1.1 	A bill for an act
1.2 	relating to human services; modifying health care provisions in consumer 
1.3 	information, foster care, asset limitations, annuities, telehealth services, managed 
1.4 	care, clinical trials, and certain trusts;amending Minnesota Statutes 2020, sections 
1.5 	62J.2930, subdivision 3; 256B.055, subdivision 2; 256B.056, subdivisions 3b, 3c, 
1.6 	11; 256B.0595, subdivision 1; 256B.0625, subdivision 64; 256B.77, subdivision 
1.7 	13; Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 3b; 
1.8 	proposing coding for new law in Minnesota Statutes, chapter 256B; repealing 
1.9 	Minnesota Statutes 2020, sections 256B.057, subdivision 7; 256B.69, subdivision 
1.10 	20; 501C.1206.
1.11 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.12 	Section 1. Minnesota Statutes 2020, section 62J.2930, subdivision 3, is amended to read:
1.13 		Subd. 3.Consumer information. (a) The information clearinghouse or another entity 
1.14 	designated by the commissioner shall provide consumer information to health plan company 
1.15 	enrollees to:
1.16 	(1) assist enrollees in understanding their rights;
1.17 	(2) explain and assist in the use of all available complaint systems, including internal 
1.18 	complaint systems within health carriers, community integrated service networks, and the 
1.19 	Departments of Health and Commerce;
1.20 	(3) provide information on coverage options in each region of the state;
1.21 	(4) provide information on the availability of purchasing pools and enrollee subsidies; 
1.22 	and
1.23 	(5) help consumers use the health care system to obtain coverage.
2.1 	(b) The information clearinghouse or other entity designated by the commissioner for 
2.2 	the purposes of this subdivision shall not:
2.3 	(1) provide legal services to consumers;
2.4 	(2) represent a consumer or enrollee; or
2.5 	(3) serve as an advocate for consumers in disputes with health plan companies.
2.6 	(c) Nothing in this subdivision shall interfere with the ombudsman program established 
2.7 	under section 256B.69, subdivision 20 256B.6903, or other existing ombudsman programs.

2.8 	Sec. 2. Minnesota Statutes 2020, section 256B.055, subdivision 2, is amended to read:
2.9 		Subd. 2.Subsidized foster children. Medical assistance may be paid for a child eligible 
2.10 	for or receiving foster care maintenance payments under Title IV-E of the Social Security 
2.11 	Act, United States Code, title 42, sections 670 to 676, and for a child who is not eligible for 
2.12 	Title IV-E of the Social Security Act but who is determined eligible for placed in foster 
2.13 	care as determined by Minnesota Statutes or kinship assistance under chapter 256N.

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

2.15 	Sec. 3. Minnesota Statutes 2020, section 256B.056, subdivision 3b, is amended to read:
2.16 		Subd. 3b.Treatment of trusts. (a) It is the public policy of this state that individuals 
2.17 	use all available resources to pay for the cost of long-term care services, as defined in section 
2.18 	256B.0595, before turning to Minnesota health care program funds, and that trust instruments 
2.19 	should not be permitted to shield available resources of an individual or an individual's 
2.20 	spouse from such use.
2.21 	(a) (b) A "medical assistance qualifying trust" is a revocable or irrevocable trust, or 
2.22 	similar legal device, established on or before August 10, 1993, by a person or the person's 
2.23 	spouse under the terms of which the person receives or could receive payments from the 
2.24 	trust principal or income and the trustee has discretion in making payments to the person 
2.25 	from the trust principal or income. Notwithstanding that definition, a medical assistance 
2.26 	qualifying trust does not include: (1) a trust set up by will; (2) a trust set up before April 7, 
2.27 	1986, solely to benefit a person with a developmental disability living in an intermediate 
2.28 	care facility for persons with developmental disabilities; or (3) a trust set up by a person 
2.29 	with payments made by the Social Security Administration pursuant to the United States 
2.30 	Supreme Court decision in Sullivan v. Zebley, 110 S. Ct. 885 (1990). The maximum amount 
2.31 	of payments that a trustee of a medical assistance qualifying trust may make to a person 
2.32 	under the terms of the trust is considered to be available assets to the person, without regard 
3.1 	to whether the trustee actually makes the maximum payments to the person and without 
3.2 	regard to the purpose for which the medical assistance qualifying trust was established.
3.3 	(b) (c) Trusts established after August 10, 1993, are treated according to United States 
3.4 	Code, title 42, section 1396p(d).
3.5 	(c) (d) For purposes of paragraph (d) (e), a pooled trust means a trust established under 
3.6 	United States Code, title 42, section 1396p(d)(4)(C).
3.7 	(d) (e) A beneficiary's interest in a pooled trust is considered an available asset unless 
3.8 	the trust provides that upon the death of the beneficiary or termination of the trust during 
3.9 	the beneficiary's lifetime, whichever is sooner, the department receives any amount, up to 
3.10 	the amount of medical assistance benefits paid on behalf of the beneficiary, remaining in 
3.11 	the beneficiary's trust account after a deduction for reasonable administrative fees and 
3.12 	expenses, and an additional remainder amount. The retained remainder amount of the 
3.13 	subaccount must not exceed ten percent of the account value at the time of the beneficiary's 
3.14 	death or termination of the trust, and must only be used for the benefit of disabled individuals 
3.15 	who have a beneficiary interest in the pooled trust.
3.16 	(e) (f) Trusts may be established on or after December 12, 2016, by a person who has 
3.17 	been determined to be disabled, according to United States Code, title 42, section 
3.18 	1396p(d)(4)(A), as amended by section 5007 of the 21st Century Cures Act, Public Law 
3.19 	114-255.

