1.1 	A bill for an act
1.2 	relating to state government; modifying provisions for human services health care 
1.3 	finance, human services health care policy, health care generally, health insurance, 
1.4 	Department of Health finance, Department of Health policy, emergency medical 
1.5 	services, pharmacy practice, mental health, Department of Human Services Office 
1.6 	of Inspector General; imposing penalties; making forecast adjustments; requiring 
1.7 	reports; appropriating money;amending Minnesota Statutes 2022, sections 62A.28, 
1.8 	subdivision 2; 62D.02, subdivisions 4, 7; 62D.03, subdivision 1, by adding a 
1.9 	subdivision; 62D.05, subdivision 1; 62D.12, subdivision 19; 62D.14, subdivision 
1.10 	1; 62D.19; 62D.20, subdivision 1; 62D.22, subdivision 5, by adding a subdivision; 
1.11 	62J.49, subdivision 1; 62J.61, subdivision 5; 62M.01, subdivision 3; 62M.02, 
1.12 	subdivisions 1a, 5, 11, 12, 21, by adding a subdivision; 62M.04, subdivision 1; 
1.13 	62M.05, subdivision 3a; 62M.07, subdivisions 2, 4, by adding a subdivision; 
1.14 	62M.10, subdivisions 7, 8; 62M.17, subdivision 2; 62Q.14; 62Q.19, subdivisions 
1.15 	3, 5, by adding a subdivision; 62Q.73, subdivision 2; 62V.05, subdivision 12; 
1.16 	62V.08; 62V.11, subdivision 4; 103I.621, subdivisions 1, 2; 144.05, subdivisions 
1.17 	6, 7; 144.058; 144.0724, subdivisions 2, 3a, 4, 6, 7, 8, 9, 11; 144.1464, subdivisions 
1.18 	1, 2, 3; 144.1501, subdivision 5; 144.1911, subdivision 2; 144.292, subdivision 6; 
1.19 	144.293, subdivisions 2, 4, 9, 10; 144.493, by adding a subdivision; 144.494, 
1.20 	subdivision 2; 144.551, subdivision 1; 144.555, subdivisions 1a, 1b, 2, by adding 
1.21 	subdivisions; 144.605, by adding a subdivision; 144.7067, subdivision 2; 144A.10, 
1.22 	subdivisions 15, 16; 144A.471, by adding a subdivision; 144A.474, subdivision 
1.23 	13; 144A.70, subdivisions 3, 5, 6, 7; 144A.71, subdivision 2, by adding a 
1.24 	subdivision; 144A.72, subdivision 1; 144A.73; 144E.001, subdivision 3a, by adding 
1.25 	subdivisions; 144E.101, by adding a subdivision; 144E.16, subdivisions 5, 7; 
1.26 	144E.19, subdivision 3; 144E.27, subdivisions 3, 5, 6; 144E.28, subdivisions 3, 
1.27 	5, 6, 8; 144E.285, subdivisions 1, 2, 4, 6, by adding subdivisions; 144E.287; 
1.28 	144E.305, subdivision 3; 144G.08, subdivision 29; 144G.10, by adding a 
1.29 	subdivision; 144G.16, subdivision 6; 146B.03, subdivision 7a; 146B.10, 
1.30 	subdivisions 1, 3; 148F.025, subdivision 2; 149A.02, subdivisions 3, 16, 26a, 27, 
1.31 	35, 37c, by adding subdivisions; 149A.03; 149A.65; 149A.70, subdivisions 1, 2, 
1.32 	3, 5; 149A.71, subdivisions 2, 4; 149A.72, subdivisions 3, 9; 149A.73, subdivision 
1.33 	1; 149A.74, subdivision 1; 149A.93, subdivision 3; 149A.94, subdivisions 1, 3, 
1.34 	4; 151.01, subdivisions 23, 27; 151.37, by adding a subdivision; 151.74, subdivision 
1.35 	6; 214.025; 214.04, subdivision 2a; 214.29; 214.31; 214.355; 245.462, subdivision 
1.36 	6; 245.4663, subdivision 2; 245A.04, by adding a subdivision; 245A.043, 
1.37 	subdivisions 2, 4, by adding subdivisions; 245A.07, subdivision 6; 245A.52, 
1.38 	subdivision 2; 245C.05, subdivision 5; 245C.08, subdivision 4; 245C.10, 
2.1 	subdivision 18; 245C.14, by adding a subdivision; 245C.22, subdivision 4; 245C.24, 
2.2 	subdivisions 2, 5, 6; 245C.30, by adding a subdivision; 245F.09, subdivision 2; 
2.3 	245F.14, by adding a subdivision; 245F.17; 245G.07, subdivision 4; 245G.08, 
2.4 	subdivisions 5, 6; 245G.10, by adding a subdivision; 245G.22, subdivisions 6, 7; 
2.5 	245I.02, subdivisions 17, 19; 245I.04, subdivision 6; 245I.10, subdivision 9; 
2.6 	245I.11, subdivision 1, by adding a subdivision; 245I.20, subdivision 4; 245I.23, 
2.7 	subdivision 14; 256.9657, subdivision 8, by adding a subdivision; 256.969, by 
2.8 	adding subdivisions; 256B.056, subdivisions 1a, 10; 256B.0622, subdivisions 2a, 
2.9 	3a, 7a, 7d; 256B.0623, subdivision 5; 256B.0625, subdivisions 12, 20, 32, by 
2.10 	adding subdivisions; 256B.0757, subdivisions 4a, 4d; 256B.0943, subdivision 12; 
2.11 	256B.0947, subdivision 5; 256B.69, by adding a subdivision; 256B.76, subdivision 
2.12 	6; 256I.04, subdivision 2f; 256R.02, subdivision 20; 260E.33, subdivision 2, as 
2.13 	amended; 317A.811, subdivision 1; 383B.908, subdivision 7, by adding a 
2.14 	subdivision; 383B.922; 519.05; 524.3-801, as amended; Minnesota Statutes 2023 
2.15 	Supplement, sections 13.46, subdivision 4, as amended; 15A.0815, subdivision 2; 
2.16 	43A.08, subdivision 1a; 62Q.46, subdivision 1; 62Q.473, by adding a subdivision; 
2.17 	62Q.522, subdivision 1; 62Q.523, subdivision 1; 144.0526, subdivision 1; 144.1501, 
2.18 	subdivision 2; 144.1505, subdivision 2; 144.587, subdivisions 1, 4; 144.651, 
2.19 	subdivision 10a; 144A.4791, subdivision 10; 144E.101, subdivisions 6, 7, as 
2.20 	amended; 145.561, subdivision 4; 145D.01, subdivision 1; 151.555, subdivisions 
2.21 	1, 4, 5, 6, 7, 8, 9, 11, 12; 151.74, subdivision 3; 152.126, subdivision 6; 245.4889, 
2.22 	subdivision 1; 245.991, subdivision 1; 245A.03, subdivision 2, as amended; 
2.23 	245A.043, subdivision 3; 245A.07, subdivision 1, as amended; 245A.11, 
2.24 	subdivision 7; 245A.16, subdivision 1, as amended; 245A.211, subdivision 4; 
2.25 	245A.242, subdivision 2; 245C.02, subdivision 13e; 245C.033, subdivision 3; 
2.26 	245C.08, subdivision 1; 245C.10, subdivision 15; 245G.22, subdivisions 2, 17; 
2.27 	254B.04, subdivision 1a; 256.046, subdivision 3; 256.0471, subdivision 1, as 
2.28 	amended; 256.9631; 256.969, subdivision 2b; 256B.0622, subdivisions 7b, 8; 
2.29 	256B.0625, subdivisions 5m, 13e, as amended, 13f, 16; 256B.064, subdivision 4; 
2.30 	256B.0671, subdivision 5; 256B.0701, subdivision 6; 256B.0947, subdivision 7; 
2.31 	256B.764; 256D.01, subdivision 1a; 256I.05, subdivisions 1a, 11; 256L.03, 
2.32 	subdivision 1; 270A.03, subdivision 2; 342.06; Laws 2020, chapter 73, section 8; 
2.33 	Laws 2023, chapter 22, section 4, subdivision 2; Laws 2023, chapter 70, article 
2.34 	20, sections 2, subdivisions 5, 7, 29; 3, subdivision 2; 12, as amended; Laws 2024, 
2.35 	chapter 80, article 2, sections 6, subdivisions 2, 3, by adding subdivisions; 10, 
2.36 	subdivisions 1, 6; proposing coding for new law in Minnesota Statutes, chapters 
2.37 	62A; 62C; 62D; 62J; 62M; 62Q; 62V; 144; 144A; 144E; 145D; 149A; 151; 245C; 
2.38 	256B; proposing coding for new law as Minnesota Statutes, chapter 332C; repealing 
2.39 	Minnesota Statutes 2022, sections 62A.041, subdivision 3; 144.497; 144E.001, 
2.40 	subdivision 5; 144E.01; 144E.123, subdivision 5; 144E.27, subdivisions 1, 1a; 
2.41 	144E.50, subdivision 3; 151.74, subdivision 16; 245C.125; 256D.19, subdivisions 
2.42 	1, 2; 256D.20, subdivisions 1, 2, 3, 4; 256D.23, subdivisions 1, 2, 3; 256R.02, 
2.43 	subdivision 46; Minnesota Statutes 2023 Supplement, sections 62J.312, subdivision 
2.44 	6; 62Q.522, subdivisions 3, 4; 144.0528, subdivision 5; 245C.08, subdivision 2; 
2.45 	Laws 2023, chapter 70, article 20, section 2, subdivision 31, as amended; Laws 
2.46 	2023, chapter 75, section 10; Laws 2024, chapter 80, article 2, section 6, subdivision 
2.47 	4; Minnesota Rules, part 9502.0425, subpart 5.
3.1 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.2 	ARTICLE 1
3.3 	DEPARTMENT OF HUMAN SERVICES HEALTH CARE FINANCE

3.4 	Section 1. [62V.12] STATE-FUNDED COST-SHARING REDUCTIONS.
3.5 		Subdivision 1.Establishment. (a) The board must develop and administer a state-funded 
3.6 	cost-sharing reduction program for eligible persons who enroll in a silver level qualified 
3.7 	health plan through MNsure. The board must implement the cost-sharing reduction program 
3.8 	for plan years beginning on or after January 1, 2027.
3.9 	(b) For purposes of this section, an "eligible person" is an individual who meets the 
3.10 	eligibility criteria to receive a cost-sharing reduction under Code of Federal Regulations, 
3.11 	title 45, section 155.305(g).
3.12 		Subd. 2.Reduction in cost-sharing. The cost-sharing reduction program must use state 
3.13 	money to reduce enrollee cost-sharing by increasing the actuarial value of silver level health 
3.14 	plans for eligible persons beyond the 73 percent value established in Code of Federal 
3.15 	Regulations, title 45, section 156.420(a)(3)(ii), to an actuarial value of 87 percent.
3.16 		Subd. 3.Administration. The board, when administering the program, must:
3.17 	(1) allow eligible persons to enroll in a silver level health plan with a state-funded 
3.18 	cost-sharing reduction;
3.19 	(2) modify the MNsure shopping tool to display the total cost-sharing reduction benefit 
3.20 	available to individuals eligible under this section; and
3.21 	(3) reimburse health carriers on a quarterly basis for the cost to the health plan providing 
3.22 	the state-funded cost-sharing reductions.

3.23 	Sec. 2. Minnesota Statutes 2023 Supplement, section 256.9631, is amended to read:
3.24 	256.9631 DIRECT PAYMENT SYSTEM ALTERNATIVE CARE DELIVERY 
3.25 	MODELS FOR MEDICAL ASSISTANCE AND MINNESOTACARE.
3.26 		Subdivision 1.Direction to the commissioner. (a) The commissioner, in order to deliver 
3.27 	services to eligible individuals, achieve better health outcomes, and reduce the cost of health 
3.28 	care for the state, shall develop an implementation plan plans for a direct payment system 
3.29 	to deliver services to eligible individuals in order to achieve better health outcomes and 
3.30 	reduce the cost of health care for the state. Under this system, at least three care delivery 
3.31 	models that:
4.1 	(1) are alternatives to the use of commercial managed care plans to deliver health care 
4.2 	to Minnesota health care program enrollees; and
4.3 	(2) do not shift financial risk to nongovernmental entities.
4.4 	(b) One of the alternative models must be a direct payment system under which eligible 
4.5 	individuals must receive services through the medical assistance fee-for-service system, 
4.6 	county-based purchasing plans, or and county-owned health maintenance organizations. At 
4.7 	least one additional model must include county-based purchasing plans and county-owned 
4.8 	health maintenance organizations in their design, and must allow these entities to deliver 
4.9 	care in geographic areas on a single plan basis, if:
4.10 	(1) these entities contract with all providers that agree to contract terms for network 
4.11 	participation; and
4.12 	(2) the commissioner of human services determines that an entity's provider network is 
4.13 	adequate to ensure enrollee access and choice.
4.14 	(c) Before determining the alternative models for which implementation plans will be 
4.15 	developed, the commissioner shall consult with the chairs and ranking minority members 
4.16 	of the legislative committees with jurisdiction over health care finance and policy.
4.17 	(d) The commissioner shall present an implementation plan plans for the direct payment 
4.18 	system selected models to the chairs and ranking minority members of the legislative 
4.19 	committees with jurisdiction over health care finance and policy by January 15, 2026. The 
4.20 	commissioner may contract for technical assistance in developing the implementation plan
4.21 	plans and conducting related studies and analyses.
4.22 	(b) For the purposes of the direct payment system, the commissioner shall make the 
4.23 	following assumptions:
4.24 	(1) health care providers are reimbursed directly for all medical assistance covered 
4.25 	services provided to eligible individuals, using the fee-for-service payment methods specified 
4.26 	in chapters 256, 256B, 256R, and 256S;
4.27 	(2) payments to a qualified hospital provider are equivalent to the payments that would 
4.28 	have been received based on managed care direct payment arrangements. If necessary, a 
4.29 	qualified hospital provider may use a county-owned health maintenance organization to 
4.30 	receive direct payments as described in section 256B.1973; and
4.31 	(3) county-based purchasing plans and county-owned health maintenance organizations 
4.32 	must be reimbursed at the capitation rate determined under sections 256B.69 and 256B.692.
5.1 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
5.2 	meanings given.
5.3 	(b) "Eligible individuals" means qualified all medical assistance enrollees, defined as 
5.4 	persons eligible for medical assistance as families and children and adults without children
5.5 	and MinnesotaCare enrollees.
5.6 	(c) "Minnesota health care programs" means the medical assistance and MinnesotaCare 
5.7 	programs.
5.8 	(c) (d) "Qualified hospital provider" means a nonstate government teaching hospital 
5.9 	with high medical assistance utilization and a level 1 trauma center, and all of the hospital's 
5.10 	owned or affiliated health care professionals, ambulance services, sites, and clinics.
5.11 		Subd. 3.Implementation plan plans. (a) The Each implementation plan must include:
5.12 	(1) a timeline for the development and recommended implementation date of the direct 
5.13 	payment system alternative model. In recommending a timeline, the commissioner must 
5.14 	consider:
5.15 	(i) timelines required by the existing contracts with managed care plans and county-based 
5.16 	purchasing plans to sunset existing delivery models;
5.17 	(ii) in counties that choose to operate a county-based purchasing plan under section 
5.18 	256B.692, timelines for any new procurements required for those counties to establish a 
5.19 	new county-based purchasing plan or participate in an existing county-based purchasing 
5.20 	plan;
5.21 	(iii) in counties that choose to operate a county-owned health maintenance organization 
5.22 	under section 256B.69, timelines for any new procurements required for those counties to 
5.23 	establish a new county-owned health maintenance organization or to continue serving 
5.24 	enrollees through an existing county-owned health maintenance organization; and
5.25 	(iv) a recommendation on whether the commissioner should contract with a third-party 
5.26 	administrator to administer the direct payment system alternative model, and the timeline 
5.27 	needed for procuring an administrator;
5.28 	(2) the procedures to be used to ensure continuity of care for enrollees who transition 
5.29 	from managed care to fee-for-service and any administrative resources needed to carry out 
5.30 	these procedures;
5.31 	(3) recommended quality measures for health care service delivery;
6.1 	(4) any changes to fee-for-service payment rates that the commissioner determines are 
6.2 	necessary to ensure provider access and high-quality care and to reduce health disparities;
6.3 	(5) recommendations on ensuring effective care coordination under the direct payment 
6.4 	system alternative model, especially for enrollees who:
6.5 	(i) are age 65 or older, blind, or have disabilities;
6.6 	(ii) have complex medical conditions, who;
6.7 	(iii) face socioeconomic barriers to receiving care, or who; or
6.8 	(iv) are from underserved populations that experience health disparities;
6.9 	(6) recommendations on whether the direct payment system should provide supplemental 
6.10 	payments payment arrangements for care coordination, including:
6.11 	(i) the provider types eligible for supplemental care coordination payments;
6.12 	(ii) procedures to coordinate supplemental care coordination payments with existing 
6.13 	supplemental or cost-based payment methods or to replace these existing methods; and
6.14 	(iii) procedures to align care coordination initiatives funded through supplemental 
6.15 	payments under this section the alternative model with existing care coordination initiatives;
6.16 	(7) recommendations on whether the direct payment system alternative model should 
6.17 	include funding to providers for outreach initiatives to patients who, because of mental 
6.18 	illness, homelessness, or other circumstances, are unlikely to obtain needed care and 
6.19 	treatment;
6.20 	(8) recommendations for a supplemental payment to qualified hospital providers to offset 
6.21 	any potential revenue losses resulting from the shift from managed care payments; and
6.22 	(9) recommendations on whether and how the direct payment system should be expanded 
6.23 	to deliver services and care coordination to medical assistance enrollees who are age 65 or 
6.24 	older, are blind, or have a disability and to persons enrolled in MinnesotaCare; and
6.25 	(10) (9) recommendations for statutory changes necessary to implement the direct 
6.26 	payment system alternative model.
6.27 	(b) In developing the each implementation plan, the commissioner shall:
6.28 	(1) calculate the projected cost of a direct payment system the alternative model relative 
6.29 	to the cost of the current system;
6.30 	(2) assess gaps in care coordination under the current medical assistance and 
6.31 	MinnesotaCare programs;
7.1 	(3) evaluate the effectiveness of approaches other states have taken to coordinate care 
7.2 	under a fee-for-service system, including the coordination of care provided to persons who 
7.3 	are age 65 or older, are blind, or have disabilities;
7.4 	(4) estimate the loss of revenue and cost savings from other payment enhancements 
7.5 	based on managed care plan directed payments and pass-throughs;
7.6 	(5) estimate cost trends under a direct payment system the alternative model for managed 
7.7 	care payments to county-based purchasing plans and county-owned health maintenance 
7.8 	organizations;
7.9 	(6) estimate the impact of a direct payment system the alternative model on other revenue, 
7.10 	including taxes, surcharges, or other federally approved in lieu of services and on other 
7.11 	arrangements allowed under managed care;
7.12 	(7) consider allowing eligible individuals to opt out of managed care as an alternative 
7.13 	approach;
7.14 	(8) assess the feasibility of a medical assistance outpatient prescription drug benefit 
7.15 	carve-out under section 256B.69, subdivision 6d, and in consultation with the commissioners 
7.16 	of commerce and health, assess the feasibility of including MinnesotaCare enrollees and 
7.17 	private sector enrollees of health plan companies in the drug benefit carve-out. The 
7.18 	assessment of feasibility must address and include recommendations related to the process 
7.19 	and terms by which the commissioner would contract with health plan companies to 
7.20 	administer prescription drug benefits and develop and manage a drug formulary, and the 
7.21 	impact of the drug-benefit carve-out on health care providers, including small pharmacies;
7.22 	(9) (8) consult with the commissioners of health and commerce and the contractor or 
7.23 	contractors analyzing the Minnesota Health Plan under section 19 and other health reform 
7.24 	models on plan design and assumptions; and
7.25 	(10) (9) conduct other analyses necessary to develop the implementation plan.

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

7.27 	Sec. 3. Minnesota Statutes 2022, section 256.9657, is amended by adding a subdivision 
7.28 	to read:
7.29 		Subd. 2a.Teaching hospital surcharge. (a) Each teaching hospital shall pay to the 
7.30 	medical assistance account a surcharge equal to 0.01 percent of net non-Medicare patient 
7.31 	care revenue. The initial surcharge must be paid 60 days after both this subdivision and 
8.1 	section 256.969, subdivision 2g, have received federal approval, and subsequent surcharge 
8.2 	payments must be made annually in the form and manner specified by the commissioner.
8.3 	(b) The commissioner shall use revenue from the surcharge only to pay the nonfederal 
8.4 	share of the medical assistance supplemental payments described in section 256.969, 
8.5 	subdivision 2g, and to supplement, and not supplant, medical assistance reimbursement to 
8.6 	teaching hospitals. The surcharge must comply with Code of Federal Regulations, title 42, 
8.7 	section 433.68.
8.8 	(c) For purposes of this subdivision, "teaching hospital" means any Minnesota hospital, 
8.9 	except facilities of the federal Indian Health Service and regional treatment centers, with a 
8.10 	Centers for Medicare and Medicaid Services designation of "teaching hospital" as reported 
8.11 	on form CMS-2552-10, worksheet S-2, line 56, that is eligible for reimbursement under 
8.12 	section 256.969, subdivision 2g.

8.13 	EFFECTIVE DATE. This section is effective the later of January 1, 2025, or federal 
8.14 	approval of this section and sections 4 and 5. The commissioner of human services shall 
8.15 	notify the revisor of statutes when federal approval is obtained.

8.16 	Sec. 4. Minnesota Statutes 2023 Supplement, section 256.969, subdivision 2b, is amended 
8.17 	to read:
8.18 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
8.19 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
8.20 	to the following:
8.21 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
8.22 	methodology;
8.23 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
8.24 	under subdivision 25;
8.25 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
8.26 	distinct parts as defined by Medicare shall be paid according to the methodology under 
8.27 	subdivision 12; and
8.28 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
8.29 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
8.30 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
8.31 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
8.32 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
9.1 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
9.2 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
9.3 	period as other hospitals.
9.4 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
9.5 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
9.6 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
9.7 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
9.8 	manner similar to Medicare. The base year or years for the rates effective November 1, 
9.9 	2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral, 
9.10 	ensuring that the total aggregate payments under the rebased system are equal to the total 
9.11 	aggregate payments that were made for the same number and types of services in the base 
9.12 	year. Separate budget neutrality calculations shall be determined for payments made to 
9.13 	critical access hospitals and payments made to hospitals paid under the DRG system. Only 
9.14 	the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being 
9.15 	rebased during the entire base period shall be incorporated into the budget neutrality 
9.16 	calculation.
9.17 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
9.18 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
9.19 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
9.20 	a five percent increase or decrease from the base year payments for any hospital. Any 
9.21 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
9.22 	shall maintain budget neutrality as described in paragraph (c).
9.23 	(e) For discharges occurring on or after November 1, 2014, the commissioner may make 
9.24 	additional adjustments to the rebased rates, and when evaluating whether additional 
9.25 	adjustments should be made, the commissioner shall consider the impact of the rates on the 
9.26 	following:
9.27 	(1) pediatric services;
9.28 	(2) behavioral health services;
9.29 	(3) trauma services as defined by the National Uniform Billing Committee;
9.30 	(4) transplant services;
9.31 	(5) obstetric services, newborn services, and behavioral health services provided by 
9.32 	hospitals outside the seven-county metropolitan area;
9.33 	(6) outlier admissions;
10.1 	(7) low-volume providers; and
10.2 	(8) services provided by small rural hospitals that are not critical access hospitals.
10.3 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
10.4 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
10.5 	admission is standardized by the applicable Medicare wage index and adjusted by the 
10.6 	hospital's disproportionate population adjustment;
10.7 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
10.8 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
10.9 	October 31, 2014;
10.10 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
10.11 	inpatient services covered by medical assistance; and
10.12 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
10.13 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
10.14 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
10.15 	program in effect during the base year or years. In determining hospital payment rates for 
10.16 	discharges in subsequent base years, the per discharge rates shall be based on the cost-finding 
10.17 	methods and allowable costs of the Medicare program in effect during the base year or 
10.18 	years.
10.19 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
10.20 	the rates established under paragraph (c), and any adjustments made to the rates under 
10.21 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
10.22 	total aggregate payments for the same number and types of services under the rebased rates 
10.23 	are equal to the total aggregate payments made during calendar year 2013.
10.24 	(h) Effective for discharges occurring on or after July 1, 2017, and every two years 
10.25 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
10.26 	in hospital costs between the existing base year or years and the next base year or years. In 
10.27 	any year that inpatient claims volume falls below the threshold required to ensure a 
10.28 	statistically valid sample of claims, the commissioner may combine claims data from two 
10.29 	consecutive years to serve as the base year. Years in which inpatient claims volume is 
10.30 	reduced or altered due to a pandemic or other public health emergency shall not be used as 
10.31 	a base year or part of a base year if the base year includes more than one year. Changes in 
10.32 	costs between base years shall be measured using the lower of the hospital cost index defined 
10.33 	in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per 
11.1 	claim. The commissioner shall establish the base year for each rebasing period considering 
11.2 	the most recent year or years for which filed Medicare cost reports are available, except 
11.3 	that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019. 
11.4 	The estimated change in the average payment per hospital discharge resulting from a 
11.5 	scheduled rebasing must be calculated and made available to the legislature by January 15 
11.6 	of each year in which rebasing is scheduled to occur, and must include by hospital the 
11.7 	differential in payment rates compared to the individual hospital's costs.
11.8 	(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates 
11.9 	for critical access hospitals located in Minnesota or the local trade area shall be determined 
11.10 	using a new cost-based methodology. The commissioner shall establish within the 
11.11 	methodology tiers of payment designed to promote efficiency and cost-effectiveness. 
11.12 	Payment rates for hospitals under this paragraph shall be set at a level that does not exceed 
11.13 	the total cost for critical access hospitals as reflected in base year cost reports. Until the 
11.14 	next rebasing that occurs, the new methodology shall result in no greater than a five percent 
11.15 	decrease from the base year payments for any hospital, except a hospital that had payments 
11.16 	that were greater than 100 percent of the hospital's costs in the base year shall have their 
11.17 	rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and 
11.18 	after July 1, 2016, covered under this paragraph shall be increased by the inflation factor 
11.19 	in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not 
11.20 	be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the 
11.21 	following criteria:
11.22 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
11.23 	shall have a rate set that equals 85 percent of their base year costs;
11.24 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
11.25 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
11.26 	base year costs; and
11.27 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
11.28 	shall have a rate set that equals 100 percent of their base year costs.
11.29 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
11.30 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
11.31 	methodology may include, but are not limited to:
11.32 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
11.33 	hospital's charges to the medical assistance program;
12.1 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
12.2 	hospital's payments received from the medical assistance program for the care of medical 
12.3 	assistance patients;
12.4 	(3) the ratio between the hospital's charges to the medical assistance program and the 
12.5 	hospital's payments received from the medical assistance program for the care of medical 
12.6 	assistance patients;
12.7 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
12.8 	(5) the proportion of that hospital's costs that are administrative and trends in 
12.9 	administrative costs; and
12.10 	(6) geographic location.
12.11 	(k) Subject to section 256.969, subdivision 2g, paragraph (i), effective for discharges 
12.12 	occurring on or after January 1, 2024, the rates paid to hospitals described in paragraph (a), 
12.13 	clauses (2) to (4), must include a rate factor specific to each hospital that qualifies for a 
12.14 	medical education and research cost distribution under section 62J.692, subdivision 4, 
12.15 	paragraph (a).

12.16 	EFFECTIVE DATE. This section is effective the later of January 1, 2025, or federal 
12.17 	approval of this section and sections 3 and 5. The commissioner of human services shall 
12.18 	notify the revisor of statutes when federal approval is obtained.

12.19 	Sec. 5. Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to 
12.20 	read:
12.21 		Subd. 2g.Annual supplemental payments; direct and indirect physician graduate 
12.22 	medical education. (a) For discharges occurring on or after January 1, 2025, the 
12.23 	commissioner shall determine and pay annual supplemental payments to all eligible hospitals 
12.24 	as provided in this subdivision for direct and indirect physician graduate medical education 
12.25 	cost reimbursement. A hospital must be an eligible hospital to receive an annual supplemental 
12.26 	payment under this subdivision.
12.27 	(b) The commissioner must use the following information to calculate the total cost of 
12.28 	direct graduate medical education incurred by each eligible hospital:
12.29 	(1) the total allowable direct graduate medical education cost, as calculated by adding 
12.30 	form CMS-2552-10, worksheet B, part 1, columns 21 and 22, line 202; and
12.31 	(2) the Medicaid share of total allowable direct graduate medical education cost 
12.32 	percentage, representing the allocation of total graduate medical education costs to Medicaid 
13.1 	based on the share of all Medicaid inpatient days, as reported on form CMS-2552-10, 
13.2 	worksheets S-2 and S-3, divided by the hospital's total inpatient days, as reported on 
13.3 	worksheet S-3.
13.4 	(c) The commissioner may obtain the information in paragraph (b) from an eligible 
13.5 	hospital upon request by the commissioner or from the eligible hospital's most recently filed 
13.6 	form CMS-2552-10.
13.7 	(d) The commissioner must use the following information to calculate the total allowable 
13.8 	indirect cost of graduate medical education incurred by each eligible hospital:
13.9 	(1) for eligible hospitals that are not children's hospitals, the indirect graduate medical 
13.10 	education amount attributable to Medicaid, calculated based on form CMS-2552-10, 
13.11 	worksheet E, part A, including:
13.12 	(i) the Medicare indirect medical education formula, using Medicaid variables;
13.13 	(ii) Medicaid payments for inpatient services under fee-for-service and managed care, 
13.14 	as determined by the commissioner in consultation with each eligible hospital;
13.15 	(iii) total inpatient beds available, as reported on form CMS-2552-10, worksheet E, part 
13.16 	A, line 4; and
13.17 	(iv) full-time employees, as determined by adding form CMS-2552-10, worksheet E, 
13.18 	part A, lines 10 and 11; and
13.19 	(2) for eligible hospitals that are children's hospitals:
13.20 	(i) the Medicare indirect medical education formula, using Medicaid variables;
13.21 	(ii) Medicaid payments for inpatient services under fee-for-service and managed care, 
13.22 	as determined by the commissioner in consultation with each eligible hospital;
13.23 	(iii) total inpatient beds available, as reported on form CMS-2552-10, worksheet S-3, 
13.24 	part 1; and
13.25 	(iv) full-time equivalent interns and residents, as determined by adding form 
13.26 	CMS-2552-10, worksheet E-4, lines 6, 10.01, and 15.01.
13.27 	(e) The commissioner shall determine each eligible hospital's maximum allowable 
13.28 	Medicaid direct graduate medical education supplemental payment amount by calculating 
13.29 	the sum of:
14.1 	(1) the total allowable direct graduate medical education costs determined under paragraph 
14.2 	(b), clause (1), multiplied by the Medicaid share of total allowable direct graduate medical 
14.3 	education cost percentage in paragraph (b), clause (2); and
14.4 	(2) the total allowable direct graduate medical education costs determined under paragraph 
14.5 	(b), clause (1), multiplied by the most recently updated Medicaid utilization percentage 
14.6 	from form CMS-2552-10, as submitted to Medicare by each eligible hospital.
14.7 	(f) The commissioner shall determine each eligible hospital's indirect graduate medical 
14.8 	education supplemental payment amount by multiplying the total allowable indirect cost 
14.9 	of graduate medical education amount calculated in paragraph (d) by:
14.10 	(1) 0.95 for prospective payment system, for hospitals that are not children's hospitals 
14.11 	and have fewer than 50 full-time equivalent trainees;
14.12 	(2) 1.0 for prospective payment system, for hospitals that are not children's hospitals 
14.13 	and have equal to or greater than 50 full-time equivalent trainees; and
14.14 	(3) 1.05 for children's hospitals.
14.15 	(g) An eligible hospital's annual supplemental payment under this subdivision equals 
14.16 	the sum of the amount calculated for the eligible hospital under paragraph (e) and the amount 
14.17 	calculated for the eligible hospital under paragraph (f).
14.18 	(h) The annual supplemental payments under this subdivision are contingent upon federal 
14.19 	approval and must conform with the requirements for permissible supplemental payments 
14.20 	for direct and indirect graduate medical education under all applicable federal laws.
14.21 	(i) An eligible hospital is only eligible for reimbursement under section 62J.692 for 
14.22 	nonphysician graduate medical education training costs that are not accounted for in the 
14.23 	calculation of an annual supplemental payment under this section. An eligible hospital must 
14.24 	not accept reimbursement under section 62J.692 for physician graduate medical education 
14.25 	training costs that are accounted for in the calculation of an annual supplemental payment 
14.26 	under this section.
14.27 	(j) For purposes of this subdivision, "children's hospital" means a Minnesota hospital 
14.28 	designated as a children's hospital under Medicare.
14.29 	(k) For purposes of this subdivision, "eligible hospital" means a hospital located in 
14.30 	Minnesota:
14.31 	(1) participating in Minnesota's medical assistance program;
15.1 	(2) that has received fee-for-service medical assistance payments in the payment year; 
15.2 	and
15.3 	(3) that is either:
15.4 	(i) eligible to receive graduate medical education payments from the Medicare program 
15.5 	under Code of Federal Regulations, title 42, section 413.75; or
15.6 	(ii) a children's hospital.

15.7 	EFFECTIVE DATE. This section is effective the later of January 1, 2025, or federal 
15.8 	approval of this section and sections 3 and 4. The commissioner of human services shall 
15.9 	notify the revisor of statutes when federal approval is obtained.

15.10 	Sec. 6. Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to 
15.11 	read:
15.12 		Subd. 2h.Alternate inpatient payment rate for a discharge. (a) Effective retroactively 
15.13 	from January 1, 2024, in any rate year in which a children's hospital discharge is included 
15.14 	in the federally required disproportionate share hospital payment audit where the patient 
15.15 	discharged had resided in a children's hospital for over 20 years, the commissioner shall 
15.16 	compute an alternate inpatient rate for the children's hospital. The alternate payment rate 
15.17 	must be the rate computed under this section excluding the disproportionate share hospital 
15.18 	payment under subdivision 9, paragraph (d), clause (1), increased by an amount equal to 
15.19 	99 percent of what the disproportionate share hospital payment would have been under 
15.20 	subdivision 9, paragraph (d), clause (1), had the discharge been excluded.
15.21 	(b) In any rate year in which payment to a children's hospital is made using this alternate 
15.22 	payment rate, payments must not be made to the hospital under subdivisions 2e, 2f, and 9.

15.23 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
15.24 	of human services shall notify the revisor of statutes when federal approval is obtained.

15.25 	Sec. 7. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13e, as 
15.26 	amended by Laws 2024, chapter 85, section 66, is amended to read:
15.27 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment shall 
15.28 	be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the 
15.29 	usual and customary price charged to the public. The usual and customary price means the 
15.30 	lowest price charged by the provider to a patient who pays for the prescription by cash, 
15.31 	check, or charge account and includes prices the pharmacy charges to a patient enrolled in 
15.32 	a prescription savings club or prescription discount club administered by the pharmacy or 
16.1 	pharmacy chain. The amount of payment basis must be reduced to reflect all discount 
16.2 	amounts applied to the charge by any third-party provider/insurer agreement or contract for 
16.3 	submitted charges to medical assistance programs. The net submitted charge may not be 
16.4 	greater than the patient liability for the service. The professional dispensing fee shall be 
16.5 	$10.77 $11.55 for prescriptions filled with legend drugs meeting the definition of "covered 
16.6 	outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The 
16.7 	dispensing fee for intravenous solutions that must be compounded by the pharmacist shall 
16.8 	be $10.77 $11.55 per claim. The professional dispensing fee for prescriptions filled with 
16.9 	over-the-counter drugs meeting the definition of covered outpatient drugs shall be $10.77
16.10 	$11.55 for dispensed quantities equal to or greater than the number of units contained in 
16.11 	the manufacturer's original package. The professional dispensing fee shall be prorated based 
16.12 	on the percentage of the package dispensed when the pharmacy dispenses a quantity less 
16.13 	than the number of units contained in the manufacturer's original package. The pharmacy 
16.14 	dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered 
16.15 	outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units 
16.16 	contained in the manufacturer's original package and shall be prorated based on the 
16.17 	percentage of the package dispensed when the pharmacy dispenses a quantity less than the 
16.18 	number of units contained in the manufacturer's original package. The National Average 
16.19 	Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug. 
16.20 	For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient 
16.21 	cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for 
16.22 	a provider participating in the federal 340B Drug Pricing Program shall be either the 340B 
16.23 	Drug Pricing Program ceiling price established by the Health Resources and Services 
16.24 	Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as 
16.25 	the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in 
16.26 	the United States, not including prompt pay or other discounts, rebates, or reductions in 
16.27 	price, for the most recent month for which information is available, as reported in wholesale 
16.28 	price guides or other publications of drug or biological pricing data. The maximum allowable 
16.29 	cost of a multisource drug may be set by the commissioner and it shall be comparable to 
16.30 	the actual acquisition cost of the drug product and no higher than the NADAC of the generic 
16.31 	product. Establishment of the amount of payment for drugs shall not be subject to the 
16.32 	requirements of the Administrative Procedure Act.
16.33 	(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using 
16.34 	an automated drug distribution system meeting the requirements of section 151.58, or a 
16.35 	packaging system meeting the packaging standards set forth in Minnesota Rules, part 
16.36 	6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ 
17.1 	retrospective billing for prescription drugs dispensed to long-term care facility residents. A 
17.2 	retrospectively billing pharmacy must submit a claim only for the quantity of medication 
17.3 	used by the enrolled recipient during the defined billing period. A retrospectively billing 
17.4 	pharmacy must use a billing period not less than one calendar month or 30 days.
17.5 	(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota 
17.6 	Rules, part 6800.2700, is required to credit the department for the actual acquisition cost 
17.7 	of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective 
17.8 	billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that 
17.9 	is less than a 30-day supply.
17.10 	(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC 
17.11 	of the generic product or the maximum allowable cost established by the commissioner 
17.12 	unless prior authorization for the brand name product has been granted according to the 
17.13 	criteria established by the Drug Formulary Committee as required by subdivision 13f, 
17.14 	paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in 
17.15 	a manner consistent with section 151.21, subdivision 2.
17.16 	(e) The basis for determining the amount of payment for drugs administered in an 
17.17 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
17.18 	provider, 106 percent of the average sales price as determined by the United States 
17.19 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
17.20 	federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost 
17.21 	set by the commissioner. If average sales price is unavailable, the amount of payment must 
17.22 	be lower of the usual and customary cost submitted by the provider, the wholesale acquisition 
17.23 	cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. 
17.24 	The commissioner shall discount the payment rate for drugs obtained through the federal 
17.25 	340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an 
17.26 	outpatient setting shall be made to the administering facility or practitioner. A retail or 
17.27 	specialty pharmacy dispensing a drug for administration in an outpatient setting is not 
17.28 	eligible for direct reimbursement.
17.29 	(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy 
17.30 	products that are lower than the ingredient cost formulas specified in paragraph (a). The 
17.31 	commissioner may require individuals enrolled in the health care programs administered 
17.32 	by the department to obtain specialty pharmacy products from providers with whom the 
17.33 	commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are 
17.34 	defined as those used by a small number of recipients or recipients with complex and chronic 
17.35 	diseases that require expensive and challenging drug regimens. Examples of these conditions 
18.1 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, 
18.2 	growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of 
18.3 	cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
18.4 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that 
18.5 	require complex care. The commissioner shall consult with the Formulary Committee to 
18.6 	develop a list of specialty pharmacy products subject to maximum allowable cost 
18.7 	reimbursement. In consulting with the Formulary Committee in developing this list, the 
18.8 	commissioner shall take into consideration the population served by specialty pharmacy 
18.9 	products, the current delivery system and standard of care in the state, and access to care 
18.10 	issues. The commissioner shall have the discretion to adjust the maximum allowable cost 
18.11 	to prevent access to care issues.
18.12 	(g) Home infusion therapy services provided by home infusion therapy pharmacies must 
18.13 	be paid at rates according to subdivision 8d.
18.14 	(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey 
18.15 	for all pharmacies that are physically located in the state of Minnesota that dispense outpatient 
18.16 	drugs under medical assistance. The commissioner shall ensure that the vendor has prior 
18.17 	experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the 
18.18 	department to dispense outpatient prescription drugs to fee-for-service members must 
18.19 	respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under 
18.20 	section 256B.064 for failure to respond. The commissioner shall require the vendor to 
18.21 	measure a single statewide cost of dispensing for specialty prescription drugs and a single 
18.22 	statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies 
18.23 	to measure the mean, mean weighted by total prescription volume, mean weighted by 
18.24 	medical assistance prescription volume, median, median weighted by total prescription 
18.25 	volume, and median weighted by total medical assistance prescription volume. The 
18.26 	commissioner shall post a copy of the final cost of dispensing survey report on the 
18.27 	department's website. The initial survey must be completed no later than January 1, 2021, 
18.28 	and repeated every three years. The commissioner shall provide a summary of the results 
18.29 	of each cost of dispensing survey and provide recommendations for any changes to the 
18.30 	dispensing fee to the chairs and ranking minority members of the legislative committees 
18.31 	with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section 
18.32 	256.01, subdivision 42, this paragraph does not expire.
18.33 	(i) The commissioner shall increase the ingredient cost reimbursement calculated in 
18.34 	paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to 
18.35 	the wholesale drug distributor tax under section 295.52.

19.1 	EFFECTIVE DATE. This section is effective July 1, 2024.

19.2 	Sec. 8. Minnesota Statutes 2022, section 256B.69, is amended by adding a subdivision to 
19.3 	read:
19.4 		Subd. 38.Reimbursement of network providers. (a) A managed care plan that is a 
19.5 	staff model health plan company, when reimbursing network providers for services provided 
19.6 	to medical assistance and MinnesotaCare enrollees, must not reimburse network providers 
19.7 	who are employees at a higher rate than network providers who provide services under 
19.8 	contract for each separate service or grouping of services. This requirement does not apply 
19.9 	to reimbursement:
19.10 	(1) of network providers when participating in value-based purchasing models that are 
19.11 	intended to recognize value or outcomes over volume of services, including:
19.12 	(i) total cost of care and risk/gain sharing arrangements under section 256B.0755; and
19.13 	(ii) other pay-for-performance arrangements or service payments, as long as the terms 
19.14 	and conditions of the value-based purchasing model are applied uniformly to all participating 
19.15 	network providers; and
19.16 	(2) for services furnished by providers who are out-of-network.
19.17 	(b) Any contract or agreement between a managed care plan and a network administrator, 
19.18 	for purposes of delivering services to medical assistance and MinnesotaCare enrollees, must 
19.19 	require the network administrator to comply with the requirements that apply to a managed 
19.20 	care plan that is a staff model health plan company under paragraph (a) when reimbursing 
19.21 	providers who are employees of the network administrator and providers who provide 
19.22 	services under contract with the network administrator. This provision applies whether or 
19.23 	not the managed care plan, network administrator, and providers are under the same corporate 
19.24 	ownership.
19.25 	(c) For purposes of this subdivision, "network provider" has the meaning specified in 
19.26 	subdivision 37. For purposes of this subdivision, "network administrator" means any entity 
19.27 	that furnishes a provider network for a managed care plan company, or furnishes individual 
19.28 	health care providers or provider groups to a managed care plan for inclusion in the managed 
19.29 	care plan's provider network.

19.30 	Sec. 9. COUNTY-ADMINISTERED MEDICAL ASSISTANCE MODEL.
 19.31 		Subdivision 1.Model development. (a) The commissioner of human services, in 
19.32 	collaboration with the Association of Minnesota Counties and county-based purchasing 
20.1 	plans, shall develop a county-administered medical assistance (CAMA) model and a detailed 
20.2 	plan for implementing the CAMA model.
20.3 	(b) The CAMA model must be designed to achieve the following objectives:
20.4 	(1) provide a distinct county owned and administered alternative to the prepaid medical 
20.5 	assistance program;
20.6 	(2) facilitate greater integration of health care and social services to address social 
20.7 	determinants of health in rural and nonrural communities, with the degree of integration of 
20.8 	social services varying with each county's needs and resources;
20.9 	(3) account for differences between counties in the number of medical assistance enrollees 
20.10 	and locally available providers of behavioral health, oral health, specialty and tertiary care, 
20.11 	nonemergency medical transportation, and other health care services in rural communities; 
20.12 	and
20.13 	(4) promote greater accountability for health outcomes, health equity, customer service, 
20.14 	community outreach, and cost of care.
20.15 		Subd. 2.County participation. (a) The CAMA model must give each rural and nonrural 
20.16 	county the option of applying to participate in the CAMA model as an alternative to 
20.17 	participation in the prepaid medical assistance program. The CAMA model must include a 
20.18 	process for the commissioner to determine whether and how a county can participate.
20.19 	(b) The CAMA model may allow a county-administered managed care organization to 
20.20 	deliver care on a single-plan basis to all medical assistance enrollees residing in a county 
20.21 	if:
20.22 	(1) the managed care organization contracts with all health care providers that agree to 
20.23 	accept the contract terms for network participation; and
20.24 	(2) the commissioner determines that the health care provider network of the managed 
20.25 	care organization is adequate to ensure enrollee access to care and enrollee choice of 
20.26 	providers.
20.27 		Subd. 3.Report to the legislature. (a) The commissioner shall report recommendations 
20.28 	and an implementation plan for the CAMA model to the chairs and ranking minority members 
20.29 	of the legislative committees with jurisdiction over health care policy and finance by January 
20.30 	15, 2025. The CAMA model and implementation plan must address the issues and consider 
20.31 	the recommendations identified in the document titled "Recommendations Not Contingent 
20.32 	on Outcome(s) of Current Litigation," attached to the September 13, 2022, e-filing to the 
20.33 	Second Judicial District Court (Correspondence for Judicial Approval Index #102), that 
21.1 	relates to the final contract decisions of the commissioner of human services regarding 
21.2 	South Country Health Alliance v. Minnesota Department of Human Services, No. 
21.3 	62-CV-22-907 (Ramsey Cnty. Dist. Ct. 2022).
21.4 	(b) The report must also identify the clarifications, approvals, and waivers that are needed 
21.5 	from the Centers for Medicare and Medicaid Services and include any draft legislation 
21.6 	necessary to implement the CAMA model.

21.7 	Sec. 10. REVISOR INSTRUCTION.
 21.8 	When the proposed rule published at Federal Register, volume 88, page 25313, becomes 
21.9 	effective, the revisor of statutes must change: (1) the reference in Minnesota Statutes, section 
21.10 	256B.06, subdivision 4, paragraph (d), from Code of Federal Regulations, title 8, section 
21.11 	103.12, to Code of Federal Regulations, title 42, section 435.4; and (2) the reference in 
21.12 	Minnesota Statutes, section 256L.04, subdivision 10, paragraph (a), from Code of Federal 
21.13 	Regulations, title 8, section 103.12, to Code of Federal Regulations, title 45, section 155.20. 
21.14 	The commissioner of human services shall notify the revisor of statutes when the proposed 
21.15 	rule published at Federal Register, volume 88, page 25313, becomes effective.

21.16 	ARTICLE 2
21.17 	DEPARTMENT OF HUMAN SERVICES HEALTH CARE POLICY

21.18 	Section 1. Minnesota Statutes 2023 Supplement, section 256.0471, subdivision 1, as 
21.19 	amended by Laws 2024, chapter 80, article 1, section 76, is amended to read:
21.20 		Subdivision 1.Qualifying overpayment. Any overpayment for state-funded medical
21.21 	assistance under chapter 256B and state-funded MinnesotaCare under chapter 256L granted 
21.22 	pursuant to section 256.045, subdivision 10; chapter 256B for state-funded medical 
21.23 	assistance; and for assistance granted under chapters 256D, 256I, and 256K, and 256L for 
21.24 	state-funded MinnesotaCare except agency error claims, become a judgment by operation 
21.25 	of law 90 days after the notice of overpayment is personally served upon the recipient in a 
21.26 	manner that is sufficient under rule 4.03(a) of the Rules of Civil Procedure for district courts, 
21.27 	or by certified mail, return receipt requested. This judgment shall be entitled to full faith 
21.28 	and credit in this and any other state.

21.29 	EFFECTIVE DATE. This section is effective July 1, 2024.

22.1 	Sec. 2. Minnesota Statutes 2022, section 256.9657, subdivision 8, is amended to read:
22.2 		Subd. 8.Commissioner's duties. (a) Beginning October 1, 2023, the commissioner of 
22.3 	human services shall annually report to the chairs and ranking minority members of the 
22.4 	legislative committees with jurisdiction over health care policy and finance regarding the 
22.5 	provider surcharge program. The report shall include information on total billings, total 
22.6 	collections, and administrative expenditures for the previous fiscal year. This paragraph 
22.7 	expires January 1, 2032.
22.8 	(b) (a) The surcharge shall be adjusted by inflationary and caseload changes in future 
22.9 	bienniums to maintain reimbursement of health care providers in accordance with the 
22.10 	requirements of the state and federal laws governing the medical assistance program, 
22.11 	including the requirements of the Medicaid moratorium amendments of 1991 found in 
22.12 	Public Law No. 102-234.
22.13 	(c) (b) The commissioner shall request the Minnesota congressional delegation to support 
22.14 	a change in federal law that would prohibit federal disallowances for any state that makes 
22.15 	a good faith effort to comply with Public Law 102-234 by enacting conforming legislation 
22.16 	prior to the issuance of federal implementing regulations.

22.17 	Sec. 3. Minnesota Statutes 2022, section 256B.056, subdivision 1a, is amended to read:
22.18 		Subd. 1a.Income and assets generally. (a)(1) Unless specifically required by state law 
22.19 	or rule or federal law or regulation, the methodologies used in counting income and assets 
22.20 	to determine eligibility for medical assistance for persons whose eligibility category is based 
22.21 	on blindness, disability, or age of 65 or more years, the methodologies for the Supplemental 
22.22 	Security Income program shall be used, except as provided under in clause (2) and
22.23 	subdivision 3, paragraph (a), clause (6).
22.24 	(2) State tax credits, rebates, and refunds must not be counted as income. State tax credits, 
22.25 	rebates, and refunds must not be counted as assets for a period of 12 months after the month 
22.26 	of receipt.
22.27 	(2) (3) Increases in benefits under title II of the Social Security Act shall not be counted 
22.28 	as income for purposes of this subdivision until July 1 of each year. Effective upon federal 
22.29 	approval, for children eligible under section 256B.055, subdivision 12, or for home and 
22.30 	community-based waiver services whose eligibility for medical assistance is determined 
22.31 	without regard to parental income, child support payments, including any payments made 
22.32 	by an obligor in satisfaction of or in addition to a temporary or permanent order for child 
22.33 	support, and Social Security payments are not counted as income.
23.1 	(b)(1) The modified adjusted gross income methodology as defined in United States 
23.2 	Code, title 42, section 1396a(e)(14), shall be used for eligibility categories based on:
23.3 	(i) children under age 19 and their parents and relative caretakers as defined in section 
23.4 	256B.055, subdivision 3a;
23.5 	(ii) children ages 19 to 20 as defined in section 256B.055, subdivision 16;
23.6 	(iii) pregnant women as defined in section 256B.055, subdivision 6;
23.7 	(iv) infants as defined in sections 256B.055, subdivision 10, and 256B.057, subdivision 
23.8 	1; and
23.9 	(v) adults without children as defined in section 256B.055, subdivision 15.
23.10 	For these purposes, a "methodology" does not include an asset or income standard, or 
23.11 	accounting method, or method of determining effective dates.
23.12 	(2) For individuals whose income eligibility is determined using the modified adjusted 
23.13 	gross income methodology in clause (1):
23.14 	(i) the commissioner shall subtract from the individual's modified adjusted gross income 
23.15 	an amount equivalent to five percent of the federal poverty guidelines; and
23.16 	(ii) the individual's current monthly income and household size is used to determine 
23.17 	eligibility for the 12-month eligibility period. If an individual's income is expected to vary 
23.18 	month to month, eligibility is determined based on the income predicted for the 12-month 
23.19 	eligibility period.

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

23.21 	Sec. 4. Minnesota Statutes 2022, section 256B.056, subdivision 10, is amended to read:
23.22 		Subd. 10.Eligibility verification. (a) The commissioner shall require women who are 
23.23 	applying for the continuation of medical assistance coverage following the end of the 
23.24 	12-month postpartum period to update their income and asset information and to submit 
23.25 	any required income or asset verification.
23.26 	(b) The commissioner shall determine the eligibility of private-sector health care coverage 
23.27 	for infants less than one year of age eligible under section 256B.055, subdivision 10, or 
23.28 	256B.057, subdivision 1, paragraph (c), and shall pay for private-sector coverage if this is 
23.29 	determined to be cost-effective.
23.30 	(c) The commissioner shall verify assets and income for all applicants, and for all 
23.31 	recipients upon renewal.
24.1 	(d) The commissioner shall utilize information obtained through the electronic service 
24.2 	established by the secretary of the United States Department of Health and Human Services 
24.3 	and other available electronic data sources in Code of Federal Regulations, title 42, sections 
24.4 	435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish 
24.5 	standards to define when information obtained electronically is reasonably compatible with 
24.6 	information provided by applicants and enrollees, including use of self-attestation, to 
24.7 	accomplish real-time eligibility determinations and maintain program integrity.
24.8 	(e) Each person applying for or receiving medical assistance under section 256B.055, 
24.9 	subdivision 7, and any other person whose resources are required by law to be disclosed to 
24.10 	determine the applicant's or recipient's eligibility must authorize the commissioner to obtain 
24.11 	information from financial institutions to identify unreported accounts verify assets as 
24.12 	required in section 256.01, subdivision 18f. If a person refuses or revokes the authorization, 
24.13 	the commissioner may determine that the applicant or recipient is ineligible for medical 
24.14 	assistance. For purposes of this paragraph, an authorization to identify unreported accounts
24.15 	verify assets meets the requirements of the Right to Financial Privacy Act, United States 
24.16 	Code, title 12, chapter 35, and need not be furnished to the financial institution.
24.17 	(f) County and tribal agencies shall comply with the standards established by the 
24.18 	commissioner for appropriate use of the asset verification system specified in section 256.01, 
24.19 	subdivision 18f.

24.20 	Sec. 5. Minnesota Statutes 2023 Supplement, section 256B.0701, subdivision 6, is amended 
24.21 	to read:
24.22 		Subd. 6.Recuperative care facility rate. (a) The recuperative care facility rate is for 
24.23 	facility costs and must be paid from state money in an amount equal to the medical assistance 
24.24 	room and board MSA equivalent rate as defined in section 256I.03, subdivision 11a, at the 
24.25 	time the recuperative care services were provided. The eligibility standards in chapter 256I
24.26 	do not apply to the recuperative care facility rate. The recuperative care facility rate is only 
24.27 	paid when the recuperative care services rate is paid to a provider. Providers may opt to 
24.28 	only receive the recuperative care services rate.
24.29 	(b) Before a recipient is discharged from a recuperative care setting, the provider must 
24.30 	ensure that the recipient's medical condition is stabilized or that the recipient is being 
24.31 	discharged to a setting that is able to meet that recipient's needs.

25.1 	Sec. 6. Minnesota Statutes 2022, section 256B.0757, subdivision 4a, is amended to read:
25.2 		Subd. 4a.Behavioral health home services provider requirements. A behavioral 
25.3 	health home services provider must:
25.4 	(1) be an enrolled Minnesota Health Care Programs provider;
25.5 	(2) provide a medical assistance covered primary care or behavioral health service;
25.6 	(3) utilize an electronic health record;
25.7 	(4) utilize an electronic patient registry that contains data elements required by the 
25.8 	commissioner;
25.9 	(5) demonstrate the organization's capacity to administer screenings approved by the 
25.10 	commissioner for substance use disorder or alcohol and tobacco use;
25.11 	(6) demonstrate the organization's capacity to refer an individual to resources appropriate 
25.12 	to the individual's screening results;
25.13 	(7) have policies and procedures to track referrals to ensure that the referral met the 
25.14 	individual's needs;
25.15 	(8) conduct a brief needs assessment when an individual begins receiving behavioral 
25.16 	health home services. The brief needs assessment must be completed with input from the 
25.17 	individual and the individual's identified supports. The brief needs assessment must address 
25.18 	the individual's immediate safety and transportation needs and potential barriers to 
25.19 	participating in behavioral health home services;
25.20 	(9) conduct a health wellness assessment within 60 days after intake that contains all 
25.21 	required elements identified by the commissioner;
25.22 	(10) conduct a health action plan that contains all required elements identified by the 
25.23 	commissioner. The plan must be completed within 90 days after intake and must be updated 
25.24 	at least once every six months, or more frequently if significant changes to an individual's 
25.25 	needs or goals occur;
25.26 	(11) agree to cooperate with and participate in the state's monitoring and evaluation of 
25.27 	behavioral health home services; and
25.28 	(12) obtain the individual's written consent to begin receiving behavioral health home 
25.29 	services using a form approved by the commissioner.

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

26.1 	Sec. 7. Minnesota Statutes 2022, section 256B.0757, subdivision 4d, is amended to read:
26.2 		Subd. 4d.Behavioral health home services delivery standards. (a) A behavioral health 
26.3 	home services provider must meet the following service delivery standards:
26.4 	(1) establish and maintain processes to support the coordination of an individual's primary 
26.5 	care, behavioral health, and dental care;
26.6 	(2) maintain a team-based model of care, including regular coordination and 
26.7 	communication between behavioral health home services team members;
26.8 	(3) use evidence-based practices that recognize and are tailored to the medical, social, 
26.9 	economic, behavioral health, functional impairment, cultural, and environmental factors 
26.10 	affecting the individual's health and health care choices;
26.11 	(4) use person-centered planning practices to ensure the individual's health action plan 
26.12 	accurately reflects the individual's preferences, goals, resources, and optimal outcomes for 
26.13 	the individual and the individual's identified supports;
26.14 	(5) use the patient registry to identify individuals and population subgroups requiring 
26.15 	specific levels or types of care and provide or refer the individual to needed treatment, 
26.16 	intervention, or services;
26.17 	(6) utilize the Department of Human Services Partner Portal to identify past and current 
26.18 	treatment or services and identify potential gaps in care using a tool approved by the 
26.19 	commissioner;
26.20 	(7) deliver services consistent with the standards for frequency and face-to-face contact 
26.21 	required by the commissioner;
26.22 	(8) ensure that a diagnostic assessment is completed for each individual receiving 
26.23 	behavioral health home services within six months of the start of behavioral health home 
26.24 	services;
26.25 	(9) deliver services in locations and settings that meet the needs of the individual;
26.26 	(10) provide a central point of contact to ensure that individuals and the individual's 
26.27 	identified supports can successfully navigate the array of services that impact the individual's 
26.28 	health and well-being;
26.29 	(11) have capacity to assess an individual's readiness for change and the individual's 
26.30 	capacity to integrate new health care or community supports into the individual's life;
27.1 	(12) offer or facilitate the provision of wellness and prevention education on 
27.2 	evidenced-based curriculums specific to the prevention and management of common chronic 
27.3 	conditions;
27.4 	(13) help an individual set up and prepare for medical, behavioral health, social service, 
27.5 	or community support appointments, including accompanying the individual to appointments 
27.6 	as appropriate, and providing follow-up with the individual after these appointments;
27.7 	(14) offer or facilitate the provision of health coaching related to chronic disease 
27.8 	management and how to navigate complex systems of care to the individual, the individual's 
27.9 	family, and identified supports;
27.10 	(15) connect an individual, the individual's family, and identified supports to appropriate 
27.11 	support services that help the individual overcome access or service barriers, increase 
27.12 	self-sufficiency skills, and improve overall health;
27.13 	(16) provide effective referrals and timely access to services; and
27.14 	(17) establish a continuous quality improvement process for providing behavioral health 
27.15 	home services.
27.16 	(b) The behavioral health home services provider must also create a plan, in partnership 
27.17 	with the individual and the individual's identified supports, to support the individual after 
27.18 	discharge from a hospital, residential treatment program, or other setting. The plan must 
27.19 	include protocols for:
27.20 	(1) maintaining contact between the behavioral health home services team member, the 
27.21 	individual, and the individual's identified supports during and after discharge;
27.22 	(2) linking the individual to new resources as needed;
27.23 	(3) reestablishing the individual's existing services and community and social supports; 
27.24 	and
27.25 	(4) following up with appropriate entities to transfer or obtain the individual's service 
27.26 	records as necessary for continued care.
27.27 	(c) If the individual is enrolled in a managed care plan, a behavioral health home services 
27.28 	provider must:
27.29 	(1) notify the behavioral health home services contact designated by the managed care 
27.30 	plan within 30 days of when the individual begins behavioral health home services; and
27.31 	(2) adhere to the managed care plan communication and coordination requirements 
27.32 	described in the behavioral health home services manual.
28.1 	(d) Before terminating behavioral health home services, the behavioral health home 
28.2 	services provider must:
28.3 	(1) provide a 60-day notice of termination of behavioral health home services to all 
28.4 	individuals receiving behavioral health home services, the commissioner, and managed care 
28.5 	plans, if applicable; and
28.6 	(2) refer individuals receiving behavioral health home services to a new behavioral 
28.7 	health home services provider.

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

28.9 	Sec. 8. Minnesota Statutes 2023 Supplement, section 256B.764, is amended to read:
28.10 	256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
28.11 	(a) Effective for services rendered on or after July 1, 2007, payment rates for family 
28.12 	planning services shall be increased by 25 percent over the rates in effect June 30, 2007, 
28.13 	when these services are provided by a community clinic as defined in section 145.9268, 
28.14 	subdivision 1.
28.15 	(b) Effective for services rendered on or after July 1, 2013, payment rates for family 
28.16 	planning services shall be increased by 20 percent over the rates in effect June 30, 2013, 
28.17 	when these services are provided by a community clinic as defined in section 145.9268, 
28.18 	subdivision 1. The commissioner shall adjust capitation rates to managed care and 
28.19 	county-based purchasing plans to reflect this increase, and shall require plans to pass on the 
28.20 	full amount of the rate increase to eligible community clinics, in the form of higher payment 
28.21 	rates for family planning services.
28.22 	(c) Effective for services provided on or after January 1, 2024, payment rates for family 
28.23 	planning, when such services are provided by an eligible community clinic as defined in 
28.24 	section 145.9268, subdivision 1, and abortion services shall be increased by 20 percent. 
28.25 	This increase does not apply to federally qualified health centers, rural health centers, or 
28.26 	Indian health services.

28.27 	Sec. 9. Minnesota Statutes 2023 Supplement, section 256L.03, subdivision 1, is amended 
28.28 	to read:
28.29 		Subdivision 1.Covered health services. (a) "Covered health services" means the health 
28.30 	services reimbursed under chapter 256B, with the exception of special education services, 
28.31 	home care nursing services, adult dental care services other than services covered under 
28.32 	section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation 
29.1 	services, personal care assistance and case management services, community first services 
29.2 	and supports under section 256B.85, behavioral health home services under section 
29.3 	256B.0757, housing stabilization services under section 256B.051, and nursing home or 
29.4 	intermediate care facilities services.
29.5 	(b) Covered health services shall be expanded as provided in this section.
29.6 	(c) For the purposes of covered health services under this section, "child" means an 
29.7 	individual younger than 19 years of age.

29.8 	Sec. 10. Minnesota Statutes 2022, section 524.3-801, as amended by Laws 2024, chapter 
29.9 	79, article 9, section 20, is amended to read:
29.10 	524.3-801 NOTICE TO CREDITORS.
29.11 	(a) Unless notice has already been given under this section, upon appointment of a 
29.12 	general personal representative in informal proceedings or upon the filing of a petition for 
29.13 	formal appointment of a general personal representative, notice thereof, in the form prescribed 
29.14 	by court rule, shall be given under the direction of the court administrator by publication 
29.15 	once a week for two successive weeks in a legal newspaper in the county wherein the 
29.16 	proceedings are pending giving the name and address of the general personal representative 
29.17 	and notifying creditors of the estate to present their claims within four months after the date 
29.18 	of the court administrator's notice which is subsequently published or be forever barred, 
29.19 	unless they are entitled to further service of notice under paragraph (b) or (c).
29.20 	(b) The personal representative shall, within three months after the date of the first 
29.21 	publication of the notice, serve a copy of the notice upon each then known and identified 
29.22 	creditor in the manner provided in paragraph (c). If the decedent or a predeceased spouse 
29.23 	of the decedent received assistance for which a claim could be filed under section 246.53, 
29.24 	256B.15, 256D.16, or 261.04, notice to the commissioner of human services or direct care 
29.25 	and treatment executive board, as applicable, must be given under paragraph (d) instead of 
29.26 	under this paragraph or paragraph (c). A creditor is "known" if: (i) the personal representative 
29.27 	knows that the creditor has asserted a claim that arose during the decedent's life against 
29.28 	either the decedent or the decedent's estate; (ii) the creditor has asserted a claim that arose 
29.29 	during the decedent's life and the fact is clearly disclosed in accessible financial records 
29.30 	known and available to the personal representative; or (iii) the claim of the creditor would 
29.31 	be revealed by a reasonably diligent search for creditors of the decedent in accessible 
29.32 	financial records known and available to the personal representative. Under this section, a 
29.33 	creditor is "identified" if the personal representative's knowledge of the name and address 
29.34 	of the creditor will permit service of notice to be made under paragraph (c).
30.1 	(c) Unless the claim has already been presented to the personal representative or paid, 
30.2 	the personal representative shall serve a copy of the notice required by paragraph (b) upon 
30.3 	each creditor of the decedent who is then known to the personal representative and identified 
30.4 	either by delivery of a copy of the required notice to the creditor, or by mailing a copy of 
30.5 	the notice to the creditor by certified, registered, or ordinary first class mail addressed to 
30.6 	the creditor at the creditor's office or place of residence.
30.7 	(d)(1) Effective for decedents dying on or after July 1, 1997, if the decedent or a 
30.8 	predeceased spouse of the decedent received assistance for which a claim could be filed 
30.9 	under section 246.53, 256B.15, 256D.16, or 261.04, the personal representative or the 
30.10 	attorney for the personal representative shall serve the commissioner or executive board, 
30.11 	as applicable, with notice in the manner prescribed in paragraph (c), or electronically in a 
30.12 	manner prescribed by the commissioner, as soon as practicable after the appointment of the 
30.13 	personal representative. The notice must state the decedent's full name, date of birth, and 
30.14 	Social Security number and, to the extent then known after making a reasonably diligent 
30.15 	inquiry, the full name, date of birth, and Social Security number for each of the decedent's 
30.16 	predeceased spouses. The notice may also contain a statement that, after making a reasonably 
30.17 	diligent inquiry, the personal representative has determined that the decedent did not have 
30.18 	any predeceased spouses or that the personal representative has been unable to determine 
30.19 	one or more of the previous items of information for a predeceased spouse of the decedent. 
30.20 	A copy of the notice to creditors must be attached to and be a part of the notice to the 
30.21 	commissioner or executive board.
30.22 	(2) Notwithstanding a will or other instrument or law to the contrary, except as allowed 
30.23 	in this paragraph, no property subject to administration by the estate may be distributed by 
30.24 	the estate or the personal representative until 70 days after the date the notice is served on 
30.25 	the commissioner or executive board as provided in paragraph (c), unless the local agency 
30.26 	consents as provided for in clause (6). This restriction on distribution does not apply to the 
30.27 	personal representative's sale of real or personal property, but does apply to the net proceeds 
30.28 	the estate receives from these sales. The personal representative, or any person with personal 
30.29 	knowledge of the facts, may provide an affidavit containing the description of any real or 
30.30 	personal property affected by this paragraph and stating facts showing compliance with this 
30.31 	paragraph. If the affidavit describes real property, it may be filed or recorded in the office 
30.32 	of the county recorder or registrar of titles for the county where the real property is located. 
30.33 	This paragraph does not apply to proceedings under sections 524.3-1203 and 525.31, or 
30.34 	when a duly authorized agent of a county is acting as the personal representative of the 
30.35 	estate.
31.1 	(3) At any time before an order or decree is entered under section 524.3-1001 or 
31.2 	524.3-1002, or a closing statement is filed under section 524.3-1003, the personal 
31.3 	representative or the attorney for the personal representative may serve an amended notice 
31.4 	on the commissioner or executive board to add variations or other names of the decedent 
31.5 	or a predeceased spouse named in the notice, the name of a predeceased spouse omitted 
31.6 	from the notice, to add or correct the date of birth or Social Security number of a decedent 
31.7 	or predeceased spouse named in the notice, or to correct any other deficiency in a prior 
31.8 	notice. The amended notice must state the decedent's name, date of birth, and Social Security 
31.9 	number, the case name, case number, and district court in which the estate is pending, and 
31.10 	the date the notice being amended was served on the commissioner or executive board. If 
31.11 	the amendment adds the name of a predeceased spouse omitted from the notice, it must also 
31.12 	state that spouse's full name, date of birth, and Social Security number. The amended notice 
31.13 	must be served on the commissioner or executive board in the same manner as the original 
31.14 	notice. Upon service, the amended notice relates back to and is effective from the date the 
31.15 	notice it amends was served, and the time for filing claims arising under section 246.53, 
31.16 	256B.15, 256D.16 or 261.04 is extended by 60 days from the date of service of the amended 
31.17 	notice. Claims filed during the 60-day period are undischarged and unbarred claims, may 
31.18 	be prosecuted by the entities entitled to file those claims in accordance with section 
31.19 	524.3-1004, and the limitations in section 524.3-1006 do not apply. The personal 
31.20 	representative or any person with personal knowledge of the facts may provide and file or 
31.21 	record an affidavit in the same manner as provided for in clause (1).
31.22 	(4) Within one year after the date an order or decree is entered under section 524.3-1001
31.23 	or 524.3-1002 or a closing statement is filed under section 524.3-1003, any person who has 
31.24 	an interest in property that was subject to administration by the estate may serve an amended 
31.25 	notice on the commissioner or executive board to add variations or other names of the 
31.26 	decedent or a predeceased spouse named in the notice, the name of a predeceased spouse 
31.27 	omitted from the notice, to add or correct the date of birth or Social Security number of a 
31.28 	decedent or predeceased spouse named in the notice, or to correct any other deficiency in 
31.29 	a prior notice. The amended notice must be served on the commissioner or executive board 
31.30 	in the same manner as the original notice and must contain the information required for 
31.31 	amendments under clause (3). If the amendment adds the name of a predeceased spouse 
31.32 	omitted from the notice, it must also state that spouse's full name, date of birth, and Social 
31.33 	Security number. Upon service, the amended notice relates back to and is effective from 
31.34 	the date the notice it amends was served. If the amended notice adds the name of an omitted 
31.35 	predeceased spouse or adds or corrects the Social Security number or date of birth of the 
31.36 	decedent or a predeceased spouse already named in the notice, then, notwithstanding any 
32.1 	other laws to the contrary, claims against the decedent's estate on account of those persons 
32.2 	resulting from the amendment and arising under section 246.53, 256B.15, 256D.16, or 
32.3 	261.04 are undischarged and unbarred claims, may be prosecuted by the entities entitled to 
32.4 	file those claims in accordance with section 524.3-1004, and the limitations in section 
32.5 	524.3-1006 do not apply. The person filing the amendment or any other person with personal 
32.6 	knowledge of the facts may provide and file or record an affidavit describing affected real 
32.7 	or personal property in the same manner as clause (1).
32.8 	(5) After one year from the date an order or decree is entered under section 524.3-1001
32.9 	or 524.3-1002, or a closing statement is filed under section 524.3-1003, no error, omission, 
32.10 	or defect of any kind in the notice to the commissioner or executive board required under 
32.11 	this paragraph or in the process of service of the notice on the commissioner or executive 
32.12 	board, or the failure to serve the commissioner or executive board with notice as required 
32.13 	by this paragraph, makes any distribution of property by a personal representative void or 
32.14 	voidable. The distributee's title to the distributed property shall be free of any claims based 
32.15 	upon a failure to comply with this paragraph.
32.16 	(6) The local agency may consent to a personal representative's request to distribute 
32.17 	property subject to administration by the estate to distributees during the 70-day period after 
32.18 	service of notice on the commissioner or executive board. The local agency may grant or 
32.19 	deny the request in whole or in part and may attach conditions to its consent as it deems 
32.20 	appropriate. When the local agency consents to a distribution, it shall give the estate a written 
32.21 	certificate evidencing its consent to the early distribution of assets at no cost. The certificate 
32.22 	must include the name, case number, and district court in which the estate is pending, the 
32.23 	name of the local agency, describe the specific real or personal property to which the consent 
32.24 	applies, state that the local agency consents to the distribution of the specific property 
32.25 	described in the consent during the 70-day period following service of the notice on the 
32.26 	commissioner or executive board, state that the consent is unconditional or list all of the 
32.27 	terms and conditions of the consent, be dated, and may include other contents as may be 
32.28 	appropriate. The certificate must be signed by the director of the local agency or the director's 
32.29 	designees and is effective as of the date it is dated unless it provides otherwise. The signature 
32.30 	of the director or the director's designee does not require any acknowledgment. The certificate 
32.31 	shall be prima facie evidence of the facts it states, may be attached to or combined with a 
32.32 	deed or any other instrument of conveyance and, when so attached or combined, shall 
32.33 	constitute a single instrument. If the certificate describes real property, it shall be accepted 
32.34 	for recording or filing by the county recorder or registrar of titles in the county in which the 
32.35 	property is located. If the certificate describes real property and is not attached to or combined 
33.1 	with a deed or other instrument of conveyance, it shall be accepted for recording or filing 
33.2 	by the county recorder or registrar of titles in the county in which the property is located. 
33.3 	The certificate constitutes a waiver of the 70-day period provided for in clause (2) with 
33.4 	respect to the property it describes and is prima facie evidence of service of notice on the 
33.5 	commissioner or executive board. The certificate is not a waiver or relinquishment of any 
33.6 	claims arising under section 246.53, 256B.15, 256D.16, or 261.04, and does not otherwise 
33.7 	constitute a waiver of any of the personal representative's duties under this paragraph. 
33.8 	Distributees who receive property pursuant to a consent to an early distribution shall remain 
33.9 	liable to creditors of the estate as provided for by law.
33.10 	(7) All affidavits provided for under this paragraph:
33.11 	(i) shall be provided by persons who have personal knowledge of the facts stated in the 
33.12 	affidavit;
33.13 	(ii) may be filed or recorded in the office of the county recorder or registrar of titles in 
33.14 	the county in which the real property they describe is located for the purpose of establishing 
33.15 	compliance with the requirements of this paragraph; and
33.16 	(iii) are prima facie evidence of the facts stated in the affidavit.
33.17 	(8) This paragraph applies to the estates of decedents dying on or after July 1, 1997. 
33.18 	Clause (5) also applies with respect to all notices served on the commissioner of human 
33.19 	services before July 1, 1997, under Laws 1996, chapter 451, article 2, section 55. All notices 
33.20 	served on the commissioner before July 1, 1997, pursuant to Laws 1996, chapter 451, article 
33.21 	2, section 55, shall be deemed to be legally sufficient for the purposes for which they were 
33.22 	intended, notwithstanding any errors, omissions or other defects.

33.23 	ARTICLE 3
33.24 	HEALTH CARE

33.25 	Section 1. [62J.805] DEFINITIONS.
33.26 		Subdivision 1.Application. For purposes of sections 62J.805 to 62J.808, the following 
33.27 	terms have the meanings given.
33.28 		Subd. 2.Billing error. "Billing error" means an error in a bill from a health care provider 
33.29 	to a patient for health treatment or services that affects the amount owed by the patient 
33.30 	according to that bill. Billing error includes but is not limited to miscoding of a health 
33.31 	treatment or service, an error in whether a health treatment or service is covered under the 
33.32 	patient's health plan, or an error in determining the cost-sharing owed by the patient.
34.1 		Subd. 3.Group practice. "Group practice" has the meaning given to health care provider 
34.2 	group practice in section 145D.01, subdivision 1.
34.3 		Subd. 4.Health care provider. "Health care provider" means:
34.4 	(1) a health professional who is licensed or registered by the state to provide health 
34.5 	treatment and services within the professional's scope of practice and in accordance with 
34.6 	state law;
34.7 	(2) a group practice; or
34.8 	(3) a hospital.
34.9 		Subd. 5.Health plan. "Health plan" has the meaning given in section 62A.011, 
34.10 	subdivision 3.
34.11 		Subd. 6.Hospital. "Hospital" means a health care facility licensed as a hospital under 
34.12 	sections 144.50 to 144.56.
34.13 		Subd. 7.Medically necessary. "Medically necessary" means:
34.14 	(1) safe and effective;
34.15 	(2) not experimental or investigational, except as provided in Code of Federal Regulations, 
34.16 	title 42, section 411.15(o);
34.17 	(3) furnished in accordance with acceptable medical standards of medical practice for 
34.18 	the diagnosis or treatment of the patient's condition or to improve the function of a malformed 
34.19 	body member;
34.20 	(4) furnished in a setting appropriate to the patient's medical need and condition;
34.21 	(5) ordered and furnished by qualified personnel;
34.22 	(6) meets, but does not exceed, the patient's medical need; and
34.23 	(7) is at least as beneficial as an existing and available medically appropriate alternative.
34.24 		Subd. 8.Payment. "Payment" includes co-payments and coinsurance and deductible 
34.25 	payments made by a patient.

34.26 	Sec. 2. [62J.806] POLICY FOR COLLECTION OF MEDICAL DEBT.
34.27 		Subdivision 1.Requirement. Each health care provider must make available to the 
34.28 	public the health care provider's policy for the collection of medical debt from patients. This 
34.29 	policy must be made available by:
35.1 	(1) clearly posting it on the health care provider's website or, for health professionals, 
35.2 	on the website of the health clinic, group practice, or hospital at which the health professional 
35.3 	is employed or under contract; and
35.4 	(2) providing a copy of the policy to any individual who requests it.
35.5 		Subd. 2.Content. A policy made available under this section must at least specify the 
35.6 	procedures followed by the health care provider for:
35.7 	(1) communicating with patients about the medical debt owed and collecting medical 
35.8 	debt;
35.9 	(2) referring medical debt to a collection agency or law firm for collection; and
35.10 	(3) identifying medical debt as uncollectible or satisfied, and ending collection activities.

35.11 	Sec. 3. [62J.807] DENIAL OF HEALTH TREATMENT OR SERVICES DUE TO 
35.12 	OUTSTANDING MEDICAL DEBT.
35.13 	(a) A health care provider must not deny medically necessary health treatment or services 
35.14 	to a patient or any member of the patient's family or household because of current or previous 
35.15 	outstanding medical debt owed by the patient or any member of the patient's family or 
35.16 	household to the health care provider, regardless of whether the health treatment or service 
35.17 	may be available from another health care provider.
35.18 	(b) As a condition of providing medically necessary health treatment or services in the 
35.19 	circumstances described in paragraph (a), a health care provider may require the patient to 
35.20 	enroll in a payment plan for the outstanding medical debt owed to the health care provider. 
35.21 	The payment plan must be reasonable and must take into account any information disclosed 
35.22 	by the patient regarding the patient's ability to pay. Before entering into the payment plan, 
35.23 	a health care provider must notify the patient that if the patient is unable to make all or part 
35.24 	of the agreed-upon installment payments, the patient must communicate the patient's situation 
35.25 	to the health care provider and must pay an amount the patient can afford.

35.26 	Sec. 4. [62J.808] BILLING ERRORS; HEALTH TREATMENT OR SERVICES.
35.27 		Subdivision 1.Billing and acceptance of payment. (a) If a health care provider or 
35.28 	health plan company determines or receives notice from a patient or other person that a bill 
35.29 	from the health care provider to a patient for health treatment or services may contain one 
35.30 	or more billing errors, the health care provider or health plan company must review the bill 
35.31 	and correct any billing errors found. While the review is being conducted, the health care 
35.32 	provider must not bill the patient for any health treatment or service subject to review for 
36.1 	potential billing errors. A health care provider may bill the patient for the health treatment 
36.2 	and services that were reviewed for potential billing errors under this subdivision only after 
36.3 	the review is complete, any billing errors are corrected, and a notice of completed review 
36.4 	required under subdivision 3 is transmitted to the patient.
36.5 	(b) If, after completing the review under paragraph (a) and correcting any billing errors, 
36.6 	a health care provider or health plan company determines the patient overpaid the health 
36.7 	care provider under that bill, the health care provider must refund to the patient, within 30 
36.8 	days after completing the review, the amount the patient overpaid under that bill.
36.9 		Subd. 2.Notice to patient of potential billing error. (a) If a health care provider or 
36.10 	health plan company determines or receives notice from a patient or other person that a bill 
36.11 	from the health care provider to a patient for health treatment or services may contain one 
36.12 	or more billing errors, the health care provider or health plan company must notify the 
36.13 	patient:
36.14 	(1) of the potential billing error;
36.15 	(2) that the health care provider or health plan company will review the bill and correct 
36.16 	any billing errors found; and
36.17 	(3) that while the review is being conducted, the health care provider will not bill the 
36.18 	patient for any health treatment or service subject to review for potential billing errors.
36.19 	(b) The notice required under this subdivision must be transmitted to the patient within 
36.20 	30 days after the health care provider or health plan company determines or receives notice 
36.21 	that the patient's bill may contain one or more billing errors.
36.22 		Subd. 3.Notice to patient of completed review. When a health care provider or health 
36.23 	plan company completes a review of a bill for potential billing errors, the health care provider 
36.24 	or health plan company must notify the patient that the review is complete, explain in detail 
36.25 	how any identified billing errors were corrected or explain in detail why the health care 
36.26 	provider or health plan company did not modify the bill as requested by the patient or other 
36.27 	person, and include applicable coding guidelines, references to health records, and other 
36.28 	relevant information. This notice must be transmitted to the patient within 30 days after the 
36.29 	health care provider or health plan company completes the review.

36.30 	Sec. 5. Minnesota Statutes 2023 Supplement, section 144.587, subdivision 1, is amended 
36.31 	to read:
36.32 		Subdivision 1.Definitions. (a) The terms defined in this subdivision apply to this section 
36.33 	and sections 144.588 to 144.589.
37.1 	(b) "Charity care" means the provision of free or discounted care to a patient according 
37.2 	to a hospital's financial assistance policies.
37.3 	(c) "Hospital" means a private, nonprofit, or municipal hospital licensed under sections 
37.4 	144.50 to 144.56.
37.5 	(d) "Insurance affordability program" has the meaning given in section 256B.02, 
37.6 	subdivision 19.
37.7 	(e) "Navigator" has the meaning given in section 62V.02, subdivision 9.
37.8 	(f) "Presumptive eligibility" has the meaning given in section 256B.057, subdivision 
37.9 	12.
37.10 	(g) "Revenue recapture" means the use of the procedures in chapter 270A to collect debt.
37.11 	(h) (g) "Uninsured service or treatment" means any service or treatment that is not 
37.12 	covered by:
37.13 	(1) a health plan, contract, or policy that provides health coverage to a patient; or
37.14 	(2) any other type of insurance coverage, including but not limited to no-fault automobile 
37.15 	coverage, workers' compensation coverage, or liability coverage.
37.16 	(i) (h) "Unreasonable burden" includes requiring a patient to apply for enrollment in a 
37.17 	state or federal program for which the patient is obviously or categorically ineligible or has 
37.18 	been found to be ineligible in the previous 12 months.

37.19 	Sec. 6. Minnesota Statutes 2023 Supplement, section 144.587, subdivision 4, is amended 
37.20 	to read:
37.21 		Subd. 4.Prohibited actions. (a) A hospital must not initiate one or more of the following 
37.22 	actions until the hospital determines that the patient is ineligible for charity care or denies 
37.23 	an application for charity care:
37.24 	(1) offering to enroll or enrolling the patient in a payment plan;
37.25 	(2) changing the terms of a patient's payment plan;
37.26 	(3) offering the patient a loan or line of credit, application materials for a loan or line of 
37.27 	credit, or assistance with applying for a loan or line of credit, for the payment of medical 
37.28 	debt;
37.29 	(4) referring a patient's debt for collections, including in-house collections, third-party 
37.30 	collections, revenue recapture, or any other process for the collection of debt; or
38.1 	(5) denying health care services to the patient or any member of the patient's household 
38.2 	because of outstanding medical debt, regardless of whether the services are deemed necessary 
38.3 	or may be available from another provider; or
38.4 	(6) (5) accepting a credit card payment of over $500 for the medical debt owed to the 
38.5 	hospital.
38.6 	(b) A violation of section 62J.807 is a violation of this subdivision.

38.7 	Sec. 7. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 1, is amended 
38.8 	to read:
38.9 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in this 
38.10 	subdivision have the meanings given.
38.11 	(b) "Central repository" means a wholesale distributor that meets the requirements under 
38.12 	subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this 
38.13 	section.
38.14 	(c) "Distribute" means to deliver, other than by administering or dispensing.
38.15 	(d) "Donor" means:
38.16 	(1) a health care facility as defined in this subdivision an individual at least 18 years of 
38.17 	age, provided that the drug or medical supply that is donated was obtained legally and meets 
38.18 	the requirements of this section for donation; or
38.19 	(2) a skilled nursing facility licensed under chapter 144A; any entity legally authorized 
38.20 	to possess medicine with a license or permit in good standing in the state in which it is 
38.21 	located, without further restrictions, including but not limited to a health care facility, skilled 
38.22 	nursing facility, assisted living facility, pharmacy, wholesaler, and drug manufacturer.
38.23 	(3) an assisted living facility licensed under chapter 144G;
38.24 	(4) a pharmacy licensed under section 151.19, and located either in the state or outside 
38.25 	the state;
38.26 	(5) a drug wholesaler licensed under section 151.47;
38.27 	(6) a drug manufacturer licensed under section 151.252; or
38.28 	(7) an individual at least 18 years of age, provided that the drug or medical supply that 
38.29 	is donated was obtained legally and meets the requirements of this section for donation.
38.30 	(e) "Drug" means any prescription drug that has been approved for medical use in the 
38.31 	United States, is listed in the United States Pharmacopoeia or National Formulary, and 
39.1 	meets the criteria established under this section for donation; or any over-the-counter 
39.2 	medication that meets the criteria established under this section for donation. This definition 
39.3 	includes cancer drugs and antirejection drugs, but does not include controlled substances, 
39.4 	as defined in section 152.01, subdivision 4, or a prescription drug that can only be dispensed 
39.5 	to a patient registered with the drug's manufacturer in accordance with federal Food and 
39.6 	Drug Administration requirements.
39.7 	(f) "Health care facility" means:
39.8 	(1) a physician's office or health care clinic where licensed practitioners provide health 
39.9 	care to patients;
39.10 	(2) a hospital licensed under section 144.50;
39.11 	(3) a pharmacy licensed under section 151.19 and located in Minnesota; or
39.12 	(4) a nonprofit community clinic, including a federally qualified health center; a rural 
39.13 	health clinic; public health clinic; or other community clinic that provides health care utilizing 
39.14 	a sliding fee scale to patients who are low-income, uninsured, or underinsured.
39.15 	(g) "Local repository" means a health care facility that elects to accept donated drugs 
39.16 	and medical supplies and meets the requirements of subdivision 4.
39.17 	(h) "Medical supplies" or "supplies" means any prescription or nonprescription medical 
39.18 	supplies needed to administer a drug.
39.19 	(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is 
39.20 	sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or 
39.21 	unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose 
39.22 	packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules, 
39.23 	part 6800.3750.
39.24 	(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that 
39.25 	it does not include a veterinarian.

39.26 	Sec. 8. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 4, is amended 
39.27 	to read:
39.28 		Subd. 4.Local repository requirements. (a) To be eligible for participation in the 
39.29 	medication repository program, a health care facility must agree to comply with all applicable 
39.30 	federal and state laws, rules, and regulations pertaining to the medication repository program, 
39.31 	drug storage, and dispensing. The facility must also agree to maintain in good standing any 
39.32 	required state license or registration that may apply to the facility.
40.1 	(b) A local repository may elect to participate in the program by submitting the following 
40.2 	information to the central repository on a form developed by the board and made available 
40.3 	on the board's website:
40.4 	(1) the name, street address, and telephone number of the health care facility and any 
40.5 	state-issued license or registration number issued to the facility, including the issuing state 
40.6 	agency;
40.7 	(2) the name and telephone number of a responsible pharmacist or practitioner who is 
40.8 	employed by or under contract with the health care facility; and
40.9 	(3) a statement signed and dated by the responsible pharmacist or practitioner indicating 
40.10 	that the health care facility meets the eligibility requirements under this section and agrees 
40.11 	to comply with this section.
40.12 	(c) Participation in the medication repository program is voluntary. A local repository 
40.13 	may withdraw from participation in the medication repository program at any time by 
40.14 	providing written notice to the central repository on a form developed by the board and 
40.15 	made available on the board's website. The central repository shall provide the board with 
40.16 	a copy of the withdrawal notice within ten business days from the date of receipt of the 
40.17 	withdrawal notice.

40.18 	Sec. 9. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 5, is amended 
40.19 	to read:
40.20 		Subd. 5.Individual eligibility and application requirements. (a) To be eligible for 
40.21 	the medication repository program At the time of or before receiving donated drugs or 
40.22 	supplies as a new eligible patient, an individual must submit to a local repository an electronic 
40.23 	or physical intake application form that is signed by the individual and attests that the 
40.24 	individual:
40.25 	(1) is a resident of Minnesota;
40.26 	(2) is uninsured and is not enrolled in the medical assistance program under chapter 
40.27 	256B or the MinnesotaCare program under chapter 256L, has no prescription drug coverage, 
40.28 	or is underinsured;
40.29 	(3) acknowledges that the drugs or medical supplies to be received through the program 
40.30 	may have been donated; and
40.31 	(4) consents to a waiver of the child-resistant packaging requirements of the federal 
40.32 	Poison Prevention Packaging Act.
41.1 	(b) Upon determining that an individual is eligible for the program, the local repository 
41.2 	shall furnish the individual with an identification card. The card shall be valid for one year 
41.3 	from the date of issuance and may be used at any local repository. A new identification card 
41.4 	may be issued upon expiration once the individual submits a new application form.
41.5 	(c) (b) The local repository shall send a copy of the intake application form to the central 
41.6 	repository by regular mail, facsimile, or secured email within ten days from the date the 
41.7 	application is approved by the local repository.
41.8 	(d) (c) The board shall develop and make available on the board's website an application 
41.9 	form and the format for the identification card.

41.10 	Sec. 10. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 6, is amended 
41.11 	to read:
41.12 		Subd. 6.Standards and procedures for accepting donations of drugs and supplies. (a) 
41.13 	Notwithstanding any other law or rule, a donor may donate drugs or medical supplies to 
41.14 	the central repository or a local repository if the drug or supply meets the requirements of 
41.15 	this section as determined by a pharmacist or practitioner who is employed by or under 
41.16 	contract with the central repository or a local repository.
41.17 	(b) A drug is eligible for donation under the medication repository program if the 
41.18 	following requirements are met:
41.19 	(1) the donation is accompanied by a medication repository donor form described under 
41.20 	paragraph (d) that is signed by an individual who is authorized by the donor to attest to the 
41.21 	donor's knowledge in accordance with paragraph (d);
41.22 	(2) (1) the drug's expiration date is at least six months after the date the drug was donated. 
41.23 	If a donated drug bears an expiration date that is less than six months from the donation 
41.24 	date, the drug may be accepted and distributed if the drug is in high demand and can be 
41.25 	dispensed for use by a patient before the drug's expiration date;
41.26 	(3) (2) the drug is in its original, sealed, unopened, tamper-evident packaging that includes 
41.27 	the expiration date. Single-unit-dose drugs may be accepted if the single-unit-dose packaging 
41.28 	is unopened;
41.29 	(4) (3) the drug or the packaging does not have any physical signs of tampering, 
41.30 	misbranding, deterioration, compromised integrity, or adulteration;
41.31 	(5) (4) the drug does not require storage temperatures other than normal room temperature 
41.32 	as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being 
42.1 	donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located 
42.2 	in Minnesota; and
42.3 	(6) (5) the drug is not a controlled substance.
42.4 	(c) A medical supply is eligible for donation under the medication repository program 
42.5 	if the following requirements are met:
42.6 	(1) the supply has no physical signs of tampering, misbranding, or alteration and there 
42.7 	is no reason to believe it has been adulterated, tampered with, or misbranded;
42.8 	(2) the supply is in its original, unopened, sealed packaging; and
42.9 	(3) the donation is accompanied by a medication repository donor form described under 
42.10 	paragraph (d) that is signed by an individual who is authorized by the donor to attest to the 
42.11 	donor's knowledge in accordance with paragraph (d); and
42.12 	(4) (3) if the supply bears an expiration date, the date is at least six months later than 
42.13 	the date the supply was donated. If the donated supply bears an expiration date that is less 
42.14 	than six months from the date the supply was donated, the supply may be accepted and 
42.15 	distributed if the supply is in high demand and can be dispensed for use by a patient before 
42.16 	the supply's expiration date.
42.17 	(d) The board shall develop the medication repository donor form and make it available 
42.18 	on the board's website. The form must state that to the best of the donor's knowledge the 
42.19 	donated drug or supply has been properly stored under appropriate temperature and humidity 
42.20 	conditions and that the drug or supply has never been opened, used, tampered with, 
42.21 	adulterated, or misbranded. Prior to the first donation from a new donor, a central repository 
42.22 	or local repository shall verify and record the following information on the donor form:
42.23 	(1) the donor's name, address, phone number, and license number, if applicable;
42.24 	(2) that the donor will only make donations in accordance with the program;
42.25 	(3) to the best of the donor's knowledge, only drugs or supplies that have been properly 
42.26 	stored under appropriate temperature and humidity conditions will be donated; and
42.27 	(4) to the best of the donor's knowledge, only drugs or supplies that have never been 
42.28 	opened, used, tampered with, adulterated, or misbranded will be donated.
42.29 	(e) Notwithstanding any other law or rule, a central repository or a local repository may 
42.30 	receive donated drugs from donors. Donated drugs and supplies may be shipped or delivered 
42.31 	to the premises of the central repository or a local repository, and shall be inspected by a 
42.32 	pharmacist or an authorized practitioner who is employed by or under contract with the 
43.1 	repository and who has been designated by the repository to accept donations prior to 
43.2 	dispensing. A drop box must not be used to deliver or accept donations.
43.3 	(f) The central repository and local repository shall maintain a written or electronic 
43.4 	inventory of all drugs and supplies donated to the repository upon acceptance of each drug 
43.5 	or supply. For each drug, the inventory must include the drug's name, strength, quantity, 
43.6 	manufacturer, expiration date, and the date the drug was donated. For each medical supply, 
43.7 	the inventory must include a description of the supply, its manufacturer, the date the supply 
43.8 	was donated, and, if applicable, the supply's brand name and expiration date. The board 
43.9 	may waive the requirement under this paragraph if an entity is under common ownership 
43.10 	or control with a central repository or local repository and either the entity or the repository 
43.11 	maintains an inventory containing all the information required under this paragraph.

43.12 	Sec. 11. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 7, is amended 
43.13 	to read:
43.14 		Subd. 7.Standards and procedures for inspecting and storing donated drugs and 
43.15 	supplies. (a) A pharmacist or authorized practitioner who is employed by or under contract 
43.16 	with the central repository or a local repository shall inspect all donated drugs and supplies 
43.17 	before the drug or supply is dispensed to determine, to the extent reasonably possible in the 
43.18 	professional judgment of the pharmacist or practitioner, that the drug or supply is not 
43.19 	adulterated or misbranded, has not been tampered with, is safe and suitable for dispensing, 
43.20 	has not been subject to a recall, and meets the requirements for donation. The pharmacist 
43.21 	or practitioner who inspects the drugs or supplies shall sign an inspection record stating that 
43.22 	the requirements for donation have been met. If a local repository receives drugs and supplies 
43.23 	from the central repository, the local repository does not need to reinspect the drugs and 
43.24 	supplies.
43.25 	(b) The central repository and local repositories shall store donated drugs and supplies 
43.26 	in a secure storage area under environmental conditions appropriate for the drug or supply 
43.27 	being stored. Donated drugs and supplies may not be stored with nondonated inventory.
43.28 	(c) The central repository and local repositories shall dispose of all drugs and medical 
43.29 	supplies that are not suitable for donation in compliance with applicable federal and state 
43.30 	statutes, regulations, and rules concerning hazardous waste.
43.31 	(d) In the event that controlled substances or drugs that can only be dispensed to a patient 
43.32 	registered with the drug's manufacturer are shipped or delivered to a central or local repository 
43.33 	for donation, the shipment delivery must be documented by the repository and returned 
43.34 	immediately to the donor or the donor's representative that provided the drugs.
44.1 	(e) Each repository must develop drug and medical supply recall policies and procedures. 
44.2 	If a repository receives a recall notification, the repository shall destroy all of the drug or 
44.3 	medical supply in its inventory that is the subject of the recall and complete a record of 
44.4 	destruction form in accordance with paragraph (f). If a drug or medical supply that is the 
44.5 	subject of a Class I or Class II recall has been dispensed, the repository shall immediately 
44.6 	notify the recipient of the recalled drug or medical supply. A drug that potentially is subject 
44.7 	to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug 
44.8 	is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.
44.9 	(f) A record of destruction of donated drugs and supplies that are not dispensed under 
44.10 	subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation 
44.11 	shall be maintained by the repository for at least two years. For each drug or supply destroyed, 
44.12 	the record shall include the following information:
44.13 	(1) the date of destruction;
44.14 	(2) the name, strength, and quantity of the drug destroyed; and
44.15 	(3) the name of the person or firm that destroyed the drug.
44.16 	No other record of destruction is required.

