evidence such as a positive skin test 
108.3 	for tuberculosis infection, coughing, sputum production, fever, or other symptoms compatible 
108.4 	with pulmonary tuberculosis; or
108.5 	(3) a condition in which clinical specimens are not available for culture, but there is 
108.6 	radiographic evidence of tuberculosis such as an abnormal chest x-ray, and clinical evidence 
108.7 	such as a positive skin test for tuberculosis infection, coughing, sputum production, fever, 
108.8 	or other symptoms compatible with pulmonary tuberculosis, that lead a physician or advanced 
108.9 	practice registered nurse to reasonably diagnose active tuberculosis according to currently 
108.10 	accepted standards of medical practice and to initiate treatment for tuberculosis.

108.11 	Sec. 27. Minnesota Statutes 2018, section 144.4803, is amended by adding a subdivision 
108.12 	to read:
108.13 		Subd. 1a.Advanced practice registered nurse. "Advanced practice registered nurse" 
108.14 	means a person who is licensed by the Board of Nursing under chapter 148 to practice as 
108.15 	an advanced practice registered nurse.

108.16 	Sec. 28. Minnesota Statutes 2018, section 144.4803, subdivision 4, is amended to read:
108.17 		Subd. 4.Clinically suspected of having active tuberculosis. "Clinically suspected of 
108.18 	having active tuberculosis" means presenting a reasonable possibility of having active 
108.19 	tuberculosis based upon epidemiologic, clinical, or radiographic evidence, laboratory test 
108.20 	results, or other reliable evidence as determined by a physician or advanced practice 
108.21 	registered nurse using currently accepted standards of medical practice.

108.22 	Sec. 29. Minnesota Statutes 2018, section 144.4803, subdivision 10, is amended to read:
108.23 		Subd. 10.Endangerment to the public health. "Endangerment to the public health" 
108.24 	means a carrier who may transmit tuberculosis to another person or persons because the 
108.25 	carrier has engaged or is engaging in any of the following conduct:
108.26 	(1) refuses or fails to submit to a diagnostic tuberculosis examination that is ordered by 
108.27 	a physician or advanced practice registered nurse and is reasonable according to currently 
108.28 	accepted standards of medical practice;
108.29 	(2) refuses or fails to initiate or complete treatment for tuberculosis that is prescribed 
108.30 	by a physician or advanced practice registered nurse and is reasonable according to currently 
108.31 	accepted standards of medical practice;
109.1 	(3) refuses or fails to keep appointments for treatment of tuberculosis;
109.2 	(4) refuses or fails to provide the commissioner, upon request, with evidence showing 
109.3 	the completion of a course of treatment for tuberculosis that is prescribed by a physician or 
109.4 	advanced practice registered nurse and is reasonable according to currently accepted standards 
109.5 	of medical practice;
109.6 	(5) refuses or fails to initiate or complete a course of directly observed therapy that is 
109.7 	prescribed by a physician or advanced practice registered nurse and is reasonable according 
109.8 	to currently accepted standards of medical practice;
109.9 	(6) misses at least 20 percent of scheduled appointments for directly observed therapy, 
109.10 	or misses at least two consecutive appointments for directly observed therapy;
109.11 	(7) refuses or fails to follow contagion precautions for tuberculosis after being instructed 
109.12 	on the precautions by a licensed health professional or by the commissioner;
109.13 	(8) based on evidence of the carrier's past or present behavior, may not complete a course 
109.14 	of treatment for tuberculosis that is reasonable according to currently accepted standards 
109.15 	of medical practice; or
109.16 	(9) may expose other persons to tuberculosis based on epidemiological, medical, or other 
109.17 	reliable evidence.

109.18 	Sec. 30. Minnesota Statutes 2018, section 144.4806, is amended to read:
109.19 	144.4806 PREVENTIVE MEASURES UNDER HEALTH ORDER.
109.20 	A health order may include, but need not be limited to, an order:
109.21 	(1) requiring the carrier's attending physician, advanced practice registered nurse, or 
109.22 	treatment facility to isolate and detain the carrier for treatment or for a diagnostic examination 
109.23 	for tuberculosis, pursuant to section 144.4807, subdivision 1, if the carrier is an endangerment 
109.24 	to the public health and is in a treatment facility;
109.25 	(2) requiring a carrier who is an endangerment to the public health to submit to diagnostic 
109.26 	examination for tuberculosis and to remain in the treatment facility until the commissioner 
109.27 	receives the results of the examination;
109.28 	(3) requiring a carrier who is an endangerment to the public health to remain in or present 
109.29 	at a treatment facility until the carrier has completed a course of treatment for tuberculosis 
109.30 	that is prescribed by a physician or advanced practice registered nurse and is reasonable 
109.31 	according to currently accepted standards of medical practice;
110.1 	(4) requiring a carrier who is an endangerment to the public health to complete a course 
110.2 	of treatment for tuberculosis that is prescribed by a physician or advanced practice registered 
110.3 	nurse and is reasonable according to currently accepted standards of medical practice and, 
110.4 	if necessary, to follow contagion precautions for tuberculosis;
110.5 	(5) requiring a carrier who is an endangerment to the public health to follow a course 
110.6 	of directly observed therapy that is prescribed by a physician or advanced practice registered 
110.7 	nurse and is reasonable according to currently accepted standards of medical practice;
110.8 	(6) excluding a carrier who is an endangerment to the public health from the carrier's 
110.9 	place of work or school, or from other premises if the commissioner determines that exclusion 
110.10 	is necessary because contagion precautions for tuberculosis cannot be maintained in a 
110.11 	manner adequate to protect others from being exposed to tuberculosis;
110.12 	(7) requiring a licensed health professional or treatment facility to provide to the 
110.13 	commissioner certified copies of all medical and epidemiological data relevant to the carrier's 
110.14 	tuberculosis and status as an endangerment to the public health;
110.15 	(8) requiring the diagnostic examination for tuberculosis of other persons in the carrier's 
110.16 	household, workplace, or school, or other persons in close contact with the carrier if the 
110.17 	commissioner has probable cause to believe that the persons may have active tuberculosis 
110.18 	or may have been exposed to tuberculosis based on epidemiological, medical, or other 
110.19 	reliable evidence; or
110.20 	(9) requiring a carrier or other persons to follow contagion precautions for tuberculosis.

110.21 	Sec. 31. Minnesota Statutes 2018, section 144.4807, subdivision 1, is amended to read:
110.22 		Subdivision 1.Obligation to isolate. If the carrier is in a treatment facility, the 
110.23 	commissioner or a carrier's attending physician or advanced practice registered nurse, after 
110.24 	obtaining approval from the commissioner, may issue a notice of obligation to isolate to a 
110.25 	treatment facility if the commissioner or attending physician or advanced practice registered 
110.26 	nurse has probable cause to believe that a carrier is an endangerment to the public health.

110.27 	Sec. 32. Minnesota Statutes 2018, section 144.4807, subdivision 2, is amended to read:
110.28 		Subd. 2.Obligation to examine. If the carrier is clinically suspected of having active 
110.29 	tuberculosis, the commissioner may issue a notice of obligation to examine to the carrier's 
110.30 	attending physician or advanced practice registered nurse to conduct a diagnostic examination 
110.31 	for tuberculosis on the carrier.

111.1 	Sec. 33. Minnesota Statutes 2018, section 144.4807, subdivision 4, is amended to read:
111.2 		Subd. 4.Service of health order on carrier. When issuing a notice of obligation to 
111.3 	isolate or examine to the carrier's physician or advanced practice registered nurse or a 
111.4 	treatment facility, the commissioner shall simultaneously serve a health order on the carrier 
111.5 	ordering the carrier to remain in the treatment facility for treatment or examination.

111.6 	Sec. 34. Minnesota Statutes 2018, section 144.50, subdivision 2, is amended to read:
111.7 		Subd. 2.Hospital, sanitarium, other institution; definition. Hospital, sanitarium or 
111.8 	other institution for the hospitalization or care of human beings, within the meaning of 
111.9 	sections 144.50 to 144.56 shall mean any institution, place, building, or agency, in which 
111.10 	any accommodation is maintained, furnished, or offered for five or more persons for: the 
111.11 	hospitalization of the sick or injured; the provision of care in a swing bed authorized under 
111.12 	section 144.562; elective outpatient surgery for preexamined, prediagnosed low risk patients; 
111.13 	emergency medical services offered 24 hours a day, seven days a week, in an ambulatory 
111.14 	or outpatient setting in a facility not a part of a licensed hospital; or the institutional care of 
111.15 	human beings. Nothing in sections 144.50 to 144.56 shall apply to a clinic, a physician's or 
111.16 	advanced practice registered nurse's office or to hotels or other similar places that furnish 
111.17 	only board and room, or either, to their guests.

111.18 	Sec. 35. Minnesota Statutes 2019 Supplement, section 144.55, subdivision 2, is amended 
111.19 	to read:
111.20 		Subd. 2.Definitions. (a) For the purposes of this section, the terms in this subdivision 
111.21 	have the meanings given them.
111.22 	(b) "Outpatient surgical center" or "center" means a facility organized for the specific 
111.23 	purpose of providing elective outpatient surgery for preexamined, prediagnosed, low-risk 
111.24 	patients. An outpatient surgical center is not organized to provide regular emergency medical 
111.25 	services and does not include a physician's, advanced practice nurse's,  or dentist's office 
111.26 	or clinic for the practice of medicine, the practice of dentistry, or the delivery of primary 
111.27 	care.
111.28 	(c) "Approved accrediting organization" means any organization recognized as an 
111.29 	accreditation organization by the Centers for Medicare and Medicaid Services.

111.30 	Sec. 36. Minnesota Statutes 2018, section 144.55, subdivision 6, is amended to read:
111.31 		Subd. 6.Suspension, revocation, and refusal to renew. (a) The commissioner may 
111.32 	refuse to grant or renew, or may suspend or revoke, a license on any of the following grounds:
112.1 	(1) violation of any of the provisions of sections 144.50 to 144.56 or the rules or standards 
112.2 	issued pursuant thereto, or Minnesota Rules, chapters 4650 and 4675;
112.3 	(2) permitting, aiding, or abetting the commission of any illegal act in the institution;
112.4 	(3) conduct or practices detrimental to the welfare of the patient; or
112.5 	(4) obtaining or attempting to obtain a license by fraud or misrepresentation; or
112.6 	(5) with respect to hospitals and outpatient surgical centers, if the commissioner 
112.7 	determines that there is a pattern of conduct that one or more physicians or advanced practice 
112.8 	registered nurses who have a "financial or economic interest," as defined in section 144.6521, 
112.9 	subdivision 3, in the hospital or outpatient surgical center, have not provided the notice and 
112.10 	disclosure of the financial or economic interest required by section 144.6521.
112.11 	(b) The commissioner shall not renew a license for a boarding care bed in a resident 
112.12 	room with more than four beds.

112.13 	Sec. 37. Minnesota Statutes 2018, section 144.6501, subdivision 7, is amended to read:
112.14 		Subd. 7.Consent to treatment. An admission contract must not include a clause 
112.15 	requiring a resident to sign a consent to all treatment ordered by any physician or advanced 
112.16 	practice registered nurse. An admission contract may require consent only for routine nursing 
112.17 	care or emergency care. An admission contract must contain a clause that informs the 
112.18 	resident of the right to refuse treatment.

112.19 	Sec. 38. Minnesota Statutes 2018, section 144.651, subdivision 7, is amended to read:
112.20 		Subd. 7.Physician's or advanced practice registered nurse's identity. Patients and 
112.21 	residents shall have or be given, in writing, the name, business address, telephone number, 
112.22 	and specialty, if any, of the physician or advanced practice registered nurse responsible for 
112.23 	coordination of their care. In cases where it is medically inadvisable, as documented by the 
112.24 	attending physician or advanced practice registered nurse in a patient's or resident's care 
112.25 	record, the information shall be given to the patient's or resident's guardian or other person 
112.26 	designated by the patient or resident as a representative.

112.27 	Sec. 39. Minnesota Statutes 2018, section 144.651, subdivision 8, is amended to read:
112.28 		Subd. 8.Relationship with other health services. Patients and residents who receive 
112.29 	services from an outside provider are entitled, upon request, to be told the identity of the 
112.30 	provider. Residents shall be informed, in writing, of any health care services which are 
112.31 	provided to those residents by individuals, corporations, or organizations other than their 
113.1 	facility. Information shall include the name of the outside provider, the address, and a 
113.2 	description of the service which may be rendered. In cases where it is medically inadvisable, 
113.3 	as documented by the attending physician or advanced practice registered nurse in a patient's 
113.4 	or resident's care record, the information shall be given to the patient's or resident's guardian 
113.5 	or other person designated by the patient or resident as a representative.

113.6 	Sec. 40. Minnesota Statutes 2018, section 144.651, subdivision 9, is amended to read:
113.7 		Subd. 9.Information about treatment. Patients and residents shall be given by their 
113.8 	physicians or advanced practice registered nurses complete and current information 
113.9 	concerning their diagnosis, treatment, alternatives, risks, and prognosis as required by the 
113.10 	physician's or advanced practice registered nurse's legal duty to disclose. This information 
113.11 	shall be in terms and language the patients or residents can reasonably be expected to 
113.12 	understand. Patients and residents may be accompanied by a family member or other chosen 
113.13 	representative, or both. This information shall include the likely medical or major 
113.14 	psychological results of the treatment and its alternatives. In cases where it is medically 
113.15 	inadvisable, as documented by the attending physician or advanced practice registered nurse
113.16 	in a patient's or resident's medical record, the information shall be given to the patient's or 
113.17 	resident's guardian or other person designated by the patient or resident as a representative. 
113.18 	Individuals have the right to refuse this information.
113.19 	Every patient or resident suffering from any form of breast cancer shall be fully informed, 
113.20 	prior to or at the time of admission and during her stay, of all alternative effective methods 
113.21 	of treatment of which the treating physician or advanced practice registered nurse is 
113.22 	knowledgeable, including surgical, radiological, or chemotherapeutic treatments or 
113.23 	combinations of treatments and the risks associated with each of those methods.

113.24 	Sec. 41. Minnesota Statutes 2018, section 144.651, subdivision 10, is amended to read:
113.25 		Subd. 10.Participation in planning treatment; notification of family members. (a) 
113.26 	Patients and residents shall have the right to participate in the planning of their health care. 
113.27 	This right includes the opportunity to discuss treatment and alternatives with individual 
113.28 	caregivers, the opportunity to request and participate in formal care conferences, and the 
113.29 	right to include a family member or other chosen representative, or both. In the event that 
113.30 	the patient or resident cannot be present, a family member or other representative chosen 
113.31 	by the patient or resident may be included in such conferences. A chosen representative 
113.32 	may include a doula of the patient's choice.
114.1 	(b) If a patient or resident who enters a facility is unconscious or comatose or is unable 
114.2 	to communicate, the facility shall make reasonable efforts as required under paragraph (c) 
114.3 	to notify either a family member or a person designated in writing by the patient as the 
114.4 	person to contact in an emergency that the patient or resident has been admitted to the 
114.5 	facility. The facility shall allow the family member to participate in treatment planning, 
114.6 	unless the facility knows or has reason to believe the patient or resident has an effective 
114.7 	advance directive to the contrary or knows the patient or resident has specified in writing 
114.8 	that they do not want a family member included in treatment planning. After notifying a 
114.9 	family member but prior to allowing a family member to participate in treatment planning, 
114.10 	the facility must make reasonable efforts, consistent with reasonable medical practice, to 
114.11 	determine if the patient or resident has executed an advance directive relative to the patient 
114.12 	or resident's health care decisions. For purposes of this paragraph, "reasonable efforts" 
114.13 	include:
114.14 	(1) examining the personal effects of the patient or resident;
114.15 	(2) examining the medical records of the patient or resident in the possession of the 
114.16 	facility;
114.17 	(3) inquiring of any emergency contact or family member contacted under this section 
114.18 	whether the patient or resident has executed an advance directive and whether the patient 
114.19 	or resident has a physician or advanced practice registered nurse to whom the patient or 
114.20 	resident normally goes for care; and
114.21 	(4) inquiring of the physician or advanced practice registered nurse to whom the patient 
114.22 	or resident normally goes for care, if known, whether the patient or resident has executed 
114.23 	an advance directive. If a facility notifies a family member or designated emergency contact 
114.24 	or allows a family member to participate in treatment planning in accordance with this 
114.25 	paragraph, the facility is not liable to the patient or resident for damages on the grounds 
114.26 	that the notification of the family member or emergency contact or the participation of the 
114.27 	family member was improper or violated the patient's privacy rights.
114.28 	(c) In making reasonable efforts to notify a family member or designated emergency 
114.29 	contact, the facility shall attempt to identify family members or a designated emergency 
114.30 	contact by examining the personal effects of the patient or resident and the medical records 
114.31 	of the patient or resident in the possession of the facility. If the facility is unable to notify 
114.32 	a family member or designated emergency contact within 24 hours after the admission, the 
114.33 	facility shall notify the county social service agency or local law enforcement agency that 
114.34 	the patient or resident has been admitted and the facility has been unable to notify a family 
115.1 	member or designated emergency contact. The county social service agency and local law 
115.2 	enforcement agency shall assist the facility in identifying and notifying a family member 
115.3 	or designated emergency contact. A county social service agency or local law enforcement 
115.4 	agency that assists a facility in implementing this subdivision is not liable to the patient or 
115.5 	resident for damages on the grounds that the notification of the family member or emergency 
115.6 	contact or the participation of the family member was improper or violated the patient's 
115.7 	privacy rights.

115.8 	Sec. 42. Minnesota Statutes 2018, section 144.651, subdivision 12, is amended to read:
115.9 		Subd. 12.Right to refuse care. Competent patients and residents shall have the right 
115.10 	to refuse treatment based on the information required in subdivision 9. Residents who refuse 
115.11 	treatment, medication, or dietary restrictions shall be informed of the likely medical or major 
115.12 	psychological results of the refusal, with documentation in the individual medical record. 
115.13 	In cases where a patient or resident is incapable of understanding the circumstances but has 
115.14 	not been adjudicated incompetent, or when legal requirements limit the right to refuse 
115.15 	treatment, the conditions and circumstances shall be fully documented by the attending 
115.16 	physician or advanced practice registered nurse in the patient's or resident's medical record.

115.17 	Sec. 43. Minnesota Statutes 2018, section 144.651, subdivision 14, is amended to read:
115.18 		Subd. 14.Freedom from maltreatment. Patients and residents shall be free from 
115.19 	maltreatment as defined in the Vulnerable Adults Protection Act. "Maltreatment" means 
115.20 	conduct described in section 626.5572, subdivision 15, or the intentional and nontherapeutic 
115.21 	infliction of physical pain or injury, or any persistent course of conduct intended to produce 
115.22 	mental or emotional distress. Every patient and resident shall also be free from nontherapeutic 
115.23 	chemical and physical restraints, except in fully documented emergencies, or as authorized 
115.24 	in writing after examination by a patient's or resident's physician or advanced practice 
115.25 	registered nurse for a specified and limited period of time, and only when necessary to 
115.26 	protect the resident from self-injury or injury to others.

115.27 	Sec. 44. Minnesota Statutes 2018, section 144.651, subdivision 31, is amended to read:
115.28 		Subd. 31.Isolation and restraints. A minor patient who has been admitted to a 
115.29 	residential program as defined in section 253C.01 has the right to be free from physical 
115.30 	restraint and isolation except in emergency situations involving a likelihood that the patient 
115.31 	will physically harm the patient's self or others. These procedures may not be used for 
115.32 	disciplinary purposes, to enforce program rules, or for the convenience of staff. Isolation 
115.33 	or restraint may be used only upon the prior authorization of a physician, advanced practice 
116.1 	registered nurse, psychiatrist, or licensed psychologist, only when less restrictive measures 
116.2 	are ineffective or not feasible and only for the shortest time necessary.

116.3 	Sec. 45. Minnesota Statutes 2018, section 144.651, subdivision 33, is amended to read:
116.4 		Subd. 33.Restraints. (a) Competent nursing home residents, family members of residents 
116.5 	who are not competent, and legally appointed conservators, guardians, and health care agents 
116.6 	as defined under section 145C.01, have the right to request and consent to the use of a 
116.7 	physical restraint in order to treat the medical symptoms of the resident.
116.8 	(b) Upon receiving a request for a physical restraint, a nursing home shall inform the 
116.9 	resident, family member, or legal representative of alternatives to and the risks involved 
116.10 	with physical restraint use. The nursing home shall provide a physical restraint to a resident 
116.11 	only upon receipt of a signed consent form authorizing restraint use and a written order 
116.12 	from the attending physician or advanced practice registered nurse that contains statements 
116.13 	and determinations regarding medical symptoms and specifies the circumstances under 
116.14 	which restraints are to be used.
116.15 	(c) A nursing home providing a restraint under paragraph (b) must:
116.16 	(1) document that the procedures outlined in that paragraph have been followed;
116.17 	(2) monitor the use of the restraint by the resident; and
116.18 	(3) periodically, in consultation with the resident, the family, and the attending physician
116.19 	or advanced practice registered nurse, reevaluate the resident's need for the restraint.
116.20 	(d) A nursing home shall not be subject to fines, civil money penalties, or other state or 
116.21 	federal survey enforcement remedies solely as the result of allowing the use of a physical 
116.22 	restraint as authorized in this subdivision. Nothing in this subdivision shall preclude the 
116.23 	commissioner from taking action to protect the health and safety of a resident if:
116.24 	(1) the use of the restraint has jeopardized the health and safety of the resident; and
116.25 	(2) the nursing home failed to take reasonable measures to protect the health and safety 
116.26 	of the resident.
116.27 	(e) For purposes of this subdivision, "medical symptoms" include:
116.28 	(1) a concern for the physical safety of the resident; and
116.29 	(2) physical or psychological needs expressed by a resident. A resident's fear of falling 
116.30 	may be the basis of a medical symptom.
117.1 	A written order from the attending physician or advanced practice registered nurse that 
117.2 	contains statements and determinations regarding medical symptoms is sufficient evidence 
117.3 	of the medical necessity of the physical restraint.
117.4 	(f) When determining nursing facility compliance with state and federal standards for 
117.5 	the use of physical restraints, the commissioner of health is bound by the statements and 
117.6 	determinations contained in the attending physician's or advanced practice registered nurse's
117.7 	order regarding medical symptoms. For purposes of this order, "medical symptoms" include 
117.8 	the request by a competent resident, family member of a resident who is not competent, or 
117.9 	legally appointed conservator, guardian, or health care agent as defined under section 
117.10 	145C.01, that the facility provide a physical restraint in order to enhance the physical safety 
117.11 	of the resident.

117.12 	Sec. 46. Minnesota Statutes 2018, section 144.652, subdivision 2, is amended to read:
117.13 		Subd. 2.Correction order; emergencies. A substantial violation of the rights of any 
117.14 	patient or resident as defined in section 144.651, shall be grounds for issuance of a correction 
117.15 	order pursuant to section 144.653 or 144A.10. The issuance or nonissuance of a correction 
117.16 	order shall not preclude, diminish, enlarge, or otherwise alter private action by or on behalf 
117.17 	of a patient or resident to enforce any unreasonable violation of the patient's or resident's 
117.18 	rights. Compliance with the provisions of section 144.651 shall not be required whenever 
117.19 	emergency conditions, as documented by the attending physician or advanced practice 
117.20 	registered nurse in a patient's medical record or a resident's care record, indicate immediate 
117.21 	medical treatment, including but not limited to surgical procedures, is necessary and it is 
117.22 	impossible or impractical to comply with the provisions of section 144.651 because delay 
117.23 	would endanger the patient's or resident's life, health, or safety.

117.24 	Sec. 47. Minnesota Statutes 2018, section 144.69, is amended to read:
117.25 	144.69 CLASSIFICATION OF DATA ON INDIVIDUALS.
117.26 	Notwithstanding any law to the contrary, including section 13.05, subdivision 9, data 
117.27 	collected on individuals by the cancer surveillance system, including the names and personal 
117.28 	identifiers of persons required in section 144.68 to report, shall be private and may only be 
117.29 	used for the purposes set forth in this section and sections 144.671, 144.672, and 144.68. 
117.30 	Any disclosure other than is provided for in this section and sections 144.671, 144.672, and 
117.31 	144.68, is declared to be a misdemeanor and punishable as such. Except as provided by 
117.32 	rule, and as part of an epidemiologic investigation, an officer or employee of the 
117.33 	commissioner of health may interview patients named in any such report, or relatives of 
118.1 	any such patient, only after the consent of the attending physician, advanced practice 
118.2 	registered nurse, or surgeon is obtained.

118.3 	Sec. 48. Minnesota Statutes 2018, section 144.7402, subdivision 2, is amended to read:
118.4 		Subd. 2.Conditions. A facility shall follow the procedures outlined in sections 144.7401
118.5 	to 144.7415 when all of the following conditions are met:
118.6 	(1) the facility determines that significant exposure has occurred, following the protocol 
118.7 	under section 144.7414;
118.8 	(2) the licensed physician or advanced practice registered nurse for the emergency 
118.9 	medical services person needs the source individual's blood-borne pathogen test results to 
118.10 	begin, continue, modify, or discontinue treatment, in accordance with the most current 
118.11 	guidelines of the United States Public Health Service, because of possible exposure to a 
118.12 	blood-borne pathogen; and
118.13 	(3) the emergency medical services person consents to provide a blood sample for testing 
118.14 	for a blood-borne pathogen. If the emergency medical services person consents to blood 
118.15 	collection, but does not consent at that time to blood-borne pathogen testing, the facility 
118.16 	shall preserve the sample for at least 90 days. If the emergency medical services person 
118.17 	elects to have the sample tested within 90 days, the testing shall be done as soon as feasible.

118.18 	Sec. 49. Minnesota Statutes 2018, section 144.7406, subdivision 2, is amended to read:
118.19 		Subd. 2.Procedures without consent. If the source individual has provided a blood 
118.20 	sample with consent but does not consent to blood-borne pathogen testing, the facility shall 
118.21 	test for blood-borne pathogens if the emergency medical services person or emergency 
118.22 	medical services agency requests the test, provided all of the following criteria are met:
118.23 	(1) the emergency medical services person or emergency medical services agency has 
118.24 	documented exposure to blood or body fluids during performance of that person's occupation 
118.25 	or while acting as a Good Samaritan under section 604A.01 or executing a citizen's arrest 
118.26 	under section 629.30;
118.27 	(2) the facility has determined that a significant exposure has occurred and a licensed 
118.28 	physician or advanced practice registered nurse for the emergency medical services person 
118.29 	has documented in the emergency medical services person's medical record that blood-borne 
118.30 	pathogen test results are needed for beginning, modifying, continuing, or discontinuing 
118.31 	medical treatment for the emergency medical services person under section 144.7414, 
118.32 	subdivision 2;
119.1 	(3) the emergency medical services person provides a blood sample for testing for 
119.2 	blood-borne pathogens as soon as feasible;
119.3 	(4) the facility asks the source individual to consent to a test for blood-borne pathogens 
119.4 	and the source individual does not consent;
119.5 	(5) the facility has provided the source individual with all of the information required 
119.6 	by section 144.7403; and
119.7 	(6) the facility has informed the emergency medical services person of the confidentiality 
119.8 	requirements of section 144.7411 and the penalties for unauthorized release of source 
119.9 	information under section 144.7412.

119.10 	Sec. 50. Minnesota Statutes 2018, section 144.7407, subdivision 2, is amended to read:
119.11 		Subd. 2.Procedures without consent. (a) An emergency medical services agency, or, 
119.12 	if there is no agency, an emergency medical services person, may bring a petition for a court 
119.13 	order to require a source individual to provide a blood sample for testing for blood-borne 
119.14 	pathogens. The petition shall be filed in the district court in the county where the source 
119.15 	individual resides or is hospitalized. The petitioner shall serve the petition on the source 
119.16 	individual at least three days before a hearing on the petition. The petition shall include one 
119.17 	or more affidavits attesting that:
119.18 	(1) the facility followed the procedures in sections 144.7401 to 144.7415 and attempted 
119.19 	to obtain blood-borne pathogen test results according to those sections;
119.20 	(2) it has been determined under section 144.7414, subdivision 2, that a significant 
119.21 	exposure has occurred to the emergency medical services person; and
119.22 	(3) a physician with specialty training in infectious diseases, including HIV, has 
119.23 	documented that the emergency medical services person has provided a blood sample and 
119.24 	consented to testing for blood-borne pathogens and blood-borne pathogen test results are 
119.25 	needed for beginning, continuing, modifying, or discontinuing medical treatment for the 
119.26 	emergency medical services person.
119.27 	(b) Facilities shall cooperate with petitioners in providing any necessary affidavits to 
119.28 	the extent that facility staff can attest under oath to the facts in the affidavits.
119.29 	(c) The court may order the source individual to provide a blood sample for blood-borne 
119.30 	pathogen testing if:
119.31 	(1) there is probable cause to believe the emergency medical services person has 
119.32 	experienced a significant exposure to the source individual;
120.1 	(2) the court imposes appropriate safeguards against unauthorized disclosure that must 
120.2 	specify the persons who have access to the test results and the purposes for which the test 
120.3 	results may be used;
120.4 	(3) a licensed physician or advanced practice registered nurse for the emergency medical 
120.5 	services person needs the test results for beginning, continuing, modifying, or discontinuing 
120.6 	medical treatment for the emergency medical services person; and
120.7 	(4) the court finds a compelling need for the test results. In assessing compelling need, 
120.8 	the court shall weigh the need for the court-ordered blood collection and test results against 
120.9 	the interests of the source individual, including, but not limited to, privacy, health, safety, 
120.10 	or economic interests. The court shall also consider whether the involuntary blood collection 
120.11 	and testing would serve the public interest.
120.12 	(d) The court shall conduct the proceeding in camera unless the petitioner or the source 
120.13 	individual requests a hearing in open court and the court determines that a public hearing 
120.14 	is necessary to the public interest and the proper administration of justice.
120.15 	(e) The court shall conduct an ex parte hearing if the source individual does not attend 
120.16 	the noticed hearing and the petitioner complied with the notice requirements in paragraph 
120.17 	(a).
120.18 	(f) The source individual has the right to counsel in any proceeding brought under this 
120.19 	subdivision.
120.20 	(g) The court may order a source individual taken into custody by a peace officer for 
120.21 	purposes of obtaining a blood sample if the source individual does not comply with an order 
120.22 	issued by the court pursuant to paragraph (c). The source individual shall be held no longer 
120.23 	than is necessary to secure a blood sample. A person may not be held for more than 24 hours 
120.24 	without receiving a court hearing.

120.25 	Sec. 51. Minnesota Statutes 2018, section 144.7414, subdivision 2, is amended to read:
120.26 		Subd. 2.Facility protocol requirements. Every facility shall adopt and follow a 
120.27 	postexposure protocol for emergency medical services persons who have experienced a 
120.28 	significant exposure. The postexposure protocol must adhere to the most current 
120.29 	recommendations of the United States Public Health Service and include, at a minimum, 
120.30 	the following:
120.31 	(1) a process for emergency medical services persons to report an exposure in a timely 
120.32 	fashion;
121.1 	(2) a process for an infectious disease specialist, or a licensed physician or advanced 
121.2 	practice registered nurse who is knowledgeable about the most current recommendations 
121.3 	of the United States Public Health Service in consultation with an infectious disease specialist, 
121.4 	(i) to determine whether a significant exposure to one or more blood-borne pathogens has 
121.5 	occurred and (ii) to provide, under the direction of a licensed physician or advanced practice 
121.6 	registered nurse, a recommendation or recommendations for follow-up treatment appropriate 
121.7 	to the particular blood-borne pathogen or pathogens for which a significant exposure has 
121.8 	been determined;
121.9 	(3) if there has been a significant exposure, a process to determine whether the source 
121.10 	individual has a blood-borne pathogen through disclosure of test results, or through blood 
121.11 	collection and testing as required by sections 144.7401 to 144.7415;
121.12 	(4) a process for providing appropriate counseling prior to and following testing for a 
121.13 	blood-borne pathogen regarding the likelihood of blood-borne pathogen transmission and 
121.14 	follow-up recommendations according to the most current recommendations of the United 
121.15 	States Public Health Service, recommendations for testing, and treatment to the emergency 
121.16 	medical services person;
121.17 	(5) a process for providing appropriate counseling under clause (4) to the emergency 
121.18 	medical services person and the source individual; and
121.19 	(6) compliance with applicable state and federal laws relating to data practices, 
121.20 	confidentiality, informed consent, and the patient bill of rights.