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

3.21 	Sec. 4. Minnesota Statutes 2020, section 256B.056, subdivision 3c, is amended to read:
3.22 		Subd. 3c.Asset limitations for families and children. (a) A household of two or more 
3.23 	persons must not own more than $20,000 in total net assets, and a household of one person 
3.24 	must not own more than $10,000 in total net assets. In addition to these maximum amounts, 
3.25 	an eligible individual or family may accrue interest on these amounts, but they must be 
3.26 	reduced to the maximum at the time of an eligibility redetermination. The value of assets 
3.27 	that are not considered in determining eligibility for medical assistance for families and 
3.28 	children is the value of those assets excluded under the AFDC state plan as of July 16, 1996, 
3.29 	as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 
3.30 	1996 (PRWORA), Public Law 104-193, with the following exceptions:
3.31 	(1) household goods and personal effects are not considered;
3.32 	(2) capital and operating assets of a trade or business up to $200,000 are not considered;
4.1 	(3) one motor vehicle is excluded for each person of legal driving age who is employed 
4.2 	or seeking employment;
4.3 	(4) assets designated as burial expenses are excluded to the same extent they are excluded 
4.4 	by the Supplemental Security Income program;
4.5 	(5) court-ordered settlements up to $10,000 are not considered;
4.6 	(6) individual retirement accounts and funds are not considered;
4.7 	(7) assets owned by children are not considered; and
4.8 	(8) effective July 1, 2009, certain assets owned by American Indians are excluded as 
4.9 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
4.10 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
4.11 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
4.12 	(b) Beginning January 1, 2014, this subdivision Paragraph (a) applies only to parents 
4.13 	and caretaker relatives who qualify for medical assistance under subdivision 5.
4.14 	(c) Eligibility for children under age 21 must be determined without regard to the asset 
4.15 	limitations described in paragraphs (a) and (b) and subdivision 3.

4.16 	Sec. 5. Minnesota Statutes 2020, section 256B.056, subdivision 11, is amended to read:
4.17 		Subd. 11.Treatment of annuities. (a) Any person requesting medical assistance payment 
4.18 	of long-term care services shall provide a complete description of any interest either the 
4.19 	person or the person's spouse has in annuities on a form designated by the department. The 
4.20 	form shall include a statement that the state becomes a preferred remainder beneficiary of 
4.21 	annuities or similar financial instruments by virtue of the receipt of medical assistance 
4.22 	payment of long-term care services. The person and the person's spouse shall furnish the 
4.23 	agency responsible for determining eligibility with complete current copies of their annuities 
4.24 	and related documents and complete the form designating the state as the preferred remainder 
4.25 	beneficiary for each annuity in which the person or the person's spouse has an interest.
4.26 	(b) The department shall provide notice to the issuer of the department's right under this 
4.27 	section as a preferred remainder beneficiary under the annuity or similar financial instrument 
4.28 	for medical assistance furnished to the person or the person's spouse, and provide notice of 
4.29 	the issuer's responsibilities as provided in paragraph (c).
4.30 	(c) An issuer of an annuity or similar financial instrument who receives notice of the 
4.31 	state's right to be named a preferred remainder beneficiary as described in paragraph (b) 
4.32 	shall provide confirmation to the requesting agency that the state has been made a preferred 
5.1 	remainder beneficiary. The issuer shall also notify the county agency when a change in the 
5.2 	amount of income or principal being withdrawn from the annuity or other similar financial 
5.3 	instrument or a change in the state's preferred remainder beneficiary designation under the 
5.4 	annuity or other similar financial instrument occurs. The county agency shall provide the 
5.5 	issuer with the name, address, and telephone number of a unit within the department that 
5.6 	the issuer can contact to comply with this paragraph.
5.7 	(d) "Preferred remainder beneficiary" for purposes of this subdivision and sections 
5.8 	256B.0594 and 256B.0595 means the state is a remainder beneficiary in the first position 
5.9 	in an amount equal to the amount of medical assistance paid on behalf of the institutionalized 
5.10 	person, or is a remainder beneficiary in the second position if the institutionalized person 
5.11 	designates and is survived by a remainder beneficiary who is (1) a spouse who does not 
5.12 	reside in a medical institution, (2) a minor child, or (3) a child of any age who is blind or 
5.13 	permanently and totally disabled as defined in the Supplemental Security Income program. 
5.14 	Notwithstanding this paragraph, the state is the remainder beneficiary in the first position 
5.15 	if the spouse or child disposes of the remainder for less than fair market value.
5.16 	(e) For purposes of this subdivision, "institutionalized person" and "long-term care 
5.17 	services" have the meanings given in section 256B.0595, subdivision 1, paragraph (g) (f).
5.18 	(f) For purposes of this subdivision, "medical institution" means a skilled nursing facility, 
5.19 	intermediate care facility, intermediate care facility for persons with developmental 
5.20 	disabilities, nursing facility, or inpatient hospital.

