HF 140

as introduced - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to state government; appropriating money and 
  1.3             reducing appropriations for health and human services; 
  1.4             establishing and modifying certain programs; providing 
  1.5             for regulation of certain activities and practices; 
  1.6             providing for accounts, assessments, and fees; 
  1.7             amending Minnesota Statutes 2002, sections 119B.011, 
  1.8             by adding a subdivision; 119B.09, subdivisions 1, 2; 
  1.9             119B.12, subdivision 2; 252.27, subdivision 2a; 
  1.10            256.9657, subdivision 1; 256.969, subdivision 3a; 
  1.11            256B.056, subdivisions 1a, 4; 256B.057, subdivision 2; 
  1.12            256B.06, subdivisions 4, 5; 256B.0625, subdivision 13, 
  1.13            by adding a subdivision; 256B.0635, subdivisions 1, 2; 
  1.14            256B.19, subdivision 1d; 256B.195, subdivision 4; 
  1.15            256B.32, subdivision 1; 256B.431, subdivision 23, by 
  1.16            adding a subdivision; 256B.75; 256J.11, subdivision 1; 
  1.17            256J.48, subdivision 1; 256J.52, subdivision 2; 
  1.18            256J.53, subdivision 1; 256L.07, subdivision 1; 
  1.19            256L.17, subdivision 2; Laws 2001, First Special 
  1.20            Session chapter 3, article 1, section 17, subdivision 
  1.21            11, as amended; repealing Minnesota Statutes 2002, 
  1.22            sections 256.973; 256B.056, subdivisions 1c, 3c; 
  1.23            256B.195, subdivision 5; 256D.053; 256J.11, 
  1.24            subdivisions 2, 3; Laws 1999, chapter 205, article 1, 
  1.25            section 63. 
  1.26  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.27  Section 1.  [HEALTH AND HUMAN SERVICES REDUCTIONS.] 
  1.28     The dollar amounts in the columns under "APPROPRIATION 
  1.29  CHANGE" are added to or, if shown in parentheses, are subtracted 
  1.30  from the appropriations in Laws 2001, First Special Session 
  1.31  chapter 9, as amended, by Laws 2002, chapter 220 or 374, as 
  1.32  amended, or other law to the specified agencies.  The 
  1.33  appropriations are from the general fund or other named fund and 
  1.34  are available for the fiscal years indicated for each purpose.  
  1.35  The figure "2003" means that the addition to or subtraction from 
  2.1   the appropriations listed under the figure is for the fiscal 
  2.2   year ending June 30, 2003. 
  2.3                                                          2003
  2.4   TRANSFERS FROM OTHER FUNDS                       $    9,900,000 
  2.5   APPROPRIATION REDUCTIONS                            (16,938,000)
  2.6                                              APPROPRIATION CHANGE
  2.7   Sec. 2.  COMMISSIONER OF HUMAN SERVICES 
  2.8   Subdivision 1.  Total
  2.9   Appropriation Reductions                            (11,212,000)
  2.10                Summary by Fund
  2.11  General                           (11,212,000)
  2.12  Subd. 2.  Agency Management 
  2.13  General                                              (3,333,000)
  2.14  [ADMINISTRATION REDUCTION.] The 
  2.15  department's general fund fiscal year 
  2.16  2003 administrative appropriation is 
  2.17  reduced by $3,333,000. 
  2.18  [SPECIAL REVENUE FUND TRANSFER.] 
  2.19  Notwithstanding any law to the 
  2.20  contrary, excluding accounts authorized 
  2.21  under Minnesota Statutes, section 
  2.22  16A.1286, and chapter 254B, the 
  2.23  commissioner shall transfer $1,200,000 
  2.24  of uncommitted special revenue fund 
  2.25  balances to the general fund upon final 
  2.26  enactment.  The actual transfers shall 
  2.27  be identified within the standard 
  2.28  information provided to the chairs of 
  2.29  the house health and human services 
  2.30  finance committee and the senate 
  2.31  health, human services, and corrections 
  2.32  budget division in December 2003. 
  2.33  [STATE-OPERATED SERVICES TRANSFER.] The 
  2.34  commissioner shall transfer $3,200,000 
  2.35  from the TBI enterprise, $1,000,000 
  2.36  from lease income, and $500,000 from 
  2.37  the ICF/MR depreciation accounts to the 
  2.38  general fund upon final enactment. 
  2.39  Subd. 3.  Administrative
  2.40  Reimbursement/Pass-through
  2.41  Federal TANF                                            894,000 
  2.42  [TANF INDIRECT COSTS.] The fiscal year 
  2.43  2003 federal TANF appropriation for 
  2.44  TANF indirect costs is increased by 
  2.45  $894,000.  Notwithstanding Minnesota 
  2.46  Statutes, section 256J.02, subdivision 
  2.47  5, the limit on TANF indirect cost 
  2.48  liability for fiscal year 2003 shall be 
  2.49  $2,929,000.  For the calendar quarter 
  2.50  starting October 1, 2002, and until the 
  2.51  indirect cost liability limit is 
  2.52  reached, the commissioner shall 
  2.53  reimburse the general fund a rate of 
  2.54  100 percent of TANF-allowable indirect 
  3.1   costs. 
  3.2   Subd. 4.  Children's Services Grants 
  3.3   General                                                (750,000)
  3.4   [CRIMINAL JUSTICE TRAINING GRANT.] The 
  3.5   fiscal year 2003 appropriation for the 
  3.6   criminal justice training grant is 
  3.7   reduced by $5,000. 
  3.8   [FETAL ALCOHOL SYNDROME GRANT.] The 
  3.9   fiscal year 2003 appropriation for the 
  3.10  fetal alcohol syndrome grant is reduced 
  3.11  by $106,000. 
  3.12  [FOSTER AND ADOPT RECRUITMENT GRANT.] 
  3.13  The fiscal year 2003 appropriation for 
  3.14  the foster and adopt recruitment grant 
  3.15  is reduced by $55,000. 
  3.16  [ADOPTION ASSISTANCE AND RELATIVE 
  3.17  CUSTODY ASSISTANCE GRANTS.] The fiscal 
  3.18  year 2003 appropriation for the 
  3.19  adoption assistance and relative 
  3.20  custody assistance grants is reduced by 
  3.21  $584,000. 
  3.22  Subd. 5.  MA Basic Health Care Grants -
  3.23  Families and Children 
  3.24  General                                              (1,007,000)
  3.25  Subd. 6.  MA Basic Health Care Grants -  
  3.26  Elderly and Disabled
  3.27  General                                              (2,686,000)
  3.28  Subd. 7.  General Assistance Medical 
  3.29  Care Grants
  3.30  General                                                (457,000)
  3.31  Subd. 8.  Health Care Policy Administration 
  3.32  General                                                  (5,000)
  3.33  Subd. 9.  Prescription Drug Program 
  3.34  General                                                (143,000)
  3.35  Subd. 10.  Aging and Adult Service Grants 
  3.36  General                                                (671,000)
  3.37  [HOME SHARE GRANT.] The fiscal year 
  3.38  2003 appropriation for the home share 
  3.39  grant is reduced by $156,000. 
  3.40  [COMMUNITY SERVICE GRANT.] The fiscal 
  3.41  year 2003 appropriation for the 
  3.42  community service grant is reduced by 
  3.43  $515,000. 
  3.44  [SAIL GRANTS.] The fiscal year 2003 
  3.45  appropriation for SAIL grants under 
  3.46  Minnesota Statutes, section 256B.0917, 
  3.47  is reduced by $28,000.  This is a 
  3.48  onetime reduction and does not affect 
  3.49  base funding for the program. 
  4.1   [COMMUNITY SERVICES DEVELOPMENT 
  4.2   GRANTS.] The fiscal year 2003 
  4.3   appropriation for community services 
  4.4   development grants under Minnesota 
  4.5   Statutes, section 256.9754, is reduced 
  4.6   by $39,000.  This is a onetime 
  4.7   reduction and does not affect base 
  4.8   funding for the program. 
  4.9   [HEALTH CARE CONSUMER ASSISTANCE 
  4.10  GRANTS.] The fiscal year 2003 
  4.11  appropriation for health care consumer 
  4.12  assistance grants under Minnesota 
  4.13  Statutes, section 256.9772, is reduced 
  4.14  by $38,000.  This is a onetime 
  4.15  reduction and does not affect base 
  4.16  funding for the program. 
  4.17  Subd. 11.  Medical Assistance Long-term Care
  4.18  Waivers and Home Care Grants 
  4.19  General                                                 66,000 
  4.20  [TARGETED CASE MANAGEMENT FOR HOME CARE 
  4.21  RECIPIENTS.] Implementation of the 
  4.22  targeted case management benefit for 
  4.23  home care recipients, pursuant to Laws 
  4.24  2001, First Special Session chapter 9, 
  4.25  article 3, sections 20, 21, 23 to 25, 
  4.26  27, and 28 (Minnesota Statutes, section 
  4.27  256B.0621, subdivisions 2, 3, 5 to 7, 
  4.28  9, and 10) will be delayed until July 
  4.29  1, 2005. 
  4.30  [COMMON SERVICE MENU.] Implementation 
  4.31  of the common service menu option 
  4.32  within the home- and community-based 
  4.33  waivers, pursuant to Laws 2001, First 
  4.34  Special Session chapter 9, article 3, 
  4.35  section 63 (Minnesota Statutes, section 
  4.36  256B.49, subdivision 16) will be 
  4.37  delayed until July 1, 2005. 
  4.38  Subd. 12.  Medical Assistance Long-term
  4.39  Care Facilities Grants
  4.40  General                                              7,659,000
  4.41  [ICF/MR SPECIAL RATE PROVISIONS FOR 
  4.42  OCCUPANCY.] Notwithstanding Minnesota 
  4.43  Statutes, section 256B.5013, 
  4.44  subdivision 4, the commissioner shall 
  4.45  suspend new authorizations of rate 
  4.46  adjustments to ICF/MR facilities with 
  4.47  seven or more beds for the purposes of 
  4.48  addressing occupancy.  This suspension 
  4.49  shall take effect as of April 1, 2003, 
  4.50  and shall sunset on July 1, 2003.  
  4.51  Notwithstanding Minnesota Statutes, 
  4.52  section 256B.5013, subdivision 4, the 
  4.53  commissioner, for the period April 1, 
  4.54  2003, through June 30, 2003, shall 
  4.55  adjust the total payment rate for up to 
  4.56  30 days for the remaining recipients in 
  4.57  facilities with six or fewer beds in 
  4.58  which the monthly occupancy rate of 
  4.59  licensed beds is 75 percent or higher.  
  4.60   Subd. 13.  Community Support Grants 
  5.1   [PUBLIC GUARDIANSHIP GRANTS.] The 
  5.2   fiscal year 2003 appropriation for 
  5.3   public guardianship grants is reduced 
  5.4   by $250,000.  This is a onetime 
  5.5   reduction and does not affect base 
  5.6   funding for the program. 
  5.7   Subd. 14.  Alternative Care Grants 
  5.8   General                                              (1,700,000)
  5.9   [ALTERNATIVE CARE TARGETED FUNDS 
  5.10  REDUCTION.] The commissioner shall 
  5.11  adjust the allocation of targeted 
  5.12  alternative care funds to reduce net 
  5.13  general fund expenditures by $1,000,000 
  5.14  in fiscal year 2003.  The reduction 
  5.15  shall be achieved by delaying 
  5.16  implementation of common service menu 
  5.17  provisions and by working with counties 
  5.18  to create efficiencies, including 
  5.19  moving medical assistance eligible 
  5.20  persons from alternative care to the 
  5.21  elderly waiver more quickly. 
