HF 1995

as introduced - 88th Legislature (2013 - 2014) Posted on 02/25/2014 02:20pm

A bill for an act
relating to human services; modifying participation requirements in certain
public health care programs for dental service providers; amending Minnesota
Statutes 2012, section 256B.0644.

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

Section 1.

Minnesota Statutes 2012, section 256B.0644, is amended to read:

256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
PROGRAMS.

(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
health maintenance organization, as defined in chapter 62D, must participate as a provider
or contractor in the medical assistance program and MinnesotaCare as a condition of
participating as a provider in health insurance plans and programs or contractor for state
employees established under section 43A.18, the public employees insurance program
under section 43A.316, for health insurance plans offered to local statutory or home
rule charter city, county, and school district employees, the workers' compensation
system under section 176.135, and insurance plans provided through the Minnesota
Comprehensive Health Association under sections 62E.01 to 62E.19. The limitations
on insurance plans offered to local government employees shall not be applicable in
geographic areas where provider participation is limited by managed care contracts
with the Department of Human Services. new text begin This section does not apply to dental service
providers providing dental services outside the seven-county metropolitan area.
new text end

(b) For providers other than health maintenance organizations, participation in the
medical assistance program means that:

(1) the provider accepts new medical assistance and MinnesotaCare patients;

(2) for providers other than dental service providers, at least 20 percent of the
provider's patients are covered by medical assistance and MinnesotaCare as their primary
source of coverage; or

(3) for dental service providers new text begin providing dental services in the seven-county
metropolitan area new text end , at least ten percent of the provider's patients are covered by medical
assistance and MinnesotaCare as their primary source of coverage, or the provider accepts
new medical assistance and MinnesotaCare patients who are children with special health
care needs. For purposes of this section, "children with special health care needs" means
children up to age 18 who: (i) require health and related services beyond that required
by children generally; and (ii) have or are at risk for a chronic physical, developmental,
behavioral, or emotional condition, including: bleeding and coagulation disorders;
immunodeficiency disorders; cancer; endocrinopathy; developmental disabilities;
epilepsy, cerebral palsy, and other neurological diseases; visual impairment or deafness;
Down syndrome and other genetic disorders; autism; fetal alcohol syndrome; and other
conditions designated by the commissioner after consultation with representatives of
pediatric dental providers and consumers.

(c) Patients seen on a volunteer basis by the provider at a location other than
the provider's usual place of practice may be considered in meeting the participation
requirement in this section. The commissioner shall establish participation requirements
for health maintenance organizations. The commissioner shall provide lists of participating
medical assistance providers on a quarterly basis to the commissioner of management and
budget, the commissioner of labor and industry, and the commissioner of commerce. Each
of the commissioners shall develop and implement procedures to exclude as participating
providers in the program or programs under their jurisdiction those providers who do
not participate in the medical assistance program. The commissioner of management
and budget shall implement this section through contracts with participating health and
dental carriers.

(d) A volunteer dentist who has signed a volunteer agreement under section
256B.0625, subdivision 9a, shall not be considered to be participating in medical
assistance or MinnesotaCare for the purpose of this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon receipt of any necessary federal
waiver or approval. The commissioner of human services shall notify the revisor of
statutes if a federal waiver or approval is sought and, if sought, when a federal waiver
or approval is obtained.
new text end

Sec. 2. new text begin FEDERAL WAIVER OR APPROVAL.
new text end

new text begin The commissioner of human services shall seek any federal waiver or approval
necessary to implement section 1.
new text end