121.21 	Sec. 52. Minnesota Statutes 2018, section 144.7415, subdivision 2, is amended to read:
121.22 		Subd. 2.Immunity. A facility, licensed physician, advanced practice registered nurse,
121.23 	and designated health care personnel are immune from liability in any civil, administrative, 
121.24 	or criminal action relating to the disclosure of test results to an emergency medical services 
121.25 	person or emergency medical services agency and the testing of a blood sample from the 
121.26 	source individual for blood-borne pathogens if a good faith effort has been made to comply 
121.27 	with sections 144.7401 to 144.7415.

121.28 	Sec. 53. Minnesota Statutes 2018, section 144.9502, subdivision 4, is amended to read:
121.29 		Subd. 4.Blood lead analyses and epidemiologic information. The blood lead analysis 
121.30 	reports required in this section must specify:
121.31 	(1) whether the specimen was collected as a capillary or venous sample;
121.32 	(2) the date the sample was collected;
122.1 	(3) the results of the blood lead analysis;
122.2 	(4) the date the sample was analyzed;
122.3 	(5) the method of analysis used;
122.4 	(6) the full name, address, and phone number of the laboratory performing the analysis;
122.5 	(7) the full name, address, and phone number of the physician, advanced practice 
122.6 	registered nurse, or facility requesting the analysis;
122.7 	(8) the full name, address, and phone number of the person with the blood lead level, 
122.8 	and the person's birthdate, gender, and race.

122.9 	Sec. 54. Minnesota Statutes 2018, section 144.966, subdivision 3, is amended to read:
122.10 		Subd. 3.Early hearing detection and intervention programs.  All hospitals shall 
122.11 	establish an early hearing detection and intervention (EHDI) program. Each EHDI program 
122.12 	shall:
122.13 	(1) in advance of any hearing screening testing, provide to the newborn's or infant's 
122.14 	parents or parent information concerning the nature of the screening procedure, applicable 
122.15 	costs of the screening procedure, the potential risks and effects of hearing loss, and the 
122.16 	benefits of early detection and intervention;
122.17 	(2) comply with parental election as described under section 144.125, subdivision 4;
122.18 	(3) develop policies and procedures for screening and rescreening based on Department 
122.19 	of Health recommendations;
122.20 	(4) provide appropriate training and monitoring of individuals responsible for performing 
122.21 	hearing screening tests as recommended by the Department of Health;
122.22 	(5) test the newborn's hearing prior to discharge, or, if the newborn is expected to remain 
122.23 	in the hospital for a prolonged period, testing shall be performed prior to three months of 
122.24 	age or when medically feasible;
122.25 	(6) develop and implement procedures for documenting the results of all hearing screening 
122.26 	tests;
122.27 	(7) inform the newborn's or infant's parents or parent, primary care physician or advanced 
122.28 	practice registered nurse, and the Department of Health according to recommendations of 
122.29 	the Department of Health of the results of the hearing screening test or rescreening if 
122.30 	conducted, or if the newborn or infant was not successfully tested. The hospital that 
122.31 	discharges the newborn or infant to home is responsible for the screening; and
123.1 	(8) collect performance data specified by the Department of Health.

123.2 	Sec. 55. Minnesota Statutes 2018, section 144.966, subdivision 6, is amended to read:
123.3 		Subd. 6.Civil and criminal immunity and penalties. (a) No physician, advanced 
123.4 	practice registered nurse, or hospital shall be civilly or criminally liable for failure to conduct 
123.5 	hearing screening testing.
123.6 	(b) No physician, midwife, nurse, other health professional, or hospital acting in 
123.7 	compliance with this section shall be civilly or criminally liable for any acts conforming 
123.8 	with this section, including furnishing information required according to this section.

123.9 	Sec. 56. Minnesota Statutes 2018, section 144A.135, is amended to read:
123.10 	144A.135 TRANSFER AND DISCHARGE APPEALS.
123.11 	(a) The commissioner shall establish a mechanism for hearing appeals on transfers and 
123.12 	discharges of residents by nursing homes or boarding care homes licensed by the 
123.13 	commissioner. The commissioner may adopt permanent rules to implement this section.
123.14 	(b) Until federal regulations are adopted under sections 1819(f)(3) and 1919(f)(3) of the 
123.15 	Social Security Act that govern appeals of the discharges or transfers of residents from 
123.16 	nursing homes and boarding care homes certified for participation in Medicare or medical 
123.17 	assistance, the commissioner shall provide hearings under sections 14.57 to 14.62 and the 
123.18 	rules adopted by the Office of Administrative Hearings governing contested cases. To appeal 
123.19 	the discharge or transfer, or notification of an intended discharge or transfer, a resident or 
123.20 	the resident's representative must request a hearing in writing no later than 30 days after 
123.21 	receiving written notice, which conforms to state and federal law, of the intended discharge 
123.22 	or transfer.
123.23 	(c) Hearings under this section shall be held no later than 14 days after receipt of the 
123.24 	request for hearing, unless impractical to do so or unless the parties agree otherwise. Hearings 
123.25 	shall be held in the facility in which the resident resides, unless impractical to do so or unless 
123.26 	the parties agree otherwise.
123.27 	(d) A resident who timely appeals a notice of discharge or transfer, and who resides in 
123.28 	a certified nursing home or boarding care home, may not be discharged or transferred by 
123.29 	the nursing home or boarding care home until resolution of the appeal. The commissioner 
123.30 	can order the facility to readmit the resident if the discharge or transfer was in violation of 
123.31 	state or federal law. If the resident is required to be hospitalized for medical necessity before 
123.32 	resolution of the appeal, the facility shall readmit the resident unless the resident's attending 
124.1 	physician or advanced practice registered nurse documents, in writing, why the resident's 
124.2 	specific health care needs cannot be met in the facility.
124.3 	(e) The commissioner and Office of Administrative Hearings shall conduct the hearings 
124.4 	in compliance with the federal regulations described in paragraph (b), when adopted.
124.5 	(f) Nothing in this section limits the right of a resident or the resident's representative 
124.6 	to request or receive assistance from the Office of Ombudsman for Long-Term Care or the 
124.7 	Office of Health Facility Complaints with respect to an intended discharge or transfer.
124.8 	(g) A person required to inform a health care facility of the person's status as a registered 
124.9 	predatory offender under section 243.166, subdivision 4b, who knowingly fails to do so 
124.10 	shall be deemed to have endangered the safety of individuals in the facility under Code of 
124.11 	Federal Regulations, chapter 42, section 483.12. Notwithstanding paragraph (d), any appeal 
124.12 	of the notice and discharge shall not constitute a stay of the discharge.

124.13 	Sec. 57. Minnesota Statutes 2018, section 144A.161, subdivision 5, is amended to read:
124.14 		Subd. 5.Licensee responsibilities related to sending the notice in subdivision 5a. (a) 
124.15 	The licensee shall establish an interdisciplinary team responsible for coordinating and 
124.16 	implementing the plan. The interdisciplinary team shall include representatives from the 
124.17 	county social services agency, the Office of Ombudsman for Long-Term Care, the Office 
124.18 	of the Ombudsman for Mental Health and Developmental Disabilities, facility staff that 
124.19 	provide direct care services to the residents, and facility administration.
124.20 	(b) Concurrent with the notice provided in subdivision 5a, the licensee shall provide an 
124.21 	updated resident census summary document to the county social services agency, the 
124.22 	Ombudsman for Long-Term Care, and the Ombudsman for Mental Health and Developmental 
124.23 	Disabilities that includes the following information on each resident to be relocated:
124.24 	(1) resident name;
124.25 	(2) date of birth;
124.26 	(3) Social Security number;
124.27 	(4) payment source and medical assistance identification number, if applicable;
124.28 	(5) county of financial responsibility if the resident is enrolled in a Minnesota health 
124.29 	care program;
124.30 	(6) date of admission to the facility;
124.31 	(7) all current diagnoses;
125.1 	(8) the name of and contact information for the resident's physician or advanced practice 
125.2 	registered nurse;
125.3 	(9) the name and contact information for the resident's responsible party;
125.4 	(10) the name of and contact information for any case manager, managed care coordinator, 
125.5 	or other care coordinator, if known;
125.6 	(11) information on the resident's status related to commitment and probation; and
125.7 	(12) the name of the managed care organization in which the resident is enrolled, if 
125.8 	known.

125.9 	Sec. 58. Minnesota Statutes 2018, section 144A.161, subdivision 5a, is amended to read:
125.10 		Subd. 5a.Administrator and licensee responsibility to provide notice. At least 60 
125.11 	days before the proposed date of closing, reduction, or change in operations as agreed to in 
125.12 	the plan, the administrator shall send a written notice of closure, reduction, or change in 
125.13 	operations to each resident being relocated, the resident's responsible party, the resident's 
125.14 	managed care organization if it is known, the county social services agency, the commissioner 
125.15 	of health, the commissioner of human services, the Office of Ombudsman for Long-Term 
125.16 	Care and the Office of Ombudsman for Mental Health and Developmental Disabilities, the 
125.17 	resident's attending physician or advanced practice registered nurse, and, in the case of a 
125.18 	complete facility closure, the Centers for Medicare and Medicaid Services regional office 
125.19 	designated representative. The notice must include the following:
125.20 	(1) the date of the proposed closure, reduction, or change in operations;
125.21 	(2) the contact information of the individual or individuals in the facility responsible for 
125.22 	providing assistance and information;
125.23 	(3) notification of upcoming meetings for residents, responsible parties, and resident 
125.24 	and family councils to discuss the plan for relocation of residents;
125.25 	(4) the contact information of the county social services agency contact person; and
125.26 	(5) the contact information of the Office of Ombudsman for Long-Term Care and the 
125.27 	Office of Ombudsman for Mental Health and Developmental Disabilities.

125.28 	Sec. 59. Minnesota Statutes 2018, section 144A.161, subdivision 5e, is amended to read:
125.29 		Subd. 5e.Licensee responsibility for site visits. The licensee shall assist residents 
125.30 	desiring to make site visits to facilities with available beds or other appropriate living options 
125.31 	to which the resident may relocate, unless it is medically inadvisable, as documented by 
126.1 	the attending physician or advanced practice registered nurse in the resident's care record. 
126.2 	The licensee shall make available to the resident at no charge transportation for up to three 
126.3 	site visits to facilities or other living options within the county or contiguous counties.

126.4 	Sec. 60. Minnesota Statutes 2018, section 144A.161, subdivision 5g, is amended to read:
126.5 		Subd. 5g.Licensee responsibilities for final written discharge notice and records 
126.6 	transfer. (a) The licensee shall provide the resident, the resident's responsible parties, the 
126.7 	resident's managed care organization, if known, and the resident's attending physician or 
126.8 	advanced practice registered nurse with a final written discharge notice prior to the relocation 
126.9 	of the resident. The notice must:
126.10 	(1) be provided prior to the actual relocation; and
126.11 	(2) identify the effective date of the anticipated relocation and the destination to which 
126.12 	the resident is being relocated.
126.13 	(b) The licensee shall provide the receiving facility or other health, housing, or care 
126.14 	entity with complete and accurate resident records including contact information for family 
126.15 	members, responsible parties, social service or other caseworkers, and managed care 
126.16 	coordinators. These records must also include all information necessary to provide appropriate 
126.17 	medical care and social services. This includes, but is not limited to, information on 
126.18 	preadmission screening, Level I and Level II screening, minimum data set (MDS), all other 
126.19 	assessments, current resident diagnoses, social, behavioral, and medication information, 
126.20 	required forms, and discharge summaries.
126.21 	(c) For residents with special care needs, the licensee shall consult with the receiving 
126.22 	facility or other placement entity and provide staff training or other preparation as needed 
126.23 	to assist in providing for the special needs.

126.24 	Sec. 61. Minnesota Statutes 2018, section 144A.75, subdivision 3, is amended to read:
126.25 		Subd. 3.Core services. "Core services" means physician services, registered nursing 
126.26 	services, advanced practice registered nurse services, medical social services, and counseling 
126.27 	services. A hospice must ensure that at least two core services are regularly provided directly 
126.28 	by hospice employees. A hospice provider may use contracted staff if necessary to 
126.29 	supplement hospice employees in order to meet the needs of patients during peak patient 
126.30 	loads or under extraordinary circumstances.

127.1 	Sec. 62. Minnesota Statutes 2018, section 144A.75, subdivision 6, is amended to read:
127.2 		Subd. 6.Hospice patient. "Hospice patient" means an individual whose illness has been 
127.3 	documented by the individual's attending physician or advanced practice registered nurse
127.4 	and hospice medical director, who alone or, when unable, through the individual's family 
127.5 	has voluntarily consented to and received admission to a hospice provider, and who:
127.6 	(1) has been diagnosed as terminally ill, with a probable life expectancy of under one 
127.7 	year; or
127.8 	(2) is 21 years of age or younger; has been diagnosed with a chronic, complex, and 
127.9 	life-threatening illness contributing to a shortened life expectancy; and is not expected to 
127.10 	survive to adulthood.

127.11 	Sec. 63. Minnesota Statutes 2018, section 144A.752, subdivision 1, is amended to read:
127.12 		Subdivision 1.Rules. The commissioner shall adopt rules for the regulation of hospice 
127.13 	providers according to sections 144A.75 to 144A.755. The rules shall include the following:
127.14 	(1) provisions to ensure, to the extent possible, the health, safety, well-being, and 
127.15 	appropriate treatment of persons who receive hospice care;
127.16 	(2) requirements that hospice providers furnish the commissioner with specified 
127.17 	information necessary to implement sections 144A.75 to 144A.755;
127.18 	(3) standards of training of hospice provider personnel;
127.19 	(4) standards for medication management, which may vary according to the nature of 
127.20 	the hospice care provided, the setting in which the hospice care is provided, or the status of 
127.21 	the patient;
127.22 	(5) standards for hospice patient and hospice patient's family evaluation or assessment, 
127.23 	which may vary according to the nature of the hospice care provided or the status of the 
127.24 	patient; and
127.25 	(6) requirements for the involvement of a patient's physician or advanced practice 
127.26 	registered nurse; documentation of physicians' or advanced practice registered nurses' orders, 
127.27 	if required, and the patient's hospice plan of care; and maintenance of accurate, current 
127.28 	clinical records.

127.29 	Sec. 64. Minnesota Statutes 2018, section 145.853, subdivision 5, is amended to read:
127.30 		Subd. 5.Notification; medical care. A law enforcement officer who determines or has 
127.31 	reason to believe that a disabled person is suffering from an illness causing the person's 
128.1 	condition shall promptly notify the person's physician or advanced practice registered nurse, 
128.2 	if practicable. If the officer is unable to ascertain the physician's or advanced practice 
128.3 	registered nurse's identity or to communicate with the physician or advanced practice 
128.4 	registered nurse, the officer shall make a reasonable effort to cause the disabled person to 
128.5 	be transported immediately to a medical practitioner or to a facility where medical treatment 
128.6 	is available. If the officer believes it unduly dangerous to move the disabled person, the 
128.7 	officer shall make a reasonable effort to obtain the assistance of a medical practitioner.

128.8 	Sec. 65. Minnesota Statutes 2018, section 145.892, subdivision 3, is amended to read:
128.9 		Subd. 3.Pregnant woman. "Pregnant woman" means an individual determined by a 
128.10 	licensed physician, advanced practice registered nurse, midwife, or appropriately trained 
128.11 	registered nurse to have one or more fetuses in utero.

128.12 	Sec. 66. Minnesota Statutes 2018, section 145.94, subdivision 2, is amended to read:
128.13 		Subd. 2.Disclosure of information. The commissioner may disclose to individuals or 
128.14 	to the community, information including data made nonpublic by law, relating to the 
128.15 	hazardous properties and health hazards of hazardous substances released from a workplace 
128.16 	if the commissioner finds:
128.17 	(1) evidence that a person requesting the information may have suffered or is likely to 
128.18 	suffer illness or injury from exposure to a hazardous substance; or
128.19 	(2) evidence of a community health risk and if the commissioner seeks to have the 
128.20 	employer cease an activity which results in release of a hazardous substance.
128.21 	Nonpublic data obtained under subdivision 1 is subject to handling, use, and storage 
128.22 	according to established standards to prevent unauthorized use or disclosure. If the nonpublic 
128.23 	data is required for the diagnosis, treatment, or prevention of illness or injury, a personal 
128.24 	physician or advanced practice registered nurse may be provided with this information if 
128.25 	the physician or advanced practice registered nurse agrees to preserve the confidentiality 
128.26 	of the information, except for patient health records subject to sections 144.291 to 144.298. 
128.27 	After the disclosure of any hazardous substance information relating to a particular 
128.28 	workplace, the commissioner shall advise the employer of the information disclosed, the 
128.29 	date of the disclosure, and the person who received the information.

129.1 	Sec. 67. Minnesota Statutes 2018, section 145B.13, is amended to read:
129.2 	145B.13 REASONABLE MEDICAL PRACTICE REQUIRED.
129.3 	In reliance on a patient's living will, a decision to administer, withhold, or withdraw 
129.4 	medical treatment after the patient has been diagnosed by the attending physician or advanced 
129.5 	practice registered nurse to be in a terminal condition must always be based on reasonable 
129.6 	medical practice, including:
129.7 	(1) continuation of appropriate care to maintain the patient's comfort, hygiene, and human 
129.8 	dignity and to alleviate pain;
129.9 	(2) oral administration of food or water to a patient who accepts it, except for clearly 
129.10 	documented medical reasons; and
129.11 	(3) in the case of a living will of a patient that the attending physician or advanced 
129.12 	practice registered nurse knows is pregnant, the living will must not be given effect as long 
129.13 	as it is possible that the fetus could develop to the point of live birth with continued 
129.14 	application of life-sustaining treatment.

129.15 	Sec. 68. Minnesota Statutes 2018, section 145C.02, is amended to read:
129.16 	145C.02 HEALTH CARE DIRECTIVE.
129.17 	A principal with the capacity to do so may execute a health care directive. A health care 
129.18 	directive may include one or more health care instructions to direct health care providers, 
129.19 	others assisting with health care, family members, and a health care agent. A health care 
129.20 	directive may include a health care power of attorney to appoint a health care agent to make 
129.21 	health care decisions for the principal when the principal, in the judgment of the principal's 
129.22 	attending physician or advanced practice registered nurse, lacks decision-making capacity, 
129.23 	unless otherwise specified in the health care directive.

129.24 	Sec. 69. Minnesota Statutes 2019 Supplement, section 145C.05, subdivision 2, is amended 
129.25 	to read:
129.26 		Subd. 2.Provisions that may be included. (a) A health care directive may include 
129.27 	provisions consistent with this chapter, including, but not limited to:
129.28 	(1) the designation of one or more alternate health care agents to act if the named health 
129.29 	care agent is not reasonably available to serve;
130.1 	(2) directions to joint health care agents regarding the process or standards by which the 
130.2 	health care agents are to reach a health care decision for the principal, and a statement 
130.3 	whether joint health care agents may act independently of one another;
130.4 	(3) limitations, if any, on the right of the health care agent or any alternate health care 
130.5 	agents to receive, review, obtain copies of, and consent to the disclosure of the principal's 
130.6 	medical records or to visit the principal when the principal is a patient in a health care 
130.7 	facility;
130.8 	(4) limitations, if any, on the nomination of the health care agent as guardian for purposes 
130.9 	of sections 524.5-202, 524.5-211, 524.5-302, and 524.5-303;
130.10 	(5) a document of gift for the purpose of making an anatomical gift, as set forth in chapter 
130.11 	525A, or an amendment to, revocation of, or refusal to make an anatomical gift;
130.12 	(6) a declaration regarding intrusive mental health treatment under section 253B.03, 
130.13 	subdivision 6d, or a statement that the health care agent is authorized to give consent for 
130.14 	the principal under section 253B.04, subdivision 1a;
130.15 	(7) a funeral directive as provided in section 149A.80, subdivision 2;
130.16 	(8) limitations, if any, to the effect of dissolution or annulment of marriage or termination 
130.17 	of domestic partnership on the appointment of a health care agent under section 145C.09, 
130.18 	subdivision 2;
130.19 	(9) specific reasons why a principal wants a health care provider or an employee of a 
130.20 	health care provider attending the principal to be eligible to act as the principal's health care 
130.21 	agent;
130.22 	(10) health care instructions by a woman of child bearing age regarding how she would 
130.23 	like her pregnancy, if any, to affect health care decisions made on her behalf;
130.24 	(11) health care instructions regarding artificially administered nutrition or hydration; 
130.25 	and
130.26 	(12) health care instructions to prohibit administering, dispensing, or prescribing an 
130.27 	opioid, except that these instructions must not be construed to limit the administering, 
130.28 	dispensing, or prescribing an opioid to treat substance abuse, opioid dependence, or an 
130.29 	overdose, unless otherwise prohibited in the health care directive.
130.30 	(b) A health care directive may include a statement of the circumstances under which 
130.31 	the directive becomes effective other than upon the judgment of the principal's attending 
130.32 	physician or advanced practice registered nurse in the following situations:
131.1 	(1) a principal who in good faith generally selects and depends upon spiritual means or 
131.2 	prayer for the treatment or care of disease or remedial care and does not have an attending 
131.3 	physician or advanced practice registered nurse, may include a statement appointing an 
131.4 	individual who may determine the principal's decision-making capacity; and
131.5 	(2) a principal who in good faith does not generally select a physician or advanced 
131.6 	practice registered nurse or a health care facility for the principal's health care needs may 
131.7 	include a statement appointing an individual who may determine the principal's 
131.8 	decision-making capacity, provided that if the need to determine the principal's capacity 
131.9 	arises when the principal is receiving care under the direction of an attending physician or 
131.10 	advanced practice registered nurse in a health care facility, the determination must be made 
131.11 	by an attending physician or advanced practice registered nurse after consultation with the 
131.12 	appointed individual.
131.13 	If a person appointed under clause (1) or (2) is not reasonably available and the principal 
131.14 	is receiving care under the direction of an attending physician or advanced practice registered 
131.15 	nurse in a health care facility, an attending physician or advanced practice registered nurse 
131.16 	shall determine the principal's decision-making capacity.
131.17 	(c) A health care directive may authorize a health care agent to make health care decisions 
131.18 	for a principal even though the principal retains decision-making capacity.

131.19 	Sec. 70. Minnesota Statutes 2018, section 145C.06, is amended to read:
131.20 	145C.06 WHEN EFFECTIVE.
131.21 	A health care directive is effective for a health care decision when:
131.22 	(1) it meets the requirements of section 145C.03, subdivision 1; and
131.23 	(2) the principal, in the determination of the attending physician or advanced practice 
131.24 	registered nurse of the principal, lacks decision-making capacity to make the health care 
131.25 	decision; or if other conditions for effectiveness otherwise specified by the principal have 
131.26 	been met.
131.27 	A health care directive is not effective for a health care decision when the principal, in 
131.28 	the determination of the attending physician or advanced practice registered nurse of the 
131.29 	principal, recovers decision-making capacity; or if other conditions for effectiveness 
131.30 	otherwise specified by the principal have been met.

132.1 	Sec. 71. Minnesota Statutes 2018, section 145C.07, subdivision 1, is amended to read:
132.2 		Subdivision 1.Authority. The health care agent has authority to make any particular 
132.3 	health care decision only if the principal lacks decision-making capacity, in the determination 
132.4 	of the attending physician or advanced practice registered nurse, to make or communicate 
132.5 	that health care decision; or if other conditions for effectiveness otherwise specified by the 
132.6 	principal have been met. The physician, advanced practice registered nurse, or other health 
132.7 	care provider shall continue to obtain the principal's informed consent to all health care 
132.8 	decisions for which the principal has decision-making capacity, unless other conditions for 
132.9 	effectiveness otherwise specified by the principal have been met. An alternate health care 
132.10 	agent has authority to act if the primary health care agent is not reasonably available to act.

132.11 	Sec. 72. Minnesota Statutes 2018, section 145C.16, is amended to read:
132.12 	145C.16 SUGGESTED FORM.
132.13 	The following is a suggested form of a health care directive and is not a required form.
132.14 	HEALTH CARE DIRECTIVE
132.15 	I, ..........................., understand this document allows me to do ONE OR BOTH of the 
132.16 	following:
132.17 	PART I: Name another person (called the health care agent) to make health care decisions 
132.18 	for me if I am unable to decide or speak for myself. My health care agent must make health 
132.19 	care decisions for me based on the instructions I provide in this document (Part II), if any, 
132.20 	the wishes I have made known to him or her, or must act in my best interest if I have not 
132.21 	made my health care wishes known.
132.22 	AND/OR
132.23 	PART II: Give health care instructions to guide others making health care decisions for 
132.24 	me. If I have named a health care agent, these instructions are to be used by the agent. These 
132.25 	instructions may also be used by my health care providers, others assisting with my health 
132.26 	care and my family, in the event I cannot make decisions for myself.
132.27 	PART I: APPOINTMENT OF HEALTH CARE AGENT
132.28 	THIS IS WHO I WANT TO MAKE HEALTH CARE DECISIONS
132.29 	FOR ME IF I AM UNABLE TO DECIDE OR SPEAK FOR MYSELF
132.30 	(I know I can change my agent or alternate agent at any time and I know I do not have 
132.31 	to appoint an agent or an alternate agent)
133.1 	NOTE: If you appoint an agent, you should discuss this health care directive with your agent 
133.2 	and give your agent a copy. If you do not wish to appoint an agent, you may leave Part I 
133.3 	blank and go to Part II.
133.4 	When I am unable to decide or speak for myself, I trust and appoint .......................... to 
133.5 	make health care decisions for me. This person is called my health care agent.
133.6 	Relationship of my health care agent to me:........
133.7 	Telephone number of my health care agent:........
133.8 	Address of my health care agent:........
133.9 	(OPTIONAL) APPOINTMENT OF ALTERNATE HEALTH CARE AGENT: If my 
133.10 	health care agent is not reasonably available, I trust and appoint .................... to be my health 
133.11 	care agent instead.
133.12 	Relationship of my alternate health care agent to me:........
133.13 	Telephone number of my alternate health care agent:........
133.14 	Address of my alternate health care agent:........
133.15 	THIS IS WHAT I WANT MY HEALTH CARE AGENT TO BE ABLE TO
133.16 	DO IF I AM UNABLE TO DECIDE OR SPEAK FOR MYSELF
133.17 	(I know I can change these choices)
133.18 	My health care agent is automatically given the powers listed below in (A) through (D). 
133.19 	My health care agent must follow my health care instructions in this document or any other 
133.20 	instructions I have given to my agent. If I have not given health care instructions, then my 
133.21 	agent must act in my best interest.
133.22 	Whenever I am unable to decide or speak for myself, my health care agent has the power 
133.23 	to:
133.24 	(A) Make any health care decision for me. This includes the power to give, refuse, or 
133.25 	withdraw consent to any care, treatment, service, or procedures. This includes deciding 
133.26 	whether to stop or not start health care that is keeping me or might keep me alive, and 
133.27 	deciding about intrusive mental health treatment.
133.28 	(B) Choose my health care providers.
133.29 	(C) Choose where I live and receive care and support when those choices relate to my 
133.30 	health care needs.
134.1 	(D) Review my medical records and have the same rights that I would have to give my 
134.2 	medical records to other people.
134.3 	If I DO NOT want my health care agent to have a power listed above in (A) through (D) 
134.4 	OR if I want to LIMIT any power in (A) through (D), I MUST say that here:
134.5 	........
134.6 	........
134.7 	........
134.8 	My health care agent is NOT automatically given the powers listed below in (1) and (2). 
134.9 	If I WANT my agent to have any of the powers in (1) and (2), I must INITIAL the line in 
134.10 	front of the power; then my agent WILL HAVE that power.

134.11134.12		........
	(1)
		To decide whether to donate any parts of my body, including organs, tissues, 
and eyes, when I die.
	
134.13		........
	(2)
		To decide what will happen with my body when I die (burial, cremation).
	
134.14 	If I want to say anything more about my health care agent's powers or limits on the 
134.15 	powers, I can say it here:
134.16 	........
134.17 	........
134.18 	........
134.19 	PART II: HEALTH CARE INSTRUCTIONS
134.20 	NOTE: Complete this Part II if you wish to give health care instructions. If you appointed 
134.21 	an agent in Part I, completing this Part II is optional but would be very helpful to your agent. 
134.22 	However, if you chose not to appoint an agent in Part I, you MUST complete some or all 
134.23 	of this Part II if you wish to make a valid health care directive.
134.24 	These are instructions for my health care when I am unable to decide or speak for myself. 
134.25 	These instructions must be followed (so long as they address my needs).
134.26 	THESE ARE MY BELIEFS AND VALUES ABOUT MY HEALTH CARE
134.27 	(I know I can change these choices or leave any of them blank)
134.28 	I want you to know these things about me to help you make decisions about my health 
134.29 	care:
134.30 	My goals for my health care:........
134.31 	........
135.1 	........
135.2 	My fears about my health care:........
135.3 	........
135.4 	........
135.5 	My spiritual or religious beliefs and traditions:........
135.6 	........
135.7 	........
135.8 	My beliefs about when life would be no longer worth living:........
135.9 	........
135.10 	........
135.11 	My thoughts about how my medical condition might affect my family:
135.12 	........
135.13 	........
135.14 	THIS IS WHAT I WANT AND DO NOT WANT FOR MY HEALTH CARE
135.15 	(I know I can change these choices or leave any of them blank)
135.16 	Many medical treatments may be used to try to improve my medical condition or to 
135.17 	prolong my life. Examples include artificial breathing by a machine connected to a tube in 
135.18 	the lungs, artificial feeding or fluids through tubes, attempts to start a stopped heart, surgeries, 
135.19 	dialysis, antibiotics, and blood transfusions. Most medical treatments can be tried for a 
135.20 	while and then stopped if they do not help.
135.21 	I have these views about my health care in these situations:
135.22 	(Note: You can discuss general feelings, specific treatments, or leave any of them blank)
135.23 	If I had a reasonable chance of recovery, and were temporarily unable to decide or speak 
135.24 	for myself, I would want:........
135.25 	........
135.26 	........
135.27 	If I were dying and unable to decide or speak for myself, I would want:........
135.28 	........
136.1 	........
136.2 	If I were permanently unconscious and unable to decide or speak for myself, I would 
136.3 	want:........
136.4 	........
136.5 	........
136.6 	If I were completely dependent on others for my care and unable to decide or speak for 
136.7 	myself, I would want:........
136.8 	........
136.9 	........
136.10 	In all circumstances, my doctors or advanced practice registered nurses will try to keep 
136.11 	me comfortable and reduce my pain. This is how I feel about pain relief if it would affect 
136.12 	my alertness or if it could shorten my life:........
136.13 	........
136.14 	........
136.15 	There are other things that I want or do not want for my health care, if possible:
136.16 	Who I would like to be my doctor or advanced practice registered nurse:........
136.17 	........
136.18 	........
136.19 	Where I would like to live to receive health care:........
136.20 	........
136.21 	........
136.22 	Where I would like to die and other wishes I have about dying:........
136.23 	........
136.24 	........
136.25 	My wishes about donating parts of my body when I die:........
136.26 	........
136.27 	........
136.28 	My wishes about what happens to my body when I die (cremation, burial):........
137.1 	........
137.2 	........
137.3 	Any other things:........
137.4 	........
137.5 	........
137.6 	PART III: MAKING THE DOCUMENT LEGAL
137.7 	This document must be signed by me. It also must either be verified by a notary public 
137.8 	(Option 1) OR witnessed by two witnesses (Option 2). It must be dated when it is verified 
137.9 	or witnessed.
137.10 	I am thinking clearly, I agree with everything that is written in this document, and I have 
137.11 	made this document willingly.

