SF 2896

Introduction - 94th Legislature (2025 - 2026)

Posted on 07/09/2025 09:09 a.m.

A bill for an act
relating to human services; modifying nonemergency medical transportation
provisions; amending Minnesota Statutes 2024, sections 256B.04, subdivisions
12, 14; 256B.0625, subdivision 17, by adding a subdivision; repealing Minnesota
Statutes 2024, section 256B.0625, subdivisions 18b, 18e, 18h.

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

Section 1.

Minnesota Statutes 2024, section 256B.04, subdivision 12, is amended to read:

Subd. 12.

Limitation on services.

(a) new text begin The commissioner shall new text end place limits on the types
of services covered by medical assistance, the frequency with which the same or similar
services may be covered by medical assistance for an individual recipient, and the amount
paid for each covered service. The state agency shall promulgate rules establishing maximum
reimbursement rates for emergency and nonemergency transportation.

The rules shall provide:

(1) an opportunity for all recognized transportation providers to be reimbursed for
nonemergency transportation consistent with the maximum rates established by the agency;
and

(2) reimbursement of public and private nonprofit providers serving the population with
a disability generally at reasonable maximum rates that reflect the cost of providing the
service regardless of the fare that might be charged by the provider for similar services to
individuals other than those receiving medical assistance or medical care under this chapter. new text begin
This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.
new text end

(b) The commissioner shall encourage providers reimbursed under this chapter to
coordinate their operation with similar services that are operating in the same community.
To the extent practicable, the commissioner shall encourage eligible individuals to utilize
less expensive providers capable of serving their needs. new text begin This paragraph expires July 1, 2026,
for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
new text end

(c) For the purpose of this subdivision and section 256B.02, subdivision 8, and effective
on January 1, 1981, "recognized provider of transportation services" means an operator of
special transportation service as defined in section 174.29 that has been issued a current
certificate of compliance with operating standards of the commissioner of transportation
or, if those standards do not apply to the operator, that the agency finds is able to provide
the required transportation in a safe and reliable manner. Until January 1, 1981, "recognized
transportation provider" includes an operator of special transportation service that the agency
finds is able to provide the required transportation in a safe and reliable manner. new text begin This
paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance.
new text end

new text begin (d) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, the commissioner shall place limits on the types of services
covered by medical assistance, the frequency with which the same or similar services may
be covered by medical assistance for an individual recipient, and the amount paid for each
covered service.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Minnesota Statutes 2024, section 256B.04, subdivision 14, is amended to read:

Subd. 14.

Competitive bidding.

(a) When determined to be effective, economical, and
feasible, the commissioner may utilize volume purchase through competitive bidding and
negotiation under the provisions of chapter 16C, to provide items under the medical assistance
program including but not limited to the following:

(1) eyeglasses;

(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
on a short-term basis, until the vendor can obtain the necessary supply from the contract
dealer;

(3) hearing aids and supplies;

(4) durable medical equipment, including but not limited to:

(i) hospital beds;

(ii) commodes;

(iii) glide-about chairs;

(iv) patient lift apparatus;

(v) wheelchairs and accessories;

(vi) oxygen administration equipment;

(vii) respiratory therapy equipment;

(viii) electronic diagnostic, therapeutic and life-support systems; and

(ix) allergen-reducing products as described in section 256B.0625, subdivision 67,
paragraph (c) or (d);

(5) nonemergency medical transportation level of need determinations, disbursement of
public transportation passes and tokens, and volunteer and recipient mileage and parking
reimbursements;

(6) drugs; and

(7) quitline services as described in section 256B.0625, subdivision 68, paragraph (c).

new text begin This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.
new text end

new text begin (b) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, when determined to be effective, economical, and feasible,
the commissioner may utilize volume purchase through competitive bidding and negotiation
under the provisions of chapter 16C to provide items under the medical assistance program,
including but not limited to the following:
new text end

new text begin (1) eyeglasses;
new text end

new text begin (2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
on a short-term basis, until the vendor can obtain the necessary supply from the contract
dealer;
new text end

new text begin (3) hearing aids and supplies;
new text end

new text begin (4) durable medical equipment, including but not limited to:
new text end

new text begin (i) hospital beds;
new text end

new text begin (ii) commodes;
new text end

new text begin (iii) glide-about chairs;
new text end

new text begin (iv) patient lift apparatus;
new text end

new text begin (v) wheelchairs and accessories;
new text end

new text begin (vi) oxygen administration equipment;
new text end

new text begin (vii) respiratory therapy equipment; and
new text end

new text begin (viii) electronic diagnostic, therapeutic, and life-support systems;
new text end

new text begin (5) nonemergency medical transportation; and
new text end

new text begin (6) drugs.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end Rate changes and recipient cost-sharing under this chapter and chapter 256L do
not affect contract payments under this subdivision unless specifically identified.

deleted text begin (c) deleted text end new text begin (d) new text end The commissioner may not utilize volume purchase through competitive bidding
and negotiation under the provisions of chapter 16C for special transportation services or
incontinence products and related supplies. new text begin This paragraph expires July 1, 2026, for medical
assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
new text end

new text begin (e) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, the commissioner may not utilize volume purchase through
competitive bidding and negotiation under the provisions of chapter 16C for incontinence
products and related supplies.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 3.

