Engrossments
Introduction		Posted on 06/15/2021
1st Engrossment		Posted on 06/24/2021
2nd Engrossment		Posted on 06/27/2021

Unofficial Engrossments
1st Unofficial Engrossment		Posted on 06/26/2021

ARTICLE 1

DEPARTMENT OF HUMAN SERVICES HEALTH CARE PROGRAMS

Section 1.

Minnesota Statutes 2020, section 256.01, subdivision 28, is amended to read:

Subd. 28.

Statewide health information exchange.

(a) The commissioner has the
authority to join and participate as a member in a legal entity developing and operating a
statewide health information exchange new text begin or to develop and operate an encounter alerting
service new text end that shall meet the following criteria:

(1) the legal entity must meet all constitutional and statutory requirements to allow the
commissioner to participate; and

(2) the commissioner or the commissioner's designated representative must have the
right to participate in the governance of the legal entity under the same terms and conditions
and subject to the same requirements as any other member in the legal entity and in that
role shall act to advance state interests and lessen the burdens of government.

(b) Notwithstanding chapter 16C, the commissioner may pay the state's prorated share
of development-related expenses of the legal entity retroactively from October 29, 2007,
regardless of the date the commissioner joins the legal entity as a member.

Sec. 2.

new text begin [256B.0371] PERFORMANCE BENCHMARKS FOR DENTAL ACCESS;
CONTINGENT DENTAL ADMINISTRATOR.
new text end

new text begin Subdivision 1. new text end

new text begin Benchmark for dental access. new text end

new text begin For coverage years 2022 to 2024, the
commissioner shall establish a performance benchmark under which at least 55 percent of
children and adults who were continuously enrolled for at least 11 months in either medical
assistance or MinnesotaCare through a managed care or county-based purchasing plan
received at least one dental visit during the coverage year.
new text end

new text begin Subd. 2. new text end

new text begin Corrective action plan. new text end

new text begin For coverage years 2022 to 2024, if a managed care
or county-based purchasing plan under contract with the commissioner to provide dental
services under this chapter or chapter 256L has a rate of dental utilization that is ten percent
or more below the performance benchmark specified in subdivision 1, the commissioner
shall require the managed care or county-based purchasing plan to submit a corrective action
plan to the commissioner describing how the entity intends to increase dental utilization to
meet the performance benchmark. The managed care or county-based purchasing plan must:
new text end

new text begin (1) provide a written corrective action plan to the commissioner for approval;
new text end

new text begin (2) implement the plan; and
new text end

new text begin (3) provide the commissioner with documentation of each corrective action taken.
new text end

new text begin Subd. 3. new text end

new text begin Contingent contract with dental administrator. new text end

new text begin (a) The commissioner shall
determine the extent to which managed care and county-based purchasing plans in the
aggregate meet the performance benchmark specified in subdivision 1 for coverage year
2024. If managed care and county-based purchasing plans in the aggregate fail to meet the
performance benchmark, the commissioner, after issuing a request for information followed
by a request for proposals, shall contract with a dental administrator to administer dental
services beginning January 1, 2026, for all recipients of medical assistance and
MinnesotaCare, including persons served under fee-for-service and persons receiving
services through managed care and county-based purchasing plans.
new text end

new text begin (b) The dental administrator must provide administrative services, including but not
limited to:
new text end

new text begin (1) provider recruitment, contracting, and assistance;
new text end

new text begin (2) recipient outreach and assistance;
new text end

new text begin (3) utilization management and reviews of medical necessity for dental services;
new text end

new text begin (4) dental claims processing;
new text end

new text begin (5) coordination of dental care with other services;
new text end

new text begin (6) management of fraud and abuse;
new text end

new text begin (7) monitoring access to dental services;
new text end

new text begin (8) performance measurement;
new text end

new text begin (9) quality improvement and evaluation; and
new text end

new text begin (10) management of third-party liability requirements.
new text end

new text begin (c) Dental administrator payments to contracted dental providers must be at the rates
established under sections 256B.76 and 256L.11.
new text end

new text begin (d) Recipients must be given a choice of dental provider, including any provider who
agrees to provider participation requirements and payment rates established by the
commissioner and dental administrator. The dental administrator must comply with the
network adequacy and geographic access requirements that apply to managed care and
county-based purchasing plans for dental services under section 62K.14.
new text end

new text begin (e) The contract with the dental administrator must include a provision that states that
if the dental administrator fails to meet, by calendar year 2029, a performance benchmark
under which at least 55 percent of children and adults who were continuously enrolled for
at least 11 months in either medical assistance or MinnesotaCare received at least one dental
visit during the calendar year, the contract must be terminated and the commissioner must
enter into a contract with a new dental administrator as soon as practicable.
new text end

new text begin (f) The commissioner shall implement this subdivision in consultation with representatives
of providers who provide dental services to patients enrolled in medical assistance or
MinnesotaCare, including but not limited to providers serving primarily low-income and
socioeconomically complex populations, and with representatives of managed care plans
and county-based purchasing plans.
new text end

new text begin Subd. 4. new text end

new text begin Dental utilization report. new text end

new text begin (a) The commissioner shall submit an annual report
beginning March 15, 2022, and ending March 15, 2026, to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance that includes the percentage for adults and children one through 20 years
of age for the most recent complete calendar year receiving at least one dental visit for both
fee-for-service and the prepaid medical assistance program. The report must include:
new text end

new text begin (1) statewide utilization for both fee-for-service and for the prepaid medical assistance
program;
new text end

new text begin (2) utilization by county;
new text end

new text begin (3) utilization by children receiving dental services through fee-for-service and through
a managed care plan or county-based purchasing plan;
new text end

new text begin (4) utilization by adults receiving dental services through fee-for-service and through a
managed care plan or county-based purchasing plan.
new text end

new text begin (b) The report must also include a description of any corrective action plans required to
be submitted under subdivision 2.
new text end

new text begin (c) The initial report due on March 15, 2022, must include the utilization metrics described
in paragraph (a) for each of the following calendar years: 2017, 2018, 2019, and 2020.
new text end

Sec. 3.

Minnesota Statutes 2020, 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; deleted text begin and
deleted text end

(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;new text begin and
new text end

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

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

(6) drugs.

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

(c) 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 EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later.
new text end

Sec. 4.

Minnesota Statutes 2020, section 256B.055, subdivision 6, is amended to read:

Subd. 6.

Pregnant women; needy unborn child.

Medical assistance may be paid for
a pregnant woman who meets the other eligibility criteria of this section and whose unborn
child would be eligible as a needy child under subdivision 10 if born and living with the
woman. In accordance with Code of Federal Regulations, title 42, section 435.956, the
commissioner must accept self-attestation of pregnancy unless the agency has information
that is not reasonably compatible with such attestation. For purposes of this subdivision, a
woman is considered pregnant for deleted text begin 60 daysdeleted text end new text begin 12 monthsnew text end postpartum.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval has been obtained.
new text end

Sec. 5.

Minnesota Statutes 2020, section 256B.056, subdivision 10, is amended to read:

Subd. 10.

Eligibility verification.

(a) The commissioner shall require women who are
applying for the continuation of medical assistance coverage following the end of the deleted text begin 60-daydeleted text end new text begin
12-monthnew text end postpartum period to update their income and asset information and to submit
any required income or asset verification.

(b) The commissioner shall determine the eligibility of private-sector health care coverage
for infants less than one year of age eligible under section 256B.055, subdivision 10, or
256B.057, subdivision 1, paragraph (c), and shall pay for private-sector coverage if this is
determined to be cost-effective.

(d) The commissioner shall utilize information obtained through the electronic service
established by the secretary of the United States Department of Health and Human Services
and other available electronic data sources in Code of Federal Regulations, title 42, sections
435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish
standards to define when information obtained electronically is reasonably compatible with
information provided by applicants and enrollees, including use of self-attestation, to
accomplish real-time eligibility determinations and maintain program integrity.

(e) Each person applying for or receiving medical assistance under section 256B.055,
subdivision 7, and any other person whose resources are required by law to be disclosed to
determine the applicant's or recipient's eligibility must authorize the commissioner to obtain
information from financial institutions to identify unreported accounts as required in section
256.01, subdivision 18f. If a person refuses or revokes the authorization, the commissioner
may determine that the applicant or recipient is ineligible for medical assistance. For purposes
of this paragraph, an authorization to identify unreported accounts meets the requirements
of the Right to Financial Privacy Act, United States Code, title 12, chapter 35, and need not
be furnished to the financial institution.

(f) County and tribal agencies shall comply with the standards established by the
commissioner for appropriate use of the asset verification system specified in section 256.01,
subdivision 18f.

new text begin EFFECTIVE DATE. new text end

Sec. 6.

Minnesota Statutes 2020, section 256B.06, subdivision 4, is amended to read:

Subd. 4.

Citizenship requirements.

(a) Eligibility for medical assistance is limited to
citizens of the United States, qualified noncitizens as defined in this subdivision, and other
persons residing lawfully in the United States. Citizens or nationals of the United States
must cooperate in obtaining satisfactory documentary evidence of citizenship or nationality
according to the requirements of the federal Deficit Reduction Act of 2005, Public Law
109-171.

(b) "Qualified noncitizen" means a person who meets one of the following immigration
criteria:

(1) admitted for lawful permanent residence according to United States Code, title 8;

(2) admitted to the United States as a refugee according to United States Code, title 8,
section 1157;

(3) granted asylum according to United States Code, title 8, section 1158;

(4) granted withholding of deportation according to United States Code, title 8, section
1253(h);

(5) paroled for a period of at least one year according to United States Code, title 8,
section 1182(d)(5);

(6) granted conditional entrant status according to United States Code, title 8, section
1153(a)(7);

(7) determined to be a battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;

(8) is a child of a noncitizen determined to be a battered noncitizen by the United States
Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility
Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
or

(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
Law 96-422, the Refugee Education Assistance Act of 1980.

(c) All qualified noncitizens who were residing in the United States before August 22,
1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical
assistance with federal financial participation.

(d) Beginning December 1, 1996, qualified noncitizens who entered the United States
on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
chapter are eligible for medical assistance with federal participation for five years if they
meet one of the following criteria:

(1) refugees admitted to the United States according to United States Code, title 8, section
1157;

(2) persons granted asylum according to United States Code, title 8, section 1158;

(3) persons granted withholding of deportation according to United States Code, title 8,
section 1253(h);

(4) veterans of the United States armed forces with an honorable discharge for a reason
other than noncitizen status, their spouses and unmarried minor dependent children; or

(5) persons on active duty in the United States armed forces, other than for training,
their spouses and unmarried minor dependent children.

Beginning July 1, 2010, children and pregnant women who are noncitizens described
in paragraph (b) or who are lawfully present in the United States as defined in Code of
Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements
of this chapter, are eligible for medical assistance with federal financial participation as
provided by the federal Children's Health Insurance Program Reauthorization Act of 2009,
Public Law 111-3.

(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter are
eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this subdivision,
a "nonimmigrant" is a person in one of the classes listed in United States Code, title 8,
section 1101(a)(15).

(f) Payment shall also be made for care and services that are furnished to noncitizens,
regardless of immigration status, who otherwise meet the eligibility requirements of this
chapter, if such care and services are necessary for the treatment of an emergency medical
condition.

(g) For purposes of this subdivision, the term "emergency medical condition" means a
medical condition that meets the requirements of United States Code, title 42, section
1396b(v).

(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment of
an emergency medical condition are limited to the following:

(i) services delivered in an emergency room or by an ambulance service licensed under
chapter 144E that are directly related to the treatment of an emergency medical condition;

(ii) services delivered in an inpatient hospital setting following admission from an
emergency room or clinic for an acute emergency condition; and

(iii) follow-up services that are directly related to the original service provided to treat
the emergency medical condition and are covered by the global payment made to the
provider.

(2) Services for the treatment of emergency medical conditions do not include:

(i) services delivered in an emergency room or inpatient setting to treat a nonemergency
condition;

(ii) organ transplants, stem cell transplants, and related care;

(iii) services for routine prenatal care;

(iv) continuing care, including long-term care, nursing facility services, home health
care, adult day care, day training, or supportive living services;

(v) elective surgery;

(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part
of an emergency room visit;

(vii) preventative health care and family planning services;

(viii) rehabilitation services;

(ix) physical, occupational, or speech therapy;

(x) transportation services;

(xi) case management;

(xii) prosthetics, orthotics, durable medical equipment, or medical supplies;

(xiii) dental services;

(xiv) hospice care;

(xv) audiology services and hearing aids;

(xvi) podiatry services;

(xvii) chiropractic services;

(xviii) immunizations;

(xix) vision services and eyeglasses;

(xx) waiver services;

(xxi) individualized education programs; or

(xxii) chemical dependency treatment.

(i) Pregnant noncitizens who are ineligible for federally funded medical assistance
because of immigration status, are not covered by a group health plan or health insurance
coverage according to Code of Federal Regulations, title 42, section 457.310, and who
otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance
through the period of pregnancy, including labor and delivery, and deleted text begin 60 daysdeleted text end new text begin 12 monthsnew text end
postpartumdeleted text begin , to the extent federal funds are available under title XXI of the Social Security
Act, and the state children's health insurance programdeleted text end .

(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation services
from a nonprofit center established to serve victims of torture and are otherwise ineligible
for medical assistance under this chapter are eligible for medical assistance without federal
financial participation. These individuals are eligible only for the period during which they
are receiving services from the center. Individuals eligible under this paragraph shall not
be required to participate in prepaid medical assistance. The nonprofit center referenced
under this paragraph may establish itself as a provider of mental health targeted case
management services through a county contract under section 256.0112, subdivision 6. If
the nonprofit center is unable to secure a contract with a lead county in its service area, then,
notwithstanding the requirements of section 256B.0625, subdivision 20, the commissioner
may negotiate a contract with the nonprofit center for provision of mental health targeted
case management services. When serving clients who are not the financial responsibility
of their contracted lead county, the nonprofit center must gain the concurrence of the county
of financial responsibility prior to providing mental health targeted case management services
for those clients.

(k) Notwithstanding paragraph (h), clause (2), the following services are covered as
emergency medical conditions under paragraph (f) except where coverage is prohibited
under federal law for services under clauses (1) and (2):

(1) dialysis services provided in a hospital or freestanding dialysis facility;

(2) surgery and the administration of chemotherapy, radiation, and related services
necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission and
requires surgery, chemotherapy, or radiation treatment; and

(3) kidney transplant if the person has been diagnosed with end stage renal disease, is
currently receiving dialysis services, and is a potential candidate for a kidney transplant.