  5.22  Subd. 15.  Chemical Dependency
  5.23  Nonentitlement Grants 
  5.24  General                                                (268,000)
  5.25  [CD NONENTITLEMENT GRANTS.] The fiscal 
  5.26  year 2003 appropriation for chemical 
  5.27  health nonentitlement grants shall be 
  5.28  reduced by $268,000.  This reduction 
  5.29  affects only the chemical use 
  5.30  assessment of minors authorized under 
  5.31  Minnesota Statutes, section 260B.157, 
  5.32  subdivision 1, and the statewide 
  5.33  detoxification transportation program 
  5.34  authorized under Minnesota Statutes, 
  5.35  section 254A.17, subdivision 3. 
  5.36  Subd. 16.  Work Grants 
  5.37  Federal TANF                                           (894,000)
  5.38  [SUPPORTIVE WORK GRANTS.] The fiscal 
  5.39  year 2003 federal TANF appropriation 
  5.40  for supportive work grants is reduced 
  5.41  by $894,000. 
  5.42  Subd. 17.  Economic Support Grants -
  5.43  Other Assistance 
  5.44  General                                                 (64,000)
  5.45  [FRAUD PREVENTION INVESTIGATION 
  5.46  GRANTS.] The fiscal year 2003 general 
  5.47  fund appropriation for fraud prevention 
  5.48  investigation grants is reduced by 
  5.49  $64,000. 
  5.50  Sec. 3.  COMMISSIONER OF HEALTH 
  5.51  Subdivision 1.  Total General Fund
  5.52  Appropriation Reductions                             (5,446,000)
  5.53                Summary by Fund
  5.54  General                            (5,446,000)
  6.1   Transfers from
  6.2   Other Funds                        (4,000,000)
  6.3   $500,000 of the appropriation reduction 
  6.4   is from long-term care quality 
  6.5   demonstration grants authorized in Laws 
  6.6   2001, First Special Session chapter 9, 
  6.7   article 17, section 3. 
  6.8   $500,000 of the appropriation reduction 
  6.9   is from long-term care transition 
  6.10  planning grants authorized in Laws 
  6.11  2001, First Special Session chapter 9, 
  6.12  article 17, section 3. 
  6.13  $3,557,549 of the appropriation 
  6.14  reduction is from WIC grants 
  6.15  administration authorized in Laws 2001, 
  6.16  First Special Session chapter 9, 
  6.17  article 17, section 3. 
  6.18  [HEALTH DISPARITIES; IMMUNIZATIONS.] 
  6.19  The fiscal year 2003 appropriation for 
  6.20  grants under Minnesota Statutes, 
  6.21  section 145.928, subdivision 7, to 
  6.22  reduce health disparities in infant 
  6.23  mortality and immunization rates, is 
  6.24  reduced by $314,000.  This is a onetime 
  6.25  reduction and does not affect base 
  6.26  funding.  
  6.27  [HEALTH DISPARITIES; GRANTS.] The 
  6.28  fiscal year 2003 appropriation for 
  6.29  grants under Minnesota Statutes, 
  6.30  section 145.928, subdivision 8, to 
  6.31  reduce health disparities in certain 
  6.32  priority areas, is reduced by 
  6.33  $108,000.  This is a onetime reduction 
  6.34  and does not affect base funding. 
  6.35  [LEAD GRANTS.] The fiscal year 2003 
  6.36  appropriation for grants under 
  6.37  Minnesota Statutes, section 144.9507, 
  6.38  subdivision 3, to meet relocation 
  6.39  requirements during lead-hazard 
  6.40  reduction work, is reduced by $25,000.  
  6.41  This is a onetime reduction and does 
  6.42  not affect base funding. 
  6.43  [FAMILY PLANNING GRANTS.] The fiscal 
  6.44  year 2003 appropriation for family 
  6.45  planning grants under Minnesota 
  6.46  Statutes, section 145.925, is reduced 
  6.47  by $56,000.  This is a onetime 
  6.48  reduction and does not affect base 
  6.49  funding. 
  6.50  [TANF WIC CLIENT SERVICES ALLOWANCE.] 
  6.51  Of the TANF funds appropriated to the 
  6.52  commissioner of health for the home 
  6.53  visiting program in Laws 2001, First 
  6.54  Special Session chapter 9, article 17, 
  6.55  section 3, subdivision 2, and Laws 
  6.56  2000, chapter 488, article 8, section 
  6.57  2, subdivision 6, clause (3), and 
  6.58  allocated to community health boards 
  6.59  and tribal governments under Minnesota 
  6.60  Statutes, section 145A.17, up to 
  6.61  $3,500,000 may be spent for WIC client 
  6.62  services under Minnesota Statutes, 
  6.63  section 145.894, clause (c).  The 
  7.1   commissioner of health shall determine 
  7.2   a method for apportioning this 
  7.3   allowance between family home visiting 
  7.4   and WIC client services within the 
  7.5   allocations provided to the community 
  7.6   health boards and tribal governments 
  7.7   for the remainder of fiscal year 2003. 
  7.8   $4,000,000 of the appropriation for 
  7.9   tobacco use and prevention activities 
  7.10  under Minnesota Statutes, section 
  7.11  144.395, subdivision 2, is transferred 
  7.12  to the commissioner of finance for 
  7.13  cancellation to the general fund. 
  7.14  Sec. 4.  EMERGENCY MEDICAL SERVICES BOARD               (45,000)
  7.15  Sec. 5.  COUNCIL ON DISABILITY                          (29,000) 
  7.16  Sec. 6.  OMBUDSMAN FOR MENTAL HEALTH
  7.17  AND MENTAL RETARDATION                                  (73,000)
  7.18  [CANCELLATION.] $14,500 of the amount 
  7.19  for crime victims oversight is canceled 
  7.20  to the general fund. 
  7.21  Sec. 7.  OMBUDSMAN FOR FAMILIES                          (9,000)
  7.22  Sec. 8.  VETERANS HOMES BOARD                          (124,000)
  7.23     Sec. 9.  Minnesota Statutes 2002, section 119B.011, is 
  7.24  amended by adding a subdivision to read: 
  7.25     Subd. 23.  [FEDERAL POVERTY GUIDELINES.] "Federal poverty 
  7.26  guidelines" means the annual poverty guidelines for a family of 
  7.27  four, adjusted for family size, published annually by the United 
  7.28  States Department of Health and Human Services in the Federal 
  7.29  Register. 
  7.30     Sec. 10.  Minnesota Statutes 2002, section 119B.09, 
  7.31  subdivision 1, is amended to read: 
  7.32     Subdivision 1.  [GENERAL ELIGIBILITY REQUIREMENTS FOR ALL 
  7.33  APPLICANTS FOR CHILD CARE ASSISTANCE.] (a) Child care services 
  7.34  must be available to families who need child care to find or 
  7.35  keep employment or to obtain the training or education necessary 
  7.36  to find employment and who: 
  7.37     (1) meet the requirements of section 119B.05; receive MFIP 
  7.38  assistance; and are participating in employment and training 
  7.39  services under chapter 256J or 256K; 
  7.40     (2) have household income below the eligibility levels for 
  7.41  MFIP; or 
  7.42     (3) have household income within a range established by the 
  7.43  commissioner no greater than 250 percent of the federal poverty 
  8.1   guidelines, adjusted for family size. 
  8.2      (b) Child care services must be made available as in-kind 
  8.3   services.  
  8.4      (c) All applicants for child care assistance and families 
  8.5   currently receiving child care assistance must be assisted and 
  8.6   required to cooperate in establishment of paternity and 
  8.7   enforcement of child support obligations for all children in the 
  8.8   family as a condition of program eligibility.  For purposes of 
  8.9   this section, a family is considered to meet the requirement for 
  8.10  cooperation when the family complies with the requirements of 
  8.11  section 256.741. 
  8.12     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
  8.13     Sec. 11.  Minnesota Statutes 2002, section 119B.09, 
  8.14  subdivision 2, is amended to read: 
  8.15     Subd. 2.  [SLIDING FEE.] Child care services to 
  8.16  families with incomes in the commissioner's established range 
  8.17  must be made available on a sliding fee basis.  The upper limit 
  8.18  of the range must be neither less than 70 percent nor more than 
  8.19  90 percent of the state median income for a family of four, 
  8.20  adjusted for family size. 
  8.21     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
  8.22     Sec. 12.  Minnesota Statutes 2002, section 119B.12, 
  8.23  subdivision 2, is amended to read: 
  8.24     Subd. 2.  [PARENT FEE.] A family's monthly parent fee must 
  8.25  be a fixed percentage of its annual gross income.  Parent fees 
  8.26  must apply to families eligible for child care assistance under 
  8.27  sections 119B.03 and 119B.05.  Income must be as defined in 
  8.28  section 119B.011, subdivision 15.  The fixed percent is based on 
  8.29  the relationship of the family's annual gross income to 100 250 
  8.30  percent of state median income the federal poverty guidelines.  
  8.31  Beginning January 1, 1998, parent fees must begin at 75 percent 
  8.32  of the poverty level.  The minimum parent fees for families 
  8.33  between 75 percent and 100 percent of poverty level must 
  8.34  be $5 $10 per month.  Parent fees must be established in rule 
  8.35  and must provide for graduated movement to full payment. 
  8.36     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
  9.1      Sec. 13.  Minnesota Statutes 2002, section 252.27, 
  9.2   subdivision 2a, is amended to read: 
  9.3      Subd. 2a.  [CONTRIBUTION AMOUNT.] (a) The natural or 
  9.4   adoptive parents of a minor child, including a child determined 
  9.5   eligible for medical assistance without consideration of 
  9.6   parental income, must contribute monthly to the cost of 
  9.7   services, unless the child is married or has been married, 
  9.8   parental rights have been terminated, or the child's adoption is 
  9.9   subsidized according to section 259.67 or through title IV-E of 
  9.10  the Social Security Act. 
  9.11     (b) The parental contribution shall be the greater of a 
  9.12  minimum monthly fee of $25 for households with adjusted gross 
  9.13  income of $30,000 and over, or an amount to be computed by 
  9.14  applying to the adjusted gross income of the natural or adoptive 
  9.15  parents that exceeds 150 percent of the federal poverty 
  9.16  guidelines for the applicable household size, the following 
  9.17  schedule of rates: 
  9.18     (1) on the amount of adjusted gross income over 150 percent 
  9.19  of poverty, but not over $50,000, ten percent; 
  9.20     (2) on the amount of adjusted gross income over 150 percent 
  9.21  of poverty and over $50,000 but not over $60,000, 12 percent; 
  9.22     (3) on the amount of adjusted gross income over 150 percent 
  9.23  of poverty, and over $60,000 but not over $75,000, 14 percent; 
  9.24  and 
  9.25     (4) on all adjusted gross income amounts over 150 percent 
  9.26  of poverty, and over $75,000, 15 percent. 
  9.27     If the child lives with the parent, the parental 
  9.28  contribution is reduced by $200, except that the parent must pay 
  9.29  the minimum monthly $25 fee under this paragraph.  If the child 
  9.30  resides in an institution specified in section 256B.35, the 
  9.31  parent is responsible for the personal needs allowance specified 
  9.32  under that section in addition to the parental contribution 
  9.33  determined under this section.  The parental contribution is 
  9.34  reduced by any amount required to be paid directly to the child 
  9.35  pursuant to a court order, but only if actually paid. 
  9.36     (c) The household size to be used in determining the amount 
 10.1   of contribution under paragraph (b) includes natural and 
 10.2   adoptive parents and their dependents under age 21, including 
 10.3   the child receiving services.  Adjustments in the contribution 
 10.4   amount due to annual changes in the federal poverty guidelines 
 10.5   shall be implemented on the first day of July following 
 10.6   publication of the changes. 
