Minnesota Legislature
HF 374
1st Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:36am
Current Version - 1st Engrossment
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A bill for an act
relating to human services; modifying medical transportation requirements;
modifying reimbursement; amending Minnesota Statutes 2008, sections 256.045,
by adding a subdivision; 256B.04, subdivision 14a; 256B.0625, by adding
subdivisions; repealing Minnesota Statutes 2008, section 256B.0625, subdivision
17.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2008, section 256.045, is amended by adding a
subdivision to read:
new text begin Subd. 3d. new text end
new text begin
Special requirements regarding medical assistance nonemergency
transportation services.
new text end
new text begin
Notwithstanding the provisions of Minnesota Rules, parts
9505.0125, subpart 1, and 9505.0130, subpart 2, a recipient of nonemergency medical
transportation services under section 256B.0625, subdivisions 17a to 17f, shall be given a
written notice of a denial, reduction, termination, or suspension of those services no later
than 30 days before the effective date of the action, and a local agency shall not reduce,
suspend, or terminate eligibility for those services when a recipient appeals within 30 days
of the agency's mailing of the notice, unless the recipient requests in writing not to receive
continued nonemergency medical transportation services while the appeal is pending.
new text end
Sec. 2.
Minnesota Statutes 2008, section 256B.04, subdivision 14a, is amended to read:
Subd. 14a.
Level of need determination.
new text begin (a) new text end Nonemergency medical transportation
level of need determinations must be performed by a physician, a registered nurse working
under direct supervision of a physician, a physician's assistant, a nurse practitioner,
a licensed practical nurse,new text begin a county social worker,new text end or a discharge plannernew text begin , on a form
prescribed by the commissioner of human services that is designed to determine the
recipient's appropriate level of need for nonemergency medical transportation servicesnew text end .
new text begin
(b) The prescribed form, when completed by any of the individuals specified
in paragraph (a), shall be submitted to commissioner. The completed form shall
serve as sufficient evidence of the recipient's level of need for nonemergency medical
transportation services, and the recipient shall be eligible to receive transportation services
at the level of need determined appropriate by the form. Upon receipt of this form, the
commissioner may not reimburse any other person or entity for performing a level of need
determination for that recipient at any time sooner than described in this subdivision.
new text end
new text begin (c) new text end Nonemergency medical transportation level of need determinations must
not be performed more than semiannually on any individual, unless the individual's
circumstances have sufficiently changed so as to require a new level of need determination.new text begin
Nonemergency medical transportation level of need determinations must not be performed
more frequently than every seven years on an individual, if a physician certifies that
the individual's medical condition that requires the use of nonemergency medical
transportation is permanent and is not likely to improve, and this certification by the
physician is confirmed by a level of need determination. new text end Individuals residing in licensed
nursing facilities are exempt from a level of need determination and are eligible for
special transportation services until the individual no longer resides in a licensed nursing
facility. If a person authorized by this subdivision to perform a level of need determination
determines that an individual requires stretcher transportation, the individual is presumed
to maintain that level of need until otherwise determined by a person authorized to
perform a level of need determination, or for six months, whichever is sooner.
new text begin
(d) The form used to determine recipients' level of need under this subdivision shall
be developed by the department in consultation with metro special transportation service
providers, nonmetro special transportation service providers, and other interested parties.
This form must be developed by October 1, 2009.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2009.
new text end
Sec. 3.
Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 17b. new text end
new text begin Medical transportation. new text end
new text begin
(a) For purposes of this subdivision and
subdivisions 17a to 17f, the following definitions apply:
new text end
new text begin
(1) "access transportation service" means curb-to-curb or door-through-door
nonemergency medical transportation to or from a covered service that is provided to
a recipient without a physical or mental impairment, but who requires transportation
services to be able to access a covered service, and who is unable to do so by bus or
private automobile;
new text end
new text begin
(2) "curb-to-curb" means access transportation service for recipients who do not
require driver-assisted services;
new text end
new text begin
(3) "door-through-door" means access transportation service for recipients who
require driver-assisted services to be able to safely move from inside of the main portion
of the building at the recipients' pickup, and into the main portion of the building at the
recipients' destination; the driver shall assist with opening the first door of the building or,
if the building has a vestibule, shall also open the door of the vestibule;
new text end
new text begin
(4) "driver-assisted services" means any assistance that a recipient may need beyond
the recipient's initial point of exit from the vehicle;
new text end
new text begin
(5) "medical transportation" means the transport of a recipient to obtain a covered
service or the transport of a recipient after the covered service is provided;
new text end
new text begin
(6) "rural urban commuting area" or "RUCA" means an area determined to be urban,
rural, or super rural by the Centers for Medicare and Medicaid Services for purposes of
Medicare reimbursement of ambulance services;
new text end
new text begin
(7) "special transportation" means station-to-station nonemergency medical
transportation to or from a covered service for a recipient who has a physical or mental
impairment that prohibits the recipient from independently and safely accessing and using
a bus, taxi, other commercial transportation, or private automobile; and
new text end
new text begin
(8) "station-to-station" means transportation for recipients who require
driver-assisted services to and within the building at which the recipients are being picked
up from or transported to, beyond the first door or vestibule, which may include assistance
to or from a nursing station or medical practitioner's reception station, or assistance with
admittance to the medical facility.
new text end
Sec. 4.
Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 17c. new text end
new text begin Transportation costs. new text end
new text begin
(a) Medical assistance covers medical
transportation costs incurred solely for obtaining emergency medical care or transportation
costs incurred by eligible persons in obtaining emergency or nonemergency medical
care when paid directly to an ambulance company, common carrier, or other recognized
providers of transportation services. Medical transportation must be provided by:
new text end
new text begin
(l) ambulance, as defined in section 144E.001, subdivision 2;
new text end
new text begin
(2) special transportation;
new text end
new text begin
(3) access transportation service; or
new text end
new text begin
(4) other common carrier, including, but not limited to, bus, taxicab, other
commercial carrier, or private automobile.
new text end
new text begin
(b) The commissioner shall certify that the recipient requires special transportation
services by use of a level of need determination, as described in section 256B.04,
subdivision l4a. Drivers providing nonemergency medical transportation in a vehicle
equipped to transport a recipient in a wheelchair or stretcher shall be responsible for
assistance in passenger securement and in securing of wheelchairs or stretchers in the
vehicle. Special transportation providers must obtain written documentation from the
health care service provider who is serving the recipient being transported, identifying
the time that the recipient arrived. Special transportation and access transportation
providers may not bill for separate base rates for the continuation of a trip beyond the
original destination. Special transportation and access transportation providers must
take recipients to the nearest appropriate health care provider, using the quickest route
available as determined by a commercially available software program approved by the
commissioner and designated by the provider as the program to be used to determine
the route and mileage for all trips.
new text end
Sec. 5.
Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 17d. new text end
new text begin Payment for nonemergency medical transportation. new text end
new text begin
The minimum
medical assistance reimbursement rates for nonemergency medical transportation services
are:
new text end
new text begin
(1) for areas defined under Rural-Urban Commuting Area codes (RUCA) as urban:
new text end
new text begin
(i) $17 for the base rate and $1.50 per mile for services to eligible persons who need
a wheelchair-accessible van for special transportation services;
new text end
new text begin
(ii) $11 for the base rate and $1.45 per mile for services to eligible persons who do
not need a wheelchair-accessible van for special transportation services;
new text end
new text begin
(iii) $8 for the base rate and $1.45 per mile for services to eligible persons who need
a wheelchair-accessible van for curb-to-curb access transportation service;
new text end
new text begin
(iv) $11 for the base rate and $1.45 per mile for services to eligible persons who
need a wheelchair-accessible van for door-through-door access transportation service;
new text end
new text begin
(v) $5 for the base rate and $1.45 per mile for services to eligible persons who do not
need a wheelchair-accessible van for curb-to-curb access transportation service;
new text end
new text begin
(vi) $7 for the base rate and $1.45 per mile for services to eligible persons who do not
need a wheelchair-accessible van for door-through-door access transportation service; and
new text end
new text begin
(vii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
services to eligible persons who need a stretcher-accessible vehicle;
new text end
new text begin
(2) for areas defined under RUCA as rural: the same base rate as for areas defined
under RUCA as urban and 110 percent of the urban mileage rate;
new text end
new text begin
(3) for areas defined under RUCA as super rural: the same base rate as for areas
defined under RUCA as urban and 115 percent of the urban mileage rate;
new text end
new text begin
(4) for all special transportation and access transportation services, for a trip equal to
or exceeding 51 miles, the provider shall receive mileage reimbursement for each mile
equal to or exceeding 51 miles at 125 percent or the urban mileage rate; this rate shall
supersede that specified in clauses (2) and (3) for areas defined as rural and super rural; and
new text end
new text begin
(5) For purposes of reimbursement rates for special transportation and access
transportation services, the recipient's place of residence shall determine whether the
RUCA urban, rural, or super rural reimbursement rate applies.
new text end
Sec. 6.
Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 17e. new text end
new text begin Access transportation services in metropolitan area. new text end
new text begin
Access
transportation services in the 11-county metropolitan area shall be coordinated by the
"Minnesota Non-Emergency Transportation" (MNET) program. MNET shall ensure that
the most appropriate and cost-effective form of transportation is utilized for any eligible
person in obtaining nonemergency medical care. The contractor or broker administering
this program shall be paid as follows:
new text end
new text begin
(1) for the actual cost of service that is reimbursed to access transportation service
providers or actual cost incurred for each bus pass or mileage reimbursement provided to
recipients, plus a "trip administration fee" in the amount of $5 for each completed trip;
new text end
new text begin
(2) for "standing orders," defined as a trip by a recipient with the same origin and
destination for which the recipient is transported two or more times per week, the trip
administration fee for that trip shall be $7.50 per calendar week, regardless of the number
of times the recipient travels from that same origin to that same destination during that
week;
new text end
new text begin
(3) the trip administration fee shall only be paid for trips for which the recipient
received transportation, and shall not be paid for any "no-shows" or "cancellations"; and
new text end
new text begin
(4) level of need determinations shall be paid at a rate of $25 each for recipients
who are ambulatory, who use wheelchairs, or who require nonemergency stretcher
transportation; there shall not be any payment for level of need determinations in excess of
the number that is authorized for a recipient in section 256B.04, subdivision 14a.
new text end
Sec. 7.
Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 17f. new text end
new text begin Applicability. new text end
new text begin
Subdivisions 17b to 17e shall not apply to transit or
paratransit services provided or assisted by the Metropolitan Council under Minnesota
Statutes, sections 473.371 to 473.449.
new text end
Sec. 8. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2008, section 256B.0625, subdivision 17,
new text end
new text begin
is repealed.
new text end