Minnesota Statutes 2024, section 256B.0625, subdivision 17, is amended to read:

Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural. new text begin This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.
new text end

(c) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transportation, within the meaning of "public transportation" as defined in
section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
subdivision 1, paragraph (p).

(d) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.

(e) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(f) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services. new text begin This
paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance.
new text end

new text begin (g) Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid
medical assistance, the administrative agency of nonemergency medical transportation must:
new text end

new text begin (1) adhere to the policies defined by the commissioner;
new text end

new text begin (2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services; and
new text end

new text begin (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode.
new text end

deleted text begin (g) deleted text end new text begin (h) new text end Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph deleted text begin (l) deleted text end new text begin (n) new text end , clauses (4), (5), (6), and (7). new text begin
This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.
new text end

deleted text begin (h) deleted text end new text begin (i) new text end The commissioner may use an order by the recipient's attending physician,
advanced practice registered nurse, physician assistant, or a medical or mental health
professional to certify that the recipient requires nonemergency medical transportation
services. Nonemergency medical transportation providers shall perform driver-assisted
services for eligible individuals, when appropriate. Driver-assisted service includes passenger
pickup at and return to the individual's residence or place of business, assistance with
admittance of the individual to the medical facility, and assistance in passenger securement
or in securing of wheelchairs, child seats, or stretchers in the vehicle.

deleted text begin (i) deleted text end new text begin (j) new text end Nonemergency medical transportation providers must take clients to the health
care provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency. new text begin This paragraph expires July 1, 2026, for medical
assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
new text end

new text begin (k) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, nonemergency medical transportation providers must take
clients to the health care provider using the most direct route and must not exceed 30 miles
for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless
the client receives authorization from the administrator.
new text end

deleted text begin (j) deleted text end new text begin (l) new text end Nonemergency medical transportation providers may not bill for separate base
rates for the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

deleted text begin (k) deleted text end new text begin (m) new text end The administrative agency shall use the level of service process established by
the commissioner to determine the client's most appropriate mode of transportation. If public
transit or a certified transportation provider is not available to provide the appropriate service
mode for the client, the client may receive a onetime service upgrade.

deleted text begin (l) deleted text end new text begin (n) new text end The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

deleted text begin (m) deleted text end new text begin (o) new text end The local agency shall be the single administrative agency and shall administer
and reimburse for modes defined in paragraph deleted text begin (l) deleted text end new text begin (n) new text end according to paragraphs deleted text begin (p) and (q) deleted text end new text begin
(r) to (t) new text end when the commissioner has developed, made available, and funded the web-based
single administrative structure, assessment tool, and level of need assessment under
subdivision 18e. The local agency's financial obligation is limited to funds provided by the
state or federal government. new text begin This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.
new text end

deleted text begin (n) deleted text end new text begin (p) new text end The commissioner shall:

(1) verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

deleted text begin (o) deleted text end new text begin (q) new text end The administrative agency shall pay for the services provided in this subdivision
and seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245. new text begin
This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.
new text end

deleted text begin (p) deleted text end new text begin (r) new text end Payments for nonemergency medical transportation must be paid based on the
client's assessed mode under paragraph deleted text begin (k) deleted text end new text begin (m) new text end , not the type of vehicle used to provide the
service. The medical assistance reimbursement rates for nonemergency medical transportation
services that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
medical transportation provider;

(4) $14.30 for the base rate and $1.43 per mile for assisted transport;

(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;