5.21 	Sec. 6. Minnesota Statutes 2020, section 256B.0595, subdivision 1, is amended to read:
5.22 		Subdivision 1.Prohibited transfers. (a) Effective for transfers made after August 10, 
5.23 	1993, an institutionalized person, an institutionalized person's spouse, or any person, court, 
5.24 	or administrative body with legal authority to act in place of, on behalf of, at the direction 
5.25 	of, or upon the request of the institutionalized person or institutionalized person's spouse, 
5.26 	may not give away, sell, or dispose of, for less than fair market value, any asset or interest 
5.27 	therein, except assets other than the homestead that are excluded under the Supplemental 
5.28 	Security Income program, for the purpose of establishing or maintaining medical assistance 
5.29 	eligibility. This applies to all transfers, including those made by a community spouse after 
5.30 	the month in which the institutionalized spouse is determined eligible for medical assistance. 
5.31 	For purposes of determining eligibility for long-term care services, any transfer of such 
5.32 	assets within 36 months before or any time after an institutionalized person requests medical 
5.33 	assistance payment of long-term care services, or 36 months before or any time after a 
5.34 	medical assistance recipient becomes an institutionalized person, for less than fair market 
6.1 	value may be considered. Any such transfer is presumed to have been made for the purpose 
6.2 	of establishing or maintaining medical assistance eligibility and the institutionalized person 
6.3 	is ineligible for long-term care services for the period of time determined under subdivision 
6.4 	2, unless the institutionalized person furnishes convincing evidence to establish that the 
6.5 	transaction was exclusively for another purpose, or unless the transfer is permitted under 
6.6 	subdivision 3 or 4. In the case of payments from a trust or portions of a trust that are 
6.7 	considered transfers of assets under federal law, or in the case of any other disposal of assets 
6.8 	made on or after February 8, 2006, any transfers made within 60 months before or any time 
6.9 	after an institutionalized person requests medical assistance payment of long-term care 
6.10 	services and within 60 months before or any time after a medical assistance recipient becomes 
6.11 	an institutionalized person, may be considered.
6.12 	(b) This section applies to transfers, for less than fair market value, of income or assets, 
6.13 	including assets that are considered income in the month received, such as inheritances, 
6.14 	court settlements, and retroactive benefit payments or income to which the institutionalized 
6.15 	person or the institutionalized person's spouse is entitled but does not receive due to action 
6.16 	by the institutionalized person, the institutionalized person's spouse, or any person, court, 
6.17 	or administrative body with legal authority to act in place of, on behalf of, at the direction 
6.18 	of, or upon the request of the institutionalized person or the institutionalized person's spouse.
6.19 	(c) This section applies to payments for care or personal services provided by a relative, 
6.20 	unless the compensation was stipulated in a notarized, written agreement which that was 
6.21 	in existence when the service was performed, the care or services directly benefited the 
6.22 	person, and the payments made represented reasonable compensation for the care or services 
6.23 	provided. A notarized written agreement is not required if payment for the services was 
6.24 	made within 60 days after the service was provided.
6.25 	(d) This section applies to the portion of any asset or interest that an institutionalized 
6.26 	person, an institutionalized person's spouse, or any person, court, or administrative body 
6.27 	with legal authority to act in place of, on behalf of, at the direction of, or upon the request 
6.28 	of the institutionalized person or the institutionalized person's spouse, transfers to any 
6.29 	annuity that exceeds the value of the benefit likely to be returned to the institutionalized 
6.30 	person or institutionalized person's spouse while alive, based on estimated life expectancy 
6.31 	as determined according to the current actuarial tables published by the Office of the Chief 
6.32 	Actuary of the Social Security Administration. The commissioner may adopt rules reducing 
6.33 	life expectancies based on the need for long-term care. This section applies to an annuity 
6.34 	purchased on or after March 1, 2002, that:
7.1 	(1) is not purchased from an insurance company or financial institution that is subject 
7.2 	to licensing or regulation by the Minnesota Department of Commerce or a similar regulatory 
7.3 	agency of another state;
7.4 	(2) does not pay out principal and interest in equal monthly installments; or
7.5 	(3) does not begin payment at the earliest possible date after annuitization.
7.6 	(e) (d) Effective for transactions, including the purchase of an annuity, occurring on or 
