HF 2000

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

A bill for an act
relating to human services; expanding state direct contracting with providers for
health care delivery under medical assistance, general assistance medical care,
and MinnesotaCare; eliminating delivery of services to state health care program
enrollees by prepaid health plans; proposing coding for new law in Minnesota
Statutes, chapter 256; repealing Minnesota Statutes 2006, sections 256B.031;
256B.69, subdivisions 1, 2, 3, 3a, 3b, 4, 4b, 5, 5a, 5b, 5c, 5d, 5e, 5f, 5g, 5h, 6, 6a,
6b, 6c, 6d, 7, 8, 9, 10, 11, 16, 17, 18, 19, 20, 21, 22, 23, 24a, 25, 26, 27; 256L.12.

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

Section 1.

new text begin [256.0135] EXPANSION OF STATE DIRECT CONTRACTING WITH
PROVIDERS FOR HEALTH CARE DELIVERY.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following definitions
apply.
new text end

new text begin (b) "Prepaid health plan" means an entity under contract with the commissioner to
provide health care services on a prepaid capitated basis to enrollees of a state-managed
care program.
new text end

new text begin (c) "State health care program" means the medical assistance, general assistance
medical care, and MinnesotaCare programs.
new text end

new text begin (d) "State-managed care program" means the prepaid medical assistance program
established under section 256B.69, the prepaid general assistance medical care established
under section 256D.03, subdivision 4, paragraph (c), and the prepaid MinnesotaCare
program established under section 256L.12. State-managed care program does not include
county-based purchasing projects established under section 256B.692.
new text end

new text begin Subd. 2. new text end

new text begin Expansion of direct contracting. new text end

new text begin Beginning January 1, 2008, the
commissioner shall deliver health care services to state health care program enrollees
receiving health care services through a state-managed care program as of December 31,
2007, through direct contracting with providers, and shall not contract with prepaid health
plans to provide health care services to these enrollees after December 31, 2007.
new text end

new text begin Subd. 3. new text end

new text begin Elimination of prior authorization and utilization controls. new text end

new text begin Beginning
January 1, 2008, the commissioner shall not use prior authorization or other utilization
controls when providing health care services by direct contracting with providers to
state health care program enrollees. This prohibition applies both to services provided
to enrollees who had been receiving services through state-managed care programs and
services provided to enrollees who had been excluded from mandatory enrollment in a
state-managed care program. This subdivision does not apply to: (1) the coverage and
provision of prescription drugs; (2) preadmission screening for nursing facility admission;
and (3) utilization control activities required by federal law.
new text end

new text begin Subd. 4. new text end

new text begin Exemption for county-based purchasing. new text end

new text begin County-based purchasing
projects are exempt from this section and shall continue to be governed by section
256B.692.
new text end

Sec. 2. new text begin RECOMMENDATIONS ON TRANSITION TO EXPANDED DIRECT
CONTRACTING.
new text end

new text begin The commissioner of human services shall present to the legislature, by December
15, 2007, recommendations and draft legislation for any changes in the operation of state
health care programs necessary to comply with and implement section 1.
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. 3. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin (a) The revisor of statutes, in consultation with the Department of Human Services,
shall prepare for the 2008 legislature draft legislation containing any additional repealers
and conforming changes needed to terminate health care delivery through state-managed
care programs and to eliminate the use of prior authorization and other utilization controls
under the expanded fee-for-service system for state program enrollees, as provided in
Minnesota Statutes, section 256.0135. The revisor of statutes shall include in this draft
legislation a repeal of Minnesota Statutes, section 256D.03, subdivision 4, paragraph (c).
new text end

new text begin (b) The revisor of statutes shall correct internal cross-references to sections that are
affected by section 4, the repealer section in this bill. The revisor may make changes
necessary to correct the punctuation, grammar, or structure of the remaining test and
preserve its meaning.
new text end

Sec. 4. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2006, sections 256B.031; 256B.69, subdivisions 1, 2, 3, 3a, 3b,
4, 4b, 5, 5a, 5b, 5c, 5d, 5e, 5f, 5g, 5h, 6, 6a, 6b, 6c, 6d, 7, 8, 9, 10, 11, 16, 17, 18, 19, 20,
21, 22, 23, 24a, 25, 26, and 27; and 256L.12, new text end new text begin are repealed effective January 1, 2008.
new text end