 10.7      (d) For purposes of paragraph (b), "income" means the 
 10.8   adjusted gross income of the natural or adoptive parents 
 10.9   determined according to the previous year's federal tax form. 
 10.10     (e) The contribution shall be explained in writing to the 
 10.11  parents at the time eligibility for services is being 
 10.12  determined.  The contribution shall be made on a monthly basis 
 10.13  effective with the first month in which the child receives 
 10.14  services.  Annually upon redetermination or at termination of 
 10.15  eligibility, if the contribution exceeded the cost of services 
 10.16  provided, the local agency or the state shall reimburse that 
 10.17  excess amount to the parents, either by direct reimbursement if 
 10.18  the parent is no longer required to pay a contribution, or by a 
 10.19  reduction in or waiver of parental fees until the excess amount 
 10.20  is exhausted. 
 10.21     (f) The monthly contribution amount must be reviewed at 
 10.22  least every 12 months; when there is a change in household size; 
 10.23  and when there is a loss of or gain in income from one month to 
 10.24  another in excess of ten percent.  The local agency shall mail a 
 10.25  written notice 30 days in advance of the effective date of a 
 10.26  change in the contribution amount.  A decrease in the 
 10.27  contribution amount is effective in the month that the parent 
 10.28  verifies a reduction in income or change in household size. 
 10.29     (g) Parents of a minor child who do not live with each 
 10.30  other shall each pay the contribution required under paragraph 
 10.31  (a), except that a court-ordered child support payment actually 
 10.32  paid on behalf of the child receiving services shall be deducted 
 10.33  from the contribution of the parent making the payment. 
 10.34     (h) The contribution under paragraph (b) shall be increased 
 10.35  by an additional five percent if the local agency determines 
 10.36  that insurance coverage is available but not obtained for the 
 11.1   child.  For purposes of this section, "available" means the 
 11.2   insurance is a benefit of employment for a family member at an 
 11.3   annual cost of no more than five percent of the family's annual 
 11.4   income.  For purposes of this section, "insurance" means health 
 11.5   and accident insurance coverage, enrollment in a nonprofit 
 11.6   health service plan, health maintenance organization, 
 11.7   self-insured plan, or preferred provider organization. 
 11.8      Parents who have more than one child receiving services 
 11.9   shall not be required to pay more than the amount for the child 
 11.10  with the highest expenditures.  There shall be no resource 
 11.11  contribution from the parents.  The parent shall not be required 
 11.12  to pay a contribution in excess of the cost of the services 
 11.13  provided to the child, not counting payments made to school 
 11.14  districts for education-related services.  Notice of an increase 
 11.15  in fee payment must be given at least 30 days before the 
 11.16  increased fee is due.  
 11.17     (i) The contribution under paragraph (b) shall be reduced 
 11.18  by $300 per fiscal year if, in the 12 months prior to July 1: 
 11.19     (1) the parent applied for insurance for the child; 
 11.20     (2) the insurer denied insurance; 
 11.21     (3) the parents submitted a complaint or appeal, in writing 
 11.22  to the insurer, submitted a complaint or appeal, in writing, to 
 11.23  the commissioner of health or the commissioner of commerce, or 
 11.24  litigated the complaint or appeal; and 
 11.25     (4) as a result of the dispute, the insurer reversed its 
 11.26  decision and granted insurance. 
 11.27     For purposes of this section, "insurance" has the meaning 
 11.28  given in paragraph (h). 
 11.29     A parent who has requested a reduction in the contribution 
 11.30  amount under this paragraph shall submit proof in the form and 
 11.31  manner prescribed by the commissioner or county agency, 
 11.32  including, but not limited to, the insurer's denial of 
 11.33  insurance, the written letter or complaint of the parents, court 
 11.34  documents, and the written response of the insurer approving 
 11.35  insurance.  The determinations of the commissioner or county 
 11.36  agency under this paragraph are not rules subject to chapter 14. 
 12.1      (j) The contribution calculated under paragraph (b) shall 
 12.2   be increased by five percent.  
 12.3      [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 12.4      Sec. 14.  Minnesota Statutes 2002, section 256.9657, 
 12.5   subdivision 1, is amended to read: 
 12.6      Subdivision 1.  [NURSING HOME LICENSE SURCHARGE.] (a) 
 12.7   Effective July 1, 1993, each non-state-operated nursing home 
 12.8   licensed under chapter 144A shall pay to the commissioner an 
 12.9   annual surcharge according to the schedule in subdivision 4.  
 12.10  The surcharge shall be calculated as $620 per licensed bed.  If 
 12.11  the number of licensed beds is reduced, the surcharge shall be 
 12.12  based on the number of remaining licensed beds the second month 
 12.13  following the receipt of timely notice by the commissioner of 
 12.14  human services that beds have been delicensed.  The nursing home 
 12.15  must notify the commissioner of health in writing when beds are 
 12.16  delicensed.  The commissioner of health must notify the 
 12.17  commissioner of human services within ten working days after 
 12.18  receiving written notification.  If the notification is received 
 12.19  by the commissioner of human services by the 15th of the month, 
 12.20  the invoice for the second following month must be reduced to 
 12.21  recognize the delicensing of beds.  Beds on layaway status 
 12.22  continue to be subject to the surcharge.  The commissioner of 
 12.23  human services must acknowledge a medical care surcharge appeal 
 12.24  within 30 days of receipt of the written appeal from the 
 12.25  provider. 
 12.26     (b) Effective July 1, 1994, the surcharge in paragraph (a) 
 12.27  shall be increased to $625. 
 12.28     (c) Effective August 15, 2002, the surcharge under 
 12.29  paragraph (b) shall be increased to $990. 
 12.30     (d) Effective April 15, 2003, the surcharge under paragraph 
 12.31  (c) shall be increased to $2,741. 
 12.32     (e) Between April 1, 2002, and August 15, 2003 2004, a 
 12.33  facility governed by this subdivision may elect to assume full 
 12.34  participation in the medical assistance program by agreeing to 
 12.35  comply with all of the requirements of the medical assistance 
 12.36  program, including the rate equalization law in section 256B.48, 
 13.1   subdivision 1, paragraph (a), and all other requirements 
 13.2   established in law or rule, and to begin intake of new medical 
 13.3   assistance recipients.  Rates will be determined under Minnesota 
 13.4   Rules, parts 9549.0010 to 9549.0080.  Notwithstanding section 
 13.5   256B.431, subdivision 27, paragraph (i), rate calculations will 
 13.6   be subject to limits as prescribed in rule and law.  Other than 
 13.7   the adjustments in sections 256B.431, subdivisions 30 and 32; 
 13.8   256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 
 13.9   9549.0057, and any other applicable legislation enacted prior to 
 13.10  the finalization of rates, facilities assuming full 
 13.11  participation in medical assistance under this paragraph are not 
 13.12  eligible for any rate adjustments until the July 1 following 
 13.13  their settle-up period. 
 13.14     [EFFECTIVE DATE.] This section is effective February 28, 
 13.15  2003. 
 13.16     Sec. 15.  Minnesota Statutes 2002, section 256.969, 
 13.17  subdivision 3a, is amended to read: 
 13.18     Subd. 3a.  [PAYMENTS.] (a) Acute care hospital billings 
 13.19  under the medical assistance program must not be submitted until 
 13.20  the recipient is discharged.  However, the commissioner shall 
 13.21  establish monthly interim payments for inpatient hospitals that 
 13.22  have individual patient lengths of stay over 30 days regardless 
 13.23  of diagnostic category.  Except as provided in section 256.9693, 
 13.24  medical assistance reimbursement for treatment of mental illness 
 13.25  shall be reimbursed based on diagnostic classifications.  
 13.26  Individual hospital payments established under this section and 
 13.27  sections 256.9685, 256.9686, and 256.9695, in addition to third 
 13.28  party and recipient liability, for discharges occurring during 
 13.29  the rate year shall not exceed, in aggregate, the charges for 
 13.30  the medical assistance covered inpatient services paid for the 
 13.31  same period of time to the hospital.  This payment limitation 
 13.32  shall be calculated separately for medical assistance and 
 13.33  general assistance medical care services.  The limitation on 
 13.34  general assistance medical care shall be effective for 
 13.35  admissions occurring on or after July 1, 1991.  Services that 
 13.36  have rates established under subdivision 11 or 12, must be 
 14.1   limited separately from other services.  After consulting with 
 14.2   the affected hospitals, the commissioner may consider related 
 14.3   hospitals one entity and may merge the payment rates while 
 14.4   maintaining separate provider numbers.  The operating and 
 14.5   property base rates per admission or per day shall be derived 
 14.6   from the best Medicare and claims data available when rates are 
 14.7   established.  The commissioner shall determine the best Medicare 
 14.8   and claims data, taking into consideration variables of recency 
 14.9   of the data, audit disposition, settlement status, and the 
 14.10  ability to set rates in a timely manner.  The commissioner shall 
 14.11  notify hospitals of payment rates by December 1 of the year 
 14.12  preceding the rate year.  The rate setting data must reflect the 
 14.13  admissions data used to establish relative values.  Base year 
 14.14  changes from 1981 to the base year established for the rate year 
 14.15  beginning January 1, 1991, and for subsequent rate years, shall 
 14.16  not be limited to the limits ending June 30, 1987, on the 
 14.17  maximum rate of increase under subdivision 1.  The commissioner 
 14.18  may adjust base year cost, relative value, and case mix index 
 14.19  data to exclude the costs of services that have been 
 14.20  discontinued by the October 1 of the year preceding the rate 
 14.21  year or that are paid separately from inpatient services.  
 14.22  Inpatient stays that encompass portions of two or more rate 
 14.23  years shall have payments established based on payment rates in 
 14.24  effect at the time of admission unless the date of admission 
 14.25  preceded the rate year in effect by six months or more.  In this 
 14.26  case, operating payment rates for services rendered during the 
 14.27  rate year in effect and established based on the date of 
 14.28  admission shall be adjusted to the rate year in effect by the 
 14.29  hospital cost index. 
 14.30     (b) For fee-for-service admissions occurring on or after 
 14.31  July 1, 2002, the total payment, before third-party liability 
 14.32  and spenddown, made to hospitals for inpatient services is 
 14.33  reduced by .5 percent from the current statutory rates. 
 14.34     (c) For fee-for-service admissions occurring on or after 
 14.35  March 1, 2003, the total payment, before third-party liability 
 14.36  and spenddown, made to hospitals for inpatient services is 
 15.1   reduced five percent from the current statutory rates.  Mental 
 15.2   health services within diagnosis related groups 424 to 432 and 
 15.3   facilities defined under subdivision 16 are excluded from this 
 15.4   paragraph. 
 15.5      Sec. 16.  Minnesota Statutes 2002, section 256B.056, 
 15.6   subdivision 1a, is amended to read: 
 15.7      Subd. 1a.  [INCOME AND ASSETS GENERALLY.] Unless 
 15.8   specifically required by state law or rule or federal law or 
 15.9   regulation, the methodologies used in counting income and assets 
 15.10  to determine eligibility for medical assistance for persons 
 15.11  whose eligibility category is based on blindness, disability, or 
 15.12  age of 65 or more years, the methodologies for the supplemental 
 15.13  security income program shall be used.  Increases in benefits 
 15.14  under title II of the Social Security Act shall not be counted 
 15.15  as income for purposes of this subdivision until July 1 of each 
 15.16  year.  Effective upon federal approval, for children eligible 
 15.17  under section 256B.055, subdivision 12, or for home and 
 15.18  community-based waiver services whose eligibility for medical 
 15.19  assistance is determined without regard to parental income, 
 15.20  child support payments, including any payments made by an 
 15.21  obligor in satisfaction of or in addition to a temporary or 
 15.22  permanent order for child support, and social security payments 
 15.23  are not counted as income.  For families and children, which 
 15.24  includes all other eligibility categories, the methodologies 
 15.25  under the state's AFDC plan in effect as of July 16, 1996, as 
 15.26  required by the Personal Responsibility and Work Opportunity 
 15.27  Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193, 
 15.28  shall be used, except that effective July 1, 2002, the $90 and 
 15.29  $30 and one-third earned income disregards shall not apply and 
 15.30  the disregard specified in subdivision 1c shall apply.  For 
 15.31  these purposes, a "methodology" does not include an asset or 
 15.32  income standard, or accounting method, or method of determining 
 15.33  effective dates. 
