HF 1862

4th Engrossment - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to health; establishing practice standards and evidence-based guidelines
for treating patients; implementing health care cost-containment measures;
requiring the disclosure of executive compensation; establishing liability limits
for certain licensed ambulance services and medical directors; modifying the
qualification standards of certain licenses; establishing certain fees; requiring
a study of hospital uncompensated care; allowing discounted payment for
health care under certain circumstances; regulating eligibility criteria for
medical assistance special transportation services; allowing entity certain
specific administrative efficiency reports to be published on the state agency
Web sites; requiring certain reports; adding provisions for service cooperatives
contracts; appropriating money; amending Minnesota Statutes 2004, sections
62D.095, subdivisions 3, 4; 62Q.64; 72A.20, by adding a subdivision; 123A.21,
subdivision 7; 148.06, subdivision 1; 151.214, subdivision 1; Minnesota Statutes
2005 Supplement, section 214.071; Laws 2003, First Special Session chapter 14,
article 12, section 93, as amended; proposing coding for new law in Minnesota
Statutes, chapters 62J; 62M; 62Q; 144; 144E; 147; 148; 214; 256B; repealing
Minnesota Statutes 2005 Supplement, section 62Q.251.

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

ARTICLE 1

HEALTH CARE COST-CONTAINMENT

Section 1.

new text begin [62J.431] PRACTICE STANDARDS.
new text end

new text begin Subdivision 1. new text end

new text begin Health-related boards and provider organizations; practice
standards. new text end

new text begin The health-related boards, under chapter 148, or professional provider
organizations may establish practice standards for treating patients within their respective
scopes of practice. The boards or provider organizations may utilize the services of
appropriate public or private entities to facilitate the development or review of practice
standards. Each board or provider organization that has established or ratified existing
standards shall report these standards to the legislative committees with jurisdiction over
the public health occupations by January 15, 2007, and shall report subsequent changes
annually thereafter. If a board or provider organization has existing standards, nothing in
this section requires a board or provider organization to establish new standards. Nothing
in this section shall require a health plan company to cover treatments, testing, or imaging,
based on standards developed under this section.
new text end

new text begin Subd. 2. new text end

new text begin Criteria for practice standards. new text end

new text begin (a) Practice standards developed under
this section must meet the following criteria:
new text end

new text begin (1) the scope and application are clear for treating specific conditions addressed
by the standards and for treating the specific condition in combination with multiple
medical conditions;
new text end

new text begin (2) authorship is stated and all contributing individuals are listed with any conflicts
of interest disclosed, including sources of funding for development, review and updating;
new text end

new text begin (3) authors represent all pertinent clinical fields or other means of input have been
used;
new text end

new text begin (4) the development process is explicitly stated;
new text end

new text begin (5) the standard is grounded on valid, timely research and clinical practice;
new text end

new text begin (6) the practice standards allow for reasonable situational variations;
new text end

new text begin (7) the research, data and randomized clinical trials used are cited and graded and
based on longitudinally representative samples of the population as appropriate;
new text end

new text begin new text end

new text begin (8) the document itself is clear and practical;
new text end

new text begin (9) the document is flexible in use for individual patient physiology, including
treatment tolerances and multiple medical conditions, with discretion for practitioner
judgement allowed and noted; and
new text end

new text begin (10) the practice standard has scheduled reviews and updating.
new text end

new text begin (b) Upon request, an entity that is subject to paragraph (a) must disclose its practice
standards and the basis for them.
new text end

Sec. 2.

new text begin [62J.62] ELECTRONIC BILLING ASSISTANCE.
new text end

new text begin The commissioner of human services shall, out of existing resources, encourage and
assist providers to adopt and use electronic billing for state programs, including but not
limited to the provision of training.
new text end

Sec. 3.

new text begin [62M.071] PRIOR AUTHORIZATION.
new text end

new text begin Health plan companies, in cooperation with health care providers, shall review prior
authorization procedures administered by utilization review organizations and health plan
companies to ensure the cost-effective use of prior authorization and minimization of
provider, clinic, and central office administrative burden.
new text end