(6) $75 for the base rate and $2.40 per mile for protected transport; and

(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary. new text begin This paragraph expires July 1, 2026,
for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
new text end

new text begin (s) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, payments for nonemergency medical transportation must
be paid based on the client's assessed mode under paragraph (m), not the type of vehicle
used to provide the service.
new text end

deleted text begin (q) deleted text end new text begin (t) new text end The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph deleted text begin (p) deleted text end new text begin (r) new text end , clauses (1) to (7). The mileage rate for nonemergency medical
transportation services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph deleted text begin (p) deleted text end new text begin (r) new text end , clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph deleted text begin (p) deleted text end new text begin (r) new text end , clauses (1) to (7). new text begin This paragraph expires July 1, 2026, for medical
assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
new text end

deleted text begin (r) deleted text end new text begin (u) new text end For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs deleted text begin (p) and (q) deleted text end new text begin (r) to (t) new text end , the zip code of the recipient's place of
residence shall determine whether the urban, rural, or super rural reimbursement rate applies. new text begin
This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.
new text end

deleted text begin (s) deleted text end new text begin (v) new text end The commissioner, when determining reimbursement rates for nonemergency
medical transportation deleted text begin under paragraphs (p) and (q) deleted text end , shall exempt all modes of transportation
listed under paragraph deleted text begin (l) deleted text end new text begin (n) new text end from Minnesota Rules, part 9505.0445, item R, subitem (2).

deleted text begin (t) deleted text end new text begin (w) new text end Effective for the first day of each calendar quarter in which the price of gasoline
as posted publicly by the United States Energy Information Administration exceeds $3.00
per gallon, the commissioner shall adjust the rate paid per mile in paragraph deleted text begin (p) deleted text end new text begin (r) new text end by one
percent up or down for every increase or decrease of ten cents for the price of gasoline. The
increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
increase or decrease must be calculated using the average of the most recently available
price of all grades of gasoline for Minnesota as posted publicly by the United States Energy
Information Administration. new text begin This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 4.

Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 18i. new text end

new text begin Administration of nonemergency medical transportation. new text end

new text begin Effective July
1, 2026, for medical assistance fee-for-service and January 1, 2027, for prepaid medical
assistance, the commissioner must contract either statewide or regionally for the
administration of the nonemergency medical transportation program in compliance with
the provisions of this chapter. The contract must include the administration of the
nonemergency medical transportation benefit for those enrolled in managed care as described
in section 256B.69.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 5. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2024, section 256B.0625, subdivisions 18b, 18e, and 18h, new text end new text begin are
repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.
new text end

APPENDIX

Repealed Minnesota Statutes: 25-03141

256B.0625 COVERED SERVICES.

Subd. 18b.

Broker dispatching prohibition.

Except for establishing level of service process, the commissioner shall not use a broker or coordinator for any purpose related to nonemergency medical transportation services under subdivision 18.

Subd. 18e.

Single administrative structure and delivery system.

The commissioner, in coordination with the commissioner of transportation, shall implement a single administrative structure and delivery system for nonemergency medical transportation, beginning the latter of the date the single administrative assessment tool required in this subdivision is available for use, as determined by the commissioner or by July 1, 2016.

In coordination with the Department of Transportation, the commissioner shall develop and authorize a web-based single administrative structure and assessment tool, which must operate 24 hours a day, seven days a week, to facilitate the enrollee assessment process for nonemergency medical transportation services. The web-based tool shall facilitate the transportation eligibility determination process initiated by clients and client advocates; shall include an accessible automated intake and assessment process and real-time identification of level of service eligibility; and shall authorize an appropriate and auditable mode of transportation authorization. The tool shall provide a single framework for reconciling trip information with claiming and collecting complaints regarding inappropriate level of need determinations, inappropriate transportation modes utilized, and interference with accessing nonemergency medical transportation. The web-based single administrative structure shall operate on a trial basis for one year from implementation and, if approved by the commissioner, shall be permanent thereafter.

Subd. 18h.

Nonemergency medical transportation provisions related to managed care.

(a) The following nonemergency medical transportation (NEMT) subdivisions apply to managed care plans and county-based purchasing plans:

(1) subdivision 17, paragraphs (a), (b), (i), and (n);

(2) subdivision 18; and

(3) subdivision 18a.

(b) A nonemergency medical transportation provider must comply with the operating standards for special transportation service specified in sections 174.29 to 174.30 and Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire vehicles are exempt from the requirements in this paragraph.

(c) Managed care plans and county-based purchasing plans must provide a fuel adjustment for NEMT rates when fuel exceeds $3 per gallon. If, for any contract year, federal approval is not received for this paragraph, the commissioner must adjust the capitation rates paid to managed care plans and county-based purchasing plans for that contract year to reflect the removal of this provision. Contracts between managed care plans and county-based purchasing plans and providers to whom this paragraph applies must allow recovery of payments from those providers if capitation rates are adjusted in accordance with this paragraph. Payment recoveries must not exceed the amount equal to any increase in rates that results from this paragraph. This paragraph expires if federal approval is not received for this paragraph at any time.