1.1 	A bill for an act
1.2 	relating to health care; modifying coverage for health care services and consultation 
1.3 	provided through telehealth;amending Minnesota Statutes 2020, sections 147.033; 
1.4 	151.37, subdivision 2; 245G.01, subdivisions 13, 26; 245G.06, subdivision 1; 
1.5 	254A.19, subdivision 5; 254B.05, subdivision 5; 256B.0596; 256B.0625, 
1.6 	subdivisions 3b, 13h, 20, 20b, 46, by adding a subdivision; 256B.0924, subdivisions 
1.7 	4a, 6; 256B.094, subdivision 6; proposing coding for new law in Minnesota Statutes, 
1.8 	chapter 62A; repealing Minnesota Statutes 2020, sections 62A.67; 62A.671; 
1.9 	62A.672.
1.10 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.11 	Section 1. [62A.673] COVERAGE OF SERVICES PROVIDED THROUGH 
1.12 	TELEHEALTH.
1.13 		Subdivision 1.Citation. This section may be cited as the "Minnesota Telehealth Act."
1.14 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
1.15 	have the meanings given.
1.16 	(b) "Distant site" means a site at which a health care provider is located while providing 
1.17 	health care services or consultations by means of telehealth.
1.18 	(c) "Health care provider" means a health care professional who is licensed or registered 
1.19 	by the state to perform health care services within the provider's scope of practice and in 
1.20 	accordance with state law. A health care provider includes a mental health professional as 
1.21 	defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; and a mental 
1.22 	health practitioner as defined under section 245.462, subdivision 17, or 245.4871, subdivision 
1.23 	26.
1.24 	(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
2.1 	(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan 
2.2 	includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental 
2.3 	plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed 
2.4 	to pay benefits directly to the policy holder.
2.5 	(f) "Originating site" means a site at which a patient is located at the time health care 
2.6 	services are provided to the patient by means of telehealth. For purposes of store-and-forward 
2.7 	transfer, the originating site also means the location at which a health care provider transfers 
2.8 	or transmits information to the distant site.
2.9 	(g) "Store-and-forward transfer" means the asynchronous electronic transfer of a patient's 
2.10 	medical information or data from an originating site to a distant site for the purposes of 
2.11 	diagnostic and therapeutic assistance in the care of a patient.
2.12 	(h) "Telehealth" means the delivery of health care services or consultations through the 
2.13 	use of real time two-way interactive audio and visual or audio-only communications to 
2.14 	provide or support health care delivery and facilitate the assessment, diagnosis, consultation, 
2.15 	treatment, education, and care management of a patient's health care. Telehealth includes 
2.16 	the application of secure video conferencing, store-and-forward transfers, and synchronous 
2.17 	interactions between a patient located at an originating site and a health care provider located 
2.18 	at a distant site. Telehealth includes audio-only communication between a health care 
2.19 	provider and a patient if the communication is a scheduled appointment and the standard 
2.20 	of care for the service can be met through the use of audio-only communication. Telehealth 
2.21 	does not include communication between health care providers or between a health care 
2.22 	provider and a patient that consists solely of an e-mail or facsimile transmission. Telehealth 
2.23 	does not include communication between health care providers that consists solely of a 
2.24 	telephone conversation subject to the health care provider network available to the enrollee 
2.25 	through the enrollee's health plan.
2.26 	(i) "Telemonitoring services" means the remote monitoring of clinical data related to 
2.27 	the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits 
2.28 	the data electronically to a health care provider for analysis. Telemonitoring is intended to 
2.29 	collect an enrollee's health-related data for the purpose of assisting a health care provider 
2.30 	in assessing and monitoring the enrollee's medical condition or status.
2.31 		Subd. 3.Coverage of telehealth. (a) A health plan sold, issued, or renewed by a health 
2.32 	carrier in Minnesota must (1) cover benefits delivered through telehealth in the same manner 
2.33 	as any other benefits covered under the health plan, and (2) comply with this section.
3.1 	(b) Coverage for services delivered through telehealth must not be limited on the basis 
3.2 	of geography, location, or distance for travel.
3.3 	(c) A health carrier must not create a separate provider network or provide incentives 
3.4 	to enrollees to use a separate provider network to deliver services through telehealth that 
3.5 	does not include network providers who provide in-person care to patients for the same 
3.6 	service.
3.7 	(d) A health carrier may require a deductible, co-payment, or coinsurance payment for 
3.8 	a health care service provided through telehealth, provided that the deductible, co-payment, 
3.9 	or coinsurance payment is not in addition to, and does not exceed, the deductible, co-payment, 
3.10 	or coinsurance applicable for the same service provided through in-person contact.
3.11 	(e) Nothing in this section:
3.12 	(1) requires a health carrier to provide coverage for services that are not medically 
3.13 	necessary or are not covered under the enrollee's health plan; or
3.14 	(2) prohibits a health carrier from:
3.15 	(i) establishing criteria that a health care provider must meet to demonstrate the safety 
3.16 	or efficacy of delivering a particular service through telehealth for which the health carrier 
3.17 	does not already reimburse other health care providers for delivering the service through 
3.18 	telehealth; or
3.19 	(ii) establishing reasonable medical management techniques, provided the criteria or 
3.20 	techniques are not unduly burdensome or unreasonable for the particular service; or
3.21 	(iii) requiring documentation or billing practices designed to protect the health carrier 
3.22 	or patient from fraudulent claims, provided the practices are not unduly burdensome or 
3.23 	unreasonable for the particular service.
3.24 	(f) Nothing in this section requires the use of telehealth when a health care provider 
3.25 	determines that the delivery of a health care service through telehealth is not appropriate or 
3.26 	when an enrollee chooses not to receive a health care service through telehealth.
3.27 		Subd. 4.Parity between telehealth and in-person services. (a) A health carrier must 
3.28 	not restrict or deny coverage of a health care service that is covered under a health plan 
3.29 	solely:
3.30 	(1) because the health care service provided by the health care provider through telehealth 
3.31 	is not provided through in-person contact; or
4.1 	(2) based on the communication technology or application used to deliver the health 
4.2 	care service through telehealth, provided the technology or application complies with this 
4.3 	section and is appropriate for the particular service.
4.4 	(b) Prior authorization may be required for health care services delivered through 
4.5 	telehealth only if prior authorization is required before the delivery of the same service 
4.6 	through in-person contact.
4.7 	(c) A health carrier may require a utilization review for services delivered through 
4.8 	telehealth, provided the utilization review is conducted in the same manner and uses the 
4.9 	same clinical review criteria as a utilization review for the same services delivered through 
4.10 	in-person contact.
4.11 		Subd. 5.Reimbursement for services delivered through telehealth. (a) A health carrier 
4.12 	must reimburse the health care provider for services delivered through telehealth on the 
4.13 	same basis and at the same rate as the health carrier would apply to those services if the 
4.14 	services had been delivered by the health care provider through in-person contact.
4.15 	(b) A health carrier must not deny or limit reimbursement based solely on a health care 
4.16 	provider delivering the service or consultation through telehealth instead of through in-person 
4.17 	contact.
4.18 	(c) A health carrier must not deny or limit reimbursement based solely on the technology 
4.19 	and equipment used by the health care provider to deliver the health care service or 
4.20 	consultation through telehealth, provided the technology and equipment used by the provider 
4.21 	meets the requirements of this section and is appropriate for the particular service.
4.22 		Subd. 6.Telehealth equipment. (a) A health carrier must not require a health care 
4.23 	provider to use specific telecommunications technology and equipment as a condition of 
4.24 	coverage under this section, provided the health care provider uses telecommunications 
4.25 	technology and equipment that complies with current industry interoperable standards and  
4.26 	complies with standards required under the federal Health Insurance Portability and 
4.27 	Accountability Act of 1996, Public Law 104-191, and regulations promulgated under that 
4.28 	Act, unless authorized under this section.
4.29 	(b) A health carrier must provide coverage for health care services delivered through 
4.30 	telehealth by means of the use of audio-only telephone communication if the communication 
4.31 	is a scheduled appointment and the standard of care for that particular service can be met 
4.32 	through the use of audio-only communication.
5.1 		Subd. 7.Telemonitoring services. A health carrier must provide coverage for 
5.2 	telemonitoring services if:
5.3 	(1) the telemonitoring service is medically appropriate based on the enrollee's medical 
5.4 	condition or status;
5.5 	(2) the enrollee is cognitively and physically capable of operating the monitoring device 
5.6 	or equipment, or the enrollee has a caregiver who is willing and able to assist with the 
5.7 	monitoring device or equipment; and
5.8 	(3) the enrollee resides in a setting that is suitable for telemonitoring and not in a setting 
5.9 	that has health care staff on site.

