HF 1318

as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:48am

A bill for an act
relating to human services; requiring commissioner to establish a MinnesotaCare
demonstration project to allow flexibility in the delivery of benefits; requiring
a health benefits account to be established for each demonstration project
participant; proposing coding for new law in Minnesota Statutes, chapter 256L.

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

Section 1.

new text begin [256L.29] MINNESOTACARE DEMONSTRATION PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner, beginning January 1, 2011, or
one year after issuance of the request for proposals under subdivision 2, whichever is
later, shall establish a two-year statewide demonstration project to allow flexibility in the
delivery of MinnesotaCare services to enrollees who are children, through the use of
an alternative benefit set and an enrollee health benefits account. Participation in the
demonstration project is voluntary.
new text end

new text begin Subd. 2. new text end

new text begin Request for proposals. new text end

new text begin (a) The commissioner, by January 1, 2010, or
upon federal approval, whichever is later, shall request proposals from managed care
and county-based purchasing plans to provide services to MinnesotaCare children on a
statewide basis. The commissioner shall include in the request for proposals expenditure,
utilization, and demographic information on the MinnesotaCare population to be covered.
new text end

new text begin (b) Proposals submitted by plan applicants must:
new text end

new text begin (1) provide a description of covered services and any deductible and cost-sharing
requirements;
new text end

new text begin (2) specify the dollar amount to be contributed annually by the plan to the health
benefit account;
new text end

new text begin (3) specify the monthly per-capita payment to be charged by the plan for providing
coverage to enrollees;
new text end

new text begin (4) describe any proposed changes in the MinnesotaCare sliding scale; and
new text end

new text begin (5) include other information required by the commissioner for the request for
proposals.
new text end

new text begin Subd. 3. new text end

new text begin Benefit flexibility; sliding scale. new text end

new text begin (a) Under the demonstration project, a
plan shall have the flexibility to develop benefit sets and cost-sharing requirements that
vary from those that apply to the standard MinnesotaCare program. A benefit set may
vary the amount, duration, and scope of benefits, relative to the standard MinnesotaCare
benefit set, but must cover key benefits at a level sufficient to meet the needs of the
target population. To determine compliance with this criterion, the commissioner shall
establish standards of sufficiency based on the target population's historical use of health
care services.
new text end

new text begin (b) The benefit design must exempt preventive services, as specified by the
commissioner, from any deductible requirement.
new text end

new text begin (c) The plan may, but is not required to, establish a new sliding scale for enrollees
that reflects changes made to the standard MinnesotaCare benefit set and other plan design
features.
new text end

new text begin Subd. 4. new text end

new text begin Health benefit account. new text end

new text begin (a) The plan awarded the contract must establish
and fund a health benefit account for each enrollee and provide each enrollee with a
health benefit card to allow electronic withdrawals and payments. The enrollee may
use money in the account to pay for deductibles, cost-sharing, and health care services
not covered under the benefit design. The commissioner shall establish procedures to
penalize or disenroll from the demonstration project individuals who make nonqualified
withdrawals from a health benefit account.
new text end

new text begin (b) Money in the account must carry over from year to year. At the end of the
demonstration project, or upon loss of MinnesotaCare eligibility, money in the account
must remain available to the individual for a two-year period for payment, as approved by
the commissioner, of health coverage premiums and other health care costs.
new text end

new text begin (c) Amounts in, or contributed to, a health benefit account shall not be counted as
income or assets for purposes of determining MinnesotaCare eligibility.
new text end

new text begin Subd. 5. new text end

new text begin Contract award. new text end

new text begin The commissioner shall accept one plan proposal to
provide alternative coverage on a statewide basis. The commissioner shall award the
demonstration project contract to the plan submitting the proposal with the highest value,
based upon an evaluation of relative cost and quality and consumer satisfaction. The
entity awarded the contract must agree to accept all enrollees on a guaranteed issue,
community-rated basis.
new text end

new text begin Subd. 6. new text end

new text begin Report. new text end

new text begin The commissioner of human services shall evaluate the extent to
which the demonstration project improved health care quality and enrollee satisfaction,
and reduced health care spending. The commissioner shall report findings to the
legislature by December 1, 2013. The report must include recommendations on whether
the demonstration project should be expanded to additional MinnesotaCare enrollees,
and whether health care delivery under MinnesotaCare should be modified based upon
the results of the demonstration project.
new text end

new text begin Subd. 7. new text end

new text begin Federal approval. new text end

new text begin The commissioner shall seek all federal waivers and
approvals necessary to implement this section.
new text end