7.7 	after February 8, 2006, by or on behalf of an institutionalized person who has applied for 
7.8 	or is receiving long-term care services or the institutionalized person's spouse shall be treated 
7.9 	as the disposal of an asset for less than fair market value unless the department is named a 
7.10 	preferred remainder beneficiary as described in section 256B.056, subdivision 11. Any 
7.11 	subsequent change to the designation of the department as a preferred remainder beneficiary 
7.12 	shall result in the annuity being treated as a disposal of assets for less than fair market value. 
7.13 	The amount of such transfer shall be the maximum amount the institutionalized person or 
7.14 	the institutionalized person's spouse could receive from the annuity or similar financial 
7.15 	instrument. Any change in the amount of the income or principal being withdrawn from the 
7.16 	annuity or other similar financial instrument at the time of the most recent disclosure shall 
7.17 	be deemed to be a transfer of assets for less than fair market value unless the institutionalized 
7.18 	person or the institutionalized person's spouse demonstrates that the transaction was for fair 
7.19 	market value. In the event a distribution of income or principal has been improperly 
7.20 	distributed or disbursed from an annuity or other retirement planning instrument of an 
7.21 	institutionalized person or the institutionalized person's spouse, a cause of action exists 
7.22 	against the individual receiving the improper distribution for the cost of medical assistance 
7.23 	services provided or the amount of the improper distribution, whichever is less.
7.24 	(f) (e) Effective for transactions, including the purchase of an annuity, occurring on or 
7.25 	after February 8, 2006, by or on behalf of an institutionalized person applying for or receiving 
7.26 	long-term care services shall be treated as a disposal of assets for less than fair market value 
7.27 	unless it is:
7.28 	(1) an annuity described in subsection (b) or (q) of section 408 of the Internal Revenue 
7.29 	Code of 1986; or
7.30 	(2) purchased with proceeds from:
7.31 	(i) an account or trust described in subsection (a), (c), or (p) of section 408 of the Internal 
7.32 	Revenue Code;
8.1 	(ii) a simplified employee pension within the meaning of section 408(k) of the Internal 
8.2 	Revenue Code; or
8.3 	(iii) a Roth IRA described in section 408A of the Internal Revenue Code; or
8.4 	(3) an annuity that is irrevocable and nonassignable; is actuarially sound as determined 
8.5 	in accordance with actuarial publications of the Office of the Chief Actuary of the Social 
8.6 	Security Administration; and provides for payments in equal amounts during the term of 
8.7 	the annuity, with no deferral and no balloon payments made.
8.8 	(g) (f) For purposes of this section, long-term care services include services in a nursing 
8.9 	facility, services that are eligible for payment according to section 256B.0625, subdivision 
8.10 	2, because they are provided in a swing bed, intermediate care facility for persons with 
8.11 	developmental disabilities, and home and community-based services provided pursuant to 
8.12 	chapter 256S and sections 256B.092 and 256B.49. For purposes of this subdivision and 
8.13 	subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient in 
8.14 	a nursing facility or in a swing bed, or intermediate care facility for persons with 
8.15 	developmental disabilities or who is receiving home and community-based services under 
8.16 	chapter 256S and sections 256B.092 and 256B.49.
8.17 	(h) (g) This section applies to funds used to purchase a promissory note, loan, or mortgage 
8.18 	unless the note, loan, or mortgage:
8.19 	(1) has a repayment term that is actuarially sound;
8.20 	(2) provides for payments to be made in equal amounts during the term of the loan, with 
8.21 	no deferral and no balloon payments made; and
8.22 	(3) prohibits the cancellation of the balance upon the death of the lender.
8.23 	(h) In the case of a promissory note, loan, or mortgage that does not meet an exception 
8.24 	in paragraph (g), clauses (1) to (3), the value of such note, loan, or mortgage shall be the 
8.25 	outstanding balance due as of the date of the institutionalized person's request for medical 
8.26 	assistance payment of long-term care services.
8.27 	(i) This section applies to the purchase of a life estate interest in another person's home 
8.28 	unless the purchaser resides in the home for a period of at least one year after the date of 
8.29 	purchase.
8.30 	(j) This section applies to transfers into a pooled trust that qualifies under United States 
8.31 	Code, title 42, section 1396p(d)(4)(C), by:
8.32 	(1) a person age 65 or older or the person's spouse; or
9.1 	(2) any person, court, or administrative body with legal authority to act in place of, on 
9.2 	behalf of, at the direction of, or upon the request of a person age 65 or older or the person's 
9.3 	spouse.

