Minnesota Legislature
HF 2128
1st Engrossment - 92nd Legislature (2021 - 2022) Posted on 04/12/2021 04:55pm
2.28 2.29
2.30 2.31 2.32 2.33
2.34 2.35 2.36 2.37 2.38
3.1 3.2 3.3 3.4 3.5
3.6 3.7 3.8 3.9
3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23
3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11
4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25
4.26 4.27 4.28 4.29 4.30 4.31 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 7.34 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20
8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30
8.31
9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 9.34 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 11.1 11.2 11.3 11.4 11.5 11.6 11.7
11.8 11.9
11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29
11.30 11.31 11.32 11.33 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33 12.34 12.35 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 13.33 13.34
14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18
14.19
14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16
15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15
16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23
16.24 16.25 16.26
16.27 16.28 16.29 16.30 16.31 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25
17.26 17.27 17.28
17.29 17.30 17.31 17.32 17.33 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17
18.18
18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31
22.32 22.33 22.34
23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 23.34 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22
24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13
25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22
25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16
27.17 27.18
27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 28.34 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8
30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29
30.30 30.31 30.32 30.33 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22
31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 33.33 33.34 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 34.32 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 36.1 36.2 36.3 36.4 36.5 36.6
36.7
36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13
37.14
37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30
37.31
38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10
38.11
38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 38.33 38.34 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 40.33 40.34 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 43.33 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9
44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21
45.22 45.23 45.24
45.25 45.26 45.27 45.28 45.29 45.30 45.31 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21
46.22 46.23
46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29
47.30 47.31 47.32
48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32 48.33 49.1 49.2 49.3 49.4 49.5 49.6 49.7
49.8 49.9 49.10
49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16
50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18
51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32
52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 52.33 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11
53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 53.33 53.34 53.35 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 54.34 54.35 54.36 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 55.34 55.35 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10
56.11 56.12 56.13 56.14
56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 57.31 57.32 57.33 57.34 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10
58.11 58.12 58.13 58.14 58.15 58.16
58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27
58.28 58.29 58.30 58.31
59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24
59.25 59.26 59.27 59.28 59.29 59.30 59.31 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8
60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16
61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 62.32 62.33 62.34 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10
63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 64.33 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27
65.28 65.29 65.30 65.31 65.32 65.33 65.34 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14
67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 68.34 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 69.33 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 70.33 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16
71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30 71.31 71.32 71.33 72.1 72.2 72.3 72.4 72.5
72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20
72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32
73.1 73.2 73.3 73.4 73.5
73.6
73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20
73.21 73.22 73.23
73.24 73.25 73.26 73.27
73.28
73.29 73.30 73.31 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9
74.10
74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18
74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28
74.29 74.30 74.31 74.32 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22
76.23 76.24
76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 77.1 77.2
77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 78.1 78.2 78.3
78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9
79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 80.1 80.2 80.3 80.4 80.5
80.6 80.7
80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20
80.21 80.22 80.23 80.24
80.25
80.26 80.27 80.28 80.29 80.30 80.31 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10
82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24
82.25 82.26 82.27
82.28 82.29 82.30 82.31 82.32
83.1 83.2 83.3 83.4 83.5 83.6 83.7
83.8 83.9
83.10 83.11
83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30
84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22
84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30
85.31
86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31
86.32
87.1 87.2 87.3 87.5 87.4 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 87.33 87.34 87.35 87.36 87.37 87.38 87.39 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 88.33 88.34 88.35 88.36 88.37 88.38 88.39 88.40 88.41 88.42 88.43 88.44 88.45 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 89.32 89.33 89.34 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 90.32 90.33 90.34 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11
91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 93.1 93.2 93.3 93.4 93.5 93.6 93.7
93.8
93.9 93.10 93.11 93.12 93.13 93.14
93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23
93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 94.1 94.2 94.3
94.4 94.5 94.6 94.7
94.8 94.9 94.10 94.11 94.12
94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 97.32 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 98.33 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 99.32 99.33 99.34 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20
103.21 103.22 103.23 103.24
103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 104.33 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 105.33 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 108.32 108.33 108.34 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30
110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25
110.26 110.27 110.28 110.29 110.30 110.31 111.1 111.2 111.3 111.4 111.5
111.6 111.7 111.8 111.9 111.10
111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20
111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 113.1 113.2
113.3 113.4 113.5 113.6 113.7 113.8 113.9
113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 114.1 114.2
114.3
114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 115.1 115.2 115.3
115.4 115.5 115.6 115.7
115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25
115.26 115.27 115.28 115.29 115.30 115.31 116.1 116.2 116.3
116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19
116.20 116.21 116.22
116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 116.32 117.1 117.2 117.3 117.4
117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12
117.13
117.14 117.15 117.16 117.17 117.18 117.19
117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28
118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13
119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12
120.13
120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29
121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 121.32 121.33 121.34 121.35 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 122.33 122.34 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 123.33 123.34 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21
124.22
124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 126.1 126.2
126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21
126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13
127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24
127.25 127.26 127.27 127.28 127.29 127.30 127.31 127.32 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28
128.29 128.30 128.31 128.32 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 130.1 130.2 130.3
130.4
130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 130.33 130.34 130.35 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15
131.16
131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30
131.31
132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10
132.11
132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29
133.1 133.2 133.3 133.4 133.5 133.6
133.7
133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17
134.18
134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27
134.28 134.29 134.30
135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9
135.10 135.11 135.12 135.13
135.14 135.15 135.16
135.17 135.18
135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28
136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30
136.31
137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22
137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 138.33 138.34 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28
139.29 139.30 139.31 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17
141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14
142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13
146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 149.32 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19
151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 156.1 156.2 156.3
156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15
156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19
157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24
158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 158.33 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9
159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20
160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 161.1 161.2
161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32
162.1
162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 162.33 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20
163.21
163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 163.32 163.33 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14
164.15
164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 165.1 165.2 165.3 165.4 165.5 165.6
165.7
165.8 165.9 165.10 165.11 165.12
165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13
166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27
166.28 166.29 166.30 166.31 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9
167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31
168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 168.33 168.34 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23
170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18
172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 172.33 173.1 173.2
173.3 173.4 173.5 173.6 173.7 173.9 173.8 173.11 173.10 173.12 173.13 173.14 173.15 173.17 173.16 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 173.33 173.34 173.35 173.36 173.37 173.39 173.38 174.2 174.1 174.3 174.4 174.6 174.5 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 174.33 174.34 174.35 174.36 174.37 174.38 174.39 174.40 174.41 174.42 174.43 175.1 175.3 175.2 175.4 175.5 175.6 175.7 175.8 175.9 175.11 175.10 175.12 175.13 175.15 175.14 175.16 175.17 175.18 175.19 175.20 175.21 175.23 175.22 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 175.32 175.33 175.34 175.35 175.36 175.37 175.38 175.39 175.40
176.1 176.2 176.3 176.4 176.6 176.5 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32 176.33 176.34 176.35 176.36 176.37 176.38 176.39 177.1 177.2 177.3 177.4 177.5 177.7 177.6 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 177.32 177.33 177.34 177.35 177.36
178.1 178.2 178.3 178.4 178.5 178.6
178.7 178.8 178.9 178.10 178.11 178.12 178.13
178.14 178.15 178.16 178.17 178.18
178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 179.1 179.2 179.3 179.4 179.5
179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13
180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12
181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 181.33 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23
182.24 182.25 182.26 182.27
182.28 182.29 182.30 182.31 182.32 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26
183.27 183.28 183.29 183.30 183.31 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 185.1 185.2 185.3 185.4 185.5 185.6
185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21
186.22 186.23
186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 186.33 187.1 187.2
187.3 187.4 187.5 187.6 187.7
187.8 187.9
187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32 187.33 188.1 188.2 188.3 188.4
188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23
188.24 188.25
188.26 188.27 188.28 188.29 188.30 188.31 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 189.32 189.33 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 191.32 191.33 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 192.32 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32 193.33 193.34
194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12
194.13 194.14 194.15 194.16 194.17 194.18 194.19
194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 194.32 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 196.1 196.2 196.3
196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17
196.18 196.19 196.20 196.21 196.22
196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11
197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 197.33 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 198.32 198.33 198.34 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21
199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 199.33 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23
200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 200.33 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 202.1 202.2
202.3
202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26
203.27
203.28 203.29 203.30 203.31 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 206.1 206.2 206.3
206.4 206.5 206.6 206.7 206.8
206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14
207.15 207.16 207.17 207.18 207.19 207.20 207.21
207.22 207.23 207.24 207.25 207.26 207.27 207.28
207.29 207.30 207.31 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 208.32 208.33 209.1 209.2
209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21
209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 210.32 210.33 210.34 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21
211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 211.32 211.33 212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10
212.11 212.12
212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11
227.12 227.13
227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12
231.13 231.14
231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29
232.1 232.2 232.3 232.4
232.5 232.6 232.7 232.8
232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22
232.23 232.24 232.25 232.26
233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16
233.17 233.18 233.19 233.20 233.21 233.22 233.23
233.24 233.25 233.26 233.27 233.28 233.29 233.30 234.1 234.2 234.3 234.4
234.5 234.6 234.7 234.8 234.9 234.10
234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8
235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20
235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29
235.30
236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 236.32
237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19 237.20 237.21 237.22
237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30
239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 240.1 240.2 240.3 240.4 240.5
240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 240.32 240.33 241.1 241.2 241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 241.32 242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19
242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29 243.30 243.31 243.32 244.1 244.2 244.3 244.4 244.5
244.6 244.7 244.8 244.9 244.10 244.11 244.12
244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 244.32 245.1 245.2
245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10
245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23 245.24 245.25 245.26
245.27 245.28 245.29 245.30 245.31 245.32 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27
246.28 246.29 246.30 246.31 246.32 246.33 247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18
247.19 247.20
247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11 248.12 248.13
248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13
249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 249.32 249.33 249.34
250.1 250.2 250.3 250.4
250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12
250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20
250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 250.31 250.32 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26
251.27
251.28 251.29 251.30 251.31 251.32
252.1
252.2 252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11
252.12 252.13 252.14 252.15 252.16 252.17 252.18 252.19 252.20 252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28
252.29 252.30 252.31 252.32 252.33 253.1 253.2 253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14 253.15 253.16 253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25
253.26 253.27 253.28 253.29 253.30 253.31 254.1 254.2 254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 254.31 254.32 254.33
255.1 255.2 255.3 255.4
255.5 255.6 255.7
255.8 255.9
255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 255.30 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14
256.15 256.16
256.17 256.18 256.19 256.20 256.21 256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29 256.30 256.31 256.32 257.1 257.2 257.3 257.4 257.5 257.6
257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19 257.20 257.21 257.22 257.23 257.24 257.25 257.26
257.27 257.28 257.29 257.30
258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30 258.31 259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14 259.15
259.16 259.17 259.18 259.19 259.20 259.21 259.22 259.23 259.24 259.25 259.26 259.27
259.28 259.29 259.30 260.1 260.2
260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25 260.26 260.27 260.28 260.29 260.30
260.31 260.32
261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25 261.26 261.27 261.28 261.29 261.30 261.31 261.32 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17
262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 262.31 262.32 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16
263.17
263.18 263.19 263.20 263.21 263.22 263.23 263.24 263.25 263.26 263.27 263.28 263.29 263.30 263.31 263.32 263.33 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14
264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29
264.30 264.31
265.1 265.2 265.3 265.4 265.5
265.6
265.7 265.8 265.9 265.10 265.11 265.12 265.13
265.14
265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 265.31 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9
266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 266.31 266.32 266.33 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 267.33 267.34 268.1 268.2 268.3 268.4 268.5 268.6 268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19 268.20 268.21 268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 268.30 268.31 268.32 268.33 268.34 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12 270.13 270.14 270.15 270.16 270.17 270.18 270.19 270.20
270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30
271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14
272.15
272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 272.32 272.33 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24
273.25
273.26 273.27 273.28 273.29 273.30 273.31 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9 274.10 274.11 274.12 274.13
274.14
274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22 274.23
274.24
274.25 274.26 274.27 274.28 274.29 274.30 274.31 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17
275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25
275.26 275.27 275.28 275.29 275.30 275.31 275.32
276.1 276.2
276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 276.33 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 277.33 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31 278.32 278.33 278.34 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 279.33 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 280.31 280.32 280.33 281.1 281.2 281.3
281.4 281.5
281.6 281.7 281.8 281.9 281.10 281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 281.32 281.33 282.1 282.2
282.3 282.4
282.5 282.6 282.7 282.8 282.9 282.10 282.11
282.12 282.13
282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 282.30
283.1 283.2
283.3 283.4 283.5 283.6
283.7 283.8
283.9 283.10 283.11 283.12
283.13 283.14
283.15 283.16 283.17 283.18
283.19 283.20
283.21 283.22 283.23 283.24 283.25
283.26 283.27
284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12
284.13 284.14
284.15 284.16 284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11
285.12 285.13
285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31 285.32 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26
286.27 286.28
286.29 286.30 286.31 286.32 286.33 287.1 287.2 287.3 287.4 287.5
287.6 287.7
287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27 287.28 287.29 287.30 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 289.1 289.2 289.3 289.4 289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 289.30 289.31 289.32 289.33 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 290.30 290.31 290.32 291.1 291.2 291.3 291.4 291.5 291.6 291.7
291.8 291.9
291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24
291.25 291.26
291.27 291.28 291.29 291.30 291.31
292.1 292.2
292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30 292.31 293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27 293.28 293.29 293.30 293.31 294.1 294.2 294.3 294.4 294.5 294.6 294.7 294.8 294.9 294.10 294.11 294.12 294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9
295.10 295.11
295.12 295.13 295.14 295.15 295.16
295.17
295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 296.33 296.34 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14 297.15 297.16
297.17 297.18
297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31 297.32 298.1 298.2 298.3 298.4 298.5 298.6 298.7 298.8
298.9 298.10
298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 298.32 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 299.31 299.32 299.33 299.34 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 301.32 301.33
302.1
302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20
302.21 302.22 302.23 302.24 302.25 302.26 302.27 302.28 302.29 302.30 302.31 302.32 302.33 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11 303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 303.31 303.32 303.33 303.34 304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14 304.15 304.16 304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25 304.26 304.27 304.28 304.29 304.30 304.31 305.1 305.2 305.3 305.4 305.5 305.6 305.7 305.8 305.9 305.10 305.11 305.12 305.13 305.14 305.15 305.16 305.17 305.18 305.19 305.20 305.21 305.22
305.23
305.24 305.25 305.26 305.27 305.28 305.29
305.30 305.31 305.32
306.1 306.2 306.3 306.4 306.5 306.6
306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15 306.16 306.17 306.18 306.19 306.20 306.21 306.22 306.23 306.24 306.25 306.26
306.27 306.28 306.29 306.30
306.31 306.32 306.33
307.1 307.2 307.3 307.4 307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19 307.20 307.21 307.22 307.23 307.24 307.25 307.26 307.27 307.28 307.29 307.30 307.31 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 309.1 309.2 309.3 309.4 309.5 309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21 309.22 309.23 309.24 309.25 309.26 309.27 309.28 309.29 309.30 309.31 309.32 309.33 310.1 310.2 310.3 310.4 310.5 310.6
310.7 310.8 310.9
310.10 310.11 310.12 310.13 310.14 310.15 310.16 310.17 310.18 310.19 310.20 310.21 310.22
310.23 310.24
310.25 310.26 310.27 310.28 310.29 310.30 311.1 311.2 311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 312.1 312.2 312.3 312.4 312.5 312.6 312.7 312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16 312.17 312.18 312.19 312.20 312.21 312.22 312.23 312.24 312.25 312.26 312.27 312.28 312.29 312.30 312.31 312.32 312.33 312.34 312.35 313.1 313.2 313.3 313.4 313.5 313.6 313.7 313.8 313.9 313.10 313.11 313.12 313.13
313.14 313.15 313.16
313.17 313.18 313.19 313.20 313.21 313.22 313.23 313.24 313.25 313.26 313.27 313.28 313.29 313.30 313.31 313.32 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9
314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20 314.21 314.22 314.23 314.24 314.25 314.26 314.27 314.28 314.29 314.30 314.31 314.32 315.1 315.2 315.3 315.4 315.5 315.6 315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 315.30 315.31 315.32 316.1 316.2 316.3 316.4 316.5 316.6 316.7
316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16 316.17 316.18 316.19 316.20 316.21 316.22 316.23 316.24 316.25 316.26 316.27 316.28 316.29 316.30 316.31 316.32 316.33 317.1 317.2 317.3 317.4 317.5 317.6 317.7 317.8 317.9 317.10 317.11 317.12 317.13 317.14 317.15 317.16 317.17 317.18 317.19 317.20 317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 317.31 317.32 317.33 317.34 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11 318.12 318.13 318.14 318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24 318.25 318.26
318.27 318.28
319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10 319.11 319.12 319.13 319.14 319.15 319.16 319.17 319.18 319.19 319.20 319.21 319.22 319.23 319.24 319.25 319.26 319.27 319.28 319.29 319.30 319.31 320.1 320.2 320.3 320.4 320.5 320.6 320.7 320.8 320.9 320.10 320.11 320.12 320.13 320.14 320.15 320.16 320.17 320.18 320.19 320.20 320.21 320.22 320.23
320.24 320.25
320.26 320.27 320.28 320.29 320.30 320.31 321.1 321.2 321.3
321.4 321.5 321.6
321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26 321.27 321.28 321.29 321.30 321.31 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 323.1 323.2 323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23
323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 323.33 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 324.32 324.33 324.34 324.35 325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10 325.11 325.12 325.13 325.14 325.15 325.16 325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26 325.27 325.28 325.29 326.1 326.2 326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14 326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30 326.31 326.32 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15 327.16 327.17 327.18 327.19 327.20 327.21 327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 327.31 327.32 327.33 327.34 328.1 328.2 328.3 328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13 328.14 328.15 328.16 328.17 328.18 328.19 328.20 328.21 328.22 328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30
328.31 328.32 328.33 328.34 329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15 329.16 329.17
329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30 329.31 329.32 329.33 330.1 330.2 330.3 330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25 330.26 330.27 330.28 330.29 330.30 330.31 330.32 330.33 330.34 331.1 331.2 331.3 331.4 331.5
331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 331.32 331.33 331.34 332.1 332.2 332.3 332.4 332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31
333.1 333.2
333.3 333.4 333.5 333.6 333.7 333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19 333.20 333.21 333.22 333.23 333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31 333.32 333.33 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18 334.19 334.20 334.21 334.22
334.23 334.24
334.25 334.26 334.27 334.28 334.29 334.30 334.31 334.32 334.33 335.1 335.2 335.3 335.4 335.5 335.6
335.7 335.8 335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 336.1 336.2 336.3 336.4 336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13 336.14 336.15 336.16 336.17 336.18 336.19 336.20 336.21 336.22 336.23 336.24 336.25 336.26
336.27 336.28 336.29 336.30 336.31 337.1 337.2 337.3 337.4 337.5 337.6 337.7
337.8 337.9 337.10 337.11 337.12 337.13 337.14
337.15 337.16 337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26 337.27 337.28 337.29 337.30 337.31 337.32 338.1 338.2 338.3 338.4 338.5 338.6
338.7 338.8 338.9 338.10
338.11 338.12 338.13 338.14 338.15 338.16 338.17
338.18 338.19 338.20 338.21 338.22
338.23 338.24 338.25 338.26 338.27
338.28 338.29
338.30 339.1 339.2 339.3 339.4 339.5 339.6 339.7 339.8 339.9 339.10 339.11
339.12 339.13 339.14 339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 339.30 339.31 339.32 339.33 339.34 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27 340.28 340.29 340.30 340.31 340.32 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 341.32 341.33 341.34 342.1 342.2 342.3 342.4 342.5 342.6 342.7 342.8 342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 342.32 342.33 342.34 342.35 343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28 343.29 343.30 343.31 343.32 343.33 343.34 343.35 344.1 344.2 344.3 344.4 344.5 344.6 344.7 344.8 344.9 344.10 344.11 344.12 344.13 344.14 344.15 344.16 344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31 344.32 344.33 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8 345.9 345.10 345.11 345.12 345.13 345.14 345.15 345.16 345.17 345.18 345.19 345.20 345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30 345.31 345.32 345.33 345.34 346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20 346.21 346.22 346.23 346.24 346.25 346.26 346.27 346.28 346.29 346.30 346.31 346.32 346.33 346.34 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11 347.12 347.13 347.14 347.15 347.16 347.17 347.18 347.19 347.20 347.21 347.22 347.23 347.24 347.25 347.26 347.27 347.28 347.29 347.30 347.31 347.32 347.33 347.34 347.35 348.1 348.2 348.3 348.4 348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16 348.17 348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 348.30 348.31 348.32 348.33 348.34 348.35 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31 349.32 349.33 349.34 350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 350.30 350.31 350.32 350.33 350.34 350.35 351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 351.32 351.33 351.34 351.35 352.1 352.2 352.3 352.4 352.5 352.6 352.7 352.8 352.9 352.10 352.11 352.12 352.13 352.14 352.15 352.16 352.17 352.18 352.19 352.20 352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30 352.31 352.32 352.33 352.34 352.35 352.36 353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28 353.29 353.30 353.31 353.32 353.33 353.34 353.35 353.36 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14 354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 354.32 354.33 354.34 355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9 355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 355.32 355.33 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9 356.10 356.11 356.12 356.13 356.14 356.15 356.16 356.17 356.18 356.19 356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30 356.31 356.32 356.33 356.34 357.1 357.2 357.3 357.4 357.5 357.6 357.7 357.8 357.9 357.10 357.11 357.12 357.13 357.14 357.15 357.16 357.17 357.18 357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 357.30 357.31 357.32 357.33 357.34 357.35 358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9 358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 358.28 358.29 358.30 358.31 358.32 358.33 358.34 359.1 359.2 359.3 359.4 359.5 359.6 359.7 359.8 359.9 359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23
359.24 359.25 359.26 359.27 359.28 359.29 359.30 359.31 359.32 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29 360.30 360.31 360.32 360.33 360.34 360.35 361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13 361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27 361.28 361.29 361.30 361.31 361.32 361.33 361.34 362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 362.29 362.30 362.31 362.32 362.33 362.34 362.35 363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14 363.15 363.16 363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29 363.30 363.31 363.32 363.33 363.34 363.35 364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19 364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 364.30 364.31 364.32 364.33 364.34 364.35 365.1 365.2 365.3 365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 365.30 365.31 365.32 365.33 365.34 365.35 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14 366.15 366.16 366.17 366.18 366.19
366.20 366.21 366.22 366.23 366.24 366.25 366.26 366.27 366.28 366.29 366.30 366.31 366.32 366.33 366.34 367.1 367.2 367.3 367.4 367.5 367.6 367.7 367.8 367.9 367.10 367.11 367.12 367.13 367.14 367.15 367.16 367.17 367.18 367.19 367.20 367.21 367.22 367.23 367.24 367.25 367.26 367.27 367.28 367.29 367.30 367.31 367.32 367.33 367.34 367.35 368.1 368.2 368.3 368.4 368.5 368.6 368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25 368.26 368.27 368.28 368.29 368.30 368.31 368.32 369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12 369.13
369.14 369.15 369.16 369.17 369.18 369.19 369.20 369.21 369.22 369.23 369.24 369.25 369.26 369.27 369.28 369.29 369.30 369.31 369.32 369.33 370.1 370.2 370.3 370.4 370.5 370.6 370.7 370.8 370.9 370.10 370.11 370.12 370.13 370.14 370.15 370.16 370.17
370.18
370.19 370.20 370.21 370.22 370.23 370.24 370.25 370.26
370.27
370.28 370.29 370.30 370.31 370.32 370.33
371.1 371.2 371.3 371.5 371.4 371.6 371.7 371.9 371.8 371.10 371.11 371.12 371.13 371.14 371.15 371.16 371.17 371.18 371.20 371.19 371.21 371.22 371.23 371.24 371.25 371.26 371.27 371.28 371.29 371.30 371.31 371.32 371.33 371.34 371.35 371.36 372.1 372.2 372.3 372.4 372.5 372.6 372.7 372.8 372.9 372.10 372.11 372.12 372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20 372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 372.31 372.32 372.33 372.34 373.1 373.2 373.3 373.4 373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14 373.15 373.16 373.17 373.18 373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29 373.30 373.31 373.32 373.33 373.34 373.35 374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31 374.32 374.33 374.34 375.1 375.2 375.3 375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12 375.13 375.14 375.15 375.16 375.17 375.18 375.19 375.20 375.21 375.22 375.23 375.24 375.25 375.26 375.27 375.28 375.29 375.30 375.31 375.32 375.33 375.34 376.1 376.2 376.3 376.4 376.5 376.6 376.7 376.8
376.9 376.10
376.11 376.12 376.13 376.14 376.15 376.16 376.17 376.18
376.19
376.20 376.21 376.22 376.23 376.24 376.25 376.26
376.27
377.1 377.2 377.3 377.4 377.5
377.6
377.7 377.8 377.9 377.10
377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19
377.20
377.21 377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29 377.30 377.31 377.32 378.1 378.2 378.3 378.4 378.5 378.6 378.7
378.8 378.9 378.10 378.11 378.12 378.13
378.14 378.15 378.16
378.17 378.18 378.19
378.20
378.21 378.22 378.23
378.24 378.25 378.26
378.27 378.28
A bill for an act
relating to health; modifying provisions governing health care, human services,
licensing and background studies, the Department of Health, health-related licensing
boards, prescription drugs, health insurance, and telehealth; establishing a budget
for health and human services; making technical and conforming changes; requiring
reports; transferring money; appropriating money; amending Minnesota Statutes
2020, sections 62A.04, subdivision 2; 62A.10, by adding a subdivision; 62A.65,
subdivision 1, by adding a subdivision; 62C.01, by adding a subdivision; 62D.01,
by adding a subdivision; 62D.095, subdivisions 2, 3, 4, 5; 62J.495, subdivisions
1, 2, 3, 4; 62J.497, subdivisions 1, 3; 62J.498; 62J.4981; 62J.4982; 62J.63,
subdivisions 1, 2; 62Q.01, subdivision 2a; 62Q.02; 62Q.46; 62Q.677, by adding
a subdivision; 62Q.81; 62U.04, subdivisions 4, 5, 11; 62V.05, by adding a
subdivision; 62W.11; 62W.12; 103H.201, subdivision 1; 122A.18, subdivision 8;
144.0724, subdivisions 1, 2, 3a, 5, 7, 8, 9, 12; 144.1205, subdivisions 2, 4, 8, 9,
by adding a subdivision; 144.125, subdivision 1; 144.1481, subdivision 1; 144.1911,
subdivision 6; 144.212, by adding a subdivision; 144.225, subdivisions 2, 7;
144.226, by adding subdivisions; 144.55, subdivisions 4, 6; 144.551, subdivision
1, by adding a subdivision; 144.555; 144.9501, subdivision 17; 144.9502,
subdivision 3; 144.9504, subdivisions 2, 5; 144G.08, subdivision 7, as amended;
144G.84; 145.893, subdivision 1; 145.894; 145.897; 145.899; 145.901, subdivisions
2, 4; 147.033; 151.01, by adding subdivisions; 151.071, subdivisions 1, 2; 151.37,
subdivision 2; 151.555, subdivisions 1, 7, 11, by adding a subdivision; 152.01,
subdivision 23; 152.02, subdivisions 2, 3; 152.11, subdivision 1a, by adding a
subdivision; 152.12, by adding a subdivision; 152.125, subdivision 3; 152.22,
subdivisions 6, 11, by adding subdivisions; 152.23; 152.25, by adding a subdivision;
152.26; 152.27, subdivisions 3, 4, 6; 152.28, subdivision 1; 152.29, subdivisions
1, 3, by adding subdivisions; 152.31; 152.32, subdivision 3; 156.12, subdivision
2; 171.07, by adding a subdivision; 174.30, subdivision 3; 245A.05; 245A.07,
subdivision 1; 245A.10, subdivision 4; 245A.16, by adding a subdivision; 245C.02,
subdivisions 4a, 5, by adding subdivisions; 245C.03; 245C.05, subdivisions 1, 2,
2a, 2b, 2c, 2d, 4; 245C.08, subdivision 3, by adding a subdivision; 245C.10,
subdivision 15, by adding subdivisions; 245C.13, subdivision 2; 245C.14,
subdivision 1, by adding a subdivision; 245C.15, by adding a subdivision; 245C.16,
subdivisions 1, 2; 245C.17, subdivision 1, by adding a subdivision; 245C.18;
245C.24, subdivisions 2, 3, 4, by adding a subdivision; 245C.32, subdivision 1a;
245G.01, subdivisions 13, 26; 245G.06, subdivision 1; 254A.19, subdivision 5;
254B.05, subdivision 5; 256.01, subdivision 28; 256.969, subdivisions 2b, 9, by
adding a subdivision; 256.9695, subdivision 1; 256.98, subdivision 1; 256.983;
256B.04, subdivisions 12, 14; 256B.055, subdivision 6; 256B.056, subdivision
10; 256B.057, subdivision 3; 256B.06, subdivision 4; 256B.0621, subdivision 10;
256B.0625, subdivisions 3b, 3c, 3d, 3e, 9, 10, 13, 13c, 13d, 13h, 17, 17b, 18, 18b,
20, 20b, 30, 31, 46, 52, 58, by adding subdivisions; 256B.0631, subdivision 1;
256B.0638, subdivisions 3, 5, 6; 256B.0659, subdivision 13; 256B.0911,
subdivisions 1a, 3a, 3f, 4d; 256B.0924, subdivision 6; 256B.094, subdivision 6;
256B.0949, by adding a subdivision; 256B.196, subdivision 2; 256B.49, subdivision
14; 256B.69, subdivisions 6, 6d, by adding subdivisions; 256B.6928, subdivision
5; 256B.75; 256B.76, subdivisions 2, 4; 256B.766; 256B.767; 256B.79,
subdivisions 1, 3; 256J.09, subdivision 3; 256J.45, subdivision 1; 256L.01,
subdivision 5; 256L.03, subdivision 5; 256L.04, subdivision 7b; 256L.05,
subdivision 3a; 256L.11, subdivisions 6a, 7; 256S.05, subdivision 2; 260C.215,
subdivision 4; 295.53, subdivision 1; 326.71, subdivision 4; 326.75, subdivisions
1, 2, 3; Laws 2019, First Special Session chapter 9, article 14, section 3, as
amended; Laws 2020, First Special Session chapter 7, section 1, subdivision 2, as
amended; Laws 2020, Seventh Special Session chapter 1, article 6, section 12,
subdivision 4; proposing coding for new law in Minnesota Statutes, chapters 62A;
62J; 62Q; 62W; 144; 145; 151; 245C; 256B; repealing Minnesota Statutes 2020,
sections 16A.724, subdivision 2; 62A.67; 62A.671; 62A.672; 62J.63, subdivision
3; 144.0721, subdivision 1; 144.0722; 144.0724, subdivision 10; 144.693; 245C.10,
subdivisions 2, 2a, 3, 4, 5, 6, 7, 8, 9, 9a, 10, 11, 12, 13, 14, 16; 256B.0596;
256B.0625, subdivisions 18c, 18d, 18e, 18h; 256B.0924, subdivision 4a; Minnesota
Rules, parts 9505.0275; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9,
11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22; 9505.1699; 9505.1701; 9505.1703;
9505.1706; 9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730;
9505.1733; 9505.1736; 9505.1739; 9505.1742; 9505.1745; 9505.1748.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
DHS HEALTH CARE PROGRAMS
Section 1.