5.10 	Sec. 2. Minnesota Statutes 2020, section 147.033, is amended to read:
5.11 	147.033 PRACTICE OF TELEMEDICINE TELEHEALTH.
5.12 		Subdivision 1.Definition. For the purposes of this section, "telemedicine" means the 
5.13 	delivery of health care services or consultations while the patient is at an originating site 
5.14 	and the licensed health care provider is at a distant site. A communication between licensed 
5.15 	health care providers that consists solely of a telephone conversation, e-mail, or facsimile 
5.16 	transmission does not constitute telemedicine consultations or services. A communication 
5.17 	between a licensed health care provider and a patient that consists solely of an e-mail or 
5.18 	facsimile transmission does not constitute telemedicine consultations or services. 
5.19 	Telemedicine may be provided by means of real-time two-way interactive audio, and visual 
5.20 	communications, including the application of secure video conferencing or store-and-forward 
5.21 	technology to provide or support health care delivery, that facilitate the assessment, diagnosis, 
5.22 	consultation, treatment, education, and care management of a patient's health care.
5.23 	"telehealth" has the meaning given in section 62A.673, subdivision 2, paragraph (h).
5.24 		Subd. 2.Physician-patient relationship. A physician-patient relationship may be 
5.25 	established through telemedicine telehealth.
5.26 		Subd. 3.Standards of practice and conduct. A physician providing health care services 
5.27 	by telemedicine telehealth in this state shall be held to the same standards of practice and 
5.28 	conduct as provided in this chapter for in-person health care services.

5.29 	Sec. 3. Minnesota Statutes 2020, section 151.37, subdivision 2, is amended to read:
5.30 		Subd. 2.Prescribing and filing. (a) A licensed practitioner in the course of professional 
5.31 	practice only, may prescribe, administer, and dispense a legend drug, and may cause the 
5.32 	same to be administered by a nurse, a physician assistant, or medical student or resident 
6.1 	under the practitioner's direction and supervision, and may cause a person who is an 
6.2 	appropriately certified, registered, or licensed health care professional to prescribe, dispense, 
6.3 	and administer the same within the expressed legal scope of the person's practice as defined 
6.4 	in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, without reference 
6.5 	to a specific patient, by directing a licensed dietitian or licensed nutritionist, pursuant to 
6.6 	section 148.634; a nurse, pursuant to section 148.235, subdivisions 8 and 9; physician 
6.7 	assistant; medical student or resident; or pharmacist according to section 151.01, subdivision 
6.8 	27, to adhere to a particular practice guideline or protocol when treating patients whose 
6.9 	condition falls within such guideline or protocol, and when such guideline or protocol 
6.10 	specifies the circumstances under which the legend drug is to be prescribed and administered. 
6.11 	An individual who verbally, electronically, or otherwise transmits a written, oral, or electronic 
6.12 	order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug. 
6.13 	This paragraph applies to a physician assistant only if the physician assistant meets the 
6.14 	requirements of section 147A.18 sections 147A.02 and 147A.09.
6.15 	(b) The commissioner of health, if a licensed practitioner, or a person designated by the 
6.16 	commissioner who is a licensed practitioner, may prescribe a legend drug to an individual 
6.17 	or by protocol for mass dispensing purposes where the commissioner finds that the conditions 
6.18 	triggering section 144.4197 or 144.4198, subdivision 2, paragraph (b), exist. The 
6.19 	commissioner, if a licensed practitioner, or a designated licensed practitioner, may prescribe, 
6.20 	dispense, or administer a legend drug or other substance listed in subdivision 10 to control 
6.21 	tuberculosis and other communicable diseases. The commissioner may modify state drug 
6.22 	labeling requirements, and medical screening criteria and documentation, where time is 
6.23 	critical and limited labeling and screening are most likely to ensure legend drugs reach the 
6.24 	maximum number of persons in a timely fashion so as to reduce morbidity and mortality.
6.25 	(c) A licensed practitioner that dispenses for profit a legend drug that is to be administered 
6.26 	orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must file with the 
6.27 	practitioner's licensing board a statement indicating that the practitioner dispenses legend 
6.28 	drugs for profit, the general circumstances under which the practitioner dispenses for profit, 
6.29 	and the types of legend drugs generally dispensed. It is unlawful to dispense legend drugs 
6.30 	for profit after July 31, 1990, unless the statement has been filed with the appropriate 
6.31 	licensing board. For purposes of this paragraph, "profit" means (1) any amount received by 
6.32 	the practitioner in excess of the acquisition cost of a legend drug for legend drugs that are 
6.33 	purchased in prepackaged form, or (2) any amount received by the practitioner in excess 
6.34 	of the acquisition cost of a legend drug plus the cost of making the drug available if the 
6.35 	legend drug requires compounding, packaging, or other treatment. The statement filed under 
7.1 	this paragraph is public data under section 13.03. This paragraph does not apply to a licensed 
7.2 	doctor of veterinary medicine or a registered pharmacist. Any person other than a licensed 
7.3 	practitioner with the authority to prescribe, dispense, and administer a legend drug under 
7.4 	paragraph (a) shall not dispense for profit. To dispense for profit does not include dispensing 
7.5 	by a community health clinic when the profit from dispensing is used to meet operating 
7.6 	expenses.
7.7 	(d) A prescription drug order for the following drugs is not valid, unless it can be 
7.8 	established that the prescription drug order was based on a documented patient evaluation, 
7.9 	including an examination, adequate to establish a diagnosis and identify underlying conditions 
7.10 	and contraindications to treatment:
7.11 	(1) controlled substance drugs listed in section 152.02, subdivisions 3 to 5;
7.12 	(2) drugs defined by the Board of Pharmacy as controlled substances under section 
7.13 	152.02, subdivisions 7, 8, and 12;
7.14 	(3) muscle relaxants;
7.15 	(4) centrally acting analgesics with opioid activity;
7.16 	(5) drugs containing butalbital; or
7.17 	(6) phosphodiesterase type 5 inhibitors when used to treat erectile dysfunction.
7.18 	For purposes of prescribing drugs listed in clause (6), the requirement for a documented 
7.19 	patient evaluation, including an examination, may be met through the use of telemedicine, 
7.20 	as defined in section 147.033, subdivision 1.
7.21 	(e) For the purposes of paragraph (d), the requirement for an examination shall be met 
7.22 	if:
7.23 	(1) an in-person examination has been completed in any of the following circumstances:
7.24 	(1) (i) the prescribing practitioner examines the patient at the time the prescription or 
7.25 	drug order is issued;
7.26 	(2) (ii) the prescribing practitioner has performed a prior examination of the patient;
7.27 	(3) (iii) another prescribing practitioner practicing within the same group or clinic as 
7.28 	the prescribing practitioner has examined the patient;
7.29 	(4) (iv) a consulting practitioner to whom the prescribing practitioner has referred the 
7.30 	patient has examined the patient; or
8.1 	(5) (v) the referring practitioner has performed an examination in the case of a consultant 
8.2 	practitioner issuing a prescription or drug order when providing services by means of 
8.3 	telemedicine.; or
8.4 	(2) the prescription order is for a drug listed in paragraph (d), clause (6), or for medication 
8.5 	assisted therapy for a substance use disorder, and the prescribing practitioner has completed 
8.6 	an examination of the patient via telehealth as defined in section 62A.673, subdivision 2, 
8.7 	paragraph (h).
8.8 	(f) Nothing in paragraph (d) or (e) prohibits a licensed practitioner from prescribing a 
8.9 	drug through the use of a guideline or protocol pursuant to paragraph (a).
8.10 	(g) Nothing in this chapter prohibits a licensed practitioner from issuing a prescription 
8.11 	or dispensing a legend drug in accordance with the Expedited Partner Therapy in the 
8.12 	Management of Sexually Transmitted Diseases guidance document issued by the United 
8.13 	States Centers for Disease Control.
8.14 	(h) Nothing in paragraph (d) or (e) limits prescription, administration, or dispensing of 
8.15 	legend drugs through a public health clinic or other distribution mechanism approved by 
8.16 	the commissioner of health or a community health board in order to prevent, mitigate, or 
8.17 	treat a pandemic illness, infectious disease outbreak, or intentional or accidental release of 
8.18 	a biological, chemical, or radiological agent.
8.19 	(i) No pharmacist employed by, under contract to, or working for a pharmacy located 
8.20 	within the state and licensed under section 151.19, subdivision 1, may dispense a legend 
8.21 	drug based on a prescription that the pharmacist knows, or would reasonably be expected 
8.22 	to know, is not valid under paragraph (d).
8.23 	(j) No pharmacist employed by, under contract to, or working for a pharmacy located 
8.24 	outside the state and licensed under section 151.19, subdivision 1, may dispense a legend 
8.25 	drug to a resident of this state based on a prescription that the pharmacist knows, or would 
8.26 	reasonably be expected to know, is not valid under paragraph (d).
8.27 	(k) Nothing in this chapter prohibits the commissioner of health, if a licensed practitioner, 
8.28 	or, if not a licensed practitioner, a designee of the commissioner who is a licensed 
8.29 	practitioner, from prescribing legend drugs for field-delivered therapy in the treatment of 
8.30 	a communicable disease according to the Centers For Disease Control and Prevention Partner 
8.31 	Services Guidelines.

