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HF 1412

1st Engrossment - 92nd Legislature (2021 - 2022) Posted on 03/05/2021 10:46am

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

Current Version - 1st Engrossment

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A bill for an act
relating to health care; modifying coverage for health care services and consultation
provided through telehealth; amending Minnesota Statutes 2020, sections 147.033;
151.37, subdivision 2; 245G.01, subdivisions 13, 26; 245G.06, subdivision 1;
254A.19, subdivision 5; 254B.05, subdivision 5; 256B.0596; 256B.0625,
subdivisions 3b, 13h, 20, 20b, 46, by adding a subdivision; 256B.0924, subdivisions
4a, 6; 256B.094, subdivision 6; proposing coding for new law in Minnesota Statutes,
chapter 62A; repealing Minnesota Statutes 2020, sections 62A.67; 62A.671;
62A.672.

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

Section 1.

new text begin [62A.673] COVERAGE OF SERVICES PROVIDED THROUGH
TELEHEALTH.
new text end

new text begin Subdivision 1. new text end

new text begin Citation. new text end

new text begin This section may be cited as the "Minnesota Telehealth Act."
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms defined in this subdivision
have the meanings given.
new text end

new text begin (b) "Distant site" means a site at which a health care provider is located while providing
health care services or consultations by means of telehealth.
new text end

new text begin (c) "Health care provider" means a health care professional who is licensed or registered
by the state to perform health care services within the provider's scope of practice and in
accordance with state law. A health care provider includes a mental health professional as
defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; and a mental
health practitioner as defined under section 245.462, subdivision 17, or 245.4871, subdivision
26.
new text end

new text begin (d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
new text end

new text begin (e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan
includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental
plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed
to pay benefits directly to the policy holder.
new text end

new text begin (f) "Originating site" means a site at which a patient is located at the time health care
services are provided to the patient by means of telehealth. For purposes of store-and-forward
transfer, the originating site also means the location at which a health care provider transfers
or transmits information to the distant site.
new text end

new text begin (g) "Store-and-forward transfer" means the asynchronous electronic transfer of a patient's
medical information or data from an originating site to a distant site for the purposes of
diagnostic and therapeutic assistance in the care of a patient.
new text end

new text begin (h) "Telehealth" means the delivery of health care services or consultations through the
use of real time two-way interactive audio and visual or audio-only communications to
provide or support health care delivery and facilitate the assessment, diagnosis, consultation,
treatment, education, and care management of a patient's health care. Telehealth includes
the application of secure video conferencing, store-and-forward transfers, and synchronous
interactions between a patient located at an originating site and a health care provider located
at a distant site. Telehealth includes audio-only communication between a health care
provider and a patient if the communication is a scheduled appointment and the standard
of care for the service can be met through the use of audio-only communication. Telehealth
does not include communication between health care providers or between a health care
provider and a patient that consists solely of an e-mail or facsimile transmission. Telehealth
does not include communication between health care providers that consists solely of a
telephone conversation.
new text end

new text begin (i) "Telemonitoring services" means the remote monitoring of clinical data related to
the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits
the data electronically to a health care provider for analysis. Telemonitoring is intended to
collect an enrollee's health-related data for the purpose of assisting a health care provider
in assessing and monitoring the enrollee's medical condition or status.
new text end

new text begin Subd. 3. new text end

new text begin Coverage of telehealth. new text end

new text begin (a) A health plan sold, issued, or renewed by a health
carrier in Minnesota must (1) cover benefits delivered through telehealth in the same manner
as any other benefits covered under the health plan, and (2) comply with this section.
new text end

new text begin (b) Coverage for services delivered through telehealth must not be limited on the basis
of geography, location, or distance for travel.
new text end

new text begin (c) A health carrier must not create a separate provider network or provide incentives
to enrollees to use a separate provider network to deliver services through telehealth that
does not include network providers who provide in-person care to patients for the same
service.
new text end

new text begin (d) A health carrier may require a deductible, co-payment, or coinsurance payment for
a health care service provided through telehealth, provided that the deductible, co-payment,
or coinsurance payment is not in addition to, and does not exceed, the deductible, co-payment,
or coinsurance applicable for the same service provided through in-person contact.
new text end

new text begin (e) Nothing in this section:
new text end

new text begin (1) requires a health carrier to provide coverage for services that are not medically
necessary or are not covered under the enrollee's health plan; or
new text end

new text begin (2) prohibits a health carrier from:
new text end

new text begin (i) establishing criteria that a health care provider must meet to demonstrate the safety
or efficacy of delivering a particular service through telehealth for which the health carrier
does not already reimburse other health care providers for delivering the service through
telehealth; or
new text end

new text begin (ii) establishing reasonable medical management techniques, provided the criteria or
techniques are not unduly burdensome or unreasonable for the particular service; or
new text end

new text begin (iii) requiring documentation or billing practices designed to protect the health carrier
or patient from fraudulent claims, provided the practices are not unduly burdensome or
unreasonable for the particular service.
new text end

new text begin (f) Nothing in this section requires the use of telehealth when a health care provider
determines that the delivery of a health care service through telehealth is not appropriate or
when an enrollee chooses not to receive a health care service through telehealth.
new text end

new text begin Subd. 4. new text end

new text begin Parity between telehealth and in-person services. new text end

new text begin (a) A health carrier must
not restrict or deny coverage of a health care service that is covered under a health plan
solely:
new text end

new text begin (1) because the health care service provided by the health care provider through telehealth
is not provided through in-person contact; or
new text end

new text begin (2) based on the communication technology or application used to deliver the health
care service through telehealth, provided the technology or application complies with this
section and is appropriate for the particular service.
new text end

new text begin (b) Prior authorization may be required for health care services delivered through
telehealth only if prior authorization is required before the delivery of the same service
through in-person contact.
new text end

new text begin (c) A health carrier may require a utilization review for services delivered through
telehealth, provided the utilization review is conducted in the same manner and uses the
same clinical review criteria as a utilization review for the same services delivered through
in-person contact.
new text end

new text begin Subd. 5. new text end

new text begin Reimbursement for services delivered through telehealth. new text end

new text begin (a) A health carrier
must reimburse the health care provider for services delivered through telehealth on the
same basis and at the same rate as the health carrier would apply to those services if the
services had been delivered by the health care provider through in-person contact.
new text end

new text begin (b) A health carrier must not deny or limit reimbursement based solely on a health care
provider delivering the service or consultation through telehealth instead of through in-person
contact.
new text end

new text begin (c) A health carrier must not deny or limit reimbursement based solely on the technology
and equipment used by the health care provider to deliver the health care service or
consultation through telehealth, provided the technology and equipment used by the provider
meets the requirements of this section and is appropriate for the particular service.
new text end

