HF 132

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; creating a children's
health security account; establishing the children's
health security program; specifying eligibility
criteria, covered services, and administrative
procedures; increasing the tax on tobacco products;
appropriating money; amending Minnesota Statutes 2004,
sections 297F.05, subdivisions 1, 3, 4; 297F.10;
proposing coding for new law in Minnesota Statutes,
chapter 16A; proposing coding for new law as Minnesota
Statutes, chapter 256N.

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

Section 1.

new text begin [16A.725] CHILDREN'S HEALTH SECURITY ACCOUNT.
new text end

new text begin A children's health security account is created in the
state treasury. The account is a direct appropriated special
revenue account. The commissioner shall deposit to the credit
of the account money made available to the account.
Notwithstanding section 11A.20, all investment income and all
investment losses attributable to the investment of the
children's health security account not currently needed shall be
credited to the children's health security account.
new text end

Sec. 2.

new text begin [256N.01] CITATION.
new text end

new text begin This chapter may be cited as the Children's Health Security
Act.
new text end

Sec. 3.

new text begin [256N.02] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin The terms used in this
chapter have the following meanings unless otherwise provided
for by text.
new text end

new text begin Subd. 2. new text end

new text begin Child. new text end

new text begin "Child" means an individual under age 19
or an unmarried child who is a full-time student under the age
of 25 years who is financially dependent upon a parent,
grandparent, foster parent, relative caretaker, or legal
guardian.
new text end

new text begin Subd. 3. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the
commissioner of human services.
new text end

Sec. 4.

new text begin [256N.03] ESTABLISHMENT.
new text end

new text begin The commissioner shall establish the children's health
security program. The commissioner shall begin implementation
of the program on July 1, 2006.
new text end

Sec. 5.

new text begin [256N.05] ELIGIBILITY.
new text end

new text begin Subdivision 1. new text end

new text begin General requirements. new text end

new text begin Children meeting
the eligibility requirements of this section are eligible for
the children's health security program.
new text end

new text begin Subd. 2. new text end

new text begin Phase-in of eligible groups. new text end

new text begin (a) Children who
are eligible for MinnesotaCare or medical assistance are
eligible to enroll effective July 1, 2006, or upon federal
approval, whichever is later.
new text end

new text begin (b) Effective July 1, 2008, eligibility is expanded to
include all children, regardless of household income or assets,
who are not eligible for medical assistance or MinnesotaCare.
new text end

new text begin Subd. 3. new text end

new text begin Residency. new text end

new text begin (a) To be eligible for health
coverage under the children's health security program, children
must be permanent residents of Minnesota. For purposes of this
requirement, a permanent Minnesota resident is a person who has
demonstrated, through persuasive and objective evidence, that
the person is domiciled in the state and intends to live in the
state permanently.
new text end

new text begin (b) To be eligible as a permanent resident, an applicant,
or the applicant's parent or guardian as applicable, must
demonstrate the requisite intent to live in the state
permanently by:
new text end

new text begin (1) showing that the applicant, or the applicant's parent
or guardian as applicable, maintains a residence at a verified
address, through the use of evidence of residence described in
paragraph (c); and
new text end

new text begin (2) signing an affidavit declaring that the applicant
currently resides in the state and intends to reside in the
state permanently, and the applicant did not come to the state
for the primary purpose of obtaining medical coverage or
treatment.
new text end

new text begin (c) An applicant, or a parent or guardian of an applicant,
may verify a residence address by presenting a valid state
driver's license, a state identification card, a voter
registration card, a rent receipt, a statement by the landlord,
apartment or emergency shelter manager, or homeowner verifying
that the individual is residing at the address, or other form of
verification approved by the commissioner.
new text end

new text begin (d) A child who is temporarily absent from the state does
not lose eligibility for the children's health security
program. "Temporarily absent from the state" means the person
is out of the state for a temporary purpose and intends to
return when the purpose of the absence has been accomplished. A
person is not temporarily absent from the state if another state
has determined that the person is a resident for any purpose.
If temporarily absent from the state, the person must follow the
requirements of the health plan in which the person is enrolled
to receive services.
new text end

new text begin (e) A child who moved to Minnesota primarily to obtain
medical treatment or health coverage for a preexisting condition
is not a permanent resident.
new text end

new text begin Subd. 4. new text end

new text begin Enrollment voluntary. new text end

new text begin Enrollment in the
children's health security program is voluntary. Parents or
guardians may retain private sector or Medicare coverage for a
child as the sole source of coverage. Parents or guardians who
have private sector or Medicare coverage for children may also
enroll children in the children's health security program. If
private sector or Medicare coverage is available, coverage under
the children's health security program is secondary to the
private sector or Medicare coverage.
new text end