137.12	........
		
137.13	My Signature
			
137.14		Date signed:
	........
		
137.15		Date of birth:
	........
		
137.16		Address:
	........
	
137.17			........
	
137.18	If I cannot sign my name, I can ask someone to sign this document for me.
	
137.19	........
		
137.20	Signature of the person who I asked to sign this document for me.
	
137.21	........
		
137.22	Printed name of the person who I asked to sign this document for me.
	
137.23 	Option 1: Notary Public
137.24 	In my presence on .................... (date), ....................... (name) acknowledged his/her 
137.25 	signature on this document or acknowledged that he/she authorized the person signing this 
137.26 	document to sign on his/her behalf. I am not named as a health care agent or alternate health 
137.27 	care agent in this document.

137.28	........
		
137.29	(Signature of Notary)
	(Notary Stamp)
	
137.30 	Option 2: Two Witnesses
138.1 	Two witnesses must sign. Only one of the two witnesses can be a health care provider 
138.2 	or an employee of a health care provider giving direct care to me on the day I sign this 
138.3 	document.
138.4 	Witness One:
138.5 	(i) In my presence on ............... (date), ............... (name) acknowledged his/her signature 
138.6 	on this document or acknowledged that he/she authorized the person signing this document 
138.7 	to sign on his/her behalf.
138.8 	(ii) I am at least 18 years of age.
138.9 	(iii) I am not named as a health care agent or an alternate health care agent in this 
138.10 	document.
138.11 	(iv) If I am a health care provider or an employee of a health care provider giving direct 
138.12 	care to the person listed above in (A), I must initial this box: [ ]
138.13 	I certify that the information in (i) through (iv) is true and correct.

138.14	........
		
138.15	(Signature of Witness One)
		
138.16	Address:
	........
	
138.17		........
	
138.18 	Witness Two:
138.19 	(i) In my presence on .............. (date), ................. (name) acknowledged his/her signature 
138.20 	on this document or acknowledged that he/she authorized the person signing this document 
138.21 	to sign on his/her behalf.
138.22 	(ii) I am at least 18 years of age.
138.23 	(iii) I am not named as a health care agent or an alternate health care agent in this 
138.24 	document.
138.25 	(iv) If I am a health care provider or an employee of a health care provider giving direct 
138.26 	care to the person listed above in (A), I must initial this box: [ ]
138.27 	I certify that the information in (i) through (iv) is true and correct.

138.28	........
		
138.29	(Signature of Witness Two)
		
138.30	Address:
	........
	
138.31		........
	
139.1 	REMINDER: Keep this document with your personal papers in a safe place (not in a safe 
139.2 	deposit box). Give signed copies to your doctors or advanced practice registered nurses, 
139.3 	family, close friends, health care agent, and alternate health care agent. Make sure your 
139.4 	doctor or advanced practice registered nurse is willing to follow your wishes. This document 
139.5 	should be part of your medical record at your physician's or advanced practice registered 
139.6 	nurse's office and at the hospital, home care agency, hospice, or nursing facility where you 
139.7 	receive your care.

139.8 	Sec. 73. Minnesota Statutes 2018, section 148.6438, subdivision 1, is amended to read:
139.9 		Subdivision 1.Required notification. In the absence of a physician or advanced practice 
139.10 	registered nurse referral or prior authorization, and before providing occupational therapy 
139.11 	services for remuneration or expectation of payment from the client, an occupational therapist 
139.12 	must provide the following written notification in all capital letters of 12-point or larger 
139.13 	boldface type, to the client, parent, or guardian:
139.14 	"Your health care provider, insurer, or plan may require a physician or advanced practice 
139.15 	registered nurse referral or prior authorization and you may be obligated for partial or full 
139.16 	payment for occupational therapy services rendered."
139.17 	Information other than this notification may be included as long as the notification 
139.18 	remains conspicuous on the face of the document. A nonwritten disclosure format may be 
139.19 	used to satisfy the recipient notification requirement when necessary to accommodate the 
139.20 	physical condition of a client or client's guardian.

139.21 	Sec. 74. Minnesota Statutes 2018, section 151.19, subdivision 4, is amended to read:
139.22 		Subd. 4.Licensing of physicians and advanced practice registered nurses to dispense 
139.23 	drugs; renewals. (a) The board may grant a license to any physician licensed under chapter 
139.24 	147 or advanced practice registered nurse licensed under chapter 148 who provides services 
139.25 	in a health care facility located in a designated health professional shortage area authorizing 
139.26 	the physician or advanced practice registered nurse to dispense drugs to individuals for 
139.27 	whom pharmaceutical care is not reasonably available. The license may be renewed annually. 
139.28 	Any physician or advanced practice registered nurse licensed under this subdivision shall 
139.29 	be limited to dispensing drugs in a limited service pharmacy and shall be governed by the 
139.30 	rules adopted by the board when dispensing drugs.
139.31 	(b) For the purposes of this subdivision, pharmaceutical care is not reasonably available 
139.32 	if the limited service pharmacy in which the physician or advanced practice registered nurse
140.1 	is dispensing drugs is located in a health professional shortage area, and no other licensed 
140.2 	pharmacy is located within 15 miles of the limited service pharmacy.
140.3 	(c) For the purposes of this subdivision, section 151.15, subdivision 2, shall not apply, 
140.4 	and section 151.215 shall not apply provided that a physician or advanced practice registered 
140.5 	nurse granted a license under this subdivision certifies each filled prescription in accordance 
140.6 	with Minnesota Rules, part 6800.3100, subpart 3.
140.7 	(d) Notwithstanding section 151.102, a physician or advanced practice registered nurse
140.8 	granted a license under this subdivision may be assisted by a pharmacy technician if the 
140.9 	technician holds a valid certification from the Pharmacy Technician Certification Board or 
140.10 	from another national certification body for pharmacy technicians that requires passage of 
140.11 	a nationally recognized psychometrically valid certification examination for certification 
140.12 	as determined by the board. The physician or advanced practice registered nurse may 
140.13 	supervise the pharmacy technician as long as the physician or advanced practice registered 
140.14 	nurse assumes responsibility for all functions performed by the technician. For purposes of 
140.15 	this subdivision, supervision does not require the physician or advanced practice registered 
140.16 	nurse to be physically present if the physician, advanced practice registered nurse, or a 
140.17 	licensed pharmacist is available, either electronically or by telephone.
140.18 	(e) Nothing in this subdivision shall be construed to prohibit a physician or advanced 
140.19 	practice registered nurse from dispensing drugs pursuant to section 151.37 and Minnesota 
140.20 	Rules, parts 6800.9950 to 6800.9954.

140.21 	Sec. 75. Minnesota Statutes 2018, section 151.21, subdivision 4a, is amended to read:
140.22 		Subd. 4a.Sign. A pharmacy must post a sign in a conspicuous location and in a typeface 
140.23 	easily seen at the counter where prescriptions are dispensed stating: "In order to save you 
140.24 	money, this pharmacy will substitute whenever possible an FDA-approved, less expensive, 
140.25 	generic drug product, which is therapeutically equivalent to and safely interchangeable with 
140.26 	the one prescribed by your doctor or advanced practice registered nurse, unless you object 
140.27 	to this substitution."

140.28 	Sec. 76. Minnesota Statutes 2018, section 152.32, subdivision 3, is amended to read:
140.29 		Subd. 3.Discrimination prohibited. (a) No school or landlord may refuse to enroll or 
140.30 	lease to and may not otherwise penalize a person solely for the person's status as a patient 
140.31 	enrolled in the registry program under sections 152.22 to 152.37, unless failing to do so 
140.32 	would violate federal law or regulations or cause the school or landlord to lose a monetary 
140.33 	or licensing-related benefit under federal law or regulations.
141.1 	(b) For the purposes of medical care, including organ transplants, a registry program 
141.2 	enrollee's use of medical cannabis under sections 152.22 to 152.37 is considered the 
141.3 	equivalent of the authorized use of any other medication used at the discretion of a physician
141.4 	or advanced practice registered nurse and does not constitute the use of an illicit substance 
141.5 	or otherwise disqualify a patient from needed medical care.
141.6 	(c) Unless a failure to do so would violate federal law or regulations or cause an employer 
141.7 	to lose a monetary or licensing-related benefit under federal law or regulations, an employer 
141.8 	may not discriminate against a person in hiring, termination, or any term or condition of 
141.9 	employment, or otherwise penalize a person, if the discrimination is based upon either of 
141.10 	the following:
141.11 	(1) the person's status as a patient enrolled in the registry program under sections 152.22
141.12 	to 152.37; or
141.13 	(2) a patient's positive drug test for cannabis components or metabolites, unless the 
141.14 	patient used, possessed, or was impaired by medical cannabis on the premises of the place 
141.15 	of employment or during the hours of employment.
141.16 	(d) An employee who is required to undergo employer drug testing pursuant to section 
141.17 	181.953 may present verification of enrollment in the patient registry as part of the employee's 
141.18 	explanation under section 181.953, subdivision 6.
141.19 	(e) A person shall not be denied custody of a minor child or visitation rights or parenting 
141.20 	time with a minor child solely based on the person's status as a patient enrolled in the registry 
141.21 	program under sections 152.22 to 152.37. There shall be no presumption of neglect or child 
141.22 	endangerment for conduct allowed under sections 152.22 to 152.37, unless the person's 
141.23 	behavior is such that it creates an unreasonable danger to the safety of the minor as 
141.24 	established by clear and convincing evidence.

141.25 	Sec. 77. Minnesota Statutes 2018, section 245A.143, subdivision 8, is amended to read:
141.26 		Subd. 8.Nutritional services. (a) The license holder shall ensure that food served is 
141.27 	nutritious and meets any special dietary needs of the participants as prescribed by the 
141.28 	participant's physician, advanced practice registered nurse, or dietitian as specified in the 
141.29 	service delivery plan.
141.30 	(b) Food and beverages must be obtained, handled, and properly stored to prevent 
141.31 	contamination, spoilage, or a threat to the health of a resident.

142.1 	Sec. 78. Minnesota Statutes 2018, section 245A.1435, is amended to read:
142.2 	245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT DEATH 
142.3 	IN LICENSED PROGRAMS.
142.4 	(a) When a license holder is placing an infant to sleep, the license holder must place the 
142.5 	infant on the infant's back, unless the license holder has documentation from the infant's 
142.6 	physician or advanced practice registered nurse directing an alternative sleeping position 
142.7 	for the infant. The physician or advanced practice registered nurse directive must be on a 
142.8 	form approved by the commissioner and must remain on file at the licensed location. An 
142.9 	infant who independently rolls onto its stomach after being placed to sleep on its back may 
142.10 	be allowed to remain sleeping on its stomach if the infant is at least six months of age or 
142.11 	the license holder has a signed statement from the parent indicating that the infant regularly 
142.12 	rolls over at home.
142.13 	(b) The license holder must place the infant in a crib directly on a firm mattress with a 
142.14 	fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress, and 
142.15 	overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner of 
142.16 	the sheet with reasonable effort. The license holder must not place anything in the crib with 
142.17 	the infant except for the infant's pacifier, as defined in Code of Federal Regulations, title 
142.18 	16, part 1511. The requirements of this section apply to license holders serving infants 
142.19 	younger than one year of age. Licensed child care providers must meet the crib requirements 
142.20 	under section 245A.146. A correction order shall not be issued under this paragraph unless 
142.21 	there is evidence that a violation occurred when an infant was present in the license holder's 
142.22 	care.
142.23 	(c) If an infant falls asleep before being placed in a crib, the license holder must move 
142.24 	the infant to a crib as soon as practicable, and must keep the infant within sight of the license 
142.25 	holder until the infant is placed in a crib. When an infant falls asleep while being held, the 
142.26 	license holder must consider the supervision needs of other children in care when determining 
142.27 	how long to hold the infant before placing the infant in a crib to sleep. The sleeping infant 
142.28 	must not be in a position where the airway may be blocked or with anything covering the 
142.29 	infant's face.
142.30 	(d) Placing a swaddled infant down to sleep in a licensed setting is not recommended 
142.31 	for an infant of any age and is prohibited for any infant who has begun to roll over 
142.32 	independently. However, with the written consent of a parent or guardian according to this 
142.33 	paragraph, a license holder may place the infant who has not yet begun to roll over on its 
142.34 	own down to sleep in a one-piece sleeper equipped with an attached system that fastens 
143.1 	securely only across the upper torso, with no constriction of the hips or legs, to create a 
143.2 	swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter, 
143.3 	the license holder must obtain informed written consent for the use of swaddling from the 
143.4 	parent or guardian of the infant on a form provided by the commissioner and prepared in 
143.5 	partnership with the Minnesota Sudden Infant Death Center.

143.6 	Sec. 79. Minnesota Statutes 2018, section 245C.02, subdivision 18, is amended to read:
143.7 		Subd. 18.Serious maltreatment. (a) "Serious maltreatment" means sexual abuse, 
143.8 	maltreatment resulting in death, neglect resulting in serious injury which reasonably requires 
143.9 	the care of a physician or advanced practice registered nurse whether or not the care of a 
143.10 	physician or advanced practice registered nurse was sought, or abuse resulting in serious 
143.11 	injury.
143.12 	(b) For purposes of this definition, "care of a physician or advanced practice registered 
143.13 	nurse" is treatment received or ordered by a physician, physician assistant, advanced practice 
143.14 	registered nurse, or nurse practitioner, but does not include:
143.15 	(1) diagnostic testing, assessment, or observation;
143.16 	(2) the application of, recommendation to use, or prescription solely for a remedy that 
143.17 	is available over the counter without a prescription; or
143.18 	(3) a prescription solely for a topical antibiotic to treat burns when there is no follow-up 
143.19 	appointment.
143.20 	(c) For purposes of this definition, "abuse resulting in serious injury" means: bruises, 
143.21 	bites, skin laceration, or tissue damage; fractures; dislocations; evidence of internal injuries; 
143.22 	head injuries with loss of consciousness; extensive second-degree or third-degree burns and 
143.23 	other burns for which complications are present; extensive second-degree or third-degree 
143.24 	frostbite and other frostbite for which complications are present; irreversible mobility or 
143.25 	avulsion of teeth; injuries to the eyes; ingestion of foreign substances and objects that are 
143.26 	harmful; near drowning; and heat exhaustion or sunstroke.
143.27 	(d) Serious maltreatment includes neglect when it results in criminal sexual conduct 
143.28 	against a child or vulnerable adult.

143.29 	Sec. 80. Minnesota Statutes 2018, section 245C.04, subdivision 1, is amended to read:
143.30 		Subdivision 1.Licensed programs; other child care programs. (a) The commissioner 
143.31 	shall conduct a background study of an individual required to be studied under section 
143.32 	245C.03, subdivision 1, at least upon application for initial license for all license types.
144.1 	(b) The commissioner shall conduct a background study of an individual required to be 
144.2 	studied under section 245C.03, subdivision 1, including a child care background study 
144.3 	subject as defined in section 245C.02, subdivision 6a, in a family child care program, licensed 
144.4 	child care center, certified license-exempt child care center, or legal nonlicensed child care 
144.5 	provider, on a schedule determined by the commissioner. Except as provided in section 
144.6 	245C.05, subdivision 5a, a child care background study must include submission of 
144.7 	fingerprints for a national criminal history record check and a review of the information 
144.8 	under section 245C.08. A background study for a child care program must be repeated 
144.9 	within five years from the most recent study conducted under this paragraph.
144.10 	(c) At reapplication for a family child care license:
144.11 	(1) for a background study affiliated with a licensed family child care center or legal 
144.12 	nonlicensed child care provider, the individual shall provide information required under 
144.13 	section 245C.05, subdivision 1, paragraphs (a), (b), and (d), to the county agency, and be 
144.14 	fingerprinted and photographed under section 245C.05, subdivision 5;
144.15 	(2) the county agency shall verify the information received under clause (1) and forward 
144.16 	the information to the commissioner to complete the background study; and
144.17 	(3) the background study conducted by the commissioner under this paragraph must 
144.18 	include a review of the information required under section 245C.08.
144.19 	(d) The commissioner is not required to conduct a study of an individual at the time of 
144.20 	reapplication for a license if the individual's background study was completed by the 
144.21 	commissioner of human services and the following conditions are met:
144.22 	(1) a study of the individual was conducted either at the time of initial licensure or when 
144.23 	the individual became affiliated with the license holder;
144.24 	(2) the individual has been continuously affiliated with the license holder since the last 
144.25 	study was conducted; and
144.26 	(3) the last study of the individual was conducted on or after October 1, 1995.
144.27 	(e) The commissioner of human services shall conduct a background study of an 
144.28 	individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), 
144.29 	who is newly affiliated with a child foster care license holder:
144.30 	(1) the county or private agency shall collect and forward to the commissioner the 
144.31 	information required under section 245C.05, subdivisions 1 and 5, when the child foster 
144.32 	care applicant or license holder resides in the home where child foster care services are 
144.33 	provided;
145.1 	(2) the child foster care license holder or applicant shall collect and forward to the 
145.2 	commissioner the information required under section 245C.05, subdivisions 1 and 5, when 
145.3 	the applicant or license holder does not reside in the home where child foster care services 
145.4 	are provided; and
145.5 	(3) the background study conducted by the commissioner of human services under this 
145.6 	paragraph must include a review of the information required under section 245C.08, 
145.7 	subdivisions 1, 3, and 4.
145.8 	(f) The commissioner shall conduct a background study of an individual specified under 
145.9 	section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated 
145.10 	with an adult foster care or family adult day services and with a family child care license 
145.11 	holder or a legal nonlicensed child care provider authorized under chapter 119B and:
145.12 	(1) except as provided in section 245C.05, subdivision 5a, the county shall collect and 
145.13 	forward to the commissioner the information required under section 245C.05, subdivision 
145.14 	1, paragraphs (a) and (b), and subdivision 5, paragraphs (a), (b), and (d), for background 
145.15 	studies conducted by the commissioner for all family adult day services, for adult foster 
145.16 	care when the adult foster care license holder resides in the adult foster care residence, and 
145.17 	for family child care and legal nonlicensed child care authorized under chapter 119B;
145.18 	(2) the license holder shall collect and forward to the commissioner the information 
145.19 	required under section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs 
145.20 	(a) and (b), for background studies conducted by the commissioner for adult foster care 
145.21 	when the license holder does not reside in the adult foster care residence; and
145.22 	(3) the background study conducted by the commissioner under this paragraph must 
145.23 	include a review of the information required under section 245C.08, subdivision 1, paragraph 
145.24 	(a), and subdivisions 3 and 4.
145.25 	(g) Applicants for licensure, license holders, and other entities as provided in this chapter 
145.26 	must submit completed background study requests to the commissioner using the electronic 
145.27 	system known as NETStudy before individuals specified in section 245C.03, subdivision 
145.28 	1, begin positions allowing direct contact in any licensed program.
145.29 	(h) For an individual who is not on the entity's active roster, the entity must initiate a 
145.30 	new background study through NETStudy when:
145.31 	(1) an individual returns to a position requiring a background study following an absence 
145.32 	of 120 or more consecutive days; or
146.1 	(2) a program that discontinued providing licensed direct contact services for 120 or 
146.2 	more consecutive days begins to provide direct contact licensed services again.
146.3 	The license holder shall maintain a copy of the notification provided to the commissioner 
146.4 	under this paragraph in the program's files. If the individual's disqualification was previously 
146.5 	set aside for the license holder's program and the new background study results in no new 
146.6 	information that indicates the individual may pose a risk of harm to persons receiving 
146.7 	services from the license holder, the previous set-aside shall remain in effect.
146.8 	(i) For purposes of this section, a physician licensed under chapter 147 or advanced 
146.9 	practice registered nurse licensed under chapter 148 is considered to be continuously affiliated 
146.10 	upon the license holder's receipt from the commissioner of health or human services of the 
146.11 	physician's or advanced practice registered nurse's background study results.
146.12 	(j) For purposes of family child care, a substitute caregiver must receive repeat 
146.13 	background studies at the time of each license renewal.
146.14 	(k) A repeat background study at the time of license renewal is not required if the family 
146.15 	child care substitute caregiver's background study was completed by the commissioner on 
146.16 	or after October 1, 2017, and the substitute caregiver is on the license holder's active roster 
146.17 	in NETStudy 2.0.
146.18 	(l) Before and after school programs authorized under chapter 119B, are exempt from 
146.19 	the background study requirements under section 123B.03, for an employee for whom a 
146.20 	background study under this chapter has been completed.

146.21 	Sec. 81. Minnesota Statutes 2018, section 245D.02, subdivision 11, is amended to read:
146.22 		Subd. 11.Incident. "Incident" means an occurrence which involves a person and requires 
146.23 	the program to make a response that is not a part of the program's ordinary provision of 
146.24 	services to that person, and includes:
146.25 	(1) serious injury of a person as determined by section 245.91, subdivision 6;
146.26 	(2) a person's death;
146.27 	(3) any medical emergency, unexpected serious illness, or significant unexpected change 
146.28 	in an illness or medical condition of a person that requires the program to call 911, physician
146.29 	or advanced practice registered nurse treatment, or hospitalization;
146.30 	(4) any mental health crisis that requires the program to call 911, a mental health crisis 
146.31 	intervention team, or a similar mental health response team or service when available and 
146.32 	appropriate;
147.1 	(5) an act or situation involving a person that requires the program to call 911, law 
147.2 	enforcement, or the fire department;
147.3 	(6) a person's unauthorized or unexplained absence from a program;
147.4 	(7) conduct by a person receiving services against another person receiving services 
147.5 	that:
147.6 	(i) is so severe, pervasive, or objectively offensive that it substantially interferes with a 
147.7 	person's opportunities to participate in or receive service or support;
147.8 	(ii) places the person in actual and reasonable fear of harm;
147.9 	(iii) places the person in actual and reasonable fear of damage to property of the person; 
147.10 	or
147.11 	(iv) substantially disrupts the orderly operation of the program;
147.12 	(8) any sexual activity between persons receiving services involving force or coercion 
147.13 	as defined under section 609.341, subdivisions 3 and 14;
147.14 	(9) any emergency use of manual restraint as identified in section 245D.061 or successor 
147.15 	provisions; or
147.16 	(10) a report of alleged or suspected child or vulnerable adult maltreatment under section 
147.17 	626.556 or 626.557.

147.18 	Sec. 82. Minnesota Statutes 2018, section 245D.11, subdivision 2, is amended to read:
147.19 		Subd. 2.Health and welfare. The license holder must establish policies and procedures 
147.20 	that promote health and welfare by ensuring:
147.21 	(1) use of universal precautions and sanitary practices in compliance with section 
147.22 	245D.06, subdivision 2, clause (5);
147.23 	(2) if the license holder operates a residential program, health service coordination and 
147.24 	care according to the requirements in section 245D.05, subdivision 1;
147.25 	(3) safe medication assistance and administration according to the requirements in 
147.26 	sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in 
147.27 	consultation with a registered nurse, nurse practitioner advanced practice registered nurse, 
147.28 	physician assistant, or medical doctor and require completion of medication administration 
147.29 	training according to the requirements in section 245D.09, subdivision 4a, paragraph (d). 
147.30 	Medication assistance and administration includes, but is not limited to:
147.31 	(i) providing medication-related services for a person;
148.1 	(ii) medication setup;
148.2 	(iii) medication administration;
148.3 	(iv) medication storage and security;
148.4 	(v) medication documentation and charting;
148.5 	(vi) verification and monitoring of effectiveness of systems to ensure safe medication 
148.6 	handling and administration;
148.7 	(vii) coordination of medication refills;
148.8 	(viii) handling changes to prescriptions and implementation of those changes;
148.9 	(ix) communicating with the pharmacy; and
148.10 	(x) coordination and communication with prescriber;
148.11 	(4) safe transportation, when the license holder is responsible for transportation of 
148.12 	persons, with provisions for handling emergency situations according to the requirements 
148.13 	in section 245D.06, subdivision 2, clauses (2) to (4);
148.14 	(5) a plan for ensuring the safety of persons served by the program in emergencies as 
148.15 	defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies 
148.16 	to the license holder. A license holder with a community residential setting or a day service 
148.17 	facility license must ensure the policy and procedures comply with the requirements in 
148.18 	section 245D.22, subdivision 4;
148.19 	(6) a plan for responding to all incidents as defined in section 245D.02, subdivision 11; 
148.20 	and reporting all incidents required to be reported according to section 245D.06, subdivision 
148.21 	1. The plan must:
148.22 	(i) provide the contact information of a source of emergency medical care and 
148.23 	transportation; and
148.24 	(ii) require staff to first call 911 when the staff believes a medical emergency may be 
148.25 	life threatening, or to call the mental health crisis intervention team or similar mental health 
148.26 	response team or service when such a team is available and appropriate when the person is 
148.27 	experiencing a mental health crisis; and
148.28 	(7) a procedure for the review of incidents and emergencies to identify trends or patterns, 
148.29 	and corrective action if needed. The license holder must establish and maintain a 
148.30 	record-keeping system for the incident and emergency reports. Each incident and emergency 
148.31 	report file must contain a written summary of the incident. The license holder must conduct 
149.1 	a review of incident reports for identification of incident patterns, and implementation of 
149.2 	corrective action as necessary to reduce occurrences. Each incident report must include:
149.3 	(i) the name of the person or persons involved in the incident. It is not necessary to 
149.4 	identify all persons affected by or involved in an emergency unless the emergency resulted 
149.5 	in an incident;
149.6 	(ii) the date, time, and location of the incident or emergency;
149.7 	(iii) a description of the incident or emergency;
149.8 	(iv) a description of the response to the incident or emergency and whether a person's 
149.9 	coordinated service and support plan addendum or program policies and procedures were 
149.10 	implemented as applicable;
149.11 	(v) the name of the staff person or persons who responded to the incident or emergency; 
149.12 	and
149.13 	(vi) the determination of whether corrective action is necessary based on the results of 
149.14 	the review.

149.15 	Sec. 83. Minnesota Statutes 2018, section 245D.22, subdivision 7, is amended to read:
149.16 		Subd. 7.Telephone and posted numbers. A facility must have a non-coin-operated 
149.17 	telephone that is readily accessible. A list of emergency numbers must be posted in a 
149.18 	prominent location. When an area has a 911 number or a mental health crisis intervention 
149.19 	team number, both numbers must be posted and the emergency number listed must be 911. 
149.20 	In areas of the state without a 911 number, the numbers listed must be those of the local 
149.21 	fire department, police department, emergency transportation, and poison control center. 
149.22 	The names and telephone numbers of each person's representative, physician or advanced 
149.23 	practice registered nurse, and dentist must be readily available.

149.24 	Sec. 84. Minnesota Statutes 2018, section 245D.25, subdivision 2, is amended to read:
149.25 		Subd. 2.Food. Food served must meet any special dietary needs of a person as prescribed 
149.26 	by the person's physician, advanced practice registered nurse, or dietitian. Three nutritionally 
149.27 	balanced meals a day must be served or made available to persons, and nutritious snacks 
149.28 	must be available between meals.

149.29 	Sec. 85. Minnesota Statutes 2018, section 245G.08, subdivision 2, is amended to read:
149.30 		Subd. 2.Procedures. The applicant or license holder must have written procedures for 
149.31 	obtaining a medical intervention for a client, that are approved in writing by a physician 
150.1 	who is licensed under chapter 147 or advanced practice registered nurse who is licensed 
150.2 	under chapter 148, unless:
150.3 	(1) the license holder does not provide a service under section 245G.21; and
150.4 	(2) a medical intervention is referred to 911, the emergency telephone number, or the 
150.5 	client's physician or advanced practice registered nurse.

150.6 	Sec. 86. Minnesota Statutes 2019 Supplement, section 245G.08, subdivision 3, is amended 
150.7 	to read:
150.8 		Subd. 3.Standing order protocol. A license holder that maintains a supply of naloxone 
150.9 	available for emergency treatment of opioid overdose must have a written standing order 
150.10 	protocol by a physician who is licensed under chapter 147 or advanced practice registered 
150.11 	nurse who is licensed under chapter 148, that permits the license holder to maintain a supply 
150.12 	of naloxone on site. A license holder must require staff to undergo training in the specific 
150.13 	mode of administration used at the program, which may include intranasal administration, 
150.14 	intramuscular injection, or both.

150.15 	Sec. 87. Minnesota Statutes 2018, section 245G.08, subdivision 5, is amended to read:
150.16 		Subd. 5.Administration of medication and assistance with self-medication. (a) A 
150.17 	license holder must meet the requirements in this subdivision if a service provided includes 
150.18 	the administration of medication.
150.19 	(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a 
150.20 	licensed practitioner or a registered nurse the task of administration of medication or assisting 
150.21 	with self-medication, must:
150.22 	(1) successfully complete a medication administration training program for unlicensed 
150.23 	personnel through an accredited Minnesota postsecondary educational institution. A staff 
150.24 	member's completion of the course must be documented in writing and placed in the staff 
150.25 	member's personnel file;
150.26 	(2) be trained according to a formalized training program that is taught by a registered 
150.27 	nurse and offered by the license holder. The training must include the process for 
150.28 	administration of naloxone, if naloxone is kept on site. A staff member's completion of the 
150.29 	training must be documented in writing and placed in the staff member's personnel records; 
150.30 	or
151.1 	(3) demonstrate to a registered nurse competency to perform the delegated activity. A 
151.2 	registered nurse must be employed or contracted to develop the policies and procedures for 
151.3 	administration of medication or assisting with self-administration of medication, or both.
151.4 	(c) A registered nurse must provide supervision as defined in section 148.171, subdivision 
151.5 	23. The registered nurse's supervision must include, at a minimum, monthly on-site 
151.6 	supervision or more often if warranted by a client's health needs. The policies and procedures 
151.7 	must include:
151.8 	(1) a provision that a delegation of administration of medication is limited to the 
151.9 	administration of a medication that is administered orally, topically, or as a suppository, an 
151.10 	eye drop, an ear drop, or an inhalant;
151.11 	(2) a provision that each client's file must include documentation indicating whether 
151.12 	staff must conduct the administration of medication or the client must self-administer 
151.13 	medication, or both;
151.14 	(3) a provision that a client may carry emergency medication such as nitroglycerin as 
151.15 	instructed by the client's physician or advanced practice registered nurse;
151.16 	(4) a provision for the client to self-administer medication when a client is scheduled to 
151.17 	be away from the facility;
151.18 	(5) a provision that if a client self-administers medication when the client is present in 
151.19 	the facility, the client must self-administer medication under the observation of a trained 
151.20 	staff member;
151.21 	(6) a provision that when a license holder serves a client who is a parent with a child, 
151.22 	the parent may only administer medication to the child under a staff member's supervision;
151.23 	(7) requirements for recording the client's use of medication, including staff signatures 
151.24 	with date and time;
151.25 	(8) guidelines for when to inform a nurse of problems with self-administration of 
151.26 	medication, including a client's failure to administer, refusal of a medication, adverse 
151.27 	reaction, or error; and
151.28 	(9) procedures for acceptance, documentation, and implementation of a prescription, 
151.29 	whether written, verbal, telephonic, or electronic.

151.30 	Sec. 88. Minnesota Statutes 2018, section 245G.21, subdivision 2, is amended to read:
151.31 		Subd. 2.Visitors. A client must be allowed to receive visitors at times prescribed by 
151.32 	the license holder. The license holder must set and post a notice of visiting rules and hours, 
152.1 	including both day and evening times. A client's right to receive visitors other than a personal 
152.2 	physician or advanced practice registered nurse, religious adviser, county case manager, 
152.3 	parole or probation officer, or attorney may be subject to visiting hours established by the 
152.4 	license holder for all clients. The treatment director or designee may impose limitations as 
152.5 	necessary for the welfare of a client provided the limitation and the reasons for the limitation 
152.6 	are documented in the client's file. A client must be allowed to receive visits at all reasonable 
152.7 	times from the client's personal physician or advanced practice registered nurse, religious 
152.8 	adviser, county case manager, parole or probation officer, and attorney.