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

9.1 	Sec. 4. Minnesota Statutes 2020, section 245G.01, subdivision 13, is amended to read:
9.2 		Subd. 13.Face-to-face. "Face-to-face" means two-way, real-time, interactive and visual
9.3 	communication between a client and a treatment service provider and includes services 
9.4 	delivered in person or via telemedicine telehealth with priority being given to interactive 
9.5 	audio and visual communication, if available.

9.6 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
9.7 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
9.8 	when federal approval is obtained.

9.9 	Sec. 5. Minnesota Statutes 2020, section 245G.01, subdivision 26, is amended to read:
9.10 		Subd. 26.Telemedicine Telehealth. "Telemedicine" "Telehealth" means the delivery 
9.11 	of a substance use disorder treatment service while the client is at an originating site and 
9.12 	the licensed health care provider is at a distant site via telehealth as defined in section 
9.13 	256B.0625, subdivision 3b, and as specified in section 254B.05, subdivision 5, paragraph 
9.14 	(f).

9.15 	Sec. 6. Minnesota Statutes 2020, section 245G.06, subdivision 1, is amended to read:
9.16 		Subdivision 1.General. Each client must have a person-centered individual treatment 
9.17 	plan developed by an alcohol and drug counselor within ten days from the day of service 
9.18 	initiation for a residential program and within five calendar days on which a treatment 
9.19 	session has been provided from the day of service initiation for a client in a nonresidential 
9.20 	program. Opioid treatment programs must complete the individual treatment plan within 
9.21 	21 days from the day of service initiation. The individual treatment plan must be signed by 
9.22 	the client and the alcohol and drug counselor and document the client's involvement in the 
9.23 	development of the plan. The individual treatment plan is developed upon the qualified staff 
9.24 	member's dated signature. Treatment planning must include ongoing assessment of client 
9.25 	needs. An individual treatment plan must be updated based on new information gathered 
9.26 	about the client's condition, the client's level of participation, and on whether methods 
9.27 	identified have the intended effect. A change to the plan must be signed by the client and 
9.28 	the alcohol and drug counselor. If the client chooses to have family or others involved in 
9.29 	treatment services, the client's individual treatment plan must include how the family or 
9.30 	others will be involved in the client's treatment. If a client is receiving treatment services 
9.31 	or an assessment via telehealth, the alcohol and drug counselor may document the client's 
9.32 	verbal approval of the treatment plan or change to the treatment plan in lieu of the client's 
9.33 	signature.

10.1 	Sec. 7. Minnesota Statutes 2020, section 254A.19, subdivision 5, is amended to read:
10.2 		Subd. 5.Assessment via telemedicine telehealth. Notwithstanding Minnesota Rules, 
10.3 	part 9530.6615, subpart 3, item A, a chemical use assessment may be conducted via 
10.4 	telemedicine telehealth as defined in section 256B.0625, subdivision 3b.

10.5 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
10.6 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
10.7 	when federal approval is obtained.

10.8 	Sec. 8. Minnesota Statutes 2020, section 254B.05, subdivision 5, is amended to read:
10.9 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for substance 
10.10 	use disorder services and service enhancements funded under this chapter.
10.11 	(b) Eligible substance use disorder treatment services include:
10.12 	(1) outpatient treatment services that are licensed according to sections 245G.01 to 
10.13 	245G.17, or applicable tribal license;
10.14 	(2) comprehensive assessments provided according to sections 245.4863, paragraph (a), 
10.15 	and 245G.05;
10.16 	(3) care coordination services provided according to section 245G.07, subdivision 1, 
10.17 	paragraph (a), clause (5);
10.18 	(4) peer recovery support services provided according to section 245G.07, subdivision 
10.19 	2, clause (8);
10.20 	(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management 
10.21 	services provided according to chapter 245F;
10.22 	(6) medication-assisted therapy services that are licensed according to sections 245G.01 
10.23 	to 245G.17 and 245G.22, or applicable tribal license;
10.24 	(7) medication-assisted therapy plus enhanced treatment services that meet the 
10.25 	requirements of clause (6) and provide nine hours of clinical services each week;
10.26 	(8) high, medium, and low intensity residential treatment services that are licensed 
10.27 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which 
10.28 	provide, respectively, 30, 15, and five hours of clinical services each week;
10.29 	(9) hospital-based treatment services that are licensed according to sections 245G.01 to 
10.30 	245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to 
10.31 	144.56;
11.1 	(10) adolescent treatment programs that are licensed as outpatient treatment programs 
11.2 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
11.3 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
11.4 	applicable tribal license;
11.5 	(11) high-intensity residential treatment services that are licensed according to sections 
11.6 	245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of 
11.7 	clinical services each week provided by a state-operated vendor or to clients who have been 
11.8 	civilly committed to the commissioner, present the most complex and difficult care needs, 
11.9 	and are a potential threat to the community; and
11.10 	(12) room and board facilities that meet the requirements of subdivision 1a.
11.11 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
11.12 	of paragraph (b) and one of the following additional requirements:
11.13 	(1) programs that serve parents with their children if the program:
11.14 	(i) provides on-site child care during the hours of treatment activity that:
11.15 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
11.16 	9503; or
11.17 	(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph 
11.18 	(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
11.19 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
11.20 	licensed under chapter 245A as:
11.21 	(A) a child care center under Minnesota Rules, chapter 9503; or
11.22 	(B) a family child care home under Minnesota Rules, chapter 9502;
11.23 	(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or 
11.24 	programs or subprograms serving special populations, if the program or subprogram meets 
11.25 	the following requirements:
11.26 	(i) is designed to address the unique needs of individuals who share a common language, 
11.27 	racial, ethnic, or social background;
11.28 	(ii) is governed with significant input from individuals of that specific background; and
11.29 	(iii) employs individuals to provide individual or group therapy, at least 50 percent of 
11.30 	whom are of that specific background, except when the common social background of the 
11.31 	individuals served is a traumatic brain injury or cognitive disability and the program employs 
12.1 	treatment staff who have the necessary professional training, as approved by the 
12.2 	commissioner, to serve clients with the specific disabilities that the program is designed to 
12.3 	serve;
12.4 	(3) programs that offer medical services delivered by appropriately credentialed health 
12.5 	care staff in an amount equal to two hours per client per week if the medical needs of the 
12.6 	client and the nature and provision of any medical services provided are documented in the 
12.7 	client file; and
12.8 	(4) programs that offer services to individuals with co-occurring mental health and 
12.9 	chemical dependency problems if:
12.10 	(i) the program meets the co-occurring requirements in section 245G.20;
12.11 	(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined 
12.12 	in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates 
12.13 	under the supervision of a licensed alcohol and drug counselor supervisor and licensed 
12.14 	mental health professional, except that no more than 50 percent of the mental health staff 
12.15 	may be students or licensing candidates with time documented to be directly related to 
12.16 	provisions of co-occurring services;
12.17 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
12.18 	health diagnostic assessment within ten days of admission;
12.19 	(iv) the program has standards for multidisciplinary case review that include a monthly 
12.20 	review for each client that, at a minimum, includes a licensed mental health professional 
12.21 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
12.22 	(v) family education is offered that addresses mental health and substance abuse disorders 
12.23 	and the interaction between the two; and
12.24 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
12.25 	training annually.
12.26 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
12.27 	that provides arrangements for off-site child care must maintain current documentation at 
12.28 	the chemical dependency facility of the child care provider's current licensure to provide 
12.29 	child care services. Programs that provide child care according to paragraph (c), clause (1), 
12.30 	must be deemed in compliance with the licensing requirements in section 245G.19.
12.31 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
12.32 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
12.33 	in paragraph (c), clause (4), items (i) to (iv).
13.1 	(f) Subject to federal approval, chemical dependency services that are otherwise covered 
13.2 	as direct face-to-face services may be provided via two-way interactive video telehealth as 
13.3 	defined in section 256B.0625, subdivision 3b. The use of two-way interactive video telehealth 
13.4 	to deliver services must be medically appropriate to the condition and needs of the person 
13.5 	being served. Reimbursement shall be at the same rates and under the same conditions that 
13.6 	would otherwise apply to direct face-to-face services. The interactive video equipment and 
13.7 	connection must comply with Medicare standards in effect at the time the service is provided.
13.8 	(g) For the purpose of reimbursement under this section, substance use disorder treatment 
13.9 	services provided in a group setting without a group participant maximum or maximum 
13.10 	client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one. 
13.11 	At least one of the attending staff must meet the qualifications as established under this 
13.12 	chapter for the type of treatment service provided. A recovery peer may not be included as 
13.13 	part of the staff ratio.

