1.1 	A bill for an act
1.2 	relating to human services; establishing MinnesotaCare as the state's basic health 
1.3 	program; amending Minnesota Statutes 2012, sections 16A.724, subdivision 
1.4 	3; 256.962, subdivisions 1, 2, by adding a subdivision; 256L.01, by adding 
1.5 	subdivisions; 256L.02, subdivision 2, by adding subdivisions; 256L.03, 
1.6 	subdivisions 1, 6, by adding subdivisions; 256L.04, subdivision 7b, by adding 
1.7 	subdivisions; 256L.05, subdivisions 1, 2, 3, 3a, 3c, by adding a subdivision; 
1.8 	256L.09, subdivision 2; 256L.11, subdivision 1, by adding a subdivision; 
1.9 	proposing coding for new law in Minnesota Statutes, chapter 256L; repealing 
1.10 	Minnesota Statutes 2012, sections 256L.01, subdivisions 3, 3a, 4a, 5; 256L.02, 
1.11 	subdivision 3; 256L.03, subdivisions 1a, 3, 4, 5; 256L.031; 256L.04, subdivisions 
1.12 	1, 1b, 2a, 7, 7a, 8, 9, 13; 256L.05, subdivisions 1b, 1c, 5; 256L.06, subdivision 
1.13 	3; 256L.07, subdivisions 1, 2, 3, 4, 5, 8, 9; 256L.09, subdivisions 1, 4, 5, 6, 
1.14 	7; 256L.11, subdivisions 2a, 3, 6; 256L.12; 256L.15, subdivisions 1, 1a, 1b, 
1.15 	2; 256L.17, subdivisions 1, 2, 3, 4, 5.
1.16 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.17 	Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:
1.18 		Subd. 3.MinnesotaCare federal receipts. Receipts received as a result of federal 
1.19 	participation pertaining to administrative costs of the Minnesota health care reform waiver 
1.20 	shall be deposited as nondedicated revenue in the health care access fund. Receipts 
1.21 	received as a result of federal participation pertaining to grants shall be deposited in the 
1.22 	federal fund and shall offset health care access funds for payments to providers. The 
1.23 	commissioner of Minnesota Management and Budget shall deposit all federal funding 
1.24 	received by Minnesota for implementation and administration of MinnesotaCare as a basic 
1.25 	health program, as authorized in section 1331 of the Affordable Care Act (Public Law 
1.26 	111-148, as amended by Public Law 111-152), into the health care access fund. Federal 
1.27 	funding that is received for implementing and administering MinnesotaCare as a basic 
1.28 	health program and deposited in the fund shall be used only for that program to purchase 
2.1 	health care coverage for enrollees and reduce enrollee premiums and cost-sharing or 
2.2 	provide additional enrollee benefits.

2.3 	EFFECTIVE DATE. This section is effective July 1, 2013.

2.4 	Sec. 2. Minnesota Statutes 2012, section 256.962, subdivision 1, is amended to read:
2.5 		Subdivision 1.Public awareness and education. The commissioner, in consultation 
2.6 	with community organizations, health plans, and other public entities experienced in 
2.7 	outreach to the uninsured, shall design and implement a statewide campaign to raise public 
2.8 	awareness on the availability of health coverage through medical assistance, general 
2.9 	assistance medical care, and MinnesotaCare and to educate the public on the importance of 
2.10 	obtaining and maintaining health care coverage. The campaign shall include multimedia 
2.11 	messages directed to the general population.