new text begin Subd. 6. new text end

new text begin Telehealth equipment. new text end

new text begin (a) A health carrier must not require a health care
provider to use specific telecommunications technology and equipment as a condition of
coverage under this section, provided the health care provider uses telecommunications
technology and equipment that complies with current industry interoperable standards and
complies with standards required under the federal Health Insurance Portability and
Accountability Act of 1996, Public Law 104-191, and regulations promulgated under that
Act, unless authorized under this section.
new text end

new text begin (b) A health carrier must provide coverage for health care services delivered through
telehealth by means of the use of audio-only telephone communication if the communication
is a scheduled appointment and the standard of care for that particular service can be met
through the use of audio-only communication.
new text end

new text begin Subd. 7. new text end

new text begin Telemonitoring services. new text end

new text begin A health carrier must provide coverage for
telemonitoring services if:
new text end

new text begin (1) the telemonitoring service is medically appropriate based on the enrollee's medical
condition or status;
new text end

new text begin (2) the enrollee is cognitively and physically capable of operating the monitoring device
or equipment, or the enrollee has a caregiver who is willing and able to assist with the
monitoring device or equipment; and
new text end

new text begin (3) the enrollee resides in a setting that is suitable for telemonitoring and not in a setting
that has health care staff on site.
new text end

Sec. 2.

Minnesota Statutes 2020, section 147.033, is amended to read:


147.033 PRACTICE OF deleted text beginTELEMEDICINEdeleted text endnew text begin TELEHEALTHnew text end.

Subdivision 1.

Definition.

For the purposes of this section, deleted text begin"telemedicine" means the
delivery of health care services or consultations while the patient is at an originating site
and the licensed health care provider is at a distant site. A communication between licensed
health care providers that consists solely of a telephone conversation, e-mail, or facsimile
transmission does not constitute telemedicine consultations or services. A communication
between a licensed health care provider and a patient that consists solely of an e-mail or
facsimile transmission does not constitute telemedicine consultations or services.
Telemedicine may be provided by means of real-time two-way interactive audio, and visual
communications, including the application of secure video conferencing or store-and-forward
technology to provide or support health care delivery, that facilitate the assessment, diagnosis,
consultation, treatment, education, and care management of a patient's health care.
deleted text endnew text begin
"telehealth" has the meaning given in section 62A.673, subdivision 2, paragraph (h).
new text end

Subd. 2.

Physician-patient relationship.

A physician-patient relationship may be
established through deleted text begintelemedicinedeleted text endnew text begin telehealthnew text end.

Subd. 3.

Standards of practice and conduct.

A physician providing health care services
by deleted text begintelemedicinedeleted text endnew text begin telehealthnew text end in this state shall be held to the same standards of practice and
conduct as provided in this chapter for in-person health care services.

Sec. 3.

Minnesota Statutes 2020, section 151.37, subdivision 2, is amended to read:


Subd. 2.

Prescribing and filing.

(a) A licensed practitioner in the course of professional
practice only, may prescribe, administer, and dispense a legend drug, and may cause the
same to be administered by a nurse, a physician assistant, or medical student or resident
under the practitioner's direction and supervision, and may cause a person who is an
appropriately certified, registered, or licensed health care professional to prescribe, dispense,
and administer the same within the expressed legal scope of the person's practice as defined
in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, without reference
to a specific patient, by directing a licensed dietitian or licensed nutritionist, pursuant to
section 148.634; a nurse, pursuant to section 148.235, subdivisions 8 and 9; physician
assistant; medical student or resident; or pharmacist according to section 151.01, subdivision
27, to adhere to a particular practice guideline or protocol when treating patients whose
condition falls within such guideline or protocol, and when such guideline or protocol
specifies the circumstances under which the legend drug is to be prescribed and administered.
An individual who verbally, electronically, or otherwise transmits a written, oral, or electronic
order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug.
This paragraph applies to a physician assistant only if the physician assistant meets the
requirements of deleted text beginsection 147A.18deleted text endnew text begin sections 147A.02 and 147A.09new text end.

(b) The commissioner of health, if a licensed practitioner, or a person designated by the
commissioner who is a licensed practitioner, may prescribe a legend drug to an individual
or by protocol for mass dispensing purposes where the commissioner finds that the conditions
triggering section 144.4197 or 144.4198, subdivision 2, paragraph (b), exist. The
commissioner, if a licensed practitioner, or a designated licensed practitioner, may prescribe,
dispense, or administer a legend drug or other substance listed in subdivision 10 to control
tuberculosis and other communicable diseases. The commissioner may modify state drug
labeling requirements, and medical screening criteria and documentation, where time is
critical and limited labeling and screening are most likely to ensure legend drugs reach the
maximum number of persons in a timely fashion so as to reduce morbidity and mortality.

(c) A licensed practitioner that dispenses for profit a legend drug that is to be administered
orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must file with the
practitioner's licensing board a statement indicating that the practitioner dispenses legend
drugs for profit, the general circumstances under which the practitioner dispenses for profit,
and the types of legend drugs generally dispensed. It is unlawful to dispense legend drugs
for profit after July 31, 1990, unless the statement has been filed with the appropriate
licensing board. For purposes of this paragraph, "profit" means (1) any amount received by
the practitioner in excess of the acquisition cost of a legend drug for legend drugs that are
purchased in prepackaged form, or (2) any amount received by the practitioner in excess
of the acquisition cost of a legend drug plus the cost of making the drug available if the
legend drug requires compounding, packaging, or other treatment. The statement filed under
this paragraph is public data under section 13.03. This paragraph does not apply to a licensed
doctor of veterinary medicine or a registered pharmacist. Any person other than a licensed
practitioner with the authority to prescribe, dispense, and administer a legend drug under
paragraph (a) shall not dispense for profit. To dispense for profit does not include dispensing
by a community health clinic when the profit from dispensing is used to meet operating
expenses.

(d) A prescription drug order for the following drugs is not valid, unless it can be
established that the prescription drug order was based on a documented patient evaluation,
including an examination, adequate to establish a diagnosis and identify underlying conditions
and contraindications to treatment:

(1) controlled substance drugs listed in section 152.02, subdivisions 3 to 5;

(2) drugs defined by the Board of Pharmacy as controlled substances under section
152.02, subdivisions 7, 8, and 12;

(3) muscle relaxants;

(4) centrally acting analgesics with opioid activity;

(5) drugs containing butalbital; or

(6) phosphodiesterase type 5 inhibitors when used to treat erectile dysfunction.

deleted text begin For purposes of prescribing drugs listed in clause (6), the requirement for a documented
patient evaluation, including an examination, may be met through the use of telemedicine,
as defined in section 147.033, subdivision 1.
deleted text end