(l) Effective July 1, 2013, recipients of emergency medical assistance under this
subdivision are eligible for coverage of the elderly waiver services provided under chapter
256S, and coverage of rehabilitative services provided in a nursing facility. The age limit
for elderly waiver services does not apply. In order to qualify for coverage, a recipient of
emergency medical assistance is subject to the assessment and reassessment requirements
of section 256B.0911. Initial and continued enrollment under this paragraph is subject to
the limits of available funding.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. If federal approval is not obtained, this section is effective on the effective
date of the amendment to Minnesota Statutes, section 256B.055, subdivision 6, and shall
be funded using only state funds. The commissioner shall notify the revisor of statutes when
federal approval has been obtained.
new text end

Sec. 7.

Minnesota Statutes 2020, section 256B.0625, subdivision 9, is amended to read:

Subd. 9.

Dental services.

(a) Medical assistance covers dental services.

(b) Medical assistance dental coverage for nonpregnant adults is limited to the following
services:

(1) comprehensive exams, limited to once every five years;

(2) periodic exams, limited to one per year;

(3) limited exams;

(4) bitewing x-rays, limited to one per year;

(5) periapical x-rays;

(6) panoramic x-rays, limited to one every five years except (1) when medically necessary
for the diagnosis and follow-up of oral and maxillofacial pathology and trauma or (2) once
every two years for patients who cannot cooperate for intraoral film due to a developmental
disability or medical condition that does not allow for intraoral film placement;

(7) prophylaxis, limited to one per year;

(8) application of fluoride varnish, limited to one per year;

(9) posterior fillings, all at the amalgam rate;

(10) anterior fillings;

(11) endodontics, limited to root canals on the anterior and premolars only;

(12) removable prostheses, each dental arch limited to one every six years;

(13) oral surgery, limited to extractions, biopsies, and incision and drainage of abscesses;

(14) palliative treatment and sedative fillings for relief of pain; deleted text begin and
deleted text end

(15) full-mouth debridement, limited to one every five yearsdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (16) nonsurgical treatment for periodontal disease, including scaling and root planing
once every two years for each quadrant, and routine periodontal maintenance procedures.
new text end

(c) In addition to the services specified in paragraph (b), medical assistance covers the
following services for adults, if provided in an outpatient hospital setting or freestanding
ambulatory surgical center as part of outpatient dental surgery:

(1) periodontics, limited to periodontal scaling and root planing once every two years;

(2) general anesthesia; and

(3) full-mouth survey once every five years.

(d) Medical assistance covers medically necessary dental services for children and
pregnant women. The following guidelines apply:

(1) posterior fillings are paid at the amalgam rate;

(2) application of sealants are covered once every five years per permanent molar for
children only;

(3) application of fluoride varnish is covered once every six months; and

(4) orthodontia is eligible for coverage for children only.

(e) In addition to the services specified in paragraphs (b) and (c), medical assistance
covers the following services for adults:

(1) house calls or extended care facility calls for on-site delivery of covered services;

(2) behavioral management when additional staff time is required to accommodate
behavioral challenges and sedation is not used;

(3) oral or IV sedation, if the covered dental service cannot be performed safely without
it or would otherwise require the service to be performed under general anesthesia in a
hospital or surgical center; and

(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but
no more than four times per year.

(f) The commissioner shall not require prior authorization for the services included in
paragraph (e), clauses (1) to (3), and shall prohibit managed care and county-based purchasing
plans from requiring prior authorization for the services included in paragraph (e), clauses
(1) to (3), when provided under sections 256B.69, 256B.692, and 256L.12.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, or upon federal approval,
whichever is later.
new text end

Sec. 8.

Minnesota Statutes 2020, section 256B.0625, subdivision 13, is amended to read:

Subd. 13.

Drugs.

(a) Medical assistance covers drugs, except for fertility drugs when
specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
dispensing physician, or by a physician, a physician assistant, or an advanced practice
registered nurse employed by or under contract with a community health board as defined
in section 145A.02, subdivision 5, for the purposes of communicable disease control.

(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
unless authorized by the commissionerdeleted text begin .deleted text end new text begin or the drug appears on the 90-day supply list
published by the commissioner. The 90-day supply list shall be published by the
commissioner on the department's website. The commissioner may add to, delete from, and
otherwise modify the 90-day supply list after providing public notice and the opportunity
for a 15-day public comment period. The 90-day supply list may include cost-effective
generic drugs and shall not include controlled substances.
new text end

(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
ingredient" is defined as a substance that is represented for use in a drug and when used in
the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
excipients which are included in the medical assistance formulary. Medical assistance covers
selected active pharmaceutical ingredients and excipients used in compounded prescriptions
when the compounded combination is specifically approved by the commissioner or when
a commercially available product:

(1) is not a therapeutic option for the patient;

(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and

(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
prescription.

(d) Medical assistance covers the following over-the-counter drugs when prescribed by
a licensed practitioner or by a licensed pharmacist who meets standards established by the
commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
with documented vitamin deficiencies, vitamins for children under the age of seven and
pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions, or
disorders, and this determination shall not be subject to the requirements of chapter 14. A
pharmacist may prescribe over-the-counter medications as provided under this paragraph
for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for potential adverse interactions,
and make referrals as needed to other health care professionals.

(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
individuals, medical assistance may cover drugs from the drug classes listed in United States
Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
not be covered.

(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under common
ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.

(g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal
contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section
151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a
licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists
used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed
pharmacist in accordance with section 151.37, subdivision 16.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022.
new text end

Sec. 9.

Minnesota Statutes 2020, section 256B.0625, subdivision 13c, is amended to read:

Subd. 13c.

Formulary Committee.

The commissioner, after receiving recommendations
from professional medical associations and professional pharmacy associations, and consumer
groups shall designate a Formulary Committee to carry out duties as described in subdivisions
13 to 13g. The Formulary Committee shall be comprised of four licensed physicians actively
engaged in the practice of medicine in Minnesotanew text begin ,new text end one of whom must be actively engaged
in the treatment of persons with mental illness; at least three licensed pharmacists actively
engaged in the practice of pharmacy in Minnesota; and one consumer representative; the
remainder to be made up of health care professionals who are licensed in their field and
have recognized knowledge in the clinically appropriate prescribing, dispensing, and
monitoring of covered outpatient drugs. Members of the Formulary Committee shall not
be employed by the Department of Human Services, but the committee shall be staffed by
an employee of the department who shall serve as an ex officio, nonvoting member of the
committee. The department's medical director shall also serve as an ex officio, nonvoting
member for the committee. Committee members shall serve three-year terms and may be
reappointed by the commissioner. The Formulary Committee shall meet at least twice per
year. The commissioner may require more frequent Formulary Committee meetings as
needed. An honorarium of $100 per meeting and reimbursement for mileage shall be paid
to each committee member in attendance. The Formulary Committee expires June 30, deleted text begin 2022deleted text end new text begin
2023new text end .

Sec. 10.

Minnesota Statutes 2020, section 256B.0625, subdivision 13d, is amended to
read:

Subd. 13d.

Drug formulary.

(a) The commissioner shall establish a drug formulary. Its
establishment and publication shall not be subject to the requirements of the Administrative
Procedure Act, but the Formulary Committee shall review and comment on the formulary
contents.

(b) The formulary shall not include:

(1) drugs, active pharmaceutical ingredients, or products for which there is no federal
funding;

(2) over-the-counter drugs, except as provided in subdivision 13;

deleted text begin (3) drugs or active pharmaceutical ingredients used for weight loss, except that medically
necessary lipase inhibitors may be covered for a recipient with type II diabetes;
deleted text end

deleted text begin (4)deleted text end new text begin (3)new text end drugs or active pharmaceutical ingredients when used for the treatment of
impotence or erectile dysfunction;

deleted text begin (5)deleted text end new text begin (4)new text end drugs or active pharmaceutical ingredients for which medical value has not been
established;

deleted text begin (6)deleted text end new text begin (5)new text end drugs from manufacturers who have not signed a rebate agreement with the
Department of Health and Human Services pursuant to section 1927 of title XIX of the
Social Security Act; and

deleted text begin (7)deleted text end new text begin (6)new text end medical cannabis as defined in section 152.22, subdivision 6.

(c) If a single-source drug used by at least two percent of the fee-for-service medical
assistance recipients is removed from the formulary due to the failure of the manufacturer
to sign a rebate agreement with the Department of Health and Human Services, the
commissioner shall notify prescribing practitioners within 30 days of receiving notification
from the Centers for Medicare and Medicaid Services (CMS) that a rebate agreement was
not signed.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end

Sec. 11.

Minnesota Statutes 2020, section 256B.0625, subdivision 13e, is amended to
read:

Subd. 13e.

Payment rates.

(a) The basis for determining the amount of payment shall
be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the
usual and customary price charged to the public. The usual and customary price means the
lowest price charged by the provider to a patient who pays for the prescription by cash,
check, or charge account and includes prices the pharmacy charges to a patient enrolled in
a prescription savings club or prescription discount club administered by the pharmacy or
pharmacy chain. The amount of payment basis must be reduced to reflect all discount
amounts applied to the charge by any third-party provider/insurer agreement or contract for
submitted charges to medical assistance programs. The net submitted charge may not be
greater than the patient liability for the service. The professional dispensing fee shall be
deleted text begin $10.48deleted text end new text begin $10.77new text end for prescriptions filled with legend drugs meeting the definition of "covered
outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The
dispensing fee for intravenous solutions that must be compounded by the pharmacist shall
be deleted text begin $10.48deleted text end new text begin $10.77new text end per deleted text begin bagdeleted text end new text begin claimnew text end . The professional dispensing fee for prescriptions filled
with over-the-counter drugs meeting the definition of covered outpatient drugs shall be
deleted text begin $10.48deleted text end new text begin $10.77new text end for dispensed quantities equal to or greater than the number of units contained
in the manufacturer's original package. The professional dispensing fee shall be prorated
based on the percentage of the package dispensed when the pharmacy dispenses a quantity
less than the number of units contained in the manufacturer's original package. The pharmacy
dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered
outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units
contained in the manufacturer's original package and shall be prorated based on the
percentage of the package dispensed when the pharmacy dispenses a quantity less than the
number of units contained in the manufacturer's original package. The National Average
Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug.
For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient
cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for
a provider participating in the federal 340B Drug Pricing Program shall be either the 340B
Drug Pricing Program ceiling price established by the Health Resources and Services
Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as
the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in
the United States, not including prompt pay or other discounts, rebates, or reductions in
price, for the most recent month for which information is available, as reported in wholesale
price guides or other publications of drug or biological pricing data. The maximum allowable
cost of a multisource drug may be set by the commissioner and it shall be comparable to
the actual acquisition cost of the drug product and no higher than the NADAC of the generic
product. Establishment of the amount of payment for drugs shall not be subject to the
requirements of the Administrative Procedure Act.

(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
an automated drug distribution system meeting the requirements of section 151.58, or a
packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents. A
retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.

(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota
Rules, part 6800.2700, is required to credit the department for the actual acquisition cost
of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective
billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that
is less than a 30-day supply.

(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC
of the generic product or the maximum allowable cost established by the commissioner
unless prior authorization for the brand name product has been granted according to the
criteria established by the Drug Formulary Committee as required by subdivision 13f,
paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in
a manner consistent with section 151.21, subdivision 2.

(e) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
set by the commissioner. If average sales price is unavailable, the amount of payment must
be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
The commissioner shall discount the payment rate for drugs obtained through the federal
340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an
outpatient setting shall be made to the administering facility or practitioner. A retail or
specialty pharmacy dispensing a drug for administration in an outpatient setting is not
eligible for direct reimbursement.

(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy
products that are lower than the ingredient cost formulas specified in paragraph (a). The
commissioner may require individuals enrolled in the health care programs administered
by the department to obtain specialty pharmacy products from providers with whom the
commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are
defined as those used by a small number of recipients or recipients with complex and chronic
diseases that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C,
growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of
cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that
require complex care. The commissioner shall consult with the Formulary Committee to
develop a list of specialty pharmacy products subject to maximum allowable cost
reimbursement. In consulting with the Formulary Committee in developing this list, the
commissioner shall take into consideration the population served by specialty pharmacy
products, the current delivery system and standard of care in the state, and access to care
issues. The commissioner shall have the discretion to adjust the maximum allowable cost
to prevent access to care issues.

(g) Home infusion therapy services provided by home infusion therapy pharmacies must
be paid at rates according to subdivision 8d.

(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey
for all pharmacies that are physically located in the state of Minnesota that dispense outpatient
drugs under medical assistance. The commissioner shall ensure that the vendor has prior
experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the
department to dispense outpatient prescription drugs to fee-for-service members must
respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under
section 256B.064 for failure to respond. The commissioner shall require the vendor to
measure a single statewide cost of dispensing for new text begin specialty prescription drugs and a single
statewide cost of dispensing for nonspecialty prescription drugs for new text end all responding pharmacies
to measure the mean, mean weighted by total prescription volume, mean weighted by
medical assistance prescription volume, median, median weighted by total prescription
volume, and median weighted by total medical assistance prescription volume. The
commissioner shall post a copy of the final cost of dispensing survey report on the
department's website. The initial survey must be completed no later than January 1, 2021,
and repeated every three years. The commissioner shall provide a summary of the results
of each cost of dispensing survey and provide recommendations for any changes to the
dispensing fee to the chairs and ranking members of the legislative committees with
jurisdiction over medical assistance pharmacy reimbursement.

(i) The commissioner shall increase the ingredient cost reimbursement calculated in
paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to
the wholesale drug distributor tax under section 295.52.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, except the amendment
to paragraph (h) is effective the day following final enactment.
new text end

Sec. 12.

Minnesota Statutes 2020, section 256B.0625, subdivision 13g, is amended to
read:

Subd. 13g.

Preferred drug list.

(a) The commissioner shall adopt and implement a
preferred drug list by January 1, 2004. The commissioner may enter into a contract with a
vendor for the purpose of participating in a preferred drug list and supplemental rebate
program. The commissioner shall ensure that any contract meets all federal requirements
and maximizes federal financial participation. The commissioner shall publish the preferred
drug list annually in the State Register and shall maintain an accurate and up-to-date list on
the agency website.

(b) The commissioner may add to, delete from, and otherwise modify the preferred drug
list, after consulting with the Formulary Committee and appropriate medical specialists and
providing public notice and the opportunity for public comment.

(c) The commissioner shall adopt and administer the preferred drug list as part of the
administration of the supplemental drug rebate program. Reimbursement for prescription
drugs not on the preferred drug list may be subject to prior authorization.

(d) For purposes of this subdivision, "preferred drug list" means a list of prescription
drugs within designated therapeutic classes selected by the commissioner, for which prior
authorization based on the identity of the drug or class is not required.