 15.34     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 15.35     Sec. 17.  Minnesota Statutes 2002, section 256B.056, 
 15.36  subdivision 4, is amended to read: 
 16.1      Subd. 4.  [INCOME.] (a) To be eligible for medical 
 16.2   assistance, a person eligible under section 256B.055, 
 16.3   subdivisions 7, 7a, and 12, may have income up to 100 percent of 
 16.4   the federal poverty guidelines.  Effective January 1, 2000, and 
 16.5   each successive January, recipients of supplemental security 
 16.6   income may have an income up to the supplemental security income 
 16.7   standard in effect on that date.  
 16.8      (b) To be eligible for medical assistance, families and 
 16.9   children may have an income up to 133-1/3 percent of the AFDC 
 16.10  income standard in effect under the July 16, 1996, AFDC state 
 16.11  plan.  Effective July 1, 2000, the base AFDC standard in effect 
 16.12  on July 16, 1996, shall be increased by three percent.  
 16.13     (c) Effective July 1, 2002, to be eligible for medical 
 16.14  assistance, families and children may have an income up to 100 
 16.15  percent of the federal poverty guidelines for the family size.  
 16.16     (d) In computing income to determine eligibility of persons 
 16.17  under paragraphs (a) to (c) and (b) who are not residents of 
 16.18  long-term care facilities, the commissioner shall disregard 
 16.19  increases in income as required by Public Law Numbers 94-566, 
 16.20  section 503; 99-272; and 99-509.  Veterans aid and attendance 
 16.21  benefits and Veterans Administration unusual medical expense 
 16.22  payments are considered income to the recipient. 
 16.23     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 16.24     Sec. 18.  Minnesota Statutes 2002, section 256B.057, 
 16.25  subdivision 2, is amended to read: 
 16.26     Subd. 2.  [CHILDREN.] Except as specified in subdivision 
 16.27  1b, effective July 1, 2002, A child one through 18 five years of 
 16.28  age in a family whose countable income is no greater less than 
 16.29  170 133 percent of the federal poverty guidelines for the same 
 16.30  family size, is eligible for medical assistance.  A child six 
 16.31  through 18 years of age, in a family whose countable income is 
 16.32  less than 100 percent of the federal poverty guidelines for the 
 16.33  same family size, is eligible for medical assistance. 
 16.34     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 16.35     Sec. 19.  Minnesota Statutes 2002, section 256B.06, 
 16.36  subdivision 4, is amended to read: 
 17.1      Subd. 4.  [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 
 17.2   medical assistance is limited to citizens of the United States, 
 17.3   qualified noncitizens as defined in this subdivision, and other 
 17.4   persons residing lawfully in the United States. 
 17.5      (b) "Qualified noncitizen" means a person who meets one of 
 17.6   the following immigration criteria: 
 17.7      (1) admitted for lawful permanent residence according to 
 17.8   United States Code, title 8; 
 17.9      (2) admitted to the United States as a refugee according to 
 17.10  United States Code, title 8, section 1157; 
 17.11     (3) granted asylum according to United States Code, title 
 17.12  8, section 1158; 
 17.13     (4) granted withholding of deportation according to United 
 17.14  States Code, title 8, section 1253(h); 
 17.15     (5) paroled for a period of at least one year according to 
 17.16  United States Code, title 8, section 1182(d)(5); 
 17.17     (6) granted conditional entrant status according to United 
 17.18  States Code, title 8, section 1153(a)(7); 
 17.19     (7) determined to be a battered noncitizen by the United 
 17.20  States Attorney General according to the Illegal Immigration 
 17.21  Reform and Immigrant Responsibility Act of 1996, title V of the 
 17.22  Omnibus Consolidated Appropriations Bill, Public Law Number 
 17.23  104-200; 
 17.24     (8) is a child of a noncitizen determined to be a battered 
 17.25  noncitizen by the United States Attorney General according to 
 17.26  the Illegal Immigration Reform and Immigrant Responsibility Act 
 17.27  of 1996, title V, of the Omnibus Consolidated Appropriations 
 17.28  Bill, Public Law Number 104-200; or 
 17.29     (9) determined to be a Cuban or Haitian entrant as defined 
 17.30  in section 501(e) of Public Law Number 96-422, the Refugee 
 17.31  Education Assistance Act of 1980; 
 17.32     (10) determined to be an Amerasian immigrant; 
 17.33     (11) determined to be an American Indian born outside of 
 17.34  the United States who is a member of a federally recognized 
 17.35  tribe; 
 17.36     (12) determined to be a Canadian with 50 percent or more 
 18.1   American Indian blood; 
 18.2      (13) is a noncitizen veteran of the United States Armed 
 18.3   Forces with an honorable discharge for a reason other than 
 18.4   noncitizen status, the person's spouse and unmarried minor 
 18.5   dependent children; or 
 18.6      (14) is a noncitizen on active duty in the United States 
 18.7   Armed Forces, other than for training, the person's spouse and 
 18.8   unmarried minor dependent children. 
 18.9      (c) All qualified noncitizens who were residing in the 
 18.10  United States before August 22, 1996, who otherwise meet the 
 18.11  eligibility requirements of chapter 256B, are eligible for 
 18.12  medical assistance with federal financial participation. 
 18.13     (d) All Qualified noncitizens described in paragraph (b), 
 18.14  clauses (1), (5), (6), (7), and (8), who entered the United 
 18.15  States on or after August 22, 1996, and who otherwise meet the 
 18.16  eligibility requirements of chapter 256B, are eligible for 
 18.17  medical assistance with federal financial participation through 
 18.18  November 30, 1996 after five years from date of entry. 
 18.19     Beginning December 1, 1996, qualified noncitizens who 
 18.20  entered the United States on or after August 22, 1996, and who 
 18.21  otherwise meet the eligibility requirements of chapter 256B are 
 18.22  eligible for medical assistance with federal participation for 
 18.23  five years if they meet one of the following criteria: 
 18.24     (i) refugees admitted to the United States according to 
 18.25  United States Code, title 8, section 1157; 
 18.26     (ii) persons granted asylum according to United States 
 18.27  Code, title 8, section 1158; 
 18.28     (iii) persons granted withholding of deportation according 
 18.29  to United States Code, title 8, section 1253(h); 
 18.30     (iv) noncitizen veterans of the United States Armed Forces 
 18.31  with an honorable discharge for a reason other than noncitizen 
 18.32  status, their spouses and unmarried minor dependent children; or 
 18.33     (v) noncitizen persons on active duty in the United States 
 18.34  Armed Forces, other than for training, their spouses and 
 18.35  unmarried minor dependent children; 
 18.36     (vi) Amerasian immigrants; 
 19.1      (vii) Cuban or Haitian entrants as defined in section 
 19.2   501(e) of Public Law 96-422, the Refugee Education Assistance 
 19.3   Act of 1980; 
 19.4      (viii) American Indians born outside of the United States 
 19.5   who are members of federally recognized tribes; or 
 19.6      (ix) Canadians with 50 percent or more American Indian 
 19.7   blood. 
 19.8      Beginning December 1, 1996, qualified noncitizens who do 
 19.9   not meet one of the criteria in items (i) to (v) are eligible 
 19.10  for medical assistance without federal financial participation 
 19.11  as described in paragraph (j). 
 19.12     (e) Noncitizens who are not qualified noncitizens as 
 19.13  defined in paragraph (b), who are lawfully residing in the 
 19.14  United States and who otherwise meet the eligibility 
 19.15  requirements of chapter 256B, are eligible for medical 
 19.16  assistance under clauses (1) to (3).  These individuals must 
 19.17  cooperate with the Immigration and Naturalization Service to 
 19.18  pursue any applicable immigration status, including citizenship, 
 19.19  that would qualify them for medical assistance with federal 
 19.20  financial participation. 
 19.21     (1) Persons who were medical assistance recipients on 
 19.22  August 22, 1996, are eligible for medical assistance with 
 19.23  federal financial participation through December 31, 1996. 
 19.24     (2) Beginning January 1, 1997, persons described in clause 
 19.25  (1) are eligible for medical assistance without federal 
 19.26  financial participation as described in paragraph (j). 
 19.27     (3) Beginning December 1, 1996, persons residing in the 
 19.28  United States prior to August 22, 1996, who were not receiving 
 19.29  medical assistance and persons who arrived on or after August 
 19.30  22, 1996, are eligible for medical assistance without federal 
 19.31  financial participation as described in paragraph (j). 
 19.32     (f) Nonimmigrants who otherwise meet the eligibility 
 19.33  requirements of chapter 256B are eligible for the benefits as 
 19.34  provided in paragraphs (g) to (i).  For purposes of this 
 19.35  subdivision, a "nonimmigrant" is a person in one of the classes 
 19.36  listed in United States Code, title 8, section 1101(a)(15). 
 20.1      (g) (e) Payment shall also be made for care and services 
 20.2   that are furnished to noncitizens, regardless of immigration 
 20.3   status, who otherwise meet the eligibility requirements of 
 20.4   chapter 256B, if such care and services are necessary for the 
 20.5   treatment of an emergency medical condition, except for organ 
 20.6   transplants and related care and services and routine prenatal 
 20.7   care.  
 20.8      (h) (f) For purposes of this subdivision, the term 
 20.9   "emergency medical condition" means a medical condition that 
 20.10  meets the requirements of United States Code, title 42, section 
 20.11  1396b(v). 
 20.12     (i) Pregnant noncitizens who are undocumented or 
 20.13  nonimmigrants, who otherwise meet the eligibility requirements 
 20.14  of chapter 256B, are eligible for medical assistance payment 
 20.15  without federal financial participation for care and services 
 20.16  through the period of pregnancy, and 60 days postpartum, except 
 20.17  for labor and delivery.  
 20.18     (j) Qualified noncitizens as described in paragraph (d), 
 20.19  and all other noncitizens lawfully residing in the United States 
 20.20  as described in paragraph (e), who are ineligible for medical 
 20.21  assistance with federal financial participation and who 
 20.22  otherwise meet the eligibility requirements of chapter 256B and 
 20.23  of this paragraph, are eligible for medical assistance without 
 20.24  federal financial participation.  Qualified noncitizens as 
 20.25  described in paragraph (d) are only eligible for medical 
 20.26  assistance without federal financial participation for five 
 20.27  years from their date of entry into the United States.  
 20.28     (k) The commissioner shall submit to the legislature by 
 20.29  December 31, 1998, a report on the number of recipients and cost 
 20.30  of coverage of care and services made according to paragraphs 
 20.31  (i) and (j). 
 20.32     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 20.33     Sec. 20.  Minnesota Statutes 2002, section 256B.06, 
 20.34  subdivision 5, is amended to read: 
 20.35     Subd. 5.  [DEEMING OF SPONSOR INCOME AND RESOURCES.] When 
 20.36  determining eligibility for any federal or state funded medical 
 21.1   assistance under this section, the income and resources of all 
 21.2   noncitizens shall be deemed to include their sponsors' income 
 21.3   and resources as required under the Personal Responsibility and 
 21.4   Work Opportunity Reconciliation Act of 1996, title IV, Public 
 21.5   Law Number 104-193, sections 421 and 422, and subsequently set 
 21.6   out in federal rules.  This section is effective May 1, 1997. 
