HF 1576

1st Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; requiring a quality of care impact statement prior to
contracting for basic health care services to persons with disabilities; amending
Minnesota Statutes 2006, section 256B.69, subdivision 28.

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

Section 1.

Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to
read:

Subd. 28.

Medicare special needs plans; medical assistance basic health care.

(a) The commissioner may contract with qualified Medicare-approved special needs
plans to provide medical assistance basic health care services to persons with disabilities,
including those with developmental disabilities. Basic health care services include:

(1) those services covered by the medical assistance state plan except for ICF/MR
services, home and community-based waiver services, case management for persons with
developmental disabilities under section 256B.0625, subdivision 20a, and personal care
and certain home care services defined by the commissioner in consultation with the
stakeholder group established under paragraph (d); and

(2) basic health care services may also include risk for up to 100 days of nursing
facility services for persons who reside in a noninstitutional setting and home health
services related to rehabilitation as defined by the commissioner after consultation with
the stakeholder group.

The commissioner may exclude other medical assistance services from the basic
health care benefit set. Enrollees in these plans can access any excluded services on the
same basis as other medical assistance recipients who have not enrolled.

Unless a person is otherwise required to enroll in managed care, enrollment in these
plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
enrollment with an option to opt out is not voluntary enrollment.

(b) Beginning January 1, 2007, the commissioner may contract with qualified
Medicare special needs plans to provide basic health care services under medical
assistance to persons who are dually eligible for both Medicare and Medicaid and those
Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
The commissioner shall consult with the stakeholder group under paragraph deleted text begin (d) deleted text end new text begin (e) new text end in
developing program specifications for these services. The commissioner shall report to
the chairs of the house and senate committees with jurisdiction over health and human
services policy and finance by February 1, 2007, on implementation of these programs and
the need for increased funding for the ombudsman for managed care and other consumer
assistance and protections needed due to enrollment in managed care of persons with
disabilities. Payment for Medicaid services provided under this subdivision for the months
of May and June will be made no earlier than July 1 of the same calendar year.

(c) Beginning January 1, 2008, the commissioner may expand contracting under this
subdivision to all persons with disabilities not otherwise required to enroll in managed
care.

(d) new text begin By February 1, 2009, the commissioner shall report to the chairs of the house and
senate committees with jurisdiction over health and human services policy and finance on
the initial results of implementation of contracts with qualified Medicare special needs
plans to provide basic health care services under medical assistance to persons who are
dually eligible for both Medicare and Medicaid. This report shall include an overall
assessment of the impact on quality of care including actual costs and benefits.
new text end

new text begin (e) new text end The commissioner shall establish a state-level stakeholder group to provide
advice on managed care programs for persons with disabilities, including both MnDHO
and contracts with special needs plans that provide basic health care services as described
in paragraphs (a) and (b). The stakeholder group shall new text begin include representatives of the
counties and labor organizations representing county social service workers, members,
consumer advocates, and providers, and new text end provide advice on program expansions under this
subdivision and subdivision 23, including:

(1) implementation efforts;

(2) consumer protections; deleted text begin and deleted text end

(3) program specifications such as quality assurance measures, data collection and
reporting, and evaluation of costs, quality, and results deleted text begin . deleted text end new text begin ; and
new text end

new text begin (4) county safety net protections for persons with disabilities.
new text end

deleted text begin (e) deleted text end new text begin (f) new text end Each plan under contract to provide medical assistance basic health care
services shall establish a local or regional stakeholder group, including representatives
of the counties covered by the plan new text begin and labor organizations representing county social
service workers new text end , members, consumer advocates, and new text begin current new text end providers, for advice on
issues that arise in the local or regional area.