13.14 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
13.15 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
13.16 	when federal approval is obtained.

13.17 	Sec. 9. Minnesota Statutes 2020, section 256B.0596, is amended to read:
13.18 	256B.0596 MENTAL HEALTH CASE MANAGEMENT.
13.19 	Counties shall contract with eligible providers willing to provide mental health case 
13.20 	management services under section 256B.0625, subdivision 20. In order to be eligible, in 
13.21 	addition to general provider requirements under this chapter, the provider must:
13.22 	(1) be willing to provide the mental health case management services; and
13.23 	(2) have a minimum of at least one contact with the client per week, either in person or 
13.24 	through telehealth, and at least one face-to-face in-person contact with the client every six 
13.25 	months. This section is not intended to limit the ability of a county to provide its own mental 
13.26 	health case management services.

13.27 	Sec. 10. Minnesota Statutes 2020, section 256B.0625, subdivision 3b, is amended to read:
13.28 		Subd. 3b.Telemedicine Telehealth services. (a) Medical assistance covers medically 
13.29 	necessary services and consultations delivered by a licensed health care provider via 
13.30 	telemedicine through telehealth in the same manner as if the service or consultation was 
13.31 	delivered in person through in-person contact. Coverage is limited to three telemedicine 
13.32 	services per enrollee per calendar week, except as provided in paragraph (f). Telemedicine
14.1 	Services or consultations delivered through telehealth shall be paid at the full allowable 
14.2 	rate.
14.3 	(b) The commissioner shall may establish criteria that a health care provider must attest 
14.4 	to in order to demonstrate the safety or efficacy of delivering a particular service via 
14.5 	telemedicine through telehealth. The attestation may include that the health care provider:
14.6 	(1) has identified the categories or types of services the health care provider will provide 
14.7 	via telemedicine through telehealth;
14.8 	(2) has written policies and procedures specific to telemedicine services delivered through 
14.9 	telehealth that are regularly reviewed and updated;
14.10 	(3) has policies and procedures that adequately address patient safety before, during, 
14.11 	and after the telemedicine service is rendered delivered through telehealth;
14.12 	(4) has established protocols addressing how and when to discontinue telemedicine 
14.13 	services; and
14.14 	(5) has an established quality assurance process related to telemedicine delivering services
14.15 	through telehealth.
14.16 	(c) As a condition of payment, a licensed health care provider must document each 
14.17 	occurrence of a health service provided by telemedicine delivered through telehealth to a 
14.18 	medical assistance enrollee. Health care service records for services provided by telemedicine
14.19 	delivered through telehealth must meet the requirements set forth in Minnesota Rules, part 
14.20 	9505.2175, subparts 1 and 2, and must document:
14.21 	(1) the type of service provided by telemedicine delivered through telehealth;
14.22 	(2) the time the service began and the time the service ended, including an a.m. and p.m. 
14.23 	designation;
14.24 	(3) the licensed health care provider's basis for determining that telemedicine telehealth
14.25 	is an appropriate and effective means for delivering the service to the enrollee;
14.26 	(4) the mode of transmission of used to deliver the telemedicine service through telehealth 
14.27 	and records evidencing that a particular mode of transmission was utilized;
14.28 	(5) the location of the originating site and the distant site;
14.29 	(6) if the claim for payment is based on a physician's telemedicine consultation with 
14.30 	another physician through telehealth, the written opinion from the consulting physician 
14.31 	providing the telemedicine telehealth consultation; and
15.1 	(7) compliance with the criteria attested to by the health care provider in accordance 
15.2 	with paragraph (b).
15.3 	(d) For purposes of this subdivision, unless otherwise covered under this chapter, 
15.4 	"telemedicine" is defined as the delivery of health care services or consultations while the 
15.5 	patient is at an originating site and the licensed health care provider is at a distant site. A 
15.6 	communication between licensed health care providers, or a licensed health care provider 
15.7 	and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission 
15.8 	does not constitute telemedicine consultations or services. Telemedicine may be provided 
15.9 	by means of real-time two-way, interactive audio and visual communications, including the 
15.10 	application of secure video conferencing or store-and-forward technology to provide or 
15.11 	support health care delivery, which facilitate the assessment, diagnosis, consultation, 
15.12 	treatment, education, and care management of a patient's health care.:
15.13 	(1) "telehealth" means the delivery of health care services or consultations through the 
15.14 	use of real time two-way interactive audio and visual or audio-only communications to 
15.15 	provide or support health care delivery and facilitate the assessment, diagnosis, consultation, 
15.16 	treatment, education, and care management of a patient's health care. Telehealth includes 
15.17 	the application of secure video conferencing, store-and-forward transfers, and synchronous 
15.18 	interactions between a patient located at an originating site and a health care provider located 
15.19 	at a distant site. Unless interactive visual and audio communication is specifically required, 
15.20 	telehealth includes audio-only communication between a health care provider and a patient, 
15.21 	if the communication is a scheduled appointment with the health care provider and the 
15.22 	standard of care for the service can be met through the use of audio-only communication. 
15.23 	Telehealth does not include communication between health care providers or between a 
15.24 	health care provider and a patient that consists solely of an e-mail or facsimile transmission. 
15.25 	Telehealth does not include communication between health care providers that consists 
15.26 	solely of a telephone conversation;
15.27 	(e) For purposes of this section, "licensed(2) "health care provider" means a licensed
15.28 	health care provider under section 62A.671, subdivision 6 as defined under section 62A.673, 
15.29 	a community paramedic as defined under section 144E.001, subdivision 5f, or a mental 
15.30 	health practitioner defined under section 245.462, subdivision 17, or 245.4871, subdivision 
15.31 	26, working under the general supervision of a mental health professional, and a community 
15.32 	health worker who meets the criteria under subdivision 49, paragraph (a); "health care 
15.33 	provider" is defined under section 62A.671, subdivision 3;, a mental health certified peer 
15.34 	specialist under section 256B.0615, subdivision 5, a mental health certified family peer 
15.35 	specialist under section 256B.0616, subdivision 5, a mental health rehabilitation worker 
16.1 	under section 256B.0623, subdivision 5, paragraph (a), clause (4), and paragraph (b), a 
16.2 	mental health behavioral aide under section 256B.0943, subdivision 7, paragraph (b), clause 
16.3 	(3), a treatment coordinator under section 245G.11, subdivision 7, an alcohol and drug 
16.4 	counselor under section 245G.11, subdivision 5, a recovery peer under section 245G.11, 
16.5 	subdivision 8, and a mental health case manager under section 245.462, subdivision 4; and
16.6 	(3) "originating site" is defined under section 62A.671, subdivision 7, "distant site," and 
16.7 	"store-and-forward transfer" have the meanings given in section 62A.673, subdivision 2.
16.8 	(f) The limit on coverage of three telemedicine services per enrollee per calendar week 
16.9 	does not apply if:
16.10 	(1) the telemedicine services provided by the licensed health care provider are for the 
16.11 	treatment and control of tuberculosis; and
16.12 	(2) the services are provided in a manner consistent with the recommendations and best 
16.13 	practices specified by the Centers for Disease Control and Prevention and the commissioner 
16.14 	of health.