Sec. 4.

new text begin [62M.072] USE OF EVIDENCE-BASED STANDARDS.
new text end

new text begin If no independently developed evidence-based standards exist for a particular
treatment, testing, or imaging procedure, then an insurer or utilization review organization
shall not deny coverage of the treatment, testing, or imaging based solely on the grounds
that the treatment, testing, or imaging does not meet an evidence-based standard. This
section does not prohibit an insurer or utilization review organization from denying
coverage for services that are investigational, experimental, or not medically necessary.
new text end

Sec. 5.

Minnesota Statutes 2004, section 62Q.64, is amended to read:

62Q.64 DISCLOSURE OF EXECUTIVE COMPENSATION.

(a) Each health plan company doing business in this state new text begin , each holding company
located in this state that owns a health maintenance organization located in this state or
elsewhere, and each Minnesota hospital new text end shall annually file with the deleted text begin Consumer Advisory
Board created in section 62J.75:
deleted text end

deleted text begin (1) a copy of the health plan company's form 990 filed with the federal Internal
Revenue Service; or
deleted text end

deleted text begin (2) if the health plan company did not file a form 990 with the federal Internal
Revenue Service deleted text end new text begin commissioner new text end , a list of the amount and deleted text begin recipients deleted text end new text begin job titles new text end of the deleted text begin health
plan company's five deleted text end new text begin entity's 20 new text end highest salaries, including all types of compensation,
in excess of deleted text begin $50,000 deleted text end new text begin $200,000 new text end .

(b) A filing under this section is public data under section 13.03 new text begin , and must be placed
on the minnesotahealthinfo.com Web site new text end .

Sec. 6.

new text begin [144.0506] AGENCY WEB SITES.
new text end

new text begin Subdivision 1. new text end

new text begin Information to be posted. new text end

new text begin The commissioner of health may post the
following information on agency Web sites, including minnesotahealthinfo.com:
new text end

new text begin (1) healthy lifestyle and preventive health care information, organized by sex and
age, with procedures and treatments categorized by level of effectiveness and reliability of
the supporting evidence on effectiveness;
new text end

new text begin (2) health plan company administrative efficiency report cards;
new text end

new text begin (3) health care provider charges for common procedures, based on information
available under section 62J.052;
new text end

new text begin (4) evidence-based medicine guidelines and related information for use as resources
by health care professionals, and summaries of the guidelines and related information for
use by patients and consumers;
new text end

new text begin (5) resources and Web links related to improving efficiency in medical clinics and
health care professional practices; and
new text end

new text begin (6) lists of nonprofit and charitable entities that accept donations of used medical
equipment and supplies, such as crutches and walkers.
new text end

new text begin Subd. 2. new text end

new text begin Other Internet resources. new text end

new text begin The commissioner of health, in implementing
subdivision 1, shall include relevant Web links and materials from private sector and other
government sources in order to avoid duplication and reduce state administrative costs.
new text end

new text begin Subd. 3. new text end

new text begin Cooperation with commissioner of commerce. new text end

new text begin The commissioner of
health shall consult and work in cooperation with the commissioner of commerce when
posting on the Web site information collected from health plan companies regulated by
the commissioner of commerce.
new text end

Sec. 7.

new text begin [144E.20] LIABILITY LIMITS OF NONGOVERNMENT LICENSEES
AND MEDICAL DIRECTORS.
new text end

new text begin (a) A licensee that is not a unit of government is subject to the same liability limits
under chapter 466 as a licensee that is a unit of government. new text end

new text begin (b) The medical director of a licensed ambulance service and the medical director's
designee are subject to the same liability limits under chapter 466 as a licensee that is a
unit of government.
new text end

new text begin (c) All actuary based savings from this section must be reflected in the insurance
medical liability premiums for ambulance services.
new text end

new text begin EFFECTIVE DATE; APPLICATION. new text end

new text begin This section is effective August 1, 2006,
and applies to claims arising from incidents occurring on or after that date.
new text end

Sec. 8.

new text begin [147.37] INFORMATION PROVISION; PHARMACEUTICAL
ASSISTANCE PROGRAMS.
new text end

new text begin The board shall encourage licensees to make available to patients information on
free and discounted prescription drug programs offered by pharmaceutical manufacturers
when the information is provided to the licensees at no cost.
new text end

Sec. 9.