152.9 	Sec. 89. Minnesota Statutes 2018, section 245G.21, subdivision 3, is amended to read:
152.10 		Subd. 3.Client property management. A license holder who provides room and board 
152.11 	and treatment services to a client in the same facility, and any license holder that accepts 
152.12 	client property must meet the requirements for handling client funds and property in section 
152.13 	245A.04, subdivision 13. License holders:
152.14 	(1) may establish policies regarding the use of personal property to ensure that treatment 
152.15 	activities and the rights of other clients are not infringed upon;
152.16 	(2) may take temporary custody of a client's property for violation of a facility policy;
152.17 	(3) must retain the client's property for a minimum of seven days after the client's service 
152.18 	termination if the client does not reclaim property upon service termination, or for a minimum 
152.19 	of 30 days if the client does not reclaim property upon service termination and has received 
152.20 	room and board services from the license holder; and
152.21 	(4) must return all property held in trust to the client at service termination regardless 
152.22 	of the client's service termination status, except that:
152.23 	(i) a drug, drug paraphernalia, or drug container that is subject to forfeiture under section 
152.24 	609.5316, must be given to the custody of a local law enforcement agency. If giving the 
152.25 	property to the custody of a local law enforcement agency violates Code of Federal 
152.26 	Regulations, title 42, sections 2.1 to 2.67, or title 45, parts 160 to 164, a drug, drug 
152.27 	paraphernalia, or drug container must be destroyed by a staff member designated by the 
152.28 	program director; and
152.29 	(ii) a weapon, explosive, and other property that can cause serious harm to the client or 
152.30 	others must be given to the custody of a local law enforcement agency, and the client must 
152.31 	be notified of the transfer and of the client's right to reclaim any lawful property transferred; 
152.32 	and
153.1 	(iii) a medication that was determined by a physician or advanced practice registered 
153.2 	nurse to be harmful after examining the client must be destroyed, except when the client's 
153.3 	personal physician or advanced practice registered nurse approves the medication for 
153.4 	continued use.

153.5 	Sec. 90. Minnesota Statutes 2019 Supplement, section 245H.11, is amended to read:
153.6 	245H.11 REPORTING.
153.7 	(a) The certification holder must comply and must have written policies for staff to 
153.8 	comply with the reporting requirements for abuse and neglect specified in section 626.556. 
153.9 	A person mandated to report physical or sexual child abuse or neglect occurring within a 
153.10 	certified center shall report the information to the commissioner.
153.11 	(b) The certification holder must inform the commissioner within 24 hours of:
153.12 	(1) the death of a child in the program; and
153.13 	(2) any injury to a child in the program that required treatment by a physician or advanced 
153.14 	practice registered nurse.

153.15 	Sec. 91. Minnesota Statutes 2018, section 246.711, subdivision 2, is amended to read:
153.16 		Subd. 2.Conditions. The secure treatment facility shall follow the procedures in sections 
153.17 	246.71 to 246.722 when all of the following conditions are met:
153.18 	(1) a licensed physician or advanced practice registered nurse determines that a significant 
153.19 	exposure has occurred following the protocol under section 246.721;
153.20 	(2) the licensed physician or advanced practice registered nurse for the employee needs 
153.21 	the patient's blood-borne pathogens test results to begin, continue, modify, or discontinue 
153.22 	treatment in accordance with the most current guidelines of the United States Public Health 
153.23 	Service, because of possible exposure to a blood-borne pathogen; and
153.24 	(3) the employee consents to providing a blood sample for testing for a blood-borne 
153.25 	pathogen.

153.26 	Sec. 92. Minnesota Statutes 2018, section 246.715, subdivision 2, is amended to read:
153.27 		Subd. 2.Procedures without consent. If the patient has provided a blood sample, but 
153.28 	does not consent to blood-borne pathogens testing, the secure treatment facility shall ensure 
153.29 	that the blood is tested for blood-borne pathogens if the employee requests the test, provided 
153.30 	all of the following criteria are met:
154.1 	(1) the employee and secure treatment facility have documented exposure to blood or 
154.2 	body fluids during performance of the employee's work duties;
154.3 	(2) a licensed physician or advanced practice registered nurse has determined that a 
154.4 	significant exposure has occurred under section 246.711 and has documented that blood-borne 
154.5 	pathogen test results are needed for beginning, modifying, continuing, or discontinuing 
154.6 	medical treatment for the employee as recommended by the most current guidelines of the 
154.7 	United States Public Health Service;
154.8 	(3) the employee provides a blood sample for testing for blood-borne pathogens as soon 
154.9 	as feasible;
154.10 	(4) the secure treatment facility asks the patient to consent to a test for blood-borne 
154.11 	pathogens and the patient does not consent;
154.12 	(5) the secure treatment facility has provided the patient and the employee with all of 
154.13 	the information required by section 246.712; and
154.14 	(6) the secure treatment facility has informed the employee of the confidentiality 
154.15 	requirements of section 246.719 and the penalties for unauthorized release of patient 
154.16 	information under section 246.72.

154.17 	Sec. 93. Minnesota Statutes 2018, section 246.716, subdivision 2, is amended to read:
154.18 		Subd. 2.Procedures without consent. (a) A secure treatment facility or an employee 
154.19 	of a secure treatment facility may bring a petition for a court order to require a patient to 
154.20 	provide a blood sample for testing for blood-borne pathogens. The petition shall be filed in 
154.21 	the district court in the county where the patient is receiving treatment from the secure 
154.22 	treatment facility. The secure treatment facility shall serve the petition on the patient three 
154.23 	days before a hearing on the petition. The petition shall include one or more affidavits 
154.24 	attesting that:
154.25 	(1) the secure treatment facility followed the procedures in sections 246.71 to 246.722
154.26 	and attempted to obtain blood-borne pathogen test results according to those sections;
154.27 	(2) a licensed physician or advanced practice registered nurse knowledgeable about the 
154.28 	most current recommendations of the United States Public Health Service has determined 
154.29 	that a significant exposure has occurred to the employee of a secure treatment facility under 
154.30 	section 246.721; and
154.31 	(3) a physician or advanced practice registered nurse has documented that the employee 
154.32 	has provided a blood sample and consented to testing for blood-borne pathogens and 
155.1 	blood-borne pathogen test results are needed for beginning, continuing, modifying, or 
155.2 	discontinuing medical treatment for the employee under section 246.721.
155.3 	(b) Facilities shall cooperate with petitioners in providing any necessary affidavits to 
155.4 	the extent that facility staff can attest under oath to the facts in the affidavits.
155.5 	(c) The court may order the patient to provide a blood sample for blood-borne pathogen 
155.6 	testing if:
155.7 	(1) there is probable cause to believe the employee of a secure treatment facility has 
155.8 	experienced a significant exposure to the patient;
155.9 	(2) the court imposes appropriate safeguards against unauthorized disclosure that must 
155.10 	specify the persons who have access to the test results and the purposes for which the test 
155.11 	results may be used;
155.12 	(3) a licensed physician or advanced practice registered nurse for the employee of a 
155.13 	secure treatment facility needs the test results for beginning, continuing, modifying, or 
155.14 	discontinuing medical treatment for the employee; and
155.15 	(4) the court finds a compelling need for the test results. In assessing compelling need, 
155.16 	the court shall weigh the need for the court-ordered blood collection and test results against 
155.17 	the interests of the patient, including, but not limited to, privacy, health, safety, or economic 
155.18 	interests. The court shall also consider whether involuntary blood collection and testing 
155.19 	would serve the public interests.
155.20 	(d) The court shall conduct the proceeding in camera unless the petitioner or the patient 
155.21 	requests a hearing in open court and the court determines that a public hearing is necessary 
155.22 	to the public interest and the proper administration of justice.
155.23 	(e) The patient may arrange for counsel in any proceeding brought under this subdivision.

155.24 	Sec. 94. Minnesota Statutes 2018, section 246.721, is amended to read:
155.25 	246.721 PROTOCOL FOR EXPOSURE TO BLOOD-BORNE PATHOGENS.
155.26 	(a) A secure treatment facility shall follow applicable Occupational Safety and Health 
155.27 	Administration guidelines under Code of Federal Regulations, title 29, part 1910.1030, for 
155.28 	blood-borne pathogens.
155.29 	(b) Every secure treatment facility shall adopt and follow a postexposure protocol for 
155.30 	employees at a secure treatment facility who have experienced a significant exposure. The 
155.31 	postexposure protocol must adhere to the most current recommendations of the United 
155.32 	States Public Health Service and include, at a minimum, the following:
156.1 	(1) a process for employees to report an exposure in a timely fashion;
156.2 	(2) a process for an infectious disease specialist, or a licensed physician or advanced 
156.3 	practice registered nurse who is knowledgeable about the most current recommendations 
156.4 	of the United States Public Health Service in consultation with an infectious disease specialist, 
156.5 	(i) to determine whether a significant exposure to one or more blood-borne pathogens has 
156.6 	occurred, and (ii) to provide, under the direction of a licensed physician or advanced practice 
156.7 	registered nurse, a recommendation or recommendations for follow-up treatment appropriate 
156.8 	to the particular blood-borne pathogen or pathogens for which a significant exposure has 
156.9 	been determined;
156.10 	(3) if there has been a significant exposure, a process to determine whether the patient 
156.11 	has a blood-borne pathogen through disclosure of test results, or through blood collection 
156.12 	and testing as required by sections 246.71 to 246.722;
156.13 	(4) a process for providing appropriate counseling prior to and following testing for a 
156.14 	blood-borne pathogen regarding the likelihood of blood-borne pathogen transmission and 
156.15 	follow-up recommendations according to the most current recommendations of the United 
156.16 	States Public Health Service, recommendations for testing, and treatment;
156.17 	(5) a process for providing appropriate counseling under clause (4) to the employee of 
156.18 	a secure treatment facility and to the patient; and
156.19 	(6) compliance with applicable state and federal laws relating to data practices, 
156.20 	confidentiality, informed consent, and the patient bill of rights.

156.21 	Sec. 95. Minnesota Statutes 2018, section 246.722, is amended to read:
156.22 	246.722 IMMUNITY.
156.23 	A secure treatment facility, licensed physician or advanced practice registered nurse, 
156.24 	and designated health care personnel are immune from liability in any civil, administrative, 
156.25 	or criminal action relating to the disclosure of test results of a patient to an employee of a 
156.26 	secure treatment facility and the testing of a blood sample from the patient for blood-borne 
156.27 	pathogens if a good faith effort has been made to comply with sections 246.71 to 246.722.

156.28 	Sec. 96. Minnesota Statutes 2018, section 251.043, subdivision 1, is amended to read:
156.29 		Subdivision 1.Duty to seek treatment. If upon the evidence mentioned in the preceding 
156.30 	section, the workers' compensation division finds that an employee is suffering from 
156.31 	tuberculosis contracted in the institution or department by contact with inmates or patients 
156.32 	therein or by contact with tuberculosis contaminated material therein, it shall order the 
157.1 	employee to seek the services of a physician, advanced practice registered nurse, or medical 
157.2 	care facility. There shall be paid to the physician, advanced practice registered nurse, or 
157.3 	facility where the employee may be received, the same fee for the maintenance and care of 
157.4 	the person as is received by the institution for the maintenance and care of a nonresident 
157.5 	patient. If the employee worked in a state hospital or nursing home, payment for the care 
157.6 	shall be made by the commissioner of human services. If employed in any other institution 
157.7 	or department the payment shall be made from funds allocated or appropriated for the 
157.8 	operation of the institution or department. If the employee dies from the effects of the disease 
157.9 	of tuberculosis and if the tuberculosis was the primary infection and the authentic cause of 
157.10 	death, the workers' compensation division shall order payment to dependents as provided 
157.11 	for under the general provisions of the workers' compensation law.

157.12 	Sec. 97. Minnesota Statutes 2018, section 252A.02, subdivision 12, is amended to read:
157.13 		Subd. 12.Comprehensive evaluation. "Comprehensive evaluation" shall consist of:
157.14 	(1) a medical report on the health status and physical condition of the proposed ward, 
157.15 	prepared under the direction of a licensed physician or advanced practice registered nurse;
157.16 	(2) a report on the proposed ward's intellectual capacity and functional abilities, specifying 
157.17 	the tests and other data used in reaching its conclusions, prepared by a psychologist who is 
157.18 	qualified in the diagnosis of developmental disability; and
157.19 	(3) a report from the case manager that includes:
157.20 	(i) the most current assessment of individual service needs as described in rules of the 
157.21 	commissioner;
157.22 	(ii) the most current individual service plan under section 256B.092, subdivision 1b; 
157.23 	and
157.24 	(iii) a description of contacts with and responses of near relatives of the proposed ward 
157.25 	notifying them that a nomination for public guardianship has been made and advising them 
157.26 	that they may seek private guardianship.
157.27 	Each report shall contain recommendations as to the amount of assistance and supervision 
157.28 	required by the proposed ward to function as independently as possible in society. To be 
157.29 	considered part of the comprehensive evaluation, reports must be completed no more than 
157.30 	one year before filing the petition under section 252A.05.

158.1 	Sec. 98. Minnesota Statutes 2018, section 252A.04, subdivision 2, is amended to read:
158.2 		Subd. 2.Medication; treatment. A proposed ward who, at the time the comprehensive 
158.3 	evaluation is to be performed, has been under medical care shall not be so under the influence 
158.4 	or so suffer the effects of drugs, medication, or other treatment as to be hampered in the 
158.5 	testing or evaluation process. When in the opinion of the licensed physician or advanced 
158.6 	practice registered nurse attending the proposed ward, the discontinuance of medication or 
158.7 	other treatment is not in the proposed ward's best interest, the physician or advanced practice 
158.8 	registered nurse shall record a list of all drugs, medication or other treatment which the 
158.9 	proposed ward received 48 hours immediately prior to any examination, test or interview 
158.10 	conducted in preparation for the comprehensive evaluation.

158.11 	Sec. 99. Minnesota Statutes 2018, section 252A.20, subdivision 1, is amended to read:
158.12 		Subdivision 1.Witness and attorney fees. In each proceeding under sections 252A.01
158.13 	to 252A.21, the court shall allow and order paid to each witness subpoenaed the fees and 
158.14 	mileage prescribed by law; to each physician, advanced practice registered nurse,
158.15 	psychologist, or social worker who assists in the preparation of the comprehensive evaluation 
158.16 	and who is not in the employ of the local agency or the state Department of Human Services, 
158.17 	a reasonable sum for services and for travel; and to the ward's counsel, when appointed by 
158.18 	the court, a reasonable sum for travel and for each day or portion of a day actually employed 
158.19 	in court or actually consumed in preparing for the hearing. Upon order the county auditor 
158.20 	shall issue a warrant on the county treasurer for payment of the amount allowed.

158.21 	Sec. 100. Minnesota Statutes 2018, section 253B.03, subdivision 4, is amended to read:
158.22 		Subd. 4.Special visitation; religion. A patient has the right to meet with or call a 
158.23 	personal physician or advanced practice registered nurse, spiritual advisor, and counsel at 
158.24 	all reasonable times. The patient has the right to continue the practice of religion.

158.25 	Sec. 101. Minnesota Statutes 2018, section 253B.03, subdivision 6d, is amended to read:
158.26 		Subd. 6d.Adult mental health treatment. (a) A competent adult may make a declaration 
158.27 	of preferences or instructions regarding intrusive mental health treatment. These preferences 
158.28 	or instructions may include, but are not limited to, consent to or refusal of these treatments.
158.29 	(b) A declaration may designate a proxy to make decisions about intrusive mental health 
158.30 	treatment. A proxy designated to make decisions about intrusive mental health treatments 
158.31 	and who agrees to serve as proxy may make decisions on behalf of a declarant consistent 
158.32 	with any desires the declarant expresses in the declaration.
159.1 	(c) A declaration is effective only if it is signed by the declarant and two witnesses. The 
159.2 	witnesses must include a statement that they believe the declarant understands the nature 
159.3 	and significance of the declaration. A declaration becomes operative when it is delivered 
159.4 	to the declarant's physician, advanced practice registered nurse, or other mental health 
159.5 	treatment provider. The physician, advanced practice registered nurse, or provider must 
159.6 	comply with it to the fullest extent possible, consistent with reasonable medical practice, 
159.7 	the availability of treatments requested, and applicable law. The physician, advanced practice 
159.8 	registered nurse, or provider shall continue to obtain the declarant's informed consent to all 
159.9 	intrusive mental health treatment decisions if the declarant is capable of informed consent. 
159.10 	A treatment provider may not require a person to make a declaration under this subdivision 
159.11 	as a condition of receiving services.
159.12 	(d) The physician, advanced practice registered nurse, or other provider shall make the 
159.13 	declaration a part of the declarant's medical record. If the physician, advanced practice 
159.14 	registered nurse, or other provider is unwilling at any time to comply with the declaration, 
159.15 	the physician, advanced practice registered nurse, or provider must promptly notify the 
159.16 	declarant and document the notification in the declarant's medical record. If the declarant 
159.17 	has been committed as a patient under this chapter, the physician, advanced practice 
159.18 	registered nurse, or provider may subject a declarant to intrusive treatment in a manner 
159.19 	contrary to the declarant's expressed wishes, only upon order of the committing court. If 
159.20 	the declarant is not a committed patient under this chapter, the physician, advanced practice 
159.21 	registered nurse, or provider may subject the declarant to intrusive treatment in a manner 
159.22 	contrary to the declarant's expressed wishes, only if the declarant is committed as mentally 
159.23 	ill or mentally ill and dangerous to the public and a court order authorizing the treatment 
159.24 	has been issued.
159.25 	(e) A declaration under this subdivision may be revoked in whole or in part at any time 
159.26 	and in any manner by the declarant if the declarant is competent at the time of revocation. 
159.27 	A revocation is effective when a competent declarant communicates the revocation to the 
159.28 	attending physician, advanced practice registered nurse, or other provider. The attending 
159.29 	physician, advanced practice registered nurse, or other provider shall note the revocation 
159.30 	as part of the declarant's medical record.
159.31 	(f) A provider who administers intrusive mental health treatment according to and in 
159.32 	good faith reliance upon the validity of a declaration under this subdivision is held harmless 
159.33 	from any liability resulting from a subsequent finding of invalidity.
160.1 	(g) In addition to making a declaration under this subdivision, a competent adult may 
160.2 	delegate parental powers under section 524.5-211 or may nominate a guardian under sections 
160.3 	524.5-101 to 524.5-502.

160.4 	Sec. 102. Minnesota Statutes 2018, section 253B.06, subdivision 2, is amended to read:
160.5 		Subd. 2.Chemically dependent persons. Patients hospitalized as chemically dependent 
160.6 	pursuant to section 253B.04 or 253B.05 shall also be examined within 48 hours of admission. 
160.7 	At a minimum, the examination shall consist of a physical evaluation by facility staff 
160.8 	according to procedures established by a physician or advanced practice registered nurse
160.9 	and an evaluation by staff knowledgeable and trained in the diagnosis of the alleged disability 
160.10 	related to the need for admission as a chemically dependent person.

160.11 	Sec. 103. Minnesota Statutes 2018, section 253B.23, subdivision 4, is amended to read:
160.12 		Subd. 4.Immunity. All persons acting in good faith, upon either actual knowledge or 
160.13 	information thought by them to be reliable, who act pursuant to any provision of this chapter 
160.14 	or who procedurally or physically assist in the commitment of any individual, pursuant to 
160.15 	this chapter, are not subject to any civil or criminal liability under this chapter. Any privilege 
160.16 	otherwise existing between patient and physician, patient and advanced practice registered 
160.17 	nurse, patient and registered nurse, patient and psychologist, patient and examiner, or patient 
160.18 	and social worker, is waived as to any physician, advanced practice registered nurse, 
160.19 	registered nurse, psychologist, examiner, or social worker who provides information with 
160.20 	respect to a patient pursuant to any provision of this chapter.

160.21 	Sec. 104. Minnesota Statutes 2018, section 254A.08, subdivision 2, is amended to read:
160.22 		Subd. 2.Program requirements. For the purpose of this section, a detoxification 
160.23 	program means a social rehabilitation program licensed by the Department of Human 
160.24 	Services under chapter 245A, and governed by the standards of Minnesota Rules, parts 
160.25 	9530.6510 to 9530.6590, and established for the purpose of facilitating access into care and 
160.26 	treatment by detoxifying and evaluating the person and providing entrance into a 
160.27 	comprehensive program. Evaluation of the person shall include verification by a professional, 
160.28 	after preliminary examination, that the person is intoxicated or has symptoms of substance 
160.29 	misuse or substance use disorder and appears to be in imminent danger of harming self or 
160.30 	others. A detoxification program shall have available the services of a licensed physician
160.31 	or advanced practice registered nurse for medical emergencies and routine medical 
160.32 	surveillance. A detoxification program licensed by the Department of Human Services to 
161.1 	serve both adults and minors at the same site must provide for separate sleeping areas for 
161.2 	adults and minors.

161.3 	Sec. 105. Minnesota Statutes 2018, section 256.9685, subdivision 1a, is amended to read:
161.4 		Subd. 1a.Administrative reconsideration. Notwithstanding section 256B.04, 
161.5 	subdivision 15, the commissioner shall establish an administrative reconsideration process 
161.6 	for appeals of inpatient hospital services determined to be medically unnecessary. A 
161.7 	physician, advanced practice registered nurse, or hospital may request a reconsideration of 
161.8 	the decision that inpatient hospital services are not medically necessary by submitting a 
161.9 	written request for review to the commissioner within 30 days after receiving notice of the 
161.10 	decision. The reconsideration process shall take place prior to the procedures of subdivision 
161.11 	1b and shall be conducted by the medical review agent that is independent of the case under 
161.12 	reconsideration.

161.13 	Sec. 106. Minnesota Statutes 2018, section 256.9685, subdivision 1b, is amended to read:
161.14 		Subd. 1b.Appeal of reconsideration. Notwithstanding section 256B.72, the 
161.15 	commissioner may recover inpatient hospital payments for services that have been determined 
161.16 	to be medically unnecessary after the reconsideration and determinations. A physician, 
161.17 	advanced practice registered nurse, or hospital may appeal the result of the reconsideration 
161.18 	process by submitting a written request for review to the commissioner within 30 days after 
161.19 	receiving notice of the action. The commissioner shall review the medical record and 
161.20 	information submitted during the reconsideration process and the medical review agent's 
161.21 	basis for the determination that the services were not medically necessary for inpatient 
161.22 	hospital services. The commissioner shall issue an order upholding or reversing the decision 
161.23 	of the reconsideration process based on the review.

161.24 	Sec. 107. Minnesota Statutes 2018, section 256.9685, subdivision 1c, is amended to read:
161.25 		Subd. 1c.Judicial review. A hospital or, physician, or advanced practice registered 
161.26 	nurse aggrieved by an order of the commissioner under subdivision 1b may appeal the order 
161.27 	to the district court of the county in which the physician, advanced practice registered nurse,
161.28 	or hospital is located by:
161.29 	(1) serving a written copy of a notice of appeal upon the commissioner within 30 days 
161.30 	after the date the commissioner issued the order; and
161.31 	(2) filing the original notice of appeal and proof of service with the court administrator 
161.32 	of the district court. The appeal shall be treated as a dispositive motion under the Minnesota 
162.1 	General Rules of Practice, rule 115. The district court scope of review shall be as set forth 
162.2 	in section 14.69.

162.3 	Sec. 108. Minnesota Statutes 2018, section 256.975, subdivision 7a, is amended to read:
162.4 		Subd. 7a.Preadmission screening activities related to nursing facility admissions. (a) 
162.5 	All individuals seeking admission to Medicaid-certified nursing facilities, including certified 
162.6 	boarding care facilities, must be screened prior to admission regardless of income, assets, 
162.7 	or funding sources for nursing facility care, except as described in subdivision 7b, paragraphs 
162.8 	(a) and (b). The purpose of the screening is to determine the need for nursing facility level 
162.9 	of care as described in section 256B.0911, subdivision 4e, and to complete activities required 
162.10 	under federal law related to mental illness and developmental disability as outlined in 
162.11 	paragraph (b).
162.12 	(b) A person who has a diagnosis or possible diagnosis of mental illness or developmental 
162.13 	disability must receive a preadmission screening before admission regardless of the 
162.14 	exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify the need for further 
162.15 	evaluation and specialized services, unless the admission prior to screening is authorized 
162.16 	by the local mental health authority or the local developmental disabilities case manager, 
162.17 	or unless authorized by the county agency according to Public Law 101-508.
162.18 	(c) The following criteria apply to the preadmission screening:
162.19 	(1) requests for preadmission screenings must be submitted via an online form developed 
162.20 	by the commissioner;
162.21 	(2) the Senior LinkAge Line must use forms and criteria developed by the commissioner 
162.22 	to identify persons who require referral for further evaluation and determination of the need 
162.23 	for specialized services; and
162.24 	(3) the evaluation and determination of the need for specialized services must be done 
162.25 	by:
162.26 	(i) a qualified independent mental health professional, for persons with a primary or 
162.27 	secondary diagnosis of a serious mental illness; or
162.28 	(ii) a qualified developmental disability professional, for persons with a primary or 
162.29 	secondary diagnosis of developmental disability. For purposes of this requirement, a qualified 
162.30 	developmental disability professional must meet the standards for a qualified developmental 
162.31 	disability professional under Code of Federal Regulations, title 42, section 483.430.
163.1 	(d) The local county mental health authority or the state developmental disability authority 
163.2 	under Public Laws 100-203 and 101-508 may prohibit admission to a nursing facility if the 
163.3 	individual does not meet the nursing facility level of care criteria or needs specialized 
163.4 	services as defined in Public Laws 100-203 and 101-508. For purposes of this section, 
163.5 	"specialized services" for a person with developmental disability means active treatment as 
163.6 	that term is defined under Code of Federal Regulations, title 42, section 483.440 (a)(1).
163.7 	(e) In assessing a person's needs, the screener shall:
163.8 	(1) use an automated system designated by the commissioner;
163.9 	(2) consult with care transitions coordinators or, physician, or advanced practice registered 
163.10 	nurse; and
163.11 	(3) consider the assessment of the individual's physician or advanced practice registered 
163.12 	nurse.
163.13 	Other personnel may be included in the level of care determination as deemed necessary 
163.14 	by the screener.

163.15 	Sec. 109. Minnesota Statutes 2018, section 256.975, subdivision 11, is amended to read:
163.16 		Subd. 11.Regional and local dementia grants. (a) The Minnesota Board on Aging 
163.17 	shall award competitive grants to eligible applicants for regional and local projects and 
163.18 	initiatives targeted to a designated community, which may consist of a specific geographic 
163.19 	area or population, to increase awareness of Alzheimer's disease and other dementias, 
163.20 	increase the rate of cognitive testing in the population at risk for dementias, promote the 
163.21 	benefits of early diagnosis of dementias, or connect caregivers of persons with dementia to 
163.22 	education and resources.
163.23 	(b) The project areas for grants include:
163.24 	(1) local or community-based initiatives to promote the benefits of physician or advanced 
163.25 	practice registered nurse consultations for all individuals who suspect a memory or cognitive 
163.26 	problem;
163.27 	(2) local or community-based initiatives to promote the benefits of early diagnosis of 
163.28 	Alzheimer's disease and other dementias; and
163.29 	(3) local or community-based initiatives to provide informational materials and other 
163.30 	resources to caregivers of persons with dementia.
164.1 	(c) Eligible applicants for local and regional grants may include, but are not limited to, 
164.2 	community health boards, school districts, colleges and universities, community clinics, 
164.3 	tribal communities, nonprofit organizations, and other health care organizations.
164.4 	(d) Applicants must:
164.5 	(1) describe the proposed initiative, including the targeted community and how the 
164.6 	initiative meets the requirements of this subdivision; and
164.7 	(2) identify the proposed outcomes of the initiative and the evaluation process to be used 
164.8 	to measure these outcomes.
164.9 	(e) In awarding the regional and local dementia grants, the Minnesota Board on Aging 
164.10 	must give priority to applicants who demonstrate that the proposed project:
164.11 	(1) is supported by and appropriately targeted to the community the applicant serves;
164.12 	(2) is designed to coordinate with other community activities related to other health 
164.13 	initiatives, particularly those initiatives targeted at the elderly;
164.14 	(3) is conducted by an applicant able to demonstrate expertise in the project areas;
164.15 	(4) utilizes and enhances existing activities and resources or involves innovative 
164.16 	approaches to achieve success in the project areas; and
164.17 	(5) strengthens community relationships and partnerships in order to achieve the project 
164.18 	areas.
164.19 	(f) The board shall divide the state into specific geographic regions and allocate a 
164.20 	percentage of the money available for the local and regional dementia grants to projects or 
164.21 	initiatives aimed at each geographic region.
164.22 	(g) The board shall award any available grants by January 1, 2016, and each July 1 
164.23 	thereafter.
164.24 	(h) Each grant recipient shall report to the board on the progress of the initiative at least 
164.25 	once during the grant period, and within two months of the end of the grant period shall 
164.26 	submit a final report to the board that includes the outcome results.
164.27 	(i) The Minnesota Board on Aging shall:
164.28 	(1) develop the criteria and procedures to allocate the grants under this subdivision, 
164.29 	evaluate all applicants on a competitive basis and award the grants, and select qualified 
164.30 	providers to offer technical assistance to grant applicants and grantees. The selected provider 
165.1 	shall provide applicants and grantees assistance with project design, evaluation methods, 
165.2 	materials, and training; and
165.3 	(2) submit by January 15, 2017, and on each January 15 thereafter, a progress report on 
165.4 	the dementia grants programs under this subdivision to the chairs and ranking minority 
165.5 	members of the senate and house of representatives committees and divisions with jurisdiction 
165.6 	over health finance and policy. The report shall include:
165.7 	(i) information on each grant recipient;
165.8 	(ii) a summary of all projects or initiatives undertaken with each grant;
165.9 	(iii) the measurable outcomes established by each grantee, an explanation of the 
165.10 	evaluation process used to determine whether the outcomes were met, and the results of the 
165.11 	evaluation; and
165.12 	(iv) an accounting of how the grant funds were spent.

165.13 	Sec. 110. Minnesota Statutes 2018, section 256B.04, subdivision 14a, is amended to read:
165.14 		Subd. 14a.Level of need determination. Nonemergency medical transportation level 
165.15 	of need determinations must be performed by a physician, a registered nurse working under 
165.16 	direct supervision of a physician, a physician assistant, a nurse practitioner an advanced 
165.17 	practice registered nurse, a licensed practical nurse, or a discharge planner. Nonemergency 
165.18 	medical transportation level of need determinations must not be performed more than 
165.19 	annually on any individual, unless the individual's circumstances have sufficiently changed 
165.20 	so as to require a new level of need determination. Individuals residing in licensed nursing 
165.21 	facilities are exempt from a level of need determination and are eligible for special 
165.22 	transportation services until the individual no longer resides in a licensed nursing facility. 
165.23 	If a person authorized by this subdivision to perform a level of need determination determines 
165.24 	that an individual requires stretcher transportation, the individual is presumed to maintain 
165.25 	that level of need until otherwise determined by a person authorized to perform a level of 
165.26 	need determination, or for six months, whichever is sooner.

165.27 	Sec. 111. Minnesota Statutes 2018, section 256B.043, subdivision 2, is amended to read:
165.28 		Subd. 2.Access to care. (a) The commissioners of human services and health, as part 
165.29 	of their ongoing duties, shall consider the adequacy of the current system of community 
165.30 	health clinics and centers both statewide and in urban areas with significant disparities in 
165.31 	health status and access to services across racial and ethnic groups, including:
165.32 	(1) methods to provide 24-hour availability of care through the clinics and centers;
166.1 	(2) methods to expand the availability of care through the clinics and centers;
166.2 	(3) the use of grants to expand the number of clinics and centers, the services provided, 
166.3 	and the availability of care; and
166.4 	(4) the extent to which increased use of physician assistants, nurse practitioners advanced 
166.5 	practice registered nurses, medical residents and interns, and other allied health professionals 
166.6 	in clinics and centers would increase the availability of services.
166.7 	(b) The commissioners shall make departmental modifications and legislative 
166.8 	recommendations as appropriate on the basis of their considerations under paragraph (a).

