HF 1997

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

A bill for an act
relating to human services; requiring a withhold from
state health care program capitation rates for blood
lead testing performance targets; amending Minnesota
Statutes 2004, section 256B.69, subdivision 5a.

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

Section 1.

Minnesota Statutes 2004, section 256B.69,
subdivision 5a, is amended to read:

Subd. 5a.

Managed care contracts.

(a) Managed care
contracts under this section and sections 256L.12 and 256D.03,
shall be entered into or renewed on a calendar year basis
beginning January 1, 1996. Managed care contracts which were in
effect on June 30, 1995, and set to renew on July 1, 1995, shall
be renewed for the period July 1, 1995 through December 31, 1995
at the same terms that were in effect on June 30, 1995. The
commissioner may issue separate contracts with requirements
specific to services to medical assistance recipients age 65 and
older.

(b) A prepaid health plan providing covered health services
for eligible persons pursuant to chapters 256B, 256D, and 256L,
is responsible for complying with the terms of its contract with
the commissioner. Requirements applicable to managed care
programs under chapters 256B, 256D, and 256L, established after
the effective date of a contract with the commissioner take
effect when the contract is next issued or renewed.

(c) Effective for services rendered on or after January 1,
2003, the commissioner shall withhold five percent of managed
care plan payments under this section for the prepaid medical
assistance and general assistance medical care programs pending
completion of performance targets. new text begin Effective for services
rendered on or after January 1, 2006, 20 percent of this
withhold amount shall be withheld pending attainment of
performance targets related to testing children for lead
exposure. new text end Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the
case of a performance target based on a federal or state law or
rule. Criteria for assessment of each performance target must
be outlined in writing prior to the contract effective date.
The withheld funds must be returned no sooner than July of the
following year if performance targets in the contract are
achieved. The commissioner may exclude special demonstration
projects under subdivision 23. A managed care plan or a
county-based purchasing plan under section 256B.692 may include
as admitted assets under section 62D.044 any amount withheld
under this paragraph that is reasonably expected to be returned.