(e) For the purposes of paragraph (d), the requirement for an examination shall be met
ifnew text begin:
new text end

new text begin (1)new text end an in-person examination has been completed in any of the following circumstances:

deleted text begin (1)deleted text endnew text begin (i)new text end the prescribing practitioner examines the patient at the time the prescription or
drug order is issued;

deleted text begin (2)deleted text endnew text begin (ii)new text end the prescribing practitioner has performed a prior examination of the patient;

deleted text begin (3)deleted text endnew text begin (iii)new text end another prescribing practitioner practicing within the same group or clinic as
the prescribing practitioner has examined the patient;

deleted text begin (4)deleted text endnew text begin (iv)new text end a consulting practitioner to whom the prescribing practitioner has referred the
patient has examined the patient; or

deleted text begin (5)deleted text endnew text begin (v)new text end the referring practitioner has performed an examination in the case of a consultant
practitioner issuing a prescription or drug order when providing services by means of
telemedicinedeleted text begin.deleted text endnew text begin; or
new text end

new text begin (2) the prescription order is for a drug listed in paragraph (d), clause (6), or for medication
assisted therapy for a substance use disorder, and the prescribing practitioner has completed
an examination of the patient via telehealth as defined in section 62A.673, subdivision 2,
paragraph (h).
new text end

(f) Nothing in paragraph (d) or (e) prohibits a licensed practitioner from prescribing a
drug through the use of a guideline or protocol pursuant to paragraph (a).

(g) Nothing in this chapter prohibits a licensed practitioner from issuing a prescription
or dispensing a legend drug in accordance with the Expedited Partner Therapy in the
Management of Sexually Transmitted Diseases guidance document issued by the United
States Centers for Disease Control.

(h) Nothing in paragraph (d) or (e) limits prescription, administration, or dispensing of
legend drugs through a public health clinic or other distribution mechanism approved by
the commissioner of health or a community health board in order to prevent, mitigate, or
treat a pandemic illness, infectious disease outbreak, or intentional or accidental release of
a biological, chemical, or radiological agent.

(i) No pharmacist employed by, under contract to, or working for a pharmacy located
within the state and licensed under section 151.19, subdivision 1, may dispense a legend
drug based on a prescription that the pharmacist knows, or would reasonably be expected
to know, is not valid under paragraph (d).

(j) No pharmacist employed by, under contract to, or working for a pharmacy located
outside the state and licensed under section 151.19, subdivision 1, may dispense a legend
drug to a resident of this state based on a prescription that the pharmacist knows, or would
reasonably be expected to know, is not valid under paragraph (d).

(k) Nothing in this chapter prohibits the commissioner of health, if a licensed practitioner,
or, if not a licensed practitioner, a designee of the commissioner who is a licensed
practitioner, from prescribing legend drugs for field-delivered therapy in the treatment of
a communicable disease according to the Centers For Disease Control and Prevention Partner
Services Guidelines.

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 2020, section 245G.01, subdivision 13, is amended to read:


Subd. 13.

Face-to-face.

"Face-to-face" means two-way, real-time, interactive deleted text beginand visualdeleted text end
communication between a client and a treatment service provider and includes services
delivered in person or via deleted text begintelemedicinedeleted text endnew text begin telehealth with priority being given to interactive
audio and visual communication, if available
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 5.

Minnesota Statutes 2020, section 245G.01, subdivision 26, is amended to read:


Subd. 26.

deleted text beginTelemedicinedeleted text endnew text begin Telehealthnew text end.

deleted text begin"Telemedicine"deleted text endnew text begin "Telehealth"new text end means the delivery
of a substance use disorder treatment service while the client is at an originating site and
the deleted text beginlicenseddeleted text end health care provider is at a distant sitenew text begin via telehealth as defined in section
256B.0625, subdivision 3b, and
new text end as specified in section 254B.05, subdivision 5, paragraph
(f).

Sec. 6.

Minnesota Statutes 2020, section 245G.06, subdivision 1, is amended to read:


Subdivision 1.

General.

Each client must have a person-centered individual treatment
plan developed by an alcohol and drug counselor within ten days from the day of service
initiation for a residential program and within five calendar days on which a treatment
session has been provided from the day of service initiation for a client in a nonresidential
program. Opioid treatment programs must complete the individual treatment plan within
21 days from the day of service initiation. The individual treatment plan must be signed by
the client and the alcohol and drug counselor and document the client's involvement in the
development of the plan. The individual treatment plan is developed upon the qualified staff
member's dated signature. Treatment planning must include ongoing assessment of client
needs. An individual treatment plan must be updated based on new information gathered
about the client's condition, the client's level of participation, and on whether methods
identified have the intended effect. A change to the plan must be signed by the client and
the alcohol and drug counselor. If the client chooses to have family or others involved in
treatment services, the client's individual treatment plan must include how the family or
others will be involved in the client's treatment.new text begin If a client is receiving treatment services
or an assessment via telehealth, the alcohol and drug counselor may document the client's
verbal approval of the treatment plan or change to the treatment plan in lieu of the client's
signature.
new text end

Sec. 7.

Minnesota Statutes 2020, section 254A.19, subdivision 5, is amended to read:


Subd. 5.

Assessment via deleted text begintelemedicinedeleted text endnew text begin telehealthnew text end.

Notwithstanding Minnesota Rules,
part 9530.6615, subpart 3, item A, a chemical use assessment may be conducted via
deleted text begin telemedicinedeleted text endnew text begin telehealth as defined in section 256B.0625, subdivision 3bnew text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 8.

Minnesota Statutes 2020, section 254B.05, subdivision 5, is amended to read:


Subd. 5.

Rate requirements.

(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.

(b) Eligible substance use disorder treatment services include:

(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;

(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;

(3) care coordination services provided according to section 245G.07, subdivision 1,
paragraph (a), clause (5);

(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);

(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;

(6) medication-assisted therapy services that are licensed according to sections 245G.01
to 245G.17 and 245G.22, or applicable tribal license;

(7) medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause (6) and provide nine hours of clinical services each week;

(8) high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
provide, respectively, 30, 15, and five hours of clinical services each week;

(9) hospital-based treatment services that are licensed according to sections 245G.01 to
245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;

(10) adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable tribal license;

(11) high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of
clinical services each week provided by a state-operated vendor or to clients who have been
civilly committed to the commissioner, present the most complex and difficult care needs,
and are a potential threat to the community; and

(12) room and board facilities that meet the requirements of subdivision 1a.