16.15 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
16.16 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
16.17 	when federal approval is obtained.

16.18 	Sec. 11. Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision 
16.19 	to read:
16.20 		Subd. 3h.Telemonitoring services. (a) Medical assistance covers telemonitoring services 
16.21 	if a recipient:
16.22 	(1) has been diagnosed and is receiving services for at least one of the following chronic 
16.23 	conditions: hypertension, cancer, congestive heart failure, chronic obstructive pulmonary 
16.24 	disease, asthma, or diabetes;
16.25 	(2) requires at least five times per week monitoring to manage the chronic condition, as 
16.26 	ordered by the recipient's health care provider;
16.27 	(3) has had two or more emergency room or inpatient hospitalization stays within the 
16.28 	last 12 months due to the chronic condition or the recipient's health care provider has 
16.29 	identified that telemonitoring services would likely prevent the recipient's admission or 
16.30 	readmission to a hospital, emergency room, or nursing facility;
17.1 	(4) is cognitively and physically capable of operating the monitoring device or equipment, 
17.2 	or the recipient has a caregiver who is willing and able to assist with the monitoring device 
17.3 	or equipment; and
17.4 	(5) resides in a setting that is suitable for telemonitoring and not in a setting that has 
17.5 	health care staff on site.
17.6 	(b) For purposes of this subdivision, "telemonitoring services" means the remote 
17.7 	monitoring of data related to a recipient's vital signs or biometric data by a monitoring 
17.8 	device or equipment that transmits the data electronically to a provider for analysis. The 
17.9 	assessment and monitoring of the health data transmitted by telemonitoring must be 
17.10 	performed by one of the following licensed health care professionals: physician, podiatrist, 
17.11 	registered nurse, advanced practice registered nurse, physician assistant, respiratory therapist, 
17.12 	or licensed professional working under the supervision of a medical director.

17.13 	Sec. 12. Minnesota Statutes 2020, section 256B.0625, subdivision 13h, is amended to 
17.14 	read:
17.15 		Subd. 13h.Medication therapy management services. (a) Medical assistance covers 
17.16 	medication therapy management services for a recipient taking prescriptions to treat or 
17.17 	prevent one or more chronic medical conditions. For purposes of this subdivision, 
17.18 	"medication therapy management" means the provision of the following pharmaceutical 
17.19 	care services by a licensed pharmacist to optimize the therapeutic outcomes of the patient's 
17.20 	medications:
17.21 	(1) performing or obtaining necessary assessments of the patient's health status;
17.22 	(2) formulating a medication treatment plan, which may include prescribing medications 
17.23 	or products in accordance with section 151.37, subdivision 14, 15, or 16;
17.24 	(3) monitoring and evaluating the patient's response to therapy, including safety and 
17.25 	effectiveness;
17.26 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
17.27 	medication-related problems, including adverse drug events;
17.28 	(5) documenting the care delivered and communicating essential information to the 
17.29 	patient's other primary care providers;
17.30 	(6) providing verbal education and training designed to enhance patient understanding 
17.31 	and appropriate use of the patient's medications;
18.1 	(7) providing information, support services, and resources designed to enhance patient 
18.2 	adherence with the patient's therapeutic regimens; and
18.3 	(8) coordinating and integrating medication therapy management services within the 
18.4 	broader health care management services being provided to the patient.
18.5 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
18.6 	the pharmacist as defined in section 151.01, subdivision 27.
18.7 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
18.8 	must meet the following requirements:
18.9 	(1) have a valid license issued by the Board of Pharmacy of the state in which the 
18.10 	medication therapy management service is being performed;
18.11 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
18.12 	completed a structured and comprehensive education program approved by the Board of 
18.13 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
18.14 	documentation of pharmaceutical care management services that has both clinical and 
18.15 	didactic elements; and
18.16 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
18.17 	have developed a structured patient care process that is offered in a private or semiprivate 
18.18 	patient care area that is separate from the commercial business that also occurs in the setting, 
18.19 	or in home settings, including long-term care settings, group homes, and facilities providing 
18.20 	assisted living services, but excluding skilled nursing facilities; and
18.21 	(4) (3) make use of an electronic patient record system that meets state standards.
18.22 	(c) For purposes of reimbursement for medication therapy management services, the 
18.23 	commissioner may enroll individual pharmacists as medical assistance providers. The 
18.24 	commissioner may also establish contact requirements between the pharmacist and recipient, 
18.25 	including limitinglimits on the number of reimbursable consultations per recipient.
18.26 	(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing 
18.27 	within a reasonable geographic distance of the patient, a pharmacist who meets the 
18.28 	requirements may provide The Medication therapy management services may be provided 
18.29 	via two-way interactive video telehealth as defined in subdivision 3b and may be delivered 
18.30 	into a patient's residence. Reimbursement shall be at the same rates and under the same 
18.31 	conditions that would otherwise apply to the services provided. To qualify for reimbursement 
18.32 	under this paragraph, the pharmacist providing the services must meet the requirements of 
18.33 	paragraph (b), and must be located within an ambulatory care setting that meets the 
19.1 	requirements of paragraph (b), clause (3). The patient must also be located within an 
19.2 	ambulatory care setting that meets the requirements of paragraph (b), clause (3). Services 
19.3 	provided under this paragraph may not be transmitted into the patient's residence.
19.4 	(e) Medication therapy management services may be delivered into a patient's residence 
19.5 	via secure interactive video if the medication therapy management services are performed 
19.6 	electronically during a covered home care visit by an enrolled provider. Reimbursement 
19.7 	shall be at the same rates and under the same conditions that would otherwise apply to the 
19.8 	services provided. To qualify for reimbursement under this paragraph, the pharmacist 
19.9 	providing the services must meet the requirements of paragraph (b) and must be located 
19.10 	within an ambulatory care setting that meets the requirements of paragraph (b), clause (3).

