Legislative Session number- 86

Bill Name: SF0418

Relating to health

ARTICLE 1 - GENERAL PROVISIONS

"Minnesota Health Act";
establishing the Minnesota Health Plan to provide
residents all medically
necessary health care services; specifying health plan
requirements; defining
certain terms; providing for ethics and conflict of
interest; requiring certain
data sharing

ARTICLE 2 - ELIGIBILITY

Providing for eligibility to all
state residents; establishing residency
standards; requiring the Minnesota
health board to establish a procedure to
enroll residents and provide enrollees
with appropriate identification, allowing health care coverage for residents
temporarily residing out of state, visitors, nonresident persons working in the
state and retiree benefits; providing for presumptive eligibility

ARTICLE 3 -
BENEFITS

Authorizing eligible persons to receive services under the Minnesota
Health Plan from any licensed participating providers; prohibiting provider
patient care refusal based on unfair employment practice; specifying minimum
covered medical benefits; allowing the board to expand minimum benefits,
specifying certain exclusions; prohibiting payment for prescription drugs from
pharmaceutical companies directly marketing to consumers; prohibiting
deductibles, co-payments, co-insurance and other cost sharing; requiring primary
care provider use for patient care coordination

ARTICLE 4 -
FUNDING

Requiring the board to establish a Minnesota Health Fund to implement
the
Minnesota Health Plan and to receive premiums and other sources of revenue;
providing for fund accounts, budgets, program administration and training;
providing for revenue sources, specifying premium requirements and requiring the
board to submit a report to the governor and legislature by a certain date on
premium structure; permitting donations, requiring federal waivers and federal
preemption, providing for subrogation, plan reimbursement and defaults


ARTICLE 5 - PAYMENTS

Allowing plan participation to all licensed health
care providers; requiring
noninstitutional providers uniform fee schedule
establishment; providing for
payments to institutional providers; requiring the
board to develop a capital
investment plan

ARTICLE 6 -
GOVERNANCE

Providing certain conforming statutory changes; establishing a
Minnesota Health Plan executive officer and the Minnesota health board,
prescribing board composition, terms, compensation and duties; defining
metropolitan health planning region; prescribing regional health planning board
composition and duties; requiring the Minnesota health board to establish an
office of health quality and planning and prescribing duties, assessment and
benefits evaluation; creating the ombudsman office for patient advocacy,
prescribing duties; requiring the ombudsman to establish a grievance system for
complaints; requiring the attorney general to appoint an inspector general,
prescribing duties; requiring the legislative auditor to examine the books and
operating policies of the board

ARTICLE 7 - IMPLEMENTATION

Appropriating
money to the Minnesota health fund under the Minnesota Health Plan for
implementation
(rt)