HF 591

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; increasing the withhold and the number of
performance targets for state managed care contracts; amending Minnesota
Statutes 2006, section 256B.69, subdivision 5a.

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

Section 1.

Minnesota Statutes 2006, section 256B.69, subdivision 5a, is amended to
read:

Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section
and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year
basis beginning January 1, 1996. Managed care contracts which were in effect on June
30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
commissioner may issue separate contracts with requirements specific to services to
medical assistance recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons
pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
of its contract with the commissioner. Requirements applicable to managed care programs
under chapters 256B, 256D, and 256L, established after the effective date of a contract
with the commissioner take effect when the contract is next issued or renewed.

(c) Effective for services rendered on or after January 1, 2003, the commissioner
shall withhold five percent of managed care plan payments under this section for the
prepaid medical assistance and general assistance medical care programs pending
completion of performance targets. new text begin Effective for services rendered on or after January
1, 2008, the commissioner shall increase the withhold by one-half percent, for a total
withhold of 5-1/2 percent of managed care plan payments, and shall add well child
services, including immunizations and vision screening, as a new performance target.
Effective for services rendered on or after January 1, 2009, the commissioner shall
increase the withhold by an additional one percent, for a total withhold of 6-1/2 percent of
managed care plan payments, and shall add cancer screening, treatment of asthma, and
treatment of diabetes as new performance targets. Effective for services rendered on or
after January 1, 2010, the commissioner shall increase the withhold by an additional one
percent, for a total withhold of 7-1/2 percent of managed care plan payments, and shall
add treatment of depression, treatment of heart disease, and treatment of tobacco addiction
as new performance targets. new text end Each performance target must be quantifiable, objective,
measurable, and reasonably attainable, except in the case of a performance target based
on a federal or state law or rule. Criteria for assessment of each performance target must
be outlined in writing prior to the contract effective date. The withheld funds must be
returned no sooner than July of the following year if performance targets in the contract
are achieved. The commissioner may exclude special demonstration projects under
subdivision 23. A managed care plan or a county-based purchasing plan under section
256B.692 may include as admitted assets under section 62D.044 any amount withheld
under this paragraph that is reasonably expected to be returned.