(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:

(1) programs that serve parents with their children if the program:

(i) provides on-site child care during the hours of treatment activity that:

(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or

(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or

(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:

(A) a child care center under Minnesota Rules, chapter 9503; or

(B) a family child care home under Minnesota Rules, chapter 9502;

(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or
programs or subprograms serving special populations, if the program or subprogram meets
the following requirements:

(i) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;

(ii) is governed with significant input from individuals of that specific background; and

(iii) employs individuals to provide individual or group therapy, at least 50 percent of
whom are of that specific background, except when the common social background of the
individuals served is a traumatic brain injury or cognitive disability and the program employs
treatment staff who have the necessary professional training, as approved by the
commissioner, to serve clients with the specific disabilities that the program is designed to
serve;

(3) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; and

(4) programs that offer services to individuals with co-occurring mental health and
chemical dependency problems if:

(i) the program meets the co-occurring requirements in section 245G.20;

(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined
in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates
under the supervision of a licensed alcohol and drug counselor supervisor and licensed
mental health professional, except that no more than 50 percent of the mental health staff
may be students or licensing candidates with time documented to be directly related to
provisions of co-occurring services;

(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;

(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;

(v) family education is offered that addresses mental health and substance abuse disorders
and the interaction between the two; and

(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.

(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the chemical dependency facility of the child care provider's current licensure to provide
child care services. Programs that provide child care according to paragraph (c), clause (1),
must be deemed in compliance with the licensing requirements in section 245G.19.

(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).

(f) Subject to federal approval, chemical dependency services that are otherwise covered
as direct face-to-face services may be provided via deleted text begintwo-way interactive videodeleted text endnew text begin telehealth as
defined in section 256B.0625, subdivision 3b
new text end. The use of deleted text begintwo-way interactive videodeleted text endnew text begin telehealth
to deliver services
new text end must be medically appropriate to the condition and needs of the person
being served. Reimbursement shall be at the same rates and under the same conditions that
would otherwise apply to direct face-to-face services. deleted text beginThe interactive video equipment and
connection must comply with Medicare standards in effect at the time the service is provided.
deleted text end

(g) For the purpose of reimbursement under this section, substance use disorder treatment
services provided in a group setting without a group participant maximum or maximum
client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
At least one of the attending staff must meet the qualifications as established under this
chapter for the type of treatment service provided. A recovery peer may not be included as
part of the staff ratio.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 9.

Minnesota Statutes 2020, section 256B.0596, is amended to read:


256B.0596 MENTAL HEALTH CASE MANAGEMENT.

Counties shall contract with eligible providers willing to provide mental health case
management services under section 256B.0625, subdivision 20. In order to be eligible, in
addition to general provider requirements under this chapter, the provider must:

(1) be willing to provide the mental health case management services; and

(2) have a minimum of at least one contact with the client per weeknew text begin, either in person or
through telehealth, and at least one face-to-face in-person contact with the client every six
months
new text end. This section is not intended to limit the ability of a county to provide its own mental
health case management services.

Sec. 10.

Minnesota Statutes 2020, section 256B.0625, subdivision 3b, is amended to read:


Subd. 3b.

deleted text beginTelemedicinedeleted text endnew text begin Telehealthnew text end services.

(a) Medical assistance covers medically
necessary services and consultations delivered by a deleted text beginlicenseddeleted text end health care provider deleted text beginvia
telemedicine
deleted text endnew text begin through telehealthnew text end in the same manner as if the service or consultation was
delivered deleted text beginin persondeleted text endnew text begin through in-person contactnew text end. deleted text beginCoverage is limited to three telemedicine
services per enrollee per calendar week, except as provided in paragraph (f). Telemedicine
deleted text end
Services new text beginor consultations delivered through telehealth new text endshall be paid at the full allowable
rate.

(b) The commissioner deleted text beginshalldeleted text endnew text begin maynew text end establish criteria that a health care provider must attest
to in order to demonstrate the safety or efficacy of delivering a particular service deleted text beginvia
telemedicine
deleted text endnew text begin through telehealthnew text end. The attestation may include that the health care provider:

(1) has identified the categories or types of services the health care provider will provide
deleted text begin via telemedicinedeleted text endnew text begin through telehealthnew text end;

(2) has written policies and procedures specific to deleted text begintelemedicinedeleted text end servicesnew text begin delivered through
telehealth
new text end that are regularly reviewed and updated;

(3) has policies and procedures that adequately address patient safety before, during,
and after the deleted text begintelemedicinedeleted text end service is deleted text beginrendereddeleted text endnew text begin delivered through telehealthnew text end;

(4) has established protocols addressing how and when to discontinue telemedicine
services; and

(5) has an established quality assurance process related to deleted text begintelemedicinedeleted text endnew text begin deliveringnew text end servicesnew text begin
through telehealth
new text end.

(c) As a condition of payment, a licensed health care provider must document each
occurrence of a health service deleted text beginprovided by telemedicinedeleted text endnew text begin delivered through telehealthnew text end to a
medical assistance enrollee. Health care service records for services deleted text beginprovided by telemedicinedeleted text endnew text begin
delivered through telehealth
new text end must meet the requirements set forth in Minnesota Rules, part
9505.2175, subparts 1 and 2, and must document:

(1) the type of service deleted text beginprovided by telemedicinedeleted text endnew text begin delivered through telehealthnew text end;

(2) the time the service began and the time the service ended, including an a.m. and p.m.
designation;

(3) the deleted text beginlicenseddeleted text end health care provider's basis for determining that deleted text begintelemedicinedeleted text endnew text begin telehealthnew text end
is an appropriate and effective means for delivering the service to the enrollee;

(4) the mode of transmission deleted text beginofdeleted text endnew text begin used to delivernew text end the deleted text begintelemedicinedeleted text end service new text beginthrough telehealth
new text end and records evidencing that a particular mode of transmission was utilized;

(5) the location of the originating site and the distant site;

(6) if the claim for payment is based on a physician's deleted text begintelemedicinedeleted text end consultation with
another physiciannew text begin through telehealthnew text end, the written opinion from the consulting physician
providing the deleted text begintelemedicinedeleted text endnew text begin telehealthnew text end consultation; and

(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).

(d) For purposes of this subdivision, unless otherwise covered under this chapterdeleted text begin,
"telemedicine" is defined as the delivery of health care services or consultations while the
patient is at an originating site and the licensed health care provider is at a distant site. A
communication between licensed health care providers, or a licensed health care provider
and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission
does not constitute telemedicine consultations or services. Telemedicine may be provided
by means of real-time two-way, interactive audio and visual communications, including the
application of secure video conferencing or store-and-forward technology to provide or
support health care delivery, which facilitate the assessment, diagnosis, consultation,
treatment, education, and care management of a patient's health care.
deleted text endnew text begin:
new text end

new text begin (1) "telehealth" means the delivery of health care services or consultations through the
use of real time two-way interactive audio and visual or audio-only communications to
provide or support health care delivery and facilitate the assessment, diagnosis, consultation,
treatment, education, and care management of a patient's health care. Telehealth includes
the application of secure video conferencing, store-and-forward transfers, and synchronous
interactions between a patient located at an originating site and a health care provider located
at a distant site. Unless interactive visual and audio communication is specifically required,
telehealth includes audio-only communication between a health care provider and a patient,
if the communication is a scheduled appointment with the health care provider and the
standard of care for the service can be met through the use of audio-only communication.
Telehealth does not include communication between health care providers or between a
health care provider and a patient that consists solely of an e-mail or facsimile transmission.
Telehealth does not include communication between health care providers that consists
solely of a telephone conversation;
new text end