2.12 	EFFECTIVE DATE. This section is effective the day following final enactment.

2.13 	Sec. 3. Minnesota Statutes 2012, section 256.962, subdivision 2, is amended to read:
2.14 		Subd. 2.Outreach grants. (a) The commissioner shall implement, and may award 
2.15 	grants to public and private organizations, regional collaboratives, and regional health care 
2.16 	outreach centers for to implement outreach activities, including, but not limited to:
2.17 	(1) providing information, applications, and assistance in obtaining coverage 
2.18 	through Minnesota public health care programs;
2.19 	(2) collaborating with public and private entities such as hospitals, providers, health 
2.20 	plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to 
2.21 	develop outreach activities and partnerships to ensure the distribution of information 
2.22 	and applications and provide assistance in obtaining coverage through Minnesota health 
2.23 	care programs;
2.24 	(3) providing or collaborating with public and private entities to provide multilingual 
2.25 	and culturally specific information and assistance to applicants in areas of high 
2.26 	uninsurance in the state or populations with high rates of uninsurance; and
2.27 	(4) targeting geographic areas with high rates of (i) eligible but unenrolled children, 
2.28 	including children who reside in rural areas, or (ii) racial and ethnic minorities and health 
2.29 	disparity populations.
2.30 	(b) The commissioner shall ensure that all outreach materials are available in 
2.31 	languages other than English.
2.32 	(c) The commissioner shall establish an outreach trainer program to provide 
2.33 	training to designated individuals from the community and public and private entities on 
3.1 	application assistance in order for these individuals to provide training to others in the 
3.2 	community on an as-needed basis. This program shall be coordinated with any navigator, 
3.3 	in-person assister, or other enrollment assistance program developed to provide consumer 
3.4 	assistance with enrollment on the health benefits exchange.

3.5 	EFFECTIVE DATE. This section is effective July 1, 2013.

3.6 	Sec. 4. Minnesota Statutes 2012, section 256.962, is amended by adding a subdivision 
3.7 	to read:
3.8 		Subd. 9.Coordination with health benefit exchange. The commissioner shall 
3.9 	ensure that information on coverage through state health care programs is included in 
3.10 	all health benefits exchange outreach and promotional activities, written materials, and 
3.11 	training for navigators, in-person assisters, and other individuals and entities who will 
3.12 	assist individuals in obtaining health coverage enrollment through the exchange.

3.13 	EFFECTIVE DATE. This section is effective July 1, 2013.

3.14 	Sec. 5. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision 
3.15 	to read:
3.16 		Subd. 1b.Affordable Care Act.  "Affordable Care Act" means Public Law 111-148, 
3.17 	as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public 
3.18 	Law 111-152), and any amendments to, or regulations or guidance issued under, those acts.

3.19 	EFFECTIVE DATE. This section is effective January 1, 2014.

3.20 	Sec. 6. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision 
3.21 	to read:
3.22 		Subd. 2a.Cost-sharing.  "Cost-sharing" means any deductible, coinsurance, and 
3.23 	co-payment obligations of a MinnesotaCare enrollee.

3.24 	EFFECTIVE DATE. This section is effective January 1, 2014.

3.25 	Sec. 7. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision 
3.26 	to read:
3.27 		Subd. 4b.Health benefit exchange. "Health benefit exchange" or "exchange" 
3.28 	means the health benefit exchange established in Minnesota under section 1311 of the 
3.29 	Affordable Care Act.

3.30 	EFFECTIVE DATE. This section is effective January 1, 2014.

4.1 	Sec. 8. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision 
4.2 	to read:
4.3 		Subd. 6.MinnesotaCare. "MinnesotaCare" means a health coverage program that 
4.4 	meets the standards of this chapter and the requirements for a basic health program under 
4.5 	section 1331 of the Affordable Care Act.

4.6 	EFFECTIVE DATE. This section is effective January 1, 2014.

4.7 	Sec. 9. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision 
4.8 	to read:
4.9 		Subd. 7.Modified adjusted gross income and household income. "Modified 
4.10 	adjusted gross income" and "household income" have the meanings provided in section 
4.11 	2002 of the Affordable Care Act.

4.12 	EFFECTIVE DATE. This section is effective January 1, 2014.

4.13 	Sec. 10. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision 
4.14 	to read:
4.15 		Subd. 8.Participating entity. "Participating entity" means a health plan company 
4.16 	as defined in section 62Q.01, subdivision 4; a county-based purchasing plan established 
4.17 	under section 256B.692; an accountable care organization or other entity operating a 
4.18 	health care delivery systems demonstration project authorized under section 256B.0755; 
4.19 	an entity operating a county integrated health care delivery network pilot project 
4.20 	authorized under section 256B.0756; or a network of health care providers established to 
4.21 	offer services under MinnesotaCare.