new text begin
[62A.002] APPLICABILITY OF CHAPTER.
new text end
new text begin
Any benefit or coverage mandate included in this chapter does not apply to managed
care plans or county-based purchasing plans when the plan is providing coverage to state
public health care program enrollees under chapter 256B or 256L.
new text end
Sec. 2.
Minnesota Statutes 2020, section 62C.01, is amended by adding a subdivision to
read:
new text begin Subd. 4. new text end
new text begin Applicability. new text end
new text begin
Any benefit or coverage mandate included in this chapter does
not apply to managed care plans or county-based purchasing plans when the plan is providing
coverage to state public health care program enrollees under chapter 256B or 256L.
new text end
Sec. 3.
Minnesota Statutes 2020, section 62D.01, is amended by adding a subdivision to
read:
new text begin Subd. 3. new text end
new text begin Applicability. new text end
new text begin
Any benefit or coverage mandate included in this chapter does
not apply to managed care plans or county-based purchasing plans when the plan is providing
coverage to state public health care program enrollees under chapter 256B or 256L.
new text end
Sec. 4.
new text begin
[62J.011] APPLICABILITY OF CHAPTER.
new text end
new text begin
Any benefit or coverage mandate included in this chapter does not apply to managed
care plans or county-based purchasing plans when the plan is providing coverage to state
public health care program enrollees under chapter 256B or 256L.
new text end
Sec. 5.
Minnesota Statutes 2020, section 62Q.02, is amended to read:
62Q.02 APPLICABILITY OF CHAPTER.
(a) This chapter applies only to health plans, as defined in section 62Q.01, and not to
other types of insurance issued or renewed by health plan companies, unless otherwise
specified.
(b) This chapter applies to a health plan company only with respect to health plans, as
defined in section 62Q.01, issued or renewed by the health plan company, unless otherwise
specified.
(c) If a health plan company issues or renews health plans in other states, this chapter
applies only to health plans issued or renewed in this state for Minnesota residents, or to
cover a resident of the state, unless otherwise specified.
new text begin
(d) Any benefit or coverage mandate included in this chapter does not apply to managed
care plans or county-based purchasing plans when the plan is providing coverage to state
public health care program enrollees under chapter 256B or 256L.
new text end
Sec. 6.
Minnesota Statutes 2020, section 174.30, subdivision 3, is amended to read:
Subd. 3.
Other standards; wheelchair securement; protected transport.
(a) A special
transportation service that transports individuals occupying wheelchairs is subject to the
provisions of sections 299A.11 to 299A.17 concerning wheelchair securement devices. The
commissioners of transportation and public safety shall cooperate in the enforcement of
this section and sections 299A.11 to 299A.17 so that a single inspection is sufficient to
ascertain compliance with sections 299A.11 to 299A.17 and with the standards adopted
under this section. Representatives of the Department of Transportation may inspect
wheelchair securement devices in vehicles operated by special transportation service
providers to determine compliance with sections 299A.11 to 299A.17 and to issue certificates
under section 299A.14, subdivision 4.
(b) In place of a certificate issued under section 299A.14, the commissioner may issue
a decal under subdivision 4 for a vehicle equipped with a wheelchair securement device if
the device complies with sections 299A.11 to 299A.17 and the decal displays the information
in section 299A.14, subdivision 4.
(c) For vehicles designated as protected transport under section 256B.0625, subdivision
17, paragraph deleted text begin (h)deleted text end new text begin (g)new text end , the commissioner of transportation, during the commissioner's
inspection, shall check to ensure the safety provisions contained in that paragraph are in
working order.
Sec. 7.
Minnesota Statutes 2020, section 256.01, subdivision 28, is amended to read:
Subd. 28.
Statewide health information exchange.
(a) The commissioner has the
authority to join and participate as a member in a legal entity developing and operating a
statewide health information exchange new text begin or to develop and operate an encounter alerting
service new text end that shall meet the following criteria:
(1) the legal entity must meet all constitutional and statutory requirements to allow the
commissioner to participate; and
(2) the commissioner or the commissioner's designated representative must have the
right to participate in the governance of the legal entity under the same terms and conditions
and subject to the same requirements as any other member in the legal entity and in that
role shall act to advance state interests and lessen the burdens of government.
(b) Notwithstanding chapter 16C, the commissioner may pay the state's prorated share
of development-related expenses of the legal entity retroactively from October 29, 2007,
regardless of the date the commissioner joins the legal entity as a member.
Sec. 8.
Minnesota Statutes 2020, section 256.969, subdivision 2b, is amended to read:
Subd. 2b.
Hospital payment rates.
(a) For discharges occurring on or after November
1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according
to the following:
(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
methodology;
(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology
under subdivision 25;
(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
distinct parts as defined by Medicare shall be paid according to the methodology under
subdivision 12; and
(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not
be rebased, except that a Minnesota long-term hospital shall be rebased effective January
1, 2011, based on its most recent Medicare cost report ending on or before September 1,
2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on
December 31, 2010. For rate setting periods after November 1, 2014, in which the base
years are updated, a Minnesota long-term hospital's base year shall remain within the same
period as other hospitals.
(c) Effective for discharges occurring on and after November 1, 2014, payment rates
for hospital inpatient services provided by hospitals located in Minnesota or the local trade
area, except for the hospitals paid under the methodologies described in paragraph (a),
clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
manner similar to Medicare. The base yearnew text begin or yearsnew text end for the rates effective November 1,
2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral,
ensuring that the total aggregate payments under the rebased system are equal to the total
aggregate payments that were made for the same number and types of services in the base
year. Separate budget neutrality calculations shall be determined for payments made to
critical access hospitals and payments made to hospitals paid under the DRG system. Only
the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being
rebased during the entire base period shall be incorporated into the budget neutrality
calculation.
(d) For discharges occurring on or after November 1, 2014, through the next rebasing
that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph
(a), clause (4), shall include adjustments to the projected rates that result in no greater than
a five percent increase or decrease from the base year payments for any hospital. Any
adjustments to the rates made by the commissioner under this paragraph and paragraph (e)
shall maintain budget neutrality as described in paragraph (c).
(e) For discharges occurring on or after November 1, 2014, the commissioner may make
additional adjustments to the rebased rates, and when evaluating whether additional
adjustments should be made, the commissioner shall consider the impact of the rates on the
following:
(1) pediatric services;
(2) behavioral health services;
(3) trauma services as defined by the National Uniform Billing Committee;
(4) transplant services;
(5) obstetric services, newborn services, and behavioral health services provided by
hospitals outside the seven-county metropolitan area;
(6) outlier admissions;
(7) low-volume providers; and
(8) services provided by small rural hospitals that are not critical access hospitals.
(f) Hospital payment rates established under paragraph (c) must incorporate the following:
(1) for hospitals paid under the DRG methodology, the base year payment rate per
admission is standardized by the applicable Medicare wage index and adjusted by the
hospital's disproportionate population adjustment;
(2) for critical access hospitals, payment rates for discharges between November 1, 2014,
and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
October 31, 2014;
(3) the cost and charge data used to establish hospital payment rates must only reflect
inpatient services covered by medical assistance; and
(4) in determining hospital payment rates for discharges occurring on or after the rate
year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per
discharge shall be based on the cost-finding methods and allowable costs of the Medicare
program in effect during the base year or years. In determining hospital payment rates for
discharges in subsequent base years, the per discharge rates shall be based on the cost-finding
methods and allowable costs of the Medicare program in effect during the base year or
years.
(g) The commissioner shall validate the rates effective November 1, 2014, by applying
the rates established under paragraph (c), and any adjustments made to the rates under
paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the
total aggregate payments for the same number and types of services under the rebased rates
are equal to the total aggregate payments made during calendar year 2013.
(h) Effective for discharges occurring on or after July 1, 2017, and every two years
thereafter, payment rates under this section shall be rebased to reflect only those changes
in hospital costs between the existing base yearnew text begin or yearsnew text end and the next base yearnew text begin or yearsnew text end .new text begin In
any year that inpatient claims volume falls below the threshold required to ensure a statically
valid sample of claims, the commissioner may combine claims data from two consecutive
years to serve as the base year. Years in which inpatient claims volume is reduced or altered
due to a pandemic or other public health emergency shall not be used as a base year or part
of a base year if the base year includes more than one year.new text end Changes in costs between base
years shall be measured using the lower of the hospital cost index defined in subdivision 1,
paragraph (a), or the percentage change in the case mix adjusted cost per claim. The
commissioner shall establish the base year for each rebasing period considering the most
recent yearnew text begin or yearsnew text end for which filed Medicare cost reports are available. The estimated
change in the average payment per hospital discharge resulting from a scheduled rebasing
must be calculated and made available to the legislature by January 15 of each year in which
rebasing is scheduled to occur, and must include by hospital the differential in payment
rates compared to the individual hospital's costs.
(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates
for critical access hospitals located in Minnesota or the local trade area shall be determined
using a new cost-based methodology. The commissioner shall establish within the
methodology tiers of payment designed to promote efficiency and cost-effectiveness.
Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
the total cost for critical access hospitals as reflected in base year cost reports. Until the
next rebasing that occurs, the new methodology shall result in no greater than a five percent
decrease from the base year payments for any hospital, except a hospital that had payments
that were greater than 100 percent of the hospital's costs in the base year shall have their
rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and
after July 1, 2016, covered under this paragraph shall be increased by the inflation factor
in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not
be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the
following criteria:
(1) hospitals that had payments at or below 80 percent of their costs in the base year
shall have a rate set that equals 85 percent of their base year costs;
(2) hospitals that had payments that were above 80 percent, up to and including 90
percent of their costs in the base year shall have a rate set that equals 95 percent of their
base year costs; and
(3) hospitals that had payments that were above 90 percent of their costs in the base year
shall have a rate set that equals 100 percent of their base year costs.
(j) The commissioner may refine the payment tiers and criteria for critical access hospitals
to coincide with the next rebasing under paragraph (h). The factors used to develop the new
methodology may include, but are not limited to:
(1) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's charges to the medical assistance program;
(2) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;
(3) the ratio between the hospital's charges to the medical assistance program and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;
(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
(5) the proportion of that hospital's costs that are administrative and trends in
administrative costs; and
(6) geographic location.
Sec. 9.
Minnesota Statutes 2020, section 256.969, is amended by adding a subdivision to
read:
new text begin Subd. 2f. new text end
new text begin Alternate inpatient payment rate. new text end
new text begin
Effective January 1, 2022, for a hospital
eligible to receive disproportionate share hospital payments under subdivision 9, paragraph
(d), clause (6), the commissioner shall reduce the amount calculated under subdivision 9,
paragraph (d), clause (6), by 99 percent and compute an alternate inpatient payment rate.
The alternate payment rate shall be structured to target a total aggregate reimbursement
amount equal to what the hospital would have received for providing fee-for-service inpatient
services under this section to patients enrolled in medical assistance had the hospital received
the entire amount calculated under subdivision 9, paragraph (d), clause (6).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 10.
Minnesota Statutes 2020, section 256.969, subdivision 9, is amended to read:
Subd. 9.
Disproportionate numbers of low-income patients served.
(a) For admissions
occurring on or after July 1, 1993, the medical assistance disproportionate population
adjustment shall comply with federal law and shall be paid to a hospital, excluding regional
treatment centers and facilities of the federal Indian Health Service, with a medical assistance
inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined
as follows:
(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic
mean for all hospitals excluding regional treatment centers and facilities of the federal Indian
Health Service but less than or equal to one standard deviation above the mean, the
adjustment must be determined by multiplying the total of the operating and property
payment rates by the difference between the hospital's actual medical assistance inpatient
utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers
and facilities of the federal Indian Health Service; and
(2) for a hospital with a medical assistance inpatient utilization rate above one standard
deviation above the mean, the adjustment must be determined by multiplying the adjustment
that would be determined under clause (1) for that hospital by 1.1. The commissioner shall
report annually on the number of hospitals likely to receive the adjustment authorized by
this paragraph. The commissioner shall specifically report on the adjustments received by
public hospitals and public hospital corporations located in cities of the first class.
(b) Certified public expenditures made by Hennepin County Medical Center shall be
considered Medicaid disproportionate share hospital payments. Hennepin County and
Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning
July 1, 2005, or another date specified by the commissioner, that may qualify for
reimbursement under federal law. Based on these reports, the commissioner shall apply for
federal matching funds.
(c) Upon federal approval of the related state plan amendment, paragraph (b) is effective
retroactively from July 1, 2005, or the earliest effective date approved by the Centers for
Medicare and Medicaid Services.
(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid
in accordance with a new methodology using 2012 as the base year. Annual payments made
under this paragraph shall equal the total amount of payments made for 2012. A licensed
children's hospital shall receive only a single DSH factor for children's hospitals. Other
DSH factors may be combined to arrive at a single factor for each hospital that is eligible
for DSH payments. The new methodology shall make payments only to hospitals located
in Minnesota and include the following factors:
(1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the
base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000
fee-for-service discharges in the base year shall receive a factor of 0.7880;
(2) a hospital that has in effect for the initial rate year a contract with the commissioner
to provide extended psychiatric inpatient services under section 256.9693 shall receive a
factor of 0.0160;
(3) a hospital that has receivednew text begin medical assistancenew text end payment deleted text begin from the fee-for-service
programdeleted text end for at least 20 transplant services in the base year shall receive a factor of 0.0435;
(4) a hospital that has a medical assistance utilization rate in the base year between 20
percent up to one standard deviation above the statewide mean utilization rate shall receive
a factor of 0.0468;
(5) a hospital that has a medical assistance utilization rate in the base year that is at least
one standard deviation above the statewide mean utilization rate but is less than two and
one-half standard deviations above the mean shall receive a factor of 0.2300; and
(6) a hospitalnew text begin that is a level one trauma center andnew text end that has a medical assistance utilization
rate in the base year that is at least two and one-half standard deviations above the statewide
mean utilization rate shall receive a factor of 0.3711.
new text begin
(e) For the purposes of determining eligibility for the disproportionate share hospital
factors in paragraph (d), clauses (1) to (6), the medical assistance utilization rate and
discharge thresholds shall be measured using only one year when a two-year base period
is used.
new text end
deleted text begin (e)deleted text end new text begin (f)new text end Any payments or portion of payments made to a hospital under this subdivision
that are subsequently returned to the commissioner because the payments are found to
exceed the hospital-specific DSH limit for that hospital shall be redistributed, proportionate
to the number of fee-for-service discharges, to other DSH-eligible non-children's hospitals
that have a medical assistance utilization rate that is at least one standard deviation above
the mean.
deleted text begin (f)deleted text end new text begin (g)new text end An additional payment adjustment shall be established by the commissioner under
this subdivision for a hospital that provides high levels of administering high-cost drugs to
enrollees in fee-for-service medical assistance. The commissioner shall consider factors
including fee-for-service medical assistance utilization rates and payments made for drugs
purchased through the 340B drug purchasing program and administered to fee-for-service
enrollees. If any part of this adjustment exceeds a hospital's hospital-specific disproportionate
share hospital limit, new text begin or if the hospital qualifies for the alternative payment rate described in
subdivision 2e, new text end the commissioner shall make a payment to the hospital that equals the
nonfederal share of the amount that exceeds the limit. The total nonfederal share of the
amount of the payment adjustment under this paragraph shall not exceed deleted text begin $1,500,000deleted text end new text begin
$9,000,000new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2021, except that the amendment
to paragraph (g) is effective January 1, 2023.
new text end
Sec. 11.
Minnesota Statutes 2020, section 256.9695, subdivision 1, is amended to read:
Subdivision 1.
Appeals.
A hospital may appeal a decision arising from the application
of standards or methods under section 256.9685, 256.9686, or 256.969, if an appeal would
result in a change to the hospital's payment rate or payments. Both overpayments and
underpayments that result from the submission of appeals shall be implemented. Regardless
of any appeal outcome, relative values, Medicare wage indexes, Medicare cost-to-charge
ratios, and policy adjusters shall not be changed. The appeal shall be heard by an
administrative law judge according to sections 14.57 to 14.62, or upon agreement by both
parties, according to a modified appeals procedure established by the commissioner and the
Office of Administrative Hearings. In any proceeding under this section, the appealing party
must demonstrate by a preponderance of the evidence that the commissioner's determination
is incorrect or not according to law.
To appeal a payment rate or payment determination or a determination made from base
year information, the hospital shall file a written appeal request to the commissioner within
60 days of the date the preliminary payment rate determination was mailed. The appeal
request shall specify: (i) the disputed items; (ii) the authority in federal or state statute or
rule upon which the hospital relies for each disputed item; and (iii) the name and address
of the person to contact regarding the appeal. Facts to be considered in any appeal of base
year information are limited to those in existence deleted text begin 12deleted text end new text begin 18new text end months after the last day of the
calendar year that is the base year for the payment rates in dispute.
Sec. 12.
Minnesota Statutes 2020, section 256.983, is amended to read:
256.983 FRAUD PREVENTION INVESTIGATIONS.
Subdivision 1.
Programs established.
Within the limits of available appropriations, the
commissioner of human services shall require the maintenance of budget neutral fraud
prevention investigation programs in the counties new text begin or tribal agencies new text end participating in the
fraud prevention investigation project established under this section. If funds are sufficient,
the commissioner may also extend fraud prevention investigation programs to other counties
new text begin or tribal agencies new text end provided the expansion is budget neutral to the state. Under any expansion,
the commissioner has the final authority in decisions regarding the creation and realignment
of individual countynew text begin , tribal agency,new text end or regional operations.
Subd. 2.
County new text begin and tribal agency new text end proposals.
Each participating county new text begin and tribal
new text end agency shall develop and submit an annual staffing and funding proposal to the commissioner
no later than April 30 of each year. Each proposal shall include, but not be limited to, the
staffing and funding of the fraud prevention investigation program, a job description for
investigators involved in the fraud prevention investigation program, and the organizational
structure of the county new text begin or tribal new text end agency unit, training programs for case workers, and the
operational requirements which may be directed by the commissioner. The proposal shall
be approved, to include any changes directed or negotiated by the commissioner, no later
than June 30 of each year.
Subd. 3.
Department responsibilities.
The commissioner shall establish training
programs which shall be attended by all investigative and supervisory staff of the involved
county new text begin and tribal new text end agencies. The commissioner shall also develop the necessary operational
guidelines, forms, and reporting mechanisms, which shall be used by the involved countynew text begin
or tribalnew text end agencies. An individual's application or redetermination form for public assistance
benefits, including child care assistance programs and medical care programs, must include
an authorization for release by the individual to obtain documentation for any information
on that form which is involved in a fraud prevention investigation. The authorization for
release is effective for six months after public assistance benefits have ceased.
Subd. 4.
Funding.
(a) County new text begin and tribal new text end agency reimbursement shall be made through
the settlement provisions applicable to the Supplemental Nutrition Assistance Program
(SNAP), MFIP, child care assistance programs, the medical assistance program, and other
federal and state-funded programs.
(b) The commissioner will maintain program compliance if for any three consecutive
month period, a county new text begin or tribal new text end agency fails to comply with fraud prevention investigation
program guidelines, or fails to meet the cost-effectiveness standards developed by the
commissioner. This result is contingent on the commissioner providing written notice,
including an offer of technical assistance, within 30 days of the end of the third or subsequent
month of noncompliance. The county new text begin or tribal new text end agency shall be required to submit a corrective
action plan to the commissioner within 30 days of receipt of a notice of noncompliance.
Failure to submit a corrective action plan or, continued deviation from standards of more
than ten percent after submission of a corrective action plan, will result in denial of funding
for each subsequent month, or billing the county new text begin or tribal new text end agency for fraud prevention
investigation (FPI) service provided by the commissioner, or reallocation of program grant
funds, or investigative resources, or both, to other countiesnew text begin or tribal agenciesnew text end . The denial of
funding shall apply to the general settlement received by the county new text begin or tribal new text end agency on a
quarterly basis and shall not reduce the grant amount applicable to the FPI project.
Subd. 5.
Child care providers; financial misconduct.
(a) A county or tribal agency
may conduct investigations of financial misconduct by child care providers as described in
chapter 245E. Prior to opening an investigation, a county or tribal agency must contact the
commissioner to determine whether an investigation under this chapter may compromise
an ongoing investigation.
(b) If, upon investigation, a preponderance of evidence shows a provider committed an
intentional program violation, intentionally gave the county or tribe materially false
information on the provider's billing forms, provided false attendance records to a county,
tribe, or the commissioner, or committed financial misconduct as described in section
245E.01, subdivision 8, the county or tribal agency may suspend a provider's payment
pursuant to chapter 245E, or deny or revoke a provider's authorization pursuant to section
119B.13, subdivision 6, paragraph (d), clause (2), prior to pursuing other available remedies.