Sec. 6.

new text begin [256N.07] COVERED SERVICES.
new text end

new text begin Covered services under the children's health security
program consist of all services reimbursed under chapter 256B.
new text end

Sec. 7.

new text begin [256N.09] NO ENROLLEE PREMIUMS OR COST SHARING.
new text end

new text begin In order to ensure broad access to coverage, the children's
health security program has no enrollee premium or cost-sharing
requirements.
new text end

Sec. 8.

new text begin [256N.11] APPLICATION PROCEDURES.
new text end

new text begin Subdivision 1. new text end

new text begin Application procedure. new text end

new text begin Applications for
the program must be made available to provider offices, local
human services agencies, school districts, schools, community
health offices, and other sites willing to cooperate in program
outreach. These sites may accept applications and forward
applications to the commissioner. Applicants may also apply
directly to the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Eligibility determination. new text end

new text begin The commissioner
shall determine an applicant's eligibility for the program
within 30 days of the date the application is received by the
Department of Human Services. The effective date of coverage is
the day upon which eligibility is approved, except in cases of
persons applying under presumptive eligibility.
new text end

new text begin Subd. 3. new text end

new text begin Presumptive eligibility. new text end

new text begin Coverage under the
program is available during a presumptive eligibility period.
The presumptive eligibility period begins on the date a health
care provider or other entity designated by the commissioner
determines, based on preliminary information, that the person
meets the criteria in section 256N.05. The presumptive
eligibility period ends on the day on which a determination is
made as to the person's eligibility, except that if an
application is not submitted by the last day of the month
following the month during which the determination based on
preliminary information is made, the presumptive eligibility
period ends on the last day of the month.
new text end

Sec. 9.

new text begin [256N.13] SERVICE DELIVERY.
new text end

new text begin (a) The commissioner may contract with health maintenance
organizations licensed under chapter 62D, community integrated
service networks licensed under chapter 62N, and accountable
provider networks licensed under chapter 62T to provide health
care services to program enrollees. Health plan companies under
contract are responsible for coordinating health care services
provided to eligible individuals. Health plan companies under
contract:
new text end

new text begin (1) shall authorize and arrange for the provision of all
needed health services reimbursed under chapter 256B, with the
exception of services available only under a medical assistance
home and community-based waiver, in order to ensure appropriate
health care is delivered to enrollees;
new text end

new text begin (2) shall accept the prospective, per capita payment from
the commissioner in return for the provision of comprehensive
and coordinated health care services for enrollees;
new text end

new text begin (3) may contract with health care and social service
providers to provide services to enrollees; and
new text end

new text begin (4) shall institute enrollee grievance procedures according
to the method established by the commissioner, utilizing
applicable requirements of chapter 62D. Disputes not resolved
through this process may be appealed to the commissioner using
the procedures in section 256.045.
new text end

new text begin (b) The commissioner may contract with a private sector
entity to administer and manage contracts with health plan
companies under paragraph (a).
new text end

new text begin (c) The commissioner shall contract with health care and
social service providers, on a fee-for-service basis, to provide
program enrollees with services available only under a medical
assistance home and community-based waiver. The commissioner
shall determine eligibility for home and community-based waiver
services using the criteria and procedures in chapter 256B.
Disputes related to services provided on a fee-for-service basis
may be appealed to the commissioner using the procedures in
section 256.045.
new text end

Sec. 10.

new text begin [256N.15] PAYMENT RATES.
new text end

new text begin The commissioner, in consultation with a health care
actuary, shall establish the method and amount of payments for
services. The commissioner shall annually contract with
eligible entities to provide services to program enrollees. The
commissioner, in consultation with the risk adjustment
association established under section 62Q.03, subdivision 6,
shall develop and implement a risk adjustment system for the
program.
new text end

Sec. 11.

new text begin [256N.17] CONSUMER ASSISTANCE.
new text end

new text begin Subdivision 1. new text end

new text begin Assistance to applicants. new text end

new text begin The
commissioner shall assist applicants in choosing a health plan
company by:
new text end

new text begin (1) establishing a Web site to provide information about
health plan companies and to allow on-line enrollment;
new text end

new text begin (2) make information on health plan companies available at
the sites specified in section 256N.11, subdivision 1;
new text end

new text begin (3) make applications and information on health plan
companies available in Spanish, Hmong, Laotian, Russian, Somali,
Vietnamese, and Cambodian, and provide language interpreter
services as necessary to assist applicants in choosing a health
plan company; and
new text end

new text begin (4) make benefit educators available to assist applicants
in choosing a health plan company.
new text end

new text begin Subd. 2. new text end

new text begin Ombudsperson. new text end

new text begin The commissioner shall designate
an ombudsperson to advocate for children enrolled in the
children's health security program. The ombudsperson shall
assist enrollees in understanding and making use of complaint
and appeal procedures and ensure that necessary medical services
are provided to enrollees. At the time of enrollment, the
commissioner shall inform enrollees about: the ombudsperson
program; the right to a resolution of the enrollee's complaint
by the health plan company if the enrollee experiences a problem
with the health plan company or its providers; and appeal rights
under section 256.045.
new text end