(e) The commissioner shall seek any federal waivers or approvals necessary to implement
this subdivision.

new text begin (f) Notwithstanding paragraph (b), before the commissioner may delete a drug from the
preferred drug list or modify the inclusion of a drug on the preferred drug list, the
commissioner shall consider any implications that the deletion or modification may have
on state public health policies or initiatives and any impact that the deletion or modification
may have on increasing health disparities in the state. Prior to deleting a drug or modifying
the inclusion of a drug, the commissioner shall also conduct a public hearing. The
commissioner shall provide adequate notice to the public and the commissioner of health
prior to the hearing that specifies the drug that the commissioner is proposing to delete or
modify, any public medical or clinical analysis that the commissioner has relied on in
proposing the deletion or modification, and evidence that the commissioner has evaluated
the impact of the proposed deletion or modification on public health and health disparities.
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. 13.

Minnesota Statutes 2020, section 256B.0625, subdivision 18, is amended to read:

Subd. 18.

deleted text begin Busdeleted text end new text begin Public transitnew text end or taxicab transportation.

new text begin (a) new text end To the extent authorized
by rule of the state agency, medical assistance covers the most appropriate and cost-effective
form of transportation incurred by any ambulatory eligible person for obtaining
nonemergency medical care.

new text begin (b) The commissioner may provide a monthly public transit pass to recipients who are
well-served by public transit for the recipient's nonemergency medical transportation needs.
Any recipient who is eligible for one public transit trip for a medically necessary covered
service may select to receive a transit pass for that month. Recipients who do not have any
transportation needs for a medically necessary service in any given month or who have
received a transit pass for that month through another program administered by a county or
Tribe are not eligible for a transit pass that month. The commissioner shall not require
recipients to select a monthly transit pass if the recipient's transportation needs cannot be
served by public transit systems. Recipients who receive a monthly transit pass are not
eligible for other modes of transportation, unless an unexpected need arises that cannot be
accessed through public transit.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 14.

Minnesota Statutes 2020, section 256B.0625, subdivision 31, is amended to read:

Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall be
made for wheelchairs and wheelchair accessories for recipients who are residents of
intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs
and wheelchair accessories for ICF/DD recipients shall be subject to the same conditions
and limitations as coverage for recipients who do not reside in institutions. A wheelchair
purchased outside of the facility's payment rate is the property of the recipient.

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics,
or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment
requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic,
or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or similar
durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with the
Medicare program's supplier and quality standards and the vendor serves primarily pediatric
patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical condition
or is generally used primarily for a medical purpose.

(e) Electronic tablets may be considered durable medical equipment if the electronic
tablet will be used as an augmentative and alternative communication system as defined
under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must
be locked in order to prevent use not related to communication.

(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must be
locked to prevent use not as an augmentative communication device, a recipient of waiver
services may use an electronic tablet for a use not related to communication when the
recipient has been authorized under the waiver to receive one or more additional applications
that can be loaded onto the electronic tablet, such that allowing the additional use prevents
the purchase of a separate electronic tablet with waiver funds.

(g) An order or prescription for medical supplies, equipment, or appliances must meet
the requirements in Code of Federal Regulations, title 42, part 440.70.

new text begin (h) Allergen-reducing products provided according to subdivision 67, paragraph (c) or
(d), shall be considered durable medical equipment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, 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. 15.

Minnesota Statutes 2020, section 256B.0625, subdivision 58, is amended to read:

Subd. 58.

Early and periodic screening, diagnosis, and treatment services.

new text begin (a) new text end Medical
assistance covers early and periodic screening, diagnosis, and treatment services (EPSDT).
new text begin In administering the EPSDT program, the commissioner shall, at a minimum:
new text end

new text begin (1) provide information to children and families, using the most effective mode identified,
regarding:
new text end

new text begin (i) the benefits of preventative health care visits;
new text end

new text begin (ii) the services available as part of the EPSDT program; and
new text end

new text begin (iii) assistance finding a provider, transportation, or interpreter services;
new text end

new text begin (2) maintain an up-to-date periodicity schedule published in the department policy
manual, taking into consideration the most up-to-date community standard of care; and
new text end

new text begin (3) maintain up-to-date policies for providers on the delivery of EPSDT services that
are in the provider manual on the department website.
new text end

new text begin (b) The commissioner may contract for the administration of the outreach services as
required within the EPSDT program.
new text end

new text begin (c) The commissioner may contract for the required EPSDT outreach services, including
but not limited to children enrolled or attributed to an integrated health partnership
demonstration project described in section 256B.0755. Integrated health partnerships that
choose to include the EPSDT outreach services within the integrated health partnership's
contracted responsibilities must receive compensation from the commissioner on a
per-member per-month basis for each included child. Integrated health partnerships must
accept responsibility for the effectiveness of outreach services it delivers. For children who
are not a part of the demonstration project, the commissioner may contract for the
administration of the outreach services.
new text end

new text begin (d) new text end The payment amount for a complete EPSDT screening shall not include charges for
health care services and products that are available at no cost to the provider and shall not
exceed the rate established per Minnesota Rules, part 9505.0445, item M, effective October
1, 2010.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, except that paragraph (c)
is effective January 1, 2022.
new text end

Sec. 16.

Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 67. new text end

new text begin Enhanced asthma care services. new text end

new text begin (a) Medical assistance covers enhanced
asthma care services and related products to be provided in the children's homes for children
with poorly controlled asthma. To be eligible for services and products under this subdivision,
a child must:
new text end

new text begin (1) have poorly controlled asthma defined by having received health care for the child's
asthma from a hospital emergency department at least one time in the past year or have
been hospitalized for the treatment of asthma at least one time in the past year; and
new text end

new text begin (2) receive a referral for services and products under this subdivision from a treating
health care provider.
new text end

new text begin (b) Covered services include home visits provided by a registered environmental health
specialist or lead risk assessor currently credentialed by the Department of Health or a
healthy homes specialist credentialed by the Building Performance Institute.
new text end

new text begin (c) Covered products include the following allergen-reducing products that are identified
as needed and recommended for the child by a registered environmental health specialist,
healthy homes specialist, lead risk assessor, certified asthma educator, public health nurse,
or other health care professional providing asthma care for the child, and proven to reduce
asthma triggers:
new text end

new text begin (1) allergen encasements for mattresses, box springs, and pillows;
new text end

new text begin (2) an allergen-rated vacuum cleaner, filters, and bags;
new text end

new text begin (3) a dehumidifier and filters;
new text end

new text begin (4) HEPA single-room air cleaners and filters;
new text end

new text begin (5) integrated pest management, including traps and starter packages of food storage
containers;
new text end

new text begin (6) a damp mopping system;
new text end

new text begin (7) if the child does not have access to a bed, a waterproof hospital-grade mattress; and
new text end

new text begin (8) for homeowners only, furnace filters.
new text end

new text begin (d) The commissioner shall determine additional products that may be covered as new
best practices for asthma care are identified.
new text end

new text begin (e) A home assessment is a home visit to identify asthma triggers in the home and to
provide education on trigger-reducing products. A child is limited to two home assessments
except that a child may receive an additional home assessment if the child moves to a new
home; if a new asthma trigger, including tobacco smoke, enters the home; or if the child's
health care provider identifies a new allergy for the child, including an allergy to mold,
pests, pets, or dust mites. The commissioner shall determine the frequency with which a
child may receive a product under paragraph (c) or (d) based on the reasonable expected
lifetime of the product.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 17.

Minnesota Statutes 2020, section 256B.0631, subdivision 1, is amended to read:

Subdivision 1.

Cost-sharing.

(a) Except as provided in subdivision 2, the medical
assistance benefit plan shall include the following cost-sharing for all recipients, effective
for services provided on or after September 1, 2011:

(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes of this
subdivision, a visit means an episode of service which is required because of a recipient's
symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting
by a physician or physician assistant, chiropractor, podiatrist, nurse midwife, advanced
practice nurse, audiologist, optician, or optometrist;

(2) $3.50 for nonemergency visits to a hospital-based emergency room, except that this
co-payment shall be increased to $20 upon federal approval;

(3) $3 per brand-name drug prescription deleted text begin anddeleted text end new text begin ,new text end $1 per generic drug prescription, new text begin and $1
per prescription for a brand-name multisource drug listed in preferred status on the preferred
drug list, new text end subject to a $12 per month maximum for prescription drug co-payments. No
co-payments shall apply to antipsychotic drugs when used for the treatment of mental illness;

(4) a family deductible equal to $2.75 per month per family and adjusted annually by
the percentage increase in the medical care component of the CPI-U for the period of
September to September of the preceding calendar year, rounded to the next higher five-cent
increment; and

(5) total monthly cost-sharing must not exceed five percent of family income. For
purposes of this paragraph, family income is the total earned and unearned income of the
individual and the individual's spouse, if the spouse is enrolled in medical assistance and
also subject to the five percent limit on cost-sharing. This paragraph does not apply to
premiums charged to individuals described under section 256B.057, subdivision 9.

(b) Recipients of medical assistance are responsible for all co-payments and deductibles
in this subdivision.

(c) Notwithstanding paragraph (b), the commissioner, through the contracting process
under sections 256B.69 and 256B.692, may allow managed care plans and county-based
purchasing plans to waive the family deductible under paragraph (a), clause (4). The value
of the family deductible shall not be included in the capitation payment to managed care
plans and county-based purchasing plans. Managed care plans and county-based purchasing
plans shall certify annually to the commissioner the dollar value of the family deductible.

(d) Notwithstanding paragraph (b), the commissioner may waive the collection of the
family deductible described under paragraph (a), clause (4), from individuals and allow
long-term care and waivered service providers to assume responsibility for payment.

(e) Notwithstanding paragraph (b), the commissioner, through the contracting process
under section 256B.0756 shall allow the pilot program in Hennepin County to waive
co-payments. The value of the co-payments shall not be included in the capitation payment
amount to the integrated health care delivery networks under the pilot program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022.
new text end

Sec. 18.

Minnesota Statutes 2020, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 6f. new text end

new text begin Dental fee schedules. new text end

new text begin (a) A managed care plan, county-based purchasing plan,
or dental benefits administrator must provide individual dental providers, upon request, the
applicable fee schedules for covered dental services provided under the contract between
the dental provider and the managed care plan, county-based purchasing plan, or dental
benefits administrator.
new text end

new text begin (b) A managed care plan, county-based purchasing plan, or dental benefits administrator
may fulfill this requirement by making the applicable fee schedules available through a
secure web portal for the contracted dental provider to access.
new text end

new text begin (c) For purposes of this subdivision, "dental benefits administrator" means an organization
licensed under chapter 62C or 62D that contracts with a managed care plan or county-based
purchasing plan to provide covered dental care services to enrollees of the plan.
new text end

Sec. 19.

Minnesota Statutes 2020, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 6g. new text end

new text begin Uniform dental credentialing process. new text end

new text begin (a) By January 1, 2022, the managed
care plans, county-based purchasing plans, and dental benefit administrators that contract
with the commissioner or subcontract with plans to provide dental services to medical
assistance or MinnesotaCare enrollees shall develop a uniform credentialing process for
dental providers.
new text end

new text begin (b) The process developed in this subdivision must include a uniform credentialing
application that must be available in electronic format and accessible on each plan or dental
benefit administrator's website. The process developed under this subdivision must include
an option to electronically submit a completed application. The uniform credentialing
application must be available for free to providers.
new text end

new text begin (c) If applicable, a managed care plan, county-based purchasing plan, dental benefit
administrator, contractor, or vendor that reviews and approves a credentialing application
must notify a provider regarding a deficiency on a submitted credentialing application form
no later than 30 business days after receiving the application form from the provider.
new text end

new text begin (d) For purposes of this subdivision, "dental benefits administrator" means an
organization, including an organization licensed under chapter 62C or 62D, that contracts
with a managed care plan or county-based purchasing plan to provide covered dental care
services to enrollees of the plan.
new text end

new text begin (e) This subdivision must be in compliance with the federal requirements for Medicaid
and Basic Health Program provider enrollment.
new text end

Sec. 20.

Minnesota Statutes 2020, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 9f. new text end

new text begin Annual report on provider reimbursement rates. new text end

new text begin (a) The commissioner,
by December 15 of each year, beginning December 15, 2021, shall submit to the chairs and
ranking minority members of the legislative committees with jurisdiction over health care
policy and finance a report on managed care and county-based purchasing plan provider
reimbursement rates.
new text end

new text begin (b) The report must include, for each managed care and county-based purchasing plan,
the mean and median provider reimbursement rates by county for the calendar year preceding
the reporting year, for the five most common billing codes statewide across all plans, in
each of the following provider service categories if within the county there are more than
three medical assistance enrolled providers providing the specific service within the specific
category:
new text end

new text begin (1) physician prenatal services;
new text end

new text begin (2) physician preventive services;
new text end

new text begin (3) physician services other than prenatal or preventive;
new text end

new text begin (4) dental services;
new text end

new text begin (5) inpatient hospital services;
new text end

new text begin (6) outpatient hospital services; and
new text end

new text begin (7) mental health services.
new text end

new text begin (c) The commissioner shall also include in the report:
new text end

new text begin (1) the mean and median reimbursement rates across all plans by county for the calendar
year preceding the reporting year for the billing codes and provider service categories
described in paragraph (b); and
new text end

new text begin (2) the mean and median fee-for-service reimbursement rates by county for the calendar
year preceding the reporting year for the billing codes and provider service categories
described in paragraph (b).
new text end

Sec. 21.

Minnesota Statutes 2020, section 256B.75, is amended to read:

256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.

(a) For outpatient hospital facility fee payments for services rendered on or after October
1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge,
or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for
which there is a federal maximum allowable payment. Effective for services rendered on
or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and
emergency room facility fees shall be increased by eight percent over the rates in effect on
December 31, 1999, except for those services for which there is a federal maximum allowable
payment. Services for which there is a federal maximum allowable payment shall be paid
at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total
aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare
upper limit. If it is determined that a provision of this section conflicts with existing or
future requirements of the United States government with respect to federal financial
participation in medical assistance, the federal requirements prevail. The commissioner
may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial
participation resulting from rates that are in excess of the Medicare upper limitations.

(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory
surgery hospital facility fee services for critical access hospitals designated under section
144.1483, clause (9), shall be paid on a cost-based payment system that is based on the
cost-finding methods and allowable costs of the Medicare program. Effective for services
provided on or after July 1, 2015, rates established for critical access hospitals under this
paragraph for the applicable payment year shall be the final payment and shall not be settled
to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal
year ending in 2017, the rate for outpatient hospital services shall be computed using
information from each hospital's Medicare cost report as filed with Medicare for the year
that is two years before the year that the rate is being computed. Rates shall be computed
using information from Worksheet C series until the department finalizes the medical
assistance cost reporting process for critical access hospitals. After the cost reporting process
is finalized, rates shall be computed using information from Title XIX Worksheet D series.
The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs
related to rural health clinics and federally qualified health clinics, divided by ancillary
charges plus outpatient charges, excluding charges related to rural health clinics and federally
qualified health clinics.