166.9 	Sec. 112. Minnesota Statutes 2018, section 256B.055, subdivision 12, is amended to read:
166.10 		Subd. 12.Children with disabilities. (a) A person is eligible for medical assistance if 
166.11 	the person is under age 19 and qualifies as a disabled individual under United States Code, 
166.12 	title 42, section 1382c(a), and would be eligible for medical assistance under the state plan 
166.13 	if residing in a medical institution, and the child requires a level of care provided in a hospital, 
166.14 	nursing facility, or intermediate care facility for persons with developmental disabilities, 
166.15 	for whom home care is appropriate, provided that the cost to medical assistance under this 
166.16 	section is not more than the amount that medical assistance would pay for if the child resides 
166.17 	in an institution. After the child is determined to be eligible under this section, the 
166.18 	commissioner shall review the child's disability under United States Code, title 42, section 
166.19 	1382c(a) and level of care defined under this section no more often than annually and may 
166.20 	elect, based on the recommendation of health care professionals under contract with the 
166.21 	state medical review team, to extend the review of disability and level of care up to a 
166.22 	maximum of four years. The commissioner's decision on the frequency of continuing review 
166.23 	of disability and level of care is not subject to administrative appeal under section 256.045. 
166.24 	The county agency shall send a notice of disability review to the enrollee six months prior 
166.25 	to the date the recertification of disability is due. Nothing in this subdivision shall be 
166.26 	construed as affecting other redeterminations of medical assistance eligibility under this 
166.27 	chapter and annual cost-effective reviews under this section.
166.28 	(b) For purposes of this subdivision, "hospital" means an institution as defined in section 
166.29 	144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part 4640.3600, and 
166.30 	licensed pursuant to sections 144.50 to 144.58. For purposes of this subdivision, a child 
166.31 	requires a level of care provided in a hospital if the child is determined by the commissioner 
166.32 	to need an extensive array of health services, including mental health services, for an 
166.33 	undetermined period of time, whose health condition requires frequent monitoring and 
166.34 	treatment by a health care professional or by a person supervised by a health care 
167.1 	professional, who would reside in a hospital or require frequent hospitalization if these 
167.2 	services were not provided, and the daily care needs are more complex than a nursing facility 
167.3 	level of care.
167.4 	A child with serious emotional disturbance requires a level of care provided in a hospital 
167.5 	if the commissioner determines that the individual requires 24-hour supervision because 
167.6 	the person exhibits recurrent or frequent suicidal or homicidal ideation or behavior, recurrent 
167.7 	or frequent psychosomatic disorders or somatopsychic disorders that may become life 
167.8 	threatening, recurrent or frequent severe socially unacceptable behavior associated with 
167.9 	psychiatric disorder, ongoing and chronic psychosis or severe, ongoing and chronic 
167.10 	developmental problems requiring continuous skilled observation, or severe disabling 
167.11 	symptoms for which office-centered outpatient treatment is not adequate, and which overall 
167.12 	severely impact the individual's ability to function.
167.13 	(c) For purposes of this subdivision, "nursing facility" means a facility which provides 
167.14 	nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to sections 
167.15 	144A.02 to 144A.10, which is appropriate if a person is in active restorative treatment; is 
167.16 	in need of special treatments provided or supervised by a licensed nurse; or has unpredictable 
167.17 	episodes of active disease processes requiring immediate judgment by a licensed nurse. For 
167.18 	purposes of this subdivision, a child requires the level of care provided in a nursing facility 
167.19 	if the child is determined by the commissioner to meet the requirements of the preadmission 
167.20 	screening assessment document under section 256B.0911, adjusted to address age-appropriate 
167.21 	standards for children age 18 and under.
167.22 	(d) For purposes of this subdivision, "intermediate care facility for persons with 
167.23 	developmental disabilities" or "ICF/DD" means a program licensed to provide services to 
167.24 	persons with developmental disabilities under section 252.28, and chapter 245A, and a 
167.25 	physical plant licensed as a supervised living facility under chapter 144, which together are 
167.26 	certified by the Minnesota Department of Health as meeting the standards in Code of Federal 
167.27 	Regulations, title 42, part 483, for an intermediate care facility which provides services for 
167.28 	persons with developmental disabilities who require 24-hour supervision and active treatment 
167.29 	for medical, behavioral, or habilitation needs. For purposes of this subdivision, a child 
167.30 	requires a level of care provided in an ICF/DD if the commissioner finds that the child has 
167.31 	a developmental disability in accordance with section 256B.092, is in need of a 24-hour 
167.32 	plan of care and active treatment similar to persons with developmental disabilities, and 
167.33 	there is a reasonable indication that the child will need ICF/DD services.
167.34 	(e) For purposes of this subdivision, a person requires the level of care provided in a 
167.35 	nursing facility if the person requires 24-hour monitoring or supervision and a plan of mental 
168.1 	health treatment because of specific symptoms or functional impairments associated with 
168.2 	a serious mental illness or disorder diagnosis, which meet severity criteria for mental health 
168.3 	established by the commissioner and published in March 1997 as the Minnesota Mental 
168.4 	Health Level of Care for Children and Adolescents with Severe Emotional Disorders.
168.5 	(f) The determination of the level of care needed by the child shall be made by the 
168.6 	commissioner based on information supplied to the commissioner by the parent or guardian, 
168.7 	the child's physician or physicians or advanced practice registered nurse or advanced practice 
168.8 	registered nurses, and other professionals as requested by the commissioner. The 
168.9 	commissioner shall establish a screening team to conduct the level of care determinations 
168.10 	according to this subdivision.
168.11 	(g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner 
168.12 	must assess the case to determine whether:
168.13 	(1) the child qualifies as a disabled individual under United States Code, title 42, section 
168.14 	1382c(a), and would be eligible for medical assistance if residing in a medical institution; 
168.15 	and
168.16 	(2) the cost of medical assistance services for the child, if eligible under this subdivision, 
168.17 	would not be more than the cost to medical assistance if the child resides in a medical 
168.18 	institution to be determined as follows:
168.19 	(i) for a child who requires a level of care provided in an ICF/DD, the cost of care for 
168.20 	the child in an institution shall be determined using the average payment rate established 
168.21 	for the regional treatment centers that are certified as ICF's/DD;
168.22 	(ii) for a child who requires a level of care provided in an inpatient hospital setting 
168.23 	according to paragraph (b), cost-effectiveness shall be determined according to Minnesota 
168.24 	Rules, part 9505.3520, items F and G; and
168.25 	(iii) for a child who requires a level of care provided in a nursing facility according to 
168.26 	paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota Rules, 
168.27 	part 9505.3040, except that the nursing facility average rate shall be adjusted to reflect rates 
168.28 	which would be paid for children under age 16. The commissioner may authorize an amount 
168.29 	up to the amount medical assistance would pay for a child referred to the commissioner by 
168.30 	the preadmission screening team under section 256B.0911.

169.1 	Sec. 113. Minnesota Statutes 2018, section 256B.0622, subdivision 2b, is amended to 
169.2 	read:
169.3 		Subd. 2b.Continuing stay and discharge criteria for assertive community 
169.4 	treatment. (a) A client receiving assertive community treatment is eligible to continue 
169.5 	receiving services if:
169.6 	(1) the client has not achieved the desired outcomes of their individual treatment plan;
169.7 	(2) the client's level of functioning has not been restored, improved, or sustained over 
169.8 	the time frame outlined in the individual treatment plan;
169.9 	(3) the client continues to be at risk for relapse based on current clinical assessment, 
169.10 	history, or the tenuous nature of the functional gains; or
169.11 	(4) the client is functioning effectively with this service and discharge would otherwise 
169.12 	be indicated but without continued services the client's functioning would decline; and
169.13 	(5) one of the following must also apply:
169.14 	(i) the client has achieved current individual treatment plan goals but additional goals 
169.15 	are indicated as evidenced by documented symptoms;
169.16 	(ii) the client is making satisfactory progress toward meeting goals and there is 
169.17 	documentation that supports that continuation of this service shall be effective in addressing 
169.18 	the goals outlined in the individual treatment plan;
169.19 	(iii) the client is making progress, but the specific interventions in the individual treatment 
169.20 	plan need to be modified so that greater gains, which are consistent with the client's potential 
169.21 	level of functioning, are possible; or
169.22 	(iv) the client fails to make progress or demonstrates regression in meeting goals through 
169.23 	the interventions outlined in the individual treatment plan.
169.24 	(b) Clients receiving assertive community treatment are eligible to be discharged if they 
169.25 	meet at least one of the following criteria:
169.26 	(1) the client and the ACT team determine that assertive community treatment services 
169.27 	are no longer needed based on the attainment of goals as identified in the individual treatment 
169.28 	plan and a less intensive level of care would adequately address current goals;
169.29 	(2) the client moves out of the ACT team's service area and the ACT team has facilitated 
169.30 	the referral to either a new ACT team or other appropriate mental health service and has 
169.31 	assisted the individual in the transition process;
170.1 	(3) the client, or the client's legal guardian when applicable, chooses to withdraw from 
170.2 	assertive community treatment services and documented attempts by the ACT team to 
170.3 	re-engage the client with the service have not been successful;
170.4 	(4) the client has a demonstrated need for a medical nursing home placement lasting 
170.5 	more than three months, as determined by a physician or advanced practice registered nurse;
170.6 	(5) the client is hospitalized, in residential treatment, or in jail for a period of greater 
170.7 	than three months. However, the ACT team must make provisions for the client to return 
170.8 	to the ACT team upon their discharge or release from the hospital or jail if the client still 
170.9 	meets eligibility criteria for assertive community treatment and the team is not at full capacity;
170.10 	(6) the ACT team is unable to locate, contact, and engage the client for a period of greater 
170.11 	than three months after persistent efforts by the ACT team to locate the client; or
170.12 	(7) the client requests a discharge, despite repeated and proactive efforts by the ACT 
170.13 	team to engage the client in service planning. The ACT team must develop a transition plan 
170.14 	to arrange for alternate treatment for clients in this situation who have a history of suicide 
170.15 	attempts, assault, or forensic involvement.
170.16 	(c) For all clients who are discharged from assertive community treatment to another 
170.17 	service provider within the ACT team's service area there is a three-month transfer period, 
170.18 	from the date of discharge, during which a client who does not adjust well to the new service, 
170.19 	may voluntarily return to the ACT team. During this period, the ACT team must maintain 
170.20 	contact with the client's new service provider.

170.21 	Sec. 114. Minnesota Statutes 2018, section 256B.0623, subdivision 2, is amended to read:
170.22 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
170.23 	given them.
170.24 	(a) "Adult rehabilitative mental health services" means mental health services which are 
170.25 	rehabilitative and enable the recipient to develop and enhance psychiatric stability, social 
170.26 	competencies, personal and emotional adjustment, independent living, parenting skills, and 
170.27 	community skills, when these abilities are impaired by the symptoms of mental illness. 
170.28 	Adult rehabilitative mental health services are also appropriate when provided to enable a 
170.29 	recipient to retain stability and functioning, if the recipient would be at risk of significant 
170.30 	functional decompensation or more restrictive service settings without these services.
170.31 	(1) Adult rehabilitative mental health services instruct, assist, and support the recipient 
170.32 	in areas such as: interpersonal communication skills, community resource utilization and 
170.33 	integration skills, crisis assistance, relapse prevention skills, health care directives, budgeting 
171.1 	and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills, 
171.2 	transportation skills, medication education and monitoring, mental illness symptom 
171.3 	management skills, household management skills, employment-related skills, parenting 
171.4 	skills, and transition to community living services.
171.5 	(2) These services shall be provided to the recipient on a one-to-one basis in the recipient's 
171.6 	home or another community setting or in groups.
171.7 	(b) "Medication education services" means services provided individually or in groups 
171.8 	which focus on educating the recipient about mental illness and symptoms; the role and 
171.9 	effects of medications in treating symptoms of mental illness; and the side effects of 
171.10 	medications. Medication education is coordinated with medication management services 
171.11 	and does not duplicate it. Medication education services are provided by physicians, advanced 
171.12 	practice registered nurses, pharmacists, physician assistants, or registered nurses.
171.13 	(c) "Transition to community living services" means services which maintain continuity 
171.14 	of contact between the rehabilitation services provider and the recipient and which facilitate 
171.15 	discharge from a hospital, residential treatment program under Minnesota Rules, chapter 
171.16 	9505, board and lodging facility, or nursing home. Transition to community living services 
171.17 	are not intended to provide other areas of adult rehabilitative mental health services.

171.18 	Sec. 115. Minnesota Statutes 2018, section 256B.0625, subdivision 12, is amended to 
171.19 	read:
171.20 		Subd. 12.Eyeglasses, dentures, and prosthetic devices. (a) Medical assistance covers 
171.21 	eyeglasses, dentures, and prosthetic and orthotic devices if prescribed by a licensed 
171.22 	practitioner.
171.23 	(b) For purposes of prescribing prosthetic and orthotic devices, "licensed practitioner" 
171.24 	includes a physician, an advanced practice registered nurse, or a podiatrist.

171.25 	Sec. 116. Minnesota Statutes 2019 Supplement, section 256B.0625, subdivision 13, is 
171.26 	amended to read:
171.27 		Subd. 13.Drugs. (a) Medical assistance covers drugs, except for fertility drugs when 
171.28 	specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed 
171.29 	by a licensed pharmacist, by a physician enrolled in the medical assistance program as a 
171.30 	dispensing physician, or by a physician, a physician assistant, or a nurse practitioner an 
171.31 	advanced practice registered nurse employed by or under contract with a community health 
172.1 	board as defined in section 145A.02, subdivision 5, for the purposes of communicable 
172.2 	disease control.
172.3 	(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, 
172.4 	unless authorized by the commissioner.
172.5 	(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical 
172.6 	ingredient" is defined as a substance that is represented for use in a drug and when used in 
172.7 	the manufacturing, processing, or packaging of a drug becomes an active ingredient of the 
172.8 	drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle 
172.9 	for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and 
172.10 	excipients which are included in the medical assistance formulary. Medical assistance covers 
172.11 	selected active pharmaceutical ingredients and excipients used in compounded prescriptions 
172.12 	when the compounded combination is specifically approved by the commissioner or when 
172.13 	a commercially available product:
172.14 	(1) is not a therapeutic option for the patient;
172.15 	(2) does not exist in the same combination of active ingredients in the same strengths 
172.16 	as the compounded prescription; and
172.17 	(3) cannot be used in place of the active pharmaceutical ingredient in the compounded 
172.18 	prescription.
172.19 	(d) Medical assistance covers the following over-the-counter drugs when prescribed by 
172.20 	a licensed practitioner or by a licensed pharmacist who meets standards established by the 
172.21 	commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family 
172.22 	planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults 
172.23 	with documented vitamin deficiencies, vitamins for children under the age of seven and 
172.24 	pregnant or nursing women, and any other over-the-counter drug identified by the 
172.25 	commissioner, in consultation with the Formulary Committee, as necessary, appropriate, 
172.26 	and cost-effective for the treatment of certain specified chronic diseases, conditions, or 
172.27 	disorders, and this determination shall not be subject to the requirements of chapter 14. A 
172.28 	pharmacist may prescribe over-the-counter medications as provided under this paragraph 
172.29 	for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter 
172.30 	drugs under this paragraph, licensed pharmacists must consult with the recipient to determine 
172.31 	necessity, provide drug counseling, review drug therapy for potential adverse interactions, 
172.32 	and make referrals as needed to other health care professionals.
172.33 	(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable 
172.34 	under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and 
173.1 	Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible 
173.2 	for drug coverage as defined in the Medicare Prescription Drug, Improvement, and 
173.3 	Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these 
173.4 	individuals, medical assistance may cover drugs from the drug classes listed in United States 
173.5 	Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to 
173.6 	13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall 
173.7 	not be covered.
173.8 	(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing 
173.9 	Program and dispensed by 340B covered entities and ambulatory pharmacies under common 
173.10 	ownership of the 340B covered entity. Medical assistance does not cover drugs acquired 
173.11 	through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.

173.12 	Sec. 117. Minnesota Statutes 2019 Supplement, section 256B.0625, subdivision 17, is 
173.13 	amended to read:
173.14 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
173.15 	means motor vehicle transportation provided by a public or private person that serves 
173.16 	Minnesota health care program beneficiaries who do not require emergency ambulance 
173.17 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
173.18 	(b) Medical assistance covers medical transportation costs incurred solely for obtaining 
173.19 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
173.20 	emergency or nonemergency medical care when paid directly to an ambulance company, 
173.21 	nonemergency medical transportation company, or other recognized providers of 
173.22 	transportation services. Medical transportation must be provided by:
173.23 	(1) nonemergency medical transportation providers who meet the requirements of this 
173.24 	subdivision;
173.25 	(2) ambulances, as defined in section 144E.001, subdivision 2;
173.26 	(3) taxicabs that meet the requirements of this subdivision;
173.27 	(4) public transit, as defined in section 174.22, subdivision 7; or
173.28 	(5) not-for-hire vehicles, including volunteer drivers.
173.29 	(c) Medical assistance covers nonemergency medical transportation provided by 
173.30 	nonemergency medical transportation providers enrolled in the Minnesota health care 
173.31 	programs. All nonemergency medical transportation providers must comply with the 
173.32 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
174.1 	and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the 
174.2 	commissioner and reported on the claim as the individual who provided the service. All 
174.3 	nonemergency medical transportation providers shall bill for nonemergency medical 
174.4 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
174.5 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
174.6 	requirements outlined in this paragraph.
174.7 	(d) An organization may be terminated, denied, or suspended from enrollment if:
174.8 	(1) the provider has not initiated background studies on the individuals specified in 
174.9 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
174.10 	(2) the provider has initiated background studies on the individuals specified in section 
174.11 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
174.12 	(i) the commissioner has sent the provider a notice that the individual has been 
174.13 	disqualified under section 245C.14; and
174.14 	(ii) the individual has not received a disqualification set-aside specific to the special 
174.15 	transportation services provider under sections 245C.22 and 245C.23.
174.16 	(e) The administrative agency of nonemergency medical transportation must:
174.17 	(1) adhere to the policies defined by the commissioner in consultation with the 
174.18 	Nonemergency Medical Transportation Advisory Committee;
174.19 	(2) pay nonemergency medical transportation providers for services provided to 
174.20 	Minnesota health care programs beneficiaries to obtain covered medical services;
174.21 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
174.22 	trips, and number of trips by mode; and
174.23 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
174.24 	administrative structure assessment tool that meets the technical requirements established 
174.25 	by the commissioner, reconciles trip information with claims being submitted by providers, 
174.26 	and ensures prompt payment for nonemergency medical transportation services.
174.27 	(f) Until the commissioner implements the single administrative structure and delivery 
174.28 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
174.29 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
174.30 	clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
174.31 	(g) The commissioner may use an order by the recipient's attending physician, advanced 
174.32 	practice registered nurse, or a medical or mental health professional to certify that the 
175.1 	recipient requires nonemergency medical transportation services. Nonemergency medical 
175.2 	transportation providers shall perform driver-assisted services for eligible individuals, when 
175.3 	appropriate. Driver-assisted service includes passenger pickup at and return to the individual's 
175.4 	residence or place of business, assistance with admittance of the individual to the medical 
175.5 	facility, and assistance in passenger securement or in securing of wheelchairs, child seats, 
175.6 	or stretchers in the vehicle.
175.7 	Nonemergency medical transportation providers must take clients to the health care 
175.8 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
175.9 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
175.10 	authorization from the local agency.
175.11 	Nonemergency medical transportation providers may not bill for separate base rates for 
175.12 	the continuation of a trip beyond the original destination. Nonemergency medical 
175.13 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
175.14 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
175.15 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
175.16 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
175.17 	services.
175.18 	(h) The administrative agency shall use the level of service process established by the 
175.19 	commissioner in consultation with the Nonemergency Medical Transportation Advisory 
175.20 	Committee to determine the client's most appropriate mode of transportation. If public transit 
175.21 	or a certified transportation provider is not available to provide the appropriate service mode 
175.22 	for the client, the client may receive a onetime service upgrade.
175.23 	(i) The covered modes of transportation are:
175.24 	(1) client reimbursement, which includes client mileage reimbursement provided to 
175.25 	clients who have their own transportation, or to family or an acquaintance who provides 
175.26 	transportation to the client;
175.27 	(2) volunteer transport, which includes transportation by volunteers using their own 
175.28 	vehicle;
175.29 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
175.30 	or public transit. If a taxicab or public transit is not available, the client can receive 
175.31 	transportation from another nonemergency medical transportation provider;
175.32 	(4) assisted transport, which includes transport provided to clients who require assistance 
175.33 	by a nonemergency medical transportation provider;
176.1 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
176.2 	dependent on a device and requires a nonemergency medical transportation provider with 
176.3 	a vehicle containing a lift or ramp;
176.4 	(6) protected transport, which includes transport provided to a client who has received 
176.5 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
176.6 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
176.7 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
176.8 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
176.9 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
176.10 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
176.11 	a client in a prone or supine position.
176.12 	(j) The local agency shall be the single administrative agency and shall administer and 
176.13 	reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the 
176.14 	commissioner has developed, made available, and funded the web-based single administrative 
176.15 	structure, assessment tool, and level of need assessment under subdivision 18e. The local 
176.16 	agency's financial obligation is limited to funds provided by the state or federal government.
176.17 	(k) The commissioner shall:
176.18 	(1) in consultation with the Nonemergency Medical Transportation Advisory Committee, 
176.19 	verify that the mode and use of nonemergency medical transportation is appropriate;
176.20 	(2) verify that the client is going to an approved medical appointment; and
176.21 	(3) investigate all complaints and appeals.
176.22 	(l) The administrative agency shall pay for the services provided in this subdivision and 
176.23 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
176.24 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
176.25 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
176.26 	(m) Payments for nonemergency medical transportation must be paid based on the client's 
176.27 	assessed mode under paragraph (h), not the type of vehicle used to provide the service. The 
176.28 	medical assistance reimbursement rates for nonemergency medical transportation services 
176.29 	that are payable by or on behalf of the commissioner for nonemergency medical 
176.30 	transportation services are:
176.31 	(1) $0.22 per mile for client reimbursement;
177.1 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
177.2 	transport;
177.3 	(3) equivalent to the standard fare for unassisted transport when provided by public 
177.4 	transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency 
177.5 	medical transportation provider;
177.6 	(4) $13 for the base rate and $1.30 per mile for assisted transport;
177.7 	(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
177.8 	(6) $75 for the base rate and $2.40 per mile for protected transport; and
177.9 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
177.10 	an additional attendant if deemed medically necessary.
177.11 	(n) The base rate for nonemergency medical transportation services in areas defined 
177.12 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
177.13 	paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
177.14 	services in areas defined under RUCA to be rural or super rural areas is:
177.15 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
177.16 	rate in paragraph (m), clauses (1) to (7); and
177.17 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
177.18 	rate in paragraph (m), clauses (1) to (7).
177.19 	(o) For purposes of reimbursement rates for nonemergency medical transportation 
177.20 	services under paragraphs (m) and (n), the zip code of the recipient's place of residence 
177.21 	shall determine whether the urban, rural, or super rural reimbursement rate applies.
177.22 	(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
177.23 	a census-tract based classification system under which a geographical area is determined 
177.24 	to be urban, rural, or super rural.
177.25 	(q) The commissioner, when determining reimbursement rates for nonemergency medical 
177.26 	transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed 
177.27 	under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

177.28 	Sec. 118. Minnesota Statutes 2018, section 256B.0625, subdivision 26, is amended to 
177.29 	read:
177.30 		Subd. 26.Special education services. (a) Medical assistance covers evaluations necessary 
177.31 	in making a determination for eligibility for individualized education program and 
178.1 	individualized family service plan services and for medical services identified in a recipient's 
178.2 	individualized education program and individualized family service plan and covered under 
178.3 	the medical assistance state plan. Covered services include occupational therapy, physical 
178.4 	therapy, speech-language therapy, clinical psychological services, nursing services, school 
178.5 	psychological services, school social work services, personal care assistants serving as 
178.6 	management aides, assistive technology devices, transportation services, health assessments, 
178.7 	and other services covered under the medical assistance state plan. Mental health services 
178.8 	eligible for medical assistance reimbursement must be provided or coordinated through a 
178.9 	children's mental health collaborative where a collaborative exists if the child is included 
178.10 	in the collaborative operational target population. The provision or coordination of services 
178.11 	does not require that the individualized education program be developed by the collaborative.
178.12 	The services may be provided by a Minnesota school district that is enrolled as a medical 
178.13 	assistance provider or its subcontractor, and only if the services meet all the requirements 
178.14 	otherwise applicable if the service had been provided by a provider other than a school 
178.15 	district, in the following areas: medical necessity, physician's or advanced practice registered 
178.16 	nurse's orders, documentation, personnel qualifications, and prior authorization requirements. 
178.17 	The nonfederal share of costs for services provided under this subdivision is the responsibility 
178.18 	of the local school district as provided in section 125A.74. Services listed in a child's 
178.19 	individualized education program are eligible for medical assistance reimbursement only 
178.20 	if those services meet criteria for federal financial participation under the Medicaid program.
178.21 	(b) Approval of health-related services for inclusion in the individualized education 
178.22 	program does not require prior authorization for purposes of reimbursement under this 
178.23 	chapter. The commissioner may require physician or advanced practice registered nurse
178.24 	review and approval of the plan not more than once annually or upon any modification of 
178.25 	the individualized education program that reflects a change in health-related services.
178.26 	(c) Services of a speech-language pathologist provided under this section are covered 
178.27 	notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person:
178.28 	(1) holds a masters degree in speech-language pathology;
178.29 	(2) is licensed by the Professional Educator Licensing and Standards Board as an 
178.30 	educational speech-language pathologist; and
178.31 	(3) either has a certificate of clinical competence from the American Speech and Hearing 
178.32 	Association, has completed the equivalent educational requirements and work experience 
178.33 	necessary for the certificate or has completed the academic program and is acquiring 
178.34 	supervised work experience to qualify for the certificate.
179.1 	(d) Medical assistance coverage for medically necessary services provided under other 
179.2 	subdivisions in this section may not be denied solely on the basis that the same or similar 
179.3 	services are covered under this subdivision.
179.4 	(e) The commissioner shall develop and implement package rates, bundled rates, or per 
179.5 	diem rates for special education services under which separately covered services are grouped 
179.6 	together and billed as a unit in order to reduce administrative complexity.
179.7 	(f) The commissioner shall develop a cost-based payment structure for payment of these 
179.8 	services. Only costs reported through the designated Minnesota Department of Education 
179.9 	data systems in distinct service categories qualify for inclusion in the cost-based payment 
179.10 	structure. The commissioner shall reimburse claims submitted based on an interim rate, and 
179.11 	shall settle at a final rate once the department has determined it. The commissioner shall 
179.12 	notify the school district of the final rate. The school district has 60 days to appeal the final 
179.13 	rate. To appeal the final rate, the school district shall file a written appeal request to the 
179.14 	commissioner within 60 days of the date the final rate determination was mailed. The appeal 
179.15 	request shall specify (1) the disputed items and (2) the name and address of the person to 
179.16 	contact regarding the appeal.
179.17 	(g) Effective July 1, 2000, medical assistance services provided under an individualized 
179.18 	education program or an individual family service plan by local school districts shall not 
179.19 	count against medical assistance authorization thresholds for that child.
179.20 	(h) Nursing services as defined in section 148.171, subdivision 15, and provided as an 
179.21 	individualized education program health-related service, are eligible for medical assistance 
179.22 	payment if they are otherwise a covered service under the medical assistance program. 
179.23 	Medical assistance covers the administration of prescription medications by a licensed nurse 
179.24 	who is employed by or under contract with a school district when the administration of 
179.25 	medications is identified in the child's individualized education program. The simple 
179.26 	administration of medications alone is not covered under medical assistance when 
179.27 	administered by a provider other than a school district or when it is not identified in the 
179.28 	child's individualized education program.

179.29 	Sec. 119. Minnesota Statutes 2018, section 256B.0625, subdivision 28, is amended to 
179.30 	read:
179.31 		Subd. 28.Certified nurse practitioner Advanced practice registered nurse
179.32 	services. Medical assistance covers services performed by a certified pediatric nurse 
179.33 	practitioner advanced practice registered nurse, a certified family nurse practitioner advanced 
179.34 	practice registered nurse, a certified adult nurse practitioner advanced practice registered 
180.1 	nurse, a certified obstetric/gynecological nurse practitioner advanced practice registered 
180.2 	nurse, a certified neonatal nurse practitioner advanced practice registered nurse, or a certified 
180.3 	geriatric nurse practitioner advanced practice registered nurse in independent practice, if:
180.4 	(1) the service provided on an inpatient basis is not included as part of the cost for 
180.5 	inpatient services included in the operating payment rate;
180.6 	(2) the service is otherwise covered under this chapter as a physician service; and
180.7 	(3) the service is within the scope of practice of the nurse practitioner's advanced practice 
180.8 	registered nurse's license as a registered nurse, as defined in section 148.171.

180.9 	Sec. 120. Minnesota Statutes 2019 Supplement, section 256B.0625, subdivision 60a, is 
180.10 	amended to read:
180.11 		Subd. 60a.Community emergency medical technician services. (a) Medical assistance 
180.12 	covers services provided by a community emergency medical technician (CEMT) who is 
180.13 	certified under section 144E.275, subdivision 7, when the services are provided in accordance 
180.14 	with this subdivision.
180.15 	(b) A CEMT may provide a postdischarge visit, after discharge from a hospital or skilled 
180.16 	nursing facility, when ordered by a treating physician or advanced practice registered nurse. 
180.17 	The postdischarge visit includes:
180.18 	(1) verbal or visual reminders of discharge orders;
180.19 	(2) recording and reporting of vital signs to the patient's primary care provider;
180.20 	(3) medication access confirmation;
180.21 	(4) food access confirmation; and
180.22 	(5) identification of home hazards.
180.23 	(c) An individual who has repeat ambulance calls due to falls or has been identified by 
180.24 	the individual's primary care provider as at risk for nursing home placement, may receive 
180.25 	a safety evaluation visit from a CEMT when ordered by a primary care provider in accordance 
180.26 	with the individual's care plan. A safety evaluation visit includes:
180.27 	(1) medication access confirmation;
180.28 	(2) food access confirmation; and
180.29 	(3) identification of home hazards.
181.1 	(d) A CEMT shall be paid at $9.75 per 15-minute increment. A safety evaluation visit 
181.2 	may not be billed for the same day as a postdischarge visit for the same individual.

181.3 	Sec. 121. Minnesota Statutes 2018, section 256B.0654, subdivision 1, is amended to read:
181.4 		Subdivision 1.Definitions. (a) "Complex home care nursing" means home care nursing 
181.5 	services provided to recipients who meet the criteria for regular home care nursing and 
181.6 	require life-sustaining interventions to reduce the risk of long-term injury or death.
181.7 	(b) "Home care nursing" means ongoing physician-ordered hourly nursing ordered by 
181.8 	a physician or advanced practice registered nurse and services performed by a registered 
181.9 	nurse or licensed practical nurse within the scope of practice as defined by the Minnesota 
181.10 	Nurse Practice Act under sections 148.171 to 148.285, in order to maintain or restore a 
181.11 	person's health.
181.12 	(c) "Home care nursing agency" means a medical assistance enrolled provider licensed 
181.13 	under chapter 144A to provide home care nursing services.
181.14 	(d) "Regular home care nursing" means home care nursing provided because:
181.15 	(1) the recipient requires more individual and continuous care than can be provided 
181.16 	during a skilled nurse visit; or
181.17 	(2) the cares are outside of the scope of services that can be provided by a home health 
181.18 	aide or personal care assistant.
181.19 	(e) "Shared home care nursing" means the provision of home care nursing services by 
181.20 	a home care nurse to two recipients at the same time and in the same setting.