Sec. 12.

new text begin [256N.19] MONITORING AND EVALUATION OF QUALITY
AND COSTS.
new text end

new text begin The commissioner, as a condition of contract, shall require
each participating health plan company and participating
provider to submit, in the form and manner specified by the
commissioner, data required for assessing enrollee satisfaction,
quality of care, cost, and utilization of services. The
commissioner shall evaluate this data, in order to:
new text end

new text begin (1) make summary information on the quality of care across
health plan companies, medical clinics, and providers available
to consumers;
new text end

new text begin (2) require health plan companies and providers, as a
condition of contract, to implement quality improvement plans;
and
new text end

new text begin (3) compare the cost and quality of services under the
program to the cost and quality of services provided to private
sector enrollees.
new text end

Sec. 13.

Minnesota Statutes 2004, section 297F.05,
subdivision 1, is amended to read:

Subdivision 1.

Rates; cigarettes.

A tax is imposed upon
the sale of cigarettes in this state, upon having cigarettes in
possession in this state with intent to sell, upon any person
engaged in business as a distributor, and upon the use or
storage by consumers, at the following rates:

(1) on cigarettes weighing not more than three pounds per
thousand, deleted text begin 24 deleted text end new text begin 74 new text end mills on each such cigarette; and

(2) on cigarettes weighing more than three pounds per
thousand, deleted text begin 48 deleted text end new text begin 148 new text end mills on each such cigarette.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2006.
new text end

Sec. 14.

Minnesota Statutes 2004, section 297F.05,
subdivision 3, is amended to read:

Subd. 3.

Rates; tobacco products.

A tax is imposed upon
all tobacco products in this state and upon any person engaged
in business as a distributor, at the rate of deleted text begin 35 deleted text end new text begin 108 new text end percent of
the wholesale sales price of the tobacco products. The tax is
imposed at the time the distributor:

(1) brings, or causes to be brought, into this state from
outside the state tobacco products for sale;

(2) makes, manufactures, or fabricates tobacco products in
this state for sale in this state; or

(3) ships or transports tobacco products to retailers in
this state, to be sold by those retailers.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2006.
new text end

Sec. 15.

Minnesota Statutes 2004, section 297F.05,
subdivision 4, is amended to read:

Subd. 4.

Use tax; tobacco products.

A tax is imposed
upon the use or storage by consumers of tobacco products in this
state, and upon such consumers, at the rate of deleted text begin 35 deleted text end new text begin 108 new text end percent of
the cost to the consumer of the tobacco products.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2006.
new text end

Sec. 16.

Minnesota Statutes 2004, section 297F.10, is
amended to read:

297F.10 DEPOSIT OF PROCEEDS.

Subdivision 1.

Tax and use tax on cigarettes.

Revenue
received from cigarette taxes, as well as related penalties,
interest, license fees, and miscellaneous sources of revenue
shall be deposited by the commissioner in the state treasury and
credited as follows:

(1) the revenue produced by 3.25 mills of the tax on
cigarettes weighing not more than three pounds a thousand and
6.5 mills of the tax on cigarettes weighing more than three
pounds a thousand must be credited to the Academic Health Center
special revenue fund hereby created and is annually appropriated
to the Board of Regents at the University of Minnesota for
Academic Health Center funding at the University of Minnesota;
and

(2) the revenue produced by 1.25 mills of the tax on
cigarettes weighing not more than three pounds a thousand and
2.5 mills of the tax on cigarettes weighing more than three
pounds a thousand must be credited to the medical education and
research costs account hereby created in the special revenue
fund and is annually appropriated to the commissioner of health
for distribution under section 62J.692, subdivision 4; and

(3) the balance of the revenues derived from taxes,
penalties, and interest (under this chapter) and from license
fees and miscellaneous sources of revenue shall be credited to
the general fund new text begin , except that the portion of tax revenue
resulting from the increase in the tax on cigarettes weighing
not more than three pounds per thousand from 24 to 74 mills and
the increase in the tax on cigarettes weighing more than three
pounds per thousand from 48 to 148 mills shall be deposited in
the children's health security account new text end .