4.22 	EFFECTIVE DATE. This section is effective January 1, 2014.

4.23 	Sec. 11. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:
4.24 		Subd. 2.Commissioner's duties. The commissioner shall establish an office for 
4.25 	the state administration of this plan. The plan shall be used to provide covered health 
4.26 	services for eligible persons. Payment for these services shall be made to all eligible 
4.27 	providers participating entities under contract with the commissioner. The commissioner 
4.28 	shall adopt rules to administer the MinnesotaCare program as a basic health program in 
4.29 	accordance with section 1331 of the Affordable Care Act and this chapter and shall adopt 
4.30 	any necessary rules. Nothing in this chapter is intended to violate the requirements of the 
4.31 	Affordable Care Act. The commissioner shall not implement any provision of this chapter 
4.32 	if the provision is found to violate the Affordable Care Act. The commissioner shall 
5.1 	establish marketing efforts and conduct outreach, as provided under section 256.962, to 
5.2 	encourage potentially eligible persons to receive information about the program and about 
5.3 	other medical care programs administered or supervised by the Department of Human 
5.4 	Services. A toll-free telephone number must be used to provide information about medical 
5.5 	programs and to promote access to the covered services.

5.6 	EFFECTIVE DATE. This section is effective January 1, 2014.

5.7 	Sec. 12. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision 
5.8 	to read:
5.9 		Subd. 5.Determination of funding adequacy. The commissioner of Minnesota 
5.10 	Management and Budget, in consultation with the commissioner of human services, shall 
5.11 	conduct an assessment of the health care access fund, as part of the state revenue and 
5.12 	expenditure forecast in November 2016, to determine whether state funding will be required 
5.13 	after December 31, 2019, in addition to the federal payments made available under section 
5.14 	1331 of the Affordable Care Act, for administration of the MinnesotaCare program. The 
5.15 	commissioners shall report the results of this assessment to the governor and legislature by 
5.16 	January 15, 2017, along with recommendations for continuing state revenue for the health 
5.17 	care access fund if state funding will continue to be required beyond December 31, 2019.

5.18 	Sec. 13. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision 
5.19 	to read:
5.20 		Subd. 6.Federal approval. (a) The commissioner of human services shall seek 
5.21 	federal approval to implement the MinnesotaCare program under this chapter as a basic 
5.22 	health program. In any agreement with the Centers for Medicare and Medicaid Services 
5.23 	to operate MinnesotaCare as a basic health program, the commissioner shall seek to 
5.24 	include procedures to ensure that federal funding is predictable, stable, and sufficient 
5.25 	to sustain ongoing operation of MinnesotaCare. These procedures must address issues 
5.26 	related to the timing of federal payments, payment reconciliation, enrollee risk adjustment, 
5.27 	and minimization of state financial risk. The commissioner shall consult with the 
5.28 	commissioner of Minnesota Management and Budget, when developing the proposal for 
5.29 	establishing MinnesotaCare as a basic health program to be submitted to the Centers for 
5.30 	Medicare and Medicaid Services.
5.31 	(b) The commissioner of human services, in consultation with the commissioner 
5.32 	of Minnesota Management and Budget, shall work with the Centers for Medicare and 
5.33 	Medicaid Services to establish a process for reconciliation and adjustment of federal 
5.34 	payments that balances state and federal liability over time. The commissioner of human 
6.1 	services shall request that the secretary of health and human services hold the state, and 
6.2 	enrollees, harmless in the reconciliation process for the first three years, to allow the state 
6.3 	to develop a statistically valid methodology for predicting enrollment trends and their 
6.4 	net effect on federal payments.
6.5 	(c) The commissioner of human services shall work with the Centers for Medicare 
6.6 	and Medicaid Services to obtain a federal financial match for health coverage provided 
6.7 	to: (1) parents, guardians, and relative caretakers with incomes greater than 200 percent, 
6.8 	but not exceeding 275 percent of the federal poverty guidelines; and (2) adults without 
6.9 	children with incomes greater than 200 percent not exceeding 250 percent of the federal 
6.10 	poverty guidelines, who would have been eligible under the MinnesotaCare program as it 
6.11 	existed on January 1, 2013. The actuarial value of this coverage must not be less than that 
6.12 	of coverage that would have been available to the individual under the MinnesotaCare 
6.13 	program as it existed on June 30, 2012. Enrollee premiums and cost-sharing requirements 
6.14 	must not exceed what the individual would have paid under the MinnesotaCare program 
6.15 	as it existed on June 30, 2012. If a federal match for this coverage is approved by the 
6.16 	federal government, the commissioner shall make the coverage available to eligible 
6.17 	persons beginning January 1, 2014.
6.18 	(d) The commissioner of human services, through December 31, 2014, may modify 
6.19 	implementation of the terms and requirements for the MinnesotaCare program specified 
6.20 	in this chapter, if this is necessary to comply with the terms and conditions of federal 
6.21 	approval. If the commissioner modifies implementation of the terms and requirements for 
6.22 	MinnesotaCare under this chapter, the commissioner shall provide the governor and the 
6.23 	legislature with notice of implementation of the modification at least ten working days 
6.24 	before notifying enrollees and participating entities.

