HF 1952

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

A bill for an act
relating to human services; requiring information
regarding amounts paid for patient care under certain
public health coverage programs; amending Minnesota
Statutes 2004, section 256B.035.

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

Section 1.

Minnesota Statutes 2004, section 256B.035, is
amended to read:

256B.035 MANAGED CARE.

new text begin (a) new text end The commissioner of human services may contract with
public or private entities or operate a preferred provider
program to deliver health care services to medical assistance,
general assistance medical care, and MinnesotaCare program
recipients. The commissioner may enter into risk-based and
non-risk-based contracts. Contracts may be for the full range
of health services, or a portion thereof, for medical assistance
and general assistance medical care populations to determine the
effectiveness of various provider reimbursement and care
delivery mechanisms. The commissioner may seek necessary
federal waivers and implement projects when approval of the
waivers is obtained from the Centers for Medicare and Medicaid
Services of the United States Department of Health and Human
Services.

new text begin (b) A contract entered into under paragraph (a) must
require that the entities contracting with the commissioner
agree to annually provide to the commissioner, on a form and a
date prescribed by the commissioner, the following information
regarding the health care services provided under the contract
for the previous fiscal year:
new text end

new text begin (1) a description of the extent to which the entity entered
into capitated payment arrangements with health care providers
in connection with the contract;
new text end

new text begin (2) the total dollars paid as capitation payments to
providers, as fee-for-service payments to providers, and as
other types of payments to providers;
new text end

new text begin (3) if the entity did enter into capitated payment
arrangements, the average capitation amount paid to health care
providers, expressed as the dollar amount per member per month;
new text end

new text begin (4) if the entity did enter into capitation payment
arrangements, the total and average per member per month
capitation payments, reported separately for the three
categories of dentists, nursing homes, and all other providers;
new text end

new text begin (5) the range among providers of the capitation amounts
paid under clauses (3) and (4);
new text end

new text begin (6) if the entity paid some or all health care providers on
a fee-for-service basis, the total amount paid to health care
providers on that basis, expressed as the average dollar amount
per member per month.
new text end

new text begin (c) The commissioner shall provide a written report to the
legislature annually summarizing the information provided under
paragraph (b). The summary must include for each contract the
total amount paid by the commissioner to the contracting entity
under that contract.
new text end

new text begin (d) The commission has authority to audit entities in
connection with their reporting requirements under paragraphs
(b) and (c).
new text end

new text begin (e) Paragraphs (b), (c), and (d) expire June 30, 2008.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2005,
and applies to contracts that become effective on or after that
date.
new text end