The countynew text begin or tribenew text end must send notice in accordance with the requirements of section
119B.161, subdivision 2. If a provider's payment is suspended under this section, the payment
suspension shall remain in effect until: (1) the commissioner, county,new text begin tribe,new text end or a law
enforcement authority determines that there is insufficient evidence warranting the action
and a county, tribe, or the commissioner does not pursue an additional administrative remedy
under chapter 119B or 245E, or section 256.046 or 256.98; or (2) all criminal, civil, and
administrative proceedings related to the provider's alleged misconduct conclude and any
appeal rights are exhausted.
(c) For the purposes of this section, an intentional program violation includes intentionally
making false or misleading statements; intentionally misrepresenting, concealing, or
withholding facts; and repeatedly and intentionally violating program regulations under
chapters 119B and 245E.
(d) A provider has the right to administrative review under section 119B.161 if: (1)
payment is suspended under chapter 245E; or (2) the provider's authorization was denied
or revoked under section 119B.13, subdivision 6, paragraph (d), clause (2).
Sec. 13.
new text begin
[256B.0371] ADMINISTRATION OF DENTAL SERVICES.
new text end
new text begin
(a) Effective January 1, 2023, the commissioner shall contract with a dental administrator
to administer dental services for all recipients of medical assistance and MinnesotaCare,
including persons enrolled in managed care as described in section 256B.69.
new text end
new text begin
(b) The dental administrator must provide administrative services, including but not
limited to:
new text end
new text begin
(1) provider recruitment, contracting, and assistance;
new text end
new text begin
(2) recipient outreach and assistance;
new text end
new text begin
(3) utilization management and reviews of medical necessity for dental services;
new text end
new text begin
(4) dental claims processing;
new text end
new text begin
(5) coordination of dental care with other services;
new text end
new text begin
(6) management of fraud and abuse;
new text end
new text begin
(7) monitoring access to dental services;
new text end
new text begin
(8) performance measurement;
new text end
new text begin
(9) quality improvement and evaluation; and
new text end
new text begin
(10) management of third-party liability requirements.
new text end
new text begin
(c) Payments to contracted dental providers must be at the rates established under section
256B.76.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2023.
new text end
Sec. 14.
Minnesota Statutes 2020, section 256B.04, subdivision 12, is amended to read:
Subd. 12.
Limitation on services.
deleted text begin (a)deleted text end Place limits on the types of services covered by
medical assistance, the frequency with which the same or similar services may be covered
by medical assistance for an individual recipient, and the amount paid for each covered
service. deleted text begin The state agency shall promulgate rules establishing maximum reimbursement rates
for emergency and nonemergency transportation.
deleted text end
deleted text begin
The rules shall provide:
deleted text end
deleted text begin
(1) an opportunity for all recognized transportation providers to be reimbursed for
nonemergency transportation consistent with the maximum rates established by the agency;
and
deleted text end
deleted text begin
(2) reimbursement of public and private nonprofit providers serving the population with
a disability generally at reasonable maximum rates that reflect the cost of providing the
service regardless of the fare that might be charged by the provider for similar services to
individuals other than those receiving medical assistance or medical care under this chapter.
deleted text end
deleted text begin
(b) The commissioner shall encourage providers reimbursed under this chapter to
coordinate their operation with similar services that are operating in the same community.
To the extent practicable, the commissioner shall encourage eligible individuals to utilize
less expensive providers capable of serving their needs.
deleted text end
deleted text begin
(c) For the purpose of this subdivision and section 256B.02, subdivision 8, and effective
on January 1, 1981, "recognized provider of transportation services" means an operator of
special transportation service as defined in section 174.29 that has been issued a current
certificate of compliance with operating standards of the commissioner of transportation
or, if those standards do not apply to the operator, that the agency finds is able to provide
the required transportation in a safe and reliable manner. Until January 1, 1981, "recognized
transportation provider" includes an operator of special transportation service that the agency
finds is able to provide the required transportation in a safe and reliable manner.
deleted text end
Sec. 15.
Minnesota Statutes 2020, section 256B.04, subdivision 14, is amended to read:
Subd. 14.
Competitive bidding.
(a) When determined to be effective, economical, and
feasible, the commissioner may utilize volume purchase through competitive bidding and
negotiation under the provisions of chapter 16C, to provide items under the medical assistance
program including but not limited to the following:
(1) eyeglasses;
(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
on a short-term basis, until the vendor can obtain the necessary supply from the contract
dealer;
(3) hearing aids and supplies; deleted text begin and
deleted text end
(4) durable medical equipment, including but not limited to:
(i) hospital beds;
(ii) commodes;
(iii) glide-about chairs;
(iv) patient lift apparatus;
(v) wheelchairs and accessories;
(vi) oxygen administration equipment;
(vii) respiratory therapy equipment;
(viii) electronic diagnostic, therapeutic and life-support systems;new text begin and
new text end
new text begin
(ix) allergen-reducing products as described in section 256B.0625, subdivision 67,
paragraph (c) or (d);
new text end
(5) nonemergency medical transportation deleted text begin level of need determinations, disbursement of
public transportation passes and tokens, and volunteer and recipient mileage and parking
reimbursementsdeleted text end ; and
(6) drugs.
(b) Rate changes and recipient cost-sharing under this chapter and chapter 256L do not
affect contract payments under this subdivision unless specifically identified.
(c) The commissioner may not utilize volume purchase through competitive bidding
and negotiation under the provisions of chapter 16C for deleted text begin special transportation services ordeleted text end
incontinence products and related supplies.
Sec. 16.
Minnesota Statutes 2020, section 256B.055, subdivision 6, is amended to read:
Subd. 6.
Pregnant women; needy unborn child.
Medical assistance may be paid for
a pregnant woman who meets the other eligibility criteria of this section and whose unborn
child would be eligible as a needy child under subdivision 10 if born and living with the
woman. In accordance with Code of Federal Regulations, title 42, section 435.956, the
commissioner must accept self-attestation of pregnancy unless the agency has information
that is not reasonably compatible with such attestation. For purposes of this subdivision, a
woman is considered pregnant for deleted text begin 60 daysdeleted text end new text begin six monthsnew text end postpartum.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval has been obtained.
new text end
Sec. 17.
Minnesota Statutes 2020, section 256B.056, subdivision 10, is amended to read:
Subd. 10.
Eligibility verification.
(a) The commissioner shall require women who are
applying for the continuation of medical assistance coverage following the end of the deleted text begin 60-daydeleted text end new text begin
six-monthnew text end postpartum period to update their income and asset information and to submit
any required income or asset verification.
(b) The commissioner shall determine the eligibility of private-sector health care coverage
for infants less than one year of age eligible under section 256B.055, subdivision 10, or
256B.057, subdivision 1, paragraph (c), and shall pay for private-sector coverage if this is
determined to be cost-effective.
(c) The commissioner shall verify assets and income for all applicants, and for all
recipients upon renewal.
(d) The commissioner shall utilize information obtained through the electronic service
established by the secretary of the United States Department of Health and Human Services
and other available electronic data sources in Code of Federal Regulations, title 42, sections
435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish
standards to define when information obtained electronically is reasonably compatible with
information provided by applicants and enrollees, including use of self-attestation, to
accomplish real-time eligibility determinations and maintain program integrity.
(e) Each person applying for or receiving medical assistance under section 256B.055,
subdivision 7, and any other person whose resources are required by law to be disclosed to
determine the applicant's or recipient's eligibility must authorize the commissioner to obtain
information from financial institutions to identify unreported accounts as required in section
256.01, subdivision 18f. If a person refuses or revokes the authorization, the commissioner
may determine that the applicant or recipient is ineligible for medical assistance. For purposes
of this paragraph, an authorization to identify unreported accounts meets the requirements
of the Right to Financial Privacy Act, United States Code, title 12, chapter 35, and need not
be furnished to the financial institution.
(f) County and tribal agencies shall comply with the standards established by the
commissioner for appropriate use of the asset verification system specified in section 256.01,
subdivision 18f.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval has been obtained.
new text end
Sec. 18.
Minnesota Statutes 2020, section 256B.057, subdivision 3, is amended to read:
Subd. 3.
Qualified Medicare beneficiaries.
new text begin (a) new text end A person deleted text begin who is entitled to Part A
Medicare benefits, whose income is equal to or less than 100 percent of the federal poverty
guidelines, and whose assets are no more than $10,000 for a single individual and $18,000
for a married couple or family of two or more,deleted text end is eligible for medical assistance
reimbursement of new text begin Medicare new text end Part A and Part B premiums, Part A and Part B coinsurance
and deductibles, and cost-effective premiums for enrollment with a health maintenance
organization or a competitive medical plan under section 1876 of the Social Security Actdeleted text begin .deleted text end new text begin
if:
new text end
new text begin
(1) the person is entitled to Medicare Part A benefits;
new text end
new text begin
(2) the person's income is equal to or less than 100 percent of the federal poverty
guidelines; and
new text end
new text begin
(3) the person's assets are no more than (i) $10,000 for a single individual, or (ii) $18,000
for a married couple or family of two or more; or, when the resource limits for eligibility
for the Medicare Part D extra help low income subsidy (LIS) exceed either amount in item
(i) or (ii), the person's assets are no more than the LIS resource limit in United States Code,
title 42, section 1396d, subsection (p).
new text end
new text begin (b)new text end Reimbursement of the Medicare coinsurance and deductibles, when added to the
amount paid by Medicare, must not exceed the total rate the provider would have received
for the same service or services if the person were a medical assistance recipient with
Medicare coverage. Increases in benefits under Title II of the Social Security Act shall not
be counted as income for purposes of this subdivision until July 1 of each year.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 19.
Minnesota Statutes 2020, section 256B.06, subdivision 4, is amended to read:
Subd. 4.
Citizenship requirements.
(a) Eligibility for medical assistance is limited to
citizens of the United States, qualified noncitizens as defined in this subdivision, and other
persons residing lawfully in the United States. Citizens or nationals of the United States
must cooperate in obtaining satisfactory documentary evidence of citizenship or nationality
according to the requirements of the federal Deficit Reduction Act of 2005, Public Law
109-171.
(b) "Qualified noncitizen" means a person who meets one of the following immigration
criteria:
(1) admitted for lawful permanent residence according to United States Code, title 8;
(2) admitted to the United States as a refugee according to United States Code, title 8,
section 1157;
(3) granted asylum according to United States Code, title 8, section 1158;
(4) granted withholding of deportation according to United States Code, title 8, section
1253(h);
(5) paroled for a period of at least one year according to United States Code, title 8,
section 1182(d)(5);
(6) granted conditional entrant status according to United States Code, title 8, section
1153(a)(7);
(7) determined to be a battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
(8) is a child of a noncitizen determined to be a battered noncitizen by the United States
Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility
Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
or
(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
Law 96-422, the Refugee Education Assistance Act of 1980.
(c) All qualified noncitizens who were residing in the United States before August 22,
1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical
assistance with federal financial participation.
(d) Beginning December 1, 1996, qualified noncitizens who entered the United States
on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
chapter are eligible for medical assistance with federal participation for five years if they
meet one of the following criteria:
(1) refugees admitted to the United States according to United States Code, title 8, section
1157;
(2) persons granted asylum according to United States Code, title 8, section 1158;
(3) persons granted withholding of deportation according to United States Code, title 8,
section 1253(h);
(4) veterans of the United States armed forces with an honorable discharge for a reason
other than noncitizen status, their spouses and unmarried minor dependent children; or
(5) persons on active duty in the United States armed forces, other than for training,
their spouses and unmarried minor dependent children.
Beginning July 1, 2010, children and pregnant women who are noncitizens described
in paragraph (b) or who are lawfully present in the United States as defined in Code of
Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements
of this chapter, are eligible for medical assistance with federal financial participation as
provided by the federal Children's Health Insurance Program Reauthorization Act of 2009,
Public Law 111-3.
(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter are
eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this subdivision,
a "nonimmigrant" is a person in one of the classes listed in United States Code, title 8,
section 1101(a)(15).
(f) Payment shall also be made for care and services that are furnished to noncitizens,
regardless of immigration status, who otherwise meet the eligibility requirements of this
chapter, if such care and services are necessary for the treatment of an emergency medical
condition.
(g) For purposes of this subdivision, the term "emergency medical condition" means a
medical condition that meets the requirements of United States Code, title 42, section
1396b(v).
(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment of
an emergency medical condition are limited to the following:
(i) services delivered in an emergency room or by an ambulance service licensed under
chapter 144E that are directly related to the treatment of an emergency medical condition;
(ii) services delivered in an inpatient hospital setting following admission from an
emergency room or clinic for an acute emergency condition; and
(iii) follow-up services that are directly related to the original service provided to treat
the emergency medical condition and are covered by the global payment made to the
provider.
(2) Services for the treatment of emergency medical conditions do not include:
(i) services delivered in an emergency room or inpatient setting to treat a nonemergency
condition;
(ii) organ transplants, stem cell transplants, and related care;
(iii) services for routine prenatal care;
(iv) continuing care, including long-term care, nursing facility services, home health
care, adult day care, day training, or supportive living services;
(v) elective surgery;
(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part
of an emergency room visit;
(vii) preventative health care and family planning services;
(viii) rehabilitation services;
(ix) physical, occupational, or speech therapy;
(x) transportation services;
(xi) case management;
(xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
(xiii) dental services;
(xiv) hospice care;
(xv) audiology services and hearing aids;
(xvi) podiatry services;
(xvii) chiropractic services;
(xviii) immunizations;
(xix) vision services and eyeglasses;
(xx) waiver services;
(xxi) individualized education programs; or
(xxii) chemical dependency treatment.
(i) Pregnant noncitizens who are ineligible for federally funded medical assistance
because of immigration status, are not covered by a group health plan or health insurance
coverage according to Code of Federal Regulations, title 42, section 457.310, and who
otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance
through the period of pregnancy, including labor and delivery, and deleted text begin 60 daysdeleted text end new text begin six monthsnew text end
postpartumdeleted text begin , deleted text end deleted text begin to the extent federal funds are available under title XXI of the Social Security
Act, and the deleted text end deleted text begin state children's health insurance programdeleted text end .
(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation services
from a nonprofit center established to serve victims of torture and are otherwise ineligible
for medical assistance under this chapter are eligible for medical assistance without federal
financial participation. These individuals are eligible only for the period during which they
are receiving services from the center. Individuals eligible under this paragraph shall not
be required to participate in prepaid medical assistance. The nonprofit center referenced
under this paragraph may establish itself as a provider of mental health targeted case
management services through a county contract under section 256.0112, subdivision 6. If
the nonprofit center is unable to secure a contract with a lead county in its service area, then,
notwithstanding the requirements of section 256B.0625, subdivision 20, the commissioner
may negotiate a contract with the nonprofit center for provision of mental health targeted
case management services. When serving clients who are not the financial responsibility
of their contracted lead county, the nonprofit center must gain the concurrence of the county
of financial responsibility prior to providing mental health targeted case management services
for those clients.
(k) Notwithstanding paragraph (h), clause (2), the following services are covered as
emergency medical conditions under paragraph (f) except where coverage is prohibited
under federal law for services under clauses (1) and (2):
(1) dialysis services provided in a hospital or freestanding dialysis facility;
(2) surgery and the administration of chemotherapy, radiation, and related services
necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission and
requires surgery, chemotherapy, or radiation treatment; and
(3) kidney transplant if the person has been diagnosed with end stage renal disease, is
currently receiving dialysis services, and is a potential candidate for a kidney transplant.
(l) Effective July 1, 2013, recipients of emergency medical assistance under this
subdivision are eligible for coverage of the elderly waiver services provided under chapter
256S, and coverage of rehabilitative services provided in a nursing facility. The age limit
for elderly waiver services does not apply. In order to qualify for coverage, a recipient of
emergency medical assistance is subject to the assessment and reassessment requirements
of section 256B.0911. Initial and continued enrollment under this paragraph is subject to
the limits of available funding.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval has been obtained.
new text end
Sec. 20.
Minnesota Statutes 2020, section 256B.0625, subdivision 3c, is amended to read:
Subd. 3c.
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end .
(a) The commissioner,
after receiving recommendations from professional physician associations, professional
associations representing licensed nonphysician health care professionals, and consumer
groups, shall establish a deleted text begin 13-memberdeleted text end new text begin 14-membernew text end Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory
Councilnew text end , which consists of deleted text begin 12deleted text end new text begin 13new text end voting members and one nonvoting member. The Health
Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end shall advise the commissioner regardingnew text begin (1)new text end
health services pertaining to the administration of health care benefits covered under deleted text begin the
medical assistance and MinnesotaCare programsdeleted text end new text begin Minnesota health care programs (MHCP);
and (2) evidence-based decision-making and health care benefit and coverage policies for
MHCP. The Health Services Advisory Council shall consider available evidence regarding
quality, safety, and cost-effectiveness when advising the commissionernew text end . The Health Services
deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end shall meet at least quarterly. The Health Services deleted text begin Policy
Committeedeleted text end new text begin Advisory Councilnew text end shall annually deleted text begin electdeleted text end new text begin selectnew text end a deleted text begin physiciandeleted text end chair from among its
membersdeleted text begin ,deleted text end who shall work directly with the commissioner's medical directordeleted text begin ,deleted text end to establish
the agenda for each meeting. The Health Services deleted text begin Policy Committee shall alsodeleted text end new text begin Advisory
Council maynew text end recommend criteria for verifying centers of excellence for specific aspects of
medical care where a specific set of combined services, a volume of patients necessary to
maintain a high level of competency, or a specific level of technical capacity is associated
with improved health outcomes.
(b) The commissioner shall establish a dental deleted text begin subcommitteedeleted text end new text begin subcouncilnew text end to operate under
the Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end . The dental deleted text begin subcommitteedeleted text end new text begin
subcouncilnew text end consists of general dentists, dental specialists, safety net providers, dental
hygienists, health plan company and county and public health representatives, health
researchers, consumers, and a designee of the commissioner of health. The dental
deleted text begin subcommitteedeleted text end new text begin subcouncilnew text end shall advise the commissioner regarding:
(1) the critical access dental program under section 256B.76, subdivision 4, including
but not limited to criteria for designating and terminating critical access dental providers;
(2) any changes to the critical access dental provider program necessary to comply with
program expenditure limits;
(3) dental coverage policy based on evidence, quality, continuity of care, and best
practices;
(4) the development of dental delivery models; and
(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
deleted text begin
(c) The Health Services Policy Committee shall study approaches to making provider
reimbursement under the medical assistance and MinnesotaCare programs contingent on
patient participation in a patient-centered decision-making process, and shall evaluate the
impact of these approaches on health care quality, patient satisfaction, and health care costs.
The committee shall present findings and recommendations to the commissioner and the
legislative committees with jurisdiction over health care by January 15, 2010.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end The Health Services deleted text begin Policy Committee shalldeleted text end new text begin Advisory Council maynew text end monitor and
track the practice patterns of deleted text begin physicians providing services to medical assistance and
MinnesotaCare enrolleesdeleted text end new text begin health care providers who serve MHCP recipientsnew text end under
fee-for-service, managed care, and county-based purchasing. The deleted text begin committeedeleted text end new text begin monitoring
and trackingnew text end shall focus on services or specialties for which there is a high variation in
utilization new text begin or quality new text end across deleted text begin physiciansdeleted text end new text begin providersnew text end , or which are associated with high medical
costs. The commissioner, based upon the findings of the deleted text begin committeedeleted text end new text begin Health Services Advisory
Councilnew text end , deleted text begin shall regularlydeleted text end new text begin maynew text end notify deleted text begin physiciansdeleted text end new text begin providersnew text end whose practice patterns indicate
new text begin below average quality or new text end higher than average utilization or costs. Managed care and
county-based purchasing plans shall provide the commissioner with utilization and cost
data necessary to implement this paragraph, and the commissioner shall make deleted text begin thisdeleted text end new text begin thesenew text end
data available to the deleted text begin committeedeleted text end new text begin Health Services Advisory Councilnew text end .
deleted text begin
(e) The Health Services Policy Committee shall review caesarean section rates for the
fee-for-service medical assistance population. The committee may develop best practices
policies related to the minimization of caesarean sections, including but not limited to
standards and guidelines for health care providers and health care facilities.
deleted text end
Sec. 21.
Minnesota Statutes 2020, section 256B.0625, subdivision 3d, is amended to read:
Subd. 3d.
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end members.
(a) The
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end consists of:
(1) deleted text begin sevendeleted text end new text begin sixnew text end voting members who are licensed physicians actively engaged in the practice
of medicine in Minnesota, deleted text begin one of whom must be actively engaged in the treatment of persons
with mental illness, anddeleted text end three of whom must represent health plans currently under contract
to serve deleted text begin medical assistancedeleted text end new text begin MHCPnew text end recipients;
(2) two voting members who are new text begin licensed new text end physician specialists actively practicing their
specialty in Minnesota;
(3) two voting members who are nonphysician health care professionals licensed or
registered in their profession and actively engaged in their practice of their profession in
Minnesota;
new text begin
(4) one voting member who is a health care or mental health professional licensed or
registered in the member's profession, actively engaged in the practice of the member's
profession in Minnesota, and actively engaged in the treatment of persons with mental
illness;
new text end
deleted text begin (4) one consumerdeleted text end new text begin (5) two consumersnew text end who shall serve as deleted text begin adeleted text end voting deleted text begin memberdeleted text end new text begin membersnew text end ; and
deleted text begin (5)deleted text end new text begin (6)new text end the commissioner's medical director who shall serve as a nonvoting member.
(b) Members of the Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end shall not be
employed by the deleted text begin Department of Human Servicesdeleted text end new text begin state of Minnesotanew text end , except for the medical
director.new text begin A quorum shall comprise a simple majority of the voting members. Vacant seats
shall not count toward a quorum.
new text end
Sec. 22.
Minnesota Statutes 2020, section 256B.0625, subdivision 3e, is amended to read:
Subd. 3e.
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end terms and
compensation.
deleted text begin Committeedeleted text end Members shall serve staggered three-year terms, with one-third
of the voting members' terms expiring annually. Members may be reappointed by the
commissioner. The commissioner may require more frequent Health Services deleted text begin Policy
Committeedeleted text end new text begin Advisory Councilnew text end meetings as needed. An honorarium of $200 per meeting and
reimbursement for mileage and parking shall be paid to each deleted text begin committeedeleted text end new text begin councilnew text end member
in attendance except the medical director. The Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory
Councilnew text end does not expire as provided in section 15.059, subdivision 6.
Sec. 23.
Minnesota Statutes 2020, section 256B.0625, subdivision 9, is amended to read:
Subd. 9.
Dental services.
(a) Medical assistance covers dental services.new text begin The commissioner
shall contract with a dental administrator for the administration of dental services. The
contract shall include the administration of dental services for persons enrolled in managed
care as described in section 256B.69.
new text end
(b) Medical assistance dental coverage for nonpregnant adults is limited to the following
services:
(1) comprehensive exams, limited to once every five years;
(2) periodic exams, limited to one per year;
(3) limited exams;
(4) bitewing x-rays, limited to one per year;
(5) periapical x-rays;
(6) panoramic x-rays, limited to one every five years except (1) when medically necessary
for the diagnosis and follow-up of oral and maxillofacial pathology and trauma or (2) once
every two years for patients who cannot cooperate for intraoral film due to a developmental
disability or medical condition that does not allow for intraoral film placement;
(7) prophylaxis, limited to one per year;
(8) application of fluoride varnish, limited to one per year;
(9) posterior fillings, all at the amalgam rate;
(10) anterior fillings;
(11) endodontics, limited to root canals on the anterior and premolars only;
(12) removable prostheses, each dental arch limited to one every six years;
(13) oral surgery, limited to extractions, biopsies, and incision and drainage of abscesses;
(14) palliative treatment and sedative fillings for relief of pain; deleted text begin and
deleted text end
(15) full-mouth debridement, limited to one every five yearsdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(16) nonsurgical treatment for periodontal disease, including scaling and root planing
once every two years for each quadrant, and routine periodontal maintenance procedures.
new text end
(c) In addition to the services specified in paragraph (b), medical assistance covers the
following services for adults, if provided in an outpatient hospital setting or freestanding
ambulatory surgical center as part of outpatient dental surgery:
(1) periodontics, limited to periodontal scaling and root planing once every two years;
(2) general anesthesia; and
(3) full-mouth survey once every five years.
(d) Medical assistance covers medically necessary dental services for children and
pregnant women. The following guidelines apply:
(1) posterior fillings are paid at the amalgam rate;
(2) application of sealants are covered once every five years per permanent molar for
children only;
(3) application of fluoride varnish is covered once every six months; and
(4) orthodontia is eligible for coverage for children only.
(e) In addition to the services specified in paragraphs (b) and (c), medical assistance
covers the following services for adults:
(1) house calls or extended care facility calls for on-site delivery of covered services;
(2) behavioral management when additional staff time is required to accommodate
behavioral challenges and sedation is not used;
(3) oral or IV sedation, if the covered dental service cannot be performed safely without
it or would otherwise require the service to be performed under general anesthesia in a
hospital or surgical center; and
(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but
no more than four times per year.
(f) The commissioner shall not require prior authorization for the services included in
paragraph (e), clauses (1) to (3)deleted text begin , and shall prohibit managed care and county-based purchasing
plans from requiring prior authorization for the services included in paragraph (e), clauses
(1) to (3), when provided under sections 256B.69, 256B.692, and 256L.12deleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2021, except that the amendments
to paragraphs (a) and (f) are effective January 1, 2023.
new text end
Sec. 24.
Minnesota Statutes 2020, section 256B.0625, subdivision 13, is amended to read:
Subd. 13.
Drugs.
(a) Medical assistance covers drugs, except for fertility drugs when
specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
dispensing physician, or by a physician, a physician assistant, or an advanced practice
registered nurse employed by or under contract with a community health board as defined
in section 145A.02, subdivision 5, for the purposes of communicable disease control.