181.21 	Sec. 122. Minnesota Statutes 2018, section 256B.0654, subdivision 2a, is amended to 
181.22 	read:
181.23 		Subd. 2a.Home care nursing services. (a) Home care nursing services must be used:
181.24 	(1) in the recipient's home or outside the home when normal life activities require;
181.25 	(2) when the recipient requires more individual and continuous care than can be provided 
181.26 	during a skilled nurse visit; and
181.27 	(3) when the care required is outside of the scope of services that can be provided by a 
181.28 	home health aide or personal care assistant.
181.29 	(b) Home care nursing services must be:
181.30 	(1) assessed by a registered nurse on a form approved by the commissioner;
182.1 	(2) ordered by a physician or advanced practice registered nurse and documented in a 
182.2 	plan of care that is reviewed by the physician at least once every 60 days; and
182.3 	(3) authorized by the commissioner under section 256B.0652.

182.4 	Sec. 123. Minnesota Statutes 2018, section 256B.0654, subdivision 3, is amended to read:
182.5 		Subd. 3.Shared home care nursing option. (a) Medical assistance payments for shared 
182.6 	home care nursing services by a home care nurse shall be limited according to this 
182.7 	subdivision. Unless otherwise provided in this subdivision, all other statutory and regulatory 
182.8 	provisions relating to home care nursing services apply to shared home care nursing services. 
182.9 	Nothing in this subdivision shall be construed to reduce the total number of home care 
182.10 	nursing hours authorized for an individual recipient.
182.11 	(b) Shared home care nursing is the provision of nursing services by a home care nurse 
182.12 	to two medical assistance eligible recipients at the same time and in the same setting. This 
182.13 	subdivision does not apply when a home care nurse is caring for multiple recipients in more 
182.14 	than one setting.
182.15 	(c) For the purposes of this subdivision, "setting" means:
182.16 	(1) the home residence or foster care home of one of the individual recipients as defined 
182.17 	in section 256B.0651;
182.18 	(2) a child care program licensed under chapter 245A or operated by a local school 
182.19 	district or private school;
182.20 	(3) an adult day care service licensed under chapter 245A; or
182.21 	(4) outside the home residence or foster care home of one of the recipients when normal 
182.22 	life activities take the recipients outside the home.
182.23 	(d) The home care nursing agency must offer the recipient the option of shared or 
182.24 	one-on-one home care nursing services. The recipient may withdraw from participating in 
182.25 	a shared service arrangement at any time.
182.26 	(e) The recipient or the recipient's legal representative, and the recipient's physician or 
182.27 	advanced practice registered nurse, in conjunction with the home care nursing agency, shall 
182.28 	determine:
182.29 	(1) whether shared home care nursing care is an appropriate option based on the individual 
182.30 	needs and preferences of the recipient; and
183.1 	(2) the amount of shared home care nursing services authorized as part of the overall 
183.2 	authorization of nursing services.
183.3 	(f) The recipient or the recipient's legal representative, in conjunction with the home 
183.4 	care nursing agency, shall approve the setting, grouping, and arrangement of shared home 
183.5 	care nursing care based on the individual needs and preferences of the recipients. Decisions 
183.6 	on the selection of recipients to share services must be based on the ages of the recipients, 
183.7 	compatibility, and coordination of their care needs.
183.8 	(g) The following items must be considered by the recipient or the recipient's legal 
183.9 	representative and the home care nursing agency, and documented in the recipient's health 
183.10 	service record:
183.11 	(1) the additional training needed by the home care nurse to provide care to two recipients 
183.12 	in the same setting and to ensure that the needs of the recipients are met appropriately and 
183.13 	safely;
183.14 	(2) the setting in which the shared home care nursing care will be provided;
183.15 	(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness of 
183.16 	the service and process used to make changes in service or setting;
183.17 	(4) a contingency plan which accounts for absence of the recipient in a shared home 
183.18 	care nursing setting due to illness or other circumstances;
183.19 	(5) staffing backup contingencies in the event of employee illness or absence; and
183.20 	(6) arrangements for additional assistance to respond to urgent or emergency care needs 
183.21 	of the recipients.
183.22 	(h) The documentation for shared home care nursing must be on a form approved by 
183.23 	the commissioner for each individual recipient sharing home care nursing. The documentation 
183.24 	must be part of the recipient's health service record and include:
183.25 	(1) permission by the recipient or the recipient's legal representative for the maximum 
183.26 	number of shared nursing hours per week chosen by the recipient and permission for shared 
183.27 	home care nursing services provided in and outside the recipient's home residence;
183.28 	(2) revocation by the recipient or the recipient's legal representative for the shared home 
183.29 	care nursing permission, or services provided to others in and outside the recipient's 
183.30 	residence; and
183.31 	(3) daily documentation of the shared home care nursing services provided by each 
183.32 	identified home care nurse, including:
184.1 	(i) the names of each recipient receiving shared home care nursing services;
184.2 	(ii) the setting for the shared services, including the starting and ending times that the 
184.3 	recipient received shared home care nursing care; and
184.4 	(iii) notes by the home care nurse regarding changes in the recipient's condition, problems 
184.5 	that may arise from the sharing of home care nursing services, and scheduling and care 
184.6 	issues.
184.7 	(i) The commissioner shall provide a rate methodology for shared home care nursing. 
184.8 	For two persons sharing nursing care, the rate paid to a provider must not exceed 1.5 times 
184.9 	the regular home care nursing rates paid for serving a single individual by a registered nurse 
184.10 	or licensed practical nurse. These rates apply only to situations in which both recipients are 
184.11 	present and receive shared home care nursing care on the date for which the service is billed.

184.12 	Sec. 124. Minnesota Statutes 2018, section 256B.0654, subdivision 4, is amended to read:
184.13 		Subd. 4.Hardship criteria; home care nursing. (a) Payment is allowed for extraordinary 
184.14 	services that require specialized nursing skills and are provided by parents of minor children, 
184.15 	family foster parents, spouses, and legal guardians who are providing home care nursing 
184.16 	care under the following conditions:
184.17 	(1) the provision of these services is not legally required of the parents, spouses, or legal 
184.18 	guardians;
184.19 	(2) the services are necessary to prevent hospitalization of the recipient; and
184.20 	(3) the recipient is eligible for state plan home care or a home and community-based 
184.21 	waiver and one of the following hardship criteria are met:
184.22 	(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to 
184.23 	provide nursing care for the recipient;
184.24 	(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with 
184.25 	less compensation to provide nursing care for the recipient;
184.26 	(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to provide 
184.27 	nursing care for the recipient; or
184.28 	(iv) because of labor conditions, special language needs, or intermittent hours of care 
184.29 	needed, the parent, spouse, or legal guardian is needed in order to provide adequate home 
184.30 	care nursing services to meet the medical needs of the recipient.
185.1 	(b) Home care nursing may be provided by a parent, spouse, family foster parent, or 
185.2 	legal guardian who is a nurse licensed in Minnesota. Home care nursing services provided 
185.3 	by a parent, spouse, family foster parent, or legal guardian cannot be used in lieu of nursing 
185.4 	services covered and available under liable third-party payors, including Medicare. The 
185.5 	home care nursing provided by a parent, spouse, family foster parent, or legal guardian must 
185.6 	be included in the service agreement. Authorized nursing services for a single recipient or 
185.7 	recipients with the same residence and provided by the parent, spouse, family foster parent, 
185.8 	or legal guardian may not exceed 50 percent of the total approved nursing hours, or eight 
185.9 	hours per day, whichever is less, up to a maximum of 40 hours per week. A parent or parents, 
185.10 	spouse, family foster parent, or legal guardian shall not provide more than 40 hours of 
185.11 	services in a seven-day period. For parents, family foster parents, and legal guardians, 40 
185.12 	hours is the total amount allowed regardless of the number of children or adults who receive 
185.13 	services. Nothing in this subdivision precludes the parent's, spouse's, or legal guardian's 
185.14 	obligation of assuming the nonreimbursed family responsibilities of emergency backup 
185.15 	caregiver and primary caregiver.
185.16 	(c) A parent, family foster parent, or a spouse may not be paid to provide home care 
185.17 	nursing care if:
185.18 	(1) the parent or spouse fails to pass a criminal background check according to chapter 
185.19 	245C;
185.20 	(2) it has been determined by the home care nursing agency, the case manager, or the 
185.21 	physician or advanced practice registered nurse that the home care nursing provided by the 
185.22 	parent, family foster parent, spouse, or legal guardian is unsafe; or
185.23 	(3) the parent, family foster parent, spouse, or legal guardian does not follow physician
185.24 	or advanced practice registered nurse orders.
185.25 	(d) For purposes of this section, "assessment" means a review and evaluation of a 
185.26 	recipient's need for home care services conducted in person. Assessments for home care 
185.27 	nursing must be conducted by a registered nurse.

185.28 	Sec. 125. Minnesota Statutes 2018, section 256B.0659, subdivision 2, is amended to read:
185.29 		Subd. 2.Personal care assistance services; covered services. (a) The personal care 
185.30 	assistance services eligible for payment include services and supports furnished to an 
185.31 	individual, as needed, to assist in:
185.32 	(1) activities of daily living;
185.33 	(2) health-related procedures and tasks;
186.1 	(3) observation and redirection of behaviors; and
186.2 	(4) instrumental activities of daily living.
186.3 	(b) Activities of daily living include the following covered services:
186.4 	(1) dressing, including assistance with choosing, application, and changing of clothing 
186.5 	and application of special appliances, wraps, or clothing;
186.6 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
186.7 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, 
186.8 	except for recipients who are diabetic or have poor circulation;
186.9 	(3) bathing, including assistance with basic personal hygiene and skin care;
186.10 	(4) eating, including assistance with hand washing and application of orthotics required 
186.11 	for eating, transfers, and feeding;
186.12 	(5) transfers, including assistance with transferring the recipient from one seating or 
186.13 	reclining area to another;
186.14 	(6) mobility, including assistance with ambulation, including use of a wheelchair. 
186.15 	Mobility does not include providing transportation for a recipient;
186.16 	(7) positioning, including assistance with positioning or turning a recipient for necessary 
186.17 	care and comfort; and
186.18 	(8) toileting, including assistance with helping recipient with bowel or bladder elimination 
186.19 	and care including transfers, mobility, positioning, feminine hygiene, use of toileting 
186.20 	equipment or supplies, cleansing the perineal area, inspection of the skin, and adjusting 
186.21 	clothing.
186.22 	(c) Health-related procedures and tasks include the following covered services:
186.23 	(1) range of motion and passive exercise to maintain a recipient's strength and muscle 
186.24 	functioning;
186.25 	(2) assistance with self-administered medication as defined by this section, including 
186.26 	reminders to take medication, bringing medication to the recipient, and assistance with 
186.27 	opening medication under the direction of the recipient or responsible party, including 
186.28 	medications given through a nebulizer;
186.29 	(3) interventions for seizure disorders, including monitoring and observation; and
186.30 	(4) other activities considered within the scope of the personal care service and meeting 
186.31 	the definition of health-related procedures and tasks under this section.
187.1 	(d) A personal care assistant may provide health-related procedures and tasks associated 
187.2 	with the complex health-related needs of a recipient if the procedures and tasks meet the 
187.3 	definition of health-related procedures and tasks under this section and the personal care 
187.4 	assistant is trained by a qualified professional and demonstrates competency to safely 
187.5 	complete the procedures and tasks. Delegation of health-related procedures and tasks and 
187.6 	all training must be documented in the personal care assistance care plan and the recipient's 
187.7 	and personal care assistant's files. A personal care assistant must not determine the medication 
187.8 	dose or time for medication.
187.9 	(e) Effective January 1, 2010, for a personal care assistant to provide the health-related 
187.10 	procedures and tasks of tracheostomy suctioning and services to recipients on ventilator 
187.11 	support there must be:
187.12 	(1) delegation and training by a registered nurse, advanced practice registered nurse,
187.13 	certified or licensed respiratory therapist, or a physician;
187.14 	(2) utilization of clean rather than sterile procedure;
187.15 	(3) specialized training about the health-related procedures and tasks and equipment, 
187.16 	including ventilator operation and maintenance;
187.17 	(4) individualized training regarding the needs of the recipient; and
187.18 	(5) supervision by a qualified professional who is a registered nurse.
187.19 	(f) Effective January 1, 2010, a personal care assistant may observe and redirect the 
187.20 	recipient for episodes where there is a need for redirection due to behaviors. Training of 
187.21 	the personal care assistant must occur based on the needs of the recipient, the personal care 
187.22 	assistance care plan, and any other support services provided.
187.23 	(g) Instrumental activities of daily living under subdivision 1, paragraph (i).

187.24 	Sec. 126. Minnesota Statutes 2018, section 256B.0659, subdivision 4, is amended to read:
187.25 		Subd. 4.Assessment for personal care assistance services; limitations. (a) An 
187.26 	assessment as defined in subdivision 3a must be completed for personal care assistance 
187.27 	services.
187.28 	(b) The following limitations apply to the assessment:
187.29 	(1) a person must be assessed as dependent in an activity of daily living based on the 
187.30 	person's daily need or need on the days during the week the activity is completed for:
187.31 	(i) cuing and constant supervision to complete the task; or
188.1 	(ii) hands-on assistance to complete the task; and
188.2 	(2) a child may not be found to be dependent in an activity of daily living if because of 
188.3 	the child's age an adult would either perform the activity for the child or assist the child 
188.4 	with the activity. Assistance needed is the assistance appropriate for a typical child of the 
188.5 	same age.
188.6 	(c) Assessment for complex health-related needs must meet the criteria in this paragraph. 
188.7 	A recipient qualifies as having complex health-related needs if the recipient has one or more 
188.8 	of the interventions that are ordered by a physician or advanced practice registered nurse, 
188.9 	specified in a personal care assistance care plan or community support plan developed under 
188.10 	section 256B.0911, and found in the following:
188.11 	(1) tube feedings requiring:
188.12 	(i) a gastrojejunostomy tube; or
188.13 	(ii) continuous tube feeding lasting longer than 12 hours per day;
188.14 	(2) wounds described as:
188.15 	(i) stage III or stage IV;
188.16 	(ii) multiple wounds;
188.17 	(iii) requiring sterile or clean dressing changes or a wound vac; or
188.18 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized 
188.19 	care;
188.20 	(3) parenteral therapy described as:
188.21 	(i) IV therapy more than two times per week lasting longer than four hours for each 
188.22 	treatment; or
188.23 	(ii) total parenteral nutrition (TPN) daily;
188.24 	(4) respiratory interventions, including:
188.25 	(i) oxygen required more than eight hours per day;
188.26 	(ii) respiratory vest more than one time per day;
188.27 	(iii) bronchial drainage treatments more than two times per day;
188.28 	(iv) sterile or clean suctioning more than six times per day;
188.29 	(v) dependence on another to apply respiratory ventilation augmentation devices such 
188.30 	as BiPAP and CPAP; and
189.1 	(vi) ventilator dependence under section 256B.0652;
189.2 	(5) insertion and maintenance of catheter, including:
189.3 	(i) sterile catheter changes more than one time per month;
189.4 	(ii) clean intermittent catheterization, and including self-catheterization more than six 
189.5 	times per day; or
189.6 	(iii) bladder irrigations;
189.7 	(6) bowel program more than two times per week requiring more than 30 minutes to 
189.8 	perform each time;
189.9 	(7) neurological intervention, including:
189.10 	(i) seizures more than two times per week and requiring significant physical assistance 
189.11 	to maintain safety; or
189.12 	(ii) swallowing disorders diagnosed by a physician or advanced practice registered nurse
189.13 	and requiring specialized assistance from another on a daily basis; and
189.14 	(8) other congenital or acquired diseases creating a need for significantly increased direct 
189.15 	hands-on assistance and interventions in six to eight activities of daily living.
189.16 	(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient 
189.17 	qualifies as having a need for assistance due to behaviors if the recipient's behavior requires 
189.18 	assistance at least four times per week and shows one or more of the following behaviors:
189.19 	(1) physical aggression towards self or others, or destruction of property that requires 
189.20 	the immediate response of another person;
189.21 	(2) increased vulnerability due to cognitive deficits or socially inappropriate behavior; 
189.22 	or
189.23 	(3) increased need for assistance for recipients who are verbally aggressive or resistive 
189.24 	to care so that the time needed to perform activities of daily living is increased.

189.25 	Sec. 127. Minnesota Statutes 2018, section 256B.0659, subdivision 8, is amended to read:
189.26 		Subd. 8.Communication with recipient's physician or advanced practice registered 
189.27 	nurse. The personal care assistance program requires communication with the recipient's 
189.28 	physician or advanced practice registered nurse about a recipient's assessed needs for personal 
189.29 	care assistance services. The commissioner shall work with the state medical director to 
189.30 	develop options for communication with the recipient's physician or advanced practice 
189.31 	registered nurse.

190.1 	Sec. 128. Minnesota Statutes 2019 Supplement, section 256B.0659, subdivision 11, is 
190.2 	amended to read:
190.3 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant must 
190.4 	meet the following requirements:
190.5 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of 
190.6 	age with these additional requirements:
190.7 	(i) supervision by a qualified professional every 60 days; and
190.8 	(ii) employment by only one personal care assistance provider agency responsible for 
190.9 	compliance with current labor laws;
190.10 	(2) be employed by a personal care assistance provider agency;
190.11 	(3) enroll with the department as a personal care assistant after clearing a background 
190.12 	study. Except as provided in subdivision 11a, before a personal care assistant provides 
190.13 	services, the personal care assistance provider agency must initiate a background study on 
190.14 	the personal care assistant under chapter 245C, and the personal care assistance provider 
190.15 	agency must have received a notice from the commissioner that the personal care assistant 
190.16 	is:
190.17 	(i) not disqualified under section 245C.14; or
190.18 	(ii) disqualified, but the personal care assistant has received a set aside of the 
190.19 	disqualification under section 245C.22;
190.20 	(4) be able to effectively communicate with the recipient and personal care assistance 
190.21 	provider agency;
190.22 	(5) be able to provide covered personal care assistance services according to the recipient's 
190.23 	personal care assistance care plan, respond appropriately to recipient needs, and report 
190.24 	changes in the recipient's condition to the supervising qualified professional or,  physician, 
190.25 	or advanced practice registered nurse;
190.26 	(6) not be a consumer of personal care assistance services;
190.27 	(7) maintain daily written records including, but not limited to, time sheets under 
190.28 	subdivision 12;
190.29 	(8) effective January 1, 2010, complete standardized training as determined by the 
190.30 	commissioner before completing enrollment. The training must be available in languages 
190.31 	other than English and to those who need accommodations due to disabilities. Personal care 
190.32 	assistant training must include successful completion of the following training components: 
191.1 	basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic 
191.2 	roles and responsibilities of personal care assistants including information about assistance 
191.3 	with lifting and transfers for recipients, emergency preparedness, orientation to positive 
191.4 	behavioral practices, fraud issues, and completion of time sheets. Upon completion of the 
191.5 	training components, the personal care assistant must demonstrate the competency to provide 
191.6 	assistance to recipients;
191.7 	(9) complete training and orientation on the needs of the recipient; and
191.8 	(10) be limited to providing and being paid for up to 275 hours per month of personal 
191.9 	care assistance services regardless of the number of recipients being served or the number 
191.10 	of personal care assistance provider agencies enrolled with. The number of hours worked 
191.11 	per day shall not be disallowed by the department unless in violation of the law.
191.12 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
191.13 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
191.14 	(c) Persons who do not qualify as a personal care assistant include parents, stepparents, 
191.15 	and legal guardians of minors; spouses; paid legal guardians of adults; family foster care 
191.16 	providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of 
191.17 	a residential setting.
191.18 	(d) Personal care assistance services qualify for the enhanced rate described in subdivision 
191.19 	17a if the personal care assistant providing the services:
191.20 	(1) provides covered services to a recipient who qualifies for 12 or more hours per day 
191.21 	of personal care assistance services; and
191.22 	(2) satisfies the current requirements of Medicare for training and competency or 
191.23 	competency evaluation of home health aides or nursing assistants, as provided in the Code 
191.24 	of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved 
191.25 	training or competency requirements.

191.26 	Sec. 129. Minnesota Statutes 2019 Supplement, section 256B.0913, subdivision 8, is 
191.27 	amended to read:
191.28 		Subd. 8.Requirements for individual coordinated service and support plan. (a) The 
191.29 	case manager shall implement the coordinated service and support plan for each alternative 
191.30 	care client and ensure that a client's service needs and eligibility are reassessed at least every 
191.31 	12 months. The coordinated service and support plan must meet the requirements in section 
191.32 	256S.10. The plan shall include any services prescribed by the individual's attending 
191.33 	physician or advanced practice registered nurse as necessary to allow the individual to 
192.1 	remain in a community setting. In developing the individual's care plan, the case manager 
192.2 	should include the use of volunteers from families and neighbors, religious organizations, 
192.3 	social clubs, and civic and service organizations to support the formal home care services. 
192.4 	The lead agency shall be held harmless for damages or injuries sustained through the use 
192.5 	of volunteers under this subdivision including workers' compensation liability. The case 
192.6 	manager shall provide documentation in each individual's plan and, if requested, to the 
192.7 	commissioner that the most cost-effective alternatives available have been offered to the 
192.8 	individual and that the individual was free to choose among available qualified providers, 
192.9 	both public and private, including qualified case management or service coordination 
192.10 	providers other than those employed by any county; however, the county or tribe maintains 
192.11 	responsibility for prior authorizing services in accordance with statutory and administrative 
192.12 	requirements. The case manager must give the individual a ten-day written notice of any 
192.13 	denial, termination, or reduction of alternative care services.
192.14 	(b) The county of service or tribe must provide access to and arrange for case management 
192.15 	services, including assuring implementation of the coordinated service and support plan. 
192.16 	"County of service" has the meaning given it in Minnesota Rules, part 9505.0015, subpart 
192.17 	11. The county of service must notify the county of financial responsibility of the approved 
192.18 	care plan and the amount of encumbered funds.

192.19 	Sec. 130. Minnesota Statutes 2018, section 256B.73, subdivision 5, is amended to read:
192.20 		Subd. 5.Enrollee benefits. (a) Eligible persons enrolled by a demonstration provider 
192.21 	shall receive a health services benefit package that includes health services which the 
192.22 	enrollees might reasonably require to be maintained in good health, including emergency 
192.23 	care, inpatient hospital and physician or advanced practice registered nurse care, outpatient 
192.24 	health services, and preventive health services.
192.25 	(b) Services related to chemical dependency, mental illness, vision care, dental care, 
192.26 	and other benefits may be excluded or limited upon approval by the commissioners. The 
192.27 	coalition may petition the commissioner of commerce or health, whichever is appropriate, 
192.28 	for waivers that allow these benefits to be excluded or limited.
192.29 	(c) The commissioners, the coalition, and demonstration providers shall work together 
192.30 	to design a package of benefits or packages of benefits that can be provided to enrollees for 
192.31 	an affordable monthly premium.

193.1 	Sec. 131. Minnesota Statutes 2018, section 256J.08, subdivision 73a, is amended to read:
193.2 		Subd. 73a.Qualified professional. (a) For physical illness, injury, or incapacity, a 
193.3 	"qualified professional" means a licensed physician, a physician assistant, a nurse practitioner
193.4 	an advanced practice registered nurse, or a licensed chiropractor.
193.5 	(b) For developmental disability and intelligence testing, a "qualified professional" 
193.6 	means an individual qualified by training and experience to administer the tests necessary 
193.7 	to make determinations, such as tests of intellectual functioning, assessments of adaptive 
193.8 	behavior, adaptive skills, and developmental functioning. These professionals include 
193.9 	licensed psychologists, certified school psychologists, or certified psychometrists working 
193.10 	under the supervision of a licensed psychologist.
193.11 	(c) For learning disabilities, a "qualified professional" means a licensed psychologist or 
193.12 	school psychologist with experience determining learning disabilities.
193.13 	(d) For mental health, a "qualified professional" means a licensed physician or a qualified 
193.14 	mental health professional. A "qualified mental health professional" means:
193.15 	(1) for children, in psychiatric nursing, a registered nurse or advanced practice registered 
193.16 	nurse who is licensed under sections 148.171 to 148.285, and who is certified as a clinical 
193.17 	specialist in child and adolescent psychiatric or mental health nursing by a national nurse 
193.18 	certification organization or who has a master's degree in nursing or one of the behavioral 
193.19 	sciences or related fields from an accredited college or university or its equivalent, with at 
193.20 	least 4,000 hours of post-master's supervised experience in the delivery of clinical services 
193.21 	in the treatment of mental illness;
193.22 	(2) for adults, in psychiatric nursing, a registered nurse or advanced practice registered 
193.23 	nurse who is licensed under sections 148.171 to 148.285, and who is certified as a clinical 
193.24 	specialist in adult psychiatric and mental health nursing by a national nurse certification 
193.25 	organization or who has a master's degree in nursing or one of the behavioral sciences or 
193.26 	related fields from an accredited college or university or its equivalent, with at least 4,000 
193.27 	hours of post-master's supervised experience in the delivery of clinical services in the 
193.28 	treatment of mental illness;
193.29 	(3) in clinical social work, a person licensed as an independent clinical social worker 
193.30 	under chapter 148D, or a person with a master's degree in social work from an accredited 
193.31 	college or university, with at least 4,000 hours of post-master's supervised experience in 
193.32 	the delivery of clinical services in the treatment of mental illness;
194.1 	(4) in psychology, an individual licensed by the Board of Psychology under sections 
194.2 	148.88 to 148.98, who has stated to the Board of Psychology competencies in the diagnosis 
194.3 	and treatment of mental illness;
194.4 	(5) in psychiatry, a physician licensed under chapter 147 and certified by the American 
194.5 	Board of Psychiatry and Neurology or eligible for board certification in psychiatry;
194.6 	(6) in marriage and family therapy, the mental health professional must be a marriage 
194.7 	and family therapist licensed under sections 148B.29 to 148B.39, with at least two years of 
194.8 	post-master's supervised experience in the delivery of clinical services in the treatment of 
194.9 	mental illness; and
194.10 	(7) in licensed professional clinical counseling, the mental health professional shall be 
194.11 	a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours 
194.12 	of post-master's supervised experience in the delivery of clinical services in the treatment 
194.13 	of mental illness.

194.14 	Sec. 132. Minnesota Statutes 2019 Supplement, section 256R.44, is amended to read:
194.15 	256R.44 RATE ADJUSTMENT FOR PRIVATE ROOMS FOR MEDICAL 
194.16 	NECESSITY.
194.17 	(a) The amount paid for a private room is 111.5 percent of the established total payment 
194.18 	rate for a resident if the resident is a medical assistance recipient and the private room is 
194.19 	considered a medical necessity for the resident or others who are affected by the resident's 
194.20 	condition, except as provided in Minnesota Rules, part 9549.0060, subpart 11, item C. 
194.21 	Conditions requiring a private room must be determined by the resident's attending physician 
194.22 	or advanced practice registered nurse and submitted to the commissioner for approval or 
194.23 	denial by the commissioner on the basis of medical necessity.
194.24 	(b) For a nursing facility with a total property payment rate determined under section 
194.25 	256R.26, subdivision 8, the amount paid for a private room is 111.5 percent of the established 
194.26 	total payment rate for a resident if the resident is a medical assistance recipient and the 
194.27 	private room is considered a medical necessity for the resident or others who are affected 
194.28 	by the resident's condition. Conditions requiring a private room must be determined by the 
194.29 	resident's attending physician and submitted to the commissioner for approval or denial by 
194.30 	the commissioner on the basis of medical necessity.

195.1 	Sec. 133. Minnesota Statutes 2018, section 256R.54, subdivision 1, is amended to read:
195.2 		Subdivision 1.Setting payment; monitoring use of therapy services. (a) The 
195.3 	commissioner shall adopt rules under the Administrative Procedure Act to set the amount 
195.4 	and method of payment for ancillary materials and services provided to recipients residing 
195.5 	in nursing facilities. Payment for materials and services may be made to either the vendor 
195.6 	of ancillary services pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475, or to a 
195.7 	nursing facility pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475.
195.8 	(b) Payment for the same or similar service to a recipient shall not be made to both the 
195.9 	nursing facility and the vendor. The commissioner shall ensure: (1) the avoidance of double 
195.10 	payments through audits and adjustments to the nursing facility's annual cost report as 
195.11 	required by section 256R.12, subdivisions 8 and 9; and (2) that charges and arrangements 
195.12 	for ancillary materials and services are cost-effective and as would be incurred by a prudent 
195.13 	and cost-conscious buyer.
195.14 	(c) Therapy services provided to a recipient must be medically necessary and appropriate 
195.15 	to the medical condition of the recipient. If the vendor, nursing facility, or ordering physician
195.16 	or advanced practice registered nurse cannot provide adequate medical necessity justification, 
195.17 	as determined by the commissioner, the commissioner may recover or disallow the payment 
195.18 	for the services and may require prior authorization for therapy services as a condition of 
195.19 	payment or may impose administrative sanctions to limit the vendor, nursing facility, or 
195.20 	ordering physician's or advanced practice registered nurse's participation in the medical 
195.21 	assistance program. If the provider number of a nursing facility is used to bill services 
195.22 	provided by a vendor of therapy services that is not related to the nursing facility by 
195.23 	ownership, control, affiliation, or employment status, no withholding of payment shall be 
195.24 	imposed against the nursing facility for services not medically necessary except for funds 
195.25 	due the unrelated vendor of therapy services as provided in subdivision 5. For the purpose 
195.26 	of this subdivision, no monetary recovery may be imposed against the nursing facility for 
195.27 	funds paid to the unrelated vendor of therapy services as provided in subdivision 5, for 
195.28 	services not medically necessary.
195.29 	(d) For purposes of this section and section 256R.12, subdivisions 8 and 9, therapy 
195.30 	includes physical therapy, occupational therapy, speech therapy, audiology, and mental 
195.31 	health services that are covered services according to Minnesota Rules, parts 9505.0170 to 
195.32 	9505.0475.
195.33 	(e) For purposes of this subdivision, "ancillary services" includes transportation defined 
195.34 	as a covered service in section 256B.0625, subdivision 17.

196.1 	Sec. 134. Minnesota Statutes 2018, section 256R.54, subdivision 2, is amended to read:
196.2 		Subd. 2.Certification that treatment is appropriate. The physical therapist, 
196.3 	occupational therapist, speech therapist, mental health professional, or audiologist who 
196.4 	provides or supervises the provision of therapy services, other than an initial evaluation, to 
196.5 	a medical assistance recipient must certify in writing that the therapy's nature, scope, duration, 
196.6 	and intensity are appropriate to the medical condition of the recipient every 30 days. The 
196.7 	therapist's statement of certification must be maintained in the recipient's medical record 
196.8 	together with the specific orders by the physician or advanced practice registered nurse and 
196.9 	the treatment plan. If the recipient's medical record does not include these documents, the 
196.10 	commissioner may recover or disallow the payment for such services. If the therapist 
196.11 	determines that the therapy's nature, scope, duration, or intensity is not appropriate to the 
196.12 	medical condition of the recipient, the therapist must provide a statement to that effect in 
196.13 	writing to the nursing facility for inclusion in the recipient's medical record. The 
196.14 	commissioner shall make recommendations regarding the medical necessity of services 
196.15 	provided.

196.16 	Sec. 135. Minnesota Statutes 2018, section 257.63, subdivision 3, is amended to read:
196.17 		Subd. 3.Medical privilege. Testimony of a physician or advanced practice registered 
196.18 	nurse concerning the medical circumstances of the pregnancy itself and the condition and 
196.19 	characteristics of the child upon birth is not privileged.

196.20 	Sec. 136. Minnesota Statutes 2018, section 257B.01, subdivision 3, is amended to read:
196.21 		Subd. 3.Attending physician or advanced practice registered nurse. "Attending 
196.22 	physician or advanced practice registered nurse" means a physician or advanced practice 
196.23 	registered nurse who has primary responsibility for the treatment and care of the designator. 
196.24 	If physicians or advanced practice registered nurses share responsibility, another physician
196.25 	or advanced practice registered nurse is acting on the attending physician's or advanced 
196.26 	practice registered nurse's behalf, or no physician or advanced practice registered nurse has 
196.27 	primary responsibility, any physician or advanced practice registered nurse who is familiar 
196.28 	with the designator's medical condition may act as an attending physician or advanced 
196.29 	practice registered nurse under this chapter.