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

9.5 	Sec. 7. Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 3b, is 
9.6 	amended to read:
9.7 		Subd. 3b.Telehealth services. (a) Medical assistance covers medically necessary services 
9.8 	and consultations delivered by a health care provider through telehealth in the same manner 
9.9 	as if the service or consultation was delivered through in-person contact. Services or 
9.10 	consultations delivered through telehealth shall be paid at the full allowable rate.
9.11 	(b) The commissioner may establish criteria that a health care provider must attest to in 
9.12 	order to demonstrate the safety or efficacy of delivering a particular service through 
9.13 	telehealth. The attestation may include that the health care provider:
9.14 	(1) has identified the categories or types of services the health care provider will provide 
9.15 	through telehealth;
9.16 	(2) has written policies and procedures specific to services delivered through telehealth 
9.17 	that are regularly reviewed and updated;
9.18 	(3) has policies and procedures that adequately address patient safety before, during, 
9.19 	and after the service is delivered through telehealth;
9.20 	(4) has established protocols addressing how and when to discontinue telehealth services; 
9.21 	and
9.22 	(5) has an established quality assurance process related to delivering services through 
9.23 	telehealth.
9.24 	(c) As a condition of payment, a licensed health care provider must document each 
9.25 	occurrence of a health service delivered through telehealth to a medical assistance enrollee. 
9.26 	Health care service records for services delivered through telehealth must meet the 
9.27 	requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must 
9.28 	document:
9.29 	(1) the type of service delivered through telehealth;
9.30 	(2) the time the service began and the time the service ended, including an a.m. and p.m. 
9.31 	designation;
10.1 	(3) the health care provider's basis for determining that telehealth is an appropriate and 
10.2 	effective means for delivering the service to the enrollee;
10.3 	(4) the mode of transmission used to deliver the service through telehealth and records 
10.4 	evidencing that a particular mode of transmission was utilized;
10.5 	(5) the location of the originating site and the distant site;
10.6 	(6) if the claim for payment is based on a physician's consultation with another physician 
10.7 	through telehealth, the written opinion from the consulting physician providing the telehealth 
10.8 	consultation; and
10.9 	(7) compliance with the criteria attested to by the health care provider in accordance 
10.10 	with paragraph (b).
10.11 	(d) Telehealth visits, as described in this subdivision provided through audio and visual 
10.12 	communication, may be used to satisfy the face-to-face requirement for reimbursement 
10.13 	under the payment methods that apply to a federally qualified health center, rural health 
10.14 	clinic, Indian health service, 638 Tribal clinic, and certified community behavioral health 
10.15 	clinic, if the service would have otherwise qualified for payment if performed in person.
10.16 	(e) For mental health services or assessments delivered through telehealth that are based 
10.17 	on an individual treatment plan, the provider may document the client's verbal approval or 
10.18 	electronic written approval of the treatment plan or change in the treatment plan in lieu of 
10.19 	the client's signature in accordance with Minnesota Rules, part 9505.0371.
10.20 	(f) For purposes of this subdivision, unless otherwise covered under this chapter:
10.21 	(1) "telehealth" means the delivery of health care services or consultations through the 
10.22 	use of using real-time two-way interactive audio and visual communication or accessible 
10.23 	telemedicine video-based platforms to provide or support health care delivery and facilitate 
10.24 	the assessment, diagnosis, consultation, treatment, education, and care management of a 
10.25 	patient's health care. Telehealth includes the application of secure video conferencing,
10.26 	consisting of a real-time, full-motion synchronized video; store-and-forward technology,;
10.27 	and synchronous interactions between a patient located at an originating site and a health 
10.28 	care provider located at a distant site. Telehealth does not include communication between 
10.29 	health care providers, or between a health care provider and a patient that consists solely 
10.30 	of an audio-only communication, e-mail, or facsimile transmission or as specified by law;
10.31 	(2) "health care provider" means:
10.32 	(i) a health care provider as defined under section 62A.673,;
11.1 	(ii) a community paramedic as defined under section 144E.001, subdivision 5f,;
11.2 	(iii) a community health worker who meets the criteria under subdivision 49, paragraph 
11.3 	(a),;
11.4 	(iv) a mental health certified peer specialist under section 256B.0615, subdivision 5,;
11.5 	(v) a mental health certified family peer specialist under section 256B.0616, subdivision 
11.6 	5,;
11.7 	(vi) a mental health rehabilitation worker under section 256B.0623, subdivision 5, 
11.8 	paragraph (a), clause (4), and paragraph (b),;
11.9 	(vii) a mental health behavioral aide under section 256B.0943, subdivision 7, paragraph 
11.10 	(b), clause (3),;
11.11 	(viii) a treatment coordinator under section 245G.11, subdivision 7,;
11.12 	(ix) an alcohol and drug counselor under section 245G.11, subdivision 5,; or
11.13 	(x) a recovery peer under section 245G.11, subdivision 8; and
11.14 	(3) "originating site," "distant site," and "store-and-forward technology" have the 
11.15 	meanings given in section 62A.673, subdivision 2.