44.17 	Sec. 12. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 8, is amended 
44.18 	to read:
44.19 		Subd. 8.Dispensing requirements. (a) Donated prescription drugs and supplies may 
44.20 	be dispensed if the drugs or supplies are prescribed by a practitioner for use by an eligible 
44.21 	individual and are dispensed by a pharmacist or practitioner. A repository shall dispense 
44.22 	drugs and supplies to eligible individuals in the following priority order: (1) individuals 
44.23 	who are uninsured; (2) individuals with no prescription drug coverage; and (3) individuals 
44.24 	who are underinsured. A repository shall dispense donated drugs in compliance with 
44.25 	applicable federal and state laws and regulations for dispensing drugs, including all 
44.26 	requirements relating to packaging, labeling, record keeping, drug utilization review, and 
44.27 	patient counseling.
44.28 	(b) Before dispensing or administering a drug or supply, the pharmacist or practitioner 
44.29 	shall visually inspect the drug or supply for adulteration, misbranding, tampering, and date 
44.30 	of expiration. Drugs or supplies that have expired or appear upon visual inspection to be 
44.31 	adulterated, misbranded, or tampered with in any way must not be dispensed or administered.
44.32 	(c) Before a the first drug or supply is dispensed or administered to an individual, the 
44.33 	individual must sign a an electronic or physical drug repository recipient form acknowledging 
45.1 	that the individual understands the information stated on the form. The board shall develop 
45.2 	the form and make it available on the board's website. The form must include the following 
45.3 	information:
45.4 	(1) that the drug or supply being dispensed or administered has been donated and may 
45.5 	have been previously dispensed;
45.6 	(2) that a visual inspection has been conducted by the pharmacist or practitioner to ensure 
45.7 	that the drug or supply has not expired, has not been adulterated or misbranded, and is in 
45.8 	its original, unopened packaging; and
45.9 	(3) that the dispensing pharmacist, the dispensing or administering practitioner, the 
45.10 	central repository or local repository, the Board of Pharmacy, and any other participant of 
45.11 	the medication repository program cannot guarantee the safety of the drug or medical supply 
45.12 	being dispensed or administered and that the pharmacist or practitioner has determined that 
45.13 	the drug or supply is safe to dispense or administer based on the accuracy of the donor's 
45.14 	form submitted with the donated drug or medical supply and the visual inspection required 
45.15 	to be performed by the pharmacist or practitioner before dispensing or administering.

45.16 	Sec. 13. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 9, is amended 
45.17 	to read:
45.18 		Subd. 9.Handling fees. (a) The central or local repository may charge the individual 
45.19 	receiving a drug or supply a handling fee of no more than 250 percent of the medical 
45.20 	assistance program dispensing fee for each drug or medical supply dispensed or administered 
45.21 	by that repository.
45.22 	(b) A repository that dispenses or administers a drug or medical supply through the 
45.23 	medication repository program shall not receive reimbursement under the medical assistance 
45.24 	program or the MinnesotaCare program for that dispensed or administered drug or supply.
45.25 	(c) A supply or handling fee must not be charged to an individual enrolled in the medical 
45.26 	assistance or MinnesotaCare program.

45.27 	Sec. 14. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 11, is amended 
45.28 	to read:
45.29 		Subd. 11.Forms and record-keeping requirements. (a) The following forms developed 
45.30 	for the administration of this program shall be utilized by the participants of the program 
45.31 	and shall be available on the board's website:
45.32 	(1) intake application form described under subdivision 5;
46.1 	(2) local repository participation form described under subdivision 4;
46.2 	(3) local repository withdrawal form described under subdivision 4;
46.3 	(4) medication repository donor form described under subdivision 6;
46.4 	(5) record of destruction form described under subdivision 7; and
46.5 	(6) medication repository recipient form described under subdivision 8.
46.6 	Participants may use substantively similar electronic or physical forms.
46.7 	(b) All records, including drug inventory, inspection, and disposal of donated drugs and 
46.8 	medical supplies, must be maintained by a repository for a minimum of two years. Records 
46.9 	required as part of this program must be maintained pursuant to all applicable practice acts.
46.10 	(c) Data collected by the medication repository program from all local repositories shall 
46.11 	be submitted quarterly or upon request to the central repository. Data collected may consist 
46.12 	of the information, records, and forms required to be collected under this section.
46.13 	(d) The central repository shall submit reports to the board as required by the contract 
46.14 	or upon request of the board.

46.15 	Sec. 15. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 12, is amended 
46.16 	to read:
46.17 		Subd. 12.Liability. (a) The manufacturer of a drug or supply is not subject to criminal 
46.18 	or civil liability for injury, death, or loss to a person or to property for causes of action 
46.19 	described in clauses (1) and (2). A manufacturer is not liable for:
46.20 	(1) the intentional or unintentional alteration of the drug or supply by a party not under 
46.21 	the control of the manufacturer; or
46.22 	(2) the failure of a party not under the control of the manufacturer to transfer or 
46.23 	communicate product or consumer information or the expiration date of the donated drug 
46.24 	or supply.
46.25 	(b) A health care facility participating in the program, a pharmacist dispensing a drug 
46.26 	or supply pursuant to the program, a practitioner dispensing or administering a drug or 
46.27 	supply pursuant to the program, or a donor of a drug or medical supply, or a person or entity 
46.28 	that facilitates any of the above is immune from civil liability for an act or omission that 
46.29 	causes injury to or the death of an individual to whom the drug or supply is dispensed and 
46.30 	no disciplinary action by a health-related licensing board shall be taken against a pharmacist 
46.31 	or practitioner person or entity so long as the drug or supply is donated, accepted, distributed, 
47.1 	and dispensed according to the requirements of this section. This immunity does not apply 
47.2 	if the act or omission involves reckless, wanton, or intentional misconduct, or malpractice 
47.3 	unrelated to the quality of the drug or medical supply.

47.4 	Sec. 16. Minnesota Statutes 2023 Supplement, section 151.74, subdivision 3, is amended 
47.5 	to read:
47.6 		Subd. 3.Access to urgent-need insulin. (a) MNsure shall develop an application form 
47.7 	to be used by an individual who is in urgent need of insulin. The application must ask the 
47.8 	individual to attest to the eligibility requirements described in subdivision 2. The form shall 
47.9 	be accessible through MNsure's website. MNsure shall also make the form available to 
47.10 	pharmacies and health care providers who prescribe or dispense insulin, hospital emergency 
47.11 	departments, urgent care clinics, and community health clinics. By submitting a completed, 
47.12 	signed, and dated application to a pharmacy, the individual attests that the information 
47.13 	contained in the application is correct.
47.14 	(b) If the individual is in urgent need of insulin, the individual may present a completed, 
47.15 	signed, and dated application form to a pharmacy. The individual must also:
47.16 	(1) have a valid insulin prescription; and
47.17 	(2) present the pharmacist with identification indicating Minnesota residency in the form 
47.18 	of a valid Minnesota identification card, driver's license or permit, individual taxpayer 
47.19 	identification number, or Tribal identification card as defined in section 171.072, paragraph 
47.20 	(b). If the individual in urgent need of insulin is under the age of 18, the individual's parent 
47.21 	or legal guardian must provide the pharmacist with proof of residency.
47.22 	(c) Upon receipt of a completed and signed application, the pharmacist shall dispense 
47.23 	the prescribed insulin in an amount that will provide the individual with a 30-day supply. 
47.24 	The pharmacy must notify the health care practitioner who issued the prescription order no 
47.25 	later than 72 hours after the insulin is dispensed.
47.26 	(d) The pharmacy may submit to the manufacturer of the dispensed insulin product or 
47.27 	to the manufacturer's vendor a claim for payment that is in accordance with the National 
47.28 	Council for Prescription Drug Program standards for electronic claims processing, unless 
47.29 	the manufacturer agrees to send to the pharmacy a replacement supply of the same insulin 
47.30 	as dispensed in the amount dispensed. If the pharmacy submits an electronic claim to the 
47.31 	manufacturer or the manufacturer's vendor, the manufacturer or vendor shall reimburse the 
47.32 	pharmacy in an amount that covers the pharmacy's acquisition cost.
48.1 	(e) The pharmacy may collect an insulin co-payment from the individual to cover the 
48.2 	pharmacy's costs of processing and dispensing in an amount not to exceed $35 for the 30-day 
48.3 	supply of insulin dispensed.
48.4 	(f) The pharmacy shall also provide each eligible individual with the information sheet 
48.5 	described in subdivision 7 and a list of trained navigators provided by the Board of Pharmacy 
48.6 	for the individual to contact if the individual is in need of accessing needs to access ongoing 
48.7 	insulin coverage options, including assistance in:
48.8 	(1) applying for medical assistance or MinnesotaCare;
48.9 	(2) applying for a qualified health plan offered through MNsure, subject to open and 
48.10 	special enrollment periods;
48.11 	(3) accessing information on providers who participate in prescription drug discount 
48.12 	programs, including providers who are authorized to participate in the 340B program under 
48.13 	section 340b of the federal Public Health Services Act, United States Code, title 42, section 
48.14 	256b; and
48.15 	(4) accessing insulin manufacturers' patient assistance programs, co-payment assistance 
48.16 	programs, and other foundation-based programs.
48.17 	(g) The pharmacist shall retain a copy of the application form submitted by the individual 
48.18 	to the pharmacy for reporting and auditing purposes.
48.19 	(h) A manufacturer may submit to the commissioner of administration a request for 
48.20 	reimbursement in an amount not to exceed $35 for each 30-day supply of insulin the 
48.21 	manufacturer provides under paragraph (d). The commissioner of administration shall 
48.22 	determine the manner and format for submitting and processing requests for reimbursement. 
48.23 	After receiving a reimbursement request, the commissioner of administration shall reimburse 
48.24 	the manufacturer in an amount not to exceed $35 for each 30-day supply of insulin the 
48.25 	manufacturer provided under paragraph (d).

48.26 	EFFECTIVE DATE. This section is effective July 1, 2024.

48.27 	Sec. 17. Minnesota Statutes 2022, section 151.74, subdivision 6, is amended to read:
48.28 		Subd. 6.Continuing safety net program; process. (a) The individual shall submit to 
48.29 	a pharmacy the statement of eligibility provided by the manufacturer under subdivision 5, 
48.30 	paragraph (b). Upon receipt of an individual's eligibility status, the pharmacy shall submit 
48.31 	an order containing the name of the insulin product and the daily dosage amount as contained 
48.32 	in a valid prescription to the product's manufacturer.
49.1 	(b) The pharmacy must include with the order to the manufacturer the following 
49.2 	information:
49.3 	(1) the pharmacy's name and shipping address;
49.4 	(2) the pharmacy's office telephone number, fax number, email address, and contact 
49.5 	name; and
49.6 	(3) any specific days or times when deliveries are not accepted by the pharmacy.
49.7 	(c) Upon receipt of an order from a pharmacy and the information described in paragraph 
49.8 	(b), the manufacturer shall send to the pharmacy a 90-day supply of insulin as ordered, 
49.9 	unless a lesser amount is requested in the order, at no charge to the individual or pharmacy.
49.10 	(d) Except as authorized under paragraph (e), the pharmacy shall provide the insulin to 
49.11 	the individual at no charge to the individual. The pharmacy shall not provide insulin received 
49.12 	from the manufacturer to any individual other than the individual associated with the specific 
49.13 	order. The pharmacy shall not seek reimbursement for the insulin received from the 
49.14 	manufacturer or from any third-party payer.
49.15 	(e) The pharmacy may collect a co-payment from the individual to cover the pharmacy's 
49.16 	costs for processing and dispensing in an amount not to exceed $50 for each 90-day supply 
49.17 	if the insulin is sent to the pharmacy.
49.18 	(f) The pharmacy may submit to a manufacturer a reorder for an individual if the 
49.19 	individual's eligibility statement has not expired. Upon receipt of a reorder from a pharmacy, 
49.20 	the manufacturer must send to the pharmacy an additional 90-day supply of the product, 
49.21 	unless a lesser amount is requested, at no charge to the individual or pharmacy if the 
49.22 	individual's eligibility statement has not expired.
49.23 	(g) Notwithstanding paragraph (c), a manufacturer may send the insulin as ordered 
49.24 	directly to the individual if the manufacturer provides a mail order service option.
49.25 	(h) A manufacturer may submit to the commissioner of administration a request for 
49.26 	reimbursement in an amount not to exceed $105 for each 90-day supply of insulin the 
49.27 	manufacturer provides under paragraphs (c) and (f). The commissioner of administration 
49.28 	shall determine the manner and format for submitting and processing requests for 
49.29 	reimbursement. After receiving a reimbursement request, the commissioner of administration 
49.30 	shall reimburse the manufacturer in an amount not to exceed $105 for each 90-day supply 
49.31 	of insulin the manufacturer provided under paragraphs (c) and (f). If the manufacturer 
49.32 	provides less than a 90-day supply of insulin under paragraphs (c) and (f), the manufacturer 
50.1 	may submit a request for reimbursement not to exceed $35 for each 30-day supply of insulin 
50.2 	provided.

50.3 	EFFECTIVE DATE. This section is effective July 1, 2024.

50.4 	Sec. 18. [151.741] INSULIN MANUFACTURER REGISTRATION FEE.
50.5 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
50.6 	the meanings given.
50.7 	(b) "Board" means the Minnesota Board of Pharmacy under section 151.02.
50.8 	(c) "Manufacturer" means a manufacturer licensed under section 151.252 and engaged 
50.9 	in the manufacturing of prescription insulin.
50.10 		Subd. 2.Assessment of registration fee. (a) The board shall assess each manufacturer 
50.11 	an annual registration fee of $100,000, except as provided in paragraph (b). The board shall 
50.12 	notify each manufacturer of this requirement beginning November 1, 2024, and each 
50.13 	November 1 thereafter.
50.14 	(b) A manufacturer may request an exemption from the annual registration fee. The 
50.15 	board shall exempt a manufacturer from the annual registration fee if the manufacturer can 
50.16 	demonstrate to the board, in the form and manner specified by the board, that sales of 
50.17 	prescription insulin produced by that manufacturer and sold or delivered within or into the 
50.18 	state totaled $2,000,000 or less in the previous calendar year.
50.19 		Subd. 3.Payment of the registration fee; deposit of fee. (a) Each manufacturer must 
50.20 	pay the registration fee by March 1, 2025, and by each March 1 thereafter. In the event of 
50.21 	a change in ownership of the manufacturer, the new owner must pay the registration fee 
50.22 	that the original owner would have been assessed had the original owner retained ownership. 
50.23 	The board may assess a late fee of ten percent per month or any portion of a month that the 
50.24 	registration fee is paid after the due date.
50.25 	(b) The registration fee, including any late fees, must be deposited in the insulin safety 
50.26 	net program account.
50.27 		Subd. 4.Insulin safety net program account. The insulin safety net program account 
50.28 	is established in the special revenue fund in the state treasury. Money in the account is 
50.29 	appropriated each fiscal year to:
50.30 	(1) the MNsure board in an amount sufficient to carry out assigned duties under section 
50.31 	151.74, subdivision 7; and
51.1 	(2) the Board of Pharmacy in an amount sufficient to cover costs incurred by the board 
51.2 	in assessing and collecting the registration fee under this section and in administering the 
51.3 	insulin safety net program under section 151.74.
51.4 		Subd. 5.Insulin repayment account; annual transfer from health care access fund. (a) 
51.5 	The insulin repayment account is established in the special revenue fund in the state treasury. 
51.6 	Money in the account is appropriated each fiscal year to the commissioner of administration 
51.7 	in an amount sufficient for the commissioner to reimburse manufacturers for insulin dispensed 
51.8 	under the insulin safety net program in section 151.74, in accordance with section 151.74, 
51.9 	subdivisions 3, paragraph (h), and 6, paragraph (h), and to cover costs incurred by the 
51.10 	commissioner in providing these reimbursement payments.
51.11 	(b) The commissioner of management and budget shall transfer from the health care 
51.12 	access fund to the insulin repayment account, beginning July 1, 2025, and each July 1 
51.13 	thereafter, an amount sufficient for the commissioner of administration to implement 
51.14 	paragraph (a).
51.15 		Subd. 6.Contingent transfer by commissioner. If subdivisions 2 and 3, or the 
51.16 	application of subdivisions 2 and 3 to any person or circumstance, are held invalid for any 
51.17 	reason in a court of competent jurisdiction, the validity of subdivisions 2 and 3 does not 
51.18 	affect other provisions of this act, and the commissioner of management and budget shall 
51.19 	annually transfer from the health care access fund to the insulin safety net program account 
51.20 	an amount sufficient to implement subdivision 4.

51.21 	EFFECTIVE DATE. This section is effective July 1, 2024.

51.22 	Sec. 19. Minnesota Statutes 2023 Supplement, section 270A.03, subdivision 2, is amended 
51.23 	to read:
51.24 		Subd. 2.Claimant agency. "Claimant agency" means any state agency, as defined by 
51.25 	section 14.02, subdivision 2, the regents of the University of Minnesota, any district court 
51.26 	of the state, any county, any statutory or home rule charter city, including a city that is 
51.27 	presenting a claim for a municipal hospital or a public library or a municipal ambulance 
51.28 	service, a hospital district, any ambulance service licensed under chapter 144E, any public 
51.29 	agency responsible for child support enforcement, any public agency responsible for the 
51.30 	collection of court-ordered restitution, and any public agency established by general or 
51.31 	special law that is responsible for the administration of a low-income housing program.

52.1 	Sec. 20. [332C.01] DEFINITIONS.
52.2 		Subdivision 1.Application. For purposes of this chapter, the following terms have the 
52.3 	meanings given.
52.4 		Subd. 2.Collecting party. "Collecting party" means a party engaged in the collection 
52.5 	of medical debt. Collecting party does not include banks, credit unions, public officers, 
52.6 	garnishees, and other parties complying with a court order or statutory obligation to garnish 
52.7 	or levy a debtor's property.
52.8 		Subd. 3.Debtor. "Debtor" means a person obligated or alleged to be obligated to pay 
52.9 	any debt.
52.10 		Subd. 4.Medical debt. (a) "Medical debt" means debt incurred primarily for medically 
52.11 	necessary health treatment or services. Medical debt includes debt charged to any credit 
52.12 	card or other credit instrument under an open-end or closed-end credit plan:
52.13 	(1) offered solely for the payment of health care; or
52.14 	(2) advertised, promoted, or offered for the payment of health care at the facility in which 
52.15 	the credit card or other credit instrument is advertised, promoted, or offered.
52.16 	(b) Medical debt does not include:
52.17 	(1) debt charged to a credit card that is not advertised, promoted, or offered expressly 
52.18 	for the payment of health care and is intended, advertised, promoted, or offered to make 
52.19 	credit purchases for personal, family, or household purposes;
52.20 	(2) debt incurred for veterinary services;
52.21 	(3) debt incurred for dental services; or
52.22 	(4) debt charged to a home equity line of credit.
52.23 		Subd. 5.Medically necessary. "Medically necessary" has the meaning given in section 
52.24 	62J.805, subdivision 7.
52.25 		Subd. 6.Person. "Person" means any individual, partnership, association, or corporation.

52.26 	Sec. 21. [332C.02] PROHIBITED PRACTICES.
52.27 	No collecting party shall:
52.28 	(1) in a collection letter, publication, invoice, or any oral or written communication, 
52.29 	threaten wage garnishment or legal suit by a particular lawyer, unless the collecting party 
52.30 	has actually retained the lawyer to do so;
53.1 	(2) use or employ sheriffs or any other officer authorized to serve legal papers in 
53.2 	connection with the collection of a claim, except when performing their legally authorized 
53.3 	duties;
53.4 	(3) use or threaten to use methods of collection which violate Minnesota law;
53.5 	(4) furnish legal advice to debtors or represent that the collecting party is competent or 
53.6 	able to furnish legal advice to debtors;
53.7 	(5) communicate with debtors in a misleading or deceptive manner by falsely using the 
53.8 	stationery of a lawyer, forms or instruments which only lawyers are authorized to prepare, 
53.9 	or instruments which simulate the form and appearance of judicial process;
53.10 	(6) publish or cause to be published any list of debtors, use shame cards or shame 
53.11 	automobiles, advertise or threaten to advertise for sale any claim as a means of forcing 
53.12 	payment thereof, or use similar devices or methods of intimidation;
53.13 	(7) operate under a name or in a manner which falsely implies the collecting party is a 
53.14 	branch of or associated with any department of federal, state, county, or local government 
53.15 	or an agency thereof;
53.16 	(8) transact business or hold itself out as a debt settlement company, debt management 
53.17 	company, debt adjuster, or any person who settles, adjusts, prorates, pools, liquidates, or 
53.18 	pays the indebtedness of a debtor, unless there is no charge to the debtor, or the pooling or 
53.19 	liquidation is done pursuant to court order or under the supervision of a creditor's committee;
53.20 	(9) unless an exemption in the law exists, violate Code of Federal Regulations, title 12, 
53.21 	part 1006, while attempting to collect on any account, bill, or other indebtedness. For 
53.22 	purposes of this section, Public Law 95-109 and Code of Federal Regulations, title 12, part 
53.23 	1006, apply to collecting parties other than health care providers collecting medical debt in 
53.24 	their own name;
53.25 	(10) communicate with a debtor about medical debt by use of an automatic telephone 
53.26 	dialing system or an artificial or prerecorded voice after the debtor expressly informs the 
53.27 	collecting party to cease communication utilizing an automatic telephone dialing system or 
53.28 	an artificial or prerecorded voice. For purposes of this clause, an automatic telephone dialing 
53.29 	system or an artificial or prerecorded voice includes but is not limited to (i) artificial 
53.30 	intelligence chat bots, and (ii) the usage of the term under the Telephone Consumer Protection 
53.31 	Act, United States Code, title 47, section 227(b)(1)(A);
54.1 	(11) in collection letters or publications, or in any oral or written communication, imply 
54.2 	or suggest that medically necessary health treatment or services will be denied as a result 
54.3 	of a medical debt;
54.4 	(12) when a debtor has a listed telephone number, enlist the aid of a neighbor or third 
54.5 	party to request that the debtor contact the collecting party, except a person who resides 
54.6 	with the debtor or a third party with whom the debtor has authorized with the collecting 
54.7 	party to place the request. This clause does not apply to a call back message left at the 
54.8 	debtor's place of employment which is limited solely to the collecting party's telephone 
54.9 	number and name;
54.10 	(13) when attempting to collect a medical debt, fail to provide the debtor with the full 
54.11 	name of the collecting party, as registered with the secretary of state;
54.12 	(14) fail to return any amount of overpayment from a debtor to the debtor or to the state 
54.13 	of Minnesota pursuant to the requirements of chapter 345;
54.14 	(15) accept currency or coin as payment for a medical debt without issuing an original 
54.15 	receipt to the debtor and maintaining a duplicate receipt in the debtor's payment records;
54.16 	(16) except for court costs for filing a civil action with the court and service of process, 
54.17 	attempt to collect any interest, fee, charge, or expense incidental to the charge-off obligation 
54.18 	from a debtor unless the amount is expressly authorized by the agreement creating the 
54.19 	medical debt or is otherwise permitted by law;
54.20 	(17) falsify any documents with the intent to deceive;
54.21 	(18) when initially contacting a Minnesota debtor by mail to collect a medical debt, fail 
54.22 	to include a disclosure on the contact notice, in a type size or font which is equal to or larger 
54.23 	than the largest other type of type size or font used in the text of the notice, that includes 
54.24 	and identifies the Office of the Minnesota Attorney General's general telephone number, 
54.25 	and states: "You have the right to hire your own attorney to represent you in this matter.";
54.26 	(19) commence legal action to collect a medical debt outside the limitations period set 
54.27 	forth in section 541.053;
54.28 	(20) report to a credit reporting agency any medical debt which the collecting party 
54.29 	knows or should know is or was originally owed to a health care provider, as defined in 
54.30 	section 62J.805, subdivision 4; or
54.31 	(21) challenge a debtor's claim of exemption to garnishment or levy in a manner that is 
54.32 	baseless, frivolous, or otherwise in bad faith.

55.1 	Sec. 22. [332C.03] MEDICAL DEBT REPORTING PROHIBITED.
55.2 	(a) A collecting party is prohibited from reporting medical debt to a consumer reporting 
55.3 	agency.
55.4 	(b) A consumer reporting agency is prohibited from making a consumer report containing 
55.5 	an item of information that the consumer reporting agency knows or should know concerns 
55.6 	medical debt.
55.7 	(c) For purposes of this section, "consumer report" and "consumer reporting agency" 
55.8 	have the meanings given in the Fair Credit Reporting Act, United States Code, title 15, 
55.9 	section 1681a.
55.10 	(d) This section also applies to collection agencies and debt buyers licensed under chapter 
55.11 	332.

55.12 	Sec. 23. [332C.04] DEFENDING MEDICAL DEBT CASES.
55.13 	A debtor who successfully defends against a claim for payment of medical debt that is 
55.14 	alleged by a collecting party must be awarded the debtor's costs and a reasonable attorney 
55.15 	fee, as determined by the court, incurred in defending against the collecting party's claim 
55.16 	for debt payment. For purposes of this section, a resolution mutually agreed upon by the 
55.17 	debtor and collecting party is not a successful defense subject to an additional award of an 
55.18 	attorney fee.

55.19 	Sec. 24. [332C.05] ENFORCEMENT.
55.20 	(a) The attorney general may enforce this chapter under section 8.31.
55.21 	(b) A collecting party that violates this chapter is strictly liable to the debtor in question 
55.22 	for the sum of:
55.23 	(1) actual damage sustained by the debtor as a result of the violation;
55.24 	(2) additional damages as the court may allow, but not exceeding $1,000 per violation; 
55.25 	and
55.26 	(3) in the case of any successful action to enforce the foregoing, the costs of the action, 
55.27 	together with a reasonable attorney fee as determined by the court.
55.28 	(c) A collecting party that willfully and maliciously violates this chapter is strictly liable 
55.29 	to the debtor for three times the sums allowable under paragraph (b), clauses (1) and (2).
56.1 	(d) The dollar amount limit under paragraph (b), clause (2), changes on July 1 of each 
56.2 	even-numbered year in an amount equal to changes made in the Consumer Price Index, 
56.3 	compiled by the United States Bureau of Labor Statistics. The Consumer Price Index for 
56.4 	December 2024 is the reference base index. If the Consumer Price Index is revised, the 
56.5 	percentage of change made under this section must be calculated on the basis of the revised 
56.6 	Consumer Price Index. If a Consumer Price Index revision changes the reference base index, 
56.7 	a revised reference base index must be determined by multiplying the reference base index 
56.8 	that is effective at the time by the rebasing factor furnished by the Bureau of Labor Statistics.
56.9 	(e) If the Consumer Price Index is superseded, the Consumer Price Index referred to in 
56.10 	this section is the Consumer Price Index represented by the Bureau of Labor Statistics as 
56.11 	most accurately reflecting changes in the prices paid by consumers for consumer goods and 
56.12 	services.
56.13 	(f) The attorney general must publish the base reference index under paragraph (d) in 
56.14 	the State Register no later than September 1, 2024. The attorney general must calculate and 
56.15 	then publish the revised Consumer Price Index under paragraph (d) in the State Register no 
56.16 	later than September 1 each even-numbered year.
56.17 	(g) A collecting party must not be held liable in any action brought under this section if 
56.18 	the collecting party shows by a preponderance of evidence that the violation:
56.19 	(1) was not intentional and resulted from a bona fide error made notwithstanding the 
56.20 	maintenance of procedures reasonably adopted to avoid any such error; or
56.21 	(2) was the result of inaccurate or incorrect information provided to the collecting party 
56.22 	by a health care provider as defined in section 62J.805, subdivision 4; a health carrier as 
56.23 	defined in section 62A.011, subdivision 2; or another collecting party currently or previously 
56.24 	engaged in collection of the medical debt in question.

56.25 	Sec. 25. Minnesota Statutes 2022, section 519.05, is amended to read:
56.26 	519.05 LIABILITY OF HUSBAND AND WIFE SPOUSES.
56.27 	(a) A spouse is not liable to a creditor for any debts of the other spouse. Where husband 
56.28 	and wife are living together, they Spouses shall be jointly and severally liable for necessary 
56.29 	medical services that have been furnished to either spouse, including any claims arising 
56.30 	under section 246.53,256B.15, 256D.16, or 261.04, and necessary household articles and 
56.31 	supplies furnished to and used by the family. Notwithstanding this paragraph, in a proceeding 
56.32 	under chapter 518 the court may apportion such debt between the spouses.
57.1 	(b) Either spouse may close a credit card account or other unsecured consumer line of 
57.2 	credit on which both spouses are contractually liable, by giving written notice to the creditor.
57.3 	(c) Nothing in this section prevents a creditor's claim against a decedent's estate.

57.4 	Sec. 26. Laws 2020, chapter 73, section 8, is amended to read:
57.5 	Sec. 8. APPROPRIATIONS.
 57.6 	(a) $297,000 is appropriated in fiscal year 2020 from the health care access fund to the 
57.7 	Board of Directors of MNsure to train navigators to assist individuals and provide 
57.8 	compensation as required for the insulin safety net program under Minnesota Statutes, 
57.9 	section 151.74, subdivision 7. Of this appropriation, $108,000 is for implementing the 
57.10 	training requirements for navigators and $189,000 is for application assistance bonus 
57.11 	payments. This is a onetime appropriation and is available until December 31, 2024 June 
57.12 	30, 2027.
57.13 	(b) $250,000 is appropriated in fiscal year 2020 from the health care access fund to the 
57.14 	Board of Directors of MNsure for a public awareness campaign for the insulin safety net 
57.15 	program established under Minnesota Statutes, section 151.74. This is a onetime appropriation 
57.16 	and is available until December 31, 2024.
57.17 	(c) $76,000 is appropriated in fiscal year 2021 from the health care access fund to the 
57.18 	Board of Pharmacy to implement Minnesota Statutes, section 151.74. The base for this 
57.19 	appropriation is $76,000 in fiscal year 2022; $76,000 in fiscal year 2023; $76,000 in fiscal 
57.20 	year 2024; $38,000 in fiscal year 2025; and $0 in fiscal year 2026.
57.21 	(d) $136,000 in fiscal year 2021 is appropriated from the health care access fund to the 
57.22 	commissioner of health to implement the survey to assess program satisfaction in Minnesota 
57.23 	Statutes, section 151.74, subdivision 12. The base for this appropriation is $80,000 in fiscal 
57.24 	year 2022 and $0 in fiscal year 2023. This is a onetime appropriation.

57.25 	Sec. 27. REPEALER; SUNSET FOR THE LONG-TERM SAFETY NET INSULIN 
57.26 	PROGRAM.
 57.27 	Minnesota Statutes 2022, section 151.74, subdivision 16, is repealed.

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

58.1 	ARTICLE 4
58.2 	HEALTH INSURANCE

58.3 	Section 1. Minnesota Statutes 2022, section 62A.28, subdivision 2, is amended to read:
58.4 		Subd. 2.Required coverage. (a) Every policy, plan, certificate, or contract referred to 
58.5 	in subdivision 1 issued or renewed after August 1, 1987, must provide coverage for scalp 
58.6 	hair prostheses, including all equipment and accessories necessary for regular use of scalp 
58.7 	hair prostheses, worn for hair loss suffered as a result of a health condition, including, but 
58.8 	not limited to, alopecia areata or the treatment for cancer, unless there is a clinical basis for 
58.9 	limitation.
58.10 	(b) The coverage required by this section is subject to the co-payment, coinsurance, 
58.11 	deductible, and other enrollee cost-sharing requirements that apply to similar types of items 
58.12 	under the policy, plan, certificate, or contract and may be limited to one prosthesis per 
58.13 	benefit year.
58.14 	(c) The coverage required by this section for scalp hair prostheses is limited to $1,000 
58.15 	per benefit year.
58.16 	(d) A scalp hair prostheses must be prescribed by a doctor to be covered under this 
58.17 	section.

58.18 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all policies, 
58.19 	plans, certificates, and contracts offered, issued, or renewed on or after that date.

58.20 	Sec. 2. [62A.3098] RAPID WHOLE GENOME SEQUENCING; COVERAGE.
58.21 		Subdivision 1.Definition. For purposes of this section, "rapid whole genome sequencing" 
58.22 	or "rWGS" means an investigation of the entire human genome, including coding and 
58.23 	noncoding regions and mitochondrial deoxyribonucleic acid, to identify disease-causing 
58.24 	genetic changes that returns the final results in 14 days. Rapid whole genome sequencing 
58.25 	includes patient-only whole genome sequencing and duo and trio whole genome sequencing 
58.26 	of the patient and the patient's biological parent or parents.
58.27 		Subd. 2.Required coverage. A health plan that provides coverage to Minnesota residents 
58.28 	must cover rWGS testing if the enrollee:
58.29 	(1) is 21 years of age or younger;
58.30 	(2) has a complex or acute illness of unknown etiology that is not confirmed to have 
58.31 	been caused by an environmental exposure, toxic ingestion, an infection with a normal 
58.32 	response to therapy, or trauma; and
59.1 	(3) is receiving inpatient hospital services in an intensive care unit or a neonatal or high 
59.2 	acuity pediatric care unit.
59.3 		Subd. 3.Coverage criteria. Coverage may be based on the following medical necessity 
59.4 	criteria:
59.5 	(1) the enrollee has symptoms that suggest a broad differential diagnosis that would 
59.6 	require an evaluation by multiple genetic tests if rWGS testing is not performed;
59.7 	(2) timely identification of a molecular diagnosis is necessary in order to guide clinical 
59.8 	decision making, and the rWGS testing may aid in guiding the treatment or management 
59.9 	of the enrollee's condition; and
59.10 	(3) the enrollee's complex or acute illness of unknown etiology includes at least one of 
59.11 	the following conditions:
59.12 	(i) congenital anomalies involving at least two organ systems, or complex or multiple 
59.13 	congenital anomalies in one organ system;
59.14 	(ii) specific organ malformations that are highly suggestive of a genetic etiology;
59.15 	(iii) abnormal laboratory tests or abnormal chemistry profiles suggesting the presence 
59.16 	of a genetic disease, complex metabolic disorder, or inborn error of metabolism;
59.17 	(iv) refractory or severe hypoglycemia or hyperglycemia;
59.18 	(v) abnormal response to therapy related to an underlying medical condition affecting 
59.19 	vital organs or bodily systems;
59.20 	(vi) severe muscle weakness, rigidity, or spasticity;
59.21 	(vii) refractory seizures;
59.22 	(viii) a high-risk stratification on evaluation for a brief resolved unexplained event with 
59.23 	any of the following features:
59.24 	(A) a recurrent event without respiratory infection;
59.25 	(B) a recurrent seizure-like event; or
59.26 	(C) a recurrent cardiopulmonary resuscitation;
59.27 	(ix) abnormal cardiac diagnostic testing results that are suggestive of possible 
59.28 	channelopathies, arrhythmias, cardiomyopathies, myocarditis, or structural heart disease;
59.29 	(x) abnormal diagnostic imaging studies that are suggestive of underlying genetic 
59.30 	condition;
60.1 	(xi) abnormal physiologic function studies that are suggestive of an underlying genetic 
60.2 	etiology; or
60.3 	(xii) family genetic history related to the patient's condition.
60.4 		Subd. 4.Cost sharing. Coverage provided in this section is subject to the enrollee's 
60.5 	health plan cost-sharing requirements, including any deductibles, co-payments, or coinsurance 
60.6 	requirements that apply to diagnostic testing services.
60.7 		Subd. 5.Payment for services provided. If the enrollee's health plan uses a capitated 
60.8 	or bundled payment arrangement to reimburse a provider for services provided in an inpatient 
60.9 	setting, reimbursement for services covered under this section must be paid separately and 
60.10 	in addition to any reimbursement otherwise payable to the provider under the capitated or 
60.11 	bundled payment arrangement, unless the health carrier and the provider have negotiated 
60.12 	an increased capitated or bundled payment rate that includes the services covered under this 
60.13 	section.
60.14 		Subd. 6.Genetic data. Genetic data generated as a result of performing rWGS and 
60.15 	covered under this section: (1) must be used for the primary purpose of assisting the ordering 
60.16 	provider and treating care team to diagnose and treat the patient; (2) is protected health 
60.17 	information as set forth under the Health Insurance Portability and Accountability Act 
60.18 	(HIPAA), the Health Information Technology for Economic and Clinical Health Act, and 
60.19 	any promulgated regulations, including but not limited to Code of Federal Regulations, title 
60.20 	45, parts 160 and 164, subparts A and E; and (3) is a protected health record under sections 
60.21 	144.291 to 144.298.
60.22 		Subd. 7.Reimbursement. The commissioner of commerce must reimburse health 
60.23 	carriers for coverage under this section. Reimbursement is available only for coverage that 
60.24 	would not have been provided by the health carrier without the requirements of this section. 
60.25 	Each fiscal year, an amount necessary to make payments to health carriers to defray the 
60.26 	cost of providing coverage under this section is appropriated to the commissioner of 
60.27 	commerce. Health carriers must report to the commissioner quantified costs attributable to 
60.28 	the additional benefit under this section in a format developed by the commissioner. The 
60.29 	commissioner must evaluate submissions and make payments to health carriers as provided 
60.30 	in Code of Federal Regulations, title 45, section 155.170.

60.31 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to a health 
60.32 	plan offered, issued, or sold on or after that date.

61.1 	Sec. 3. [62A.59] COVERAGE OF SERVICE; PRIOR AUTHORIZATION.
61.2 		Subdivision 1.Service for which prior authorization not required. A health carrier 
61.3 	must not retrospectively deny or limit coverage of a health care service for which prior 
61.4 	authorization was not required by the health carrier, unless there is evidence that the health 
61.5 	care service was provided based on fraud or misinformation.
61.6 		Subd. 2.Service for which prior authorization required but not obtained. A health 
61.7 	carrier must not deny or limit coverage of a health care service which the enrollee has already 
61.8 	received solely on the basis of lack of prior authorization if the service would otherwise 
61.9 	have been covered had the prior authorization been obtained.

61.10 	EFFECTIVE DATE. This section is effective January 1, 2026, and applies to health 
61.11 	plans offered, sold, issued, or renewed on or after that date.

61.12 	Sec. 4. [62C.045] APPLICATION OF OTHER LAW.
61.13 	Sections 145D.30 to 145D.37 apply to service plan corporations operating under this 
61.14 	chapter.

61.15 	Sec. 5. Minnesota Statutes 2022, section 62D.02, subdivision 4, is amended to read:
61.16 		Subd. 4.Health maintenance organization.  "Health maintenance organization" means 
61.17 	a foreign or domestic nonprofit corporation organized under chapter 317A, or a local 
61.18 	governmental unit as defined in subdivision 11, or an entity which is not a nonprofit 
61.19 	corporation organized under chapter 317A or a local governmental unit and which holds a 
61.20 	certificate of authority under sections 62D.01 to 62D.30 as of June 1, 2024, controlled and 
61.21 	operated as provided in sections 62D.01 to 62D.30, which provides, either directly or through 
61.22 	arrangements with providers or other persons, comprehensive health maintenance services, 
61.23 	or arranges for the provision of these services, to enrollees on the basis of a fixed prepaid 
61.24 	sum without regard to the frequency or extent of services furnished to any particular enrollee.

61.25 	Sec. 6. Minnesota Statutes 2022, section 62D.02, subdivision 7, is amended to read:
61.26 		Subd. 7.Comprehensive health maintenance services. "Comprehensive health 
61.27 	maintenance services" means a set of comprehensive health services which the enrollees 
61.28 	might reasonably require to be maintained in good health including as a minimum, but not 
61.29 	limited to, emergency care, emergency ground ambulance transportation services, inpatient 
61.30 	hospital and physician care, outpatient health services and preventive health services. 
61.31 	Elective, induced abortion, except as medically necessary to prevent the death of the mother, 
62.1 	whether performed in a hospital, other abortion facility or the office of a physician, shall 
62.2 	not be mandatory for any health maintenance organization.

62.3 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
62.4 	plans offered, sold, issued, or renewed on or after that date.

62.5 	Sec. 7. Minnesota Statutes 2022, section 62D.03, subdivision 1, is amended to read:
62.6 		Subdivision 1.Certificate of authority required. Notwithstanding any law of this state 
62.7 	to the contrary, any foreign or domestic nonprofit corporation organized to do so or a local 
62.8 	governmental unit may apply to the commissioner of health for a certificate of authority to 
62.9 	establish and operate a health maintenance organization in compliance with sections 62D.01 
62.10 	to 62D.30. No person shall establish or operate a health maintenance organization in this 
62.11 	state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic 
62.12 	consideration in conjunction with a health maintenance organization or health maintenance 
62.13 	contract unless the organization has a certificate of authority under sections 62D.01 to 
62.14 	62D.30.

62.15 	Sec. 8. Minnesota Statutes 2022, section 62D.03, is amended by adding a subdivision to 
62.16 	read:
62.17 		Subd. 1a.Certificate of authority; for-profit corporation. The commissioner of health 
62.18 	must not issue a new certificate of authority to an entity to operate a health maintenance 
62.19 	organization unless the entity is a nonprofit corporation organized under chapter 317A or 
62.20 	a local governmental unit.

62.21 	Sec. 9. Minnesota Statutes 2022, section 62D.05, subdivision 1, is amended to read:
62.22 		Subdivision 1.Authority granted. Any nonprofit corporation or local governmental 
62.23 	unit may, upon obtaining a certificate of authority as required in sections 62D.01 to 62D.30, 
62.24 	operate as a health maintenance organization. An entity that: (1) is not a nonprofit corporation 
62.25 	organized under chapter 317A or a local governmental unit; and (2) holds a certificate of 
62.26 	authority under sections 62D.01 to 62D.30 as of June 1, 2024, may continue to operate as 
62.27 	a health maintenance organization for as long as the corporation holds a certificate of 
62.28 	authority.

62.29 	Sec. 10. Minnesota Statutes 2022, section 62D.12, subdivision 19, is amended to read:
62.30 		Subd. 19.Coverage of service. A health maintenance organization may not deny or 
62.31 	limit coverage of a service which the enrollee has already received solely on the basis of 
63.1 	lack of prior authorization or second opinion, to the extent that the service would otherwise 
63.2 	have been covered under the member's contract by the health maintenance organization had 
63.3 	prior authorization or second opinion been obtained. This subdivision expires December 
63.4 	31, 2025, for health plans offered, sold, issued, or renewed on or after that date.

63.5 	Sec. 11. Minnesota Statutes 2022, section 62D.19, is amended to read:
63.6 	62D.19 UNREASONABLE EXPENSES.
63.7 	No health maintenance organization shall incur or pay for any expense of any nature 
63.8 	which is unreasonably high in relation to the value of the service or goods provided. The 
63.9 	commissioner of health shall implement and enforce this section by rules adopted under 
63.10 	this section.
63.11 	In an effort to achieve the stated purposes of sections 62D.01 to 62D.30; for nonprofit 
63.12 	health maintenance organizations, in order to safeguard the underlying nonprofit status of 
63.13 	health maintenance organizations; and in order to ensure that the payment of health 
63.14 	maintenance organization money to major participating entities results in a corresponding 
63.15 	benefit to the health maintenance organization and its enrollees, when determining whether 
63.16 	an organization has incurred an unreasonable expense in relation to a major participating 
63.17 	entity, due consideration shall be given to, in addition to any other appropriate factors, 
63.18 	whether the officers and trustees of the health maintenance organization have acted with 
63.19 	good faith and in the best interests of the health maintenance organization in entering into, 
63.20 	and performing under, a contract under which the health maintenance organization has 
63.21 	incurred an expense. The commissioner has standing to sue, on behalf of a health maintenance 
63.22 	organization, officers or trustees of the health maintenance organization who have breached 
63.23 	their fiduciary duty in entering into and performing such contracts.

63.24 	Sec. 12. Minnesota Statutes 2022, section 62D.20, subdivision 1, is amended to read:
63.25 		Subdivision 1.Rulemaking. The commissioner of health may, pursuant to chapter 14, 
63.26 	promulgate such reasonable rules as are necessary or proper to carry out the provisions of 
63.27 	sections 62D.01 to 62D.30. Included among such rules shall be those which provide minimum 
63.28 	requirements for the provision of comprehensive health maintenance services, as defined 
63.29 	in section 62D.02, subdivision 7, and reasonable exclusions therefrom. Nothing in such 
63.30 	rules shall force or require a health maintenance organization to provide elective, induced 
63.31 	abortions, except as medically necessary to prevent the death of the mother, whether 
63.32 	performed in a hospital, other abortion facility, or the office of a physician; the rules shall 
63.33 	provide every health maintenance organization the option of excluding or including elective, 
64.1 	induced abortions, except as medically necessary to prevent the death of the mother, as part 
64.2 	of its comprehensive health maintenance services.

64.3 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
64.4 	plans offered, sold, issued, or renewed on or after that date.

64.5 	Sec. 13. Minnesota Statutes 2022, section 62D.22, subdivision 5, is amended to read:
64.6 		Subd. 5.Other state law. Except as otherwise provided in sections 62A.01 to 62A.42
64.7 	and 62D.01 to 62D.30, and except as they eliminate elective, induced abortions, wherever 
64.8 	performed, from health or maternity benefits, provisions of the insurance laws and provisions 
64.9 	of nonprofit health service plan corporation laws shall not be applicable to any health 
64.10 	maintenance organization granted a certificate of authority under sections 62D.01 to 62D.30.

64.11 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
64.12 	plans offered, sold, issued, or renewed on or after that date.

64.13 	Sec. 14. Minnesota Statutes 2022, section 62D.22, is amended by adding a subdivision to 
64.14 	read:
64.15 		Subd. 5a.Application of other law. Sections 145D.30 to 145D.37 apply to nonprofit 
64.16 	health maintenance organizations operating under this chapter.

64.17 	Sec. 15. [62D.221] OVERSIGHT OF TRANSACTIONS.
64.18 		Subdivision 1.Insurance provisions applicable to health maintenance 
64.19 	organizations. (a) Health maintenance organizations are subject to sections 60A.135, 
64.20 	60A.136, 60A.137, 60A.16, 60A.161, 60D.17, 60D.18, and 60D.20 and must comply with 
64.21 	the provisions of these sections applicable to insurers. In applying these sections to health 
64.22 	maintenance organizations, "the commissioner" means the commissioner of health. Health 
64.23 	maintenance organizations are subject to Minnesota Rules, chapter 2720, as applicable to 
64.24 	sections 60D.17, 60D.18, and 60D.20, and must comply with those provisions of the chapter 
64.25 	applicable to insurers unless the commissioner of health adopts rules to implement this 
64.26 	subdivision.
64.27 	(b) In addition to the conditions in section 60D.17, subdivision 1, subjecting a health 
64.28 	maintenance organization to filing requirements, no person other than the issuer shall acquire 
64.29 	all or substantially all of the assets of a domestic nonprofit health maintenance organization 
64.30 	through any means unless at the time the offer, request, or invitation is made or the agreement 
64.31 	is entered into the person has filed with the commissioner and has sent to the health 
64.32 	maintenance organization a statement containing the information required in section 60D.17 
65.1 	and the offer, request, invitation, agreement, or acquisition has been approved by the 
65.2 	commissioner of health in the manner prescribed in section 60D.17.
65.3 		Subd. 2.Conversion transactions. If a health maintenance organization must notify or 
65.4 	report a transaction to the commissioner under subdivision 1, the health maintenance 
65.5 	organization must include information regarding the plan for a conversion benefit entity, 
65.6 	in the form and manner determined by the commissioner, if the reportable transaction 
65.7 	qualifies as a conversion transaction as defined in section 145D.30, subdivision 5. The 
65.8 	commissioner may consider information regarding the conversion transaction and the 
65.9 	conversion benefit entity plan in any actions taken under subdivision 1, including in decisions 
65.10 	to approve or disapprove transactions, and may extend time frames to a total of 90 days, 
65.11 	with notice to the parties to the transaction.

65.12 	Sec. 16. Minnesota Statutes 2022, section 62M.01, subdivision 3, is amended to read:
65.13 		Subd. 3.Scope. (a) Nothing in this chapter applies to review of claims after submission 
65.14 	to determine eligibility for benefits under a health benefit plan. The appeal procedure 
65.15 	described in section 62M.06 applies to any complaint as defined under section 62Q.68, 
65.16 	subdivision 2, that requires a medical determination in its resolution.
65.17 	(b) Effective January 1, 2026, this chapter does not apply applies to managed care plans 
65.18 	or county-based purchasing plans when the plan is providing coverage to state public health 
65.19 	care program enrollees under chapter 256B or 256L.
65.20 	(c) Effective January 1, 2026, the following sections of this chapter apply to services 
65.21 	delivered through fee-for-service under chapters 256B and 256L: 62M.02, subdivisions 1 
65.22 	to 5, 7 to 12, 13, 14 to 18, and 21; 62M.04; 62M.05, subdivisions 1 to 4; 62M.06, subdivisions 
65.23 	1 to 3; 62M.07; 62M.072; 62M.09; 62M.10; 62M.12; 62M.17, subdivision 2; and 62M.18. 
65.24 	The commissioner shall comply with the requirements of section 62M.18 using existing 
65.25 	appropriations.

65.26 	Sec. 17. Minnesota Statutes 2022, section 62M.02, subdivision 1a, is amended to read:
65.27 		Subd. 1a.Adverse determination. "Adverse determination" means a decision by a 
65.28 	utilization review organization relating to an admission, extension of stay, or health care 
65.29 	service that is partially or wholly adverse to the enrollee, including:
65.30 	(1) a decision to deny an admission, extension of stay, or health care service on the basis 
65.31 	that it is not medically necessary; or
66.1 	(2) an authorization for a health care service that is less intensive than the health care 
66.2 	service specified in the original request for authorization.

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

66.4 	Sec. 18. Minnesota Statutes 2022, section 62M.02, subdivision 5, is amended to read:
66.5 		Subd. 5.Authorization. "Authorization" means a determination by a utilization review 
66.6 	organization that an admission, extension of stay, or other health care service has been 
66.7 	reviewed and that, based on the information provided, it satisfies the utilization review 
66.8 	requirements of the applicable health benefit plan and the health plan company or 
66.9 	commissioner will then pay for the covered benefit, provided the preexisting limitation 
66.10 	provisions, the general exclusion provisions, and any deductible, co-payment, coinsurance, 
66.11 	or other policy requirements have been met.

66.12 	Sec. 19. Minnesota Statutes 2022, section 62M.02, is amended by adding a subdivision 
66.13 	to read:
66.14 		Subd. 8a.Commissioner. "Commissioner" means, effective January 1, 2026, for the 
66.15 	sections specified in section 62M.01, subdivision 3, paragraph (c), the commissioner of 
66.16 	human services, unless otherwise specified.

66.17 	Sec. 20. Minnesota Statutes 2022, section 62M.02, subdivision 11, is amended to read:
66.18 		Subd. 11.Enrollee. "Enrollee" means:
66.19 	(1) an individual covered by a health benefit plan and includes an insured policyholder, 
66.20 	subscriber, contract holder, member, covered person, or certificate holder; or
66.21 	(2) effective January 1, 2026, for the sections specified in section 62M.01, subdivision 
66.22 	3, paragraph (c), a recipient receiving coverage through fee-for-service under chapters 256B 
66.23 	and 256L.

66.24 	Sec. 21. Minnesota Statutes 2022, section 62M.02, subdivision 12, is amended to read:
66.25 		Subd. 12.Health benefit plan. (a) "Health benefit plan" means:
66.26 	(1) a policy, contract, or certificate issued by a health plan company for the coverage of 
66.27 	medical, dental, or hospital benefits; or
66.28 	(2) effective January 1, 2026, for the sections specified in section 62M.01, subdivision 
66.29 	3, paragraph (c), coverage of medical, dental, or hospital benefits through fee-for-service 
67.1 	under chapters 256B and 256L, as specified by the commissioner on the agency's public 
67.2 	website or through other forms of recipient and provider guidance.
67.3 	(b) A health benefit plan does not include coverage that is:
67.4 	(1) limited to disability or income protection coverage;
67.5 	(2) automobile medical payment coverage;
67.6 	(3) supplemental to liability insurance;
67.7 	(4) designed solely to provide payments on a per diem, fixed indemnity, or nonexpense 
67.8 	incurred basis;
67.9 	(5) credit accident and health insurance issued under chapter 62B;
67.10 	(6) blanket accident and sickness insurance as defined in section 62A.11;
67.11 	(7) accident only coverage issued by a licensed and tested insurance agent; or
67.12 	(8) workers' compensation.

67.13 	Sec. 22. Minnesota Statutes 2022, section 62M.02, subdivision 21, is amended to read:
67.14 		Subd. 21.Utilization review organization. "Utilization review organization" means an 
67.15 	entity including but not limited to an insurance company licensed under chapter 60A to 
67.16 	offer, sell, or issue a policy of accident and sickness insurance as defined in section 62A.01; 
67.17 	a prepaid limited health service organization issued a certificate of authority and operating 
67.18 	under sections 62A.451 to 62A.4528; a health service plan licensed under chapter 62C; a 
67.19 	health maintenance organization licensed under chapter 62D; a community integrated service 
67.20 	network licensed under chapter 62N; an accountable provider network operating under 
67.21 	chapter 62T; a fraternal benefit society operating under chapter 64B; a joint self-insurance 
67.22 	employee health plan operating under chapter 62H; a multiple employer welfare arrangement, 
67.23 	as defined in section 3 of the Employee Retirement Income Security Act of 1974 (ERISA), 
67.24 	United States Code, title 29, section 1103, as amended; a third-party administrator licensed 
67.25 	under section 60A.23, subdivision 8, which conducts utilization review and authorizes or 
67.26 	makes adverse determinations regarding an admission, extension of stay, or other health 
67.27 	care services for a Minnesota resident; effective January 1, 2026, for the sections specified 
67.28 	in section 62M.01, subdivision 3, paragraph (c), the commissioner of human services for 
67.29 	purposes of delivering services through fee-for-service under chapters 256B and 256L; any 
67.30 	other entity that provides, offers, or administers hospital, outpatient, medical, prescription 
67.31 	drug, or other health benefits to individuals treated by a health professional under a policy, 
67.32 	plan, or contract; or any entity performing utilization review that is affiliated with, under 
68.1 	contract with, or conducting utilization review on behalf of, a business entity in this state. 
68.2 	Utilization review organization does not include a clinic or health care system acting pursuant 
68.3 	to a written delegation agreement with an otherwise regulated utilization review organization 
68.4 	that contracts with the clinic or health care system. The regulated utilization review 
68.5 	organization is accountable for the delegated utilization review activities of the clinic or 
68.6 	health care system.

68.7 	Sec. 23. Minnesota Statutes 2022, section 62M.04, subdivision 1, is amended to read:
68.8 		Subdivision 1.Responsibility for obtaining authorization. A health benefit plan that 
68.9 	includes utilization review requirements must specify the process for notifying the utilization 
68.10 	review organization in a timely manner and obtaining authorization for health care services. 
68.11 	Each health plan company must provide a clear and concise description of this process to 
68.12 	an enrollee as part of the policy, subscriber contract, or certificate of coverage. Effective 
68.13 	January 1, 2026, the commissioner must provide a clear and concise description of this 
68.14 	process to fee-for-service recipients receiving services under chapters 256B and 256L, 
68.15 	through the agency's public website or through other forms of recipient guidance. In addition 
68.16 	to the enrollee, the utilization review organization must allow any provider or provider's 
68.17 	designee, or responsible patient representative, including a family member, to fulfill the 
68.18 	obligations under the health benefit plan.
68.19 	A claims administrator that contracts directly with providers for the provision of health 
68.20 	care services to enrollees may, through contract, require the provider to notify the review 
68.21 	organization in a timely manner and obtain authorization for health care services.

68.22 	Sec. 24. Minnesota Statutes 2022, section 62M.05, subdivision 3a, is amended to read:
68.23 		Subd. 3a.Standard review determination. (a) Notwithstanding subdivision 3b, a 
68.24 	standard review determination on all requests for utilization review must be communicated 
68.25 	to the provider and enrollee in accordance with this subdivision within five business days 
68.26 	after receiving the request if the request is received electronically, or within six business 
68.27 	days if received through nonelectronic means, provided that all information reasonably 
68.28 	necessary to make a determination on the request has been made available to the utilization 
68.29 	review organization. Effective January 1, 2022, A standard review determination on all 
68.30 	requests for utilization review must be communicated to the provider and enrollee in 
68.31 	accordance with this subdivision within five business days after receiving the request, 
68.32 	regardless of how the request was received, provided that all information reasonably 
69.1 	necessary to make a determination on the request has been made available to the utilization 
69.2 	review organization.
69.3 	(b) When a determination is made to authorize, notification must be provided promptly 
69.4 	by telephone to the provider. The utilization review organization shall send written 
69.5 	notification to the provider or shall maintain an audit trail of the determination and telephone 
69.6 	notification. For purposes of this subdivision, "audit trail" includes documentation of the 
69.7 	telephone notification, including the date; the name of the person spoken to; the enrollee; 
69.8 	the service, procedure, or admission authorized; and the date of the service, procedure, or 
69.9 	admission. If the utilization review organization indicates authorization by use of a number, 
69.10 	the number must be called the "authorization number." For purposes of this subdivision, 
69.11 	notification may also be made by facsimile to a verified number or by electronic mail to a 
69.12 	secure electronic mailbox. These electronic forms of notification satisfy the "audit trail" 
69.13 	requirement of this paragraph.
69.14 	(c) When an adverse determination is made, notification must be provided within the 
69.15 	time periods specified in paragraph (a) by telephone, by facsimile to a verified number, or 
69.16 	by electronic mail to a secure electronic mailbox to the attending health care professional 
69.17 	and hospital or physician office as applicable. Written notification must also be sent to the 
69.18 	hospital or physician office as applicable and attending health care professional if notification 
69.19 	occurred by telephone. For purposes of this subdivision, notification may be made by 
69.20 	facsimile to a verified number or by electronic mail to a secure electronic mailbox. Written 
69.21 	notification must be sent to the enrollee and may be sent by United States mail, facsimile 
69.22 	to a verified number, or by electronic mail to a secure mailbox. The written notification 
69.23 	must include all reasons relied on by the utilization review organization for the determination 
69.24 	and the process for initiating an appeal of the determination. Upon request, the utilization 
69.25 	review organization shall provide the provider or enrollee with the criteria used to determine 
69.26 	the necessity, appropriateness, and efficacy of the health care service and identify the 
69.27 	database, professional treatment parameter, or other basis for the criteria. Reasons for an 
69.28 	adverse determination may include, among other things, the lack of adequate information 
69.29 	to authorize after a reasonable attempt has been made to contact the provider or enrollee.
69.30 	(d) When an adverse determination is made, the written notification must inform the 
69.31 	enrollee and the attending health care professional of the right to submit an appeal to the 
69.32 	internal appeal process described in section 62M.06 and the procedure for initiating the 
69.33 	internal appeal. The written notice shall be provided in a culturally and linguistically 
69.34 	appropriate manner consistent with the provisions of the Affordable Care Act as defined 
69.35 	under section 62A.011, subdivision 1a.

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

70.2 	Sec. 25. Minnesota Statutes 2022, section 62M.07, subdivision 2, is amended to read:
70.3 		Subd. 2.Prior authorization of emergency certain services prohibited.  No utilization 
70.4 	review organization, health plan company, or claims administrator may conduct or require 
70.5 	prior authorization of:
70.6 	(1) emergency confinement or an emergency service. The enrollee or the enrollee's 
70.7 	authorized representative may be required to notify the health plan company, claims 
70.8 	administrator, or utilization review organization as soon as reasonably possible after the 
70.9 	beginning of the emergency confinement or emergency service.;
70.10 	(2) oral buprenorphine to treat a substance use disorder;
70.11 	(3) outpatient mental health treatment or outpatient substance use disorder treatment, 
70.12 	except for treatment which is: (i) a medication; and (ii) not otherwise listed in this 
70.13 	subdivision. Prior authorizations required for medications used for outpatient mental health 
70.14 	treatment or outpatient substance use disorder treatment, and not otherwise listed in this 
70.15 	subdivision, must be processed according to section 62M.05, subdivision 3b, for initial 
70.16 	determinations, and according to section 62M.06, subdivision 2, for appeals;
70.17 	(4) antineoplastic cancer treatment that is consistent with guidelines of the National 
70.18 	Comprehensive Cancer Network, except for treatment which is: (i) a medication; and (ii) 
70.19 	not otherwise listed in this subdivision. Prior authorizations required for medications used 
70.20 	for antineoplastic cancer treatment, and not otherwise listed in this subdivision, must be 
70.21 	processed according to section 62M.05, subdivision 3b, for initial determinations, and 
70.22 	according to section 62M.06, subdivision 2, for appeals;
70.23 	(5) services that currently have a rating of A or B from the United States Preventive 
70.24 	Services Task Force, immunizations recommended by the Advisory Committee on 
70.25 	Immunization Practices of the Centers for Disease Control and Prevention, or preventive 
70.26 	services and screenings provided to women as described in Code of Federal Regulations, 
70.27 	title 45, section 147.130;
70.28 	(6) pediatric hospice services provided by a hospice provider licensed under sections 
70.29 	144A.75 to 144A.755; and
70.30 	(7) treatment delivered through a neonatal abstinence program operated by pediatric 
70.31 	pain or palliative care subspecialists.
71.1 	Clauses (2) to (7) are effective January 1, 2026, and apply to health benefit plans offered, 
71.2 	sold, issued, or renewed on or after that date.

71.3 	Sec. 26. Minnesota Statutes 2022, section 62M.07, subdivision 4, is amended to read:
71.4 		Subd. 4.Submission of prior authorization requests. (a) If prior authorization for a 
71.5 	health care service is required, the utilization review organization, health plan company, or 
71.6 	claim administrator must allow providers to submit requests for prior authorization of the 
71.7 	health care services without unreasonable delay by telephone, facsimile, or voice mail or 
71.8 	through an electronic mechanism 24 hours a day, seven days a week. This subdivision does 
71.9 	not apply to dental service covered under MinnesotaCare or medical assistance.
71.10 	(b) Effective January 1, 2027, for health benefit plans offered, sold, issued, or renewed 
71.11 	on or after that date, utilization review organizations, health plan companies, and claims 
71.12 	administrators must have and maintain a prior authorization application programming 
71.13 	interface (API) that automates the prior authorization process for health care services, 
71.14 	excluding prescription drugs and medications. The API must allow providers to determine 
71.15 	whether a prior authorization is required for health care services, identify prior authorization 
71.16 	information and documentation requirements, and facilitate the exchange of prior 
71.17 	authorization requests and determinations from provider electronic health records or practice 
71.18 	management systems. The API must use the Health Level Seven (HL7) Fast Healthcare 
71.19 	Interoperability Resources (FHIR) standard in accordance with Code of Federal Regulations, 
71.20 	title 45, section 170.215(a)(1), and the most recent standards and guidance adopted by the 
71.21 	United States Department of Health and Human Services to implement that section. Prior 
71.22 	authorization submission requests for prescription drugs and medications must comply with 
71.23 	the requirements of section 62J.497.

71.24 	Sec. 27. Minnesota Statutes 2022, section 62M.07, is amended by adding a subdivision 
71.25 	to read:
71.26 		Subd. 5.Treatment of a chronic condition. This subdivision is effective January 1, 
71.27 	2026, and applies to health benefit plans offered, sold, issued, or renewed on or after that 
71.28 	date. An authorization for treatment of a chronic health condition does not expire unless 
71.29 	the standard of treatment for that health condition changes. A chronic health condition is a 
71.30 	condition that is expected to last one year or more and:
71.31 	(1) requires ongoing medical attention to effectively manage the condition or prevent 
71.32 	an adverse health event; or
71.33 	(2) limits one or more activities of daily living.

72.1 	Sec. 28. Minnesota Statutes 2022, section 62M.10, subdivision 7, is amended to read:
72.2 		Subd. 7.Availability of criteria. (a) For utilization review determinations other than 
72.3 	prior authorization, a utilization review organization shall, upon request, provide to an 
72.4 	enrollee, a provider, and the commissioner of commerce the criteria used to determine the 
72.5 	medical necessity, appropriateness, and efficacy of a procedure or service and identify the 
72.6 	database, professional treatment guideline, or other basis for the criteria.
72.7 	(b) For prior authorization determinations, a utilization review organization must submit 
72.8 	the organization's current prior authorization requirements and restrictions, including written, 
72.9 	evidence-based, clinical criteria used to make an authorization or adverse determination, to 
72.10 	all health plan companies for which the organization performs utilization review. A health 
72.11 	plan company must post on its public website the prior authorization requirements and 
72.12 	restrictions of any utilization review organization that performs utilization review for the 
72.13 	health plan company. These prior authorization requirements and restrictions must be detailed 
72.14 	and written in language that is easily understandable to providers. This paragraph does not 
72.15 	apply to the commissioner of human services when delivering services through fee-for-service 
72.16 	under chapters 256B and 256L.
72.17 	(c) Effective January 1, 2026, the commissioner of human services must post on the 
72.18 	department's public website the prior authorization requirements and restrictions, including 
72.19 	written, evidence-based, clinical criteria used to make an authorization or adverse 
72.20 	determination, that apply to prior authorization determinations for fee-for-service under 
72.21 	chapters 256B and 256L. These prior authorization requirements and restrictions must be 
72.22 	detailed and written in language that is easily understandable to providers.

72.23 	Sec. 29. Minnesota Statutes 2022, section 62M.10, subdivision 8, is amended to read:
72.24 		Subd. 8.Notice; new prior authorization requirements or restrictions; change to 
72.25 	existing requirement or restriction. (a) Before a utilization review organization may 
72.26 	implement a new prior authorization requirement or restriction or amend an existing prior 
72.27 	authorization requirement or restriction, the utilization review organization must submit the 
72.28 	new or amended requirement or restriction to all health plan companies for which the 
72.29 	organization performs utilization review. A health plan company must post on its website 
72.30 	the new or amended requirement or restriction. This paragraph does not apply to the 
72.31 	commissioner of human services when delivering services through fee-for-service under 
72.32 	chapters 256B and 256L.
72.33 	(b) At least 45 days before a new prior authorization requirement or restriction or an 
72.34 	amended existing prior authorization requirement or restriction is implemented, the utilization 
73.1 	review organization, health plan company, or claims administrator must provide written or 
73.2 	electronic notice of the new or amended requirement or restriction to all Minnesota-based, 
73.3 	in-network attending health care professionals who are subject to the prior authorization 
73.4 	requirements and restrictions. This paragraph does not apply to the commissioner of human 
73.5 	services when delivering services through fee-for-service under chapters 256B and 256L.
73.6 	(c) Effective January 1, 2026, before the commissioner of human services may implement 
73.7 	a new prior authorization requirement or restriction or amend an existing prior authorization 
73.8 	requirement or restriction, the commissioner, at least 45 days before the new or amended 
73.9 	requirement or restriction takes effect, must provide written or electronic notice of the new 
73.10 	or amended requirement or restriction, to all health care professionals participating as 
73.11 	fee-for-service providers under chapters 256B and 256L who are subject to the prior 
73.12 	authorization requirements and restrictions.

73.13 	Sec. 30. Minnesota Statutes 2022, section 62M.17, subdivision 2, is amended to read:
73.14 		Subd. 2.Effect of change in prior authorization clinical criteria. (a) If, during a plan 
73.15 	year, a utilization review organization changes coverage terms for a health care service or 
73.16 	the clinical criteria used to conduct prior authorizations for a health care service, the change 
73.17 	in coverage terms or change in clinical criteria shall not apply until the next plan year for 
73.18 	any enrollee who received prior authorization for a health care service using the coverage 
73.19 	terms or clinical criteria in effect before the effective date of the change.
73.20 	(b) Paragraph (a) does not apply if a utilization review organization changes coverage 
73.21 	terms for a drug or device that has been deemed unsafe by the United States Food and Drug 
73.22 	Administration (FDA); that has been withdrawn by either the FDA or the product 
73.23 	manufacturer; or when an independent source of research, clinical guidelines, or 
73.24 	evidence-based standards has issued drug- or device-specific warnings or recommended 
73.25 	changes in drug or device usage.
73.26 	(c) Paragraph (a) does not apply if a utilization review organization changes coverage 
73.27 	terms for a service or the clinical criteria used to conduct prior authorizations for a service 
73.28 	when an independent source of research, clinical guidelines, or evidence-based standards 
73.29 	has recommended changes in usage of the service for reasons related to patient harm. This 
73.30 	paragraph expires December 31, 2025, for health benefit plans offered, sold, issued, or 
73.31 	renewed on or after that date.
73.32 	(d) Effective January 1, 2026, and applicable to health benefit plans offered, sold, issued, 
73.33 	or renewed on or after that date, paragraph (a) does not apply if a utilization review 
73.34 	organization changes coverage terms for a service or the clinical criteria used to conduct 
74.1 	prior authorizations for a service when an independent source of research, clinical guidelines, 
74.2 	or evidence-based standards has recommended changes in usage of the service for reasons 
74.3 	related to previously unknown and imminent patient harm.
74.4 	(d) (e) Paragraph (a) does not apply if a utilization review organization removes a brand 
74.5 	name drug from its formulary or places a brand name drug in a benefit category that increases 
74.6 	the enrollee's cost, provided the utilization review organization (1) adds to its formulary a 
74.7 	generic or multisource brand name drug rated as therapeutically equivalent according to 
74.8 	the FDA Orange Book, or a biologic drug rated as interchangeable according to the FDA 
74.9 	Purple Book, at a lower cost to the enrollee, and (2) provides at least a 60-day notice to 
74.10 	prescribers, pharmacists, and affected enrollees.

74.11 	Sec. 31. [62M.19] ANNUAL REPORT TO COMMISSIONER OF HEALTH; PRIOR 
74.12 	AUTHORIZATIONS.
74.13 	On or before September 1 each year, each utilization review organization must report 
74.14 	to the commissioner of health, in a form and manner specified by the commissioner, 
74.15 	information on prior authorization requests for the previous calendar year. The report 
74.16 	submitted under this subdivision must include the following data:
74.17 	(1) the total number of prior authorization requests received;
74.18 	(2) the number of prior authorization requests for which an authorization was issued;
74.19 	(3) the number of prior authorization requests for which an adverse determination was 
74.20 	issued;
74.21 	(4) the number of adverse determinations reversed on appeal;
74.22 	(5) the 25 codes with the highest number of prior authorization requests and the 
74.23 	percentage of authorizations for each of these codes;
74.24 	(6) the 25 codes with the highest percentage of prior authorization requests for which 
74.25 	an authorization was issued and the total number of the requests;
74.26 	(7) the 25 codes with the highest percentage of prior authorization requests for which 
74.27 	an adverse determination was issued but which was reversed on appeal and the total number 
74.28 	of the requests;
74.29 	(8) the 25 codes with the highest percentage of prior authorization requests for which 
74.30 	an adverse determination was issued and the total number of the requests; and
75.1 	(9) the reasons an adverse determination to a prior authorization request was issued, 
75.2 	expressed as a percentage of all adverse determinations. The reasons listed may include but 
75.3 	are not limited to:
75.4 	(i) the patient did not meet prior authorization criteria;
75.5 	(ii) incomplete information was submitted by the provider to the utilization review 
75.6 	organization;
75.7 	(iii) the treatment program changed; and
75.8 	(iv) the patient is no longer covered by the health benefit plan.

75.9 	Sec. 32. Minnesota Statutes 2022, section 62Q.14, is amended to read:
75.10 	62Q.14 RESTRICTIONS ON ENROLLEE SERVICES.
75.11 	No health plan company may restrict the choice of an enrollee as to where the enrollee 
75.12 	receives services related to:
75.13 	(1) the voluntary planning of the conception and bearing of children, provided that this 
75.14 	clause does not refer to abortion services;
75.15 	(2) the diagnosis of infertility;
75.16 	(3) the testing and treatment of a sexually transmitted disease; and
75.17 	(4) the testing for AIDS or other HIV-related conditions.

75.18 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
75.19 	plans offered, sold, issued, or renewed on or after that date.

75.20 	Sec. 33. Minnesota Statutes 2022, section 62Q.19, subdivision 3, is amended to read:
75.21 		Subd. 3.Health plan company affiliation. A health plan company must offer a provider 
75.22 	contract to any all designated essential community provider providers located within the 
75.23 	area served by the health plan company. A health plan company must include all essential 
75.24 	community providers that have accepted a contract in each of the company's provider 
75.25 	networks. A health plan company shall not restrict enrollee access to services designated 
75.26 	to be provided by the essential community provider for the population that the essential 
75.27 	community provider is certified to serve. A health plan company may also make other 
75.28 	providers available for these services. A health plan company may require an essential 
75.29 	community provider to meet all data requirements, utilization review, and quality assurance 
75.30 	requirements on the same basis as other health plan providers.

76.1 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
76.2 	plans offered, issued, or renewed on or after that date.

76.3 	Sec. 34. Minnesota Statutes 2022, section 62Q.19, is amended by adding a subdivision to 
76.4 	read:
76.5 		Subd. 4a.Contract payment rates; private. An essential community provider and a 
76.6 	health plan company may negotiate the payment rate for covered services provided by the 
76.7 	essential community provider. This rate must be at least the same rate per unit of service 
76.8 	as is paid by the health plan company to the essential community provider under the provider 
76.9 	contract between the two with the highest number of enrollees receiving health care services 
76.10 	from the provider or, if there is no provider contract between the health plan company and 
76.11 	the essential community provider, the rate must be at least the same rate per unit of service 
76.12 	as is paid to other plan providers for the same or similar services. The provider contract 
76.13 	used to set the rate under this subdivision must be in relation to an individual, small group, 
76.14 	or large group health plan. This subdivision applies only to provider contracts in relation 
76.15 	to individual, small employer, and large group health plans.

76.16 	Sec. 35. Minnesota Statutes 2022, section 62Q.19, subdivision 5, is amended to read:
76.17 		Subd. 5.Contract payment rates; public. An essential community provider and a 
76.18 	health plan company may negotiate the payment rate for covered services provided by the 
76.19 	essential community provider. This rate must be at least the same rate per unit of service 
76.20 	as is paid to other health plan providers for the same or similar services. This subdivision 
76.21 	applies only to provider contracts in relation to health plans offered through the State 
76.22 	Employee Group Insurance Program, medical assistance, and MinnesotaCare.

76.23 	Sec. 36. Minnesota Statutes 2023 Supplement, section 62Q.473, is amended by adding a 
76.24 	subdivision to read:
76.25 		Subd. 3.Reimbursement. The commissioner of commerce must reimburse health plan 
76.26 	companies for coverage under this section. Reimbursement is available only for coverage 
76.27 	that would not have been provided by the health plan company without the requirements 
76.28 	of this section. Each fiscal year, an amount necessary to make payments to health plan 
76.29 	companies to defray the cost of providing coverage under this section is appropriated to the 
76.30 	commissioner of commerce. Health plan companies must report to the commissioner 
76.31 	quantified costs attributable to the additional benefit under this section in a format developed 
76.32 	by the commissioner. The commissioner must evaluate submissions and make payments to 
76.33 	health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.

77.1 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
77.2 	plans offered, issued, or renewed on or after that date.

77.3 	Sec. 37. Minnesota Statutes 2023 Supplement, section 62Q.522, subdivision 1, is amended 
77.4 	to read:
77.5 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
77.6 	(b) "Closely held for-profit entity" means an entity that:
77.7 	(1) is not a nonprofit entity;
77.8 	(2) has more than 50 percent of the value of its ownership interest owned directly or 
77.9 	indirectly by five or fewer owners; and
77.10 	(3) has no publicly traded ownership interest.
77.11 	For purposes of this paragraph:
77.12 	(i) ownership interests owned by a corporation, partnership, limited liability company, 
77.13 	estate, trust, or similar entity are considered owned by that entity's shareholders, partners, 
77.14 	members, or beneficiaries in proportion to their interest held in the corporation, partnership, 
77.15 	limited liability company, estate, trust, or similar entity;
77.16 	(ii) ownership interests owned by a nonprofit entity are considered owned by a single 
77.17 	owner;
77.18 	(iii) ownership interests owned by all individuals in a family are considered held by a 
77.19 	single owner. For purposes of this item, "family" means brothers and sisters, including 
77.20 	half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
77.21 	(iv) if an individual or entity holds an option, warrant, or similar right to purchase an 
77.22 	ownership interest, the individual or entity is considered to be the owner of those ownership 
77.23 	interests.
77.24 	(c) (b) "Contraceptive method" means a drug, device, or other product approved by the 
77.25 	Food and Drug Administration to prevent unintended pregnancy.
77.26 	(d) (c) "Contraceptive service" means consultation, examination, procedures, and medical 
77.27 	services related to the prevention of unintended pregnancy, excluding vasectomies. This 
77.28 	includes but is not limited to voluntary sterilization procedures, patient education, counseling 
77.29 	on contraceptives, and follow-up services related to contraceptive methods or services, 
77.30 	management of side effects, counseling for continued adherence, and device insertion or 
77.31 	removal.
78.1 	(e) "Eligible organization" means an organization that opposes providing coverage for 
78.2 	some or all contraceptive methods or services on account of religious objections and that 
78.3 	is:
78.4 	(1) organized as a nonprofit entity and holds itself out to be religious; or
78.5 	(2) organized and operates as a closely held for-profit entity, and the organization's 
78.6 	owners or highest governing body has adopted, under the organization's applicable rules of 
78.7 	governance and consistent with state law, a resolution or similar action establishing that the 
78.8 	organization objects to covering some or all contraceptive methods or services on account 
78.9 	of the owners' sincerely held religious beliefs.
78.10 	(f) "Exempt organization" means an organization that is organized and operates as a 
78.11 	nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal 
78.12 	Revenue Code of 1986, as amended.
78.13 	(g) (d) "Medical necessity" includes but is not limited to considerations such as severity 
78.14 	of side effects, difference in permanence and reversibility of a contraceptive method or 
78.15 	service, and ability to adhere to the appropriate use of the contraceptive method or service, 
78.16 	as determined by the attending provider.
78.17 	(h) (e) "Therapeutic equivalent version" means a drug, device, or product that can be 
78.18 	expected to have the same clinical effect and safety profile when administered to a patient 
78.19 	under the conditions specified in the labeling, and that:
78.20 	(1) is approved as safe and effective;
78.21 	(2) is a pharmaceutical equivalent: (i) containing identical amounts of the same active 
78.22 	drug ingredient in the same dosage form and route of administration; and (ii) meeting 
78.23 	compendial or other applicable standards of strength, quality, purity, and identity;
78.24 	(3) is bioequivalent in that:
78.25 	(i) the drug, device, or product does not present a known or potential bioequivalence 
78.26 	problem and meets an acceptable in vitro standard; or
78.27 	(ii) if the drug, device, or product does present a known or potential bioequivalence 
78.28 	problem, it is shown to meet an appropriate bioequivalence standard;
78.29 	(4) is adequately labeled; and
78.30 	(5) is manufactured in compliance with current manufacturing practice regulations.

78.31 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
78.32 	plans offered, sold, issued, or renewed on of after that date.

79.1 	Sec. 38. Minnesota Statutes 2023 Supplement, section 62Q.523, subdivision 1, is amended 
79.2 	to read:
79.3 		Subdivision 1.Scope of coverage. Except as otherwise provided in section 62Q.522
79.4 	62Q.679, subdivisions 2 and 3 and 4, all health plans that provide prescription coverage 
79.5 	must comply with the requirements of this section.

79.6 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
79.7 	plans offered, sold, issued, or renewed on or after that date.

79.8 	Sec. 39. [62Q.524] COVERAGE OF ABORTIONS AND ABORTION-RELATED 
79.9 	SERVICES.
79.10 		Subdivision 1.Definition. For purposes of this section, "abortion" means any medical 
79.11 	treatment intended to induce the termination of a pregnancy with a purpose other than 
79.12 	producing a live birth.
79.13 		Subd. 2.Required coverage; cost-sharing. (a) A health plan must provide coverage 
79.14 	for abortions and abortion-related services, including preabortion services and follow-up 
79.15 	services.
79.16 	(b) A health plan must not impose on the coverage under this section any co-payment, 
79.17 	coinsurance, deductible, or other enrollee cost-sharing that is greater than the cost-sharing 
79.18 	that applies to similar services covered under the health plan.
79.19 	(c) A health plan must not impose any limitation on the coverage under this section, 
79.20 	including but not limited to any utilization review, prior authorization, referral requirements, 
79.21 	restrictions, or delays, that is not generally applicable to other coverages under the plan.
79.22 		Subd. 3.Exclusion. This section does not apply to managed care organizations or 
79.23 	county-based purchasing plans when the plan provides coverage to public health care 
79.24 	program enrollees under chapter 256B or 256L.
79.25 		Subd. 4.Reimbursement. The commissioner of commerce must reimburse health plan 
79.26 	companies for coverage under this section. Reimbursement is available only for coverage 
79.27 	that would not have been provided by the health plan company without the requirements 
79.28 	of this section. Each fiscal year, an amount necessary to make payments to health plan 
79.29 	companies to defray the cost of providing coverage under this section is appropriated to the 
79.30 	commissioner of commerce. Health plan companies must report to the commissioner 
79.31 	quantified costs attributable to the additional benefit under this section in a format developed 
79.32 	by the commissioner. The commissioner must evaluate submissions and make payments to 
79.33 	health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.

80.1 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
80.2 	plans offered, sold, issued, or renewed on or after that date.

80.3 	Sec. 40. [62Q.531] AMINO ACID-BASED FORMULA COVERAGE.
80.4 		Subdivision 1.Definition. (a) For purposes of this section, the following term has the 
80.5 	meaning given.
80.6 	(b) "Formula" means an amino acid-based elemental formula.
80.7 		Subd. 2.Required coverage. A health plan company must provide coverage for formula 
80.8 	when formula is medically necessary.
80.9 		Subd. 3.Covered conditions. Conditions for which formula is medically necessary 
80.10 	include but are not limited to:
80.11 	(1) cystic fibrosis;
80.12 	(2) amino acid, organic acid, and fatty acid metabolic and malabsorption disorders;
80.13 	(3) IgE mediated allergies to food proteins;
80.14 	(4) food protein-induced enterocolitis syndrome;
80.15 	(5) eosinophilic esophagitis;
80.16 	(6) eosinophilic gastroenteritis;
80.17 	(7) eosinophilic colitis; and
80.18 	(8) mast cell activation syndrome.

80.19 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
80.20 	plans offered, issued, or sold on or after that date.

80.21 	Sec. 41. [62Q.585] GENDER-AFFIRMING CARE COVERAGE; MEDICALLY 
80.22 	NECESSARY CARE.
80.23 		Subdivision 1.Requirement. No health plan that covers physical or mental health 
80.24 	services may be offered, sold, issued, or renewed in this state that:
80.25 	(1) excludes coverage for medically necessary gender-affirming care; or
80.26 	(2) requires gender-affirming treatments to satisfy a definition of "medically necessary 
80.27 	care," "medical necessity," or any similar term that is more restrictive than the definition 
80.28 	provided in subdivision 2.
81.1 		Subd. 2.Minimum definition. "Medically necessary care" means health care services 
81.2 	appropriate in terms of type, frequency, level, setting, and duration to the enrollee's diagnosis 
81.3 	or condition and diagnostic testing and preventive services. Medically necessary care must 
81.4 	be consistent with generally accepted practice parameters as determined by health care 
81.5 	providers in the same or similar general specialty as typically manages the condition, 
81.6 	procedure, or treatment at issue and must:
81.7 	(1) help restore or maintain the enrollee's health; or
81.8 	(2) prevent deterioration of the enrollee's condition.
81.9 		Subd. 3.Definitions. (a) For purposes of this section, the following terms have the 
81.10 	meanings given.
81.11 	(b) "Gender-affirming care" means all medical, surgical, counseling, or referral services, 
81.12 	including telehealth services, that an individual may receive to support and affirm the 
81.13 	individual's gender identity or gender expression and that are legal under the laws of this 
81.14 	state.
81.15 	(c) "Health plan" has the meaning given in section 62Q.01, subdivision 3, but includes 
81.16 	the coverages listed in section 62A.011, subdivision 3, clauses (7) and (10).

81.17 	Sec. 42. [62Q.665] COVERAGE FOR ORTHOTIC AND PROSTHETIC DEVICES.
81.18 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
81.19 	the meanings given.
81.20 	(b) "Accredited facility" means any entity that is accredited to provide comprehensive 
81.21 	orthotic or prosthetic devices or services by a Centers for Medicare and Medicaid Services 
81.22 	approved accrediting agency.
81.23 	(c) "Orthosis" means:
81.24 	(1) an external medical device that is:
81.25 	(i) custom-fabricated or custom-fitted to a specific patient based on the patient's unique 
81.26 	physical condition;
81.27 	(ii) applied to a part of the body to correct a deformity, provide support and protection, 
81.28 	restrict motion, improve function, or relieve symptoms of a disease, syndrome, injury, or 
81.29 	postoperative condition; and
82.1 	(iii) deemed medically necessary by a prescribing physician or licensed health care 
82.2 	provider who has authority in Minnesota to prescribe orthotic and prosthetic devices, supplies, 
82.3 	and services; and
82.4 	(2) any provision, repair, or replacement of a device that is furnished or performed by:
82.5 	(i) an accredited facility in comprehensive orthotic services; or
82.6 	(ii) a health care provider licensed in Minnesota and operating within the provider's 
82.7 	scope of practice which allows the provider to provide orthotic or prosthetic devices, supplies, 
82.8 	or services.
82.9 	(d) "Orthotics" means:
82.10 	(1) the science and practice of evaluating, measuring, designing, fabricating, assembling, 
82.11 	fitting, adjusting, or servicing and providing the initial training necessary to accomplish the 
82.12 	fitting of an orthotic device for the support, correction, or alleviation of a neuromuscular 
82.13 	or musculoskeletal dysfunction, disease, injury, or deformity;
82.14 	(2) evaluation, treatment, and consultation related to an orthotic device;
82.15 	(3) basic observation of gait and postural analysis;
82.16 	(4) assessing and designing orthosis to maximize function and provide support and 
82.17 	alignment necessary to prevent or correct a deformity or to improve the safety and efficiency 
82.18 	of mobility and locomotion;
82.19 	(5) continuing patient care to assess the effect of an orthotic device on the patient's 
82.20 	tissues; and
82.21 	(6) proper fit and function of the orthotic device by periodic evaluation.
82.22 	(e) "Prosthesis" means:
82.23 	(1) an external medical device that is:
82.24 	(i) used to replace or restore a missing limb, appendage, or other external human body 
82.25 	part; and
82.26 	(ii) deemed medically necessary by a prescribing physician or licensed health care 
82.27 	provider who has authority in Minnesota to prescribe orthotic and prosthetic devices, supplies, 
82.28 	and services; and
82.29 	(2) any provision, repair, or replacement of a device that is furnished or performed by:
82.30 	(i) an accredited facility in comprehensive prosthetic services; or
83.1 	(ii) a health care provider licensed in Minnesota and operating within the provider's 
83.2 	scope of practice which allows the provider to provide orthotic or prosthetic devices, supplies, 
83.3 	or services.
83.4 	(f) "Prosthetics" means:
83.5 	(1) the science and practice of evaluating, measuring, designing, fabricating, assembling, 
83.6 	fitting, aligning, adjusting, or servicing, as well as providing the initial training necessary 
83.7 	to accomplish the fitting of, a prosthesis through the replacement of external parts of a 
83.8 	human body lost due to amputation or congenital deformities or absences;
83.9 	(2) the generation of an image, form, or mold that replicates the patient's body segment 
83.10 	and that requires rectification of dimensions, contours, and volumes for use in the design 
83.11 	and fabrication of a socket to accept a residual anatomic limb to, in turn, create an artificial 
83.12 	appendage that is designed either to support body weight or to improve or restore function 
83.13 	or anatomical appearance, or both;
83.14 	(3) observational gait analysis and clinical assessment of the requirements necessary to 
83.15 	refine and mechanically fix the relative position of various parts of the prosthesis to maximize 
83.16 	function, stability, and safety of the patient;
83.17 	(4) providing and continuing patient care in order to assess the prosthetic device's effect 
83.18 	on the patient's tissues; and
83.19 	(5) assuring proper fit and function of the prosthetic device by periodic evaluation.
83.20 		Subd. 2.Coverage. (a) A health plan must provide coverage for orthotic and prosthetic 
83.21 	devices, supplies, and services, including repair and replacement, at least equal to the 
83.22 	coverage provided under federal law for health insurance for the aged and disabled under 
83.23 	sections 1832, 1833, and 1834 of the Social Security Act, United States Code, title 42, 
83.24 	sections 1395k, 1395l, and 1395m, but only to the extent consistent with this section.
83.25 	(b) A health plan must not subject orthotic and prosthetic benefits to separate financial 
83.26 	requirements that apply only with respect to those benefits. A health plan may impose 
83.27 	co-payment and coinsurance amounts on those benefits, except that any financial 
83.28 	requirements that apply to such benefits must not be more restrictive than the financial 
83.29 	requirements that apply to the health plan's medical and surgical benefits, including those 
83.30 	for internal restorative devices.
83.31 	(c) A health plan may limit the benefits for, or alter the financial requirements for, 
83.32 	out-of-network coverage of prosthetic and orthotic devices, except that the restrictions and 
83.33 	requirements that apply to those benefits must not be more restrictive than the financial 
84.1 	requirements that apply to the out-of-network coverage for the health plan's medical and 
84.2 	surgical benefits.
84.3 	(d) A health plan must cover orthoses and prostheses when furnished under an order by 
84.4 	a prescribing physician or licensed health care prescriber who has authority in Minnesota 
84.5 	to prescribe orthoses and prostheses, and that coverage for orthotic and prosthetic devices, 
84.6 	supplies, accessories, and services must include those devices or device systems, supplies, 
84.7 	accessories, and services that are customized to the covered individual's needs.
84.8 	(e) A health plan must cover orthoses and prostheses determined by the enrollee's provider 
84.9 	to be the most appropriate model that meets the medical needs of the enrollee for purposes 
84.10 	of performing physical activities, as applicable, including but not limited to running, biking, 
84.11 	and swimming, and maximizing the enrollee's limb function.
84.12 	(f) A health plan must cover orthoses and prostheses for showering or bathing.
84.13 		Subd. 3.Prior authorization. A health plan may require prior authorization for orthotic 
84.14 	and prosthetic devices, supplies, and services in the same manner and to the same extent as 
84.15 	prior authorization is required for any other covered benefit.
84.16 		Subd. 4.Reimbursement. The commissioner of commerce must reimburse health plan 
84.17 	companies for coverage under this section. Reimbursement is available only for coverage 
84.18 	that would not have been provided by the health plan company without the requirements 
84.19 	of this section. Each fiscal year, an amount necessary to make payments to health plan 
84.20 	companies to defray the cost of providing coverage under this section is appropriated to the 
84.21 	commissioner of commerce. Health plan companies must report to the commissioner 
84.22 	quantified costs attributable to the additional benefit under this section in a format developed 
84.23 	by the commissioner. The commissioner must evaluate submissions and make payments to 
84.24 	health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.

84.25 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all health 
84.26 	plans offered, issued, or renewed on or after that date.

84.27 	Sec. 43. [62Q.666] MEDICAL NECESSITY AND NONDISCRIMINATION 
84.28 	STANDARDS FOR COVERAGE OF PROSTHETICS OR ORTHOTICS.
84.29 	(a) When performing a utilization review for a request for coverage of prosthetic or 
84.30 	orthotic benefits, a health plan company shall apply the most recent version of evidence-based 
84.31 	treatment and fit criteria as recognized by relevant clinical specialists.
84.32 	(b) A health plan company shall render utilization review determinations in a 
84.33 	nondiscriminatory manner and shall not deny coverage for habilitative or rehabilitative 
85.1 	benefits, including prosthetics or orthotics, solely on the basis of an enrollee's actual or 
85.2 	perceived disability.
85.3 	(c) A health plan company shall not deny a prosthetic or orthotic benefit for an individual 
85.4 	with limb loss or absence that would otherwise be covered for a nondisabled person seeking 
85.5 	medical or surgical intervention to restore or maintain the ability to perform the same 
85.6 	physical activity.
85.7 	(d) A health plan offered, issued, or renewed in Minnesota that offers coverage for 
85.8 	prosthetics and custom orthotic devices shall include language describing an enrollee's rights 
85.9 	pursuant to paragraphs (b) and (c) in its evidence of coverage and any benefit denial letters.
85.10 	(e) A health plan that provides coverage for prosthetic or orthotic services shall ensure 
85.11 	access to medically necessary clinical care and to prosthetic and custom orthotic devices 
85.12 	and technology from not less than two distinct prosthetic and custom orthotic providers in 
85.13 	the plan's provider network located in Minnesota. In the event that medically necessary 
85.14 	covered orthotics and prosthetics are not available from an in-network provider, the health 
85.15 	plan company shall provide processes to refer a member to an out-of-network provider and 
85.16 	shall fully reimburse the out-of-network provider at a mutually agreed upon rate less member 
85.17 	cost sharing determined on an in-network basis.
85.18 	(f) If coverage for prosthetic or custom orthotic devices is provided, payment shall be 
85.19 	made for the replacement of a prosthetic or custom orthotic device or for the replacement 
85.20 	of any part of the devices, without regard to continuous use or useful lifetime restrictions, 
85.21 	if an ordering health care provider determines that the provision of a replacement device, 
85.22 	or a replacement part of a device, is necessary because:
85.23 	(1) of a change in the physiological condition of the patient;
85.24 	(2) of an irreparable change in the condition of the device or in a part of the device; or
85.25 	(3) the condition of the device, or the part of the device, requires repairs and the cost of 
85.26 	the repairs would be more than 60 percent of the cost of a replacement device or of the part 
85.27 	being replaced.
85.28 	(g) Confirmation from a prescribing health care provider may be required if the prosthetic 
85.29 	or custom orthotic device or part being replaced is less than three years old.

85.30 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all health 
85.31 	plans offered, issued, or renewed on or after that date.

86.1 	Sec. 44. [62Q.679] RELIGIOUS OBJECTIONS.
86.2 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
86.3 	(b) "Closely held for-profit entity" means an entity that is not a nonprofit entity, has 
86.4 	more than 50 percent of the value of its ownership interest owned directly or indirectly by 
86.5 	five or fewer owners, and has no publicly traded ownership interest. For purposes of this 
86.6 	paragraph:
86.7 	(1) ownership interests owned by a corporation, partnership, limited liability company, 
86.8 	estate, trust, or similar entity are considered owned by that entity's shareholders, partners, 
86.9 	members, or beneficiaries in proportion to their interest held in the corporation, partnership, 
86.10 	limited liability company, estate, trust, or similar entity;
86.11 	(2) ownership interests owned by a nonprofit entity are considered owned by a single 
86.12 	owner;
86.13 	(3) ownership interests owned by all individuals in a family are considered held by a 
86.14 	single owner. For purposes of this clause, "family" means brothers and sisters, including 
86.15 	half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
86.16 	(4) if an individual or entity holds an option, warrant, or similar right to purchase an 
86.17 	ownership interest, the individual or entity is considered to be the owner of those ownership 
86.18 	interests.
86.19 	(c) "Eligible organization" means an organization that opposes covering some or all 
86.20 	health benefits under section 62Q.522, 62Q.524, or 62Q.585 on account of religious 
86.21 	objections and that is:
86.22 	(1) organized as a nonprofit entity and holds itself out to be religious; or
86.23 	(2) organized and operates as a closely held for-profit entity, and the organization's 
86.24 	owners or highest governing body has adopted, under the organization's applicable rules of 
86.25 	governance and consistent with state law, a resolution or similar action establishing that the 
86.26 	organization objects to covering some or all health benefits under section 62Q.522, 62Q.524, 
86.27 	or 62Q.585 on account of the owners' sincerely held religious beliefs.
86.28 	(d) "Exempt organization" means an organization that is organized and operates as a 
86.29 	nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal 
86.30 	Revenue Code of 1986, as amended.
86.31 		Subd. 2.Exemption. (a) An exempt organization is not required to provide coverage 
86.32 	under section 62Q.522, 62Q.524, or 62Q.585 if the exempt organization has religious 
87.1 	objections to the coverage. An exempt organization that chooses to not provide coverage 
87.2 	pursuant to this paragraph must notify employees as part of the hiring process and must 
87.3 	notify all employees at least 30 days before:
87.4 	(1) an employee enrolls in the health plan; or
87.5 	(2) the effective date of the health plan, whichever occurs first.
87.6 	(b) If the exempt organization provides partial coverage under section 62Q.522, 62Q.524, 
87.7 	or 62Q.585, the notice required under paragraph (a) must provide a list of the portions of 
87.8 	such coverage which the organization refuses to cover.
87.9 		Subd. 3.Accommodation for eligible organizations. (a) A health plan established or 
87.10 	maintained by an eligible organization complies with the coverage requirements of section 
87.11 	62Q.522, 62Q.524, or 62Q.585, with respect to the health benefits identified in the notice 
87.12 	under this paragraph, if the eligible organization provides notice to any health plan company 
87.13 	with which the eligible organization contracts that it is an eligible organization and that the 
87.14 	eligible organization has a religious objection to coverage for all or a subset of the health 
87.15 	benefits under section 62Q.522, 62Q.524, or 62Q.585.
87.16 	(b) The notice from an eligible organization to a health plan company under paragraph 
87.17 	(a) must include: (1) the name of the eligible organization; (2) a statement that it objects to 
87.18 	coverage for some or all of the health benefits under section 62Q.522, 62Q.524, or 62Q.585, 
87.19 	including a list of the health benefits to which the eligible organization objects, if applicable; 
87.20 	and (3) the health plan name. The notice must be executed by a person authorized to provide 
87.21 	notice on behalf of the eligible organization.
87.22 	(c) An eligible organization must provide a copy of the notice under paragraph (a) to 
87.23 	prospective employees as part of the hiring process and to all employees at least 30 days 
87.24 	before:
87.25 	(1) an employee enrolls in the health plan; or
87.26 	(2) the effective date of the health plan, whichever occurs first.
87.27 	(d) A health plan company that receives a copy of the notice under paragraph (a) with 
87.28 	respect to a health plan established or maintained by an eligible organization must, for all 
87.29 	future enrollments in the health plan:
87.30 	(1) expressly exclude coverage for those health benefits identified in the notice under 
87.31 	paragraph (a) from the health plan; and
88.1 	(2) provide separate payments for any health benefits required to be covered under 
88.2 	section 62Q.522, 62Q.524, or 62Q.585 for enrollees as long as the enrollee remains enrolled 
88.3 	in the health plan.
88.4 	(e) The health plan company must not impose any cost-sharing requirements, including 
88.5 	co-pays, deductibles, or coinsurance, or directly or indirectly impose any premium, fee, or 
88.6 	other charge for the health benefits under section 62Q.522 on the enrollee. The health plan 
88.7 	company must not directly or indirectly impose any premium, fee, or other charge for the 
88.8 	health benefits under section 62Q.522, 62Q.524, or 62Q.585 on the eligible organization 
88.9 	or health plan.
88.10 	(f) On January 1, 2024, and every year thereafter a health plan company must notify the 
88.11 	commissioner, in a manner determined by the commissioner, of the number of eligible 
88.12 	organizations granted an accommodation under this subdivision.