196.30 	Sec. 137. Minnesota Statutes 2018, section 257B.01, subdivision 9, is amended to read:
196.31 		Subd. 9.Determination of debilitation. "Determination of debilitation" means a written 
196.32 	finding made by an attending physician or advanced practice registered nurse which states 
197.1 	that the designator suffers from a physically incapacitating disease or injury. No identification 
197.2 	of the illness in question is required.

197.3 	Sec. 138. Minnesota Statutes 2018, section 257B.01, subdivision 10, is amended to read:
197.4 		Subd. 10.Determination of incapacity. "Determination of incapacity" means a written 
197.5 	finding made by an attending physician or advanced practice registered nurse which states 
197.6 	the nature, extent, and probable duration of the designator's mental or organic incapacity.

197.7 	Sec. 139. Minnesota Statutes 2018, section 257B.06, subdivision 7, is amended to read:
197.8 		Subd. 7.Restored capacity. If a licensed physician or advanced practice registered 
197.9 	nurse determines that the designator has regained capacity, the co-custodian's authority that 
197.10 	commenced on the occurrence of a triggering event becomes inactive. Failure of a 
197.11 	co-custodian to immediately return the child(ren) to the designator's care entitles the 
197.12 	designator to an emergency hearing within five days of a request for a hearing.

197.13 	Sec. 140. REPEALER.
 197.14 	Minnesota Rules, part 9505.0365, subpart 3, is repealed.

197.15 	ARTICLE 5
197.16 	CONTROLLED SUBSTANCES SCHEDULES

197.17 	Section 1. Minnesota Statutes 2018, section 152.02, subdivision 2, is amended to read:
197.18 		Subd. 2.Schedule I. (a) Schedule I consists of the substances listed in this subdivision.
197.19 	(b) Opiates. Unless specifically excepted or unless listed in another schedule, any of the 
197.20 	following substances, including their analogs, isomers, esters, ethers, salts, and salts of 
197.21 	isomers, esters, and ethers, whenever the existence of the analogs, isomers, esters, ethers, 
197.22 	and salts is possible:
197.23 	(1) acetylmethadol;
197.24 	(2) allylprodine;
197.25 	(3) alphacetylmethadol (except levo-alphacetylmethadol, also known as levomethadyl 
197.26 	acetate);
197.27 	(4) alphameprodine;
197.28 	(5) alphamethadol;
197.29 	(6) alpha-methylfentanyl benzethidine;
198.1 	(7) betacetylmethadol;
198.2 	(8) betameprodine;
198.3 	(9) betamethadol;
198.4 	(10) betaprodine;
198.5 	(11) clonitazene;
198.6 	(12) dextromoramide;
198.7 	(13) diampromide;
198.8 	(14) diethyliambutene;
198.9 	(15) difenoxin;
198.10 	(16) dimenoxadol;
198.11 	(17) dimepheptanol;
198.12 	(18) dimethyliambutene;
198.13 	(19) dioxaphetyl butyrate;
198.14 	(20) dipipanone;
198.15 	(21) ethylmethylthiambutene;
198.16 	(22) etonitazene;
198.17 	(23) etoxeridine;
198.18 	(24) furethidine;
198.19 	(25) hydroxypethidine;
198.20 	(26) ketobemidone;
198.21 	(27) levomoramide;
198.22 	(28) levophenacylmorphan;
198.23 	(29) 3-methylfentanyl;
198.24 	(30) acetyl-alpha-methylfentanyl;
198.25 	(31) alpha-methylthiofentanyl;
198.26 	(32) benzylfentanyl beta-hydroxyfentanyl;
198.27 	(33) beta-hydroxy-3-methylfentanyl;
199.1 	(34) 3-methylthiofentanyl;
199.2 	(35) thenylfentanyl;
199.3 	(36) thiofentanyl;
199.4 	(37) para-fluorofentanyl;
199.5 	(38) morpheridine;
199.6 	(39) 1-methyl-4-phenyl-4-propionoxypiperidine;
199.7 	(40) noracymethadol;
199.8 	(41) norlevorphanol;
199.9 	(42) normethadone;
199.10 	(43) norpipanone;
199.11 	(44) 1-(2-phenylethyl)-4-phenyl-4-acetoxypiperidine (PEPAP);
199.12 	(45) phenadoxone;
199.13 	(46) phenampromide;
199.14 	(47) phenomorphan;
199.15 	(48) phenoperidine;
199.16 	(49) piritramide;
199.17 	(50) proheptazine;
199.18 	(51) properidine;
199.19 	(52) propiram;
199.20 	(53) racemoramide;
199.21 	(54) tilidine;
199.22 	(55) trimeperidine;
199.23 	(56) N-(1-Phenethylpiperidin-4-yl)-N-phenylacetamide (acetyl fentanyl);
199.24 	(57) 3,4-dichloro-N-[(1R,2R)-2-(dimethylamino)cyclohexyl]-N-
199.25 	methylbenzamide(U47700);
199.26 	(58) N-phenyl-N-[1-(2-phenylethyl)piperidin-4-yl]furan-2-carboxamide(furanylfentanyl); 
199.27 	and
199.28 	(59) 4-(4-bromophenyl)-4-dimethylamino-1-phenethylcyclohexanol (bromadol).;
200.1 	(60) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopropanecarboxamide (Cyclopropryl 
200.2 	fentanyl);
200.3 	(61) N-(1-phenethylpiperidin-4-yl)-N-phenylbutanamide) (butyryl fentanyl);
200.4 	(62) 1-cyclohexyl-4-(1,2-diphenylethyl)piperazine) (MT-45);
200.5 	(63) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopentanecarboxamide (cyclopentyl 
200.6 	fentanyl);
200.7 	(64) N-(1-phenethylpiperidin-4-yl)-N-phenylisobutyramide (isobutyryl fentanyl);
200.8 	(65) N-(1-phenethylpiperidin-4-yl)-N-phenylpentanamide (valeryl fentanyl);
200.9 	(66) N-(4-chlorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide 
200.10 	(para-chloroisobutyryl fentanyl);
200.11 	(67) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)butyramide (para-fluorobutyryl 
200.12 	fentanyl);
200.13 	(68) N-(4-methoxyphenyl)-N-(1-phenethylpiperidin-4-yl)butyramide 
200.14 	(para-methoxybutyryl fentanyl);
200.15 	(69) N-(2-fluorophenyl)-2-methoxy-N-(1-phenethylpiperidin-4-yl)acetamide (ocfentanil);
200.16 	(70) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide (4-fluoroisobutyryl 
200.17 	fentanyl or para-fluoroisobutyryl fentanyl);
200.18 	(71) N-(1-phenethylpiperidin-4-yl)-N-phenylacrylamide (acryl fentanyl or 
200.19 	acryloylfentanyl);
200.20 	(72) 2-methoxy-N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide (methoxyacetyl 
200.21 	fentanyl);
200.22 	(73) N-(2-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)propionamide (ortho-fluorofentanyl 
200.23 	or 2-fluorofentanyl);
200.24 	(74) N-(1-phenethylpiperidin-4-yl)-N-phenyltetrahydrofuran-2-carboxamide 
200.25 	(tetrahydrofuranyl fentanyl); and
200.26 	(75) Fentanyl-related substances, their isomers, esters, ethers, salts and salts of isomers, 
200.27 	esters and ethers, meaning any substance not otherwise listed under another federal 
200.28 	Administration Controlled Substance Code Number or not otherwise listed in this section, 
200.29 	and for which no exemption or approval is in effect under section 505 of the Federal Food, 
200.30 	Drug, and Cosmetic Act, United States Code , title 21, section 355, that is structurally related 
200.31 	to fentanyl by one or more of the following modifications:
201.1 	(i) replacement of the phenyl portion of the phenethyl group by any monocycle, whether 
201.2 	or not further substituted in or on the monocycle;
201.3 	(ii) substitution in or on the phenethyl group with alkyl, alkenyl, alkoxyl, hydroxyl, halo, 
201.4 	haloalkyl, amino, or nitro groups;
201.5 	(iii) substitution in or on the piperidine ring with alkyl, alkenyl, alkoxyl, ester, ether, 
201.6 	hydroxyl, halo, haloalkyl, amino, or nitro groups;
201.7 	(iv) replacement of the aniline ring with any aromatic monocycle whether or not further 
201.8 	substituted in or on the aromatic monocycle; or
201.9 	(v) replacement of the N-propionyl group by another acyl group.
201.10 	(c) Opium derivatives. Any of the following substances, their analogs, salts, isomers, 
201.11 	and salts of isomers, unless specifically excepted or unless listed in another schedule, 
201.12 	whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:
201.13 	(1) acetorphine;
201.14 	(2) acetyldihydrocodeine;
201.15 	(3) benzylmorphine;
201.16 	(4) codeine methylbromide;
201.17 	(5) codeine-n-oxide;
201.18 	(6) cyprenorphine;
201.19 	(7) desomorphine;
201.20 	(8) dihydromorphine;
201.21 	(9) drotebanol;
201.22 	(10) etorphine;
201.23 	(11) heroin;
201.24 	(12) hydromorphinol;
201.25 	(13) methyldesorphine;
201.26 	(14) methyldihydromorphine;
201.27 	(15) morphine methylbromide;
201.28 	(16) morphine methylsulfonate;
201.29 	(17) morphine-n-oxide;
202.1 	(18) myrophine;
202.2 	(19) nicocodeine;
202.3 	(20) nicomorphine;
202.4 	(21) normorphine;
202.5 	(22) pholcodine; and
202.6 	(23) thebacon.
202.7 	(d) Hallucinogens. Any material, compound, mixture or preparation which contains any 
202.8 	quantity of the following substances, their analogs, salts, isomers (whether optical, positional, 
202.9 	or geometric), and salts of isomers, unless specifically excepted or unless listed in another 
202.10 	schedule, whenever the existence of the analogs, salts, isomers, and salts of isomers is 
202.11 	possible:
202.12 	(1) methylenedioxy amphetamine;
202.13 	(2) methylenedioxymethamphetamine;
202.14 	(3) methylenedioxy-N-ethylamphetamine (MDEA);
202.15 	(4) n-hydroxy-methylenedioxyamphetamine;
202.16 	(5) 4-bromo-2,5-dimethoxyamphetamine (DOB);
202.17 	(6) 2,5-dimethoxyamphetamine (2,5-DMA);
202.18 	(7) 4-methoxyamphetamine;
202.19 	(8) 5-methoxy-3, 4-methylenedioxyamphetamine;
202.20 	(9) alpha-ethyltryptamine;
202.21 	(10) bufotenine;
202.22 	(11) diethyltryptamine;
202.23 	(12) dimethyltryptamine;
202.24 	(13) 3,4,5-trimethoxyamphetamine;
202.25 	(14) 4-methyl-2, 5-dimethoxyamphetamine (DOM);
202.26 	(15) ibogaine;
202.27 	(16) lysergic acid diethylamide (LSD);
202.28 	(17) mescaline;
203.1 	(18) parahexyl;
203.2 	(19) N-ethyl-3-piperidyl benzilate;
203.3 	(20) N-methyl-3-piperidyl benzilate;
203.4 	(21) psilocybin;
203.5 	(22) psilocyn;
203.6 	(23) tenocyclidine (TPCP or TCP);
203.7 	(24) N-ethyl-1-phenyl-cyclohexylamine (PCE);
203.8 	(25) 1-(1-phenylcyclohexyl) pyrrolidine (PCPy);
203.9 	(26) 1-[1-(2-thienyl)cyclohexyl]-pyrrolidine (TCPy);
203.10 	(27) 4-chloro-2,5-dimethoxyamphetamine (DOC);
203.11 	(28) 4-ethyl-2,5-dimethoxyamphetamine (DOET);
203.12 	(29) 4-iodo-2,5-dimethoxyamphetamine (DOI);
203.13 	(30) 4-bromo-2,5-dimethoxyphenethylamine (2C-B);
203.14 	(31) 4-chloro-2,5-dimethoxyphenethylamine (2C-C);
203.15 	(32) 4-methyl-2,5-dimethoxyphenethylamine (2C-D);
203.16 	(33) 4-ethyl-2,5-dimethoxyphenethylamine (2C-E);
203.17 	(34) 4-iodo-2,5-dimethoxyphenethylamine (2C-I);
203.18 	(35) 4-propyl-2,5-dimethoxyphenethylamine (2C-P);
203.19 	(36) 4-isopropylthio-2,5-dimethoxyphenethylamine (2C-T-4);
203.20 	(37) 4-propylthio-2,5-dimethoxyphenethylamine (2C-T-7);
203.21 	(38) 2-(8-bromo-2,3,6,7-tetrahydrofuro [2,3-f][1]benzofuran-4-yl)ethanamine 
203.22 	(2-CB-FLY);
203.23 	(39) bromo-benzodifuranyl-isopropylamine (Bromo-DragonFLY);
203.24 	(40) alpha-methyltryptamine (AMT);
203.25 	(41) N,N-diisopropyltryptamine (DiPT);
203.26 	(42) 4-acetoxy-N,N-dimethyltryptamine (4-AcO-DMT);
203.27 	(43) 4-acetoxy-N,N-diethyltryptamine (4-AcO-DET);
204.1 	(44) 4-hydroxy-N-methyl-N-propyltryptamine (4-HO-MPT);
204.2 	(45) 4-hydroxy-N,N-dipropyltryptamine (4-HO-DPT);
204.3 	(46) 4-hydroxy-N,N-diallyltryptamine (4-HO-DALT);
204.4 	(47) 4-hydroxy-N,N-diisopropyltryptamine (4-HO-DiPT);
204.5 	(48) 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DiPT);
204.6 	(49) 5-methoxy-α-methyltryptamine (5-MeO-AMT);
204.7 	(50) 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT);
204.8 	(51) 5-methylthio-N,N-dimethyltryptamine (5-MeS-DMT);
204.9 	(52) 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT);
204.10 	(53) 5-methoxy-α-ethyltryptamine (5-MeO-AET);
204.11 	(54) 5-methoxy-N,N-dipropyltryptamine (5-MeO-DPT);
204.12 	(55) 5-methoxy-N,N-diethyltryptamine (5-MeO-DET);
204.13 	(56) 5-methoxy-N,N-diallyltryptamine (5-MeO-DALT);
204.14 	(57) methoxetamine (MXE);
204.15 	(58) 5-iodo-2-aminoindane (5-IAI);
204.16 	(59) 5,6-methylenedioxy-2-aminoindane (MDAI);
204.17 	(60) 2-(4-bromo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25B-NBOMe);
204.18 	(61) 2-(4-chloro-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25C-NBOMe);
204.19 	(62) 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25I-NBOMe);
204.20 	(63) 2-(2,5-Dimethoxyphenyl)ethanamine (2C-H);
204.21 	(64) 2-(4-Ethylthio-2,5-dimethoxyphenyl)ethanamine (2C-T-2);
204.22 	(65) N,N-Dipropyltryptamine (DPT);
204.23 	(66) 3-[1-(Piperidin-1-yl)cyclohexyl]phenol (3-HO-PCP);
204.24 	(67) N-ethyl-1-(3-methoxyphenyl)cyclohexanamine (3-MeO-PCE);
204.25 	(68) 4-[1-(3-methoxyphenyl)cyclohexyl]morpholine (3-MeO-PCMo);
204.26 	(69) 1-[1-(4-methoxyphenyl)cyclohexyl]-piperidine (methoxydine, 4-MeO-PCP);
205.1 	(70) 2-(2-Chlorophenyl)-2-(ethylamino)cyclohexan-1-one (N-Ethylnorketamine, 
205.2 	ethketamine, NENK);
205.3 	(71) methylenedioxy-N,N-dimethylamphetamine (MDDMA);
205.4 	(72) 3-(2-Ethyl(methyl)aminoethyl)-1H-indol-4-yl (4-AcO-MET); and
205.5 	(73) 2-Phenyl-2-(methylamino)cyclohexanone (deschloroketamine).
205.6 	(e) Peyote. All parts of the plant presently classified botanically as Lophophora williamsii 
205.7 	Lemaire, whether growing or not, the seeds thereof, any extract from any part of the plant, 
205.8 	and every compound, manufacture, salts, derivative, mixture, or preparation of the plant, 
205.9 	its seeds or extracts. The listing of peyote as a controlled substance in Schedule I does not 
205.10 	apply to the nondrug use of peyote in bona fide religious ceremonies of the American Indian 
205.11 	Church, and members of the American Indian Church are exempt from registration. Any 
205.12 	person who manufactures peyote for or distributes peyote to the American Indian Church, 
205.13 	however, is required to obtain federal registration annually and to comply with all other 
205.14 	requirements of law.
205.15 	(f) Central nervous system depressants. Unless specifically excepted or unless listed in 
205.16 	another schedule, any material compound, mixture, or preparation which contains any 
205.17 	quantity of the following substances, their analogs, salts, isomers, and salts of isomers 
205.18 	whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:
205.19 	(1) mecloqualone;
205.20 	(2) methaqualone;
205.21 	(3) gamma-hydroxybutyric acid (GHB), including its esters and ethers;
205.22 	(4) flunitrazepam; and
205.23 	(5) 2-(2-Methoxyphenyl)-2-(methylamino)cyclohexanone (2-MeO-2-deschloroketamine, 
205.24 	methoxyketamine).;
205.25 	(6) tianeptine;
205.26 	(7) clonazolam;
205.27 	(8) etizolam;
205.28 	(9) flubromazolam; and
205.29 	(10) flubromazepam.
205.30 	(g) Stimulants. Unless specifically excepted or unless listed in another schedule, any 
205.31 	material compound, mixture, or preparation which contains any quantity of the following 
206.1 	substances, their analogs, salts, isomers, and salts of isomers whenever the existence of the 
206.2 	analogs, salts, isomers, and salts of isomers is possible:
206.3 	(1) aminorex;
206.4 	(2) cathinone;
206.5 	(3) fenethylline;
206.6 	(4) methcathinone;
206.7 	(5) methylaminorex;
206.8 	(6) N,N-dimethylamphetamine;
206.9 	(7) N-benzylpiperazine (BZP);
206.10 	(8) methylmethcathinone (mephedrone);
206.11 	(9) 3,4-methylenedioxy-N-methylcathinone (methylone);
206.12 	(10) methoxymethcathinone (methedrone);
206.13 	(11) methylenedioxypyrovalerone (MDPV);
206.14 	(12) 3-fluoro-N-methylcathinone (3-FMC);
206.15 	(13) methylethcathinone (MEC);
206.16 	(14) 1-benzofuran-6-ylpropan-2-amine (6-APB);
206.17 	(15) dimethylmethcathinone (DMMC);
206.18 	(16) fluoroamphetamine;
206.19 	(17) fluoromethamphetamine;
206.20 	(18) α-methylaminobutyrophenone (MABP or buphedrone);
206.21 	(19) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)butan-1-one (butylone);
206.22 	(20) 2-(methylamino)-1-(4-methylphenyl)butan-1-one (4-MEMABP or BZ-6378);
206.23 	(21) 1-(naphthalen-2-yl)-2-(pyrrolidin-1-yl) pentan-1-one (naphthylpyrovalerone or 
206.24 	naphyrone);
206.25 	(22) (alpha-pyrrolidinopentiophenone (alpha-PVP);
206.26 	(23) (RS)-1-(4-methylphenyl)-2-(1-pyrrolidinyl)-1-hexanone (4-Me-PHP or MPHP);
206.27 	(24) 2-(1-pyrrolidinyl)-hexanophenone (Alpha-PHP);
206.28 	(25) 4-methyl-N-ethylcathinone (4-MEC);
207.1 	(26) 4-methyl-alpha-pyrrolidinopropiophenone (4-MePPP);
207.2 	(27) 2-(methylamino)-1-phenylpentan-1-one (pentedrone);
207.3 	(28) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)pentan-1-one (pentylone);
207.4 	(29) 4-fluoro-N-methylcathinone (4-FMC);
207.5 	(30) 3,4-methylenedioxy-N-ethylcathinone (ethylone);
207.6 	(31) alpha-pyrrolidinobutiophenone (α-PBP);
207.7 	(32) 5-(2-Aminopropyl)-2,3-dihydrobenzofuran (5-APDB);
207.8 	(33) 1-phenyl-2-(1-pyrrolidinyl)-1-heptanone (PV8);
207.9 	(34) 6-(2-Aminopropyl)-2,3-dihydrobenzofuran (6-APDB);
207.10 	(35) 4-methyl-alpha-ethylaminopentiophenone (4-MEAPP);
207.11 	(36) 4'-chloro-alpha-pyrrolidinopropiophenone (4'-chloro-PPP);
207.12 	(37) 1-(1,3-Benzodioxol-5-yl)-2-(dimethylamino)butan-1-one (dibutylone, bk-DMBDB);
207.13 	(38) 1-(3-chlorophenyl) piperazine (meta-chlorophenylpiperazine or mCPP); and
207.14 	(39) 1-(1,3-benzodioxol-5-yl)-2-(ethylamino)-pentan-1-one (N-ethylpentylone, ephylone); 
207.15 	and
207.16 	(40) any other substance, except bupropion or compounds listed under a different 
207.17 	schedule, that is structurally derived from 2-aminopropan-1-one by substitution at the 
207.18 	1-position with either phenyl, naphthyl, or thiophene ring systems, whether or not the 
207.19 	compound is further modified in any of the following ways:
207.20 	(i) by substitution in the ring system to any extent with alkyl, alkylenedioxy, alkoxy, 
207.21 	haloalkyl, hydroxyl, or halide substituents, whether or not further substituted in the ring 
207.22 	system by one or more other univalent substituents;
207.23 	(ii) by substitution at the 3-position with an acyclic alkyl substituent;
207.24 	(iii) by substitution at the 2-amino nitrogen atom with alkyl, dialkyl, benzyl, or 
207.25 	methoxybenzyl groups; or
207.26 	(iv) by inclusion of the 2-amino nitrogen atom in a cyclic structure.
207.27 	(h) Marijuana, tetrahydrocannabinols, and synthetic cannabinoids. Unless specifically 
207.28 	excepted or unless listed in another schedule, any natural or synthetic material, compound, 
207.29 	mixture, or preparation that contains any quantity of the following substances, their analogs, 
208.1 	isomers, esters, ethers, salts, and salts of isomers, esters, and ethers, whenever the existence 
208.2 	of the isomers, esters, ethers, or salts is possible:
208.3 	(1) marijuana;
208.4 	(2) tetrahydrocannabinols naturally contained in a plant of the genus Cannabis, synthetic 
208.5 	equivalents of the substances contained in the cannabis plant or in the resinous extractives 
208.6 	of the plant, or synthetic substances with similar chemical structure and pharmacological 
208.7 	activity to those substances contained in the plant or resinous extract, including, but not 
208.8 	limited to, 1 cis or trans tetrahydrocannabinol, 6 cis or trans tetrahydrocannabinol, and 3,4 
208.9 	cis or trans tetrahydrocannabinol;
208.10 	(3) synthetic cannabinoids, including the following substances:
208.11 	(i) Naphthoylindoles, which are any compounds containing a 3-(1-napthoyl)indole 
208.12 	structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, 
208.13 	alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or 
208.14 	2-(4-morpholinyl)ethyl group, whether or not further substituted in the indole ring to any 
208.15 	extent and whether or not substituted in the naphthyl ring to any extent. Examples of 
208.16 	naphthoylindoles include, but are not limited to:
208.17 	(A) 1-Pentyl-3-(1-naphthoyl)indole (JWH-018 and AM-678);
208.18 	(B) 1-Butyl-3-(1-naphthoyl)indole (JWH-073);
208.19 	(C) 1-Pentyl-3-(4-methoxy-1-naphthoyl)indole (JWH-081);
208.20 	(D) 1-[2-(4-morpholinyl)ethyl]-3-(1-naphthoyl)indole (JWH-200);
208.21 	(E) 1-Propyl-2-methyl-3-(1-naphthoyl)indole (JWH-015);
208.22 	(F) 1-Hexyl-3-(1-naphthoyl)indole (JWH-019);
208.23 	(G) 1-Pentyl-3-(4-methyl-1-naphthoyl)indole (JWH-122);
208.24 	(H) 1-Pentyl-3-(4-ethyl-1-naphthoyl)indole (JWH-210);
208.25 	(I) 1-Pentyl-3-(4-chloro-1-naphthoyl)indole (JWH-398);
208.26 	(J) 1-(5-fluoropentyl)-3-(1-naphthoyl)indole (AM-2201).
208.27 	(ii) Napthylmethylindoles, which are any compounds containing a 
208.28 	1H-indol-3-yl-(1-naphthyl)methane structure with substitution at the nitrogen atom of the 
208.29 	indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 
208.30 	1-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group, whether or not further 
209.1 	substituted in the indole ring to any extent and whether or not substituted in the naphthyl 
209.2 	ring to any extent. Examples of naphthylmethylindoles include, but are not limited to:
209.3 	(A) 1-Pentyl-1H-indol-3-yl-(1-naphthyl)methane (JWH-175);
209.4 	(B) 1-Pentyl-1H-indol-3-yl-(4-methyl-1-naphthyl)methane (JWH-184).
209.5 	(iii) Naphthoylpyrroles, which are any compounds containing a 3-(1-naphthoyl)pyrrole 
209.6 	structure with substitution at the nitrogen atom of the pyrrole ring by an alkyl, haloalkyl, 
209.7 	alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or 
209.8 	2-(4-morpholinyl)ethyl group whether or not further substituted in the pyrrole ring to any 
209.9 	extent, whether or not substituted in the naphthyl ring to any extent. Examples of 
209.10 	naphthoylpyrroles include, but are not limited to, 
209.11 	(5-(2-fluorophenyl)-1-pentylpyrrol-3-yl)-naphthalen-1-ylmethanone (JWH-307).
209.12 	(iv) Naphthylmethylindenes, which are any compounds containing a naphthylideneindene 
209.13 	structure with substitution at the 3-position of the indene ring by an alkyl, haloalkyl, alkenyl, 
209.14 	cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or 
209.15 	2-(4-morpholinyl)ethyl group whether or not further substituted in the indene ring to any 
209.16 	extent, whether or not substituted in the naphthyl ring to any extent. Examples of 
209.17 	naphthylemethylindenes include, but are not limited to, 
209.18 	E-1-[1-(1-naphthalenylmethylene)-1H-inden-3-yl]pentane (JWH-176).
209.19 	(v) Phenylacetylindoles, which are any compounds containing a 3-phenylacetylindole 
209.20 	structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, 
209.21 	alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or 
209.22 	2-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any 
209.23 	extent, whether or not substituted in the phenyl ring to any extent. Examples of 
209.24 	phenylacetylindoles include, but are not limited to:
209.25 	(A) 1-(2-cyclohexylethyl)-3-(2-methoxyphenylacetyl)indole (RCS-8);
209.26 	(B) 1-pentyl-3-(2-methoxyphenylacetyl)indole (JWH-250);
209.27 	(C) 1-pentyl-3-(2-methylphenylacetyl)indole (JWH-251);
209.28 	(D) 1-pentyl-3-(2-chlorophenylacetyl)indole (JWH-203).
209.29 	(vi) Cyclohexylphenols, which are compounds containing a 
209.30 	2-(3-hydroxycyclohexyl)phenol structure with substitution at the 5-position of the phenolic 
209.31 	ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 
209.32 	1-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group whether or not substituted 
210.1 	in the cyclohexyl ring to any extent. Examples of cyclohexylphenols include, but are not 
210.2 	limited to:
210.3 	(A) 5-(1,1-dimethylheptyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol (CP 47,497);
210.4 	(B) 5-(1,1-dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol 
210.5 	(Cannabicyclohexanol or CP 47,497 C8 homologue);
210.6 	(C) 5-(1,1-dimethylheptyl)-2-[(1R,2R)-5-hydroxy-2-(3-hydroxypropyl)cyclohexyl] 
210.7 	-phenol (CP 55,940).
210.8 	(vii) Benzoylindoles, which are any compounds containing a 3-(benzoyl)indole structure 
210.9 	with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl, 
210.10 	cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or 
210.11 	2-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any 
210.12 	extent and whether or not substituted in the phenyl ring to any extent. Examples of 
210.13 	benzoylindoles include, but are not limited to:
210.14 	(A) 1-Pentyl-3-(4-methoxybenzoyl)indole (RCS-4);
210.15 	(B) 1-(5-fluoropentyl)-3-(2-iodobenzoyl)indole (AM-694);
210.16 	(C) (4-methoxyphenyl-[2-methyl-1-(2-(4-morpholinyl)ethyl)indol-3-yl]methanone (WIN 
210.17 	48,098 or Pravadoline).
210.18 	(viii) Others specifically named:
210.19 	(A) (6aR,10aR)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl) 
210.20 	-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (HU-210);
210.21 	(B) (6aS,10aS)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl) 
210.22 	-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (Dexanabinol or HU-211);
210.23 	(C) 2,3-dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo[1,2,3-de] 
210.24 	-1,4-benzoxazin-6-yl-1-naphthalenylmethanone (WIN 55,212-2);
210.25 	(D) (1-pentylindol-3-yl)-(2,2,3,3-tetramethylcyclopropyl)methanone (UR-144);
210.26 	(E) (1-(5-fluoropentyl)-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl)methanone 
210.27 	(XLR-11);
210.28 	(F) 1-pentyl-N-tricyclo[3.3.1.13,7]dec-1-yl-1H-indazole-3-carboxamide 
210.29 	(AKB-48(APINACA));
210.30 	(G) N-((3s,5s,7s)-adamantan-1-yl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide 
210.31 	(5-Fluoro-AKB-48);
211.1 	(H) 1-pentyl-8-quinolinyl ester-1H-indole-3-carboxylic acid (PB-22);
211.2 	(I) 8-quinolinyl ester-1-(5-fluoropentyl)-1H-indole-3-carboxylic acid (5-Fluoro PB-22);
211.3 	(J) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-pentyl-1H-indazole- 3-carboxamide 
211.4 	(AB-PINACA);
211.5 	(K) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-[(4-fluorophenyl)methyl]- 
211.6 	1H-indazole-3-carboxamide (AB-FUBINACA);
211.7 	(L) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-(cyclohexylmethyl)-1H- 
211.8 	indazole-3-carboxamide(AB-CHMINACA);
211.9 	(M) (S)-methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3- methylbutanoate 
211.10 	(5-fluoro-AMB);
211.11 	(N) [1-(5-fluoropentyl)-1H-indazol-3-yl](naphthalen-1-yl) methanone (THJ-2201);
211.12 	(O) (1-(5-fluoropentyl)-1H-benzo[d]imidazol-2-yl)(naphthalen-1-yl)methanone) 
211.13 	(FUBIMINA);
211.14 	(P) (7-methoxy-1-(2-morpholinoethyl)-N-((1S,2S,4R)-1,3,3-trimethylbicyclo 
211.15 	[2.2.1]heptan-2-yl)-1H-indole-3-carboxamide (MN-25 or UR-12);
211.16 	(Q) (S)-N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl) 
211.17 	-1H-indole-3-carboxamide (5-fluoro-ABICA);
211.18 	(R) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl) 
211.19 	-1H-indole-3-carboxamide;
211.20 	(S) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl) 
211.21 	-1H-indazole-3-carboxamide;
211.22 	(T) methyl 2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido) -3,3-dimethylbutanoate;
211.23 	(U) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1(cyclohexylmethyl)-1 
211.24 	H-indazole-3-carboxamide (MAB-CHMINACA);
211.25 	(V) N-(1-Amino-3,3-dimethyl-1-oxo-2-butanyl)-1-pentyl-1H-indazole-3-carboxamide 
211.26 	(ADB-PINACA);
211.27 	(W) methyl (1-(4-fluorobenzyl)-1H-indazole-3-carbonyl)-L-valinate (FUB-AMB);
211.28 	(X) N-[(1S)-2-amino-2-oxo-1-(phenylmethyl)ethyl]-1-(cyclohexylmethyl)-1H-Indazole-
211.29 	3-carboxamide. (APP-CHMINACA);
211.30 	(Y) quinolin-8-yl 1-(4-fluorobenzyl)-1H-indole-3-carboxylate (FUB-PB-22); and
212.1 	(Z) methyl N-[1-(cyclohexylmethyl)-1H-indole-3-carbonyl]valinate (MMB-CHMICA).
212.2 	(ix) Additional substances specifically named:
212.3 	(A) 1-(5-fluoropentyl)-N-(2-phenylpropan-2-yl)-1 
212.4 	H-pyrrolo[2,3-B]pyridine-3-carboxamide (5F-CUMYL-P7AICA);
212.5 	(B) 1-(4-cyanobutyl)-N-(2- phenylpropan-2-yl)-1 H-indazole-3-carboxamide 
212.6 	(4-CN-Cumyl-Butinaca);
212.7 	(C) naphthalen-1-yl-1-(5-fluoropentyl)-1-H-indole-3-carboxylate (NM2201; CBL2201);
212.8 	(D) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)-1 
212.9 	H-indazole-3-carboxamide (5F-ABPINACA);
212.10 	(E) methyl-2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3,3-dimethylbutanoate 
212.11 	(MDMB CHMICA);
212.12 	(F) methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate 
212.13 	(5F-ADB; 5F-MDMB-PINACA); and
212.14 	(G) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl) 
212.15 	1H-indazole-3-carboxamide (ADB-FUBINACA).
212.16 	(i) A controlled substance analog, to the extent that it is implicitly or explicitly intended 
212.17 	for human consumption.