6.25 	EFFECTIVE DATE. This section is effective the day following final enactment.

6.26 	Sec. 14. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:
6.27 		Subdivision 1.Covered health services. (a) "Covered health services" means the 
6.28 	health services reimbursed under chapter 256B, with the exception of inpatient hospital 
6.29 	services, special education services, private duty nursing services, adult dental care 
6.30 	services other than services covered under section 256B.0625, subdivision 9, orthodontic 
6.31 	services, nonemergency medical transportation services, personal care assistance and case 
6.32 	management services, nursing home or intermediate care facilities services, inpatient 
6.33 	mental health services, and chemical dependency services nursing facility services and 
6.34 	intermediate care facility for persons with developmental disabilities (ICF/DD) services, 
6.35 	and except as provided in this section.
7.1 	(b) No public funds shall be used for coverage of abortion under MinnesotaCare 
7.2 	except where the life of the female would be endangered or substantial and irreversible 
7.3 	impairment of a major bodily function would result if the fetus were carried to term; or 
7.4 	where the pregnancy is the result of rape or incest.
7.5 	(c) Covered health services shall be expanded as provided in this section.

7.6 	EFFECTIVE DATE. This section is effective January 1, 2014.

7.7 	Sec. 15. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision 
7.8 	to read:
7.9 		Subd. 4a.Cost-sharing. (a) Except as provided in paragraph (b), the MinnesotaCare 
7.10 	program shall include the following cost-sharing requirements for all enrollees:
7.11 	(1) $3 per brand-name prescription and $1 per generic drug prescription, subject to a 
7.12 	$12 per month maximum for prescription drug co-payments. No co-payments shall apply 
7.13 	to antipsychotic drugs when used for treatment of mental illness;
7.14 	(2) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
7.15 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
7.16 	established illness, and which is delivered in an ambulatory setting by a physician or 
7.17 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
7.18 	audiologist, optician, or optometrist;
7.19 	(3) $3.50 for nonemergency visits to a hospital-based emergency room, except that 
7.20 	this co-payment shall be increased to $20 upon federal approval; and
7.21 	(4) a family deductible equal to the maximum amount allowed under Code of 
7.22 	Federal Regulations, title 42, part 447.54.
7.23 	(b) Paragraph (a), clause (2), does not apply to mental health services.
7.24 	(c) The commissioner, through the contracting process under section 256L.121, may 
7.25 	allow participating entities to waive the family deductible described under paragraph (a), 
7.26 	clause (4). The value of the family deductible shall not be included in any capitation or 
7.27 	other payment made by the commissioner to participating entities. Participating entities 
7.28 	shall certify annually to the commissioner the dollar value of the family deductible.
7.29 	(d) The commissioner may waive the collection of the family deductible described 
7.30 	under paragraph (a), clause (4), from individuals and allow long-term care and waivered 
7.31 	service providers to assume responsibility for payment.

7.32 	EFFECTIVE DATE. This section is effective January 1, 2014.

8.1 	Sec. 16. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision 
8.2 	to read:
8.3 		Subd. 4b.Loss ratio. Health coverage provided through the MinnesotaCare 
8.4 	program must have a medical loss ratio of at least 85 percent.