88.13 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
88.14 	plans offered, sold, issued, or renewed on or after that date.

88.15 	Sec. 45. Minnesota Statutes 2022, section 62Q.73, subdivision 2, is amended to read:
88.16 		Subd. 2.Exception. (a) This section does not apply to governmental programs except 
88.17 	as permitted under paragraph (b). For purposes of this subdivision, "governmental programs" 
88.18 	means the prepaid medical assistance program,;effective January 1, 2026, the medical 
88.19 	assistance fee-for-service program; the MinnesotaCare program,; the demonstration project 
88.20 	for people with disabilities,; and the federal Medicare program.
88.21 	(b) In the course of a recipient's appeal of a medical determination to the commissioner 
88.22 	of human services under section 256.045, the recipient may request an expert medical 
88.23 	opinion be arranged by the external review entity under contract to provide independent 
88.24 	external reviews under this section. If such a request is made, the cost of the review shall 
88.25 	be paid by the commissioner of human services. Any medical opinion obtained under this 
88.26 	paragraph shall only be used by a state human services judge as evidence in the recipient's 
88.27 	appeal to the commissioner of human services under section 256.045.
88.28 	(c) Nothing in this subdivision shall be construed to limit or restrict the appeal rights 
88.29 	provided in section 256.045 for governmental program recipients.

88.30 	Sec. 46. Minnesota Statutes 2022, section 62V.05, subdivision 12, is amended to read:
88.31 		Subd. 12.Reports on interagency agreements and intra-agency transfers. The 
88.32 	MNsure Board shall provide quarterly reports to the chairs and ranking minority members 
89.1 	of the legislative committees with jurisdiction over health and human services policy and 
89.2 	finance on: legislative reports on interagency agreements and intra-agency transfers according 
89.3 	to section 15.0395.
89.4 	(1) interagency agreements or service-level agreements and any renewals or extensions 
89.5 	of existing interagency or service-level agreements with a state department under section 
89.6 	15.01, state agency under section 15.012, or the Department of Information Technology 
89.7 	Services, with a value of more than $100,000, or related agreements with the same department 
89.8 	or agency with a cumulative value of more than $100,000; and
89.9 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
89.10 	agencies.
89.11 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
89.12 	amount, purpose, and effective date of the agreement, the duration of the agreement, and a 
89.13 	copy of the agreement.

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

89.15 	Sec. 47. Minnesota Statutes 2022, section 62V.08, is amended to read:
89.16 	62V.08 REPORTS.
89.17 	(a) MNsure shall submit a report to the legislature by January 15, 2015 March 31, 2025, 
89.18 	and each January 15 March 31 thereafter, on: (1) the performance of MNsure operations; 
89.19 	(2) meeting MNsure responsibilities; (3) an accounting of MNsure budget activities; (4) 
89.20 	practices and procedures that have been implemented to ensure compliance with data 
89.21 	practices laws, and a description of any violations of data practices laws or procedures; and 
89.22 	(5) the effectiveness of the outreach and implementation activities of MNsure in reducing 
89.23 	the rate of uninsurance.
89.24 	(b) MNsure must publish its administrative and operational costs on a website to educate 
89.25 	consumers on those costs. The information published must include: (1) the amount of 
89.26 	premiums and federal premium subsidies collected; (2) the amount and source of revenue 
89.27 	received under section 62V.05, subdivision 1, paragraph (b), clause (3); (3) the amount and 
89.28 	source of any other fees collected for purposes of supporting operations; and (4) any misuse 
89.29 	of funds as identified in accordance with section 3.975. The website must be updated at 
89.30 	least annually.

90.1 	Sec. 48. Minnesota Statutes 2022, section 62V.11, subdivision 4, is amended to read:
90.2 		Subd. 4.Review of costs. The board shall submit for review the annual budget of MNsure 
90.3 	for the next fiscal year by March 15 31 of each year, beginning March 15, 2014 31, 2025.

90.4 	Sec. 49. Minnesota Statutes 2023 Supplement, section 145D.01, subdivision 1, is amended 
90.5 	to read:
90.6 		Subdivision 1.Definitions. (a) For purposes of this chapter section and section 145D.02, 
90.7 	the following terms have the meanings given.
90.8 	(b) "Captive professional entity" means a professional corporation, limited liability 
90.9 	company, or other entity formed to render professional services in which a beneficial owner 
90.10 	is a health care provider employed by, controlled by, or subject to the direction of a hospital 
90.11 	or hospital system.
90.12 	(c) "Commissioner" means the commissioner of health.
90.13 	(d) "Control," including the terms "controlling," "controlled by," and "under common 
90.14 	control with," means the possession, direct or indirect, of the power to direct or cause the 
90.15 	direction of the management and policies of a health care entity, whether through the 
90.16 	ownership of voting securities, membership in an entity formed under chapter 317A, by 
90.17 	contract other than a commercial contract for goods or nonmanagement services, or otherwise, 
90.18 	unless the power is the result of an official position with, corporate office held by, or court 
90.19 	appointment of, the person. Control is presumed to exist if any person, directly or indirectly, 
90.20 	owns, controls, holds with the power to vote, or holds proxies representing 40 percent or 
90.21 	more of the voting securities of any other person, or if any person, directly or indirectly, 
90.22 	constitutes 40 percent or more of the membership of an entity formed under chapter 317A. 
90.23 	The attorney general may determine that control exists in fact, notwithstanding the absence 
90.24 	of a presumption to that effect.
90.25 	(e) "Health care entity" means:
90.26 	(1) a hospital;
90.27 	(2) a hospital system;
90.28 	(3) a captive professional entity;
90.29 	(4) a medical foundation;
90.30 	(5) a health care provider group practice;
90.31 	(6) an entity organized or controlled by an entity listed in clauses (1) to (5); or
91.1 	(7) an entity that owns or exercises control over an entity listed in clauses (1) to (5).
91.2 	(f) "Health care provider" means a physician licensed under chapter 147, a physician 
91.3 	assistant licensed under chapter 147A, or an advanced practice registered nurse as defined 
91.4 	in section 148.171, subdivision 3, who provides health care services, including but not 
91.5 	limited to medical care, consultation, diagnosis, or treatment.
91.6 	(g) "Health care provider group practice" means two or more health care providers legally 
91.7 	organized in a partnership, professional corporation, limited liability company, medical 
91.8 	foundation, nonprofit corporation, faculty practice plan, or other similar entity:
91.9 	(1) in which each health care provider who is a member of the group provides services 
91.10 	that a health care provider routinely provides, including but not limited to medical care, 
91.11 	consultation, diagnosis, and treatment, through the joint use of shared office space, facilities, 
91.12 	equipment, or personnel;
91.13 	(2) for which substantially all services of the health care providers who are group 
91.14 	members are provided through the group and are billed in the name of the group practice 
91.15 	and amounts so received are treated as receipts of the group; or
91.16 	(3) in which the overhead expenses of, and the income from, the group are distributed 
91.17 	in accordance with methods previously determined by members of the group.
91.18 	An entity that otherwise meets the definition of health care provider group practice in this 
91.19 	paragraph shall be considered a health care provider group practice even if its shareholders, 
91.20 	partners, members, or owners include a professional corporation, limited liability company, 
91.21 	or other entity in which any beneficial owner is a health care provider and that is formed to 
91.22 	render professional services.
91.23 	(h) "Hospital" means a health care facility licensed as a hospital under sections 144.50 
91.24 	to 144.56.
91.25 	(i) "Medical foundation" means a nonprofit legal entity through which health care 
91.26 	providers perform research or provide medical services.
91.27 	(j) "Transaction" means a single action, or a series of actions within a five-year period, 
91.28 	which occurs in part within the state of Minnesota or involves a health care entity formed 
91.29 	or licensed in Minnesota, that constitutes:
91.30 	(1) a merger or exchange of a health care entity with another entity;
91.31 	(2) the sale, lease, or transfer of 40 percent or more of the assets of a health care entity 
91.32 	to another entity;
92.1 	(3) the granting of a security interest of 40 percent or more of the property and assets 
92.2 	of a health care entity to another entity;
92.3 	(4) the transfer of 40 percent or more of the shares or other ownership of a health care 
92.4 	entity to another entity;
92.5 	(5) an addition, removal, withdrawal, substitution, or other modification of one or more 
92.6 	members of the health care entity's governing body that transfers control, responsibility for, 
92.7 	or governance of the health care entity to another entity;
92.8 	(6) the creation of a new health care entity;
92.9 	(7) an agreement or series of agreements that results in the sharing of 40 percent or more 
92.10 	of the health care entity's revenues with another entity, including affiliates of such other 
92.11 	entity;
92.12 	(8) an addition, removal, withdrawal, substitution, or other modification of the members 
92.13 	of a health care entity formed under chapter 317A that results in a change of 40 percent or 
92.14 	more of the membership of the health care entity; or
92.15 	(9) any other transfer of control of a health care entity to, or acquisition of control of a 
92.16 	health care entity by, another entity.
92.17 	(k) A transaction as defined in paragraph (j) does not include:
92.18 	(1) an action or series of actions that meets one or more of the criteria set forth in 
92.19 	paragraph (j), clauses (1) to (9), if, immediately prior to all such actions, the health care 
92.20 	entity directly, or indirectly through one or more intermediaries, controls, is controlled by, 
92.21 	or is under common control with, all other parties to the action or series of actions;
92.22 	(2) a mortgage or other secured loan for business improvement purposes entered into 
92.23 	by a health care entity that does not directly affect delivery of health care or governance of 
92.24 	the health care entity;
92.25 	(3) a clinical affiliation of health care entities formed solely for the purpose of 
92.26 	collaborating on clinical trials or providing graduate medical education;
92.27 	(4) the mere offer of employment to, or hiring of, a health care provider by a health care 
92.28 	entity;
92.29 	(5) contracts between a health care entity and a health care provider primarily for clinical 
92.30 	services; or
92.31 	(6) a single action or series of actions within a five-year period involving only entities 
92.32 	that operate solely as a nursing home licensed under chapter 144A; a boarding care home 
93.1 	licensed under sections 144.50 to 144.56; a supervised living facility licensed under sections 
93.2 	144.50 to 144.56; an assisted living facility licensed under chapter 144G; a foster care setting 
93.3 	licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, for a physical location that 
93.4 	is not the primary residence of the license holder; a community residential setting as defined 
93.5 	in section 245D.02, subdivision 4a; or a home care provider licensed under sections 144A.471 
93.6 	to 144A.483.

93.7 	Sec. 50. [145D.30] DEFINITIONS.
93.8 		Subdivision 1.Application. For purposes of sections 145D.30 to 145D.37, the following 
93.9 	terms have the meanings given unless the context clearly indicates otherwise.
93.10 		Subd. 2.Commissioner "Commissioner" means the commissioner of commerce for a 
93.11 	nonprofit health coverage entity that is a nonprofit health service plan corporation operating 
93.12 	under chapter 62C or the commissioner of health for a nonprofit health coverage entity that 
93.13 	is a nonprofit health maintenance organization operating under chapter 62D.
93.14 		Subd. 3.Control. "Control," including the terms "controlling," "controlled by," and 
93.15 	"under common control with," means the possession, direct or indirect, of the power to 
93.16 	direct or cause the direction of the management and policies of a nonprofit health coverage 
93.17 	entity, whether through the ownership of voting securities, through membership in an entity 
93.18 	formed under chapter 317A, by contract other than a commercial contract for goods or 
93.19 	nonmanagement services, or otherwise, unless the power is the result of an official position 
93.20 	with, corporate office held by, or court appointment of the person. Control is presumed to 
93.21 	exist if any person, directly or indirectly, owns, controls, holds with the power to vote, or 
93.22 	holds proxies representing 40 percent or more of the voting securities of any other person 
93.23 	or if any person, directly or indirectly, constitutes 40 percent or more of the membership 
93.24 	of an entity formed under chapter 317A. The attorney general may determine that control 
93.25 	exists in fact, notwithstanding the absence of a presumption to that effect.
93.26 		Subd. 4.Conversion benefit entity. "Conversion benefit entity" means a foundation, 
93.27 	corporation, limited liability company, trust, partnership, or other entity that receives, in 
93.28 	connection with a conversion transaction, the value of any public benefit asset in accordance 
93.29 	with section 145D.32, subdivision 5.
93.30 		Subd. 5.Conversion transaction. "Conversion transaction" means a transaction otherwise 
93.31 	permitted under applicable law in which a nonprofit health coverage entity:
94.1 	(1) merges, consolidates, converts, or transfers all or substantially all of its assets to any 
94.2 	entity except a corporation that is exempt under United States Code, title 26, section 
94.3 	501(c)(3);
94.4 	(2) makes a series of separate transfers within a 60-month period that in the aggregate 
94.5 	constitute a transfer of all or substantially all of the nonprofit health coverage entity's assets 
94.6 	to any entity except a corporation that is exempt under United States Code, title 26, section 
94.7 	501(c)(3); or
94.8 	(3) adds or substitutes one or more directors or officers that effectively transfer the 
94.9 	control of, responsibility for, or governance of the nonprofit health coverage entity to any 
94.10 	entity except a corporation that is exempt under United States Code, title 26, section 
94.11 	501(c)(3).
94.12 		Subd. 6.Corporation. "Corporation" has the meaning given in section 317A.011, 
94.13 	subdivision 6, and also includes a nonprofit limited liability company organized under 
94.14 	section 322C.1101.
94.15 		Subd. 7.Director. "Director" has the meaning given in section 317A.011, subdivision 
94.16 	7.
94.17 		Subd. 8.Family member. "Family member" means a spouse, parent, child, spouse of 
94.18 	a child, brother, sister, or spouse of a brother or sister.
94.19 		Subd. 9.Full and fair value. "Full and fair value" means at least the amount that the 
94.20 	public benefit assets of the nonprofit health coverage entity would be worth if the assets 
94.21 	were equal to stock in the nonprofit health coverage entity, if the nonprofit health coverage 
94.22 	entity was a for-profit corporation and if the nonprofit health coverage entity had 100 percent 
94.23 	of its stock authorized by the corporation and available for purchase without transfer 
94.24 	restrictions. The valuation shall consider market value, investment or earning value, net 
94.25 	asset value, goodwill, amount of donations received, and control premium, if any.
94.26 		Subd. 10.Key employee. "Key employee" means an individual, regardless of title, who:
94.27 	(1) has responsibilities, power, or influence over an organization similar to those of an 
94.28 	officer or director;
94.29 	(2) manages a discrete segment or activity of the organization that represents ten percent 
94.30 	or more of the activities, assets, income, or expenses of the organization, as compared to 
94.31 	the organization as a whole; or
94.32 	(3) has or shares authority to control or determine ten percent or more of the organization's 
94.33 	capital expenditures, operating budget, or compensation for employees.
95.1 		Subd. 11.Nonprofit health coverage entity. "Nonprofit health coverage entity" means 
95.2 	a nonprofit health service plan corporation operating under chapter 62C or a nonprofit health 
95.3 	maintenance organization operating under chapter 62D.
95.4 		Subd. 12.Officer. "Officer" has the meaning given in section 317A.011, subdivision 
95.5 	15.
95.6 		Subd. 13.Public benefit assets. "Public benefit assets" means the entirety of a nonprofit 
95.7 	health coverage entity's assets, whether tangible or intangible, including but not limited to 
95.8 	its goodwill and anticipated future revenue.
95.9 		Subd. 14.Related organization. "Related organization" has the meaning given in section 
95.10 	317A.011, subdivision 18.

95.11 	Sec. 51. [145D.31] CERTAIN CONVERSION TRANSACTIONS PROHIBITED.
95.12 	A nonprofit health coverage entity must not enter into a conversion transaction if:
95.13 	(1) doing so would result in less than the full and fair market value of all public benefit 
95.14 	assets remaining dedicated to the public benefit; or
95.15 	(2) an individual who has been an officer, director, or other executive of the nonprofit 
95.16 	health coverage entity or of a related organization, or a family member of such an individual:
95.17 	(i) has held or will hold, whether guaranteed or contingent, an ownership stake, stock, 
95.18 	securities, investment, or other financial interest in an entity to which the nonprofit health 
95.19 	coverage entity transfers public benefit assets in connection with the conversion transaction;
95.20 	(ii) has received or will receive any type of compensation or other financial benefit from 
95.21 	an entity to which the nonprofit health coverage entity transfers public benefit assets in 
95.22 	connection with the conversion transaction;
95.23 	(iii) has held or will hold, whether guaranteed or contingent, an ownership stake, stock, 
95.24 	securities, investment, or other financial interest in an entity that has or will have a business 
95.25 	relationship with an entity to which the nonprofit health coverage entity transfers public 
95.26 	benefit assets in connection with the conversion transaction; or
95.27 	(iv) has received or will receive any type of compensation or other financial benefit from 
95.28 	an entity that has or will have a business relationship with an entity to which the nonprofit 
95.29 	health coverage entity transfers public benefit assets in connection with the conversion 
95.30 	transaction.

96.1 	Sec. 52. [145D.32] REQUIREMENTS FOR NONPROFIT HEALTH COVERAGE 
96.2 	ENTITY CONVERSION TRANSACTIONS.
96.3 		Subdivision 1.Notice. (a) Before entering into a conversion transaction, a nonprofit 
96.4 	health coverage entity must notify the attorney general according to section 317A.811. In 
96.5 	addition to the elements listed in section 317A.811, subdivision 1, the notice required by 
96.6 	this subdivision must also include: (1) an itemization of the nonprofit health coverage entity's 
96.7 	public benefit assets and an independent third-party valuation of the nonprofit health coverage 
96.8 	entity's public benefit assets; (2) a proposed plan to distribute the value of those public 
96.9 	benefit assets to a conversion benefit entity that meets the requirements of section 145D.33; 
96.10 	and (3) other information contained in forms provided by the attorney general.
96.11 	(b) When the nonprofit health coverage entity provides the attorney general with the 
96.12 	notice and other information required under paragraph (a), the nonprofit health coverage 
96.13 	entity must also provide a copy of this notice and other information to the applicable 
96.14 	commissioner.
96.15 		Subd. 2.Nonprofit health coverage entity requirements. Before entering into a 
96.16 	conversion transaction, a nonprofit health coverage entity must ensure that:
96.17 	(1) the proposed conversion transaction complies with chapters 317A and 501B and 
96.18 	other applicable laws;
96.19 	(2) the proposed conversion transaction does not involve or constitute a breach of 
96.20 	charitable trust;
96.21 	(3) the nonprofit health coverage entity shall receive full and fair value for its public 
96.22 	benefit assets;
96.23 	(4) the value of the public benefit assets to be transferred has not been manipulated in 
96.24 	a manner that causes or caused the value of the assets to decrease;
96.25 	(5) the proceeds of the proposed conversion transaction shall be used in a manner 
96.26 	consistent with the public benefit for which the assets are held by the nonprofit health 
96.27 	coverage entity;
96.28 	(6) the proposed conversion transaction shall not result in a breach of fiduciary duty; 
96.29 	and
96.30 	(7) the conversion benefit entity that receives the value of the nonprofit health coverage 
96.31 	entity's public benefit assets meets the requirements in section 145D.33.
97.1 		Subd. 3.Listening sessions and public comment. The attorney general or the 
97.2 	commissioner may hold public listening sessions or forums and may solicit public comments 
97.3 	regarding the proposed conversion transaction, including on the formation of a conversion 
97.4 	benefit entity under section 145D.33.
97.5 		Subd. 4.Waiting period. (a) Subject to paragraphs (b) and (c), a nonprofit health 
97.6 	coverage entity must not enter into a conversion transaction until 90 days after the nonprofit 
97.7 	health coverage entity has given written notice as required in subdivision 1.
97.8 	(b) The attorney general may waive all or part of the waiting period or may extend the 
97.9 	waiting period for an additional 90 days by notifying the nonprofit health coverage entity 
97.10 	of the extension in writing.
97.11 	(c) The time periods specified in this subdivision shall be suspended while an 
97.12 	investigation into the conversion transaction is pending or while a request from the attorney 
97.13 	general for additional information is outstanding.
97.14 		Subd. 5.Transfer of value of assets required. As part of a conversion transaction for 
97.15 	which notice is provided under subdivision 1, the nonprofit health coverage entity must 
97.16 	transfer the entirety of the full and fair value of its public benefit assets to one or more 
97.17 	conversion benefit entities that meet the requirements in section 145D.33.
97.18 		Subd. 6.Funds restricted for a particular purpose. Nothing in this section relieves a 
97.19 	nonprofit health coverage entity from complying with requirements for funds that are 
97.20 	restricted for a particular purpose. Funds restricted for a particular purpose must continue 
97.21 	to be used in accordance with the purpose for which they were restricted under sections 
97.22 	317A.671 and 501B.31. A nonprofit health coverage entity may not convert assets that 
97.23 	would conflict with their restricted purpose.

97.24 	Sec. 53. [145D.33] CONVERSION BENEFIT ENTITY REQUIREMENTS.
97.25 		Subdivision 1.Requirements. In order to receive the value of a nonprofit health coverage 
97.26 	entity's public benefit assets as part of a conversion transaction, a conversion benefit entity 
97.27 	must:
97.28 	(1) be: (i) an existing or new domestic, nonprofit corporation operating under chapter 
97.29 	317A, a nonprofit limited liability company operating under chapter 322C, or a wholly 
97.30 	owned subsidiary thereof; and (ii) exempt under United States Code, title 26, section 
97.31 	501(c)(3);
97.32 	(2) have in place procedures and policies to prohibit conflicts of interest, including but 
97.33 	not limited to conflicts of interest relating to any grant-making activities that may benefit:
98.1 	(i) the officers, directors, or key employees of the conversion benefit entity;
98.2 	(ii) any entity to which the nonprofit health coverage entity transfers public benefit assets 
98.3 	in connection with a conversion transaction; or
98.4 	(iii) any officers, directors, or key employees of an entity to which the nonprofit health 
98.5 	coverage entity transfers public benefit assets in connection with a conversion transaction;
98.6 	(3) operate to benefit the health of the people in this state;
98.7 	(4) have in place procedures and policies that prohibit:
98.8 	(i) an officer, director, or key employee of the nonprofit health coverage entity from 
98.9 	serving as an officer, director, or key employee of the conversion benefit entity for the 
98.10 	five-year period following the conversion transaction;
98.11 	(ii) an officer, director, or key employee of the nonprofit health coverage entity or of 
98.12 	the conversion benefit entity from directly or indirectly benefiting from the conversion 
98.13 	transaction; and
98.14 	(iii) elected or appointed public officials from serving as an officer, director, or key 
98.15 	employee of the conversion benefit entity;
98.16 	(5) not make grants or payments or otherwise provide financial benefit to an entity to 
98.17 	which a nonprofit health coverage entity transfers public benefit assets as part of a conversion 
98.18 	transaction or to a related organization of the entity to which the nonprofit health coverage 
98.19 	entity transfers public benefit assets as part of a conversion transaction; and
98.20 	(6) not have as an officer director, or key employee any individual who has been an 
98.21 	officer, director, or key employee of an entity that receives public benefit assets as part of 
98.22 	a conversion transaction.
98.23 		Subd. 2.Review and approval. The commissioner must review and approve a conversion 
98.24 	benefit entity before the conversion benefit entity receives the value of public benefit assets 
98.25 	from a nonprofit health coverage entity. In order to be approved under this subdivision, the 
98.26 	conversion benefit entity's governance must be broadly based in the community served by 
98.27 	the nonprofit health coverage entity and must be independent of the entity to which the 
98.28 	nonprofit health coverage entity transfers public benefit assets as part of the conversion 
98.29 	transaction. As part of the review of the conversion benefit entity's governance, the 
98.30 	commissioner may hold a public hearing. The public hearing, if held by the commissioner 
98.31 	of health, may be held concurrently with the hearing authorized under section 62D.31. If 
98.32 	the commissioner finds it necessary, a portion of the value of the public benefit assets must 
98.33 	be used to develop a community-based plan for use by the conversion benefit entity.
99.1 		Subd. 3.Community advisory committee. The commissioner must establish a 
99.2 	community advisory committee for a conversion benefit entity receiving the value of public 
99.3 	benefit assets. The members of the community advisory committee must be selected to 
99.4 	represent the diversity of the community previously served by the nonprofit health coverage 
99.5 	entity. The community advisory committee must:
99.6 	(1) provide a slate of three nominees for each vacancy on the governing board of the 
99.7 	conversion benefit entity, from which the remaining board members must select new 
99.8 	members to the board;
99.9 	(2) provide the conversion benefit entity's governing board with guidance on the health 
99.10 	needs of the community previously served by the nonprofit health coverage entity; and
99.11 	(3) promote dialogue and information sharing between the conversion benefit entity and 
99.12 	the community previously served by the nonprofit health coverage entity.

99.13 	Sec. 54. [145D.34] ENFORCEMENT AND REMEDIES.
99.14 		Subdivision 1.Investigation. The attorney general has the powers in section 8.31. 
99.15 	Nothing in this subdivision limits the powers, remedies, or responsibilities of the attorney 
99.16 	general under this chapter; chapter 8, 309, 317A, or 501B; or any other chapter. For purposes 
99.17 	of this section, an approval by the commissioner for regulatory purposes does not impair 
99.18 	or inform the attorney general's authority.
99.19 		Subd. 2.Enforcement and penalties. (a) The attorney general may bring an action in 
99.20 	district court to enjoin or unwind a conversion transaction or seek other equitable relief 
99.21 	necessary to protect the public interest if:
99.22 	(1) a nonprofit health coverage entity or conversion transaction violates sections 145D.30 
99.23 	to 145D.33; or
99.24 	(2) the conversion transaction is contrary to the public interest.
99.25 	In seeking injunctive relief, the attorney general must not be required to establish irreparable 
99.26 	harm but must instead establish that a violation of sections 145D.30 to 145D.33 occurred 
99.27 	or that the requested order promotes the public interest.
99.28 	(b) Factors informing whether a conversion transaction is contrary to the public interest 
99.29 	include but are not limited to whether:
99.30 	(1) the conversion transaction shall result in increased health care costs for patients; and
99.31 	(2) the conversion transaction shall adversely impact provider cost trends and containment 
99.32 	of total health care spending.
100.1 	(c) The attorney general may enforce sections 145D.30 to 145D.33 under section 8.31.
100.2 	(d) Failure of the entities involved in a conversion transaction to provide timely 
100.3 	information as required by the attorney general or the commissioner shall be an independent 
100.4 	and sufficient ground for a court to enjoin or unwind the transaction or provide other equitable 
100.5 	relief, provided the attorney general notifies the entities of the inadequacy of the information 
100.6 	provided and provides the entities with a reasonable opportunity to remedy the inadequacy.
100.7 	(e) An officer, director, or other executive found to have violated sections 145D.30 to 
100.8 	145D.33 shall be subject to a civil penalty of up to $100,000 for each violation. A corporation 
100.9 	or other entity which is a party to or materially participated in a conversion transaction 
100.10 	found to have violated sections 145D.30 to 145D.33 shall be subject to a civil penalty of 
100.11 	up to $1,000,000. A court may also award reasonable attorney fees and costs of investigation 
100.12 	and litigation.
100.13 		Subd. 3.Commissioner of health; data and research. The commissioner of health 
100.14 	must provide the attorney general, upon request, with data and research on broader market 
100.15 	trends, impacts on prices and outcomes, public health and population health considerations, 
100.16 	and health care access, for the attorney general to use when evaluating whether a conversion 
100.17 	transaction is contrary to public interest. The commissioner may share with the attorney 
100.18 	general, according to section 13.05, subdivision 9, any not public data, as defined in section 
100.19 	13.02, subdivision 8a, held by the commissioner to aid in the investigation and review of 
100.20 	the conversion transaction, and the attorney general must maintain this data with the same 
100.21 	classification according to section 13.03, subdivision 4, paragraph (c).
100.22 		Subd. 4.Failure to take action. Failure by the attorney general to take action with 
100.23 	respect to a conversion transaction under this section does not constitute approval of the 
100.24 	conversion transaction or waiver, nor shall failure prevent the attorney general from taking 
100.25 	action in the same, similar, or subsequent circumstances.

100.26 	Sec. 55. [145D.35] DATA PRACTICES.
100.27 	Section 13.65 applies to data provided by a nonprofit health coverage entity or the 
100.28 	commissioner to the attorney general under sections 145D.30 to 145D.33. Section 13.39 
100.29 	applies to data provided by a nonprofit health coverage entity to the commissioner under 
100.30 	sections 145D.30 to 145D.33. The attorney general or the commissioner may make any 
100.31 	data classified as confidential or protected nonpublic under this section accessible to any 
100.32 	civil or criminal law enforcement agency if the attorney general or commissioner determines 
100.33 	that the access aids the law enforcement process.

101.1 	Sec. 56. [145D.36] COMMISSIONER OF HEALTH; REPORTS AND ANALYSIS.
101.2 	Notwithstanding any law to the contrary, the commissioner of health may use data or 
101.3 	information submitted under sections 60A.135 to 60A.137, 60A.17, 60D.18, 60D.20, 
101.4 	62D.221, and 145D.32 to conduct analyses of the aggregate impact of transactions within 
101.5 	nonprofit health coverage entities and organizations which include nonprofit health coverage 
101.6 	entities or their affiliates on access to or the cost of health care services, health care market 
101.7 	consolidation, and health care quality. The commissioner of health must issue periodic 
101.8 	public reports on the number and types of conversion transactions subject to sections 145D.30 
101.9 	to 145D.35 and on the aggregate impact of conversion transactions on health care costs, 
101.10 	quality, and competition in Minnesota.

101.11 	Sec. 57. [145D.37] RELATION TO OTHER LAW.
101.12 	(a) Sections 145D.30 to 145D.36 are in addition to and do not affect or limit any power, 
101.13 	remedy, or responsibility of a health maintenance organization, a service plan corporation, 
101.14 	a conversion benefit entity, the attorney general, the commissioner of health, or the 
101.15 	commissioner of commerce under this chapter; chapter 8, 62C, 62D, 309, 317A, or 501B; 
101.16 	or other law.
101.17 	(b) Nothing in sections 145D.03 to 145D.36 authorizes a nonprofit health coverage entity 
101.18 	to enter into a conversion transaction not otherwise permitted under chapter 317A or 501B 
101.19 	or other law.

101.20 	Sec. 58. Minnesota Statutes 2022, section 256B.0625, subdivision 12, is amended to read:
101.21 		Subd. 12.Eyeglasses, dentures, and prosthetic and orthotic devices. (a) Medical 
101.22 	assistance covers eyeglasses, dentures, and prosthetic and orthotic devices if prescribed by 
101.23 	a licensed practitioner.
101.24 	(b) For purposes of prescribing prosthetic and orthotic devices, "licensed practitioner" 
101.25 	includes a physician, an advanced practice registered nurse, a physician assistant, or a 
101.26 	podiatrist.

101.27 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
101.28 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
101.29 	when federal approval is obtained.

102.1 	Sec. 59. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 16, is 
102.2 	amended to read:
102.3 		Subd. 16.Abortion services. Medical assistance covers abortion services determined 
102.4 	to be medically necessary by the treating provider and delivered in accordance with all 
102.5 	applicable Minnesota laws abortions and abortion-related services, including preabortion 
102.6 	services and follow-up services.

102.7 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
102.8 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
102.9 	when federal approval is obtained.

102.10 	Sec. 60. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
102.11 	to read:
102.12 		Subd. 25c.Applicability of utilization review provisions. Effective January 1, 2026, 
102.13 	the following provisions of chapter 62M apply to the commissioner when delivering services 
102.14 	through fee-for-service under chapters 256B and 256L: 62M.02, subdivisions 1 to 5, 7 to 
102.15 	12, 13, 14 to 18, and 21; 62M.04; 62M.05, subdivisions 1 to 4; 62M.06, subdivisions 1 to 
102.16 	3; 62M.07; 62M.072; 62M.09; 62M.10; 62M.12; and 62M.17, subdivision 2.

102.17 	Sec. 61. Minnesota Statutes 2022, section 256B.0625, subdivision 32, is amended to read:
102.18 		Subd. 32.Nutritional products. Medical assistance covers nutritional products needed 
102.19 	for nutritional supplementation because solid food or nutrients thereof cannot be properly 
102.20 	absorbed by the body or needed for treatment of phenylketonuria, hyperlysinemia, maple 
102.21 	syrup urine disease, a combined allergy to human milk, cow's milk, and soy formula, or 
102.22 	any other childhood or adult diseases, conditions, or disorders identified by the commissioner 
102.23 	as requiring a similarly necessary nutritional product. Medical assistance covers amino 
102.24 	acid-based elemental formulas in the same manner as is required under section 62Q.531. 
102.25 	Nutritional products needed for the treatment of a combined allergy to human milk, cow's 
102.26 	milk, and soy formula require prior authorization. Separate payment shall not be made for 
102.27 	nutritional products for residents of long-term care facilities. Payment for dietary 
102.28 	requirements is a component of the per diem rate paid to these facilities.

102.29 	EFFECTIVE DATE. This section is effective January 1, 2025.

103.1 	Sec. 62. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
103.2 	to read:
103.3 		Subd. 72.Orthotic and prosthetic devices. Medical assistance covers orthotic and 
103.4 	prosthetic devices, supplies, and services according to section 256B.066.

103.5 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
103.6 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
103.7 	when federal approval is obtained.

103.8 	Sec. 63. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
103.9 	to read:
103.10 		Subd. 73.Rapid whole genome sequencing. Medical assistance covers rapid whole 
103.11 	genome sequencing (rWGS) testing. Coverage and eligibility for rWGS testing, and the use 
103.12 	of genetic data, must meet the requirements specified in section 62A.3098, subdivisions 1 
103.13 	to 3 and 6.

103.14 	EFFECTIVE DATE. This section is effective January 1, 2025.

103.15 	Sec. 64. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
103.16 	to read:
103.17 		Subd. 74.Scalp hair prostheses. Medical assistance covers scalp hair prostheses and 
103.18 	all equipment and accessories necessary for their regular use under the conditions and in 
103.19 	compliance with the requirements specified in section 62A.28, except that the limitation on 
103.20 	coverage required per benefit year set forth in section 62A.28, subdivision 2, paragraph (c), 
103.21 	does not apply.

103.22 	EFFECTIVE DATE. This section is effective January 1, 2025.

103.23 	Sec. 65. [256B.066] ORTHOTIC AND PROSTHETIC DEVICES, SUPPLIES, AND 
103.24 	SERVICES.
103.25 		Subdivision 1.Definitions.  All terms used in this section have the meanings given them 
103.26 	in section 62Q.665, subdivision 1.
103.27 		Subd. 2.Coverage requirements.  (a) Medical assistance covers orthotic and prosthetic 
103.28 	devices, supplies, and services:
103.29 	(1) furnished under an order by a prescribing physician or licensed health care prescriber 
103.30 	who has authority in Minnesota to prescribe orthoses and prostheses. Coverage for orthotic 
103.31 	and prosthetic devices, supplies, accessories, and services under this clause includes those 
104.1 	devices or device systems, supplies, accessories, and services that are customized to the 
104.2 	enrollee's needs;
104.3 	(2) determined by the enrollee's provider to be the most appropriate model that meets 
104.4 	the medical needs of the enrollee for purposes of performing physical activities, as applicable, 
104.5 	including but not limited to running, biking, and swimming, and maximizing the enrollee's 
104.6 	limb function; or
104.7 	(3) for showering or bathing.
104.8 	(b) The coverage set forth in paragraph (a) includes the repair and replacement of those 
104.9 	orthotic and prosthetic devices, supplies, and services described therein.
104.10 	(c) Coverage of a prosthetic or orthotic benefit must not be denied for an individual with 
104.11 	limb loss or absence that would otherwise be covered for a nondisabled person seeking 
104.12 	medical or surgical intervention to restore or maintain the ability to perform the same 
104.13 	physical activity.
104.14 	(d) If coverage for prosthetic or custom orthotic devices is provided, payment must be 
104.15 	made for the replacement of a prosthetic or custom orthotic device or for the replacement 
104.16 	of any part of the devices, without regard to useful lifetime restrictions, if an ordering health 
104.17 	care provider determines that the provision of a replacement device, or a replacement part 
104.18 	of a device, is necessary because:
104.19 	(1) of a change in the physiological condition of the enrollee;
104.20 	(2) of an irreparable change in the condition of the device or in a part of the device; or
104.21 	(3) the condition of the device, or the part of the device, requires repairs and the cost of 
104.22 	the repairs would be more than 60 percent of the cost of a replacement device or of the part 
104.23 	being replaced.
104.24 		Subd. 3.Restrictions on coverage. (a) Prior authorization may be required for orthotic 
104.25 	and prosthetic devices, supplies, and services.
104.26 	(b) A utilization review for a request for coverage of prosthetic or orthotic benefits must 
104.27 	apply the most recent version of evidence-based treatment and fit criteria as recognized by 
104.28 	relevant clinical specialists.
104.29 	(c) Utilization review determinations must be rendered in a nondiscriminatory manner 
104.30 	and must not deny coverage for habilitative or rehabilitative benefits, including prosthetics 
104.31 	or orthotics, solely on the basis of an enrollee's actual or perceived disability.
105.1 	(d) Evidence of coverage and any benefit denial letters must include language describing 
105.2 	an enrollee's rights pursuant to paragraphs (b) and (c).
105.3 	(e) Confirmation from a prescribing health care provider may be required if the prosthetic 
105.4 	or custom orthotic device or part being replaced is less than three years old.
105.5 		Subd. 4.Managed care plan access to care.  (a) Managed care plans and county-based 
105.6 	purchasing plans subject to this section must ensure access to medically necessary clinical 
105.7 	care and to prosthetic and custom orthotic devices and technology from at least two distinct 
105.8 	prosthetic and custom orthotic providers in the plan's provider network located in Minnesota.
105.9 	(b) In the event that medically necessary covered orthotics and prosthetics are not 
105.10 	available from an in-network provider, the plan must provide processes to refer an enrollee 
105.11 	to an out-of-network provider and must fully reimburse the out-of-network provider at a 
105.12 	mutually agreed upon rate less enrollee cost sharing determined on an in-network basis.

105.13 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
105.14 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
105.15 	when federal approval is obtained.

105.16 	Sec. 66. Minnesota Statutes 2022, section 317A.811, subdivision 1, is amended to read:
105.17 		Subdivision 1.When required. (a) Except as provided in subdivision 6, the following 
105.18 	corporations shall notify the attorney general of their intent to dissolve, merge, consolidate, 
105.19 	or convert, or to transfer all or substantially all of their assets:
105.20 	(1) a corporation that holds assets for a charitable purpose as defined in section 501B.35, 
105.21 	subdivision 2; or
105.22 	(2) a corporation that is exempt under section 501(c)(3) of the Internal Revenue Code 
105.23 	of 1986, or any successor section.; or
105.24 	(3) a nonprofit health coverage entity as defined in section 145D.30.
105.25 	(b) The notice must include:
105.26 	(1) the purpose of the corporation that is giving the notice;
105.27 	(2) a list of assets owned or held by the corporation for charitable purposes;
105.28 	(3) a description of restricted assets and purposes for which the assets were received;
105.29 	(4) a description of debts, obligations, and liabilities of the corporation;
105.30 	(5) a description of tangible assets being converted to cash and the manner in which 
105.31 	they will be sold;
106.1 	(6) anticipated expenses of the transaction, including attorney fees;
106.2 	(7) a list of persons to whom assets will be transferred, if known, or the name of the 
106.3 	converted organization;
106.4 	(8) the purposes of persons receiving the assets or of the converted organization; and
106.5 	(9) the terms, conditions, or restrictions, if any, to be imposed on the transferred or 
106.6 	converted assets.
106.7 	The notice must be signed on behalf of the corporation by an authorized person.

106.8 	Sec. 67. INITIAL REPORTS TO COMMISSIONER OF HEALTH; UTILIZATION 
106.9 	MANAGEMENT TOOLS.
 106.10 	Utilization review organizations must submit initial reports to the commissioner of health 
106.11 	under Minnesota Statutes, section 62M.19, by September 1, 2025.

106.12 	Sec. 68. REPEALER.
 106.13 	(a) Minnesota Statutes 2022, section 62A.041, subdivision 3, is repealed.
106.14 	(b) Minnesota Statutes 2023 Supplement, section 62Q.522, subdivisions 3 and 4, are 
106.15 	repealed.

106.16 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
106.17 	plans offered, sold, issued, or renewed on or after that date.

106.18 	ARTICLE 5
106.19 	DEPARTMENT OF HEALTH FINANCE

106.20 	Section 1. Minnesota Statutes 2022, section 62D.14, subdivision 1, is amended to read:
106.21 		Subdivision 1.Examination authority. The commissioner of health may make an 
106.22 	examination of the affairs of any health maintenance organization and its contracts, 
106.23 	agreements, or other arrangements with any participating entity as often as the commissioner 
106.24 	of health deems necessary for the protection of the interests of the people of this state, but 
106.25 	not less frequently than once every three five years. Examinations of participating entities 
106.26 	pursuant to this subdivision shall be limited to their dealings with the health maintenance 
106.27 	organization and its enrollees, except that examinations of major participating entities may 
106.28 	include inspection of the entity's financial statements kept in the ordinary course of business. 
106.29 	The commissioner may require major participating entities to submit the financial statements 
106.30 	directly to the commissioner. Financial statements of major participating entities are subject 
107.1 	to the provisions of section 13.37, subdivision 1, clause (b), upon request of the major 
107.2 	participating entity or the health maintenance organization with which it contracts.

107.3 	Sec. 2. Minnesota Statutes 2022, section 103I.621, subdivision 1, is amended to read:
107.4 		Subdivision 1.Permit. (a) Notwithstanding any department or agency rule to the contrary, 
107.5 	the commissioner shall issue, on request by the owner of the property and payment of the 
107.6 	permit fee, permits for the reinjection of water by a properly constructed well into the same 
107.7 	aquifer from which the water was drawn for the operation of a groundwater thermal exchange 
107.8 	device.
107.9 	(b) As a condition of the permit, an applicant must agree to allow inspection by the 
107.10 	commissioner during regular working hours for department inspectors.
107.11 	(c) Not more than 200 permits may be issued for small systems having maximum 
107.12 	capacities of 20 gallons per minute or less and that are compliant with the natural resource 
107.13 	water-use requirements under subdivision 2. The small systems are subject to inspection 
107.14 	twice a year.
107.15 	(d) Not more than ten 100 permits may be issued for larger systems having maximum 
107.16 	capacities from over 20 to 50 gallons per minute and are compliant with the natural resource 
107.17 	water-use requirements under subdivision 2. The larger systems are subject to inspection 
107.18 	four times a year.
107.19 	(e) A person issued a permit must comply with this section and permit conditions deemed 
107.20 	necessary to protect public health and safety of groundwater for the permit to be valid. The 
107.21 	permit conditions may include but are not limited to requirements for:
107.22 	(1) notification to the commissioner at intervals specified in the permit conditions;
107.23 	(2) system operation and maintenance;
107.24 	(3) system location and construction;
107.25 	(4) well location and construction;
107.26 	(5) signage;
107.27 	(6) reports of system construction, performance, operation, and maintenance;
107.28 	(7) removal of the system upon termination of its use or system failure;
107.29 	(8) disclosure of the system at the time of property transfer;
107.30 	(9) obtaining approval from the commissioner prior to deviation from the approval plan 
107.31 	and conditions;
108.1 	(10) groundwater level monitoring; or
108.2 	(11) groundwater quality monitoring.
108.3 	(f) The property owner or the property owner's agent must submit to the commissioner 
108.4 	a permit application on a form provided by the commissioner, or in a format approved by 
108.5 	the commissioner, that provides any information necessary to protect public health and 
108.6 	safety of groundwater.
108.7 	(g) A permit granted under this section is not valid if a water-use permit is required for 
108.8 	the project and is not approved by the commissioner of natural resources.

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

108.10 	Sec. 3. Minnesota Statutes 2022, section 103I.621, subdivision 2, is amended to read:
108.11 		Subd. 2.Water-use requirements apply. Water-use permit requirements and penalties 
108.12 	under chapter 103F 103G and related rules adopted and enforced by the commissioner of 
108.13 	natural resources apply to groundwater thermal exchange permit recipients. A person who 
108.14 	violates a provision of this section is subject to enforcement or penalties for the noncomplying 
108.15 	activity that are available to the commissioner and the Pollution Control Agency.

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

108.17 	Sec. 4. Minnesota Statutes 2022, section 144.05, subdivision 6, is amended to read:
108.18 		Subd. 6.Reports on interagency agreements and intra-agency transfers. The 
108.19 	commissioner of health shall provide quarterly reports to the chairs and ranking minority 
108.20 	members of the legislative committees with jurisdiction over health and human services 
108.21 	policy and finance on: the interagency agreements and intra-agency transfers report per 
108.22 	section 15.0395.
108.23 	(1) interagency agreements or service-level agreements and any renewals or extensions 
108.24 	of existing interagency or service-level agreements with a state department under section 
108.25 	15.01, state agency under section 15.012, or the Department of Information Technology 
108.26 	Services, with a value of more than $100,000, or related agreements with the same department 
108.27 	or agency with a cumulative value of more than $100,000; and
108.28 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
108.29 	agencies.
109.1 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
109.2 	amount, purpose, and effective date of the agreement, duration of the agreement, and a copy 
109.3 	of the agreement.

109.4 	Sec. 5. Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 2, is amended 
109.5 	to read:
109.6 		Subd. 2.Creation of account Availability. (a) A health professional education loan 
109.7 	forgiveness program account is established. The commissioner of health shall use money 
109.8 	from the account to establish a appropriated for health professional education loan forgiveness 
109.9 	program in this section:
109.10 	(1) for medical residents, physicians, mental health professionals, and alcohol and drug 
109.11 	counselors agreeing to practice in designated rural areas or underserved urban communities 
109.12 	or specializing in the area of pediatric psychiatry;
109.13 	(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach 
109.14 	at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program 
109.15 	at the undergraduate level or the equivalent at the graduate level;
109.16 	(3) for nurses who agree to practice in a Minnesota nursing home; in an intermediate 
109.17 	care facility for persons with developmental disability; in a hospital if the hospital owns 
109.18 	and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked 
109.19 	by the nurse is in the nursing home; in an assisted living facility as defined in section 
109.20 	144G.08, subdivision 7; or for a home care provider as defined in section 144A.43, 
109.21 	subdivision 4; or agree to teach at least 12 credit hours, or 720 hours per year in the nursing 
109.22 	field in a postsecondary program at the undergraduate level or the equivalent at the graduate 
109.23 	level;
109.24 	(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 
109.25 	hours per year in their designated field in a postsecondary program at the undergraduate 
109.26 	level or the equivalent at the graduate level. The commissioner, in consultation with the 
109.27 	Healthcare Education-Industry Partnership, shall determine the health care fields where the 
109.28 	need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory 
109.29 	technology, radiologic technology, and surgical technology;
109.30 	(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses 
109.31 	who agree to practice in designated rural areas;
109.32 	(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient 
109.33 	encounters to state public program enrollees or patients receiving sliding fee schedule 
110.1 	discounts through a formal sliding fee schedule meeting the standards established by the 
110.2 	United States Department of Health and Human Services under Code of Federal Regulations, 
110.3 	title 42, section 51, chapter 303 51c.303; and
110.4 	(7) for nurses employed as a hospital nurse by a nonprofit hospital and providing direct 
110.5 	care to patients at the nonprofit hospital.
110.6 	(b) Appropriations made to the account for health professional education loan forgiveness 
110.7 	in this section do not cancel and are available until expended, except that at the end of each 
110.8 	biennium, any remaining balance in the account that is not committed by contract and not 
110.9 	needed to fulfill existing commitments shall cancel to the fund.

110.10 	Sec. 6. Minnesota Statutes 2022, section 144.1501, subdivision 5, is amended to read:
110.11 		Subd. 5.Penalty for nonfulfillment. If a participant does not fulfill the required 
110.12 	minimum commitment of service according to subdivision 3, the commissioner of health 
110.13 	shall collect from the participant the total amount paid to the participant under the loan 
110.14 	forgiveness program plus interest at a rate established according to section 270C.40. The 
110.15 	commissioner shall deposit the money collected in the health care access fund to be credited 
110.16 	to a dedicated account in the special revenue fund. The balance of the account is appropriated 
110.17 	annually to the commissioner for the health professional education loan forgiveness program 
110.18 	account established in subdivision 2. The commissioner shall allow waivers of all or part 
110.19 	of the money owed the commissioner as a result of a nonfulfillment penalty if emergency 
110.20 	circumstances prevented fulfillment of the minimum service commitment.

110.21 	Sec. 7. Minnesota Statutes 2023 Supplement, section 144.1505, subdivision 2, is amended 
110.22 	to read:
110.23 		Subd. 2.Programs. (a) For advanced practice provider clinical training expansion grants, 
110.24 	the commissioner of health shall award health professional training site grants to eligible 
110.25 	physician assistant, advanced practice registered nurse, pharmacy, dental therapy, and mental 
110.26 	health professional programs to plan and implement expanded clinical training. A planning 
110.27 	grant shall not exceed $75,000, and a three-year training grant shall not exceed $150,000 
110.28 	for the first year, $100,000 for the second year, and $50,000 for the third year $300,000 per 
110.29 	program project. The commissioner may provide a one-year, no-cost extension for grants.
110.30 	(b) For health professional rural and underserved clinical rotations grants, the 
110.31 	commissioner of health shall award health professional training site grants to eligible 
110.32 	physician, physician assistant, advanced practice registered nurse, pharmacy, dentistry, 
110.33 	dental therapy, and mental health professional programs to augment existing clinical training 
111.1 	programs to add rural and underserved rotations or clinical training experiences, such as 
111.2 	credential or certificate rural tracks or other specialized training. For physician and dentist 
111.3 	training, the expanded training must include rotations in primary care settings such as 
111.4 	community clinics, hospitals, health maintenance organizations, or practices in rural 
111.5 	communities.
111.6 	(c) Funds may be used for:
111.7 	(1) establishing or expanding rotations and clinical training;
111.8 	(2) recruitment, training, and retention of students and faculty;
111.9 	(3) connecting students with appropriate clinical training sites, internships, practicums, 
111.10 	or externship activities;
111.11 	(4) travel and lodging for students;
111.12 	(5) faculty, student, and preceptor salaries, incentives, or other financial support;
111.13 	(6) development and implementation of cultural competency training;
111.14 	(7) evaluations;
111.15 	(8) training site improvements, fees, equipment, and supplies required to establish, 
111.16 	maintain, or expand a training program; and
111.17 	(9) supporting clinical education in which trainees are part of a primary care team model.

111.18 	Sec. 8. Minnesota Statutes 2022, section 144.555, subdivision 1a, is amended to read:
111.19 		Subd. 1a.Notice of closing, curtailing operations, relocating services, or ceasing to 
111.20 	offer certain services; hospitals. (a) The controlling persons of a hospital licensed under 
111.21 	sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health and,
111.22 	the public, and others at least 120 182 days before the hospital or hospital campus voluntarily 
111.23 	plans to implement one of the following scheduled actions:
111.24 	(1) cease operations;
111.25 	(2) curtail operations to the extent that patients must be relocated;
111.26 	(3) relocate the provision of health services to another hospital or another hospital 
111.27 	campus; or
111.28 	(4) cease offering maternity care and newborn care services, intensive care unit services, 
111.29 	inpatient mental health services, or inpatient substance use disorder treatment services.
112.1 	(b) A notice required under this subdivision must comply with the requirements in 
112.2 	subdivision 1d.
112.3 	(b) (c) The commissioner shall cooperate with the controlling persons and advise them 
112.4 	about relocating the patients.

112.5 	Sec. 9. Minnesota Statutes 2022, section 144.555, subdivision 1b, is amended to read:
112.6 		Subd. 1b.Public hearing. Within 45 30 days after receiving notice under subdivision 
112.7 	1a, the commissioner shall conduct a public hearing on the scheduled cessation of operations, 
112.8 	curtailment of operations, relocation of health services, or cessation in offering health 
112.9 	services. The commissioner must provide adequate public notice of the hearing in a time 
112.10 	and manner determined by the commissioner. The controlling persons of the hospital or 
112.11 	hospital campus must participate in the public hearing. The public hearing must be held at 
112.12 	a location that is within 30 miles of the hospital or hospital campus and that is provided or 
112.13 	arranged by the hospital or hospital campus. A hospital or hospital campus is encouraged 
112.14 	to hold the public hearing at a location that is within ten miles of the hospital or hospital 
112.15 	campus. Video conferencing technology must be used to allow members of the public to 
112.16 	view and participate in the hearing. The public hearing must include:
112.17 	(1) an explanation by the controlling persons of the reasons for ceasing or curtailing 
112.18 	operations, relocating health services, or ceasing to offer any of the listed health services;
112.19 	(2) a description of the actions that controlling persons will take to ensure that residents 
112.20 	in the hospital's or campus's service area have continued access to the health services being 
112.21 	eliminated, curtailed, or relocated;
112.22 	(3) an opportunity for public testimony on the scheduled cessation or curtailment of 
112.23 	operations, relocation of health services, or cessation in offering any of the listed health 
112.24 	services, and on the hospital's or campus's plan to ensure continued access to those health 
112.25 	services being eliminated, curtailed, or relocated; and
112.26 	(4) an opportunity for the controlling persons to respond to questions from interested 
112.27 	persons.

112.28 	Sec. 10. Minnesota Statutes 2022, section 144.555, is amended by adding a subdivision 
112.29 	to read:
112.30 		Subd. 1d.Methods of providing notice; content of notice. (a) A notice required under 
112.31 	subdivision 1a must be provided to patients, hospital personnel, the public, local units of 
112.32 	government, and the commissioner of health using at least the following methods:
113.1 	(1) posting a notice of the proposed cessation of operations, curtailment, relocation of 
113.2 	health services, or cessation in offering health services at the main public entrance of the 
113.3 	hospital or hospital campus;
113.4 	(2) providing written notice to the commissioner of health, to the city council in the city 
113.5 	where the hospital or hospital campus is located, and to the county board in the county 
113.6 	where the hospital or hospital campus is located;
113.7 	(3) providing written notice to the local health department as defined in section 145A.02, 
113.8 	subdivision 8b, for the community where the hospital or hospital campus is located;
113.9 	(4) providing notice to the public through a written public announcement which must 
113.10 	be distributed to local media outlets;
113.11 	(5) providing written notice to existing patients of the hospital or hospital campus; and
113.12 	(6) notifying all personnel currently employed in the unit, hospital, or hospital campus 
113.13 	impacted by the proposed cessation, curtailment, or relocation.
113.14 	(b) A notice required under subdivision 1a must include:
113.15 	(1) a description of the proposed cessation of operations, curtailment, relocation of health 
113.16 	services, or cessation in offering health services. The description must include:
113.17 	(i) the number of beds, if any, that will be eliminated, repurposed, reassigned, or otherwise 
113.18 	reconfigured to serve populations or patients other than those currently served;
113.19 	(ii) the current number of beds in the impacted unit, hospital, or hospital campus, and 
113.20 	the number of beds in the impacted unit, hospital, or hospital campus after the proposed 
113.21 	cessation, curtailment, or relocation takes place;
113.22 	(iii) the number of existing patients who will be impacted by the proposed cessation, 
113.23 	curtailment, or relocation;
113.24 	(iv) any decrease in personnel, or relocation of personnel to a different unit, hospital, or 
113.25 	hospital campus, caused by the proposed cessation, curtailment, or relocation;
113.26 	(v) a description of the health services provided by the unit, hospital, or hospital campus 
113.27 	impacted by the proposed cessation, curtailment, or relocation; and
113.28 	(vi) identification of the three nearest available health care facilities where patients may 
113.29 	obtain the health services provided by the unit, hospital, or hospital campus impacted by 
113.30 	the proposed cessation, curtailment, or relocation, and any potential barriers to seamlessly 
113.31 	transition patients to receive services at one of these facilities. If the unit, hospital, or hospital 
113.32 	campus impacted by the proposed cessation, curtailment, or relocation serves medical 
114.1 	assistance or Medicare enrollees, the information required under this item must specify 
114.2 	whether any of the three nearest available facilities serves medical assistance or Medicare 
114.3 	enrollees; and
114.4 	(2) a telephone number, email address, and address for each of the following, to which 
114.5 	interested parties may offer comments on the proposed cessation, curtailment, or relocation:
114.6 	(i) the hospital or hospital campus; and
114.7 	(ii) the parent entity, if any, or the entity under contract, if any, that acts as the corporate 
114.8 	administrator of the hospital or hospital campus.

114.9 	Sec. 11. Minnesota Statutes 2022, section 144.555, subdivision 2, is amended to read:
114.10 		Subd. 2.Penalty; facilities other than hospitals. Failure to notify the commissioner 
114.11 	under subdivision 1, 1a, or 1c or failure to participate in a public hearing under subdivision 
114.12 	1b may result in issuance of a correction order under section 144.653, subdivision 5.

114.13 	Sec. 12. Minnesota Statutes 2022, section 144.555, is amended by adding a subdivision 
114.14 	to read:
114.15 		Subd. 3.Penalties; hospitals. (a) Failure to participate in a public hearing under 
114.16 	subdivision 1b or failure to notify the commissioner under subdivision 1c may result in 
114.17 	issuance of a correction order under section 144.653, subdivision 5.
114.18 	(b) Notwithstanding any law to the contrary, the commissioner must impose on the 
114.19 	controlling persons of a hospital or hospital campus a fine of $20,000 for each failure to 
114.20 	provide notice to an individual or entity or at a location required under subdivision 1d, 
114.21 	paragraph (a), with the total fine amount imposed not to exceed $60,000 for failures to 
114.22 	comply with the notice requirements for a single scheduled action. The commissioner is 
114.23 	not required to issue a correction order before imposing a fine under this paragraph. Section 
114.24 	144.653, subdivision 8, applies to fines imposed under this paragraph.

114.25 	Sec. 13. [144.556] RIGHT OF FIRST REFUSAL; SALE OF HOSPITAL OR 
114.26 	HOSPITAL CAMPUS.
114.27 	(a) The controlling persons of a hospital licensed under sections 144.50 to 144.56 or a 
114.28 	hospital campus must not sell or convey the hospital or hospital campus, offer to sell or 
114.29 	convey the hospital or hospital campus to a person other than a local unit of government 
114.30 	listed in this paragraph, or voluntarily cease operations of the hospital or hospital campus 
114.31 	unless the controlling persons have first made a good faith offer to sell or convey the hospital 
115.1 	or hospital campus to the home rule charter or statutory city, county, town, or hospital 
115.2 	district in which the hospital or hospital campus is located.
115.3 	(b) The offer to sell or convey the hospital or hospital campus to a local unit of 
115.4 	government under paragraph (a) must be at a price that does not exceed the current fair 
115.5 	market value of the hospital or hospital campus. A party to whom an offer is made under 
115.6 	paragraph (a) must accept or decline the offer within 60 days of receipt. If the party to whom 
115.7 	the offer is made fails to respond within 60 days of receipt, the offer is deemed declined.

115.8 	Sec. 14. Minnesota Statutes 2022, section 144A.70, subdivision 3, is amended to read:
115.9 		Subd. 3.Controlling person. "Controlling person" means a business entity or entities, 
115.10 	officer, program administrator, or director, whose responsibilities include the direction of 
115.11 	the management or policies of a supplemental nursing services agency the management and 
115.12 	decision-making authority to establish or control business policy and all other policies of a 
115.13 	supplemental nursing services agency. Controlling person also means an individual who, 
115.14 	directly or indirectly, beneficially owns an interest in a corporation, partnership, or other 
115.15 	business association that is a controlling person.

115.16 	Sec. 15. Minnesota Statutes 2022, section 144A.70, subdivision 5, is amended to read:
115.17 		Subd. 5.Person. "Person" includes an individual, firm, corporation, partnership, limited 
115.18 	liability company, or association.

115.19 	Sec. 16. Minnesota Statutes 2022, section 144A.70, subdivision 6, is amended to read:
115.20 		Subd. 6.Supplemental nursing services agency. "Supplemental nursing services 
115.21 	agency" means a person, firm, corporation, partnership, limited liability company, or 
115.22 	association engaged for hire in the business of providing or procuring temporary employment 
115.23 	in health care facilities for nurses, nursing assistants, nurse aides, and orderlies. Supplemental 
115.24 	nursing services agency does not include an individual who only engages in providing the 
115.25 	individual's services on a temporary basis to health care facilities. Supplemental nursing 
115.26 	services agency does not include a professional home care agency licensed under section 
115.27 	144A.471 that only provides staff to other home care providers.

115.28 	Sec. 17. Minnesota Statutes 2022, section 144A.70, subdivision 7, is amended to read:
115.29 		Subd. 7.Oversight. The commissioner is responsible for the oversight of supplemental 
115.30 	nursing services agencies through annual semiannual unannounced surveys and follow-up 
116.1 	surveys, complaint investigations under sections 144A.51 to 144A.53, and other actions 
116.2 	necessary to ensure compliance with sections 144A.70 to 144A.74.

116.3 	Sec. 18. Minnesota Statutes 2022, section 144A.71, subdivision 2, is amended to read:
116.4 		Subd. 2.Application information and fee. The commissioner shall establish forms and 
116.5 	procedures for processing each supplemental nursing services agency registration application. 
116.6 	An application for a supplemental nursing services agency registration must include at least 
116.7 	the following:
116.8 	(1) the names and addresses of the owner or owners all owners and controlling persons
116.9 	of the supplemental nursing services agency;
116.10 	(2) if the owner is a corporation, copies of its articles of incorporation and current bylaws, 
116.11 	together with the names and addresses of its officers and directors;
116.12 	(3) satisfactory proof of compliance with section 144A.72, subdivision 1, clauses (5) to 
116.13 	(7) if the owner is a limited liability company, copies of its articles of organization and 
116.14 	operating agreement, together with the names and addresses of its officers and directors;
116.15 	(4) documentation that the supplemental nursing services agency has medical malpractice 
116.16 	insurance to insure against the loss, damage, or expense of a claim arising out of the death 
116.17 	or injury of any person as the result of negligence or malpractice in the provision of health 
116.18 	care services by the supplemental nursing services agency or by any employee of the agency;
116.19 	(5) documentation that the supplemental nursing services agency has an employee 
116.20 	dishonesty bond in the amount of $10,000;
116.21 	(6) documentation that the supplemental nursing services agency has insurance coverage 
116.22 	for workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies 
116.23 	provided or procured by the agency;
116.24 	(7) documentation that the supplemental nursing services agency filed with the 
116.25 	commissioner of revenue: (i) the name and address of the bank, savings bank, or savings 
116.26 	association in which the supplemental nursing services agency deposits all employee income 
116.27 	tax withholdings; and (ii) the name and address of any nurse, nursing assistant, nurse aide, 
116.28 	or orderly whose income is derived from placement by the agency, if the agency purports 
116.29 	the income is not subject to withholding;
116.30 	(4) (8) any other relevant information that the commissioner determines is necessary to 
116.31 	properly evaluate an application for registration;
117.1 	(5) (9) a policy and procedure that describes how the supplemental nursing services 
117.2 	agency's records will be immediately available at all times to the commissioner and facility; 
117.3 	and
117.4 	(6) (10) a nonrefundable registration fee of $2,035.
117.5 	If a supplemental nursing services agency fails to provide the items in this subdivision 
117.6 	to the department, the commissioner shall immediately suspend or refuse to issue the 
117.7 	supplemental nursing services agency registration. The supplemental nursing services agency 
117.8 	may appeal the commissioner's findings according to section 144A.475, subdivisions 3a 
117.9 	and 7, except that the hearing must be conducted by an administrative law judge within 60 
117.10 	calendar days of the request for hearing assignment.

117.11 	Sec. 19. Minnesota Statutes 2022, section 144A.71, is amended by adding a subdivision 
117.12 	to read:
117.13 		Subd. 2a.Renewal applications. An applicant for registration renewal must complete 
117.14 	the registration application form supplied by the department. An application must be 
117.15 	submitted at least 60 days before the expiration of the current registration.

117.16 	Sec. 20. [144A.715] PENALTIES.
117.17 		Subdivision 1.Authority. The fines imposed under this section are in accordance with 
117.18 	section 144.653, subdivision 6.
117.19 		Subd. 2.Fines. Each violation of sections 144A.70 to 144A.74, not corrected at the time 
117.20 	of a follow-up survey, is subject to a fine. A fine must be assessed according to the schedules 
117.21 	established in the sections violated.
117.22 		Subd. 3.Failure to correct. If, upon a subsequent follow-up survey after a fine has been 
117.23 	imposed under subdivision 2, a violation is still not corrected, another fine shall be assessed. 
117.24 	The fine shall be double the amount of the previous fine.
117.25 		Subd. 4.Payment of fines. Payment of fines is due 15 business days from the registrant's 
117.26 	receipt of notice of the fine from the department.

117.27 	Sec. 21. Minnesota Statutes 2022, section 144A.72, subdivision 1, is amended to read:
117.28 		Subdivision 1.Minimum criteria. (a) The commissioner shall require that, as a condition 
117.29 	of registration:
117.30 	(1) all owners and controlling persons must complete a background study under section 
117.31 	144.057 and receive a clearance or set aside of any disqualification;
118.1 	(1) (2) the supplemental nursing services agency shall document that each temporary 
118.2 	employee provided to health care facilities currently meets the minimum licensing, training, 
118.3 	and continuing education standards for the position in which the employee will be working
118.4 	and verifies competency for the position. A supplemental nursing services agency that 
118.5 	violates this clause may be subject to a fine of $3,000;
118.6 	(2) (3) the supplemental nursing services agency shall comply with all pertinent 
118.7 	requirements relating to the health and other qualifications of personnel employed in health 
118.8 	care facilities;
118.9 	(3) (4) the supplemental nursing services agency must not restrict in any manner the 
118.10 	employment opportunities of its employees;. A supplemental nursing services agency that 
118.11 	violates this clause may be subject to a fine of $3,000;
118.12 	(4) the supplemental nursing services agency shall carry medical malpractice insurance 
118.13 	to insure against the loss, damage, or expense incident to a claim arising out of the death 
118.14 	or injury of any person as the result of negligence or malpractice in the provision of health 
118.15 	care services by the supplemental nursing services agency or by any employee of the agency;
118.16 	(5) the supplemental nursing services agency shall carry an employee dishonesty bond 
118.17 	in the amount of $10,000;
118.18 	(6) the supplemental nursing services agency shall maintain insurance coverage for 
118.19 	workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies provided 
118.20 	or procured by the agency;
118.21 	(7) the supplemental nursing services agency shall file with the commissioner of revenue: 
118.22 	(i) the name and address of the bank, savings bank, or savings association in which the 
118.23 	supplemental nursing services agency deposits all employee income tax withholdings; and 
118.24 	(ii) the name and address of any nurse, nursing assistant, nurse aide, or orderly whose income 
118.25 	is derived from placement by the agency, if the agency purports the income is not subject 
118.26 	to withholding;
118.27 	(8) (5) the supplemental nursing services agency must not, in any contract with any 
118.28 	employee or health care facility, require the payment of liquidated damages, employment 
118.29 	fees, or other compensation should the employee be hired as a permanent employee of a 
118.30 	health care facility;. A supplemental nursing services agency that violates this clause may 
118.31 	be subject to a fine of $3,000;
119.1 	(9) (6) the supplemental nursing services agency shall document that each temporary 
119.2 	employee provided to health care facilities is an employee of the agency and is not an 
119.3 	independent contractor; and
119.4 	(10) (7) the supplemental nursing services agency shall retain all records for five calendar 
119.5 	years. All records of the supplemental nursing services agency must be immediately available 
119.6 	to the department.
119.7 	(b) In order to retain registration, the supplemental nursing services agency must provide 
119.8 	services to a health care facility during the year in Minnesota within the past 12 months
119.9 	preceding the supplemental nursing services agency's registration renewal date.

119.10 	Sec. 22. Minnesota Statutes 2022, section 144A.73, is amended to read:
119.11 	144A.73 COMPLAINT SYSTEM.
119.12 	The commissioner shall establish a system for reporting complaints against a supplemental 
119.13 	nursing services agency or its employees. Complaints may be made by any member of the 
119.14 	public. Complaints against a supplemental nursing services agency shall be investigated by 
119.15 	the Office of Health Facility Complaints commissioner of health under sections 144A.51
119.16 	to 144A.53.

119.17 	Sec. 23. Minnesota Statutes 2023 Supplement, section 145.561, subdivision 4, is amended 
119.18 	to read:
119.19 		Subd. 4.988 telecommunications fee. (a) In compliance with the National Suicide 
119.20 	Hotline Designation Act of 2020, the commissioner shall impose a monthly statewide fee 
119.21 	on each subscriber of a wireline, wireless, or IP-enabled voice service at a rate that provides
119.22 	must pay a monthly fee to provide for the robust creation, operation, and maintenance of a 
119.23 	statewide 988 suicide prevention and crisis system.
119.24 	(b) The commissioner shall annually recommend to the Public Utilities Commission an 
119.25 	adequate and appropriate fee to implement this section. The amount of the fee must comply 
119.26 	with the limits in paragraph (c). The commissioner shall provide telecommunication service 
119.27 	providers and carriers a minimum of 45 days' notice of each fee change.
119.28 	(c) (b) The amount of the 988 telecommunications fee must not be more than 25 is 12
119.29 	cents per month on or after January 1, 2024, for each consumer access line, including trunk 
119.30 	equivalents as designated by the commission Public Utilities Commission pursuant to section 
119.31 	403.11, subdivision 1. The 988 telecommunications fee must be the same for all subscribers.
120.1 	(d) (c) Each wireline, wireless, and IP-enabled voice telecommunication service provider 
120.2 	shall collect the 988 telecommunications fee and transfer the amounts collected to the 
120.3 	commissioner of public safety in the same manner as provided in section 403.11, subdivision 
120.4 	1, paragraph (d).
120.5 	(e) (d) The commissioner of public safety shall deposit the money collected from the 
120.6 	988 telecommunications fee to the 988 special revenue account established in subdivision 
120.7 	3.
120.8 	(f) (e) All 988 telecommunications fee revenue must be used to supplement, and not 
120.9 	supplant, federal, state, and local funding for suicide prevention.
120.10 	(g) (f) The 988 telecommunications fee amount shall be adjusted as needed to provide 
120.11 	for continuous operation of the lifeline centers and 988 hotline, volume increases, and 
120.12 	maintenance.
120.13 	(h) (g) The commissioner shall annually report to the Federal Communications 
120.14 	Commission on revenue generated by the 988 telecommunications fee.

120.15 	EFFECTIVE DATE. This section is effective September 1, 2024.

120.16 	Sec. 24. Minnesota Statutes 2022, section 149A.02, subdivision 3, is amended to read:
120.17 		Subd. 3.Arrangements for disposition. "Arrangements for disposition" means any 
120.18 	action normally taken by a funeral provider in anticipation of or preparation for the 
120.19 	entombment, burial in a cemetery, alkaline hydrolysis, or cremation, or, effective July 1, 
120.20 	2025, natural organic reduction of a dead human body.

120.21 	Sec. 25. Minnesota Statutes 2022, section 149A.02, subdivision 16, is amended to read:
120.22 		Subd. 16.Final disposition. "Final disposition" means the acts leading to and the 
120.23 	entombment, burial in a cemetery, alkaline hydrolysis, or cremation, or, effective July 1, 
120.24 	2025, natural organic reduction of a dead human body.

120.25 	Sec. 26. Minnesota Statutes 2022, section 149A.02, subdivision 26a, is amended to read:
120.26 		Subd. 26a.Inurnment. "Inurnment" means placing hydrolyzed or cremated remains in 
120.27 	a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.
120.28 	Effective July 1, 2025, inurnment also includes placing naturally reduced remains in a 
120.29 	naturally reduced remains container suitable for placement, burial, or shipment.

121.1 	Sec. 27. Minnesota Statutes 2022, section 149A.02, subdivision 27, is amended to read:
121.2 		Subd. 27.Licensee. "Licensee" means any person or entity that has been issued a license 
121.3 	to practice mortuary science, to operate a funeral establishment, to operate an alkaline 
121.4 	hydrolysis facility, or to operate a crematory, or, effective July 1, 2025, to operate a natural 
121.5 	organic reduction facility by the Minnesota commissioner of health.

121.6 	Sec. 28. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
121.7 	to read:
121.8 		Subd. 30b.Natural organic reduction or naturally reduce. "Natural organic reduction" 
121.9 	or "naturally reduce" means the contained, accelerated conversion of a dead human body 
121.10 	to soil. This subdivision is effective July 1, 2025.

121.11 	Sec. 29. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
121.12 	to read:
121.13 		Subd. 30c.Natural organic reduction facility. "Natural organic reduction facility" 
121.14 	means a structure, room, or other space in a building or real property where natural organic 
121.15 	reduction of a dead human body occurs. This subdivision is effective July 1, 2025.

121.16 	Sec. 30. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
121.17 	to read:
121.18 		Subd. 30d.Natural organic reduction vessel. "Natural organic reduction vessel" means 
121.19 	the enclosed container in which natural organic reduction takes place. This subdivision is 
121.20 	effective July 1, 2025.

121.21 	Sec. 31. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
121.22 	to read:
121.23 		Subd. 30e.Naturally reduced remains. "Naturally reduced remains" means the soil 
121.24 	remains following the natural organic reduction of a dead human body and the accompanying 
121.25 	plant material. This subdivision is effective July 1, 2025.

121.26 	Sec. 32. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
121.27 	to read:
121.28 		Subd. 30f.Naturally reduced remains container. "Naturally reduced remains container" 
121.29 	means a receptacle in which naturally reduced remains are placed. This subdivision is 
121.30 	effective July 1, 2025.

122.1 	Sec. 33. Minnesota Statutes 2022, section 149A.02, subdivision 35, is amended to read:
122.2 		Subd. 35.Processing. "Processing" means the removal of foreign objects, drying or 
122.3 	cooling, and the reduction of the hydrolyzed orremains, cremated remains, or, effective 
122.4 	July 1, 2025, naturally reduced remains by mechanical means including, but not limited to, 
122.5 	grinding, crushing, or pulverizing, to a granulated appearance appropriate for final 
122.6 	disposition.

122.7 	Sec. 34. Minnesota Statutes 2022, section 149A.02, subdivision 37c, is amended to read:
122.8 		Subd. 37c.Scattering. "Scattering" means the authorized dispersal of hydrolyzed or
122.9 	remains, cremated remains, or, effective July 1, 2025, naturally reduced remains in a defined 
122.10 	area of a dedicated cemetery or in areas where no local prohibition exists provided that the 
122.11 	hydrolyzed or, cremated, or naturally reduced remains are not distinguishable to the public, 
122.12 	are not in a container, and that the person who has control over disposition of the hydrolyzed 
122.13 	or, cremated, or naturally reduced remains has obtained written permission of the property 
122.14 	owner or governing agency to scatter on the property.

122.15 	Sec. 35. Minnesota Statutes 2022, section 149A.03, is amended to read:
122.16 	149A.03 DUTIES OF COMMISSIONER.
122.17 	The commissioner shall:
122.18 	(1) enforce all laws and adopt and enforce rules relating to the:
122.19 	(i) removal, preparation, transportation, arrangements for disposition, and final disposition 
122.20 	of dead human bodies;
122.21 	(ii) licensure and professional conduct of funeral directors, morticians, interns, practicum 
122.22 	students, and clinical students;
122.23 	(iii) licensing and operation of a funeral establishment;
122.24 	(iv) licensing and operation of an alkaline hydrolysis facility; and
122.25 	(v) licensing and operation of a crematory; and
122.26 	(vi) effective July 1, 2025, licensing and operation of a natural organic reduction facility;
122.27 	(2) provide copies of the requirements for licensure and permits to all applicants;
122.28 	(3) administer examinations and issue licenses and permits to qualified persons and other 
122.29 	legal entities;
122.30 	(4) maintain a record of the name and location of all current licensees and interns;
123.1 	(5) perform periodic compliance reviews and premise inspections of licensees;
123.2 	(6) accept and investigate complaints relating to conduct governed by this chapter;
123.3 	(7) maintain a record of all current preneed arrangement trust accounts;
123.4 	(8) maintain a schedule of application, examination, permit, and licensure fees, initial 
123.5 	and renewal, sufficient to cover all necessary operating expenses;
123.6 	(9) educate the public about the existence and content of the laws and rules for mortuary 
123.7 	science licensing and the removal, preparation, transportation, arrangements for disposition, 
123.8 	and final disposition of dead human bodies to enable consumers to file complaints against 
123.9 	licensees and others who may have violated those laws or rules;
123.10 	(10) evaluate the laws, rules, and procedures regulating the practice of mortuary science 
123.11 	in order to refine the standards for licensing and to improve the regulatory and enforcement 
123.12 	methods used; and
123.13 	(11) initiate proceedings to address and remedy deficiencies and inconsistencies in the 
123.14 	laws, rules, or procedures governing the practice of mortuary science and the removal, 
123.15 	preparation, transportation, arrangements for disposition, and final disposition of dead 
123.16 	human bodies.

123.17 	Sec. 36. [149A.56] LICENSE TO OPERATE A NATURAL ORGANIC REDUCTION 
123.18 	FACILITY.
123.19 		Subdivision 1.License requirement. This section is effective July 1, 2025. Except as 
123.20 	provided in section 149A.01, subdivision 3, no person shall maintain, manage, or operate 
123.21 	a place or premises devoted to or used in the holding and natural organic reduction of a 
123.22 	dead human body without possessing a valid license to operate a natural organic reduction 
123.23 	facility issued by the commissioner of health.
123.24 		Subd. 2.Requirements for natural organic reduction facility. (a) A natural organic 
123.25 	reduction facility licensed under this section must consist of:
123.26 	(1) a building or structure that complies with applicable local and state building codes, 
123.27 	zoning laws and ordinances, and environmental standards, and that contains one or more 
123.28 	natural organic reduction vessels for the natural organic reduction of dead human bodies;
123.29 	(2) a motorized mechanical device for processing naturally reduced remains; and
123.30 	(3) an appropriate refrigerated holding facility for dead human bodies awaiting natural 
123.31 	organic reduction.
124.1 	(b) A natural organic reduction facility licensed under this section may also contain a 
124.2 	display room for funeral goods.
124.3 		Subd. 3.Application procedure; documentation; initial inspection. (a) An applicant 
124.4 	for a license to operate a natural organic reduction facility shall submit a completed 
124.5 	application to the commissioner. A completed application includes:
124.6 	(1) a completed application form, as provided by the commissioner;
124.7 	(2) proof of business form and ownership; and
124.8 	(3) proof of liability insurance coverage or other financial documentation, as determined 
124.9 	by the commissioner, that demonstrates the applicant's ability to respond in damages for 
124.10 	liability arising from the ownership, maintenance, management, or operation of a natural 
124.11 	organic reduction facility.
124.12 	(b) Upon receipt of the application and appropriate fee, the commissioner shall review 
124.13 	and verify all information. Upon completion of the verification process and resolution of 
124.14 	any deficiencies in the application information, the commissioner shall conduct an initial 
124.15 	inspection of the premises to be licensed. After the inspection and resolution of any 
124.16 	deficiencies found and any reinspections as may be necessary, the commissioner shall make 
124.17 	a determination, based on all the information available, to grant or deny licensure. If the 
124.18 	commissioner's determination is to grant the license, the applicant shall be notified and the 
124.19 	license shall issue and remain valid for a period prescribed on the license, but not to exceed 
124.20 	one calendar year from the date of issuance of the license. If the commissioner's determination 
124.21 	is to deny the license, the commissioner must notify the applicant, in writing, of the denial 
124.22 	and provide the specific reason for denial.
124.23 		Subd. 4.Nontransferability of license. A license to operate a natural organic reduction 
124.24 	facility is not assignable or transferable and shall not be valid for any entity other than the 
124.25 	one named. Each license issued to operate a natural organic reduction facility is valid only 
124.26 	for the location identified on the license. A 50 percent or more change in ownership or 
124.27 	location of the natural organic reduction facility automatically terminates the license. Separate 
124.28 	licenses shall be required of two or more persons or other legal entities operating from the 
124.29 	same location.
124.30 		Subd. 5.Display of license. Each license to operate a natural organic reduction facility 
124.31 	must be conspicuously displayed in the natural organic reduction facility at all times. 
124.32 	Conspicuous display means in a location where a member of the general public within the 
124.33 	natural organic reduction facility is able to observe and read the license.
125.1 		Subd. 6.Period of licensure. All licenses to operate a natural organic reduction facility 
125.2 	issued by the commissioner are valid for a period of one calendar year beginning on July 1 
125.3 	and ending on June 30, regardless of the date of issuance.
125.4 		Subd. 7.Reporting changes in license information. Any change of license information 
125.5 	must be reported to the commissioner, on forms provided by the commissioner, no later 
125.6 	than 30 calendar days after the change occurs. Failure to report changes is grounds for 
125.7 	disciplinary action.
125.8 		Subd. 8.Licensing information. Section 13.41 applies to data collected and maintained 
125.9 	by the commissioner pursuant to this section.

125.10 	Sec. 37. [149A.57] RENEWAL OF LICENSE TO OPERATE A NATURAL 
125.11 	ORGANIC REDUCTION FACILITY.
125.12 		Subdivision 1.Renewal required. This section is effective July 1, 2025. All licenses 
125.13 	to operate a natural organic reduction facility issued by the commissioner expire on June 
125.14 	30 following the date of issuance of the license and must be renewed to remain valid.
125.15 		Subd. 2.Renewal procedure and documentation. (a) Licensees who wish to renew 
125.16 	their licenses must submit to the commissioner a completed renewal application no later 
125.17 	than June 30 following the date the license was issued. A completed renewal application 
125.18 	includes:
125.19 	(1) a completed renewal application form, as provided by the commissioner; and
125.20 	(2) proof of liability insurance coverage or other financial documentation, as determined 
125.21 	by the commissioner, that demonstrates the applicant's ability to respond in damages for 
125.22 	liability arising from the ownership, maintenance, management, or operation of a natural 
125.23 	organic reduction facility.
125.24 	(b) Upon receipt of the completed renewal application, the commissioner shall review 
125.25 	and verify the information. Upon completion of the verification process and resolution of 
125.26 	any deficiencies in the renewal application information, the commissioner shall make a 
125.27 	determination, based on all the information available, to reissue or refuse to reissue the 
125.28 	license. If the commissioner's determination is to reissue the license, the applicant shall be 
125.29 	notified and the license shall issue and remain valid for a period prescribed on the license, 
125.30 	but not to exceed one calendar year from the date of issuance of the license. If the 
125.31 	commissioner's determination is to refuse to reissue the license, section 149A.09, subdivision 
125.32 	2, applies.
126.1 		Subd. 3.Penalty for late filing. Renewal applications received after the expiration date 
126.2 	of a license will result in the assessment of a late filing penalty. The late filing penalty must 
126.3 	be paid before the reissuance of the license and received by the commissioner no later than 
126.4 	31 calendar days after the expiration date of the license.
126.5 		Subd. 4.Lapse of license. A license to operate a natural organic reduction facility shall 
126.6 	automatically lapse when a completed renewal application is not received by the 
126.7 	commissioner within 31 calendar days after the expiration date of a license, or a late filing 
126.8 	penalty assessed under subdivision 3 is not received by the commissioner within 31 calendar 
126.9 	days after the expiration of a license.
126.10 		Subd. 5.Effect of lapse of license. Upon the lapse of a license, the person to whom the 
126.11 	license was issued is no longer licensed to operate a natural organic reduction facility in 
126.12 	Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed 
126.13 	license holder from operating a natural organic reduction facility in Minnesota and may 
126.14 	pursue any additional lawful remedies as justified by the case.
126.15 		Subd. 6.Restoration of lapsed license. The commissioner may restore a lapsed license 
126.16 	upon receipt and review of a completed renewal application, receipt of the late filing penalty, 
126.17 	and reinspection of the premises, provided that the receipt is made within one calendar year 
126.18 	from the expiration date of the lapsed license and the cease and desist order issued by the 
126.19 	commissioner has not been violated. If a lapsed license is not restored within one calendar 
126.20 	year from the expiration date of the lapsed license, the holder of the lapsed license cannot 
126.21 	be relicensed until the requirements in section 149A.56 are met.
126.22 		Subd. 7.Reporting changes in license information. Any change of license information 
126.23 	must be reported to the commissioner, on forms provided by the commissioner, no later 
126.24 	than 30 calendar days after the change occurs. Failure to report changes is grounds for 
126.25 	disciplinary action.
126.26 		Subd. 8.Licensing information. Section 13.41 applies to data collected and maintained 
126.27 	by the commissioner pursuant to this section.

126.28 	Sec. 38. Minnesota Statutes 2022, section 149A.65, is amended by adding a subdivision 
126.29 	to read:
126.30 		Subd. 6a.Natural organic reduction facilities. This subdivision is effective July 1, 
126.31 	2025. The initial and renewal fee for a natural organic reduction facility is $425. The late 
126.32 	fee charge for a license renewal is $100.

127.1 	Sec. 39. Minnesota Statutes 2022, section 149A.70, subdivision 1, is amended to read:
127.2 		Subdivision 1.Use of titles. Only a person holding a valid license to practice mortuary 
127.3 	science issued by the commissioner may use the title of mortician, funeral director, or any 
127.4 	other title implying that the licensee is engaged in the business or practice of mortuary 
127.5 	science. Only the holder of a valid license to operate an alkaline hydrolysis facility issued 
127.6 	by the commissioner may use the title of alkaline hydrolysis facility, water cremation, 
127.7 	water-reduction, biocremation, green-cremation, resomation, dissolution, or any other title, 
127.8 	word, or term implying that the licensee operates an alkaline hydrolysis facility. Only the 
127.9 	holder of a valid license to operate a funeral establishment issued by the commissioner may 
127.10 	use the title of funeral home, funeral chapel, funeral service, or any other title, word, or 
127.11 	term implying that the licensee is engaged in the business or practice of mortuary science. 
127.12 	Only the holder of a valid license to operate a crematory issued by the commissioner may 
127.13 	use the title of crematory, crematorium, green-cremation, or any other title, word, or term 
127.14 	implying that the licensee operates a crematory or crematorium. Effective July 1, 2025, 
127.15 	only the holder of a valid license to operate a natural organic reduction facility issued by 
127.16 	the commissioner may use the title of natural organic reduction facility, human composting, 
127.17 	or any other title, word, or term implying that the licensee operates a natural organic reduction 
127.18 	facility.

127.19 	Sec. 40. Minnesota Statutes 2022, section 149A.70, subdivision 2, is amended to read:
127.20 		Subd. 2.Business location. A funeral establishment, alkaline hydrolysis facility, or
127.21 	crematory, or, effective July 1, 2025, natural organic reduction facility shall not do business 
127.22 	in a location that is not licensed as a funeral establishment, alkaline hydrolysis facility, or
127.23 	crematory, or natural organic reduction facility and shall not advertise a service that is 
127.24 	available from an unlicensed location.

127.25 	Sec. 41. Minnesota Statutes 2022, section 149A.70, subdivision 3, is amended to read:
127.26 		Subd. 3.Advertising. No licensee, clinical student, practicum student, or intern shall 
127.27 	publish or disseminate false, misleading, or deceptive advertising. False, misleading, or 
127.28 	deceptive advertising includes, but is not limited to:
127.29 	(1) identifying, by using the names or pictures of, persons who are not licensed to practice 
127.30 	mortuary science in a way that leads the public to believe that those persons will provide 
127.31 	mortuary science services;
128.1 	(2) using any name other than the names under which the funeral establishment, alkaline 
128.2 	hydrolysis facility, or crematory, or, effective July 1, 2025, natural organic reduction facility
128.3 	is known to or licensed by the commissioner;
128.4 	(3) using a surname not directly, actively, or presently associated with a licensed funeral 
128.5 	establishment, alkaline hydrolysis facility, or crematory, or, effective July 1, 2025, natural 
128.6 	organic reduction facility, unless the surname had been previously and continuously used 
128.7 	by the licensed funeral establishment, alkaline hydrolysis facility, or crematory, or natural 
128.8 	organic reduction facility; and
128.9 	(4) using a founding or establishing date or total years of service not directly or 
128.10 	continuously related to a name under which the funeral establishment, alkaline hydrolysis 
128.11 	facility, or crematory, or, effective July 1, 2025, natural organic reduction facility is currently 
128.12 	or was previously licensed.
128.13 	Any advertising or other printed material that contains the names or pictures of persons 
128.14 	affiliated with a funeral establishment, alkaline hydrolysis facility, or crematory, or, effective 
128.15 	July 1, 2025, natural organic reduction facility shall state the position held by the persons 
128.16 	and shall identify each person who is licensed or unlicensed under this chapter.

128.17 	Sec. 42. Minnesota Statutes 2022, section 149A.70, subdivision 5, is amended to read:
128.18 		Subd. 5.Reimbursement prohibited. No licensee, clinical student, practicum student, 
128.19 	or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other 
128.20 	reimbursement in consideration for recommending or causing a dead human body to be 
128.21 	disposed of by a specific body donation program, funeral establishment, alkaline hydrolysis 
128.22 	facility, crematory, mausoleum, or cemetery, or, effective July 1, 2025, natural organic 
128.23 	reduction facility.

128.24 	Sec. 43. Minnesota Statutes 2022, section 149A.71, subdivision 2, is amended to read:
128.25 		Subd. 2.Preventive requirements. (a) To prevent unfair or deceptive acts or practices, 
128.26 	the requirements of this subdivision must be met. This subdivision applies to natural organic 
128.27 	reduction and naturally reduced remains goods and services effective July 1, 2025.
128.28 	(b) Funeral providers must tell persons who ask by telephone about the funeral provider's 
128.29 	offerings or prices any accurate information from the price lists described in paragraphs (c) 
128.30 	to (e) and any other readily available information that reasonably answers the questions 
128.31 	asked.
129.1 	(c) Funeral providers must make available for viewing to people who inquire in person 
129.2 	about the offerings or prices of funeral goods or burial site goods, separate printed or 
129.3 	typewritten price lists using a ten-point font or larger. Each funeral provider must have a 
129.4 	separate price list for each of the following types of goods that are sold or offered for sale:
129.5 	(1) caskets;
129.6 	(2) alternative containers;
129.7 	(3) outer burial containers;
129.8 	(4) alkaline hydrolysis containers;
129.9 	(5) cremation containers;
129.10 	(6) hydrolyzed remains containers;
129.11 	(7) cremated remains containers;
129.12 	(8) markers; and
129.13 	(9) headstones.; and
129.14 	(10) naturally reduced remains containers.
129.15 	(d) Each separate price list must contain the name of the funeral provider's place of 
129.16 	business, address, and telephone number and a caption describing the list as a price list for 
129.17 	one of the types of funeral goods or burial site goods described in paragraph (c), clauses 
129.18 	(1) to (9) (10). The funeral provider must offer the list upon beginning discussion of, but 
129.19 	in any event before showing, the specific funeral goods or burial site goods and must provide 
129.20 	a photocopy of the price list, for retention, if so asked by the consumer. The list must contain, 
129.21 	at least, the retail prices of all the specific funeral goods and burial site goods offered which 
129.22 	do not require special ordering, enough information to identify each, and the effective date 
129.23 	for the price list. However, funeral providers are not required to make a specific price list 
129.24 	available if the funeral providers place the information required by this paragraph on the 
129.25 	general price list described in paragraph (e).
129.26 	(e) Funeral providers must give a printed price list, for retention, to persons who inquire 
129.27 	in person about the funeral goods, funeral services, burial site goods, or burial site services 
129.28 	or prices offered by the funeral provider. The funeral provider must give the list upon 
129.29 	beginning discussion of either the prices of or the overall type of funeral service or disposition 
129.30 	or specific funeral goods, funeral services, burial site goods, or burial site services offered 
129.31 	by the provider. This requirement applies whether the discussion takes place in the funeral 
129.32 	establishment or elsewhere. However, when the deceased is removed for transportation to 
130.1 	the funeral establishment, an in-person request for authorization to embalm does not, by 
130.2 	itself, trigger the requirement to offer the general price list. If the provider, in making an 
130.3 	in-person request for authorization to embalm, discloses that embalming is not required by 
130.4 	law except in certain special cases, the provider is not required to offer the general price 
130.5 	list. Any other discussion during that time about prices or the selection of funeral goods, 
130.6 	funeral services, burial site goods, or burial site services triggers the requirement to give 
130.7 	the consumer a general price list. The general price list must contain the following 
130.8 	information:
130.9 	(1) the name, address, and telephone number of the funeral provider's place of business;
130.10 	(2) a caption describing the list as a "general price list";
130.11 	(3) the effective date for the price list;
130.12 	(4) the retail prices, in any order, expressed either as a flat fee or as the prices per hour, 
130.13 	mile, or other unit of computation, and other information described as follows:
130.14 	(i) forwarding of remains to another funeral establishment, together with a list of the 
130.15 	services provided for any quoted price;
130.16 	(ii) receiving remains from another funeral establishment, together with a list of the 
130.17 	services provided for any quoted price;
130.18 	(iii) separate prices for each alkaline hydrolysis, natural organic reduction, or cremation 
130.19 	offered by the funeral provider, with the price including an alternative container or shroud 
130.20 	or alkaline hydrolysis facility or cremation container,; any alkaline hydrolysis, natural 
130.21 	organic reduction facility, or crematory charges,; and a description of the services and 
130.22 	container included in the price, where applicable, and the price of alkaline hydrolysis or 
130.23 	cremation where the purchaser provides the container;
130.24 	(iv) separate prices for each immediate burial offered by the funeral provider, including 
130.25 	a casket or alternative container, and a description of the services and container included 
130.26 	in that price, and the price of immediate burial where the purchaser provides the casket or 
130.27 	alternative container;
130.28 	(v) transfer of remains to the funeral establishment or other location;
130.29 	(vi) embalming;
130.30 	(vii) other preparation of the body;
130.31 	(viii) use of facilities, equipment, or staff for viewing;
130.32 	(ix) use of facilities, equipment, or staff for funeral ceremony;
131.1 	(x) use of facilities, equipment, or staff for memorial service;
131.2 	(xi) use of equipment or staff for graveside service;
131.3 	(xii) hearse or funeral coach;
131.4 	(xiii) limousine; and
131.5 	(xiv) separate prices for all cemetery-specific goods and services, including all goods 
131.6 	and services associated with interment and burial site goods and services and excluding 
131.7 	markers and headstones;
131.8 	(5) the price range for the caskets offered by the funeral provider, together with the 
131.9 	statement "A complete price list will be provided at the funeral establishment or casket sale 
131.10 	location." or the prices of individual caskets, as disclosed in the manner described in 
131.11 	paragraphs (c) and (d);
131.12 	(6) the price range for the alternative containers or shrouds offered by the funeral provider, 
131.13 	together with the statement "A complete price list will be provided at the funeral 
131.14 	establishment or alternative container sale location." or the prices of individual alternative 
131.15 	containers, as disclosed in the manner described in paragraphs (c) and (d);
131.16 	(7) the price range for the outer burial containers offered by the funeral provider, together 
131.17 	with the statement "A complete price list will be provided at the funeral establishment or 
131.18 	outer burial container sale location." or the prices of individual outer burial containers, as 
131.19 	disclosed in the manner described in paragraphs (c) and (d);
131.20 	(8) the price range for the alkaline hydrolysis container offered by the funeral provider, 
131.21 	together with the statement "A complete price list will be provided at the funeral 
131.22 	establishment or alkaline hydrolysis container sale location." or the prices of individual 
131.23 	alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c) and 
131.24 	(d);
131.25 	(9) the price range for the hydrolyzed remains container offered by the funeral provider, 
131.26 	together with the statement "A complete price list will be provided at the funeral 
131.27 	establishment or hydrolyzed remains container sale location." or the prices of individual 
131.28 	hydrolyzed remains container, as disclosed in the manner described in paragraphs (c) and 
131.29 	(d);
131.30 	(10) the price range for the cremation containers offered by the funeral provider, together 
131.31 	with the statement "A complete price list will be provided at the funeral establishment or 
131.32 	cremation container sale location." or the prices of individual cremation containers, as 
131.33 	disclosed in the manner described in paragraphs (c) and (d);
132.1 	(11) the price range for the cremated remains containers offered by the funeral provider, 
132.2 	together with the statement, "A complete price list will be provided at the funeral 
132.3 	establishment or cremated remains container sale location," or the prices of individual 
132.4 	cremation containers as disclosed in the manner described in paragraphs (c) and (d);
132.5 	(12) the price range for the naturally reduced remains containers offered by the funeral 
132.6 	provider, together with the statement, "A complete price list will be provided at the funeral 
132.7 	establishment or naturally reduced remains container sale location," or the prices of individual 
132.8 	naturally reduced remains containers as disclosed in the manner described in paragraphs 
132.9 	(c) and (d);
132.10 	(12) (13) the price for the basic services of funeral provider and staff, together with a 
132.11 	list of the principal basic services provided for any quoted price and, if the charge cannot 
132.12 	be declined by the purchaser, the statement "This fee for our basic services will be added 
132.13 	to the total cost of the funeral arrangements you select. (This fee is already included in our 
132.14 	charges for alkaline hydrolysis, natural organic reduction, direct cremations, immediate 
132.15 	burials, and forwarding or receiving remains.)" If the charge cannot be declined by the 
132.16 	purchaser, the quoted price shall include all charges for the recovery of unallocated funeral 
132.17 	provider overhead, and funeral providers may include in the required disclosure the phrase 
132.18 	"and overhead" after the word "services." This services fee is the only funeral provider fee 
132.19 	for services, facilities, or unallocated overhead permitted by this subdivision to be 
132.20 	nondeclinable, unless otherwise required by law;
132.21 	(13) (14) the price range for the markers and headstones offered by the funeral provider, 
132.22 	together with the statement "A complete price list will be provided at the funeral 
132.23 	establishment or marker or headstone sale location." or the prices of individual markers and 
132.24 	headstones, as disclosed in the manner described in paragraphs (c) and (d); and
132.25 	(14) (15) any package priced funerals offered must be listed in addition to and following 
132.26 	the information required in paragraph (e) and must clearly state the funeral goods and 
132.27 	services being offered, the price being charged for those goods and services, and the 
132.28 	discounted savings.
132.29 	(f) Funeral providers must give an itemized written statement, for retention, to each 
132.30 	consumer who arranges an at-need funeral or other disposition of human remains at the 
132.31 	conclusion of the discussion of the arrangements. The itemized written statement must be 
132.32 	signed by the consumer selecting the goods and services as required in section 149A.80. If 
132.33 	the statement is provided by a funeral establishment, the statement must be signed by the 
132.34 	licensed funeral director or mortician planning the arrangements. If the statement is provided 
133.1 	by any other funeral provider, the statement must be signed by an authorized agent of the 
133.2 	funeral provider. The statement must list the funeral goods, funeral services, burial site 
133.3 	goods, or burial site services selected by that consumer and the prices to be paid for each 
133.4 	item, specifically itemized cash advance items (these prices must be given to the extent then 
133.5 	known or reasonably ascertainable if the prices are not known or reasonably ascertainable, 
133.6 	a good faith estimate shall be given and a written statement of the actual charges shall be 
133.7 	provided before the final bill is paid), and the total cost of goods and services selected. At 
133.8 	the conclusion of an at-need arrangement, the funeral provider is required to give the 
133.9 	consumer a copy of the signed itemized written contract that must contain the information 
133.10 	required in this paragraph.
133.11 	(g) Upon receiving actual notice of the death of an individual with whom a funeral 
133.12 	provider has entered a preneed funeral agreement, the funeral provider must provide a copy 
133.13 	of all preneed funeral agreement documents to the person who controls final disposition of 
133.14 	the human remains or to the designee of the person controlling disposition. The person 
133.15 	controlling final disposition shall be provided with these documents at the time of the 
133.16 	person's first in-person contact with the funeral provider, if the first contact occurs in person 
133.17 	at a funeral establishment, alkaline hydrolysis facility, crematory, natural organic reduction 
133.18 	facility, or other place of business of the funeral provider. If the contact occurs by other 
133.19 	means or at another location, the documents must be provided within 24 hours of the first 
133.20 	contact.