212.18 	Sec. 2. Minnesota Statutes 2018, section 152.02, subdivision 3, is amended to read:
212.19 		Subd. 3.Schedule II. (a) Schedule II consists of the substances listed in this subdivision.
212.20 	(b) Unless specifically excepted or unless listed in another schedule, any of the following 
212.21 	substances whether produced directly or indirectly by extraction from substances of vegetable 
212.22 	origin or independently by means of chemical synthesis, or by a combination of extraction 
212.23 	and chemical synthesis:
212.24 	(1) Opium and opiate, and any salt, compound, derivative, or preparation of opium or 
212.25 	opiate.
212.26 	(i) Excluding:
212.27 	(A) apomorphine;
212.28 	(B) thebaine-derived butorphanol;
212.29 	(C) dextrophan;
212.30 	(D) nalbuphine;
213.1 	(E) nalmefene;
213.2 	(F) naloxegol;
213.3 	(G) naloxone;
213.4 	(H) naltrexone; and
213.5 	(I) their respective salts;
213.6 	(ii) but including the following:
213.7 	(A) opium, in all forms and extracts;
213.8 	(B) codeine;
213.9 	(C) dihydroetorphine;
213.10 	(D) ethylmorphine;
213.11 	(E) etorphine hydrochloride;
213.12 	(F) hydrocodone;
213.13 	(G) hydromorphone;
213.14 	(H) metopon;
213.15 	(I) morphine;
213.16 	(J) oxycodone;
213.17 	(K) oxymorphone;
213.18 	(L) thebaine;
213.19 	(M) oripavine;
213.20 	(2) any salt, compound, derivative, or preparation thereof which is chemically equivalent 
213.21 	or identical with any of the substances referred to in clause (1), except that these substances 
213.22 	shall not include the isoquinoline alkaloids of opium;
213.23 	(3) opium poppy and poppy straw;
213.24 	(4) coca leaves and any salt, cocaine compound, derivative, or preparation of coca leaves 
213.25 	(including cocaine and ecgonine and their salts, isomers, derivatives, and salts of isomers 
213.26 	and derivatives), and any salt, compound, derivative, or preparation thereof which is 
213.27 	chemically equivalent or identical with any of these substances, except that the substances 
213.28 	shall not include decocainized coca leaves or extraction of coca leaves, which extractions 
213.29 	do not contain cocaine or ecgonine;
214.1 	(5) concentrate of poppy straw (the crude extract of poppy straw in either liquid, solid, 
214.2 	or powder form which contains the phenanthrene alkaloids of the opium poppy).
214.3 	(c) Any of the following opiates, including their isomers, esters, ethers, salts, and salts 
214.4 	of isomers, esters and ethers, unless specifically excepted, or unless listed in another schedule, 
214.5 	whenever the existence of such isomers, esters, ethers and salts is possible within the specific 
214.6 	chemical designation:
214.7 	(1) alfentanil;
214.8 	(2) alphaprodine;
214.9 	(3) anileridine;
214.10 	(4) bezitramide;
214.11 	(5) bulk dextropropoxyphene (nondosage forms);
214.12 	(6) carfentanil;
214.13 	(7) dihydrocodeine;
214.14 	(8) dihydromorphinone;
214.15 	(9) diphenoxylate;
214.16 	(10) fentanyl;
214.17 	(11) isomethadone;
214.18 	(12) levo-alpha-acetylmethadol (LAAM);
214.19 	(13) levomethorphan;
214.20 	(14) levorphanol;
214.21 	(15) metazocine;
214.22 	(16) methadone;
214.23 	(17) methadone - intermediate, 4-cyano-2-dimethylamino-4, 4-diphenylbutane;
214.24 	(18) moramide - intermediate, 2-methyl-3-morpholino-1, 1-diphenyl-propane-carboxylic 
214.25 	acid;
214.26 	(19) pethidine;
214.27 	(20) pethidine - intermediate - a, 4-cyano-1-methyl-4-phenylpiperidine;
214.28 	(21) pethidine - intermediate - b, ethyl-4-phenylpiperidine-4-carboxylate;
215.1 	(22) pethidine - intermediate - c, 1-methyl-4-phenylpiperidine-4-carboxylic acid;
215.2 	(23) phenazocine;
215.3 	(24) piminodine;
215.4 	(25) racemethorphan;
215.5 	(26) racemorphan;
215.6 	(27) remifentanil;
215.7 	(28) sufentanil;
215.8 	(29) tapentadol;
215.9 	(30) 4-Anilino-N-phenethyl-4-piperidine (ANPP)4-Anilino-N-phenethylpiperidine.
215.10 	(d) Unless specifically excepted or unless listed in another schedule, any material, 
215.11 	compound, mixture, or preparation which contains any quantity of the following substances 
215.12 	having a stimulant effect on the central nervous system:
215.13 	(1) amphetamine, its salts, optical isomers, and salts of its optical isomers;
215.14 	(2) methamphetamine, its salts, isomers, and salts of its isomers;
215.15 	(3) phenmetrazine and its salts;
215.16 	(4) methylphenidate;
215.17 	(5) lisdexamfetamine.
215.18 	(e) Unless specifically excepted or unless listed in another schedule, any material, 
215.19 	compound, mixture, or preparation which contains any quantity of the following substances 
215.20 	having a depressant effect on the central nervous system, including its salts, isomers, and 
215.21 	salts of isomers whenever the existence of such salts, isomers, and salts of isomers is possible 
215.22 	within the specific chemical designation:
215.23 	(1) amobarbital;
215.24 	(2) glutethimide;
215.25 	(3) secobarbital;
215.26 	(4) pentobarbital;
215.27 	(5) phencyclidine;
215.28 	(6) phencyclidine immediate precursors:
215.29 	(i) 1-phenylcyclohexylamine;
216.1 	(ii) 1-piperidinocyclohexanecarbonitrile;
216.2 	(7) phenylacetone.
216.3 	(f) Hallucinogenic substances Cannabinoids:
216.4 	(1) nabilone.;
216.5 	(2) dronabinol [(-)-delta-9-trans-tetrahydrocannabinol (delta-9-THC)] in an oral solution 
216.6 	in a drug product approved for marketing by the United States Food and Drug Administration.

216.7 	Sec. 3. Minnesota Statutes 2018, section 152.02, subdivision 4, is amended to read:
216.8 		Subd. 4.Schedule III. (a) Schedule III consists of the substances listed in this subdivision.
216.9 	(b) Stimulants. Unless specifically excepted or unless listed in another schedule, any 
216.10 	material, compound, mixture, or preparation which contains any quantity of the following 
216.11 	substances having a potential for abuse associated with a stimulant effect on the central 
216.12 	nervous system, including its salts, isomers, and salts of such isomers whenever the existence 
216.13 	of such salts, isomers, and salts of isomers is possible within the specific chemical 
216.14 	designation:
216.15 	(1) benzphetamine;
216.16 	(2) chlorphentermine;
216.17 	(3) clortermine;
216.18 	(4) phendimetrazine.
216.19 	(c) Depressants. Unless specifically excepted or unless listed in another schedule, any 
216.20 	material, compound, mixture, or preparation which contains any quantity of the following 
216.21 	substances having a potential for abuse associated with a depressant effect on the central 
216.22 	nervous system:
216.23 	(1) any compound, mixture, or preparation containing amobarbital, secobarbital, 
216.24 	pentobarbital or any salt thereof and one or more other active medicinal ingredients which 
216.25 	are not listed in any schedule;
216.26 	(2) any suppository dosage form containing amobarbital, secobarbital, pentobarbital, or 
216.27 	any salt of any of these drugs and approved by the food and drug administration for marketing 
216.28 	only as a suppository;
216.29 	(3) any substance which contains any quantity of a derivative of barbituric acid, or any 
216.30 	salt of a derivative of barbituric acid, except those substances which are specifically listed 
216.31 	in other schedules;
217.1 	(4) any drug product containing gamma hydroxybutyric acid, including its salts, isomers, 
217.2 	and salts of isomers, for which an application is approved under section 505 of the federal 
217.3 	Food, Drug, and Cosmetic Act;
217.4 	(5) any of the following substances:
217.5 	(i) chlorhexadol;
217.6 	(ii) ketamine, its salts, isomers and salts of isomers;
217.7 	(iii) lysergic acid;
217.8 	(iv) lysergic acid amide;
217.9 	(v) methyprylon;
217.10 	(vi) sulfondiethylmethane;
217.11 	(vii) sulfonenthylmethane;
217.12 	(viii) sulfonmethane;
217.13 	(ix) tiletamine and zolazepam and any salt thereof;
217.14 	(x) embutramide;
217.15 	(xi) Perampanel [2-(2-oxo-1-phenyl-5-pyridin-2-yl-1,2-Dihydropyridin-3-yl) 
217.16 	benzonitrile].
217.17 	(d) Nalorphine.
217.18 	(e) Narcotic drugs. Unless specifically excepted or unless listed in another schedule, 
217.19 	any material, compound, mixture, or preparation containing any of the following narcotic 
217.20 	drugs, or their salts calculated as the free anhydrous base or alkaloid, in limited quantities 
217.21 	as follows:
217.22 	(1) not more than 1.80 grams of codeine per 100 milliliters or not more than 90 milligrams 
217.23 	per dosage unit, with an equal or greater quantity of an isoquinoline alkaloid of opium;
217.24 	(2) not more than 1.80 grams of codeine per 100 milliliters or not more than 90 milligrams 
217.25 	per dosage unit, with one or more active, nonnarcotic ingredients in recognized therapeutic 
217.26 	amounts;
217.27 	(3) not more than 1.80 grams of dihydrocodeine per 100 milliliters or not more than 90 
217.28 	milligrams per dosage unit, with one or more active, nonnarcotic ingredients in recognized 
217.29 	therapeutic amounts;
218.1 	(4) not more than 300 milligrams of ethylmorphine per 100 milliliters or not more than 
218.2 	15 milligrams per dosage unit, with one or more active, nonnarcotic ingredients in recognized 
218.3 	therapeutic amounts;
218.4 	(5) not more than 500 milligrams of opium per 100 milliliters or per 100 grams, or not 
218.5 	more than 25 milligrams per dosage unit, with one or more active, nonnarcotic ingredients 
218.6 	in recognized therapeutic amounts;
218.7 	(6) not more than 50 milligrams of morphine per 100 milliliters or per 100 grams with 
218.8 	one or more active, nonnarcotic ingredients in recognized therapeutic amounts;
218.9 	(f) Anabolic steroids, human growth hormone, and chorionic gonadotropin.
218.10 	(1) Anabolic steroids, for purposes of this subdivision, means any drug or hormonal 
218.11 	substance, chemically and pharmacologically related to testosterone, other than estrogens, 
218.12 	progestins, corticosteroids, and dehydroepiandrosterone, and includes:
218.13 	(i) 3[beta],17[beta]-dihydroxy-5[alpha]-androstane;
218.14 	(ii) 3[alpha],17[beta]-dihydroxy-5[alpha]-androstane;
218.15 	(iii) androstanedione (5[alpha]-androstan-3,17-dione);
218.16 	(iv) 1-androstenediol (3[beta],17[beta]-dihydroxy-5[alpha]-androst-l-ene;
218.17 	(v) 3[alpha],17[beta]-dihydroxy-5[alpha]-androst-1-ene);
218.18 	(vi) 4-androstenediol (3[beta],17[beta]-dihydroxy-androst-4-ene);
218.19 	(vii) 5-androstenediol (3[beta],17[beta]-dihydroxy-androst-5-ene);
218.20 	(viii) 1-androstenedione (5[alpha]-androst-1-en-3,17-dione);
218.21 	(ix) 4-androstenedione (androst-4-en-3,17-dione);
218.22 	(x) 5-androstenedione (androst-5-en-3,17-dione);
218.23 	(xi) bolasterone (7[alpha],17[alpha]-dimethyl-17[beta]-hydroxyandrost-4-en-3-one);
218.24 	(xii) boldenone (17[beta]-hydroxyandrost-1,4-diene-3-one);
218.25 	(xiii) boldione (androsta-1,4-diene-3,17-dione);
218.26 	(xiv) calusterone (7[beta],17[alpha]-dimethyl-17[beta]-hydroxyandrost-4-en-3-one);
218.27 	(xv) clostebol (4-chloro-17[beta]-hydroxyandrost-4-en-3-one);
218.28 	(xvi) dehydrochloromethyltestosterone 
218.29 	(4-chloro-17[beta]-hydroxy-17[alpha]-methylandrost-1,4-dien-3-one);
219.1 	(xvii) desoxymethyltestosterone (17[alpha]-methyl-5[alpha]-androst-2-en-17[beta]-ol);
219.2 	(xviii) [delta]1-dihydrotestosterone- (17[beta]-hydroxy-5[alpha]-androst-1-en-3-one);
219.3 	(xix) 4-dihydrotestosterone (17[beta]-hydroxy-androstan-3-one);
219.4 	(xx) drostanolone (17[beta]hydroxy-2[alpha]-methyl-5[alpha]-androstan-3-one);
219.5 	(xxi) ethylestrenol (17[alpha]-ethyl-17[beta]-hydroxyestr-4-ene);
219.6 	(xxii) fluoxymesterone 
219.7 	(9-fluoro-17[alpha]-methyl-11[beta],17[beta]-dihydroxyandrost-4-en-3-one);
219.8 	(xxiii) formebolone 
219.9 	(2-formyl-17[alpha]-methyl-11[alpha],17[beta]-dihydroxyandrost-1,4-dien-3-one);
219.10 	(xxiv) furazabol 
219.11 	(17[alpha]-methyl-17[beta]-hydroxyandrostano[2,3-c]-furazan)13[beta]-ethyl-17[beta] 
219.12 	-hydroxygon-4-en-3-one;
219.13 	(xxv) 4-hydroxytestosterone (4,17[beta]-dihydroxyandrost-4-en-3-one);
219.14 	(xxvi) 4-hydroxy-19-nortestosterone (4,17[beta]-dihydroxyestr-4-en-3-one);
219.15 	(xxvii) mestanolone (17[alpha]-methyl-17[beta]-hydroxy-5[alpha]-androstan-3-one);
219.16 	(xxviii) mesterolone (1[alpha]-methyl-17[beta]-hydroxy-5[alpha]-androstan-3-one);
219.17 	(xxix) methandienone (17[alpha]-methyl-17[beta]-hydroxyandrost-1,4-dien-3-one);
219.18 	(xxx) methandriol (17[alpha]-methyl-3[beta],17[beta]-dihydroxyandrost-5-ene);
219.19 	(xxxi) methasterone (2 alpha-17 alpha-dimethyl-5 alpha-androstan-17beta-ol-3-one);
219.20 	(xxxii) methenolone (1-methyl-17[beta]-hydroxy-5[alpha]-androst-1-en-3-one);
219.21 	(xxxiii) 17[alpha]-methyl-3[beta],17[beta]-dihydroxy-5[alpha]-androstane;
219.22 	(xxxiv) 17[alpha]-methyl-3[alpha],17[beta]-dihydroxy-5[alpha]-androstane;
219.23 	(xxxv) 17[alpha]-methyl-3[beta],17[beta]-dihydroxyandrost-4-ene;
219.24 	(xxxvi) 17[alpha]-methyl-4-hydroxynandrolone 
219.25 	(17[alpha]-methyl-4-hydroxy-17[beta]-hydroxyestr-4-en-3-one);
219.26 	(xxxvii) methyldienolone (17[alpha]-methyl-17[beta]-hydroxyestra-4,9(10)-dien-3-one);
219.27 	(xxxviii) methyltrienolone (17[alpha]-methyl-17[beta]-hydroxyestra-4,9-11-trien-3-one);
219.28 	(xxxix) methyltestosterone (17[alpha]-methyl-17[beta]-hydroxyandrost-4-en-3-one);
220.1 	(xl) mibolerone (7[alpha],17[alpha]-dimethyl-17[beta]-hydroxyestr-4-en-3-one);
220.2 	(xli) 17[alpha]-methyl-[delta]1-dihydrotestosterone 
220.3 	(17[beta]-hydroxy-17[alpha]-methyl-5[alpha]-androst-1-en-3-one);
220.4 	(xlii) nandrolone (17[beta]-hydroxyestr-4-en-3-one);
220.5 	(xliii) 19-nor-4-androstenediol (3[beta],17[beta]-dihydroxyestr-4-ene;
220.6 	(xliv) 3[alpha],17[beta]-dihydroxyestr-4-ene); 19-nor-5-androstenediol 
220.7 	(3[beta],17[beta]-dihydroxyestr-5-ene;
220.8 	(xlv) 3[alpha],17[beta]-dihydroxyestr-5-ene);
220.9 	(xlvi) 19-nor-4,9(10)-androstadienedione (estra-4,9(10)-diene-3,17-dione);
220.10 	(xlvii) 19-nor-5-androstenedione (estr-5-en-3,17-dione);
220.11 	(xlviii) norbolethone (13[beta],17[alpha]-diethyl-17[beta]-hydroxygon-4-en-3-one);
220.12 	(xlix) norclostebol (4-chloro-17[beta]-hydroxyestr-4-en-3-one);
220.13 	(l) norethandrolone (17[alpha]-ethyl-17[beta]-hydroxyestr-4-en-3-one);
220.14 	(li) normethandrolone (17[alpha]-methyl-17[beta]-hydroxyestr-4-en-3-one);
220.15 	(lii) oxandrolone (17[alpha]-methyl-17[beta]-hydroxy-2-oxa-5[alpha]-androstan-3-one);
220.16 	(liii) oxymesterone (17[alpha]-methyl-4,17[beta]-dihydroxyandrost-4-en-3-one);
220.17 	(liv) oxymetholone 
220.18 	(17[alpha]-methyl-2-hydroxymethylene-17[beta]-hydroxy-5[alpha]-androstan-3-one);
220.19 	(lv) prostanozol (17 beta-hydroxy-5 alpha-androstano[3,2-C]pryazole;
220.20 	(lvi) stanozolol 
220.21 	(17[alpha]-methyl-17[beta]-hydroxy-5[alpha]-androst-2-eno[3,2-c]-pyrazole);
220.22 	(lvii) stenbolone (17[beta]-hydroxy-2-methyl-5[alpha]-androst-1-en-3-one);
220.23 	(lviii) testolactone (13-hydroxy-3-oxo-13,17-secoandrosta-1,4-dien-17-oic acid lactone);
220.24 	(lix) testosterone (17[beta]-hydroxyandrost-4-en-3-one);
220.25 	(lx) tetrahydrogestrinone 
220.26 	(13[beta],17[alpha]-diethyl-17[beta]-hydroxygon-4,9,11-trien-3-one);
220.27 	(lxi) trenbolone (17[beta]-hydroxyestr-4,9,11-trien-3-one);
220.28 	(lxii) any salt, ester, or ether of a drug or substance described in this paragraph.
221.1 	Anabolic steroids are not included if they are: (A) expressly intended for administration 
221.2 	through implants to cattle or other nonhuman species; and (B) approved by the United States 
221.3 	Food and Drug Administration for that use;
221.4 	(2) Human growth hormones.
221.5 	(3) Chorionic gonadotropin, except that a product containing chorionic gonadotropin is 
221.6 	not included if it is:
221.7 	(i) expressly intended for administration to cattle or other nonhuman species; and
221.8 	(ii) approved by the United States Food and Drug Administration for that use.
221.9 	(g) Hallucinogenic substances. Dronabinol (synthetic) in sesame oil and encapsulated 
221.10 	in a soft gelatin capsule in a United States Food and Drug Administration approved product.
221.11 	(h) Any material, compound, mixture, or preparation containing the following narcotic 
221.12 	drug or its salt: buprenorphine.

APPENDIX 

Repealed Minnesota Statutes: S0013-3 

62U.15 ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING MEASURES.Subd. 2.Learning collaborative. 
By July 1, 2012, the commissioner shall develop a health care home learning collaborative curriculum that includes screening and education on best practices regarding identification and management of Alzheimer's and other dementia patients under section 256B.0751, subdivision 5, for providers, clinics, care coordinators, clinic administrators, patient partners and families, and community resources including public health. 

144.121 X-RAY MACHINES; OTHER SOURCES OF IONIZING RADIATION.Subd. 3.Exemption. 
Notwithstanding rules adopted by the commissioner under section 144.12, subdivision 1, clause (15), practitioners of veterinary medicine are not required to conduct densitometry and sensitometry tests as part of any ionizing radiation quality assurance program. 

Subd. 5b.Variance of scope of practice. 
The commissioner may grant a variance according to Minnesota Rules, parts 4717.7000 to 4717.7050, to a facility for the scope of practice of an x-ray operator in cases where the delivery of health care would otherwise be compromised if a variance were not granted. The request for a variance must be in writing, state the circumstances that constitute hardship, state the period of time the facility wishes to have the variance for the scope of practice in place, and state the alternative measures that will be taken if the variance is granted. The commissioner shall set forth in writing the reasons for granting or denying the variance. Variances granted by the commissioner must specify in writing the time limitation and required alternative measures to be taken by the facility. A request for the variance shall be denied if the commissioner finds the circumstances stated by the facility do not support a claim of hardship, the requested time period for the variance is unreasonable, the alternative measures proposed by the facility are not equivalent to the scope of practice, or the request for the variance is not submitted to the commissioner in a timely manner. 

147A.01 DEFINITIONS.Subd. 4.Agreement. 
"Agreement" means the document described in section 147A.20. 

Subd. 11.Drug category. 
"Drug category" means one of the categories listed on the physician-physician assistant delegation agreement. 

Subd. 16a.Notice of intent to practice. 
"Notice of intent to practice" means a document sent to the board by a licensed physician assistant that documents the adoption of a physician-physician assistant delegation agreement and provides the names, addresses, and information required by section 147A.20. 

Subd. 17a.Physician-physician assistant delegation agreement. 
"Physician-physician assistant delegation agreement" means the document prepared and signed by the physician and physician assistant affirming the supervisory relationship and defining the physician assistant scope of practice. The physician-physician assistant delegation agreement outlines the role of the physician assistant in the practice, describes the means of supervision, and specifies the categories of drugs, controlled substances, and medical devices that the supervising physician delegates to the physician assistant to prescribe. The physician-physician assistant delegation agreement must comply with the requirements of section 147A.20, be kept on file at the address of record, and be made available to the board or its representative upon request. 

Subd. 24.Supervision. 
"Supervision" means overseeing the activities of, and accepting responsibility for, the medical services rendered by a physician assistant. The constant physical presence of the supervising physician is not required so long as the supervising physician and physician assistant are or can be easily in contact with one another by radio, telephone, or other telecommunication device. The scope and nature of the supervision shall be defined by the individual physician-physician assistant delegation agreement. 

Subd. 25.Temporary license. 
"Temporary license" means a license granted to a physician assistant who meets all of the qualifications for licensure but has not yet been approved for licensure at a meeting of the board. 

147A.04 TEMPORARY LICENSE.
The board may issue a temporary license to practice to a physician assistant eligible for licensure under this chapter only if the application for licensure is complete, all requirements have been met, and a nonrefundable fee set by the board has been paid. The temporary license remains valid only until the next meeting of the board at which a decision is made on the application for licensure. 

147A.10 SATELLITE SETTINGS.
Physician assistants may render services in a setting geographically remote from the supervising physician. 

147A.11 EXCLUSIONS OF LIMITATIONS ON EMPLOYMENT.
Nothing in this chapter shall be construed to limit the employment arrangement of a physician assistant licensed under this chapter. 

147A.18 DELEGATED AUTHORITY TO PRESCRIBE, DISPENSE, AND ADMINISTER DRUGS AND MEDICAL DEVICES.Subdivision 1.Delegation. 
(a) A supervising physician may delegate to a physician assistant who is licensed by the board, certified by the National Commission on Certification of Physician Assistants or successor agency approved by the board, and who is under the supervising physician's supervision, the authority to prescribe, dispense, and administer legend drugs, controlled substances, and medical devices subject to the requirements in this section. The authority to dispense includes, but is not limited to, the authority to request, receive, and dispense sample drugs. This authority to dispense extends only to those drugs described in the written agreement developed under paragraph (b). 

(b) The delegation agreement between the physician assistant and supervising physician must include a statement by the supervising physician regarding delegation or nondelegation of the functions of prescribing, dispensing, and administering legend drugs, controlled substances, and medical devices to the physician assistant. The statement must include categories of drugs for which the supervising physician delegates prescriptive and dispensing authority, including controlled substances when applicable. The delegation must be appropriate to the physician assistant's practice and within the scope of the physician assistant's training. Physician assistants who have been delegated the authority to prescribe, dispense, and administer legend drugs, controlled substances, and medical devices shall provide evidence of current certification by the National Commission on Certification of Physician Assistants or its successor agency when applying for licensure or license renewal as physician assistants. Physician assistants who have been delegated the authority to prescribe controlled substances must also hold a valid DEA registration. Supervising physicians shall retrospectively review the prescribing, dispensing, and administering of legend drugs, controlled substances, and medical devices by physician assistants, when this authority has been delegated to the physician assistant as part of the physician-physician assistant delegation agreement. The process and schedule for the review must be outlined in the physician-physician assistant delegation agreement. 

(c) The board may establish by rule: 

(1) a system of identifying physician assistants eligible to prescribe, administer, and dispense legend drugs and medical devices; 

(2) a system of identifying physician assistants eligible to prescribe, administer, and dispense controlled substances; 

(3) a method of determining the categories of legend drugs, controlled substances, and medical devices that each physician assistant is allowed to prescribe, administer, and dispense; and 

(4) a system of transmitting to pharmacies a listing of physician assistants eligible to prescribe legend drugs, controlled substances, and medical devices. 

Subd. 2.Termination and reinstatement of prescribing authority. 
 The authority of a physician assistant to prescribe, dispense, and administer legend drugs, controlled substances, and medical devices shall end immediately when: 

(1) the physician-physician assistant delegation agreement is terminated; 

(2) the authority to prescribe, dispense, and administer is terminated or withdrawn by the supervising physician; 

(3) the physician assistant's license is placed on inactive status; 

(4) the physician assistant loses National Commission on Certification of Physician Assistants or successor agency certification; or 

(5) the physician assistant loses or terminates licensure status. 

Subd. 3.Other requirements and restrictions. 
(a) Each prescription initiated by a physician assistant shall indicate the following: 

(1) the date of issue; 

(2) the name and address of the patient; 

(3) the name and quantity of the drug prescribed; 

(4) directions for use; and 

(5) the name and address of the prescribing physician assistant. 

(b) In prescribing, dispensing, and administering legend drugs, controlled substances, and medical devices, a physician assistant must conform with the agreement, chapter 151, and this chapter. 

147A.20 PHYSICIAN-PHYSICIAN ASSISTANT AGREEMENT DOCUMENTS.Subdivision 1.Physician-physician assistant delegation agreement. 
(a) A physician assistant and supervising physician must sign a physician-physician assistant delegation agreement which specifies scope of practice and manner of supervision as required by the board. The agreement must contain: 

(1) a description of the practice setting; 

(2) a listing of categories of delegated duties; 

(3) a description of supervision type; and 

(4) a description of the process and schedule for review of prescribing, dispensing, and administering legend and controlled drugs and medical devices by the physician assistant authorized to prescribe. 

(b) The agreement must be maintained by the supervising physician and physician assistant and made available to the board upon request. If there is a delegation of prescribing, administering, and dispensing of legend drugs, controlled substances, and medical devices, the agreement shall include a description of the prescriptive authority delegated to the physician assistant. Physician assistants shall have a separate agreement for each place of employment. Agreements must be reviewed and updated on an annual basis. The supervising physician and physician assistant must maintain the physician-physician assistant delegation agreement at the address of record. 

(c) Physician assistants must provide written notification to the board within 30 days of the following: 

(1) name change; 

(2) address of record change; and 

(3) telephone number of record change. 

Subd. 2. Practice location notification. 
A licensed physician assistant shall submit a practice location notification to the board within 30 business days of starting practice, changing practice location, or changing supervising physician. The notification shall include the name, business address, and telephone number of the supervising physician and the physician assistant. Individuals who practice without submitting a practice location notification shall be subject to disciplinary action under section 147A.13 for practicing without a license, unless the care is provided in response to a disaster or emergency situation pursuant to section 147A.23. 

256B.057 ELIGIBILITY REQUIREMENTS FOR SPECIAL CATEGORIES.Subd. 8.Children under age two. 
Medical assistance may be paid for a child under two years of age whose countable household income is above 275 percent of the federal poverty guidelines for the same household size but less than or equal to 280 percent of the federal poverty guidelines for the same household size or an equivalent standard when converted using modified adjusted gross income methodology as required under the Affordable Care Act. 

256B.0752 HEALTH CARE HOME REPORTING REQUIREMENTS.Subdivision 1.Annual reports on implementation and administration. 
The commissioners shall report annually to the legislature on the implementation and administration of the health care home model for state health care program enrollees in the fee-for-service, managed care, and county-based purchasing sectors beginning December 15, 2009, and each December 15 thereafter. 

Subd. 2.Evaluation reports. 
The commissioners shall provide to the legislature comprehensive evaluations of the health care home model three years and five years after implementation. The report must include: 

(1) the number of state health care program enrollees in health care homes and the number and characteristics of enrollees with complex or chronic conditions, identified by income, race, ethnicity, and language; 

(2) the number and geographic distribution of health care home providers; 

(3) the performance and quality of care of health care homes; 

(4) measures of preventive care; 

(5) health care home payment arrangements, and costs related to implementation and payment of care coordination fees; 

(6) the estimated impact of health care homes on health disparities; and 

(7) estimated savings from implementation of the health care home model for the fee-for-service, managed care, and county-based purchasing sectors. 

256L.04 ELIGIBLE PERSONS.Subd. 13.Families with relative caretakers, foster parents, or legal guardians. 
Beginning January 1, 1999, in families that include a relative caretaker as defined in the medical assistance program, foster parent, or legal guardian, the relative caretaker, foster parent, or legal guardian may apply as a family or may apply separately for the children. If the caretaker applies separately for the children, only the children's income is counted and the provisions of subdivision 1, paragraph (b), do not apply. If the relative caretaker, foster parent, or legal guardian applies with the children, their income is included in the gross family income for determining eligibility and premium amount. 

7380.0280
[Repealed, L 2020 c 115 art 1 s 17] 

9505.0365PROSTHETIC AND ORTHOTIC DEVICES. Subp. 3.
[Repealed, L 2020 c 115 art 4 s 140] 

Prior authorization of an ambulatory aid is required for an aid that costs in excess of the limits specified in the provider's performance agreement.