8.5 	EFFECTIVE DATE. This section is effective January 1, 2014.

8.6 	Sec. 17. Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:
8.7 		Subd. 6.Lien. When the state agency provides, pays for, or becomes liable for 
8.8 	covered health services, the agency shall have a lien for the cost of the covered health 
8.9 	services upon any and all causes of action accruing to the enrollee, or to the enrollee's 
8.10 	legal representatives, as a result of the occurrence that necessitated the payment for the 
8.11 	covered health services. All liens under this section shall be subject to the provisions 
8.12 	of section 256.015. For purposes of this subdivision, "state agency" includes prepaid 
8.13 	health plans participating entities, under contract with the commissioner according to 
8.14 	sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based 
8.15 	purchasing entities under section 256B.692 section 256L.121.

8.16 	EFFECTIVE DATE. This section is effective January 1, 2014.

8.17 	Sec. 18. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision 
8.18 	to read:
8.19 		Subd. 1c.General requirements. To be eligible for coverage under MinnesotaCare, 
8.20 	a person must meet the eligibility requirements of this section. A person eligible for 
8.21 	MinnesotaCare shall not be treated as a qualified individual under section 1312 of the 
8.22 	Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered 
8.23 	through the health benefit exchange under section 1331 of the Affordable Care Act.

8.24 	EFFECTIVE DATE. This section is effective January 1, 2014.

8.25 	Sec. 19. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision 
8.26 	to read:
8.27 		Subd. 1d.Eligible groups; income limits. (a) To be eligible under MinnesotaCare, 
8.28 	a person must:
8.29 	(1) be a resident of Minnesota;
8.30 	(2) not be eligible under medical assistance;
8.31 	(3) have a household income that is greater than 133 percent but does not exceed 200 
8.32 	percent of the federal poverty guidelines for family size, except that a noncitizen lawfully 
9.1 	present in the United States, who is not eligible for the Medicaid program under title XIX 
9.2 	of the Social Security Act due to immigration status, may have a household income that is 
9.3 	less than or equal to 133 percent of the federal poverty guidelines for family size;
9.4 	(4) not be eligible for minimum essential coverage, as defined in section 5000A(f) 
9.5 	of the Internal Revenue Code of 1986, except that a person may be eligible for an 
9.6 	employer-sponsored plan that is not affordable coverage, as defined in section 5000A(e)(2) 
9.7 	of the Internal Revenue Code of 1986; and
9.8 	(5) not have attained the age of 65 as of the beginning of the plan year.
9.9 	(b) The commissioner shall calculate income eligibility using modified adjusted 
9.10 	gross income and shall apply a standard five percent income disregard, as provided under 
9.11 	section 2012 of the Affordable Care Act.

9.12 	EFFECTIVE DATE. This section is effective January 1, 2014.

9.13 	Sec. 20. Minnesota Statutes 2012, section 256L.04, subdivision 7b, is amended to read:
9.14 		Subd. 7b.Annual income limits adjustment. The commissioner shall adjust 
9.15 	the income limits under this section each July 1 by the annual update of the federal 
9.16 	poverty guidelines following publication by the United States Department of Health and 
9.17 	Human Services except that the income standards shall not go below those in effect on
9.18 	 the previous July 1, 2009.

9.19 	EFFECTIVE DATE. This section is effective July 1, 2013.

9.20 	Sec. 21. Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:
9.21 		Subdivision 1.Application assistance and information availability. (a)
9.22 	 Applicants may submit applications online, in person, by mail, or by phone in accordance 
9.23 	with the Affordable Care Act, and by any other means by which medical assistance 
9.24 	applications may be submitted. Applicants may submit applications through the health 
9.25 	benefit exchange or through the MinnesotaCare program. Applications and application 
9.26 	assistance must be made available at provider offices, local human services agencies, 
9.27 	school districts, public and private elementary schools in which 25 percent or more of 
9.28 	the students receive free or reduced price lunches, community health offices, Women, 
9.29 	Infants and Children (WIC) program sites, Head Start program sites, public housing 
9.30 	councils, crisis nurseries, child care centers, early childhood education and preschool 
9.31 	program sites, legal aid offices, and libraries, and at any other locations at which medical 
9.32 	assistance applications must be made available. These sites may accept applications and 
9.33 	forward the forms to the commissioner or local county human services agencies that 
10.1 	choose to participate as an enrollment site. Otherwise, applicants may apply directly to the 
10.2 	commissioner or to participating local county human services agencies.
10.3 	(b) Application assistance must be available for applicants choosing to file an online 
10.4 	application through the health benefit exchange.