deleted text begin (e) For purposes of this section, "licenseddeleted text end new text begin(2) "new text endhealth care provider" means a deleted text beginlicenseddeleted text end
health care provider deleted text beginunder section 62A.671, subdivision 6deleted text endnew text begin as defined under section 62A.673new text end,
a community paramedic as defined under section 144E.001, subdivision 5f, deleted text beginor a mental
health practitioner defined under section 245.462, subdivision 17, or 245.4871, subdivision
26
, working under the general supervision of a mental health professional, and
deleted text end a community
health worker who meets the criteria under subdivision 49, paragraph (a)deleted text begin; "health care
provider" is defined under section 62A.671, subdivision 3;
deleted text endnew text begin, a mental health certified peer
specialist under section 256B.0615, subdivision 5, a mental health certified family peer
specialist under section 256B.0616, subdivision 5, a mental health rehabilitation worker
under section 256B.0623, subdivision 5, paragraph (a), clause (4), and paragraph (b), a
mental health behavioral aide under section 256B.0943, subdivision 7, paragraph (b), clause
(3), a treatment coordinator under section 245G.11, subdivision 7, an alcohol and drug
counselor under section 245G.11, subdivision 5, a recovery peer under section 245G.11,
subdivision 8, and a mental health case manager under section 245.462, subdivision 4;
new text end and

new text begin (3) new text end"originating site" deleted text beginis defined under section 62A.671, subdivision 7deleted text endnew text begin, "distant site," and
"store-and-forward transfer" have the meanings given in section 62A.673, subdivision 2
new text end.

deleted text begin (f) The limit on coverage of three telemedicine services per enrollee per calendar week
does not apply if:
deleted text end

deleted text begin (1) the telemedicine services provided by the licensed health care provider are for the
treatment and control of tuberculosis; and
deleted text end

deleted text begin (2) the services are provided in a manner consistent with the recommendations and best
practices specified by the Centers for Disease Control and Prevention and the commissioner
of health.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 11.

Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision
to read:


new text begin Subd. 3h. new text end

new text begin Telemonitoring services. new text end

new text begin (a) Medical assistance covers telemonitoring services
if a recipient:
new text end

new text begin (1) has been diagnosed and is receiving services for at least one of the following chronic
conditions: hypertension, cancer, congestive heart failure, chronic obstructive pulmonary
disease, asthma, or diabetes;
new text end

new text begin (2) requires at least five times per week monitoring to manage the chronic condition, as
ordered by the recipient's health care provider;
new text end

new text begin (3) has had two or more emergency room or inpatient hospitalization stays within the
last 12 months due to the chronic condition or the recipient's health care provider has
identified that telemonitoring services would likely prevent the recipient's admission or
readmission to a hospital, emergency room, or nursing facility;
new text end

new text begin (4) is cognitively and physically capable of operating the monitoring device or equipment,
or the recipient has a caregiver who is willing and able to assist with the monitoring device
or equipment; and
new text end

new text begin (5) resides in a setting that is suitable for telemonitoring and not in a setting that has
health care staff on site.
new text end

new text begin (b) For purposes of this subdivision, "telemonitoring services" means the remote
monitoring of data related to a recipient's vital signs or biometric data by a monitoring
device or equipment that transmits the data electronically to a provider for analysis. The
assessment and monitoring of the health data transmitted by telemonitoring must be
performed by one of the following licensed health care professionals: physician, podiatrist,
registered nurse, advanced practice registered nurse, physician assistant, respiratory therapist,
or licensed professional working under the supervision of a medical director.
new text end

Sec. 12.

Minnesota Statutes 2020, section 256B.0625, subdivision 13h, is amended to
read:


Subd. 13h.

Medication therapy management services.

(a) Medical assistance covers
medication therapy management services for a recipient taking prescriptions to treat or
prevent one or more chronic medical conditions. For purposes of this subdivision,
"medication therapy management" means the provision of the following pharmaceutical
care services by a licensed pharmacist to optimize the therapeutic outcomes of the patient's
medications:

(1) performing or obtaining necessary assessments of the patient's health status;

(2) formulating a medication treatment plan, which may include prescribing medications
or products in accordance with section 151.37, subdivision 14, 15, or 16;

(3) monitoring and evaluating the patient's response to therapy, including safety and
effectiveness;

(4) performing a comprehensive medication review to identify, resolve, and prevent
medication-related problems, including adverse drug events;

(5) documenting the care delivered and communicating essential information to the
patient's other primary care providers;

(6) providing verbal education and training designed to enhance patient understanding
and appropriate use of the patient's medications;

(7) providing information, support services, and resources designed to enhance patient
adherence with the patient's therapeutic regimens; and

(8) coordinating and integrating medication therapy management services within the
broader health care management services being provided to the patient.

Nothing in this subdivision shall be construed to expand or modify the scope of practice of
the pharmacist as defined in section 151.01, subdivision 27.

(b) To be eligible for reimbursement for services under this subdivision, a pharmacist
must meet the following requirements:

(1) have a valid license issued by the Board of Pharmacy of the state in which the
medication therapy management service is being performed;

(2) have graduated from an accredited college of pharmacy on or after May 1996, or
completed a structured and comprehensive education program approved by the Board of
Pharmacy and the American Council of Pharmaceutical Education for the provision and
documentation of pharmaceutical care management services that has both clinical and
didactic elements;new text begin and
new text end

deleted text begin (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
have developed a structured patient care process that is offered in a private or semiprivate
patient care area that is separate from the commercial business that also occurs in the setting,
or in home settings, including long-term care settings, group homes, and facilities providing
assisted living services, but excluding skilled nursing facilities; and
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end make use of an electronic patient record system that meets state standards.

(c) For purposes of reimbursement for medication therapy management services, the
commissioner may enroll individual pharmacists as medical assistance providers. The
commissioner may also establish deleted text begincontact requirements between the pharmacist and recipient,
including limiting
deleted text end new text beginlimits on new text endthe number of reimbursable consultations per recipient.