(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
unless authorized by the commissionerdeleted text begin .deleted text end new text begin or the drug appears on the 90-day supply list
published by the commissioner. The 90-day supply list shall be published by the
commissioner on the department's website. The commissioner may add to, delete from, and
otherwise modify the 90-day supply list after providing public notice and the opportunity
for a 15-day public comment period. The 90-day supply list may include cost-effective
generic drugs and shall not include controlled substances.
new text end
(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
ingredient" is defined as a substance that is represented for use in a drug and when used in
the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
excipients which are included in the medical assistance formulary. Medical assistance covers
selected active pharmaceutical ingredients and excipients used in compounded prescriptions
when the compounded combination is specifically approved by the commissioner or when
a commercially available product:
(1) is not a therapeutic option for the patient;
(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and
(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
prescription.
(d) Medical assistance covers the following over-the-counter drugs when prescribed by
a licensed practitioner or by a licensed pharmacist who meets standards established by the
commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
with documented vitamin deficiencies, vitamins for children under the age of seven and
pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions, or
disorders, and this determination shall not be subject to the requirements of chapter 14. A
pharmacist may prescribe over-the-counter medications as provided under this paragraph
for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for potential adverse interactions,
and make referrals as needed to other health care professionals.
(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
individuals, medical assistance may cover drugs from the drug classes listed in United States
Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
not be covered.
(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under common
ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.new text begin
By March 1 of each year, each 340B covered entity and ambulatory pharmacy under common
ownership of the 340B covered entity must report to the commissioner its reimbursements
for the previous calendar year from each managed care and county-based purchasing plan,
or the pharmacy benefit manager contracted with the managed care or county-based
purchasing plan. The report must include:
new text end
new text begin
(1) the National Provider Identification (NPI) number for each 340B covered entity or
ambulatory pharmacy under common ownership of the 340B covered entity;
new text end
new text begin
(2) the name of each 340B covered entity;
new text end
new text begin
(3) the servicing address of each 340B covered entity;
new text end
new text begin
(4) the aggregate cost of drugs purchased during the prior calendar year through the
340B program;
new text end
new text begin
(5) the aggregate cost of drugs purchased during the prior calendar year outside of the
340B program;
new text end
new text begin
(6) the total reimbursement received by the 340B covered entity from all payers, including
uninsured patients, for all drugs during the prior calendar year; and
new text end
new text begin
(7) either: (i) the number of outpatient 340B pharmacy claims and reimbursement amounts
from each managed care and county-based purchasing plan, or pharmacy benefit manager
contracted with the managed care or county-based purchasing plan; or (ii) the number of
professional or facility 340B claim lines and reimbursement amounts during the prior
calendar year from each managed care and county-based purchasing plan.
new text end
new text begin
The commissioner shall submit a copy of the reports to the chairs and ranking minority
members of the legislative committees with jurisdiction over health care policy and finance
by April 1 of each year. Drugs acquired through the federal 340B Drug Pricing Program
and dispensed by a 340B covered entity or ambulatory pharmacy under common ownership
of the 340B covered entity are not eligible for coverage if the 340B covered entity or
ambulatory pharmacy under common ownership of the 340B covered entity fails to submit
a report to the commissioner containing the information required under clauses (1) to (7).
new text end
(g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal
contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section
151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a
licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists
used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed
pharmacist in accordance with section 151.37, subdivision 16.
Sec. 25.
Minnesota Statutes 2020, section 256B.0625, subdivision 13c, is amended to
read:
Subd. 13c.
Formulary Committee.
The commissioner, after receiving recommendations
from professional medical associations and professional pharmacy associations, and consumer
groups shall designate a Formulary Committee to carry out duties as described in subdivisions
13 to 13g. The Formulary Committee shall be comprised of four licensed physicians actively
engaged in the practice of medicine in Minnesotanew text begin ,new text end one of whom must be actively engaged
in the treatment of persons with mental illness; at least three licensed pharmacists actively
engaged in the practice of pharmacy in Minnesota; and one consumer representative; the
remainder to be made up of health care professionals who are licensed in their field and
have recognized knowledge in the clinically appropriate prescribing, dispensing, and
monitoring of covered outpatient drugs. Members of the Formulary Committee shall not
be employed by the Department of Human Services, but the committee shall be staffed by
an employee of the department who shall serve as an ex officio, nonvoting member of the
committee. The department's medical director shall also serve as an ex officio, nonvoting
member for the committee. Committee members shall serve three-year terms and may be
reappointed by the commissioner. The Formulary Committee shall meet at least twice per
year. The commissioner may require more frequent Formulary Committee meetings as
needed. An honorarium of $100 per meeting and reimbursement for mileage shall be paid
to each committee member in attendance. deleted text begin The Formulary Committee expires June 30, 2022.deleted text end new text begin
Notwithstanding section 15.059, subdivision 6, the Formulary Committee does not expire.
new text end
Sec. 26.
Minnesota Statutes 2020, section 256B.0625, subdivision 13d, is amended to
read:
Subd. 13d.
Drug formulary.
(a) The commissioner shall establish a drug formulary. Its
establishment and publication shall not be subject to the requirements of the Administrative
Procedure Act, but the Formulary Committee shall review and comment on the formulary
contents.
(b) The formulary shall not include:
(1) drugs, active pharmaceutical ingredients, or products for which there is no federal
funding;
(2) over-the-counter drugs, except as provided in subdivision 13;
deleted text begin
(3) drugs or active pharmaceutical ingredients used for weight loss, except that medically
necessary lipase inhibitors may be covered for a recipient with type II diabetes;
deleted text end
deleted text begin (4)deleted text end new text begin (3)new text end drugs or active pharmaceutical ingredients when used for the treatment of
impotence or erectile dysfunction;
deleted text begin (5)deleted text end new text begin (4)new text end drugs or active pharmaceutical ingredients for which medical value has not been
established;
deleted text begin (6)deleted text end new text begin (5)new text end drugs from manufacturers who have not signed a rebate agreement with the
Department of Health and Human Services pursuant to section 1927 of title XIX of the
Social Security Act; and
deleted text begin (7)deleted text end new text begin (6)new text end medical cannabis as defined in section 152.22, subdivision 6.
(c) If a single-source drug used by at least two percent of the fee-for-service medical
assistance recipients is removed from the formulary due to the failure of the manufacturer
to sign a rebate agreement with the Department of Health and Human Services, the
commissioner shall notify prescribing practitioners within 30 days of receiving notification
from the Centers for Medicare and Medicaid Services (CMS) that a rebate agreement was
not signed.
Sec. 27.
Minnesota Statutes 2020, section 256B.0625, subdivision 17, is amended to read:
Subd. 17.
Transportation costs.
(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
(b) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:
(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;
(2) ambulances, as defined in section 144E.001, subdivision 2;
(3) taxicabs that meet the requirements of this subdivision;
(4) public transit, as defined in section 174.22, subdivision 7; or
(5) not-for-hire vehicles, including volunteer drivers.
(c) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.
(d) An organization may be terminated, denied, or suspended from enrollment if:
(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and
(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.
(e) The administrative agency of nonemergency medical transportation must:
(1) adhere to the policies defined by the commissioner deleted text begin in consultation with the
Nonemergency Medical Transportation Advisory Committeedeleted text end ;
(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;new text begin and
new text end
(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by modedeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.
deleted text end
deleted text begin
(f) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
deleted text end
deleted text begin (g)deleted text end new text begin (f)new text end The commissioner may use an order by the recipient's attending physician,
advanced practice registered nurse, or a medical or mental health professional to certify that
the recipient requires nonemergency medical transportation services. Nonemergency medical
transportation providers shall perform driver-assisted services for eligible individuals, when
appropriate. Driver-assisted service includes passenger pickup at and return to the individual's
residence or place of business, assistance with admittance of the individual to the medical
facility, and assistance in passenger securement or in securing of wheelchairs, child seats,
or stretchers in the vehicle.
Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the deleted text begin local agencydeleted text end new text begin administratornew text end .
Nonemergency medical transportation providers may not bill for separate base rates for
the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.
deleted text begin (h)deleted text end new text begin (g) new text end The administrative agency shall use the level of service process established by
the commissioner deleted text begin in consultation with the Nonemergency Medical Transportation Advisory
Committeedeleted text end to determine the client's most appropriate mode of transportation. If public transit
or a certified transportation provider is not available to provide the appropriate service mode
for the client, the client may receive a onetime service upgrade.
deleted text begin (i)deleted text end new text begin (h)new text end The covered modes of transportation are:
(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;
(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;
(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;
(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;
(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;
(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and
(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.
deleted text begin
(j) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
commissioner has developed, made available, and funded the web-based single administrative
structure, assessment tool, and level of need assessment under subdivision 18e. The local
agency's financial obligation is limited to funds provided by the state or federal government.
deleted text end
deleted text begin (k)deleted text end new text begin (i)new text end The commissioner shall:
(1) deleted text begin in consultation with the Nonemergency Medical Transportation Advisory Committee,deleted text end
verify that the mode and use of nonemergency medical transportation is appropriate;
(2) verify that the client is going to an approved medical appointment; and
(3) investigate all complaints and appeals.
deleted text begin
(l) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
deleted text end
deleted text begin (m)deleted text end new text begin (j) new text end Payments for nonemergency medical transportation must be paid based on the
client's assessed mode under paragraph deleted text begin (h)deleted text end new text begin (g)new text end , not the type of vehicle used to provide the
service. deleted text begin The medical assistance reimbursement rates for nonemergency medical transportation
services that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:
deleted text end
deleted text begin
(1) $0.22 per mile for client reimbursement;
deleted text end
deleted text begin
(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;
deleted text end
deleted text begin
(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
medical transportation provider;
deleted text end
deleted text begin
(4) $13 for the base rate and $1.30 per mile for assisted transport;
deleted text end
deleted text begin
(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
deleted text end
deleted text begin
(6) $75 for the base rate and $2.40 per mile for protected transport; and
deleted text end
deleted text begin
(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.
deleted text end
deleted text begin
(n) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:
deleted text end
deleted text begin
(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7); and
deleted text end
deleted text begin
(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7).
deleted text end
deleted text begin
(o) For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) and (n), the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.
deleted text end
deleted text begin
(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.
deleted text end
deleted text begin (q)deleted text end new text begin (k)new text end The commissioner, when determining reimbursement rates for nonemergency
medical transportation deleted text begin under paragraphs (m) and (n)deleted text end , shall exempt all modes of transportation
listed under paragraph deleted text begin (i)deleted text end new text begin (h)new text end from Minnesota Rules, part 9505.0445, item R, subitem (2).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2023.
new text end
Sec. 28.
Minnesota Statutes 2020, section 256B.0625, subdivision 17b, is amended to
read:
Subd. 17b.
Documentation required.
(a) As a condition for payment, nonemergency
medical transportation providers must document each occurrence of a service provided to
a recipient according to this subdivision. Providers must maintain odometer and other records
sufficient to distinguish individual trips with specific vehicles and drivers. The documentation
may be collected and maintained using electronic systems or software or in paper form but
must be made available and produced upon request. Program funds paid for transportation
that is not documented according to this subdivision shall be recovered by the new text begin nonemergency
medical transportation vendor or new text end department.
(b) A nonemergency medical transportation provider must compile transportation records
that meet the following requirements:
(1) the record must be in English and must be legible according to the standard of a
reasonable person;
(2) the recipient's name must be on each page of the record; and
(3) each entry in the record must document:
(i) the date on which the entry is made;
(ii) the date or dates the service is provided;
(iii) the printed last name, first name, and middle initial of the driver;
(iv) the signature of the driver attesting to the following: "I certify that I have accurately
reported in this record the trip miles I actually drove and the dates and times I actually drove
them. I understand that misreporting the miles driven and hours worked is fraud for which
I could face criminal prosecution or civil proceedings.";
(v) the signature of the recipient or authorized party attesting to the following: "I certify
that I received the reported transportation service.", or the signature of the provider of
medical services certifying that the recipient was delivered to the provider;
(vi) the address, or the description if the address is not available, of both the origin and
destination, and the mileage for the most direct route from the origin to the destination;
(vii) the mode of transportation in which the service is provided;
(viii) the license plate number of the vehicle used to transport the recipient;
(ix) whether the service was ambulatory or nonambulatory;
(x) the time of the pickup and the time of the drop-off with "a.m." and "p.m."
designations;
(xi) the name of the extra attendant when an extra attendant is used to provide special
transportation service; and
(xii) the electronic source documentation used to calculate driving directions and mileage.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2023.
new text end
Sec. 29.
Minnesota Statutes 2020, section 256B.0625, subdivision 18, is amended to read:
Subd. 18.
deleted text begin Busdeleted text end new text begin Public transitnew text end or taxicab transportation.
new text begin (a) new text end To the extent authorized
by rule of the state agency, medical assistance covers the most appropriate and cost-effective
form of transportation incurred by any ambulatory eligible person for obtaining
nonemergency medical care.
new text begin
(b) The commissioner may provide a monthly public transit pass to recipients who are
well-served by public transit for the recipient's nonemergency medical transportation needs.
Any recipient who is eligible for one public transit trip for a medically necessary covered
service may select to receive a transit pass for that month. Recipients who do not have any
transportation needs for a medically necessary service in any given month or who have
received a transit pass for that month through another program administered by a county or
Tribe are not eligible for a transit pass that month. The commissioner shall not require
recipients to select a monthly transit pass if the recipient's transportation needs cannot be
served by public transit systems. Recipients who receive a monthly transit pass are not
eligible for other modes of transportation, unless an unexpected need arises that cannot be
accessed through public transit.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 30.
Minnesota Statutes 2020, section 256B.0625, subdivision 18b, is amended to
read:
Subd. 18b.
deleted text begin Broker dispatching prohibitiondeleted text end new text begin Administration of nonemergency medical
transportationnew text end .
deleted text begin
Except for establishing level of service process, the commissioner shall
not use a broker or coordinator for any purpose related to nonemergency medical
transportation services under subdivision 18.
deleted text end
new text begin
The commissioner shall contract either statewide
or regionally for the administration of the nonemergency medical transportation program
in compliance with the provisions of this chapter. The contract shall include the
administration of all covered modes under the nonemergency medical transportation benefit
for those enrolled in managed care as described in section 256B.69.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2023.
new text end
Sec. 31.
Minnesota Statutes 2020, section 256B.0625, subdivision 30, is amended to read:
Subd. 30.
Other clinic services.
(a) Medical assistance covers rural health clinic services,
federally qualified health center services, nonprofit community health clinic services, and
public health clinic services. Rural health clinic services and federally qualified health center
services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and
(C). Payment for rural health clinic and federally qualified health center services shall be
made according to applicable federal law and regulation.
(b) A federally qualified health center (FQHC) that is beginning initial operation shall
submit an estimate of budgeted costs and visits for the initial reporting period in the form
and detail required by the commissioner. An FQHC that is already in operation shall submit
an initial report using actual costs and visits for the initial reporting period. Within 90 days
of the end of its reporting period, an FQHC shall submit, in the form and detail required by
the commissioner, a report of its operations, including allowable costs actually incurred for
the period and the actual number of visits for services furnished during the period, and other
information required by the commissioner. FQHCs that file Medicare cost reports shall
provide the commissioner with a copy of the most recent Medicare cost report filed with
the Medicare program intermediary for the reporting year which support the costs claimed
on their cost report to the state.
(c) In order to continue cost-based payment under the medical assistance program
according to paragraphs (a) and (b), an FQHC or rural health clinic must apply for designation
as an essential community provider within six months of final adoption of rules by the
Department of Health according to section 62Q.19, subdivision 7. For those FQHCs and
rural health clinics that have applied for essential community provider status within the
six-month time prescribed, medical assistance payments will continue to be made according
to paragraphs (a) and (b) for the first three years after application. For FQHCs and rural
health clinics that either do not apply within the time specified above or who have had
essential community provider status for three years, medical assistance payments for health
services provided by these entities shall be according to the same rates and conditions
applicable to the same service provided by health care providers that are not FQHCs or rural
health clinics.
(d) Effective July 1, 1999, the provisions of paragraph (c) requiring an FQHC or a rural
health clinic to make application for an essential community provider designation in order
to have cost-based payments made according to paragraphs (a) and (b) no longer apply.
(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall
be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
(f) Effective January 1, 2001, through December 31, 2020, each FQHC and rural health
clinic may elect to be paid either under the prospective payment system established in United
States Code, title 42, section 1396a(aa), or under an alternative payment methodology
consistent with the requirements of United States Code, title 42, section 1396a(aa), and
approved by the Centers for Medicare and Medicaid Services. The alternative payment
methodology shall be 100 percent of cost as determined according to Medicare cost
principles.
(g) Effective for services provided on or after January 1, 2021, all claims for payment
of clinic services provided by FQHCs and rural health clinics shall be paid by the
commissioner, according to an annual election by the FQHC or rural health clinic, under
the current prospective payment system described in paragraph (f) or the alternative payment
methodology described in paragraph (l).
(h) For purposes of this section, "nonprofit community clinic" is a clinic that:
(1) has nonprofit status as specified in chapter 317A;
(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
(3) is established to provide health services to low-income population groups, uninsured,
high-risk and special needs populations, underserved and other special needs populations;
(4) employs professional staff at least one-half of which are familiar with the cultural
background of their clients;
(5) charges for services on a sliding fee scale designed to provide assistance to
low-income clients based on current poverty income guidelines and family size; and
(6) does not restrict access or services because of a client's financial limitations or public
assistance status and provides no-cost care as needed.
(i) Effective for services provided on or after January 1, 2015, all claims for payment
of clinic services provided by FQHCs and rural health clinics shall be paid by the
commissioner. the commissioner shall determine the most feasible method for paying claims
from the following options:
(1) FQHCs and rural health clinics submit claims directly to the commissioner for
payment, and the commissioner provides claims information for recipients enrolled in a
managed care or county-based purchasing plan to the plan, on a regular basis; or
(2) FQHCs and rural health clinics submit claims for recipients enrolled in a managed
care or county-based purchasing plan to the plan, and those claims are submitted by the
plan to the commissioner for payment to the clinic.
(j) For clinic services provided prior to January 1, 2015, the commissioner shall calculate
and pay monthly the proposed managed care supplemental payments to clinics, and clinics
shall conduct a timely review of the payment calculation data in order to finalize all
supplemental payments in accordance with federal law. Any issues arising from a clinic's
review must be reported to the commissioner by January 1, 2017. Upon final agreement
between the commissioner and a clinic on issues identified under this subdivision, and in
accordance with United States Code, title 42, section 1396a(bb), no supplemental payments
for managed care plan or county-based purchasing plan claims for services provided prior
to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are
unable to resolve issues under this subdivision, the parties shall submit the dispute to the
arbitration process under section 14.57.
(k) The commissioner shall seek a federal waiver, authorized under section 1115 of the
Social Security Act, to obtain federal financial participation at the 100 percent federal
matching percentage available to facilities of the Indian Health Service or tribal organization
in accordance with section 1905(b) of the Social Security Act for expenditures made to
organizations dually certified under Title V of the Indian Health Care Improvement Act,
Public Law 94-437, and as a federally qualified health center under paragraph (a) that
provides services to American Indian and Alaskan Native individuals eligible for services
under this subdivision.
(l) All claims for payment of clinic services provided by FQHCs and rural health clinics,
that have elected to be paid under this paragraph, shall be paid by the commissioner according
to the following requirements:
(1) the commissioner shall establish a single medical and single dental organization
encounter rate for each FQHC and rural health clinic when applicable;
(2) each FQHC and rural health clinic is eligible for same day reimbursement of one
medical and one dental organization encounter rate if eligible medical and dental visits are
provided on the same day;
(3) the commissioner shall reimburse FQHCs and rural health clinics, in accordance
with current applicable Medicare cost principles, their allowable costs, including direct
patient care costs and patient-related support services. Nonallowable costs include, but are
not limited to:
(i) general social services and administrative costs;
(ii) retail pharmacy;
(iii) patient incentives, food, housing assistance, and utility assistance;
(iv) external lab and x-ray;
(v) navigation services;
(vi) health care taxes;
(vii) advertising, public relations, and marketing;
(viii) office entertainment costs, food, alcohol, and gifts;
(ix) contributions and donations;
(x) bad debts or losses on awards or contracts;
(xi) fines, penalties, damages, or other settlements;
(xii) fund-raising, investment management, and associated administrative costs;
(xiii) research and associated administrative costs;
(xiv) nonpaid workers;
(xv) lobbying;
(xvi) scholarships and student aid; and
(xvii) nonmedical assistance covered services;
(4) the commissioner shall review the list of nonallowable costs in the years between
the rebasing process established in clause (5), in consultation with the Minnesota Association
of Community Health Centers, FQHCs, and rural health clinics. The commissioner shall
publish the list and any updates in the Minnesota health care programs provider manual;
(5) the initial applicable base year organization encounter rates for FQHCs and rural
health clinics shall be computed for services delivered on or after January 1, 2021, and:
(i) must be determined using each FQHC's and rural health clinic's Medicare cost reports
from 2017 and 2018;
(ii) must be according to current applicable Medicare cost principles as applicable to
FQHCs and rural health clinics without the application of productivity screens and upper
payment limits or the Medicare prospective payment system FQHC aggregate mean upper
payment limit;
(iii) must be subsequently rebased every two years thereafter using the Medicare cost
reports that are three and four years prior to the rebasing yearnew text begin . Years in which organizational
cost or claims volume is reduced or altered due to a pandemic, disease, or other public health
emergency shall not be used as part of a base year when the base year includes more than
one year. The commissioner may use the Medicare cost reports of a year unaffected by a
pandemic, disease, or other public health emergency, or previous two consecutive years,
inflated to the base year as established under item (iv)new text end ;
(iv) must be inflated to the base year using the inflation factor described in clause (6);
and
(v) the commissioner must provide for a 60-day appeals process under section 14.57;
(6) the commissioner shall annually inflate the applicable organization encounter rates
for FQHCs and rural health clinics from the base year payment rate to the effective date by
using the CMS FQHC Market Basket inflator established under United States Code, title
42, section 1395m(o), less productivity;
(7) FQHCs and rural health clinics that have elected the alternative payment methodology
under this paragraph shall submit all necessary documentation required by the commissioner
to compute the rebased organization encounter rates no later than six months following the
date the applicable Medicare cost reports are due to the Centers for Medicare and Medicaid
Services;
(8) the commissioner shall reimburse FQHCs and rural health clinics an additional
amount relative to their medical and dental organization encounter rates that is attributable
to the tax required to be paid according to section 295.52, if applicable;
(9) FQHCs and rural health clinics may submit change of scope requests to the
commissioner if the change of scope would result in an increase or decrease of 2.5 percent
or higher in the medical or dental organization encounter rate currently received by the
FQHC or rural health clinic;
(10) for FQHCs and rural health clinics seeking a change in scope with the commissioner
under clause (9) that requires the approval of the scope change by the federal Health
Resources Services Administration:
(i) FQHCs and rural health clinics shall submit the change of scope request, including
the start date of services, to the commissioner within seven business days of submission of
the scope change to the federal Health Resources Services Administration;
(ii) the commissioner shall establish the effective date of the payment change as the
federal Health Resources Services Administration date of approval of the FQHC's or rural
health clinic's scope change request, or the effective start date of services, whichever is
later; and
(iii) within 45 days of one year after the effective date established in item (ii), the
commissioner shall conduct a retroactive review to determine if the actual costs established
under clause (3) or encounters result in an increase or decrease of 2.5 percent or higher in
the medical or dental organization encounter rate, and if this is the case, the commissioner
shall revise the rate accordingly and shall adjust payments retrospectively to the effective
date established in item (ii);
(11) for change of scope requests that do not require federal Health Resources Services
Administration approval, the FQHC and rural health clinic shall submit the request to the
commissioner before implementing the change, and the effective date of the change is the
date the commissioner received the FQHC's or rural health clinic's request, or the effective
start date of the service, whichever is later. The commissioner shall provide a response to
the FQHC's or rural health clinic's request within 45 days of submission and provide a final
approval within 120 days of submission. This timeline may be waived at the mutual
agreement of the commissioner and the FQHC or rural health clinic if more information is
needed to evaluate the request;
(12) the commissioner, when establishing organization encounter rates for new FQHCs
and rural health clinics, shall consider the patient caseload of existing FQHCs and rural
health clinics in a 60-mile radius for organizations established outside of the seven-county
metropolitan area, and in a 30-mile radius for organizations in the seven-county metropolitan
area. If this information is not available, the commissioner may use Medicare cost reports
or audited financial statements to establish base rate;
(13) the commissioner shall establish a quality measures workgroup that includes
representatives from the Minnesota Association of Community Health Centers, FQHCs,
and rural health clinics, to evaluate clinical and nonclinical measures; and
(14) the commissioner shall not disallow or reduce costs that are related to an FQHC's
or rural health clinic's participation in health care educational programs to the extent that
the costs are not accounted for in the alternative payment methodology encounter rate
established in this paragraph.
Sec. 32.
Minnesota Statutes 2020, section 256B.0625, subdivision 31, is amended to read:
Subd. 31.
Medical supplies and equipment.
(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall be
made for wheelchairs and wheelchair accessories for recipients who are residents of
intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs
and wheelchair accessories for ICF/DD recipients shall be subject to the same conditions
and limitations as coverage for recipients who do not reside in institutions. A wheelchair
purchased outside of the facility's payment rate is the property of the recipient.
(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.
(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics,
or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment
requirement if:
(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic,
or medical supply;
(2) the vendor serves ten or fewer medical assistance recipients per year;
(3) the commissioner finds that other vendors are not available to provide same or similar
durable medical equipment, prosthetics, orthotics, or medical supplies; and
(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with the
Medicare program's supplier and quality standards and the vendor serves primarily pediatric
patients.
(d) Durable medical equipment means a device or equipment that:
(1) can withstand repeated use;
(2) is generally not useful in the absence of an illness, injury, or disability; and
(3) is provided to correct or accommodate a physiological disorder or physical condition
or is generally used primarily for a medical purpose.
(e) Electronic tablets may be considered durable medical equipment if the electronic
tablet will be used as an augmentative and alternative communication system as defined
under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must
be locked in order to prevent use not related to communication.