10.5 	EFFECTIVE DATE. This section is effective January 1, 2014.

10.6 	Sec. 22. Minnesota Statutes 2012, section 256L.05, is amended by adding a subdivision 
10.7 	to read:
10.8 		Subd. 1d.Streamlined application and enrollment process. The commissioner 
10.9 	shall work with the board of the health benefit exchange and local human services agencies 
10.10 	to develop a single, streamlined application and automatic enrollment process that meets 
10.11 	the requirements of the Affordable Care Act, including but not limited to being structured 
10.12 	to maximize an applicant's ability to complete the form satisfactorily, taking into account 
10.13 	the characteristics of individuals who qualify for MinnesotaCare and medical assistance.

10.14 	EFFECTIVE DATE. This section is effective the day following final enactment.

10.15 	Sec. 23. Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:
10.16 		Subd. 2.Commissioner's duties.  The commissioner or county agency shall use 
10.17 	electronic verification through the health benefit exchange as the primary method of 
10.18 	income verification. If there is a discrepancy between reported income and electronically 
10.19 	verified income, an individual may be required to submit additional verification to the 
10.20 	extent permitted under the Affordable Care Act. In addition, the commissioner shall 
10.21 	perform random audits to verify reported income and eligibility. The commissioner 
10.22 	may execute data sharing arrangements with the Department of Revenue and any other 
10.23 	governmental agency in order to perform income verification related to eligibility and any 
10.24 	applicable premium payment under the MinnesotaCare program.

10.25 	EFFECTIVE DATE. This section is effective January 1, 2014.

10.26 	Sec. 24. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:
10.27 		Subd. 3.Effective date of coverage. (a) The effective date of coverage is the 
10.28 	first day of the month following the month in which eligibility is approved and the first 
10.29 	premium payment has been received. As provided in section 256B.057, coverage for 
10.30 	newborns is automatic from the date of birth and must be coordinated with other health 
10.31 	coverage. The effective date of coverage for eligible newly adoptive children added to a 
10.32 	family receiving covered health services is the month of placement. The effective date 
11.1 	of coverage for other new members added to the family is the first day of the month 
11.2 	following the month in which the change is reported. All eligibility criteria must be met 
11.3 	by the family at the time the new family member is added. The income of the new family 
11.4 	member is included with the family's gross income and the adjusted premium begins in 
11.5 	the month the new family member is added.
11.6 	(b) The initial premium must be received by the last working day of the month for 
11.7 	coverage to begin the first day of the following month.
11.8 	(c) Benefits are not available until the day following discharge if an enrollee is 
11.9 	hospitalized on the first day of coverage.
11.10 	(d) (b) Notwithstanding any other law to the contrary, benefits under sections 
11.11 	256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which 
11.12 	an eligible person may have coverage and the commissioner shall use cost avoidance 
11.13 	techniques to ensure coordination of any other health coverage for eligible persons. The 
11.14 	commissioner shall identify eligible persons who may have coverage or benefits under 
11.15 	other plans of insurance or who become eligible for medical assistance.
11.16 	(e) The effective date of coverage for individuals or families who are exempt from 
11.17 	paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first day of 
11.18 	the month following the month in which verification of American Indian status is received 
11.19 	or eligibility is approved, whichever is later.
11.20 	(f) (c) The effective date of coverage for children eligible under section 256L.07, 
11.21 	subdivision 8, is the first day of the month following the date of termination from foster 
11.22 	care or release from a juvenile residential correctional facility.