Minnesota Statutes 2004, section 148.06, subdivision 1, is amended to read:

Subdivision 1.

License required; qualifications.

No person shall practice
chiropractic in this state without first being licensed by the State Board of Chiropractic
Examiners. The applicant shall have earned at least one-half of all academic credits
required for awarding of a baccalaureate degree from the University of Minnesota, or
other university, college, or community college of equal standing, in subject matter
determined by the board, and taken a four-year resident course of at least eight months
each in a school or college of chiropractic or in a chiropractic program that is accredited
by the Council on Chiropractic Education new text begin , holds a recognition agreement with the Council
on Chiropractic Education, new text end or new text begin is new text end accredited by an agency approved by the United States
Office of Education or their successors as of January 1, 1988. The board may issue
licenses to practice chiropractic without compliance with prechiropractic or academic
requirements listed above if in the opinion of the board the applicant has the qualifications
equivalent to those required of other applicants, the applicant satisfactorily passes written
and practical examinations as required by the Board of Chiropractic Examiners, and the
applicant is a graduate of a college of chiropractic with a deleted text begin reciprocal deleted text end recognition agreement
with the Council on Chiropractic Education deleted text begin as of January 1, 1988 deleted text end . The board may
recommend a two-year prechiropractic course of instruction to any university, college,
or community college which in its judgment would satisfy the academic prerequisite
for licensure as established by this section.

An examination for a license shall be in writing and shall include testing in:

(a) The basic sciences including but not limited to anatomy, physiology, bacteriology,
pathology, hygiene, and chemistry as related to the human body or mind;

(b) The clinical sciences including but not limited to the science and art of
chiropractic, chiropractic physiotherapy, diagnosis, roentgenology, and nutrition; and

(c) Professional ethics and any other subjects that the board may deem advisable.

The board may consider a valid certificate of examination from the National Board
of Chiropractic Examiners as evidence of compliance with the examination requirements
of this subdivision. The applicant shall be required to give practical demonstration in
vertebral palpation, neurology, adjusting and any other subject that the board may deem
advisable. A license, countersigned by the members of the board and authenticated by the
seal thereof, shall be granted to each applicant who correctly answers 75 percent of the
questions propounded in each of the subjects required by this subdivision and meets the
standards of practical demonstration established by the board. Each application shall be
accompanied by a fee set by the board. The fee shall not be returned but the applicant
may, within one year, apply for examination without the payment of an additional fee. The
board may grant a license to an applicant who holds a valid license to practice chiropractic
issued by the appropriate licensing board of another state, provided the applicant meets
the other requirements of this section and satisfactorily passes a practical examination
approved by the board. The burden of proof is on the applicant to demonstrate these
qualifications or satisfaction of these requirements.

Sec. 10.

new text begin [148.108] FEES.
new text end

new text begin Subdivision 1. new text end

new text begin Fees. new text end

new text begin In addition to the fees established in Minnesota Rules, chapter
2500, the board is authorized to charge the fees in this section.
new text end

new text begin Subd. 2. new text end

new text begin Annual renewal of inactive acupuncture registration. new text end

new text begin The annual
renewal of inactive acupuncture registration fee is $25.
new text end

new text begin Subd. 3. new text end

new text begin Acupuncture reinstatement. new text end

new text begin The acupuncture reinstatement fee is $50.
new text end

Sec. 11.

Minnesota Statutes 2004, section 151.214, subdivision 1, is amended to read:

Subdivision 1.

Explanation of pharmacy benefits.