(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must be
locked to prevent use not as an augmentative communication device, a recipient of waiver
services may use an electronic tablet for a use not related to communication when the
recipient has been authorized under the waiver to receive one or more additional applications
that can be loaded onto the electronic tablet, such that allowing the additional use prevents
the purchase of a separate electronic tablet with waiver funds.
(g) An order or prescription for medical supplies, equipment, or appliances must meet
the requirements in Code of Federal Regulations, title 42, part 440.70.
new text begin
(h) Allergen-reducing products provided according to subdivision 67, paragraph (c) or
(d), shall be considered durable medical equipment.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 33.
Minnesota Statutes 2020, section 256B.0625, subdivision 58, is amended to read:
Subd. 58.
Early and periodic screening, diagnosis, and treatment services.
new text begin (a) new text end Medical
assistance covers early and periodic screening, diagnosis, and treatment services (EPSDT).
new text begin In administering the EPSDT program, the commissioner shall, at a minimum:
new text end
new text begin
(1) provide information to children and families, using the most effective mode identified,
regarding:
new text end
new text begin
(i) the benefits of preventative health care visits;
new text end
new text begin
(ii) the services available as part of the EPSDT program; and
new text end
new text begin
(iii) assistance finding a provider, transportation, or interpreter services;
new text end
new text begin
(2) maintain an up-to-date periodicity schedule published in the department policy
manual, taking into consideration the most up-to-date community standard of care; and
new text end
new text begin
(3) maintain up-to-date policies for providers on the delivery of EPSDT services that
are in the provider manual on the department website.
new text end
new text begin
(b) The commissioner may contract for the administration of the outreach services as
required within the EPSDT program.
new text end
new text begin
(c) The commissioner may contract for the required EPSDT outreach services, including
but not limited to children enrolled or attributed to an integrated health partnership
demonstration project described in section 256B.0755. Integrated health partnerships that
choose to include the EPSDT outreach services within the integrated health partnership's
contracted responsibilities must receive compensation from the commissioner on a
per-member per-month basis for each included child. Integrated health partnerships must
accept responsibility for the effectiveness of outreach services it delivers. For children who
are not a part of the demonstration project, the commissioner may contract for the
administration of the outreach services.
new text end
new text begin (d) new text end The payment amount for a complete EPSDT screening shall not include charges for
health care services and products that are available at no cost to the provider and shall not
exceed the rate established per Minnesota Rules, part 9505.0445, item M, effective October
1, 2010.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2021, except that paragraph (c)
is effective January 1, 2022.
new text end
Sec. 34.
Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 67. new text end
new text begin Enhanced asthma care services. new text end
new text begin
(a) Medical assistance covers enhanced
asthma care services and related products to be provided in the children's homes for children
with poorly controlled asthma. To be eligible for services and products under this subdivision,
a child must:
new text end
new text begin
(1) have poorly controlled asthma defined by having received health care for the child's
asthma from a hospital emergency department at least one time in the past year or have
been hospitalized for the treatment of asthma at least one time in the past year; and
new text end
new text begin
(2) receive a referral for services and products under this subdivision from a treating
health care provider.
new text end
new text begin
(b) Covered services include home visits provided by a registered environmental health
specialist or lead risk assessor currently credentialed by the Department of Health or a
healthy homes specialist credentialed by the Building Performance Institute.
new text end
new text begin
(c) Covered products include the following allergen-reducing products that are identified
as needed and recommended for the child by a registered environmental health specialist,
healthy homes specialist, lead risk assessor, certified asthma educator, public health nurse,
or other health care professional providing asthma care for the child, and proven to reduce
asthma triggers:
new text end
new text begin
(1) allergen encasements for mattresses, box springs, and pillows;
new text end
new text begin
(2) an allergen-rated vacuum cleaner, filters, and bags;
new text end
new text begin
(3) a dehumidifier and filters;
new text end
new text begin
(4) HEPA single-room air cleaners and filters;
new text end
new text begin
(5) integrated pest management, including traps and starter packages of food storage
containers;
new text end
new text begin
(6) a damp mopping system;
new text end
new text begin
(7) if the child does not have access to a bed, a waterproof hospital-grade mattress; and
new text end
new text begin
(8) for homeowners only, furnace filters.
new text end
new text begin
(d) The commissioner shall determine additional products that may be covered as new
best practices for asthma care are identified.
new text end
new text begin
(e) A home assessment is a home visit to identify asthma triggers in the home and to
provide education on trigger-reducing products. A child is limited to two home assessments
except that a child may receive an additional home assessment if the child moves to a new
home; if a new asthma trigger, including tobacco smoke, enters the home; or if the child's
health care provider identifies a new allergy for the child, including an allergy to mold,
pests, pets, or dust mites. The commissioner shall determine the frequency with which a
child may receive a product under paragraph (c) or (d) based on the reasonable expected
lifetime of the product.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 35.
Minnesota Statutes 2020, section 256B.0631, subdivision 1, is amended to read:
Subdivision 1.
Cost-sharing.
(a) Except as provided in subdivision 2, the medical
assistance benefit plan shall include the following cost-sharing for all recipients, effective
for services provided on or after September 1, 2011:
(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes of this
subdivision, a visit means an episode of service which is required because of a recipient's
symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting
by a physician or physician assistant, chiropractor, podiatrist, nurse midwife, advanced
practice nurse, audiologist, optician, or optometrist;
(2) $3.50 for nonemergency visits to a hospital-based emergency room, except that this
co-payment shall be increased to $20 upon federal approval;
(3) $3 per brand-name drug prescription and $1 per generic drug prescription, subject
to a $12 per month maximum for prescription drug co-payments. No co-payments shall
apply to antipsychotic drugs when used for the treatment of mental illnessnew text begin . No co-payments
shall apply to medications when used for the prevention or treatment of the human
immunodeficiency virus (HIV)new text end ;
(4) a family deductible equal to $2.75 per month per family and adjusted annually by
the percentage increase in the medical care component of the CPI-U for the period of
September to September of the preceding calendar year, rounded to the next higher five-cent
increment; and
(5) total monthly cost-sharing must not exceed five percent of family income. For
purposes of this paragraph, family income is the total earned and unearned income of the
individual and the individual's spouse, if the spouse is enrolled in medical assistance and
also subject to the five percent limit on cost-sharing. This paragraph does not apply to
premiums charged to individuals described under section 256B.057, subdivision 9.
(b) Recipients of medical assistance are responsible for all co-payments and deductibles
in this subdivision.
(c) Notwithstanding paragraph (b), the commissioner, through the contracting process
under sections 256B.69 and 256B.692, may allow managed care plans and county-based
purchasing plans to waive the family deductible under paragraph (a), clause (4). The value
of the family deductible shall not be included in the capitation payment to managed care
plans and county-based purchasing plans. Managed care plans and county-based purchasing
plans shall certify annually to the commissioner the dollar value of the family deductible.
(d) Notwithstanding paragraph (b), the commissioner may waive the collection of the
family deductible described under paragraph (a), clause (4), from individuals and allow
long-term care and waivered service providers to assume responsibility for payment.
(e) Notwithstanding paragraph (b), the commissioner, through the contracting process
under section 256B.0756 shall allow the pilot program in Hennepin County to waive
co-payments. The value of the co-payments shall not be included in the capitation payment
amount to the integrated health care delivery networks under the pilot program.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, subject to federal
approval. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 36.
Minnesota Statutes 2020, section 256B.0638, subdivision 3, is amended to read:
Subd. 3.
Opioid prescribing work group.
(a) The commissioner of human services, in
consultation with the commissioner of health, shall appoint the following voting members
to an opioid prescribing work group:
(1) two consumer members who have been impacted by an opioid abuse disorder or
opioid dependence disorder, either personally or with family members;
(2) one member who is a licensed physician actively practicing in Minnesota and
registered as a practitioner with the DEA;
(3) one member who is a licensed pharmacist actively practicing in Minnesota and
registered as a practitioner with the DEA;
(4) one member who is a licensed nurse practitioner actively practicing in Minnesota
and registered as a practitioner with the DEA;
(5) one member who is a licensed dentist actively practicing in Minnesota and registered
as a practitioner with the DEA;
(6) two members who are nonphysician licensed health care professionals actively
engaged in the practice of their profession in Minnesota, and their practice includes treating
pain;
(7) one member who is a mental health professional who is licensed or registered in a
mental health profession, who is actively engaged in the practice of that profession in
Minnesota, and whose practice includes treating patients with chemical dependency or
substance abuse;
(8) one member who is a medical examiner for a Minnesota county;
(9) one member of the Health Services Policy Committee established under section
256B.0625, subdivisions 3c to 3e;
(10) one member who is a medical director of a health plan company doing business in
Minnesota;
(11) one member who is a pharmacy director of a health plan company doing business
in Minnesota; deleted text begin and
deleted text end
(12) one member representing Minnesota law enforcementdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(13) two consumer members who are Minnesota residents and who have used or are
using opioids to manage chronic pain.
new text end
(b) In addition, the work group shall include the following nonvoting members:
(1) the medical director for the medical assistance program;
(2) a member representing the Department of Human Services pharmacy unit; deleted text begin and
deleted text end
(3) the medical director for the Department of Labor and Industrydeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(4) a member representing the Minnesota Department of Health.
new text end
(c) An honorarium of $200 per meeting and reimbursement for mileage and parking
shall be paid to each voting member in attendance.
Sec. 37.
Minnesota Statutes 2020, section 256B.0638, subdivision 5, is amended to read:
Subd. 5.
Program implementation.
(a) The commissioner shall implement the programs
within the Minnesota health care program to improve the health of and quality of care
provided to Minnesota health care program enrollees. The commissioner shall annually
collect and report tonew text begin provider groups the sentinel measures of data showing individualnew text end opioid
deleted text begin prescribers data showing the sentinel measures of theirdeleted text end new text begin prescribers'new text end opioid prescribing
patterns compared to their anonymized peers.new text begin Provider groups shall distribute data to their
affiliated, contracted, or employed opioid prescribers.
new text end
(b) The commissioner shall notify an opioid prescriber and all provider groups with
which the opioid prescriber is employed or affiliated when the opioid prescriber's prescribing
pattern exceeds the opioid quality improvement standard thresholds. An opioid prescriber
and any provider group that receives a notice under this paragraph shall submit to the
commissioner a quality improvement plan for review and approval by the commissioner
with the goal of bringing the opioid prescriber's prescribing practices into alignment with
community standards. A quality improvement plan must include:
(1) components of the program described in subdivision 4, paragraph (a);
(2) internal practice-based measures to review the prescribing practice of the opioid
prescriber and, where appropriate, any other opioid prescribers employed by or affiliated
with any of the provider groups with which the opioid prescriber is employed or affiliated;
and
(3) appropriate use of the prescription monitoring program under section 152.126.
(c) If, after a year from the commissioner's notice under paragraph (b), the opioid
prescriber's prescribing practices do not improve so that they are consistent with community
standards, the commissioner shall take one or more of the following steps:
(1) monitor prescribing practices more frequently than annually;
(2) monitor more aspects of the opioid prescriber's prescribing practices than the sentinel
measures; or
(3) require the opioid prescriber to participate in additional quality improvement efforts,
including but not limited to mandatory use of the prescription monitoring program established
under section 152.126.
(d) The commissioner shall terminate from Minnesota health care programs all opioid
prescribers and provider groups whose prescribing practices fall within the applicable opioid
disenrollment standards.
Sec. 38.
Minnesota Statutes 2020, section 256B.0638, subdivision 6, is amended to read:
Subd. 6.
Data practices.
(a) Reports and data identifying an opioid prescriber are private
data on individuals as defined under section 13.02, subdivision 12, until an opioid prescriber
is subject to termination as a medical assistance provider under this section. Notwithstanding
this data classification, the commissioner shall share with all of the provider groups with
which an opioid prescriber is employednew text begin , contracted,new text end or affiliated, deleted text begin a report identifying an
opioid prescriber who is subject to quality improvement activitiesdeleted text end new text begin the datanew text end under subdivision
5, paragraphnew text begin (a),new text end (b)new text begin ,new text end or (c).
(b) Reports and data identifying a provider group are nonpublic data as defined under
section 13.02, subdivision 9, until the provider group is subject to termination as a medical
assistance provider under this section.
(c) Upon termination under this section, reports and data identifying an opioid prescriber
or provider group are public, except that any identifying information of Minnesota health
care program enrollees must be redacted by the commissioner.
Sec. 39.
Minnesota Statutes 2020, section 256B.0659, subdivision 13, is amended to read:
Subd. 13.
Qualified professional; qualifications.
(a) The qualified professional must
work for a personal care assistance provider agency, meet the definition of qualified
professional under section 256B.0625, subdivision 19c, deleted text begin and enroll with the department as
a qualified professional after clearingdeleted text end new text begin clearnew text end a background studynew text begin , and meet provider training
requirementsnew text end . Before a qualified professional provides services, the personal care assistance
provider agency must initiate a background study on the qualified professional under chapter
245C, and the personal care assistance provider agency must have received a notice from
the commissioner that the qualified professional:
(1) is not disqualified under section 245C.14; or
(2) is disqualified, but the qualified professional has received a set aside of the
disqualification under section 245C.22.
(b) The qualified professional shall perform the duties of training, supervision, and
evaluation of the personal care assistance staff and evaluation of the effectiveness of personal
care assistance services. The qualified professional shall:
(1) develop and monitor with the recipient a personal care assistance care plan based on
the service plan and individualized needs of the recipient;
(2) develop and monitor with the recipient a monthly plan for the use of personal care
assistance services;
(3) review documentation of personal care assistance services provided;
(4) provide training and ensure competency for the personal care assistant in the individual
needs of the recipient; and
(5) document all training, communication, evaluations, and needed actions to improve
performance of the personal care assistants.
(c) deleted text begin Effective July 1, 2011,deleted text end The qualified professional shall complete the provider training
with basic information about the personal care assistance program approved by the
commissioner. Newly hired qualified professionals must complete the training within six
months of the date hired by a personal care assistance provider agency. Qualified
professionals who have completed the required training as a worker from a personal care
assistance provider agency do not need to repeat the required training if they are hired by
another agency, if they have completed the training within the last three years. The required
training must be available with meaningful access according to title VI of the Civil Rights
Act and federal regulations adopted under that law or any guidance from the United States
Health and Human Services Department. The required training must be available online or
by electronic remote connection. The required training must provide for competency testing
to demonstrate an understanding of the content without attending in-person training. A
qualified professional is allowed to be employed and is not subject to the training requirement
until the training is offered online or through remote electronic connection. A qualified
professional employed by a personal care assistance provider agency certified for
participation in Medicare as a home health agency is exempt from the training required in
this subdivision. When available, the qualified professional working for a Medicare-certified
home health agency must successfully complete the competency test. The commissioner
shall ensure there is a mechanism in place to verify the identity of persons completing the
competency testing electronically.
Sec. 40.
Minnesota Statutes 2020, section 256B.196, subdivision 2, is amended to read:
Subd. 2.
Commissioner's duties.
(a) For the purposes of this subdivision and subdivision
3, the commissioner shall determine the fee-for-service outpatient hospital services upper
payment limit for nonstate government hospitals. The commissioner shall then determine
the amount of a supplemental payment to Hennepin County Medical Center and Regions
Hospital for these services that would increase medical assistance spending in this category
to the aggregate upper payment limit for all nonstate government hospitals in Minnesota.
In making this determination, the commissioner shall allot the available increases between
Hennepin County Medical Center and Regions Hospital based on the ratio of medical
assistance fee-for-service outpatient hospital payments to the two facilities. The commissioner
shall adjust this allotment as necessary based on federal approvals, the amount of
intergovernmental transfers received from Hennepin and Ramsey Counties, and other factors,
in order to maximize the additional total payments. The commissioner shall inform Hennepin
County and Ramsey County of the periodic intergovernmental transfers necessary to match
federal Medicaid payments available under this subdivision in order to make supplementary
medical assistance payments to Hennepin County Medical Center and Regions Hospital
equal to an amount that when combined with existing medical assistance payments to
nonstate governmental hospitals would increase total payments to hospitals in this category
for outpatient services to the aggregate upper payment limit for all hospitals in this category
in Minnesota. Upon receipt of these periodic transfers, the commissioner shall make
supplementary payments to Hennepin County Medical Center and Regions Hospital.
(b) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for physicians and other billing professionals affiliated
with Hennepin County Medical Center and with Regions Hospital. The upper payment limit
shall be based on the average commercial rate or be determined using another method
acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall
inform Hennepin County and Ramsey County of the periodic intergovernmental transfers
necessary to match the federal Medicaid payments available under this subdivision in order
to make supplementary payments to physicians and other billing professionals affiliated
with Hennepin County Medical Center and to make supplementary payments to physicians
and other billing professionals affiliated with Regions Hospital through HealthPartners
Medical Group equal to the difference between the established medical assistance payment
for physician and other billing professional services and the upper payment limit. Upon
receipt of these periodic transfers, the commissioner shall make supplementary payments
to physicians and other billing professionals affiliated with Hennepin County Medical Center
and shall make supplementary payments to physicians and other billing professionals
affiliated with Regions Hospital through HealthPartners Medical Group.
(c) Beginning January 1, 2010, deleted text begin Hennepin County anddeleted text end Ramsey County may make monthly
voluntary intergovernmental transfers to the commissioner in amounts not to exceed
deleted text begin $12,000,000 per year from Hennepin County anddeleted text end $6,000,000 per year deleted text begin from Ramsey Countydeleted text end .
The commissioner shall increase the medical assistance capitation payments to any licensed
health plan under contract with the medical assistance program that agrees to make enhanced
payments to deleted text begin Hennepin County Medical Center ordeleted text end Regions Hospital. The increase shall be
in an amount equal to the annual value of the monthly transfers plus federal financial
participation, with each health plan receiving its pro rata share of the increase based on the
pro rata share of medical assistance admissions to deleted text begin Hennepin County Medical Center anddeleted text end
Regions Hospital by those plans. For the purposes of this paragraph, "the base amount"
means the total annual value of increased medical assistance capitation payments, including
the voluntary intergovernmental transfers, under this paragraph in calendar year 2017. For
managed care contracts beginning on or after January 1, 2018, the commissioner shall reduce
the total annual value of increased medical assistance capitation payments under this
paragraph by an amount equal to ten percent of the base amount, and by an additional ten
percent of the base amount for each subsequent contract year until December 31, 2025.
Upon the request of the commissioner, health plans shall submit individual-level cost data
for verification purposes. The commissioner may ratably reduce these payments on a pro
rata basis in order to satisfy federal requirements for actuarial soundness. If payments are
reduced, transfers shall be reduced accordingly. Any licensed health plan that receives
increased medical assistance capitation payments under the intergovernmental transfer
described in this paragraph shall increase its medical assistance payments to deleted text begin Hennepin
County Medical Center anddeleted text end Regions Hospital by the same amount as the increased payments
received in the capitation payment described in this paragraph. This paragraph expires
January 1, 2026.
(d) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for ambulance services affiliated with Hennepin County
Medical Center and the city of St. Paul, and ambulance services owned and operated by
another governmental entity that chooses to participate by requesting the commissioner to
determine an upper payment limit. The upper payment limit shall be based on the average
commercial rate or be determined using another method acceptable to the Centers for
Medicare and Medicaid Services. The commissioner shall inform Hennepin County, the
city of St. Paul, and other participating governmental entities of the periodic
intergovernmental transfers necessary to match the federal Medicaid payments available
under this subdivision in order to make supplementary payments to Hennepin County
Medical Center, the city of St. Paul, and other participating governmental entities equal to
the difference between the established medical assistance payment for ambulance services
and the upper payment limit. Upon receipt of these periodic transfers, the commissioner
shall make supplementary payments to Hennepin County Medical Center, the city of St.
Paul, and other participating governmental entities. A tribal government that owns and
operates an ambulance service is not eligible to participate under this subdivision.
(e) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for physicians, dentists, and other billing professionals
affiliated with the University of Minnesota and University of Minnesota Physicians. The
upper payment limit shall be based on the average commercial rate or be determined using
another method acceptable to the Centers for Medicare and Medicaid Services. The
commissioner shall inform the University of Minnesota Medical School and University of
Minnesota School of Dentistry of the periodic intergovernmental transfers necessary to
match the federal Medicaid payments available under this subdivision in order to make
supplementary payments to physicians, dentists, and other billing professionals affiliated
with the University of Minnesota and the University of Minnesota Physicians equal to the
difference between the established medical assistance payment for physician, dentist, and
other billing professional services and the upper payment limit. Upon receipt of these periodic
transfers, the commissioner shall make supplementary payments to physicians, dentists,
and other billing professionals affiliated with the University of Minnesota and the University
of Minnesota Physicians.
(f) The commissioner shall inform the transferring governmental entities on an ongoing
basis of the need for any changes needed in the intergovernmental transfers in order to
continue the payments under paragraphs (a) to (e), at their maximum level, including
increases in upper payment limits, changes in the federal Medicaid match, and other factors.
(g) The payments in paragraphs (a) to (e) shall be implemented independently of each
other, subject to federal approval and to the receipt of transfers under subdivision 3.
(h) All of the data and funding transactions related to the payments in paragraphs (a) to
(e) shall be between the commissioner and the governmental entities.
(i) For purposes of this subdivision, billing professionals are limited to physicians, nurse
practitioners, nurse midwives, clinical nurse specialists, physician assistants,
anesthesiologists, certified registered nurse anesthetists, dentists, dental hygienists, and
dental therapists.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval
of both this section and Minnesota Statutes, section 256B.1973, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end
Sec. 41.
new text begin
[256B.1973] DIRECTED PAYMENT ARRANGEMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For the purposes of this section, the following terms have
the meanings given them.
new text end
new text begin
(b) "Billing professionals" means physicians, nurse practitioners, nurse midwives, clinical
nurse specialists, physician assistants, anesthesiologists, and certified registered anesthetists,
and may include dentists, individually enrolled dental hygienists, and dental therapists.
new text end
new text begin
(c) "Health plan" means a managed care or county-based purchasing plan that is under
contract with the commissioner to deliver services to medical assistance enrollees under
section 256B.69.
new text end
new text begin
(d) "High medical assistance utilization" means a medical assistance utilization rate
equal to the standard established in section 256.969, subdivision 9, paragraph (d), clause
(6).
new text end
new text begin Subd. 2. new text end
new text begin Federal approval required. new text end
new text begin
Each directed payment arrangement under this
section is contingent on federal approval and must conform with the requirements for
permissible directed managed care organization expenditures under section 256B.6928,
subdivision 5.
new text end
new text begin Subd. 3. new text end
new text begin Eligible providers. new text end
new text begin
Eligible providers under this section are nonstate government
teaching hospitals with high medical assistance utilization and a level 1 trauma center and
the hospital's affiliated billing professionals, ambulance services, and clinics.
new text end
new text begin Subd. 4. new text end
new text begin Voluntary intergovernmental transfers. new text end
new text begin
A nonstate governmental entity that
is eligible to perform intergovernmental transfers may make voluntary intergovernmental
transfers to the commissioner. The commissioner shall inform the nonstate governmental
entity of the intergovernmental transfers necessary to maximize the allowable directed
payments.
new text end
new text begin Subd. 5. new text end
new text begin Commissioner's duties; state-directed fee schedule requirement. new text end
new text begin
(a) For
each federally approved directed payment arrangement that is a state-directed fee schedule
requirement, the commissioner shall determine a uniform adjustment factor to be applied
to each claim submitted by an eligible provider to a health plan. The uniform adjustment
factor shall be determined using the average commercial payer rate or using another method
acceptable to the Centers for Medicare and Medicaid Services if the average commercial
payer rate is not approved, minus the amount necessary for the plan to satisfy tax liabilities
under sections 256.9657 and 297I.05 attributable to the directed payment arrangement. The
commissioner shall ensure that the application of the uniform adjustment factor maximizes
the allowable directed payments and does not result in payments exceeding federal limits,
and may use an annual settle-up process. The directed payment shall be specific to each
health plan and prospectively incorporated into capitation payments for that plan.
new text end
new text begin
(b) For each federally approved directed payment arrangement that is a state-directed
fee schedule requirement, the commissioner shall develop a plan for the initial
implementation of the state-directed fee schedule requirement to ensure that the eligible
provider receives the entire permissible value of the federally approved directed payment
arrangement. If federal approval of a directed payment arrangement under this subdivision
is retroactive, the commissioner shall make a onetime pro rata increase to the uniform
adjustment factor and the initial payments in order to include claims submitted between the
retroactive federal approval date and the period captured by the initial payments.
new text end
new text begin Subd. 6. new text end
new text begin Health plan duties; submission of claims. new text end
new text begin
In accordance with its contract,
each health plan shall submit to the commissioner payment information for each claim paid
to an eligible provider for services provided to a medical assistance enrollee.
new text end
new text begin Subd. 7. new text end
new text begin Health plan duties; directed payments. new text end
new text begin
In accordance with its contract, each
health plan shall make directed payments to the eligible provider in an amount equal to the
payment amounts the plan received from the commissioner.
new text end
new text begin Subd. 8. new text end
new text begin State quality goals. new text end
new text begin
The directed payment arrangement and state-directed fee
schedule requirement must align the state quality goals to Hennepin Healthcare medical
assistance patients, including unstably housed individuals, those with higher levels of social
and clinical risk, limited English proficiency (LEP) patients, adults with serious chronic
conditions, and individuals of color. The directed payment arrangement must maintain
quality and access to a full range of health care delivery mechanisms for these patients that
may include behavioral health, emergent care, preventive care, hospitalization, transportation,
interpreter services, and pharmaceutical services. The commissioner, in consultation with
Hennepin Healthcare, shall submit to the Centers for Medicare and Medicaid Services a
methodology to measure access to care and the achievement of state quality goals.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later, unless the federal approval provides for an effective date that is before
the date the federal approval was issued, including a retroactive effective date, in which
case this section is effective retroactively from the federally approved effective date. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end
Sec. 42.
Minnesota Statutes 2020, section 256B.69, subdivision 6d, is amended to read:
Subd. 6d.