(d) deleted text beginIf there are no pharmacists who meet the requirements of paragraph (b) practicing
within a reasonable geographic distance of the patient, a pharmacist who meets the
requirements may provide The
deleted text endnew text begin Medication therapy managementnew text end services new text beginmay be provided
new text end via deleted text begintwo-way interactive videodeleted text endnew text begin telehealth as defined in subdivision 3b and may be delivered
into a patient's residence
new text end. Reimbursement shall be at the same rates and under the same
conditions that would otherwise apply to the services provided. To qualify for reimbursement
under this paragraph, the pharmacist providing the services must meet the requirements of
paragraph (b)deleted text begin, and must be located within an ambulatory care setting that meets the
requirements of paragraph (b), clause (3). The patient must also be located within an
ambulatory care setting that meets the requirements of paragraph (b), clause (3). Services
provided under this paragraph may not be transmitted into the patient's residence
deleted text end.

deleted text begin (e) Medication therapy management services may be delivered into a patient's residence
via secure interactive video if the medication therapy management services are performed
electronically during a covered home care visit by an enrolled provider. Reimbursement
shall be at the same rates and under the same conditions that would otherwise apply to the
services provided. To qualify for reimbursement under this paragraph, the pharmacist
providing the services must meet the requirements of paragraph (b) and must be located
within an ambulatory care setting that meets the requirements of paragraph (b), clause (3).
deleted text end

Sec. 13.

Minnesota Statutes 2020, section 256B.0625, subdivision 20, is amended to read:


Subd. 20.

Mental health case management.

(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illness and children with severe emotional disturbance. Services
provided under this section must meet the relevant standards in sections 245.461 to 245.4887,
the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts
9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.

(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules, parts
9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.

(c) Medical assistance and MinnesotaCare payment for mental health case management
shall be made on a monthly basis. In order to receive payment for an eligible child, the
provider must document at least a face-to-face new text beginin-person new text endcontact with the child, the child's
parents, or the child's legal representative. To receive payment for an eligible adult, the
provider must document:

(1) at least a face-to-face new text beginin-person new text endcontact with the adult or the adult's legal representative
or deleted text beginadeleted text end contact by deleted text begininteractive videodeleted text endnew text begin telehealthnew text end that meets the requirements of subdivision 20b;
or

(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face new text beginin-person new text endcontact or a contact by deleted text begininteractive videodeleted text endnew text begin telehealthnew text end that
meets the requirements of subdivision 20b with the adult or the adult's legal representative
within the preceding two months.

(d) Payment for mental health case management provided by county or state staff shall
be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental health, and within mental
health, separate rates for children and adults.

(e) Payment for mental health case management provided by Indian health services or
by agencies operated by Indian tribes may be made according to this section or other relevant
federally approved rate setting methodology.

(f) Payment for mental health case management provided by vendors who contract with
a county or Indian tribe shall be based on a monthly rate negotiated by the host county or
tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the county
or tribe may negotiate a team rate with a vendor who is a member of the team. The team
shall determine how to distribute the rate among its members. No reimbursement received
by contracted vendors shall be returned to the county or tribe, except to reimburse the county
or tribe for advance funding provided by the county or tribe to the vendor.

(g) If the service is provided by a team which includes contracted vendors, tribal staff,
and county or state staff, the costs for county or state staff participation in the team shall be
included in the rate for county-provided services. In this case, the contracted vendor, the
tribal agency, and the county may each receive separate payment for services provided by
each entity in the same month. In order to prevent duplication of services, each entity must
document, in the recipient's file, the need for team case management and a description of
the roles of the team members.

(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
mental health case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall be provided by
the recipient's county of responsibility.

(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.

(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency,
is responsible for any federal disallowances. The county or tribe may share this responsibility
with its contracted vendors.

(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (o). The repayment is limited to:

(1) the costs of developing and implementing this section; and

(2) programming the information systems.

(l) Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.

(m) Case management services under this subdivision do not include therapy, treatment,
legal, or outreach services.

(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.

(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.

Sec. 14.

Minnesota Statutes 2020, section 256B.0625, subdivision 20b, is amended to
read:


Subd. 20b.

Mental health targeted case management through deleted text begininteractive videodeleted text endnew text begin
telehealth
new text end.

(a) Subject to federal approval, contact made for targeted case management by
deleted text begin interactive videodeleted text endnew text begin telehealthnew text end shall be eligible for payment if:

(1) the person receiving targeted case management services is residing in:

(i) a hospital;

(ii) a nursing facility; or

(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging
establishment or lodging establishment that provides supportive services or health supervision
services according to section 157.17 that is staffed 24 hours a day, seven days a week;

(2) deleted text begininteractive videodeleted text endnew text begin telehealthnew text end is in the best interests of the person and is deemed
appropriate by the person receiving targeted case management or the person's legal guardian,
the case management provider, and the provider operating the setting where the person is
residing;

(3) the use of deleted text begininteractive videodeleted text endnew text begin telehealthnew text end is approved as part of the person's written
personal service or case plan, taking into consideration the person's vulnerability and active
personal relationships; and

(4) deleted text begininteractive videodeleted text endnew text begin telehealthnew text end is used for up to, but not more than, 50 percent of the
minimum required face-to-face new text beginin-person new text endcontact.

(b) The person receiving targeted case management or the person's legal guardian has
the right to choose and consent to the use of deleted text begininteractive videodeleted text endnew text begin telehealthnew text end under this subdivision
and has the right to refuse the use of deleted text begininteractive videodeleted text endnew text begin telehealthnew text end at any time.

(c) The commissioner shall establish criteria that a targeted case management provider
must attest to in order to demonstrate the safety or efficacy of delivering the service via
deleted text begin interactive videodeleted text endnew text begin telehealthnew text end. The attestation may include that the case management provider
has:

(1) written policies and procedures specific to deleted text begininteractive videodeleted text end services new text begindelivered by
telehealth
new text endthat are regularly reviewed and updated;

(2) policies and procedures that adequately address client safety before, during, and after
the deleted text begininteractive videodeleted text end services are renderednew text begin by telehealthnew text end;

(3) established protocols addressing how and when to discontinue deleted text begininteractive videodeleted text end
servicesnew text begin delivered by telehealthnew text end; and

(4) established a quality assurance process related to deleted text begininteractive videodeleted text end servicesnew text begin delivered
by telehealth
new text end.

(d) As a condition of payment, the targeted case management provider must document
the following for each occurrence of targeted case management provided by deleted text begininteractive
video
deleted text endnew text begin telehealthnew text end:

(1) the time the service began and the time the service ended, including an a.m. and p.m.
designation;

(2) the basis for determining that deleted text begininteractive videodeleted text endnew text begin telehealthnew text end is an appropriate and
effective means for delivering the service to the person receiving case management services;

(3) the mode of transmission of the deleted text begininteractive videodeleted text end services new text begindelivered by telehealth
new text end and records evidencing that a particular mode of transmission was utilized;

(4) the location of the originating site and the distant site; and

(5) compliance with the criteria attested to by the targeted case management provider
as provided in paragraph (c).

new text begin (e) For purposes of this section, telehealth is defined in accordance with section
256B.0625, subdivision 3b. The commissioner may limit the delivery of services by telehealth
to audio and visual communications if the commissioner determines that face-to-face
interaction is necessary to ensure that services are delivered appropriately and effectively.
new text end

Sec. 15.

Minnesota Statutes 2020, section 256B.0625, subdivision 46, is amended to read:


Subd. 46.