133.21 	Sec. 44. Minnesota Statutes 2022, section 149A.71, subdivision 4, is amended to read:
133.22 		Subd. 4.Casket, alternate container, alkaline hydrolysis container, naturally reduced 
133.23 	remains container, and cremation container sales; records; required disclosures. Any 
133.24 	funeral provider who sells or offers to sell a casket, alternate container, alkaline hydrolysis 
133.25 	container, hydrolyzed remains container, cremation container, or cremated remains container, 
133.26 	or, effective July 1, 2025, naturally reduced remains container to the public must maintain 
133.27 	a record of each sale that includes the name of the purchaser, the purchaser's mailing address, 
133.28 	the name of the decedent, the date of the decedent's death, and the place of death. These 
133.29 	records shall be open to inspection by the regulatory agency. Any funeral provider selling 
133.30 	a casket, alternate container, or cremation container to the public, and not having charge of 
133.31 	the final disposition of the dead human body, shall provide a copy of the statutes and rules 
133.32 	controlling the removal, preparation, transportation, arrangements for disposition, and final 
133.33 	disposition of a dead human body. This subdivision does not apply to morticians, funeral 
133.34 	directors, funeral establishments, crematories, or wholesale distributors of caskets, alternate 
133.35 	containers, alkaline hydrolysis containers, or cremation containers.

134.1 	Sec. 45. Minnesota Statutes 2022, section 149A.72, subdivision 3, is amended to read:
134.2 		Subd. 3.Casket for alkaline hydrolysis, natural organic reduction, or cremation 
134.3 	provisions; deceptive acts or practices. In selling or offering to sell funeral goods or 
134.4 	funeral services to the public, it is a deceptive act or practice for a funeral provider to 
134.5 	represent that a casket is required for alkaline hydrolysis or, cremations, or, effective July 
134.6 	1, 2025, natural organic reduction by state or local law or otherwise.

134.7 	Sec. 46. Minnesota Statutes 2022, section 149A.72, subdivision 9, is amended to read:
134.8 		Subd. 9.Deceptive acts or practices. In selling or offering to sell funeral goods, funeral 
134.9 	services, burial site goods, or burial site services to the public, it is a deceptive act or practice 
134.10 	for a funeral provider to represent that federal, state, or local laws, or particular cemeteries, 
134.11 	alkaline hydrolysis facilities, or crematories, or, effective July 1, 2025, natural organic 
134.12 	reduction facilities require the purchase of any funeral goods, funeral services, burial site 
134.13 	goods, or burial site services when that is not the case.

134.14 	Sec. 47. Minnesota Statutes 2022, section 149A.73, subdivision 1, is amended to read:
134.15 		Subdivision 1.Casket for alkaline hydrolysis, natural organic reduction, or cremation 
134.16 	provisions; deceptive acts or practices. In selling or offering to sell funeral goods, funeral 
134.17 	services, burial site goods, or burial site services to the public, it is a deceptive act or practice 
134.18 	for a funeral provider to require that a casket be purchased for alkaline hydrolysis or,
134.19 	cremation, or, effective July 1, 2025, natural organic reduction.

134.20 	Sec. 48. Minnesota Statutes 2022, section 149A.74, subdivision 1, is amended to read:
134.21 		Subdivision 1.Services provided without prior approval; deceptive acts or 
134.22 	practices. In selling or offering to sell funeral goods or funeral services to the public, it is 
134.23 	a deceptive act or practice for any funeral provider to embalm a dead human body unless 
134.24 	state or local law or regulation requires embalming in the particular circumstances regardless 
134.25 	of any funeral choice which might be made, or prior approval for embalming has been 
134.26 	obtained from an individual legally authorized to make such a decision. In seeking approval 
134.27 	to embalm, the funeral provider must disclose that embalming is not required by law except 
134.28 	in certain circumstances; that a fee will be charged if a funeral is selected which requires 
134.29 	embalming, such as a funeral with viewing; and that no embalming fee will be charged if 
134.30 	the family selects a service which does not require embalming, such as direct alkaline 
134.31 	hydrolysis, direct cremation, or immediate burial, or, effective July 1, 2025, natural organic 
134.32 	reduction.

135.1 	Sec. 49. Minnesota Statutes 2022, section 149A.93, subdivision 3, is amended to read:
135.2 		Subd. 3.Disposition permit. A disposition permit is required before a body can be 
135.3 	buried, entombed, alkaline hydrolyzed, or cremated, or, effective July 1, 2025, naturally 
135.4 	reduced. No disposition permit shall be issued until a fact of death record has been completed 
135.5 	and filed with the state registrar of vital records.

135.6 	Sec. 50. Minnesota Statutes 2022, section 149A.94, subdivision 1, is amended to read:
135.7 		Subdivision 1.Generally. Every dead human body lying within the state, except 
135.8 	unclaimed bodies delivered for dissection by the medical examiner, those delivered for 
135.9 	anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through 
135.10 	the state for the purpose of disposition elsewhere; and the remains of any dead human body 
135.11 	after dissection or anatomical study, shall be decently buried or entombed in a public or 
135.12 	private cemetery, alkaline hydrolyzed, or cremated, or, effective July 1, 2025, naturally 
135.13 	reduced within a reasonable time after death. Where final disposition of a body will not be 
135.14 	accomplished, or, effective July 1, 2025, when natural organic reduction will not be initiated,
135.15 	within 72 hours following death or release of the body by a competent authority with 
135.16 	jurisdiction over the body, the body must be properly embalmed, refrigerated, or packed 
135.17 	with dry ice. A body may not be kept in refrigeration for a period exceeding six calendar 
135.18 	days, or packed in dry ice for a period that exceeds four calendar days, from the time of 
135.19 	death or release of the body from the coroner or medical examiner.

135.20 	Sec. 51. Minnesota Statutes 2022, section 149A.94, subdivision 3, is amended to read:
135.21 		Subd. 3.Permit required. No dead human body shall be buried, entombed, or cremated, 
135.22 	alkaline hydrolyzed, or, effective July 1, 2025, naturally reduced without a disposition 
135.23 	permit. The disposition permit must be filed with the person in charge of the place of final 
135.24 	disposition. Where a dead human body will be transported out of this state for final 
135.25 	disposition, the body must be accompanied by a certificate of removal.

135.26 	Sec. 52. Minnesota Statutes 2022, section 149A.94, subdivision 4, is amended to read:
135.27 		Subd. 4.Alkaline hydrolysis or, cremation, or natural organic reduction. Inurnment 
135.28 	of alkaline hydrolyzed or remains, cremated remains, or, effective July 1, 2025, naturally 
135.29 	reduced remains and release to an appropriate party is considered final disposition and no 
135.30 	further permits or authorizations are required for transportation, interment, entombment, or 
135.31 	placement of the cremated remains, except as provided in section 149A.95, subdivision 16.

136.1 	Sec. 53. [149A.955] NATURAL ORGANIC REDUCTION FACILITIES AND 
136.2 	NATURAL ORGANIC REDUCTION.
136.3 		Subdivision 1.License required. This section is effective July 1, 2025. A dead human 
136.4 	body may only undergo natural organic reduction in this state at a natural organic reduction 
136.5 	facility licensed by the commissioner of health.
136.6 		Subd. 2.General requirements. Any building to be used as a natural organic reduction 
136.7 	facility must comply with all applicable local and state building codes, zoning laws and 
136.8 	ordinances, and environmental standards. A natural organic reduction facility must have, 
136.9 	on site, a natural organic reduction system approved by the commissioner and a motorized 
136.10 	mechanical device for processing naturally reduced remains and must have, in the building, 
136.11 	a refrigerated holding facility for the retention of dead human bodies awaiting natural organic 
136.12 	reduction. The holding facility must be secure from access by anyone except the authorized 
136.13 	personnel of the natural organic reduction facility, preserve the dignity of the remains, and 
136.14 	protect the health and safety of the natural organic reduction facility personnel.
136.15 		Subd. 3.Aerobic reduction vessel. A natural organic reduction facility must use as a 
136.16 	natural organic reduction vessel, a contained reduction vessel that is designed to promote 
136.17 	aerobic reduction and that minimizes odors.
136.18 		Subd. 4.Unlicensed personnel. A licensed natural organic reduction facility may employ 
136.19 	unlicensed personnel, provided that all applicable provisions of this chapter are followed. 
136.20 	It is the duty of the licensed natural organic reduction facility to provide proper training for 
136.21 	all unlicensed personnel, and the licensed natural organic reduction facility shall be strictly 
136.22 	accountable for compliance with this chapter and other applicable state and federal regulations 
136.23 	regarding occupational and workplace health and safety.
136.24 		Subd. 5.Authorization to naturally reduce. No natural organic reduction facility shall 
136.25 	naturally reduce or cause to be naturally reduced any dead human body or identifiable body 
136.26 	part without receiving written authorization to do so from the person or persons who have 
136.27 	the legal right to control disposition as described in section 149A.80 or the person's legal 
136.28 	designee. The written authorization must include:
136.29 	(1) the name of the deceased and the date of death of the deceased;
136.30 	(2) a statement authorizing the natural organic reduction facility to naturally reduce the 
136.31 	body;
136.32 	(3) the name, address, phone number, relationship to the deceased, and signature of the 
136.33 	person or persons with the legal right to control final disposition or a legal designee;
137.1 	(4) directions for the disposition of any non-naturally reduced materials or items recovered 
137.2 	from the natural organic reduction vessel;
137.3 	(5) acknowledgment that some of the naturally reduced remains will be mechanically 
137.4 	reduced to a granulated appearance and included in the appropriate containers with the 
137.5 	naturally reduced remains; and
137.6 	(6) directions for the ultimate disposition of the naturally reduced remains.
137.7 		Subd. 6.Limitation of liability. The limitations in section 149A.95, subdivision 5, apply 
137.8 	to natural organic reduction facilities.
137.9 		Subd. 7.Acceptance of delivery of body. (a) No dead human body shall be accepted 
137.10 	for final disposition by natural organic reduction unless:
137.11 	(1) a licensed mortician is present;
137.12 	(2) the body is wrapped in a container, such as a pouch or shroud, that is impermeable 
137.13 	or leak-resistant;
137.14 	(3) the body is accompanied by a disposition permit issued pursuant to section 149A.93, 
137.15 	subdivision 3, including a photocopy of the complete death record or a signed release 
137.16 	authorizing natural organic reduction received from a coroner or medical examiner; and
137.17 	(4) the body is accompanied by a natural organic reduction authorization that complies 
137.18 	with subdivision 5.
137.19 	(b) A natural organic reduction facility shall refuse to accept delivery of the dead human 
137.20 	body:
137.21 	(1) where there is a known dispute concerning natural organic reduction of the body 
137.22 	delivered;
137.23 	(2) where there is a reasonable basis for questioning any of the representations made on 
137.24 	the written authorization to naturally reduce; or
137.25 	(3) for any other lawful reason.
137.26 	(c) When a container, pouch, or shroud containing a dead human body shows evidence 
137.27 	of leaking bodily fluid, the container, pouch, or shroud and the body must be returned to 
137.28 	the contracting funeral establishment, or the body must be transferred to a new container, 
137.29 	pouch, or shroud by a licensed mortician.
138.1 	(d) If a dead human body is delivered to a natural organic reduction facility in a container, 
138.2 	pouch, or shroud that is not suitable for placement in a natural organic reduction vessel, the 
138.3 	transfer of the body to the vessel must be performed by a licensed mortician.
138.4 		Subd. 8.Bodies awaiting natural organic reduction. A dead human body must be 
138.5 	placed in the natural organic reduction vessel to initiate the natural reduction process within 
138.6 	24 hours after the natural organic reduction facility accepts legal and physical custody of 
138.7 	the body.
138.8 		Subd. 9.Handling of dead human bodies. All natural organic reduction facility 
138.9 	employees handling the containers, pouches, or shrouds for dead human bodies shall use 
138.10 	universal precautions and otherwise exercise all reasonable precautions to minimize the 
138.11 	risk of transmitting any communicable disease from the body. No dead human body shall 
138.12 	be removed from the container, pouch, or shroud in which it is delivered to the natural 
138.13 	organic reduction facility without express written authorization of the person or persons 
138.14 	with legal right to control the disposition and only by a licensed mortician. The remains 
138.15 	shall be considered a dead human body until after the processing and curing of the remains 
138.16 	are completed.
138.17 		Subd. 10.Identification of the body. All licensed natural organic reduction facilities 
138.18 	shall develop, implement, and maintain an identification procedure whereby dead human 
138.19 	bodies can be identified from the time the natural organic reduction facility accepts delivery 
138.20 	of the body until the naturally reduced remains are released to an authorized party. After 
138.21 	natural organic reduction, an identifying disk, tab, or other permanent label shall be placed 
138.22 	within the naturally reduced remains container or containers before the remains are released 
138.23 	from the natural organic reduction facility. Each identification disk, tab, or label shall have 
138.24 	a number that shall be recorded on all paperwork regarding the decedent. This procedure 
138.25 	shall be designed to reasonably ensure that the proper body is naturally reduced and that 
138.26 	the remains are returned to the appropriate party. Loss of all or part of the remains or the 
138.27 	inability to individually identify the remains is a violation of this subdivision.
138.28 		Subd. 11.Natural organic reduction vessel for human remains. A licensed natural 
138.29 	organic reduction facility shall knowingly naturally reduce only dead human bodies or 
138.30 	human remains in a natural organic reduction vessel.
138.31 		Subd. 12.Natural organic reduction procedures; privacy. The final disposition of 
138.32 	dead human bodies by natural organic reduction shall be done in privacy. Unless there is 
138.33 	written authorization from the person with the legal right to control the final disposition, 
138.34 	only authorized natural organic reduction facility personnel shall be permitted in the natural 
139.1 	organic reduction area while any human body is awaiting placement in a natural organic 
139.2 	reduction vessel, being removed from the vessel, or being processed for placement in a 
139.3 	naturally reduced remains container. This does not prohibit an in-person laying-in ceremony 
139.4 	to honor the deceased and the transition prior to the placement.
139.5 		Subd. 13.Natural organic reduction procedures; commingling of bodies 
139.6 	prohibited. Except with the express written permission of the person with the legal right 
139.7 	to control the final disposition, no natural organic reduction facility shall naturally reduce 
139.8 	more than one dead human body at the same time and in the same natural organic reduction 
139.9 	vessel or introduce a second dead human body into same natural organic reduction vessel 
139.10 	until reasonable efforts have been employed to remove all fragments of remains from the 
139.11 	preceding natural organic reduction. This subdivision does not apply where commingling 
139.12 	of human remains during natural organic reduction is otherwise provided by law. The fact 
139.13 	that there is incidental and unavoidable residue in the natural organic reduction vessel used 
139.14 	in a prior natural organic reduction is not a violation of this subdivision.
139.15 		Subd. 14.Natural organic reduction procedures; removal from natural organic 
139.16 	reduction vessel. Upon completion of the natural organic reduction process, reasonable 
139.17 	efforts shall be made to remove from the natural organic reduction vessel all the recoverable 
139.18 	naturally reduced remains. The naturally reduced remains shall be transported to the 
139.19 	processing area, and any non-naturally reducible materials or items shall be separated from 
139.20 	the naturally reduced remains and disposed of, in any lawful manner, by the natural organic 
139.21 	reduction facility.
139.22 		Subd. 15.Natural organic reduction procedures; processing naturally reduced 
139.23 	remains. The remaining intact naturally reduced remains shall be reduced by a motorized 
139.24 	mechanical processor to a granulated appearance. The granulated remains and the rest of 
139.25 	the naturally reduced remains shall be returned to a natural organic reduction vessel for 
139.26 	final reduction.
139.27 		Subd. 16.Natural organic reduction procedures; commingling of naturally reduced 
139.28 	remains prohibited. Except with the express written permission of the person with the 
139.29 	legal right to control the final deposition or as otherwise provided by law, no natural organic 
139.30 	reduction facility shall mechanically process the naturally reduced remains of more than 
139.31 	one body at a time in the same mechanical processor, or introduce the naturally reduced 
139.32 	remains of a second body into a mechanical processor until reasonable efforts have been 
139.33 	employed to remove all fragments of naturally reduced remains already in the processor. 
139.34 	The presence of incidental and unavoidable residue in the mechanical processor does not 
139.35 	violate this subdivision.
140.1 		Subd. 17.Natural organic reduction procedures; testing naturally reduced 
140.2 	remains. A natural organic reduction facility must:
140.3 	(1) ensure that the material in the natural organic reduction vessel naturally reaches and 
140.4 	maintains a minimum temperature of 131 degrees Fahrenheit for a minimum of 72 
140.5 	consecutive hours during the process of natural organic reduction;
140.6 	(2) analyze each instance of the naturally reduced remains for physical contaminants, 
140.7 	including but are not limited to intact bone, dental fillings, and medical implants, and ensure 
140.8 	naturally reduced remains have less than 0.01 mg/kg dry weight of any physical contaminants;
140.9 	(3) collect material samples for analysis that are representative of each instance of natural 
140.10 	organic reduction, using a sampling method such as that described in the U.S. Composting 
140.11 	Council 2002 Test Methods for the Examination of Composting and Compost, method 
140.12 	02.01-A through E;
140.13 	(4) develop and use a natural organic reduction process in which the naturally reduced 
140.14 	remains from the process do not exceed the following limits:

140.15
140.16		Metals and other testing 
parameters
	Limit (mg/kg dry weight), unless otherwise 
specified
	
140.18140.17
		Fecal coliform
	Less than 1,000 most probable number per gram 
of total solids (dry weight)
	
140.20140.19
		Salmonella
	Less than 3 most probable number per 4 grams 
of total solids (dry weight)
	
140.21		Arsenic
	Less than or equal to 11 ppm
	
140.22		Cadmium
	Less than or equal to 7.1 ppm
	
140.23		Lead
	Less than or equal to 150 ppm
	
140.24		Mercury
	Less than or equal to 8 ppm
	
140.25		Selenium
	Less than or equal to 18 ppm;
	
140.26 	(5) analyze, using a third-party laboratory, the natural organic reduction facility's material 
140.27 	samples of naturally reduced remains according to the following schedule:
140.28 	(i) the natural organic reduction facility must analyze each of the first 20 instances of 
140.29 	naturally reduced remains for the parameters in clause (4);
140.30 	(ii) if any of the first 20 instances of naturally reduced remains yield results exceeding 
140.31 	the limits in clause (4), the natural organic reduction facility must conduct appropriate 
140.32 	processes to correct the levels of the substances in clause (4) and have the resultant remains 
140.33 	tested to ensure they fall within the identified limits;
140.34 	(iii) if any of the first 20 instances of naturally reduced remains yield results exceeding 
140.35 	the limits in clause (4), the natural organic reduction facility must analyze each additional 
141.1 	instance of naturally reduced remains for the parameters in clause (4) until a total of 20 
141.2 	samples, not including those from remains that were reprocessed as required in item (ii), 
141.3 	have yielded results within the limits in clause (4) on initial testing;
141.4 	(iv) after 20 material samples of naturally reduced remains have met the limits in clause 
141.5 	(4), the natural organic reduction facility must analyze at least 25 percent of the natural 
141.6 	organic reduction facility's monthly instances of naturally reduced remains for the parameters 
141.7 	in clause (4) until 80 total material samples of naturally reduced remains are found to meet 
141.8 	the limits in clause (4), not including any samples that required reprocessing to meet those 
141.9 	limits; and
141.10 	(v) after 80 material samples of naturally reduced remains are found to meet the limits 
141.11 	in clause (4), the natural organic reduction facility must analyze at least one instance of 
141.12 	naturally reduced remains each month for the parameters in clause (4);
141.13 	(6) comply with any testing requirements established by the commissioner for content 
141.14 	parameters in addition to those specified in clause (4);
141.15 	(7) not release any naturally reduced remains that exceed the limits in clause (4); and
141.16 	(8) prepare, maintain, and provide to the commissioner upon request, a report for each 
141.17 	calendar year detailing the natural organic reduction facility's activities during the previous 
141.18 	calendar year. The report must include the following information:
141.19 	(i) the name and address of the natural organic reduction facility;
141.20 	(ii) the calendar year covered by the report;
141.21 	(iii) the annual quantity of naturally reduced remains;
141.22 	(iv) the results of any laboratory analyses of naturally reduced remains; and
141.23 	(v) any additional information required by the commissioner.
141.24 		Subd. 18.Natural organic reduction procedures; use of more than one naturally 
141.25 	reduced remains container. If the naturally reduced remains are to be separated into two 
141.26 	or more naturally reduced remains containers according to the directives provided in the 
141.27 	written authorization for natural organic reduction, all of the containers shall contain duplicate 
141.28 	identification disks, tabs, or permanent labels and all paperwork regarding the given body 
141.29 	shall include a notation of the number of and disposition of each container, as provided in 
141.30 	the written authorization.
141.31 		Subd. 19.Natural organic reduction procedures; disposition of accumulated 
141.32 	residue. Every natural organic reduction facility shall provide for the removal and disposition 
142.1 	of any accumulated residue from any natural organic reduction vessel, mechanical processor, 
142.2 	or other equipment used in natural organic reduction. Disposition of accumulated residue 
142.3 	shall be by any lawful manner deemed appropriate.
142.4 		Subd. 20.Natural organic reduction procedures; release of naturally reduced 
142.5 	remains. Following completion of the natural organic reduction process, the inurned naturally 
142.6 	reduced remains shall be released according to the instructions given on the written 
142.7 	authorization for natural organic reduction. If the remains are to be shipped, they must be 
142.8 	securely packaged and transported by a method which has an internal tracing system available 
142.9 	and which provides a receipt signed by the person accepting delivery. Where there is a 
142.10 	dispute over release or disposition of the naturally reduced remains, a natural organic 
142.11 	reduction facility may deposit the naturally reduced remains in accordance with the directives 
142.12 	of a court of competent jurisdiction pending resolution of the dispute or retain the naturally 
142.13 	reduced remains until the person with the legal right to control disposition presents 
142.14 	satisfactory indication that the dispute is resolved. A natural organic reduction facility must 
142.15 	not sell naturally reduced remains and must make every effort to not release naturally reduced 
142.16 	remains for sale or for use for commercial purposes.
142.17 		Subd. 21.Unclaimed naturally reduced remains. If, after 30 calendar days following 
142.18 	the inurnment, the naturally reduced remains are not claimed or disposed of according to 
142.19 	the written authorization for natural organic reduction, the natural organic reduction facility 
142.20 	shall give written notice, by certified mail, to the person with the legal right to control the 
142.21 	final disposition or a legal designee, that the naturally reduced remains are unclaimed and 
142.22 	requesting further release directions. Should the naturally reduced remains be unclaimed 
142.23 	120 calendar days following the mailing of the written notification, the natural organic 
142.24 	reduction facility may return the remains to the earth respectfully in any lawful manner 
142.25 	deemed appropriate.
142.26 		Subd. 22.Required records. Every natural organic reduction facility shall create and 
142.27 	maintain on its premises or other business location in Minnesota an accurate record of every 
142.28 	natural organic reduction provided. The record shall include all of the following information 
142.29 	for each natural organic reduction:
142.30 	(1) the name of the person or funeral establishment delivering the body for natural 
142.31 	organic reduction;
142.32 	(2) the name of the deceased and the identification number assigned to the body;
142.33 	(3) the date of acceptance of delivery;
143.1 	(4) the names of the operator of the natural organic reduction process and mechanical 
143.2 	processor operator;
143.3 	(5) the times and dates that the body was placed in and removed from the natural organic 
143.4 	reduction vessel;
143.5 	(6) the time and date that processing and inurnment of the naturally reduced remains 
143.6 	was completed;
143.7 	(7) the time, date, and manner of release of the naturally reduced remains;
143.8 	(8) the name and address of the person who signed the authorization for natural organic 
143.9 	reduction;
143.10 	(9) all supporting documentation, including any transit or disposition permits, a photocopy 
143.11 	of the death record, and the authorization for natural organic reduction; and
143.12 	(10) the type of natural organic reduction vessel.
143.13 		Subd. 23.Retention of records. Records required under subdivision 22 shall be 
143.14 	maintained for a period of three calendar years after the release of the naturally reduced 
143.15 	remains. Following this period and subject to any other laws requiring retention of records, 
143.16 	the natural organic reduction facility may then place the records in storage or reduce them 
143.17 	to microfilm, a digital format, or any other method that can produce an accurate reproduction 
143.18 	of the original record, for retention for a period of ten calendar years from the date of release 
143.19 	of the naturally reduced remains. At the end of this period and subject to any other laws 
143.20 	requiring retention of records, the natural organic reduction facility may destroy the records 
143.21 	by shredding, incineration, or any other manner that protects the privacy of the individuals 
143.22 	identified.

143.23 	Sec. 54. REQUEST FOR INFORMATION; EVALUATION OF STATEWIDE 
143.24 	HEALTH CARE NEEDS AND CAPACITY AND PROJECTIONS OF FUTURE 
143.25 	HEALTH CARE NEEDS.
 143.26 	(a) By November 1, 2024, the commissioner of health must publish a request for 
143.27 	information to assist the commissioner in a future comprehensive evaluation of current 
143.28 	health care needs and capacity in the state and projections of future health care needs in the 
143.29 	state based on population and provider characteristics. The request for information:
143.30 	(1) must provide guidance on defining the scope of the study and assist in answering 
143.31 	methodological questions that will inform the development of a request for proposals to 
143.32 	contract for performance of the study; and
144.1 	(2) may address topics that include but are not limited to how to define health care 
144.2 	capacity, expectations for capacity by geography or service type, how to consider health 
144.3 	centers that have areas of particular expertise or services that generally have a higher margin, 
144.4 	how hospital-based services should be considered as compared with evolving 
144.5 	nonhospital-based services, the role of technology in service delivery, health care workforce 
144.6 	supply issues, and other issues related to data or methods.
144.7 	(b) By February 1, 2025, the commissioner must submit a report to the chairs and ranking 
144.8 	minority members of the legislative committees with jurisdiction over health care, with the 
144.9 	results of the request for information and recommendations regarding conducting a 
144.10 	comprehensive evaluation of current health care needs and capacity in the state and 
144.11 	projections of future health care needs in the state.

144.12 	Sec. 55. REPEALER.
 144.13 	Minnesota Statutes 2023 Supplement, section 144.0528, subdivision 5, is repealed.

144.14 	ARTICLE 6
144.15 	DEPARTMENT OF HEALTH POLICY

144.16 	Section 1. [62J.461] 340B COVERED ENTITY REPORT.
144.17 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
144.18 	apply.
144.19 	(b) "340B covered entity" or "covered entity" means a covered entity as defined in United 
144.20 	States Code, title 42, section 256b(a)(4), with a service address in Minnesota as of January 
144.21 	1 of the reporting year. 340B covered entity includes all entity types and grantees. All 
144.22 	facilities that are identified as child sites or grantee associated sites under the federal 340B 
144.23 	Drug Pricing Program are considered part of the 340B covered entity.
144.24 	(c) "340B Drug Pricing Program" or "340B program" means the drug discount program 
144.25 	established under United States Code, title 42, section 256b.
144.26 	(d) "340B entity type" is the designation of the 340B covered entity according to the 
144.27 	entity types specified in United States Code, title 42, section 256b(a)(4).
144.28 	(e) "340B ID" is the unique identification number provided by the Health Resources 
144.29 	and Services Administration to identify a 340B-eligible entity in the 340B Office of Pharmacy 
144.30 	Affairs Information System.
145.1 	(f) "Contract pharmacy" means a pharmacy with which a 340B covered entity has an 
145.2 	arrangement to dispense drugs purchased under the 340B Drug Pricing Program.
145.3 	(g) "Pricing unit" means the smallest dispensable amount of a prescription drug product 
145.4 	that can be dispensed or administered.
145.5 		Subd. 2.Current registration. Beginning April 1, 2024, each 340B covered entity must 
145.6 	maintain a current registration with the commissioner in a form and manner prescribed by 
145.7 	the commissioner. The registration must include the following information:
145.8 	(1) the name of the 340B covered entity;
145.9 	(2) the 340B ID of the 340B covered entity;
145.10 	(3) the servicing address of the 340B covered entity; and
145.11 	(4) the 340B entity type of the 340B covered entity.
145.12 		Subd. 3.Reporting by covered entities to the commissioner. (a) Each 340B covered 
145.13 	entity shall report to the commissioner by April 1, 2024, and by April 1 of each year 
145.14 	thereafter, the following information for transactions conducted by the 340B covered entity 
145.15 	or on its behalf, and related to its participation in the federal 340B program for the previous 
145.16 	calendar year:
145.17 	(1) the aggregated acquisition cost for prescription drugs obtained under the 340B 
145.18 	program;
145.19 	(2) the aggregated payment amount received for drugs obtained under the 340B program 
145.20 	and dispensed or administered to patients;
145.21 	(3) the number of pricing units dispensed or administered for prescription drugs described 
145.22 	in clause (2); and
145.23 	(4) the aggregated payments made:
145.24 	(i) to contract pharmacies to dispense drugs obtained under the 340B program;
145.25 	(ii) to any other entity that is not the covered entity and is not a contract pharmacy for 
145.26 	managing any aspect of the covered entity's 340B program; and
145.27 	(iii) for all other expenses related to administering the 340B program.
145.28 	The information under clauses (2) and (3) must be reported by payer type, including but 
145.29 	not limited to commercial insurance, medical assistance, MinnesotaCare, and Medicare, in 
145.30 	the form and manner prescribed by the commissioner.
146.1 	(b) For covered entities that are hospitals, the information required under paragraph (a), 
146.2 	clauses (1) to (3), must also be reported at the national drug code level for the 50 most 
146.3 	frequently dispensed or administered drugs by the facility under the 340B program.
146.4 	(c) Data submitted to the commissioner under paragraphs (a) and (b) are classified as 
146.5 	nonpublic data, as defined in section 13.02, subdivision 9.
146.6 		Subd. 4.Enforcement and exceptions. (a) Any health care entity subject to reporting 
146.7 	under this section that fails to provide data in the form and manner prescribed by the 
146.8 	commissioner is subject to a fine paid to the commissioner of up to $500 for each day the 
146.9 	data are past due. Any fine levied against the entity under this subdivision is subject to the 
146.10 	contested case and judicial review provisions of sections 14.57 and 14.69.
146.11 	(b) The commissioner may grant an entity an extension of or exemption from the reporting 
146.12 	obligations under this subdivision, upon a showing of good cause by the entity.
146.13 		Subd. 5.Reports to the legislature. By November 15, 2024, and by November 15 of 
146.14 	each year thereafter, the commissioner shall submit to the chairs and ranking minority 
146.15 	members of the legislative committees with jurisdiction over health care finance and policy, 
146.16 	a report that aggregates the data submitted under subdivision 3, paragraphs (a) and (b). The 
146.17 	following information must be included in the report for all 340B entities whose net 340B 
146.18 	revenue constitutes a significant share, as determined by the commissioner, of all net 340B 
146.19 	revenue across all 340B covered entities in Minnesota:
146.20 	(1) the information submitted under subdivision 2; and
146.21 	(2) for each 340B entity identified in subdivision 2, that entity's 340B net revenue as 
146.22 	calculated using the data submitted under subdivision 3, paragraph (a), with net revenue 
146.23 	being subdivision 3, paragraph (a), clause (2), less the sum of subdivision 3, paragraph (a), 
146.24 	clauses (1) and (4).
146.25 	For all other entities, the data in the report must be aggregated to the entity type or groupings 
146.26 	of entity types in a manner that prevents the identification of an individual entity and any 
146.27 	entity's specific data value reported for an individual data element.

146.28 	Sec. 2. Minnesota Statutes 2022, section 62J.61, subdivision 5, is amended to read:
146.29 		Subd. 5.Biennial review of rulemaking procedures and rules Opportunity for 
146.30 	comment. The commissioner shall biennially seek comments from affected parties maintain 
146.31 	an email address for submission of comments from interested parties to provide input about 
146.32 	the effectiveness of and continued need for the rulemaking procedures set out in subdivision 
146.33 	2 and about the quality and effectiveness of rules adopted using these procedures. The 
147.1 	commissioner shall seek comments by holding a meeting and by publishing a notice in the 
147.2 	State Register that contains the date, time, and location of the meeting and a statement that 
147.3 	invites oral or written comments. The notice must be published at least 30 days before the 
147.4 	meeting date. The commissioner shall write a report summarizing the comments and shall 
147.5 	submit the report to the Minnesota Health Data Institute and to the Minnesota Administrative 
147.6 	Uniformity Committee by January 15 of every even-numbered year may seek additional 
147.7 	input and provide additional opportunities for input as needed.

147.8 	Sec. 3. Minnesota Statutes 2022, section 144.05, subdivision 7, is amended to read:
147.9 		Subd. 7.Expiration of report mandates. (a) If the submission of a report by the 
147.10 	commissioner of health to the legislature is mandated by statute and the enabling legislation 
147.11 	does not include a date for the submission of a final report, the mandate to submit the report 
147.12 	shall expire in accordance with this section.
147.13 	(b) If the mandate requires the submission of an annual report and the mandate was 
147.14 	enacted before January 1, 2021, the mandate shall expire on January 1, 2023. If the mandate 
147.15 	requires the submission of a biennial or less frequent report and the mandate was enacted 
147.16 	before January 1, 2021, the mandate shall expire on January 1, 2024.
147.17 	(c) Any reporting mandate enacted on or after January 1, 2021, shall expire three years 
147.18 	after the date of enactment if the mandate requires the submission of an annual report and 
147.19 	shall expire five years after the date of enactment if the mandate requires the submission 
147.20 	of a biennial or less frequent report, unless the enacting legislation provides for a different 
147.21 	expiration date.
147.22 	(d) The commissioner shall submit a list to the chairs and ranking minority members of 
147.23 	the legislative committees with jurisdiction over health by February 15 of each year, 
147.24 	beginning February 15, 2022, of all reports set to expire during the following calendar year 
147.25 	in accordance with this section. The mandate to submit a report to the legislature under this 
147.26 	paragraph does not expire.

147.27 	EFFECTIVE DATE. This section is effective retroactively from January 1, 2024.

147.28 	Sec. 4. Minnesota Statutes 2023 Supplement, section 144.0526, subdivision 1, is amended 
147.29 	to read:
147.30 		Subdivision 1.Establishment. The commissioner of health shall establish the Minnesota 
147.31 	One Health Antimicrobial Stewardship Collaborative. The commissioner shall appoint hire
147.32 	a director to execute operations, conduct health education, and provide technical assistance.

148.1 	Sec. 5. Minnesota Statutes 2022, section 144.058, is amended to read:
148.2 	144.058 INTERPRETER SERVICES QUALITY INITIATIVE.
148.3 	(a) The commissioner of health shall establish a voluntary statewide roster, and develop 
148.4 	a plan for a registry and certification process for interpreters who provide high quality, 
148.5 	spoken language health care interpreter services. The roster, registry, and certification 
148.6 	process shall be based on the findings and recommendations set forth by the Interpreter 
148.7 	Services Work Group required under Laws 2007, chapter 147, article 12, section 13.
148.8 	(b) By January 1, 2009, the commissioner shall establish a roster of all available 
148.9 	interpreters to address access concerns, particularly in rural areas.
148.10 	(c) By January 15, 2010, the commissioner shall:
148.11 	(1) develop a plan for a registry of spoken language health care interpreters, including:
148.12 	(i) development of standards for registration that set forth educational requirements, 
148.13 	training requirements, demonstration of language proficiency and interpreting skills, 
148.14 	agreement to abide by a code of ethics, and a criminal background check;
148.15 	(ii) recommendations for appropriate alternate requirements in languages for which 
148.16 	testing and training programs do not exist;
148.17 	(iii) recommendations for appropriate fees; and
148.18 	(iv) recommendations for establishing and maintaining the standards for inclusion in 
148.19 	the registry; and
148.20 	(2) develop a plan for implementing a certification process based on national testing and 
148.21 	certification processes for spoken language interpreters 12 months after the establishment 
148.22 	of a national certification process.
148.23 	(d) The commissioner shall consult with the Interpreter Stakeholder Group of the Upper 
148.24 	Midwest Translators and Interpreters Association for advice on the standards required to 
148.25 	plan for the development of a registry and certification process.
148.26 	(e) The commissioner shall charge an annual fee of $50 to include an interpreter in the 
148.27 	roster. Fee revenue shall be deposited in the state government special revenue fund. All fees 
148.28 	are nonrefundable.

148.29 	Sec. 6. Minnesota Statutes 2022, section 144.0724, subdivision 2, is amended to read:
148.30 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
148.31 	given.
149.1 	(a) "Assessment reference date" or "ARD" means the specific end point for look-back 
149.2 	periods in the MDS assessment process. This look-back period is also called the observation 
149.3 	or assessment period.
149.4 	(b) "Case mix index" means the weighting factors assigned to the RUG-IV case mix 
149.5 	reimbursement classifications determined by an assessment.
149.6 	(c) "Index maximization" means classifying a resident who could be assigned to more 
149.7 	than one category, to the category with the highest case mix index.
149.8 	(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment, 
149.9 	and functional status elements, that include common definitions and coding categories 
149.10 	specified by the Centers for Medicare and Medicaid Services and designated by the 
149.11 	Department of Health.
149.12 	(e) "Representative" means a person who is the resident's guardian or conservator, the 
149.13 	person authorized to pay the nursing home expenses of the resident, a representative of the 
149.14 	Office of Ombudsman for Long-Term Care whose assistance has been requested, or any 
149.15 	other individual designated by the resident.
149.16 	(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing 
149.17 	facility's residents according to their clinical and functional status identified in data supplied 
149.18 	by the facility's Minimum Data Set.
149.19 	(g) (f) "Activities of daily living" includes personal hygiene, dressing, bathing, 
149.20 	transferring, bed mobility, locomotion, eating, and toileting.
149.21 	(h) (g) "Nursing facility level of care determination" means the assessment process that 
149.22 	results in a determination of a resident's or prospective resident's need for nursing facility 
149.23 	level of care as established in subdivision 11 for purposes of medical assistance payment 
149.24 	of long-term care services for:
149.25 	(1) nursing facility services under section 256B.434 or chapter 256R;
149.26 	(2) elderly waiver services under chapter 256S;
149.27 	(3) CADI and BI waiver services under section 256B.49; and
149.28 	(4) state payment of alternative care services under section 256B.0913.

149.29 	Sec. 7. Minnesota Statutes 2022, section 144.0724, subdivision 3a, is amended to read:
149.30 		Subd. 3a.Resident reimbursement case mix reimbursement classifications beginning 
149.31 	January 1, 2012. (a) Beginning January 1, 2012, Resident reimbursement case mix
150.1 	reimbursement classifications shall be based on the Minimum Data Set, version 3.0 
150.2 	assessment instrument, or its successor version mandated by the Centers for Medicare and 
150.3 	Medicaid Services that nursing facilities are required to complete for all residents. The 
150.4 	commissioner of health shall establish resident classifications according to the RUG-IV, 
150.5 	48 group, resource utilization groups. Resident classification must be established based on 
150.6 	the individual items on the Minimum Data Set, which must be completed according to the 
150.7 	Long Term Care Facility Resident Assessment Instrument User's Manual Version 3.0 or its 
150.8 	successor issued by the Centers for Medicare and Medicaid Services. Case mix 
150.9 	reimbursement classifications shall also be based on assessments required under subdivision 
150.10 	4. Assessments must be completed according to the Long Term Care Facility Resident 
150.11 	Assessment Instrument User's Manual Version 3.0 or a successor manual issued by the 
150.12 	Centers for Medicare and Medicaid Services. The optional state assessment must be 
150.13 	completed according to the OSA Manual Version 1.0 v.2.
150.14 	(b) Each resident must be classified based on the information from the Minimum Data 
150.15 	Set according to the general categories issued by the Minnesota Department of Health, 
150.16 	utilized for reimbursement purposes.

150.17 	Sec. 8. Minnesota Statutes 2022, section 144.0724, subdivision 4, is amended to read:
150.18 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and electronically 
150.19 	submit to the federal database MDS assessments that conform with the assessment schedule 
150.20 	defined by the Long Term Care Facility Resident Assessment Instrument User's Manual, 
150.21 	version 3.0, or its successor issued by the Centers for Medicare and Medicaid Services. The 
150.22 	commissioner of health may substitute successor manuals or question and answer documents 
150.23 	published by the United States Department of Health and Human Services, Centers for 
150.24 	Medicare and Medicaid Services, to replace or supplement the current version of the manual 
150.25 	or document.
150.26 	(b) The assessments required under the Omnibus Budget Reconciliation Act of 1987 
150.27 	(OBRA) used to determine a case mix reimbursement classification for reimbursement
150.28 	include:
150.29 	(1) a new admission comprehensive assessment, which must have an assessment reference 
150.30 	date (ARD) within 14 calendar days after admission, excluding readmissions;
150.31 	(2) an annual comprehensive assessment, which must have an ARD within 92 days of 
150.32 	a previous quarterly review assessment or a previous comprehensive assessment, which 
150.33 	must occur at least once every 366 days;
151.1 	(3) a significant change in status comprehensive assessment, which must have an ARD 
151.2 	within 14 days after the facility determines, or should have determined, that there has been 
151.3 	a significant change in the resident's physical or mental condition, whether an improvement 
151.4 	or a decline, and regardless of the amount of time since the last comprehensive assessment 
151.5 	or quarterly review assessment;
151.6 	(4) a quarterly review assessment must have an ARD within 92 days of the ARD of the 
151.7 	previous quarterly review assessment or a previous comprehensive assessment;
151.8 	(5) any significant correction to a prior comprehensive assessment, if the assessment 
151.9 	being corrected is the current one being used for RUG reimbursement classification;
151.10 	(6) any significant correction to a prior quarterly review assessment, if the assessment 
151.11 	being corrected is the current one being used for RUG reimbursement classification; and
151.12 	(7) a required significant change in status assessment when:
151.13 	(i) all speech, occupational, and physical therapies have ended. If the most recent OBRA 
151.14 	comprehensive or quarterly assessment completed does not result in a rehabilitation case 
151.15 	mix classification, then the significant change in status assessment is not required. The ARD 
151.16 	of this assessment must be set on day eight after all therapy services have ended; and
151.17 	(ii) isolation for an infectious disease has ended. If isolation was not coded on the most 
151.18 	recent OBRA comprehensive or quarterly assessment completed, then the significant change 
151.19 	in status assessment is not required. The ARD of this assessment must be set on day 15 after 
151.20 	isolation has ended; and
151.21 	(8) (7) any modifications to the most recent assessments under clauses (1) to (7) (6).
151.22 	(c) The optional state assessment must accompany all OBRA assessments. The optional 
151.23 	state assessment is also required to determine reimbursement when:
151.24 	(i) all speech, occupational, and physical therapies have ended. If the most recent optional 
151.25 	state assessment completed does not result in a rehabilitation case mix reimbursement 
151.26 	classification, then the optional state assessment is not required. The ARD of this assessment 
151.27 	must be set on day eight after all therapy services have ended; and
151.28 	(ii) isolation for an infectious disease has ended. If isolation was not coded on the most 
151.29 	recent optional state assessment completed, then the optional state assessment is not required. 
151.30 	The ARD of this assessment must be set on day 15 after isolation has ended.
151.31 	(c) (d) In addition to the assessments listed in paragraph paragraphs (b) and (c), the 
151.32 	assessments used to determine nursing facility level of care include the following:
152.1 	(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by 
152.2 	the Senior LinkAge Line or other organization under contract with the Minnesota Board on 
152.3 	Aging; and
152.4 	(2) a nursing facility level of care determination as provided for under section 256B.0911, 
152.5 	subdivision 26, as part of a face-to-face long-term care consultation assessment completed 
152.6 	under section 256B.0911, by a county, tribe, or managed care organization under contract 
152.7 	with the Department of Human Services.

152.8 	Sec. 9. Minnesota Statutes 2022, section 144.0724, subdivision 6, is amended to read:
152.9 		Subd. 6.Penalties for late or nonsubmission. (a) A facility that fails to complete or 
152.10 	submit an assessment according to subdivisions 4 and 5 for a RUG-IV case mix 
152.11 	reimbursement classification within seven days of the time requirements listed in the 
152.12 	Long-Term Care Facility Resident Assessment Instrument User's Manual when the 
152.13 	assessment is due is subject to a reduced rate for that resident. The reduced rate shall be the 
152.14 	lowest rate for that facility. The reduced rate is effective on the day of admission for new 
152.15 	admission assessments, on the ARD for significant change in status assessments, or on the 
152.16 	day that the assessment was due for all other assessments and continues in effect until the 
152.17 	first day of the month following the date of submission and acceptance of the resident's 
152.18 	assessment.
152.19 	(b) If loss of revenue due to penalties incurred by a facility for any period of 92 days 
152.20 	are equal to or greater than 0.1 percent of the total operating costs on the facility's most 
152.21 	recent annual statistical and cost report, a facility may apply to the commissioner of human 
152.22 	services for a reduction in the total penalty amount. The commissioner of human services, 
152.23 	in consultation with the commissioner of health, may, at the sole discretion of the 
152.24 	commissioner of human services, limit the penalty for residents covered by medical assistance 
152.25 	to ten days.

152.26 	Sec. 10. Minnesota Statutes 2022, section 144.0724, subdivision 7, is amended to read:
152.27 		Subd. 7.Notice of resident reimbursement case mix reimbursement classification. (a) 
152.28 	The commissioner of health shall provide to a nursing facility a notice for each resident of 
152.29 	the classification established under subdivision 1. The notice must inform the resident of 
152.30 	the case mix reimbursement classification assigned, the opportunity to review the 
152.31 	documentation supporting the classification, the opportunity to obtain clarification from the 
152.32 	commissioner, and the opportunity to request a reconsideration of the classification , and 
152.33 	the address and telephone number of the Office of Ombudsman for Long-Term Care. The 
153.1 	commissioner must transmit the notice of resident classification by electronic means to the 
153.2 	nursing facility. The nursing facility is responsible for the distribution of the notice to each 
153.3 	resident or the resident's representative. This notice must be distributed within three business 
153.4 	days after the facility's receipt.
153.5 	(b) If a facility submits a modifying modified assessment resulting in a change in the 
153.6 	case mix reimbursement classification, the facility must provide a written notice to the 
153.7 	resident or the resident's representative regarding the item or items that were modified and 
153.8 	the reason for the modifications. The written notice must be provided within three business 
153.9 	days after distribution of the resident case mix reimbursement classification notice.

153.10 	Sec. 11. Minnesota Statutes 2022, section 144.0724, subdivision 8, is amended to read:
153.11 		Subd. 8.Request for reconsideration of resident classifications. (a) The resident, or
153.12 	the resident's representative, or the nursing facility, or the boarding care home may request 
153.13 	that the commissioner of health reconsider the assigned reimbursement case mix
153.14 	reimbursement classification and any item or items changed during the audit process. The 
153.15 	request for reconsideration must be submitted in writing to the commissioner of health.
153.16 	(b) For reconsideration requests initiated by the resident or the resident's representative:
153.17 	(1) The resident or the resident's representative must submit in writing a reconsideration 
153.18 	request to the facility administrator within 30 days of receipt of the resident classification 
153.19 	notice. The written request must include the reasons for the reconsideration request.
153.20 	(2) Within three business days of receiving the reconsideration request, the nursing 
153.21 	facility must submit to the commissioner of health a completed reconsideration request 
153.22 	form, a copy of the resident's or resident's representative's written request, and all supporting 
153.23 	documentation used to complete the assessment being considered reconsidered. If the facility 
153.24 	fails to provide the required information, the reconsideration will be completed with the 
153.25 	information submitted and the facility cannot make further reconsideration requests on this 
153.26 	classification.
153.27 	(3) Upon written request and within three business days, the nursing facility must give 
153.28 	the resident or the resident's representative a copy of the assessment being reconsidered and 
153.29 	all supporting documentation used to complete the assessment. Notwithstanding any law 
153.30 	to the contrary, the facility may not charge a fee for providing copies of the requested 
153.31 	documentation. If a facility fails to provide the required documents within this time, it is 
153.32 	subject to the issuance of a correction order and penalty assessment under sections 144.653
153.33 	and 144A.10. Notwithstanding those sections, any correction order issued under this 
154.1 	subdivision must require that the nursing facility immediately comply with the request for 
154.2 	information, and as of the date of the issuance of the correction order, the facility shall 
154.3 	forfeit to the state a $100 fine for the first day of noncompliance, and an increase in the 
154.4 	$100 fine by $50 increments for each day the noncompliance continues.
154.5 	(c) For reconsideration requests initiated by the facility:
154.6 	(1) The facility is required to inform the resident or the resident's representative in writing 
154.7 	that a reconsideration of the resident's case mix reimbursement classification is being 
154.8 	requested. The notice must inform the resident or the resident's representative:
154.9 	(i) of the date and reason for the reconsideration request;
154.10 	(ii) of the potential for a case mix reimbursement classification change and subsequent 
154.11 	rate change;
154.12 	(iii) of the extent of the potential rate change;
154.13 	(iv) that copies of the request and supporting documentation are available for review; 
154.14 	and
154.15 	(v) that the resident or the resident's representative has the right to request a 
154.16 	reconsideration also.
154.17 	(2) Within 30 days of receipt of the audit exit report or resident classification notice, the 
154.18 	facility must submit to the commissioner of health a completed reconsideration request 
154.19 	form, all supporting documentation used to complete the assessment being reconsidered, 
154.20 	and a copy of the notice informing the resident or the resident's representative that a 
154.21 	reconsideration of the resident's classification is being requested.
154.22 	(3) If the facility fails to provide the required information, the reconsideration request 
154.23 	may be denied and the facility may not make further reconsideration requests on this 
154.24 	classification.
154.25 	(d) Reconsideration by the commissioner must be made by individuals not involved in 
154.26 	reviewing the assessment, audit, or reconsideration that established the disputed classification. 
154.27 	The reconsideration must be based upon the assessment that determined the classification 
154.28 	and upon the information provided to the commissioner of health under paragraphs (a) to 
154.29 	(c). If necessary for evaluating the reconsideration request, the commissioner may conduct 
154.30 	on-site reviews. Within 15 business days of receiving the request for reconsideration, the 
154.31 	commissioner shall affirm or modify the original resident classification. The original 
154.32 	classification must be modified if the commissioner determines that the assessment resulting 
154.33 	in the classification did not accurately reflect characteristics of the resident at the time of 
155.1 	the assessment. The commissioner must transmit the reconsideration classification notice 
155.2 	by electronic means to the nursing facility. The nursing facility is responsible for the 
155.3 	distribution of the notice to the resident or the resident's representative. The notice must be 
155.4 	distributed by the nursing facility within three business days after receipt. A decision by 
155.5 	the commissioner under this subdivision is the final administrative decision of the agency 
155.6 	for the party requesting reconsideration.
155.7 	(e) The case mix reimbursement classification established by the commissioner shall be 
155.8 	the classification which applies to the resident while the request for reconsideration is 
155.9 	pending. If a request for reconsideration applies to an assessment used to determine nursing 
155.10 	facility level of care under subdivision 4, paragraph (c) (d), the resident shall continue to 
155.11 	be eligible for nursing facility level of care while the request for reconsideration is pending.
155.12 	(f) The commissioner may request additional documentation regarding a reconsideration 
155.13 	necessary to make an accurate reconsideration determination.
155.14 	(g) Data collected as part of the reconsideration process under this section is classified 
155.15 	as private data on individuals and nonpublic data pursuant to section 13.02. Notwithstanding 
155.16 	the classification of these data as private or nonpublic, the commissioner is authorized to 
155.17 	share these data with the U.S. Centers for Medicare and Medicaid Services and the 
155.18 	commissioner of human services as necessary for reimbursement purposes.

155.19 	Sec. 12. Minnesota Statutes 2022, section 144.0724, subdivision 9, is amended to read:
155.20 		Subd. 9.Audit authority. (a) The commissioner shall audit the accuracy of resident 
155.21 	assessments performed under section 256R.17 through any of the following: desk audits; 
155.22 	on-site review of residents and their records; and interviews with staff, residents, or residents' 
155.23 	families. The commissioner shall reclassify a resident if the commissioner determines that 
155.24 	the resident was incorrectly classified.
155.25 	(b) The commissioner is authorized to conduct on-site audits on an unannounced basis.
155.26 	(c) A facility must grant the commissioner access to examine the medical records relating 
155.27 	to the resident assessments selected for audit under this subdivision. The commissioner may 
155.28 	also observe and speak to facility staff and residents.
155.29 	(d) The commissioner shall consider documentation under the time frames for coding 
155.30 	items on the minimum data set as set out in the Long-Term Care Facility Resident Assessment 
155.31 	Instrument User's Manual or OSA Manual version 1.0 v.2 published by the Centers for 
155.32 	Medicare and Medicaid Services.
156.1 	(e) The commissioner shall develop an audit selection procedure that includes the 
156.2 	following factors:
156.3 	(1) Each facility shall be audited annually. If a facility has two successive audits in which 
156.4 	the percentage of change is five percent or less and the facility has not been the subject of 
156.5 	a special audit in the past 36 months, the facility may be audited biannually. A stratified 
156.6 	sample of 15 percent, with a minimum of ten assessments, of the most current assessments 
156.7 	shall be selected for audit. If more than 20 percent of the RUG-IV case mix reimbursement
156.8 	classifications are changed as a result of the audit, the audit shall be expanded to a second 
156.9 	15 percent sample, with a minimum of ten assessments. If the total change between the first 
156.10 	and second samples is 35 percent or greater, the commissioner may expand the audit to all 
156.11 	of the remaining assessments.
156.12 	(2) If a facility qualifies for an expanded audit, the commissioner may audit the facility 
156.13 	again within six months. If a facility has two expanded audits within a 24-month period, 
156.14 	that facility will be audited at least every six months for the next 18 months.
156.15 	(3) The commissioner may conduct special audits if the commissioner determines that 
156.16 	circumstances exist that could alter or affect the validity of case mix reimbursement
156.17 	classifications of residents. These circumstances include, but are not limited to, the following:
156.18 	(i) frequent changes in the administration or management of the facility;
156.19 	(ii) an unusually high percentage of residents in a specific case mix reimbursement
156.20 	classification;
156.21 	(iii) a high frequency in the number of reconsideration requests received from a facility;
156.22 	(iv) frequent adjustments of case mix reimbursement classifications as the result of 
156.23 	reconsiderations or audits;
156.24 	(v) a criminal indictment alleging provider fraud;
156.25 	(vi) other similar factors that relate to a facility's ability to conduct accurate assessments;
156.26 	(vii) an atypical pattern of scoring minimum data set items;
156.27 	(viii) nonsubmission of assessments;
156.28 	(ix) late submission of assessments; or
156.29 	(x) a previous history of audit changes of 35 percent or greater.
156.30 	(f) If the audit results in a case mix reimbursement classification change, the 
156.31 	commissioner must transmit the audit classification notice by electronic means to the nursing 
157.1 	facility within 15 business days of completing an audit. The nursing facility is responsible 
157.2 	for distribution of the notice to each resident or the resident's representative. This notice 
157.3 	must be distributed by the nursing facility within three business days after receipt. The 
157.4 	notice must inform the resident of the case mix reimbursement classification assigned, the 
157.5 	opportunity to review the documentation supporting the classification, the opportunity to 
157.6 	obtain clarification from the commissioner, the opportunity to request a reconsideration of 
157.7 	the classification, and the address and telephone number of the Office of Ombudsman for 
157.8 	Long-Term Care.

157.9 	Sec. 13. Minnesota Statutes 2022, section 144.0724, subdivision 11, is amended to read:
157.10 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance payment 
157.11 	of long-term care services, a recipient must be determined, using assessments defined in 
157.12 	subdivision 4, to meet one of the following nursing facility level of care criteria:
157.13 	(1) the person requires formal clinical monitoring at least once per day;
157.14 	(2) the person needs the assistance of another person or constant supervision to begin 
157.15 	and complete at least four of the following activities of living: bathing, bed mobility, dressing, 
157.16 	eating, grooming, toileting, transferring, and walking;
157.17 	(3) the person needs the assistance of another person or constant supervision to begin 
157.18 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
157.19 	(4) the person has significant difficulty with memory, using information, daily decision 
157.20 	making, or behavioral needs that require intervention;
157.21 	(5) the person has had a qualifying nursing facility stay of at least 90 days;
157.22 	(6) the person meets the nursing facility level of care criteria determined 90 days after 
157.23 	admission or on the first quarterly assessment after admission, whichever is later; or
157.24 	(7) the person is determined to be at risk for nursing facility admission or readmission 
157.25 	through a face-to-face long-term care consultation assessment as specified in section 
157.26 	256B.0911, subdivision 17 to 21, 23, 24, 27, or 28, by a county, tribe, or managed care 
157.27 	organization under contract with the Department of Human Services. The person is 
157.28 	considered at risk under this clause if the person currently lives alone or will live alone or 
157.29 	be homeless without the person's current housing and also meets one of the following criteria:
157.30 	(i) the person has experienced a fall resulting in a fracture;
157.31 	(ii) the person has been determined to be at risk of maltreatment or neglect, including 
157.32 	self-neglect; or
158.1 	(iii) the person has a sensory impairment that substantially impacts functional ability 
158.2 	and maintenance of a community residence.
158.3 	(b) The assessment used to establish medical assistance payment for nursing facility 
158.4 	services must be the most recent assessment performed under subdivision 4, paragraph
158.5 	paragraphs (b) and (c), that occurred no more than 90 calendar days before the effective 
158.6 	date of medical assistance eligibility for payment of long-term care services. In no case 
158.7 	shall medical assistance payment for long-term care services occur prior to the date of the 
158.8 	determination of nursing facility level of care.
158.9 	(c) The assessment used to establish medical assistance payment for long-term care 
158.10 	services provided under chapter 256S and section 256B.49 and alternative care payment 
158.11 	for services provided under section 256B.0913 must be the most recent face-to-face 
158.12 	assessment performed under section 256B.0911, subdivisions 17 to 21, 23, 24, 27, or 28, 
158.13 	that occurred no more than 60 calendar days before the effective date of medical assistance 
158.14 	eligibility for payment of long-term care services.

158.15 	Sec. 14. Minnesota Statutes 2022, section 144.1464, subdivision 1, is amended to read:
158.16 		Subdivision 1.Summer internships. The commissioner of health, through a contract 
158.17 	with a nonprofit organization as required by subdivision 4, shall award grants, within 
158.18 	available appropriations, to hospitals, clinics, nursing facilities, assisted living facilities, 
158.19 	and home care providers to establish a secondary and postsecondary summer health care 
158.20 	intern program. The purpose of the program is to expose interested secondary and 
158.21 	postsecondary pupils to various careers within the health care profession.

158.22 	Sec. 15. Minnesota Statutes 2022, section 144.1464, subdivision 2, is amended to read:
158.23 		Subd. 2.Criteria. (a) The commissioner, through the organization under contract, shall 
158.24 	award grants to hospitals, clinics, nursing facilities, assisted living facilities, and home care 
158.25 	providers that agree to:
158.26 	(1) provide secondary and postsecondary summer health care interns with formal exposure 
158.27 	to the health care profession;
158.28 	(2) provide an orientation for the secondary and postsecondary summer health care 
158.29 	interns;
158.30 	(3) pay one-half the costs of employing the secondary and postsecondary summer health 
158.31 	care intern;
159.1 	(4) interview and hire secondary and postsecondary pupils for a minimum of six weeks 
159.2 	and a maximum of 12 weeks; and
159.3 	(5) employ at least one secondary student for each postsecondary student employed, to 
159.4 	the extent that there are sufficient qualifying secondary student applicants.
159.5 	(b) In order to be eligible to be hired as a secondary summer health intern by a hospital, 
159.6 	clinic, nursing facility, assisted living facility, or home care provider, a pupil must:
159.7 	(1) intend to complete high school graduation requirements and be between the junior 
159.8 	and senior year of high school; and
159.9 	(2) be from a school district in proximity to the facility.
159.10 	(c) In order to be eligible to be hired as a postsecondary summer health care intern by 
159.11 	a hospital or clinic, a pupil must:
159.12 	(1) intend to complete a health care training program or a two-year or four-year degree 
159.13 	program and be planning on enrolling in or be enrolled in that training program or degree 
159.14 	program; and
159.15 	(2) be enrolled in a Minnesota educational institution or be a resident of the state of 
159.16 	Minnesota; priority must be given to applicants from a school district or an educational 
159.17 	institution in proximity to the facility.
159.18 	(d) Hospitals, clinics, nursing facilities, assisted living facilities, and home care providers 
159.19 	awarded grants may employ pupils as secondary and postsecondary summer health care 
159.20 	interns beginning on or after June 15, 1993, if they agree to pay the intern, during the period 
159.21 	before disbursement of state grant money, with money designated as the facility's 50 percent 
159.22 	contribution towards internship costs.

159.23 	Sec. 16. Minnesota Statutes 2022, section 144.1464, subdivision 3, is amended to read:
159.24 		Subd. 3.Grants. The commissioner, through the organization under contract, shall 
159.25 	award separate grants to hospitals, clinics, nursing facilities, assisted living facilities, and 
159.26 	home care providers meeting the requirements of subdivision 2. The grants must be used 
159.27 	to pay one-half of the costs of employing secondary and postsecondary pupils in a hospital, 
159.28 	clinic, nursing facility, assisted living facility, or home care setting during the course of the 
159.29 	program. No more than 50 percent of the participants may be postsecondary students, unless 
159.30 	the program does not receive enough qualified secondary applicants per fiscal year. No 
159.31 	more than five pupils may be selected from any secondary or postsecondary institution to 
160.1 	participate in the program and no more than one-half of the number of pupils selected may 
160.2 	be from the seven-county metropolitan area.

160.3 	Sec. 17. Minnesota Statutes 2022, section 144.1911, subdivision 2, is amended to read:
160.4 		Subd. 2.Definitions. (a) For the purposes of this section, the following terms have the 
160.5 	meanings given.
160.6 	(b) "Commissioner" means the commissioner of health.
160.7 	(c) "Immigrant international medical graduate" means an international medical graduate 
160.8 	who was born outside the United States, now resides permanently in the United States or 
160.9 	who has entered the United States on a temporary status based on urgent humanitarian or 
160.10 	significant public benefit reasons, and who did not enter the United States on a J1 or similar 
160.11 	nonimmigrant visa following acceptance into a United States medical residency or fellowship 
160.12 	program.
160.13 	(d) "International medical graduate" means a physician who received a basic medical 
160.14 	degree or qualification from a medical school located outside the United States and Canada.
160.15 	(e) "Minnesota immigrant international medical graduate" means an immigrant 
160.16 	international medical graduate who has lived in Minnesota for at least two years.
160.17 	(f) "Rural community" means a statutory and home rule charter city or township that is 
160.18 	outside the seven-county metropolitan area as defined in section 473.121, subdivision 2, 
160.19 	excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.
160.20 	(g) "Underserved community" means a Minnesota area or population included in the 
160.21 	list of designated primary medical care health professional shortage areas, medically 
160.22 	underserved areas, or medically underserved populations (MUPs) maintained and updated 
160.23 	by the United States Department of Health and Human Services.

160.24 	Sec. 18. Minnesota Statutes 2022, section 144.292, subdivision 6, is amended to read:
160.25 		Subd. 6.Cost. (a) When a patient requests a copy of the patient's record for purposes of 
160.26 	reviewing current medical care, the provider must not charge a fee.
160.27 	(b) When a provider or its representative makes copies of patient records upon a patient's 
160.28 	request under this section, the provider or its representative may charge the patient or the 
160.29 	patient's representative no more than 75 cents per page, plus $10 for time spent retrieving 
160.30 	and copying the records, unless other law or a rule or contract provide for a lower maximum 
160.31 	charge. This limitation does not apply to x-rays. The provider may charge a patient no more 
161.1 	than the actual cost of reproducing x-rays, plus no more than $10 for the time spent retrieving 
161.2 	and copying the x-rays.
161.3 	(c) The respective maximum charges of 75 cents per page and $10 for time provided in 
161.4 	this subdivision are in effect for calendar year 1992 and may be adjusted annually each 
161.5 	calendar year as provided in this subdivision. The permissible maximum charges shall 
161.6 	change each year by an amount that reflects the change, as compared to the previous year, 
161.7 	in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U), 
161.8 	published by the Department of Labor.
161.9 	(d) A provider or its representative may charge the $10 retrieval fee, but must not charge 
161.10 	a per page fee, a retrieval fee, or any other fee to provide copies of records requested by a 
161.11 	patient or the patient's authorized representative if the request for copies of records is for 
161.12 	purposes of appealing a denial of Social Security disability income or Social Security 
161.13 	disability benefits under title II or title XVI of the Social Security Act; except that no fee 
161.14 	shall be charged to a patient who is receiving public assistance, or to a patient who is 
161.15 	represented by an attorney on behalf of a civil legal services program or a volunteer attorney 
161.16 	program based on indigency. when the patient is:
161.17 	(1) receiving public assistance;
161.18 	(2) represented by an attorney on behalf of a civil legal services program; or
161.19 	(3) represented by a volunteer attorney program based on indigency.
161.20 	The patient or the patient's representative must submit one of the following to show that 
161.21 	they are entitled to receive records without charge under this paragraph: (1) a public 
161.22 	assistance statement from the county or state administering assistance; (2) a request for 
161.23 	records on the letterhead of the civil legal services program or volunteer attorney program 
161.24 	based on indigency; or (3) a benefits statement from the Social Security Administration.
161.25 	For the purpose of further appeals, a patient may receive no more than two medical 
161.26 	record updates without charge, but only for medical record information previously not 
161.27 	provided.
161.28 	For purposes of this paragraph, a patient's authorized representative does not include 
161.29 	units of state government engaged in the adjudication of Social Security disability claims.

161.30 	Sec. 19. [144.2925] CONSTRUCTION.
161.31 	Sections 144.291 to 144.298 shall be construed to protect the privacy of a patient's health 
161.32 	records in a more stringent manner than provided in Code of Federal Regulations, title 45, 
162.1 	part 164. For purposes of this section, "more stringent" has the meaning given to that term 
162.2 	in Code of Federal Regulations, title 45, section 160.202, with respect to a use or disclosure 
162.3 	or the need for express legal permission from an individual to disclose individually 
162.4 	identifiable health information.

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

162.6 	Sec. 20. Minnesota Statutes 2022, section 144.293, subdivision 2, is amended to read:
162.7 		Subd. 2.Patient consent to release of records. A provider, or a person who receives 
162.8 	health records from a provider, may not release a patient's health records to a person without:
162.9 	(1) a signed and dated consent from the patient or the patient's legally authorized 
162.10 	representative authorizing the release;
162.11 	(2) specific authorization in Minnesota law; or
162.12 	(3) a representation from a provider that holds a signed and dated consent from the 
162.13 	patient authorizing the release.

162.14 	EFFECTIVE DATE. This section is effective the day following final enactment and 
162.15 	applies to health records released on or after that date.

162.16 	Sec. 21. Minnesota Statutes 2022, section 144.293, subdivision 4, is amended to read:
162.17 		Subd. 4.Duration of consent. Except as provided in this section, a consent is valid for 
162.18 	one year or for a period specified in the consent or for a different period provided by 
162.19 	Minnesota law.

162.20 	EFFECTIVE DATE. This section is effective the day following final enactment and 
162.21 	applies to health records released on or after that date.

162.22 	Sec. 22. Minnesota Statutes 2022, section 144.293, subdivision 9, is amended to read:
162.23 		Subd. 9.Documentation of release. (a) In cases where a provider releases health records 
162.24 	without patient consent as authorized by Minnesota law, the release must be documented 
162.25 	in the patient's health record. In the case of a release under section 144.294, subdivision 2, 
162.26 	the documentation must include the date and circumstances under which the release was 
162.27 	made, the person or agency to whom the release was made, and the records that were released.
162.28 	(b) When a health record is released using a representation from a provider that holds a 
162.29 	consent from the patient, the releasing provider shall document:
162.30 	(1) the provider requesting the health records;
163.1 	(2) the identity of the patient;
163.2 	(3) the health records requested; and
163.3 	(4) the date the health records were requested.

163.4 	EFFECTIVE DATE. This section is effective the day following final enactment and 
163.5 	applies to health records released on or after that date.

163.6 	Sec. 23. Minnesota Statutes 2022, section 144.293, subdivision 10, is amended to read:
163.7 		Subd. 10.Warranties regarding consents, requests, and disclosures. (a) When 
163.8 	requesting health records using consent, a person warrants that the consent:
163.9 	(1) contains no information known to the person to be false; and
163.10 	(2) accurately states the patient's desire to have health records disclosed or that there is 
163.11 	specific authorization in Minnesota law.
163.12 	(b) When requesting health records using consent, or a representation of holding a 
163.13 	consent, a provider warrants that the request:
163.14 	(1) contains no information known to the provider to be false;
163.15 	(2) accurately states the patient's desire to have health records disclosed or that there is 
163.16 	specific authorization in Minnesota law; and
163.17 	(3) does not exceed any limits imposed by the patient in the consent.
163.18 	(c) When disclosing health records, a person releasing health records warrants that the 
163.19 	person:
163.20 	(1) has complied with the requirements of this section regarding disclosure of health 
163.21 	records;
163.22 	(2) knows of no information related to the request that is false; and
163.23 	(3) has complied with the limits set by the patient in the consent.

163.24 	EFFECTIVE DATE. This section is effective the day following final enactment and 
163.25 	applies to health records released on or after that date.

163.26 	Sec. 24. Minnesota Statutes 2022, section 144.493, is amended by adding a subdivision 
163.27 	to read:
163.28 		Subd. 2a.Thrombectomy-capable stroke center. A hospital meets the criteria for a 
163.29 	thrombectomy-capable stroke center if the hospital has been certified as a 
164.1 	thrombectomy-capable stroke center by the joint commission or another nationally recognized 
164.2 	accreditation entity, or is a primary stroke center that is not certified as a thrombectomy-based 
164.3 	capable stroke center but the hospital has attained a level of stroke care distinction by offering 
164.4 	mechanical endovascular therapies and has been certified by a department approved certifying 
164.5 	body that is a nationally recognized guidelines-based organization.

164.6 	Sec. 25. Minnesota Statutes 2022, section 144.494, subdivision 2, is amended to read:
164.7 		Subd. 2.Designation. A hospital that voluntarily meets the criteria for a comprehensive 
164.8 	stroke center, thrombectomy-capable stroke center, primary stroke center, or acute stroke 
164.9 	ready hospital may apply to the commissioner for designation, and upon the commissioner's 
164.10 	review and approval of the application, shall be designated as a comprehensive stroke center, 
164.11 	a thrombectomy-capable stroke center, a primary stroke center, or an acute stroke ready 
164.12 	hospital for a three-year period. If a hospital loses its certification as a comprehensive stroke 
164.13 	center or primary stroke center from the joint commission or other nationally recognized 
164.14 	accreditation entity, or no longer participates in the Minnesota stroke registry program, its 
164.15 	Minnesota designation shall be immediately withdrawn. Prior to the expiration of the 
164.16 	three-year designation period, a hospital seeking to remain part of the voluntary acute stroke 
164.17 	system may reapply to the commissioner for designation.

164.18 	Sec. 26. Minnesota Statutes 2022, section 144.551, subdivision 1, is amended to read:
164.19 		Subdivision 1.Restricted construction or modification. (a) The following construction 
164.20 	or modification may not be commenced:
164.21 	(1) any erection, building, alteration, reconstruction, modernization, improvement, 
164.22 	extension, lease, or other acquisition by or on behalf of a hospital that increases the bed 
164.23 	capacity of a hospital, relocates hospital beds from one physical facility, complex, or site 
164.24 	to another, or otherwise results in an increase or redistribution of hospital beds within the 
164.25 	state; and
164.26 	(2) the establishment of a new hospital.
164.27 	(b) This section does not apply to:
164.28 	(1) construction or relocation within a county by a hospital, clinic, or other health care 
164.29 	facility that is a national referral center engaged in substantial programs of patient care, 
164.30 	medical research, and medical education meeting state and national needs that receives more 
164.31 	than 40 percent of its patients from outside the state of Minnesota;
165.1 	(2) a project for construction or modification for which a health care facility held an 
165.2 	approved certificate of need on May 1, 1984, regardless of the date of expiration of the 
165.3 	certificate;
165.4 	(3) a project for which a certificate of need was denied before July 1, 1990, if a timely 
165.5 	appeal results in an order reversing the denial;
165.6 	(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, 
165.7 	section 2;
165.8 	(5) a project involving consolidation of pediatric specialty hospital services within the 
165.9 	Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number 
165.10 	of pediatric specialty hospital beds among the hospitals being consolidated;
165.11 	(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to 
165.12 	an existing licensed hospital that will allow for the reconstruction of a new philanthropic, 
165.13 	pediatric-orthopedic hospital on an existing site and that will not result in a net increase in 
165.14 	the number of hospital beds. Upon completion of the reconstruction, the licenses of both 
165.15 	hospitals must be reinstated at the capacity that existed on each site before the relocation;
165.16 	(7) the relocation or redistribution of hospital beds within a hospital building or 
165.17 	identifiable complex of buildings provided the relocation or redistribution does not result 
165.18 	in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from 
165.19 	one physical site or complex to another; or (iii) redistribution of hospital beds within the 
165.20 	state or a region of the state;
165.21 	(8) relocation or redistribution of hospital beds within a hospital corporate system that 
165.22 	involves the transfer of beds from a closed facility site or complex to an existing site or 
165.23 	complex provided that: (i) no more than 50 percent of the capacity of the closed facility is 
165.24 	transferred; (ii) the capacity of the site or complex to which the beds are transferred does 
165.25 	not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal 
165.26 	health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution 
165.27 	does not involve the construction of a new hospital building; and (v) the transferred beds 
165.28 	are used first to replace within the hospital corporate system the total number of beds 
165.29 	previously used in the closed facility site or complex for mental health services and substance 
165.30 	use disorder services. Only after the hospital corporate system has fulfilled the requirements 
165.31 	of this item may the remainder of the available capacity of the closed facility site or complex 
165.32 	be transferred for any other purpose;
166.1 	(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice 
166.2 	County that primarily serves adolescents and that receives more than 70 percent of its 
166.3 	patients from outside the state of Minnesota;
166.4 	(10) a project to replace a hospital or hospitals with a combined licensed capacity of 
166.5 	130 beds or less if: (i) the new hospital site is located within five miles of the current site; 
166.6 	and (ii) the total licensed capacity of the replacement hospital, either at the time of 
166.7 	construction of the initial building or as the result of future expansion, will not exceed 70 
166.8 	licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
166.9 	(11) the relocation of licensed hospital beds from an existing state facility operated by 
166.10 	the commissioner of human services to a new or existing facility, building, or complex 
166.11 	operated by the commissioner of human services; from one regional treatment center site 
166.12 	to another; or from one building or site to a new or existing building or site on the same 
166.13 	campus;
166.14 	(12) the construction or relocation of hospital beds operated by a hospital having a 
166.15 	statutory obligation to provide hospital and medical services for the indigent that does not 
166.16 	result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 
166.17 	beds, of which 12 serve mental health needs, may be transferred from Hennepin County 
166.18 	Medical Center to Regions Hospital under this clause;
166.19 	(13) a construction project involving the addition of up to 31 new beds in an existing 
166.20 	nonfederal hospital in Beltrami County;
166.21 	(14) a construction project involving the addition of up to eight new beds in an existing 
166.22 	nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
166.23 	(15) a construction project involving the addition of 20 new hospital beds in an existing 
166.24 	hospital in Carver County serving the southwest suburban metropolitan area;
166.25 	(16) a project for the construction or relocation of up to 20 hospital beds for the operation 
166.26 	of up to two psychiatric facilities or units for children provided that the operation of the 
166.27 	facilities or units have received the approval of the commissioner of human services;
166.28 	(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation 
166.29 	services in an existing hospital in Itasca County;
166.30 	(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County 
166.31 	that closed 20 rehabilitation beds in 2002, provided that the beds are used only for 
166.32 	rehabilitation in the hospital's current rehabilitation building. If the beds are used for another 
166.33 	purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
167.1 	(19) a critical access hospital established under section 144.1483, clause (9), and section 
167.2 	1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that 
167.3 	delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, 
167.4 	to the extent that the critical access hospital does not seek to exceed the maximum number 
167.5 	of beds permitted such hospital under federal law;
167.6 	(20) notwithstanding section 144.552, a project for the construction of a new hospital 
167.7 	in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
167.8 	(i) the project, including each hospital or health system that will own or control the entity 
167.9 	that will hold the new hospital license, is approved by a resolution of the Maple Grove City 
167.10 	Council as of March 1, 2006;
167.11 	(ii) the entity that will hold the new hospital license will be owned or controlled by one 
167.12 	or more not-for-profit hospitals or health systems that have previously submitted a plan or 
167.13 	plans for a project in Maple Grove as required under section 144.552, and the plan or plans 
167.14 	have been found to be in the public interest by the commissioner of health as of April 1, 
167.15 	2005;
167.16 	(iii) the new hospital's initial inpatient services must include, but are not limited to, 
167.17 	medical and surgical services, obstetrical and gynecological services, intensive care services, 
167.18 	orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health 
167.19 	services, and emergency room services;
167.20 	(iv) the new hospital:
167.21 	(A) will have the ability to provide and staff sufficient new beds to meet the growing 
167.22 	needs of the Maple Grove service area and the surrounding communities currently being 
167.23 	served by the hospital or health system that will own or control the entity that will hold the 
167.24 	new hospital license;
167.25 	(B) will provide uncompensated care;
167.26 	(C) will provide mental health services, including inpatient beds;
167.27 	(D) will be a site for workforce development for a broad spectrum of health-care-related 
167.28 	occupations and have a commitment to providing clinical training programs for physicians 
167.29 	and other health care providers;
167.30 	(E) will demonstrate a commitment to quality care and patient safety;
167.31 	(F) will have an electronic medical records system, including physician order entry;
167.32 	(G) will provide a broad range of senior services;
168.1 	(H) will provide emergency medical services that will coordinate care with regional 
168.2 	providers of trauma services and licensed emergency ambulance services in order to enhance 
168.3 	the continuity of care for emergency medical patients; and
168.4 	(I) will be completed by December 31, 2009, unless delayed by circumstances beyond 
168.5 	the control of the entity holding the new hospital license; and
168.6 	(v) as of 30 days following submission of a written plan, the commissioner of health 
168.7 	has not determined that the hospitals or health systems that will own or control the entity 
168.8 	that will hold the new hospital license are unable to meet the criteria of this clause;
168.9 	(21) a project approved under section 144.553;
168.10 	(22) a project for the construction of a hospital with up to 25 beds in Cass County within 
168.11 	a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder 
168.12 	is approved by the Cass County Board;
168.13 	(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity 
168.14 	from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing 
168.15 	a separately licensed 13-bed skilled nursing facility;
168.16 	(24) notwithstanding section 144.552, a project for the construction and expansion of a 
168.17 	specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients 
168.18 	who are under 21 years of age on the date of admission. The commissioner conducted a 
168.19 	public interest review of the mental health needs of Minnesota and the Twin Cities 
168.20 	metropolitan area in 2008. No further public interest review shall be conducted for the 
168.21 	construction or expansion project under this clause;
168.22 	(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the 
168.23 	commissioner finds the project is in the public interest after the public interest review 
168.24 	conducted under section 144.552 is complete;
168.25 	(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city 
168.26 	of Maple Grove, exclusively for patients who are under 21 years of age on the date of 
168.27 	admission, if the commissioner finds the project is in the public interest after the public 
168.28 	interest review conducted under section 144.552 is complete;
168.29 	(ii) this project shall serve patients in the continuing care benefit program under section 
168.30 	256.9693. The project may also serve patients not in the continuing care benefit program; 
168.31 	and
168.32 	(iii) if the project ceases to participate in the continuing care benefit program, the 
168.33 	commissioner must complete a subsequent public interest review under section 144.552. If 
169.1 	the project is found not to be in the public interest, the license must be terminated six months 
169.2 	from the date of that finding. If the commissioner of human services terminates the contract 
169.3 	without cause or reduces per diem payment rates for patients under the continuing care 
169.4 	benefit program below the rates in effect for services provided on December 31, 2015, the 
169.5 	project may cease to participate in the continuing care benefit program and continue to 
169.6 	operate without a subsequent public interest review;
169.7 	(27) a project involving the addition of 21 new beds in an existing psychiatric hospital 
169.8 	in Hennepin County that is exclusively for patients who are under 21 years of age on the 
169.9 	date of admission;
169.10 	(28) a project to add 55 licensed beds in an existing safety net, level I trauma center 
169.11 	hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which 
169.12 	15 beds are to be used for inpatient mental health and 40 are to be used for other services. 
169.13 	In addition, five unlicensed observation mental health beds shall be added;
169.14 	(29) upon submission of a plan to the commissioner for public interest review under 
169.15 	section 144.552 and the addition of the 15 inpatient mental health beds specified in clause 
169.16 	(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I 
169.17 	trauma center hospital in Ramsey County as designated under section 383A.91, subdivision 
169.18 	5. Five of the 45 additional beds authorized under this clause must be designated for use 
169.19 	for inpatient mental health and must be added to the hospital's bed capacity before the 
169.20 	remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed 
169.21 	beds under this clause prior to completion of the public interest review, provided the hospital 
169.22 	submits its plan by the 2021 deadline and adheres to the timelines for the public interest 
169.23 	review described in section 144.552;
169.24 	(30) upon submission of a plan to the commissioner for public interest review under 
169.25 	section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital 
169.26 	in Hennepin County that exclusively provides care to patients who are under 21 years of 
169.27 	age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital 
169.28 	may add licensed beds under this clause prior to completion of the public interest review, 
169.29 	provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for 
169.30 	the public interest review described in section 144.552;
169.31 	(31) any project to add licensed beds in a hospital located in Cook County or Mahnomen 
169.32 	County that: (i) is designated as a critical access hospital under section 144.1483, clause 
169.33 	(9), and United States Code, title 42, section 1395i-4; (ii) has a licensed bed capacity of 
169.34 	fewer than 25 beds; and (iii) has an attached nursing home, so long as the total number of 
170.1 	licensed beds in the hospital after the bed addition does not exceed 25 beds. Notwithstanding 
170.2 	section 144.552, a public interest review is not required for a project authorized under this 
170.3 	clause;
170.4 	(32) upon submission of a plan to the commissioner for public interest review under 
170.5 	section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's 
170.6 	hospital in St. Paul that is part of an independent pediatric health system with freestanding 
170.7 	inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric 
170.8 	inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add 
170.9 	licensed beds under this clause prior to completion of the public interest review, provided 
170.10 	the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public 
170.11 	interest review described in section 144.552; or
170.12 	(33) a project for a 144-bed psychiatric hospital on the site of the former Bethesda 
170.13 	hospital in the city of Saint Paul, Ramsey County, if the commissioner finds the project is 
170.14 	in the public interest after the public interest review conducted under section 144.552 is 
170.15 	complete. Following the completion of the construction project, the commissioner of health 
170.16 	shall monitor the hospital, including by assessing the hospital's case mix and payer mix, 
170.17 	patient transfers, and patient diversions. The hospital must have an intake and assessment 
170.18 	area. The hospital must accommodate patients with acute mental health needs, whether they 
170.19 	walk up to the facility, are delivered by ambulances or law enforcement, or are transferred 
170.20 	from other facilities. The hospital must comply with subdivision 1a, paragraph (b). The 
170.21 	hospital must annually submit de-identified data to the department in the format and manner 
170.22 	defined by the commissioner.; or
170.23 	(34) a project involving the relocation of up to 26 licensed long-term acute care hospital 
170.24 	beds from an existing long-term care hospital located in Hennepin County with a licensed 
170.25 	capacity prior to the relocation of 92 beds to dedicated space on the campus of an existing 
170.26 	safety net, level I trauma center hospital in Ramsey County as designated under section 
170.27 	383A.91, subdivision 5, provided both the commissioner finds the project is in the public 
170.28 	interest after the public interest review conducted under section 144.552 is complete and 
170.29 	the relocated beds continue to be used as long-term acute care hospital beds after the 
170.30 	relocation.

171.1 	Sec. 27. Minnesota Statutes 2022, section 144.605, is amended by adding a subdivision 
171.2 	to read:
171.3 		Subd. 10.Chapter 16C waiver. Pursuant to subdivisions 4, paragraph (b), and 5, 
171.4 	paragraph (b), the commissioner of administration may waive provisions of chapter 16C 
171.5 	for the purposes of approving contracts for independent clinical teams.

171.6 	Sec. 28. Minnesota Statutes 2023 Supplement, section 144.651, subdivision 10a, is amended 
171.7 	to read:
171.8 		Subd. 10a.Designated support person for pregnant patient or other patient. (a) 
171.9 	Subject to paragraph (c), a health care provider and a health care facility must allow, at a 
171.10 	minimum, one designated support person of a pregnant patient's choosing chosen by a 
171.11 	patient, including but not limited to a pregnant patient, to be physically present while the 
171.12 	patient is receiving health care services including during a hospital stay.
171.13 	(b) For purposes of this subdivision, "designated support person" means any person 
171.14 	chosen by the patient to provide comfort to the patient including but not limited to the 
171.15 	patient's spouse, partner, family member, or another person related by affinity. Certified 
171.16 	doulas and traditional midwives may not be counted toward the limit of one designated 
171.17 	support person.
171.18 	(c) A facility may restrict or prohibit the presence of a designated support person in 
171.19 	treatment rooms, procedure rooms, and operating rooms when such a restriction or prohibition 
171.20 	is strictly necessary to meet the appropriate standard of care. A facility may also restrict or 
171.21 	prohibit the presence of a designated support person if the designated support person is 
171.22 	acting in a violent or threatening manner toward others. Any restriction or prohibition of a 
171.23 	designated support person by the facility is subject to the facility's written internal grievance 
171.24 	procedure required by subdivision 20.

171.25 	Sec. 29. [144.6985] COMMUNITY HEALTH NEEDS ASSESSMENT; COMMUNITY 
171.26 	HEALTH IMPROVEMENT SERVICES; IMPLEMENTATION.
171.27 		Subdivision 1.Community health needs assessment. A nonprofit hospital that is exempt 
171.28 	from taxation under section 501(c)(3) of the Internal Revenue Code must make available 
171.29 	to the public and submit to the commissioner of health, by January 15, 2026, the most recent 
171.30 	community health needs assessment submitted by the hospital to the Internal Revenue 
171.31 	Service. Each time the hospital conducts a subsequent community health needs assessment, 
171.32 	the hospital must, within 15 business days after submitting the subsequent community health 
172.1 	needs assessment to the Internal Revenue Service, make the subsequent assessment available 
172.2 	to the public and submit the subsequent assessment to the commissioner.
172.3 		Subd. 2.Description of community. A nonprofit hospital subject to subdivision 1 must 
172.4 	make available to the public and submit to the commissioner of health a description of the 
172.5 	community served by the hospital. The description must include a geographic description 
172.6 	of the area where the hospital is located, a description of the general population served by 
172.7 	the hospital, and demographic information about the community served by the hospital, 
172.8 	such as leading causes of death, levels of chronic illness, and descriptions of the medically 
172.9 	underserved, low-income, minority, or chronically ill populations in the community. A 
172.10 	hospital is not required to separately make the information available to the public or 
172.11 	separately submit the information to the commissioner if the information is included in the 
172.12 	hospital's community health needs assessment made available and submitted under 
172.13 	subdivision 1.
172.14 		Subd. 3.Addendum; community health improvement services. (a) A nonprofit hospital 
172.15 	subject to subdivision 1 must annually submit to the commissioner an addendum which 
172.16 	details information about hospital activities identified as community health improvement 
172.17 	services with a cost of $5,000 or more. The addendum must include the type of activity, the 
172.18 	method through which the activity was delivered, how the activity relates to an identified 
172.19 	community need in the community health needs assessment, the target population for the 
172.20 	activity, strategies to reach the target population, identified outcome metrics, the cost to the 
172.21 	hospital to provide the activity, the methodology used to calculate the hospital's costs, and 
172.22 	the number of people served by the activity. If a community health improvement service is 
172.23 	administered by an entity other than the hospital, the administering entity must be identified 
172.24 	in the addendum. This paragraph does not apply to hospitals required to submit an addendum 
172.25 	under paragraph (b).
172.26 	(b) A nonprofit hospital subject to subdivision 1 must annually submit to the 
172.27 	commissioner an addendum which details information about the ten highest-cost activities 
172.28 	of the hospital identified as community health improvement services if the nonprofit hospital:
172.29 	(1) is designated as a critical access hospital under section 144.1483, clause (9), and 
172.30 	United States Code, title 42, section 1395i-4;
172.31 	(2) meets the definition of sole community hospital in section 62Q.19, subdivision 1, 
172.32 	paragraph (a), clause (5); or
172.33 	(3) meets the definition of rural emergency hospital in United States Code, title 42, 
172.34 	section 1395x(kkk)(2).
173.1 	The addendum must include the type of activity, the method in which the activity was 
173.2 	delivered, how the activity relates to an identified community need in the community health 
173.3 	needs assessment, the target population for the activity, strategies to reach the target 
173.4 	population, identified outcome metrics, the cost to the hospital to provide the activity, the 
173.5 	methodology used to calculate the hospital's costs, and the number of people served by the 
173.6 	activity. If a community health improvement service is administered by an entity other than 
173.7 	the hospital, the administering entity must be identified in the addendum.
173.8 		Subd. 4.Community benefit implementation strategy. A nonprofit hospital subject 
173.9 	to subdivision 1 must make available to the public, within one year after completing each 
173.10 	community health needs assessment, a community benefit implementation strategy. In 
173.11 	developing the community benefit implementation strategy, the hospital must consult with 
173.12 	community-based organizations, stakeholders, local public health organizations, and others 
173.13 	as determined by the hospital. The implementation strategy must include how the hospital 
173.14 	shall address the top three community health priorities identified in the community health 
173.15 	needs assessment. Implementation strategies must be evidence-based, when available, and 
173.16 	development and implementation of innovative programs and strategies may be supported 
173.17 	by evaluation measures.
173.18 		Subd. 5.Information made available to the public. A nonprofit hospital required to 
173.19 	make information available to the public under this section may do so by posting the 
173.20 	information on the hospital's website in a consolidated location and with clear labeling.

173.21 	EFFECTIVE DATE. This section is effective January 1, 2026.

173.22 	Sec. 30. Minnesota Statutes 2022, section 144.7067, subdivision 2, is amended to read:
173.23 		Subd. 2.Duty to analyze reports; communicate findings. (a) The commissioner shall:
173.24 	(1) analyze adverse event reports, corrective action plans, and findings of the root cause 
173.25 	analyses to determine patterns of systemic failure in the health care system and successful 
173.26 	methods to correct these failures;
173.27 	(2) communicate to individual facilities the commissioner's conclusions, if any, regarding 
173.28 	an adverse event reported by the facility;
173.29 	(3) communicate with relevant health care facilities any recommendations for corrective 
173.30 	action resulting from the commissioner's analysis of submissions from facilities; and
173.31 	(4) publish an annual report:
173.32 	(i) describing, by institution, adverse events reported;
174.1 	(ii) outlining, in aggregate, corrective action plans and the findings of root cause analyses; 
174.2 	and
174.3 	(iii) making recommendations for modifications of state health care operations.
174.4 	(b) Notwithstanding section 144.05, subdivision 7, the mandate to publish an annual 
174.5 	report under this subdivision does not expire.

174.6 	EFFECTIVE DATE. This section is effective retroactively from January 1, 2023.

174.7 	Sec. 31. Minnesota Statutes 2022, section 144A.10, subdivision 15, is amended to read:
174.8 		Subd. 15.Informal dispute resolution. The commissioner shall respond in writing to 
174.9 	a request from a nursing facility certified under the federal Medicare and Medicaid programs 
174.10 	for an informal dispute resolution within 30 days of the exit date of the facility's survey ten 
174.11 	calendar days of the facility's receipt of the notice of deficiencies. The commissioner's 
174.12 	response shall identify the commissioner's decision regarding the continuation of each 
174.13 	deficiency citation challenged by the nursing facility, as well as a statement of any changes 
174.14 	in findings, level of severity or scope, and proposed remedies or sanctions for each deficiency 
174.15 	citation.

