SF 4057
Introduction - 94th Legislature (2025 - 2026)
Posted on 03/12/2026 09:36 a.m.
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A bill for an act
relating to medical assistance; requiring an express statement of application to the
county-administered rural medical assistance (CARMA) program for a medical
assistance modification to apply to the CARMA program; requiring estimate of
local fiscal impacts to counties or groups of counties administering CARMA;
amending Minnesota Statutes 2025 Supplement, section 256B.695, subdivisions
6, 7.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2025 Supplement, section 256B.695, subdivision 6, is
amended to read:
Subd. 6.
Benefits and services.
(a) Counties or groups of counties administering CARMA
must cover all benefits and services required to be covered by medical assistance under
section 256B.0625.
(b) Counties or groups of counties administering CARMA may reimburse enrollees
directly for out-of-pocket costs incurred obtaining assessed HRSN services provided by
nontraditional providers who are unable to accept payment via traditional health insurance
methods. Enrollees must not be reimbursed for out-of-pocket costs paid to providers eligible
to enroll.
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(c) Any modification to the entity administering, or with primary control over the
administration of, a benefit or service required to be covered by medical assistance does
not apply to CARMA unless:
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(1) the modification is expressly described in this section; and
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(2) the commissioner has published the written estimate of local fiscal impacts described
in paragraph (e).
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(d) Any modification to the benefits or services required to be covered by medical
assistance does not apply to CARMA unless:
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(1) the modification is expressly described in this section; and
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(2) the commissioner has published the written estimate of local fiscal impacts described
in paragraph (e).
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(e) Prior to the effective date of a modification described in paragraph (c) or (d), the
commissioner must publish a written estimate of the local fiscal impacts to counties or
groups of counties administering CARMA arising from the modification.
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new text begin EFFECTIVE DATE. new text end
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This section is effective on the effective date of Laws 2025, First
Special Session chapter 3, article 8, section 25.
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Sec. 2.
Minnesota Statutes 2025 Supplement, section 256B.695, subdivision 7, is amended
to read:
Subd. 7.
Payment.
deleted text begin (a)deleted text end The commissioner, in consultation with counties and groups of
counties administering CARMA, must develop a mechanism for making payments to
counties and groups of counties that administer CARMA. The payment mechanism must:
(1) be governed by contracts with terms, including but not limited to payment rates,
amended on an as-needed basis;
(2) pay a full-risk monthly capitation payment for services included in CARMA, including
the cost for administering CARMA benefits and services;
(3) include risk corridors based on minimum loss ratio, total cost of care, or other metrics;
(4) include a settle-up process tied to the risk corridor arrangement allowing a county
or group of counties administering CARMA to retain savings for reinvestment in health
care activities and operations to protect against significant losses that a county or group of
counties administering CARMA or the state might realize, beginning no sooner than after
a county's or group of counties' third year of CARMA operations;
(5) include a collaborative rate-setting process accounting for CARMA experience,
regional experience, and the Department of Human Services fee-for-service experience;
and
(6) be exempt from section 256B.69, subdivisions 5a, paragraphs (c) and (f), and 5d,
and payment for Medicaid services provided under section 256B.69, subdivision 28,
paragraph (b), no sooner than three years after CARMA implementation.
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(b) Payments for benefits and services under subdivision 6, paragraph (a), must not
exceed payments that otherwise would have been paid to health plans under medical
assistance for that county or region.
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new text begin EFFECTIVE DATE. new text end
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This section is effective on the effective date of Laws 2025, First
Special Session chapter 3, article 8, section 25.
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