(c) Effective for services provided on or after July 1, 2003, rates that are based on the
Medicare outpatient prospective payment system shall be replaced by a budget neutral
prospective payment system that is derived using medical assistance data. The commissioner
shall provide a proposal to the 2003 legislature to define and implement this provision.new text begin
When implementing prospective payment methodologies, the commissioner shall use general
methods and rate calculation parameters similar to the applicable Medicare prospective
payment systems for services delivered in outpatient hospital and ambulatory surgical center
settings unless other payment methodologies for these services are specified in this chapter.
new text end

(d) For fee-for-service services provided on or after July 1, 2002, the total payment,
before third-party liability and spenddown, made to hospitals for outpatient hospital facility
services is reduced by .5 percent from the current statutory rate.

(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility
services before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from
this paragraph.

(f) In addition to the reductions in paragraphs (d) and (e), the total payment for
fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
hospital facility services before third-party liability and spenddown, is reduced three percent
from the current statutory rates. Mental health services and facilities defined under section
256.969, subdivision 16, are excluded from this paragraph.

Sec. 22.

Minnesota Statutes 2020, section 256B.76, subdivision 2, is amended to read:

Subd. 2.

Dental reimbursement.

(a) Effective for services rendered on or after October
1, 1992, the commissioner shall make payments for dental services as follows:

(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent
above the rate in effect on June 30, 1992; and

(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile
of 1989, less the percent in aggregate necessary to equal the above increases.

(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.

(c) Effective for services rendered on or after January 1, 2000, payment rates for dental
services shall be increased by three percent over the rates in effect on December 31, 1999.

(d) Effective for services provided on or after January 1, 2002, payment for diagnostic
examinations and dental x-rays provided to children under age 21 shall be the lower of (1)
the submitted charge, or (2) 85 percent of median 1999 charges.

(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000,
for managed care.

(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated
dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare
principles of reimbursement. This payment shall be effective for services rendered on or
after January 1, 2011, to recipients enrolled in managed care plans or county-based
purchasing plans.

(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in
paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a
supplemental state payment equal to the difference between the total payments in paragraph
(f) and $1,850,000 shall be paid from the general fund to state-operated services for the
operation of the dental clinics.

deleted text begin (h) If the cost-based payment system for state-operated dental clinics described in
paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
designated as critical access dental providers under subdivision 4, paragraph (b), and shall
receive the critical access dental reimbursement rate as described under subdivision 4,
paragraph (a).
deleted text end

deleted text begin (i) Effective for services rendered on or after September 1, 2011, through June 30, 2013,
payment rates for dental services shall be reduced by three percent. This reduction does not
apply to state-operated dental clinics in paragraph (f).
deleted text end

deleted text begin (j)deleted text end new text begin (h)new text end Effective for services rendered on or after January 1, 2014new text begin , through December
31, 2021new text end , payment rates for dental services shall be increased by five percent from the rates
in effect on December 31, 2013. This increase does not apply to state-operated dental clinics
in paragraph (f), federally qualified health centers, rural health centers, and Indian health
services. Effective January 1, 2014, payments made to managed care plans and county-based
purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment
increase described in this paragraph.

deleted text begin (k) Effective for services rendered on or after July 1, 2015, through December 31, 2016,
the commissioner shall increase payment rates for services furnished by dental providers
located outside of the seven-county metropolitan area by the maximum percentage possible
above the rates in effect on June 30, 2015, while remaining within the limits of funding
appropriated for this purpose. This increase does not apply to state-operated dental clinics
in paragraph (f), federally qualified health centers, rural health centers, and Indian health
services. Effective January 1, 2016, through December 31, 2016, payments to managed care
plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect
the payment increase described in this paragraph. The commissioner shall require managed
care and county-based purchasing plans to pass on the full amount of the increase, in the
form of higher payment rates to dental providers located outside of the seven-county
metropolitan area.
deleted text end

deleted text begin (l)deleted text end new text begin (i)new text end Effective for services provided on or after January 1, 2017new text begin , through December 31,
2021new text end , the commissioner shall increase payment rates by 9.65 percent for dental services
provided outside of the seven-county metropolitan area. This increase does not apply to
state-operated dental clinics in paragraph (f), federally qualified health centers, rural health
centers, or Indian health services. Effective January 1, 2017, payments to managed care
plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect
the payment increase described in this paragraph.

deleted text begin (m)deleted text end new text begin (j)new text end Effective for services provided on or after July 1, 2017new text begin , through December 31,
2022new text end , the commissioner shall increase payment rates by 23.8 percent for dental services
provided to enrollees under the age of 21. This rate increase does not apply to state-operated
dental clinics in paragraph (f), federally qualified health centers, rural health centers, or
Indian health centers. This rate increase does not apply to managed care plans and
county-based purchasing plans.

new text begin (k) Effective for services provided on or after January 1, 2022, the commissioner shall
exclude from medical assistance and MinnesotaCare payments for dental services to public
health and community health clinics the 20 percent increase authorized under Laws 1989,
chapter 327, section 5, subdivision 2, paragraph (b).
new text end

new text begin (l) Effective for services provided on or after January 1, 2022, the commissioner shall
increase payment rates by 98 percent for all dental services. This rate increase does not
apply to state-operated dental clinics, federally qualified health centers, rural health centers,
or Indian health services.
new text end

new text begin (m) Managed care plans and county-based purchasing plans shall reimburse providers
at a level that is at least equal to the rate paid under fee-for-service for dental services. If,
for any coverage 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 an amount equal
to any increase in rates that results from this provision. If, for any coverage year, federal
approval is not received for this paragraph, the commissioner shall not implement this
paragraph for subsequent coverage years.
new text end

Sec. 23.

Minnesota Statutes 2020, section 256B.76, subdivision 4, is amended to read:

Subd. 4.

Critical access dental providers.

(a) The commissioner shall increase
reimbursements to dentists and dental clinics deemed by the commissioner to be critical
access dental providers. For dental services rendered on or after July 1, 2016new text begin , through
December 31, 2021new text end , the commissioner shall increase reimbursement by 37.5 percent above
the reimbursement rate that would otherwise be paid to the critical access dental provider,
except as specified under paragraph (b). The commissioner shall pay the managed care
plans and county-based purchasing plans in amounts sufficient to reflect increased
reimbursements to critical access dental providers as approved by the commissioner.

(b) For dental services rendered on or after July 1, 2016new text begin , through December 31, 2021new text end ,
by a dental clinic or dental group that meets the critical access dental provider designation
under paragraph deleted text begin (d)deleted text end new text begin (f)new text end , clause (4), and is owned and operated by a health maintenance
organization licensed under chapter 62D, the commissioner shall increase reimbursement
by 35 percent above the reimbursement rate that would otherwise be paid to the critical
access provider.

new text begin (c) The commissioner shall increase reimbursement to dentists and dental clinics deemed
by the commissioner to be critical access dental providers. For dental services provided on
or after January 1, 2022, by a dental provider deemed to be a critical access dental provider
under paragraph (f), the commissioner shall increase reimbursement by 20 percent above
the reimbursement rate that would otherwise be paid to the critical access dental provider.
This paragraph does not apply to federally qualified health centers, rural health centers,
state-operated dental clinics, or Indian health centers.
new text end

new text begin (d) Managed care plans and county-based purchasing plans shall increase reimbursement
to critical access dental providers by at least the amount specified in paragraph (c). If, for
any coverage 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 an amount equal
to any increase in rates that results from this provision. If, for any coverage year, federal
approval is not received for this paragraph, the commissioner shall not implement this
paragraph for subsequent coverage years.
new text end

deleted text begin (c)deleted text end new text begin (e)new text end Critical access dental payments made under deleted text begin paragraph (a) or (b)deleted text end new text begin this subdivisionnew text end
for dental services provided by a critical access dental provider to an enrollee of a managed
care plan or county-based purchasing plan must not reflect any capitated payments or
cost-based payments from the managed care plan or county-based purchasing plan. The
managed care plan or county-based purchasing plan must base the additional critical access
dental payment on the amount that would have been paid for that service had the dental
provider been paid according to the managed care plan or county-based purchasing plan's
fee schedule that applies to dental providers that are not paid under a capitated payment or
cost-based payment.

deleted text begin (d)deleted text end new text begin (f)new text end The commissioner shall designate the following dentists and dental clinics as
critical access dental providers:

(1) nonprofit community clinics that:

(i) have nonprofit status in accordance with chapter 317A;

(ii) have tax exempt status in accordance with the Internal Revenue Code, section
501(c)(3);

(iii) are established to provide oral health services to patients who are low income,
uninsured, have special needs, and are underserved;

(iv) have professional staff familiar with the cultural background of the clinic's patients;

(v) charge for services on a sliding fee scale designed to provide assistance to low-income
patients based on current poverty income guidelines and family size;

(vi) do not restrict access or services because of a patient's financial limitations or public
assistance status; and

(vii) have free care available as needed;

(2) federally qualified health centers, rural health clinics, and public health clinics;

(3) hospital-based dental clinics owned and operated by a city, county, or former state
hospital as defined in section 62Q.19, subdivision 1, paragraph (a), clause (4);

(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
accordance with chapter 317A with more than 10,000 patient encounters per year with
patients who are uninsured or covered by medical assistance or MinnesotaCare;

(5) a dental clinic owned and operated by the University of Minnesota or the Minnesota
State Colleges and Universities system; and

(6) private practicing dentists if:

(i) the dentist's office is located within the seven-county metropolitan area and more
than 50 percent of the dentist's patient encounters per year are with patients who are uninsured
or covered by medical assistance or MinnesotaCare; or

(ii) the dentist's office is located outside the seven-county metropolitan area and more
than 25 percent of the dentist's patient encounters per year are with patients who are uninsured
or covered by medical assistance or MinnesotaCare.

Sec. 24.

Minnesota Statutes 2020, section 256B.79, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For purposes of this section, the following terms have
the meanings given them.

(b) "Adverse outcomes" means maternal opiate addiction, other reportable prenatal
substance abuse, low birth weight, or preterm birth.

(c) "Qualified integrated perinatal care collaborative" or "collaborative" means a
combination of (1) members of community-based organizations that represent communities
within the identified targeted populations, and (2) local or tribally based service entities,
including health care, public health, social services, mental health, chemical dependency
treatment, and community-based providers, determined by the commissioner to meet the
criteria for the provision of integrated care and enhanced services for enrollees within
targeted populations.

(d) "Targeted populations" means pregnant medical assistance enrollees residing in
deleted text begin geographic areasdeleted text end new text begin communitiesnew text end identified by the commissioner as being at above-average
risk for adverse outcomes.

Sec. 25.

Minnesota Statutes 2020, section 256B.79, subdivision 3, is amended to read:

Subd. 3.

Grant awards.

The commissioner shall award grants to qualifying applicants
to support interdisciplinary, integrated perinatal care. Grant funds must be distributed through
a request for proposals process to a designated lead agency within an entity that has been
determined to be a qualified integrated perinatal care collaborative or within an entity in
the process of meeting the qualifications to become a qualified integrated perinatal care
collaborativedeleted text begin , and priority shall be given to qualified integrated perinatal care collaboratives
that received grants under this section prior to January 1, 2019deleted text end . Grant awards must be used
to support interdisciplinary, team-based needs assessments, planning, and implementation
of integrated care and enhanced services for targeted populations. In determining grant
award amounts, the commissioner shall consider the identified health and social risks linked
to adverse outcomes and attributed to enrollees within the identified targeted population.

Sec. 26.

new text begin [256B.795] MATERNAL AND INFANT HEALTH REPORT.
new text end

new text begin (a) The commissioner of human services, in consultation with the commissioner of
health, shall submit a biennial report beginning April 15, 2022, to the chairs and ranking
minority members of the legislative committees with jurisdiction over health policy and
finance on the effectiveness of state maternal and infant health policies and programs
addressing health disparities in prenatal and postpartum health outcomes. For each reporting
period, the commissioner shall determine the number of women enrolled in the medical
assistance program who are pregnant or are in the 12-month postpartum period of eligibility
and the percentage of women in that group who, during each reporting period:
new text end

new text begin (1) received prenatal services;
new text end

new text begin (2) received doula services;
new text end

new text begin (3) gave birth by primary cesarean section;
new text end

new text begin (4) gave birth to an infant who received care in the neonatal intensive care unit;
new text end

new text begin (5) gave birth to an infant who was premature or who had a low birth weight;
new text end

new text begin (6) experienced postpartum hemorrhage;
new text end

new text begin (7) received postpartum care within six weeks of giving birth; and
new text end

new text begin (8) received a prenatal and postpartum follow-up home visit from a public health nurse.
new text end

new text begin (b) These measurements must be determined through an analysis of the utilization data
from claims submitted during each reporting period and by any other appropriate means.
The measurements for each metric must be determined in the aggregate stratified by race
and ethnicity.
new text end

new text begin (c) The commissioner shall establish a baseline for the metrics described in paragraph
(a) using calendar year 2017. The initial report due April 15, 2022, must contain the baseline
metrics and the metrics data for calendar years 2019 and 2020. The following reports due
biennially thereafter must contain the metrics for the preceding two calendar years.
new text end

Sec. 27.

Minnesota Statutes 2020, section 256L.07, subdivision 2, is amended to read:

Subd. 2.

Must not have access to employer-subsidized minimum essential
coverage.

(a) To be eligible, a family or individual must not have access to subsidized health
coverage that is affordable and provides minimum value as defined in Code of Federal
Regulations, title 26, section 1.36B-2.

(b) new text begin Notwithstanding paragraph (a), an individual who has access through a spouse's or
parent's employer to subsidized health coverage that is deemed minimum essential coverage
under Code of Federal Regulations, title 26, section 1.36B-2, is eligible for MinnesotaCare
if the employee's portion of the annual premium for employee and dependent coverage
exceeds the required contribution percentage, as defined for premium tax credit eligibility
under United States Code, title 26, section 36B(c)(2)(C)(i)(II), as indexed according to item
(iv) of that section, of the individual's household income for the coverage year.
new text end

new text begin (c) new text end This subdivision does not apply to a family or individual who no longer has
employer-subsidized coverage due to the employer terminating health care coverage as an
employee benefit.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 28.

Minnesota Statutes 2020, section 256L.11, subdivision 6a, is amended to read:

Subd. 6a.