11.16 	Sec. 8. Minnesota Statutes 2020, section 256B.0625, subdivision 64, is amended to read:
11.17 		Subd. 64.Investigational drugs, biological products, devices, and clinical 
11.18 	trials.  Medical assistance and the early periodic screening, diagnosis, and treatment (EPSDT) 
11.19 	program do not cover the costs of any services that are incidental to, associated with, or 
11.20 	resulting from the use of investigational drugs, biological products, or devices as defined 
11.21 	in section 151.375 or any other treatment that is part of an approved clinical trial as defined 
11.22 	in section 62Q.526. Participation of an enrollee in an approved clinical trial does not preclude 
11.23 	coverage of medically necessary services covered under this chapter that are not related to 
11.24 	the approved clinical trial. Any items or services that are provided solely to satisfy data 
11.25 	collection and analysis for a clinical trial, and not for direct clinical management of the 
11.26 	enrollee, are not covered.

11.27 	Sec. 9. [256B.6903] OMBUDSPERSON FOR MANAGED CARE.
11.28 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
11.29 	the meanings given them.
12.1 	(b) "Adverse benefit determination" has the meaning provided in Code of Federal 
12.2 	Regulations, title 42, section 438.400, subpart (b).
12.3 	(c) "Appeal" means an oral or written request from an enrollee to the managed care 
12.4 	organization for review of an adverse benefit determination.
12.5 	(d) "Commissioner" means the commissioner of human services.
12.6 	(e) "Complaint" means an enrollee's informal expression of dissatisfaction about any 
12.7 	matter relating to the enrollee's prepaid health plan other than an adverse benefit 
12.8 	determination.
12.9 	(f) "Data analyst" means the person employed by the ombudsperson that uses research 
12.10 	methodologies to conduct research on data collected from prepaid health plans, including 
12.11 	but not limited to scientific theory; hypothesis testing; survey research techniques; data 
12.12 	collection; data manipulation; and statistical analysis interpretation, including multiple 
12.13 	regression techniques.
12.14 	(g) "Enrollee" means a person enrolled in a prepaid health plan under section 256B.69. 
12.15 	When applicable, an enrollee includes an enrollee's authorized representative.
12.16 	(h) "External review" means the process described under Code of Federal Regulations, 
12.17 	title 42, section 438.408, subpart (f); and section 62Q.73, subdivision 2.
12.18 	(i) "Grievance" means an enrollee's expression of dissatisfaction about any matter relating 
12.19 	to the enrollee's prepaid health plan other than an adverse benefit determination that follows 
12.20 	the procedures outlined in Code of Federal Regulations, title 42, part 438, subpart (f). A 
12.21 	grievance may include but is not limited to concerns relating to quality of care, services 
12.22 	provided, or failure to respect an enrollee's rights under a prepaid health plan.
12.23 	(j) "Managed care advocate" means a county or Tribal employee who works with 
12.24 	managed care enrollees when the enrollee has service, billing, or access problems with the 
12.25 	enrollee's prepaid health plan.
12.26 	(k) "Prepaid health plan" means a plan under contract with the commissioner according 
12.27 	to section 256B.69.
12.28 	(l) "State fair hearing" means the appeals process mandated under section 256.045, 
12.29 	subdivision 3a.
12.30 		Subd. 2.Ombudsperson. The commissioner must designate an ombudsperson to advocate 
12.31 	for enrollees. At the time of enrollment in a prepaid health plan, the local agency must 
12.32 	inform enrollees about the ombudsperson.
13.1 		Subd. 3.Duties and cost. (a) The ombudsperson must work to ensure enrollees receive 
13.2 	covered services as described in the enrollee's prepaid health plan by:
13.3 	(1) providing assistance and education to enrollees, when requested, regarding covered 