A pharmacist licensed under
this chapter must provide to a patient, for each prescription dispensed where part or all
of the cost of the prescription is being paid or reimbursed by an employer-sponsored
plan or health plan company, or its contracted pharmacy benefit manager, the patient's
co-payment amount and the new text begin pharmacy's own new text end usual and customary price of the prescription
or the amount the pharmacy will be paid for the prescription drug by the patient's
employer-sponsored plan or health plan company, or its contracted pharmacy benefit
manager.

Sec. 12.

Minnesota Statutes 2005 Supplement, section 214.071, is amended to read:

214.071 HEALTH BOARDS; DIRECTORY OF LICENSEES.

new text begin By July 1, 2009, new text end each deleted text begin health deleted text end new text begin health-related licensing new text end board deleted text begin under chapters 147, 148,
148B, and 150A deleted text end new text begin , as defined in section 214.01, subdivision 2 new text end , shall establish a directory of
licensees that includes biographical data for each licensee.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 13.

new text begin [214.121] PRICE DISCLOSURE REMINDER.
new text end

new text begin Each health-related licensing board shall at least annually inform and remind its
licensees of the price disclosure requirements of section 62J.052 or 151.214, as applicable,
through the board's regular means of communicating with its licensees.
new text end

Sec. 14.

new text begin [256B.043] COST CONTAINMENT EFFORTS.
new text end

new text begin Subdivision 1. new text end

new text begin Alternative and complementary health care. new text end

new text begin The commissioner
of human services, through the medical director and in consultation with the health
services policy committee established under section 256B.0625, subdivision 3c, as
part of the commissioner's ongoing duties, shall consider the potential for improving
quality and obtaining cost savings through greater use of alternative and complementary
treatment methods and clinical practice; shall incorporate these methods into the medical
assistance, MinnesotaCare, and general assistance medical care programs; and shall
make related legislative recommendations as appropriate. The commissioner shall post
the recommendations required under this subdivision on agency Web sites according to
chapter 144.0506, subdivision 1.
new text end

new text begin Subd. 2. new text end

new text begin Access to care. new text end

new text begin (a) The commissioners of human services and health,
as part of their ongoing duties, shall consider the adequacy of the current system of
community health clinics and centers both statewide and in urban areas with significant
disparities in health status and access to services across racial and ethnic groups, including:
new text end

new text begin (1) methods to provide 24-hour availability of care through the clinics and centers;
new text end

new text begin (2) methods to expand the availability of care through the clinics and centers;
new text end

new text begin (3) the use of grants to expand the number of clinics and centers, the services
provided, and the availability of care; and
new text end

new text begin (4) the extent to which increased use of physician assistants, nurse practitioners,
medical residents and interns, and other allied health professionals in clinics and centers
would increase the availability of services.
new text end

new text begin (b) The commissioners shall make departmental modifications and legislative
recommendations as appropriate on the basis of their considerations under paragraph (a).
new text end

Sec. 15. new text begin REPORTING OF ACQUIRED INFECTIONS.
new text end

new text begin (a) The commissioner of health may consult with infection control specialists, health
care facility representatives, and consumers for the purpose of obtaining recommendations
regarding a determination of the need for action to implement health care associated
infection control reporting in hospitals and nursing homes. If the outcome of the
determination warrants, the commissioner shall consult with the group regarding:
new text end

new text begin (1) the selection of reporting measures relating to health care associated infections;
new text end

new text begin (2) design, implementation, validation, and ongoing evaluation of the reporting
system; and
new text end

new text begin (3) ensuring that the reporting measures remain flexible and adaptable to changing
national standards.
new text end

new text begin (b) If the commissioner determines that there is a need for the action described in
paragraph (a), the commissioner shall make written recommendations to the legislature.
new text end