174.16 	EFFECTIVE DATE. This section is effective August 1, 2024.

174.17 	Sec. 32. Minnesota Statutes 2022, section 144A.10, subdivision 16, is amended to read:
174.18 		Subd. 16.Independent informal dispute resolution. (a) Notwithstanding subdivision 
174.19 	15, a facility certified under the federal Medicare or Medicaid programs that has been 
174.20 	assessed a civil money penalty as provided by Code of Federal Regulations, title 42, section 
174.21 	488.430, may request from the commissioner, in writing, an independent informal dispute 
174.22 	resolution process regarding any deficiency citation issued to the facility. The facility must 
174.23 	specify in its written request each deficiency citation that it disputes. The commissioner 
174.24 	shall provide a hearing under sections 14.57 to 14.62. Upon the written request of the facility, 
174.25 	the parties must submit the issues raised to arbitration by an administrative law judge submit 
174.26 	its request in writing within ten calendar days of receiving notice that a civil money penalty 
174.27 	will be imposed.
174.28 	(b) The facility and commissioner have the right to be represented by an attorney at the 
174.29 	hearing.
174.30 	(c) An independent informal dispute resolution may not be requested for any deficiency 
174.31 	that is the subject of an active informal dispute resolution requested under subdivision 15. 
175.1 	The facility must withdraw its informal dispute resolution prior to requesting independent 
175.2 	informal dispute resolution.
175.3 	(b) Upon (d) Within five calendar days of receipt of a written request for an arbitration 
175.4 	proceeding independent informal dispute resolution, the commissioner shall file with the 
175.5 	Office of Administrative Hearings a request for the appointment of an arbitrator
175.6 	administrative law judge from the Office of Administrative Hearings and simultaneously 
175.7 	serve the facility with notice of the request. The arbitrator for the dispute shall be an 
175.8 	administrative law judge appointed by the Office of Administrative Hearings. The disclosure 
175.9 	provisions of section 572B.12 and the notice provisions of section 572B.15, subsection (c), 
175.10 	apply. The facility and the commissioner have the right to be represented by an attorney.
175.11 	(e) An independent informal dispute resolution proceeding shall be scheduled to occur 
175.12 	within 30 calendar days of the commissioner's request to the Office of Administrative 
175.13 	Hearings, unless the parties agree otherwise or the chief administrative law judge deems 
175.14 	the timing to be unreasonable. The independent informal dispute resolution process must 
175.15 	be completed within 60 calendar days of the facility's request.
175.16 	(c) (f) Five working days in advance of the scheduled proceeding, the commissioner 
175.17 	and the facility may present must submit written statements and arguments, documentary 
175.18 	evidence, depositions, and oral statements and arguments at the arbitration proceeding. Oral 
175.19 	statements and arguments may be made by telephone any other materials supporting their 
175.20 	position to the administrative law judge.
175.21 	(g) The independent informal dispute resolution proceeding shall be informal and 
175.22 	conducted in a manner so as to allow the parties to fully present their positions and respond 
175.23 	to the opposing party's positions. This may include presentation of oral statements and 
175.24 	arguments at the proceeding.
175.25 	(d) (h) Within ten working days of the close of the arbitration proceeding, the 
175.26 	administrative law judge shall issue findings and recommendations regarding each of the 
175.27 	deficiencies in dispute. The findings shall be one or more of the following:
175.28 	(1) Supported in full. The citation is supported in full, with no deletion of findings and 
175.29 	no change in the scope or severity assigned to the deficiency citation.
175.30 	(2) Supported in substance. The citation is supported, but one or more findings are 
175.31 	deleted without any change in the scope or severity assigned to the deficiency.
175.32 	(3) Deficient practice cited under wrong requirement of participation. The citation is 
175.33 	amended by moving it to the correct requirement of participation.
176.1 	(4) Scope not supported. The citation is amended through a change in the scope assigned 
176.2 	to the citation.
176.3 	(5) Severity not supported. The citation is amended through a change in the severity 
176.4 	assigned to the citation.
176.5 	(6) No deficient practice. The citation is deleted because the findings did not support 
176.6 	the citation or the negative resident outcome was unavoidable. The findings of the arbitrator 
176.7 	are not binding on the commissioner.
176.8 	(i) The findings and recommendations of the administrative law judge are not binding 
176.9 	on the commissioner.
176.10 	(j) Within ten calendar days of receiving the administrative law judge's findings and 
176.11 	recommendations, the commissioner shall issue a recommendation to the Center for Medicare 
176.12 	and Medicaid Services.
176.13 	(e) (k) The commissioner shall reimburse the Office of Administrative Hearings for the 
176.14 	costs incurred by that office for the arbitration proceeding. The facility shall reimburse the 
176.15 	commissioner for the proportion of the costs that represent the sum of deficiency citations 
176.16 	supported in full under paragraph (d), clause (1), or in substance under paragraph (d), clause 
176.17 	(2), divided by the total number of deficiencies disputed. A deficiency citation for which 
176.18 	the administrative law judge's sole finding is that the deficient practice was cited under the 
176.19 	wrong requirements of participation shall not be counted in the numerator or denominator 
176.20 	in the calculation of the proportion of costs.

176.21 	EFFECTIVE DATE. This section is effective October 1, 2024, or upon federal approval, 
176.22 	whichever is later, and applies to appeals of deficiencies which are issued after October 1, 
176.23 	2024, or on or after the date upon which federal approval is obtained, whichever is later. 
176.24 	The commissioner of health shall notify the revisor of statutes when federal approval is 
176.25 	obtained.

176.26 	Sec. 33. Minnesota Statutes 2022, section 144A.471, is amended by adding a subdivision 
176.27 	to read:
176.28 		Subd. 1a.Licensure under other law. A home care licensee must not provide sleeping 
176.29 	accommodations as a provision of home care services. For purposes of this subdivision, the 
176.30 	provision of sleeping accommodations and assisted living services under section 144G.08, 
176.31 	subdivision 9, requires assisted living facility licensure under chapter 144G. This subdivision 
176.32 	does not apply to those settings exempt from assisted living facility licensure under section 
176.33 	144G.08, subdivision 7.

177.1 	Sec. 34. Minnesota Statutes 2022, section 144A.474, subdivision 13, is amended to read:
177.2 		Subd. 13.Home care surveyor training. (a) Before conducting a home care survey, 
177.3 	each home care surveyor must receive training on the following topics:
177.4 	(1) Minnesota home care licensure requirements;
177.5 	(2) Minnesota home care bill of rights;
177.6 	(3) Minnesota Vulnerable Adults Act and reporting of maltreatment of minors;
177.7 	(4) principles of documentation;
177.8 	(5) survey protocol and processes;
177.9 	(6) Offices of the Ombudsman roles;
177.10 	(7) Office of Health Facility Complaints;
177.11 	(8) Minnesota landlord-tenant and housing with services laws;
177.12 	(9) types of payors for home care services; and
177.13 	(10) Minnesota Nurse Practice Act for nurse surveyors.
177.14 	(b) Materials used for the training in paragraph (a) shall be posted on the department 
177.15 	website. Requisite understanding of these topics will be reviewed as part of the quality 
177.16 	improvement plan in section 144A.483.

177.17 	Sec. 35. Minnesota Statutes 2023 Supplement, section 144A.4791, subdivision 10, is 
177.18 	amended to read:
177.19 		Subd. 10.Termination of service plan. (a) If a home care provider terminates a service 
177.20 	plan with a client, and the client continues to need home care services, the home care provider 
177.21 	shall provide the client and the client's representative, if any, with a written notice of 
177.22 	termination which includes the following information:
177.23 	(1) the effective date of termination;
177.24 	(2) the reason for termination;
177.25 	(3) for clients age 18 or older, a statement that the client may contact the Office of 
177.26 	Ombudsman for Long-Term Care to request an advocate to assist regarding the termination 
177.27 	and contact information for the office, including the office's central telephone number;
177.28 	(4) a list of known licensed home care providers in the client's immediate geographic 
177.29 	area;
178.1 	(5) a statement that the home care provider will participate in a coordinated transfer of 
178.2 	care of the client to another home care provider, health care provider, or caregiver, as 
178.3 	required by the home care bill of rights, section 144A.44, subdivision 1, clause (17); and
178.4 	(6) the name and contact information of a person employed by the home care provider 
178.5 	with whom the client may discuss the notice of termination; and.
178.6 	(7) if applicable, a statement that the notice of termination of home care services does 
178.7 	not constitute notice of termination of any housing contract.
178.8 	(b) When the home care provider voluntarily discontinues services to all clients, the 
178.9 	home care provider must notify the commissioner, lead agencies, and ombudsman for 
178.10 	long-term care about its clients and comply with the requirements in this subdivision.

178.11 	Sec. 36. Minnesota Statutes 2022, section 144E.16, subdivision 7, is amended to read:
178.12 		Subd. 7.Stroke transport protocols. Regional emergency medical services programs 
178.13 	and any ambulance service licensed under this chapter must develop stroke transport 
178.14 	protocols. The protocols must include standards of care for triage and transport of acute 
178.15 	stroke patients within a specific time frame from symptom onset until transport to the most 
178.16 	appropriate designated acute stroke ready hospital, primary stroke center, 
178.17 	thrombectomy-capable stroke center, or comprehensive stroke center.

178.18 	Sec. 37. Minnesota Statutes 2022, section 144G.08, subdivision 29, is amended to read:
178.19 		Subd. 29.Licensed health professional. "Licensed health professional" means a person 
178.20 	licensed in Minnesota to practice a profession described in section 214.01, subdivision 2, 
178.21 	other than a registered nurse or licensed practical nurse, who provides assisted living services 
178.22 	within the scope of practice of that person's health occupation license, registration, or 
178.23 	certification as a regulated person who is licensed by an appropriate Minnesota state board 
178.24 	or agency.

178.25 	Sec. 38. Minnesota Statutes 2022, section 144G.10, is amended by adding a subdivision 
178.26 	to read:
178.27 		Subd. 5.Protected title; restriction on use. (a) Effective January 1, 2026, no person 
178.28 	or entity may use the phrase "assisted living," whether alone or in combination with other 
178.29 	words and whether orally or in writing, to: advertise; market; or otherwise describe, offer, 
178.30 	or promote itself, or any housing, service, service package, or program that it provides 
178.31 	within this state, unless the person or entity is a licensed assisted living facility that meets 
178.32 	the requirements of this chapter. A person or entity entitled to use the phrase "assisted living" 
179.1 	shall use the phrase only in the context of its participation that meets the requirements of 
179.2 	this chapter.
179.3 	(b) Effective January 1, 2026, the licensee's name for a new assisted living facility may 
179.4 	not include the terms "home care" or "nursing home."

179.5 	Sec. 39. Minnesota Statutes 2022, section 144G.16, subdivision 6, is amended to read:
179.6 		Subd. 6.Requirements for notice and transfer. A provisional licensee whose license 
179.7 	is denied must comply with the requirements for notification and the coordinated move of 
179.8 	residents in sections 144G.52 and 144G.55. If the license denial is upheld by the 
179.9 	reconsideration process, the licensee must submit a closure plan as required by section 
179.10 	144G.57 within ten calendar days of receipt of the reconsideration decision.

179.11 	Sec. 40. Minnesota Statutes 2022, section 146B.03, subdivision 7a, is amended to read:
179.12 		Subd. 7a.Supervisors. (a) A technician must have been licensed in Minnesota or in a 
179.13 	jurisdiction with which Minnesota has reciprocity for at least:
179.14 	(1) two years as a tattoo technician licensed under section 146B.03, subdivision 4, 6, or 
179.15 	8, in order to supervise a temporary tattoo technician; or
179.16 	(2) one year as a body piercing technician licensed under section 146B.03, subdivision 
179.17 	4, 6, or 8, or must have performed at least 500 body piercings, in order to supervise a 
179.18 	temporary body piercing technician.
179.19 	(b) Any technician who agrees to supervise more than two temporary tattoo technicians 
179.20 	during the same time period, or more than four body piercing technicians during the same 
179.21 	time period, must provide to the commissioner a supervisory plan that describes how the 
179.22 	technician will provide supervision to each temporary technician in accordance with section 
179.23 	146B.01, subdivision 28.
179.24 	(c) The supervisory plan must include, at a minimum:
179.25 	(1) the areas of practice under supervision;
179.26 	(2) the anticipated supervision hours per week;
179.27 	(3) the anticipated duration of the training period; and
179.28 	(4) the method of providing supervision if there are multiple technicians being supervised 
179.29 	during the same time period.
180.1 	(d) If the supervisory plan is terminated before completion of the technician's supervised 
180.2 	practice, the supervisor must notify the commissioner in writing within 14 days of the change 
180.3 	in supervision and include an explanation of why the plan was not completed.
180.4 	(e) The commissioner may refuse to approve as a supervisor a technician who has been 
180.5 	disciplined in Minnesota or in another jurisdiction after considering the criteria in section 
180.6 	146B.02, subdivision 10, paragraph (b).

180.7 	Sec. 41. Minnesota Statutes 2022, section 146B.10, subdivision 1, is amended to read:
180.8 		Subdivision 1. Licensing fees. (a) The fee for the initial technician licensure application
180.9 	and biennial licensure renewal application is $420.
180.10 	(b) The fee for temporary technician licensure application is $240.
180.11 	(c) The fee for the temporary guest artist license application is $140.
180.12 	(d) The fee for a dual body art technician license application is $420.
180.13 	(e) The fee for a provisional establishment license application required in section 146B.02, 
180.14 	subdivision 5, paragraph (c), is $1,500.
180.15 	(f) The fee for an initial establishment license application and the two-year license 
180.16 	renewal period application required in section 146B.02, subdivision 2, paragraph (b), is 
180.17 	$1,500.
180.18 	(g) The fee for a temporary body art establishment event permit application is $200.
180.19 	(h) The commissioner shall prorate the initial two-year technician license fee based on 
180.20 	the number of months in the initial licensure period. The commissioner shall prorate the 
180.21 	first renewal fee for the establishment license based on the number of months from issuance 
180.22 	of the provisional license to the first renewal.
180.23 	(i) The fee for verification of licensure to other states is $25.
180.24 	(j) The fee to reissue a provisional establishment license that relocates prior to inspection 
180.25 	and removal of provisional status is $350. The expiration date of the provisional license 
180.26 	does not change.
180.27 	(k) (j) The fee to change an establishment name or establishment type, such as tattoo, 
180.28 	piercing, or dual, is $50.

181.1 	Sec. 42. Minnesota Statutes 2022, section 146B.10, subdivision 3, is amended to read:
181.2 		Subd. 3.Deposit. Fees collected by the commissioner under this section must be deposited 
181.3 	in the state government special revenue fund. All fees are nonrefundable.

181.4 	Sec. 43. Minnesota Statutes 2022, section 149A.65, is amended to read:
181.5 	149A.65 FEES.
181.6 		Subdivision 1.Generally. This section establishes the application fees for registrations, 
181.7 	examinations, initial and renewal licenses, and late fees authorized under the provisions of 
181.8 	this chapter.
181.9 		Subd. 2.Mortuary science fees. Fees for mortuary science are:
181.10 	(1) $75 for the initial and renewal registration of a mortuary science intern;
181.11 	(2) $125 for the mortuary science examination;
181.12 	(3) $200 for issuance of initial and renewal mortuary science licenses license applications;
181.13 	(4) $100 late fee charge for a license renewal application; and
181.14 	(5) $250 for issuing a an application for mortuary science license by endorsement.
181.15 		Subd. 3.Funeral directors. The license renewal application fee for funeral directors is 
181.16 	$200. The late fee charge for a license renewal is $100.
181.17 		Subd. 4.Funeral establishments. The initial and renewal application fee for funeral 
181.18 	establishments is $425. The late fee charge for a license renewal is $100.
181.19 		Subd. 5.Crematories. The initial and renewal application fee for a crematory is $425. 
181.20 	The late fee charge for a license renewal is $100.
181.21 		Subd. 6.Alkaline hydrolysis facilities. The initial and renewal application fee for an 
181.22 	alkaline hydrolysis facility is $425. The late fee charge for a license renewal is $100.
181.23 		Subd. 7.State government special revenue fund. Fees collected by the commissioner 
181.24 	under this section must be deposited in the state treasury and credited to the state government 
181.25 	special revenue fund. All fees are nonrefundable.

181.26 	Sec. 44. Minnesota Statutes 2022, section 256R.02, subdivision 20, is amended to read:
181.27 		Subd. 20.Facility average case mix index. "Facility average case mix index" or "CMI" 
181.28 	means a numerical score that describes the relative resource use for all residents within the 
181.29 	case mix classifications under the resource utilization group (RUG) classification system 
182.1 	prescribed by the commissioner based on an assessment of each resident. The facility average 
182.2 	CMI shall be computed as the standardized days divided by the sum of the facility's resident 
182.3 	days. The case mix indices used shall be based on the system prescribed in section 256R.17.

182.4 	Sec. 45. REVISOR INSTRUCTION.
 182.5 	The revisor of statutes shall substitute the term "employee" with the term "staff" in the 
182.6 	following sections of Minnesota Statutes and make any grammatical changes needed without 
182.7 	changing the meaning of the sentence: Minnesota Statutes, sections 144G.08, subdivisions 
182.8 	18 and 36; 144G.13, subdivision 1, paragraph (c); 144G.20, subdivisions 1, 2, and 21; 
182.9 	144G.30, subdivision 5; 144G.42, subdivision 8; 144G.45, subdivision 2; 144G.60, 
182.10 	subdivisions 1, paragraph (c), and 3, paragraph (a); 144G.63, subdivision 2, paragraph (a), 
182.11 	clause (9); 144G.64, paragraphs (a), clauses (2), (3), and (5), and (c); 144G.70, subdivision 
182.12 	7; and 144G.92, subdivisions 1 and 3.

182.13 	Sec. 46. REPEALER.
 182.14 	(a) Minnesota Statutes 2022, sections 144.497; and 256R.02, subdivision 46, are repealed.
182.15 	(b) Minnesota Statutes 2023 Supplement, section 62J.312, subdivision 6, is repealed.

182.16 	ARTICLE 7
182.17 	EMERGENCY MEDICAL SERVICES

182.18 	Section 1. Minnesota Statutes 2023 Supplement, section 15A.0815, subdivision 2, is 
182.19 	amended to read:
182.20 		Subd. 2.Agency head salaries. The salary for a position listed in this subdivision shall 
182.21 	be determined by the Compensation Council under section 15A.082. The commissioner of 
182.22 	management and budget must publish the salaries on the department's website. This 
182.23 	subdivision applies to the following positions:
182.24 	Commissioner of administration;
182.25 	Commissioner of agriculture;
182.26 	Commissioner of education;
182.27 	Commissioner of children, youth, and families;
182.28 	Commissioner of commerce;
182.29 	Commissioner of corrections;
183.1 	Commissioner of health;
183.2 	Commissioner, Minnesota Office of Higher Education;
183.3 	Commissioner, Minnesota IT Services;
183.4 	Commissioner, Housing Finance Agency;
183.5 	Commissioner of human rights;
183.6 	Commissioner of human services;
183.7 	Commissioner of labor and industry;
183.8 	Commissioner of management and budget;
183.9 	Commissioner of natural resources;
183.10 	Commissioner, Pollution Control Agency;
183.11 	Commissioner of public safety;
183.12 	Commissioner of revenue;
183.13 	Commissioner of employment and economic development;
183.14 	Commissioner of transportation;
183.15 	Commissioner of veterans affairs;
183.16 	Executive director of the Gambling Control Board;
183.17 	Executive director of the Minnesota State Lottery;
183.18 	Commissioner of Iron Range resources and rehabilitation;
183.19 	Commissioner, Bureau of Mediation Services;
183.20 	Ombudsman for mental health and developmental disabilities;
183.21 	Ombudsperson for corrections;
183.22 	Chair, Metropolitan Council;
183.23 	Chair, Metropolitan Airports Commission;
183.24 	School trust lands director;
183.25 	Executive director of pari-mutuel racing; and
183.26 	Commissioner, Public Utilities Commission.; and
183.27 	Director of the Office of Emergency Medical Services.

184.1 	EFFECTIVE DATE. This section is effective January 1, 2025.

184.2 	Sec. 2. Minnesota Statutes 2023 Supplement, section 43A.08, subdivision 1a, is amended 
184.3 	to read:
184.4 		Subd. 1a.Additional unclassified positions. Appointing authorities for the following 
184.5 	agencies may designate additional unclassified positions according to this subdivision: the 
184.6 	Departments of Administration; Agriculture; Children, Youth, and Families; Commerce; 
184.7 	Corrections; Direct Care and Treatment; Education; Employment and Economic 
184.8 	Development; Explore Minnesota Tourism; Management and Budget; Health; Human 
184.9 	Rights; Human Services; Labor and Industry; Natural Resources; Public Safety; Revenue; 
184.10 	Transportation; and Veterans Affairs; the Housing Finance and Pollution Control Agencies; 
184.11 	the State Lottery; the State Board of Investment; the Office of Administrative Hearings; the 
184.12 	Department of Information Technology Services; the Offices of the Attorney General, 
184.13 	Secretary of State, and State Auditor; the Minnesota State Colleges and Universities; the 
184.14 	Minnesota Office of Higher Education; the Perpich Center for Arts Education; and the 
184.15 	Minnesota Zoological Board; and the Office of Emergency Medical Services.
184.16 	A position designated by an appointing authority according to this subdivision must 
184.17 	meet the following standards and criteria:
184.18 	(1) the designation of the position would not be contrary to other law relating specifically 
184.19 	to that agency;
184.20 	(2) the person occupying the position would report directly to the agency head or deputy 
184.21 	agency head and would be designated as part of the agency head's management team;
184.22 	(3) the duties of the position would involve significant discretion and substantial 
184.23 	involvement in the development, interpretation, and implementation of agency policy;
184.24 	(4) the duties of the position would not require primarily personnel, accounting, or other 
184.25 	technical expertise where continuity in the position would be important;
184.26 	(5) there would be a need for the person occupying the position to be accountable to, 
184.27 	loyal to, and compatible with, the governor and the agency head, the employing statutory 
184.28 	board or commission, or the employing constitutional officer;
184.29 	(6) the position would be at the level of division or bureau director or assistant to the 
184.30 	agency head; and
184.31 	(7) the commissioner has approved the designation as being consistent with the standards 
184.32 	and criteria in this subdivision.

185.1 	EFFECTIVE DATE. This section is effective January 1, 2025.

185.2 	Sec. 3. Minnesota Statutes 2022, section 62J.49, subdivision 1, is amended to read:
185.3 		Subdivision 1.Establishment. The director of the Office of Emergency Medical Services 
185.4 	Regulatory Board established under chapter 144 144E shall establish a financial data 
185.5 	collection system for all ambulance services licensed in this state. To establish the financial 
185.6 	database, the Emergency Medical Services Regulatory Board director may contract with 
185.7 	an entity that has experience in ambulance service financial data collection.

185.8 	EFFECTIVE DATE. This section is effective January 1, 2025.

185.9 	Sec. 4. Minnesota Statutes 2022, section 144E.001, subdivision 3a, is amended to read:
185.10 		Subd. 3a.Ambulance service personnel. "Ambulance service personnel" means 
185.11 	individuals who are authorized by a licensed ambulance service to provide emergency care 
185.12 	for the ambulance service and are:
185.13 	(1) EMTs, AEMTs, or paramedics;
185.14 	(2) Minnesota registered nurses who are: (i) EMTs, are currently practicing nursing, and 
185.15 	have passed a paramedic practical skills test, as approved by the board and administered by 
185.16 	an educational program approved by the board been approved by the ambulance service 
185.17 	medical director; (ii) on the roster of an ambulance service on or before January 1, 2000; 
185.18 	or (iii) after petitioning the board, deemed by the board to have training and skills equivalent 
185.19 	to an EMT, as determined on a case-by-case basis; or (iv) certified as a certified flight 
185.20 	registered nurse or certified emergency nurse; or
185.21 	(3) Minnesota licensed physician assistants who are: (i) EMTs, are currently practicing 
185.22 	as physician assistants, and have passed a paramedic practical skills test, as approved by 
185.23 	the board and administered by an educational program approved by the board been approved 
185.24 	by the ambulance service medical director; (ii) on the roster of an ambulance service on or 
185.25 	before January 1, 2000; or (iii) after petitioning the board, deemed by the board to have 
185.26 	training and skills equivalent to an EMT, as determined on a case-by-case basis.

185.27 	Sec. 5. Minnesota Statutes 2022, section 144E.001, is amended by adding a subdivision 
185.28 	to read:
185.29 		Subd. 16.Director. "Director" means the director of the Office of Emergency Medical 
185.30 	Services.

185.31 	EFFECTIVE DATE. This section is effective January 1, 2025.

186.1 	Sec. 6. Minnesota Statutes 2022, section 144E.001, is amended by adding a subdivision 
186.2 	to read:
186.3 		Subd. 17.Office. "Office" means the Office of Emergency Medical Services.

186.4 	EFFECTIVE DATE. This section is effective January 1, 2025.

186.5 	Sec. 7. [144E.011] OFFICE OF EMERGENCY MEDICAL SERVICES.
186.6 		Subdivision 1.Establishment. The Office of Emergency Medical Services is established 
186.7 	with the powers and duties established in law. In administering this chapter, the office must 
186.8 	promote the public health and welfare, protect the safety of the public, and effectively 
186.9 	regulate and support the operation of the emergency medical services system in this state.
186.10 		Subd. 2.Director. The governor must appoint a director for the office with the advice 
186.11 	and consent of the senate. The director must be in the unclassified service and must serve 
186.12 	at the pleasure of the governor. The salary of the director shall be determined according to 
186.13 	section 15A.0815. The director shall direct the activities of the office.
186.14 		Subd. 3.Powers and duties. The director has the following powers and duties:
186.15 	(1) administer and enforce this chapter and adopt rules as needed to implement this 
186.16 	chapter. Rules for which notice is published in the State Register before July 1, 2026, may 
186.17 	be adopted using the expedited rulemaking process in section 14.389;
186.18 	(2) license ambulance services in the state and regulate their operation;
186.19 	(3) establish and modify primary service areas;
186.20 	(4) designate an ambulance service as authorized to provide service in a primary service 
186.21 	area and remove an ambulance service's authorization to provide service in a primary service 
186.22 	area;
186.23 	(5) register medical response units in the state and regulate their operation;
186.24 	(6) certify emergency medical technicians, advanced emergency medical technicians, 
186.25 	community emergency medical technicians, paramedics, and community paramedics and 
186.26 	to register emergency medical responders;
186.27 	(7) approve education programs for ambulance service personnel and emergency medical 
186.28 	responders and administer qualifications for instructors of education programs;
186.29 	(8) administer grant programs related to emergency medical services;
186.30 	(9) report to the legislature by February 15 each year on the work of the office and the 
186.31 	advisory councils in the previous calendar year and with recommendations for any needed 
187.1 	policy changes related to emergency medical services, including but not limited to improving 
187.2 	access to emergency medical services, improving service delivery by ambulance services 
187.3 	and medical response units, and improving the effectiveness of the state's emergency medical 
187.4 	services system. The director must develop the reports and recommendations in consultation 
187.5 	with the office's deputy directors and advisory councils;
187.6 	(10) investigate complaints against and hold hearings regarding ambulance services, 
187.7 	ambulance service personnel, and emergency medical responders and to impose disciplinary 
187.8 	action or otherwise resolve complaints; and
187.9 	(11) perform other duties related to the provision of emergency medical services in the 
187.10 	state.
187.11 		Subd. 4.Employees. The director may employ personnel in the classified service and 
187.12 	unclassified personnel as necessary to carry out the duties of this chapter.
187.13 		Subd. 5.Work plan. The director must prepare a work plan to guide the work of the 
187.14 	office. The work plan must be updated biennially.

187.15 	EFFECTIVE DATE. This section is effective January 1, 2025.

187.16 	Sec. 8. [144E.015] MEDICAL SERVICES DIVISION.
187.17 	A Medical Services Division is created in the Office of Emergency Medical Services. 
187.18 	The Medical Services Division shall be under the supervision of a deputy director of medical 
187.19 	services appointed by the director. The deputy director of medical services must be a 
187.20 	physician licensed under chapter 147. The deputy director, under the direction of the director, 
187.21 	shall enforce and coordinate the laws, rules, and policies assigned by the director, which 
187.22 	may include overseeing the clinical aspects of prehospital medical care and education 
187.23 	programs for emergency medical service personnel.

187.24 	EFFECTIVE DATE. This section is effective January 1, 2025.

187.25 	Sec. 9. [144E.016] AMBULANCE SERVICES DIVISION.
187.26 	An Ambulance Services Division is created in the Office of Emergency Medical Services. 
187.27 	The Ambulance Services Division shall be under the supervision of a deputy director of 
187.28 	ambulance services appointed by the director. The deputy director, under the direction of 
187.29 	the director, shall enforce and coordinate the laws, rules, and policies assigned by the director, 
187.30 	which may include operating standards and licensing of ambulance services, registration 
187.31 	and operation of medical response units, establishment and modification of primary service 
187.32 	areas, authorization of ambulance services to provide service in a primary service area and 
188.1 	revocation of such authorization, coordination of ambulance services within regions and 
188.2 	across the state, and administration of grants.

188.3 	EFFECTIVE DATE. This section is effective January 1, 2025.

188.4 	Sec. 10. [144E.017] EMERGENCY MEDICAL SERVICE PROVIDERS DIVISION.
188.5 	An Emergency Medical Service Providers Division is created in the Office of Emergency 
188.6 	Medical Services. The Emergency Medical Service Providers Division shall be under the 
188.7 	supervision of a deputy director of emergency medical service providers appointed by the 
188.8 	director. The deputy director, under the direction of the director, shall enforce and coordinate 
188.9 	the laws, rules, and policies assigned by the director, which may include certification and 
188.10 	registration of individual emergency medical service providers; overseeing worker safety, 
188.11 	worker well-being, and working conditions; implementation of education programs; and 
188.12 	administration of grants.

188.13 	EFFECTIVE DATE. This section is effective January 1, 2025.

188.14 	Sec. 11. [144E.03] EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL.
188.15 		Subdivision 1.Establishment; membership. The Emergency Medical Services Advisory 
188.16 	Council is established and consists of the following members:
188.17 	(1) one emergency medical technician currently practicing with a licensed ambulance 
188.18 	service, appointed by the Minnesota Ambulance Association;
188.19 	(2) one paramedic currently practicing with a licensed ambulance service or a medical 
188.20 	response unit, appointed jointly by the Minnesota Professional Fire Fighters Association 
188.21 	and the Minnesota Ambulance Association;
188.22 	(3) one medical director of a licensed ambulance service, appointed by the National 
188.23 	Association of EMS Physicians, Minnesota Chapter;
188.24 	(4) one firefighter currently serving as an emergency medical responder, appointed by 
188.25 	the Minnesota State Fire Chiefs Association;
188.26 	(5) one registered nurse who is certified or currently practicing as a flight nurse, appointed 
188.27 	jointly by the regional emergency services boards of the designated regional emergency 
188.28 	medical services systems;
188.29 	(6) one hospital administrator, appointed by the Minnesota Hospital Association;
188.30 	(7) one social worker, appointed by the Board of Social Work;
189.1 	(8) one member of a federally recognized Tribal Nation in Minnesota, appointed by the 
189.2 	Minnesota Indian Affairs Council;
189.3 	(9) three public members, appointed by the governor. At least one of the public members 
189.4 	must reside outside the metropolitan counties listed in section 473.121, subdivision 4;
189.5 	(10) one member with experience working as an employee organization representative 
189.6 	representing emergency medical service providers, appointed by an employee organization 
189.7 	representing emergency medical service providers;
189.8 	(11) one member representing a local government, appointed by the Coalition of Greater 
189.9 	Minnesota Cities;
189.10 	(12) one member representing a local government in the seven-county metropolitan area, 
189.11 	appointed by the League of Minnesota Cities;
189.12 	(13) two members of the house of representatives and two members of the senate, 
189.13 	appointed according to subdivision 2; and
189.14 	(14) the commissioner of health and commissioner of public safety or their designees 
189.15 	as ex officio members.
189.16 		Subd. 2.Legislative members. The speaker of the house and the house minority leader 
189.17 	must each appoint one member of the house of representatives to serve on the advisory 
189.18 	council. The senate majority leader and the senate minority leader must each appoint one 
189.19 	member of the senate to serve on the advisory council. Legislative members appointed under 
189.20 	this subdivision serve until successors are appointed. Legislative members may receive per 
189.21 	diem compensation and reimbursement for expenses according to the rules of their respective 
189.22 	bodies.
189.23 		Subd. 3.Terms, compensation, removal, vacancies, and expiration. Compensation 
189.24 	and reimbursement for expenses for members appointed under subdivision 1, clauses (1) 
189.25 	to (12); removal of members; filling of vacancies of members; and, except for initial 
189.26 	appointments, membership terms are governed by section 15.059. Notwithstanding section 
189.27 	15.059, subdivision 6, the advisory council does not expire.
189.28 		Subd. 4.Officers; meetings. (a) The advisory council must elect a chair and vice-chair 
189.29 	from among its membership and may elect other officers as the advisory council deems 
189.30 	necessary.
189.31 	(b) The advisory council must meet quarterly or at the call of the chair.
189.32 	(c) Meetings of the advisory council are subject to chapter 13D.
190.1 		Subd. 5.Duties. The advisory council must review and make recommendations to the 
190.2 	director and the deputy director of ambulance services on the administration of this chapter, 
190.3 	the regulation of ambulance services and medical response units, the operation of the 
190.4 	emergency medical services system in the state, and other topics as directed by the director.

190.5 	EFFECTIVE DATE. This section is effective January 1, 2025.

190.6 	Sec. 12. [144E.035] EMERGENCY MEDICAL SERVICES PHYSICIAN ADVISORY 
190.7 	COUNCIL.
190.8 		Subdivision 1.Establishment; membership. The Emergency Medical Services Physician 
190.9 	Advisory Council is established and consists of the following members:
190.10 	(1) eight physicians who meet the qualifications for medical directors in section 144E.265, 
190.11 	subdivision 1, with one physician appointed by each of the regional emergency services 
190.12 	boards of the designated regional emergency medical services systems;
190.13 	(2) one physician who meets the qualifications for medical directors in section 144E.265, 
190.14 	subdivision 1, appointed by the Minnesota State Fire Chiefs Association;
190.15 	(3) one physician who is board-certified in pediatrics, appointed by the Minnesota 
190.16 	Emergency Medical Services for Children program; and
190.17 	(4) the medical director member of the Emergency Medical Services Advisory Council 
190.18 	appointed under section 144E.03, subdivision 1, clause (3).
190.19 		Subd. 2.Terms, compensation, removal, vacancies, and expiration. Compensation 
190.20 	and reimbursement for expenses, removal of members, filling of vacancies of members, 
190.21 	and, except for initial appointments, membership terms are governed by section 15.059. 
190.22 	Notwithstanding section 15.059, subdivision 6, the advisory council does not expire.
190.23 		Subd. 3.Officers; meetings. (a) The advisory council must elect a chair and vice-chair 
190.24 	from among its membership and may elect other officers as it deems necessary.
190.25 	(b) The advisory council must meet twice per year or upon the call of the chair.
190.26 	(c) Meetings of the advisory council are subject to chapter 13D.
190.27 		Subd. 4.Duties. The advisory council must:
190.28 	(1) review and make recommendations to the director and deputy director of medical 
190.29 	services on clinical aspects of prehospital medical care. In doing so, the advisory council 
190.30 	must incorporate information from medical literature, advances in bedside clinical practice, 
190.31 	and advisory council member experience; and
191.1 	(2) serve as subject matter experts for the director and deputy director of medical services 
191.2 	on evolving topics in clinical medicine, including but not limited to infectious disease, 
191.3 	pharmaceutical and equipment shortages, and implementation of new therapeutics.

191.4 	EFFECTIVE DATE. This section is effective January 1, 2025.

191.5 	Sec. 13. [144E.04] LABOR AND EMERGENCY MEDICAL SERVICE PROVIDERS 
191.6 	ADVISORY COUNCIL.
191.7 		Subdivision 1.Establishment; membership. The Labor and Emergency Medical Service 
191.8 	Providers Advisory Council is established and consists of the following members:
191.9 	(1) one emergency medical service provider of any type from each of the designated 
191.10 	regional emergency medical services systems, appointed by their respective regional 
191.11 	emergency services boards;
191.12 	(2) one emergency medical technician instructor, appointed by an employee organization 
191.13 	representing emergency medical service providers;
191.14 	(3) two members with experience working as an employee organization representative 
191.15 	representing emergency medical service providers, appointed by an employee organization 
191.16 	representing emergency medical service providers;
191.17 	(4) one emergency medical service provider based in a fire department, appointed jointly 
191.18 	by the Minnesota State Fire Chiefs Association and the Minnesota Professional Fire Fighters 
191.19 	Association; and
191.20 	(5) one emergency medical service provider not based in a fire department, appointed 
191.21 	by the League of Minnesota Cities.
191.22 		Subd. 2.Terms, compensation, removal, vacancies, and expiration. Compensation 
191.23 	and reimbursement for expenses for members appointed under subdivision 1; removal of 
191.24 	members; filling of vacancies of members; and, except for initial appointments, membership 
191.25 	terms are governed by section 15.059. Notwithstanding section 15.059, subdivision 6, the 
191.26 	advisory council does not expire.
191.27 		Subd. 3.Officers; meetings. (a) The advisory council must elect a chair and vice-chair 
191.28 	from among its membership and may elect other officers as the advisory council deems 
191.29 	necessary.
191.30 	(b) The advisory council must meet quarterly or at the call of the chair.
191.31 	(c) Meetings of the advisory council are subject to chapter 13D.
192.1 		Subd. 4.Duties. The advisory council must review and make recommendations to the 
192.2 	director and deputy director of emergency medical service providers on the laws, rules, and 
192.3 	policies assigned to the Emergency Medical Service Providers Division and other topics as 
192.4 	directed by the director.

192.5 	EFFECTIVE DATE. This section is effective January 1, 2025.

192.6 	Sec. 14. Minnesota Statutes 2023 Supplement, section 144E.101, subdivision 6, is amended 
192.7 	to read:
192.8 		Subd. 6.Basic life support. (a) Except as provided in paragraph (f) subdivision 6a, a 
192.9 	basic life-support ambulance shall be staffed by at least two EMTs, one of whom must 
192.10 	accompany the patient and provide a level of care so as to ensure that:
192.11 	(1) one individual who is:
192.12 	(i) certified as an EMT;
192.13 	(ii) a Minnesota registered nurse who meets the qualification requirements in section 
192.14 	144E.001, subdivision 3a, clause (2); or
192.15 	(iii) a Minnesota licensed physician assistant who meets the qualification requirements 
192.16 	in section 144E.001, subdivision 3a, clause (3); and
192.17 	(2) one individual to drive the ambulance who:
192.18 	(i) either meets one of the qualification requirements in clause (1) or is a registered 
192.19 	emergency medical responder driver; and
192.20 	(ii) satisfies the requirements in subdivision 10.
192.21 	(b) An individual who meets one of the qualification requirements in paragraph (a), 
192.22 	clause (1), must accompany the patient and provide a level of care so as to ensure that:
192.23 	(1) life-threatening situations and potentially serious injuries are recognized;
192.24 	(2) patients are protected from additional hazards;
192.25 	(3) basic treatment to reduce the seriousness of emergency situations is administered; 
192.26 	and
192.27 	(4) patients are transported to an appropriate medical facility for treatment.
192.28 	(b) (c) A basic life-support service shall provide basic airway management.
192.29 	(c) (d) A basic life-support service shall provide automatic defibrillation.
193.1 	(d) (e) A basic life-support service shall administer opiate antagonists consistent with 
193.2 	protocols established by the service's medical director.
193.3 	(e) (f) A basic life-support service licensee's medical director may authorize ambulance 
193.4 	service personnel to perform intravenous infusion and use equipment that is within the 
193.5 	licensure level of the ambulance service. Ambulance service personnel must be properly 
193.6 	trained. Documentation of authorization for use, guidelines for use, continuing education, 
193.7 	and skill verification must be maintained in the licensee's files.
193.8 	(f) For emergency ambulance calls and interfacility transfers, an ambulance service may 
193.9 	staff its basic life-support ambulances with one EMT, who must accompany the patient, 
193.10 	and one registered emergency medical responder driver. For purposes of this paragraph, 
193.11 	"ambulance service" means either an ambulance service whose primary service area is 
193.12 	mainly located outside the metropolitan counties listed in section 473.121, subdivision 4, 
193.13 	and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or an 
193.14 	ambulance service based in a community with a population of less than 2,500.

193.15 	Sec. 15. Minnesota Statutes 2022, section 144E.101, is amended by adding a subdivision 
193.16 	to read:
193.17 		Subd. 6a.Variance; staffing of basic life-support ambulance. (a) Upon application 
193.18 	from an ambulance service that includes evidence demonstrating hardship, the board may 
193.19 	grant a variance from the staff requirements in subdivision 6, paragraph (a), and may 
193.20 	authorize a basic life-support ambulance to be staffed, for all emergency calls and interfacility 
193.21 	transfers, with one individual who meets the qualification requirements in paragraph (b) to 
193.22 	drive the ambulance and one individual who meets one of the qualification requirements in 
193.23 	subdivision 6, paragraph (a), clause (1), and who must accompany the patient. The variance 
193.24 	applies to basic life-support ambulances until the ambulance service renews its license. 
193.25 	When the variance expires, the ambulance service may apply for a new variance under this 
193.26 	subdivision.
193.27 	(b) In order to drive an ambulance under a variance granted under this subdivision, an 
193.28 	individual must:
193.29 	(1) hold a valid driver's license from any state;
193.30 	(2) have attended an emergency vehicle driving course approved by the ambulance 
193.31 	service;
193.32 	(3) have completed a course on cardiopulmonary resuscitation approved by the ambulance 
193.33 	service; and
194.1 	(4) register with the board according to a process established by the board.
194.2 	(c) If an individual serving as a driver under this subdivision commits or has a record 
194.3 	of committing an act listed in section 144E.27, subdivision 5, paragraph (a), the board may 
194.4 	temporarily suspend or prohibit the individual from driving an ambulance or place conditions 
194.5 	on the individual's ability to drive an ambulance using the procedures and authority in 
194.6 	section 144E.27, subdivisions 5 and 6.

194.7 	Sec. 16. Minnesota Statutes 2023 Supplement, section 144E.101, subdivision 7, as amended 
194.8 	by Laws 2024, chapter 85, section 32, is amended to read:
194.9 		Subd. 7.Advanced life support. (a) Except as provided in paragraphs (f) and (g), an 
194.10 	advanced life-support ambulance shall be staffed by at least:
194.11 	(1) one EMT or one AEMT and one paramedic;
194.12 	(2) one EMT or one AEMT and one registered nurse who: (i) is an EMT or an AEMT, 
194.13 	is currently practicing nursing, and has passed a paramedic practical skills test approved by 
194.14 	the board and administered by an education program has been approved by the ambulance 
194.15 	service medical director; or (ii) is certified as a certified flight registered nurse or certified 
194.16 	emergency nurse; or
194.17 	(3) one EMT or one AEMT and one physician assistant who is an EMT or an AEMT, 
194.18 	is currently practicing as a physician assistant, and has passed a paramedic practical skills 
194.19 	test approved by the board and administered by an education program has been approved 
194.20 	by the ambulance service medical director.
194.21 	(b) An advanced life-support service shall provide basic life support, as specified under 
194.22 	subdivision 6, paragraph (a) (b), advanced airway management, manual defibrillation, 
194.23 	administration of intravenous fluids and pharmaceuticals, and administration of opiate 
194.24 	antagonists.
194.25 	(c) In addition to providing advanced life support, an advanced life-support service may 
194.26 	staff additional ambulances to provide basic life support according to subdivision 6 and 
194.27 	section 144E.103, subdivision 1.
194.28 	(d) An ambulance service providing advanced life support shall have a written agreement 
194.29 	with its medical director to ensure medical control for patient care 24 hours a day, seven 
194.30 	days a week. The terms of the agreement shall include a written policy on the administration 
194.31 	of medical control for the service. The policy shall address the following issues:
194.32 	(1) two-way communication for physician direction of ambulance service personnel;
195.1 	(2) patient triage, treatment, and transport;
195.2 	(3) use of standing orders; and
195.3 	(4) the means by which medical control will be provided 24 hours a day.
195.4 	The agreement shall be signed by the licensee's medical director and the licensee or the 
195.5 	licensee's designee and maintained in the files of the licensee.
195.6 	(e) When an ambulance service provides advanced life support, the authority of a 
195.7 	paramedic, Minnesota registered nurse-EMT, or Minnesota registered physician 
195.8 	assistant-EMT to determine the delivery of patient care prevails over the authority of an 
195.9 	EMT.
195.10 	(f) Upon application from an ambulance service that includes evidence demonstrating 
195.11 	hardship, the board may grant a variance from the staff requirements in paragraph (a), clause 
195.12 	(1), and may authorize an advanced life-support ambulance to be staffed by a registered 
195.13 	emergency medical responder driver with a paramedic for all emergency calls and interfacility 
195.14 	transfers. The variance shall apply to advanced life-support ambulance services until the 
195.15 	ambulance service renews its license. When the variance expires, an ambulance service 
195.16 	may apply for a new variance under this paragraph. This paragraph applies only to an 
195.17 	ambulance service whose primary service area is mainly located outside the metropolitan 
195.18 	counties listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato, 
195.19 	Moorhead, Rochester, and St. Cloud, or an ambulance service based in a community with 
195.20 	a population of less than 1,000 persons.
195.21 	(g) After an initial emergency ambulance call, each subsequent emergency ambulance 
195.22 	response, until the initial ambulance is again available, and interfacility transfers, may be 
195.23 	staffed by one registered emergency medical responder driver and an EMT or paramedic. 
195.24 	This paragraph applies only to an ambulance service whose primary service area is mainly 
195.25 	located outside the metropolitan counties listed in section 473.121, subdivision 4, and outside 
195.26 	the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an ambulance service 
195.27 	based in a community with a population of less than 1,000 persons.
195.28 	(h) An individual who staffs an advanced life-support ambulance as a driver must also 
195.29 	meet the requirements in subdivision 10.

195.30 	Sec. 17. Minnesota Statutes 2022, section 144E.16, subdivision 5, is amended to read:
195.31 		Subd. 5.Local government's powers. (a) Local units of government may, with the 
195.32 	approval of the board director, establish standards for ambulance services which impose 
195.33 	additional requirements upon such services. Local units of government intending to impose 
196.1 	additional requirements shall consider whether any benefit accruing to the public health 
196.2 	would outweigh the costs associated with the additional requirements.
196.3 	(b) Local units of government that desire to impose additional requirements shall, prior 
196.4 	to adoption of relevant ordinances, rules, or regulations, furnish the board director with a 
196.5 	copy of the proposed ordinances, rules, or regulations, along with information that 
196.6 	affirmatively substantiates that the proposed ordinances, rules, or regulations:
196.7 	(1) will in no way conflict with the relevant rules of the board office;
196.8 	(2) will establish additional requirements tending to protect the public health;
196.9 	(3) will not diminish public access to ambulance services of acceptable quality; and
196.10 	(4) will not interfere with the orderly development of regional systems of emergency 
196.11 	medical care.
196.12 	(c) The board director shall base any decision to approve or disapprove local standards 
196.13 	upon whether or not the local unit of government in question has affirmatively substantiated 
196.14 	that the proposed ordinances, rules, or regulations meet the criteria specified in paragraph 
196.15 	(b).

196.16 	EFFECTIVE DATE. This section is effective January 1, 2025.

196.17 	Sec. 18. Minnesota Statutes 2022, section 144E.19, subdivision 3, is amended to read:
196.18 		Subd. 3.Temporary suspension. (a) In addition to any other remedy provided by law, 
196.19 	the board director may temporarily suspend the license of a licensee after conducting a 
196.20 	preliminary inquiry to determine whether the boarddirector believes that the licensee has 
196.21 	violated a statute or rule that the board director is empowered to enforce and determining 
196.22 	that the continued provision of service by the licensee would create an imminent risk to 
196.23 	public health or harm to others.
196.24 	(b) A temporary suspension order prohibiting a licensee from providing ambulance 
196.25 	service shall give notice of the right to a preliminary hearing according to paragraph (d) 
196.26 	and shall state the reasons for the entry of the temporary suspension order.
196.27 	(c) Service of a temporary suspension order is effective when the order is served on the 
196.28 	licensee personally or by certified mail, which is complete upon receipt, refusal, or return 
196.29 	for nondelivery to the most recent address provided to the board director for the licensee.
196.30 	(d) At the time the board director issues a temporary suspension order, the board director
196.31 	shall schedule a hearing, to be held before a group of its members designated by the board,
196.32 	that shall begin within 60 days after issuance of the temporary suspension order or within 
197.1 	15 working days of the date of the board's director's receipt of a request for a hearing from 
197.2 	a licensee, whichever is sooner. The hearing shall be on the sole issue of whether there is 
197.3 	a reasonable basis to continue, modify, or lift the temporary suspension. A hearing under 
197.4 	this paragraph is not subject to chapter 14.
197.5 	(e) Evidence presented by the board director or licensee may be in the form of an affidavit. 
197.6 	The licensee or the licensee's designee may appear for oral argument.
197.7 	(f) Within five working days of the hearing, the board director shall issue its order and, 
197.8 	if the suspension is continued, notify the licensee of the right to a contested case hearing 
197.9 	under chapter 14.
197.10 	(g) If a licensee requests a contested case hearing within 30 days after receiving notice 
197.11 	under paragraph (f), the boarddirector shall initiate a contested case hearing according to 
197.12 	chapter 14. The administrative law judge shall issue a report and recommendation within 
197.13 	30 days after the closing of the contested case hearing record. The board director shall issue 
197.14 	a final order within 30 days after receipt of the administrative law judge's report.

197.15 	EFFECTIVE DATE. This section is effective January 1, 2025.

197.16 	Sec. 19. Minnesota Statutes 2022, section 144E.27, subdivision 3, is amended to read:
197.17 		Subd. 3.Renewal. (a) The board may renew the registration of an emergency medical 
197.18 	responder who:
197.19 	(1) successfully completes a board-approved refresher course; and
197.20 	(2) successfully completes a course in cardiopulmonary resuscitation approved by the 
197.21 	board or by the licensee's medical director. This course may be a component of a 
197.22 	board-approved refresher course; and
197.23 	(2) (3) submits a completed renewal application to the board before the registration 
197.24 	expiration date.
197.25 	(b) The board may renew the lapsed registration of an emergency medical responder 
197.26 	who:
197.27 	(1) successfully completes a board-approved refresher course; and
197.28 	(2) successfully completes a course in cardiopulmonary resuscitation approved by the 
197.29 	board or by the licensee's medical director. This course may be a component of a 
197.30 	board-approved refresher course; and
198.1 	(2) (3) submits a completed renewal application to the board within 12 48 months after 
198.2 	the registration expiration date.

198.3 	Sec. 20. Minnesota Statutes 2022, section 144E.27, subdivision 5, is amended to read:
198.4 		Subd. 5.Denial, suspension, revocation; emergency medical responders and 
198.5 	drivers. (a) This subdivision applies to individuals seeking registration or registered as an 
198.6 	emergency medical responder and to individuals seeking registration or registered as a driver 
198.7 	of a basic life-support ambulance under section 144E.101, subdivision 6a. The board may 
198.8 	deny, suspend, revoke, place conditions on, or refuse to renew the registration of an individual 
198.9 	who the board determines:
198.10 	(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, an 
198.11 	agreement for corrective action, or an order that the board issued or is otherwise empowered 
198.12 	to enforce;
198.13 	(2) misrepresents or falsifies information on an application form for registration;
198.14 	(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor 
198.15 	relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any 
198.16 	misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or 
198.17 	alcohol;
198.18 	(4) is actually or potentially unable to provide emergency medical services or drive an 
198.19 	ambulance with reasonable skill and safety to patients by reason of illness, use of alcohol, 
198.20 	drugs, chemicals, or any other material, or as a result of any mental or physical condition;
198.21 	(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive, 
198.22 	defraud, or harm the public, or demonstrating a willful or careless disregard for the health, 
198.23 	welfare, or safety of the public;
198.24 	(6) maltreats or abandons a patient;
198.25 	(7) violates any state or federal controlled substance law;
198.26 	(8) engages in unprofessional conduct or any other conduct which has the potential for 
198.27 	causing harm to the public, including any departure from or failure to conform to the 
198.28 	minimum standards of acceptable and prevailing practice without actual injury having to 
198.29 	be established;
198.30 	(9) for emergency medical responders, provides emergency medical services under 
198.31 	lapsed or nonrenewed credentials;
199.1 	(10) is subject to a denial, corrective, disciplinary, or other similar action in another 
199.2 	jurisdiction or by another regulatory authority;
199.3 	(11) engages in conduct with a patient that is sexual or may reasonably be interpreted 
199.4 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
199.5 	to a patient; or
199.6 	(12) makes a false statement or knowingly provides false information to the board, or 
199.7 	fails to cooperate with an investigation of the board as required by section 144E.30.; or
199.8 	(13) fails to engage with the health professionals services program or diversion program 
199.9 	required under section 144E.287 after being referred to the program, violates the terms of 
199.10 	the program participation agreement, or leaves the program except upon fulfilling the terms 
199.11 	for successful completion of the program as set forth in the participation agreement.
199.12 	(b) Before taking action under paragraph (a), the board shall give notice to an individual 
199.13 	of the right to a contested case hearing under chapter 14. If an individual requests a contested 
199.14 	case hearing within 30 days after receiving notice, the board shall initiate a contested case 
199.15 	hearing according to chapter 14.
199.16 	(c) The administrative law judge shall issue a report and recommendation within 30 
199.17 	days after closing the contested case hearing record. The board shall issue a final order 
199.18 	within 30 days after receipt of the administrative law judge's report.
199.19 	(d) After six months from the board's decision to deny, revoke, place conditions on, or 
199.20 	refuse renewal of an individual's registration for disciplinary action, the individual shall 
199.21 	have the opportunity to apply to the board for reinstatement.

199.22 	EFFECTIVE DATE. This section is effective July 1, 2024, except that clause (13) is 
199.23 	effective January 1, 2025.

199.24 	Sec. 21. Minnesota Statutes 2022, section 144E.27, subdivision 6, is amended to read:
199.25 		Subd. 6.Temporary suspension; emergency medical responders and drivers. (a) 
199.26 	This subdivision applies to emergency medical responders registered under this section and 
199.27 	to individuals registered as drivers of basic life-support ambulances under section 144E.101, 
199.28 	subdivision 6a. In addition to any other remedy provided by law, the board may temporarily 
199.29 	suspend the registration of an individual after conducting a preliminary inquiry to determine 
199.30 	whether the board believes that the individual has violated a statute or rule that the board 
199.31 	is empowered to enforce and determining that the continued provision of service by the 
199.32 	individual would create an imminent risk to public health or harm to others.
200.1 	(b) A temporary suspension order prohibiting an individual from providing emergency 
200.2 	medical care or from driving a basic life-support ambulance shall give notice of the right 
200.3 	to a preliminary hearing according to paragraph (d) and shall state the reasons for the entry 
200.4 	of the temporary suspension order.
200.5 	(c) Service of a temporary suspension order is effective when the order is served on the 
200.6 	individual personally or by certified mail, which is complete upon receipt, refusal, or return 
200.7 	for nondelivery to the most recent address provided to the board for the individual.
200.8 	(d) At the time the board issues a temporary suspension order, the board shall schedule 
200.9 	a hearing, to be held before a group of its members designated by the board, that shall begin 
200.10 	within 60 days after issuance of the temporary suspension order or within 15 working days 
200.11 	of the date of the board's receipt of a request for a hearing from the individual, whichever 
200.12 	is sooner. The hearing shall be on the sole issue of whether there is a reasonable basis to 
200.13 	continue, modify, or lift the temporary suspension. A hearing under this paragraph is not 
200.14 	subject to chapter 14.
200.15 	(e) Evidence presented by the board or the individual may be in the form of an affidavit. 
200.16 	The individual or the individual's designee may appear for oral argument.
200.17 	(f) Within five working days of the hearing, the board shall issue its order and, if the 
200.18 	suspension is continued, notify the individual of the right to a contested case hearing under 
200.19 	chapter 14.
200.20 	(g) If an individual requests a contested case hearing within 30 days after receiving 
200.21 	notice under paragraph (f), the board shall initiate a contested case hearing according to 
200.22 	chapter 14. The administrative law judge shall issue a report and recommendation within 
200.23 	30 days after the closing of the contested case hearing record. The board shall issue a final 
200.24 	order within 30 days after receipt of the administrative law judge's report.

200.25 	Sec. 22. Minnesota Statutes 2022, section 144E.28, subdivision 3, is amended to read:
200.26 		Subd. 3.Reciprocity. The board may certify an individual who possesses a current 
200.27 	National Registry of Emergency Medical Technicians registration certification from another 
200.28 	jurisdiction if the individual submits a board-approved application form. The board 
200.29 	certification classification shall be the same as the National Registry's classification. 
200.30 	Certification shall be for the duration of the applicant's registration certification period in 
200.31 	another jurisdiction, not to exceed two years.

201.1 	Sec. 23. Minnesota Statutes 2022, section 144E.28, subdivision 5, is amended to read:
201.2 		Subd. 5.Denial, suspension, revocation. (a) The boarddirector may deny certification 
201.3 	or take any action authorized in subdivision 4 against an individual who the boarddirector 
201.4 	determines:
201.5 	(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, or 
201.6 	an order that the boarddirector issued or is otherwise authorized or empowered to enforce, 
201.7 	or agreement for corrective action;
201.8 	(2) misrepresents or falsifies information on an application form for certification;
201.9 	(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor 
201.10 	relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any 
201.11 	misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or 
201.12 	alcohol;
201.13 	(4) is actually or potentially unable to provide emergency medical services with 
201.14 	reasonable skill and safety to patients by reason of illness, use of alcohol, drugs, chemicals, 
201.15 	or any other material, or as a result of any mental or physical condition;
201.16 	(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive, 
201.17 	defraud, or harm the public or demonstrating a willful or careless disregard for the health, 
201.18 	welfare, or safety of the public;
201.19 	(6) maltreats or abandons a patient;
201.20 	(7) violates any state or federal controlled substance law;
201.21 	(8) engages in unprofessional conduct or any other conduct which has the potential for 
201.22 	causing harm to the public, including any departure from or failure to conform to the 
201.23 	minimum standards of acceptable and prevailing practice without actual injury having to 
201.24 	be established;
201.25 	(9) provides emergency medical services under lapsed or nonrenewed credentials;
201.26 	(10) is subject to a denial, corrective, disciplinary, or other similar action in another 
201.27 	jurisdiction or by another regulatory authority;
201.28 	(11) engages in conduct with a patient that is sexual or may reasonably be interpreted 
201.29 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
201.30 	to a patient; or
202.1 	(12) makes a false statement or knowingly provides false information to the boarddirector 
202.2 	or fails to cooperate with an investigation of the boarddirector as required by section 
202.3 	144E.30.; or
202.4 	(13) fails to engage with the health professionals services program or diversion program 
202.5 	required under section 144E.287 after being referred to the program, violates the terms of 
202.6 	the program participation agreement, or leaves the program except upon fulfilling the terms 
202.7 	for successful completion of the program as set forth in the participation agreement.
202.8 	(b) Before taking action under paragraph (a), the boarddirector shall give notice to an 
202.9 	individual of the right to a contested case hearing under chapter 14. If an individual requests 
202.10 	a contested case hearing within 30 days after receiving notice, the boarddirector shall initiate 
202.11 	a contested case hearing according to chapter 14 and no disciplinary action shall be taken 
202.12 	at that time.
202.13 	(c) The administrative law judge shall issue a report and recommendation within 30 
202.14 	days after closing the contested case hearing record. The boarddirector shall issue a final 
202.15 	order within 30 days after receipt of the administrative law judge's report.
202.16 	(d) After six months from the board'sdirector's decision to deny, revoke, place conditions 
202.17 	on, or refuse renewal of an individual's certification for disciplinary action, the individual 
202.18 	shall have the opportunity to apply to the boarddirector for reinstatement.

202.19 	EFFECTIVE DATE. This section is effective January 1, 2025.

202.20 	Sec. 24. Minnesota Statutes 2022, section 144E.28, subdivision 6, is amended to read:
202.21 		Subd. 6.Temporary suspension. (a) In addition to any other remedy provided by law, 
202.22 	the board director may temporarily suspend the certification of an individual after conducting 
202.23 	a preliminary inquiry to determine whether the board director believes that the individual 
202.24 	has violated a statute or rule that the board director is empowered to enforce and determining 
202.25 	that the continued provision of service by the individual would create an imminent risk to 
202.26 	public health or harm to others.
202.27 	(b) A temporary suspension order prohibiting an individual from providing emergency 
202.28 	medical care shall give notice of the right to a preliminary hearing according to paragraph 
202.29 	(d) and shall state the reasons for the entry of the temporary suspension order.
202.30 	(c) Service of a temporary suspension order is effective when the order is served on the 
202.31 	individual personally or by certified mail, which is complete upon receipt, refusal, or return 
202.32 	for nondelivery to the most recent address provided to the board director for the individual.
203.1 	(d) At the time the board director issues a temporary suspension order, the board director
203.2 	shall schedule a hearing, to be held before a group of its members designated by the board,
203.3 	that shall begin within 60 days after issuance of the temporary suspension order or within 
203.4 	15 working days of the date of the board's director's receipt of a request for a hearing from 
203.5 	the individual, whichever is sooner. The hearing shall be on the sole issue of whether there 
203.6 	is a reasonable basis to continue, modify, or lift the temporary suspension. A hearing under 
203.7 	this paragraph is not subject to chapter 14.
203.8 	(e) Evidence presented by the board director or the individual may be in the form of an 
203.9 	affidavit. The individual or individual's designee may appear for oral argument.
203.10 	(f) Within five working days of the hearing, the board director shall issue its order and, 
203.11 	if the suspension is continued, notify the individual of the right to a contested case hearing 
203.12 	under chapter 14.
203.13 	(g) If an individual requests a contested case hearing within 30 days of receiving notice 
203.14 	under paragraph (f), the board director shall initiate a contested case hearing according to 
203.15 	chapter 14. The administrative law judge shall issue a report and recommendation within 
203.16 	30 days after the closing of the contested case hearing record. The board director shall issue 
203.17 	a final order within 30 days after receipt of the administrative law judge's report.

203.18 	EFFECTIVE DATE. This section is effective January 1, 2025.

203.19 	Sec. 25. Minnesota Statutes 2022, section 144E.28, subdivision 8, is amended to read:
203.20 		Subd. 8.Reinstatement. (a) Within four years of a certification expiration date, a person 
203.21 	whose certification has expired under subdivision 7, paragraph (d), may have the certification 
203.22 	reinstated upon submission of:
203.23 	(1) evidence to the board of training equivalent to the continuing education requirements 
203.24 	of subdivision 7 or, for community paramedics, evidence to the board of training equivalent 
203.25 	to the continuing education requirements of subdivision 9, paragraph (c); and
203.26 	(2) a board-approved application form.
203.27 	(b) If more than four years have passed since a certificate expiration date, an applicant 
203.28 	must complete the initial certification process required under subdivision 1.
203.29 	(c) Beginning July 1, 2024, through December 31, 2025, and notwithstanding paragraph 
203.30 	(b), a person whose certification as an EMT, AEMT, paramedic, or community paramedic 
203.31 	expired more than four years ago but less than ten years ago may have the certification 
203.32 	reinstated upon submission of:
204.1 	(1) evidence to the board of the training required under paragraph (a), clause (1). This 
204.2 	training must have been completed within the 24 months prior to the date of the application 
204.3 	for reinstatement;
204.4 	(2) a board-approved application form; and
204.5 	(3) a recommendation from an ambulance service medical director.
204.6 	This paragraph expires December 31, 2025.

204.7 	Sec. 26. Minnesota Statutes 2022, section 144E.285, subdivision 1, is amended to read:
204.8 		Subdivision 1.Approval required. (a) All education programs for an EMR, EMT, 
204.9 	AEMT, or paramedic must be approved by the board.
204.10 	(b) To be approved by the board, an education program must:
204.11 	(1) submit an application prescribed by the board that includes:
204.12 	(i) type and length of course to be offered;
204.13 	(ii) names, addresses, and qualifications of the program medical director, program 
204.14 	education coordinator, and instructors;
204.15 	(iii) names and addresses of clinical sites, including a contact person and telephone 
204.16 	number;
204.17 	(iv) (iii) admission criteria for students; and
204.18 	(v) (iv) materials and equipment to be used;
204.19 	(2) for each course, implement the most current version of the United States Department 
204.20 	of Transportation EMS Education Standards, or its equivalent as determined by the board 
204.21 	applicable to EMR, EMT, AEMT, or paramedic education;
204.22 	(3) have a program medical director and a program coordinator;
204.23 	(4) utilize instructors who meet the requirements of section 144E.283 for teaching at 
204.24 	least 50 percent of the course content. The remaining 50 percent of the course may be taught 
204.25 	by guest lecturers approved by the education program coordinator or medical director;
204.26 	(5) have at least one instructor for every ten students at the practical skill stations;
204.27 	(6) maintain a written agreement with a licensed hospital or licensed ambulance service 
204.28 	designating a clinical training site;
204.29 	(7) (5) retain documentation of program approval by the board, course outline, and 
204.30 	student information;
205.1 	(8) (6) notify the board of the starting date of a course prior to the beginning of a course;
205.2 	and
205.3 	(9) (7) submit the appropriate fee as required under section 144E.29; and.
205.4 	(10) maintain a minimum average yearly pass rate as set by the board on an annual basis. 
205.5 	The pass rate will be determined by the percent of candidates who pass the exam on the 
205.6 	first attempt. An education program not meeting this yearly standard shall be placed on 
205.7 	probation and shall be on a performance improvement plan approved by the board until 
205.8 	meeting the pass rate standard. While on probation, the education program may continue 
205.9 	providing classes if meeting the terms of the performance improvement plan as determined 
205.10 	by the board. If an education program having probation status fails to meet the pass rate 
205.11 	standard after two years in which an EMT initial course has been taught, the board may 
205.12 	take disciplinary action under subdivision 5.

205.13 	Sec. 27. Minnesota Statutes 2022, section 144E.285, is amended by adding a subdivision 
205.14 	to read:
205.15 		Subd. 1a.EMR education program requirements. The National EMS Education 
205.16 	Standards established by the National Highway Traffic Safety Administration of the United 
205.17 	States Department of Transportation specify the minimum requirements for knowledge and 
205.18 	skills for emergency medical responders. An education program applying for approval to 
205.19 	teach EMRs must comply with the requirements under subdivision 1, paragraph (b). A 
205.20 	medical director of an emergency medical responder group may establish additional 
205.21 	knowledge and skill requirements for EMRs.

205.22 	Sec. 28. Minnesota Statutes 2022, section 144E.285, is amended by adding a subdivision 
205.23 	to read:
205.24 		Subd. 1b.EMT education program requirements. In addition to the requirements 
205.25 	under subdivision 1, paragraph (b), an education program applying for approval to teach 
205.26 	EMTs must:
205.27 	(1) include in the application prescribed by the board the names and addresses of clinical 
205.28 	sites, including a contact person and telephone number;
205.29 	(2) maintain a written agreement with at least one clinical training site that is of a type 
205.30 	recognized by the National EMS Education Standards established by the National Highway 
205.31 	Traffic Safety Administration; and
206.1 	(3) maintain a minimum average yearly pass rate as set by the board. An education 
206.2 	program not meeting this standard must be placed on probation and must comply with a 
206.3 	performance improvement plan approved by the board until the program meets the pass 
206.4 	rate standard. While on probation, the education program may continue to provide classes 
206.5 	if the program meets the terms of the performance improvement plan, as determined by the 
206.6 	board. If an education program that is on probation status fails to meet the pass rate standard 
206.7 	after two years in which an EMT initial course has been taught, the board may take 
206.8 	disciplinary action under subdivision 5.

206.9 	Sec. 29. Minnesota Statutes 2022, section 144E.285, subdivision 2, is amended to read:
206.10 		Subd. 2.AEMT and paramedic education program requirements. (a) In addition to 
206.11 	the requirements under subdivision 1, paragraph (b), an education program applying for 
206.12 	approval to teach AEMTs and paramedics must:
206.13 	(1) be administered by an educational institution accredited by the Commission of 
206.14 	Accreditation of Allied Health Education Programs (CAAHEP).;
206.15 	(2) include in the application prescribed by the board the names and addresses of clinical 
206.16 	sites, including a contact person and telephone number; and
206.17 	(3) maintain a written agreement with a licensed hospital or licensed ambulance service 
206.18 	designating a clinical training site.
206.19 	(b) An AEMT and paramedic education program that is administered by an educational 
206.20 	institution not accredited by CAAHEP, but that is in the process of completing the 
206.21 	accreditation process, may be granted provisional approval by the board upon verification 
206.22 	of submission of its self-study report and the appropriate review fee to CAAHEP.
206.23 	(c) An educational institution that discontinues its participation in the accreditation 
206.24 	process must notify the board immediately and provisional approval shall be withdrawn.
206.25 	(d) This subdivision does not apply to a paramedic education program when the program 
206.26 	is operated by an advanced life-support ambulance service licensed by the Emergency 
206.27 	Medical Services Regulatory Board under this chapter, and the ambulance service meets 
206.28 	the following criteria:
206.29 	(1) covers a rural primary service area that does not contain a hospital within the primary 
206.30 	service area or contains a hospital within the primary service area that has been designated 
206.31 	as a critical access hospital under section 144.1483, clause (9);
207.1 	(2) has tax-exempt status in accordance with the Internal Revenue Code, section 
207.2 	501(c)(3);
207.3 	(3) received approval before 1991 from the commissioner of health to operate a paramedic 
207.4 	education program;
207.5 	(4) operates an AEMT and paramedic education program exclusively to train paramedics 
207.6 	for the local ambulance service; and
207.7 	(5) limits enrollment in the AEMT and paramedic program to five candidates per 
207.8 	biennium.

207.9 	Sec. 30. Minnesota Statutes 2022, section 144E.285, subdivision 4, is amended to read:
207.10 		Subd. 4.Reapproval. An education program shall apply to the board for reapproval at 
207.11 	least three months 30 days prior to the expiration date of its approval and must:
207.12 	(1) submit an application prescribed by the board specifying any changes from the 
207.13 	information provided for prior approval and any other information requested by the board 
207.14 	to clarify incomplete or ambiguous information presented in the application; and
207.15 	(2) comply with the requirements under subdivision 1, paragraph (b), clauses (2) to (10).
207.16 	(7);
207.17 	(3) be subject to a site visit by the board;
207.18 	(4) for education programs that teach EMRs, comply with the requirements in subdivision 
207.19 	1a;
207.20 	(5) for education programs that teach EMTs, comply with the requirements in subdivision 
207.21 	1b; and
207.22 	(6) for education programs that teach AEMTs and paramedics, comply with the 
207.23 	requirements in subdivision 2 and maintain accreditation with CAAHEP.

207.24 	Sec. 31. Minnesota Statutes 2022, section 144E.285, subdivision 6, is amended to read:
207.25 		Subd. 6.Temporary suspension. (a) In addition to any other remedy provided by law, 
207.26 	the board director may temporarily suspend approval of the education program after 
207.27 	conducting a preliminary inquiry to determine whether the board director believes that the 
207.28 	education program has violated a statute or rule that the board director is empowered to 
207.29 	enforce and determining that the continued provision of service by the education program 
207.30 	would create an imminent risk to public health or harm to others.
208.1 	(b) A temporary suspension order prohibiting the education program from providing 
208.2 	emergency medical care training shall give notice of the right to a preliminary hearing 
208.3 	according to paragraph (d) and shall state the reasons for the entry of the temporary 
208.4 	suspension order.
208.5 	(c) Service of a temporary suspension order is effective when the order is served on the 
208.6 	education program personally or by certified mail, which is complete upon receipt, refusal, 
208.7 	or return for nondelivery to the most recent address provided to the board director for the 
208.8 	education program.
208.9 	(d) At the time the board director issues a temporary suspension order, the board director
208.10 	shall schedule a hearing, to be held before a group of its members designated by the board,
208.11 	that shall begin within 60 days after issuance of the temporary suspension order or within 
208.12 	15 working days of the date of the board's director's receipt of a request for a hearing from 
208.13 	the education program, whichever is sooner. The hearing shall be on the sole issue of whether 
208.14 	there is a reasonable basis to continue, modify, or lift the temporary suspension. A hearing 
208.15 	under this paragraph is not subject to chapter 14.
208.16 	(e) Evidence presented by the board director or the individual may be in the form of an 
208.17 	affidavit. The education program or counsel of record may appear for oral argument.
208.18 	(f) Within five working days of the hearing, the board director shall issue its order and, 
208.19 	if the suspension is continued, notify the education program of the right to a contested case 
208.20 	hearing under chapter 14.
208.21 	(g) If an education program requests a contested case hearing within 30 days of receiving 
208.22 	notice under paragraph (f), the board director shall initiate a contested case hearing according 
208.23 	to chapter 14. The administrative law judge shall issue a report and recommendation within 
208.24 	30 days after the closing of the contested case hearing record. The board director shall issue 
208.25 	a final order within 30 days after receipt of the administrative law judge's report.

208.26 	EFFECTIVE DATE. This section is effective January 1, 2025.

208.27 	Sec. 32. Minnesota Statutes 2022, section 144E.287, is amended to read:
208.28 	144E.287 DIVERSION PROGRAM.
208.29 	The board director shall either conduct a health professionals service services program 
208.30 	under sections 214.31 to 214.37 or contract for a diversion program under section 214.28
208.31 	for professionals regulated by the board under this chapter who are unable to perform their 
208.32 	duties with reasonable skill and safety by reason of illness, use of alcohol, drugs, chemicals, 
208.33 	or any other materials, or as a result of any mental, physical, or psychological condition.

209.1 	EFFECTIVE DATE. This section is effective January 1, 2025.

209.2 	Sec. 33. Minnesota Statutes 2022, section 144E.305, subdivision 3, is amended to read:
209.3 		Subd. 3.Immunity. (a) An individual, licensee, health care facility, business, or 
209.4 	organization is immune from civil liability or criminal prosecution for submitting in good 
209.5 	faith a report to the boarddirector under subdivision 1 or 2 or for otherwise reporting in 
209.6 	good faith to the boarddirector violations or alleged violations of sections 144E.001 to 
209.7 	144E.33. Reports are classified as confidential data on individuals or protected nonpublic 
209.8 	data under section 13.02 while an investigation is active. Except for the board'sdirector's 
209.9 	final determination, all communications or information received by or disclosed to the board
209.10 	director relating to disciplinary matters of any person or entity subject to the board'sdirector's 
209.11 	regulatory jurisdiction are confidential and privileged and any disciplinary hearing shall be 
209.12 	closed to the public.
209.13 	(b) Members of the board The director, persons employed by the board director, persons 
209.14 	engaged in the investigation of violations and in the preparation and management of charges 
209.15 	of violations of sections 144E.001 to 144E.33 on behalf of the board director, and persons 
209.16 	participating in the investigation regarding charges of violations are immune from civil 
209.17 	liability and criminal prosecution for any actions, transactions, or publications, made in 
209.18 	good faith, in the execution of, or relating to, their duties under sections 144E.001 to 144E.33.
209.19 	(c) For purposes of this section, a member of the board is considered a state employee 
209.20 	under section 3.736, subdivision 9.

209.21 	EFFECTIVE DATE. This section is effective January 1, 2025.

209.22 	Sec. 34. Minnesota Statutes 2023 Supplement, section 152.126, subdivision 6, is amended 
209.23 	to read:
209.24 		Subd. 6.Access to reporting system data. (a) Except as indicated in this subdivision, 
209.25 	the data submitted to the board under subdivision 4 is private data on individuals as defined 
209.26 	in section 13.02, subdivision 12, and not subject to public disclosure.
209.27 	(b) Except as specified in subdivision 5, the following persons shall be considered 
209.28 	permissible users and may access the data submitted under subdivision 4 in the same or 
209.29 	similar manner, and for the same or similar purposes, as those persons who are authorized 
209.30 	to access similar private data on individuals under federal and state law:
210.1 	(1) a prescriber or an agent or employee of the prescriber to whom the prescriber has 
210.2 	delegated the task of accessing the data, to the extent the information relates specifically to 
210.3 	a current patient, to whom the prescriber is:
210.4 	(i) prescribing or considering prescribing any controlled substance;
210.5 	(ii) providing emergency medical treatment for which access to the data may be necessary;
210.6 	(iii) providing care, and the prescriber has reason to believe, based on clinically valid 
210.7 	indications, that the patient is potentially abusing a controlled substance; or
210.8 	(iv) providing other medical treatment for which access to the data may be necessary 
210.9 	for a clinically valid purpose and the patient has consented to access to the submitted data, 
210.10 	and with the provision that the prescriber remains responsible for the use or misuse of data 
210.11 	accessed by a delegated agent or employee;
210.12 	(2) a dispenser or an agent or employee of the dispenser to whom the dispenser has 
210.13 	delegated the task of accessing the data, to the extent the information relates specifically to 
210.14 	a current patient to whom that dispenser is dispensing or considering dispensing any 
210.15 	controlled substance and with the provision that the dispenser remains responsible for the 
210.16 	use or misuse of data accessed by a delegated agent or employee;
210.17 	(3) a licensed dispensing practitioner or licensed pharmacist to the extent necessary to 
210.18 	determine whether corrections made to the data reported under subdivision 4 are accurate;
210.19 	(4) a licensed pharmacist who is providing pharmaceutical care for which access to the 
210.20 	data may be necessary to the extent that the information relates specifically to a current 
210.21 	patient for whom the pharmacist is providing pharmaceutical care: (i) if the patient has 
210.22 	consented to access to the submitted data; or (ii) if the pharmacist is consulted by a prescriber 
210.23 	who is requesting data in accordance with clause (1);
210.24 	(5) an individual who is the recipient of a controlled substance prescription for which 
210.25 	data was submitted under subdivision 4, or a guardian of the individual, parent or guardian 
210.26 	of a minor, or health care agent of the individual acting under a health care directive under 
210.27 	chapter 145C. For purposes of this clause, access by individuals includes persons in the 
210.28 	definition of an individual under section 13.02;
210.29 	(6) personnel or designees of a health-related licensing board listed in section 214.01, 
210.30 	subdivision 2, or of the Office of Emergency Medical Services Regulatory Board, assigned 
210.31 	to conduct a bona fide investigation of a complaint received by that board or office that 
210.32 	alleges that a specific licensee is impaired by use of a drug for which data is collected under 
211.1 	subdivision 4, has engaged in activity that would constitute a crime as defined in section 
211.2 	152.025, or has engaged in the behavior specified in subdivision 5, paragraph (a);
211.3 	(7) personnel of the board engaged in the collection, review, and analysis of controlled 
211.4 	substance prescription information as part of the assigned duties and responsibilities under 
211.5 	this section;
211.6 	(8) authorized personnel under contract with the board, or under contract with the state 
211.7 	of Minnesota and approved by the board, who are engaged in the design, evaluation, 
211.8 	implementation, operation, or maintenance of the prescription monitoring program as part 
211.9 	of the assigned duties and responsibilities of their employment, provided that access to data 
211.10 	is limited to the minimum amount necessary to carry out such duties and responsibilities, 
211.11 	and subject to the requirement of de-identification and time limit on retention of data specified 
211.12 	in subdivision 5, paragraphs (d) and (e);
211.13 	(9) federal, state, and local law enforcement authorities acting pursuant to a valid search 
211.14 	warrant;
211.15 	(10) personnel of the Minnesota health care programs assigned to use the data collected 
211.16 	under this section to identify and manage recipients whose usage of controlled substances 
211.17 	may warrant restriction to a single primary care provider, a single outpatient pharmacy, and 
211.18 	a single hospital;
211.19 	(11) personnel of the Department of Human Services assigned to access the data pursuant 
211.20 	to paragraph (k);
211.21 	(12) personnel of the health professionals services program established under section 
211.22 	214.31, to the extent that the information relates specifically to an individual who is currently 
211.23 	enrolled in and being monitored by the program, and the individual consents to access to 
211.24 	that information. The health professionals services program personnel shall not provide this 
211.25 	data to a health-related licensing board or the Emergency Medical Services Regulatory 
211.26 	Board, except as permitted under section 214.33, subdivision 3;
211.27 	(13) personnel or designees of a health-related licensing board other than the Board of 
211.28 	Pharmacy listed in section 214.01, subdivision 2, assigned to conduct a bona fide 
211.29 	investigation of a complaint received by that board that alleges that a specific licensee is 
211.30 	inappropriately prescribing controlled substances as defined in this section. For the purposes 
211.31 	of this clause, the health-related licensing board may also obtain utilization data; and
212.1 	(14) personnel of the board specifically assigned to conduct a bona fide investigation 
212.2 	of a specific licensee or registrant. For the purposes of this clause, the board may also obtain 
212.3 	utilization data.
212.4 	(c) By July 1, 2017, every prescriber licensed by a health-related licensing board listed 
212.5 	in section 214.01, subdivision 2, practicing within this state who is authorized to prescribe 
212.6 	controlled substances for humans and who holds a current registration issued by the federal 
212.7 	Drug Enforcement Administration, and every pharmacist licensed by the board and practicing 
212.8 	within the state, shall register and maintain a user account with the prescription monitoring 
212.9 	program. Data submitted by a prescriber, pharmacist, or their delegate during the registration 
212.10 	application process, other than their name, license number, and license type, is classified 
212.11 	as private pursuant to section 13.02, subdivision 12.
212.12 	(d) Notwithstanding paragraph (b), beginning January 1, 2021, a prescriber or an agent 
212.13 	or employee of the prescriber to whom the prescriber has delegated the task of accessing 
212.14 	the data, must access the data submitted under subdivision 4 to the extent the information 
212.15 	relates specifically to the patient:
212.16 	(1) before the prescriber issues an initial prescription order for a Schedules II through 
212.17 	IV opiate controlled substance to the patient; and
212.18 	(2) at least once every three months for patients receiving an opiate for treatment of 
212.19 	chronic pain or participating in medically assisted treatment for an opioid addiction.
212.20 	(e) Paragraph (d) does not apply if:
212.21 	(1) the patient is receiving palliative care, or hospice or other end-of-life care;
212.22 	(2) the patient is being treated for pain due to cancer or the treatment of cancer;
212.23 	(3) the prescription order is for a number of doses that is intended to last the patient five 
212.24 	days or less and is not subject to a refill;
212.25 	(4) the prescriber and patient have a current or ongoing provider/patient relationship of 
212.26 	a duration longer than one year;
212.27 	(5) the prescription order is issued within 14 days following surgery or three days 
212.28 	following oral surgery or follows the prescribing protocols established under the opioid 
212.29 	prescribing improvement program under section 256B.0638;
212.30 	(6) the controlled substance is prescribed or administered to a patient who is admitted 
212.31 	to an inpatient hospital;
213.1 	(7) the controlled substance is lawfully administered by injection, ingestion, or any other 
213.2 	means to the patient by the prescriber, a pharmacist, or by the patient at the direction of a 
213.3 	prescriber and in the presence of the prescriber or pharmacist;
213.4 	(8) due to a medical emergency, it is not possible for the prescriber to review the data 
213.5 	before the prescriber issues the prescription order for the patient; or
213.6 	(9) the prescriber is unable to access the data due to operational or other technological 
213.7 	failure of the program so long as the prescriber reports the failure to the board.
213.8 	(f) Only permissible users identified in paragraph (b), clauses (1), (2), (3), (4), (7), (8), 
213.9 	(10), and (11), may directly access the data electronically. No other permissible users may 
213.10 	directly access the data electronically. If the data is directly accessed electronically, the 
213.11 	permissible user shall implement and maintain a comprehensive information security program 
213.12 	that contains administrative, technical, and physical safeguards that are appropriate to the 
213.13 	user's size and complexity, and the sensitivity of the personal information obtained. The 
213.14 	permissible user shall identify reasonably foreseeable internal and external risks to the 
213.15 	security, confidentiality, and integrity of personal information that could result in the 
213.16 	unauthorized disclosure, misuse, or other compromise of the information and assess the 
213.17 	sufficiency of any safeguards in place to control the risks.
213.18 	(g) The board shall not release data submitted under subdivision 4 unless it is provided 
213.19 	with evidence, satisfactory to the board, that the person requesting the information is entitled 
213.20 	to receive the data.
213.21 	(h) The board shall maintain a log of all persons who access the data for a period of at 
213.22 	least three years and shall ensure that any permissible user complies with paragraph (c) 
213.23 	prior to attaining direct access to the data.
213.24 	(i) Section 13.05, subdivision 6, shall apply to any contract the board enters into pursuant 
213.25 	to subdivision 2. A vendor shall not use data collected under this section for any purpose 
213.26 	not specified in this section.
213.27 	(j) The board may participate in an interstate prescription monitoring program data 
213.28 	exchange system provided that permissible users in other states have access to the data only 
213.29 	as allowed under this section, and that section 13.05, subdivision 6, applies to any contract 
213.30 	or memorandum of understanding that the board enters into under this paragraph.
213.31 	(k) With available appropriations, the commissioner of human services shall establish 
213.32 	and implement a system through which the Department of Human Services shall routinely 
213.33 	access the data for the purpose of determining whether any client enrolled in an opioid 
214.1 	treatment program licensed according to chapter 245A has been prescribed or dispensed a 
214.2 	controlled substance in addition to that administered or dispensed by the opioid treatment 
214.3 	program. When the commissioner determines there have been multiple prescribers or multiple 
214.4 	prescriptions of controlled substances, the commissioner shall:
214.5 	(1) inform the medical director of the opioid treatment program only that the 
214.6 	commissioner determined the existence of multiple prescribers or multiple prescriptions of 
214.7 	controlled substances; and
214.8 	(2) direct the medical director of the opioid treatment program to access the data directly, 
214.9 	review the effect of the multiple prescribers or multiple prescriptions, and document the 
214.10 	review.
214.11 	If determined necessary, the commissioner of human services shall seek a federal waiver 
214.12 	of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section 
214.13 	2.34, paragraph (c), prior to implementing this paragraph.
214.14 	(l) The board shall review the data submitted under subdivision 4 on at least a quarterly 
214.15 	basis and shall establish criteria, in consultation with the advisory task force, for referring 
214.16 	information about a patient to prescribers and dispensers who prescribed or dispensed the 
214.17 	prescriptions in question if the criteria are met.
214.18 	(m) The board shall conduct random audits, on at least a quarterly basis, of electronic 
214.19 	access by permissible users, as identified in paragraph (b), clauses (1), (2), (3), (4), (7), (8), 
214.20 	(10), and (11), to the data in subdivision 4, to ensure compliance with permissible use as 
214.21 	defined in this section. A permissible user whose account has been selected for a random 
214.22 	audit shall respond to an inquiry by the board, no later than 30 days after receipt of notice 
214.23 	that an audit is being conducted. Failure to respond may result in deactivation of access to 
214.24 	the electronic system and referral to the appropriate health licensing board, or the 
214.25 	commissioner of human services, for further action. The board shall report the results of 
214.26 	random audits to the chairs and ranking minority members of the legislative committees 
214.27 	with jurisdiction over health and human services policy and finance and government data 
214.28 	practices.
214.29 	(n) A permissible user who has delegated the task of accessing the data in subdivision 
214.30 	4 to an agent or employee shall audit the use of the electronic system by delegated agents 
214.31 	or employees on at least a quarterly basis to ensure compliance with permissible use as 
214.32 	defined in this section. When a delegated agent or employee has been identified as 
214.33 	inappropriately accessing data, the permissible user must immediately remove access for 
215.1 	that individual and notify the board within seven days. The board shall notify all permissible 
215.2 	users associated with the delegated agent or employee of the alleged violation.
215.3 	(o) A permissible user who delegates access to the data submitted under subdivision 4 
215.4 	to an agent or employee shall terminate that individual's access to the data within three 
215.5 	business days of the agent or employee leaving employment with the permissible user. The 
215.6 	board may conduct random audits to determine compliance with this requirement.

215.7 	EFFECTIVE DATE. This section is effective January 1, 2025.

215.8 	Sec. 35. Minnesota Statutes 2022, section 214.025, is amended to read:
215.9 	214.025 COUNCIL OF HEALTH BOARDS.
215.10 	The health-related licensing boards may establish a Council of Health Boards consisting 
215.11 	of representatives of the health-related licensing boards and the Emergency Medical Services 
215.12 	Regulatory Board. When reviewing legislation or legislative proposals relating to the 
215.13 	regulation of health occupations, the council shall include the commissioner of health or a 
215.14 	designee and the director of the Office of Emergency Medical Services or a designee.

215.15 	EFFECTIVE DATE. This section is effective January 1, 2025.

215.16 	Sec. 36. Minnesota Statutes 2022, section 214.04, subdivision 2a, is amended to read:
215.17 		Subd. 2a.Performance of executive directors. The governor may request that a 
215.18 	health-related licensing board or the Emergency Medical Services Regulatory Board review 
215.19 	the performance of the board's executive director. Upon receipt of the request, the board 
215.20 	must respond by establishing a performance improvement plan or taking disciplinary or 
215.21 	other corrective action, including dismissal. The board shall include the governor's 
215.22 	representative as a voting member of the board in the board's discussions and decisions 
215.23 	regarding the governor's request. The board shall report to the governor on action taken by 
215.24 	the board, including an explanation if no action is deemed necessary.

215.25 	EFFECTIVE DATE. This section is effective January 1, 2025.

215.26 	Sec. 37. Minnesota Statutes 2022, section 214.29, is amended to read:
215.27 	214.29 PROGRAM REQUIRED.
215.28 	Each health-related licensing board, including the Emergency Medical Services 
215.29 	Regulatory Board under chapter 144E, shall either conduct a health professionals service 
215.30 	program under sections 214.31 to 214.37 or contract for a diversion program under section 
215.31 	214.28.

216.1 	EFFECTIVE DATE. This section is effective January 1, 2025.

216.2 	Sec. 38. Minnesota Statutes 2022, section 214.31, is amended to read:
216.3 	214.31 AUTHORITY.
216.4 	Two or more of the health-related licensing boards listed in section 214.01, subdivision 
216.5 	2, may jointly conduct a health professionals services program to protect the public from 
216.6 	persons regulated by the boards who are unable to practice with reasonable skill and safety 
216.7 	by reason of illness, use of alcohol, drugs, chemicals, or any other materials, or as a result 
216.8 	of any mental, physical, or psychological condition. The program does not affect a board's 
216.9 	authority to discipline violations of a board's practice act. For purposes of sections 214.31
216.10 	to 214.37, the emergency medical services regulatory board shall be included in the definition 
216.11 	of a health-related licensing board under chapter 144E.

216.12 	EFFECTIVE DATE. This section is effective January 1, 2025.

216.13 	Sec. 39. Minnesota Statutes 2022, section 214.355, is amended to read:
216.14 	214.355 GROUNDS FOR DISCIPLINARY ACTION.
216.15 	Each health-related licensing board, including the Emergency Medical Services 
216.16 	Regulatory Board under chapter 144E, shall consider it grounds for disciplinary action if a 
216.17 	regulated person violates the terms of the health professionals services program participation 
216.18 	agreement or leaves the program except upon fulfilling the terms for successful completion 
216.19 	of the program as set forth in the participation agreement.

216.20 	EFFECTIVE DATE. This section is effective January 1, 2025.

216.21 	Sec. 40. INITIAL MEMBERS AND FIRST MEETING; EMERGENCY MEDICAL 
216.22 	SERVICES ADVISORY COUNCIL.
 216.23 	(a) Initial appointments of members to the Emergency Medical Services Advisory 
216.24 	Council must be made by January 1, 2025. The terms of initial appointees must be determined 
216.25 	by lot by the secretary of state and must be as follows:
216.26 	(1) eight members shall serve two-year terms; and
216.27 	(2) eight members shall serve three-year terms.
216.28 	(b) The medical director appointee must convene the first meeting of the Emergency 
216.29 	Medical Services Advisory Council by February 1, 2025.

217.1 	Sec. 41. INITIAL MEMBERS AND FIRST MEETING; EMERGENCY MEDICAL 
217.2 	SERVICES PHYSICIAN ADVISORY COUNCIL.
 217.3 	(a) Initial appointments of members to the Emergency Medical Services Physician 
217.4 	Advisory Council must be made by January 1, 2025. The terms of initial appointees must 
217.5 	be determined by lot by the secretary of state and must be as follows:
217.6 	(1) five members shall serve two-year terms;
217.7 	(2) five members shall serve three-year terms; and
217.8 	(3) the term for the medical director appointee to the Emergency Medical Services 
217.9 	Physician Advisory Council must coincide with that member's term on the Emergency 
217.10 	Medical Services Advisory Council.
217.11 	(b) The medical director appointee must convene the first meeting of the Emergency 
217.12 	Medical Services Physician Advisory Council by February 1, 2025.

217.13 	Sec. 42. INITIAL MEMBERS AND FIRST MEETING; LABOR AND EMERGENCY 
217.14 	MEDICAL SERVICE PROVIDERS ADVISORY COUNCIL.
 217.15 	(a) Initial appointments of members to the Labor and Emergency Medical Service 
217.16 	Providers Advisory Council must be made by January 1, 2025. The terms of initial appointees 
217.17 	must be determined by lot by the secretary of state and must be as follows:
217.18 	(1) six members shall serve two-year terms; and
217.19 	(2) seven members shall serve three-year terms.
217.20 	(b) The emergency medical technician instructor appointee must convene the first meeting 
217.21 	of the Labor and Emergency Medical Service Providers Advisory Council by February 1, 
217.22 	2025.

217.23 	Sec. 43. TRANSITION.
 217.24 		Subdivision 1.Appointment of director; operation of office. No later than October 
217.25 	1, 2024, the governor shall appoint a director-designee of the Office of Emergency Medical 
217.26 	Services. The individual appointed as the director-designee of the Office of Emergency 
217.27 	Medical Services shall become the governor's appointee as director of the Office of 
217.28 	Emergency Medical Services on January 1, 2025. Effective January 1, 2025, the 
217.29 	responsibilities to regulate emergency medical services in the state under Minnesota Statutes, 
217.30 	chapter 144E, and Minnesota Rules, chapter 4690, are transferred from the Emergency 
218.1 	Medical Services Regulatory Board to the Office of Emergency Medical Services and the 
218.2 	director of the Office of Emergency Medical Services.
218.3 		Subd. 2.Transfer of responsibilities. Minnesota Statutes, section 15.039, applies to 
218.4 	the transfer of responsibilities from the Emergency Medical Services Regulatory Board to 
218.5 	the Office of Emergency Medical Services required by this act. The commissioner of 
218.6 	administration, with the approval of the governor, may issue reorganization orders under 
218.7 	Minnesota Statutes, section 16B.37, as necessary to carry out the transfer of responsibilities 
218.8 	required by this act. The provision of Minnesota Statutes, section 16B.37, subdivision 1, 
218.9 	which states that transfers under that section may be made only to an agency that has been 
218.10 	in existence for at least one year, does not apply to transfers in this act to the Office of 
218.11 	Emergency Medical Services.

218.12 	Sec. 44. REVISOR INSTRUCTION.
 218.13 	(a) In Minnesota Statutes, chapter 144E, the revisor of statutes shall replace "board" 
218.14 	with "director"; "board's" with "director's"; "Emergency Medical Services Regulatory Board" 
218.15 	or "Minnesota Emergency Medical Services Regulatory Board" with "director"; and 
218.16 	"board-approved" with "director-approved," except that:
218.17 	(1) in Minnesota Statutes, section 144E.11, the revisor of statutes shall not modify the 
218.18 	term "county board," "community health board," or "community health boards";
218.19 	(2) in Minnesota Statutes, sections 144E.40, subdivision 2; 144E.42, subdivision 2; 
218.20 	144E.44; and 144E.45, subdivision 2, the revisor of statutes shall not modify the term "State 
218.21 	Board of Investment"; and
218.22 	(3) in Minnesota Statutes, sections 144E.50 and 144E.52, the revisor of statutes shall 
218.23 	not modify the term "regional emergency medical services board," "regional board," "regional 
218.24 	emergency medical services board's," or "regional boards."
218.25 	(b) In the following sections of Minnesota Statutes, the revisor of statutes shall replace 
218.26 	"Emergency Medical Services Regulatory Board" with "director of the Office of Emergency 
218.27 	Medical Services": sections 13.717, subdivision 10; 62J.49, subdivision 2; 144.604; 144.608; 
218.28 	147.09; 156.12, subdivision 2; 169.686, subdivision 3; and 299A.41, subdivision 4.
218.29 	(c) In the following sections of Minnesota Statutes, the revisor of statutes shall replace 
218.30 	"Emergency Medical Services Regulatory Board" with "Office of Emergency Medical 
218.31 	Services": sections 144.603 and 161.045, subdivision 3.
219.1 	(d) In making the changes specified in this section, the revisor of statutes may make 
219.2 	technical and other necessary changes to sentence structure to preserve the meaning of the 
219.3 	text.

219.4 	Sec. 45. REPEALER.
 219.5 	(a) Minnesota Statutes 2022, sections 144E.001, subdivision 5; 144E.01; 144E.123, 
219.6 	subdivision 5; and 144E.50, subdivision 3, are repealed.
219.7 	(b) Minnesota Statutes 2022, section 144E.27, subdivisions 1 and 1a, are repealed.

219.8 	EFFECTIVE DATE. Paragraph (a) is effective January 1, 2025.

219.9 	ARTICLE 8
219.10 	PHARMACY PRACTICE

219.11 	Section 1. Minnesota Statutes 2023 Supplement, section 62Q.46, subdivision 1, is amended 
219.12 	to read:
219.13 		Subdivision 1.Coverage for preventive items and services. (a) "Preventive items and 
219.14 	services" has the meaning specified in the Affordable Care Act. Preventive items and services 
219.15 	includes:
219.16 	(1) evidence-based items or services that have in effect a rating of A or B in the current 
219.17 	recommendations of the United States Preventive Services Task Force with respect to the 
219.18 	individual involved;
219.19 	(2) immunizations for routine use in children, adolescents, and adults that have in effect 
219.20 	a recommendation from the Advisory Committee on Immunization Practices of the Centers 
219.21 	for Disease Control and Prevention with respect to the individual involved. For purposes 
219.22 	of this clause, a recommendation from the Advisory Committee on Immunization Practices 
219.23 	of the Centers for Disease Control and Prevention is considered in effect after the 
219.24 	recommendation has been adopted by the Director of the Centers for Disease Control and 
219.25 	Prevention, and a recommendation is considered to be for routine use if the recommendation 
219.26 	is listed on the Immunization Schedules of the Centers for Disease Control and Prevention;
219.27 	(3) with respect to infants, children, and adolescents, evidence-informed preventive care 
219.28 	and screenings provided for in comprehensive guidelines supported by the Health Resources 
219.29 	and Services Administration;
219.30 	(4) with respect to women, additional preventive care and screenings that are not listed 
219.31 	with a rating of A or B by the United States Preventive Services Task Force but that are 
220.1 	provided for in comprehensive guidelines supported by the Health Resources and Services 
220.2 	Administration;
220.3 	(5) all contraceptive methods established in guidelines published by the United States 
220.4 	Food and Drug Administration;
220.5 	(6) screenings for human immunodeficiency virus for:
220.6 	(i) all individuals at least 15 years of age but less than 65 years of age; and
220.7 	(ii) all other individuals with increased risk of human immunodeficiency virus infection 
220.8 	according to guidance from the Centers for Disease Control;
220.9 	(7) all preexposure prophylaxis when used for the prevention or treatment of human 
220.10 	immunodeficiency virus, including but not limited to all preexposure prophylaxis, as defined 
220.11 	in any guidance by the United States Preventive Services Task Force or the Centers for 
220.12 	Disease Control, including the June 11, 2019, Preexposure Prophylaxis for the Prevention 
220.13 	of HIV Infection United States Preventive Services Task Force Recommendation Statement; 
220.14 	and
220.15 	(8) all postexposure prophylaxis when used for the prevention or treatment of human 
220.16 	immunodeficiency virus, including but not limited to all postexposure prophylaxis as defined 
220.17 	in any guidance by the United States Preventive Services Task Force or the Centers for 
220.18 	Disease Control.
220.19 	(b) A health plan company must provide coverage for preventive items and services at 
220.20 	a participating provider without imposing cost-sharing requirements, including a deductible, 
220.21 	coinsurance, or co-payment. Nothing in this section prohibits a health plan company that 
220.22 	has a network of providers from excluding coverage or imposing cost-sharing requirements 
220.23 	for preventive items or services that are delivered by an out-of-network provider.
220.24 	(c) A health plan company is not required to provide coverage for any items or services 
220.25 	specified in any recommendation or guideline described in paragraph (a) if the 
220.26 	recommendation or guideline is no longer included as a preventive item or service as defined 
220.27 	in paragraph (a). Annually, a health plan company must determine whether any additional 
220.28 	items or services must be covered without cost-sharing requirements or whether any items 
220.29 	or services are no longer required to be covered.
220.30 	(d) Nothing in this section prevents a health plan company from using reasonable medical 
220.31 	management techniques to determine the frequency, method, treatment, or setting for a 
220.32 	preventive item or service to the extent not specified in the recommendation or guideline.
221.1 	(e) A health plan shall not require prior authorization or step therapy for preexposure 
221.2 	prophylaxis, except that if the United States Food and Drug Administration has approved 
221.3 	one or more therapeutic equivalents of a drug, device, or product for the prevention of HIV, 
221.4 	this paragraph does not require a health plan to cover all of the therapeutically equivalent 
221.5 	versions without prior authorization or step therapy, if at least one therapeutically equivalent 
221.6 	version is covered without prior authorization or step therapy.
221.7 	(e) (f) This section does not apply to grandfathered plans.
221.8 	(f) (g) This section does not apply to plans offered by the Minnesota Comprehensive 
221.9 	Health Association.

