HF 1811

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; directing counties to use any profits from the
county-based purchasing program to provide services to individuals receiving
medical assistance or general assistance medical care; amending Minnesota
Statutes 2006, section 256B.692, subdivision 3.

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

Section 1.

Minnesota Statutes 2006, section 256B.692, subdivision 3, is amended to
read:

Subd. 3.

Requirements of the county board.

A county board that intends to
purchase or provide health care under this section, which may include purchasing all or
part of these services from health plans or individual providers on a fee-for-service basis,
or providing these services directly, must demonstrate the ability to follow and agree to
the following requirements:

(1) purchase all covered services for a fixed payment from the state that does not
exceed the estimated state and federal cost that would have occurred under the prepaid
medical assistance and general assistance medical care programs;

(2) ensure that covered services are accessible to all enrollees and that enrollees
have a reasonable choice of providers, health plans, or networks when possible. If the
county is also a provider of service, the county board shall develop a process to ensure
that providers employed by the county are not the sole referral source and are not the
sole provider of health care services if other providers, which meet the same quality and
cost requirements are available;

(3) issue payments to participating vendors or networks in a timely manner;

(4) establish a process to ensure and improve the quality of care provided;

(5) provide appropriate quality and other required data in a format required by
the state;

(6) provide a system for advocacy, enrollee protection, and complaints and appeals
that is independent of care providers or other risk bearers and complies with section
256B.69;

(7) ensure that the implementation and operation of the Minnesota senior health
options demonstration project and the Minnesota disability health options demonstration
project, authorized under section 256B.69, subdivision 23, will not be impeded;

(8) ensure that all recipients that are enrolled in the prepaid medical assistance or
general assistance medical care program will be transferred to county-based purchasing
without utilizing the department's fee-for-service claims payment system;

(9) ensure that all recipients who are required to participate in county-based
purchasing are given sufficient information prior to enrollment in order to make informed
decisions; deleted text begin and
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(10) ensure that the state and the medical assistance and general assistance medical
care recipients will be held harmless for the payment of obligations incurred by the county
if the county, or a health plan providing services on behalf of the county, or a provider
participating in county-based purchasing becomes insolvent, and the state has made the
payments due to the county under this section deleted text begin . deleted text end new text begin ; and
new text end

new text begin (11) ensure that any profit arising out of the county's participation with this section is
allocated to programs for individuals receiving medical assistance or general assistance
medical care.
new text end