Sec. 16. new text begin STUDY OF HOSPITAL UNCOMPENSATED CARE.
new text end

new text begin (a) The commissioner of health shall study and report to the legislature by January
15, 2007, the following:
new text end

new text begin (1) trends in hospitals' cost of providing uncompensated care, separately identifying
charity care and bad debt as components of uncompensated care;
new text end

new text begin (2) the impact of any changes in hospitals' charity care policies and debt collection
practices in the past three years on the amount of uncompensated care provided and the
number of patients receiving uncompensated care; and
new text end

new text begin (3) the value of hospital uncompensated care and community benefits in comparison
to the value of tax exemptions received as a result of nonprofit status.
new text end

new text begin (b) The commissioner's report to the legislature shall include recommendations on:
(1) the need for more uniform hospital charity care policies and debt collection practices;
and (2) the need for more uniform reporting of community benefits provided by nonprofit
hospitals.
new text end

Sec. 17. new text begin STUDY; REPORT.
new text end

new text begin The medical director for medical assistance and the assistant commissioner for
chemical and mental health services of the Department of Human Services, in conjunction
with the mental health licensing boards, shall evaluate the requirements for licensed
mental health practitioners to receive medical assistance reimbursement under Minnesota
Statutes, section 256B.0625, subdivision 38. The purpose of this study is to evaluate
qualifications of all licensed mental health practitioners and licensed mental health
professionals and make recommendations regarding requirements for medical assistance
reimbursement. This study is to be completed by January 15, 2007. Written results of
the study are to be submitted to the chairs of the house of representatives and senate
committees with jurisdiction over health related licensing boards.
new text end

Sec. 18. new text begin APPROPRIATIONS.
new text end

new text begin (a) In fiscal year 2007, $50,000 is appropriated from the general fund to the
commissioner of human services for the efforts required under Minnesota Statutes, section
256B.043.
new text end

new text begin (b) $5,000 is appropriated from the state government special revenue fund in fiscal
year 2006 and $5,000 is appropriated from the state government special revenue fund
in fiscal year 2007 to the Board of Chiropractic Examiners, to correct programming
difficulties incurred during implementation of payment processing changes. This is
a onetime appropriation.
new text end

ARTICLE 2

CHARITY CARE BY HEALTH CARE PROVIDERS

Section 1.

new text begin [62J.83] REDUCED PAYMENT AMOUNTS PERMITTED.
new text end

new text begin (a) Notwithstanding any provision of chapter 148 or any other provision of law to
the contrary, a health care provider may provide care to a patient at a discounted payment
amount, including care provided for free.
new text end

new text begin (b) This section does not apply in a situation in which the discounted payment
amount is not permitted under federal law.
new text end

Sec. 2.

Minnesota Statutes 2004, section 72A.20, is amended by adding a subdivision
to read:

new text begin Subd. 39. new text end

new text begin Discounted payments by health care providers; effect on use of
usual and customary payments. new text end

new text begin An insurer, including, but not limited to, a health plan
company as defined in section 62Q.01, subdivision 4; a reparation obligor as defined in
section 65B.43, subdivision 9; and a workers' compensation insurer shall not consider in
determining a health care provider's usual and customary payment, standard payment, or
allowable payment used as a basis for determining the provider's payment by the insurer,
the following discounted payment situations:
new text end

new text begin (1) care provided to relatives of the provider;
new text end

new text begin (2) care for which a discount or free care is given in hardship situations; and
new text end

new text begin (3) care for which a discount is given in exchange for cash payment.
new text end

new text begin For purposes of this subdivision, "health care provider" and "provider" have the
meaning given in section 62J.03, subdivision 8.
new text end

Sec. 3. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2005 Supplement, section 62Q.251, new text end new text begin is repealed.
new text end

Sec. 4. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 to 3 are effective the day following final enactment.
new text end

ARTICLE 3

PRIVATE SECTOR HEALTH COVERAGE PROVISIONS

Section 1.

Minnesota Statutes 2004, section 62D.095, subdivision 3, is amended to
read:

Subd. 3.