221.10 	EFFECTIVE DATE. This section is effective January 1, 2026, and applies to health 
221.11 	plans offered, issued, or renewed on or after that date.

221.12 	Sec. 2. Minnesota Statutes 2022, section 151.01, subdivision 23, is amended to read:
221.13 		Subd. 23.Practitioner. "Practitioner" means a licensed doctor of medicine, licensed 
221.14 	doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of 
221.15 	dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, licensed 
221.16 	advanced practice registered nurse, or licensed physician assistant. For purposes of sections 
221.17 	151.15, subdivision 4; 151.211, subdivision 3; 151.252, subdivision 3; 151.37, subdivision 
221.18 	2, paragraph (b); and 151.461, "practitioner" also means a dental therapist authorized to 
221.19 	dispense and administer under chapter 150A. For purposes of sections 151.252, subdivision 
221.20 	3, and 151.461, "practitioner" also means a pharmacist authorized to prescribe 
221.21 	self-administered hormonal contraceptives, nicotine replacement medications, or opiate 
221.22 	antagonists under section 151.37, subdivision 14, 15, or 16, or authorized to prescribe drugs 
221.23 	to prevent the acquisition of human immunodeficiency virus (HIV) under section 151.37, 
221.24 	subdivision 17.

221.25 	EFFECTIVE DATE. This section is effective January 1, 2026.

221.26 	Sec. 3. Minnesota Statutes 2022, section 151.01, subdivision 27, is amended to read:
221.27 		Subd. 27.Practice of pharmacy. "Practice of pharmacy" means:
221.28 	(1) interpretation and evaluation of prescription drug orders;
221.29 	(2) compounding, labeling, and dispensing drugs and devices (except labeling by a 
221.30 	manufacturer or packager of nonprescription drugs or commercially packaged legend drugs 
221.31 	and devices);
222.1 	(3) participation in clinical interpretations and monitoring of drug therapy for assurance 
222.2 	of safe and effective use of drugs, including the performance of ordering and performing
222.3 	laboratory tests that are waived under the federal Clinical Laboratory Improvement Act of 
222.4 	1988, United States Code, title 42, section 263a et seq., provided that a pharmacist may 
222.5 	interpret the results of laboratory tests but may modify A pharmacist may collect specimens, 
222.6 	interpret results, notify the patient of results, and refer the patient to other health care 
222.7 	providers for follow-up care and may initiate, modify, or discontinue drug therapy only 
222.8 	pursuant to a protocol or collaborative practice agreement. A pharmacist may delegate the 
222.9 	authority to administer tests under this clause to a pharmacy technician or pharmacy intern. 
222.10 	A pharmacy technician or pharmacy intern may perform tests authorized under this clause 
222.11 	if the technician or intern is working under the direct supervision of a pharmacist;
222.12 	(4) participation in drug and therapeutic device selection; drug administration for first 
222.13 	dosage and medical emergencies; intramuscular and subcutaneous drug administration under 
222.14 	a prescription drug order; drug regimen reviews; and drug or drug-related research;
222.15 	(5) drug administration, through intramuscular and subcutaneous administration used 
222.16 	to treat mental illnesses as permitted under the following conditions:
222.17 	(i) upon the order of a prescriber and the prescriber is notified after administration is 
222.18 	complete; or
222.19 	(ii) pursuant to a protocol or collaborative practice agreement as defined by section 
222.20 	151.01, subdivisions 27b and 27c, and participation in the initiation, management, 
222.21 	modification, administration, and discontinuation of drug therapy is according to the protocol 
222.22 	or collaborative practice agreement between the pharmacist and a dentist, optometrist, 
222.23 	physician, physician assistant, podiatrist, or veterinarian, or an advanced practice registered 
222.24 	nurse authorized to prescribe, dispense, and administer under section 148.235. Any changes 
222.25 	in drug therapy or medication administration made pursuant to a protocol or collaborative 
222.26 	practice agreement must be documented by the pharmacist in the patient's medical record 
222.27 	or reported by the pharmacist to a practitioner responsible for the patient's care;
222.28 	(6) participation in administration of influenza vaccines andinitiating, ordering, and 
222.29 	administering influenza and COVID-19 or SARS-CoV-2 vaccines authorized or approved 
222.30 	by the United States Food and Drug Administration related to COVID-19 or SARS-CoV-2
222.31 	to all eligible individuals six three years of age and older and all other United States Food 
222.32 	and Drug Administration-approved vaccines to patients 13 six years of age and older by 
222.33 	written protocol with a physician licensed under chapter 147, a physician assistant authorized 
222.34 	to prescribe drugs under chapter 147A, or an advanced practice registered nurse authorized 
223.1 	to prescribe drugs under section 148.235, provided that according to the federal Advisory 
223.2 	Committee on Immunization Practices recommendations. A pharmacist may delegate the 
223.3 	authority to administer vaccines under this clause to a pharmacy technician or pharmacy 
223.4 	intern who has completed training in vaccine administration if:
223.5 	(i) the protocol includes, at a minimum:
223.6 	(A) the name, dose, and route of each vaccine that may be given;
223.7 	(B) the patient population for whom the vaccine may be given;
223.8 	(C) contraindications and precautions to the vaccine;
223.9 	(D) the procedure for handling an adverse reaction;
223.10 	(E) the name, signature, and address of the physician, physician assistant, or advanced 
223.11 	practice registered nurse;
223.12 	(F) a telephone number at which the physician, physician assistant, or advanced practice 
223.13 	registered nurse can be contacted; and
223.14 	(G) the date and time period for which the protocol is valid;
223.15 	(ii) (i) the pharmacist has and the pharmacy technician or pharmacy intern have
223.16 	successfully completed a program approved by the Accreditation Council for Pharmacy 
223.17 	Education (ACPE) specifically for the administration of immunizations or a program 
223.18 	approved by the board;
223.19 	(iii) (ii) the pharmacist utilizes the Minnesota Immunization Information Connection to 
223.20 	assess the immunization status of individuals prior to the administration of vaccines, except 
223.21 	when administering influenza vaccines to individuals age nine and older;
223.22 	(iv) (iii) the pharmacist reports the administration of the immunization to the Minnesota 
223.23 	Immunization Information Connection; and
223.24 	(v) the pharmacist complies with guidelines for vaccines and immunizations established 
223.25 	by the federal Advisory Committee on Immunization Practices, except that a pharmacist 
223.26 	does not need to comply with those portions of the guidelines that establish immunization 
223.27 	schedules when administering a vaccine pursuant to a valid, patient-specific order issued 
223.28 	by a physician licensed under chapter 147, a physician assistant authorized to prescribe 
223.29 	drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe 
223.30 	drugs under section 148.235, provided that the order is consistent with the United States 
223.31 	Food and Drug Administration approved labeling of the vaccine;
224.1 	(iv) if the patient is 18 years of age or younger, the pharmacist, pharmacy technician, 
224.2 	or pharmacy intern informs the patient and any adult caregiver accompanying the patient 
224.3 	of the importance of a well-child visit with a pediatrician or other licensed primary care 
224.4 	provider; and
224.5 	(v) in the case of a pharmacy technician administering vaccinations while being 
224.6 	supervised by a licensed pharmacist:
224.7 	(A) the supervision is in-person and must not be done through telehealth as defined 
224.8 	under section 62A.673, subdivision 2;
224.9 	(B) the pharmacist is readily and immediately available to the immunizing pharmacy 
224.10 	technician;
224.11 	(C) the pharmacy technician has a current certificate in basic cardiopulmonary 
224.12 	resuscitation;
224.13 	(D) the pharmacy technician has completed a minimum of two hours of ACPE-approved, 
224.14 	immunization-related continuing pharmacy education as part of the pharmacy technician's 
224.15 	two-year continuing education schedule; and
224.16 	(E) the pharmacy technician has completed one of two training programs listed under 
224.17 	Minnesota Rules, part 6800.3850, subpart 1h, item B;
224.18 	(7) participation in the initiation, management, modification, and discontinuation of 
224.19 	drug therapy according to a written protocol or collaborative practice agreement between: 
224.20 	(i) one or more pharmacists and one or more dentists, optometrists, physicians, physician 
224.21 	assistants, podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more 
224.22 	physician assistants authorized to prescribe, dispense, and administer under chapter 147A, 
224.23 	or advanced practice registered nurses authorized to prescribe, dispense, and administer 
224.24 	under section 148.235. Any changes in drug therapy made pursuant to a protocol or 
224.25 	collaborative practice agreement must be documented by the pharmacist in the patient's 
224.26 	medical record or reported by the pharmacist to a practitioner responsible for the patient's 
224.27 	care;
224.28 	(8) participation in the storage of drugs and the maintenance of records;
224.29 	(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and 
224.30 	devices;
224.31 	(10) offering or performing those acts, services, operations, or transactions necessary 
224.32 	in the conduct, operation, management, and control of a pharmacy;
225.1 	(11) participation in the initiation, management, modification, and discontinuation of 
225.2 	therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:
225.3 	(i) a written protocol as allowed under clause (7); or
225.4 	(ii) a written protocol with a community health board medical consultant or a practitioner 
225.5 	designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
225.6 	(12) prescribing self-administered hormonal contraceptives; nicotine replacement 
225.7 	medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant 
225.8 	to section 151.37, subdivision 14, 15, or 16; and
225.9 	(13) participation in the placement of drug monitoring devices according to a prescription, 
225.10 	protocol, or collaborative practice agreement.;
225.11 	(14) prescribing, dispensing, and administering drugs for preventing the acquisition of 
225.12 	human immunodeficiency virus (HIV) if the pharmacist meets the requirements in section 
225.13 	151.37, subdivision 17; and
225.14 	(15) ordering, conducting, and interpreting laboratory tests necessary for therapies that 
225.15 	use drugs for preventing the acquisition of HIV, if the pharmacist meets the requirements 
225.16 	in section 151.37, subdivision 17.

225.17 	EFFECTIVE DATE. This section is effective July 1, 2024, except that clauses (14) 
225.18 	and (15) are effective January 1, 2026.

225.19 	Sec. 4. Minnesota Statutes 2022, section 151.37, is amended by adding a subdivision to 
225.20 	read:
225.21 		Subd. 17.Drugs for preventing the acquisition of HIV. (a) A pharmacist is authorized 
225.22 	to prescribe and administer drugs to prevent the acquisition of human immunodeficiency 
225.23 	virus (HIV) in accordance with this subdivision.
225.24 	(b) By January 1, 2025, the Board of Pharmacy shall develop a standardized protocol 
225.25 	for a pharmacist to follow in prescribing the drugs described in paragraph (a). In developing 
225.26 	the protocol, the board may consult with community health advocacy groups, the Board of 
225.27 	Medical Practice, the Board of Nursing, the commissioner of health, professional pharmacy 
225.28 	associations, and professional associations for physicians, physician assistants, and advanced 
225.29 	practice registered nurses.
225.30 	(c) Before a pharmacist is authorized to prescribe a drug described in paragraph (a), the 
225.31 	pharmacist must successfully complete a training program specifically developed for 
225.32 	prescribing drugs for preventing the acquisition of HIV that is offered by a college of 
226.1 	pharmacy, a continuing education provider that is accredited by the Accreditation Council 
226.2 	for Pharmacy Education, or a program approved by the board. To maintain authorization 
226.3 	to prescribe, the pharmacist shall complete continuing education requirements as specified 
226.4 	by the board.
226.5 	(d) Before prescribing a drug described in paragraph (a), the pharmacist shall follow the 
226.6 	appropriate standardized protocol developed under paragraph (b) and, if appropriate, may 
226.7 	dispense to a patient a drug described in paragraph (a).
226.8 	(e) Before dispensing a drug described in paragraph (a) that is prescribed by the 
226.9 	pharmacist, the pharmacist must provide counseling to the patient on the use of the drugs 
226.10 	and must provide the patient with a fact sheet that includes the indications and 
226.11 	contraindications for the use of these drugs, the appropriate method for using these drugs, 
226.12 	the need for medical follow up, and any additional information listed in Minnesota Rules, 
226.13 	part 6800.0910, subpart 2, that is required to be provided to a patient during the counseling 
226.14 	process.
226.15 	(f) A pharmacist is prohibited from delegating the prescribing authority provided under 
226.16 	this subdivision to any other person. A pharmacist intern registered under section 151.101 
226.17 	may prepare the prescription, but before the prescription is processed or dispensed, a 
226.18 	pharmacist authorized to prescribe under this subdivision must review, approve, and sign 
226.19 	the prescription.
226.20 	(g) Nothing in this subdivision prohibits a pharmacist from participating in the initiation, 
226.21 	management, modification, and discontinuation of drug therapy according to a protocol as 
226.22 	authorized in this section and in section 151.01, subdivision 27.

226.23 	EFFECTIVE DATE. This section is effective January 1, 2026, except that paragraph 
226.24 	(b) is effective the day following final enactment.

226.25 	Sec. 5. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13f, is 
226.26 	amended to read:
226.27 		Subd. 13f.Prior authorization. (a) The Formulary Committee shall review and 
226.28 	recommend drugs which require prior authorization. The Formulary Committee shall 
226.29 	establish general criteria to be used for the prior authorization of brand-name drugs for 
226.30 	which generically equivalent drugs are available, but the committee is not required to review 
226.31 	each brand-name drug for which a generically equivalent drug is available.
226.32 	(b) Prior authorization may be required by the commissioner before certain formulary 
226.33 	drugs are eligible for payment. The Formulary Committee may recommend drugs for prior 
227.1 	authorization directly to the commissioner. The commissioner may also request that the 
227.2 	Formulary Committee review a drug for prior authorization. Before the commissioner may 
227.3 	require prior authorization for a drug:
227.4 	(1) the commissioner must provide information to the Formulary Committee on the 
227.5 	impact that placing the drug on prior authorization may have on the quality of patient care 
227.6 	and on program costs, information regarding whether the drug is subject to clinical abuse 
227.7 	or misuse, and relevant data from the state Medicaid program if such data is available;
227.8 	(2) the Formulary Committee must review the drug, taking into account medical and 
227.9 	clinical data and the information provided by the commissioner; and
227.10 	(3) the Formulary Committee must hold a public forum and receive public comment for 
227.11 	an additional 15 days.
227.12 	The commissioner must provide a 15-day notice period before implementing the prior 
227.13 	authorization.
227.14 	(c) Except as provided in subdivision 13j, prior authorization shall not be required or 
227.15 	utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness 
227.16 	if:
227.17 	(1) there is no generically equivalent drug available; and
227.18 	(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or
227.19 	(3) the drug is part of the recipient's current course of treatment.
227.20 	This paragraph applies to any multistate preferred drug list or supplemental drug rebate 
227.21 	program established or administered by the commissioner. Prior authorization shall 
227.22 	automatically be granted for 60 days for brand name drugs prescribed for treatment of mental 
227.23 	illness within 60 days of when a generically equivalent drug becomes available, provided 
227.24 	that the brand name drug was part of the recipient's course of treatment at the time the 
227.25 	generically equivalent drug became available.
227.26 	(d) Prior authorization must not be required for liquid methadone if only one version of 
227.27 	liquid methadone is available. If more than one version of liquid methadone is available, 
227.28 	the commissioner shall ensure that at least one version of liquid methadone is available 
227.29 	without prior authorization.
227.30 	(e) Prior authorization may be required for an oral liquid form of a drug, except as 
227.31 	described in paragraph (d). A prior authorization request under this paragraph must be 
227.32 	automatically approved within 24 hours if the drug is being prescribed for a Food and Drug 
228.1 	Administration-approved condition for a patient who utilizes an enteral tube for feedings 
228.2 	or medication administration, even if the patient has current or prior claims for pills for that 
228.3 	condition. If more than one version of the oral liquid form of a drug is available, the 
228.4 	commissioner may select the version that is able to be approved for a Food and Drug 
228.5 	Administration-approved condition for a patient who utilizes an enteral tube for feedings 
228.6 	or medication administration. This paragraph applies to any multistate preferred drug list 
228.7 	or supplemental drug rebate program established or administered by the commissioner. The 
228.8 	commissioner shall design and implement a streamlined prior authorization form for patients 
228.9 	who utilize an enteral tube for feedings or medication administration and are prescribed an 
228.10 	oral liquid form of a drug. The commissioner may require prior authorization for brand 
228.11 	name drugs whenever a generically equivalent product is available, even if the prescriber 
228.12 	specifically indicates "dispense as written-brand necessary" on the prescription as required 
228.13 	by section 151.21, subdivision 2.
228.14 	(f) Notwithstanding this subdivision, the commissioner may automatically require prior 
228.15 	authorization, for a period not to exceed 180 days, for any drug that is approved by the 
228.16 	United States Food and Drug Administration on or after July 1, 2005. The 180-day period 
228.17 	begins no later than the first day that a drug is available for shipment to pharmacies within 
228.18 	the state. The Formulary Committee shall recommend to the commissioner general criteria 
228.19 	to be used for the prior authorization of the drugs, but the committee is not required to 
228.20 	review each individual drug. In order to continue prior authorizations for a drug after the 
228.21 	180-day period has expired, the commissioner must follow the provisions of this subdivision.
228.22 	(g) Prior authorization under this subdivision shall comply with section 62Q.184.
228.23 	(h) Any step therapy protocol requirements established by the commissioner must comply 
228.24 	with section 62Q.1841.
228.25 	(i) Notwithstanding any law to the contrary, prior authorization or step therapy shall not 
228.26 	be required or utilized for any class of drugs that is approved by the United States Food and 
228.27 	Drug Administration for preexposure prophylaxis of HIV and AIDS, except under the 
228.28 	conditions specified in section 62Q.46, subdivision 1, paragraph (e).

228.29 	EFFECTIVE DATE. This section is effective January 1, 2026.

228.30 	Sec. 6. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
228.31 	to read:
228.32 		Subd. 13l.Vaccines and laboratory tests provided by pharmacists. (a) Medical 
228.33 	assistance covers vaccines initiated, ordered, or administered by a licensed pharmacist, 
229.1 	according to the requirements of section 151.01, subdivision 27, clause (6), at no less than 
229.2 	the rate for which the same services are covered when provided by any other licensed 
229.3 	practitioner.
229.4 	(b) Medical assistance covers laboratory tests ordered and performed by a licensed 
229.5 	pharmacist, according to the requirements of section 151.01, subdivision 27, clause (3), at 
229.6 	no less than the rate for which the same services are covered when provided by any other 
229.7 	licensed practitioner.

229.8 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
229.9 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
229.10 	when federal approval is obtained.

229.11 	ARTICLE 9
229.12 	MENTAL HEALTH

229.13 	Section 1. Minnesota Statutes 2022, section 245.462, subdivision 6, is amended to read:
229.14 		Subd. 6.Community support services program. "Community support services program" 
229.15 	means services, other than inpatient or residential treatment services, provided or coordinated 
229.16 	by an identified program and staff under the treatment supervision of a mental health 
229.17 	professional designed to help adults with serious and persistent mental illness to function 
229.18 	and remain in the community. A community support services program includes:
229.19 	(1) client outreach,
229.20 	(2) medication monitoring,
229.21 	(3) assistance in independent living skills,
229.22 	(4) development of employability and work-related opportunities,
229.23 	(5) crisis assistance,
229.24 	(6) psychosocial rehabilitation,
229.25 	(7) help in applying for government benefits, and
229.26 	(8) housing support services.
229.27 	The community support services program must be coordinated with the case management 
229.28 	services specified in section 245.4711. A program that meets the accreditation standards 
229.29 	for Clubhouse International model programs meets the requirements of this subdivision.

230.1 	Sec. 2. Minnesota Statutes 2022, section 245.4663, subdivision 2, is amended to read:
230.2 		Subd. 2.Eligible providers. In order to be eligible for a grant under this section, a mental 
230.3 	health provider must:
230.4 	(1) provide at least 25 percent of the provider's yearly patient encounters to state public 
230.5 	program enrollees or patients receiving sliding fee schedule discounts through a formal 
230.6 	sliding fee schedule meeting the standards established by the United States Department of 
230.7 	Health and Human Services under Code of Federal Regulations, title 42, section 51c.303; 
230.8 	or
230.9 	(2) primarily serve underrepresented communities as defined in section 148E.010, 
230.10 	subdivision 20.; or
230.11 	(3) provide services to people in a city or township that is not within the seven-county 
230.12 	metropolitan area as defined in section 473.121, subdivision 2, and is not the city of Duluth, 
230.13 	Mankato, Moorhead, Rochester, or St. Cloud.

230.14 	Sec. 3. Minnesota Statutes 2023 Supplement, section 245.4889, subdivision 1, is amended 
230.15 	to read:
230.16 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
230.17 	make grants from available appropriations to assist:
230.18 	(1) counties;
230.19 	(2) Indian tribes;
230.20 	(3) children's collaboratives under section 124D.23 or 245.493; or
230.21 	(4) mental health service providers.
230.22 	(b) The following services are eligible for grants under this section:
230.23 	(1) services to children with emotional disturbances as defined in section 245.4871, 
230.24 	subdivision 15, and their families;
230.25 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
230.26 	age 21 and their families;
230.27 	(3) respite care services for children with emotional disturbances or severe emotional 
230.28 	disturbances who are at risk of out-of-home placement or residential treatment or 
230.29 	hospitalization, who are already in out-of-home placement in family foster settings as defined 
230.30 	in chapter 245A and at risk of change in out-of-home placement or placement in a residential 
230.31 	facility or other higher level of care, who have utilized crisis services or emergency room 
231.1 	services, or who have experienced a loss of in-home staffing support. Allowable activities 
231.2 	and expenses for respite care services are defined under subdivision 4. A child is not required 
231.3 	to have case management services to receive respite care services. Counties must work to 
231.4 	provide access to regularly scheduled respite care;
231.5 	(4) children's mental health crisis services;
231.6 	(5) child-, youth-, and family-specific mobile response and stabilization services models;
231.7 	(6) mental health services for people from cultural and ethnic minorities, including 
231.8 	supervision of clinical trainees who are Black, indigenous, or people of color;
231.9 	(7) children's mental health screening and follow-up diagnostic assessment and treatment;
231.10 	(8) services to promote and develop the capacity of providers to use evidence-based 
231.11 	practices in providing children's mental health services;
231.12 	(9) school-linked mental health services under section 245.4901;
231.13 	(10) building evidence-based mental health intervention capacity for children birth to 
231.14 	age five;
231.15 	(11) suicide prevention and counseling services that use text messaging statewide;
231.16 	(12) mental health first aid training;
231.17 	(13) training for parents, collaborative partners, and mental health providers on the 
231.18 	impact of adverse childhood experiences and trauma and development of an interactive 
231.19 	website to share information and strategies to promote resilience and prevent trauma;
231.20 	(14) transition age services to develop or expand mental health treatment and supports 
231.21 	for adolescents and young adults 26 years of age or younger;
231.22 	(15) early childhood mental health consultation;
231.23 	(16) evidence-based interventions for youth at risk of developing or experiencing a first 
231.24 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
231.25 	psychosis;
231.26 	(17) psychiatric consultation for primary care practitioners; and
231.27 	(18) providers to begin operations and meet program requirements when establishing a 
231.28 	new children's mental health program. These may be start-up grants.
231.29 	(c) Services under paragraph (b) must be designed to help each child to function and 
231.30 	remain with the child's family in the community and delivered consistent with the child's 
232.1 	treatment plan. Transition services to eligible young adults under this paragraph must be 
232.2 	designed to foster independent living in the community.
232.3 	(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party 
232.4 	reimbursement sources, if applicable.
232.5 	(e) The commissioner may establish and design a pilot program to expand the mobile 
232.6 	response and stabilization services model for children, youth, and families. The commissioner 
232.7 	may use grant funding to consult with a qualified expert entity to assist in the formulation 
232.8 	of measurable outcomes and explore and position the state to submit a Medicaid state plan 
232.9 	amendment to scale the model statewide.

232.10 	Sec. 4. Minnesota Statutes 2022, section 245I.02, subdivision 17, is amended to read:
232.11 		Subd. 17.Functional assessment. "Functional assessment" means the assessment of a 
232.12 	client's current level of functioning relative to functioning that is appropriate for someone 
232.13 	the client's age. For a client five years of age or younger, a functional assessment is the 
232.14 	Early Childhood Service Intensity Instrument (ESCII). For a client six to 17 years of age, 
232.15 	a functional assessment is the Child and Adolescent Service Intensity Instrument (CASII). 
232.16 	For a client 18 years of age or older, a functional assessment is the functional assessment 
232.17 	described in section 245I.10, subdivision 9.

232.18 	Sec. 5. Minnesota Statutes 2022, section 245I.02, subdivision 19, is amended to read:
232.19 		Subd. 19.Level of care assessment. "Level of care assessment" means the level of care 
232.20 	decision support tool appropriate to the client's age. For a client five years of age or younger, 
232.21 	a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For 
232.22 	a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service 
232.23 	Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment 
232.24 	is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS) 
232.25 	or another tool authorized by the commissioner.

232.26 	Sec. 6. Minnesota Statutes 2022, section 245I.04, subdivision 6, is amended to read:
232.27 		Subd. 6.Clinical trainee qualifications. (a) A clinical trainee is a staff person who: (1) 
232.28 	is enrolled in an accredited graduate program of study to prepare the staff person for 
232.29 	independent licensure as a mental health professional and who is participating in a practicum 
232.30 	or internship with the license holder through the individual's graduate program; or (2) has 
232.31 	completed an accredited graduate program of study to prepare the staff person for independent 
232.32 	licensure as a mental health professional and who is in compliance with the requirements 
233.1 	of the applicable health-related licensing board, including requirements for supervised 
233.2 	practice.; or (3) has completed an accredited graduate program of study to prepare the staff 
233.3 	person for independent licensure as a mental health professional, has completed a practicum 
233.4 	or internship and has not yet taken or received the results from the required test or is waiting 
233.5 	for the final licensure decision.
233.6 	(b) A clinical trainee is responsible for notifying and applying to a health-related licensing 
233.7 	board to ensure that the trainee meets the requirements of the health-related licensing board. 
233.8 	As permitted by a health-related licensing board, treatment supervision under this chapter 
233.9 	may be integrated into a plan to meet the supervisory requirements of the health-related 
233.10 	licensing board but does not supersede those requirements.

233.11 	Sec. 7. Minnesota Statutes 2022, section 245I.10, subdivision 9, is amended to read:
233.12 		Subd. 9.Functional assessment; required elements. (a) When a license holder is 
233.13 	completing a functional assessment for an adult client, the license holder must:
233.14 	(1) complete a functional assessment of the client after completing the client's diagnostic 
233.15 	assessment;
233.16 	(2) use a collaborative process that allows the client and the client's family and other 
233.17 	natural supports, the client's referral sources, and the client's providers to provide information 
233.18 	about how the client's symptoms of mental illness impact the client's functioning;
233.19 	(3) if applicable, document the reasons that the license holder did not contact the client's 
233.20 	family and other natural supports;
233.21 	(4) assess and document how the client's symptoms of mental illness impact the client's 
233.22 	functioning in the following areas:
233.23 	(i) the client's mental health symptoms;
233.24 	(ii) the client's mental health service needs;
233.25 	(iii) the client's substance use;
233.26 	(iv) the client's vocational and educational functioning;
233.27 	(v) the client's social functioning, including the use of leisure time;
233.28 	(vi) the client's interpersonal functioning, including relationships with the client's family 
233.29 	and other natural supports;
233.30 	(vii) the client's ability to provide self-care and live independently;
233.31 	(viii) the client's medical and dental health;
234.1 	(ix) the client's financial assistance needs; and
234.2 	(x) the client's housing and transportation needs;
234.3 	(5) include a narrative summarizing the client's strengths, resources, and all areas of 
234.4 	functional impairment;
234.5 	(6) (5) complete the client's functional assessment before the client's initial individual 
234.6 	treatment plan unless a service specifies otherwise; and
234.7 	(7) (6) update the client's functional assessment with the client's current functioning 
234.8 	whenever there is a significant change in the client's functioning or at least every 180 365
234.9 	days, unless a service specifies otherwise.
234.10 	(b) A license holder may use any available, validated measurement tool, including but 
234.11 	not limited to the Daily Living Activities-20, when completing the required elements of a 
234.12 	functional assessment under this subdivision.

234.13 	Sec. 8. Minnesota Statutes 2022, section 245I.11, subdivision 1, is amended to read:
234.14 		Subdivision 1.Generally. (a) If a license holder is licensed as a residential program, 
234.15 	stores or administers client medications, or observes clients self-administer medications, 
234.16 	the license holder must ensure that a staff person who is a registered nurse or licensed 
234.17 	prescriber is responsible for overseeing storage and administration of client medications 
234.18 	and observing as a client self-administers medications, including training according to 
234.19 	section 245I.05, subdivision 6, and documenting the occurrence according to section 245I.08, 
234.20 	subdivision 5.
234.21 	(b) For purposes of this section, "observed self-administration" means the preparation 
234.22 	and administration of a medication by a client to themselves under the direct supervision 
234.23 	of a registered nurse or a staff member to whom a registered nurse delegates supervision 
234.24 	duty. Observed self-administration does not include a client's use of a medication that they 
234.25 	keep in their own possession while participating in a program.

234.26 	Sec. 9. Minnesota Statutes 2022, section 245I.11, is amended by adding a subdivision to 
234.27 	read:
234.28 		Subd. 6.Medication administration in children's day treatment settings. (a) For a 
234.29 	program providing children's day treatment services under section 256B.0943, the license 
234.30 	holder must maintain policies and procedures that state whether the program will store 
234.31 	medication and administer or allow observed self-administration.
235.1 	(b) For a program providing children's day treatment services under section 256B.0943 
235.2 	that does not store medications but allows clients to use a medication that they keep in their 
235.3 	own possession while participating in a program, the license holder must maintain 
235.4 	documentation from a licensed prescriber regarding the safety of medications held by clients, 
235.5 	including:
235.6 	(1) an evaluation that the client is capable of holding and administering the medication 
235.7 	safely;
235.8 	(2) an evaluation of whether the medication is prone to diversion, misuse, or self-injury; 
235.9 	and
235.10 	(3) any conditions under which the license holder should no longer allow the client to 
235.11 	maintain the medication in their own possession.

235.12 	Sec. 10. Minnesota Statutes 2022, section 245I.20, subdivision 4, is amended to read:
235.13 		Subd. 4.Minimum staffing standards. (a) A certification holder's treatment team must 
235.14 	consist of at least four mental health professionals. At least two of the mental health 
235.15 	professionals must be employed by or under contract with the mental health clinic for a 
235.16 	minimum of 35 hours per week each. Each of the two mental health professionals must 
235.17 	specialize in a different mental health discipline.
235.18 	(b) The treatment team must include:
235.19 	(1) a physician qualified as a mental health professional according to section 245I.04, 
235.20 	subdivision 2, clause (4), or a nurse qualified as a mental health professional according to 
235.21 	section 245I.04, subdivision 2, clause (1); and
235.22 	(2) a psychologist qualified as a mental health professional according to section 245I.04, 
235.23 	subdivision 2, clause (3).
235.24 	(c) The staff persons fulfilling the requirement in paragraph (b) must provide clinical 
235.25 	services at least:
235.26 	(1) eight hours every two weeks if the mental health clinic has over 25.0 full-time 
235.27 	equivalent treatment team members;
235.28 	(2) eight hours each month if the mental health clinic has 15.1 to 25.0 full-time equivalent 
235.29 	treatment team members;
235.30 	(3) four hours each month if the mental health clinic has 5.1 to 15.0 full-time equivalent 
235.31 	treatment team members; or
236.1 	(4) two hours each month if the mental health clinic has 2.0 to 5.0 full-time equivalent 
236.2 	treatment team members or only provides in-home services to clients.
236.3 	(d) The certification holder must maintain a record that demonstrates compliance with 
236.4 	this subdivision.

236.5 	Sec. 11. Minnesota Statutes 2022, section 245I.23, subdivision 14, is amended to read:
236.6 		Subd. 14.Weekly team meetings. (a) The license holder must hold weekly team meetings 
236.7 	and ancillary meetings according to this subdivision.
236.8 	(b) A mental health professional or certified rehabilitation specialist must hold at least 
236.9 	one team meeting each calendar week and. The mental health professional or certified 
236.10 	rehabilitation specialist must lead and be physically present at the team meeting, except as 
236.11 	permitted under paragraph (e). All treatment team members, including treatment team 
236.12 	members who work on a part-time or intermittent basis, must participate in a minimum of 
236.13 	one team meeting during each calendar week when the treatment team member is working 
236.14 	for the license holder. The license holder must document all weekly team meetings, including 
236.15 	the names of meeting attendees, and indicate whether the meeting was conducted remotely 
236.16 	under paragraph (e).
236.17 	(c) If a treatment team member cannot participate in a weekly team meeting, the treatment 
236.18 	team member must participate in an ancillary meeting. A mental health professional, certified 
236.19 	rehabilitation specialist, clinical trainee, or mental health practitioner who participated in 
236.20 	the most recent weekly team meeting may lead the ancillary meeting. During the ancillary 
236.21 	meeting, the treatment team member leading the ancillary meeting must review the 
236.22 	information that was shared at the most recent weekly team meeting, including revisions 
236.23 	to client treatment plans and other information that the treatment supervisors exchanged 
236.24 	with treatment team members. The license holder must document all ancillary meetings, 
236.25 	including the names of meeting attendees.
236.26 	(d) If a treatment team member working only one shift during a week cannot participate 
236.27 	in a weekly team meeting or participate in an ancillary meeting, the treatment team member 
236.28 	must read the minutes of the weekly team meeting required to be documented in paragraph 
236.29 	(b). The treatment team member must sign to acknowledge receipt of this information, and 
236.30 	document pertinent information or questions. The mental health professional or certified 
236.31 	rehabilitation specialist must review any documented questions or pertinent information 
236.32 	before the next weekly team meeting.
237.1 	(e) A license holder may permit a mental health professional or certified rehabilitation 
237.2 	specialist to lead the weekly meeting remotely due to medical or weather conditions. If the 
237.3 	conditions that do not permit physical presence persist for longer than one week, the license 
237.4 	holder must request a variance to conduct additional meetings remotely.

237.5 	Sec. 12. [256B.0617] MENTAL HEALTH SERVICES PROVIDER 
237.6 	CERTIFICATION.
237.7 	(a) The commissioner of human services shall establish an initial provider entity 
237.8 	application and certification and recertification processes to determine whether a provider 
237.9 	entity has administrative and clinical infrastructures that meet the certification requirements. 
237.10 	This process applies to providers of the following services:
237.11 	(1) children's intensive behavioral health services under section 256B.0946; and
237.12 	(2) intensive nonresidential rehabilitative mental health services under section 256B.0947.
237.13 	(b) The commissioner shall recertify a provider entity every three years using the 
237.14 	individual provider's certification anniversary or the calendar year end. The commissioner 
237.15 	may approve a recertification extension in the interest of sustaining services when a certain 
237.16 	date for recertification is identified.
237.17 	(c) The commissioner shall establish a process for decertification of a provider entity 
237.18 	and shall require corrective action, medical assistance repayment, or decertification of a 
237.19 	provider entity that no longer meets the requirements in this section or that fails to meet the 
237.20 	clinical quality standards or administrative standards provided by the commissioner in the 
237.21 	application and certification process.
237.22 	(d) The commissioner must provide the following to provider entities for the certification, 
237.23 	recertification, and decertification processes:
237.24 	(1) a structured listing of required provider certification criteria;
237.25 	(2) a formal written letter with a determination of certification, recertification, or 
237.26 	decertification signed by the commissioner or the appropriate division director; and
237.27 	(3) a formal written communication outlining the process for necessary corrective action 
237.28 	and follow-up by the commissioner signed by the commissioner or their designee, if 
237.29 	applicable. In the case of corrective action, the commissioner may schedule interim 
237.30 	recertification site reviews to confirm certification or decertification.

237.31 	EFFECTIVE DATE. This section is effective July 1, 2024, and the commissioner of 
237.32 	human services must implement all requirements of this section by September 1, 2024.

238.1 	Sec. 13. Minnesota Statutes 2022, section 256B.0622, subdivision 2a, is amended to read:
238.2 		Subd. 2a.Eligibility for assertive community treatment. (a) An eligible client for 
238.3 	assertive community treatment is an individual who meets the following criteria as assessed 
238.4 	by an ACT team:
238.5 	(1) is age 18 or older. Individuals ages 16 and 17 may be eligible upon approval by the 
238.6 	commissioner;
238.7 	(2) has a primary diagnosis of schizophrenia, schizoaffective disorder, major depressive 
238.8 	disorder with psychotic features, other psychotic disorders, or bipolar disorder. Individuals 
238.9 	with other psychiatric illnesses may qualify for assertive community treatment if they have 
238.10 	a serious mental illness and meet the criteria outlined in clauses (3) and (4), but no more 
238.11 	than ten percent of an ACT team's clients may be eligible based on this criteria. Individuals 
238.12 	with a primary diagnosis of a substance use disorder, intellectual developmental disabilities, 
238.13 	borderline personality disorder, antisocial personality disorder, traumatic brain injury, or 
238.14 	an autism spectrum disorder are not eligible for assertive community treatment;
238.15 	(3) has significant functional impairment as demonstrated by at least one of the following 
238.16 	conditions:
238.17 	(i) significant difficulty consistently performing the range of routine tasks required for 
238.18 	basic adult functioning in the community or persistent difficulty performing daily living 
238.19 	tasks without significant support or assistance;
238.20 	(ii) significant difficulty maintaining employment at a self-sustaining level or significant 
238.21 	difficulty consistently carrying out the head-of-household responsibilities; or
238.22 	(iii) significant difficulty maintaining a safe living situation;
238.23 	(4) has a need for continuous high-intensity services as evidenced by at least two of the 
238.24 	following:
238.25 	(i) two or more psychiatric hospitalizations or residential crisis stabilization services in 
238.26 	the previous 12 months;
238.27 	(ii) frequent utilization of mental health crisis services in the previous six months;
238.28 	(iii) 30 or more consecutive days of psychiatric hospitalization in the previous 24 months;
238.29 	(iv) intractable, persistent, or prolonged severe psychiatric symptoms;
238.30 	(v) coexisting mental health and substance use disorders lasting at least six months;
239.1 	(vi) recent history of involvement with the criminal justice system or demonstrated risk 
239.2 	of future involvement;
239.3 	(vii) significant difficulty meeting basic survival needs;
239.4 	(viii) residing in substandard housing, experiencing homelessness, or facing imminent 
239.5 	risk of homelessness;
239.6 	(ix) significant impairment with social and interpersonal functioning such that basic 
239.7 	needs are in jeopardy;
239.8 	(x) coexisting mental health and physical health disorders lasting at least six months;
239.9 	(xi) residing in an inpatient or supervised community residence but clinically assessed 
239.10 	to be able to live in a more independent living situation if intensive services are provided;
239.11 	(xii) requiring a residential placement if more intensive services are not available; or
239.12 	(xiii) difficulty effectively using traditional office-based outpatient services;
239.13 	(5) there are no indications that other available community-based services would be 
239.14 	equally or more effective as evidenced by consistent and extensive efforts to treat the 
239.15 	individual; and
239.16 	(6) in the written opinion of a licensed mental health professional, has the need for mental 
239.17 	health services that cannot be met with other available community-based services, or is 
239.18 	likely to experience a mental health crisis or require a more restrictive setting if assertive 
239.19 	community treatment is not provided.
239.20 	(b) An individual meets the criteria for assertive community treatment under this section 
239.21 	immediately following participation in a first episode of psychosis program if the individual:
239.22 	(1) meets the eligibility requirements outlined in paragraph (a), clauses (1), (2), (5), and 
239.23 	(6);
239.24 	(2) is currently participating in a first episode of psychosis program under section 
239.25 	245.4905; and
239.26 	(3) needs the level of intensity provided by an ACT team, in the opinion of the individual's 
239.27 	first episode of psychosis program, in order to prevent crisis services, hospitalization, 
239.28 	homelessness, and involvement with the criminal justice system.

239.29 	Sec. 14. Minnesota Statutes 2022, section 256B.0622, subdivision 3a, is amended to read:
239.30 		Subd. 3a.Provider certification and contract requirements for assertive community 
239.31 	treatment. (a) The assertive community treatment provider must:
240.1 	(1) have a contract with the host county to provide assertive community treatment 
240.2 	services; and
240.3 	(2) have each ACT team be certified by the state following the certification process and 
240.4 	procedures developed by the commissioner. The certification process determines whether 
240.5 	the ACT team meets the standards for assertive community treatment under this section, 
240.6 	the standards in chapter 245I as required in section 245I.011, subdivision 5, and minimum 
240.7 	program fidelity standards as measured by a nationally recognized fidelity tool approved 
240.8 	by the commissioner. Recertification must occur at least every three years.
240.9 	(b) An ACT team certified under this subdivision must meet the following standards:
240.10 	(1) have capacity to recruit, hire, manage, and train required ACT team members;
240.11 	(2) have adequate administrative ability to ensure availability of services;
240.12 	(3) ensure flexibility in service delivery to respond to the changing and intermittent care 
240.13 	needs of a client as identified by the client and the individual treatment plan;
240.14 	(4) keep all necessary records required by law;
240.15 	(5) be an enrolled Medicaid provider; and
240.16 	(6) establish and maintain a quality assurance plan to determine specific service outcomes 
240.17 	and the client's satisfaction with services.
240.18 	(c) The commissioner may intervene at any time and decertify an ACT team with cause. 
240.19 	The commissioner shall establish a process for decertification of an ACT team and shall 
240.20 	require corrective action, medical assistance repayment, or decertification of an ACT team 
240.21 	that no longer meets the requirements in this section or that fails to meet the clinical quality 
240.22 	standards or administrative standards provided by the commissioner in the application and 
240.23 	certification process. The decertification is subject to appeal to the state.

240.24 	Sec. 15. Minnesota Statutes 2022, section 256B.0622, subdivision 7a, is amended to read:
240.25 		Subd. 7a.Assertive community treatment team staff requirements and roles. (a) 
240.26 	The required treatment staff qualifications and roles for an ACT team are:
240.27 	(1) the team leader:
240.28 	(i) shall be a mental health professional. Individuals who are not licensed but who are 
240.29 	eligible for licensure and are otherwise qualified may also fulfill this role but must obtain 
240.30 	full licensure within 24 months of assuming the role of team leader;
241.1 	(ii) must be an active member of the ACT team and provide some direct services to 
241.2 	clients;
241.3 	(iii) must be a single full-time staff member, dedicated to the ACT team, who is 
241.4 	responsible for overseeing the administrative operations of the team, providing treatment 
241.5 	supervision of services in conjunction with the psychiatrist or psychiatric care provider, and 
241.6 	supervising team members to ensure delivery of best and ethical practices; and
241.7 	(iv) must be available to provide ensure that overall treatment supervision to the ACT 
241.8 	team is available after regular business hours and on weekends and holidays. The team 
241.9 	leader may delegate this duty to another and is provided by a qualified member of the ACT 
241.10 	team;
241.11 	(2) the psychiatric care provider:
241.12 	(i) must be a mental health professional permitted to prescribe psychiatric medications 
241.13 	as part of the mental health professional's scope of practice. The psychiatric care provider 
241.14 	must have demonstrated clinical experience working with individuals with serious and 
241.15 	persistent mental illness;
241.16 	(ii) shall collaborate with the team leader in sharing overall clinical responsibility for 
241.17 	screening and admitting clients; monitoring clients' treatment and team member service 
241.18 	delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects, 
241.19 	and health-related conditions; actively collaborating with nurses; and helping provide 
241.20 	treatment supervision to the team;
241.21 	(iii) shall fulfill the following functions for assertive community treatment clients: 
241.22 	provide assessment and treatment of clients' symptoms and response to medications, including 
241.23 	side effects; provide brief therapy to clients; provide diagnostic and medication education 
241.24 	to clients, with medication decisions based on shared decision making; monitor clients' 
241.25 	nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and 
241.26 	community visits;
241.27 	(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized 
241.28 	for mental health treatment and shall communicate directly with the client's inpatient 
241.29 	psychiatric care providers to ensure continuity of care;
241.30 	(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per 
241.31 	50 clients. Part-time psychiatric care providers shall have designated hours to work on the 
241.32 	team, with sufficient blocks of time on consistent days to carry out the provider's clinical, 
242.1 	supervisory, and administrative responsibilities. No more than two psychiatric care providers 
242.2 	may share this role; and
242.3 	(vi) shall provide psychiatric backup to the program after regular business hours and on 
242.4 	weekends and holidays. The psychiatric care provider may delegate this duty to another 
242.5 	qualified psychiatric provider;
242.6 	(3) the nursing staff:
242.7 	(i) shall consist of one to three registered nurses or advanced practice registered nurses, 
242.8 	of whom at least one has a minimum of one-year experience working with adults with 
242.9 	serious mental illness and a working knowledge of psychiatric medications. No more than 
242.10 	two individuals can share a full-time equivalent position;
242.11 	(ii) are responsible for managing medication, administering and documenting medication 
242.12 	treatment, and managing a secure medication room; and
242.13 	(iii) shall develop strategies, in collaboration with clients, to maximize taking medications 
242.14 	as prescribed; screen and monitor clients' mental and physical health conditions and 
242.15 	medication side effects; engage in health promotion, prevention, and education activities; 
242.16 	communicate and coordinate services with other medical providers; facilitate the development 
242.17 	of the individual treatment plan for clients assigned; and educate the ACT team in monitoring 
242.18 	psychiatric and physical health symptoms and medication side effects;
242.19 	(4) the co-occurring disorder specialist:
242.20 	(i) shall be a full-time equivalent co-occurring disorder specialist who has received 
242.21 	specific training on co-occurring disorders that is consistent with national evidence-based 
242.22 	practices. The training must include practical knowledge of common substances and how 
242.23 	they affect mental illnesses, the ability to assess substance use disorders and the client's 
242.24 	stage of treatment, motivational interviewing, and skills necessary to provide counseling to 
242.25 	clients at all different stages of change and treatment. The co-occurring disorder specialist 
242.26 	may also be an individual who is a licensed alcohol and drug counselor as described in 
242.27 	section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience, 
242.28 	and other requirements in section 245G.11, subdivision 5. No more than two co-occurring 
242.29 	disorder specialists may occupy this role; and
242.30 	(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients. 
242.31 	The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT 
242.32 	team members on co-occurring disorders;
242.33 	(5) the vocational specialist:
243.1 	(i) shall be a full-time vocational specialist who has at least one-year experience providing 
243.2 	employment services or advanced education that involved field training in vocational services 
243.3 	to individuals with mental illness. An individual who does not meet these qualifications 
243.4 	may also serve as the vocational specialist upon completing a training plan approved by the 
243.5 	commissioner;
243.6 	(ii) shall provide or facilitate the provision of vocational services to clients. The vocational 
243.7 	specialist serves as a consultant and educator to fellow ACT team members on these services; 
243.8 	and
243.9 	(iii) must not refer individuals to receive any type of vocational services or linkage by 
243.10 	providers outside of the ACT team;
243.11 	(6) the mental health certified peer specialist:
243.12 	(i) shall be a full-time equivalent. No more than two individuals can share this position. 
243.13 	The mental health certified peer specialist is a fully integrated team member who provides 
243.14 	highly individualized services in the community and promotes the self-determination and 
243.15 	shared decision-making abilities of clients. This requirement may be waived due to workforce 
243.16 	shortages upon approval of the commissioner;
243.17 	(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery, 
243.18 	self-advocacy, and self-direction, promote wellness management strategies, and assist clients 
243.19 	in developing advance directives; and
243.20 	(iii) must model recovery values, attitudes, beliefs, and personal action to encourage 
243.21 	wellness and resilience, provide consultation to team members, promote a culture where 
243.22 	the clients' points of view and preferences are recognized, understood, respected, and 
243.23 	integrated into treatment, and serve in a manner equivalent to other team members;
243.24 	(7) the program administrative assistant shall be a full-time office-based program 
243.25 	administrative assistant position assigned to solely work with the ACT team, providing a 
243.26 	range of supports to the team, clients, and families; and
243.27 	(8) additional staff:
243.28 	(i) shall be based on team size. Additional treatment team staff may include mental 
243.29 	health professionals; clinical trainees; certified rehabilitation specialists; mental health 
243.30 	practitioners; or mental health rehabilitation workers. These individuals shall have the 
243.31 	knowledge, skills, and abilities required by the population served to carry out rehabilitation 
243.32 	and support functions; and
243.33 	(ii) shall be selected based on specific program needs or the population served.
244.1 	(b) Each ACT team must clearly document schedules for all ACT team members.
244.2 	(c) Each ACT team member must serve as a primary team member for clients assigned 
244.3 	by the team leader and are responsible for facilitating the individual treatment plan process 
244.4 	for those clients. The primary team member for a client is the responsible team member 
244.5 	knowledgeable about the client's life and circumstances and writes the individual treatment 
244.6 	plan. The primary team member provides individual supportive therapy or counseling, and 
244.7 	provides primary support and education to the client's family and support system.
244.8 	(d) Members of the ACT team must have strong clinical skills, professional qualifications, 
244.9 	experience, and competency to provide a full breadth of rehabilitation services. Each staff 
244.10 	member shall be proficient in their respective discipline and be able to work collaboratively 
244.11 	as a member of a multidisciplinary team to deliver the majority of the treatment, 
244.12 	rehabilitation, and support services clients require to fully benefit from receiving assertive 
244.13 	community treatment.
244.14 	(e) Each ACT team member must fulfill training requirements established by the 
244.15 	commissioner.

244.16 	Sec. 16. Minnesota Statutes 2023 Supplement, section 256B.0622, subdivision 7b, is 
244.17 	amended to read:
244.18 		Subd. 7b.Assertive community treatment program size and opportunities scores. (a)
244.19 	Each ACT team shall maintain an annual average caseload that does not exceed 100 clients. 
244.20 	Staff-to-client ratios shall be based on team size as follows: must demonstrate that the team 
244.21 	attained a passing score according to the most recently issued Tool for Measurement of 
244.22 	Assertive Community Treatment (TMACT).
244.23 	(1) a small ACT team must:
244.24 	(i) employ at least six but no more than seven full-time treatment team staff, excluding 
244.25 	the program assistant and the psychiatric care provider;
244.26 	(ii) serve an annual average maximum of no more than 50 clients;
244.27 	(iii) ensure at least one full-time equivalent position for every eight clients served;
244.28 	(iv) schedule ACT team staff on weekdays and on-call duty to provide crisis services 
244.29 	and deliver services after hours when staff are not working;
244.30 	(v) provide crisis services during business hours if the small ACT team does not have 
244.31 	sufficient staff numbers to operate an after-hours on-call system. During all other hours, 
244.32 	the ACT team may arrange for coverage for crisis assessment and intervention services 
245.1 	through a reliable crisis-intervention provider as long as there is a mechanism by which the 
245.2 	ACT team communicates routinely with the crisis-intervention provider and the on-call 
245.3 	ACT team staff are available to see clients face-to-face when necessary or if requested by 
245.4 	the crisis-intervention services provider;
245.5 	(vi) adjust schedules and provide staff to carry out the needed service activities in the 
245.6 	evenings or on weekend days or holidays, when necessary;
245.7 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
245.8 	provider is not regularly scheduled to work. If availability of the ACT team's psychiatric 
245.9 	care provider during all hours is not feasible, alternative psychiatric prescriber backup must 
245.10 	be arranged and a mechanism of timely communication and coordination established in 
245.11 	writing; and
245.12 	(viii) be composed of, at minimum, one full-time team leader, at least 16 hours each 
245.13 	week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time 
245.14 	equivalent nursing, one full-time co-occurring disorder specialist, one full-time equivalent 
245.15 	mental health certified peer specialist, one full-time vocational specialist, one full-time 
245.16 	program assistant, and at least one additional full-time ACT team member who has mental 
245.17 	health professional, certified rehabilitation specialist, clinical trainee, or mental health 
245.18 	practitioner status; and
245.19 	(2) a midsize ACT team shall:
245.20 	(i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry 
245.21 	time for 51 clients, with an additional two hours for every six clients added to the team, 1.5 
245.22 	to two full-time equivalent nursing staff, one full-time co-occurring disorder specialist, one 
245.23 	full-time equivalent mental health certified peer specialist, one full-time vocational specialist, 
245.24 	one full-time program assistant, and at least 1.5 to two additional full-time equivalent ACT 
245.25 	members, with at least one dedicated full-time staff member with mental health professional 
245.26 	status. Remaining team members may have mental health professional, certified rehabilitation 
245.27 	specialist, clinical trainee, or mental health practitioner status;
245.28 	(ii) employ seven or more treatment team full-time equivalents, excluding the program 
245.29 	assistant and the psychiatric care provider;
245.30 	(iii) serve an annual average maximum caseload of 51 to 74 clients;
245.31 	(iv) ensure at least one full-time equivalent position for every nine clients served;
245.32 	(v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays 
245.33 	and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum 
246.1 	specifications, staff are regularly scheduled to provide the necessary services on a 
246.2 	client-by-client basis in the evenings and on weekends and holidays;
246.3 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
246.4 	when staff are not working;
246.5 	(vii) have the authority to arrange for coverage for crisis assessment and intervention 
246.6 	services through a reliable crisis-intervention provider as long as there is a mechanism by 
246.7 	which the ACT team communicates routinely with the crisis-intervention provider and the 
246.8 	on-call ACT team staff are available to see clients face-to-face when necessary or if requested 
246.9 	by the crisis-intervention services provider; and
246.10 	(viii) arrange for and provide psychiatric backup during all hours the psychiatric care 
246.11 	provider is not regularly scheduled to work. If availability of the psychiatric care provider 
246.12 	during all hours is not feasible, alternative psychiatric prescriber backup must be arranged 
246.13 	and a mechanism of timely communication and coordination established in writing;
246.14 	(3) a large ACT team must:
246.15 	(i) be composed of, at minimum, one full-time team leader, at least 32 hours each week 
246.16 	per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff, 
246.17 	one full-time co-occurring disorder specialist, one full-time equivalent mental health certified 
246.18 	peer specialist, one full-time vocational specialist, one full-time program assistant, and at 
246.19 	least two additional full-time equivalent ACT team members, with at least one dedicated 
246.20 	full-time staff member with mental health professional status. Remaining team members 
246.21 	may have mental health professional or mental health practitioner status;
246.22 	(ii) employ nine or more treatment team full-time equivalents, excluding the program 
246.23 	assistant and psychiatric care provider;
246.24 	(iii) serve an annual average maximum caseload of 75 to 100 clients;
246.25 	(iv) ensure at least one full-time equivalent position for every nine individuals served;
246.26 	(v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the 
246.27 	second shift providing services at least 12 hours per day weekdays. For weekends and 
246.28 	holidays, the team must operate and schedule ACT team staff to work one eight-hour shift, 
246.29 	with a minimum of two staff each weekend day and every holiday;
246.30 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
246.31 	when staff are not working; and
247.1 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
247.2 	provider is not regularly scheduled to work. If availability of the ACT team psychiatric care 
247.3 	provider during all hours is not feasible, alternative psychiatric backup must be arranged 
247.4 	and a mechanism of timely communication and coordination established in writing.
247.5 	(b) An ACT team of any size may have a staff-to-client ratio that is lower than the 
247.6 	requirements described in paragraph (a) upon approval by the commissioner, but may not 
247.7 	exceed a one-to-ten staff-to-client ratio.

247.8 	Sec. 17. Minnesota Statutes 2022, section 256B.0622, subdivision 7d, is amended to read:
247.9 		Subd. 7d.Assertive community treatment assessment and individual treatment 
247.10 	plan. (a) An initial assessment shall be completed the day of the client's admission to 
247.11 	assertive community treatment by the ACT team leader or the psychiatric care provider, 
247.12 	with participation by designated ACT team members and the client. The initial assessment 
247.13 	must include obtaining or completing a standard diagnostic assessment according to section 
247.14 	245I.10, subdivision 6, and completing a 30-day individual treatment plan. The team leader, 
247.15 	psychiatric care provider, or other mental health professional designated by the team leader 
247.16 	or psychiatric care provider, must update the client's diagnostic assessment at least annually
247.17 	as required under section 245I.10, subdivision 2, paragraphs (f) and (g).
247.18 	(b) A functional assessment must be completed according to section 245I.10, subdivision 
247.19 	9. Each part of the functional assessment areas shall be completed by each respective team 
247.20 	specialist or an ACT team member with skill and knowledge in the area being assessed.
247.21 	(c) Between 30 and 45 days after the client's admission to assertive community treatment, 
247.22 	the entire ACT team must hold a comprehensive case conference, where all team members, 
247.23 	including the psychiatric provider, present information discovered from the completed 
247.24 	assessments and provide treatment recommendations. The conference must serve as the 
247.25 	basis for the first individual treatment plan, which must be written by the primary team 
247.26 	member.
247.27 	(d) The client's psychiatric care provider, primary team member, and individual treatment 
247.28 	team members shall assume responsibility for preparing the written narrative of the results 
247.29 	from the psychiatric and social functioning history timeline and the comprehensive 
247.30 	assessment.
247.31 	(e) The primary team member and individual treatment team members shall be assigned 
247.32 	by the team leader in collaboration with the psychiatric care provider by the time of the first 
247.33 	treatment planning meeting or 30 days after admission, whichever occurs first.
248.1 	(f) Individual treatment plans must be developed through the following treatment planning 
248.2 	process:
248.3 	(1) The individual treatment plan shall be developed in collaboration with the client and 
248.4 	the client's preferred natural supports, and guardian, if applicable and appropriate. The ACT 
248.5 	team shall evaluate, together with each client, the client's needs, strengths, and preferences 
248.6 	and develop the individual treatment plan collaboratively. The ACT team shall make every 
248.7 	effort to ensure that the client and the client's family and natural supports, with the client's 
248.8 	consent, are in attendance at the treatment planning meeting, are involved in ongoing 
248.9 	meetings related to treatment, and have the necessary supports to fully participate. The 
248.10 	client's participation in the development of the individual treatment plan shall be documented.
248.11 	(2) The client and the ACT team shall work together to formulate and prioritize the 
248.12 	issues, set goals, research approaches and interventions, and establish the plan. The plan is 
248.13 	individually tailored so that the treatment, rehabilitation, and support approaches and 
248.14 	interventions achieve optimum symptom reduction, help fulfill the personal needs and 
248.15 	aspirations of the client, take into account the cultural beliefs and realities of the individual, 
248.16 	and improve all the aspects of psychosocial functioning that are important to the client. The 
248.17 	process supports strengths, rehabilitation, and recovery.
248.18 	(3) Each client's individual treatment plan shall identify service needs, strengths and 
248.19 	capacities, and barriers, and set specific and measurable short- and long-term goals for each 
248.20 	service need. The individual treatment plan must clearly specify the approaches and 
248.21 	interventions necessary for the client to achieve the individual goals, when the interventions 
248.22 	shall happen, and identify which ACT team member shall carry out the approaches and 
248.23 	interventions.
248.24 	(4) The primary team member and the individual treatment team, together with the client 
248.25 	and the client's family and natural supports with the client's consent, are responsible for 
248.26 	reviewing and rewriting the treatment goals and individual treatment plan whenever there 
248.27 	is a major decision point in the client's course of treatment or at least every six months.
248.28 	(5) The primary team member shall prepare a summary that thoroughly describes in 
248.29 	writing the client's and the individual treatment team's evaluation of the client's progress 
248.30 	and goal attainment, the effectiveness of the interventions, and the satisfaction with services 
248.31 	since the last individual treatment plan. The client's most recent diagnostic assessment must 
248.32 	be included with the treatment plan summary.
248.33 	(6) The individual treatment plan and review must be approved or acknowledged by the 
248.34 	client, the primary team member, the team leader, the psychiatric care provider, and all 
249.1 	individual treatment team members. A copy of the approved individual treatment plan must 
249.2 	be made available to the client.

249.3 	Sec. 18. Minnesota Statutes 2023 Supplement, section 256B.0622, subdivision 8, is 
249.4 	amended to read:
249.5 		Subd. 8.Medical assistance payment for assertive community treatment and 
249.6 	intensive residential treatment services. (a) Payment for intensive residential treatment 
249.7 	services and assertive community treatment in this section shall be based on one daily rate 
249.8 	per provider inclusive of the following services received by an eligible client in a given 
249.9 	calendar day: all rehabilitative services under this section, staff travel time to provide 
249.10 	rehabilitative services under this section, and nonresidential crisis stabilization services 
249.11 	under section 256B.0624.
249.12 	(b) Except as indicated in paragraph (c), payment will not be made to more than one 
249.13 	entity for each client for services provided under this section on a given day. If services 
249.14 	under this section are provided by a team that includes staff from more than one entity, the 
249.15 	team must determine how to distribute the payment among the members.
249.16 	(c) The commissioner shall determine one rate for each provider that will bill medical 
249.17 	assistance for residential services under this section and one rate for each assertive community 
249.18 	treatment provider. If a single entity provides both services, one rate is established for the 
249.19 	entity's residential services and another rate for the entity's nonresidential services under 
249.20 	this section. A provider is not eligible for payment under this section without authorization 
249.21 	from the commissioner. The commissioner shall develop rates using the following criteria:
249.22 	(1) the provider's cost for services shall include direct services costs, other program 
249.23 	costs, and other costs determined as follows:
249.24 	(i) the direct services costs must be determined using actual costs of salaries, benefits, 
249.25 	payroll taxes, and training of direct service staff and service-related transportation;
249.26 	(ii) other program costs not included in item (i) must be determined as a specified 
249.27 	percentage of the direct services costs as determined by item (i). The percentage used shall 
249.28 	be determined by the commissioner based upon the average of percentages that represent 
249.29 	the relationship of other program costs to direct services costs among the entities that provide 
249.30 	similar services;
249.31 	(iii) physical plant costs calculated based on the percentage of space within the program 
249.32 	that is entirely devoted to treatment and programming. This does not include administrative 
249.33 	or residential space;
250.1 	(iv) assertive community treatment physical plant costs must be reimbursed as part of 
250.2 	the costs described in item (ii); and
250.3 	(v) subject to federal approval, up to an additional five percent of the total rate may be 
250.4 	added to the program rate as a quality incentive based upon the entity meeting performance 
250.5 	criteria specified by the commissioner;
250.6 	(2) actual cost is defined as costs which are allowable, allocable, and reasonable, and 
250.7 	consistent with federal reimbursement requirements under Code of Federal Regulations, 
250.8 	title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and 
250.9 	Budget Circular Number A-122, relating to nonprofit entities;
250.10 	(3) the number of service units;
250.11 	(4) the degree to which clients will receive services other than services under this section; 
250.12 	and
250.13 	(5) the costs of other services that will be separately reimbursed.
250.14 	(d) The rate for intensive residential treatment services and assertive community treatment 
250.15 	must exclude the medical assistance room and board rate, as defined in section 256B.056, 
250.16 	subdivision 5d, and services not covered under this section, such as partial hospitalization, 
250.17 	home care, and inpatient services.
250.18 	(e) Physician services that are not separately billed may be included in the rate to the 
250.19 	extent that a psychiatrist, or other health care professional providing physician services 
250.20 	within their scope of practice, is a member of the intensive residential treatment services 
250.21 	treatment team. Physician services, whether billed separately or included in the rate, may 
250.22 	be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning 
250.23 	given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth 
250.24 	is used to provide intensive residential treatment services.
250.25 	(f) When services under this section are provided by an assertive community treatment 
250.26 	provider, case management functions must be an integral part of the team.
250.27 	(g) The rate for a provider must not exceed the rate charged by that provider for the 
250.28 	same service to other payors.
250.29 	(h) The rates for existing programs must be established prospectively based upon the 
250.30 	expenditures and utilization over a prior 12-month period using the criteria established in 
250.31 	paragraph (c). The rates for new programs must be established based upon estimated 
250.32 	expenditures and estimated utilization using the criteria established in paragraph (c).
251.1 	(i) Effective for the rate years beginning on and after January 1, 2024, rates for assertive 
251.2 	community treatment, adult residential crisis stabilization services, and intensive residential 
251.3 	treatment services must be annually adjusted for inflation using the Centers for Medicare 
251.4 	and Medicaid Services Medicare Economic Index, as forecasted in the fourth third quarter 
251.5 	of the calendar year before the rate year. The inflation adjustment must be based on the 
251.6 	12-month period from the midpoint of the previous rate year to the midpoint of the rate year 
251.7 	for which the rate is being determined.
251.8 	(j) Entities who discontinue providing services must be subject to a settle-up process 
251.9 	whereby actual costs and reimbursement for the previous 12 months are compared. In the 
251.10 	event that the entity was paid more than the entity's actual costs plus any applicable 
251.11 	performance-related funding due the provider, the excess payment must be reimbursed to 
251.12 	the department. If a provider's revenue is less than actual allowed costs due to lower 
251.13 	utilization than projected, the commissioner may reimburse the provider to recover its actual 
251.14 	allowable costs. The resulting adjustments by the commissioner must be proportional to the 
251.15 	percent of total units of service reimbursed by the commissioner and must reflect a difference 
251.16 	of greater than five percent.
251.17 	(k) A provider may request of the commissioner a review of any rate-setting decision 
251.18 	made under this subdivision.

251.19 	Sec. 19. Minnesota Statutes 2022, section 256B.0623, subdivision 5, is amended to read:
251.20 		Subd. 5.Qualifications of provider staff.  Adult rehabilitative mental health services 
251.21 	must be provided by qualified individual provider staff of a certified provider entity. 
251.22 	Individual provider staff must be qualified as:
251.23 	(1) a mental health professional who is qualified according to section 245I.04, subdivision 
251.24 	2;
251.25 	(2) a certified rehabilitation specialist who is qualified according to section 245I.04, 
251.26 	subdivision 8;
251.27 	(3) a clinical trainee who is qualified according to section 245I.04, subdivision 6;
251.28 	(4) a mental health practitioner qualified according to section 245I.04, subdivision 4;
251.29 	(5) a mental health certified peer specialist who is qualified according to section 245I.04, 
251.30 	subdivision 10; or
251.31 	(6) a mental health rehabilitation worker who is qualified according to section 245I.04, 
251.32 	subdivision 14.; or
252.1 	(7) a licensed occupational therapist, as defined in section 148.6402, subdivision 14.

252.2 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
252.3 	of human services must notify the revisor of statutes when federal approval is obtained.

252.4 	Sec. 20. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 5m, is 
252.5 	amended to read:
252.6 		Subd. 5m.Certified community behavioral health clinic services. (a) Medical 
252.7 	assistance covers services provided by a not-for-profit certified community behavioral health 
252.8 	clinic (CCBHC) that meets the requirements of section 245.735, subdivision 3.
252.9 	(b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an 
252.10 	eligible service is delivered using the CCBHC daily bundled rate system for medical 
252.11 	assistance payments as described in paragraph (c). The commissioner shall include a quality 
252.12 	incentive payment in the CCBHC daily bundled rate system as described in paragraph (e). 
252.13 	There is no county share for medical assistance services when reimbursed through the 
252.14 	CCBHC daily bundled rate system.
252.15 	(c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC 
252.16 	payments under medical assistance meets the following requirements:
252.17 	(1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each 
252.18 	CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable 
252.19 	CCBHC costs divided by the total annual number of CCBHC visits. For calculating the 
252.20 	payment rate, total annual visits include visits covered by medical assistance and visits not 
252.21 	covered by medical assistance. Allowable costs include but are not limited to the salaries 
252.22 	and benefits of medical assistance providers; the cost of CCBHC services provided under 
252.23 	section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as 
252.24 	insurance or supplies needed to provide CCBHC services;
252.25 	(2) payment shall be limited to one payment per day per medical assistance enrollee 
252.26 	when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement 
252.27 	if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph 
252.28 	(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or 
252.29 	licensed agency employed by or under contract with a CCBHC;
252.30 	(3) initial CCBHC daily bundled rates for newly certified CCBHCs under section 245.735, 
252.31 	subdivision 3, shall be established by the commissioner using a provider-specific rate based 
252.32 	on the newly certified CCBHC's audited historical cost report data adjusted for the expected 
252.33 	cost of delivering CCBHC services. Estimates are subject to review by the commissioner 
253.1 	and must include the expected cost of providing the full scope of CCBHC services and the 
253.2 	expected number of visits for the rate period;
253.3 	(4) the commissioner shall rebase CCBHC rates once every two years following the last 
253.4 	rebasing and no less than 12 months following an initial rate or a rate change due to a change 
253.5 	in the scope of services. For CCBHCs certified after September 31, 2020, and before January 
253.6 	1, 2021, the commissioner shall rebase rates according to this clause for services provided 
253.7 	on or after January 1, 2024;
253.8 	(5) the commissioner shall provide for a 60-day appeals process after notice of the results 
253.9 	of the rebasing;
253.10 	(6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal 
253.11 	Medicaid rate is not eligible for the CCBHC rate methodology;
253.12 	(7) payments for CCBHC services to individuals enrolled in managed care shall be 
253.13 	coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall 
253.14 	complete the phase-out of CCBHC wrap payments within 60 days of the implementation 
253.15 	of the CCBHC daily bundled rate system in the Medicaid Management Information System 
253.16 	(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments 
253.17 	due made payable to CCBHCs no later than 18 months thereafter;
253.18 	(8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each 
253.19 	provider-specific rate by the Medicare Economic Index for primary care services. This 
253.20 	update shall occur each year in between rebasing periods determined by the commissioner 
253.21 	in accordance with clause (4). CCBHCs must provide data on costs and visits to the state 
253.22 	annually using the CCBHC cost report established by the commissioner; and
253.23 	(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of 
253.24 	services when such changes are expected to result in an adjustment to the CCBHC payment 
253.25 	rate by 2.5 percent or more. The CCBHC must provide the commissioner with information 
253.26 	regarding the changes in the scope of services, including the estimated cost of providing 
253.27 	the new or modified services and any projected increase or decrease in the number of visits 
253.28 	resulting from the change. Estimated costs are subject to review by the commissioner. Rate 
253.29 	adjustments for changes in scope shall occur no more than once per year in between rebasing 
253.30 	periods per CCBHC and are effective on the date of the annual CCBHC rate update.
253.31 	(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC 
253.32 	providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of 
253.33 	this requirement on the rate of access to the services delivered by CCBHC providers. If, for 
253.34 	any contract year, federal approval is not received for this paragraph, the commissioner 
254.1 	must adjust the capitation rates paid to managed care plans and county-based purchasing 
254.2 	plans for that contract year to reflect the removal of this provision. Contracts between 
254.3 	managed care plans and county-based purchasing plans and providers to whom this paragraph 
254.4 	applies must allow recovery of payments from those providers if capitation rates are adjusted 
254.5 	in accordance with this paragraph. Payment recoveries must not exceed the amount equal 
254.6 	to any increase in rates that results from this provision. This paragraph expires if federal 
254.7 	approval is not received for this paragraph at any time.
254.8 	(e) The commissioner shall implement a quality incentive payment program for CCBHCs 
254.9 	that meets the following requirements:
254.10 	(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric 
254.11 	thresholds for performance metrics established by the commissioner, in addition to payments 
254.12 	for which the CCBHC is eligible under the CCBHC daily bundled rate system described in 
254.13 	paragraph (c);
254.14 	(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement 
254.15 	year to be eligible for incentive payments;
254.16 	(3) each CCBHC shall receive written notice of the criteria that must be met in order to 
254.17 	receive quality incentive payments at least 90 days prior to the measurement year; and
254.18 	(4) a CCBHC must provide the commissioner with data needed to determine incentive 
254.19 	payment eligibility within six months following the measurement year. The commissioner 
254.20 	shall notify CCBHC providers of their performance on the required measures and the 
254.21 	incentive payment amount within 12 months following the measurement year.
254.22 	(f) All claims to managed care plans for CCBHC services as provided under this section 
254.23 	shall be submitted directly to, and paid by, the commissioner on the dates specified no later 
254.24 	than January 1 of the following calendar year, if:
254.25 	(1) one or more managed care plans does not comply with the federal requirement for 
254.26 	payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42, 
254.27 	section 447.45(b), and the managed care plan does not resolve the payment issue within 30 
254.28 	days of noncompliance; and
254.29 	(2) the total amount of clean claims not paid in accordance with federal requirements 
254.30 	by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims 
254.31 	eligible for payment by managed care plans.
254.32 	If the conditions in this paragraph are met between January 1 and June 30 of a calendar 
254.33 	year, claims shall be submitted to and paid by the commissioner beginning on January 1 of 
255.1 	the following year. If the conditions in this paragraph are met between July 1 and December 
255.2 	31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning 
255.3 	on July 1 of the following year.
255.4 	(g) Peer services provided by a CCBHC certified under section 245.735 are a covered 
255.5 	service under medical assistance when a licensed mental health professional or alcohol and 
255.6 	drug counselor determines that peer services are medically necessary. Eligibility under this 
255.7 	subdivision for peer services provided by a CCBHC supersede eligibility standards under 
255.8 	sections 256B.0615, 256B.0616, and 245G.07, subdivision 2, clause (8).

255.9 	Sec. 21. Minnesota Statutes 2022, section 256B.0625, subdivision 20, is amended to read:
255.10 		Subd. 20.Mental health case management. (a) To the extent authorized by rule of the 
255.11 	state agency, medical assistance covers case management services to persons with serious 
255.12 	and persistent mental illness and children with severe emotional disturbance. Services 
255.13 	provided under this section must meet the relevant standards in sections 245.461 to 245.4887, 
255.14 	the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts 
255.15 	9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
255.16 	(b) Entities meeting program standards set out in rules governing family community 
255.17 	support services as defined in section 245.4871, subdivision 17, are eligible for medical 
255.18 	assistance reimbursement for case management services for children with severe emotional 
255.19 	disturbance when these services meet the program standards in Minnesota Rules, parts 
255.20 	9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
255.21 	(c) Medical assistance and MinnesotaCare payment for mental health case management 
255.22 	shall be made on a monthly basis. In order to receive payment for an eligible child, the 
255.23 	provider must document at least a face-to-face contact either in person or by interactive 
255.24 	video that meets the requirements of subdivision 20b with the child, the child's parents, or 
255.25 	the child's legal representative. To receive payment for an eligible adult, the provider must 
255.26 	document:
255.27 	(1) at least a face-to-face contact with the adult or the adult's legal representative either 
255.28 	in person or by interactive video that meets the requirements of subdivision 20b; or
255.29 	(2) at least a telephone contact or contact via secure electronic message, if preferred by 
255.30 	the adult client, with the adult or the adult's legal representative and document a face-to-face 
255.31 	contact either in person or by interactive video that meets the requirements of subdivision 
255.32 	20b with the adult or the adult's legal representative within the preceding two months.
256.1 	(d) Payment for mental health case management provided by county or state staff shall 
256.2 	be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph 
256.3 	(b), with separate rates calculated for child welfare and mental health, and within mental 
256.4 	health, separate rates for children and adults.
256.5 	(e) Payment for mental health case management provided by Indian health services or 
256.6 	by agencies operated by Indian tribes may be made according to this section or other relevant 
256.7 	federally approved rate setting methodology.
256.8 	(f) Payment for mental health case management provided by vendors who contract with 
256.9 	a county must be calculated in accordance with section 256B.076, subdivision 2. Payment 
256.10 	for mental health case management provided by vendors who contract with a Tribe must 
256.11 	be based on a monthly rate negotiated by the Tribe. The rate must not exceed the rate charged 
256.12 	by the vendor for the same service to other payers. If the service is provided by a team of 
256.13 	contracted vendors, the team shall determine how to distribute the rate among its members. 
256.14 	No reimbursement received by contracted vendors shall be returned to the county or tribe, 
256.15 	except to reimburse the county or tribe for advance funding provided by the county or tribe 
256.16 	to the vendor.
256.17 	(g) If the service is provided by a team which includes contracted vendors, tribal staff, 
256.18 	and county or state staff, the costs for county or state staff participation in the team shall be 
256.19 	included in the rate for county-provided services. In this case, the contracted vendor, the 
256.20 	tribal agency, and the county may each receive separate payment for services provided by 
256.21 	each entity in the same month. In order to prevent duplication of services, each entity must 
256.22 	document, in the recipient's file, the need for team case management and a description of 
256.23 	the roles of the team members.
256.24 	(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
256.25 	mental health case management shall be provided by the recipient's county of responsibility, 
256.26 	as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
256.27 	used to match other federal funds. If the service is provided by a tribal agency, the nonfederal 
256.28 	share, if any, shall be provided by the recipient's tribe. When this service is paid by the state 
256.29 	without a federal share through fee-for-service, 50 percent of the cost shall be provided by 
256.30 	the recipient's county of responsibility.
256.31 	(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance 
256.32 	and MinnesotaCare include mental health case management. When the service is provided 
256.33 	through prepaid capitation, the nonfederal share is paid by the state and the county pays no 
256.34 	share.
257.1 	(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider 
257.2 	that does not meet the reporting or other requirements of this section. The county of 
257.3 	responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency, 
257.4 	is responsible for any federal disallowances. The county or tribe may share this responsibility 
257.5 	with its contracted vendors.
257.6 	(k) The commissioner shall set aside a portion of the federal funds earned for county 
257.7 	expenditures under this section to repay the special revenue maximization account under 
257.8 	section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
257.9 	(1) the costs of developing and implementing this section; and
257.10 	(2) programming the information systems.
257.11 	(l) Payments to counties and tribal agencies for case management expenditures under 
257.12 	this section shall only be made from federal earnings from services provided under this 
257.13 	section. When this service is paid by the state without a federal share through fee-for-service, 
257.14 	50 percent of the cost shall be provided by the state. Payments to county-contracted vendors 
257.15 	shall include the federal earnings, the state share, and the county share.
257.16 	(m) Case management services under this subdivision do not include therapy, treatment, 
257.17 	legal, or outreach services.
257.18 	(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
257.19 	and the recipient's institutional care is paid by medical assistance, payment for case 
257.20 	management services under this subdivision is limited to the lesser of:
257.21 	(1) the last 180 days of the recipient's residency in that facility and may not exceed more 
257.22 	than six months in a calendar year; or
257.23 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
257.24 	(o) Payment for case management services under this subdivision shall not duplicate 
257.25 	payments made under other program authorities for the same purpose.
257.26 	(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting 
257.27 	licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week, 
257.28 	mental health targeted case management services must actively support identification of 
257.29 	community alternatives for the recipient and discharge planning.

258.1 	Sec. 22. Minnesota Statutes 2023 Supplement, section 256B.0671, subdivision 5, is 
258.2 	amended to read:
258.3 		Subd. 5.Child and family psychoeducation services. (a) Medical assistance covers
258.4 	child and family psychoeducation services provided to a child up to under age 21 with and 
258.5 	the child's family members when determined to be medically necessary due to a diagnosed
258.6 	mental health condition when or diagnosed mental illness identified in the child's individual 
258.7 	treatment plan and provided by a mental health professional who is qualified under section 
258.8 	245I.04, subdivision 2, and practicing within the scope of practice under section 245I.04, 
258.9 	subdivision 3; a mental health practitioner who is qualified under section 245I.04, subdivision 
258.10 	4, and practicing within the scope of practice under section 245I.04, subdivision 5; or a 
258.11 	clinical trainee who has determined it medically necessary to involve family members in 
258.12 	the child's care is qualified under section 245I.04, subdivision 6, and practicing within the 
258.13 	scope of practice under section 245I.04, subdivision 7.
258.14 	(b) "Child and family psychoeducation services" means information or demonstration 
258.15 	provided to an individual or family as part of an individual, family, multifamily group, or 
258.16 	peer group session to explain, educate, and support the child and family in understanding 
258.17 	a child's symptoms of mental illness, the impact on the child's development, and needed 
258.18 	components of treatment and skill development so that the individual, family, or group can 
258.19 	help the child to prevent relapse, prevent the acquisition of comorbid disorders, and achieve 
258.20 	optimal mental health and long-term resilience.
258.21 	(c) Child and family psychoeducation services include individual, family, or group skills 
258.22 	development or training to:
258.23 	(1) support the development of psychosocial skills that are medically necessary to support 
258.24 	the child to an age-appropriate developmental trajectory when the child's development was 
258.25 	disrupted by a mental health condition or diagnosed mental illness; or
258.26 	(2) enable the child to self-monitor, compensate for, cope with, counteract, or replace 
258.27 	skills deficits or maladaptive skills acquired over the course of the child's mental health 
258.28 	condition or mental illness.
258.29 	(d) Skills development or training delivered to a child or the child's family under this 
258.30 	subdivision must be targeted to the specific deficits related to the child's mental health 
258.31 	condition or mental illness and must be prescribed in the child's individual treatment plan. 
258.32 	Group skills training may be provided to multiple recipients who, because of the nature of 
258.33 	their emotional, behavioral, or social functional ability, may benefit from interaction in a 
258.34 	group setting.

259.1 	Sec. 23. Minnesota Statutes 2022, section 256B.0943, subdivision 12, is amended to read:
259.2 		Subd. 12.Excluded services. The following services are not eligible for medical 
259.3 	assistance payment as children's therapeutic services and supports:
259.4 	(1) service components of children's therapeutic services and supports simultaneously 
259.5 	provided by more than one provider entity unless prior authorization is obtained;
259.6 	(2) treatment by multiple providers within the same agency at the same clock time, 
259.7 	unless one service is delivered to the child and the other service is delivered to the child's 
259.8 	family or treatment team without the child present;
259.9 	(3) children's therapeutic services and supports provided in violation of medical assistance 
259.10 	policy in Minnesota Rules, part 9505.0220;
259.11 	(4) mental health behavioral aide services provided by a personal care assistant who is 
259.12 	not qualified as a mental health behavioral aide and employed by a certified children's 
259.13 	therapeutic services and supports provider entity;
259.14 	(5) service components of CTSS that are the responsibility of a residential or program 
259.15 	license holder, including foster care providers under the terms of a service agreement or 
259.16 	administrative rules governing licensure; and
259.17 	(6) adjunctive activities that may be offered by a provider entity but are not otherwise 
259.18 	covered by medical assistance, including:
259.19 	(i) a service that is primarily recreation oriented or that is provided in a setting that is 
259.20 	not medically supervised. This includes sports activities, exercise groups, activities such as 
259.21 	craft hours, leisure time, social hours, meal or snack time, trips to community activities, 
259.22 	and tours;
259.23 	(ii) a social or educational service that does not have or cannot reasonably be expected 
259.24 	to have a therapeutic outcome related to the client's emotional disturbance;
259.25 	(iii) prevention or education programs provided to the community; and
259.26 	(iv) treatment for clients with primary diagnoses of alcohol or other drug abuse.

259.27 	Sec. 24. Minnesota Statutes 2022, section 256B.0947, subdivision 5, is amended to read:
259.28 		Subd. 5.Standards for intensive nonresidential rehabilitative providers. (a) Services 
259.29 	must meet the standards in this section and chapter 245I as required in section 245I.011, 
259.30 	subdivision 5.
260.1 	(b) The treatment team must have specialized training in providing services to the specific 
260.2 	age group of youth that the team serves. An individual treatment team must serve youth 
260.3 	who are: (1) at least eight years of age or older and under 16 years of age, or (2) at least 14 
260.4 	years of age or older and under 21 years of age.
260.5 	(c) The treatment team for intensive nonresidential rehabilitative mental health services 
260.6 	comprises both permanently employed core team members and client-specific team members 
260.7 	as follows:
260.8 	(1) Based on professional qualifications and client needs, clinically qualified core team 
260.9 	members are assigned on a rotating basis as the client's lead worker to coordinate a client's 
260.10 	care. The core team must comprise at least four full-time equivalent direct care staff and 
260.11 	must minimally include:
260.12 	(i) a mental health professional who serves as team leader to provide administrative 
260.13 	direction and treatment supervision to the team;
260.14 	(ii) an advanced-practice registered nurse with certification in psychiatric or mental 
260.15 	health care or a board-certified child and adolescent psychiatrist, either of which must be 
260.16 	credentialed to prescribe medications;
260.17 	(iii) a licensed alcohol and drug counselor who is also trained in mental health 
260.18 	interventions; and
260.19 	(iv)(iii) a mental health certified peer specialist who is qualified according to section 
260.20 	245I.04, subdivision 10, and is also a former children's mental health consumer.; and
260.21 	(iv) a co-occurring disorder specialist who meets the requirements under section 
260.22 	256B.0622, subdivision 7a, paragraph (a), clause (4), who will provide or facilitate the 
260.23 	provision of co-occurring disorder treatment to clients.
260.24 	(2) The core team may also include any of the following:
260.25 	(i) additional mental health professionals;
260.26 	(ii) a vocational specialist;
260.27 	(iii) an educational specialist with knowledge and experience working with youth 
260.28 	regarding special education requirements and goals, special education plans, and coordination 
260.29 	of educational activities with health care activities;
260.30 	(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;
260.31 	(v) a clinical trainee qualified according to section 245I.04, subdivision 6;
261.1 	(vi) a mental health practitioner qualified according to section 245I.04, subdivision 4;
261.2 	(vii) a case management service provider, as defined in section 245.4871, subdivision 
261.3 	4;
261.4 	(viii) a housing access specialist; and
261.5 	(ix) a family peer specialist as defined in subdivision 2, paragraph (j).
261.6 	(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc 
261.7 	members not employed by the team who consult on a specific client and who must accept 
261.8 	overall clinical direction from the treatment team for the duration of the client's placement 
261.9 	with the treatment team and must be paid by the provider agency at the rate for a typical 
261.10 	session by that provider with that client or at a rate negotiated with the client-specific 
261.11 	member. Client-specific treatment team members may include:
261.12 	(i) the mental health professional treating the client prior to placement with the treatment 
261.13 	team;
261.14 	(ii) the client's current substance use counselor, if applicable;
261.15 	(iii) a lead member of the client's individualized education program team or school-based 
261.16 	mental health provider, if applicable;
261.17 	(iv) a representative from the client's health care home or primary care clinic, as needed 
261.18 	to ensure integration of medical and behavioral health care;
261.19 	(v) the client's probation officer or other juvenile justice representative, if applicable; 
261.20 	and
261.21 	(vi) the client's current vocational or employment counselor, if applicable.
261.22 	(d) The treatment supervisor shall be an active member of the treatment team and shall 
261.23 	function as a practicing clinician at least on a part-time basis. The treatment team shall meet 
261.24 	with the treatment supervisor at least weekly to discuss recipients' progress and make rapid 
261.25 	adjustments to meet recipients' needs. The team meeting must include client-specific case 
261.26 	reviews and general treatment discussions among team members. Client-specific case 
261.27 	reviews and planning must be documented in the individual client's treatment record.
261.28 	(e) The staffing ratio must not exceed ten clients to one full-time equivalent treatment 
261.29 	team position.
261.30 	(f) The treatment team shall serve no more than 80 clients at any one time. Should local 
261.31 	demand exceed the team's capacity, an additional team must be established rather than 
261.32 	exceed this limit.
262.1 	(g) Nonclinical staff shall have prompt access in person or by telephone to a mental 
262.2 	health practitioner, clinical trainee, or mental health professional. The provider shall have 
262.3 	the capacity to promptly and appropriately respond to emergent needs and make any 
262.4 	necessary staffing adjustments to ensure the health and safety of clients.
262.5 	(h) The intensive nonresidential rehabilitative mental health services provider shall 
262.6 	participate in evaluation of the assertive community treatment for youth (Youth ACT) model 
262.7 	as conducted by the commissioner, including the collection and reporting of data and the 
262.8 	reporting of performance measures as specified by contract with the commissioner.
262.9 	(i) A regional treatment team may serve multiple counties.

262.10 	Sec. 25. Minnesota Statutes 2023 Supplement, section 256B.0947, subdivision 7, is 
262.11 	amended to read:
262.12 		Subd. 7.Medical assistance payment and rate setting. (a) Payment for services in this 
262.13 	section must be based on one daily encounter rate per provider inclusive of the following 
262.14 	services received by an eligible client in a given calendar day: all rehabilitative services, 
262.15 	supports, and ancillary activities under this section, staff travel time to provide rehabilitative 
262.16 	services under this section, and crisis response services under section 256B.0624.
262.17 	(b) Payment must not be made to more than one entity for each client for services 
262.18 	provided under this section on a given day. If services under this section are provided by a 
262.19 	team that includes staff from more than one entity, the team shall determine how to distribute 
262.20 	the payment among the members.
262.21 	(c) The commissioner shall establish regional cost-based rates for entities that will bill 
262.22 	medical assistance for nonresidential intensive rehabilitative mental health services. In 
262.23 	developing these rates, the commissioner shall consider:
262.24 	(1) the cost for similar services in the health care trade area;
262.25 	(2) actual costs incurred by entities providing the services;
262.26 	(3) the intensity and frequency of services to be provided to each client;
262.27 	(4) the degree to which clients will receive services other than services under this section; 
262.28 	and
262.29 	(5) the costs of other services that will be separately reimbursed.
262.30 	(d) The rate for a provider must not exceed the rate charged by that provider for the 
262.31 	same service to other payers.
263.1 	(e) Effective for the rate years beginning on and after January 1, 2024, rates must be 
263.2 	annually adjusted for inflation using the Centers for Medicare and Medicaid Services 
263.3 	Medicare Economic Index, as forecasted in the fourth third quarter of the calendar year 
263.4 	before the rate year. The inflation adjustment must be based on the 12-month period from 
263.5 	the midpoint of the previous rate year to the midpoint of the rate year for which the rate is 
263.6 	being determined.

263.7 	Sec. 26. Minnesota Statutes 2022, section 256B.76, subdivision 6, is amended to read:
263.8 		Subd. 6.Medicare relative value units.  (a) Effective for services rendered on or after 
263.9 	January 1, 2007, the commissioner shall make payments for physician and professional 
263.10 	services based on the Medicare relative value units (RVU's) (RVUs). This change shall be 
263.11 	budget neutral and the cost of implementing RVU's RVUs will be incorporated in the 
263.12 	established conversion factor.
263.13 	(b) The commissioner must revise fee-for-service payment methodologies under this 
263.14 	section upon the issuance of a Medicare Physician Fee Schedule final rule by the Centers 
263.15 	for Medicare and Medicaid Services to ensure the payment rates under this subdivision are 
263.16 	at least equal to the corresponding rates in the final rule.
263.17 	(c) The commissioner must revise and implement payment rates for mental health services 
263.18 	based on RVUs and rendered on or after January 1, 2025, so that the payment rates are at 
263.19 	least equal to 84 percent of the Medicare Physician Fee Schedule.

263.20 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
263.21 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
263.22 	when federal approval is obtained.

263.23 	Sec. 27. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; 
263.24 	CHILDREN'S RESIDENTIAL FACILITY RULEMAKING.
 263.25 	(a) The commissioner of human services must use the expedited rulemaking process 
263.26 	and comply with all requirements under Minnesota Statutes, section 14.389, to adopt the 
263.27 	amendments required under this section. Notwithstanding Laws 1995, chapter 226, article 
263.28 	3, sections 50, 51, and 60, or any other law to the contrary, joint rulemaking authority with 
263.29 	the commissioner of corrections does not apply to rule amendments applicable only to the 
263.30 	commissioner of human services. An amendment to jointly administered rule parts must be 
263.31 	related to requirements under this section or to amendments that are necessary for consistency 
263.32 	with this section.
264.1 	(b) The commissioner of human services must amend Minnesota Rules, chapter 2960, 
264.2 	to replace all instances of the term "clinical supervision" with the term "treatment 
264.3 	supervision."
264.4 	(c) The commissioner of human services must amend Minnesota Rules, part 2960.0020, 
264.5 	to replace all instances of the term "clinical supervisor" with the term "treatment supervisor."
264.6 	(d) The commissioner of human services must amend Minnesota Rules, part 2960.0020, 
264.7 	to add the definition of "licensed prescriber" to mean an individual who is authorized to 
264.8 	prescribe legend drugs under Minnesota Statutes, section 151.37.
264.9 	(e) The commissioner of human services must amend Minnesota Rules, parts 2960.0020 
264.10 	to 2960.0710, to replace all instances of "physician" with "licensed prescriber." Amendments 
264.11 	to rules under this paragraph must apply only to the Department of Human Services.
264.12 	(f) The commissioner of human services must amend Minnesota Rules, part 2960.0620, 
264.13 	subpart 2, to strike all of the current language and insert the following language: "If a resident 
264.14 	is prescribed a psychotropic medication, the license holder must monitor for side effects of 
264.15 	the medication. Within 24 hours of admission, a registered nurse or licensed prescriber must 
264.16 	assess the resident for and document any current side effects and document instructions for 
264.17 	how frequently the license holder must monitor for side effects of the psychotropic 
264.18 	medications the resident is taking. When a resident begins taking a new psychotropic 
264.19 	medication or stops taking a psychotropic medication, the license holder must monitor for 
264.20 	side effects according to the instructions of the registered nurse or licensed prescriber. The 
264.21 	license holder must monitor for side effects using standardized checklists, rating scales, or 
264.22 	other tools according to the instructions of the registered nurse or licensed prescriber. The 
264.23 	license holder must provide the results of the checklist, rating scale, or other tool to the 
264.24 	licensed prescriber for review."
264.25 	(g) The commissioner of human services must amend Minnesota Rules, part 2960.0630, 
264.26 	subpart 2, to allow license holders to use the ancillary meeting process under Minnesota 
264.27 	Statutes, section 245I.23, subdivision 14, paragraph (c), if a staff member cannot participate 
264.28 	in a weekly clinical supervision session.
264.29 	(h) The commissioner of human services must amend Minnesota Rules, part 2960.0630, 
264.30 	subpart 3, to strike item D.

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

265.1 	Sec. 28. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; MEDICAL 
265.2 	ASSISTANCE CHILDREN'S RESIDENTIAL MENTAL HEALTH CRISIS 
265.3 	STABILIZATION.
 265.4 	(a) The commissioner of human services must consult with providers, advocates, Tribal 
265.5 	Nations, counties, people with lived experience as or with a child in a mental health crisis, 
265.6 	and other interested community members to develop a covered benefit under medical 
265.7 	assistance to provide residential mental health crisis stabilization for children. The benefit 
265.8 	must:
265.9 	(1) consist of evidence-based promising practices or culturally responsive treatment 
265.10 	services for children under the age of 21 experiencing a mental health crisis;
265.11 	(2) embody an integrative care model that supports individuals experiencing a mental 
265.12 	health crisis who may also be experiencing co-occurring conditions;
265.13 	(3) qualify for federal financial participation; and
265.14 	(4) include services that support children and families, including but not limited to:
265.15 	(i) an assessment of the child's immediate needs and factors that led to the mental health 
265.16 	crisis;
265.17 	(ii) individualized care to address immediate needs and restore the child to a precrisis 
265.18 	level of functioning;
265.19 	(iii) 24-hour on-site staff and assistance;
265.20 	(iv) supportive counseling and clinical services;
265.21 	(v) skills training and positive support services, as identified in the child's individual 
265.22 	crisis stabilization plan;
265.23 	(vi) referrals to other service providers in the community as needed and to support the 
265.24 	child's transition from residential crisis stabilization services;
265.25 	(vii) development of an individualized and culturally responsive crisis response action 
265.26 	plan; and
265.27 	(viii) assistance to access and store medication.
265.28 	(b) When developing the new benefit, the commissioner must make recommendations 
265.29 	for providers to be reimbursed for room and board.
266.1 	(c) The commissioner must consult with or contract with rate-setting experts to develop 
266.2 	a prospective data-based rate methodology for the children's residential mental health crisis 
266.3 	stabilization benefit.
266.4 	(d) No later than January 15, 2025, the commissioner must submit to the chairs and 
266.5 	ranking minority members of the legislative committees with jurisdiction over human 
266.6 	services policy and finance a report detailing for the children's residential mental health 
266.7 	crisis stabilization benefit the proposed:
266.8 	(1) eligibility criteria, clinical and service requirements, provider standards, licensing 
266.9 	requirements, and reimbursement rates;
266.10 	(2) the process for community engagement, community input, and crisis models studied 
266.11 	in other states;
266.12 	(3) a deadline for the commissioner to submit a state plan amendment to the Centers for 
266.13 	Medicare and Medicaid Services; and
266.14 	(4) draft legislation with the statutory changes necessary to implement the benefit.