19.11 	Sec. 13. Minnesota Statutes 2020, section 256B.0625, subdivision 20, is amended to read:
19.12 		Subd. 20.Mental health case management. (a) To the extent authorized by rule of the 
19.13 	state agency, medical assistance covers case management services to persons with serious 
19.14 	and persistent mental illness and children with severe emotional disturbance. Services 
19.15 	provided under this section must meet the relevant standards in sections 245.461 to 245.4887, 
19.16 	the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts 
19.17 	9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
19.18 	(b) Entities meeting program standards set out in rules governing family community 
19.19 	support services as defined in section 245.4871, subdivision 17, are eligible for medical 
19.20 	assistance reimbursement for case management services for children with severe emotional 
19.21 	disturbance when these services meet the program standards in Minnesota Rules, parts 
19.22 	9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
19.23 	(c) Medical assistance and MinnesotaCare payment for mental health case management 
19.24 	shall be made on a monthly basis. In order to receive payment for an eligible child, the 
19.25 	provider must document at least a face-to-face in-person contact with the child, the child's 
19.26 	parents, or the child's legal representative. To receive payment for an eligible adult, the 
19.27 	provider must document:
19.28 	(1) at least a face-to-face in-person contact with the adult or the adult's legal representative 
19.29 	or a contact by interactive video telehealth that meets the requirements of subdivision 20b; 
19.30 	or
19.31 	(2) at least a telephone contact with the adult or the adult's legal representative and 
19.32 	document a face-to-face in-person contact or a contact by interactive video telehealth that 
20.1 	meets the requirements of subdivision 20b with the adult or the adult's legal representative 
20.2 	within the preceding two months.
20.3 	(d) Payment for mental health case management provided by county or state staff shall 
20.4 	be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph 
20.5 	(b), with separate rates calculated for child welfare and mental health, and within mental 
20.6 	health, separate rates for children and adults.
20.7 	(e) Payment for mental health case management provided by Indian health services or 
20.8 	by agencies operated by Indian tribes may be made according to this section or other relevant 
20.9 	federally approved rate setting methodology.
20.10 	(f) Payment for mental health case management provided by vendors who contract with 
20.11 	a county or Indian tribe shall be based on a monthly rate negotiated by the host county or 
20.12 	tribe. The negotiated rate must not exceed the rate charged by the vendor for the same 
20.13 	service to other payers. If the service is provided by a team of contracted vendors, the county 
20.14 	or tribe may negotiate a team rate with a vendor who is a member of the team. The team 
20.15 	shall determine how to distribute the rate among its members. No reimbursement received 
20.16 	by contracted vendors shall be returned to the county or tribe, except to reimburse the county 
20.17 	or tribe for advance funding provided by the county or tribe to the vendor.
20.18 	(g) If the service is provided by a team which includes contracted vendors, tribal staff, 
20.19 	and county or state staff, the costs for county or state staff participation in the team shall be 
20.20 	included in the rate for county-provided services. In this case, the contracted vendor, the 
20.21 	tribal agency, and the county may each receive separate payment for services provided by 
20.22 	each entity in the same month. In order to prevent duplication of services, each entity must 
20.23 	document, in the recipient's file, the need for team case management and a description of 
20.24 	the roles of the team members.
20.25 	(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
20.26 	mental health case management shall be provided by the recipient's county of responsibility, 
20.27 	as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
20.28 	used to match other federal funds. If the service is provided by a tribal agency, the nonfederal 
20.29 	share, if any, shall be provided by the recipient's tribe. When this service is paid by the state 
20.30 	without a federal share through fee-for-service, 50 percent of the cost shall be provided by 
20.31 	the recipient's county of responsibility.
20.32 	(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance 
20.33 	and MinnesotaCare include mental health case management. When the service is provided 
21.1 	through prepaid capitation, the nonfederal share is paid by the state and the county pays no 
21.2 	share.
21.3 	(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider 
21.4 	that does not meet the reporting or other requirements of this section. The county of 
21.5 	responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency, 
21.6 	is responsible for any federal disallowances. The county or tribe may share this responsibility 
21.7 	with its contracted vendors.
21.8 	(k) The commissioner shall set aside a portion of the federal funds earned for county 
21.9 	expenditures under this section to repay the special revenue maximization account under 
21.10 	section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
21.11 	(1) the costs of developing and implementing this section; and
21.12 	(2) programming the information systems.
21.13 	(l) Payments to counties and tribal agencies for case management expenditures under 
21.14 	this section shall only be made from federal earnings from services provided under this 
21.15 	section. When this service is paid by the state without a federal share through fee-for-service, 
21.16 	50 percent of the cost shall be provided by the state. Payments to county-contracted vendors 
21.17 	shall include the federal earnings, the state share, and the county share.
21.18 	(m) Case management services under this subdivision do not include therapy, treatment, 
21.19 	legal, or outreach services.
21.20 	(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
21.21 	and the recipient's institutional care is paid by medical assistance, payment for case 
21.22 	management services under this subdivision is limited to the lesser of:
21.23 	(1) the last 180 days of the recipient's residency in that facility and may not exceed more 
21.24 	than six months in a calendar year; or
21.25 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
21.26 	(o) Payment for case management services under this subdivision shall not duplicate 
21.27 	payments made under other program authorities for the same purpose.
21.28 	(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting 
21.29 	licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week, 
21.30 	mental health targeted case management services must actively support identification of 
21.31 	community alternatives for the recipient and discharge planning.

22.1 	Sec. 14. Minnesota Statutes 2020, section 256B.0625, subdivision 20b, is amended to 
22.2 	read:
22.3 		Subd. 20b.Mental health targeted case management through interactive video
22.4 	telehealth. (a) Subject to federal approval, contact made for targeted case management by 
22.5 	interactive video telehealth shall be eligible for payment if:
22.6 	(1) the person receiving targeted case management services is residing in:
22.7 	(i) a hospital;
22.8 	(ii) a nursing facility; or
22.9 	(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging 
22.10 	establishment or lodging establishment that provides supportive services or health supervision 
22.11 	services according to section 157.17 that is staffed 24 hours a day, seven days a week;
22.12 	(2) interactive video telehealth is in the best interests of the person and is deemed 
22.13 	appropriate by the person receiving targeted case management or the person's legal guardian, 
22.14 	the case management provider, and the provider operating the setting where the person is 
22.15 	residing;
22.16 	(3) the use of interactive video telehealth is approved as part of the person's written 
22.17 	personal service or case plan, taking into consideration the person's vulnerability and active 
22.18 	personal relationships; and
22.19 	(4) interactive video telehealth is used for up to, but not more than, 50 percent of the 
22.20 	minimum required face-to-face in-person contact.
22.21 	(b) The person receiving targeted case management or the person's legal guardian has 
22.22 	the right to choose and consent to the use of interactive video telehealth under this subdivision 
22.23 	and has the right to refuse the use of interactive video telehealth at any time.
22.24 	(c) The commissioner shall establish criteria that a targeted case management provider 
22.25 	must attest to in order to demonstrate the safety or efficacy of delivering the service via 
22.26 	interactive video telehealth. The attestation may include that the case management provider 
22.27 	has:
22.28 	(1) written policies and procedures specific to interactive video services delivered by 
22.29 	telehealth that are regularly reviewed and updated;
22.30 	(2) policies and procedures that adequately address client safety before, during, and after 
22.31 	the interactive video services are rendered by telehealth;
23.1 	(3) established protocols addressing how and when to discontinue interactive video
23.2 	services delivered by telehealth; and
23.3 	(4) established a quality assurance process related to interactive video services delivered 
23.4 	by telehealth.
23.5 	(d) As a condition of payment, the targeted case management provider must document 
23.6 	the following for each occurrence of targeted case management provided by interactive 
23.7 	video telehealth:
23.8 	(1) the time the service began and the time the service ended, including an a.m. and p.m. 
23.9 	designation;
23.10 	(2) the basis for determining that interactive video telehealth is an appropriate and 
23.11 	effective means for delivering the service to the person receiving case management services;
23.12 	(3) the mode of transmission of the interactive video services delivered by telehealth 
23.13 	and records evidencing that a particular mode of transmission was utilized;
23.14 	(4) the location of the originating site and the distant site; and
23.15 	(5) compliance with the criteria attested to by the targeted case management provider 
23.16 	as provided in paragraph (c).
23.17 	(e) For purposes of this section, telehealth is defined in accordance with section 
23.18 	256B.0625, subdivision 3b. The commissioner may limit the delivery of services by telehealth 
23.19 	to audio and visual communications if the commissioner determines that face-to-face 
23.20 	interaction is necessary to ensure that services are delivered appropriately and effectively.

