HF 1336

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; changing hospital payment
adjustment provision for diagnostic-related group
payments; amending Minnesota Statutes 2004, sections
256.969, subdivision 26; 256B.195, subdivision 3.

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

Section 1.

Minnesota Statutes 2004, section 256.969,
subdivision 26, is amended to read:

Subd. 26.

Greater minnesota payment adjustment after june
30, 2001.

(a) For admissions occurring after June 30, 2001, the
commissioner shall pay fee-for-service inpatient admissions for
the diagnosis-related groups specified in paragraph (b) at
hospitals located outside of the seven-county metropolitan area
at the higher of:

(1) the hospital's current payment rate for the diagnostic
category to which the diagnosis-related group belongs, exclusive
of disproportionate population adjustments received under
subdivision 9 and hospital payment adjustments received under
subdivision 23; or

(2) 90 percent of the average payment rate for that
diagnostic category for hospitals located within the
seven-county metropolitan area, exclusive of disproportionate
population adjustments received under subdivision 9 and hospital
payment adjustments received under subdivisions 20 and 23. deleted text begin The
commissioner may adjust this percentage each year so that the
estimated payment increases under this paragraph are equal to
the funding provided under section 256B.195 for this purpose.
deleted text end

(b) The payment increases provided in paragraph (a) apply
to the following diagnosis-related groups, as they fall within
the diagnostic categories:

(1) 370 cesarean section with complicating diagnosis;

(2) 371 cesarean section without complicating diagnosis;

(3) 372 vaginal delivery with complicating diagnosis;

(4) 373 vaginal delivery without complicating diagnosis;

(5) 386 extreme immaturity and respiratory distress
syndrome, neonate;

(6) 388 full-term neonates with other problems;

(7) 390 prematurity without major problems;

(8) 391 normal newborn;

(9) 385 neonate, died or transferred to another acute care
facility;

(10) 425 acute adjustment reaction and psychosocial
dysfunction;

(11) 430 psychoses;

(12) 431 childhood mental disorders; and

(13) 164-167 appendectomy.

Sec. 2.

Minnesota Statutes 2004, section 256B.195,
subdivision 3, is amended to read:

Subd. 3.

Payments to certain safety net providers.

(a)
Effective July 15, 2001, the commissioner shall make the
following payments to the hospitals indicated after noon on the
15th of each month:

(1) to Hennepin County Medical Center, any federal matching
funds available to match the payments received by the medical
center under subdivision 2, to increase payments for medical
assistance admissions and to recognize higher medical assistance
costs in institutions that provide high levels of charity care;
and

(2) to Regions Hospital, any federal matching funds
available to match the payments received by the hospital under
subdivision 2, to increase payments for medical assistance
admissions and to recognize higher medical assistance costs in
institutions that provide high levels of charity care.

(b) Effective July 15, 2001, the following percentages of
the transfers under subdivision 2 shall be retained by the
commissioner for deposit each month into the general fund:

(1) 18 percent, plus any federal matching funds, shall be
allocated for the following purposes:

(i) during the fiscal year beginning July 1, 2001, of the
amount available under this clause, 39.7 percent shall be
allocated to make increased hospital payments under section
256.969, subdivision 26; 34.2 percent shall be allocated to fund
the amounts due from small rural hospitals, as defined in
section 144.148, for overpayments under section 256.969,
subdivision 5a, resulting from a determination that medical
assistance and general assistance payments exceeded the charge
limit during the period from 1994 to 1997; and 26.1 percent
shall be allocated to the commissioner of health for rural
hospital capital improvement grants under section 144.148; and

(ii) during fiscal years beginning on or after July 1,
2002, of the amount available under this clause, 55 percent
shall be allocated to make increased hospital payments under
section 256.969, subdivision 26, and 45 percent shall be
allocated to the commissioner of health for rural hospital
capital improvement grants under section 144.148; and

(2) 11 percent shall be allocated to the commissioner of
health to fund community clinic grants under section 145.9268.

(c) This subdivision shall apply to fee-for-service
payments only and shall not increase capitation payments or
payments made based on average rates. new text begin The allocation in
paragraph (b), clause (1), item (ii), to increase hospital
payments under section 256.969, subdivision 26, shall not limit
payments under that section.
new text end

(d) Medical assistance rate or payment changes, including
those required to obtain federal financial participation under
section 62J.692, subdivision 8, shall precede the determination
of intergovernmental transfer amounts determined in this
subdivision. Participation in the intergovernmental transfer
program shall not result in the offset of any health care
provider's receipt of medical assistance payment increases other
than limits resulting from hospital-specific charge limits and
limits on disproportionate share hospital payments.

(e) Effective July 1, 2003, if the amount available for
allocation under paragraph (b) is greater than the amounts
available during March 2003, after any increase in
intergovernmental transfers and payments that result from
section 256.969, subdivision 3a, paragraph (c), are paid to the
general fund, any additional amounts available under this
subdivision after reimbursement of the transfers under
subdivision 2 shall be allocated to increase medical assistance
payments, subject to hospital-specific charge limits and limits
on disproportionate share hospital payments, as follows:

(1) if the payments under subdivision 5 are approved, the
amount shall be paid to the largest ten percent of hospitals as
measured by 2001 payments for medical assistance, general
assistance medical care, and MinnesotaCare in the nonstate
government hospital category. Payments shall be allocated
according to each hospital's proportionate share of the 2001
payments; or

(2) if the payments under subdivision 5 are not approved,
the amount shall be paid to the largest ten percent of hospitals
as measured by 2001 payments for medical assistance, general
assistance medical care, and MinnesotaCare in the nonstate
government category and to the largest ten percent of hospitals
as measured by payments for medical assistance, general
assistance medical care, and MinnesotaCare in the nongovernment
hospital category. Payments shall be allocated according to
each hospital's proportionate share of the 2001 payments in
their respective category of nonstate government and
nongovernment. The commissioner shall determine which hospitals
are in the nonstate government and nongovernment hospital
categories.