266.15 	EFFECTIVE DATE. This section is effective July 1, 2024.

266.16 	Sec. 29. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; MENTAL 
266.17 	HEALTH PROCEDURE CODES.
 266.18 	The commissioner of human services must develop recommendations, in consultation 
266.19 	with external partners and medical coding and compliance experts, on simplifying mental 
266.20 	health procedure codes and the feasibility of converting mental health procedure codes to 
266.21 	the current procedural terminology (CPT) code structure. By October 1, 2025, the 
266.22 	commissioner must submit a report to the chairs and ranking minority members of the 
266.23 	legislative committees with jurisdiction over mental health on the recommendations and 
266.24 	methodology to simplify and restructure mental health procedure codes with corresponding 
266.25 	resource-based relative value scale (RBRVS) values.

266.26 	EFFECTIVE DATE. This section is effective July 1, 2024.

266.27 	Sec. 30. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; RESPITE 
266.28 	CARE ACCESS.
 266.29 	The commissioner of human services, in coordination with interested parties, must 
266.30 	develop proposals by December 31, 2025, to increase access to licensed respite foster care 
266.31 	homes that take into consideration the new rule directing title IV-E agencies to adopt one 
267.1 	set of licensing or approval standards for all relative or kinship foster family homes that is 
267.2 	different from the licensing or approval standards used for nonrelative or nonkinship foster 
267.3 	family homes, as provided by the Federal Register, volume 88, page 66700.

267.4 	Sec. 31. MENTAL HEALTH SERVICES FORMULA-BASED ALLOCATION.
 267.5 	The commissioner of human services shall consult with the commissioner of management 
267.6 	and budget, counties, Tribes, mental health providers, and advocacy organizations to develop 
267.7 	recommendations for moving from the children's and adult mental health grant funding 
267.8 	structure to a formula-based allocation structure for mental health services. The 
267.9 	recommendations must consider formula-based allocations for grants for respite care, 
267.10 	school-linked behavioral health, mobile crisis teams, and first episode of psychosis programs.

267.11 	Sec. 32. REVISOR INSTRUCTION.
 267.12 	The revisor of statutes, in consultation with the Office of Senate Counsel, Research and 
267.13 	Fiscal Analysis; the House Research Department; and the commissioner of human services, 
267.14 	shall prepare legislation for the 2025 legislative session to recodify Minnesota Statutes, 
267.15 	section 256B.0622, to move provisions related to assertive community treatment and intensive 
267.16 	residential treatment services into separate sections of statute. The revisor shall correct any 
267.17 	cross-references made necessary by this recodification.

267.18 	ARTICLE 10
267.19 	DEPARTMENT OF HUMAN SERVICES OFFICE OF INSPECTOR GENERAL

267.20 	Section 1. Minnesota Statutes 2023 Supplement, section 13.46, subdivision 4, as amended 
267.21 	by Laws 2024, chapter 80, article 8, section 4, is amended to read:
267.22 		Subd. 4.Licensing data. (a) As used in this subdivision:
267.23 	(1) "licensing data" are all data collected, maintained, used, or disseminated by the 
267.24 	welfare system pertaining to persons licensed or registered or who apply for licensure or 
267.25 	registration or who formerly were licensed or registered under the authority of the 
267.26 	commissioner of human services;
267.27 	(2) "client" means a person who is receiving services from a licensee or from an applicant 
267.28 	for licensure; and
267.29 	(3) "personal and personal financial data" are Social Security numbers, identity of and 
267.30 	letters of reference, insurance information, reports from the Bureau of Criminal 
267.31 	Apprehension, health examination reports, and social/home studies.
268.1 	(b)(1)(i) Except as provided in paragraph (c), the following data on applicants,
268.2 	certification holders, license holders, and former licensees are public: name, address, 
268.3 	telephone number of licensees, email addresses except for family child foster care, date of 
268.4 	receipt of a completed application, dates of licensure, licensed capacity, type of client 
268.5 	preferred, variances granted, record of training and education in child care and child 
268.6 	development, type of dwelling, name and relationship of other family members, previous 
268.7 	license history, class of license, the existence and status of complaints, and the number of 
268.8 	serious injuries to or deaths of individuals in the licensed program as reported to the 
268.9 	commissioner of human services; the commissioner of children, youth, and families; the 
268.10 	local social services agency; or any other county welfare agency. For purposes of this clause, 
268.11 	a serious injury is one that is treated by a physician.
268.12 	(ii) Except as provided in item (v), when a correction order, an order to forfeit a fine, 
268.13 	an order of license suspension, an order of temporary immediate suspension, an order of 
268.14 	license revocation, an order of license denial, or an order of conditional license has been 
268.15 	issued, or a complaint is resolved, the following data on current and former licensees and 
268.16 	applicants are public: the general nature of the complaint or allegations leading to the 
268.17 	temporary immediate suspension; the substance and investigative findings of the licensing 
268.18 	or maltreatment complaint, licensing violation, or substantiated maltreatment; the existence 
268.19 	of settlement negotiations; the record of informal resolution of a licensing violation; orders 
268.20 	of hearing; findings of fact; conclusions of law; specifications of the final correction order, 
268.21 	fine, suspension, temporary immediate suspension, revocation, denial, or conditional license 
268.22 	contained in the record of licensing action; whether a fine has been paid; and the status of 
268.23 	any appeal of these actions.
268.24 	(iii) When a license denial under section 142A.15 or 245A.05 or a sanction under section 
268.25 	142B.18 or 245A.07 is based on a determination that a license holder, applicant, or controlling 
268.26 	individual is responsible for maltreatment under section 626.557 or chapter 260E, the identity 
268.27 	of the applicant, license holder, or controlling individual as the individual responsible for 
268.28 	maltreatment is public data at the time of the issuance of the license denial or sanction.
268.29 	(iv) When a license denial under section 142A.15 or 245A.05 or a sanction under section 
268.30 	142B.18 or 245A.07 is based on a determination that a license holder, applicant, or controlling 
268.31 	individual is disqualified under chapter 245C, the identity of the license holder, applicant, 
268.32 	or controlling individual as the disqualified individual is public data at the time of the 
268.33 	issuance of the licensing sanction or denial. If the applicant, license holder, or controlling 
268.34 	individual requests reconsideration of the disqualification and the disqualification is affirmed, 
269.1 	the reason for the disqualification and the reason to not set aside the disqualification are 
269.2 	private data.
269.3 	(v) A correction order or fine issued to a child care provider for a licensing violation is 
269.4 	private data on individuals under section 13.02, subdivision 12, or nonpublic data under 
269.5 	section 13.02, subdivision 9, if the correction order or fine is seven years old or older.
269.6 	(2) For applicants who withdraw their application prior to licensure or denial of a license, 
269.7 	the following data are public: the name of the applicant, the city and county in which the 
269.8 	applicant was seeking licensure, the dates of the commissioner's receipt of the initial 
269.9 	application and completed application, the type of license sought, and the date of withdrawal 
269.10 	of the application.
269.11 	(3) For applicants who are denied a license, the following data are public: the name and 
269.12 	address of the applicant, the city and county in which the applicant was seeking licensure, 
269.13 	the dates of the commissioner's receipt of the initial application and completed application, 
269.14 	the type of license sought, the date of denial of the application, the nature of the basis for 
269.15 	the denial, the existence of settlement negotiations, the record of informal resolution of a 
269.16 	denial, orders of hearings, findings of fact, conclusions of law, specifications of the final 
269.17 	order of denial, and the status of any appeal of the denial.
269.18 	(4) When maltreatment is substantiated under section 626.557 or chapter 260E and the 
269.19 	victim and the substantiated perpetrator are affiliated with a program licensed under chapter 
269.20 	142B or 245A; the commissioner of human services; commissioner of children, youth, and 
269.21 	families; local social services agency; or county welfare agency may inform the license 
269.22 	holder where the maltreatment occurred of the identity of the substantiated perpetrator and 
269.23 	the victim.
269.24 	(5) Notwithstanding clause (1), for child foster care, only the name of the license holder 
269.25 	and the status of the license are public if the county attorney has requested that data otherwise 
269.26 	classified as public data under clause (1) be considered private data based on the best interests 
269.27 	of a child in placement in a licensed program.
269.28 	(c) The following are private data on individuals under section 13.02, subdivision 12, 
269.29 	or nonpublic data under section 13.02, subdivision 9: personal and personal financial data 
269.30 	on family day care program and family foster care program applicants and licensees and 
269.31 	their family members who provide services under the license.
269.32 	(d) The following are private data on individuals: the identity of persons who have made 
269.33 	reports concerning licensees or applicants that appear in inactive investigative data, and the 
269.34 	records of clients or employees of the licensee or applicant for licensure whose records are 
270.1 	received by the licensing agency for purposes of review or in anticipation of a contested 
270.2 	matter. The names of reporters of complaints or alleged violations of licensing standards 
270.3 	under chapters 142B, 245A, 245B, 245C, and 245D, and applicable rules and alleged 
270.4 	maltreatment under section 626.557 and chapter 260E, are confidential data and may be 
270.5 	disclosed only as provided in section 260E.21, subdivision 4; 260E.35; or 626.557, 
270.6 	subdivision 12b.
270.7 	(e) Data classified as private, confidential, nonpublic, or protected nonpublic under this 
270.8 	subdivision become public data if submitted to a court or administrative law judge as part 
270.9 	of a disciplinary proceeding in which there is a public hearing concerning a license which 
270.10 	has been suspended, immediately suspended, revoked, or denied.
270.11 	(f) Data generated in the course of licensing investigations that relate to an alleged 
270.12 	violation of law are investigative data under subdivision 3.
270.13 	(g) Data that are not public data collected, maintained, used, or disseminated under this 
270.14 	subdivision that relate to or are derived from a report as defined in section 260E.03, or 
270.15 	626.5572, subdivision 18, are subject to the destruction provisions of sections 260E.35, 
270.16 	subdivision 6, and 626.557, subdivision 12b.
270.17 	(h) Upon request, not public data collected, maintained, used, or disseminated under 
270.18 	this subdivision that relate to or are derived from a report of substantiated maltreatment as 
270.19 	defined in section 626.557 or chapter 260E may be exchanged with the Department of 
270.20 	Health for purposes of completing background studies pursuant to section 144.057 and with 
270.21 	the Department of Corrections for purposes of completing background studies pursuant to 
270.22 	section 241.021.
270.23 	(i) Data on individuals collected according to licensing activities under chapters 142B, 
270.24 	245A, and 245C, data on individuals collected by the commissioner of human services 
270.25 	according to investigations under section 626.557 and chapters 142B, 245A, 245B, 245C, 
270.26 	245D, and 260E may be shared with the Department of Human Rights, the Department of 
270.27 	Health, the Department of Corrections, the ombudsman for mental health and developmental 
270.28 	disabilities, and the individual's professional regulatory board when there is reason to believe 
270.29 	that laws or standards under the jurisdiction of those agencies may have been violated or 
270.30 	the information may otherwise be relevant to the board's regulatory jurisdiction. Background 
270.31 	study data on an individual who is the subject of a background study under chapter 245C 
270.32 	for a licensed service for which the commissioner of human services or children, youth, 
270.33 	and families is the license holder may be shared with the commissioner and the 
271.1 	commissioner's delegate by the licensing division. Unless otherwise specified in this chapter, 
271.2 	the identity of a reporter of alleged maltreatment or licensing violations may not be disclosed.
271.3 	(j) In addition to the notice of determinations required under sections 260E.24, 
271.4 	subdivisions 5 and 7, and 260E.30, subdivision 6, paragraphs (b), (c), (d), (e), and (f), if the 
271.5 	commissioner of children, youth, and families or the local social services agency has 
271.6 	determined that an individual is a substantiated perpetrator of maltreatment of a child based 
271.7 	on sexual abuse, as defined in section 260E.03, and the commissioner or local social services 
271.8 	agency knows that the individual is a person responsible for a child's care in another facility, 
271.9 	the commissioner or local social services agency shall notify the head of that facility of this 
271.10 	determination. The notification must include an explanation of the individual's available 
271.11 	appeal rights and the status of any appeal. If a notice is given under this paragraph, the 
271.12 	government entity making the notification shall provide a copy of the notice to the individual 
271.13 	who is the subject of the notice.
271.14 	(k) All not public data collected, maintained, used, or disseminated under this subdivision 
271.15 	and subdivision 3 may be exchanged between the Department of Human Services, Licensing 
271.16 	Division, and the Department of Corrections for purposes of regulating services for which 
271.17 	the Department of Human Services and the Department of Corrections have regulatory 
271.18 	authority.

271.19 	EFFECTIVE DATE. This section is effective January 1, 2025.

271.20 	Sec. 2. Minnesota Statutes 2023 Supplement, section 245A.03, subdivision 2, as amended 
271.21 	by Laws 2024, chapter 80, article 2, section 35, and Laws 2024, chapter 85, section 52, is 
271.22 	amended to read:
271.23 		Subd. 2.Exclusion from licensure. (a) This chapter does not apply to:
271.24 	(1) residential or nonresidential programs that are provided to a person by an individual 
271.25 	who is related;
271.26 	(2) nonresidential programs that are provided by an unrelated individual to persons from 
271.27 	a single related family;
271.28 	(3) residential or nonresidential programs that are provided to adults who do not misuse 
271.29 	substances or have a substance use disorder, a mental illness, a developmental disability, a 
271.30 	functional impairment, or a physical disability;
271.31 	(4) sheltered workshops or work activity programs that are certified by the commissioner 
271.32 	of employment and economic development;
272.1 	(5) programs operated by a public school for children 33 months or older;
272.2 	(6) nonresidential programs primarily for children that provide care or supervision for 
272.3 	periods of less than three hours a day while the child's parent or legal guardian is in the 
272.4 	same building as the nonresidential program or present within another building that is 
272.5 	directly contiguous to the building in which the nonresidential program is located;
272.6 	(7) nursing homes or hospitals licensed by the commissioner of health except as specified 
272.7 	under section 245A.02;
272.8 	(8) board and lodge facilities licensed by the commissioner of health that do not provide 
272.9 	children's residential services under Minnesota Rules, chapter 2960, mental health or 
272.10 	substance use disorder treatment;
272.11 	(9) programs licensed by the commissioner of corrections;
272.12 	(10) recreation programs for children or adults that are operated or approved by a park 
272.13 	and recreation board whose primary purpose is to provide social and recreational activities;
272.14 	(11) noncertified boarding care homes unless they provide services for five or more 
272.15 	persons whose primary diagnosis is mental illness or a developmental disability;
272.16 	(12) programs for children such as scouting, boys clubs, girls clubs, and sports and art 
272.17 	programs, and nonresidential programs for children provided for a cumulative total of less 
272.18 	than 30 days in any 12-month period;
272.19 	(13) residential programs for persons with mental illness, that are located in hospitals;
272.20 	(14) camps licensed by the commissioner of health under Minnesota Rules, chapter 
272.21 	4630;
272.22 	(15) mental health outpatient services for adults with mental illness or children with 
272.23 	emotional disturbance;
272.24 	(16) residential programs serving school-age children whose sole purpose is cultural or 
272.25 	educational exchange, until the commissioner adopts appropriate rules;
272.26 	(17) community support services programs as defined in section 245.462, subdivision 
272.27 	6, and family community support services as defined in section 245.4871, subdivision 17;
272.28 	(18) settings registered under chapter 144G that provide home care services licensed by 
272.29 	the commissioner of health to fewer than seven adults assisted living facilities licensed by 
272.30 	the commissioner of health under chapter 144G;
273.1 	(19) substance use disorder treatment activities of licensed professionals in private 
273.2 	practice as defined in section 245G.01, subdivision 17;
273.3 	(20) consumer-directed community support service funded under the Medicaid waiver 
273.4 	for persons with developmental disabilities when the individual who provided the service 
273.5 	is:
273.6 	(i) the same individual who is the direct payee of these specific waiver funds or paid by 
273.7 	a fiscal agent, fiscal intermediary, or employer of record; and
273.8 	(ii) not otherwise under the control of a residential or nonresidential program that is 
273.9 	required to be licensed under this chapter when providing the service;
273.10 	(21) a county that is an eligible vendor under section 254B.05 to provide care coordination 
273.11 	and comprehensive assessment services;
273.12 	(22) a recovery community organization that is an eligible vendor under section 254B.05 
273.13 	to provide peer recovery support services; or
273.14 	(23) programs licensed by the commissioner of children, youth, and families in chapter 
273.15 	142B.
273.16 	(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a 
273.17 	building in which a nonresidential program is located if it shares a common wall with the 
273.18 	building in which the nonresidential program is located or is attached to that building by 
273.19 	skyway, tunnel, atrium, or common roof.
273.20 	(c) Except for the home and community-based services identified in section 245D.03, 
273.21 	subdivision 1, nothing in this chapter shall be construed to require licensure for any services 
273.22 	provided and funded according to an approved federal waiver plan where licensure is 
273.23 	specifically identified as not being a condition for the services and funding.

273.24 	Sec. 3. Minnesota Statutes 2022, section 245A.04, is amended by adding a subdivision to 
273.25 	read:
273.26 		Subd. 7b.Notification to commissioner of changes in key staff positions; children's 
273.27 	residential facilities and detoxification programs. (a) A license holder must notify the 
273.28 	commissioner within five business days of a change or vacancy in a key staff position under 
273.29 	paragraph (b) or (c). The license holder must notify the commissioner of the staffing change 
273.30 	on a form approved by the commissioner and include the name of the staff person now 
273.31 	assigned to the key staff position and the staff person's qualifications for the position. The 
274.1 	license holder must notify the program licensor of a vacancy to discuss how the duties of 
274.2 	the key staff position will be fulfilled during the vacancy.
274.3 	(b) The key staff position for a children's residential facility licensed according to 
274.4 	Minnesota Rules, parts 2960.0130 to 2960.0220, is a program director; and
274.5 	(c) The key staff positions for a detoxification program licensed according to Minnesota 
274.6 	Rules, parts 9530.6510 to 9530.6590, are:
274.7 	(1) a program director as required by Minnesota Rules, part 9530.6560, subpart 1;
274.8 	(2) a registered nurse as required by Minnesota Rules, part 9530.6560, subpart 4; and
274.9 	(3) a medical director as required by Minnesota Rules, part 9530.6560, subpart 5.

274.10 	EFFECTIVE DATE. This section is effective January 1, 2025.

274.11 	Sec. 4. Minnesota Statutes 2022, section 245A.043, subdivision 2, is amended to read:
274.12 		Subd. 2.Change in ownership. (a) If the commissioner determines that there is a change 
274.13 	in ownership, the commissioner shall require submission of a new license application. This 
274.14 	subdivision does not apply to a licensed program or service located in a home where the 
274.15 	license holder resides. A change in ownership occurs when:
274.16 	(1) except as provided in paragraph (b), the license holder sells or transfers 100 percent 
274.17 	of the property, stock, or assets;
274.18 	(2) the license holder merges with another organization;
274.19 	(3) the license holder consolidates with two or more organizations, resulting in the 
274.20 	creation of a new organization;
274.21 	(4) there is a change to the federal tax identification number associated with the license 
274.22 	holder; or
274.23 	(5) except as provided in paragraph (b), all controlling individuals associated with for
274.24 	the original application license have changed.
274.25 	(b) Notwithstanding For changes under paragraph (a), clauses (1) and or (5), no change 
274.26 	in ownership has occurred and a new license application is not required if at least one 
274.27 	controlling individual has been listed affiliated as a controlling individual for the license 
274.28 	for at least the previous 12 months immediately preceding the change.

274.29 	EFFECTIVE DATE. This section is effective January 1, 2025.

275.1 	Sec. 5. Minnesota Statutes 2023 Supplement, section 245A.043, subdivision 3, is amended 
275.2 	to read:
275.3 		Subd. 3.Standard change of ownership process. (a) When a change in ownership is 
275.4 	proposed and the party intends to assume operation without an interruption in service longer 
275.5 	than 60 days after acquiring the program or service, the license holder must provide the 
275.6 	commissioner with written notice of the proposed change on a form provided by the 
275.7 	commissioner at least 60 90 days before the anticipated date of the change in ownership. 
275.8 	For purposes of this subdivision and subdivision 4 section, "party" means the party that 
275.9 	intends to operate the service or program.
275.10 	(b) The party must submit a license application under this chapter on the form and in 
275.11 	the manner prescribed by the commissioner at least 30 90 days before the change in 
275.12 	ownership is anticipated to be complete, and must include documentation to support the 
275.13 	upcoming change. The party must comply with background study requirements under chapter 
275.14 	245C and shall pay the application fee required under section 245A.10.
275.15 	(c) A party that intends to assume operation without an interruption in service longer 
275.16 	than 60 days after acquiring the program or service is exempt from the requirements of 
275.17 	sections 245G.03, subdivision 2, paragraph (b), and 254B.03, subdivision 2, paragraphs (c) 
275.18 	and (d).
275.19 	(c) (d) The commissioner may streamline application procedures when the party is an 
275.20 	existing license holder under this chapter and is acquiring a program licensed under this 
275.21 	chapter or service in the same service class as one or more licensed programs or services 
275.22 	the party operates and those licenses are in substantial compliance. For purposes of this 
275.23 	subdivision, "substantial compliance" means within the previous 12 months the commissioner 
275.24 	did not (1) issue a sanction under section 245A.07 against a license held by the party, or 
275.25 	(2) make a license held by the party conditional according to section 245A.06.
275.26 	(d) Except when a temporary change in ownership license is issued pursuant to 
275.27 	subdivision 4 (e) While the standard change of ownership process is pending, the existing 
275.28 	license holder is solely remains responsible for operating the program according to applicable 
275.29 	laws and rules until a license under this chapter is issued to the party.
275.30 	(e) (f) If a licensing inspection of the program or service was conducted within the 
275.31 	previous 12 months and the existing license holder's license record demonstrates substantial 
275.32 	compliance with the applicable licensing requirements, the commissioner may waive the 
275.33 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
275.34 	commissioner (1) proof that the premises was inspected by a fire marshal or that the fire 
276.1 	marshal deemed that an inspection was not warranted, and (2) proof that the premises was 
276.2 	inspected for compliance with the building code or that no inspection was deemed warranted.
276.3 	(f) (g) If the party is seeking a license for a program or service that has an outstanding 
276.4 	action under section 245A.06 or 245A.07, the party must submit a letter written plan as part 
276.5 	of the application process identifying how the party has or will come into full compliance 
276.6 	with the licensing requirements.
276.7 	(g) (h) The commissioner shall evaluate the party's application according to section 
276.8 	245A.04, subdivision 6. If the commissioner determines that the party has remedied or 
276.9 	demonstrates the ability to remedy the outstanding actions under section 245A.06 or 245A.07
276.10 	and has determined that the program otherwise complies with all applicable laws and rules, 
276.11 	the commissioner shall issue a license or conditional license under this chapter. A conditional 
276.12 	license issued under this section is final and not subject to reconsideration under section 
276.13 	245A.06, subdivision 4. The conditional license remains in effect until the commissioner 
276.14 	determines that the grounds for the action are corrected or no longer exist.
276.15 	(h) (i) The commissioner may deny an application as provided in section 245A.05. An 
276.16 	applicant whose application was denied by the commissioner may appeal the denial according 
276.17 	to section 245A.05.
276.18 	(i) (j) This subdivision does not apply to a licensed program or service located in a home 
276.19 	where the license holder resides.

276.20 	EFFECTIVE DATE. This section is effective January 1, 2025.

276.21 	Sec. 6. Minnesota Statutes 2022, section 245A.043, is amended by adding a subdivision 
276.22 	to read:
276.23 		Subd. 3a.Emergency change in ownership process. (a) In the event of a death of a 
276.24 	license holder or sole controlling individual or a court order or other event that results in 
276.25 	the license holder being inaccessible or unable to operate the program or service, a party 
276.26 	may submit a request to the commissioner to allow the party to assume operation of the 
276.27 	program or service under an emergency change in ownership process to ensure persons 
276.28 	continue to receive services while the commissioner evaluates the party's license application.
276.29 	(b) To request the emergency change of ownership process, the party must immediately:
276.30 	(1) notify the commissioner of the event resulting in the inability of the license holder 
276.31 	to operate the program and of the party's intent to assume operations; and
277.1 	(2) provide the commissioner with documentation that demonstrates the party has a legal 
277.2 	or legitimate ownership interest in the program or service if applicable and is able to operate 
277.3 	the program or service.
277.4 	(c) If the commissioner approves the party to continue operating the program or service 
277.5 	under an emergency change in ownership process, the party must:
277.6 	(1) request to be added as a controlling individual or license holder to the existing license;
277.7 	(2) notify persons receiving services of the emergency change in ownership in a manner 
277.8 	approved by the commissioner;
277.9 	(3) submit an application for a new license within 30 days of approval;
277.10 	(4) comply with the background study requirements under chapter 245C; and
277.11 	(5) pay the application fee required under section 245A.10.
277.12 	(d) While the emergency change of ownership process is pending, a party approved 
277.13 	under this subdivision is responsible for operating the program under the existing license 
277.14 	according to applicable laws and rules until a new license under this chapter is issued.
277.15 	(e) The provisions in subdivision 3, paragraphs (c), (d), and (f) to (i) apply to this 
277.16 	subdivision.
277.17 	(f) Once a party is issued a new license or has decided not to seek a new license, the 
277.18 	commissioner must close the existing license.
277.19 	(g) This subdivision applies to any program or service licensed under this chapter.

277.20 	EFFECTIVE DATE. This section is effective January 1, 2025.

277.21 	Sec. 7. Minnesota Statutes 2022, section 245A.043, subdivision 4, is amended to read:
277.22 		Subd. 4.Temporary change in ownership transitional license. (a) After receiving the 
277.23 	party's application pursuant to subdivision 3, upon the written request of the existing license 
277.24 	holder and the party, the commissioner may issue a temporary change in ownership license 
277.25 	to the party while the commissioner evaluates the party's application. Until a decision is 
277.26 	made to grant or deny a license under this chapter, the existing license holder and the party 
277.27 	shall both be responsible for operating the program or service according to applicable laws 
277.28 	and rules, and the sale or transfer of the existing license holder's ownership interest in the 
277.29 	licensed program or service does not terminate the existing license.
277.30 	(b) The commissioner may issue a temporary change in ownership license when a license 
277.31 	holder's death, divorce, or other event affects the ownership of the program and an applicant 
278.1 	seeks to assume operation of the program or service to ensure continuity of the program or 
278.2 	service while a license application is evaluated.
278.3 	(c) This subdivision applies to any program or service licensed under this chapter.
278.4 	If a party's application under subdivision 2 is for a satellite license for a community 
278.5 	residential setting under section 245D.23 or day services facility under 245D.27 and if the 
278.6 	party already holds an active license to provide services under chapter 245D, the 
278.7 	commissioner may issue a temporary transitional license to the party for the community 
278.8 	residential setting or day services facility while the commissioner evaluates the party's 
278.9 	application. Until a decision is made to grant or deny a community residential setting or 
278.10 	day services facility satellite license, the party must be solely responsible for operating the 
278.11 	program according to applicable laws and rules, and the existing license must be closed. 
278.12 	The temporary transitional license expires after 12 months from the date it was issued or 
278.13 	upon issuance of the community residential setting or day services facility satellite license, 
278.14 	whichever occurs first.

278.15 	EFFECTIVE DATE. This section is effective January 1, 2025.

278.16 	Sec. 8. Minnesota Statutes 2022, section 245A.043, is amended by adding a subdivision 
278.17 	to read:
278.18 		Subd. 5.Failure to comply. If the commissioner finds that the applicant or license holder 
278.19 	has not fully complied with this section, the commissioner may impose a licensing sanction 
278.20 	under section 245A.05, 245A.06, or 245A.07.

278.21 	EFFECTIVE DATE. This section is effective January 1, 2025.

278.22 	Sec. 9. Minnesota Statutes 2023 Supplement, section 245A.07, subdivision 1, as amended 
278.23 	by Laws 2024, chapter 80, article 2, section 44, is amended to read:
278.24 		Subdivision 1.Sanctions; appeals; license. (a) In addition to making a license conditional 
278.25 	under section 245A.06, the commissioner may suspend or revoke the license, impose a fine, 
278.26 	or secure an injunction against the continuing operation of the program of a license holder 
278.27 	who does not comply with applicable law or rule. When applying sanctions authorized under 
278.28 	this section, the commissioner shall consider the nature, chronicity, or severity of the violation 
278.29 	of law or rule and the effect of the violation on the health, safety, or rights of persons served 
278.30 	by the program.
278.31 	(b) If a license holder appeals the suspension or revocation of a license and the license 
278.32 	holder continues to operate the program pending a final order on the appeal, the commissioner 
279.1 	shall issue the license holder a temporary provisional license. The commissioner may include 
279.2 	terms the license holder must follow pending a final order on the appeal. Unless otherwise 
279.3 	specified by the commissioner, variances in effect on the date of the license sanction under 
279.4 	appeal continue under the temporary provisional license. If a license holder fails to comply 
279.5 	with applicable law or rule while operating under a temporary provisional license, the 
279.6 	commissioner may impose additional sanctions under this section and section 245A.06, and 
279.7 	may terminate any prior variance. If a temporary provisional license is set to expire, a new 
279.8 	temporary provisional license shall be issued to the license holder upon payment of any fee 
279.9 	required under section 245A.10. The temporary provisional license shall expire on the date 
279.10 	the final order is issued. If the license holder prevails on the appeal, a new nonprovisional 
279.11 	license shall be issued for the remainder of the current license period.
279.12 	(c) If a license holder is under investigation and the license issued under this chapter is 
279.13 	due to expire before completion of the investigation, the program shall be issued a new 
279.14 	license upon completion of the reapplication requirements and payment of any applicable 
279.15 	license fee. Upon completion of the investigation, a licensing sanction may be imposed 
279.16 	against the new license under this section, section 245A.06, or 245A.08.
279.17 	(d) Failure to reapply or closure of a license issued under this chapter by the license 
279.18 	holder prior to the completion of any investigation shall not preclude the commissioner 
279.19 	from issuing a licensing sanction under this section or section 245A.06 at the conclusion 
279.20 	of the investigation.

279.21 	EFFECTIVE DATE. This section is effective January 1, 2025.

279.22 	Sec. 10. Minnesota Statutes 2022, section 245A.07, subdivision 6, is amended to read:
279.23 		Subd. 6.Appeal of multiple sanctions. (a) When the license holder appeals more than 
279.24 	one licensing action or sanction that were simultaneously issued by the commissioner, the 
279.25 	license holder shall specify the actions or sanctions that are being appealed.
279.26 	(b) If there are different timelines prescribed in statutes for the licensing actions or 
279.27 	sanctions being appealed, the license holder must submit the appeal within the longest of 
279.28 	those timelines specified in statutes.
279.29 	(c) The appeal must be made in writing by certified mail or, personal service, or through 
279.30 	the provider licensing and reporting hub. If mailed, the appeal must be postmarked and sent 
279.31 	to the commissioner within the prescribed timeline with the first day beginning the day after 
279.32 	the license holder receives the certified letter. If a request is made by personal service, it 
279.33 	must be received by the commissioner within the prescribed timeline with the first day 
280.1 	beginning the day after the license holder receives the certified letter. If the appeal is made 
280.2 	through the provider hub, the appeal must be received by the commissioner within the 
280.3 	prescribed timeline with the first day beginning the day after the commissioner issued the 
280.4 	order through the hub.
280.5 	(d) When there are different timelines prescribed in statutes for the appeal of licensing 
280.6 	actions or sanctions simultaneously issued by the commissioner, the commissioner shall 
280.7 	specify in the notice to the license holder the timeline for appeal as specified under paragraph 
280.8 	(b).

280.9 	Sec. 11. Minnesota Statutes 2023 Supplement, section 245A.11, subdivision 7, is amended 
280.10 	to read:
280.11 		Subd. 7.Adult foster care and community residential setting; variance for alternate 
280.12 	overnight supervision. (a) The commissioner may grant a variance under section 245A.04, 
280.13 	subdivision 9, to statute or rule parts requiring a caregiver to be present in an adult foster 
280.14 	care home or a community residential setting during normal sleeping hours to allow for 
280.15 	alternative methods of overnight supervision. The commissioner may grant the variance if 
280.16 	the local county licensing agency recommends the variance and the county recommendation 
280.17 	includes documentation verifying that:
280.18 	(1) the county has approved the license holder's plan for alternative methods of providing 
280.19 	overnight supervision and determined the plan protects the residents' health, safety, and 
280.20 	rights;
280.21 	(2) the license holder has obtained written and signed informed consent from each 
280.22 	resident or each resident's legal representative documenting the resident's or legal 
280.23 	representative's agreement with the alternative method of overnight supervision; and
280.24 	(3) the alternative method of providing overnight supervision, which may include the 
280.25 	use of technology, is specified for each resident in the resident's: (i) individualized plan of 
280.26 	care; (ii) individual service support plan under section 256B.092, subdivision 1b, if required; 
280.27 	or (iii) individual resident placement agreement under Minnesota Rules, part 9555.5105, 
280.28 	subpart 19, if required.
280.29 	(b) To be eligible for a variance under paragraph (a), the adult foster care or community 
280.30 	residential setting license holder must not have had a conditional license issued under section 
280.31 	245A.06, or any other licensing sanction issued under section 245A.07 during the prior 24 
280.32 	months based on failure to provide adequate supervision, health care services, or resident 
280.33 	safety in the adult foster care home or a community residential setting.
281.1 	(c) A license holder requesting a variance under this subdivision to utilize technology 
281.2 	as a component of a plan for alternative overnight supervision may request the commissioner's 
281.3 	review in the absence of a county recommendation. Upon receipt of such a request from a 
281.4 	license holder, the commissioner shall review the variance request with the county.
281.5 	(d) The variance requirements under this subdivision for alternative overnight supervision 
281.6 	do not apply to community residential settings licensed under chapter 245D.

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

281.8 	Sec. 12. Minnesota Statutes 2023 Supplement, section 245A.16, subdivision 1, as amended 
281.9 	by Laws 2024, chapter 80, article 2, section 65, is amended to read:
281.10 		Subdivision 1.Delegation of authority to agencies. (a) County agencies that have been 
281.11 	designated by the commissioner to perform licensing functions and activities under section 
281.12 	245A.04; to recommend denial of applicants under section 245A.05; to issue correction 
281.13 	orders, to issue variances, and recommend a conditional license under section 245A.06; or 
281.14 	to recommend suspending or revoking a license or issuing a fine under section 245A.07, 
281.15 	shall comply with rules and directives of the commissioner governing those functions and 
281.16 	with this section. The following variances are excluded from the delegation of variance 
281.17 	authority and may be issued only by the commissioner:
281.18 	(1) dual licensure of family child foster care and family adult foster care, dual licensure 
281.19 	of child foster residence setting and community residential setting, and dual licensure of 
281.20 	family adult foster care and family child care;
281.21 	(2) adult foster care or community residential setting maximum capacity;
281.22 	(3) adult foster care or community residential setting minimum age requirement;
281.23 	(4) child foster care maximum age requirement;
281.24 	(5) variances regarding disqualified individuals;
281.25 	(6) the required presence of a caregiver in the adult foster care residence during normal 
281.26 	sleeping hours;
281.27 	(7) variances to requirements relating to chemical use problems of a license holder or a 
281.28 	household member of a license holder; and
281.29 	(8) variances to section 142B.46 for the use of a cradleboard for a cultural 
281.30 	accommodation.
282.1 	(b) For family adult day services programs, the commissioner may authorize licensing 
282.2 	reviews every two years after a licensee has had at least one annual review.
282.3 	(c) A license issued under this section may be issued for up to two years.
282.4 	(d) During implementation of chapter 245D, the commissioner shall consider:
282.5 	(1) the role of counties in quality assurance;
282.6 	(2) the duties of county licensing staff; and
282.7 	(3) the possible use of joint powers agreements, according to section 471.59, with counties 
282.8 	through which some licensing duties under chapter 245D may be delegated by the 
282.9 	commissioner to the counties.
282.10 	Any consideration related to this paragraph must meet all of the requirements of the corrective 
282.11 	action plan ordered by the federal Centers for Medicare and Medicaid Services.
282.12 	(e) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or 
282.13 	successor provisions; and section 245D.061 or successor provisions, for family child foster 
282.14 	care programs providing out-of-home respite, as identified in section 245D.03, subdivision 
282.15 	1, paragraph (b), clause (1), is excluded from the delegation of authority to county agencies.

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

282.17 	Sec. 13. Minnesota Statutes 2023 Supplement, section 245A.211, subdivision 4, is amended 
282.18 	to read:
282.19 		Subd. 4.Contraindicated physical restraints. A license or certification holder must 
282.20 	not implement a restraint on a person receiving services in a program in a way that is 
282.21 	contraindicated for any of the person's known medical or psychological conditions. Prior 
282.22 	to using restraints on a person, the license or certification holder must assess and document 
282.23 	a determination of any with a known medical or psychological conditions that restraints are 
282.24 	contraindicated for, the license or certification holder must document the contraindication
282.25 	and the type of restraints that will not be used on the person based on this determination.

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

282.27 	Sec. 14. Minnesota Statutes 2023 Supplement, section 245A.242, subdivision 2, is amended 
282.28 	to read:
282.29 		Subd. 2.Emergency overdose treatment. (a) A license holder must maintain a supply 
282.30 	of opiate antagonists as defined in section 604A.04, subdivision 1, available for emergency 
282.31 	treatment of opioid overdose and must have a written standing order protocol by a physician 
283.1 	who is licensed under chapter 147, advanced practice registered nurse who is licensed under 
283.2 	chapter 148, or physician assistant who is licensed under chapter 147A, that permits the 
283.3 	license holder to maintain a supply of opiate antagonists on site. A license holder must 
283.4 	require staff to undergo training in the specific mode of administration used at the program, 
283.5 	which may include intranasal administration, intramuscular injection, or both.
283.6 	(b) Notwithstanding any requirements to the contrary in Minnesota Rules, chapters 2960 
283.7 	and 9530, and Minnesota Statutes, chapters 245F, 245G, and 245I:
283.8 	(1) emergency opiate antagonist medications are not required to be stored in a locked 
283.9 	area and staff and adult clients may carry this medication on them and store it in an unlocked 
283.10 	location;
283.11 	(2) staff persons who only administer emergency opiate antagonist medications only 
283.12 	require the training required by paragraph (a), which any knowledgeable trainer may provide. 
283.13 	The trainer is not required to be a registered nurse or part of an accredited educational 
283.14 	institution; and
283.15 	(3) nonresidential substance use disorder treatment programs that do not administer 
283.16 	client medications beyond emergency opiate antagonist medications are not required to 
283.17 	have the policies and procedures required in section 245G.08, subdivisions 5 and 6, and 
283.18 	must instead describe the program's procedures for administering opiate antagonist 
283.19 	medications in the license holder's description of health care services under section 245G.08, 
283.20 	subdivision 1.

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

283.22 	Sec. 15. Minnesota Statutes 2022, section 245A.52, subdivision 2, is amended to read:
283.23 		Subd. 2.Door to attached garage. Notwithstanding Minnesota Rules, part 9502.0425, 
283.24 	subpart 5, day care residences with an attached garage are not required to have a self-closing 
283.25 	door to the residence. The door to the residence may be (a) If there is an opening between 
283.26 	an attached garage and a day care residence, there must be a door that is:
283.27 	(1) a solid wood bonded-core door at least 1-3/8 inches thick;
283.28 	(2) a steel insulated door if the door is at least 1-3/8 inches thick.; or
283.29 	(3) a door with a fire protection rating of 20 minutes.
283.30 	(b) The separation wall on the garage side between the residence and garage must consist 
283.31 	of 1/2-inch-thick gypsum wallboard or its equivalent.

284.1 	Sec. 16. Minnesota Statutes 2023 Supplement, section 245C.02, subdivision 13e, is 
284.2 	amended to read:
284.3 		Subd. 13e.NETStudy 2.0. (a) "NETStudy 2.0" means the commissioner's system that 
284.4 	replaces both NETStudy and the department's internal background study processing system. 
284.5 	NETStudy 2.0 is designed to enhance protection of children and vulnerable adults by 
284.6 	improving the accuracy of background studies through fingerprint-based criminal record 
284.7 	checks and expanding the background studies to include a review of information from the 
284.8 	Minnesota Court Information System and the national crime information database. NETStudy 
284.9 	2.0 is also designed to increase efficiencies in and the speed of the hiring process by:
284.10 	(1) providing access to and updates from public web-based data related to employment 
284.11 	eligibility;
284.12 	(2) decreasing the need for repeat studies through electronic updates of background 
284.13 	study subjects' criminal records;
284.14 	(3) supporting identity verification using subjects' Social Security numbers and 
284.15 	photographs;
284.16 	(4) using electronic employer notifications;
284.17 	(5) issuing immediate verification of subjects' eligibility to provide services as more 
284.18 	studies are completed under the NETStudy 2.0 system; and
284.19 	(6) providing electronic access to certain notices for entities and background study 
284.20 	subjects.
284.21 	(b) Information obtained by entities from public web-based data through NETStudy 2.0 
284.22 	under paragraph (a), clause (1), or any other source that is not direct correspondence from 
284.23 	the commissioner is not a notice of disqualification from the commissioner under this 
284.24 	chapter.

284.25 	Sec. 17. Minnesota Statutes 2023 Supplement, section 245C.033, subdivision 3, is amended 
284.26 	to read:
284.27 		Subd. 3.Procedure; maltreatment and state licensing agency data. (a) For requests 
284.28 	paid directly by the guardian or conservator, requests for maltreatment and state licensing 
284.29 	agency data checks must be submitted by the guardian or conservator to the commissioner 
284.30 	on the form or in the manner prescribed by the commissioner. Upon receipt of a signed 
284.31 	informed consent and payment under section 245C.10, the commissioner shall complete 
284.32 	the maltreatment and state licensing agency checks. Upon completion of the checks, the 
285.1 	commissioner shall provide the requested information to the courts on the form or in the 
285.2 	manner prescribed by the commissioner.
285.3 	(b) For requests paid by the court based on the in forma pauperis status of the guardian 
285.4 	or conservator, requests for maltreatment and state licensing agency data checks must be 
285.5 	submitted by the court to the commissioner on the form or in the manner prescribed by the 
285.6 	commissioner. The form will serve as certification that the individual has been granted in 
285.7 	forma pauperis status. Upon receipt of a signed data request consent form from the court, 
285.8 	the commissioner shall initiate the maltreatment and state licensing agency checks. Upon 
285.9 	completion of the checks, the commissioner shall provide the requested information to the 
285.10 	courts on the form or in the manner prescribed by the commissioner.

285.11 	Sec. 18. [245C.041] EMERGENCY WAIVER TO TEMPORARILY MODIFY 
285.12 	BACKGROUND STUDY REQUIREMENTS.
285.13 	(a) In the event of an emergency identified by the commissioner, the commissioner may 
285.14 	temporarily waive or modify provisions in this chapter, except that the commissioner shall 
285.15 	not waive or modify:
285.16 	(1) disqualification standards in section 245C.14 or 245C; or
285.17 	(2) any provision regarding the scope of individuals required to be subject to a background 
285.18 	study conducted under this chapter.
285.19 	(b) For the purposes of this section, an emergency may include, but is not limited to a 
285.20 	public health emergency, environmental emergency, natural disaster, or other unplanned 
285.21 	event that the commissioner has determined prevents the requirements in this chapter from 
285.22 	being met. This authority shall not exceed the amount of time needed to respond to the 
285.23 	emergency and reinstate the requirements of this chapter. The commissioner has the authority 
285.24 	to establish the process and time frame for returning to full compliance with this chapter. 
285.25 	The commissioner shall determine the length of time an emergency study is valid.
285.26 	(c) At the conclusion of the emergency, entities must submit a new, compliant background 
285.27 	study application and fee for each individual who was the subject of background study 
285.28 	affected by the powers created in this section, referred to as an "emergency study" to have 
285.29 	a new study that fully complies with this chapter within a time frame and notice period 
285.30 	established by the commissioner.

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

286.1 	Sec. 19. Minnesota Statutes 2022, section 245C.05, subdivision 5, is amended to read:
286.2 		Subd. 5.Fingerprints and photograph. (a) Notwithstanding paragraph (b) (c), for 
286.3 	background studies conducted by the commissioner for child foster care, children's residential 
286.4 	facilities, adoptions, or a transfer of permanent legal and physical custody of a child, the 
286.5 	subject of the background study, who is 18 years of age or older, shall provide the 
286.6 	commissioner with a set of classifiable fingerprints obtained from an authorized agency for 
286.7 	a national criminal history record check.
286.8 	(b) Notwithstanding paragraph (c), for background studies conducted by the commissioner 
286.9 	for Head Start programs, the subject of the background study shall provide the commissioner 
286.10 	with a set of classifiable fingerprints obtained from an authorized agency for a national 
286.11 	criminal history record check.
286.12 	(b) (c) For background studies initiated on or after the implementation of NETStudy 
286.13 	2.0, except as provided under subdivision 5a, every subject of a background study must 
286.14 	provide the commissioner with a set of the background study subject's classifiable fingerprints 
286.15 	and photograph. The photograph and fingerprints must be recorded at the same time by the 
286.16 	authorized fingerprint collection vendor or vendors and sent to the commissioner through 
286.17 	the commissioner's secure data system described in section 245C.32, subdivision 1a, 
286.18 	paragraph (b).
286.19 	(c) (d) The fingerprints shall be submitted by the commissioner to the Bureau of Criminal 
286.20 	Apprehension and, when specifically required by law, submitted to the Federal Bureau of 
286.21 	Investigation for a national criminal history record check.
286.22 	(d) (e) The fingerprints must not be retained by the Department of Public Safety, Bureau 
286.23 	of Criminal Apprehension, or the commissioner. The Federal Bureau of Investigation will 
286.24 	not retain background study subjects' fingerprints.
286.25 	(e) (f) The authorized fingerprint collection vendor or vendors shall, for purposes of 
286.26 	verifying the identity of the background study subject, be able to view the identifying 
286.27 	information entered into NETStudy 2.0 by the entity that initiated the background study, 
286.28 	but shall not retain the subject's fingerprints, photograph, or information from NETStudy 
286.29 	2.0. The authorized fingerprint collection vendor or vendors shall retain no more than the 
286.30 	name and date and time the subject's fingerprints were recorded and sent, only as necessary 
286.31 	for auditing and billing activities.
286.32 	(f) (g) For any background study conducted under this chapter, the subject shall provide 
286.33 	the commissioner with a set of classifiable fingerprints when the commissioner has reasonable 
287.1 	cause to require a national criminal history record check as defined in section 245C.02, 
287.2 	subdivision 15a.

287.3 	Sec. 20. Minnesota Statutes 2023 Supplement, section 245C.08, subdivision 1, is amended 
287.4 	to read:
287.5 		Subdivision 1.Background studies conducted by Department of Human Services. (a) 
287.6 	For a background study conducted by the Department of Human Services, the commissioner 
287.7 	shall review:
287.8 	(1) information related to names of substantiated perpetrators of maltreatment of 
287.9 	vulnerable adults that has been received by the commissioner as required under section 
287.10 	626.557, subdivision 9c, paragraph (j);
287.11 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
287.12 	programs, and from findings of maltreatment of minors as indicated through the social 
287.13 	service information system;
287.14 	(3) information from juvenile courts as required in subdivision 4 for individuals listed 
287.15 	in section 245C.03, subdivision 1, paragraph (a), for studies under this chapter when there 
287.16 	is reasonable cause;
287.17 	(4) information from the Bureau of Criminal Apprehension, including information 
287.18 	regarding a background study subject's registration in Minnesota as a predatory offender 
287.19 	under section 243.166;
287.20 	(5) except as provided in clause (6), information received as a result of submission of 
287.21 	fingerprints for a national criminal history record check, as defined in section 245C.02, 
287.22 	subdivision 13c, when the commissioner has reasonable cause for a national criminal history 
287.23 	record check as defined under section 245C.02, subdivision 15a, or as required under section 
287.24 	144.057, subdivision 1, clause (2);
287.25 	(6) for a background study related to a child foster family setting application for licensure, 
287.26 	foster residence settings, children's residential facilities, a transfer of permanent legal and 
287.27 	physical custody of a child under sections 260C.503 to 260C.515, or adoptions, and for a 
287.28 	background study required for family child care, certified license-exempt child care, child 
287.29 	care centers, and legal nonlicensed child care authorized under chapter 119B, the 
287.30 	commissioner shall also review:
287.31 	(i) information from the child abuse and neglect registry for any state in which the 
287.32 	background study subject has resided for the past five years;
288.1 	(ii) when the background study subject is 18 years of age or older, or a minor under 
288.2 	section 245C.05, subdivision 5a, paragraph (c), information received following submission 
288.3 	of fingerprints for a national criminal history record check; and
288.4 	(iii) when the background study subject is 18 years of age or older or a minor under 
288.5 	section 245C.05, subdivision 5a, paragraph (d), for licensed family child care, certified 
288.6 	license-exempt child care, licensed child care centers, and legal nonlicensed child care 
288.7 	authorized under chapter 119B, information obtained using non-fingerprint-based data 
288.8 	including information from the criminal and sex offender registries for any state in which 
288.9 	the background study subject resided for the past five years and information from the national 
288.10 	crime information database and the national sex offender registry;
288.11 	(7) for a background study required for family child care, certified license-exempt child 
288.12 	care centers, licensed child care centers, and legal nonlicensed child care authorized under 
288.13 	chapter 119B, the background study shall also include, to the extent practicable, a name 
288.14 	and date-of-birth search of the National Sex Offender Public website; and
288.15 	(8) for a background study required for treatment programs for sexual psychopathic 
288.16 	personalities or sexually dangerous persons, the background study shall only include a 
288.17 	review of the information required under paragraph (a), clauses (1) to (4).
288.18 	(b) Except as otherwise provided in this paragraph, notwithstanding expungement by a 
288.19 	court, the commissioner may consider information obtained under paragraph (a), clauses 
288.20 	(3) and (4), unless:
288.21 	(1) the commissioner received notice of the petition for expungement and the court order 
288.22 	for expungement is directed specifically to the commissioner; or
288.23 	(2) the commissioner received notice of the expungement order issued pursuant to section 
288.24 	609A.017, 609A.025, or 609A.035, and the order for expungement is directed specifically 
288.25 	to the commissioner.
288.26 	The commissioner may not consider information obtained under paragraph (a), clauses (3) 
288.27 	and (4), or from any other source that identifies a violation of chapter 152 without 
288.28 	determining if the offense involved the possession of marijuana or tetrahydrocannabinol 
288.29 	and, if so, whether the person received a grant of expungement or order of expungement, 
288.30 	or the person was resentenced to a lesser offense. If the person received a grant of 
288.31 	expungement or order of expungement, the commissioner may not consider information 
288.32 	related to that violation but may consider any other relevant information arising out of the 
288.33 	same incident.
289.1 	(c) The commissioner shall also review criminal case information received according 
289.2 	to section 245C.04, subdivision 4a, from the Minnesota court information system that relates 
289.3 	to individuals who have already been studied under this chapter and who remain affiliated 
289.4 	with the agency that initiated the background study.
289.5 	(d) When the commissioner has reasonable cause to believe that the identity of a 
289.6 	background study subject is uncertain, the commissioner may require the subject to provide 
289.7 	a set of classifiable fingerprints for purposes of completing a fingerprint-based record check 
289.8 	with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph 
289.9 	shall not be saved by the commissioner after they have been used to verify the identity of 
289.10 	the background study subject against the particular criminal record in question.
289.11 	(e) The commissioner may inform the entity that initiated a background study under 
289.12 	NETStudy 2.0 of the status of processing of the subject's fingerprints.

289.13 	Sec. 21. Minnesota Statutes 2022, section 245C.08, subdivision 4, is amended to read:
289.14 		Subd. 4.Juvenile court records. (a) For a background study conducted by the 
289.15 	Department of Human Services, the commissioner shall review records from the juvenile 
289.16 	courts for an individual studied under section 245C.03, subdivision 1, paragraph (a), this 
289.17 	chapter when the commissioner has reasonable cause.
289.18 	(b) For a background study conducted by a county agency for family child care before 
289.19 	the implementation of NETStudy 2.0, the commissioner shall review records from the 
289.20 	juvenile courts for individuals listed in section 245C.03, subdivision 1, who are ages 13 
289.21 	through 23 living in the household where the licensed services will be provided. The 
289.22 	commissioner shall also review records from juvenile courts for any other individual listed 
289.23 	under section 245C.03, subdivision 1, when the commissioner has reasonable cause.
289.24 	(c) (b) The juvenile courts shall help with the study by giving the commissioner existing 
289.25 	juvenile court records relating to delinquency proceedings held on individuals described in 
289.26 	section 245C.03, subdivision 1, paragraph (a), who are subjects of studies under this chapter
289.27 	when requested pursuant to this subdivision.
289.28 	(d) (c) For purposes of this chapter, a finding that a delinquency petition is proven in 
289.29 	juvenile court shall be considered a conviction in state district court.
289.30 	(e) (d) Juvenile courts shall provide orders of involuntary and voluntary termination of 
289.31 	parental rights under section 260C.301 to the commissioner upon request for purposes of 
289.32 	conducting a background study under this chapter.

290.1 	Sec. 22. Minnesota Statutes 2023 Supplement, section 245C.10, subdivision 15, is amended 
290.2 	to read:
290.3 		Subd. 15.Guardians and conservators. (a) The commissioner shall recover the cost 
290.4 	of conducting maltreatment and state licensing agency checks for guardians and conservators 
290.5 	under section 245C.033 through a fee of no more than $50. The fees collected under this 
290.6 	subdivision are appropriated to the commissioner for the purpose of conducting maltreatment 
290.7 	and state licensing agency checks.
290.8 	(b) The fee must be paid directly to and in the manner prescribed by the commissioner 
290.9 	before any maltreatment and state licensing agency checks under section 245C.033 may be 
290.10 	conducted.
290.11 	(c) Notwithstanding paragraph (b), the court shall pay the fee for an applicant who has 
290.12 	been granted in forma pauperis status upon receipt of the invoice from the commissioner.

290.13 	Sec. 23. Minnesota Statutes 2022, section 245C.10, subdivision 18, is amended to read:
290.14 		Subd. 18.Applicants, licensees, and other occupations regulated by commissioner 
290.15 	of health. The applicant or license holder is responsible for paying to the Department of 
290.16 	Human Services all fees associated with the preparation of the fingerprints, the criminal 
290.17 	records check consent form, and, through a fee of no more than $44 per study, the criminal 
290.18 	background check.

290.19 	Sec. 24. Minnesota Statutes 2022, section 245C.14, is amended by adding a subdivision 
290.20 	to read:
290.21 		Subd. 5.Basis for disqualification. Information obtained by entities from public 
290.22 	web-based data through NETStudy 2.0 or any other source that is not direct correspondence 
290.23 	from the commissioner is not a notice of disqualification from the commissioner under this 
290.24 	chapter.

290.25 	Sec. 25. Minnesota Statutes 2022, section 245C.22, subdivision 4, is amended to read:
290.26 		Subd. 4.Risk of harm; set aside. (a) The commissioner may set aside the disqualification 
290.27 	if the commissioner finds that the individual has submitted sufficient information to 
290.28 	demonstrate that the individual does not pose a risk of harm to any person served by the 
290.29 	applicant, license holder, or other entities as provided in this chapter.
290.30 	(b) In determining whether the individual has met the burden of proof by demonstrating 
290.31 	the individual does not pose a risk of harm, the commissioner shall consider:
291.1 	(1) the nature, severity, and consequences of the event or events that led to the 
291.2 	disqualification;
291.3 	(2) whether there is more than one disqualifying event;
291.4 	(3) the age and vulnerability of the victim at the time of the event;
291.5 	(4) the harm suffered by the victim;
291.6 	(5) vulnerability of persons served by the program;
291.7 	(6) the similarity between the victim and persons served by the program;
291.8 	(7) the time elapsed without a repeat of the same or similar event;
291.9 	(8) documentation of successful completion by the individual studied of training or 
291.10 	rehabilitation pertinent to the event; and
291.11 	(9) any other information relevant to reconsideration.
291.12 	(c) For an individual seeking a child foster care license who is a relative of the child, 
291.13 	the commissioner shall consider the importance of maintaining the child's relationship with 
291.14 	relatives as an additional significant factor in determining whether a background study 
291.15 	disqualification should be set aside.
291.16 	(c) (d) If the individual requested reconsideration on the basis that the information relied 
291.17 	upon to disqualify the individual was incorrect or inaccurate and the commissioner determines 
291.18 	that the information relied upon to disqualify the individual is correct, the commissioner 
291.19 	must also determine if the individual poses a risk of harm to persons receiving services in 
291.20 	accordance with paragraph (b).
291.21 	(d) (e) For an individual seeking employment in the substance use disorder treatment 
291.22 	field, the commissioner shall set aside the disqualification if the following criteria are met:
291.23 	(1) the individual is not disqualified for a crime of violence as listed under section 
291.24 	624.712, subdivision 5, except for the following crimes: crimes listed under section 152.021, 
291.25 	subdivision 2 or 2a; 152.022, subdivision 2; 152.023, subdivision 2; 152.024; or 152.025;
291.26 	(2) the individual is not disqualified under section 245C.15, subdivision 1;
291.27 	(3) the individual is not disqualified under section 245C.15, subdivision 4, paragraph 
291.28 	(b);
291.29 	(4) the individual provided documentation of successful completion of treatment, at least 
291.30 	one year prior to the date of the request for reconsideration, at a program licensed under 
292.1 	chapter 245G, and has had no disqualifying crimes or conduct under section 245C.15 after 
292.2 	the successful completion of treatment;
292.3 	(5) the individual provided documentation demonstrating abstinence from controlled 
292.4 	substances, as defined in section 152.01, subdivision 4, for the period of one year prior to 
292.5 	the date of the request for reconsideration; and
292.6 	(6) the individual is seeking employment in the substance use disorder treatment field.

292.7 	Sec. 26. Minnesota Statutes 2022, section 245C.24, subdivision 2, is amended to read:
292.8 		Subd. 2.Permanent bar to set aside a disqualification. (a) Except as provided in 
292.9 	paragraphs (b) to (f) (g), the commissioner may not set aside the disqualification of any 
292.10 	individual disqualified pursuant to this chapter, regardless of how much time has passed, 
292.11 	if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 
292.12 	1.
292.13 	(b) For an individual in the substance use disorder or corrections field who was 
292.14 	disqualified for a crime or conduct listed under section 245C.15, subdivision 1, and whose 
292.15 	disqualification was set aside prior to July 1, 2005, the commissioner must consider granting 
292.16 	a variance pursuant to section 245C.30 for the license holder for a program dealing primarily 
292.17 	with adults. A request for reconsideration evaluated under this paragraph must include a 
292.18 	letter of recommendation from the license holder that was subject to the prior set-aside 
292.19 	decision addressing the individual's quality of care to children or vulnerable adults and the 
292.20 	circumstances of the individual's departure from that service.
292.21 	(c) If an individual who requires a background study for nonemergency medical 
292.22 	transportation services under section 245C.03, subdivision 12, was disqualified for a crime 
292.23 	or conduct listed under section 245C.15, subdivision 1, and if more than 40 years have 
292.24 	passed since the discharge of the sentence imposed, the commissioner may consider granting 
292.25 	a set-aside pursuant to section 245C.22. A request for reconsideration evaluated under this 
292.26 	paragraph must include a letter of recommendation from the employer. This paragraph does 
292.27 	not apply to a person disqualified based on a violation of sections 243.166; 609.185 to 
292.28 	609.205; 609.25; 609.342 to 609.3453; 609.352; 617.23, subdivision 2, clause (1), or 3, 
292.29 	clause (1); 617.246; or 617.247.
292.30 	(d) When a licensed foster care provider adopts an individual who had received foster 
292.31 	care services from the provider for over six months, and the adopted individual is required 
292.32 	to receive a background study under section 245C.03, subdivision 1, paragraph (a), clause 
292.33 	(2) or (6), the commissioner may grant a variance to the license holder under section 245C.30 
293.1 	to permit the adopted individual with a permanent disqualification to remain affiliated with 
293.2 	the license holder under the conditions of the variance when the variance is recommended 
293.3 	by the county of responsibility for each of the remaining individuals in placement in the 
293.4 	home and the licensing agency for the home.
293.5 	(e) For an individual 18 years of age or older affiliated with a licensed family foster 
293.6 	setting, the commissioner must not set aside or grant a variance for the disqualification of 
293.7 	any individual disqualified pursuant to this chapter, regardless of how much time has passed, 
293.8 	if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 
293.9 	4a, paragraphs (a) and (b).
293.10 	(f) In connection with a family foster setting license, the commissioner may grant a 
293.11 	variance to the disqualification for an individual who is under 18 years of age at the time 
293.12 	the background study is submitted.
293.13 	(g) In connection with foster residence settings and children's residential facilities, the 
293.14 	commissioner must not set aside or grant a variance for the disqualification of any individual 
293.15 	disqualified pursuant to this chapter, regardless of how much time has passed, if the individual 
293.16 	was disqualified for a crime or conduct listed in section 245C.15, subdivision 4a, paragraph 
293.17 	(a) or (b).

293.18 	Sec. 27. Minnesota Statutes 2022, section 245C.24, subdivision 5, is amended to read:
293.19 		Subd. 5.Five-year bar to set aside or variance disqualification; children's residential 
293.20 	facilities, foster residence settings. The commissioner shall not set aside or grant a variance 
293.21 	for the disqualification of an individual in connection with a license for a children's residential 
293.22 	facility or foster residence setting who was convicted of a felony within the past five years 
293.23 	for: (1) physical assault or battery; or (2) a drug-related offense.

293.24 	Sec. 28. Minnesota Statutes 2022, section 245C.24, subdivision 6, is amended to read:
293.25 		Subd. 6.Five-year bar to set aside disqualification; family foster setting. (a) The 
293.26 	commissioner shall not set aside or grant a variance for the disqualification of an individual 
293.27 	18 years of age or older in connection with a foster family setting license if within five years 
293.28 	preceding the study the individual is convicted of a felony in section 245C.15, subdivision 
293.29 	4a, paragraph (d).
293.30 	(b) In connection with a foster family setting license, the commissioner may set aside 
293.31 	or grant a variance to the disqualification for an individual who is under 18 years of age at 
293.32 	the time the background study is submitted.
294.1 	(c) In connection with a foster family setting license, the commissioner may set aside 
294.2 	or grant a variance to the disqualification for an individual who is under 18 years of age at 
294.3 	the time the background study is submitted.

294.4 	Sec. 29. Minnesota Statutes 2022, section 245C.30, is amended by adding a subdivision 
294.5 	to read:
294.6 		Subd. 1b.Child foster care variances. For an individual seeking a child foster care 
294.7 	license who is a relative of the child, the commissioner shall consider the importance of 
294.8 	maintaining the child's relationship with relatives as an additional significant factor in 
294.9 	determining whether the individual should be granted a variance.

294.10 	Sec. 30. Minnesota Statutes 2022, section 245F.09, subdivision 2, is amended to read:
294.11 		Subd. 2.Protective procedures plan. A license holder must have a written policy and 
294.12 	procedure that establishes the protective procedures that program staff must follow when 
294.13 	a patient is in imminent danger of harming self or others. The policy must be appropriate 
294.14 	to the type of facility and the level of staff training. The protective procedures policy must 
294.15 	include:
294.16 	(1) an approval signed and dated by the program director and medical director prior to 
294.17 	implementation. Any changes to the policy must also be approved, signed, and dated by the 
294.18 	current program director and the medical director prior to implementation;
294.19 	(2) which protective procedures the license holder will use to prevent patients from 
294.20 	imminent danger of harming self or others;
294.21 	(3) the emergency conditions under which the protective procedures are permitted to be 
294.22 	used, if any;
294.23 	(4) the patient's health conditions that limit the specific procedures that may be used and 
294.24 	alternative means of ensuring safety;
294.25 	(5) emergency resources the program staff must contact when a patient's behavior cannot 
294.26 	be controlled by the procedures established in the policy;
294.27 	(6) the training that staff must have before using any protective procedure;
294.28 	(7) documentation of approved therapeutic holds;
294.29 	(8) the use of law enforcement personnel as described in subdivision 4;
295.1 	(9) standards governing emergency use of seclusion. Seclusion must be used only when 
295.2 	less restrictive measures are ineffective or not feasible. The standards in items (i) to (vii) 
295.3 	must be met when seclusion is used with a patient:
295.4 	(i) seclusion must be employed solely for the purpose of preventing a patient from 
295.5 	imminent danger of harming self or others;
295.6 	(ii) seclusion rooms must be equipped in a manner that prevents patients from self-harm 
295.7 	using projections, windows, electrical fixtures, or hard objects, and must allow the patient 
295.8 	to be readily observed without being interrupted;
295.9 	(iii) seclusion must be authorized by the program director, a licensed physician, a 
295.10 	registered nurse, or a licensed physician assistant. If one of these individuals is not present 
295.11 	in the facility, the program director or a licensed physician, registered nurse, or physician 
295.12 	assistant must be contacted and authorization must be obtained within 30 minutes of initiating 
295.13 	seclusion, according to written policies;
295.14 	(iv) patients must not be placed in seclusion for more than 12 hours at any one time;
295.15 	(v) once the condition of a patient in seclusion has been determined to be safe enough 
295.16 	to end continuous observation, a patient in seclusion must be observed at a minimum of 
295.17 	every 15 minutes for the duration of seclusion and must always be within hearing range of 
295.18 	program staff;
295.19 	(vi) a process for program staff to use to remove a patient to other resources available 
295.20 	to the facility if seclusion does not sufficiently assure patient safety; and
295.21 	(vii) a seclusion area may be used for other purposes, such as intensive observation, if 
295.22 	the room meets normal standards of care for the purpose and if the room is not locked; and
295.23 	(10) physical holds may only be used when less restrictive measures are not feasible. 
295.24 	The standards in items (i) to (iv) must be met when physical holds are used with a patient:
295.25 	(i) physical holds must be employed solely for preventing a patient from imminent 
295.26 	danger of harming self or others;
295.27 	(ii) physical holds must be authorized by the program director, a licensed physician, a 
295.28 	registered nurse, or a physician assistant. If one of these individuals is not present in the 
295.29 	facility, the program director or a licensed physician, registered nurse, or physician assistant 
295.30 	must be contacted and authorization must be obtained within 30 minutes of initiating a 
295.31 	physical hold, according to written policies;
296.1 	(iii) the patient's health concerns must be considered in deciding whether to use physical 
296.2 	holds and which holds are appropriate for the patient; and
296.3 	(iv) only approved holds may be utilized. Prone and contraindicated holds are not allowed 
296.4 	according to section 245A.211 and must not be authorized.

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

296.6 	Sec. 31. Minnesota Statutes 2022, section 245F.14, is amended by adding a subdivision 
296.7 	to read:
296.8 		Subd. 8.Notification to commissioner of changes in key staff positions. A license 
296.9 	holder must notify the commissioner within five business days of a change or vacancy in a 
296.10 	key staff position. The key positions are a program director as required by subdivision 1, a 
296.11 	registered nurse as required by subdivision 4, and a medical director as required by 
296.12 	subdivision 5. The license holder must notify the commissioner of the staffing change on 
296.13 	a form approved by the commissioner and include the name of the staff person now assigned 
296.14 	to the key staff position and the staff person's qualifications for the position. The license 
296.15 	holder must notify the program licensor of a vacancy to discuss how the duties of the key 
296.16 	staff position will be fulfilled during the vacancy.

296.17 	EFFECTIVE DATE. This section is effective January 1, 2025.

296.18 	Sec. 32. Minnesota Statutes 2022, section 245F.17, is amended to read:
296.19 	245F.17 PERSONNEL FILES.
296.20 	A license holder must maintain a separate personnel file for each staff member. At a 
296.21 	minimum, the file must contain:
296.22 	(1) a completed application for employment signed by the staff member that contains 
296.23 	the staff member's qualifications for employment and documentation related to the applicant's 
296.24 	background study data, as defined in chapter 245C;
296.25 	(2) documentation of the staff member's current professional license or registration, if 
296.26 	relevant;
296.27 	(3) documentation of orientation and subsequent training; and
296.28 	(4) documentation of a statement of freedom from substance use problems; and
296.29 	(5) (4) an annual job performance evaluation.

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

297.1 	Sec. 33. Minnesota Statutes 2022, section 245G.07, subdivision 4, is amended to read:
297.2 		Subd. 4.Location of service provision. The license holder may provide services at any 
297.3 	of the license holder's licensed locations or at another suitable location including a school, 
297.4 	government building, medical or behavioral health facility, or social service organization, 
297.5 	upon notification and approval of the commissioner. If services are provided off site from 
297.6 	the licensed site, the reason for the provision of services remotely must be documented. 
297.7 	The license holder may provide additional services under subdivision 2, clauses (2) to (5), 
297.8 	off-site if the license holder includes a policy and procedure detailing the off-site location 
297.9 	as a part of the treatment service description and the program abuse prevention plan.
297.10 	(a) The license holder must provide all treatment services a client receives at one of the 
297.11 	license holder's substance use disorder treatment licensed locations or at a location allowed 
297.12 	under paragraphs (b) to (f). If the services are provided at the locations in paragraphs (b) to 
297.13 	(d), the license holder must document in the client record the location services were provided.
297.14 	(b) The license holder may provide nonresidential individual treatment services at a 
297.15 	client's home or place of residence.
297.16 	(c) If the license holder provides treatment services by telehealth, the services must be 
297.17 	provided according to this paragraph:
297.18 	(1) the license holder must maintain a licensed physical location in Minnesota where 
297.19 	the license holder must offer all treatment services in subdivision 1, paragraph (a), clauses 
297.20 	(1) to (4), physically in-person to each client;
297.21 	(2) the license holder must meet all requirements for the provision of telehealth in sections 
297.22 	254B.05, subdivision 5, paragraph (f), and 256B.0625, subdivision 3b. The license holder 
297.23 	must document all items in section 256B.0625, subdivision 3b, paragraph (c), for each client 
297.24 	receiving services by telehealth, regardless of payment type or whether the client is a medical 
297.25 	assistance enrollee;
297.26 	(3) the license holder may provide treatment services by telehealth to clients individually;
297.27 	(4) the license holder may provide treatment services by telehealth to a group of clients 
297.28 	that are each in a separate physical location;
297.29 	(5) the license holder must not provide treatment services remotely by telehealth to a 
297.30 	group of clients meeting together in person, unless permitted under clause (7);
297.31 	(6) clients and staff may join an in-person group by telehealth if a staff member qualified 
297.32 	to provide the treatment service is physically present with the group of clients meeting 
297.33 	together in person; and
298.1 	(7) the qualified professional providing a residential group treatment service by telehealth 
298.2 	must be physically present on-site at the licensed residential location while the service is 
298.3 	being provided. If weather conditions or short-term illness prohibit a qualified professional 
298.4 	from traveling to the residential program and another qualified professional is not available 
298.5 	to provide the service, a qualified professional may provide a residential group treatment 
298.6 	service by telehealth from a location away from the licensed residential location. In such 
298.7 	circumstances, a qualified professional must not provide a residential group treatment service 
298.8 	by telehealth from a location away from the licensed residential location for more than three 
298.9 	consecutive days and must document the reason for providing the remote telehealth service 
298.10 	in the records of clients receiving the service.
298.11 	(d) The license holder may provide the additional treatment services under subdivision 
298.12 	2, clauses (2) to (6) and (8), away from the licensed location at a suitable location appropriate 
298.13 	to the treatment service.
298.14 	(e) Upon written approval from the commissioner for each satellite location, the license 
298.15 	holder may provide nonresidential treatment services at satellite locations that are in a 
298.16 	school, jail, or nursing home. A satellite location may only provide services to students of 
298.17 	the school, inmates of the jail, or residents of the nursing home. Schools, jails, and nursing 
298.18 	homes are exempt from the licensing requirements in section 245A.04, subdivision 2a, to 
298.19 	document compliance with building codes, fire and safety codes, health rules, and zoning 
298.20 	ordinances.
298.21 	(f) The commissioner may approve other suitable locations as satellite locations for 
298.22 	nonresidential treatment services. The commissioner may require satellite locations under 
298.23 	this paragraph to meet all applicable licensing requirements. The license holder may not 
298.24 	have more than two satellite locations per license under this paragraph.
298.25 	(g) The license holder must provide the commissioner access to all files, documentation, 
298.26 	staff persons, and any other information the commissioner requires at the main licensed 
298.27 	location for all clients served at any location under paragraphs (b) to (f).
298.28 	(h) Notwithstanding sections 245A.65, subdivision 2, and 626.557, subdivision 14, a 
298.29 	program abuse prevention plan is not required for satellite or other locations under paragraphs 
298.30 	(b) to (e). An individual abuse prevention plan is still required for any client that is a 
298.31 	vulnerable adult as defined in section 626.5572, subdivision 21.

298.32 	EFFECTIVE DATE. This section is effective January 1, 2025.

299.1 	Sec. 34. Minnesota Statutes 2022, section 245G.08, subdivision 5, is amended to read:
299.2 		Subd. 5.Administration of medication and assistance with self-medication. (a) A 
299.3 	license holder must meet the requirements in this subdivision if a service provided includes 
299.4 	the administration of medication.
299.5 	(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a 
299.6 	licensed practitioner or a registered nurse the task of administration of medication or assisting 
299.7 	with self-medication, must:
299.8 	(1) successfully complete a medication administration training program for unlicensed 
299.9 	personnel through an accredited Minnesota postsecondary educational institution. A staff 
299.10 	member's completion of the course must be documented in writing and placed in the staff 
299.11 	member's personnel file;
299.12 	(2) be trained according to a formalized training program that is taught by a registered 
299.13 	nurse and offered by the license holder. The training must include the process for 
299.14 	administration of naloxone, if naloxone is kept on site. A staff member's completion of the 
299.15 	training must be documented in writing and placed in the staff member's personnel records; 
299.16 	or
299.17 	(3) demonstrate to a registered nurse competency to perform the delegated activity. A 
299.18 	registered nurse must be employed or contracted to develop the policies and procedures for 
299.19 	administration of medication or assisting with self-administration of medication, or both.
299.20 	(c) A registered nurse must provide supervision as defined in section 148.171, subdivision 
299.21 	23. The registered nurse's supervision must include, at a minimum, monthly on-site 
299.22 	supervision or more often if warranted by a client's health needs. The policies and procedures 
299.23 	must include:
299.24 	(1) a provision that a delegation of administration of medication is limited to a method 
299.25 	a staff member has been trained to administer and limited to:
299.26 	(i) a medication that is administered orally, topically, or as a suppository, an eye drop, 
299.27 	an ear drop, an inhalant, or an intranasal; and
299.28 	(ii) an intramuscular injection of naloxone an opiate antagonist as defined in section 
299.29 	604A.04, subdivision 1, or epinephrine;
299.30 	(2) a provision that each client's file must include documentation indicating whether 
299.31 	staff must conduct the administration of medication or the client must self-administer 
299.32 	medication, or both;
300.1 	(3) a provision that a client may carry emergency medication such as nitroglycerin as 
300.2 	instructed by the client's physician, advanced practice registered nurse, or physician assistant;
300.3 	(4) a provision for the client to self-administer medication when a client is scheduled to 
300.4 	be away from the facility;
300.5 	(5) a provision that if a client self-administers medication when the client is present in 
300.6 	the facility, the client must self-administer medication under the observation of a trained 
300.7 	staff member;
300.8 	(6) a provision that when a license holder serves a client who is a parent with a child, 
300.9 	the parent may only administer medication to the child under a staff member's supervision;
300.10 	(7) requirements for recording the client's use of medication, including staff signatures 
300.11 	with date and time;
300.12 	(8) guidelines for when to inform a nurse of problems with self-administration of 
300.13 	medication, including a client's failure to administer, refusal of a medication, adverse 
300.14 	reaction, or error; and
300.15 	(9) procedures for acceptance, documentation, and implementation of a prescription, 
300.16 	whether written, verbal, telephonic, or electronic.

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

300.18 	Sec. 35. Minnesota Statutes 2022, section 245G.08, subdivision 6, is amended to read:
300.19 		Subd. 6.Control of drugs. A license holder must have and implement written policies 
300.20 	and procedures developed by a registered nurse that contain:
300.21 	(1) a requirement that each drug must be stored in a locked compartment. A Schedule 
300.22 	II drug, as defined by section 152.02, subdivision 3, must be stored in a separately locked 
300.23 	compartment, permanently affixed to the physical plant or medication cart;
300.24 	(2) a system which accounts for all scheduled drugs each shift;
300.25 	(3) a procedure for recording the client's use of medication, including the signature of 
300.26 	the staff member who completed the administration of the medication with the time and 
300.27 	date;
300.28 	(4) a procedure to destroy a discontinued, outdated, or deteriorated medication;
300.29 	(5) a statement that only authorized personnel are permitted access to the keys to a locked 
300.30 	compartment;
301.1 	(6) a statement that no legend drug supply for one client shall be given to another client; 
301.2 	and
301.3 	(7) a procedure for monitoring the available supply of naloxone an opiate antagonist as 
301.4 	defined in section 604A.04, subdivision 1, on site, and replenishing the naloxone supply 
301.5 	when needed, and destroying naloxone according to clause (4).

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

301.7 	Sec. 36. Minnesota Statutes 2022, section 245G.10, is amended by adding a subdivision 
301.8 	to read:
301.9 		Subd. 6.Notification to commissioner of changes in key staff positions. A license 
301.10 	holder must notify the commissioner within five business days of a change or vacancy in a 
301.11 	key staff position. The key positions are a treatment director as required by subdivision 1, 
301.12 	an alcohol and drug counselor supervisor as required by subdivision 2, and a registered 
301.13 	nurse as required by section 245G.08, subdivision 5, paragraph (c). The license holder must 
301.14 	notify the commissioner of the staffing change on a form approved by the commissioner 
301.15 	and include the name of the staff person now assigned to the key staff position and the staff 
301.16 	person's qualifications for the position. The license holder must notify the program licensor 
301.17 	of a vacancy to discuss how the duties of the key staff position will be fulfilled during the 
301.18 	vacancy.

301.19 	EFFECTIVE DATE. This section is effective January 1, 2025.

301.20 	Sec. 37. Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 2, is amended 
301.21 	to read:
301.22 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
301.23 	have the meanings given them.
301.24 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
301.25 	diverted from intended use of the medication.
301.26 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
301.27 	addiction to a person who is not a client of the program that is administering or dispensing 
301.28 	the medication.
301.29 	(d) "Medical director" means a practitioner licensed to practice medicine in the 
301.30 	jurisdiction that the opioid treatment program is located who assumes responsibility for 
301.31 	administering all medical services performed by the program, either by performing the 
302.1 	services directly or by delegating specific responsibility to a practitioner of the opioid 
302.2 	treatment program.
302.3 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
302.4 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
302.5 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
302.6 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
302.7 	title 42, section 8.12, and includes programs licensed under this chapter.
302.8 	(h) "Practitioner" means a staff member holding a current, unrestricted license to practice 
302.9 	medicine issued by the Board of Medical Practice or nursing issued by the Board of Nursing 
302.10 	and is currently registered with the Drug Enforcement Administration to order or dispense 
302.11 	controlled substances in Schedules II to V under the Controlled Substances Act, United 
302.12 	States Code, title 21, part B, section 821. Practitioner includes an advanced practice registered 
302.13 	nurse and physician assistant if the staff member receives a variance by the state opioid 
302.14 	treatment authority under section 254A.03 and the federal Substance Abuse and Mental 
302.15 	Health Services Administration.
302.16 	(i) "Unsupervised use" or "take-home" means the use of a medication for the treatment 
302.17 	of opioid use disorder dispensed for use by a client outside of the program setting.

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

302.19 	Sec. 38. Minnesota Statutes 2022, section 245G.22, subdivision 6, is amended to read:
302.20 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
302.21 	medication used for the treatment of opioid use disorder to the illicit market, medication 
302.22 	dispensed to a client for unsupervised use shall be subject to the requirements of this 
302.23 	subdivision. Any client in an opioid treatment program may receive a single unsupervised 
302.24 	use dose for a day that the clinic is closed for business, including Sundays and state and 
302.25 	federal holidays their individualized take-home doses as ordered for days that the clinic is 
302.26 	closed for business, on one weekend day (e.g., Sunday) and state and federal holidays, no 
302.27 	matter their length of time in treatment, as allowed under Code of Federal Regulations, title 
302.28 	42, part 8.12 (i)(1).
302.29 	(b) For take-home doses beyond those allowed by paragraph (a), a practitioner with
302.30 	authority to prescribe must review and document the criteria in this paragraph and paragraph 
302.31 	(c) the Code of Federal Regulations, title 42, part 8.12 (i)(2), when determining whether 
302.32 	dispensing medication for a client's unsupervised use is safe and it is appropriate to 
303.1 	implement, increase, or extend the amount of time between visits to the program. The criteria 
303.2 	are:
303.3 	(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics, 
303.4 	and alcohol;
303.5 	(2) regularity of program attendance;
303.6 	(3) absence of serious behavioral problems at the program;
303.7 	(4) absence of known recent criminal activity such as drug dealing;
303.8 	(5) stability of the client's home environment and social relationships;
303.9 	(6) length of time in comprehensive maintenance treatment;
303.10 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
303.11 	the client's home; and
303.12 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
303.13 	of program attendance outweighs the potential risks of diversion or unsupervised use.
303.14 	(c) The determination, including the basis of the determination must be documented by 
303.15 	a practitioner in the client's medical record.

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

303.17 	Sec. 39. Minnesota Statutes 2022, section 245G.22, subdivision 7, is amended to read:
303.18 		Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. (a) If a 
303.19 	medical director or prescribing practitioner assesses and, determines, and documents that 
303.20 	a client meets the criteria in subdivision 6 and may be dispensed a medication used for the 
303.21 	treatment of opioid addiction, the restrictions in this subdivision must be followed when 
303.22 	the medication to be dispensed is methadone hydrochloride. The results of the assessment 
303.23 	must be contained in the client file. The number of unsupervised use medication doses per 
303.24 	week in paragraphs (b) to (d) is in addition to the number of unsupervised use medication 
303.25 	doses a client may receive for days the clinic is closed for business as allowed by subdivision 
303.26 	6, paragraph (a) and that a patient is safely able to manage unsupervised doses of methadone, 
303.27 	the number of take-home doses the client receives must be limited by the number allowed 
303.28 	by the Code of Federal Regulations, title 42, part 8.12 (i)(3).
303.29 	(b) During the first 90 days of treatment, the unsupervised use medication supply must 
303.30 	be limited to a maximum of a single dose each week and the client shall ingest all other 
303.31 	doses under direct supervision.
304.1 	(c) In the second 90 days of treatment, the unsupervised use medication supply must be 
304.2 	limited to two doses per week.
304.3 	(d) In the third 90 days of treatment, the unsupervised use medication supply must not 
304.4 	exceed three doses per week.
304.5 	(e) In the remaining months of the first year, a client may be given a maximum six-day 
304.6 	unsupervised use medication supply.
304.7 	(f) After one year of continuous treatment, a client may be given a maximum two-week 
304.8 	unsupervised use medication supply.
304.9 	(g) After two years of continuous treatment, a client may be given a maximum one-month 
304.10 	unsupervised use medication supply, but must make monthly visits to the program.

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

304.12 	Sec. 40. Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 17, is amended 
304.13 	to read:
304.14 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
304.15 	policies and procedures required in this subdivision.
304.16 	(b) For a program that is not open every day of the year, the license holder must maintain 
304.17 	a policy and procedure that covers requirements under section 245G.22, subdivisions 6 and 
304.18 	7. Unsupervised use of medication used for the treatment of opioid use disorder for days 
304.19 	that the program is closed for business, including but not limited to Sundays on one weekend 
304.20 	day and state and federal holidays, must meet the requirements under section 245G.22, 
304.21 	subdivisions 6 and 7.
304.22 	(c) The license holder must maintain a policy and procedure that includes specific 
304.23 	measures to reduce the possibility of diversion. The policy and procedure must:
304.24 	(1) specifically identify and define the responsibilities of the medical and administrative 
304.25 	staff for performing diversion control measures; and
304.26 	(2) include a process for contacting no less than five percent of clients who have 
304.27 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
304.28 	paragraph (a), to require clients to physically return to the program each month. The system 
304.29 	must require clients to return to the program within a stipulated time frame and turn in all 
304.30 	unused medication containers related to opioid use disorder treatment. The license holder 
304.31 	must document all related contacts on a central log and the outcome of the contact for each 
305.1 	client in the client's record. The medical director must be informed of each outcome that 
305.2 	results in a situation in which a possible diversion issue was identified.
305.3 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
305.4 	administered, and dispensed according to applicable state and federal regulations and the 
305.5 	standards set by applicable accreditation entities. If a medication order requires assessment 
305.6 	by the person administering or dispensing the medication to determine the amount to be 
305.7 	administered or dispensed, the assessment must be completed by an individual whose 
305.8 	professional scope of practice permits an assessment. For the purposes of enforcement of 
305.9 	this paragraph, the commissioner has the authority to monitor the person administering or 
305.10 	dispensing the medication for compliance with state and federal regulations and the relevant 
305.11 	standards of the license holder's accreditation agency and may issue licensing actions 
305.12 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
305.13 	determination of noncompliance.
305.14 	(e) A counselor in an opioid treatment program must not supervise more than 50 clients.
305.15 	(f) Notwithstanding paragraph (e), from July 1, 2023, to June 30, 2024, a counselor in 
305.16 	an opioid treatment program may supervise up to 60 clients. The license holder may continue 
305.17 	to serve a client who was receiving services at the program on June 30, 2024, at a counselor 
305.18 	to client ratio of up to one to 60 and is not required to discharge any clients in order to return 
305.19 	to the counselor to client ratio of one to 50. The license holder may not, however, serve a 
305.20 	new client after June 30, 2024, unless the counselor who would supervise the new client is 
305.21 	supervising fewer than 50 existing clients.

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

305.23 	Sec. 41. Minnesota Statutes 2023 Supplement, section 256.046, subdivision 3, is amended 
305.24 	to read:
305.25 		Subd. 3.Administrative disqualification of child care providers caring for children 
305.26 	receiving child care assistance. (a) The department shall pursue an administrative 
305.27 	disqualification, if the child care provider is accused of committing an intentional program 
305.28 	violation, in lieu of a criminal action when it has not been pursued. Intentional program 
305.29 	violations include intentionally making false or misleading statements; intentionally 
305.30 	misrepresenting, concealing, or withholding facts; and repeatedly and intentionally violating 
305.31 	program regulations under chapters 119B and 245E. Intent may be proven by demonstrating 
305.32 	a pattern of conduct that violates program rules under chapters 119B and 245E.
306.1 	(b) To initiate an administrative disqualification, the commissioner must mail send
306.2 	written notice by certified mail using a signature-verified confirmed delivery method to the 
306.3 	provider against whom the action is being taken. Unless otherwise specified under chapter 
306.4 	119B or 245E or Minnesota Rules, chapter 3400, the commissioner must mail send the 
306.5 	written notice at least 15 calendar days before the adverse action's effective date. The notice 
306.6 	shall state (1) the factual basis for the agency's determination, (2) the action the agency 
306.7 	intends to take, (3) the dollar amount of the monetary recovery or recoupment, if known, 
306.8 	and (4) the provider's right to appeal the agency's proposed action.
306.9 	(c) The provider may appeal an administrative disqualification by submitting a written 
306.10 	request to the Department of Human Services, Appeals Division. A provider's request must 
306.11 	be received by the Appeals Division no later than 30 days after the date the commissioner 
306.12 	mails the notice.
306.13 	(d) The provider's appeal request must contain the following:
306.14 	(1) each disputed item, the reason for the dispute, and, if applicable, an estimate of the 
306.15 	dollar amount involved for each disputed item;
306.16 	(2) the computation the provider believes to be correct, if applicable;
306.17 	(3) the statute or rule relied on for each disputed item; and
306.18 	(4) the name, address, and telephone number of the person at the provider's place of 
306.19 	business with whom contact may be made regarding the appeal.
306.20 	(e) On appeal, the issuing agency bears the burden of proof to demonstrate by a 
306.21 	preponderance of the evidence that the provider committed an intentional program violation.
306.22 	(f) The hearing is subject to the requirements of sections 256.045 and 256.0451. The 
306.23 	human services judge may combine a fair hearing and administrative disqualification hearing 
306.24 	into a single hearing if the factual issues arise out of the same or related circumstances and 
306.25 	the provider receives prior notice that the hearings will be combined.
306.26 	(g) A provider found to have committed an intentional program violation and is 
306.27 	administratively disqualified shall be disqualified, for a period of three years for the first 
306.28 	offense and permanently for any subsequent offense, from receiving any payments from 
306.29 	any child care program under chapter 119B.
306.30 	(h) Unless a timely and proper appeal made under this section is received by the 
306.31 	department, the administrative determination of the department is final and binding.

306.32 	EFFECTIVE DATE. This section is effective August 1, 2024.

307.1 	Sec. 42. Minnesota Statutes 2023 Supplement, section 256B.064, subdivision 4, is amended 
307.2 	to read:
307.3 		Subd. 4.Notice. (a) The department shall serve the notice required under subdivision 2 
307.4 	by certified mail at using a signature-verified confirmed delivery method to the address 
307.5 	submitted to the department by the individual or entity. Service is complete upon mailing.
307.6 	(b) The department shall give notice in writing to a recipient placed in the Minnesota 
307.7 	restricted recipient program under section 256B.0646 and Minnesota Rules, part 9505.2200. 
307.8 	The department shall send the notice by first class mail to the recipient's current address on 
307.9 	file with the department. A recipient placed in the Minnesota restricted recipient program 
307.10 	may contest the placement by submitting a written request for a hearing to the department 
307.11 	within 90 days of the notice being mailed.

307.12 	Sec. 43. Minnesota Statutes 2022, section 260E.33, subdivision 2, as amended by Laws 
307.13 	2024, chapter 80, article 8, section 44, is amended to read:
307.14 		Subd. 2.Request for reconsideration. (a) Except as provided under subdivision 5, an 
307.15 	individual or facility that the commissioner of human services; commissioner of children, 
307.16 	youth, and families; a local welfare agency; or the commissioner of education determines 
307.17 	has maltreated a child, an interested person acting on behalf of the child, regardless of the 
307.18 	determination, who contests the investigating agency's final determination regarding 
307.19 	maltreatment may request the investigating agency to reconsider its final determination 
307.20 	regarding maltreatment. The request for reconsideration must be submitted in writing or 
307.21 	submitted in the provider licensing and reporting hub to the investigating agency within 15 
307.22 	calendar days after receipt of notice of the final determination regarding maltreatment or, 
307.23 	if the request is made by an interested person who is not entitled to notice, within 15 days 
307.24 	after receipt of the notice by the parent or guardian of the child. If mailed, the request for 
307.25 	reconsideration must be postmarked and sent to the investigating agency within 15 calendar 
307.26 	days of the individual's or facility's receipt of the final determination. If the request for 
307.27 	reconsideration is made by personal service, it must be received by the investigating agency 
307.28 	within 15 calendar days after the individual's or facility's receipt of the final determination.
307.29 	Upon implementation of the provider licensing and reporting hub, the individual or facility 
307.30 	must use the hub to request reconsideration. The reconsideration must be received by the 
307.31 	commissioner within 15 calendar days of the individual's receipt of the notice of 
307.32 	disqualification.
307.33 	(b) An individual who was determined to have maltreated a child under this chapter and 
307.34 	who was disqualified on the basis of serious or recurring maltreatment under sections 
308.1 	245C.14 and 245C.15 may request reconsideration of the maltreatment determination and 
308.2 	the disqualification. The request for reconsideration of the maltreatment determination and 
308.3 	the disqualification must be submitted within 30 calendar days of the individual's receipt 
308.4 	of the notice of disqualification under sections 245C.16 and 245C.17. If mailed, the request 
308.5 	for reconsideration of the maltreatment determination and the disqualification must be 
308.6 	postmarked and sent to the investigating agency within 30 calendar days of the individual's 
308.7 	receipt of the maltreatment determination and notice of disqualification. If the request for 
308.8 	reconsideration is made by personal service, it must be received by the investigating agency 
308.9 	within 30 calendar days after the individual's receipt of the notice of disqualification.

308.10 	Sec. 44. Laws 2024, chapter 80, article 2, section 6, subdivision 2, is amended to read:
308.11 		Subd. 2.Change in ownership. (a) If the commissioner determines that there is a change 
308.12 	in ownership, the commissioner shall require submission of a new license application. This 
308.13 	subdivision does not apply to a licensed program or service located in a home where the 
308.14 	license holder resides. A change in ownership occurs when:
308.15 	(1) except as provided in paragraph (b), the license holder sells or transfers 100 percent 
308.16 	of the property, stock, or assets;
308.17 	(2) the license holder merges with another organization;
308.18 	(3) the license holder consolidates with two or more organizations, resulting in the 
308.19 	creation of a new organization;
308.20 	(4) there is a change to the federal tax identification number associated with the license 
308.21 	holder; or
308.22 	(5) except as provided in paragraph (b), all controlling individuals associated with for
308.23 	the original application license have changed.
308.24 	(b) Notwithstanding For changes under paragraph (a), clauses clause (1) and or (5), no 
308.25 	change in ownership has occurred and a new license application is not required if at least 
308.26 	one controlling individual has been listed affiliated as a controlling individual for the license 
308.27 	for at least the previous 12 months immediately preceding the change.

308.28 	EFFECTIVE DATE. This section is effective January 1, 2025.

308.29 	Sec. 45. Laws 2024, chapter 80, article 2, section 6, subdivision 3, is amended to read:
308.30 		Subd. 3.Standard change of ownership process. (a) When a change in ownership is 
308.31 	proposed and the party intends to assume operation without an interruption in service longer 
309.1 	than 60 days after acquiring the program or service, the license holder must provide the 
309.2 	commissioner with written notice of the proposed change on a form provided by the 
309.3 	commissioner at least 60 90 days before the anticipated date of the change in ownership. 
309.4 	For purposes of this subdivision and subdivision 4 section, "party" means the party that 
309.5 	intends to operate the service or program.
309.6 	(b) The party must submit a license application under this chapter on the form and in 
309.7 	the manner prescribed by the commissioner at least 30 90 days before the change in 
309.8 	ownership is anticipated to be complete and must include documentation to support the 
309.9 	upcoming change. The party must comply with background study requirements under chapter 
309.10 	245C and shall pay the application fee required under section 245A.10.
309.11 	(c) The commissioner may streamline application procedures when the party is an existing 
309.12 	license holder under this chapter and is acquiring a program licensed under this chapter or 
309.13 	service in the same service class as one or more licensed programs or services the party 
309.14 	operates and those licenses are in substantial compliance. For purposes of this subdivision, 
309.15 	"substantial compliance" means within the previous 12 months the commissioner did not 
309.16 	(1) issue a sanction under section 245A.07 against a license held by the party, or (2) make 
309.17 	a license held by the party conditional according to section 245A.06.
309.18 	(d) Except when a temporary change in ownership license is issued pursuant to 
309.19 	subdivision 4 While the standard change of ownership process is pending, the existing 
309.20 	license holder is solely remains responsible for operating the program according to applicable 
309.21 	laws and rules until a license under this chapter is issued to the party.
309.22 	(e) If a licensing inspection of the program or service was conducted within the previous 
309.23 	12 months and the existing license holder's license record demonstrates substantial 
309.24 	compliance with the applicable licensing requirements, the commissioner may waive the 
309.25 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
309.26 	commissioner (1) proof that the premises was inspected by a fire marshal or that the fire 
309.27 	marshal deemed that an inspection was not warranted, and (2) proof that the premises was 
309.28 	inspected for compliance with the building code or that no inspection was deemed warranted.
309.29 	(f) If the party is seeking a license for a program or service that has an outstanding action 
309.30 	under section 245A.06 or 245A.07, the party must submit a letter as part of the application 
309.31 	process identifying how the party has or will come into full compliance with the licensing 
309.32 	requirements.
309.33 	(g) The commissioner shall evaluate the party's application according to section 245A.04, 
309.34 	subdivision 6. If the commissioner determines that the party has remedied or demonstrates 
310.1 	the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has 
310.2 	determined that the program otherwise complies with all applicable laws and rules, the 
310.3 	commissioner shall issue a license or conditional license under this chapter. A conditional 
310.4 	license issued under this section is final and not subject to reconsideration under section 
310.5 	142B.16, subdivision 4. The conditional license remains in effect until the commissioner 
310.6 	determines that the grounds for the action are corrected or no longer exist.
310.7 	(h) The commissioner may deny an application as provided in section 245A.05. An 
310.8 	applicant whose application was denied by the commissioner may appeal the denial according 
310.9 	to section 245A.05.
310.10 	(i) This subdivision does not apply to a licensed program or service located in a home 
310.11 	where the license holder resides.