Prescription drugs.
The commissioner deleted text begin maydeleted text end new text begin shallnew text end exclude deleted text begin or modifydeleted text end coverage
for new text begin outpatient new text end prescription drugs new text begin dispensed by a pharmacy to a member eligible for medical
assistance under this chapter new text end from the prepaid managed care contracts entered into under
this section deleted text begin in order to increase savings to the state by collecting additional prescription
drug rebates. The contracts must maintain incentives for the managed care plan to manage
drug costs and utilization and may require that the managed care plans maintain an open
drug formulary. In order to manage drug costs and utilization, the contracts may authorize
the managed care plans to use preferred drug lists and prior authorization. This subdivision
is contingent on federal approval of the managed care contract changes and the collection
of additional prescription drug rebatesdeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2023, or upon completion of
the Medicaid Management Information System pharmacy module modernization project,
whichever is later. The commissioner shall notify the revisor of statutes when the project
is completed.
new text end
Sec. 43.
Minnesota Statutes 2020, section 256B.69, is amended by adding a subdivision
to read:
new text begin Subd. 9f. new text end
new text begin Annual report on provider reimbursement rates. new text end
new text begin
(a) The commissioner,
by December 15 of each year, shall submit to the chairs and ranking minority members of
the legislative committees with jurisdiction over health care policy and finance a report on
managed care and county-based purchasing plan provider reimbursement rates. The report
must comply with sections 3.195 and 3.197.
new text end
new text begin
(b) The report must include, for each managed care and county-based purchasing plan,
the mean and median provider reimbursement rates by county for the calendar year preceding
the reporting year, for the five most common billing codes statewide across all plans, in
each of the following provider service categories:
new text end
new text begin
(1) physician services - prenatal and preventive;
new text end
new text begin
(2) physician services - nonprenatal and nonpreventive;
new text end
new text begin
(3) dental services;
new text end
new text begin
(4) inpatient hospital services;
new text end
new text begin
(5) outpatient hospital services; and
new text end
new text begin
(6) mental health services.
new text end
new text begin
(c) The commissioner shall also include in the report:
new text end
new text begin
(1) the mean and median reimbursement rates across all plans by county for the calendar
year preceding the reporting year for the billing codes and provider service categories
described in paragraph (b); and
new text end
new text begin
(2) the mean and median fee-for-service reimbursement rates by county for the calendar
year preceding the reporting year for the billing codes and provider service categories
described in paragraph (b).
new text end
Sec. 44.
Minnesota Statutes 2020, section 256B.69, is amended by adding a subdivision
to read:
new text begin Subd. 9g. new text end
new text begin
Annual report on prepaid health plan reimbursement to 340B covered
entities.
new text end
new text begin
(a) By March 1 of each year, each managed care and county-based purchasing plan
shall report to the commissioner its reimbursement to 340B covered entities for the previous
calendar year. The report must include:
new text end
new text begin
(1) the National Provider Identification (NPI) number for each 340B covered entity;
new text end
new text begin
(2) the name of each 340B covered entity;
new text end
new text begin
(3) the servicing address of each 340B covered entity; and
new text end
new text begin
(4) either: (i) the number of outpatient 340B pharmacy claims and reimbursement
amounts; or (ii) the number of professional or facility 340B claim lines and reimbursement
amounts.
new text end
new text begin
(b) The commissioner shall submit a copy of the reports to the chairs and ranking minority
members of the legislative committees with jurisdiction over health care policy and finance
by April 1 of each year.
new text end
Sec. 45.
Minnesota Statutes 2020, section 256B.6928, subdivision 5, is amended to read:
Subd. 5.
Direction of managed care organization expenditures.
(a) The commissioner
shall not direct managed care organizations expenditures under the managed care contract,
except deleted text begin indeleted text end new text begin as permitted under Code of Federal Regulations, part 42, section 438.6(c). The
exception under this paragraph includesnew text end the following situations:
(1) implementation of a value-based purchasing model for provider reimbursement,
including pay-for-performance arrangements, bundled payments, or other service payments
intended to recognize value or outcomes over volume of services;
(2) participation in a multipayer or medical assistance-specific delivery system reform
or performance improvement initiative; or
(3) implementation of a minimum or maximum fee schedule, or a uniform dollar or
percentage increase for network providers that provide a particular service. The maximum
fee schedule must allow the managed care organization the ability to reasonably manage
risk and provide discretion in accomplishing the goals of the contract.
(b) Any managed care contract that directs managed care organization expenditures as
permitted under paragraph (a), clauses (1) to (3), must be developed in accordance with
Code of Federal Regulations, part 42, sections 438.4 and 438.5; comply with actuarial
soundness and generally accepted actuarial principles and practices; and have written
approval from the Centers for Medicare and Medicaid Services before implementation. To
obtain approval, the commissioner shall demonstrate in writing that the contract arrangement:
(1) is based on the utilization and delivery of services;
(2) directs expenditures equally, using the same terms of performance for a class of
providers providing service under the contract;
(3) is intended to advance at least one of the goals and objectives in the commissioner's
quality strategy;
(4) has an evaluation plan that measures the degree to which the arrangement advances
at least one of the goals in the commissioner's quality strategy;
(5) does not condition network provider participation on the network provider entering
into or adhering to an intergovernmental transfer agreement; and
(6) is not renewed automatically.
(c) For contract arrangements identified in paragraph (a), clauses (1) and (2), the
commissioner shall:
(1) make participation in the value-based purchasing model, special delivery system
reform, or performance improvement initiative available, using the same terms of
performance, to a class of providers providing services under the contract related to the
model, reform, or initiative; and
(2) use a common set of performance measures across all payers and providers.
(d) The commissioner shall not set the amount or frequency of the expenditures or recoup
from the managed care organization any unspent funds allocated for these arrangements.
Sec. 46.
Minnesota Statutes 2020, section 256B.75, is amended to read:
256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
(a) For outpatient hospital facility fee payments for services rendered on or after October
1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge,
or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for
which there is a federal maximum allowable payment. Effective for services rendered on
or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and
emergency room facility fees shall be increased by eight percent over the rates in effect on
December 31, 1999, except for those services for which there is a federal maximum allowable
payment. Services for which there is a federal maximum allowable payment shall be paid
at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total
aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare
upper limit. If it is determined that a provision of this section conflicts with existing or
future requirements of the United States government with respect to federal financial
participation in medical assistance, the federal requirements prevail. The commissioner
may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial
participation resulting from rates that are in excess of the Medicare upper limitations.
(b) new text begin (1) new text end Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory
surgery hospital facility fee services for critical access hospitals designated under section
144.1483, clause (9), shall be paid on a cost-based payment system that is based on the
cost-finding methods and allowable costs of the Medicare program. Effective for services
provided on or after July 1, 2015, rates established for critical access hospitals under this
paragraph for the applicable payment year shall be the final payment and shall not be settled
to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal
year ending in 2017, the rate for outpatient hospital services shall be computed using
information from each hospital's Medicare cost report as filed with Medicare for the year
that is two years before the year that the rate is being computed. Rates shall be computed
using information from Worksheet C series until the department finalizes the medical
assistance cost reporting process for critical access hospitals. After the cost reporting process
is finalized, rates shall be computed using information from Title XIX Worksheet D series.
The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs
related to rural health clinics and federally qualified health clinics, divided by ancillary
charges plus outpatient charges, excluding charges related to rural health clinics and federally
qualified health clinics.
new text begin
(2) Effective for services provided on or after January 1, 2023, the rate described in
clause (1) shall be increased for hospitals providing high levels of high-cost drugs or 340B
drugs. The rate adjustment shall be based on each hospital's share of the total reimbursement
for 340B drugs to all critical access hospitals, but shall not exceed three percentage points.
new text end
(c) Effective for services provided on or after July 1, 2003, rates that are based on the
Medicare outpatient prospective payment system shall be replaced by a budget neutral
prospective payment system that is derived using medical assistance data. The commissioner
shall provide a proposal to the 2003 legislature to define and implement this provision.new text begin
When implementing prospective payment methodologies, the commissioner shall use general
methods and rate calculation parameters similar to the applicable Medicare prospective
payment systems for services delivered in outpatient hospital and ambulatory surgical center
settings unless other payment methodologies for these services are specified in this chapter.
new text end
(d) For fee-for-service services provided on or after July 1, 2002, the total payment,
before third-party liability and spenddown, made to hospitals for outpatient hospital facility
services is reduced by .5 percent from the current statutory rate.
(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility
services before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from
this paragraph.
(f) In addition to the reductions in paragraphs (d) and (e), the total payment for
fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
hospital facility services before third-party liability and spenddown, is reduced three percent
from the current statutory rates. Mental health services and facilities defined under section
256.969, subdivision 16, are excluded from this paragraph.
Sec. 47.
Minnesota Statutes 2020, section 256B.76, subdivision 2, is amended to read:
Subd. 2.
Dental reimbursement.
(a) Effective for services rendered on or after October
1, 1992new text begin , through December 31, 2022new text end , the commissioner shall make payments for dental
services as follows:
(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent
above the rate in effect on June 30, 1992; and
(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile
of 1989, less the percent in aggregate necessary to equal the above increases.
(b) Beginning October 1, 1999new text begin , through December 31, 2022new text end , the payment for tooth
sealants and fluoride treatments shall be the lower of (1) submitted charge, or (2) 80 percent
of median 1997 charges.
(c) Effective for services rendered on or after January 1, 2000new text begin , through December 31,
2022new text end , payment rates for dental services shall be increased by three percent over the rates in
effect on December 31, 1999.
(d) Effective for services provided on or after January 1, 2002new text begin , through December 31,
2022new text end , payment for diagnostic examinations and dental x-rays provided to children under
age 21 shall be the lower of (1) the submitted charge, or (2) 85 percent of median 1999
charges.
(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000,
for managed care.
(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated
dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare
principles of reimbursement. This payment shall be effective for services rendered on or
after January 1, 2011, to recipients enrolled in managed care plans or county-based
purchasing plans.
(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in
paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a
supplemental state payment equal to the difference between the total payments in paragraph
(f) and $1,850,000 shall be paid from the general fund to state-operated services for the
operation of the dental clinics.
(h) If the cost-based payment system for state-operated dental clinics described in
paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
designated as critical access dental providers under subdivision 4, paragraph (b), and shall
receive the critical access dental reimbursement rate as described under subdivision 4,
paragraph (a).
deleted text begin
(i) Effective for services rendered on or after September 1, 2011, through June 30, 2013,
payment rates for dental services shall be reduced by three percent. This reduction does not
apply to state-operated dental clinics in paragraph (f).
deleted text end
deleted text begin (j)deleted text end new text begin (i)new text end Effective for services rendered on or after January 1, 2014new text begin , through December 31,
2022new text end , payment rates for dental services shall be increased by five percent from the rates in
effect on December 31, 2013. This increase does not apply to state-operated dental clinics
in paragraph (f), federally qualified health centers, rural health centers, and Indian health
services. Effective January 1, 2014, payments made to managed care plans and county-based
purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment
increase described in this paragraph.
deleted text begin
(k) Effective for services rendered on or after July 1, 2015, through December 31, 2016,
the commissioner shall increase payment rates for services furnished by dental providers
located outside of the seven-county metropolitan area by the maximum percentage possible
above the rates in effect on June 30, 2015, while remaining within the limits of funding
appropriated for this purpose. This increase does not apply to state-operated dental clinics
in paragraph (f), federally qualified health centers, rural health centers, and Indian health
services. Effective January 1, 2016, through December 31, 2016, payments to managed care
plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect
the payment increase described in this paragraph. The commissioner shall require managed
care and county-based purchasing plans to pass on the full amount of the increase, in the
form of higher payment rates to dental providers located outside of the seven-county
metropolitan area.
deleted text end
deleted text begin (l)deleted text end new text begin (j)new text end Effective for services provided on or after January 1, 2017new text begin , through December 31,
2022new text end , the commissioner shall increase payment rates by 9.65 percent for dental services
provided outside of the seven-county metropolitan area. This increase does not apply to
state-operated dental clinics in paragraph (f), federally qualified health centers, rural health
centers, or Indian health services. Effective January 1, 2017, payments to managed care
plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect
the payment increase described in this paragraph.
deleted text begin (m)deleted text end new text begin (k)new text end Effective for services provided on or after July 1, 2017new text begin , through December 31,
2022new text end , the commissioner shall increase payment rates by 23.8 percent for dental services
provided to enrollees under the age of 21. This rate increase does not apply to state-operated
dental clinics in paragraph (f), federally qualified health centers, rural health centers, or
Indian health centers. This rate increase does not apply to managed care plans and
county-based purchasing plans.
new text begin
(l) Effective for services provided on or after January 1, 2023, payment for dental services
shall be the lower of the submitted charge, or the ....... percentile of 2018 submitted charges
from claims paid by the commissioner. This paragraph does not apply to federally qualified
health centers, rural health centers, state-operated dental clinics, or Indian health centers.
new text end
new text begin
(m) Beginning January 1, 2026, and every four years thereafter, the commissioner shall
rebase payment rates for dental services to the first percentile of submitted charges for the
applicable base year using charge data from paid claims submitted by providers. The
commissioner shall increase this payment amount by 20 percent for providers designated
as critical access dental providers under medical assistance and MinnesotaCare. The critical
access dental provider payment add-on shall be calculated to be specific to each individual
clinic location within a larger system. The base year used for each rebasing shall be the
calendar year that is two years prior to the effective date of the rebasing.
new text end
Sec. 48.
Minnesota Statutes 2020, section 256B.76, subdivision 4, is amended to read:
Subd. 4.
Critical access dental providers.
(a) The commissioner shall increase
reimbursements to dentists and dental clinics deemed by the commissioner to be critical
access dental providers. For dental services rendered on or after July 1, 2016new text begin , through
December 31, 2022new text end , the commissioner shall increase reimbursement by 37.5 percent above
the reimbursement rate that would otherwise be paid to the critical access dental provider,
except as specified under paragraph (b). The commissioner shall pay the managed care
plans and county-based purchasing plans in amounts sufficient to reflect increased
reimbursements to critical access dental providers as approved by the commissioner.
(b) For dental services rendered on or after July 1, 2016new text begin , through December 31, 2022new text end ,
by a dental clinic or dental group that meets the critical access dental provider designation
under paragraph (d), clause (4), and is owned and operated by a health maintenance
organization licensed under chapter 62D, the commissioner shall increase reimbursement
by 35 percent above the reimbursement rate that would otherwise be paid to the critical
access provider.
(c) Critical access dental payments made under paragraph (a) or (b) for dental services
provided by a critical access dental provider to an enrollee of a managed care plan or
county-based purchasing plan must not reflect any capitated payments or cost-based payments
from the managed care plan or county-based purchasing plan. The managed care plan or
county-based purchasing plan must base the additional critical access dental payment on
the amount that would have been paid for that service had the dental provider been paid
according to the managed care plan or county-based purchasing plan's fee schedule that
applies to dental providers that are not paid under a capitated payment or cost-based payment.
(d) The commissioner shall designate the following dentists and dental clinics as critical
access dental providers:
(1) nonprofit community clinics that:
(i) have nonprofit status in accordance with chapter 317A;
(ii) have tax exempt status in accordance with the Internal Revenue Code, section
501(c)(3);
(iii) are established to provide oral health services to patients who are low income,
uninsured, have special needs, and are underserved;
(iv) have professional staff familiar with the cultural background of the clinic's patients;
(v) charge for services on a sliding fee scale designed to provide assistance to low-income
patients based on current poverty income guidelines and family size;
(vi) do not restrict access or services because of a patient's financial limitations or public
assistance status; and
(vii) have free care available as needed;
(2) federally qualified health centers, rural health clinics, and public health clinics;
(3) hospital-based dental clinics owned and operated by a city, county, or former state
hospital as defined in section 62Q.19, subdivision 1, paragraph (a), clause (4);
(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
accordance with chapter 317A with more than 10,000 patient encounters per year with
patients who are uninsured or covered by medical assistance or MinnesotaCare;
(5) a dental clinic owned and operated by the University of Minnesota or the Minnesota
State Colleges and Universities system; and
(6) private practicing dentists if:
(i) the dentist's office is located within the seven-county metropolitan area and more
than 50 percent of the dentist's patient encounters per year are with patients who are uninsured
or covered by medical assistance or MinnesotaCare; or
(ii) the dentist's office is located outside the seven-county metropolitan area and more
than 25 percent of the dentist's patient encounters per year are with patients who are uninsured
or covered by medical assistance or MinnesotaCare.
Sec. 49.
Minnesota Statutes 2020, section 256B.766, is amended to read:
256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
(a) Effective for services provided on or after July 1, 2009, total payments for basic care
services, shall be reduced by three percent, except that for the period July 1, 2009, through
June 30, 2011, total payments shall be reduced by 4.5 percent for the medical assistance
and general assistance medical care programs, prior to third-party liability and spenddown
calculation. Effective July 1, 2010, the commissioner shall classify physical therapy services,
occupational therapy services, and speech-language pathology and related services as basic
care services. The reduction in this paragraph shall apply to physical therapy services,
occupational therapy services, and speech-language pathology and related services provided
on or after July 1, 2010.
(b) Payments made to managed care plans and county-based purchasing plans shall be
reduced for services provided on or after October 1, 2009, to reflect the reduction effective
July 1, 2009, and payments made to the plans shall be reduced effective October 1, 2010,
to reflect the reduction effective July 1, 2010.
(c) Effective for services provided on or after September 1, 2011, through June 30, 2013,
total payments for outpatient hospital facility fees shall be reduced by five percent from the
rates in effect on August 31, 2011.
(d) Effective for services provided on or after September 1, 2011, through June 30, 2013,
total payments for ambulatory surgery centers facility fees, medical supplies and durable
medical equipment not subject to a volume purchase contract, prosthetics and orthotics,
renal dialysis services, laboratory services, public health nursing services, physical therapy
services, occupational therapy services, speech therapy services, eyeglasses not subject to
a volume purchase contract, hearing aids not subject to a volume purchase contract, and
anesthesia services shall be reduced by three percent from the rates in effect on August 31,
2011.
(e) Effective for services provided on or after September 1, 2014, payments for
ambulatory surgery centers facility fees, hospice services, renal dialysis services, laboratory
services, public health nursing services, eyeglasses not subject to a volume purchase contract,
and hearing aids not subject to a volume purchase contract shall be increased by three percent
and payments for outpatient hospital facility fees shall be increased by three percent.
Payments made to managed care plans and county-based purchasing plans shall not be
adjusted to reflect payments under this paragraph.
(f) Payments for medical supplies and durable medical equipment not subject to a volume
purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014, through
June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies and durable
medical equipment not subject to a volume purchase contract, and prosthetics and orthotics,
provided on or after July 1, 2015, shall be increased by three percent from the rates as
determined under paragraphs (i) and (j).
(g) Effective for services provided on or after July 1, 2015, payments for outpatient
hospital facility fees, medical supplies and durable medical equipment not subject to a
volume purchase contract, prosthetics, and orthotics to a hospital meeting the criteria specified
in section 62Q.19, subdivision 1, paragraph (a), clause (4), shall be increased by 90 percent
from the rates in effect on June 30, 2015. Payments made to managed care plans and
county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.
(h) This section does not apply to physician and professional services, inpatient hospital
services, family planning services, mental health services, dental services, prescription
drugs, medical transportation, federally qualified health centers, rural health centers, Indian
health services, and Medicare cost-sharing.
(i) Effective for services provided on or after July 1, 2015,new text begin through June 30, 2021,new text end the
following categories of medical supplies and durable medical equipment shall be individually
priced items: enteral nutrition and supplies, customized and other specialized tracheostomy
tubes and supplies, electric patient lifts, and durable medical equipment repair and service.
This paragraph does not apply to medical supplies and durable medical equipment subject
to a volume purchase contract, products subject to the preferred diabetic testing supply
program, and items provided to dually eligible recipients when Medicare is the primary
payer for the item. The commissioner shall not apply any medical assistance rate reductions
to durable medical equipment as a result of Medicare competitive biddingnew text begin through June 30,
2021new text end .
(j) Effective for services provided on or after July 1, 2015,new text begin through June 30, 2021,new text end
medical assistance payment rates for durable medical equipment, prosthetics, orthotics, or
supplies shall be increased as follows:
(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that
were subject to the Medicare competitive bid that took effect in January of 2009 shall be
increased by 9.5 percent; and
(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on
the medical assistance fee schedule, whether or not subject to the Medicare competitive bid
that took effect in January of 2009, shall be increased by 2.94 percent, with this increase
being applied after calculation of any increased payment rate under clause (1).
This paragraph does not apply to medical supplies and durable medical equipment subject
to a volume purchase contract, products subject to the preferred diabetic testing supply
program, items provided to dually eligible recipients when Medicare is the primary payer
for the item, and individually priced items identified in paragraph (i). Payments made to
managed care plans and county-based purchasing plans shall not be adjusted to reflect the
rate increases in this paragraph.
(k) Effective for nonpressure support ventilators provided on or after January 1, 2016,new text begin
through June 30, 2021,new text end the rate shall be the lower of the submitted charge or the Medicare
fee schedule rate. Effective for pressure support ventilators provided on or after January 1,
2016,new text begin through June 30, 2021,new text end the rate shall be the lower of the submitted charge or 47 percent
above the Medicare fee schedule rate. For payments made in accordance with this paragraph,
if, and to the extent that, the commissioner identifies that the state has received federal
financial participation for ventilators in excess of the amount allowed effective January 1,
2018, under United States Code, title 42, section 1396b(i)(27), the state shall repay the
excess amount to the Centers for Medicare and Medicaid Services with state funds and
maintain the full payment rate under this paragraph.
(l) Payment rates for durable medical equipment, prosthetics, orthotics or supplies, that
are subject to the upper payment limit in accordance with section 1903(i)(27) of the Social
Security Act, shall be paid the Medicare rate. Rate increases provided in this chapter shall
not be applied to the items listed in this paragraph.
new text begin
(m) Effective July 1, 2021, the payment rates for all durable medical equipment,
prosthetics, orthotics, or supplies, except pressure support ventilators, shall be the lesser of
the provider's submitted charges or the Medicare fee schedule amount, with no increases
or decreases described in paragraphs (a) to (k) applied. Pressure support ventilators shall
be paid the Medicare rate plus 47 percent.
new text end
new text begin
(n) Effective July 1, 2021, the payment rates for durable medical equipment, prosthetics,
orthotics, or supplies for which Medicare has not established a payment amount shall be
the lesser of the provider's submitted charges, or the alternative payment methodology rate
described in clauses (1) to (4) with no increases or decreases described in paragraphs (a) to
(k) applied.
new text end
new text begin
(1) The alternate payment methodology rate is calculated from either:
new text end
new text begin
(i) at least 100 paid claim lines, as priced under paragraph (o), submitted by at least ten
different providers within one calendar month; or
new text end
new text begin
(ii) at least 20 paid claim lines, as priced under paragraph (o), submitted by at least five
different providers within two consecutive quarters for services that are not paid 100 times
in a calendar month.
new text end
new text begin
(2) The alternate payment methodology rate is the mean of the payment per unit of the
claim lines, with the top and bottom ten percent of claim lines, by payment per unit, excluded
from the calculation of the mean.
new text end
new text begin
(3) The alternate payment methodology rate for the rate period will be added to the fee
schedule on the first day of a calendar month or the first day of a calendar quarter if claims
from more than one month were used to determine the rate. The alternate payment
methodology rates will be subject to Medicare's inflation or deflation factor on January 1
of each year unless the rate was calculated and posted to the fee schedule after July 1 of the
previous year.
new text end
new text begin
(4) Not more than once every three years, the alternate payment methodology rates must
be evaluated by the commissioner for reasonableness by reviewing invoices from at least
20 paid claim lines and five different providers for claims paid during one calendar month
or one quarter if necessary to obtain the required sample. If the evaluation identifies that
the alternate payment methodology rate is more than five percent higher or lower than the
provider's actual acquisition cost plus 20 percent, then the commissioner shall recalculate
and update the fee schedule according to clauses (1) to (3). If the evaluation does not show
that the alternate payment methodology fee schedule rate is five percent higher or lower
than the provider's actual acquisition cost plus 20 percent or a sufficient sample cannot be
collected due to low utilization as defined in clause (1), then the commissioner shall maintain
the previously calculated alternate payment methodology rate on the fee schedule.
new text end
new text begin
(o) Until sufficient data is available to calculate the alternative payment methodology,
the payment shall be based on the provider's actual acquisition cost plus 20 percent as
documented on an invoice submitted by the provider. The payment may be based on a quote
the provider received from a vendor showing the provider's actual acquisition cost only if
the durable medical equipment, prosthetic, orthotic, or supply requires authorization and
the rate is required to complete the authorization.
new text end
new text begin
(p) Notwithstanding paragraph (n), durable medical equipment and supplies billed using
miscellaneous codes, and for which no Medicare rate is available, shall be paid the provider's
actual acquisition cost plus ten percent.
new text end
Sec. 50.
Minnesota Statutes 2020, section 256B.767, is amended to read:
256B.767 MEDICARE PAYMENT LIMIT.
(a) Effective for services rendered on or after July 1, 2010, fee-for-service payment rates
for physician and professional services under section 256B.76, subdivision 1, and basic care
services subject to the rate reduction specified in section 256B.766, shall not exceed the
Medicare payment rate for the applicable service, as adjusted for any changes in Medicare
payment rates after July 1, 2010. The commissioner shall implement this section after any
other rate adjustment that is effective July 1, 2010, and shall reduce rates under this section
by first reducing or eliminating provider rate add-ons.
(b) This section does not apply to services provided by advanced practice certified nurse
midwives licensed under chapter 148 or traditional midwives licensed under chapter 147D.
Notwithstanding this exemption, medical assistance fee-for-service payment rates for
advanced practice certified nurse midwives and licensed traditional midwives shall equal
and shall not exceed the medical assistance payment rate to physicians for the applicable
service.