Mental health deleted text begintelemedicinedeleted text endnew text begin telehealthnew text end.

deleted text beginEffective January 1, 2006, anddeleted text end Subject
to federal approval, mental health services that are otherwise covered by medical assistance
as direct face-to-face services may be provided via deleted text begintwo-way interactive videodeleted text endnew text begin telehealth as
defined in subdivision 3b
new text end. Use of deleted text begintwo-way interactive videodeleted text endnew text begin telehealth to deliver servicesnew text end
must be medically appropriate to the condition and needs of the person being served.
Reimbursement is at the same rates and under the same conditions that would otherwise
apply to the service. deleted text beginThe interactive video equipment and connection must comply with
Medicare standards in effect at the time the service is provided.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 16.

Minnesota Statutes 2020, section 256B.0924, subdivision 4a, is amended to read:


Subd. 4a.

Targeted case management through interactive video.

(a) Subject to federal
approval, contact made for targeted case management by interactive video shall be eligible
for payment under subdivision 6 if:

(1) the person receiving targeted case management services is residing in:

(i) a hospital;

(ii) a nursing facility; or

(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging
establishment or lodging establishment that provides supportive services or health supervision
services according to section 157.17 that is staffed 24 hours a day, seven days a week;

(2) deleted text begininteractive videodeleted text endnew text begin telehealthnew text end is in the best interests of the person and is deemed
appropriate by the person receiving targeted case management or the person's legal guardian,
the case management provider, and the provider operating the setting where the person is
residing;

(3) the use of deleted text begininteractive videodeleted text endnew text begin telehealthnew text end is approved as part of the person's written
personal service or case plan; and

(4) deleted text begininteractive videodeleted text endnew text begin telehealthnew text end is used for up to, but not more than, 50 percent of the
minimum required face-to-face new text beginin-person new text endcontact.

(b) The person receiving targeted case management or the person's legal guardian has
the right to choose and consent to the use of deleted text begininteractive videodeleted text endnew text begin telehealthnew text end under this subdivision
and has the right to refuse the use of deleted text begininteractive videodeleted text endnew text begin telehealthnew text end at any time.

(c) The commissioner shall establish criteria that a targeted case management provider
must attest to in order to demonstrate the safety or efficacy of delivering the service via
deleted text begin interactive videodeleted text endnew text begin telehealthnew text end. The attestation may include that the case management provider
has:

(1) written policies and procedures specific to deleted text begininteractive videodeleted text end services new text begindelivered by
telehealth
new text endthat are regularly reviewed and updated;

(2) policies and procedures that adequately address client safety before, during, and after
the deleted text begininteractive videodeleted text end services are renderednew text begin by telehealthnew text end;

(3) established protocols addressing how and when to discontinue deleted text begininteractive videodeleted text end
servicesnew text begin delivered by telehealthnew text end; and

(4) established a quality assurance process related to deleted text begininteractive videodeleted text end servicesnew text begin delivered
by telehealth
new text end.

(d) As a condition of payment, the targeted case management provider must document
the following for each occurrence of targeted case management provided by deleted text begininteractive
video
deleted text endnew text begin telehealthnew text end:

(1) the time the service began and the time the service ended, including an a.m. and p.m.
designation;

(2) the basis for determining that deleted text begininteractive videodeleted text end new text begintelehealth new text endis an appropriate and
effective means for delivering the service to the person receiving case management services;

(3) the mode of transmission of the deleted text begininteractive videodeleted text end services new text begindelivered by telehealth
new text end and records evidencing that a particular mode of transmission was utilized;

(4) the location of the originating site and the distant site; and

(5) compliance with the criteria attested to by the targeted case management provider
as provided in paragraph (c).

new text begin (e) For purposes of this section, telehealth is defined in accordance with section
256B.0625, subdivision 3b. The commissioner may limit the delivery of services by telehealth
to audio and visual communications if the commissioner determines that face-to-face
interaction is necessary to ensure that services are delivered appropriately and effectively.
new text end

Sec. 17.

Minnesota Statutes 2020, section 256B.0924, subdivision 6, is amended to read:


Subd. 6.

Payment for targeted case management.

(a) Medical assistance and
MinnesotaCare payment for targeted case management shall be made on a monthly basis.
In order to receive payment for an eligible adult, the provider must document at least one
contact per monthnew text begin, either in person or by telehealth,new text end and not more than two consecutive
months without a face-to-face new text beginin-person new text endcontact with the adult or the adult's legal
representative, family, primary caregiver, or other relevant persons identified as necessary
to the development or implementation of the goals of the personal service plan.

(b) Payment for targeted case management provided by county staff under this subdivision
shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
paragraph (b), calculated as one combined average rate together with adult mental health
case management under section 256B.0625, subdivision 20, except for calendar year 2002.
In calendar year 2002, the rate for case management under this section shall be the same as
the rate for adult mental health case management in effect as of December 31, 2001. Billing
and payment must identify the recipient's primary population group to allow tracking of
revenues.

(c) Payment for targeted case management provided by county-contracted vendors shall
be based on a monthly rate negotiated by the host county. The negotiated rate must not
exceed the rate charged by the vendor for the same service to other payers. If the service is
provided by a team of contracted vendors, the county may negotiate a team rate with a
vendor who is a member of the team. The team shall determine how to distribute the rate
among its members. No reimbursement received by contracted vendors shall be returned
to the county, except to reimburse the county for advance funding provided by the county
to the vendor.

(d) If the service is provided by a team that includes contracted vendors and county staff,
the costs for county staff participation on the team shall be included in the rate for
county-provided services. In this case, the contracted vendor and the county may each
receive separate payment for services provided by each entity in the same month. In order
to prevent duplication of services, the county must document, in the recipient's file, the need
for team targeted case management and a description of the different roles of the team
members.

(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
targeted case management shall be provided by the recipient's county of responsibility, as
defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds.

(f) The commissioner may suspend, reduce, or terminate reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal
disallowances. The county may share this responsibility with its contracted vendors.

(g) The commissioner shall set aside five percent of the federal funds received under
this section for use in reimbursing the state for costs of developing and implementing this
section.

(h) Payments to counties for targeted case management expenditures under this section
shall only be made from federal earnings from services provided under this section. Payments
to contracted vendors shall include both the federal earnings and the county share.

(i) Notwithstanding section 256B.041, county payments for the cost of case management
services provided by county staff shall not be made to the commissioner of management
and budget. For the purposes of targeted case management services provided by county
staff under this section, the centralized disbursement of payments to counties under section
256B.041 consists only of federal earnings from services provided under this section.

(j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for targeted case
management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(k) Payment for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.

(l) Any growth in targeted case management services and cost increases under this
section shall be the responsibility of the counties.

Sec. 18.

Minnesota Statutes 2020, section 256B.094, subdivision 6, is amended to read:


Subd. 6.

