HF 1460

1st Engrossment - 89th Legislature (2015 - 2016) Posted on 03/22/2016 07:58am

A bill for an act
relating to human services; requiring the commissioner of human services
to contract with a vendor to verify the eligibility of medical assistance and
MinnesotaCare enrollees; appropriating money; proposing coding for new law
in Minnesota Statutes, chapter 256B.

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

Section 1.

new text begin [256B.0561] ELIGIBILITY VERIFICATION.
new text end

new text begin Subdivision 1. new text end

new text begin Verification required; vendor contract. new text end

new text begin (a) The commissioner shall
ensure that medical assistance and MinnesotaCare eligibility determinations through the
MNsure information technology system and through agency eligibility determination
systems include the computerized verification of income, residency, identity, and, when
applicable, assets.
new text end

new text begin (b) The commissioner shall contract with a vendor to verify the eligibility of all
persons enrolled in medical assistance and MinnesotaCare during a specified audit period.
This contract shall be exempt from sections 16C.08, subdivision 2, clause (1); 16C.09,
paragraph (a), clause (1); 43A.047, paragraph (a), and any other law to the contrary.
new text end

new text begin (c) The contract must require the vendor to comply with enrollee data privacy
requirements and to use encryption to safeguard enrollee identity. The contract must also
provide penalties for vendor noncompliance.
new text end

new text begin Subd. 2. new text end

new text begin Verification process; vendor duties. new text end

new text begin (a) The verification process
implemented by the vendor must include, but is not limited to, data matches of the
name, date of birth, address, and Social Security number of each medical assistance and
MinnesotaCare enrollee against relevant information in federal and state data sources,
including the federal data hub established under the Affordable Care Act. In designing the
verification process, the vendor, to the extent feasible, shall incorporate procedures that are
compatible and coordinated with, and build upon or improve, existing procedures used by
the MNsure information technology system and agency eligibility determination systems.
new text end

new text begin (b) The vendor, upon preliminary determination that an enrollee is eligible or
ineligible, shall notify the commissioner. Within 20 business days of this notification, the
commissioner shall accept the preliminary determination or reject it with a stated reason.
The commissioner shall retain final authority over eligibility determinations. The vendor
shall keep a record of all preliminary determinations of ineligibility communicated to
the commissioner.
new text end

new text begin (c) The vendor shall recommend to the commissioner an eligibility verification
process that will allow ongoing verification of enrollee eligibility under the MNsure
information technology system and agency eligibility determination systems.
new text end

new text begin (d) The commissioner and the vendor, following the conclusion of the initial
contract period, shall jointly submit an eligibility verification audit report to the chairs
and ranking minority members of the legislative committees with jurisdiction over health
and human services policy and finance. The report shall include, but is not limited to,
information, in the form of unidentified summary data, on preliminary determinations
of eligibility or ineligibility communicated by the vendor; the actions taken on those
preliminary determinations by the commissioner; and the commissioner's reasons for
rejecting preliminary determinations by the vendor. The report must also include the
recommendations for ongoing verification of enrollee eligibility required under paragraph
(c).
new text end

new text begin (e) An eligibility verification vendor contract shall be awarded for an initial one-year
period. The commissioner shall renew the contract for up to three additional one-year
periods and require additional eligibility verification audits, if the commissioner or the
legislative auditor determines that the MNsure information technology system and agency
eligibility determination systems cannot effectively verify the eligibility of medical
assistance and MinnesotaCare enrollees.
new text end

Sec. 2. new text begin APPROPRIATION.
new text end

new text begin $....... is appropriated from the general fund to the commissioner of human services
for the biennium ending June 30, 2017, to contract with a vendor to verify the eligibility of
state public program enrollees, as required under Minnesota Statutes, section 256B.0561.
new text end