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Minnesota Legislature

Office of the Revisor of Statutes

HF 1619

1st Engrossment - 90th Legislature (2017 - 2018) Posted on 04/20/2017 10:13am

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

Current Version - 1st Engrossment

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A bill for an act
relating to human services; establishing a contingent, alternate medical assistance
payment method for children's hospitals; amending Minnesota Statutes 2016,
section 256.969, subdivision 4b, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2016, section 256.969, is amended by adding a subdivision
to read:


new text begin Subd. 2e. new text end

new text begin Alternate inpatient payment rate. new text end

new text begin (a) If the days, costs, and revenues
associated with patients who are eligible for medical assistance and also have private health
insurance are required to be included in the calculation of the hospital-specific
disproportionate share hospital payment limit for a rate year, then the commissioner, effective
retroactively to rate years beginning on or after January 1, 2015, shall compute an alternate
inpatient payment rate for a Minnesota hospital that is designated as a children's hospital
and enumerated as such by Medicare. The commissioner shall reimburse the hospital for a
rate year at the higher of the amount calculated under the alternate payment rate or the
amount calculated under subdivision 9.
new text end

new text begin (b) The alternate payment rate must meet the criteria in clauses (1) to (4):
new text end

new text begin (1) the alternate payment rate shall be structured to target a total aggregate reimbursement
amount equal to two percent less than each children's hospital's cost coverage percentage
in the applicable base year for providing fee-for-service inpatient services under this section
to patients enrolled in medical assistance;
new text end

new text begin (2) costs shall be determined using the most recently available medical assistance cost
report provided under subdivision 4b, paragraph (a), clause (3), for the applicable base year.
Costs shall be determined using standard Medicare cost finding and cost allocation methods
and applied in the same manner as the costs were in the rebasing for the applicable base
year. If the medical assistance cost report is not available, costs shall be determined in the
interim using the Medicare Cost Report;
new text end

new text begin (3) in any rate year in which payment to a hospital is made using the alternate payment
rate, no payments shall be made to the hospital under subdivision 9; and
new text end

new text begin (4) if the alternate payment amount increases payments at a rate that is higher than the
inflation factor applied over the rebasing period, the commissioner shall take this into
consideration when setting payment rates at the next rebasing.
new text end

Sec. 2.

Minnesota Statutes 2016, section 256.969, subdivision 4b, is amended to read:


Subd. 4b.

Medical assistance cost reports for services.

(a) A hospital that meets one
of the following criteria must annually submit to the commissioner medical assistance cost
reports within six months of the end of the hospital's fiscal year:

(1) a hospital designated as a critical access hospital that receives medical assistance
payments; deleted text beginor
deleted text end

(2) a Minnesota hospital or out-of-state hospital located within a Minnesota local trade
area that receives a disproportionate population adjustment under subdivision 9new text begin; or
new text end

new text begin (3) a Minnesota hospital that is designated as a children's hospital and enumerated as
such by Medicare
new text end.

For purposes of this subdivision, local trade area has the meaning given in subdivision
17.

(b) The commissioner shall suspend payments to any hospital that fails to submit a report
required under this subdivision. Payments must remain suspended until the report has been
filed with and accepted by the commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from January 1, 2015.
new text end