Medical assistance reimbursement of case management services.

(a) Medical
assistance reimbursement for services under this section shall be made on a monthly basis.
Payment is based on face-to-face deleted text beginor telephonedeleted text end contactsnew text begin, either in person or through telehealth,new text end
between the case manager and the client, client's family, primary caregiver, legal
representative, or other relevant person identified as necessary to the development or
implementation of the goals of the individual service plan regarding the status of the client,
the individual service plan, or the goals for the client. These contacts must meet the minimum
standards in clauses (1) and (2):

(1) there must be a face-to-face new text beginin-person new text endcontact at least once a month except as provided
in clause (2); and

(2) for a client placed outside of the county of financial responsibility, or a client served
by tribal social services placed outside the reservation, in an excluded time facility under
section 256G.02, subdivision 6, or through the Interstate Compact for the Placement of
Children, section 260.93, and the placement in either case is more than 60 miles beyond
the county or reservation boundaries, there must be at least one contact per month and not
more than two consecutive months without a face-to-face new text beginin-person new text endcontact.

(b) Except as provided under paragraph (c), the payment rate is established using time
study data on activities of provider service staff and reports required under sections 245.482
and 256.01, subdivision 2, paragraph (p).

(c) Payments for tribes may be made according to section 256B.0625 or other relevant
federally approved rate setting methodology for child welfare targeted case management
provided by Indian health services and facilities operated by a tribe or tribal organization.

(d) Payment for case management provided by county or tribal social services contracted
vendors shall be based on a monthly rate negotiated by the host county or tribal social
services. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the county
or tribal social services may negotiate a team rate with a vendor who is a member of the
team. The team shall determine how to distribute the rate among its members. No
reimbursement received by contracted vendors shall be returned to the county or tribal social
services, except to reimburse the county or tribal social services for advance funding provided
by the county or tribal social services to the vendor.

(e) If the service is provided by a team that includes contracted vendors and county or
tribal social services staff, the costs for county or tribal social services staff participation in
the team shall be included in the rate for county or tribal social services provided services.
In this case, the contracted vendor and the county or tribal social services may each receive
separate payment for services provided by each entity in the same month. To prevent
duplication of services, each entity must document, in the recipient's file, the need for team
case management and a description of the roles and services of the team members.

Separate payment rates may be established for different groups of providers to maximize
reimbursement as determined by the commissioner. The payment rate will be reviewed
annually and revised periodically to be consistent with the most recent time study and other
data. Payment for services will be made upon submission of a valid claim and verification
of proper documentation described in subdivision 7. Federal administrative revenue earned
through the time study, or under paragraph (c), shall be distributed according to earnings,
to counties, reservations, or groups of counties or reservations which have the same payment
rate under this subdivision, and to the group of counties or reservations which are not
certified providers under section 256F.10. The commissioner shall modify the requirements
set out in Minnesota Rules, parts 9550.0300 to 9550.0370, as necessary to accomplish this.

Sec. 19. new text beginREVISOR INSTRUCTION.
new text end

new text begin In Minnesota Statutes and Minnesota Rules, the revisor of statutes shall substitute the
term "telemedicine" with "telehealth" whenever the term appears and substitute Minnesota
Statutes, section 62A.673, whenever references to Minnesota Statutes, sections 62A.67,
62A.671, and 62A.672 appear.
new text end

Sec. 20. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, sections 62A.67; 62A.671; and 62A.672, new text end new text begin are repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: H1412-1

62A.67 SHORT TITLE.

Sections 62A.67 to 62A.672 may be cited as the "Minnesota Telemedicine Act."

62A.671 DEFINITIONS.

Subdivision 1.

Applicability.

For purposes of sections 62A.67 to 62A.672, the terms defined in this section have the meanings given.

Subd. 2.

Distant site.

"Distant site" means a site at which a licensed health care provider is located while providing health care services or consultations by means of telemedicine.

Subd. 3.

Health care provider.

"Health care provider" has the meaning provided in section 62A.63, subdivision 2.

Subd. 4.

Health carrier.

"Health carrier" has the meaning provided in section 62A.011, subdivision 2.

Subd. 5.

Health plan.

"Health plan" means a health plan as defined in section 62A.011, subdivision 3, and includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental plans that provide indemnity-based benefits, regardless of expenses incurred and are designed to pay benefits directly to the policyholder.

Subd. 6.

Licensed health care provider.

"Licensed health care provider" means a health care provider who is:

(1) licensed under chapter 147, 147A, 148, 148B, 148E, 148F, 150A, or 153; a mental health professional as defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; or vendor of medical care defined in section 256B.02, subdivision 7; and

(2) authorized within their respective scope of practice to provide the particular service with no supervision or under general supervision.

Subd. 7.

Originating site.

"Originating site" means a site including, but not limited to, a health care facility at which a patient is located at the time health care services are provided to the patient by means of telemedicine.

Subd. 8.

Store-and-forward technology.

"Store-and-forward technology" means the transmission of a patient's medical information from an originating site to a health care provider at a distant site without the patient being present, or the delivery of telemedicine that does not occur in real time via synchronous transmissions.

Subd. 9.

Telemedicine.

"Telemedicine" means the delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. A communication between licensed health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission does not constitute telemedicine consultations or services. A communication between a licensed health care provider and a patient that consists solely of an e-mail or facsimile transmission does not constitute telemedicine consultations or services. Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care.

62A.672 COVERAGE OF TELEMEDICINE SERVICES.

Subdivision 1.

Coverage of telemedicine.

(a) A health plan sold, issued, or renewed by a health carrier for which coverage of benefits begins on or after January 1, 2017, shall include coverage for telemedicine benefits in the same manner as any other benefits covered under the policy, plan, or contract, and shall comply with the regulations of this section.

(b) Nothing in this section shall be construed to:

(1) require a health carrier to provide coverage for services that are not medically necessary;

(2) prohibit a health carrier from establishing criteria that a health care provider must meet to demonstrate the safety or efficacy of delivering a particular service via telemedicine for which the health carrier does not already reimburse other health care providers for delivering via telemedicine, so long as the criteria are not unduly burdensome or unreasonable for the particular service; or

(3) prevent a health carrier from requiring a health care provider to agree to certain documentation or billing practices designed to protect the health carrier or patients from fraudulent claims so long as the practices are not unduly burdensome or unreasonable for the particular service.

Subd. 2.

Parity between telemedicine and in-person services.

A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient.

Subd. 3.

Reimbursement for telemedicine services.

(a) A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider.

(b) It is not a violation of this subdivision for a health carrier to include a deductible, co-payment, or coinsurance requirement for a health care service provided via telemedicine, provided that the deductible, co-payment, or coinsurance is not in addition to, and does not exceed, the deductible, co-payment, or coinsurance applicable if the same services were provided through in-person contact.