23.21 	Sec. 15. Minnesota Statutes 2020, section 256B.0625, subdivision 46, is amended to read:
23.22 		Subd. 46.Mental health telemedicine telehealth. Effective January 1, 2006, and Subject 
23.23 	to federal approval, mental health services that are otherwise covered by medical assistance 
23.24 	as direct face-to-face services may be provided via two-way interactive video telehealth as 
23.25 	defined in subdivision 3b. Use of two-way interactive video telehealth to deliver services
23.26 	must be medically appropriate to the condition and needs of the person being served. 
23.27 	Reimbursement is at the same rates and under the same conditions that would otherwise 
23.28 	apply to the service. The interactive video equipment and connection must comply with 
23.29 	Medicare standards in effect at the time the service is provided.

23.30 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
23.31 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
23.32 	when federal approval is obtained.

24.1 	Sec. 16. Minnesota Statutes 2020, section 256B.0924, subdivision 4a, is amended to read:
24.2 		Subd. 4a.Targeted case management through interactive video. (a) Subject to federal 
24.3 	approval, contact made for targeted case management by interactive video shall be eligible 
24.4 	for payment under subdivision 6 if:
24.5 	(1) the person receiving targeted case management services is residing in:
24.6 	(i) a hospital;
24.7 	(ii) a nursing facility; or
24.8 	(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging 
24.9 	establishment or lodging establishment that provides supportive services or health supervision 
24.10 	services according to section 157.17 that is staffed 24 hours a day, seven days a week;
24.11 	(2) interactive video telehealth is in the best interests of the person and is deemed 
24.12 	appropriate by the person receiving targeted case management or the person's legal guardian, 
24.13 	the case management provider, and the provider operating the setting where the person is 
24.14 	residing;
24.15 	(3) the use of interactive video telehealth is approved as part of the person's written 
24.16 	personal service or case plan; and
24.17 	(4) interactive video telehealth is used for up to, but not more than, 50 percent of the 
24.18 	minimum required face-to-face in-person contact.
24.19 	(b) The person receiving targeted case management or the person's legal guardian has 
24.20 	the right to choose and consent to the use of interactive video telehealth under this subdivision 
24.21 	and has the right to refuse the use of interactive video telehealth at any time.
24.22 	(c) The commissioner shall establish criteria that a targeted case management provider 
24.23 	must attest to in order to demonstrate the safety or efficacy of delivering the service via 
24.24 	interactive video telehealth. The attestation may include that the case management provider 
24.25 	has:
24.26 	(1) written policies and procedures specific to interactive video services delivered by 
24.27 	telehealth that are regularly reviewed and updated;
24.28 	(2) policies and procedures that adequately address client safety before, during, and after 
24.29 	the interactive video services are rendered by telehealth;
24.30 	(3) established protocols addressing how and when to discontinue interactive video
24.31 	services delivered by telehealth; and
25.1 	(4) established a quality assurance process related to interactive video services delivered 
25.2 	by telehealth.
25.3 	(d) As a condition of payment, the targeted case management provider must document 
25.4 	the following for each occurrence of targeted case management provided by interactive 
25.5 	video telehealth:
25.6 	(1) the time the service began and the time the service ended, including an a.m. and p.m. 
25.7 	designation;
25.8 	(2) the basis for determining that interactive videotelehealth is an appropriate and 
25.9 	effective means for delivering the service to the person receiving case management services;
25.10 	(3) the mode of transmission of the interactive video services delivered by telehealth 
25.11 	and records evidencing that a particular mode of transmission was utilized;
25.12 	(4) the location of the originating site and the distant site; and
25.13 	(5) compliance with the criteria attested to by the targeted case management provider 
25.14 	as provided in paragraph (c).
25.15 	(e) For purposes of this section, telehealth is defined in accordance with section 
25.16 	256B.0625, subdivision 3b. The commissioner may limit the delivery of services by telehealth 
25.17 	to audio and visual communications if the commissioner determines that face-to-face 
25.18 	interaction is necessary to ensure that services are delivered appropriately and effectively.

25.19 	Sec. 17. Minnesota Statutes 2020, section 256B.0924, subdivision 6, is amended to read:
25.20 		Subd. 6.Payment for targeted case management. (a) Medical assistance and 
25.21 	MinnesotaCare payment for targeted case management shall be made on a monthly basis. 
25.22 	In order to receive payment for an eligible adult, the provider must document at least one 
25.23 	contact per month, either in person or by telehealth, and not more than two consecutive 
25.24 	months without a face-to-face in-person contact with the adult or the adult's legal 
25.25 	representative, family, primary caregiver, or other relevant persons identified as necessary 
25.26 	to the development or implementation of the goals of the personal service plan.
25.27 	(b) Payment for targeted case management provided by county staff under this subdivision 
25.28 	shall be based on the monthly rate methodology under section 256B.094, subdivision 6, 
25.29 	paragraph (b), calculated as one combined average rate together with adult mental health 
25.30 	case management under section 256B.0625, subdivision 20, except for calendar year 2002. 
25.31 	In calendar year 2002, the rate for case management under this section shall be the same as 
25.32 	the rate for adult mental health case management in effect as of December 31, 2001. Billing 
26.1 	and payment must identify the recipient's primary population group to allow tracking of 
26.2 	revenues.
26.3 	(c) Payment for targeted case management provided by county-contracted vendors shall 
26.4 	be based on a monthly rate negotiated by the host county. The negotiated rate must not 
26.5 	exceed the rate charged by the vendor for the same service to other payers. If the service is 
26.6 	provided by a team of contracted vendors, the county may negotiate a team rate with a 
26.7 	vendor who is a member of the team. The team shall determine how to distribute the rate 
26.8 	among its members. No reimbursement received by contracted vendors shall be returned 
26.9 	to the county, except to reimburse the county for advance funding provided by the county 
26.10 	to the vendor.
26.11 	(d) If the service is provided by a team that includes contracted vendors and county staff, 
26.12 	the costs for county staff participation on the team shall be included in the rate for 
26.13 	county-provided services. In this case, the contracted vendor and the county may each 
26.14 	receive separate payment for services provided by each entity in the same month. In order 
26.15 	to prevent duplication of services, the county must document, in the recipient's file, the need 
26.16 	for team targeted case management and a description of the different roles of the team 
26.17 	members.
26.18 	(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
26.19 	targeted case management shall be provided by the recipient's county of responsibility, as 
26.20 	defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
26.21 	used to match other federal funds.
26.22 	(f) The commissioner may suspend, reduce, or terminate reimbursement to a provider 
26.23 	that does not meet the reporting or other requirements of this section. The county of 
26.24 	responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal 
26.25 	disallowances. The county may share this responsibility with its contracted vendors.
26.26 	(g) The commissioner shall set aside five percent of the federal funds received under 
26.27 	this section for use in reimbursing the state for costs of developing and implementing this 
26.28 	section.
26.29 	(h) Payments to counties for targeted case management expenditures under this section 
26.30 	shall only be made from federal earnings from services provided under this section. Payments 
26.31 	to contracted vendors shall include both the federal earnings and the county share.
26.32 	(i) Notwithstanding section 256B.041, county payments for the cost of case management 
26.33 	services provided by county staff shall not be made to the commissioner of management 
26.34 	and budget. For the purposes of targeted case management services provided by county 
27.1 	staff under this section, the centralized disbursement of payments to counties under section 
27.2 	256B.041 consists only of federal earnings from services provided under this section.
27.3 	(j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
27.4 	and the recipient's institutional care is paid by medical assistance, payment for targeted case 
27.5 	management services under this subdivision is limited to the lesser of:
27.6 	(1) the last 180 days of the recipient's residency in that facility; or
27.7 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
27.8 	(k) Payment for targeted case management services under this subdivision shall not 
27.9 	duplicate payments made under other program authorities for the same purpose.
27.10 	(l) Any growth in targeted case management services and cost increases under this 
27.11 	section shall be the responsibility of the counties.