Dental providers.

new text begin (a) new text end Effective for dental services provided to MinnesotaCare
enrollees on or after January 1, 2018new text begin , to December 31, 2021new text end , the commissioner shall increase
payment rates to dental providers by 54 percent.

new text begin (b) Effective for dental services provided on or after January 1, 2022, payment rates to
dental providers shall equal the payment rates described in section 256B.76, subdivision 2.
new text end

new text begin (c) new text end Payments made to prepaid health plans under section 256L.12 shall reflect the payment
deleted text begin increasedeleted text end new text begin ratesnew text end described in this subdivision. The prepaid health plans under contract with
the commissioner shall provide payments to dental providers that are at least equal to a rate
that includes the payment rate specified in this subdivision, and if applicable to the provider,
the rates described under subdivision 7.

Sec. 29.

Minnesota Statutes 2020, section 256L.11, subdivision 7, is amended to read:

Subd. 7.

Critical access dental providers.

new text begin (a) new text end Effective for dental services provided to
MinnesotaCare enrollees on or after July 1, 2017, the commissioner shall increase payment
rates to dentists and dental clinics deemed by the commissioner to be critical access providers
under section 256B.76, subdivision 4, by 20 percent above the payment rate that would
otherwise be paid to the provider. The commissioner shall pay the prepaid health plans
under contract with the commissioner amounts sufficient to reflect this rate increase. deleted text begin The
prepaid health plan must pass this rate increase to providers who have been identified by
the commissioner as critical access dental providers under section 256B.76, subdivision 4.
deleted text end

new text begin (b) Managed care plans and county-based purchasing plans shall increase reimbursement
to critical access dental providers by at least the amount specified in paragraph (a). If, for
any coverage 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 an amount equal
to any increase in rates that results from this provision. If, for any coverage year, federal
approval is not received for this paragraph, the commissioner shall not implement this
paragraph for subsequent coverage years.
new text end

Sec. 30.

Minnesota Statutes 2020, section 256L.15, subdivision 2, is amended to read:

Subd. 2.

Sliding fee scale; monthly individual or family income.

(a) The commissioner
shall establish a sliding fee scale to determine the percentage of monthly individual or family
income that households at different income levels must pay to obtain coverage through the
MinnesotaCare program. The sliding fee scale must be based on the enrollee's monthly
individual or family income.

(b) Beginning January 1, 2014, MinnesotaCare enrollees shall pay premiums according
to the premium scale specified in paragraph (d).

(1) children 20 years of age or younger; and

(2) individuals with household incomes below 35 percent of the federal poverty
guidelines.

(d) The following premium scale is established for each individual in the household who
is 21 years of age or older and enrolled in MinnesotaCare:

Federal Poverty Guideline Greater than or Equal to	Less than	Individual Premium Amount
35%	55%	$4
55%	80%	$6
80%	90%	$8
90%	100%	$10
100%	110%	$12
110%	120%	$14
120%	130%	$15
130%	140%	$16
140%	150%	$25
150%	160%	$37
160%	170%	$44
170%	180%	$52
180%	190%	$61
190%	200%	$71
200%		$80

new text begin (e) Beginning January 1, 2021, the commissioner shall adjust the premium scale
established under paragraph (d) to ensure that premiums do not exceed the amount that an
individual would have been required to pay if the individual was enrolled in an applicable
benchmark plan in accordance with the Code of Federal Regulations, title 42, section
600.505(a)(1).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from January 1, 2021 and
applies to premiums due on or after that date.
new text end

Sec. 31. new text begin FEDERAL APPROVAL; EXTENSION OF POSTPARTUM COVERAGE.
new text end

new text begin The commissioner of human services shall seek all federal waivers and approvals
necessary to extend medical assistance postpartum coverage, as provided in Minnesota
Statutes, sections 256B.055, subdivision 6, and 256B.06, subdivision 4.
new text end

Sec. 32. new text begin COVID-19 TREATMENT, TESTING, AND VACCINATION.
new text end

new text begin Medical assistance covers treatment, testing, and vaccination for COVID-19 as required
under and for the time periods specified in section 9811 of the federal American Rescue
Plan Act, Public Law 117-2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from March 11, 2021.
new text end

Sec. 33. new text begin DENTAL HOME DEMONSTRATION PROJECT.
new text end

new text begin (a) The Dental Services Advisory Committee, in collaboration with stakeholders, shall
design a dental home demonstration project and present recommendations by February 1,
2022, to the commissioner and the chairs and ranking minority members of the legislative
committees with jurisdiction over health finance and policy.
new text end

new text begin (b) The Dental Services Advisory Committee, at a minimum, shall engage with the
following stakeholders: the Minnesota Department of Health, the Minnesota Dental
Association, the Minnesota Dental Hygienists' Association, the University of Minnesota
School of Dentistry, dental programs operated by the Minnesota State Colleges and
Universities system, and representatives of each of the following dental provider types
serving medical assistance and MinnesotaCare enrollees:
new text end

new text begin (1) private practice dental clinics for which medical assistance and MinnesotaCare
enrollees comprise more than 25 percent of the clinic's patient load;
new text end

new text begin (2) private practice dental clinics for which medical assistance and MinnesotaCare
enrollees comprise 25 percent or less of the clinic's patient load;
new text end

new text begin (3) nonprofit dental clinics with a primary focus on serving Indigenous communities
and other communities of color;
new text end

new text begin (4) nonprofit dental clinics with a primary focus on providing eldercare;
new text end

new text begin (5) nonprofit dental clinics with a primary focus on serving children;
new text end

new text begin (6) nonprofit dental clinics providing services within the seven-county metropolitan
area;
new text end

new text begin (7) nonprofit dental clinics providing services outside of the seven-county metropolitan
area; and
new text end

new text begin (8) multispecialty hospital-based dental clinics.
new text end

new text begin (c) The dental home demonstration project shall give incentives for qualified providers
that provide high-quality, patient-centered, comprehensive, and coordinated oral health
services. The demonstration project shall seek to increase the number of new dental providers
serving medical assistance and MinnesotaCare enrollees and increase the capacity of existing
providers. The demonstration project must test payment methods that establish value-based
incentives to:
new text end

new text begin (1) increase the extent to which current dental providers serve medical assistance and
MinnesotaCare enrollees across their lifespan;
new text end

new text begin (2) develop service models that create equity and reduce disparities in access to dental
services for high-risk and medically and socially complex enrollees;
new text end

new text begin (3) advance alternative delivery models of care within community settings using
evidence-based approaches and innovative workforce teams; and
new text end

new text begin (4) improve the quality of dental care by meeting dental home goals.
new text end

Sec. 34. new text begin OVERPAYMENTS FOR DURABLE MEDICAL EQUIPMENT,
PROSTHETICS, ORTHOTICS, OR SUPPLIES.
new text end

new text begin (a) Notwithstanding any other law to the contrary, providers who received payment for
durable medical equipment, prosthetics, orthotics, or supplies between January 1, 2018, and
June 30, 2019, that were subject to the upper payment limits under United States Code, title
42, section 1396b(i)(27), shall not be required to repay any amount received in excess of
the allowable amount to either the state or the Centers for Medicare and Medicaid Services.
new text end

new text begin (b) The state shall repay with state funds any amount owed to the Centers for Medicare
and Medicaid Services for the federal financial participation amount received by the state
for payments identified in paragraph (a) in excess of the amount allowed effective January
1, 2018, and the state shall hold harmless the providers who received these payments from
recovery of both the state and federal share of the amount determined to have exceeded the
Medicare upper payment limit.
new text end

new text begin (c) Nothing in this section shall be construed to prohibit the commissioner from recouping
past overpayments due to false claims or for reasons other than exceeding the Medicare
upper payment limits or from recouping future overpayments including the recoupment of
payments that exceed the upper Medicare payment limits.
new text end

Sec. 35. new text begin PROPOSED FORMULARY COMMITTEE.
new text end

new text begin By March 1, 2022, the commissioner of human services, after soliciting recommendations
from professional medical associations, professional pharmacy associations, and consumer
groups, shall submit to the chairs and ranking minority members of the legislative committees
with jurisdiction over health and human services an overview of the Formulary Committee
under Minnesota Statutes, section 256B.0625, subdivision 13c, that includes:
new text end

new text begin (1) a review of the current composition of and any recommended revisions to the
membership of the committee. The review shall ensure the committee is composed of
adequate representation of consumers and health care professionals with expertise in clinical
prescribing; and
new text end

new text begin (2) a summary of the committee's policies and procedures for the operation of the
committee, opportunities for public input, providing public notice, and gathering public
comments on the committee's recommendations and proposed actions.
new text end

Sec. 36. new text begin RESPONSE TO COVID-19 PUBLIC HEALTH EMERGENCY.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 256B.057, subdivision 9, 256L.06,
subdivision 3, or any other provision to the contrary, the commissioner shall not collect any
unpaid premium for a coverage month that occurred during the COVID-19 public health
emergency declared by the United States Secretary of Health and Human Services.
new text end

new text begin (b) Notwithstanding any provision to the contrary, periodic data matching under
Minnesota Statutes, section 256B.0561, subdivision 2, may be suspended for up to six
months following the last day of the COVID-19 public health emergency declared by the
United States Secretary of Health and Human Services.
new text end

new text begin (c) Notwithstanding any provision to the contrary, the requirement for the commissioner
of human services to issue an annual report on periodic data matching under Minnesota
Statutes, section 256B.0561, is suspended for one year following the last day of the
COVID-19 public health emergency declared by the United States Secretary of Health and
Human Services.
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. 37. new text begin DENTAL PROGRAM DELIVERY STUDY.
new text end

new text begin (a) The commissioner of human services shall review the Medicaid dental program
delivery systems in states that have enacted and implemented a carve out dental delivery
system. At a minimum, the review must compare in those states program design, provider
rates, program costs, including administrative costs, and quality metrics for children one
through 20 years of age with at least one preventive dental service within a year.
new text end

new text begin (b) The commissioner, in consultation with interested stakeholders, shall also conduct
an analysis of dental provider hesitancy to participate in the medical assistance program as
an enrolled provider.
new text end

new text begin (c) By February 1, 2022, the commissioner shall submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance the results of the review and analysis described in this section. The
commissioner may combine the requirements in this section with the dental home
demonstration project report due on February 1, 2022.
new text end

Sec. 38. new text begin DENTAL RATE REBASING.
new text end

new text begin The commissioner of human services shall present recommendations on dental rate
rebasing to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services finance and policy by February 1, 2022. The
recommendations must be consistent with the proposed design of the dental home
demonstration project and must address the frequency of rebasing, whether rebasing should
incorporate an inflation factor, and other factors relevant to ensuring patient access to dental
providers and the delivery of high quality dental care.
new text end

Sec. 39. new text begin CONTINGENT FUNDING RELATED TO DENTAL ADMINISTRATOR.
new text end

new text begin If managed care and county-based purchasing plans do not meet in the aggregate the
dental access performance benchmark under Minnesota Statutes, section 256B.0371,
subdivision 1, for coverage year 2024, the general fund base for the department of human
services for the 2026-2027 biennium shall include $107,000 in fiscal year 2026 and $122,000
in fiscal year 2027 for staffing necessary to contract with a dental administrator, and $5,000
in fiscal year 2026 and $1,000 in fiscal year 2027 for systems changes necessary to contract
with a dental administrator.
new text end

Sec. 40. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Rules, parts 9505.0275; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6,
7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, and 22; 9505.1699; 9505.1701; 9505.1703;
9505.1706; 9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730;
9505.1733; 9505.1736; 9505.1739; 9505.1742; 9505.1745; and 9505.1748, new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2020, section 16A.724, subdivision 2, new text end new text begin is repealed effective July
1, 2025.
new text end

ARTICLE 2

DEPARTMENT OF HUMAN SERVICES
LICENSING AND BACKGROUND STUDIES

Section 1.

Minnesota Statutes 2020, section 62V.05, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Background study required. new text end

new text begin (a) The board must initiate background studies
under section 245C.031 of:
new text end

new text begin (1) each navigator;
new text end

new text begin (2) each in-person assister; and
new text end

new text begin (3) each certified application counselor.
new text end

new text begin (b) The board may initiate the background studies required by paragraph (a) using the
online NETStudy 2.0 system operated by the commissioner of human services.
new text end

new text begin (c) The board shall not permit any individual to provide any service or function listed
in paragraph (a) until the board has received notification from the commissioner of human
services indicating that the individual:
new text end

new text begin (1) is not disqualified under chapter 245C; or
new text end

new text begin (2) is disqualified, but has received a set aside from the board of that disqualification
according to sections 245C.22 and 245C.23.
new text end

new text begin (d) The board or its delegate shall review a reconsideration request of an individual in
paragraph (a), including granting a set aside, according to the procedures and criteria in
chapter 245C. The board shall notify the individual and the Department of Human Services
of the board's decision.
new text end

Sec. 2.

Minnesota Statutes 2020, section 122A.18, subdivision 8, is amended to read:

Subd. 8.

Background deleted text begin checksdeleted text end new text begin studiesnew text end .

(a) The Professional Educator Licensing and
Standards Board and the Board of School Administrators must deleted text begin obtain adeleted text end new text begin initiatenew text end criminal
history background deleted text begin check ondeleted text end new text begin studies ofnew text end all first-time deleted text begin teachingdeleted text end applicants for new text begin educator new text end licenses
under their jurisdiction. Applicants must include with their licensure applications:

(1) an executed criminal history consent form, including fingerprints; and

(2) payment to conduct the background deleted text begin checkdeleted text end new text begin studynew text end . The Professional Educator Licensing
and Standards Board must deposit payments received under this subdivision in an account
in the special revenue fund. Amounts in the account are annually appropriated to the
Professional Educator Licensing and Standards Board to pay for the costs of background
deleted text begin checksdeleted text end new text begin studiesnew text end on applicants for licensure.

(b) The background deleted text begin checkdeleted text end new text begin studynew text end for all first-time teaching applicants for licenses must
include a review of information from the Bureau of Criminal Apprehension, including
criminal history data as defined in section 13.87, and must also include a review of the
national criminal records repository. The superintendent of the Bureau of Criminal
Apprehension is authorized to exchange fingerprints with the Federal Bureau of Investigation
for purposes of the criminal history check. deleted text begin The superintendent shall recover the cost to the
bureau of a background check through the fee charged to the applicant under paragraph (a).
deleted text end

(c) The Professional Educator Licensing and Standards Board deleted text begin must contract withdeleted text end new text begin may
initiate criminal history background studies throughnew text end the commissioner of human services
new text begin according to section 245C.031 new text end to deleted text begin conduct background checks anddeleted text end obtain background deleted text begin checkdeleted text end
new text begin studynew text end data required under this chapter.