 21.7      [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 21.8      Sec. 21.  Minnesota Statutes 2002, section 256B.0625, 
 21.9   subdivision 13, is amended to read: 
 21.10     Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
 21.11  except for fertility drugs when specifically used to enhance 
 21.12  fertility, if prescribed by a licensed practitioner and 
 21.13  dispensed by a licensed pharmacist, by a physician enrolled in 
 21.14  the medical assistance program as a dispensing physician, or by 
 21.15  a physician or a nurse practitioner employed by or under 
 21.16  contract with a community health board as defined in section 
 21.17  145A.02, subdivision 5, for the purposes of communicable disease 
 21.18  control.  The commissioner, after receiving recommendations from 
 21.19  professional medical associations and professional pharmacist 
 21.20  associations, shall designate a formulary committee to advise 
 21.21  the commissioner on the names of drugs for which payment is 
 21.22  made, recommend a system for reimbursing providers on a set fee 
 21.23  or charge basis rather than the present system, and develop 
 21.24  methods encouraging use of generic drugs when they are less 
 21.25  expensive and equally effective as trademark drugs.  The 
 21.26  formulary committee shall consist of nine members, four of whom 
 21.27  shall be physicians who are not employed by the department of 
 21.28  human services, and a majority of whose practice is for persons 
 21.29  paying privately or through health insurance, three of whom 
 21.30  shall be pharmacists who are not employed by the department of 
 21.31  human services, and a majority of whose practice is for persons 
 21.32  paying privately or through health insurance, a consumer 
 21.33  representative, and a nursing home representative.  Committee 
 21.34  members shall serve three-year terms and shall serve without 
 21.35  compensation.  Members may be reappointed once.  
 21.36     (b) The commissioner shall establish a drug formulary.  Its 
 22.1   establishment and publication shall not be subject to the 
 22.2   requirements of the Administrative Procedure Act, but the 
 22.3   formulary committee shall review and comment on the formulary 
 22.4   contents.  
 22.5      The formulary shall not include:  
 22.6      (i) drugs or products for which there is no federal 
 22.7   funding; 
 22.8      (ii) over-the-counter drugs, except for antacids, 
 22.9   acetaminophen, family planning products, aspirin, insulin, 
 22.10  products for the treatment of lice, vitamins for adults with 
 22.11  documented vitamin deficiencies, vitamins for children under the 
 22.12  age of seven and pregnant or nursing women, and any other 
 22.13  over-the-counter drug identified by the commissioner, in 
 22.14  consultation with the drug formulary committee, as necessary, 
 22.15  appropriate, and cost-effective for the treatment of certain 
 22.16  specified chronic diseases, conditions or disorders, and this 
 22.17  determination shall not be subject to the requirements of 
 22.18  chapter 14; 
 22.19     (iii) anorectics, except that medically necessary 
 22.20  anorectics shall be covered for a recipient previously diagnosed 
 22.21  as having pickwickian syndrome and currently diagnosed as having 
 22.22  diabetes and being morbidly obese; 
 22.23     (iv) drugs for which medical value has not been 
 22.24  established; and 
 22.25     (v) drugs from manufacturers who have not signed a rebate 
 22.26  agreement with the Department of Health and Human Services 
 22.27  pursuant to section 1927 of title XIX of the Social Security Act.
 22.28     The commissioner shall publish conditions for prohibiting 
 22.29  payment for specific drugs after considering the formulary 
 22.30  committee's recommendations.  An honorarium of $100 per meeting 
 22.31  and reimbursement for mileage shall be paid to each committee 
 22.32  member in attendance.  
 22.33     (c) The basis for determining the amount of payment shall 
 22.34  be the lower of the actual acquisition costs of the drugs plus a 
 22.35  fixed dispensing fee; the maximum allowable cost set by the 
 22.36  federal government or by the commissioner plus the fixed 
 23.1   dispensing fee; or the usual and customary price charged to the 
 23.2   public.  The amount of payment basis must be reduced to reflect 
 23.3   all discount amounts applied to the charge by any 
 23.4   provider/insurer agreement or contract for submitted charges to 
 23.5   medical assistance programs.  The net submitted charge may not 
 23.6   be greater than the patient liability for the service.  The 
 23.7   pharmacy dispensing fee shall be $3.65, except that the 
 23.8   dispensing fee for intravenous solutions which must be 
 23.9   compounded by the pharmacist shall be $8 per bag, $14 per bag 
 23.10  for cancer chemotherapy products, and $30 per bag for total 
 23.11  parenteral nutritional products dispensed in one liter 
 23.12  quantities, or $44 per bag for total parenteral nutritional 
 23.13  products dispensed in quantities greater than one liter.  Actual 
 23.14  acquisition cost includes quantity and other special discounts 
 23.15  except time and cash discounts.  The actual acquisition cost of 
 23.16  a drug shall be estimated by the commissioner, at average 
 23.17  wholesale price minus nine 14 percent, except that where a drug 
 23.18  has had its wholesale price reduced as a result of the actions 
 23.19  of the National Association of Medicaid Fraud Control Units, the 
 23.20  estimated actual acquisition cost shall be the reduced average 
 23.21  wholesale price, without the nine 14 percent deduction.  For the 
 23.22  period March 1, 2003, through June 30, 2003, the commissioner 
 23.23  shall estimate the actual acquisition cost of a drug at average 
 23.24  wholesale price minus 12.6 percent, except that where a drug has 
 23.25  had its wholesale price reduced as a result of the actions of 
 23.26  the National Association of Medicaid Fraud Control Units, the 
 23.27  estimated actual acquisition cost shall be the reduced average 
 23.28  wholesale price, without the 12.6 percent deduction.  The 
 23.29  maximum allowable cost of a multisource drug may be set by the 
 23.30  commissioner and it shall be comparable to, but no higher than, 
 23.31  the maximum amount paid by other third-party payors in this 
 23.32  state who have maximum allowable cost programs.  The 
 23.33  commissioner shall set maximum allowable costs for multisource 
 23.34  drugs that are not on the federal upper limit list as described 
 23.35  in United States Code, title 42, chapter 7, section 1396r-8(e), 
 23.36  the Social Security Act, and Code of Federal Regulations, title 
 24.1   42, part 447, section 447.332.  Establishment of the amount of 
 24.2   payment for drugs shall not be subject to the requirements of 
 24.3   the Administrative Procedure Act.  An additional dispensing fee 
 24.4   of $.30 may be added to the dispensing fee paid to pharmacists 
 24.5   for legend drug prescriptions dispensed to residents of 
 24.6   long-term care facilities when a unit dose blister card system, 
 24.7   approved by the department, is used.  Under this type of 
 24.8   dispensing system, the pharmacist must dispense a 30-day supply 
 24.9   of drug.  The National Drug Code (NDC) from the drug container 
 24.10  used to fill the blister card must be identified on the claim to 
 24.11  the department.  The unit dose blister card containing the drug 
 24.12  must meet the packaging standards set forth in Minnesota Rules, 
 24.13  part 6800.2700, that govern the return of unused drugs to the 
 24.14  pharmacy for reuse.  The pharmacy provider will be required to 
 24.15  credit the department for the actual acquisition cost of all 
 24.16  unused drugs that are eligible for reuse.  Over-the-counter 
 24.17  medications must be dispensed in the manufacturer's unopened 
 24.18  package.  The commissioner may permit the drug clozapine to be 
 24.19  dispensed in a quantity that is less than a 30-day supply.  
 24.20  Whenever a generically equivalent product is available, payment 
 24.21  shall be on the basis of the actual acquisition cost of the 
 24.22  generic drug, unless the prescriber specifically indicates 
 24.23  "dispense as written - brand necessary" on the prescription as 
 24.24  required by section 151.21, subdivision 2. 
 24.25     (d) For purposes of this subdivision, "multisource drugs" 
 24.26  means covered outpatient drugs, excluding innovator multisource 
 24.27  drugs for which there are two or more drug products, which: 
 24.28     (1) are related as therapeutically equivalent under the 
 24.29  Food and Drug Administration's most recent publication of 
 24.30  "Approved Drug Products with Therapeutic Equivalence 
 24.31  Evaluations"; 
 24.32     (2) are pharmaceutically equivalent and bioequivalent as 
 24.33  determined by the Food and Drug Administration; and 
 24.34     (3) are sold or marketed in Minnesota. 
 24.35  "Innovator multisource drug" means a multisource drug that was 
 24.36  originally marketed under an original new drug application 
 25.1   approved by the Food and Drug Administration. 
 25.2      (e) The formulary committee shall review and recommend 
 25.3   drugs which require prior authorization.  The formulary 
 25.4   committee may recommend drugs for prior authorization directly 
 25.5   to the commissioner, as long as opportunity for public input is 
 25.6   provided.  Prior authorization may be requested by the 
 25.7   commissioner based on medical and clinical criteria and on cost 
 25.8   before certain drugs are eligible for payment.  Before a drug 
 25.9   may be considered for prior authorization at the request of the 
 25.10  commissioner: 
 25.11     (1) the drug formulary committee must develop criteria to 
 25.12  be used for identifying drugs; the development of these criteria 
 25.13  is not subject to the requirements of chapter 14, but the 
 25.14  formulary committee shall provide opportunity for public input 
 25.15  in developing criteria; 
 25.16     (2) the drug formulary committee must hold a public forum 
 25.17  and receive public comment for an additional 15 days; 
 25.18     (3) the drug formulary committee must consider data from 
 25.19  the state Medicaid program if such data is available; and 
 25.20     (4) the commissioner must provide information to the 
 25.21  formulary committee on the impact that placing the drug on prior 
 25.22  authorization will have on the quality of patient care and on 
 25.23  program costs, and information regarding whether the drug is 
 25.24  subject to clinical abuse or misuse.  
 25.25     Prior authorization may be required by the commissioner 
 25.26  before certain formulary drugs are eligible for payment.  If 
 25.27  prior authorization of a drug is required by the commissioner, 
 25.28  the commissioner must provide a 30-day notice period before 
 25.29  implementing the prior authorization.  If a prior authorization 
 25.30  request is denied by the department, the recipient may appeal 
 25.31  the denial in accordance with section 256.045.  If an appeal is 
 25.32  filed, the drug must be provided without prior authorization 
 25.33  until a decision is made on the appeal.  
 25.34     (f) (e) The basis for determining the amount of payment for 
 25.35  drugs administered in an outpatient setting shall be the lower 
 25.36  of the usual and customary cost submitted by the provider; the 
 26.1   average wholesale price minus five percent; or the maximum 
 26.2   allowable cost set by the federal government under United States 
 26.3   Code, title 42, chapter 7, section 1396r-8(e), and Code of 
 26.4   Federal Regulations, title 42, section 447.332, or by the 
 26.5   commissioner under paragraph (c). 
 26.6      (g) (f) Prior authorization shall not be required or 
 26.7   utilized for any antipsychotic drug prescribed for the treatment 
 26.8   of mental illness where there is no generically equivalent drug 
 26.9   available unless the commissioner determines that prior 
 26.10  authorization is necessary for patient safety.  This paragraph 
 26.11  applies to any supplemental drug rebate program established or 
 26.12  administered by the commissioner. 
 26.13     (h) (g) Prior authorization shall not be required or 
 26.14  utilized for any antihemophilic factor drug prescribed for the 
 26.15  treatment of hemophilia and blood disorders where there is no 
 26.16  generically equivalent drug available unless the commissioner 
 26.17  determines that prior authorization is necessary for patient 
 26.18  safety.  This paragraph applies to any supplemental drug rebate 
 26.19  program established or administered by the commissioner.  This 
 26.20  paragraph expires July 1, 2003. 
 26.21     [EFFECTIVE DATE.] This section is effective March 1, 2003. 