(c) This section does not apply to mental health services or physician services billed by
a psychiatrist or an advanced practice registered nurse with a specialty in mental health.
deleted text begin
(d) Effective July 1, 2015, this section shall not apply to durable medical equipment,
prosthetics, orthotics, or supplies.
deleted text end
deleted text begin (e)deleted text end new text begin (d)new text end This section does not apply to physical therapy, occupational therapy, speech
pathology and related services, and basic care services provided by a hospital meeting the
criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4).
Sec. 51.
Minnesota Statutes 2020, section 256B.79, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following terms have
the meanings given them.
(b) "Adverse outcomes" means maternal opiate addiction, other reportable prenatal
substance abuse, low birth weight, or preterm birth.
(c) "Qualified integrated perinatal care collaborative" or "collaborative" means a
combination of (1) members of community-based organizations that represent communities
within the identified targeted populations, and (2) local or tribally based service entities,
including health care, public health, social services, mental health, chemical dependency
treatment, and community-based providers, determined by the commissioner to meet the
criteria for the provision of integrated care and enhanced services for enrollees within
targeted populations.
(d) "Targeted populations" means pregnant medical assistance enrollees residing in
deleted text begin geographic areasdeleted text end new text begin communitiesnew text end identified by the commissioner as being at above-average
risk for adverse outcomes.
Sec. 52.
Minnesota Statutes 2020, section 256B.79, subdivision 3, is amended to read:
Subd. 3.
Grant awards.
The commissioner shall award grants to qualifying applicants
to support interdisciplinary, integrated perinatal care. Grant funds must be distributed through
a request for proposals process to a designated lead agency within an entity that has been
determined to be a qualified integrated perinatal care collaborative or within an entity in
the process of meeting the qualifications to become a qualified integrated perinatal care
collaborativedeleted text begin , and priority shall be given to qualified integrated perinatal care collaboratives
that received grants under this section prior to January 1, 2019deleted text end . Grant awards must be used
to support interdisciplinary, team-based needs assessments, planning, and implementation
of integrated care and enhanced services for targeted populations. In determining grant
award amounts, the commissioner shall consider the identified health and social risks linked
to adverse outcomes and attributed to enrollees within the identified targeted population.
Sec. 53.
Minnesota Statutes 2020, section 256L.01, subdivision 5, is amended to read:
Subd. 5.
Income.
"Income" has the meaning given for modified adjusted gross income,
as defined in Code of Federal Regulations, title 26, section 1.36B-1, and means a household's
deleted text begin current income, or if income fluctuates month to month, the income for the 12-month
eligibility perioddeleted text end new text begin projected annual income for the applicable tax yearnew 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. 54.
Minnesota Statutes 2020, section 256L.03, subdivision 5, is amended to read:
Subd. 5.
Cost-sharing.
(a) Co-payments, coinsurance, and deductibles do not apply to
children under the age of 21 deleted text begin anddeleted text end new text begin ,new text end to American Indians as defined in Code of Federal
Regulations, title 42, section 600.5new text begin , or to pre-exposure prophylaxis (PrEP) and postexposure
prophylaxis (PEP) medications when used for the prevention or treatment of the human
immunodeficiency virus (HIV)new text end .
(b) The commissioner shall adjust co-payments, coinsurance, and deductibles for covered
services in a manner sufficient to maintain the actuarial value of the benefit to 94 percent.
The cost-sharing changes described in this paragraph do not apply to eligible recipients or
services exempt from cost-sharing under state law. The cost-sharing changes described in
this paragraph shall not be implemented prior to January 1, 2016.
(c) The cost-sharing changes authorized under paragraph (b) must satisfy the requirements
for cost-sharing under the Basic Health Program as set forth in Code of Federal Regulations,
title 42, sections 600.510 and 600.520.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, subject to federal
approval. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 55.
Minnesota Statutes 2020, section 256L.04, subdivision 7b, is amended to read:
Subd. 7b.
Annual income limits adjustment.
The commissioner shall adjust the income
limits under this section annually deleted text begin each July 1deleted text end new text begin on January 1new text end as deleted text begin described in section 256B.056,
subdivision 1cdeleted text end new text begin provided in Code of Federal Regulations, title 26, section 1.36B-1(h)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. 56.
Minnesota Statutes 2020, section 256L.05, subdivision 3a, is amended to read:
Subd. 3a.
Redetermination of eligibility.
(a) An enrollee's eligibility must be
redetermined on an annual basisdeleted text begin , in accordance with Code of Federal Regulations, title 42,
section 435.916 (a). The 12-month eligibility period begins the month of application.
Beginning July 1, 2017, the commissioner shall adjust the eligibility period for enrollees to
implement renewals throughout the year according to guidance from the Centers for Medicare
and Medicaid Servicesdeleted text end .new text begin The period of eligibility is the entire calendar year following the
year in which eligibility is redetermined. Eligibility redeterminations shall occur during the
open enrollment period for qualified health plans as specified in Code of Federal Regulations,
title 45, section 155.410(e)(3).
new text end
(b) Each new period of eligibility must take into account any changes in circumstances
that impact eligibility and premium amount. Coverage begins as provided in section 256L.06.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 57.
Minnesota Statutes 2020, section 256L.11, subdivision 6a, is amended to read:
Subd. 6a.
Dental providers.
Effective for dental services provided to MinnesotaCare
enrollees on or after January 1, 2018new text begin , through December 31, 2022new text end , the commissioner shall
increase payment rates to dental providers by 54 percent. Payments made to prepaid health
plans under section 256L.12 shall reflect the payment increase described in this subdivision.
The prepaid health plans under contract with the commissioner shall provide payments to
dental providers that are at least equal to a rate that includes the payment rate specified in
this subdivision, and if applicable to the provider, the rates described under subdivision 7.
Sec. 58.
Minnesota Statutes 2020, section 256L.11, subdivision 7, is amended to read:
Subd. 7.
Critical access dental providers.
Effective for dental services provided to
MinnesotaCare enrollees on or after July 1, 2017new text begin , through December 31, 2022new text end , the
commissioner shall increase payment rates to dentists and dental clinics deemed by the
commissioner to be critical access providers under section 256B.76, subdivision 4, by 20
percent above the payment rate that would otherwise be paid to the provider. The
commissioner shall pay the prepaid health plans under contract with the commissioner
amounts sufficient to reflect this rate increase. The prepaid health plan must pass this rate
increase to providers who have been identified by the commissioner as critical access dental
providers under section 256B.76, subdivision 4.
Sec. 59.
Minnesota Statutes 2020, section 295.53, subdivision 1, is amended to read:
Subdivision 1.
Exclusions and exemptions.
(a) The following payments are excluded
from the gross revenues subject to the hospital, surgical center, or health care provider taxes
under sections 295.50 to 295.59:
(1) payments received by a health care provider or the wholly owned subsidiary of a
health care provider for care provided outside Minnesota;
(2) government payments received by the commissioner of human services for
state-operated services;
(3) payments received by a health care provider for hearing aids and related equipment
or prescription eyewear delivered outside of Minnesota; and
(4) payments received by an educational institution from student tuition, student activity
fees, health care service fees, government appropriations, donations, or grants, and for
services identified in and provided under an individualized education program as defined
in section 256B.0625 or Code of Federal Regulations, chapter 34, section 300.340(a). Fee
for service payments and payments for extended coverage are taxable.
(b) The following payments are exempted from the gross revenues subject to hospital,
surgical center, or health care provider taxes under sections 295.50 to 295.59:
(1) payments received for services provided under the Medicare program, including
payments received from the government and organizations governed by sections 1833,
1853, and 1876 of title XVIII of the federal Social Security Act, United States Code, title
42, section 1395; and enrollee deductibles, co-insurance, and co-payments, whether paid
by the Medicare enrollee, by Medicare supplemental coverage as described in section
62A.011, subdivision 3, clause (10), or by Medicaid payments under title XIX of the federal
Social Security Act. Payments for services not covered by Medicare are taxable;
(2) payments received for home health care services;
(3) payments received from hospitals or surgical centers for goods and services on which
liability for tax is imposed under section 295.52 or the source of funds for the payment is
exempt under clause (1), (6), (9), (10), or (11);
(4) payments received from the health care providers for goods and services on which
liability for tax is imposed under this chapter or the source of funds for the payment is
exempt under clause (1), (6), (9), (10), or (11);
(5) amounts paid for legend drugs to a wholesale drug distributor who is subject to tax
under section 295.52, subdivision 3, reduced by reimbursement received for legend drugs
otherwise exempt under this chapter;
(6) payments received from the chemical dependency fund under chapter 254B;
(7) payments received in the nature of charitable donations that are not designated for
providing patient services to a specific individual or group;
(8) payments received for providing patient services incurred through a formal program
of health care research conducted in conformity with federal regulations governing research
on human subjects. Payments received from patients or from other persons paying on behalf
of the patients are subject to tax;
(9) payments received from any governmental agency for services benefiting the public,
not including payments made by the government in its capacity as an employer or insurer
or payments made by the government for services provided under the MinnesotaCare
program or the medical assistance program governed by title XIX of the federal Social
Security Act, United States Code, title 42, sections 1396 to 1396v;
(10) payments received under the federal Employees Health Benefits Act, United States
Code, title 5, section 8909(f), as amended by the Omnibus Reconciliation Act of 1990.
Enrollee deductibles, co-insurance, and co-payments are subject to tax;
(11) payments received under the federal Tricare program, Code of Federal Regulations,
title 32, section 199.17(a)(7). Enrollee deductibles, co-insurance, and co-payments are
subject to tax; and
(12) supplemental deleted text begin ordeleted text end new text begin ,new text end enhancednew text begin , or uniform adjustment factornew text end payments authorized under
section 256B.196 deleted text begin ordeleted text end new text begin ,new text end 256B.197new text begin , or 256B.1973new text end .
(c) Payments received by wholesale drug distributors for legend drugs sold directly to
veterinarians or veterinary bulk purchasing organizations are excluded from the gross
revenues subject to the wholesale drug distributor tax under sections 295.50 to 295.59.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for taxable years beginning after December
31, 2021.
new text end
Sec. 60. new text begin COURT RULING ON AFFORDABLE CARE ACT.
new text end
new text begin
In the event the United States Supreme Court reverses, in whole or in part, Public Law
111-148, as amended by Public Law 111-152, the commissioner of human services shall
take all actions necessary to maintain the current policies of the medical assistance and
MinnesotaCare programs, including but not limited to pursuing federal funds, or if federal
funding is not available, operating programs with state funding for at least one year following
the date of the Supreme Court decision or until the conclusion of the next regular legislative
session, whichever is later. Nothing in this section prohibits the commissioner from making
changes necessary to comply with federal or state requirements for the medical assistance
or MinnesotaCare programs that were not affected by the Supreme Court decision.
new text end
Sec. 61. new text begin DELIVERY REFORM ANALYSIS REPORT.
new text end
new text begin
(a) The commissioner of human services shall present to the chairs and ranking minority
members of the legislative committees with jurisdiction over health care policy and finance,
by January 15, 2023, a report comparing service delivery and payment system models for
delivering services to Medical Assistance enrollees for whom income eligibility is determined
using the modified adjusted gross income methodology under Minnesota Statutes, section
256B.056, subdivision 1a, paragraph (b), clause (1), and MinnesotaCare enrollees eligible
under Minnesota Statutes, chapter 256L. The report must compare the current delivery
model with at least two alternative models. The alternative models must include a state-based
model in which the state holds the plan risk as the insurer and may contract with a third-party
administrator for claims processing and plan administration. The alternative models may
include but are not limited to:
new text end
new text begin
(1) expanding the use of integrated health partnerships under Minnesota Statutes, section
256B.0755;
new text end
new text begin
(2) delivering care under fee-for-service through a primary care case management system;
and
new text end
new text begin
(3) continuing to contract with managed care and county-based purchasing plans for
some or all enrollees under modified contracts.
new text end
new text begin
(b) The report must include:
new text end
new text begin
(1) a description of how each model would address:
new text end
new text begin
(i) racial and other inequities in the delivery of health care and health care outcomes;
new text end
new text begin
(ii) geographic inequities in the delivery of health care;
new text end
new text begin
(iii) the provision of incentives for preventive care and other best practices;
new text end
new text begin
(iv) reimbursing providers for high-quality, value-based care at levels sufficient to sustain
or increase enrollee access to care; and
new text end
new text begin
(v) transparency and simplicity for enrollees, health care providers, and policymakers;
new text end
new text begin
(2) a comparison of the projected cost of each model; and
new text end
new text begin
(3) an implementation timeline for each model, that includes the earliest date by which
each model could be implemented if authorized during the 2023 legislative session, and a
discussion of barriers to implementation.
new text end
Sec. 62. new text begin DENTAL HOME DEMONSTRATION PROJECT.
new text end
new text begin
(a) The Dental Services Advisory Committee, in collaboration with stakeholders, shall
design a dental home demonstration project and present recommendations by February 1,
2022, to the commissioner and the chairs and ranking minority members of the legislative
committees with jurisdiction over health finance and policy.
new text end
new text begin
(b) The Dental Services Advisory Committee, at a minimum, shall engage with the
following stakeholders: the Minnesota Department of Health, the Minnesota Dental
Association, the Minnesota Dental Hygienists' Association, the University of Minnesota
School of Dentistry, dental programs operated by the Minnesota State Colleges and
Universities system, and representatives of each of the following dental provider types
serving medical assistance and MinnesotaCare enrollees:
new text end
new text begin
(1) private practice dental clinics for which medical assistance and MinnesotaCare
enrollees comprise more than 25 percent of the clinic's patient load;
new text end
new text begin
(2) private practice dental clinics for which medical assistance and MinnesotaCare
enrollees comprise 25 percent or less of the clinic's patient load;
new text end
new text begin
(3) nonprofit dental clinics with a primary focus on serving Indigenous communities
and other communities of color;
new text end
new text begin
(4) nonprofit dental clinics with a primary focus on providing eldercare;
new text end
new text begin
(5) nonprofit dental clinics with a primary focus on serving children;
new text end
new text begin
(6) nonprofit dental clinics providing services within the seven-county metropolitan
area;
new text end
new text begin
(7) nonprofit dental clinics providing services outside of the seven-county metropolitan
area; and
new text end
new text begin
(8) multispecialty hospital-based dental clinics.
new text end
new text begin
(c) The dental home demonstration project shall give incentives for qualified providers
that provide high-quality, patient-centered, comprehensive, and coordinated oral health
services. The demonstration project shall seek to increase the number of new dental providers
serving medical assistance and MinnesotaCare enrollees and increase the capacity of existing
providers. The demonstration project must test payment methods that establish value-based
incentives to:
new text end
new text begin
(1) increase the extent to which current dental providers serve medical assistance and
MinnesotaCare enrollees across their lifespan;
new text end
new text begin
(2) develop service models that create equity and reduce disparities in access to dental
services for high-risk and medically and socially complex enrollees;
new text end
new text begin
(3) advance alternative delivery models of care within community settings using
evidence-based approaches and innovative workforce teams; and
new text end
new text begin
(4) improve the quality of dental care by meeting dental home goals.
new text end
Sec. 63. new text begin DIRECTION TO COMMISSIONER; INCOME AND ASSET EXCLUSION
FOR ST. PAUL GUARANTEED INCOME DEMONSTRATION PROJECT.
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 terms defined in this
subdivision have the meanings given.
new text end
new text begin
(b) "Commissioner" means the commissioner of human services unless specified
otherwise.
new text end
new text begin
(c) "Guaranteed income demonstration project" means a demonstration project in St.
Paul to evaluate how unconditional cash payments have a causal effect on income volatility,
financial well-being, and early childhood development in infants and toddlers.
new text end
new text begin Subd. 2. new text end
new text begin Commissioner; income and asset exclusion. new text end
new text begin
(a) During the duration of the
guaranteed income demonstration project, the commissioner shall not count payments made
to families by the guaranteed income demonstration project as income or assets for purposes
of determining or redetermining eligibility for the following programs:
new text end
new text begin
(1) child care assistance programs under Minnesota Statutes, chapter 119B; and
new text end
new text begin
(2) the Minnesota family investment program, work benefit program, or diversionary
work program under Minnesota Statutes, chapter 256J.
new text end
new text begin
(b) During the duration of the guaranteed income demonstration project, the commissioner
shall not count payments made to families by the guaranteed income demonstration project
as income or assets for purposes of determining or redetermining eligibility for the following
programs:
new text end
new text begin
(1) medical assistance under Minnesota Statutes, chapter 256B; and
new text end
new text begin
(2) MinnesotaCare under Minnesota Statutes, chapter 256L.
new text end
new text begin Subd. 3. new text end
new text begin Report. new text end
new text begin
The city of St. Paul shall provide a report to the chairs and ranking
minority members of the legislative committees with jurisdiction over human services policy
and finance by February 15, 2023, with information on the progress and outcomes of the
guaranteed income demonstration project under this section.
new text end
new text begin Subd. 4. new text end
new text begin Expiration. new text end
new text begin
This section expires June 30, 2023.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2021, except for subdivision 2,
paragraph (b), which is effective July 1, 2021, or upon federal approval, whichever is later.
new text end
Sec. 64. new text begin EXPANSION OF OUTPATIENT DRUG CARVE OUT; PRESCRIPTION
DRUG PURCHASING PROGRAM.
new text end
new text begin
The commissioner of human services, in consultation with the commissioners of
commerce and health, shall assess the feasibility of, and develop recommendations for: (1)
expanding the outpatient prescription drug carve out under Minnesota Statutes, section
256B.69, subdivision 6d, to include MinnesotaCare enrollees; and (2) establishing a
prescription drug purchasing program to serve nonpublic program enrollees of health plan
companies. The recommendations must address the process and terms by which the
commissioner would contract with health plan companies to administer prescription drug
benefits for the companies' enrollees and develop and manage a formulary. The commissioner
shall present recommendations to the chairs and ranking minority members of the legislative
committees with jurisdiction over commerce and health and human services policy and
finance by December 15, 2023.
new text end
Sec. 65. new text begin FEDERAL APPROVAL; EXTENSION OF POSTPARTUM COVERAGE.
new text end
new text begin
The commissioner of human services shall seek all federal waivers and approvals
necessary to extend medical assistance postpartum coverage, as provided in Minnesota
Statutes, section 256B.055, subdivision 6.
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. 66. new text begin PROPOSAL FOR A PUBLIC OPTION.
new text end
new text begin
(a) The commissioner of human services shall consult with the Centers for Medicare
and Medicaid Services, the Internal Revenue Service, and other relevant federal agencies
to develop a proposal for a public option program. The proposal may consider multiple
public option structures, at least one of which must be through expanded enrollment into
MinnesotaCare. Each option must:
new text end
new text begin
(1) allow individuals with incomes above the maximum income eligibility limit under
Minnesota Statutes, section 256L.04, subdivision 1 or 7, the option of purchasing coverage
through the public option;
new text end
new text begin
(2) allow undocumented noncitizens, and individuals with access to subsidized employer
health coverage who are subject to the family glitch, the option of purchasing through the
public option;
new text end
new text begin
(3) establish a small employer public option that allows employers with 50 or fewer
employees to offer the public option to the employer's employees and contribute to the
employees' premiums;
new text end
new text begin
(4) allow the state to:
new text end
new text begin
(i) receive the maximum pass through of federal dollars that would otherwise be used
to provide coverage for eligible public option enrollees if the enrollees were instead covered
through qualified health plans with premium tax credits, emergency medical assistance, or
other relevant programs; and
new text end
new text begin
(ii) continue to receive basic health program payments for eligible MinnesotaCare
enrollees; and
new text end
new text begin
(5) be administered in coordination with the existing MinnesotaCare program to maximize
efficiency and improve continuity of care, consistent with the requirements of Minnesota
Statutes, sections 256L.06, 256L.10, and 256L.11.
new text end
new text begin
(b) Each public option proposal must include:
new text end
new text begin
(1) a premium scale for public option enrollees that at least meets the Affordable Care
Act affordability standard for each income level;
new text end
new text begin
(2) an analysis of the impact of the public option on MNsure enrollment and the consumer
assistance program and, if necessary, a proposal to ensure that the public option has an
adequate enrollment infrastructure and consumer assistance capacity;
new text end
new text begin
(3) actuarial and financial analyses necessary to project program enrollment and costs;
and
new text end
new text begin
(4) an analysis of the cost of implementing the public option using current eligibility
and enrollment technology systems, and at the option of the commissioner, an analysis of
alternative eligibility and enrollment systems that may reduce initial and ongoing costs and
improve functionality and accessibility.
new text end
new text begin
(c) The commissioner shall incorporate into the design of the public option mechanisms
to ensure the long-term financial sustainability of MinnesotaCare and mitigate any adverse
financial impacts to MNsure. These mechanisms must minimize: (i) adverse selection; (ii)
state financial risk and expenditures; and (iii) potential impacts on premiums in the individual
and group insurance markets.
new text end
new text begin
(d) The commissioner shall present the proposal to the chairs and ranking minority
members of the legislative committees with jurisdiction over health care policy and finance
by December 15, 2021. The proposal must include recommendations on any legislative
changes necessary to implement the public option. Any implementation of the proposal that
requires a state financial contribution must be contingent on legislative approval.
new text end
Sec. 67. new text begin RESPONSE TO COVID-19 PUBLIC HEALTH EMERGENCY.
new text end
new text begin
(a) Notwithstanding Minnesota Statutes, section 256B.057, subdivision 9, 256L.06,
subdivision 3, or any other provision to the contrary, the commissioner shall not collect any
unpaid premium for a coverage month that occurred during the COVID-19 public health
emergency declared by the United States Secretary of Health and Human Services.
new text end
new text begin
(b) Notwithstanding any provision to the contrary, periodic data matching under
Minnesota Statutes, section 256B.0561, subdivision 2, may be suspended for up to six
months following the last day of the COVID-19 public health emergency declared by the
United States Secretary of Health and Human Services.
new text end
new text begin
(c) Notwithstanding any provision to the contrary, the requirement for the commissioner
of human services to issue an annual report on periodic data matching under Minnesota
Statutes, section 256B.0561, is suspended for one year following the last day of the
COVID-19 public health emergency declared by the United States Secretary of Health and
Human Services.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment, except
paragraph (a) related to MinnesotaCare premiums is effective upon federal approval. The
commissioner shall notify the revisor of statutes when federal approval is received.
new text end
Sec. 68. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes must change the term "Health Services Policy Committee" to
"Health Services Advisory Council" wherever the term appears in Minnesota Statutes and
may make any necessary changes to grammar or sentence structure to preserve the meaning
of the text.
new text end
Sec. 69. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Rules, parts 9505.0275; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6,
7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, and 22; 9505.1699; 9505.1701; 9505.1703;
9505.1706; 9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730;
9505.1733; 9505.1736; 9505.1739; 9505.1742; 9505.1745; and 9505.1748,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2020, section 256B.0625, subdivisions 18c, 18d, 18e, and 18h,
new text end
new text begin
are repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Paragraph (a) is effective July 1, 2021, and paragraph (b) is
effective January 1, 2023.
new text end
ARTICLE 2
DHS LICENSING AND BACKGROUND STUDIES
Section 1.
Minnesota Statutes 2020, section 62V.05, is amended by adding a subdivision
to read:
new text begin Subd. 4a. new text end
new text begin Background study required. new text end
new text begin
(a) The board must initiate background studies
under section 245C.031 of:
new text end
new text begin
(1) each navigator;
new text end
new text begin
(2) each in-person assister; and
new text end
new text begin
(3) each certified application counselor.
new text end
new text begin
(b) The board may initiate the background studies required by paragraph (a) using the
online NETStudy 2.0 system operated by the commissioner of human services.
new text end
new text begin
(c) The board shall not permit any individual to provide any service or function listed
in paragraph (a) until the board has received notification from the commissioner of human
services indicating that the individual:
new text end
new text begin
(1) is not disqualified under chapter 245C; or
new text end
new text begin
(2) is disqualified, but has received a set aside from the board of that disqualification
according to sections 245C.22 and 245C.23.
new text end
new text begin
(d) The board or its delegate shall review a reconsideration request of an individual in
paragraph (a), including granting a set aside, according to the procedures and criteria in
chapter 245C. The board shall notify the individual and the Department of Human Services
of the board's decision.
new text end
Sec. 2.
Minnesota Statutes 2020, section 122A.18, subdivision 8, is amended to read:
Subd. 8.
Background deleted text begin checksdeleted text end new text begin studiesnew text end .
(a) The Professional Educator Licensing and
Standards Board and the Board of School Administrators must deleted text begin obtain adeleted text end new text begin initiatenew text end criminal
history background deleted text begin check ondeleted text end new text begin studies ofnew text end all first-time deleted text begin teachingdeleted text end applicants for new text begin educator new text end licenses
under their jurisdiction. Applicants must include with their licensure applications:
(1) an executed criminal history consent form, including fingerprints; and
(2) payment to conduct the background deleted text begin checkdeleted text end new text begin studynew text end . The Professional Educator Licensing
and Standards Board must deposit payments received under this subdivision in an account
in the special revenue fund. Amounts in the account are annually appropriated to the
Professional Educator Licensing and Standards Board to pay for the costs of background
deleted text begin checksdeleted text end new text begin studiesnew text end on applicants for licensure.
(b) The background deleted text begin checkdeleted text end new text begin studynew text end for all first-time teaching applicants for licenses must
include a review of information from the Bureau of Criminal Apprehension, including
criminal history data as defined in section 13.87, and must also include a review of the
national criminal records repository. The superintendent of the Bureau of Criminal
Apprehension is authorized to exchange fingerprints with the Federal Bureau of Investigation
for purposes of the criminal history check. deleted text begin The superintendent shall recover the cost to the
bureau of a background check through the fee charged to the applicant under paragraph (a).
deleted text end
(c) The Professional Educator Licensing and Standards Board deleted text begin must contract withdeleted text end new text begin may
initiate criminal history background studies throughnew text end the commissioner of human services
new text begin according to section 245C.031 new text end to deleted text begin conduct background checks anddeleted text end obtain background deleted text begin checkdeleted text end
new text begin studynew text end data required under this chapter.
Sec. 3.
Minnesota Statutes 2020, section 245A.05, is amended to read:
245A.05 DENIAL OF APPLICATION.