Sec. 3.

new text begin [245.975] OMBUDSPERSON FOR FAMILY CHILD CARE PROVIDERS.
new text end

new text begin Subdivision 1. new text end

new text begin Appointment. new text end

new text begin The governor shall appoint an ombudsperson in the
unclassified service to assist family child care providers with licensing, compliance, and
other issues facing family child care providers. The ombudsperson must be selected without
regard to the person's political affiliation and must have been a licensed family child care
provider for at least three years. The ombudsperson shall serve a term of four years, which
may be renewed, and may be removed prior to the end of the term for just cause.
new text end

new text begin Subd. 2. new text end

new text begin Duties. new text end

new text begin (a) The ombudsperson's duties shall include:
new text end

new text begin (1) advocating on behalf of a family child care provider to address all areas of concern
related to the provision of child care services, including licensing monitoring activities,
licensing actions, and other interactions with state and county licensing staff;
new text end

new text begin (2) providing recommendations for family child care improvement or family child care
provider education;
new text end

new text begin (3) operating a telephone line to answer questions, receive complaints, and discuss
agency actions when a family child care provider believes that the provider's rights or
program may have been adversely affected; and
new text end

new text begin (4) assisting a family child care license applicant with navigating the application process.
new text end

new text begin (b) The ombudsperson must report annually by December 31 to the commissioner and
the chairs and ranking minority members of the legislative committees with jurisdiction
over child care on the services provided by the ombudsperson to child care providers,
including the number and locations of child care providers served and the activities of the
ombudsperson in carrying out the duties under this section. The commissioner shall determine
the form of the report and may specify additional reporting requirements.
new text end

new text begin Subd. 3. new text end

new text begin Staff. new text end

new text begin The ombudsperson may appoint and compensate out of available funds
a deputy, confidential secretary, and other employees in the unclassified service as authorized
by law. The ombudsperson and the full-time staff are members of the Minnesota State
Retirement Association. The ombudsperson may delegate to staff members any authority
or duties of the office, except the duty to provide reports to the governor, commissioner, or
the legislature.
new text end

new text begin Subd. 4. new text end

new text begin Access to records. new text end

new text begin (a) The ombudsperson or designee, excluding volunteers,
has access to any data of a state agency necessary for the discharge of the ombudsperson's
duties, including records classified as confidential data on individuals or private data on
individuals under chapter 13 or any other law. The ombudsperson's data request must relate
to a specific case and is subject to section 13.03, subdivision 4. If the data concerns an
individual, the ombudsperson or designee shall first obtain the individual's consent. If the
individual is unable to consent and has no parent or legal guardian, then the ombudsperson's
or designee's access to the data is authorized by this section.
new text end

new text begin (b) The ombudsperson and designees must adhere to the Minnesota Government Data
Practices Act and must not disseminate any private or confidential data on individuals unless
specifically authorized by state, local, or federal law or pursuant to a court order.
new text end

new text begin (c) The commissioner and any county agency must provide the ombudsperson copies
of all fix-it tickets, correction orders, and licensing actions issued to family child care
providers.
new text end

new text begin Subd. 5. new text end

new text begin Independence of action. new text end

new text begin In carrying out the duties under this section, the
ombudsperson may, independently of the department, provide testimony to the legislature,
make periodic reports to the legislature, and address areas of concern to family child care
providers.
new text end

new text begin Subd. 6. new text end

new text begin Civil actions. new text end

new text begin The ombudsperson or designee is not civilly liable for any action
taken under this section if the action was taken in good faith, was within the scope of the
ombudsperson's authority, and did not constitute willful or reckless misconduct.
new text end

new text begin Subd. 7. new text end

new text begin Qualifications. new text end

new text begin The ombudsperson must be a person who has knowledge and
experience concerning the provision of family child care. The ombudsperson must be
experienced in dealing with governmental entities, interpretation of laws and regulations,
investigations, record keeping, report writing, public speaking, and management. A person
is not eligible to serve as the ombudsperson while running for or holding public office or
while holding a family child care license.
new text end

new text begin Subd. 8. new text end

new text begin Office support. new text end

new text begin The commissioner shall provide the ombudsperson with the
necessary office space, supplies, equipment, and clerical support to effectively perform the
duties under this section.
new text end

new text begin Subd. 9. new text end

new text begin Posting. new text end

new text begin (a) The commissioner shall post on the department's website the
mailing address, e-mail address, and telephone number for the office of the ombudsperson.
The commissioner shall provide family child care providers with the mailing address, e-mail
address, and telephone number of the ombudsperson's office on the family child care licensing
website and upon request of a family child care applicant or provider. Counties must provide
family child care applicants and providers with the name, mailing address, e-mail address,
and telephone number of the ombudsperson's office upon request.
new text end

new text begin (b) The ombudsperson must approve all postings and notices required by the department
and counties under this subdivision.
new text end

Sec. 4.

Minnesota Statutes 2020, section 245A.05, is amended to read:

245A.05 DENIAL OF APPLICATION.

(a) The commissioner may deny a license if an applicant or controlling individual:

(1) fails to submit a substantially complete application after receiving notice from the
commissioner under section 245A.04, subdivision 1;

(2) fails to comply with applicable laws or rules;

(3) knowingly withholds relevant information from or gives false or misleading
information to the commissioner in connection with an application for a license or during
an investigation;

(4) has a disqualification that has not been set aside under section 245C.22 and no
variance has been granted;

(5) has an individual living in the household who received a background study under
section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that
has not been set aside under section 245C.22, and no variance has been granted;

(6) is associated with an individual who received a background study under section
245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to
children or vulnerable adults, and who has a disqualification that has not been set aside
under section 245C.22, and no variance has been granted;

(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g);

(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision
6;

(9) has a history of noncompliance as a license holder or controlling individual with
applicable laws or rules, including but not limited to this chapter and chapters 119B and
245C; deleted text begin or
deleted text end

(10) is prohibited from holding a license according to section 245.095deleted text begin .deleted text end new text begin ; or
new text end

new text begin (11) for a family foster setting, has nondisqualifying background study information, as
described in section 245C.05, subdivision 4, that reflects on the individual's ability to safely
provide care to foster children.
new text end

(b) An applicant whose application has been denied by the commissioner must be given
notice of the denial, which must state the reasons for the denial in plain language. Notice
must be given by certified mail or personal service. The notice must state the reasons the
application was denied and must inform the applicant of the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The applicant may
appeal the denial by notifying the commissioner in writing by certified mail or personal
service. If mailed, the appeal must be postmarked and sent to the commissioner within 20
calendar days after the applicant received the notice of denial. If an appeal request is made
by personal service, it must be received by the commissioner within 20 calendar days after
the applicant received the notice of denial. Section 245A.08 applies to hearings held to
appeal the commissioner's denial of an application.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 5.

Minnesota Statutes 2020, section 245A.07, subdivision 1, is amended to read:

Subdivision 1.

Sanctions; appeals; license.

(a) In addition to making a license conditional
under section 245A.06, the commissioner may suspend or revoke the license, impose a fine,
or secure an injunction against the continuing operation of the program of a license holder
who does not comply with applicable law or rulenew text begin , or who has nondisqualifying background
study information, as described in section 245C.05, subdivision 4, that reflects on the license
holder's ability to safely provide care to foster childrennew text end . When applying sanctions authorized
under this section, the commissioner shall consider the nature, chronicity, or severity of the
violation of law or rule and the effect of the violation on the health, safety, or rights of
persons served by the program.

(b) If a license holder appeals the suspension or revocation of a license and the license
holder continues to operate the program pending a final order on the appeal, the commissioner
shall issue the license holder a temporary provisional license. Unless otherwise specified
by the commissioner, variances in effect on the date of the license sanction under appeal
continue under the temporary provisional license. If a license holder fails to comply with
applicable law or rule while operating under a temporary provisional license, the
commissioner may impose additional sanctions under this section and section 245A.06, and
may terminate any prior variance. If a temporary provisional license is set to expire, a new
temporary provisional license shall be issued to the license holder upon payment of any fee
required under section 245A.10. The temporary provisional license shall expire on the date
the final order is issued. If the license holder prevails on the appeal, a new nonprovisional
license shall be issued for the remainder of the current license period.

(c) If a license holder is under investigation and the license issued under this chapter is
due to expire before completion of the investigation, the program shall be issued a new
license upon completion of the reapplication requirements and payment of any applicable
license fee. Upon completion of the investigation, a licensing sanction may be imposed
against the new license under this section, section 245A.06, or 245A.08.

(d) Failure to reapply or closure of a license issued under this chapter by the license
holder prior to the completion of any investigation shall not preclude the commissioner
from issuing a licensing sanction under this section or section 245A.06 at the conclusion
of the investigation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 6.

Minnesota Statutes 2020, section 245A.10, subdivision 4, as amended by Laws
2021, chapter 30, article 17, section 47, is amended to read:

Subd. 4.

License or certification fee for certain programs.

(a) Child care centers shall
pay an annual nonrefundable license fee based on the following schedule:

	Licensed Capacity	Child Care Center License Fee
	1 to 24 persons	$200
	25 to 49 persons	$300
	50 to 74 persons	$400
	75 to 99 persons	$500
	100 to 124 persons	$600
	125 to 149 persons	$700
	150 to 174 persons	$800
	175 to 199 persons	$900
	200 to 224 persons	$1,000
	225 or more persons	$1,100

(b)(1) A program licensed to provide one or more of the home and community-based
services and supports identified under chapter 245D to persons with disabilities or age 65
and older, shall pay an annual nonrefundable license fee based on revenues derived from
the provision of services that would require licensure under chapter 245D during the calendar
year immediately preceding the year in which the license fee is paid, according to the
following schedule:

License Holder Annual Revenue		License Fee
less than or equal to $10,000		$200
greater than $10,000 but less than or equal to $25,000		$300
greater than $25,000 but less than or equal to $50,000		$400
greater than $50,000 but less than or equal to $100,000		$500
greater than $100,000 but less than or equal to $150,000		$600
greater than $150,000 but less than or equal to $200,000		$800
greater than $200,000 but less than or equal to $250,000		$1,000
greater than $250,000 but less than or equal to $300,000		$1,200
greater than $300,000 but less than or equal to $350,000		$1,400
greater than $350,000 but less than or equal to $400,000		$1,600
greater than $400,000 but less than or equal to $450,000		$1,800
greater than $450,000 but less than or equal to $500,000		$2,000
greater than $500,000 but less than or equal to $600,000		$2,250
greater than $600,000 but less than or equal to $700,000		$2,500
greater than $700,000 but less than or equal to $800,000		$2,750
greater than $800,000 but less than or equal to $900,000		$3,000
greater than $900,000 but less than or equal to $1,000,000		$3,250
greater than $1,000,000 but less than or equal to $1,250,000		$3,500
greater than $1,250,000 but less than or equal to $1,500,000		$3,750
greater than $1,500,000 but less than or equal to $1,750,000		$4,000
greater than $1,750,000 but less than or equal to $2,000,000		$4,250
greater than $2,000,000 but less than or equal to $2,500,000		$4,500
greater than $2,500,000 but less than or equal to $3,000,000		$4,750
greater than $3,000,000 but less than or equal to $3,500,000		$5,000
greater than $3,500,000 but less than or equal to $4,000,000		$5,500
greater than $4,000,000 but less than or equal to $4,500,000		$6,000
greater than $4,500,000 but less than or equal to $5,000,000		$6,500
greater than $5,000,000 but less than or equal to $7,500,000		$7,000
greater than $7,500,000 but less than or equal to $10,000,000		$8,500
greater than $10,000,000 but less than or equal to $12,500,000		$10,000
greater than $12,500,000 but less than or equal to $15,000,000		$14,000
greater than $15,000,000		$18,000

(2) If requested, the license holder shall provide the commissioner information to verify
the license holder's annual revenues or other information as needed, including copies of
documents submitted to the Department of Revenue.

(3) At each annual renewal, a license holder may elect to pay the highest renewal fee,
and not provide annual revenue information to the commissioner.

(4) A license holder that knowingly provides the commissioner incorrect revenue amounts
for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount
of double the fee the provider should have paid.

(5) Notwithstanding clause (1), a license holder providing services under one or more
licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license
fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license
holder for all licenses held under chapter 245B for calendar year 2013. For calendar year
2017 and thereafter, the license holder shall pay an annual license fee according to clause
(1).

(c) A chemical dependency treatment program licensed under chapter 245G, to provide
chemical dependency treatment shall pay an annual nonrefundable license fee based on the
following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$600
	25 to 49 persons	$800
	50 to 74 persons	$1,000
	75 to 99 persons	$1,200
	100 or more persons	$1,400

(d) A deleted text begin chemical dependencydeleted text end new text begin detoxificationnew text end program licensed under Minnesota Rules,
parts 9530.6510 to 9530.6590, deleted text begin to provide detoxification servicesdeleted text end new text begin or a withdrawal management
program licensed under chapter 245Fnew text end shall pay an annual nonrefundable license fee based
on the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$760
	25 to 49 persons	$960
	50 or more persons	$1,160

new text begin A detoxification program that also operates a withdrawal management program at the same
location shall only pay one fee based upon the licensed capacity of the program with the
higher overall capacity.
new text end

(e) Except for child foster care, a residential facility licensed under Minnesota Rules,
chapter 2960, to serve children shall pay an annual nonrefundable license fee based on the
following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$1,000
	25 to 49 persons	$1,100
	50 to 74 persons	$1,200
	75 to 99 persons	$1,300
	100 or more persons	$1,400

(f) A residential facility licensed under section 245I.23 or Minnesota Rules, parts
9520.0500 to 9520.0670, to serve persons with mental illness shall pay an annual
nonrefundable license fee based on the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$2,525
	25 or more persons	$2,725

(g) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400,
to serve persons with physical disabilities shall pay an annual nonrefundable license fee
based on the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$450
	25 to 49 persons	$650
	50 to 74 persons	$850
	75 to 99 persons	$1,050
	100 or more persons	$1,250

(h) A program licensed to provide independent living assistance for youth under section
245A.22 shall pay an annual nonrefundable license fee of $1,500.

(i) A private agency licensed to provide foster care and adoption services under Minnesota
Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable license fee of $875.

(j) A program licensed as an adult day care center licensed under Minnesota Rules, parts
9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the
following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$500
	25 to 49 persons	$700
	50 to 74 persons	$900
	75 to 99 persons	$1,100
	100 or more persons	$1,300

(k) A program licensed to provide treatment services to persons with sexual psychopathic
personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to
9515.3110, shall pay an annual nonrefundable license fee of $20,000.

(l) A mental health clinic certified under section 245I.20 shall pay an annual
nonrefundable certification fee of $1,550. If the mental health clinic provides services at a
primary location with satellite facilities, the satellite facilities shall be certified with the
primary location without an additional charge.

Sec. 7.

Minnesota Statutes 2020, section 245A.14, subdivision 4, is amended to read:

Subd. 4.

Special family deleted text begin daydeleted text end new text begin childnew text end care homes.