Deductibles.

deleted text begin (a) deleted text end A health maintenance contract issued by a health
maintenance organization deleted text begin that is assessed less than three percent of the total annual amount
assessed by the Minnesota comprehensive health association deleted text end may impose deductibles not
to exceed deleted text begin $3,000 deleted text end new text begin $4,000 new text end per person, per year and deleted text begin $6,000 deleted text end new text begin $8,000 new text end per family, per year. deleted text begin For
purposes of the percentage calculation, a health maintenance organization's assessments
include those of its affiliates.
deleted text end

deleted text begin (b) All other health maintenance contracts may impose deductibles not to exceed
$2,250 per person, per year and $4,500 per family, per year.
deleted text end

new text begin new text end

Sec. 2.

Minnesota Statutes 2004, section 62D.095, subdivision 4, is amended to read:

Subd. 4.

Annual out-of-pocket maximums.

deleted text begin (a) deleted text end A health maintenance contract
issued by a health maintenance organization deleted text begin that is assessed less than three percent of the
total annual amount assessed by the Minnesota comprehensive health association deleted text end must
include a limitation not to exceed deleted text begin $4,500 deleted text end new text begin $5,000 new text end per person and deleted text begin $7,500 deleted text end new text begin $10,000 new text end per
family on total annual out-of-pocket enrollee cost-sharing expenses. deleted text begin For purposes of the
percentage calculation, a health maintenance organization's assessments include those
of its affiliates.
deleted text end

deleted text begin (b) All other health maintenance contracts must include a limitation not to
exceed $3,000 per person and $6,000 per family on total annual out-of-pocket enrollee
cost-sharing expenses.
deleted text end

Sec. 3.

new text begin [62Q.645] DISTRIBUTION OF INFORMATION; ADMINISTRATIVE
EFFICIENCY AND COVERAGE OPTIONS.
new text end

new text begin (a) The commissioner may use reports submitted by health plan companies, service
cooperatives, and the public employee insurance program created in section 43A.316
to compile entity specific administrative efficiency reports; may make these reports
available on state agency Web sites, including minnesotahealthinfo.com; and may include
information on:
new text end

new text begin (1) number of covered lives;
new text end

new text begin (2) covered services;
new text end

new text begin (3) geographic availability;
new text end

new text begin (4) whom to contact to obtain current premium rates;
new text end

new text begin (5) administrative costs, using the definition of administrative costs developed under
section 62J.38;
new text end

new text begin (6) Internet links to information on the health plan, if available; and
new text end

new text begin (7) any other information about the health plan identified by the commissioner
as being useful for employers, consumers, providers, and others in evaluating health
plan options.
new text end

new text begin (b) This section does not apply to a health plan company unless its annual Minnesota
premiums exceed $50,000,000 based on the most recent assessment base of the Minnesota
Comprehensive Health Association. For purposes of this determination, the premiums of a
health plan company include those of its affiliates.
new text end

Sec. 4. new text begin MEDICAL MALPRACTICE INSURANCE REPORT.
new text end

new text begin (a) The commissioner of commerce shall provide to the legislature annually a brief
written report on the status of the market for medical malpractice insurance in Minnesota.
The report must summarize, interpret, explain, and analyze information on that subject
available to the commissioner, through annual statements filed by insurance companies,
information obtained under paragraph (c), and other sources.
new text end

new text begin (b) The annual report must consider, to the extent possible, using definitions
developed by the commissioner, Minnesota-specific data on market shares; premiums
received; amounts paid to settle claims that were not litigated, claims that were settled
after litigation began, and claims that were litigated to court judgment; amounts spent
on processing, investigation, litigation, and otherwise handling claims; other sales and
administrative costs; and the loss ratios of the insurers.
new text end

new text begin (c) Each insurance company that provides medical malpractice insurance in this state
shall, no later than June 1 each year, file with the commissioner of commerce, on a form
prescribed by the commissioner and using definitions developed by the commissioner,
the Minnesota-specific data referenced in paragraph (b), other than market share, for the
previous calendar year for that insurance company, shown separately for various categories
of coverages including, if possible, hospitals, medical clinics, nursing homes, physicians
who provide emergency medical care, obstetrician gynecologists, and ambulance services.
An insurance company need not comply with this paragraph if its direct premium written
in the state for the previous calendar year is less than $2,000,000.
new text end

ARTICLE 4

SERVICE COOPERATIVES

Section 1.