11.23 	EFFECTIVE DATE. This section is effective January 1, 2014.

11.24 	Sec. 25. Minnesota Statutes 2012, section 256L.05, subdivision 3a, is amended to read:
11.25 		Subd. 3a.Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility 
11.26 	must be renewed every 12 months. The 12-month period begins in the month after the 
11.27 	month the application is approved.
11.28 	(b) Each new period of eligibility must take into account any changes in 
11.29 	circumstances that impact eligibility and premium amount. An enrollee must provide all 
11.30 	the information needed to redetermine eligibility by the first day of the month that ends 
11.31 	the eligibility period. The premium for the new period of eligibility must be received as 
11.32 	provided in section 256L.06 in order for eligibility to continue.
11.33 	(c) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8, 
11.34 	the first period of renewal begins the month the enrollee turns 21 years of age.

12.1 	EFFECTIVE DATE. This section is effective January 1, 2014.

12.2 	Sec. 26. Minnesota Statutes 2012, section 256L.05, subdivision 3c, is amended to read:
12.3 		Subd. 3c.Retroactive coverage. Notwithstanding subdivision 3, the effective 
12.4 	date of coverage shall be the first day of the month following termination from medical 
12.5 	assistance for families and individuals who are eligible for MinnesotaCare and who 
12.6 	submitted a written request for retroactive MinnesotaCare coverage with a completed 
12.7 	application within 30 days of the mailing of notification of termination from medical 
12.8 	assistance. The applicant must provide all required verifications within 30 days of the 
12.9 	written request for verification. For retroactive coverage, premiums must be paid in full 
12.10 	for any retroactive month, current month, and next month within 30 days of the premium 
12.11 	billing. General assistance medical care recipients may qualify for retroactive coverage 
12.12 	under this subdivision at six-month renewal.

12.13 	EFFECTIVE DATE. This section is effective January 1, 2014.

12.14 	Sec. 27. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:
12.15 		Subd. 2.Residency requirement. To be eligible for health coverage under the 
12.16 	MinnesotaCare program, pregnant women, individuals, and families with children must 
12.17 	meet the residency requirements individuals must be a resident of the state  as provided 
12.18 	by Code of Federal Regulations, title 42, section 435.403, except that the provisions of 
12.19 	section 256B.056, subdivision 1, shall apply upon receipt of federal approval section 
12.20 	1331 of the Affordable Care Act.

12.21 	EFFECTIVE DATE. This section is effective January 1, 2014.

12.22 	Sec. 28. Minnesota Statutes 2012, section 256L.11, subdivision 1, is amended to read:
12.23 		Subdivision 1.Medical assistance rate to be used. (a) Payment to providers 
12.24 	under sections 256L.01 to 256L.11 this chapter shall be at the same rates and conditions 
12.25 	established for medical assistance, except as provided in subdivisions 2 to 6 this section.
12.26 	(b) Effective for services provided on or after July 1, 2009, total payments for basic 
12.27 	care services shall be reduced by three percent, in accordance with section 256B.766. 
12.28 	Payments made to managed care and county-based purchasing plans shall be reduced for 
12.29 	services provided on or after October 1, 2009, to reflect this reduction.
12.30 	(c) Effective for services provided on or after July 1, 2009, payment rates for 
12.31 	physician and professional services shall be reduced as described under section 256B.76, 
12.32 	subdivision 1, paragraph (c). Payments made to managed care and county-based 
13.1 	purchasing plans shall be reduced for services provided on or after October 1, 2009, 
13.2 	to reflect this reduction.

13.3 	EFFECTIVE DATE. This section is effective January 1, 2014.

13.4 	Sec. 29. Minnesota Statutes 2012, section 256L.11, is amended by adding a subdivision 
13.5 	to read:
13.6 		Subd. 1a.Rate increases. Effective for services provided on or after January 1, 
13.7 	2014, the commissioner of human services shall increase payments for basic care services, 
13.8 	physician and professional services, and dental services by â€¦ percent from the rates in 
13.9 	effect for the MinnesotaCare program on December 31, 2013. Payments to participating 
13.10 	entities established through the competitive process under section 256L.121 must reflect 
13.11 	this increase.