Nonresidential child care programs
serving 14 or fewer children that are conducted at a location other than the license holder's
own residence shall be licensed under this section and the rules governing family deleted text begin daydeleted text end new text begin childnew text end
care or group family deleted text begin daydeleted text end new text begin childnew text end care if:

(a) the license holder is the primary provider of care and the nonresidential child care
program is conducted in a dwelling that is located on a residential lot;

(b) the license holder is an employer who may or may not be the primary provider of
care, and the purpose for the child care program is to provide child care services to children
of the license holder's employees;

(d) the license holder is a community collaborative child care provider. For purposes of
this subdivision, a community collaborative child care provider is a provider participating
in a cooperative agreement with a community action agency as defined in section 256E.31;

(e) the license holder is a not-for-profit agency that provides child care in a dwelling
located on a residential lot and the license holder maintains two or more contracts with
community employers or other community organizations to provide child care services.
The county licensing agency may grant a capacity variance to a license holder licensed
under this paragraph to exceed the licensed capacity of 14 children by no more than five
children during transition periods related to the work schedules of parents, if the license
holder meets the following requirements:

(1) the program does not exceed a capacity of 14 children more than a cumulative total
of four hours per day;

(2) the program meets a one to seven staff-to-child ratio during the variance period;

(3) all employees receive at least an extra four hours of training per year than required
in the rules governing family child care each year;

(4) the facility has square footage required per child under Minnesota Rules, part
9502.0425;

(5) the program is in compliance with local zoning regulations;

(6) the program is in compliance with the applicable fire code as follows:

(i) if the program serves more than five children older than 2-1/2 years of age, but no
more than five children 2-1/2 years of age or less, the applicable fire code is educational
occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015,
Section 202; or

(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire Code 2015,
Section 202, unless the rooms in which the children are cared for are located on a level of
exit discharge and each of these child care rooms has an exit door directly to the exterior,
then the applicable fire code is Group E occupancies, as provided in the Minnesota State
Fire Code 2015, Section 202; and

(7) any age and capacity limitations required by the fire code inspection and square
footage determinations shall be printed on the license; or

(f) the license holder is the primary provider of care and has located the licensed child
care program in a commercial space, if the license holder meets the following requirements:

(1) the program is in compliance with local zoning regulations;

(2) the program is in compliance with the applicable fire code as follows:

(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire Code 2015,
Section 202;

(3) any age and capacity limitations required by the fire code inspection and square
footage determinations are printed on the license; and

(4) the license holder prominently displays the license issued by the commissioner which
contains the statement "This special family child care provider is not licensed as a child
care center."

(g) deleted text begin The commissioner may approve two or more licenses under paragraphs (a) to (f) to
be issued at the same location or under one contiguous roof, if each license holder is able
to demonstrate compliance with all applicable rules and laws. Each license holder must
operate the license holder's respective licensed program as a distinct program and within
the capacity, age, and ratio distributions of each license.deleted text end new text begin Notwithstanding Minnesota Rules,
part 9502.0335, subpart 12, the commissioner may issue up to four licenses to an organization
licensed under paragraphs (b), (c), or (e). Each license must have its own primary provider
of care as required under paragraph (i). Each license must operate as a distinct and separate
program in compliance with all applicable laws and regulations.
new text end

(h) deleted text begin The commissioner may grant variances to this section to allow a primary provider
of care, a not-for-profit organization, a church or religious organization, an employer, or a
community collaborative to be licensed to provide child care under paragraphs (e) and (f)
if the license holder meets the other requirements of the statute.deleted text end new text begin For licenses issued under
paragraphs (b), (c), (d), (e), or (f), the commissioner may approve up to four licenses at the
same location or under one contiguous roof if each license holder is able to demonstrate
compliance with all applicable rules and laws. Each licensed program must operate as a
distinct program and within the capacity, age, and ratio distributions of each license.
new text end

new text begin (i) For a license issued under paragraphs (b), (c), or (e), the license holder must designate
a person to be the primary provider of care at the licensed location on a form and in a manner
prescribed by the commissioner. The license holder shall notify the commissioner in writing
before there is a change of the person designated to be the primary provider of care. The
primary provider of care:
new text end

new text begin (1) must be the person who will be the provider of care at the program and present during
the hours of operation;
new text end

new text begin (2) must operate the program in compliance with applicable laws and regulations under
chapter 245A and Minnesota Rules, chapter 9502;
new text end

new text begin (3) is considered a child care background study subject as defined in section 245C.02,
subdivision 6a, and must comply with background study requirements in chapter 245C; and
new text end

new text begin (4) must complete the training that is required of license holders in section 245A.50.
new text end

new text begin (j) For any license issued under this subdivision, the license holder must ensure that any
other caregiver, substitute, or helper who assists in the care of children meets the training
requirements in section 245A.50 and background study requirements under chapter 245C.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 8.

Minnesota Statutes 2020, section 245A.16, is amended by adding a subdivision to
read:

new text begin Subd. 9. new text end

new text begin Licensed family foster settings. new text end

new text begin (a) Before recommending to grant a license,
deny a license under section 245A.05, or revoke a license under section 245A.07 for
nondisqualifying background study information received under section 245C.05, subdivision
4, paragraph (a), clause (3), for a licensed family foster setting, a county agency or private
agency that has been designated or licensed by the commissioner must review the following:
new text end

new text begin (1) the type of offenses;
new text end

new text begin (2) the number of offenses;
new text end

new text begin (3) the nature of the offenses;
new text end

new text begin (4) the age of the individual at the time of the offenses;
new text end

new text begin (5) the length of time that has elapsed since the last offense;
new text end

new text begin (6) the relationship of the offenses and the capacity to care for a child;
new text end

new text begin (7) evidence of rehabilitation;
new text end

new text begin (8) information or knowledge from community members regarding the individual's
capacity to provide foster care;
new text end

new text begin (9) any available information regarding child maltreatment reports or child in need of
protection or services petitions, or related cases, in which the individual has been involved
or implicated, and documentation that the individual has remedied issues or conditions
identified in child protection or court records that are relevant to safely caring for a child;
new text end

new text begin (10) a statement from the study subject;
new text end

new text begin (11) a statement from the license holder; and
new text end

new text begin (12) other aggravating and mitigating factors.
new text end

new text begin (b) For purposes of this section, "evidence of rehabilitation" includes but is not limited
to the following:
new text end

new text begin (1) maintaining a safe and stable residence;
new text end

new text begin (2) continuous, regular, or stable employment;
new text end

new text begin (3) successful participation in an education or job training program;
new text end

new text begin (4) positive involvement with the community or extended family;
new text end

new text begin (5) compliance with the terms and conditions of probation or parole following the
individual's most recent conviction;
new text end

new text begin (6) if the individual has had a substance use disorder, successful completion of a substance
use disorder assessment, substance use disorder treatment, and recommended continuing
care, if applicable, demonstrated abstinence from controlled substances, as defined in section
152.01, subdivision 4, or the establishment of a sober network;
new text end

new text begin (7) if the individual has had a mental illness or documented mental health issues,
demonstrated completion of a mental health evaluation, participation in therapy or other
recommended mental health treatment, or appropriate medication management, if applicable;
new text end

new text begin (8) if the individual's offense or conduct involved domestic violence, demonstrated
completion of a domestic violence or anger management program, and the absence of any
orders for protection or harassment restraining orders against the individual since the previous
offense or conduct;
new text end

new text begin (9) written letters of support from individuals of good repute, including but not limited
to employers, members of the clergy, probation or parole officers, volunteer supervisors,
or social services workers;
new text end

new text begin (10) demonstrated remorse for convictions or conduct, or demonstrated positive behavior
changes; and
new text end

new text begin (11) absence of convictions or arrests since the previous offense or conduct, including
any convictions that were expunged or pardoned.
new text end

new text begin (c) An applicant for a family foster setting license must sign all releases of information
requested by the county or private licensing agency.
new text end

new text begin (d) When licensing a relative for a family foster setting, the commissioner shall also
consider the importance of maintaining the child's relationship with relatives as an additional
significant factor in determining whether an application will be denied.
new text end

new text begin (e) When recommending that the commissioner deny or revoke a license, the county or
private licensing agency must send a summary of the review completed according to
paragraph (a), on a form developed by the commissioner, to the commissioner and include
any recommendation for licensing action.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 9.

Minnesota Statutes 2020, section 245A.50, subdivision 7, is amended to read:

Subd. 7.

Training requirements for family and group family child care.

new text begin (a) new text end For
purposes of family and group family child care, the license holder and each second adult
caregiver must complete 16 hours of ongoing training each year. Repeat of topical training
requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training
requirement. Additional ongoing training subjects to meet the annual 16-hour training
requirement must be selected from the following areas:

(1) child development and learning training in understanding how a child develops
physically, cognitively, emotionally, and socially, and how a child learns as part of the
child's family, culture, and community;

(2) developmentally appropriate learning experiences, including training in creating
positive learning experiences, promoting cognitive development, promoting social and
emotional development, promoting physical development, promoting creative development;
and behavior guidance;

(3) relationships with families, including training in building a positive, respectful
relationship with the child's family;

(4) assessment, evaluation, and individualization, including training in observing,
recording, and assessing development; assessing and using information to plan; and assessing
and using information to enhance and maintain program quality;

(5) historical and contemporary development of early childhood education, including
training in past and current practices in early childhood education and how current events
and issues affect children, families, and programs;

(6) professionalism, including training in knowledge, skills, and abilities that promote
ongoing professional development; and

(7) health, safety, and nutrition, including training in establishing healthy practices;
ensuring safety; and providing healthy nutrition.

new text begin (b) A provider who is approved as a trainer through the Develop data system may count
up to two hours of training instruction toward the annual 16-hour training requirement in
paragraph (a). The provider may only count training instruction hours for the first instance
in which they deliver a particular content-specific training during each licensing year. Hours
counted as training instruction must be approved through the Develop data system with
attendance verified on the trainer's individual learning record and must be in Knowledge
and Competency Framework content area VII A (Establishing Healthy Practices) or B
(Ensuring Safety).
new text end

Sec. 10.

Minnesota Statutes 2020, section 245A.50, subdivision 9, is amended to read:

Subd. 9.

Supervising for safety; training requirement.

(a) Courses required by this
subdivision must include the following health and safety topics:

(1) preventing and controlling infectious diseases;

(2) administering medication;

(3) preventing and responding to allergies;

(4) ensuring building and physical premises safety;

(5) handling and storing biological contaminants;

(6) preventing and reporting child abuse and maltreatment; and

(7) emergency preparedness.

(b) Before initial licensure and before caring for a child, all family child care license
holders and each second adult caregiver shall complete and document the completion of
the six-hour Supervising for Safety for Family Child Care course developed by the
commissioner.

(c) The license holder must ensure and document that, before caring for a child, all
substitutes have completed the four-hour Basics of Licensed Family Child Care for
Substitutes course developed by the commissioner, which must include health and safety
topics as well as child development and learning.

(d) The family child care license holder and each second adult caregiver shall complete
and document:

(1) the annual completion of new text begin either:
new text end

new text begin (i) new text end a two-hour active supervision course developed by the commissioner;new text begin or
new text end

new text begin (ii) any courses in the ensuring safety competency area under the health, safety, and
nutrition standard of the Knowledge and Competency Framework that the commissioner
has identified as an active supervision training course;new text end and

(2) the completion at least once every five years of the two-hour courses Health and
Safety I and Health and Safety II. When the training is due for the first time or expires, it
must be taken no later than the day before the anniversary of the license holder's license
effective date. A license holder's or second adult caregiver's completion of either training
in a given year meets the annual active supervision training requirement in clause (1).

(e) At least once every three years, license holders must ensure and document that
substitutes have completed the four-hour Basics of Licensed Family Child Care for
Substitutes course. When the training expires, it must be retaken no later than the day before
the anniversary of the license holder's license effective date.

Sec. 11.

Minnesota Statutes 2020, section 245C.02, subdivision 4a, is amended to read:

Subd. 4a.

Authorized fingerprint collection vendor.

"Authorized fingerprint collection
vendor" means a qualified organization under a written contract with the commissioner to
provide services in accordance with section 245C.05, subdivision 5, paragraph (b).new text begin The
commissioner may retain the services of more than one authorized fingerprint collection
vendor.
new text end

Sec. 12.

Minnesota Statutes 2020, section 245C.02, subdivision 5, is amended to read:

Subd. 5.

Background study.

"Background study" meansnew text begin :
new text end

new text begin (1) the collection and processing of a background study subject's fingerprints, including
the process of obtaining a background study subject's classifiable fingerprints and photograph
as required by section 245C.05, subdivision 5, paragraph (b); and
new text end

new text begin (2)new text end the review of records conducted by the commissioner to determine whether a subject
is disqualified from direct contact with persons served by a program and, where specifically
provided in statutes, whether a subject is disqualified from having access to persons served
by a program and from working in a children's residential facility or foster residence setting.

Sec. 13.

Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision
to read:

new text begin Subd. 5b. new text end

new text begin Alternative background study. new text end

new text begin "Alternative background study" means:
new text end

new text begin (2) a review of records conducted by the commissioner pursuant to section 245C.08 in
order to forward the background study investigating information to the entity that submitted
the alternative background study request under section 245C.031, subdivision 2. The
commissioner shall not make any eligibility determinations on background studies conducted
under section 245C.031.
new text end

Sec. 14.

Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision
to read:

new text begin Subd. 5c. new text end

new text begin Public law background study. new text end

new text begin "Public law background study" means a
background study conducted by the commissioner pursuant to section 245C.032.
new text end

Sec. 15.

Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision
to read:

new text begin Subd. 11c. new text end

new text begin Entity. new text end

new text begin "Entity" means any program, organization, or agency initiating a
background study.
new text end

Sec. 16.

Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision
to read:

new text begin Subd. 16a. new text end

new text begin Results. new text end

new text begin "Results" means a determination that a study subject is eligible,
disqualified, set aside, granted a variance, or that more time is needed to complete the
background study.
new text end

Sec. 17.

Minnesota Statutes 2020, section 245C.03, is amended to read:

245C.03 BACKGROUND STUDY; INDIVIDUALS TO BE STUDIED.

Subdivision 1.

Licensed programs.

(a) The commissioner shall conduct a background
study on:

(1) the person or persons applying for a license;

(2) an individual age 13 and over living in the household where the licensed program
will be provided who is not receiving licensed services from the program;

(3) current or prospective employees or contractors of the applicant who will have direct
contact with persons served by the facility, agency, or program;

(4) volunteers or student volunteers who will have direct contact with persons served
by the program to provide program services if the contact is not under the continuous, direct
supervision by an individual listed in clause (1) or (3);

(5) an individual age ten to 12 living in the household where the licensed services will
be provided when the commissioner has reasonable cause as defined in section 245C.02,
subdivision 15;

(6) an individual who, without providing direct contact services at a licensed program,
may have unsupervised access to children or vulnerable adults receiving services from a
program, when the commissioner has reasonable cause as defined in section 245C.02,
subdivision 15;

(7) all controlling individuals as defined in section 245A.02, subdivision 5a;

(8) notwithstanding the other requirements in this subdivision, child care background
study subjects as defined in section 245C.02, subdivision 6a; and

(9) notwithstanding clause (3), for children's residential facilities and foster residence
settings, any adult working in the facility, whether or not the individual will have direct
contact with persons served by the facility.