13.4 	health care benefits or services; billing and access; or the grievance, appeal, or state fair 
13.5 	hearing processes;
13.6 	(2) with the enrollee's permission and within the ombudsperson's discretion, using an 
13.7 	informal review process to assist an enrollee with a resolution involving the enrollee's 
13.8 	prepaid health plan's benefits;
13.9 	(3) assisting enrollees, when requested, with prepaid health plan grievances, appeals, or 
13.10 	the state fair hearing process;
13.11 	(4) overseeing, reviewing, and approving documents used by enrollees relating to prepaid 
13.12 	health plans' grievances, appeals, and state fair hearings;
13.13 	(5) reviewing all state fair hearing and requests by enrollees for external review; 
13.14 	overseeing entities under contract to provide external reviews, processes, and payments for 
13.15 	services; and utilizing aggregated results of external reviews to recommend health care 
13.16 	benefits policy changes; and
13.17 	(6) providing trainings to managed care advocates.
13.18 	(b) The ombudsperson must not charge an enrollee for the ombudsperson's services.
13.19 		Subd. 4.Powers. In exercising the ombudsperson's authority under this section, the 
13.20 	ombudsperson may:
13.21 	(1) gather information and evaluate any practice, policy, procedure, or action by a prepaid 
13.22 	health plan, state human services agency, county, or Tribe; and
13.23 	(2) prescribe the methods by which complaints are to be made, received, and acted upon. 
13.24 	The ombudsperson's authority under this clause includes but is not limited to:
13.25 	(i) determining the scope and manner of a complaint;
13.26 	(ii) holding a prepaid health plan accountable to address a complaint in a timely manner 
13.27 	as outlined in state and federal laws;
13.28 	(iii) requiring a prepaid health plan to respond in a timely manner to a request for data, 
13.29 	case details, and other information as needed to help resolve a complaint or to improve a 
13.30 	prepaid health plan's policy; and
14.1 	(iv) making recommendations for policy, administrative, or legislative changes regarding 
14.2 	prepaid health plans to the proper partners.
14.3 		Subd. 5.Data. (a) The data analyst must review and analyze prepaid health plan data 
14.4 	on denial, termination, and reduction notices (DTRs), grievances, appeals, and state fair 
14.5 	hearings by:
14.6 	(1) analyzing, reviewing, and reporting on DTRs, grievances, appeals, and state fair 
14.7 	hearings data collected from each prepaid health plan;
14.8 	(2) collaborating with the commissioner's partners and the Department of Health for the 
14.9 	Triennial Compliance Assessment under Code of Federal Regulations, title 42, section 
14.10 	438.358, subpart (b);
14.11 	(3) reviewing state fair hearing decisions for policy or coverage issues that may affect 
14.12 	enrollees; and
14.13 	(4) providing data required under Code of Federal Regulations, title 42, section 438.66 
14.14 	(2016), to the Centers for Medicare and Medicaid Services.
14.15 	(b) The data analyst must share the data analyst's data observations and trends under 
14.16 	this subdivision with the ombudsperson, prepaid health plans, and commissioner's partners.
14.17 		Subd. 6.Collaboration and independence. (a) The ombudsperson must work in 
14.18 	collaboration with the commissioner and the commissioner's partners when the 
14.19 	ombudsperson's collaboration does not otherwise interfere with the ombudsperson's duties 
14.20 	under this section.
14.21 	(b) The ombudsperson may act independently of the commissioner when:
14.22 	(1) providing information or testimony to the legislature; and
14.23 	(2) contacting and making reports to federal and state officials.
14.24 		Subd. 7.Civil actions. The ombudsperson is not civilly liable for actions taken under 
14.25 	this section if the action was taken in good faith, was within the scope of the ombudsperson's 
14.26 	authority, and did not constitute willful or reckless misconduct.