310.12 	EFFECTIVE DATE. This section is effective January 1, 2025.

310.13 	Sec. 46. Laws 2024, chapter 80, article 2, section 6, is amended by adding a subdivision 
310.14 	to read:
310.15 		Subd. 3a.Emergency change in ownership process.  (a) In the event of a death of a 
310.16 	license holder or sole controlling individual or a court order or other event that results in 
310.17 	the license holder being inaccessible or unable to operate the program or service, a party 
310.18 	may submit a request to the commissioner to allow the party to assume operation of the 
310.19 	program or service under an emergency change in ownership process to ensure persons 
310.20 	continue to receive services while the commissioner evaluates the party's license application.
310.21 	(b) To request the emergency change of ownership process, the party must immediately:
310.22 	(1) notify the commissioner of the event resulting in the inability of the license holder 
310.23 	to operate the program and of the party's intent to assume operations; and
310.24 	(2) provide the commissioner with documentation that demonstrates the party has a legal 
310.25 	or legitimate ownership interest in the program or service if applicable and is able to operate 
310.26 	the program or service.
310.27 	(c) If the commissioner approves the party to continue operating the program or service 
310.28 	under an emergency change in ownership process, the party must:
310.29 	(1) request to be added as a controlling individual or license holder to the existing license;
310.30 	(2) notify persons receiving services of the emergency change in ownership in a manner 
310.31 	approved by the commissioner;
310.32 	(3) submit an application for a new license within 30 days of approval;
311.1 	(4) comply with the background study requirements under chapter 245C; and
311.2 	(5) pay the application fee required under section 142B.12.
311.3 	(d) While the emergency change of ownership process is pending, a party approved 
311.4 	under this subdivision is responsible for operating the program under the existing license 
311.5 	according to applicable laws and rules until a new license under this chapter is issued.
311.6 	(e) The provisions in subdivision 3, paragraphs (c), (g), and (h), apply to this subdivision.
311.7 	(f) Once a party is issued a new license or has decided not to seek a new license, the 
311.8 	commissioner must close the existing license.
311.9 	(g) This subdivision applies to any program or service licensed under this chapter.

311.10 	EFFECTIVE DATE. This section is effective January 1, 2025.

311.11 	Sec. 47. Laws 2024, chapter 80, article 2, section 6, is amended by adding a subdivision 
311.12 	to read:
311.13 		Subd. 5.Failure to comply. If the commissioner finds that the applicant or license holder 
311.14 	has not fully complied with this section, the commissioner may impose a licensing sanction 
311.15 	under section 142B.15, 142B.16, or 142B.18.

311.16 	EFFECTIVE DATE. This section is effective January 1, 2025.

311.17 	Sec. 48. Laws 2024, chapter 80, article 2, section 10, subdivision 1, is amended to read:
311.18 		Subdivision 1.Sanctions; appeals; license. (a) In addition to making a license conditional 
311.19 	under section 142B.16, the commissioner may suspend or revoke the license, impose a fine, 
311.20 	or secure an injunction against the continuing operation of the program of a license holder 
311.21 	who:
311.22 	(1) does not comply with applicable law or rule;
311.23 	(2) has nondisqualifying background study information, as described in section 245C.05, 
311.24 	subdivision 4, that reflects on the license holder's ability to safely provide care to foster 
311.25 	children; or
311.26 	(3) has an individual living in the household where the licensed services are provided 
311.27 	or is otherwise subject to a background study, and the individual has nondisqualifying 
311.28 	background study information, as described in section 245C.05, subdivision 4, that reflects 
311.29 	on the license holder's ability to safely provide care to foster children.
312.1 	When applying sanctions authorized under this section, the commissioner shall consider 
312.2 	the nature, chronicity, or severity of the violation of law or rule and the effect of the violation 
312.3 	on the health, safety, or rights of persons served by the program.
312.4 	(b) If a license holder appeals the suspension or revocation of a license and the license 
312.5 	holder continues to operate the program pending a final order on the appeal, the commissioner 
312.6 	shall issue the license holder a temporary provisional license. Unless otherwise specified 
312.7 	by the commissioner, variances in effect on the date of the license sanction under appeal 
312.8 	continue under the temporary provisional license. The commissioner may include terms the 
312.9 	license holder must follow pending a final order on the appeal.If a license holder fails to 
312.10 	comply with applicable law or rule while operating under a temporary provisional license, 
312.11 	the commissioner may impose additional sanctions under this section and section 142B.16
312.12 	and may terminate any prior variance. If a temporary provisional license is set to expire, a 
312.13 	new temporary provisional license shall be issued to the license holder upon payment of 
312.14 	any fee required under section 142B.12. The temporary provisional license shall expire on 
312.15 	the date the final order is issued. If the license holder prevails on the appeal, a new 
312.16 	nonprovisional license shall be issued for the remainder of the current license period.
312.17 	(c) If a license holder is under investigation and the license issued under this chapter is 
312.18 	due to expire before completion of the investigation, the program shall be issued a new 
312.19 	license upon completion of the reapplication requirements and payment of any applicable 
312.20 	license fee. Upon completion of the investigation, a licensing sanction may be imposed 
312.21 	against the new license under this section or section 142B.16 or 142B.20.
312.22 	(d) Failure to reapply or closure of a license issued under this chapter by the license 
312.23 	holder prior to the completion of any investigation shall not preclude the commissioner 
312.24 	from issuing a licensing sanction under this section or section 142B.16 at the conclusion of 
312.25 	the investigation.

312.26 	EFFECTIVE DATE. This section is effective January 1, 2025.

312.27 	Sec. 49. Laws 2024, chapter 80, article 2, section 10, subdivision 6, is amended to read:
312.28 		Subd. 6.Appeal of multiple sanctions. (a) When the license holder appeals more than 
312.29 	one licensing action or sanction that were simultaneously issued by the commissioner, the 
312.30 	license holder shall specify the actions or sanctions that are being appealed.
312.31 	(b) If there are different timelines prescribed in statutes for the licensing actions or 
312.32 	sanctions being appealed, the license holder must submit the appeal within the longest of 
312.33 	those timelines specified in statutes.
313.1 	(c) The appeal must be made in writing by certified mail or, personal service, or through 
313.2 	the provider licensing and reporting hub. If mailed, the appeal must be postmarked and sent 
313.3 	to the commissioner within the prescribed timeline with the first day beginning the day after 
313.4 	the license holder receives the certified letter. If a request is made by personal service, it 
313.5 	must be received by the commissioner within the prescribed timeline with the first day 
313.6 	beginning the day after the license holder receives the certified letter. If the appeal is made 
313.7 	through the provider hub, the appeal must be received by the commissioner within the 
313.8 	prescribed timeline with the first day beginning the day after the commissioner issued the 
313.9 	order through the hub.
313.10 	(d) When there are different timelines prescribed in statutes for the appeal of licensing 
313.11 	actions or sanctions simultaneously issued by the commissioner, the commissioner shall 
313.12 	specify in the notice to the license holder the timeline for appeal as specified under paragraph 
313.13 	(b).

313.14 	Sec. 50. REPEALER.
 313.15 	(a) Minnesota Statutes 2022, section 245C.125, is repealed.
313.16 	(b) Minnesota Statutes 2023 Supplement, section 245C.08, subdivision 2, is repealed.
313.17 	(c) Minnesota Rules, part 9502.0425, subpart 5, is repealed.
313.18 	(d) Laws 2024, chapter 80, article 2, section 6, subdivision 4, is repealed.

313.19 	ARTICLE 11
313.20 	MISCELLANEOUS

313.21 	Section 1. Minnesota Statutes 2022, section 148F.025, subdivision 2, is amended to read:
313.22 		Subd. 2.Education requirements for licensure. An applicant for licensure must submit 
313.23 	evidence satisfactory to the board that the applicant has:
313.24 	(1) received a bachelor's or master's degree from an accredited school or educational 
313.25 	program; and
313.26 	(2) received 18 semester credits or 270 clock hours of academic course work and 880 
313.27 	clock hours of supervised alcohol and drug counseling practicum from an accredited school 
313.28 	or education program. The course work and practicum do not have to be part of the bachelor's 
313.29 	degree earned under clause (1). The academic course work must be in the following areas:
313.30 	(i) an overview of the transdisciplinary foundations of alcohol and drug counseling, 
313.31 	including theories of chemical dependency, the continuum of care, and the process of change;
314.1 	(ii) pharmacology of substance abuse disorders and the dynamics of addiction, including 
314.2 	substance use disorder treatment with medications for opioid use disorder;
314.3 	(iii) professional and ethical responsibilities;
314.4 	(iv) multicultural aspects of chemical dependency;
314.5 	(v) co-occurring disorders; and
314.6 	(vi) the core functions defined in section 148F.01, subdivision 10.

314.7 	Sec. 2. Minnesota Statutes 2023 Supplement, section 245.991, subdivision 1, is amended 
314.8 	to read:
314.9 		Subdivision 1.Establishment. The commissioner of human services must establish the 
314.10 	projects for assistance in transition from homelessness program to prevent or end 
314.11 	homelessness for people with serious mental illness, substance use disorder, or co-occurring 
314.12 	substance use disorder and ensure the commissioner achieves the goals of the housing 
314.13 	mission statement in section 245.461, subdivision 4.

314.14 	Sec. 3. Minnesota Statutes 2023 Supplement, section 254B.04, subdivision 1a, is amended 
314.15 	to read:
314.16 		Subd. 1a.Client eligibility. (a) Persons eligible for benefits under Code of Federal 
314.17 	Regulations, title 25, part 20, who meet the income standards of section 256B.056, 
314.18 	subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health 
314.19 	fund services. State money appropriated for this paragraph must be placed in a separate 
314.20 	account established for this purpose.
314.21 	(b) Persons with dependent children who are determined to be in need of substance use 
314.22 	disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in 
314.23 	need of chemical dependency treatment pursuant to a case plan under section 260C.201, 
314.24 	subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment 
314.25 	services. Treatment services must be appropriate for the individual or family, which may 
314.26 	include long-term care treatment or treatment in a facility that allows the dependent children 
314.27 	to stay in the treatment facility. The county shall pay for out-of-home placement costs, if 
314.28 	applicable.
314.29 	(c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible 
314.30 	for room and board services under section 254B.05, subdivision 5, paragraph (b), clause 
314.31 	(12).
315.1 	(d) A client is eligible to have substance use disorder treatment paid for with funds from 
315.2 	the behavioral health fund when the client:
315.3 	(1) is eligible for MFIP as determined under chapter 256J;
315.4 	(2) is eligible for medical assistance as determined under Minnesota Rules, parts 
315.5 	9505.0010 to 9505.0150;
315.6 	(3) is eligible for general assistance, general assistance medical care, or work readiness 
315.7 	as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; or
315.8 	(4) has income that is within current household size and income guidelines for entitled 
315.9 	persons, as defined in this subdivision and subdivision 7.
315.10 	(e) Clients who meet the financial eligibility requirement in paragraph (a) and who have 
315.11 	a third-party payment source are eligible for the behavioral health fund if the third-party 
315.12 	payment source pays less than 100 percent of the cost of treatment services for eligible 
315.13 	clients.
315.14 	(f) A client is ineligible to have substance use disorder treatment services paid for with 
315.15 	behavioral health fund money if the client:
315.16 	(1) has an income that exceeds current household size and income guidelines for entitled 
315.17 	persons as defined in this subdivision and subdivision 7; or
315.18 	(2) has an available third-party payment source that will pay the total cost of the client's 
315.19 	treatment.
315.20 	(g) A client who is disenrolled from a state prepaid health plan during a treatment episode 
315.21 	is eligible for continued treatment service that is paid for by the behavioral health fund until 
315.22 	the treatment episode is completed or the client is re-enrolled in a state prepaid health plan 
315.23 	if the client:
315.24 	(1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance 
315.25 	medical care; or
315.26 	(2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local 
315.27 	agency under section 254B.04.
315.28 	(h) When a county commits a client under chapter 253B to a regional treatment center 
315.29 	for substance use disorder services and the client is ineligible for the behavioral health fund, 
315.30 	the county is responsible for the payment to the regional treatment center according to 
315.31 	section 254B.05, subdivision 4.
316.1 	(i) Notwithstanding paragraph (a), persons enrolled in MinnesotaCare are eligible for 
316.2 	room and board services under section 254B.05, subdivision 1a, paragraph (e).

316.3 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
316.4 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
316.5 	when federal approval is obtained.

316.6 	Sec. 4. Minnesota Statutes 2023 Supplement, section 256D.01, subdivision 1a, is amended 
316.7 	to read:
316.8 		Subd. 1a.Standards. (a) A principal objective in providing general assistance is to 
316.9 	provide for single adults, childless couples, or children as defined in section 256D.02, 
316.10 	subdivision 2b, ineligible for federal programs who are unable to provide for themselves. 
316.11 	The minimum standard of assistance determines the total amount of the general assistance 
316.12 	grant without separate standards for shelter, utilities, or other needs.
316.13 	(b) The standard of assistance for an assistance unit consisting of a recipient who is 
316.14 	childless and unmarried or living apart from children and spouse and who does not live with 
316.15 	a parent or parents or a legal custodian, or consisting of a childless couple, is $350 per month 
316.16 	effective October 1, 2024, and must be adjusted by a percentage equal to the change in the 
316.17 	consumer price index as of January 1 every year, beginning October 1, 2025.
316.18 	(c) For an assistance unit consisting of a single adult who lives with a parent or parents, 
316.19 	the general assistance standard of assistance is $350 per month effective October 1, 2023
316.20 	2024, and must be adjusted by a percentage equal to the change in the consumer price index 
316.21 	as of January 1 every year, beginning October 1, 2025. Benefits received by a responsible 
316.22 	relative of the assistance unit under the Supplemental Security Income program, a workers' 
316.23 	compensation program, the Minnesota supplemental aid program, or any other program 
316.24 	based on the responsible relative's disability, and any benefits received by a responsible 
316.25 	relative of the assistance unit under the Social Security retirement program, may not be 
316.26 	counted in the determination of eligibility or benefit level for the assistance unit. Except as 
316.27 	provided below, the assistance unit is ineligible for general assistance if the available 
316.28 	resources or the countable income of the assistance unit and the parent or parents with whom 
316.29 	the assistance unit lives are such that a family consisting of the assistance unit's parent or 
316.30 	parents, the parent or parents' other family members and the assistance unit as the only or 
316.31 	additional minor child would be financially ineligible for general assistance. For the purposes 
316.32 	of calculating the countable income of the assistance unit's parent or parents, the calculation 
316.33 	methods must follow the provisions under section 256P.06.

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

317.1 	Sec. 5. Minnesota Statutes 2022, section 256I.04, subdivision 2f, is amended to read:
317.2 		Subd. 2f.Required services. (a) In licensed and registered authorized settings under 
317.3 	subdivision 2a, providers shall ensure that participants have at a minimum:
317.4 	(1) food preparation and service for three nutritional meals a day on site;
317.5 	(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service;
317.6 	(3) housekeeping, including cleaning and lavatory supplies or service; and
317.7 	(4) maintenance and operation of the building and grounds, including heat, water, garbage 
317.8 	removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair 
317.9 	and maintain equipment and facilities.
317.10 	(b) In addition, when providers serve participants described in subdivision 1, paragraph 
317.11 	(c), the providers are required to assist the participants in applying for continuing housing 
317.12 	support payments before the end of the eligibility period.

317.13 	Sec. 6. Minnesota Statutes 2023 Supplement, section 256I.05, subdivision 1a, is amended 
317.14 	to read:
317.15 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 256I.04, 
317.16 	subdivision 3, the agency may negotiate a payment not to exceed $494.91 for other services 
317.17 	necessary to provide room and board if the residence is licensed by or registered by the 
317.18 	Department of Health, or licensed by the Department of Human Services to provide services 
317.19 	in addition to room and board, and if the provider of services is not also concurrently 
317.20 	receiving funding for services for a recipient in the residence under the following programs 
317.21 	or funding sources: (1) home and community-based waiver services under chapter 256S or 
317.22 	section 256B.0913, 256B.092, or 256B.49; (2) personal care assistance under section 
317.23 	256B.0659; (3) community first services and supports under section 256B.85; or (4) services 
317.24 	for adults with mental illness grants under section 245.73. If funding is available for other 
317.25 	necessary services through a home and community-based waiver under chapter 256S, or 
317.26 	section 256B.0913, 256B.092, or 256B.49; personal care assistance services under section 
317.27 	256B.0659; community first services and supports under section 256B.85; or services for 
317.28 	adults with mental illness grants under section 245.73, then the housing support rate is 
317.29 	limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case may 
317.30 	the supplementary service rate exceed $494.91. The registration and licensure requirement 
317.31 	does not apply to establishments which are exempt from state licensure because they are 
317.32 	located on Indian reservations and for which the tribe has prescribed health and safety 
318.1 	requirements. Service payments under this section may be prohibited under rules to prevent 
318.2 	the supplanting of federal funds with state funds.
318.3 	(b) The commissioner is authorized to make cost-neutral transfers from the housing 
318.4 	support fund for beds under this section to other funding programs administered by the 
318.5 	department after consultation with the agency in which the affected beds are located. The 
318.6 	commissioner may also make cost-neutral transfers from the housing support fund to agencies 
318.7 	for beds permanently removed from the housing support census under a plan submitted by 
318.8 	the agency and approved by the commissioner. The commissioner shall report the amount 
318.9 	of any transfers under this provision annually to the legislature.
318.10 	(c) (b) Agencies must not negotiate supplementary service rates with providers of housing 
318.11 	support that are licensed as board and lodging with special services and that do not encourage 
318.12 	a policy of sobriety on their premises and make referrals to available community services 
318.13 	for volunteer and employment opportunities for residents.

318.14 	Sec. 7. Minnesota Statutes 2023 Supplement, section 256I.05, subdivision 11, is amended 
318.15 	to read:
318.16 		Subd. 11.Transfer of emergency shelter funds Cost-neutral transfers from the 
318.17 	housing support fund. (a) The commissioner is authorized to make cost-neutral transfers 
318.18 	from the housing support fund for beds under this section to other funding programs 
318.19 	administered by the department after consultation with the agency in which the affected 
318.20 	beds are located.
318.21 	(b) The commissioner may also make cost-neutral transfers from the housing support 
318.22 	fund to agencies for beds removed from the housing support census under a plan submitted 
318.23 	by the agency and approved by the commissioner.
318.24 	(a) (c) The commissioner shall make a cost-neutral transfer of funding from the housing 
318.25 	support fund to the agency for emergency shelter beds removed from the housing support 
318.26 	census under a biennial plan submitted by the agency and approved by the commissioner.
318.27 	Plans submitted under this paragraph must include anticipated and actual outcomes for 
318.28 	persons experiencing homelessness in emergency shelters.
318.29 	The plan (d) Plans submitted under paragraph (b) or (c) must describe: (1) anticipated 
318.30 	and actual outcomes for persons experiencing homelessness in emergency shelters; (2)
318.31 	improved efficiencies in administration; (3) (2) requirements for individual eligibility; and 
318.32 	(4) (3) plans for quality assurance monitoring and quality assurance outcomes. The 
319.1 	commissioner shall review the agency plan plans to monitor implementation and outcomes 
319.2 	at least biennially, and more frequently if the commissioner deems necessary.
319.3 	(b) The (e) Funding under paragraph (a) (b), (c), or (d) may be used for the provision 
319.4 	of room and board or supplemental services according to section 256I.03, subdivisions 14a 
319.5 	and 14b. Providers must meet the requirements of section 256I.04, subdivisions 2a to 2f. 
319.6 	Funding must be allocated annually, and the room and board portion of the allocation shall 
319.7 	be adjusted according to the percentage change in the housing support room and board rate. 
319.8 	The room and board portion of the allocation shall be determined at the time of transfer.
319.9 	The commissioner or agency may return beds to the housing support fund with 180 days' 
319.10 	notice, including financial reconciliation.

319.11 	Sec. 8. Minnesota Statutes 2023 Supplement, section 342.06, is amended to read:
319.12 	342.06 APPROVAL OF CANNABIS FLOWER, PRODUCTS, AND 
319.13 	CANNABINOIDS.
319.14 	(a) For the purposes of this section, "product category" means a type of product that 
319.15 	may be sold in different sizes, distinct packaging, or at various prices but is still created 
319.16 	using the same manufacturing or agricultural processes. A new or additional stock keeping 
319.17 	unit (SKU) or Universal Product Code (UPC) shall not prevent a product from being 
319.18 	considered the same type as another unit. All other terms have the meanings provided in 
319.19 	section 342.01.
319.20 	(b) The office shall approve product categories of cannabis flower, cannabis products, 
319.21 	lower-potency hemp edibles, and hemp-derived consumer products for retail sale.
319.22 	(c) The office may establish limits on the total THC of cannabis flower, cannabis products, 
319.23 	and hemp-derived consumer products. As used in this paragraph, "total THC" means the 
319.24 	sum of the percentage by weight of tetrahydrocannabinolic acid multiplied by 0.877 plus 
319.25 	the percentage by weight of all tetrahydrocannabinols.
319.26 	(d) The office shall not approve any cannabis product, lower-potency hemp edible, or 
319.27 	hemp-derived consumer product that:
319.28 	(1) is or appears to be a lollipop or ice cream;
319.29 	(2) bears the likeness or contains characteristics of a real or fictional person, animal, or 
319.30 	fruit;
319.31 	(3) is modeled after a type or brand of products primarily consumed by or marketed to 
319.32 	children;
320.1 	(4) is substantively similar to a meat food product; poultry food product as defined in 
320.2 	section 31A.02, subdivision 10; or a dairy product as defined in section 32D.01, subdivision 
320.3 	7;
320.4 	(5) contains a synthetic cannabinoid;
320.5 	(6) is made by applying a cannabinoid, including but not limited to an artificially derived 
320.6 	cannabinoid, to a finished food product that does not contain cannabinoids and is sold to 
320.7 	consumers, including but not limited to a candy or snack food; or
320.8 	(7) if the product is an edible cannabis product or lower-potency hemp edible, contains 
320.9 	an ingredient, other than a cannabinoid, that is not approved by the United States Food and 
320.10 	Drug Administration for use in food.
320.11 	(e) The office must not approve any cannabis flower, cannabis product, or hemp-derived 
320.12 	consumer product intended to be inhaled as smoke, aerosol, or vapor from the product that 
320.13 	contains any added artificial flavoring or synthetic flavoring, either in the product itself or 
320.14 	in its components or parts, that are not naturally occurring in the cannabis plants or hemp 
320.15 	plants. For purposes of this paragraph, artificial flavoring or synthetic flavoring does not 
320.16 	include naturally occurring terpenes.

320.17 	Sec. 9. Minnesota Statutes 2022, section 383B.908, subdivision 7, is amended to read:
320.18 		Subd. 7.Dissolution or reorganization of corporation. (a) The county board shall 
320.19 	retain the right to dissolve the corporation, reorganize the corporation, or remove the majority 
320.20 	of or the entire corporate board in order to resume management of Hennepin County Medical 
320.21 	Center upon: (1) a two-thirds vote of the entire county board; and (2) identification of one 
320.22 	or more of the following: (i) a crime committed by the corporate board; (ii) a violation by 
320.23 	the corporate board of ethical and legal duties as specified in section 383B.905; or (iii) 
320.24 	repeated failure by the corporate board to act in the best interests of the corporation.
320.25 	(b) The county board must comply with subdivision 8 before taking any action to dissolve 
320.26 	the corporation, reorganize the corporation, or remove the majority of or the entire corporate 
320.27 	board.

320.28 	Sec. 10. Minnesota Statutes 2022, section 383B.908, is amended by adding a subdivision 
320.29 	to read:
320.30 		Subd. 8.Investigation. (a) The county board must conduct a formal investigation into 
320.31 	the acts identified by the county board under subdivision 7, paragraph (a), before taking 
321.1 	any action to dissolve the corporation, reorganize the corporation, or remove the majority 
321.2 	of or the entire corporate board. As part of the formal investigation, the county board must:
321.3 	(1) at least 90 business days before taking any action to dissolve the corporation, 
321.4 	reorganize the corporation, or remove the majority of or the entire corporate board, provide 
321.5 	notice to the corporate board and to the commissioner of health of the county board's 
321.6 	proposed action and identify the specific acts that constitute grounds for the proposed action;
321.7 	(2) accept a response from the corporate board, within 45 business days after the corporate 
321.8 	board receives the notice and information required under clause (1), to the allegations by 
321.9 	the county board. In its response, the corporate board may present any mitigating factors 
321.10 	or defenses to the allegations; and
321.11 	(3) assess the legal and practical implications of the proposed action, including how the 
321.12 	proposed action would affect obligations to creditors; existing contracts; outstanding bond 
321.13 	obligations; accredited programs and services; research and education commitments; 
321.14 	reimbursements; regulatory requirements; clinical care and patients, especially patients 
321.15 	covered by public programs who have complicated care needs; other providers and health 
321.16 	systems; and critical statewide services such as the Minnesota Poison Control System and 
321.17 	the emergency preparedness resources hub.
321.18 	(b) Following the formal investigation, the county board must evaluate the results of the 
321.19 	investigation and must develop a written plan detailing the procedures for the proposed 
321.20 	action in a manner that provides continuity and minimal disruption to the items in paragraph 
321.21 	(a), clause (3). The county board must hold a public hearing on the plan and must provide 
321.22 	an opportunity for public testimony at the hearing. The county board may implement the 
321.23 	proposed action only if it finds there is sufficient evidence to support a finding of a crime 
321.24 	committed by the corporate board, a violation by the corporate board of ethical and legal 
321.25 	duties as specified in section 383B.905, or repeated failure by the corporate board to act in 
321.26 	the best interests of the corporation to warrant taking the proposed action.

321.27 	Sec. 11. Minnesota Statutes 2022, section 383B.922, is amended to read:
321.28 	383B.922 LEGAL COUNSEL.
321.29 		Subdivision 1.Hennepin County attorney. With respect to the provisions of section 
321.30 	388.051, the corporation shall be deemed a part of Hennepin County for purposes of the 
321.31 	Hennepin County attorney serving as legal counsel to the corporation; provided, however, 
321.32 	that the corporation and the Hennepin County attorney may enter into an arrangement with 
321.33 	respect to the hiring of outside counsel on behalf of the corporation. The corporation shall 
322.1 	reimburse the county for legal services provided by the Hennepin County attorney, including 
322.2 	any and all costs, and the reimbursement shall be credited to the budget of the Hennepin 
322.3 	County attorney.
322.4 		Subd. 2.Separate legal counsel; investigation. Notwithstanding subdivision 1, upon 
322.5 	written notification to the county board, the corporate board may hire separate legal counsel 
322.6 	to represent the corporate board and the corporation in matters related to an investigation 
322.7 	under section 383B.908, subdivision 8. Approval from the county board or the Hennepin 
322.8 	County attorney is not required.

322.9 	Sec. 12. REVIVAL AND REENACTMENT.
 322.10 	Minnesota Statutes 2022, section 25B.051, subdivision 7, is revived and reenacted 
322.11 	effective retroactively from August 1, 2023. Any time frames within or dependent on the 
322.12 	subdivision are based on the original effective date in Laws 2017, First Special Session 
322.13 	chapter 6, article 2, section 10.

322.14 	Sec. 13. REVISOR INSTRUCTION.
 322.15 	The revisor of statutes shall renumber Minnesota Statutes, section 256D.21, as Minnesota 
322.16 	Statutes, section 261.004.

322.17 	Sec. 14. REPEALER.
 322.18 	Minnesota Statutes 2022, sections 256D.19, subdivisions 1 and 2; 256D.20, subdivisions 
322.19 	1, 2, 3, and 4; and 256D.23, subdivisions 1, 2, and 3, are repealed.

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

322.21 	ARTICLE 12
322.22 	HUMAN SERVICES FORECAST ADJUSTMENTS

322.23	Section 1. HUMAN SERVICES FORECAST ADJUSTMENTS.
 	
322.24 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
322.25 	parentheses, subtracted from the appropriations in Laws 2023, chapter 61, article 9, and 
322.26 	Laws 2023, chapter 70, article 20, to the commissioner of human services from the general 
322.27 	fund or other named fund for the purposes specified in section 2 and are available for the 
322.28 	fiscal years indicated for each purpose. The figures "2024" and "2025" used in this article 
322.29 	mean that the addition to or subtraction from the appropriation listed under them is available 
322.30 	for the fiscal year ending June 30, 2024, or June 30, 2025, respectively.

323.1				APPROPRIATIONS
	
323.2				Available for the Year
	
323.3				Ending June 30
	
323.4					2024
		2025

323.5
323.6	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

323.7	Subdivision 1.Total Appropriation
 	$
	137,604,000
	$
	329,432,000

323.8	Appropriations by Fund
	
323.9	General Fund
	139,746,000
	325,606,000
	
323.10
323.11	Health Care Access 
Fund
	10,542,000
	6,224,000
	
323.12	Federal TANF
	(12,684,000)
	(2,398,000)

323.13	Subd. 2.Forecasted Programs

323.14	(a) MFIP/DWP

323.15	Appropriations by Fund
	
323.16	General Fund
	(5,990,000)
	(2,793,000)
	
323.17	Federal TANF
	(12,684,000)
	(2,398,000)

323.18	(b) MFIP Child Care Assistance
		(36,726,000)
		(26,004,000)

323.19	(c) General Assistance
		(567,000)
		292,000

323.20	(d) Minnesota Supplemental Aid
		1,424,000
		1,500,000

323.21	(e) Housing Support
		11,200,000
		14,667,000

323.22	(f) Northstar Care for Children
		(3,697,000)
		(11,309,000)

323.23	(g) MinnesotaCare
		10,542,000
		6,224,000
	
323.24 	These appropriations are from the health care 
323.25 	access fund.

323.26	(h) Medical Assistance
		180,321,000
		352,357,000

323.27	(i) Behavioral Health Fund
		(6,219,000)
		(3,104,000)

323.28 	Sec. 3. EFFECTIVE DATE.
 323.29 	This article is effective the day following final enactment.

324.1 	ARTICLE 13
324.2 	APPROPRIATIONS

324.3	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
324.4 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
324.5 	parentheses, subtracted from the appropriations in Laws 2023, chapter 70, article 20, to the 
324.6 	agencies and for the purposes specified in this article. The appropriations are from the 
324.7 	general fund or other named fund and are available for the fiscal years indicated for each 
324.8 	purpose. The figures "2024" and "2025" used in this article mean that the addition to or 
324.9 	subtraction from the appropriation listed under them is available for the fiscal year ending 
324.10 	June 30, 2024, or June 30, 2025, respectively. Base adjustments mean the addition to or 
324.11 	subtraction from the base level adjustment set in Laws 2023, chapter 70, article 20. 
324.12 	Supplemental appropriations and reductions to appropriations for the fiscal year ending 
324.13 	June 30, 2024, are effective the day following final enactment unless a different effective 
324.14 	date is explicit.

324.15				APPROPRIATIONS
	
324.16				Available for the Year
	
324.17				Ending June 30
	
324.18					2024
		2025

324.19
324.20	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

324.21	Subdivision 1.Total Appropriation
 	$
	(10,083,000)
	$
	12,926,000

324.22	Appropriations by Fund
	
324.23		2024
	2025
	
324.24	General
	(6,867,000)
	9,760,000
	
324.25	Health Care Access
	(3,216,000)
	3,166,000
	
324.26 	The amounts that may be spent for each 
324.27 	purpose are specified in the following 
324.28 	subdivisions.

324.29	Subd. 2.Central Office; Operations

324.30	Appropriations by Fund
	
324.31	General
	(1,443,000)
	(1,443,000)
	
324.32	Health Care Access
	-0-
	572,000
	
324.33 	Base Level Adjustment. The general fund 
324.34 	base is increased by $331,000 in fiscal year 
324.35 	2026 and $252,000 in fiscal year 2027. The 
325.1 	health care access fund base is increased by 
325.2 	$114,000 in fiscal year 2026 and $114,000 in 
325.3 	fiscal year 2027.

325.4	Subd. 3.Central Office; Health Care

325.5	Appropriations by Fund
	
325.6	General
	-0-
	400,000
	
325.7	Health Care Access
	(3,216,000)
	3,216,000
	
325.8 	Base Level Adjustment. The general fund 
325.9 	base is increased by $900,000 in fiscal year 
325.10 	2026 and $900,000 in fiscal year 2027.

325.11
325.12
325.13	Subd. 4.Central Office; Behavioral Health, 
Housing, and Deaf and Hard-of-Hearing 
Services
 		(136,000)
		1,558,000
	
325.14 	Residential Mental Health Crisis 
325.15 	Stabilization. $204,000 in fiscal year 2025 is 
325.16 	to develop a covered benefit under medical 
325.17 	assistance to provide residential mental health 
325.18 	crisis stabilization for children and to submit 
325.19 	a report to the legislature. This is a onetime 
325.20 	appropriation.

325.21	Subd. 5.Forecasted Programs; MinnesotaCare
 		-0-
		(2,070,000)
	
325.22 	This appropriation is from the health care 
325.23 	access fund.

325.24
325.25	Subd. 6.Forecasted Programs; Medical 
Assistance

325.26	Appropriations by Fund
	
325.27	General
	-0-
	1,988,000
	
325.28	Health Care Access
	-0-
	1,448,000

326.1
326.2	Subd. 7.Forecasted Programs; Behavioral 
Health Fund
 		-0-
		127,000

326.3
326.4	Subd. 8.Grant Programs; Adult Mental Health 
Grants
 		(6,731,000)
		-0-

326.5
326.6	Subd. 9.Grant Programs; Children's Mental 
Health Grants
 		-0-
		13,239,000
	
326.7 	(a) Respite Care Services. $5,000,000 in 
326.8 	fiscal year 2025 is for respite care services 
326.9 	under Minnesota Statutes, section 245.4889, 
326.10 	subdivision 1, paragraph (b), clause (3). Of 
326.11 	this appropriation, $1,000,000 in fiscal year 
326.12 	2025 only is for grants to private child-placing 
326.13 	agencies, as defined in Minnesota Rules, 
326.14 	chapter 9545, to conduct recruitment and 
326.15 	support licensing activities that are specific to 
326.16 	increasing the availability of licensed foster 
326.17 	homes to provide respite care services. The 
326.18 	base for this appropriation is $8,945,000 in 
326.19 	fiscal year 2026 and $8,945,000 in fiscal year 
326.20 	2027.
326.21 	(b) School-Linked Behavioral Health 
326.22 	Grants. $8,239,000 in fiscal year 2025 is for 
326.23 	school-linked behavioral health grants under 
326.24 	Minnesota Statutes, section 245.4901. This is 
326.25 	a onetime appropriation and is available until 
326.26 	June 30, 2027.

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

326.28	Sec. 3. COMMISSIONER OF HEALTH

326.29	Subdivision 1.Total Appropriation
 	$
	(541,000)
	$
	(2,446,000)

326.30	Appropriations by Fund
	
326.31		2024
	2025
	
326.32	General
	(545,000)
	481,000
	
326.33
326.34	State Government 
Special Revenue
	4,000
	(2,736,000)
	
327.1 	The amount that may be spent for each 
327.2 	purpose is specified in the following 
327.3 	subdivisions.

327.4	Subd. 2.Health Improvement

327.5	Appropriations by Fund
	
327.6	General
	(545,000)
	91,000
	
327.7
327.8	State Government 
Special Revenue
	-0-
	(2,880,000)
	
327.9 	(a) Request for Information; Evaluation of 
327.10 	Statewide Health Care Needs and Capacity.
327.11 	$150,000 in fiscal year 2025 is from the 
327.12 	general fund for a request for information for 
327.13 	a future evaluation of statewide health care 
327.14 	needs and capacity and projections of future 
327.15 	health care needs. This is a onetime 
327.16 	appropriation.
327.17 	(b) Reports on Prior Authorization 
327.18 	Requests. $191,000 in fiscal year 2025 is from 
327.19 	the general fund for purposes of Minnesota 
327.20 	Statutes, section 62M.19. The base for this 
327.21 	appropriation is $22,000 in fiscal year 2026 
327.22 	and $22,000 in fiscal year 2027.
327.23 	(c) Base Level Adjustment. The general fund 
327.24 	base is reduced by $22,000 in fiscal year 2026 
327.25 	and increased by $323,000 in fiscal year 2027.

327.26	Subd. 3.Health Protection

327.27	Appropriations by Fund
	
327.28	General
	-0-
	390,000
	
327.29
327.30	State Government 
Special Revenue
	-0-
	144,000
	
327.31 	(a) Natural Organic Reduction. $140,000 in 
327.32 	fiscal year 2025 is from the state government 
327.33 	special revenue fund for the licensure of 
327.34 	natural organic reduction facilities. The base 
328.1 	for this appropriation is $85,000 in fiscal year 
328.2 	2026 and $16,000 in fiscal year 2027.
328.3 	(b) Groundwater Thermal Exchange Device 
328.4 	Permitting. $4,000 in fiscal year 2024 and 
328.5 	$4,000 in fiscal year 2025 are from the state 
328.6 	government special revenue fund for costs 
328.7 	related to issuing permits for groundwater 
328.8 	thermal exchange devices.
328.9 	(c) Base Level Adjustment. The general fund 
328.10 	base is increased by $448,000 in fiscal year 
328.11 	2026 and $185,000 in fiscal year 2027. The 
328.12 	state government special revenue fund base is 
328.13 	increased by $89,000 in fiscal year 2026 and 
328.14 	$20,000 in fiscal year 2027.

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

328.16	Sec. 4. BOARD OF PHARMACY
 	$
	1,500,000
	$
	36,000

328.17	Appropriations by Fund
	
328.18	General
	1,500,000
	-0-
	
328.19
328.20	State Government 
Special Revenue
	-0-
	36,000
	
328.21 	(a) Legal Costs. $1,500,000 in fiscal year 
328.22 	2024 is from the general fund for legal costs 
328.23 	of the board. This is a onetime appropriation.
328.24 	(b) Pharmacist Authority; Laboratory Tests 
328.25 	and Vaccines. $27,000 in fiscal year 2025 is 
328.26 	from the state government special revenue 
328.27 	fund for board costs related to pharmacist 
328.28 	authority to order and perform laboratory tests 
328.29 	and initiate, order, and administer vaccines.
328.30 	(c) Statewide Protocol; Drugs to Prevent 
328.31 	the Acquisition of HIV. $9,000 in fiscal year 
328.32 	2025 is from the state government special 
328.33 	revenue fund for the board to develop a 
328.34 	statewide protocol for administering drugs to 
329.1 	prevent the acquisition of human 
329.2 	immunodeficiency virus (HIV). This is a 
329.3 	onetime appropriation.

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

329.5	Sec. 5. BOARD OF DIRECTORS OF MNSURE
 	$
	-0-
	$
	807,000
	
329.6 	Cost-Sharing Reduction Program 
329.7 	Administration. $807,000 in fiscal year 2025 
329.8 	is from the general fund for MNsure 
329.9 	information technology and administrative 
329.10 	costs for the cost-sharing reduction program. 
329.11 	The base for this appropriation is $506,000 in 
329.12 	fiscal year 2026 and $0 in fiscal year 2027.

329.13	Sec. 6. ATTORNEY GENERAL
 	$
	-0-
	$
	$159,000
	
329.14 	Oversight of Nonprofit Health Coverage 
329.15 	Entity Transactions. $159,000 in fiscal year 
329.16 	2025 is for oversight and enforcement of 
329.17 	nonprofit health coverage entity transactions 
329.18 	under Minnesota Statutes, sections 145D.30 
329.19 	to 145D.37. This is a onetime appropriation 
329.20 	and is available until June 30, 2027.

329.21	Sec. 7. COMMISSIONER OF COMMERCE
 					
329.22 	Base Level Adjustment. The general fund 
329.23 	base is increased by $111,000 in fiscal year 
329.24 	2026 and $54,000 in fiscal year 2027 for 
329.25 	administrative costs for defrayal requirements 
329.26 	under Minnesota Statutes, sections 62A.3098, 
329.27 	62Q.524, and 62Q.665.

329.28 	Sec. 8. TRANSFERS.
 329.29 	(a) $8,830,000 in fiscal year 2026 is transferred from the premium security plan account 
329.30 	under Minnesota Statutes, section 62E.25, subdivision 1, to the general fund. This is a 
329.31 	onetime transfer.
330.1 	(b) $50,000 in fiscal year 2025, $50,000 in fiscal year 2026, and $50,000 in fiscal year 
330.2 	2027 are transferred from the health care access fund to the insulin repayment account under 
330.3 	Minnesota Statutes, section 151.741, subdivision 5. These are onetime transfers.

330.4 	Sec. 9. Laws 2023, chapter 22, section 4, subdivision 2, is amended to read:
330.5 		Subd. 2.Grants to navigators.
 330.6 	(a) $1,936,000 in fiscal year 2024 is 
330.7 	appropriated from the health care access fund 
330.8 	to the commissioner of human services for 
330.9 	grants to organizations with a MNsure grant 
330.10 	services navigator assister contract in good 
330.11 	standing as of the date of enactment. The grant 
330.12 	payment to each organization must be in 
330.13 	proportion to the number of medical assistance 
330.14 	and MinnesotaCare enrollees each 
330.15 	organization assisted that resulted in a 
330.16 	successful enrollment in the second quarter of 
330.17 	fiscal years 2020 and 2023, as determined by 
330.18 	MNsure's navigator payment process. This is 
330.19 	a onetime appropriation and is available until 
330.20 	June 30, 2025.
330.21 	(b) $3,000,000 in fiscal year 2024 is 
330.22 	appropriated from the health care access fund 
330.23 	to the commissioner of human services for 
330.24 	grants to organizations with a MNsure grant 
330.25 	services navigator assister contract for 
330.26 	successful enrollments in medical assistance 
330.27 	and MinnesotaCare. This is a onetime 
330.28 	appropriation and is available until June 30, 
330.29 	2025.

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

330.31 	Sec. 10. Laws 2023, chapter 70, article 20, section 2, subdivision 5, is amended to read:

330.32	Subd. 5.Central Office; Health Care

331.1	Appropriations by Fund
	
331.2	General
	35,807,000
	31,349,000
	
331.3	Health Care Access
	30,668,000
	50,168,000
	
331.4 	(a) Medical assistance and MinnesotaCare 
331.5 	accessibility improvements. $4,000,000
331.6 	$784,000 in fiscal year 2024 is and $3,216,000 
331.7 	in fiscal year 2025 are from the general fund 
331.8 	for interactive voice response upgrades and 
331.9 	translation services for medical assistance and 
331.10 	MinnesotaCare enrollees with limited English 
331.11 	proficiency. This appropriation is available 
331.12 	until June 30, 2025 2027.
331.13 	(b) Transforming service delivery. $155,000 
331.14 	in fiscal year 2024 and $180,000 in fiscal year 
331.15 	2025 are from the general fund for 
331.16 	transforming service delivery projects.
331.17 	(c) Improving the Minnesota eligibility 
331.18 	technology system functionality. $1,604,000 
331.19 	in fiscal year 2024 and $711,000 in fiscal year 
331.20 	2025 are from the general fund for improving 
331.21 	the Minnesota eligibility technology system 
331.22 	functionality. The base for this appropriation 
331.23 	is $1,421,000 in fiscal year 2026 and $0 in 
331.24 	fiscal year 2027.
331.25 	(d) Actuarial and economic analyses.
331.26 	$2,500,000 is from the health care access fund 
331.27 	for actuarial and economic analyses and to 
331.28 	prepare and submit a state innovation waiver 
331.29 	under section 1332 of the federal Affordable 
331.30 	Care Act for a Minnesota public option health 
331.31 	care plan. This is a onetime appropriation and 
331.32 	is available until June 30, 2025.
331.33 	(e) Contingent appropriation for Minnesota 
331.34 	public option health care plan. $22,000,000 
331.35 	in fiscal year 2025 is from the health care 
332.1 	access fund to implement a Minnesota public 
332.2 	option health care plan. This is a onetime 
332.3 	appropriation and is available upon approval 
332.4 	of a state innovation waiver under section 
332.5 	1332 of the federal Affordable Care Act. This 
332.6 	appropriation is available until June 30, 2027.
332.7 	(f) Carryforward authority. Notwithstanding 
332.8 	Minnesota Statutes, section 16A.28, 
332.9 	subdivision 3, $2,367,000 of the appropriation 
332.10 	in fiscal year 2024 is available until June 30, 
332.11 	2027.
332.12 	(g) Base level adjustment. The general fund 
332.13 	base is $32,315,000 in fiscal year 2026 and 
332.14 	$27,536,000 in fiscal year 2027. The health 
332.15 	care access fund base is $28,168,000 in fiscal 
332.16 	year 2026 and $28,168,000 in fiscal year 2027.

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

332.18 	Sec. 11. Laws 2023, chapter 70, article 20, section 2, subdivision 7, is amended to read:

332.19
332.20	Subd. 7.Central Office; Behavioral Health, Deaf 
and Hard of Hearing, and Housing Services

332.21	Appropriations by Fund
	
332.23332.22
	General
	27,870,000
27,734,000
	27,592,000
27,728,000
	
332.24	Lottery Prize
	163,000
	163,000
	
332.25 	(a) Homeless management system. $250,000 
332.26 	in fiscal year 2024 and $1,000,000 in fiscal 
332.27 	year 2025 are from the general fund for a 
332.28 	homeless management information system. 
332.29 	The base for this appropriation is $1,140,000 
332.30 	in fiscal year 2026 and $1,140,000 in fiscal 
332.31 	year 2027.
332.32 	(b) Online behavioral health program 
332.33 	locator. $959,000 in fiscal year 2024 and 
332.34 	$959,000 in fiscal year 2025 are from the 
333.1 	general fund for an online behavioral health 
333.2 	program locator.
333.3 	(c) Integrated services for children and 
333.4 	families. $286,000 in fiscal year 2024 and 
333.5 	$286,000 in fiscal year 2025 are from the 
333.6 	general fund for integrated services for 
333.7 	children and families projects. 
333.8 	Notwithstanding Minnesota Statutes, section 
333.9 	16A.28, subdivision 3, $1,797,000 of the 
333.10 	appropriation in fiscal year 2024 is available 
333.11 	until June 30, 2027.
333.12 	(d) Carryforward authority.
333.13 	Notwithstanding Minnesota Statutes, section 
333.14 	16A.28, subdivision 3, $842,000 of the 
333.15 	appropriation in fiscal year 2024 is available 
333.16 	until June 30, 2027, $136,000 of the 
333.17 	appropriation in fiscal year 2025 is available 
333.18 	until June 30, 2027, and $852,000 of the 
333.19 	appropriation in fiscal year 2025 is available 
333.20 	until June 30, 2028.
333.21 	(f) Base level adjustment. The general fund 
333.22 	base is $25,243,000 in fiscal year 2026 and 
333.23 	$24,682,000 in fiscal year 2027.

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

333.25 	Sec. 12. Laws 2023, chapter 70, article 20, section 2, subdivision 29, is amended to read:

333.26
333.27	Subd. 29.Grant Programs; Adult Mental Health 
Grants
 		132,327,000
		121,270,000
	
333.28 	(a) Mobile crisis grants to Tribal Nations. 
333.29 	$1,000,000 in fiscal year 2024 and $1,000,000 
333.30 	in fiscal year 2025 are for mobile crisis grants 
333.31 	under Minnesota Statutes section, sections
333.32 	245.4661, subdivision 9, paragraph (b), clause 
333.33 	(15), and 245.4889, subdivision 1, paragraph 
333.34 	(b), clause (4), to Tribal Nations.
334.1 	(b) Mental health provider supervision 
334.2 	grant program. $1,500,000 in fiscal year 
334.3 	2024 and $1,500,000 in fiscal year 2025 are 
334.4 	for the mental health provider supervision 
334.5 	grant program under Minnesota Statutes, 
334.6 	section 245.4663.
334.7 	(c) Minnesota State University, Mankato 
334.8 	community behavioral health center. 
334.9 	$750,000 in fiscal year 2024 and $750,000 in 
334.10 	fiscal year 2025 are for a grant to the Center 
334.11 	for Rural Behavioral Health at Minnesota State 
334.12 	University, Mankato to establish a community 
334.13 	behavioral health center and training clinic. 
334.14 	The community behavioral health center must 
334.15 	provide comprehensive, culturally specific, 
334.16 	trauma-informed, practice- and 
334.17 	evidence-based, person- and family-centered 
334.18 	mental health and substance use disorder 
334.19 	treatment services in Blue Earth County and 
334.20 	the surrounding region to individuals of all 
334.21 	ages, regardless of an individual's ability to 
334.22 	pay or place of residence. The community 
334.23 	behavioral health center and training clinic 
334.24 	must also provide training and workforce 
334.25 	development opportunities to students enrolled 
334.26 	in the university's training programs in the 
334.27 	fields of social work, counseling and student 
334.28 	personnel, alcohol and drug studies, 
334.29 	psychology, and nursing. Upon request, the 
334.30 	commissioner must make information 
334.31 	regarding the use of this grant funding 
334.32 	available to the chairs and ranking minority 
334.33 	members of the legislative committees with 
334.34 	jurisdiction over behavioral health. This is a 
334.35 	onetime appropriation and is available until 
334.36 	June 30, 2027.
335.1 	(d) White Earth Nation; adult mental health 
335.2 	initiative. $300,000 in fiscal year 2024 and 
335.3 	$300,000 in fiscal year 2025 are for adult 
335.4 	mental health initiative grants to the White 
335.5 	Earth Nation. This is a onetime appropriation.
335.6 	(e) Mobile crisis grants. $8,472,000 in fiscal 
335.7 	year 2024 and $8,380,000 in fiscal year 2025 
335.8 	are for the mobile crisis grants under 
335.9 	Minnesota Statutes, section sections245.4661, 
335.10 	subdivision 9, paragraph (b), clause (15), and 
335.11 	245.4889, subdivision 1, paragraph (b), clause 
335.12 	(4). This is a onetime appropriation and is 
335.13 	available until June 30, 2027.
335.14 	(f) Base level adjustment. The general fund 
335.15 	base is $121,980,000 in fiscal year 2026 and 
335.16 	$121,980,000 in fiscal year 2027.

335.17 	Sec. 13. Laws 2023, chapter 70, article 20, section 3, subdivision 2, is amended to read:

335.18	Subd. 2.Health Improvement

335.19	Appropriations by Fund
	
335.20	General
	229,600,000
	210,030,000
	
335.21
335.22	State Government 
Special Revenue
	12,392,000
	12,682,000
	
335.23	Health Care Access
	49,051,000
	53,290,000
	
335.24	Federal TANF
	11,713,000
	11,713,000
	
335.25 	(a) Studies of telehealth expansion and 
335.26 	payment parity. $1,200,000 in fiscal year 
335.27 	2024 is from the general fund for studies of 
335.28 	telehealth expansion and payment parity. This 
335.29 	is a onetime appropriation and is available 
335.30 	until June 30, 2025.
335.31 	(b) Advancing equity through capacity 
335.32 	building and resource allocation grant 
335.33 	program. $916,000 in fiscal year 2024 and 
335.34 	$916,000 in fiscal year 2025 are from the 
336.1 	general fund for grants under Minnesota 
336.2 	Statutes, section 144.9821. This is a onetime 
336.3 	appropriation.
336.4 	(c) Grant to Minnesota Community Health 
336.5 	Worker Alliance. $971,000 in fiscal year 
336.6 	2024 and $971,000 in fiscal year 2025 are 
336.7 	from the general fund for Minnesota Statutes, 
336.8 	section 144.1462.
336.9 	(d) Community solutions for healthy child 
336.10 	development grants. $2,730,000 in fiscal year 
336.11 	2024 and $2,730,000 in fiscal year 2025 are 
336.12 	from the general fund for grants under 
336.13 	Minnesota Statutes, section 145.9257. The 
336.14 	base for this appropriation is $2,415,000 in 
336.15 	fiscal year 2026 and $2,415,000 in fiscal year 
336.16 	2027.
336.17 	(e) Comprehensive Overdose and Morbidity 
336.18 	Prevention Act. $9,794,000 in fiscal year 
336.19 	2024 and $10,458,000 in fiscal year 2025 are 
336.20 	from the general fund for comprehensive 
336.21 	overdose and morbidity prevention strategies 
336.22 	under Minnesota Statutes, section 144.0528. 
336.23 	The base for this appropriation is $10,476,000 
336.24 	in fiscal year 2026 and $10,476,000 in fiscal 
336.25 	year 2027.
336.26 	(f) Emergency preparedness and response.
336.27 	$10,486,000 in fiscal year 2024 and 
336.28 	$14,314,000 in fiscal year 2025 are from the 
336.29 	general fund for public health emergency 
336.30 	preparedness and response, the sustainability 
336.31 	of the strategic stockpile, and COVID-19 
336.32 	pandemic response transition. The base for 
336.33 	this appropriation is $11,438,000 in fiscal year 
336.34 	2026 and $11,362,000 in fiscal year 2027.
337.1 	(g) Healthy Beginnings, Healthy Families.
337.2 	(1) $8,440,000 in fiscal year 2024 and 
337.3 	$7,305,000 in fiscal year 2025 are from the 
337.4 	general fund for grants under Minnesota 
337.5 	Statutes, sections 145.9571 to 145.9576. The 
337.6 	base for this appropriation is $1,500,000 in 
337.7 	fiscal year 2026 and $1,500,000 in fiscal year 
337.8 	2027. (2) Of the amount in clause (1), 
337.9 	$400,000 in fiscal year 2024 is to support the 
337.10 	transition from implementation of activities 
337.11 	under Minnesota Statutes, section 145.4235, 
337.12 	to implementation of activities under 
337.13 	Minnesota Statutes, sections 145.9571 to 
337.14 	145.9576. The commissioner shall award four 
337.15 	sole-source grants of $100,000 each to Face 
337.16 	to Face, Cradle of Hope, Division of Indian 
337.17 	Work, and Minnesota Prison Doula Project. 
337.18 	The amount in this clause is a onetime 
337.19 	appropriation.
337.20 	(h) Help Me Connect. $463,000 in fiscal year 
337.21 	2024 and $921,000 in fiscal year 2025 are 
337.22 	from the general fund for the Help Me 
337.23 	Connect program under Minnesota Statutes, 
337.24 	section 145.988.
337.25 	(i) Home visiting. $2,000,000 in fiscal year 
337.26 	2024 and $2,000,000 in fiscal year 2025 are 
337.27 	from the general fund for home visiting under 
337.28 	Minnesota Statutes, section 145.87, to provide 
337.29 	home visiting to priority populations under 
337.30 	Minnesota Statutes, section 145.87, 
337.31 	subdivision 1, paragraph (e).
337.32 	(j) No Surprises Act enforcement.
337.33 	$1,210,000 in fiscal year 2024 and $1,090,000 
337.34 	in fiscal year 2025 are from the general fund 
337.35 	for implementation of the federal No Surprises 
338.1 	Act under Minnesota Statutes, section 
338.2 	62Q.021, and an assessment of the feasibility 
338.3 	of a statewide provider directory. The general 
338.4 	fund base for this appropriation is $855,000 
338.5 	in fiscal year 2026 and $855,000 in fiscal year 
338.6 	2027.
338.7 	(k) Office of African American Health.
338.8 	$1,000,000 in fiscal year 2024 and $1,000,000 
338.9 	in fiscal year 2025 are from the general fund 
338.10 	for grants under the authority of the Office of 
338.11 	African American Health under Minnesota 
338.12 	Statutes, section 144.0756.
338.13 	(l) Office of American Indian Health.
338.14 	$1,000,000 in fiscal year 2024 and $1,000,000 
338.15 	in fiscal year 2025 are from the general fund 
338.16 	for grants under the authority of the Office of 
338.17 	American Indian Health under Minnesota 
338.18 	Statutes, section 144.0757.
338.19 	(m) Public health system transformation 
338.20 	grants. (1) $9,844,000 in fiscal year 2024 and 
338.21 	$9,844,000 in fiscal year 2025 are from the 
338.22 	general fund for grants under Minnesota 
338.23 	Statutes, section 145A.131, subdivision 1, 
338.24 	paragraph (f).
338.25 	(2) $535,000 in fiscal year 2024 and $535,000 
338.26 	in fiscal year 2025 are from the general fund 
338.27 	for grants under Minnesota Statutes, section 
338.28 	145A.14, subdivision 2b.
338.29 	(3) $321,000 in fiscal year 2024 and $321,000 
338.30 	in fiscal year 2025 are from the general fund 
338.31 	for grants under Minnesota Statutes, section 
338.32 	144.0759.
338.33 	(n) Health care workforce. (1) $1,010,000 
338.34 	in fiscal year 2024 and $2,550,000 in fiscal 
339.1 	year 2025 are from the health care access fund 
339.2 	for rural training tracks and rural clinicals 
339.3 	grants under Minnesota Statutes, sections 
339.4 	144.1505 and 144.1507. The base for this 
339.5 	appropriation is $4,060,000 in fiscal year 2026 
339.6 	and $3,600,000 in fiscal year 2027.
339.7 	(2) $420,000 in fiscal year 2024 and $420,000 
339.8 	in fiscal year 2025 are from the health care 
339.9 	access fund for immigrant international 
339.10 	medical graduate training grants under 
339.11 	Minnesota Statutes, section 144.1911.
339.12 	(3) $5,654,000 in fiscal year 2024 and 
339.13 	$5,550,000 in fiscal year 2025 are from the 
339.14 	health care access fund for site-based clinical 
339.15 	training grants under Minnesota Statutes, 
339.16 	section 144.1508. The base for this 
339.17 	appropriation is $4,657,000 in fiscal year 2026 
339.18 	and $3,451,000 in fiscal year 2027.
339.19 	(4) $1,000,000 in fiscal year 2024 and 
339.20 	$1,000,000 in fiscal year 2025 are from the 
339.21 	health care access fund for mental health for 
339.22 	health care professional grants. This is a 
339.23 	onetime appropriation and is available until 
339.24 	June 30, 2027.
339.25 	(5) $502,000 in fiscal year 2024 and $502,000 
339.26 	in fiscal year 2025 are from the health care 
339.27 	access fund for workforce research and data 
339.28 	analysis of shortages, maldistribution of health 
339.29 	care providers in Minnesota, and the factors 
339.30 	that influence decisions of health care 
339.31 	providers to practice in rural areas of 
339.32 	Minnesota.
339.33 	(o) School health. $800,000 in fiscal year 
339.34 	2024 and $1,300,000 in fiscal year 2025 are 
340.1 	from the general fund for grants under 
340.2 	Minnesota Statutes, section 145.903. The base 
340.3 	for this appropriation is $2,300,000 in fiscal 
340.4 	year 2026 and $2,300,000 in fiscal year 2027.
340.5 	(p) Long COVID. $3,146,000 in fiscal year 
340.6 	2024 and $3,146,000 in fiscal year 2025 are 
340.7 	from the general fund for grants and to 
340.8 	implement Minnesota Statutes, section 
340.9 	145.361.
340.10 	(q) Workplace safety grants. $4,400,000 in 
340.11 	fiscal year 2024 is from the general fund for 
340.12 	grants to health care entities to improve 
340.13 	employee safety or security. This is a onetime 
340.14 	appropriation and is available until June 30, 
340.15 	2027. The commissioner may use up to ten 
340.16 	percent of this appropriation for 
340.17 	administration.
340.18 	(r) Clinical dental education innovation 
340.19 	grants. $1,122,000 in fiscal year 2024 and 
340.20 	$1,122,000 in fiscal year 2025 are from the 
340.21 	general fund for clinical dental education 
340.22 	innovation grants under Minnesota Statutes, 
340.23 	section 144.1913.
340.24 	(s) Emmett Louis Till Victims Recovery 
340.25 	Program. $500,000 in fiscal year 2024 is from 
340.26 	the general fund for a grant to the Emmett 
340.27 	Louis Till Victims Recovery Program. The 
340.28 	commissioner must not use any of this 
340.29 	appropriation for administration. This is a 
340.30 	onetime appropriation and is available until 
340.31 	June 30, 2025.
340.32 	(t) Center for health care affordability.
340.33 	$2,752,000 in fiscal year 2024 and $3,989,000 
340.34 	in fiscal year 2025 are from the general fund 
341.1 	to establish a center for health care 
341.2 	affordability and to implement Minnesota 
341.3 	Statutes, section 62J.312. The general fund 
341.4 	base for this appropriation is $3,988,000 in 
341.5 	fiscal year 2026 and $3,988,000 in fiscal year 
341.6 	2027.
341.7 	(u) Federally qualified health centers 
341.8 	apprenticeship program. $690,000 in fiscal 
341.9 	year 2024 and $690,000 in fiscal year 2025 
341.10 	are from the general fund for grants under 
341.11 	Minnesota Statutes, section 145.9272.
341.12 	(v) Alzheimer's public information 
341.13 	program. $80,000 in fiscal year 2024 and 
341.14 	$80,000 in fiscal year 2025 are from the 
341.15 	general fund for grants to community-based 
341.16 	organizations to co-create culturally specific 
341.17 	messages to targeted communities and to 
341.18 	promote public awareness materials online 
341.19 	through diverse media channels.
341.20 	(w) Keeping Nurses at the Bedside Act; 
341.21 	contingent appropriation Nurse and Patient 
341.22 	Safety Act.The appropriations in this 
341.23 	paragraph are contingent upon legislative 
341.24 	enactment of 2023 Senate File 1384 by the 
341.25 	93rd Legislature. The appropriations in this 
341.26 	paragraph are available until June 30, 2027.
341.27 	(1) $5,317,000 in fiscal year 2024 and 
341.28 	$5,317,000 in fiscal year 2025 are from the 
341.29 	general fund for loan forgiveness under 
341.30 	Minnesota Statutes, section 144.1501, for 
341.31 	eligible nurses who have agreed to work as 
341.32 	hospital nurses in accordance with Minnesota 
341.33 	Statutes, section 144.1501, subdivision 2, 
341.34 	paragraph (a), clause (7).
342.1 	(2) $66,000 in fiscal year 2024 and $66,000 
342.2 	in fiscal year 2025 are from the general fund 
342.3 	for loan forgiveness under Minnesota Statutes, 
342.4 	section 144.1501, for eligible nurses who have 
342.5 	agreed to teach in accordance with Minnesota 
342.6 	Statutes, section 144.1501, subdivision 2, 
342.7 	paragraph (a), clause (3).
342.8 	(3) $545,000 in fiscal year 2024 and $879,000 
342.9 	in fiscal year 2025 are from the general fund 
342.10 	to administer Minnesota Statutes, section 
342.11 	144.7057; to perform the evaluation duties 
342.12 	described in Minnesota Statutes, section 
342.13 	144.7058; to continue prevention of violence 
342.14 	in health care program activities; to analyze 
342.15 	potential links between adverse events and 
342.16 	understaffing; to convene stakeholder groups 
342.17 	and create a best practices toolkit; and for a 
342.18 	report on the current status of the state's 
342.19 	nursing workforce employed by hospitals. The 
342.20 	base for this appropriation is $624,000 in fiscal 
342.21 	year 2026 and $454,000 in fiscal year 2027.
342.22 	(x) Supporting healthy development of 
342.23 	babies. $260,000 in fiscal year 2024 and 
342.24 	$260,000 in fiscal year 2025 are from the 
342.25 	general fund for a grant to the Amherst H. 
342.26 	Wilder Foundation for the African American 
342.27 	Babies Coalition initiative. The base for this 
342.28 	appropriation is $520,000 in fiscal year 2026 
342.29 	and $0 in fiscal year 2027. Any appropriation 
342.30 	in fiscal year 2026 is available until June 30, 
342.31 	2027. This paragraph expires on June 30, 
342.32 	2027.
342.33 	(y) Health professional education loan 
342.34 	forgiveness. $2,780,000 in fiscal year 2024 
342.35 	is from the general fund for eligible mental 
343.1 	health professional loan forgiveness under 
343.2 	Minnesota Statutes, section 144.1501. This is 
343.3 	a onetime appropriation. The commissioner 
343.4 	may use up to ten percent of this appropriation 
343.5 	for administration.
343.6 	(z) Primary care residency expansion grant 
343.7 	program. $400,000 in fiscal year 2024 and 
343.8 	$400,000 in fiscal year 2025 are from the 
343.9 	general fund for a psychiatry resident under 
343.10 	Minnesota Statutes, section 144.1506.
343.11 	(aa) Pediatric primary care mental health 
343.12 	training grant program. $1,000,000 in fiscal 
343.13 	year 2024 and $1,000,000 in fiscal year 2025 
343.14 	are from the general fund for grants under 
343.15 	Minnesota Statutes, section 144.1509. The 
343.16 	commissioner may use up to ten percent of 
343.17 	this appropriation for administration.
343.18 	(bb) Mental health cultural community 
343.19 	continuing education grant program. 
343.20 	$500,000 in fiscal year 2024 and $500,000 in 
343.21 	fiscal year 2025 are from the general fund for 
343.22 	grants under Minnesota Statutes, section 
343.23 	144.1511. The commissioner may use up to 
343.24 	ten percent of this appropriation for 
343.25 	administration.
343.26 	(cc) Labor trafficking services grant 
343.27 	program. $500,000 in fiscal year 2024 and 
343.28 	$500,000 in fiscal year 2025 are from the 
343.29 	general fund for grants under Minnesota 
343.30 	Statutes, section 144.3885.
343.31 	(dd) Palliative Care Advisory Council. 
343.32 	$40,000 $44,000 in fiscal year 2024 and 
343.33 	$40,000 $44,000 in fiscal year 2025 are from 
344.1 	the general fund for grants administration
344.2 	under Minnesota Statutes, section 144.059.
344.3 	(ee) Analysis of a universal health care 
344.4 	financing system. $1,815,000 in fiscal year 
344.5 	2024 and $580,000 in fiscal year 2025 are 
344.6 	from the general fund to the commissioner to 
344.7 	contract for an analysis of the benefits and 
344.8 	costs of a legislative proposal for a universal 
344.9 	health care financing system and a similar 
344.10 	analysis of the current health care financing 
344.11 	system. The base for this appropriation is 
344.12 	$580,000 in fiscal year 2026 and $0 in fiscal 
344.13 	year 2027. This appropriation is available until 
344.14 	June 30, 2027.
344.15 	(ff) Charitable assets public interest review.
344.16 	(1) The appropriations under this paragraph 
344.17 	are contingent upon legislative enactment of 
344.18 	2023 House File 402 by the 93rd Legislature.
344.19 	(2) $1,584,000 in fiscal year 2024 and 
344.20 	$769,000 in fiscal year 2025 are from the 
344.21 	general fund to review certain health care 
344.22 	entity transactions; to conduct analyses of the 
344.23 	impacts of health care transactions on health 
344.24 	care cost, quality, and competition; and to 
344.25 	issue public reports on health care transactions 
344.26 	in Minnesota and their impacts. The base for 
344.27 	this appropriation is $710,000 in fiscal year 
344.28 	2026 and $710,000 in fiscal year 2027.
344.29 	(gg) Study of the development of a statewide 
344.30 	registry for provider orders for 
344.31 	life-sustaining treatment. $365,000 in fiscal 
344.32 	year 2024 and $365,000 in fiscal year 2025 
344.33 	are from the general fund for a study of the 
344.34 	development of a statewide registry for 
345.1 	provider orders for life-sustaining treatment. 
345.2 	This is a onetime appropriation.
345.3 	(hh) Task Force on Pregnancy Health and 
345.4 	Substance Use Disorders. $199,000 in fiscal 
345.5 	year 2024 and $100,000 in fiscal year 2025 
345.6 	are from the general fund for the Task Force 
345.7 	on Pregnancy Health and Substance Use 
345.8 	Disorders. This is a onetime appropriation and 
345.9 	is available until June 30, 2025.
345.10 	(ii) 988 Suicide and crisis lifeline. $4,000,000 
345.11 	in fiscal year 2024 is from the general fund 
345.12 	for 988 national suicide prevention lifeline 
345.13 	grants under Minnesota Statutes, section 
345.14 	145.561. This is a onetime appropriation.
345.15 	(jj) Equitable Health Care Task Force.
345.16 	$779,000 in fiscal year 2024 and $749,000 in 
345.17 	fiscal year 2025 are from the general fund for 
345.18 	the Equitable Health Care Task Force. This is 
345.19 	a onetime appropriation.
345.20 	(kk) Psychedelic Medicine Task Force.
345.21 	$338,000 in fiscal year 2024 and $171,000 in 
345.22 	fiscal year 2025 are from the general fund for 
345.23 	the Psychedelic Medicine Task Force. This is 
345.24 	a onetime appropriation.
345.25 	(ll) Medical education and research costs.
345.26 	$300,000 in fiscal year 2024 and $300,000 in 
345.27 	fiscal year 2025 are from the general fund for 
345.28 	the medical education and research costs 
345.29 	program under Minnesota Statutes, section 
345.30 	62J.692.
345.31 	(mm) Special Guerilla Unit Veterans grant 
345.32 	program. $250,000 in fiscal year 2024 and 
345.33 	$250,000 in fiscal year 2025 are from the 
345.34 	general fund for a grant to the Special 
346.1 	Guerrilla Units Veterans and Families of the 
346.2 	United States of America to offer 
346.3 	programming and culturally specific and 
346.4 	specialized assistance to support the health 
346.5 	and well-being of Special Guerilla Unit 
346.6 	Veterans. The base for this appropriation is 
346.7 	$500,000 in fiscal year 2026 and $0 in fiscal 
346.8 	year 2027. Any amount appropriated in fiscal 
346.9 	year 2026 is available until June 30, 2027. 
346.10 	This paragraph expires June 30, 2027.
346.11 	(nn) Safe harbor regional navigator. 
346.12 	$300,000 in fiscal year 2024 and $300,000 in 
346.13 	fiscal year 2025 are for a regional navigator 
346.14 	in northwestern Minnesota. The commissioner 
346.15 	may use up to ten percent of this appropriation 
346.16 	for administration.
346.17 	(oo) Network adequacy. $798,000 in fiscal 
346.18 	year 2024 and $491,000 in fiscal year 2025 
346.19 	are from the general fund for reviews of 
346.20 	provider networks under Minnesota Statutes, 
346.21 	section 62K.10, to determine network 
346.22 	adequacy.
346.23 	(pp) Grants to Minnesota Alliance for 
346.24 	Volunteer Advancement. $278,000 in fiscal 
346.25 	year 2024 is from the general fund for a grant 
346.26 	to the Minnesota Alliance for Volunteer 
346.27 	Advancement to administer needs-based 
346.28 	volunteerism subgrants targeting 
346.29 	underresourced nonprofit organizations in 
346.30 	greater Minnesota. Subgrants must be used to 
346.31 	support the ongoing efforts of selected 
346.32 	organizations to address and minimize 
346.33 	disparities in access to human services through 
346.34 	increased volunteerism. Subgrant applicants 
346.35 	must demonstrate that the populations to be 
347.1 	served by the subgrantee are underserved or 
347.2 	suffer from or are at risk of homelessness, 
347.3 	hunger, poverty, lack of access to health care, 
347.4 	or deficits in education. The Minnesota 
347.5 	Alliance for Volunteer Advancement must 
347.6 	give priority to organizations that are serving 
347.7 	the needs of vulnerable populations. This is a 
347.8 	onetime appropriation and is available until 
347.9 	June 30, 2025.
347.10 	(pp)(1) (qq)(1)TANF Appropriations. TANF 
347.11 	funds must be used as follows:
347.12 	(i) $3,579,000 in fiscal year 2024 and 
347.13 	$3,579,000 in fiscal year 2025 are from the 
347.14 	TANF fund for home visiting and nutritional 
347.15 	services listed under Minnesota Statutes, 
347.16 	section 145.882, subdivision 7, clauses (6) and 
347.17 	(7). Funds must be distributed to community 
347.18 	health boards according to Minnesota Statutes, 
347.19 	section 145A.131, subdivision 1;
347.20 	(ii) $2,000,000 in fiscal year 2024 and 
347.21 	$2,000,000 in fiscal year 2025 are from the 
347.22 	TANF fund for decreasing racial and ethnic 
347.23 	disparities in infant mortality rates under 
347.24 	Minnesota Statutes, section 145.928, 
347.25 	subdivision 7;
347.26 	(iii) $4,978,000 in fiscal year 2024 and 
347.27 	$4,978,000 in fiscal year 2025 are from the 
347.28 	TANF fund for the family home visiting grant 
347.29 	program under Minnesota Statutes, section 
347.30 	145A.17. $4,000,000 of the funding in fiscal 
347.31 	year 2024 and $4,000,000 in fiscal year 2025 
347.32 	must be distributed to community health 
347.33 	boards under Minnesota Statutes, section 
347.34 	145A.131, subdivision 1. $978,000 of the 
347.35 	funding in fiscal year 2024 and $978,000 in 
348.1 	fiscal year 2025 must be distributed to Tribal 
348.2 	governments under Minnesota Statutes, section 
348.3 	145A.14, subdivision 2a;
348.4 	(iv) $1,156,000 in fiscal year 2024 and 
348.5 	$1,156,000 in fiscal year 2025 are from the 
348.6 	TANF fund for sexual and reproductive health 
348.7 	services grants under Minnesota Statutes, 
348.8 	section 145.925; and
348.9 	(v) the commissioner may use up to 6.23 
348.10 	percent of the funds appropriated from the 
348.11 	TANF fund each fiscal year to conduct the 
348.12 	ongoing evaluations required under Minnesota 
348.13 	Statutes, section 145A.17, subdivision 7, and 
348.14 	training and technical assistance as required 
348.15 	under Minnesota Statutes, section 145A.17, 
348.16 	subdivisions 4 and 5.
348.17 	(2) TANF Carryforward. Any unexpended 
348.18 	balance of the TANF appropriation in the first 
348.19 	year does not cancel but is available in the 
348.20 	second year.
348.21 	(qq) (rr)Base level adjustments. The general 
348.22 	fund base is $197,644,000 in fiscal year 2026 
348.23 	and $195,714,000 in fiscal year 2027. The 
348.24 	health care access fund base is $53,354,000 
348.25 	in fiscal year 2026 and $50,962,000 in fiscal 
348.26 	year 2027.

348.27 	EFFECTIVE DATE. This section is effective the day following final enactment, except 
348.28 	paragraph (pp) is effective retroactively from July 1, 2023.

348.29 	Sec. 14. Laws 2023, chapter 70, article 20, section 12, as amended by Laws 2023, chapter 
348.30 	75, section 13, is amended to read:

348.31
348.32	Sec. 12. COMMISSIONER OF 
MANAGEMENT AND BUDGET
 	$
	12,932,000
	$
	3,412,000
	
349.1 	(a) Outcomes and evaluation consultation. 
349.2 	$450,000 in fiscal year 2024 and $450,000 in 
349.3 	fiscal year 2025 are for outcomes and 
349.4 	evaluation consultation requirements.
349.5 	(b) Department of Children, Youth, and 
349.6 	Families. $11,931,000 in fiscal year 2024 and 
349.7 	$2,066,000 in fiscal year 2025 are to establish 
349.8 	the Department of Children, Youth, and 
349.9 	Families. This is a onetime appropriation.
349.10 	(c) Keeping Nurses at the Bedside Act 
349.11 	impact evaluation; contingent 
349.12 	appropriation. $232,000 in fiscal year 2025 
349.13 	is for the Keeping Nurses at the Bedside Act 
349.14 	impact evaluation. This appropriation is 
349.15 	contingent upon legislative enactment by the 
349.16 	93rd Legislature of a provision substantially 
349.17 	similar to the impact evaluation provision in 
349.18 	2023 S.F. No. 2995, the third engrossment, 
349.19 	article 3, section 22. This is a onetime 
349.20 	appropriation and is available until June 30, 
349.21 	2029.
349.22 	(d) (c)Health care subcabinet. $551,000 in 
349.23 	fiscal year 2024 and $664,000 in fiscal year 
349.24 	2025 are to hire an executive director for the 
349.25 	health care subcabinet and to provide staffing 
349.26 	and administrative support for the health care 
349.27 	subcabinet.
349.28 	(e) (d)Base level adjustment. The general 
349.29 	fund base is $1,114,000 in fiscal year 2026 
349.30 	and $1,114,000 in fiscal year 2027.

349.31 	Sec. 15. APPROPRIATIONS GIVEN EFFECT ONCE.
 349.32 	If an appropriation or transfer in this article is enacted more than once during the 2024 
349.33 	regular session, the appropriation or transfer must be given effect once.

350.1 	Sec. 16. EXPIRATION OF UNCODIFIED LANGUAGE.
 350.2 	All uncodified language contained in this article expires on June 30, 2025, unless a 
350.3 	different expiration date is explicit.

350.4 	Sec. 17. REPEALER.
 350.5 	(a) Laws 2023, chapter 70, article 20, section 2, subdivision 31, as amended by Laws 
350.6 	2023, chapter 75, section 12, is repealed.
350.7 	(b) Laws 2023, chapter 75, section 10, is repealed.

350.8 	EFFECTIVE DATE. Paragraph (b) is effective the day following final enactment.

APPENDIX 

Repealed Minnesota Statutes: UES4699-2 

62A.041 MATERNITY BENEFITS.Subd. 3.Abortion. 
For the purposes of this section, the term "maternity benefits" shall not include elective, induced abortion whether performed in a hospital, other abortion facility, or the office of a physician. 

This section applies to policies and contracts issued, delivered, or renewed after August 1, 1985, that cover Minnesota residents. 

62J.312 CENTER FOR HEALTH CARE AFFORDABILITY.Subd. 6.340B covered entity report. 
(a) Beginning April 1, 2024, each 340B covered entity, as defined by section 340B(a)(4) of the Public Health Service Act, must report to the commissioner of health by April 1 of each year the following information related to its participation in the federal 340B program for the previous calendar year: 

(1) the National Provider Identification (NPI) number; 

(2) the name of the 340B covered entity; 

(3) the servicing address of the 340B covered entity; 

(4) the classification of the 340B covered entity; 

(5) the aggregated acquisition cost for prescription drugs obtained under the 340B program; 

(6) the aggregated payment amount received for drugs obtained under the 340B program and dispensed to patients; 

(7) the aggregated payment made to pharmacies under contract to dispense drugs obtained under the 340B program; and 

(8) the number of claims for prescription drugs described in clause (6). 

(b) The information required under paragraph (a) must be reported by payer type, including commercial insurance, medical assistance and MinnesotaCare, and Medicare, in the form and manner defined by the commissioner. For covered entities that are hospitals, the information required under paragraph (a), clauses (5) to (8), must also be reported at the national drug code level for the 50 most frequently dispensed drugs by the facility under the 340B program. 

(c) Data submitted under paragraph (a) must include prescription drugs dispensed by outpatient facilities that are identified as child facilities under the federal 340B program based on their inclusion on the hospital's Medicare cost report. 

(d) Data submitted to the commissioner under paragraph (a) must be classified as nonpublic data as defined in section 13.02, subdivision 9. 

(e) Beginning November 15, 2024, and by November 15 of each year thereafter, the commissioner shall prepare a report that aggregates the data submitted under paragraph (a). The commissioner shall submit this report to the chairs and ranking minority members of the legislative committees with jurisdiction over health care finance and policy. 

62Q.522 COVERAGE OF CONTRACEPTIVE METHODS AND SERVICES.Subd. 3.Exemption. 
(a) An exempt organization is not required to cover contraceptives or contraceptive services if the exempt organization has religious objections to the coverage. An exempt organization that chooses to not provide coverage for some or all contraceptives and contraceptive services must notify employees as part of the hiring process and to all employees at least 30 days before: 

(1) an employee enrolls in the health plan; or 

(2) the effective date of the health plan, whichever occurs first. 

(b) If the exempt organization provides coverage for some contraceptive methods or services, the notice required under paragraph (a) must provide a list of the contraceptive methods or services the organization refuses to cover. 

Subd. 4.Accommodation for eligible organizations. 
(a) A health plan established or maintained by an eligible organization complies with the requirements of subdivision 2 to provide coverage of contraceptive methods and services, with respect to the contraceptive methods or services identified in the notice under this paragraph, if the eligible organization provides notice to any health plan company the eligible organization contracts with that it is an eligible organization and that the eligible organization has a religious objection to coverage for all or a subset of contraceptive methods or services. 

(b) The notice from an eligible organization to a health plan company under paragraph (a) must include: (1) the name of the eligible organization; (2) a statement that it objects to coverage for some or all of contraceptive methods or services, including a list of the contraceptive methods or services the eligible organization objects to, if applicable; and (3) the health plan name. The notice must be executed by a person authorized to provide notice on behalf of the eligible organization. 

(c) An eligible organization must provide a copy of the notice under paragraph (a) to prospective employees as part of the hiring process and to all employees at least 30 days before: 

(1) an employee enrolls in the health plan; or 

(2) the effective date of the health plan, whichever occurs first. 

(d) A health plan company that receives a copy of the notice under paragraph (a) with respect to a health plan established or maintained by an eligible organization must, for all future enrollments in the health plan: 

(1) expressly exclude coverage for those contraceptive methods or services identified in the notice under paragraph (a) from the health plan; and 

(2) provide separate payments for any contraceptive methods or services required to be covered under subdivision 2 for enrollees as long as the enrollee remains enrolled in the health plan. 

(e) The health plan company must not impose any cost-sharing requirements, including co-pays, deductibles, or coinsurance, or directly or indirectly impose any premium, fee, or other charge for contraceptive services or methods on the eligible organization, health plan, or enrollee. 

(f) On January 1, 2024, and every year thereafter a health plan company must notify the commissioner, in a manner determined by the commissioner, of the number of eligible organizations granted an accommodation under this subdivision. 

144.0528 COMPREHENSIVE DRUG OVERDOSE AND MORBIDITY PREVENTION ACT.Subd. 5.Promotion; administration.  
In fiscal years 2026 and beyond, the commissioner may spend up to 25 percent of the total funding appropriated for the comprehensive drug overdose and morbidity program in each fiscal year to promote, administer, support, and evaluate the programs authorized under this section and to provide technical assistance to program grantees. 

144.497 ST ELEVATION MYOCARDIAL INFARCTION.
The commissioner of health shall assess and report on the quality of care provided in the state for ST elevation myocardial infarction response and treatment. The commissioner shall: 

(1) utilize and analyze data provided by ST elevation myocardial infarction receiving centers to the ACTION Registry-Get with the guidelines or an equivalent data platform that does not identify individuals or associate specific ST elevation myocardial infarction heart attack events with an identifiable individual; 

(2) annually post a summary report of the data in aggregate form on the Department of Health website; and 

(3) coordinate to the extent possible with national voluntary health organizations involved in ST elevation myocardial infarction heart attack quality improvement to encourage ST elevation myocardial infarction receiving centers to report data consistent with nationally recognized guidelines on the treatment of individuals with confirmed ST elevation myocardial infarction heart attacks within the state and encourage sharing of information among health care providers on ways to improve the quality of care of ST elevation myocardial infarction patients in Minnesota. 

144E.001 DEFINITIONS.Subd. 5.Board. 
"Board" means the Emergency Medical Services Regulatory Board. 

144E.01 EMERGENCY MEDICAL SERVICES REGULATORY BOARD.Subdivision 1.Membership. 
(a) The Emergency Medical Services Regulatory Board consists of the following members, all of whom must work in Minnesota, except for the person listed in clause (14): 

(1) an emergency physician certified by the American Board of Emergency Physicians; 

(2) a representative of Minnesota hospitals; 

(3) a representative of fire chiefs; 

(4) a full-time firefighter who serves as an emergency medical responder on or within a nontransporting or nonregistered agency and who is a member of a professional firefighter's union; 

(5) a volunteer firefighter who serves as an emergency medical responder on or within a nontransporting or nonregistered agency; 

(6) an attendant currently practicing on a licensed ambulance service who is a paramedic or an emergency medical technician; 

(7) an ambulance director for a licensed ambulance service; 

(8) a representative of sheriffs; 

(9) a member of a community health board to represent community health services; 

(10) two representatives of regional emergency medical services programs, one of whom must be from the metropolitan regional emergency medical services program; 

(11) a registered nurse currently practicing in a hospital emergency department; 

(12) a pediatrician, certified by the American Board of Pediatrics, with experience in emergency medical services; 

(13) a family practice physician who is currently involved in emergency medical services; 

(14) a public member who resides in Minnesota; and 

(15) the commissioners of health and public safety or their designees. 

(b) The governor shall appoint members under paragraph (a). Appointments under paragraph (a), clauses (1) to (9) and (11) to (13), are subject to the advice and consent of the senate. In making appointments under paragraph (a), clauses (1) to (9) and (11) to (13), the governor shall consider recommendations of the American College of Emergency Physicians, the Minnesota Hospital Association, the Minnesota and State Fire Chief's Association, the Minnesota Ambulance Association, the Minnesota Emergency Medical Services Association, the Minnesota State Sheriff's Association, the Association of Minnesota Counties, the Minnesota Nurses Association, and the Minnesota chapter of the Academy of Pediatrics. 

(c) At least seven members appointed under paragraph (a) must reside outside of the seven-county metropolitan area, as defined in section 473.121. 

Subd. 2.Ex officio members. 
The speaker of the house and the Committee on Rules and Administration of the senate shall appoint one representative and one senator to serve as ex officio, nonvoting members. 

Subd. 3.Chair. 
The governor shall designate one of the members appointed under subdivision 1 as chair of the board. 

Subd. 4.Compensation; terms. 
Membership terms, compensation, and removal of members appointed under subdivision 1, are governed by section 15.0575. 

Subd. 5.Staff. 
The board shall appoint an executive director who shall serve in the unclassified service and may appoint other staff. The service of the executive director shall be subject to the terms described in section 214.04, subdivision 2a. 

Subd. 6.Duties of board. 
(a) The Emergency Medical Services Regulatory Board shall: 

(1) administer and enforce the provisions of this chapter and other duties as assigned to the board; 

(2) advise applicants for state or federal emergency medical services funds, review and comment on such applications, and approve the use of such funds unless otherwise required by federal law; 

(3) make recommendations to the legislature on improving the access, delivery, and effectiveness of the state's emergency medical services delivery system; and 

(4) establish procedures for investigating, hearing, and resolving complaints against emergency medical services providers. 

(b) The Emergency Medical Services Board may prepare an initial work plan, which may be updated biennially. The work plan may include provisions to: 

(1) prepare an emergency medical services assessment which addresses issues affecting the statewide delivery system; 

(2) establish a statewide public information and education system regarding emergency medical services; 

(3) create, in conjunction with the Department of Public Safety, a statewide injury and trauma prevention program; and 

(4) designate an annual emergency medical services personnel recognition day. 

Subd. 7.Conflict of interest. 
No member of the Emergency Medical Services Board may participate or vote in board proceedings in which the member has a direct conflict of interest, financial or otherwise. 

144E.123 PREHOSPITAL CARE DATA.Subd. 5.Working group. 
By October 1, 2011, the board must convene a working group composed of six members, three of which must be appointed by the board and three of which must be appointed by the Minnesota Ambulance Association, to redesign the board's policies related to collection of data from licenses. The issues to be considered include, but are not limited to, the following: user-friendly reporting requirements; data sets; improved accuracy of reported information; appropriate use of information gathered through the reporting system; and methods for minimizing the financial impact of data reporting on licenses, particularly for rural volunteer services. The working group must report its findings and recommendations to the board no later than July 1, 2012. 

144E.27 EDUCATION PROGRAMS; BOARD APPROVAL.Subdivision 1.Education program instructor. 
 An education program instructor must be an emergency medical responder, EMT, AEMT, paramedic, physician, physician assistant, or registered nurse. 

Subd. 1a.Approval required. 
(a) All education programs for an emergency medical responder must be approved by the board. 

(b) To be approved by the board, an education program must: 

(1) submit an application prescribed by the board that includes: 

(i) type and length of course to be offered; 

(ii) names, addresses, and qualifications of the program medical director, program education coordinator, and instructors; 

(iii) admission criteria for students; and 

(iv) materials and equipment to be used; 

(2) for each course, implement the most current version of the United States Department of Transportation EMS Education Standards, or its equivalent as determined by the board applicable to Emergency Medical Responder registration education; 

(3) have a program medical director and a program coordinator; 

(4) have at least one instructor for every ten students at the practical skill stations; 

(5) retain documentation of program approval by the board, course outline, and student information; and 

(6) submit the appropriate fee as required under section 144E.29. 

(c) The National EMS Education Standards by the NHTSA, United States Department of Transportation contains the minimal entry level of knowledge and skills for emergency medical responders. Medical directors of emergency medical responder groups may expand the knowledge and skill set. 

144E.50 EMERGENCY MEDICAL SERVICES FUND.Subd. 3.Definition. 
For purposes of this section, "board" means the Emergency Medical Services Regulatory Board. 

151.74 INSULIN SAFETY NET PROGRAM.Subd. 16.Legislative review; sunset. 
(a) The legislature shall review the reports from the Board of Pharmacy under subdivision 13, paragraph (b); the program review by the legislative auditor under subdivision 14; and the report from the commissioner of health on the survey results under subdivision 15, paragraph (e); and any other relevant information related to the cost, access, and affordability of insulin, and make a determination on whether there is a need for the continued implementation of the long-term safety net program described in subdivisions 4 to 6 to ensure that Minnesota residents have access to affordable emergency and long-term insulin or whether the market has sufficiently changed to where the continuation of this program is no longer needed past December 31, 2024, or whether there are more appropriate options available to ensure access to affordable insulin for all Minnesota residents. 

(b) Subdivisions 4 to 6, 8, and 9 expire December 31, 2024, unless the legislature affirmatively determines the need for the continuation of the long-term safety net program described in subdivisions 4 to 6. 

245C.08 BACKGROUND STUDY; COMMISSIONER REVIEWS.Subd. 2.Background studies conducted by a county agency for family child care. 
(a) Before the implementation of NETStudy 2.0, for a background study conducted by a county agency for family child care services, the commissioner shall review: 

(1) information from the county agency's record of substantiated maltreatment of adults and the maltreatment of minors; 

(2) information from juvenile courts as required in subdivision 4 for: 

(i) individuals listed in section 245C.03, subdivision 1, paragraph (a), who are ages 13 through 23 living in the household where the licensed services will be provided; and 

(ii) any other individual listed under section 245C.03, subdivision 1, when there is reasonable cause; and 

(3) information from the Bureau of Criminal Apprehension. 

(b) If the individual has resided in the county for less than five years, the study shall include the records specified under paragraph (a) for the previous county or counties of residence for the past five years. 

(c) Notwithstanding expungement by a court, the county agency may consider information obtained under paragraph (a), clause (3), unless: 

(1) the commissioner received notice of the petition for expungement and the court order for expungement is directed specifically to the commissioner; or 

(2) the commissioner received notice of the expungement order issued pursuant to section 609A.017, 609A.025, or 609A.035, and the order for expungement is directed specifically to the commissioner. 

245C.125 BACKGROUND STUDY; HEAD START PROGRAMS.
(a) Head Start programs that receive funds under section 119A.52 may contract with the commissioner to: 

(1) conduct background studies on individuals affiliated with a Head Start program; and 

(2) obtain background study data on individuals affiliated with a Head Start program. 

(b) The commissioner must include a national criminal history record check in a background study conducted under paragraph (a). 

(c) A Head Start program site that does not contract with the commissioner, is not licensed, and is not registered to receive payments under chapter 119B is exempt from the relevant requirements in this chapter. Nothing in this section supersedes requirements for background studies in this chapter or chapter 119B or 245H that relate to licensed child care programs or programs registered to receive payments under chapter 119B. For a background study conducted under this section to be transferable to other child care entities, the study must include all components of studies for a certified license-exempt child care center under this chapter. 

256D.19 ABOLITION OF TOWNSHIP SYSTEM OF POOR RELIEF.Subdivision 1.Town system abolished. 
The town system for caring for the poor in each of the counties in which it is in effect is hereby abolished. The local social services agency of each county shall administer general assistance under the provisions of Laws 1973, chapter 650, article 21. 

Subd. 2.Local social services agencies duty. 
All local social services agencies affected by Laws 1973, chapter 650, article 21 are hereby authorized to take over for the county as of January 1, 1974, the ownership of all case records relating to the administration of poor relief. 

256D.20 TRANSFER OF TOWN EMPLOYEES.Subdivision 1.Rules for merit system. 
The term "merit system" as used herein shall mean the rules for a merit system of personnel administration for employees of local social services agencies adopted by the commissioner of human services in accordance with the provisions of section 393.07, including the merit system established for Hennepin County pursuant to Laws 1965, chapter 855, as amended, the federal Social Security article as amended, and merit system standards and regulations issued by the federal Social Security Board and the United States Children's Bureau. 

Subd. 2.Designation of employees. 
All employees of any municipality or town who are engaged full time in poor relief work therein on January 1, 1974 shall be retained as employees of the county and placed under the jurisdiction of its local social services agency. 

All transferred employees shall be blanketed into the merit system with comparable status, classification, longevity, and seniority, and subject to the administrative requirements of the local social services agency. Employees with permanent status under any civil service provision on January 1, 1974, shall be granted permanent status under the merit system at comparable classifications and in accordance with work assignments made under the authority of the local social services agency as provided by the merit system rules. 

The determination of proper job allocation shall be the responsibility of the personnel officer or director as provided under merit system rules applicable to the county involved with the right of appeal of allocation to the Merit System Council or personnel board by any employee affected by this transfer. 

All transferred employees shall receive salaries for the classification to which they are allocated in accordance with the schedule in effect for local social services agency employees and at a salary step which they normally would have received had they been employed by the local social services agency for the same period of service they had previously served under the civil service provisions of any municipality or town; provided, however, that no salary shall be reduced as a result of the transfer. 

All accumulated sick leave of transferred employees in the amount of 60 days or less shall be transferred to the records of the local social services agency and such accumulated sick leave shall be the legal liability of the local social services agency. All accumulated sick leave in excess of 60 days shall be paid in cash to transferred employees by the municipality or town by which they were employed prior to their transfer, at the time of transfer. In lieu of the cash payment, the municipality or town shall, at the option of the employee concerned, allow a leave of absence with pay, prior to transfer, for all or part of the accumulated sick leave. 

Subd. 3.Merit system transfer.  
Employees of municipalities and towns engaged in the work of administering poor relief who are not covered by civil service provisions shall be blanketed into the merit system subject to a qualifying examination. Employees with one year or more service shall be subject to a qualifying examination and those with less than one year's service shall be subject to an open competitive examination. 

Subd. 4.Disbursement of vacation time.  
All vacation leave of employees referred to in subdivision 2, accumulated prior to their transfer to county employment shall be paid in cash to them by the municipality or town by which they were employed prior to their transfer, and at the time of their transfer. In lieu of the cash payment, the municipality or town shall, at the option of the employee concerned, allow a leave of absence with pay, prior to such transfer, for all or part of the accumulated vacation time. 

256D.23 TEMPORARY COUNTY ASSISTANCE PROGRAM.Subdivision 1.Program established. 
Minnesota residents who meet the income and resource standards of section 256D.01, subdivision 1a, but do not qualify for cash benefits under sections 256D.01 to 256D.21, may qualify for a county payment under this section. 

Subd. 2.Payment amount, duration, and method. 
(a) A county may make a payment of up to $203 for a single individual and up to $260 for a married couple under the terms of this subdivision. 

(b) Payments to an individual or married couple may only be made once in a calendar year. If the applicant qualifies for a payment as a result of an emergency, as defined by the county, the payment shall be made within ten working days of the date of application. If the applicant does not qualify under the county definition of emergency, the payment shall be made at the beginning of the second month following the month of application, and the applicant must receive the payment in person at the local agency office. 

(c) Payments may be made in the form of cash or as vendor payments for rent and utilities. If vendor payments are made, they shall be equal to $203 for a single individual or $260 for a married couple, or the actual amount of rent and utilities, whichever is less. 

(d) Each county must develop policies and procedures as necessary to implement this section. 

(e) Payments under this section are not an entitlement. No county is required to make a payment in excess of the amount available to the county under subdivision 3. 

Subd. 3.State allocation to counties. 
The commissioner shall allocate to each county on an annual basis the amount specifically appropriated for payments under this section. The allocation shall be based on each county's proportionate share of state fiscal year 1994 work readiness expenditures. 

256R.02 DEFINITIONS.Subd. 46.Resource utilization group. 
"Resource utilization groups" or "RUG" has the meaning given in section 144.0724, subdivision 2, paragraph (f). 

Repealed Minnesota Session Laws: UES4699-2 

Laws 2023, chapter 70, article 20, section 2, subdivision 31, as amended by Laws 2023, chapter 75, section 12; 

	Sec. 2. COMMISSIONER OF HUMAN SERVICES 					

	Subd. 31.Direct Care and Treatment - Mental Health and Substance Abuse 		-0-		6,109,000	

(a) Keeping Nurses at the Bedside Act; contingent appropriation. The appropriation in this subdivision is contingent upon legislative enactment by the 93rd Legislature of 2023 Senate File 1384 by the 93rd Legislature provisions substantially similar to 2023 S.F. No. 1561, the second engrossment, article 2. 

(b) Base level adjustment. The general fund base is increased by $7,566,000 in fiscal year 2026 and increased by $7,566,000 in fiscal year 2027. 

Laws 2023, chapter 75, section 10
Sec. 10. USE OF APPROPRIATION; LOAN FORGIVENESS ADMINISTRATION. 
The commissioner of health may also use the appropriation in S.F. No. 2995, article 20, section 3, subdivision 2, paragraph (w), clause (3), if enacted during 2023 regular legislative session, for administering sections 2 to 5. 

Laws 2024, chapter 80, article 2, section 6, subdivision 4
Sec. 6. [142B.11] LICENSE APPLICATION AFTER CHANGE OF OWNERSHIP.Subd. 4.Temporary change in ownership license. 
(a) After receiving the party's application pursuant to subdivision 3, upon the written request of the existing license holder and the party, the commissioner may issue a temporary change in ownership license to the party while the commissioner evaluates the party's application. Until a decision is made to grant or deny a license under this chapter, the existing license holder and the party shall both be responsible for operating the program or service according to applicable laws and rules, and the sale or transfer of the existing license holder's ownership interest in the licensed program or service does not terminate the existing license. 

(b) The commissioner may issue a temporary change in ownership license when a license holder's death, divorce, or other event affects the ownership of the program and an applicant seeks to assume operation of the program or service to ensure continuity of the program or service while a license application is evaluated. 

(c) This subdivision applies to any program or service licensed under this chapter. 

9502.0425PHYSICAL ENVIRONMENT. Subp. 5.Occupancy separations.  
Day care residences with an attached garage must have a self-closing, tight fitting solid wood bonded core door at least 1-3/8 inch thick, or door with a fire protection rating of 20 minutes or greater and a separation wall consisting of 5/8 inch thick gypsum wallboard or its equivalent on the garage side between the residence and garage.