(b) For child foster care when the license holder resides in the home where foster care
services are provided, a short-term substitute caregiver providing direct contact services for
a child for less than 72 hours of continuous care is not required to receive a background
study under this chapter.

new text begin (c) This subdivision applies to the following programs that must be licensed under
chapter 245A:
new text end

new text begin (1) adult foster care;
new text end

new text begin (2) child foster care;
new text end

new text begin (3) children's residential facilities;
new text end

new text begin (4) family child care;
new text end

new text begin (5) licensed child care centers;
new text end

new text begin (6) licensed home and community-based services under chapter 245D;
new text end

new text begin (7) residential mental health programs for adults;
new text end

new text begin (8) substance use disorder treatment programs under chapter 245G;
new text end

new text begin (9) withdrawal management programs under chapter 245F;
new text end

new text begin (10) adult day care centers;
new text end

new text begin (11) family adult day services;
new text end

new text begin (12) independent living assistance for youth;
new text end

new text begin (13) detoxification programs;
new text end

new text begin (14) community residential settings; and
new text end

new text begin (15) intensive residential treatment services and residential crisis stabilization under
chapter 245I.
new text end

new text begin Subd. 1a. new text end

new text begin Procedure. new text end

new text begin (a) Individuals and organizations that are required under this
section to have or initiate background studies shall comply with the requirements of this
chapter.
new text end

new text begin (b) All studies conducted under this section shall be conducted according to sections
299C.60 to 299C.64. This requirement does not apply to subdivisions 1, paragraph (c),
clauses (2) to (5), and 6a.
new text end

Subd. 2.

Personal care provider organizations.

The commissioner shall conduct
background studies on any individual required under sections 256B.0651 to 256B.0654 and
256B.0659 to have a background study completed under this chapter.

Subd. 3.

Supplemental nursing services agencies.

The commissioner shall conduct all
background studies required under this chapter and initiated by supplemental nursing services
agencies registered under section 144A.71, subdivision 1.

new text begin Subd. 3a. new text end

new text begin Personal care assistance provider agency; background studies. new text end

new text begin Personal
care assistance provider agencies enrolled to provide personal care assistance services under
the medical assistance program must meet the following requirements:
new text end

new text begin (1) owners who have a five percent interest or more and all managing employees are
subject to a background study as provided in this chapter. This requirement applies to
currently enrolled personal care assistance provider agencies and agencies seeking enrollment
as a personal care assistance provider agency. "Managing employee" has the same meaning
as Code of Federal Regulations, title 42, section 455.101. An organization is barred from
enrollment if:
new text end

new text begin (i) the organization has not initiated background studies of owners and managing
employees; or
new text end

new text begin (ii) the organization has initiated background studies of owners and managing employees
and the commissioner has sent the organization a notice that an owner or managing employee
of the organization has been disqualified under section 245C.14, and the owner or managing
employee has not received a set aside of the disqualification under section 245C.22; and
new text end

new text begin (2) a background study must be initiated and completed for all qualified professionals.
new text end

new text begin Subd. 3b. new text end

new text begin Exception to personal care assistant; requirements. new text end

new text begin The personal care
assistant for a recipient may be allowed to enroll with a different personal care assistance
provider agency upon initiation of a new background study according to this chapter if:
new text end

new text begin (1) the commissioner determines that a change in enrollment or affiliation of the personal
care assistant is needed in order to ensure continuity of services and protect the health and
safety of the recipient;
new text end

new text begin (2) the chosen agency has been continuously enrolled as a personal care assistance
provider agency for at least two years;
new text end

new text begin (3) the recipient chooses to transfer to the personal care assistance provider agency;
new text end

new text begin (4) the personal care assistant has been continuously enrolled with the former personal
care assistance provider agency since the last background study was completed; and
new text end

new text begin (5) the personal care assistant continues to meet requirements of section 256B.0659,
subdivision 11, notwithstanding paragraph (a), clause (3).
new text end

Subd. 4.

Personnel agencies; educational programs; professional services
agencies.

The commissioner also may conduct studies on individuals specified in subdivision
1, paragraph (a), clauses (3) and (4), when the studies are initiated by:

(1) personnel pool agencies;

(2) temporary personnel agencies;

(3) educational programs that train individuals by providing direct contact services in
licensed programs; and

(4) professional services agencies that are not licensed and which contract with licensed
programs to provide direct contact services or individuals who provide direct contact services.

Subd. 5.

Other state agencies.

The commissioner shall conduct background studies on
applicants and license holders under the jurisdiction of other state agencies who are required
in other statutory sections to initiate background studies under this chapter, including the
applicant's or license holder's employees, contractors, and volunteers when required under
other statutory sections.

new text begin Subd. 5a. new text end

new text begin Facilities serving children or adults licensed or regulated by the
Department of Health. new text end

new text begin (a) The commissioner shall conduct background studies of:
new text end

new text begin (1) individuals providing services who have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; assisted living facilities and assisted living
facilities with dementia care licensed under chapter 144G; and board and lodging
establishments that are registered to provide supportive or health supervision services under
section 157.17;
new text end

new text begin (2) individuals specified in subdivision 2 who provide direct contact services in a nursing
home or a home care agency licensed under chapter 144A; an assisted living facility or
assisted living facility with dementia care licensed under chapter 144G; or a boarding care
home licensed under sections 144.50 to 144.58. If the individual undergoing a study resides
outside of Minnesota, the study must include a check for substantiated findings of
maltreatment of adults and children in the individual's state of residence when the state
makes the information available;
new text end

new text begin (3) all other employees in assisted living facilities or assisted living facilities with
dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
an individual in this section shall disqualify the individual from positions allowing direct
contact with or access to patients or residents receiving services. "Access" means physical
access to a client or the client's personal property without continuous, direct supervision as
defined in section 245C.02, subdivision 8, when the employee's employment responsibilities
do not include providing direct contact services;
new text end

new text begin (4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; and
new text end

new text begin (5) controlling persons of a supplemental nursing services agency, as defined by section
144A.70.
new text end

new text begin (b) If a facility or program is licensed by the Department of Human Services and the
Department of Health and is subject to the background study provisions of this chapter, the
Department of Human Services is solely responsible for the background studies of individuals
in the jointly licensed program.
new text end

new text begin (c) The commissioner of health shall review and make decisions regarding reconsideration
requests, including whether to grant variances, according to the procedures and criteria in
this chapter. The commissioner of health shall inform the requesting individual and the
Department of Human Services of the commissioner of health's decision regarding the
reconsideration. The commissioner of health's decision to grant or deny a reconsideration
of a disqualification is a final administrative agency action.
new text end

new text begin Subd. 5b. new text end

new text begin Facilities serving children or youth licensed by the Department of
Corrections. new text end

new text begin (a) The commissioner shall conduct background studies of individuals working
in secure and nonsecure children's residential facilities, juvenile detention facilities, and
foster residence settings, whether or not the individual will have direct contact, as defined
under section 245C.02, subdivision 11, with persons served in the facilities or settings.
new text end

new text begin (b) A clerk or administrator of any court, the Bureau of Criminal Apprehension, a
prosecuting attorney, a county sheriff, or a chief of a local police department shall assist in
conducting background studies by providing the commissioner of human services or the
commissioner's representative all criminal conviction data available from local and state
criminal history record repositories related to applicants, operators, all persons living in a
household, and all staff of any facility subject to background studies under this subdivision.
new text end

new text begin (c) For the purpose of this subdivision, the term "secure and nonsecure residential facility
and detention facility" includes programs licensed or certified under section 241.021,
subdivision 2.
new text end

new text begin (d) If an individual is disqualified, the Department of Human Services shall notify the
disqualified individual and the facility in which the disqualified individual provides services
of the disqualification and shall inform the disqualified individual of the right to request a
reconsideration of the disqualification by submitting the request to the Department of
Corrections.
new text end

new text begin (e) The commissioner of corrections shall review and make decisions regarding
reconsideration requests, including whether to grant variances, according to the procedures
and criteria in this chapter. The commissioner of corrections shall inform the requesting
individual and the Department of Human Services of the commissioner of corrections'
decision regarding the reconsideration. The commissioner of corrections' decision to grant
or deny a reconsideration of a disqualification is the final administrative agency action.
new text end

Subd. 6.

Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities.

new text begin (a) new text end The commissioner shall conduct background
studies deleted text begin ondeleted text end new text begin ofnew text end any individual deleted text begin required under section 256B.4912 to have a background study
completed under this chapterdeleted text end new text begin who provides direct contact, as defined in section 245C.02,
subdivision 11, for services specified in the federally approved home and community-based
waiver plans under section 256B.4912. The individual studied must meet the requirements
of this chapter prior to providing waiver services and as part of ongoing enrollment.
new text end

new text begin (b) The requirements in paragraph (a) apply to consumer-directed community supports
under section 256B.4911new text end .

Subd. 6a.

Legal nonlicensed and certified child care programs.

The commissioner
shall conduct background studies deleted text begin on an individualdeleted text end new text begin for each child care background study
subject as defined in section 245C.02, subdivision 6a, asnew text end required deleted text begin underdeleted text end new text begin bynew text end sections 119B.125
and 245H.10 deleted text begin to complete a background study under this chapterdeleted text end .

Subd. 7.

Children's therapeutic services and supports providers.

The commissioner
shall conduct background studies deleted text begin according to this chapter when initiated by a children's
therapeutic services and supports providerdeleted text end new text begin of all direct service providers and volunteers for
children's therapeutic services and supports providersnew text end under section 256B.0943.

deleted text begin Subd. 8. deleted text end

deleted text begin Self-initiated background studies. deleted text end

deleted text begin Upon implementation of NETStudy 2.0,
the commissioner shall conduct background studies according to this chapter when initiated
by an individual who is not on the master roster. A subject under this subdivision who is
not disqualified must be placed on the inactive roster.
deleted text end

Subd. 9.

Community first services and supports new text begin and financial management services
new text end organizations.

deleted text begin The commissioner shall conduct background studies on any individual
required under section 256B.85 to have a background study completed under this chapter. deleted text end new text begin
Individuals affiliated with Community First Services and Supports (CFSS) agency-providers
and Financial Management Services (FMS) providers enrolled to provide CFSS services

HF 33

Bill Text Versions

Current Version - 2nd Engrossment

ARTICLE 1

DEPARTMENT OF HUMAN SERVICES HEALTH CARE PROGRAMS

Section 1.

Subd. 28.

Statewide health information exchange.

Sec. 2.

new text begin [256B.0371] PERFORMANCE BENCHMARKS FOR DENTAL ACCESS; CONTINGENT DENTAL ADMINISTRATOR. new text end

new text begin Subdivision 1. new text end

new text begin Benchmark for dental access. new text end

new text begin Subd. 2. new text end

new text begin Corrective action plan. new text end

new text begin Subd. 3. new text end

new text begin Contingent contract with dental administrator. new text end

new text begin Subd. 4. new text end

new text begin Dental utilization report. new text end

Sec. 3.

Subd. 14.

Competitive bidding.

new text begin EFFECTIVE DATE. new text end

Sec. 4.

Subd. 6.

Pregnant women; needy unborn child.

new text begin EFFECTIVE DATE. new text end

Sec. 5.

Subd. 10.

Eligibility verification.

new text begin EFFECTIVE DATE. new text end

Sec. 6.

Subd. 4.

Citizenship requirements.

new text begin EFFECTIVE DATE. new text end

Sec. 7.

Subd. 9.

Dental services.

new text begin EFFECTIVE DATE. new text end

Sec. 8.

Subd. 13.

Drugs.

new text begin EFFECTIVE DATE. new text end

Sec. 9.

Subd. 13c.

Formulary Committee.

Sec. 10.

Subd. 13d.

Drug formulary.

new text begin EFFECTIVE DATE. new text end

Sec. 11.

Subd. 13e.

Payment rates.

new text begin EFFECTIVE DATE. new text end

Sec. 12.

Subd. 13g.

Preferred drug list.

new text begin EFFECTIVE DATE. new text end

Sec. 13.

Subd. 18.

deleted text begin Busdeleted text end new text begin Public transitnew text end or taxicab transportation.

new text begin EFFECTIVE DATE. new text end

Sec. 14.

Subd. 31.

Medical supplies and equipment.

new text begin EFFECTIVE DATE. new text end

Sec. 15.

Subd. 58.

Early and periodic screening, diagnosis, and treatment services.

new text begin EFFECTIVE DATE. new text end

Sec. 16.

new text begin Subd. 67. new text end

new text begin Enhanced asthma care services. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 17.

Subdivision 1.

Cost-sharing.

new text begin EFFECTIVE DATE. new text end

Sec. 18.

new text begin Subd. 6f. new text end

new text begin Dental fee schedules. new text end

new text begin [256B.0371] PERFORMANCE BENCHMARKS FOR DENTAL ACCESS;
CONTINGENT DENTAL ADMINISTRATOR.
new text end

new text begin [256B.795] MATERNAL AND INFANT HEALTH REPORT.
new text end

Must not have access to employer-subsidized minimum essential
coverage.

Sec. 31. new text begin FEDERAL APPROVAL; EXTENSION OF POSTPARTUM COVERAGE.
new text end

Sec. 32. new text begin COVID-19 TREATMENT, TESTING, AND VACCINATION.
new text end

Sec. 33. new text begin DENTAL HOME DEMONSTRATION PROJECT.
new text end

Sec. 34. new text begin OVERPAYMENTS FOR DURABLE MEDICAL EQUIPMENT,
PROSTHETICS, ORTHOTICS, OR SUPPLIES.
new text end

Sec. 35. new text begin PROPOSED FORMULARY COMMITTEE.
new text end

Sec. 36. new text begin RESPONSE TO COVID-19 PUBLIC HEALTH EMERGENCY.
new text end

Sec. 37. new text begin DENTAL PROGRAM DELIVERY STUDY.
new text end

Sec. 38. new text begin DENTAL RATE REBASING.
new text end

Sec. 39. new text begin CONTINGENT FUNDING RELATED TO DENTAL ADMINISTRATOR.
new text end

Sec. 40. new text begin REPEALER.
new text end

DEPARTMENT OF HUMAN SERVICES
LICENSING AND BACKGROUND STUDIES

new text begin [245.975] OMBUDSPERSON FOR FAMILY CHILD CARE PROVIDERS.
new text end