13.12 	EFFECTIVE DATE. This section is effective January 1, 2014.

13.13 	Sec. 30. [256L.121] SERVICE DELIVERY.
13.14 		Subdivision 1.Competitive bidding. (a) The commissioner of human services 
13.15 	shall establish a competitive process for entering into contracts with participating entities 
13.16 	for the offering of standard health plans through MinnesotaCare. Coverage through 
13.17 	standard health plans must be available to enrollees beginning January 1, 2014. Each 
13.18 	standard health plan must cover the health services listed in, and meet the requirements 
13.19 	of, section 256L.03. The competitive process must be designed to ensure enrollee access 
13.20 	to high-quality health care coverage options. In establishing the competitive process, 
13.21 	the commissioner shall incorporate applicable features of the competitive price bidding 
13.22 	program established under section 256B.69, subdivision 33. The commissioner, to the 
13.23 	extent feasible, shall seek to ensure that enrollees have a choice of coverage from more 
13.24 	than one participating entity within a geographic area.
13.25 	(b) The competitive process must also include:
13.26 	(1) negotiation for the inclusion of various innovative plan features, including: 
13.27 	care coordination and care management for enrollees, especially for those with chronic 
13.28 	conditions; incentives for the use of preventive services; requirements to include providers 
13.29 	who qualify as essential community providers under section 62Q.19 and providers 
13.30 	certified as health care homes under section 256B.0751; the use of withholds or other 
13.31 	financial incentives tied to achieving measures of health care quality and efficiency; and 
13.32 	maximizing patient involvement in health care decision making, including providing 
13.33 	patient incentives for appropriate utilization;
14.1 	(2) allowances for differences in the health care needs of enrollees and the local 
14.2 	availability of, and access to, health care providers;
14.3 	(3) contracting with systems that offer as many managed care and coordinated care 
14.4 	attributes as are feasible in the local market; and
14.5 	(4) performance measures and standards for participating entities that focus on quality 
14.6 	of care and improved health outcomes, require the reporting of measures and standards to 
14.7 	the commissioner, and make information on performance and quality available to enrollees.
14.8 		Subd. 2.Other requirements for participating entities. The commissioner shall 
14.9 	require participating entities, as a condition of contract, to document to the commissioner 
14.10 	the provision of culturally and linguistically appropriate services, including marketing 
14.11 	materials, to MinnesotaCare enrollees.
14.12 		Subd. 3.Coordination with state-administered health programs. The 
14.13 	commissioner shall coordinate the administration of the MinnesotaCare program with 
14.14 	medical assistance and other state-administered health care programs to maximize 
14.15 	efficiency and improve the continuity of care. This includes, but is not limited to:
14.16 	(1) establishing geographic areas for MinnesotaCare that are consistent with the 
14.17 	geographic areas of the medical assistance program, within which participating entities 
14.18 	may offer health plans;
14.19 	(2) requiring, as a condition of participation in MinnesotaCare, participating entities 
14.20 	to also participate in the medical assistance program; and
14.21 	(3) providing MinnesotaCare enrollees, to the extent possible, with the option to 
14.22 	remain in the same health plan and provider network, if they later become eligible for 
14.23 	medical assistance or coverage through the Minnesota health benefit exchange.

14.24 	EFFECTIVE DATE. This section is effective the day following final enactment.

14.25 	Sec. 31. REVISOR'S INSTRUCTION.
 14.26 	The revisor shall remove cross-references to the repealed sections in section 32 
14.27 	wherever they appear in Minnesota Statutes and Minnesota Rules and make changes 
14.28 	necessary to correct the punctuation, grammar, or structure of the remaining text and 
14.29 	preserve its meaning.

14.30 	Sec. 32.  REPEALER.
 14.31 	Minnesota Statutes 2012, sections 256L.01, subdivisions 3, 3a, 4a, and 5; 256L.02, 
14.32 	subdivision 3; 256L.03, subdivisions 1a, 3, 4, and 5; 256L.031; 256L.04, subdivisions 
14.33 	1, 1b, 2a, 7, 7a, 8, 9, and 13; 256L.05, subdivisions 1b, 1c, and 5; 256L.06, subdivision 
14.34 	3; 256L.07, subdivisions 1, 2, 3, 4, 5, 8, and 9; 256L.09, subdivisions 1, 4, 5, 6, and 7; 
15.1 	256L.11, subdivisions 2a, 3, and 6; 256L.12; 256L.15, subdivisions 1, 1a, 1b, and 2; and 
15.2 	256L.17, subdivisions 1, 2, 3, 4, and 5, are repealed effective January 1, 2014.