 26.22     Sec. 22.  Minnesota Statutes 2002, section 256B.0625, is 
 26.23  amended by adding a subdivision to read: 
 26.24     Subd. 13c.  [COPAYMENT FOR PRESCRIPTION DRUGS.] (a) Except 
 26.25  as provided under paragraph (d), the commissioner shall require 
 26.26  a recipient to make a copayment of $1 for each noninnovator 
 26.27  multiple source drug and $3 for each single source drug or 
 26.28  innovator multiple source drug dispensed on or after March 1, 
 26.29  2003.  The total of copayments for each enrollee shall not 
 26.30  exceed $20 per month.  The commissioner shall reduce 
 26.31  reimbursement rates to pharmacies for each prescription by the 
 26.32  amount of the copayment.  A pharmacy shall not waive a copayment 
 26.33  obligation and a pharmacy provider or supplier, including a 
 26.34  pharmaceutical manufacturer, or a representative, employee, 
 26.35  independent contractor or agent of a pharmaceutical 
 26.36  manufacturer, shall not make a copayment for a recipient.  A 
 27.1   parent or guardian shall be responsible for a copayment imposed 
 27.2   on a dependent child under the age of 21. 
 27.3      (b) A pharmacy shall not refuse to provide a prescription 
 27.4   drug to a recipient if the recipient is unable to provide the 
 27.5   required copayment.  This provision does not relieve a recipient 
 27.6   of an obligation to provide a copayment, and does not prevent a 
 27.7   pharmacy from attempting to collect a copayment. 
 27.8      (c) If it is the routine business practice of a pharmacy to 
 27.9   refuse service to an individual with uncollected debt, the 
 27.10  pharmacy may include uncollected copayments under this 
 27.11  practice.  A pharmacy must give advanced notice to a recipient 
 27.12  with uncollected debt before services can be denied. 
 27.13     (d) Copayments shall not be required for prescription drugs 
 27.14  provided to children under age 18; pregnant women; individuals 
 27.15  residing for more than 30 days in a medical institution who 
 27.16  contribute all of their income to the cost of care, except for a 
 27.17  personal needs allowance; and categorically needy individuals 
 27.18  receiving services through a prepaid health plan.  Copayments 
 27.19  shall not be required for prescriptions provided as part of an 
 27.20  emergency health care service or a family planning service. 
 27.21     [EFFECTIVE DATE.] This section is effective March 1, 2003. 
 27.22     Sec. 23.  Minnesota Statutes 2002, section 256B.0635, 
 27.23  subdivision 1, is amended to read: 
 27.24     Subdivision 1.  [INCREASED EMPLOYMENT.] (a) Until June 30, 
 27.25  2002, medical assistance may be paid for persons who received 
 27.26  MFIP or medical assistance for families and children in at least 
 27.27  three of six months preceding the month in which the person 
 27.28  became ineligible for MFIP or medical assistance, if the 
 27.29  ineligibility was due to an increase in hours of employment or 
 27.30  employment income or due to the loss of an earned income 
 27.31  disregard.  In addition, to receive continued assistance under 
 27.32  this section, persons who received medical assistance for 
 27.33  families and children but did not receive MFIP must have had 
 27.34  income less than or equal to the assistance standard for their 
 27.35  family size under the state's AFDC plan in effect as of July 16, 
 27.36  1996, increased by three percent effective July 1, 2000, at the 
 28.1   time medical assistance eligibility began.  A person who is 
 28.2   eligible for extended medical assistance is entitled to six 
 28.3   months of assistance without reapplication, unless the 
 28.4   assistance unit ceases to include a dependent child.  For a 
 28.5   person under 21 years of age, medical assistance may not be 
 28.6   discontinued within the six-month period of extended eligibility 
 28.7   until it has been determined that the person is not otherwise 
 28.8   eligible for medical assistance.  Medical assistance may be 
 28.9   continued for an additional six months if the person meets all 
 28.10  requirements for the additional six months, according to title 
 28.11  XIX of the Social Security Act, as amended by section 303 of the 
 28.12  Family Support Act of 1988, Public Law Number 100-485. 
 28.13     (b) Beginning July 1, 2002 April 1, 2003, medical 
 28.14  assistance for families and children may be paid for persons who 
 28.15  were eligible under section 256B.055, subdivision 3a had income 
 28.16  less than or equal to the assistance standard for their family 
 28.17  size under the state's AFDC plan in effect as of July 16, 1996, 
 28.18  increased by three percent effective July 1, 2000, at the time 
 28.19  medical assistance eligibility began, and in at least three of 
 28.20  six months preceding the month in which the person became 
 28.21  ineligible under that section if the ineligibility was due to an 
 28.22  increase in hours of employment or employment income or due to 
 28.23  the loss of an earned income disregard.  A person who is 
 28.24  eligible for extended medical assistance is entitled to six 
 28.25  months of assistance without reapplication, unless the 
 28.26  assistance unit ceases to include a dependent child, except 
 28.27  medical assistance may not be discontinued for that dependent 
 28.28  child under 21 years of age within the six-month period of 
 28.29  extended eligibility until it has been determined that the 
 28.30  person is not otherwise eligible for medical assistance.  
 28.31  Medical assistance may be continued for an additional six months 
 28.32  if the person meets all requirements for the additional six 
 28.33  months, according to title XIX of the Social Security Act, as 
 28.34  amended by section 303 of the Family Support Act of 1988, Public 
 28.35  Law Number 100-485. 
 28.36     [EFFECTIVE DATE.] This section is effective April 1, 2003, 
 29.1   and applies to persons whose eligibility for extended medical 
 29.2   assistance is established on or after that date. 
 29.3      Sec. 24.  Minnesota Statutes 2002, section 256B.0635, 
 29.4   subdivision 2, is amended to read: 
 29.5      Subd. 2.  [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until 
 29.6   June 30, 2002, medical assistance may be paid for persons who 
 29.7   received MFIP or medical assistance for families and children in 
 29.8   at least three of the six months preceding the month in which 
 29.9   the person became ineligible for MFIP or medical assistance, if 
 29.10  the ineligibility was the result of the collection of child or 
 29.11  spousal support under part D of title IV of the Social Security 
 29.12  Act.  In addition, to receive continued assistance under this 
 29.13  section, persons who received medical assistance for families 
 29.14  and children but did not receive MFIP must have had income less 
 29.15  than or equal to the assistance standard for their family size 
 29.16  under the state's AFDC plan in effect as of July 16, 1996, 
 29.17  increased by three percent effective July 1, 2000, at the time 
 29.18  medical assistance eligibility began.  A person who is eligible 
 29.19  for extended medical assistance under this subdivision is 
 29.20  entitled to four months of assistance without reapplication, 
 29.21  unless the assistance unit ceases to include a dependent child, 
 29.22  except medical assistance may not be discontinued for that 
 29.23  dependent child under 21 years of age within the four-month 
 29.24  period of extended eligibility until it has been determined that 
 29.25  the person is not otherwise eligible for medical assistance. 
 29.26     (b) Beginning July 1, 2002 April 1, 2003, medical 
 29.27  assistance for families and children may be paid for persons who 
 29.28  were eligible under section 256B.055, subdivision 3a had income 
 29.29  less than or equal to the assistance standard for their family 
 29.30  size under the state's AFDC plan in effect as of July 16, 1996, 
 29.31  increased by three percent effective July 1, 2000, at the time 
 29.32  medical assistance eligibility began, and in at least three of 
 29.33  the six months preceding the month in which the person became 
 29.34  ineligible under that section if the ineligibility was the 
 29.35  result of the collection of child or spousal support under part 
 29.36  D of title IV of the Social Security Act.  A person who is 
 30.1   eligible for extended medical assistance under this subdivision 
 30.2   is entitled to four months of assistance without reapplication, 
 30.3   unless the assistance unit ceases to include a dependent child, 
 30.4   except medical assistance may not be discontinued for that 
 30.5   dependent child under 21 years of age within the four-month 
 30.6   period of extended eligibility until it has been determined that 
 30.7   the person is not otherwise eligible for medical assistance. 
 30.8      [EFFECTIVE DATE.] This section is effective April 1, 2003, 
 30.9   and applies to persons whose eligibility for extended medical 
 30.10  assistance is established on or after that date. 
 30.11     Sec. 25.  Minnesota Statutes 2002, section 256B.19, 
 30.12  subdivision 1d, is amended to read: 
 30.13     Subd. 1d.  [PORTION OF NONFEDERAL SHARE TO BE PAID BY 
 30.14  CERTAIN COUNTIES.] (a) In addition to the percentage 
 30.15  contribution paid by a county under subdivision 1, the 
 30.16  governmental units designated in this subdivision shall be 
 30.17  responsible for an additional portion of the nonfederal share of 
 30.18  medical assistance cost.  For purposes of this subdivision, 
 30.19  "designated governmental unit" means the counties of Becker, 
 30.20  Beltrami, Clearwater, Cook, Dodge, Hubbard, Itasca, Lake, 
 30.21  Pennington, Pipestone, Ramsey, St. Louis, Steele, Todd, 
 30.22  Traverse, and Wadena. 
 30.23     (b) Beginning in 1994, each of the governmental units 
 30.24  designated in this subdivision shall transfer before noon on May 
 30.25  31 to the state Medicaid agency an amount equal to the number of 
 30.26  licensed beds in any nursing home owned and operated by the 
 30.27  county on that date, with the county named as licensee, 
 30.28  multiplied by $5,723.  If two or more counties own and operate a 
 30.29  nursing home, the payment shall be prorated.  These sums shall 
 30.30  be part of the designated governmental unit's portion of the 
 30.31  nonfederal share of medical assistance costs. 
 30.32     (c) Beginning in 2002, in addition to any transfer under 
 30.33  paragraph (b), each of the governmental units designated in this 
 30.34  subdivision shall transfer before noon on May 31 to the state 
 30.35  Medicaid agency an amount equal to the number of licensed beds 
 30.36  in any nursing home owned and operated by the county on that 
 31.1   date, with the county named as licensee, multiplied by $10,784.  
 31.2   The provisions of paragraph (b) apply to transfers under this 
 31.3   paragraph. 
 31.4      (d) Beginning in 2003, in addition to any transfer under 
 31.5   paragraphs (b) and (c), each of the governmental units 
 31.6   designated in this subdivision shall transfer before noon on May 
 31.7   31 to the state Medicaid agency an amount equal to the number of 
 31.8   licensed beds in any nursing home owned and operated by the 
 31.9   county on that date, with the county named as licensee, 
 31.10  multiplied by $2,230.  The provisions of paragraph (b) apply to 
 31.11  transfers under this paragraph. 
 31.12     (e) The commissioner may reduce the intergovernmental 
 31.13  transfers under paragraph paragraphs (c) and (d) based on the 
 31.14  commissioner's determination of the payment rate in section 
 31.15  256B.431, subdivision 23, paragraphs (c) and, (d), and (e).  Any 
 31.16  adjustments must be made on a per-bed basis and must result in 
 31.17  an amount equivalent to the total amount resulting from the rate 
 31.18  adjustment in section 256B.431, subdivision 23, paragraphs (c) 
 31.19  and, (d), and (e). 
 31.20     [EFFECTIVE DATE.] This section is effective February 28, 
 31.21  2003. 