Subd. 2.

Tax and use tax on tobacco products.

Revenue
received from taxes on tobacco products, as well as related
penalties, interest, and license fees shall be deposited by the
commissioner in the state treasury and credited to the general
fund new text begin , except that the portion of tax revenue resulting from the
increase in the tax on the wholesale sales price of tobacco
products from 35 to 108 percent shall be deposited in the
children's health security account new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2006.
new text end

Sec. 17. new text begin FLOOR STOCKS TAX.
new text end

new text begin Subdivision 1. new text end

new text begin Cigarettes. new text end

new text begin (a) A floor stocks tax is
imposed on every person engaged in business in this state as a
distributor, retailer, subjobber, vendor, manufacturer, or
manufacturer's representative of cigarettes, on the stamped
cigarettes and unaffixed stamps in the person's possession or
under the person's control at 12:01 a.m. on January 1, 2006.
The tax is imposed at the following rates, subject to the
discounts in Minnesota Statutes, section 297F.08, subdivision 7:
new text end

new text begin (1) on cigarettes weighing not more than three pounds per
thousand, 50 mills on each cigarette; and
new text end

new text begin (2) on cigarettes weighing more than three pounds per
thousand, 100 mills on each cigarette.
new text end

new text begin (b) Each distributor, by January 8, 2006, shall file a
report with the commissioner of revenue, in the form the
commissioner prescribes, showing the stamped cigarettes and
unaffixed stamps on hand at 12:01 a.m. on January 1, 2006, and
the amount of tax due on the cigarettes and unaffixed stamps.
The tax imposed by this section is due and payable by February
1, 2006, and after that date bears interest as provided in
Minnesota Statutes, section 270.75. Each retailer, subjobber,
vendor, manufacturer, or manufacturer's representative shall
file a return with the commissioner, in the form the
commissioner prescribes, showing the cigarettes on hand at 12:01
a.m. on January 1, 2006, and pay the tax due on the cigarettes
by February 1, 2006. Tax not paid by the due date bears
interest as provided in Minnesota Statutes, section 270.75.
new text end

new text begin Subd. 2. new text end

new text begin Tobacco products. new text end

new text begin A floor stocks tax is imposed
on every person engaged in business in this state as a
distributor of tobacco products, at the rate of 73 percent of
the wholesale sales price of each tobacco product in the
person's possession or under the person's control at 12:01 a.m.
on January 1, 2006, and the amount of tax due on them. The tax
imposed by this section, less the discount provided in Minnesota
Statutes, section 297F.09, subdivision 2, is due and payable by
February 1, 2006, and thereafter bears interest as provided in
Minnesota Statutes, section 270.75.
new text end

new text begin Subd. 3. new text end

new text begin Audit and enforcement. new text end

new text begin The tax imposed by this
section is subject to the audit, assessment, and collection
provisions applicable to the taxes imposed under Minnesota
Statutes, chapter 297F. The commissioner of revenue shall
deposit the revenue from the tax imposed under this section in
the health care access fund in the state treasury.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2006.
new text end

Sec. 18. new text begin IMPLEMENTATION PLAN.
new text end

new text begin The commissioner shall develop an implementation plan for
the children's health security coverage program and shall
present this plan, any necessary draft legislation, and a draft
of proposed rules to the legislature by December 15, 2005. The
commissioner shall evaluate the provision of services under the
program to children with disabilities and shall present
recommendations to the legislature by December 15, 2007, for any
program changes necessary to ensure the quality and continuity
of care.
new text end

Sec. 19. new text begin FEDERAL APPROVAL.
new text end

new text begin The commissioner shall seek all federal waivers and
approvals necessary to implement this chapter including, but not
limited to, waivers and approvals necessary to:
new text end

new text begin (1) merge medical assistance and MinnesotaCare coverage for
children into the children's health security program;
new text end

new text begin (2) use federal medical assistance and MinnesotaCare
dollars to pay for health care services under the children's
health security program; and
new text end

new text begin (3) maximize receipt of the federal medical assistance
match for covered children, by increasing income standards
through the use of more liberal income methodologies as provided
under United States Code, title 42, sections 1396a and 1396u-1.
new text end

Sec. 20. new text begin RULEMAKING.
new text end

new text begin The commissioner shall adopt rules to implement this act.
new text end

Sec. 21. new text begin APPROPRIATION.
new text end

new text begin $....... is appropriated from the children's health
security account to the commissioner of human services for the
fiscal year ending June 30, 2006, to develop and implement the
Children's Health Security Act.
new text end