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Minnesota Legislature

Office of the Revisor of Statutes

HF 535

as introduced - 87th Legislature (2011 - 2012) Posted on 02/17/2011 09:46am

KEY: stricken = removed, old language.
underscored = added, new language.

Bill Text Versions

Engrossments
Introduction Posted on 02/17/2011

Current Version - as introduced

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A bill for an act
relating to education finance; modifying the process for third-party
reimbursement of qualifying services; amending Minnesota Statutes 2010,
section 125A.21, subdivisions 2, 3, 5, 7.

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

Section 1.

Minnesota Statutes 2010, section 125A.21, subdivision 2, is amended to
read:


Subd. 2.

Third-party reimbursement.

(a) Beginning July 1, 2000, districts
shall seek reimbursement from insurers and similar third parties for the cost of services
provided by the district whenever the services provided by the district are otherwise
covered by the child's health coverage. Districts shall request, but may not require, the
child's family to provide information about the child's health coverage when a child with a
disability begins to receive services from the district of a type that may be reimbursable,
and shall request, but may not require, updated information after that as needed.

(b) For children enrolled in medical assistance under chapter 256B or MinnesotaCare
under chapter 256L who have no other health coverage, a district shall provide an initial
written notice to the enrolled child's parent or legal representative of its intent to seek
reimbursement from medical assistance or MinnesotaCare for the individual education
plan health-related services provided by the district.new text begin The notice shall include:
new text end

new text begin (1) the right of the parent or legal representative to request a copy of all records
concerning individualized education program health-related services disclosed by the
district to any third party;
new text end

new text begin (2) the right of the parent or legal representative to withdraw consent for disclosing a
child's records at any time without consequence, including consent that was initially
given as part of the application process for MinnesotaCare or medical assistance under
section 256B.08, subdivision 1; and
new text end

new text begin (3) a statement that a decision to revoke consent for schools to share information
from education records does not impact a parent's eligibility for MinnesotaCare or medical
assistance.
new text end

(c) The district shall give the parent or legal representative annual written notice of:

(1) the district's intent to seek reimbursement from medical assistance or
MinnesotaCare for individual education plan health-related services provided by the
district;

(2) the right of the parent or legal representative to request a copy of all records
concerning individual education plan health-related services disclosed by the district to
any third party; and

(3) the right of the parent or legal representative to withdraw consent for disclosure
of a child's records at any time without consequencenew text begin, including consent that was initially
given as part of the application process for MinnesotaCare or medical assistance under
section 256B.08, subdivision 1
new text end.

The written notice shall be provided as part of the written notice required by Code of
Federal Regulations, title 34, section 300.504. new text beginThe Department of Education must ensure
that the notice requirements under this paragraph are included in the notice of procedural
safeguards.
new text end

(d) In order to access the private health care coverage of a child who is covered by
private health care coverage in whole or in part, a district must:

(1) obtain annual written informed consent from the parent or legal representative, in
compliance with subdivision 5; and

(2) inform the parent or legal representative that a refusal to permit the district
or state Medicaid agency to access their private health care coverage does not relieve
the district of its responsibility to provide all services necessary to provide free and
appropriate public education at no cost to the parent or legal representative.

(e) If the commissioner of human services obtains federal approval to exempt
covered individual education plan health-related services from the requirement that private
health care coverage refuse payment before medical assistance may be billed, paragraphs
(b), (c), and (d) shall also apply to students with a combination of private health care
coverage and health care coverage through medical assistance or MinnesotaCare.

(f) In the event that Congress or any federal agency or the Minnesota legislature
or any state agency establishes lifetime limits, limits for any health care services,
cost-sharing provisions, or otherwise provides that individual education plan health-related
services impact benefits for persons enrolled in medical assistance or MinnesotaCare, the
amendments to this subdivision adopted in 2002 are repealed on the effective date of any
federal or state law or regulation that imposes the limits. In that event, districts must
obtain informed consent consistent with this subdivision as it existed prior to the 2002
amendments and subdivision 5, before seeking reimbursement for children enrolled in
medical assistance under chapter 256B or MinnesotaCare under chapter 256L who have
no other health care coverage.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Minnesota Statutes 2010, section 125A.21, subdivision 3, is amended to read:


Subd. 3.

Use of reimbursements.

Of the reimbursements received, districts may:

(1) retain an amount sufficient to compensate the district for its administrative costs
of obtaining reimbursements;

(2) regularly obtain from education- and health-related entities training and other
appropriate technical assistance designed to improve the district's ability to deleted text begindetermine
which services are reimbursable and to seek timely reimbursement in a cost-effective
manner
deleted text endnew text begin access third-party payments for individualized education program health-related
services
new text end; or

(3) reallocate reimbursements for the benefit of students with deleted text beginspecial needsdeleted text endnew text begin
individualized education programs or individual family service plans
new text end in the district.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 3.

Minnesota Statutes 2010, section 125A.21, subdivision 5, is amended to read:


Subd. 5.

Informed consent.

When obtaining informed consent, consistent with
sections 13.05, subdivision 4adeleted text begin; anddeleted text endnew text begin,new text end 256B.77, subdivision 2, paragraph (p)new text begin, and Code of
Federal Regulations, title 34, parts 99 and 300
new text end, to bill health plans for covered services, the
school district must notify the legal representative (1) that the cost of the person's private
health insurance premium may increase due to providing the covered service in the school
setting, (2) that the school district may pay certain enrollee health plan costs, including
but not limited to, co-payments, coinsurance, deductibles, premium increases or other
enrollee cost-sharing amounts for health and related services required by an individual
service plan, or individual family service plan, and (3) that the school's billing for each
type of covered service may affect service limits and prior authorization thresholds. The
informed consent may be revoked in writing at any time by the person authorizing the
billing of the health plan.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 4.

Minnesota Statutes 2010, section 125A.21, subdivision 7, is amended to read:


Subd. 7.

District disclosure of information.

A school district may disclose
information contained in a student's individual education plan, consistent with section
13.32, subdivision 3, paragraph (a),new text begin and Code of Federal Regulations, title 34, part 99;new text end
including records of the student's diagnosis and treatment, to a health plan company only
with the signed and dated consent of the student's parent, or other legally authorized
individual. The school district shall disclose only that information necessary for the health
plan company to decide matters of coverage and payment. A health plan company may
use the information only for making decisions regarding coverage and payment, and for
any other use permitted by law.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 5. new text beginTHIRD-PARTY BILLING.
new text end

new text begin To allow the cost-effective billing of medical assistance for covered services that
are not reimbursed by other legally liable third parties, the commissioner of human
services must:
new text end

new text begin (1) summarize and document school district efforts to secure reimbursement from
legally liable third parties; and
new text end

new text begin (2) request initial and continuing waiver of the requirement to seek payment from a
student's private health plan as allowed in Code of Federal Regulations, title 42, section
433.139, chapter IV, part 433, based on the determination that this requirement is not
cost-effective from the Centers for Medicare and Medicaid Services to allow school
districts to bill Medicaid alone, without first billing private payers, when a child has
both public and private coverage.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end