Minnesota Statutes 2004, section 123A.21, subdivision 7, is amended to
read:

Subd. 7.

Educational programs and services.

new text begin (a) new text end The board of directors of each
SC shall submit annually a plan to the members. The plan shall identify the programs and
services which are suggested for implementation by the SC during the following year and
shall contain components of long-range planning determined by the SC. These programs
and services may include, but are not limited to, the following areas:

(1) administrative services;

(2) curriculum development;

(3) data processing;

(4) distance learning and other telecommunication services;

(5) evaluation and research;

(6) staff development;

(7) media and technology centers;

(8) publication and dissemination of materials;

(9) pupil personnel services;

(10) planning;

(11) secondary, postsecondary, community, adult, and adult vocational education;

(12) teaching and learning services, including services for students with special
talents and special needs;

(13) employee personnel services;

(14) vocational rehabilitation;

(15) health, diagnostic, and child development services and centers;

(16) leadership or direction in early childhood and family education;

(17) community services;

(18) shared time programs;

(19) fiscal services and risk management programs;

(20) technology planning, training, and support services;

(21) health and safety services;

(22) student academic challenges; and

(23) cooperative purchasing services.

new text begin (b) A group health, dental, or long-term disability coverage program provided by
one or more service cooperatives:
new text end

new text begin (1) must rebid contracts for insurance and third-party administration at least every
four years. The contracts may be regional or statewide in the discretion of the SC; and
new text end

new text begin (2) may determine premiums for its health, dental, or long-term disability coverage
individually for specific employers or may determine them on a pooled or other basis
established by the SC.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Laws 2003, First Special Session chapter 14, article 12, section 93, as amended
by Laws 2005, First Special Session chapter 4, article 8, section 80, is amended to read:

Sec. 93. REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY
CRITERIA AND POTENTIAL COST SAVINGS.

The commissioner of human services, in consultation with the commissioner of
transportation and special transportation service providers, shall review eligibility criteria
for medical assistance special transportation services and shall evaluate whether the level
of special transportation services provided should be based on the degree of impairment of
the client, as well as the medical diagnosis. The commissioner shall also evaluate methods
for reducing the cost of special transportation services, including, but not limited to:

(1) requiring providers to maintain a daily log book confirming delivery of clients to
medical facilities;

(2) requiring providers to implement commercially available computer mapping
programs to calculate mileage for purposes of reimbursement;

(3) restricting special transportation service from being provided solely for trips
to pharmacies;

(4) modifying eligibility for special transportation;

(5) expanding alternatives to the use of special transportation services;

(6) improving the process of certifying persons as eligible for special transportation
services; and

(7) examining the feasibility and benefits of licensing special transportation
providers.

The commissioner shall present recommendations for changes in the eligibility
criteria and potential cost-savings for special transportation services to the chairs and
ranking minority members of the house and senate committees having jurisdiction
over health and human services spending by January 15, 2004. The commissioner
is prohibited from using a broker or coordinator to manage special transportation
services until July 1, 2006, except for the purposes of checking for recipient eligibility,
authorizing recipients for appropriate level of transportation, and monitoring provider
compliance with Minnesota Statutes, section 256B.0625, subdivision 17 new text begin , and except
that the commissioner shall extend this prohibition on using a broker or coordinator to
manage special transportation services until July 1, 2007, if this extension can be done on
a budget-neutral basis new text end . The commissioner shall not amend the initial contract to broker or
manage nonemergency medical transportation to extend beyond two consecutive years.
The commissioner shall not enter into a broker or management contract for transportation
services which denies a medical assistance recipient the free choice of health service
provider, including a special transportation provider, as specified in Code of Federal
Regulations, title 42, section 431.51. This prohibition does not apply to the purchase or
management of common carrier transportation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end