 31.22     Sec. 26.  Minnesota Statutes 2002, section 256B.195, 
 31.23  subdivision 4, is amended to read: 
 31.24     Subd. 4.  [ADJUSTMENTS PERMITTED.] (a) The commissioner may 
 31.25  adjust the intergovernmental transfers under subdivision 2 and 
 31.26  the payments under subdivision 3, and payments and transfers 
 31.27  under subdivision 5, based on the commissioner's determination 
 31.28  of Medicare upper payment limits, hospital-specific charge 
 31.29  limits, and hospital-specific limitations on disproportionate 
 31.30  share payments.  Any adjustments must be made on a proportional 
 31.31  basis.  If participation by a particular hospital under this 
 31.32  section is limited, the commissioner shall adjust the payments 
 31.33  that relate to that hospital under subdivisions 2, and 3, and 5 
 31.34  on a proportional basis in order to allow the hospital to 
 31.35  participate under this section to the fullest extent possible 
 31.36  and shall increase other payments under subdivisions 2, and 3, 
 32.1   and 5 to the extent allowable to maintain the overall level of 
 32.2   payments under this section.  The commissioner may make 
 32.3   adjustments under this subdivision only after consultation with 
 32.4   the counties and hospitals identified in subdivisions 2 and 3, 
 32.5   and, if subdivision 5 receives federal approval, with the 
 32.6   hospital and educational institution identified in subdivision 5.
 32.7      (b) The ratio of medical assistance payments specified in 
 32.8   subdivision 3 to the intergovernmental transfers specified in 
 32.9   subdivision 2 shall not be reduced except as provided under 
 32.10  paragraph (a). 
 32.11     (c) The increase in intergovernmental transfers and 
 32.12  payments that result from section 256.969, subdivision 3a, 
 32.13  paragraph (c), shall be paid to the general fund. 
 32.14     Sec. 27.  Minnesota Statutes 2002, section 256B.32, 
 32.15  subdivision 1, is amended to read: 
 32.16     Subdivision 1.  [FACILITY FEE PAYMENT.] (a) The 
 32.17  commissioner shall establish a facility fee payment mechanism 
 32.18  that will pay a facility fee to all enrolled outpatient 
 32.19  hospitals for each emergency room or outpatient clinic visit 
 32.20  provided on or after July 1, 1989.  This payment mechanism may 
 32.21  not result in an overall increase in outpatient payment rates.  
 32.22  This section does not apply to federally mandated maximum 
 32.23  payment limits, department approved program packages, or 
 32.24  services billed using a nonoutpatient hospital provider number. 
 32.25     (b) For fee-for-service services provided on or after July 
 32.26  1, 2002, the total payment, before third-party liability and 
 32.27  spenddown, made to hospitals for outpatient hospital facility 
 32.28  services is reduced by .5 percent from the current statutory 
 32.29  rates. 
 32.30     (c) For fee-for-service services provided on or after March 
 32.31  1, 2003, the total payment before third-party liability and 
 32.32  spenddown, made to hospitals for outpatient hospital facility 
 32.33  services is reduced five percent from the current statutory 
 32.34  rates.  Facilities defined under section 256.969, subdivision 
 32.35  16, are excluded from this paragraph. 
 32.36     Sec. 28.  Minnesota Statutes 2002, section 256B.431, 
 33.1   subdivision 23, is amended to read: 
 33.2      Subd. 23.  [COUNTY NURSING HOME PAYMENT ADJUSTMENTS.] (a) 
 33.3   Beginning in 1994, the commissioner shall pay a nursing home 
 33.4   payment adjustment on May 31 after noon to a county in which is 
 33.5   located a nursing home that, on that date, was county-owned and 
 33.6   operated, with the county named as licensee by the commissioner 
 33.7   of health, and had over 40 beds and medical assistance occupancy 
 33.8   in excess of 50 percent during the reporting year ending 
 33.9   September 30, 1991.  The adjustment shall be an amount equal to 
 33.10  $16 per calendar day multiplied by the number of beds licensed 
 33.11  in the facility as of September 30, 1991 on that date. 
 33.12     (b) Payments under paragraph (a) are excluded from medical 
 33.13  assistance per diem rate calculations.  These payments are 
 33.14  required notwithstanding any rule prohibiting medical assistance 
 33.15  payments from exceeding payments from private pay residents.  A 
 33.16  facility receiving a payment under paragraph (a) may not 
 33.17  increase charges to private pay residents by an amount 
 33.18  equivalent to the per diem amount payments under paragraph (a) 
 33.19  would equal if converted to a per diem. 
 33.20     (c) Beginning in 2002, in addition to any payment under 
 33.21  paragraph (a), the commissioner shall pay to a nursing facility 
 33.22  described in paragraph (a) an adjustment in an amount equal to 
 33.23  $29.55 per calendar day multiplied by the number of beds 
 33.24  licensed in the facility on that date.  The provisions of 
 33.25  paragraphs (a) and (b) apply to payments under this paragraph. 
 33.26     (d) Beginning in 2003, in addition to any payment under 
 33.27  paragraphs (a) and (c), the commissioner shall pay to a nursing 
 33.28  facility described in paragraph (a) an adjustment in an amount 
 33.29  equal to $6.11 per calendar day multiplied by the number of beds 
 33.30  licensed in the facility on that date.  The provisions of 
 33.31  paragraphs (a) and (b) apply to payments under this paragraph.  
 33.32     (e) The commissioner may reduce payments under 
 33.33  paragraph paragraphs (c) and (d) based on the commissioner's 
 33.34  determination of Medicare upper payment limits.  Any adjustments 
 33.35  must be proportional to adjustments made under section 256B.19, 
 33.36  subdivision 1d, paragraph (d) (e). 
 34.1      [EFFECTIVE DATE.] This section is effective February 28, 
 34.2   2003. 
 34.3      Sec. 29.  Minnesota Statutes 2002, section 256B.431, is 
 34.4   amended by adding a subdivision to read: 
 34.5      Subd. 38.  [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL 
 34.6   YEAR 2003.] Effective the first day of the month after notice is 
 34.7   published in the State Register, the commissioner shall provide 
 34.8   to each nursing home reimbursed under this section or section 
 34.9   256B.434, an increase in each case mix payment rate equal to the 
 34.10  increase in the per-bed surcharge paid under section 256.9657, 
 34.11  subdivision 1, paragraph (d), divided by 365 and further divided 
 34.12  by .80.  The increase shall not be subject to any annual 
 34.13  percentage increase.  The 30-day advance notice requirement in 
 34.14  section 256B.47, subdivision 2, shall not apply to rate 
 34.15  increases resulting from this section. 
 34.16     [EFFECTIVE DATE.] This section is effective February 28, 
 34.17  2003. 
 34.18     Sec. 30.  Minnesota Statutes 2002, section 256B.75, is 
 34.19  amended to read: 
 34.20     256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 
 34.21     (a) For outpatient hospital facility fee payments for 
 34.22  services rendered on or after October 1, 1992, the commissioner 
 34.23  of human services shall pay the lower of (1) submitted charge, 
 34.24  or (2) 32 percent above the rate in effect on June 30, 1992, 
 34.25  except for those services for which there is a federal maximum 
 34.26  allowable payment.  Effective for services rendered on or after 
 34.27  January 1, 2000, payment rates for nonsurgical outpatient 
 34.28  hospital facility fees and emergency room facility fees shall be 
 34.29  increased by eight percent over the rates in effect on December 
 34.30  31, 1999, except for those services for which there is a federal 
 34.31  maximum allowable payment.  Services for which there is a 
 34.32  federal maximum allowable payment shall be paid at the lower of 
 34.33  (1) submitted charge, or (2) the federal maximum allowable 
 34.34  payment.  Total aggregate payment for outpatient hospital 
 34.35  facility fee services shall not exceed the Medicare upper 
 34.36  limit.  If it is determined that a provision of this section 
 35.1   conflicts with existing or future requirements of the United 
 35.2   States government with respect to federal financial 
 35.3   participation in medical assistance, the federal requirements 
 35.4   prevail.  The commissioner may, in the aggregate, prospectively 
 35.5   reduce payment rates to avoid reduced federal financial 
 35.6   participation resulting from rates that are in excess of the 
 35.7   Medicare upper limitations. 
 35.8      (b) Notwithstanding paragraph (a), payment for outpatient, 
 35.9   emergency, and ambulatory surgery hospital facility fee services 
 35.10  for critical access hospitals designated under section 144.1483, 
 35.11  clause (11), shall be paid on a cost-based payment system that 
 35.12  is based on the cost-finding methods and allowable costs of the 
 35.13  Medicare program. 
 35.14     (c) Effective for services provided on or after July 1, 
 35.15  2003, rates that are based on the Medicare outpatient 
 35.16  prospective payment system shall be replaced by a budget neutral 
 35.17  prospective payment system that is derived using medical 
 35.18  assistance data.  The commissioner shall provide a proposal to 
 35.19  the 2003 legislature to define and implement this provision. 
 35.20     (d) For fee-for-service services provided on or after July 
 35.21  1, 2002, the total payment, before third-party liability and 
 35.22  spenddown, made to hospitals for outpatient hospital facility 
 35.23  services is reduced by .5 percent from the current statutory 
 35.24  rate. 
 35.25     (e) For fee-for-service services provided on or after March 
 35.26  1, 2003, the total payment before third-party liability and 
 35.27  spenddown, made to hospitals for outpatient hospital facility 
 35.28  services is reduced five percent from the current statutory 
 35.29  rates.  Facilities defined under section 256.969, subdivision 
 35.30  16, are excluded from this paragraph. 
 35.31     Sec. 31.  Minnesota Statutes 2002, section 256J.11, 
 35.32  subdivision 1, is amended to read: 
 35.33     Subdivision 1.  [GENERAL CITIZENSHIP REQUIREMENTS.] (a) To 
 35.34  be eligible for MFIP, a member of the assistance unit must be a 
 35.35  citizen of the United States, or a qualified noncitizen as 
 35.36  defined in section 256J.08, or a noncitizen who is otherwise 
 36.1   residing lawfully in the United States. 
 36.2      (b) A qualified noncitizen who entered the United States on 
 36.3   or after August 22, 1996, is eligible for MFIP.  However, TANF 
 36.4   dollars cannot be used to fund the MFIP benefits for an 
 36.5   individual under this paragraph for a period of five years after 
 36.6   the date of entry unless if the qualified noncitizen meets one 
 36.7   of the following criteria: 
 36.8      (1) was admitted to the United States as a refugee under 
 36.9   United States Code, title 8, section 1157; 
 36.10     (2) was granted asylum under United States Code, title 8, 
 36.11  section 1158; 
 36.12     (3) was granted withholding of deportation under the United 
 36.13  States Code, title 8, section 1253(h); 
 36.14     (4) is a veteran of the United States Armed Forces with an 
 36.15  honorable discharge for a reason other than noncitizen status, 
 36.16  or is a spouse or unmarried minor dependent child of the same; 
 36.17  or 
 36.18     (5) is an individual on active duty in the United States 
 36.19  Armed Forces, other than for training, or is a spouse or 
 36.20  unmarried minor dependent child of the same. 
 36.21     (c) A person who is not a qualified noncitizen but who is 
 36.22  otherwise residing lawfully in the United States is eligible for 
 36.23  MFIP.  However, TANF dollars cannot be used to fund the MFIP 
 36.24  benefits for an individual under this paragraph. 
 36.25     (d) For purposes of this subdivision, a nonimmigrant in one 
 36.26  or more of the classes listed in United States Code, title 8, 
 36.27  section 1101(a)(15), or an undocumented immigrant who resides in 
 36.28  the United States without the approval or acquiescence of the 
 36.29  Immigration and Naturalization Service, is not eligible for MFIP.
 36.30     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 36.31     Sec. 32.  Minnesota Statutes 2002, section 256J.48, 
 36.32  subdivision 1, is amended to read: 
 36.33     Subdivision 1.  [EMERGENCY FINANCIAL ASSISTANCE.] County 
 36.34  human service agencies shall grant emergency financial 
 36.35  assistance to any needy pregnant woman or needy family with a 
 36.36  child under the age of 21 who is or was within six months prior 
 37.1   to application living with an eligible caregiver relative 
 37.2   specified in section 256J.08. 
