HF 958

1st Engrossment - 94th Legislature (2025 - 2026)

Posted on 03/03/2025 03:41 p.m.

A bill for an act
relating to human services; establishing medical assistance coverage of psychiatric
collaborative care model services; appropriating money; proposing coding for new
law in Minnesota Statutes, chapter 256B.

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

Section 1.

new text begin [256B.077] PSYCHIATRIC COLLABORATIVE CARE MODEL.
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new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the following terms have
the meanings given.
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new text begin (b) "Behavioral health care manager" means an individual who:
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new text begin (1) is clinical staff;
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new text begin (2) has formal education or specialized training in behavioral health;
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new text begin (3) works under the oversight and direction of a treating medical provider;
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new text begin (4) meets the qualifications for a mental health professional, mental health practitioner,
or clinical trainee set forth in section 245I.04; and
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new text begin (5) is directly employed by or working under contract for the treating medical provider.
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new text begin Behavioral health care manager includes a licensed addiction counselor or registered nurse
with training and experience in behavioral health when treating a substance use disorder.
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new text begin (c) "Eligible individual" means an individual diagnosed with a mental illness, substance
use disorder, or other behavioral health condition by a treating medical provider.
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new text begin (d) "Initial psychiatric collaborative care management" means psychiatric collaborative
care management directed by the treating medical provider, including the following with
appropriate documentation:
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new text begin (1) outreach and engagement;
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new text begin (2) initial assessment;
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new text begin (3) development of an individualized treatment plan;
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new text begin (4) review of a treatment plan by a psychiatric consultant;
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new text begin (5) entry into the patient registry; and
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new text begin (6) brief interventions using evidence-based techniques.
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new text begin (e) "Psychiatric collaborative care model services" means medical services provided
under an evidence-based model of behavioral health integration that utilizes behavioral
health care management and psychiatric consultation provided through a formal collaborative
arrangement among a primary care team consisting of a primary care provider, a care
manager, and a psychiatric consultant. Psychiatric collaborative care model services include
but are not limited to initial and subsequent psychiatric collaborative care management.
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new text begin (f) "Psychiatric consultant" means an individual who:
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new text begin (1) is qualified as a licensed physician, psychiatrist, medical professional specializing
in addiction medicine, advanced practice registered nurse, or a physician assistant;
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new text begin (2) is directly employed by or working under contract for the treating medical provider;
and
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new text begin (3) supports the treating medical provider and behavioral health care manager in the
patient's treatment.
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new text begin (g) "Subsequent psychiatric collaborative care management" means psychiatric
collaborative care management directed by the treating medical provider, including the
following with appropriate documentation:
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new text begin (1) tracking individual follow-up and progress using the registry;
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new text begin (2) weekly caseload consultation with the psychiatric consultant;
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new text begin (3) collaboration and coordination of the individual's behavioral health care with the
treating medical provider and any other treating behavioral health providers;
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new text begin (4) review of progress and recommended treatment modifications, including medication
management;
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new text begin (5) brief interventions using evidence-based techniques; and
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new text begin (6) monitoring of individual outcomes with (i) routine use of clinically appropriate and
culturally responsive validated rating scales, and (ii) relapse prevention planning with
individuals as they achieve remission of symptoms or other treatment goals and are prepared
for discharge from active treatment.
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new text begin (h) "Treating medical provider" means a primary care physician, advanced practice
registered nurse, or physician assistant that bills for psychiatric collaborative care services
and oversees all aspects of the individual's health care working in collaboration with the
individual's behavioral health care manager and psychiatric consultant.
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new text begin Subd. 2. new text end

new text begin Psychiatric collaborative care model covered. new text end

new text begin Medical assistance covers
psychiatric collaborative care model services for eligible individuals.
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new text begin Subd. 3. new text end

new text begin Psychiatric collaborative care provider requirements. new text end

new text begin A provider must meet
the following conditions to be eligible for reimbursement under this section:
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new text begin (1) be an enrolled provider in the Minnesota Health Care Programs;
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new text begin (2) attest that care will be delivered consistent with the core principles and fidelity to
the psychiatric collaborative care model in the manner determined by the commissioner;
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new text begin (3) provide a primary care or behavioral health service covered by medical assistance;
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new text begin (4) utilize an electronic health record;
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new text begin (5) utilize an electronic patient registry that contains relevant data elements;
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new text begin (6) have policies and procedures to track referrals to ensure that the referral meets the
individual's needs;
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new text begin (7) conduct subsequent psychiatric collaborative care management;
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new text begin (8) agree to cooperate with and participate in the state's monitoring and evaluation of
psychiatric collaborative care model services in the manner determined by the commissioner;
and
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new text begin (9) obtain the individual's verbal or written consent to begin receiving psychiatric
collaborative care model services and to consult with relevant specialists in the manner
determined by the commissioner.
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new text begin Subd. 4. new text end

new text begin Expressly allowable sites. new text end

new text begin Sites eligible to bill for services provided under this
section include but are not limited to federally qualified health centers and rural health
centers.
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new text begin Subd. 5. new text end

new text begin Payments. new text end

new text begin The commissioner must make payments to the treating medical
provider at the current Medicare reimbursement rate.
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new text begin Subd. 6. new text end

new text begin Evaluation. new text end

new text begin (a) The commissioner must identify and collect data and outcome
measures from providers of psychiatric collaborative care model services.
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new text begin (b) The commissioner must review the rates required under subdivision 5 on a regular
basis to ensure adequate sustainability.
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new text begin (c) The commissioner's findings under this subdivision may be used to establish provider
standards, modify services and eligibility, or recommend funding for provider learning
communities.
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new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
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Sec. 2. new text begin APPROPRIATIONS.
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new text begin (a) $500,000 in fiscal year 2026 and $500,000 in fiscal year 2027 are appropriated from
the ....... fund to the commissioner of human services for grants that cover start-up and
capacity building costs of implementing a psychiatric collaborative care model including
but not limited to training for providers, establishing a required patient registry, and enrolling
initial patients.
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new text begin (b) This section expires June 30, 2035.
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