27.12 	Sec. 18. Minnesota Statutes 2020, section 256B.094, subdivision 6, is amended to read:
27.13 		Subd. 6.Medical assistance reimbursement of case management services. (a) Medical 
27.14 	assistance reimbursement for services under this section shall be made on a monthly basis. 
27.15 	Payment is based on face-to-face or telephone contacts, either in person or through telehealth,
27.16 	between the case manager and the client, client's family, primary caregiver, legal 
27.17 	representative, or other relevant person identified as necessary to the development or 
27.18 	implementation of the goals of the individual service plan regarding the status of the client, 
27.19 	the individual service plan, or the goals for the client. These contacts must meet the minimum 
27.20 	standards in clauses (1) and (2):
27.21 	(1) there must be a face-to-face in-person contact at least once a month except as provided 
27.22 	in clause (2); and
27.23 	(2) for a client placed outside of the county of financial responsibility, or a client served 
27.24 	by tribal social services placed outside the reservation, in an excluded time facility under 
27.25 	section 256G.02, subdivision 6, or through the Interstate Compact for the Placement of 
27.26 	Children, section 260.93, and the placement in either case is more than 60 miles beyond 
27.27 	the county or reservation boundaries, there must be at least one contact per month and not 
27.28 	more than two consecutive months without a face-to-face in-person contact.
27.29 	(b) Except as provided under paragraph (c), the payment rate is established using time 
27.30 	study data on activities of provider service staff and reports required under sections 245.482
27.31 	and 256.01, subdivision 2, paragraph (p).
28.1 	(c) Payments for tribes may be made according to section 256B.0625 or other relevant 
28.2 	federally approved rate setting methodology for child welfare targeted case management 
28.3 	provided by Indian health services and facilities operated by a tribe or tribal organization.
28.4 	(d) Payment for case management provided by county or tribal social services contracted 
28.5 	vendors shall be based on a monthly rate negotiated by the host county or tribal social 
28.6 	services. The negotiated rate must not exceed the rate charged by the vendor for the same 
28.7 	service to other payers. If the service is provided by a team of contracted vendors, the county 
28.8 	or tribal social services may negotiate a team rate with a vendor who is a member of the 
28.9 	team. The team shall determine how to distribute the rate among its members. No 
28.10 	reimbursement received by contracted vendors shall be returned to the county or tribal social 
28.11 	services, except to reimburse the county or tribal social services for advance funding provided 
28.12 	by the county or tribal social services to the vendor.
28.13 	(e) If the service is provided by a team that includes contracted vendors and county or 
28.14 	tribal social services staff, the costs for county or tribal social services staff participation in 
28.15 	the team shall be included in the rate for county or tribal social services provided services. 
28.16 	In this case, the contracted vendor and the county or tribal social services may each receive 
28.17 	separate payment for services provided by each entity in the same month. To prevent 
28.18 	duplication of services, each entity must document, in the recipient's file, the need for team 
28.19 	case management and a description of the roles and services of the team members.
28.20 	Separate payment rates may be established for different groups of providers to maximize 
28.21 	reimbursement as determined by the commissioner. The payment rate will be reviewed 
28.22 	annually and revised periodically to be consistent with the most recent time study and other 
28.23 	data. Payment for services will be made upon submission of a valid claim and verification 
28.24 	of proper documentation described in subdivision 7. Federal administrative revenue earned 
28.25 	through the time study, or under paragraph (c), shall be distributed according to earnings, 
28.26 	to counties, reservations, or groups of counties or reservations which have the same payment 
28.27 	rate under this subdivision, and to the group of counties or reservations which are not 
28.28 	certified providers under section 256F.10. The commissioner shall modify the requirements 
28.29 	set out in Minnesota Rules, parts 9550.0300 to 9550.0370, as necessary to accomplish this.

28.30 	Sec. 19. REVISOR INSTRUCTION.
 28.31 	In Minnesota Statutes and Minnesota Rules, the revisor of statutes shall substitute the 
28.32 	term "telemedicine" with "telehealth" whenever the term appears and substitute Minnesota 
28.33 	Statutes, section 62A.673, whenever references to Minnesota Statutes, sections 62A.67, 
28.34 	62A.671, and 62A.672 appear.

29.1 	Sec. 20. REPEALER.
 29.2 	Minnesota Statutes 2020, sections 62A.67; 62A.671; and 62A.672, are repealed.

APPENDIX 

Repealed Minnesota Statutes: S1160-2 

62A.67 SHORT TITLE.
Sections 62A.67 to 62A.672 may be cited as the "Minnesota Telemedicine Act." 

62A.671 DEFINITIONS.Subdivision 1.Applicability. 
For purposes of sections 62A.67 to 62A.672, the terms defined in this section have the meanings given. 

Subd. 2.Distant site. 
"Distant site" means a site at which a licensed health care provider is located while providing health care services or consultations by means of telemedicine. 

Subd. 3.Health care provider. 
"Health care provider" has the meaning provided in section 62A.63, subdivision 2. 

Subd. 4.Health carrier. 
"Health carrier" has the meaning provided in section 62A.011, subdivision 2. 

Subd. 5.Health plan. 
"Health plan" means a health plan as defined in section 62A.011, subdivision 3, and includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental plans that provide indemnity-based benefits, regardless of expenses incurred and are designed to pay benefits directly to the policyholder. 

Subd. 6.Licensed health care provider. 
"Licensed health care provider" means a health care provider who is: 

(1) licensed under chapter 147, 147A, 148, 148B, 148E, 148F, 150A, or 153; a mental health professional as defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; or vendor of medical care defined in section 256B.02, subdivision 7; and 

(2) authorized within their respective scope of practice to provide the particular service with no supervision or under general supervision. 

Subd. 7.Originating site. 
"Originating site" means a site including, but not limited to, a health care facility at which a patient is located at the time health care services are provided to the patient by means of telemedicine. 

Subd. 8.Store-and-forward technology. 
"Store-and-forward technology" means the transmission of a patient's medical information from an originating site to a health care provider at a distant site without the patient being present, or the delivery of telemedicine that does not occur in real time via synchronous transmissions. 

Subd. 9.Telemedicine. 
"Telemedicine" means the delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. A communication between licensed health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission does not constitute telemedicine consultations or services. A communication between a licensed health care provider and a patient that consists solely of an e-mail or facsimile transmission does not constitute telemedicine consultations or services. Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care. 

62A.672 COVERAGE OF TELEMEDICINE SERVICES.Subdivision 1.Coverage of telemedicine. 
(a) A health plan sold, issued, or renewed by a health carrier for which coverage of benefits begins on or after January 1, 2017, shall include coverage for telemedicine benefits in the same manner as any other benefits covered under the policy, plan, or contract, and shall comply with the regulations of this section. 

(b) Nothing in this section shall be construed to: 

(1) require a health carrier to provide coverage for services that are not medically necessary; 

(2) prohibit a health carrier from establishing criteria that a health care provider must meet to demonstrate the safety or efficacy of delivering a particular service via telemedicine for which the health carrier does not already reimburse other health care providers for delivering via telemedicine, so long as the criteria are not unduly burdensome or unreasonable for the particular service; or 

(3) prevent a health carrier from requiring a health care provider to agree to certain documentation or billing practices designed to protect the health carrier or patients from fraudulent claims so long as the practices are not unduly burdensome or unreasonable for the particular service. 

Subd. 2.Parity between telemedicine and in-person services. 
A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient. 

Subd. 3.Reimbursement for telemedicine services. 
(a) A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider. 

(b) It is not a violation of this subdivision for a health carrier to include a deductible, co-payment, or coinsurance requirement for a health care service provided via telemedicine, provided that the deductible, co-payment, or coinsurance is not in addition to, and does not exceed, the deductible, co-payment, or coinsurance applicable if the same services were provided through in-person contact.