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

14.28 	Sec. 10. Minnesota Statutes 2020, section 256B.77, subdivision 13, is amended to read:
14.29 		Subd. 13.Ombudsman. Enrollees shall have access to ombudsman services established 
14.30 	in section 256B.69, subdivision 20 256B.6903, and advocacy services provided by the 
14.31 	ombudsman for mental health and developmental disabilities established in sections 245.91
15.1 	to 245.97. The managed care ombudsman and the ombudsman for mental health and 
15.2 	developmental disabilities shall coordinate services provided to avoid duplication of services. 
15.3 	For purposes of the demonstration project, the powers and responsibilities of the Office of 
15.4 	Ombudsman for Mental Health and Developmental Disabilities, as provided in sections 
15.5 	245.91 to 245.97 are expanded to include all eligible individuals, health plan companies, 
15.6 	agencies, and providers participating in the demonstration project.

15.7 	Sec. 11. REPEALER.
 15.8 	(a) Minnesota Statutes 2020, section 256B.057, subdivision 7, is repealed on July 1, 
15.9 	2022.
15.10 	(b) Minnesota Statutes 2020, sections 256B.69, subdivision 20; and 501C.1206, are 
15.11 	repealed the day following final enactment.

APPENDIX 

Repealed Minnesota Statutes: H3636-1 

256B.057 ELIGIBILITY REQUIREMENTS FOR SPECIAL CATEGORIES.Subd. 7.Waiver of maintenance of effort requirement. 
Unless a federal waiver of the maintenance of effort requirement of section 2105(d) of title XXI of the Balanced Budget Act of 1997, Public Law 105-33, Statutes at Large, volume 111, page 251, is granted by the federal Department of Health and Human Services by September 30, 1998, eligibility for children under age 21 must be determined without regard to asset standards established in section 256B.056, subdivision 3c. The commissioner of human services shall publish a notice in the State Register upon receipt of a federal waiver. 

256B.69 PREPAID HEALTH PLANS.Subd. 20.Ombudsperson. 
 The commissioner shall designate an ombudsperson to advocate for persons required to enroll in prepaid health plans under this section. The ombudsperson shall advocate for recipients enrolled in prepaid health plans through complaint and appeal procedures and ensure that necessary medical services are provided either by the prepaid health plan directly or by referral to appropriate social services. At the time of enrollment in a prepaid health plan, the local agency shall inform recipients about the ombudsperson program and their right to a resolution of a complaint by the prepaid health plan if they experience a problem with the plan or its providers. 

501C.1206 PUBLIC HEALTH CARE PROGRAMS AND CERTAIN TRUSTS.
(a) It is the public policy of this state that individuals use all available resources to pay for the cost of long-term care services, as defined in section 256B.0595, before turning to Minnesota health care program funds, and that trust instruments should not be permitted to shield available resources of an individual or an individual's spouse from such use. 

(b) When a state or local agency makes a determination on an application by the individual or the individual's spouse for payment of long-term care services through a Minnesota public health care program pursuant to chapter 256B, any irrevocable inter vivos trust or any legal instrument, device, or arrangement similar to an irrevocable inter vivos trust created on or after July 1, 2005, containing assets or income of an individual or an individual's spouse, including those created by a person, court, or administrative body with legal authority to act in place of, at the direction of, upon the request of, or on behalf of the individual or individual's spouse, becomes revocable for the sole purpose of that determination. For purposes of this section, any inter vivos trust and any legal instrument, device, or arrangement similar to an inter vivos trust: 

(1) shall be deemed to be located in and subject to the laws of this state; and 

(2) is created as of the date it is fully executed by or on behalf of all of the settlors or others. 

(c) For purposes of this section, a legal instrument, device, or arrangement similar to an irrevocable inter vivos trust means any instrument, device, or arrangement which involves a settlor who transfers or whose property is transferred by another including, but not limited to, any court, administrative body, or anyone else with authority to act on their behalf or at their direction, to an individual or entity with fiduciary, contractual, or legal obligations to the settlor or others to be held, managed, or administered by the individual or entity for the benefit of the settlor or others. These legal instruments, devices, or other arrangements are irrevocable inter vivos trusts for purposes of this section. 

(d) In the event of a conflict between this section and the provisions of an irrevocable trust created on or after July 1, 2005, this section shall control. 

(e) This section does not apply to trusts that qualify as supplemental needs trusts under section 501C.1205 or to trusts meeting the criteria of United States Code, title 42, section 1396p (d)(4)(a) and (c) for purposes of eligibility for medical assistance. 

(f) This section applies to all trusts first created on or after July 1, 2005, as permitted under United States Code, title 42, section 1396p, and to all interests in real or personal property regardless of the date on which the interest was created, reserved, or acquired.