 37.3      Except for ongoing special diets, emergency assistance is 
 37.4   available to a family during one 30-day period in a consecutive 
 37.5   12-month 18-month period.  A county shall issue assistance for 
 37.6   needs that accrue before that 30-day period only when it is 
 37.7   necessary to resolve emergencies arising or continuing during 
 37.8   the 30-day period of eligibility.  When emergency needs 
 37.9   continue, a county may issue assistance for up to 30 days beyond 
 37.10  the initial 30-day period of eligibility, but only when 
 37.11  assistance is authorized during the initial period. 
 37.12     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 37.13     Sec. 33.  Minnesota Statutes 2002, section 256J.52, 
 37.14  subdivision 2, is amended to read: 
 37.15     Subd. 2.  [INITIAL ASSESSMENT.] (a) The job counselor must, 
 37.16  with the cooperation of the participant, assess the 
 37.17  participant's ability to obtain and retain employment.  This 
 37.18  initial assessment must include a review of the participant's 
 37.19  education level, prior employment or work experience, 
 37.20  transferable work skills, and existing job markets. 
 37.21     (b) In assessing the participant, the job counselor must 
 37.22  determine if the participant needs refresher courses for 
 37.23  professional certification or licensure, in which case, the job 
 37.24  search plan under subdivision 3 must include the courses 
 37.25  necessary to obtain the certification or licensure, in addition 
 37.26  to other work activities, provided the combination of the 
 37.27  courses and other work activities are at least for 40 hours per 
 37.28  week.  
 37.29     (c) If a participant can demonstrate to the satisfaction of 
 37.30  the county agency that lack of proficiency in English is a 
 37.31  barrier to obtaining suitable employment, the job counselor must 
 37.32  include participation in an intensive English as a second 
 37.33  language program if available or otherwise a regular English as 
 37.34  a second language program in the individual's employment plan 
 37.35  under subdivision 5.  Lack of proficiency in English is not 
 37.36  necessarily a barrier to employment.  
 38.1      (d) The job counselor may approve an education or training 
 38.2   plan, and postpone the job search requirement, if the 
 38.3   participant has a proposal for an education program which: 
 38.4      (1) can be completed within 24 12 months; and 
 38.5      (2) meets the criteria of section 256J.53, subdivisions 1, 
 38.6   2, 3, and 5. 
 38.7      (e) A participant who, at the time of the initial 
 38.8   assessment, presents a plan that includes farming as a 
 38.9   self-employed work activity must have an employment plan 
 38.10  developed under subdivision 5 that includes the farming as an 
 38.11  approved work activity. 
 38.12     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 38.13     Sec. 34.  Minnesota Statutes 2002, section 256J.53, 
 38.14  subdivision 1, is amended to read: 
 38.15     Subdivision 1.  [LENGTH OF PROGRAM.] In order for a 
 38.16  post-secondary education or training program to be approved work 
 38.17  activity as defined in section 256J.49, subdivision 13, clause 
 38.18  (18), it must be a program lasting 24 12 months or less, and the 
 38.19  participant must meet the requirements of subdivisions 2 and 3.  
 38.20  Participants who have an approved education plan in place as of 
 38.21  April 1, 2003, that allows 24 months of postsecondary education 
 38.22  or training shall be allowed to complete that plan provided that 
 38.23  the conditions specified in subdivisions 2 and 3 continue to be 
 38.24  met. 
 38.25     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 38.26     Sec. 35.  Minnesota Statutes 2002, section 256L.07, 
 38.27  subdivision 1, is amended to read: 
 38.28     Subdivision 1.  [GENERAL REQUIREMENTS.] (a) Children 
 38.29  enrolled in the original children's health plan as of September 
 38.30  30, 1992, children who enrolled in the MinnesotaCare program 
 38.31  after September 30, 1992, pursuant to Laws 1992, chapter 549, 
 38.32  article 4, section 17, and children who have family gross 
 38.33  incomes that are equal to or less than 175 percent of the 
 38.34  federal poverty guidelines are eligible without meeting the 
 38.35  requirements of subdivision 2, as long as they maintain 
 38.36  continuous coverage in the MinnesotaCare program or medical 
 39.1   assistance.  Children who apply for MinnesotaCare on or after 
 39.2   the implementation date of the employer-subsidized health 
 39.3   coverage program as described in Laws 1998, chapter 407, article 
 39.4   5, section 45, who have family gross incomes that are equal to 
 39.5   or less than 175 percent of the federal poverty guidelines, must 
 39.6   meet the requirements of subdivision 2 to be eligible for 
 39.7   MinnesotaCare. 
 39.8      (b) Families enrolled in MinnesotaCare under section 
 39.9   256L.04, subdivision 1, whose income increases above 275 percent 
 39.10  of the federal poverty guidelines, are no longer eligible for 
 39.11  the program and shall be disenrolled by the commissioner.  
 39.12  Individuals enrolled in MinnesotaCare under section 256L.04, 
 39.13  subdivision 7, whose income increases above 175 percent of the 
 39.14  federal poverty guidelines are no longer eligible for the 
 39.15  program and shall be disenrolled by the commissioner.  For 
 39.16  persons disenrolled under this subdivision, MinnesotaCare 
 39.17  coverage terminates the last day of the calendar month following 
 39.18  the month in which the commissioner determines that the income 
 39.19  of a family or individual exceeds program income limits.  
 39.20     (c) Notwithstanding paragraph (b), individuals and families 
 39.21  may remain enrolled in MinnesotaCare if ten percent of their 
 39.22  annual income is less than the annual premium for a policy with 
 39.23  a $500 deductible available through the Minnesota comprehensive 
 39.24  health association.  Individuals and families who are no longer 
 39.25  eligible for MinnesotaCare under this subdivision shall be given 
 39.26  an 18-month a six-month notice period from the date that 
 39.27  ineligibility is determined before disenrollment.  
 39.28     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 39.29     Sec. 36.  Minnesota Statutes 2002, section 256L.17, 
 39.30  subdivision 2, is amended to read: 
 39.31     Subd. 2.  [LIMIT ON TOTAL ASSETS.] (a) Effective July 1, 
 39.32  2002, or upon federal approval, whichever is later, in order to 
 39.33  be eligible for the MinnesotaCare program, a household of two or 
 39.34  more persons must not own more than $30,000 in total net assets, 
 39.35  and a household of one person must not own more than $15,000 in 
 39.36  total net assets. 
 40.1      (b) For purposes of this subdivision, assets are determined 
 40.2   according to section 256B.056, subdivision 3c.  In addition to 
 40.3   these maximum amounts, an eligible individual or family may 
 40.4   accrue interest on these amounts, but they must be reduced to 
 40.5   the maximum at the time of an eligibility redetermination.  The 
 40.6   value of assets that are not considered in determining 
 40.7   eligibility is the value of those assets excluded under the AFDC 
 40.8   state plan as of July 16, 1996, as required by the Personal 
 40.9   Responsibility and Work Opportunity Reconciliation Act of 1996 
 40.10  (PRWORA), Public Law 104-193, with the following exceptions: 
 40.11     (1) household goods and personal effects are not 
 40.12  considered; 
 40.13     (2) capital and operating assets of a trade or business up 
 40.14  to $200,000 are not considered; 
 40.15     (3) one motor vehicle is excluded for each person of legal 
 40.16  driving age who is employed or seeking employment; 
 40.17     (4) one burial plot and all other burial expenses equal to 
 40.18  the supplemental security income program asset limit are not 
 40.19  considered for each individual; 
 40.20     (5) court-ordered settlements up to $10,000 are not 
 40.21  considered; 
 40.22     (6) individual retirement accounts and funds are not 
 40.23  considered; and 
 40.24     (7) assets owned by children are not considered.  
 40.25     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 40.26     Sec. 37.  Laws 2001, First Special Session chapter 3, 
 40.27  article 1, section 17, subdivision 11, as amended by Laws 2002, 
 40.28  chapter 220, article 2, section 6, is amended to read: 
 40.29     Subd. 11.  [CHILD CARE SERVICE GRANTS.] For child care 
 40.30  development activities under child care service grants according 
 40.31  to Minnesota Statutes, section 119B.21: 
 40.32       $1,865,000      .....     2002
 40.33       $1,365,000 $1,352,000      .....     2003
 40.34     Beginning in fiscal year 2004, the base is 
 40.35  $1,365,000 $1,352,000 from the general fund. 
 40.36     Any balance in the first year does not cancel but is 
 41.1   available in the second year. 
 41.2      Sec. 38.  Laws 2001, First Special Session chapter 9, 
 41.3   article 2, section 31, the effective date, is amended to read: 
 41.4      [EFFECTIVE DATE.] This section is effective January July 1, 
 41.5   2003. 
 41.6      Sec. 39.  [CHILD CARE ASSISTANCE PARENT FEE SCHEDULE.] 
 41.7      The commissioner shall amend the parent fee schedule in 
 41.8   Minnesota Rules, chapter 3400, to do the following: 
 41.9      (1) parent fees for families with incomes between 100.01 
 41.10  percent and 135 percent of the federal poverty guidelines must 
 41.11  equal 2.42 percent of adjusted gross income for families at 135 
 41.12  percent of the federal poverty guidelines; 
 41.13     (2) parent fees for families with incomes between 135.01 
 41.14  percent and 165 percent of the federal poverty guidelines must 
 41.15  equal 3.00 percent of adjusted gross income for families at 165 
 41.16  percent of the federal poverty guidelines; 
 41.17     (3) parent fees for families with incomes between 165.01 
 41.18  percent and 250 percent of the federal poverty guidelines must 
 41.19  begin at 4.15 percent of the adjusted gross income and provide 
 41.20  for graduated movement of fee increases; and 
 41.21     (4) parent fees for families at 250 percent of the federal 
 41.22  poverty guidelines must equal 15.00 percent of gross annual 
 41.23  income. 
 41.24     [EFFECTIVE DATE.] This section is effective April 1, 2003. 
 41.25     Sec. 40.  [REPEALER.] 
 41.26     Subdivision 1.  [HOME-SHARING GRANT PROGRAM; FAIRVIEW 
 41.27  UNIVERSITY MEDICAL CENTER.] Minnesota Statutes 2002, sections 
 41.28  256.973; and 256B.195, subdivision 5, are repealed effective 
 41.29  July 1, 2003. 
 41.30     Subd. 2.  [MINNESOTA FOOD ASSISTANCE PROGRAM.] Minnesota 
 41.31  Statutes 2002, section 256D.053, is repealed effective April 1, 
 41.32  2003. 
 41.33     Subd. 3.  [MFIP NONCITIZENS; FOOD PORTION; STATE 
 41.34  FUNDING.] Minnesota Statutes 2002, section 256J.11, subdivisions 
 41.35  2 and 3, are repealed effective April 1, 2003. 
 41.36     Subd. 4.  [PARENT FEE SCHEDULE.] Laws 1999, chapter 205, 
 42.1   article 1, section 63, is repealed effective April 1, 2003. 
 42.2      Subd. 5.  [MEDICAL ASSISTANCE INCOME DISREGARD FOR 
 42.3   FAMILIES.] Minnesota Statutes 2002, section 256B.056, 
 42.4   subdivision 1c, is repealed effective April 1, 2003. 
 42.5      Subd. 6.  [MEDICAL ASSISTANCE ASSET LIMIT FOR 
 42.6   FAMILIES.] Minnesota Statutes 2002, section 256B.056, 
 42.7   subdivision 3c, is repealed effective April 1, 2003. 
 42.8      Sec. 41.  [EFFECTIVE DATE.] 
 42.9      Sections 1 to 40 are effective the day following final 
 42.10  enactment, unless otherwise specified.