SF 974

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

Posted on 03/11/2025 09:38 a.m.

A bill for an act
relating to health insurance; requiring health plans to cover power standing systems
for wheelchairs; requiring the commissioner of commerce to defray the cost of
coverage of power standing systems; requiring coverage of power standing systems
for wheelchairs in medical assistance and MinnesotaCare; appropriating money;
amending Minnesota Statutes 2024, section 256B.0625, by adding a subdivision;
proposing coding for new law in Minnesota Statutes, chapter 62Q.

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

Section 1.

new text begin [62Q.667] COVERAGE OF POWER STANDING SYSTEMS.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For the purposes of this section, "power standing system"
means any type of power standing system, determined by a provider licensed in this state
to be medically necessary for the insured to complete activities of daily living or
rehabilitation, for a wheelchair.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage. new text end

new text begin All health plans must cover power standing systems.
new text end

new text begin Subd. 3. new text end

new text begin Cost-sharing requirements. new text end

new text begin A health plan must not impose on the coverage
under this section any cost-sharing requirement that is not generally applicable to other
coverages under the plan, including but not limited to the following requirements:
new text end

new text begin (1) deductible;
new text end

new text begin (2) co-payment; or
new text end

new text begin (3) coinsurance.
new text end

new text begin Subd. 4. new text end

new text begin Review and referral limitations. new text end

new text begin A health plan must not impose on the coverage
under this section any review or referral limitation that is not generally applicable to other
coverages under the plan, including but not limited to the following limitations:
new text end

new text begin (1) utilization review, as defined in section 62M.02;
new text end

new text begin (2) referral requirement; or
new text end

new text begin (3) delay period.
new text end

new text begin Subd. 5. new text end

new text begin Quantity limitations. new text end

new text begin A health plan must not impose on the coverage under
this section any quantity limitation, except that the health plan may limit the coverage to
one power standing system every five or fewer years.
new text end

new text begin Subd. 6. new text end

new text begin Reimbursement. new text end

new text begin (a) The commissioner of commerce must reimburse health
plan companies for coverage under this section, as required by Code of Federal Regulations,
title 45, section 155.170. Reimbursement is available only for coverage that would not have
been provided by the health plan without the requirements of this section. Treatments,
services, supplies, and equipment covered by the health plan as of January 1, 2025, are
ineligible for payments under this subdivision by the commissioner of commerce.
new text end

new text begin (b) Health plan companies must report to the commissioner of commerce quantified
costs attributable to the additional benefit under this section in a format developed by the
commissioner. A health plan's coverage as of January 1, 2025, must be used by the health
plan company as the basis for determining whether coverage would not have been provided
by the health plan for purposes of this subdivision.
new text end

new text begin (c) The commissioner of commerce must evaluate submissions and make payments to
health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.
new text end

new text begin Subd. 7. new text end

new text begin Appropriation. new text end

new text begin Each fiscal year, an amount necessary to make payments to
health plan companies to defray the cost of providing coverage under this section is
appropriated to the commissioner of commerce.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, and applies to all health
plans offered, issued, or sold on or after that date.
new text end

Sec. 2.

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

new text begin Subd. 77. new text end

new text begin Power standing systems. new text end

new text begin (a) Medical assistance covers power standing
systems, as defined in section 62Q.667.
new text end

new text begin (b) Medical assistance must meet the requirements that would otherwise apply to a health
plan under section 62Q.667, except that medical assistance is not required to comply with
any provision of section 62Q.667 if compliance with the provision would: (1) prevent the
state from receiving federal financial participation for the coverage under this subdivision;
or (2) result in a lower level of coverage or reduced access to coverage for medical assistance
enrollees.
new text end

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.
new text end

Sec. 3. new text begin APPROPRIATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Defrayal of costs. new text end

new text begin (a) $....... in fiscal year 2027 is appropriated from the
general fund to the commissioner of commerce for the estimated amount of defrayal costs
for mandated coverage of power standing systems under Minnesota Statutes, section 62Q.667.
The base for this appropriation is $....... in 2028.
new text end

new text begin (b) $....... in fiscal year 2027 is appropriated from the general fund to the commissioner
of commerce for administrative costs to implement mandated coverage of power standing
systems under Minnesota Statutes, section 62Q.667. The base for this appropriation is $.......
in 2028.
new text end

new text begin Subd. 2. new text end

new text begin Medical assistance. new text end

new text begin $....... in fiscal year 2026 and $....... in fiscal year 2027 are
appropriated from the general fund to the commissioner of human services for medical
assistance coverage of power standing systems under Minnesota Statutes, section 256B.0625,
subdivision 77. The base for this appropriation is $....... in fiscal year 2028.
new text end

new text begin Subd. 3. new text end

new text begin MinnesotaCare. new text end

new text begin $........ in fiscal year 2026 and $....... in fiscal year 2027 are
appropriated from the general fund to the commissioner of human services for MinnesotaCare
coverage of power standing systems under Minnesota Statutes, section 256L.03, subdivision
1, and as set forth in Minnesota Statutes, section 256B.0625, subdivision 77. The base for
this appropriation is $....... in fiscal year 2028.
new text end