(a) The commissioner may deny a license if an applicant or controlling individual:
(1) fails to submit a substantially complete application after receiving notice from the
commissioner under section 245A.04, subdivision 1;
(2) fails to comply with applicable laws or rules;
(3) knowingly withholds relevant information from or gives false or misleading
information to the commissioner in connection with an application for a license or during
an investigation;
(4) has a disqualification that has not been set aside under section 245C.22 and no
variance has been granted;
(5) has an individual living in the household who received a background study under
section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that
has not been set aside under section 245C.22, and no variance has been granted;
(6) is associated with an individual who received a background study under section
245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to
children or vulnerable adults, and who has a disqualification that has not been set aside
under section 245C.22, and no variance has been granted;
(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g);
(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision
6;
(9) has a history of noncompliance as a license holder or controlling individual with
applicable laws or rules, including but not limited to this chapter and chapters 119B and
245C; deleted text begin or
deleted text end
(10) is prohibited from holding a license according to section 245.095deleted text begin .deleted text end new text begin ; or
new text end
new text begin
(11) for a family foster setting, has nondisqualifying background study information, as
described in section 245C.05, subdivision 4, that reflects on the individual's ability to safely
provide care to foster children.
new text end
(b) An applicant whose application has been denied by the commissioner must be given
notice of the denial, which must state the reasons for the denial in plain language. Notice
must be given by certified mail or personal service. The notice must state the reasons the
application was denied and must inform the applicant of the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The applicant may
appeal the denial by notifying the commissioner in writing by certified mail or personal
service. If mailed, the appeal must be postmarked and sent to the commissioner within 20
calendar days after the applicant received the notice of denial. If an appeal request is made
by personal service, it must be received by the commissioner within 20 calendar days after
the applicant received the notice of denial. Section 245A.08 applies to hearings held to
appeal the commissioner's denial of an application.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2022.
new text end
Sec. 4.
Minnesota Statutes 2020, section 245A.07, subdivision 1, is amended to read:
Subdivision 1.
Sanctions; appeals; license.
(a) In addition to making a license conditional
under section 245A.06, the commissioner may suspend or revoke the license, impose a fine,
or secure an injunction against the continuing operation of the program of a license holder
who does not comply with applicable law or rulenew text begin , or who has nondisqualifying background
study information, as described in section 245C.05, subdivision 4, that reflects on the license
holder's ability to safely provide care to foster childrennew text end . When applying sanctions authorized
under this section, the commissioner shall consider the nature, chronicity, or severity of the
violation of law or rule and the effect of the violation on the health, safety, or rights of
persons served by the program.
(b) If a license holder appeals the suspension or revocation of a license and the license
holder continues to operate the program pending a final order on the appeal, the commissioner
shall issue the license holder a temporary provisional license. Unless otherwise specified
by the commissioner, variances in effect on the date of the license sanction under appeal
continue under the temporary provisional license. If a license holder fails to comply with
applicable law or rule while operating under a temporary provisional license, the
commissioner may impose additional sanctions under this section and section 245A.06, and
may terminate any prior variance. If a temporary provisional license is set to expire, a new
temporary provisional license shall be issued to the license holder upon payment of any fee
required under section 245A.10. The temporary provisional license shall expire on the date
the final order is issued. If the license holder prevails on the appeal, a new nonprovisional
license shall be issued for the remainder of the current license period.
(c) If a license holder is under investigation and the license issued under this chapter is
due to expire before completion of the investigation, the program shall be issued a new
license upon completion of the reapplication requirements and payment of any applicable
license fee. Upon completion of the investigation, a licensing sanction may be imposed
against the new license under this section, section 245A.06, or 245A.08.
(d) Failure to reapply or closure of a license issued under this chapter by the license
holder prior to the completion of any investigation shall not preclude the commissioner
from issuing a licensing sanction under this section or section 245A.06 at the conclusion
of the investigation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2022.
new text end
Sec. 5.
Minnesota Statutes 2020, section 245A.10, subdivision 4, is amended to read:
Subd. 4.
License or certification fee for certain programs.
(a) Child care centers shall
pay an annual nonrefundable license fee based on the following schedule:
| Licensed Capacity |
Child Care Center License Fee |
|
| 1 to 24 persons |
$200 |
|
| 25 to 49 persons |
$300 |
|
| 50 to 74 persons |
$400 |
|
| 75 to 99 persons |
$500 |
|
| 100 to 124 persons |
$600 |
|
| 125 to 149 persons |
$700 |
|
| 150 to 174 persons |
$800 |
|
| 175 to 199 persons |
$900 |
|
| 200 to 224 persons |
$1,000 |
|
| 225 or more persons |
$1,100 |
(b)(1) A program licensed to provide one or more of the home and community-based
services and supports identified under chapter 245D to persons with disabilities or age 65
and older, shall pay an annual nonrefundable license fee based on revenues derived from
the provision of services that would require licensure under chapter 245D during the calendar
year immediately preceding the year in which the license fee is paid, according to the
following schedule:
| License Holder Annual Revenue |
License Fee |
|
| less than or equal to $10,000 |
$200 |
|
| greater than $10,000 but less than or equal to $25,000 |
$300 |
|
| greater than $25,000 but less than or equal to $50,000 |
$400 |
|
| greater than $50,000 but less than or equal to $100,000 |
$500 |
|
| greater than $100,000 but less than or equal to $150,000 |
$600 |
|
| greater than $150,000 but less than or equal to $200,000 |
$800 |
|
| greater than $200,000 but less than or equal to $250,000 |
$1,000 |
|
| greater than $250,000 but less than or equal to $300,000 |
$1,200 |
|
| greater than $300,000 but less than or equal to $350,000 |
$1,400 |
|
| greater than $350,000 but less than or equal to $400,000 |
$1,600 |
|
| greater than $400,000 but less than or equal to $450,000 |
$1,800 |
|
| greater than $450,000 but less than or equal to $500,000 |
$2,000 |
|
| greater than $500,000 but less than or equal to $600,000 |
$2,250 |
|
| greater than $600,000 but less than or equal to $700,000 |
$2,500 |
|
| greater than $700,000 but less than or equal to $800,000 |
$2,750 |
|
| greater than $800,000 but less than or equal to $900,000 |
$3,000 |
|
| greater than $900,000 but less than or equal to $1,000,000 |
$3,250 |
|
| greater than $1,000,000 but less than or equal to $1,250,000 |
$3,500 |
|
| greater than $1,250,000 but less than or equal to $1,500,000 |
$3,750 |
|
| greater than $1,500,000 but less than or equal to $1,750,000 |
$4,000 |
|
| greater than $1,750,000 but less than or equal to $2,000,000 |
$4,250 |
|
| greater than $2,000,000 but less than or equal to $2,500,000 |
$4,500 |
|
| greater than $2,500,000 but less than or equal to $3,000,000 |
$4,750 |
|
| greater than $3,000,000 but less than or equal to $3,500,000 |
$5,000 |
|
| greater than $3,500,000 but less than or equal to $4,000,000 |
$5,500 |
|
| greater than $4,000,000 but less than or equal to $4,500,000 |
$6,000 |
|
| greater than $4,500,000 but less than or equal to $5,000,000 |
$6,500 |
|
| greater than $5,000,000 but less than or equal to $7,500,000 |
$7,000 |
|
| greater than $7,500,000 but less than or equal to $10,000,000 |
$8,500 |
|
| greater than $10,000,000 but less than or equal to $12,500,000 |
$10,000 |
|
| greater than $12,500,000 but less than or equal to $15,000,000 |
$14,000 |
|
| greater than $15,000,000 |
$18,000 |
(2) If requested, the license holder shall provide the commissioner information to verify
the license holder's annual revenues or other information as needed, including copies of
documents submitted to the Department of Revenue.
(3) At each annual renewal, a license holder may elect to pay the highest renewal fee,
and not provide annual revenue information to the commissioner.
(4) A license holder that knowingly provides the commissioner incorrect revenue amounts
for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount
of double the fee the provider should have paid.
(5) Notwithstanding clause (1), a license holder providing services under one or more
licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license
fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license
holder for all licenses held under chapter 245B for calendar year 2013. For calendar year
2017 and thereafter, the license holder shall pay an annual license fee according to clause
(1).
(c) A chemical dependency treatment program licensed under chapter 245G, to provide
chemical dependency treatment shall pay an annual nonrefundable license fee based on the
following schedule:
| Licensed Capacity |
License Fee |
|
| 1 to 24 persons |
$600 |
|
| 25 to 49 persons |
$800 |
|
| 50 to 74 persons |
$1,000 |
|
| 75 to 99 persons |
$1,200 |
|
| 100 or more persons |
$1,400 |
(d) A deleted text begin chemical dependencydeleted text end new text begin detoxificationnew text end program licensed under Minnesota Rules,
parts 9530.6510 to 9530.6590, deleted text begin to provide detoxification servicesdeleted text end new text begin or a withdrawal management
program licensed under chapter 245Fnew text end shall pay an annual nonrefundable license fee based
on the following schedule:
| Licensed Capacity |
License Fee |
|
| 1 to 24 persons |
$760 |
|
| 25 to 49 persons |
$960 |
|
| 50 or more persons |
$1,160 |
new text begin
A detoxification program that also operates a withdrawal management program at the same
location shall only pay one fee based upon the licensed capacity of the program with the
higher overall capacity.
new text end
(e) Except for child foster care, a residential facility licensed under Minnesota Rules,
chapter 2960, to serve children shall pay an annual nonrefundable license fee based on the
following schedule:
| Licensed Capacity |
License Fee |
|
| 1 to 24 persons |
$1,000 |
|
| 25 to 49 persons |
$1,100 |
|
| 50 to 74 persons |
$1,200 |
|
| 75 to 99 persons |
$1,300 |
|
| 100 or more persons |
$1,400 |
(f) A residential facility licensed under Minnesota Rules, parts 9520.0500 to 9520.0670,
to serve persons with mental illness shall pay an annual nonrefundable license fee based on
the following schedule:
| Licensed Capacity |
License Fee |
|
| 1 to 24 persons |
$2,525 |
|
| 25 or more persons |
$2,725 |
(g) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400,
to serve persons with physical disabilities shall pay an annual nonrefundable license fee
based on the following schedule:
| Licensed Capacity |
License Fee |
|
| 1 to 24 persons |
$450 |
|
| 25 to 49 persons |
$650 |
|
| 50 to 74 persons |
$850 |
|
| 75 to 99 persons |
$1,050 |
|
| 100 or more persons |
$1,250 |
(h) A program licensed to provide independent living assistance for youth under section
245A.22 shall pay an annual nonrefundable license fee of $1,500.
(i) A private agency licensed to provide foster care and adoption services under Minnesota
Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable license fee of $875.
(j) A program licensed as an adult day care center licensed under Minnesota Rules, parts
9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the
following schedule:
| Licensed Capacity |
License Fee |
|
| 1 to 24 persons |
$500 |
|
| 25 to 49 persons |
$700 |
|
| 50 to 74 persons |
$900 |
|
| 75 to 99 persons |
$1,100 |
|
| 100 or more persons |
$1,300 |
(k) A program licensed to provide treatment services to persons with sexual psychopathic
personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to
9515.3110, shall pay an annual nonrefundable license fee of $20,000.
(l) A mental health center or mental health clinic requesting certification for purposes
of insurance and subscriber contract reimbursement under Minnesota Rules, parts 9520.0750
to 9520.0870, shall pay a certification fee of $1,550 per year. If the mental health center or
mental health clinic provides services at a primary location with satellite facilities, the
satellite facilities shall be certified with the primary location without an additional charge.
Sec. 6.
Minnesota Statutes 2020, section 245A.16, is amended by adding a subdivision to
read:
new text begin Subd. 9. new text end
new text begin Licensed family foster settings. new text end
new text begin
(a) Before recommending to grant a license,
deny a license under section 245A.05, or revoke a license under section 245A.07 for
nondisqualifying background study information received under section 245C.05, subdivision
4, paragraph (a), clause (3), for a licensed family foster setting, a county agency or private
agency that has been designated or licensed by the commissioner must review the following:
new text end
new text begin
(1) the type of offenses;
new text end
new text begin
(2) the number of offenses;
new text end
new text begin
(3) the nature of the offenses;
new text end
new text begin
(4) the age of the individual at the time of the offenses;
new text end
new text begin
(5) the length of time that has elapsed since the last offense;
new text end
new text begin
(6) the relationship of the offenses and the capacity to care for a child;
new text end
new text begin
(7) evidence of rehabilitation;
new text end
new text begin
(8) information or knowledge from community members regarding the individual's
capacity to provide foster care;
new text end
new text begin
(9) any available information regarding child maltreatment reports or child in need of
protection or services petitions, or related cases, in which the individual has been involved
or implicated, and documentation that the individual has remedied issues or conditions
identified in child protection or court records that are relevant to safely caring for a child;
new text end
new text begin
(10) a statement from the study subject;
new text end
new text begin
(11) a statement from the license holder; and
new text end
new text begin
(12) other aggravating and mitigating factors.
new text end
new text begin
(b) For purposes of this section, "evidence of rehabilitation" includes but is not limited
to the following:
new text end
new text begin
(1) maintaining a safe and stable residence;
new text end
new text begin
(2) continuous, regular, or stable employment;
new text end
new text begin
(3) successful participation in an education or job training program;
new text end
new text begin
(4) positive involvement with the community or extended family;
new text end
new text begin
(5) compliance with the terms and conditions of probation or parole following the
individual's most recent conviction;
new text end
new text begin
(6) if the individual has had a substance use disorder, successful completion of a substance
use disorder assessment, substance use disorder treatment, and recommended continuing
care, if applicable, demonstrated abstinence from controlled substances, as defined in section
152.01, subdivision 4, or the establishment of a sober network;
new text end
new text begin
(7) if the individual has had a mental illness or documented mental health issues,
demonstrated completion of a mental health evaluation, participation in therapy or other
recommended mental health treatment, or appropriate medication management, if applicable;
new text end
new text begin
(8) if the individual's offense or conduct involved domestic violence, demonstrated
completion of a domestic violence or anger management program, and the absence of any
orders for protection or harassment restraining orders against the individual since the previous
offense or conduct;
new text end
new text begin
(9) written letters of support from individuals of good repute, including but not limited
to employers, members of the clergy, probation or parole officers, volunteer supervisors,
or social services workers;
new text end
new text begin
(10) demonstrated remorse for convictions or conduct, or demonstrated positive behavior
changes; and
new text end
new text begin
(11) absence of convictions or arrests since the previous offense or conduct, including
any convictions that were expunged or pardoned.
new text end
new text begin
(c) An applicant for a family foster setting license must sign all releases of information
requested by the county or private licensing agency.
new text end
new text begin
(d) When licensing a relative for a family foster setting, the commissioner shall also
consider the importance of maintaining the child's relationship with relatives as an additional
significant factor in determining whether an application will be denied.
new text end
new text begin
(e) When recommending that the commissioner deny or revoke a license, the county or
private licensing agency must send a summary of the review completed according to
paragraph (a), on a form developed by the commissioner, to the commissioner and include
any recommendation for licensing action.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2022.
new text end
Sec. 7.
Minnesota Statutes 2020, section 245C.02, subdivision 4a, is amended to read:
Subd. 4a.
Authorized fingerprint collection vendor.
"Authorized fingerprint collection
vendor" means a qualified organization under a written contract with the commissioner to
provide services in accordance with section 245C.05, subdivision 5, paragraph (b).new text begin The
commissioner may retain the services of more than one authorized fingerprint collection
vendor.
new text end
Sec. 8.
Minnesota Statutes 2020, section 245C.02, subdivision 5, is amended to read:
Subd. 5.
Background study.
"Background study" meansnew text begin :
new text end
new text begin
(1) the collection and processing of a background study subject's fingerprints, including
the process of obtaining a background study subject's classifiable fingerprints and photograph
as required by section 245C.05, subdivision 5, paragraph (b); and
new text end
new text begin (2)new text end the review of records conducted by the commissioner to determine whether a subject
is disqualified from direct contact with persons served by a program and, where specifically
provided in statutes, whether a subject is disqualified from having access to persons served
by a program and from working in a children's residential facility or foster residence setting.
Sec. 9.
Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision to
read:
new text begin Subd. 5b. new text end
new text begin Alternative background study. new text end
new text begin
"Alternative background study" means:
new text end
new text begin
(1) the collection and processing of a background study subject's fingerprints, including
the process of obtaining a background study subject's classifiable fingerprints and photograph
as required by section 245C.05, subdivision 5, paragraph (b); and
new text end
new text begin
(2) a review of records conducted by the commissioner pursuant to section 245C.08 in
order to forward the background study investigating information to the entity that submitted
the alternative background study request under section 245C.031, subdivision 2. The
commissioner shall not make any eligibility determinations on background studies conducted
under section 245C.031.
new text end
Sec. 10.
Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision
to read:
new text begin Subd. 11c. new text end
new text begin Entity. new text end
new text begin
"Entity" means any program, organization, or agency initiating a
background study.
new text end
Sec. 11.
Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision
to read:
new text begin Subd. 16a. new text end
new text begin Results. new text end
new text begin
"Results" means a determination that a study subject is eligible,
disqualified, set aside, granted a variance, or that more time is needed to complete the
background study.
new text end
Sec. 12.
Minnesota Statutes 2020, section 245C.03, is amended to read:
245C.03 BACKGROUND STUDY; INDIVIDUALS TO BE STUDIED.
Subdivision 1.
Licensed programs.
(a) The commissioner shall conduct a background
study on:
(1) the person or persons applying for a license;
(2) an individual age 13 and over living in the household where the licensed program
will be provided who is not receiving licensed services from the program;
(3) current or prospective employees or contractors of the applicant who will have direct
contact with persons served by the facility, agency, or program;
(4) volunteers or student volunteers who will have direct contact with persons served
by the program to provide program services if the contact is not under the continuous, direct
supervision by an individual listed in clause (1) or (3);
(5) an individual age ten to 12 living in the household where the licensed services will
be provided when the commissioner has reasonable cause as defined in section 245C.02,
subdivision 15;
(6) an individual who, without providing direct contact services at a licensed program,
may have unsupervised access to children or vulnerable adults receiving services from a
program, when the commissioner has reasonable cause as defined in section 245C.02,
subdivision 15;
(7) all controlling individuals as defined in section 245A.02, subdivision 5a;
(8) notwithstanding the other requirements in this subdivision, child care background
study subjects as defined in section 245C.02, subdivision 6a; and
(9) notwithstanding clause (3), for children's residential facilities and foster residence
settings, any adult working in the facility, whether or not the individual will have direct
contact with persons served by the facility.
(b) For child foster care when the license holder resides in the home where foster care
services are provided, a short-term substitute caregiver providing direct contact services for
a child for less than 72 hours of continuous care is not required to receive a background
study under this chapter.
new text begin
(c) This subdivision applies to the following programs that must be licensed under
chapter 245A:
new text end
new text begin
(1) adult foster care;
new text end
new text begin
(2) child foster care;
new text end
new text begin
(3) children's residential facilities;
new text end
new text begin
(4) family child care;
new text end
new text begin
(5) licensed child care centers;
new text end
new text begin
(6) licensed home and community-based services under chapter 245D;
new text end
new text begin
(7) residential mental health programs for adults;
new text end
new text begin
(8) substance use disorder treatment programs under chapter 245G;
new text end
new text begin
(9) withdrawal management programs under chapter 245F;
new text end
new text begin
(10) programs that provide treatment services to persons with sexual psychopathic
personalities or sexually dangerous persons;
new text end
new text begin
(11) adult day care centers;
new text end
new text begin
(12) family adult day services;
new text end
new text begin
(13) independent living assistance for youth;
new text end
new text begin
(14) detoxification programs;
new text end
new text begin
(15) community residential settings; and
new text end
new text begin
(16) intensive residential treatment services and residential crisis stabilization under
chapter 245I.
new text end
new text begin Subd. 1a. new text end
new text begin Procedure. new text end
new text begin
(a) Individuals and organizations that are required under this
section to have or initiate background studies shall comply with the requirements of this
chapter.
new text end
new text begin
(b) All studies conducted under this section shall be conducted according to sections
299C.60 to 299C.64. This requirement does not apply to subdivisions 1, paragraph (c),
clauses (2) to (5), and 6a.
new text end
Subd. 2.
Personal care provider organizations.
The commissioner shall conduct
background studies on any individual required under sections 256B.0651 to 256B.0654 and
256B.0659 to have a background study completed under this chapter.
Subd. 3.
Supplemental nursing services agencies.
The commissioner shall conduct all
background studies required under this chapter and initiated by supplemental nursing services
agencies registered under section 144A.71, subdivision 1.
new text begin Subd. 3a. new text end
new text begin Personal care assistance provider agency; background studies. new text end
new text begin
Personal
care assistance provider agencies enrolled to provide personal care assistance services under
the medical assistance program must meet the following requirements:
new text end
new text begin
(1) owners who have a five percent interest or more and all managing employees are
subject to a background study as provided in this chapter. This requirement applies to
currently enrolled personal care assistance provider agencies and agencies seeking enrollment
as a personal care assistance provider agency. "Managing employee" has the same meaning
as Code of Federal Regulations, title 42, section 455.101. An organization is barred from
enrollment if:
new text end
new text begin
(i) the organization has not initiated background studies of owners and managing
employees; or
new text end
new text begin
(ii) the organization has initiated background studies of owners and managing employees
and the commissioner has sent the organization a notice that an owner or managing employee
of the organization has been disqualified under section 245C.14, and the owner or managing
employee has not received a set aside of the disqualification under section 245C.22; and
new text end
new text begin
(2) a background study must be initiated and completed for all qualified professionals.
new text end
new text begin Subd. 3b. new text end
new text begin Exception to personal care assistant; requirements. new text end
new text begin
The personal care
assistant for a recipient may be allowed to enroll with a different personal care assistance
provider agency upon initiation of a new background study according to this chapter if:
new text end
new text begin
(1) the commissioner determines that a change in enrollment or affiliation of the personal
care assistant is needed in order to ensure continuity of services and protect the health and
safety of the recipient;
new text end
new text begin
(2) the chosen agency has been continuously enrolled as a personal care assistance
provider agency for at least two years;
new text end
new text begin
(3) the recipient chooses to transfer to the personal care assistance provider agency;
new text end
new text begin
(4) the personal care assistant has been continuously enrolled with the former personal
care assistance provider agency since the last background study was completed; and
new text end
new text begin
(5) the personal care assistant continues to meet requirements of section 256B.0659,
subdivision 11, notwithstanding paragraph (a), clause (3).
new text end
Subd. 4.
Personnel agencies; educational programs; professional services
agencies.
The commissioner also may conduct studies on individuals specified in subdivision
1, paragraph (a), clauses (3) and (4), when the studies are initiated by:
(1) personnel pool agencies;
(2) temporary personnel agencies;
(3) educational programs that train individuals by providing direct contact services in
licensed programs; and
(4) professional services agencies that are not licensed and which contract with licensed
programs to provide direct contact services or individuals who provide direct contact services.
Subd. 5.
Other state agencies.
The commissioner shall conduct background studies on
applicants and license holders under the jurisdiction of other state agencies who are required
in other statutory sections to initiate background studies under this chapter, including the
applicant's or license holder's employees, contractors, and volunteers when required under
other statutory sections.
new text begin Subd. 5a. new text end
new text begin
Facilities serving children or adults licensed or regulated by the
Department of Health.
new text end
new text begin
(a) The commissioner shall conduct background studies of:
new text end
new text begin
(1) individuals providing services who have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; assisted living facilities and assisted living
facilities with dementia care licensed under chapter 144G; and board and lodging
establishments that are registered to provide supportive or health supervision services under
section 157.17;
new text end
new text begin
(2) individuals specified in subdivision 2 who provide direct contact services in a nursing
home or a home care agency licensed under chapter 144A; an assisted living facility or
assisted living facility with dementia care licensed under chapter 144G; or a boarding care
home licensed under sections 144.50 to 144.58. If the individual undergoing a study resides
outside of Minnesota, the study must include a check for substantiated findings of
maltreatment of adults and children in the individual's state of residence when the state
makes the information available;
new text end
new text begin
(3) all other employees in assisted living facilities or assisted living facilities with
dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
an individual in this section shall disqualify the individual from positions allowing direct
contact with or access to patients or residents receiving services. "Access" means physical
access to a client or the client's personal property without continuous, direct supervision as
defined in section 245C.02, subdivision 8, when the employee's employment responsibilities
do not include providing direct contact services;
new text end
new text begin
(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; and
new text end
new text begin
(5) controlling persons of a supplemental nursing services agency, as defined by section
144A.70.
new text end
new text begin
(b) If a facility or program is licensed by the Department of Human Services and the
Department of Health and is subject to the background study provisions of this chapter, the
Department of Human Services is solely responsible for the background studies of individuals
in the jointly licensed program.
new text end
new text begin
(c) The commissioner of health shall review and make decisions regarding reconsideration
requests, including whether to grant variances, according to the procedures and criteria in
this chapter. The commissioner of health shall inform the requesting individual and the
Department of Human Services of the commissioner of health's decision regarding the
reconsideration. The commissioner of health's decision to grant or deny a reconsideration
of a disqualification is a final administrative agency action.
new text end
new text begin Subd. 5b. new text end
new text begin
Facilities serving children or youth licensed by the Department of
Corrections.
new text end
new text begin
(a) The commissioner shall conduct background studies of individuals working
in secure and nonsecure children's residential facilities, juvenile detention facilities, and
foster residence settings, whether or not the individual will have direct contact, as defined
under section 245C.02, subdivision 11, with persons served in the facilities or settings.
new text end
new text begin
(b) A clerk or administrator of any court, the Bureau of Criminal Apprehension, a
prosecuting attorney, a county sheriff, or a chief of a local police department shall assist in
conducting background studies by providing the commissioner of human services or the
commissioner's representative all criminal conviction data available from local and state
criminal history record repositories related to applicants, operators, all persons living in a
household, and all staff of any facility subject to background studies under this subdivision.
new text end
new text begin
(c) For the purpose of this subdivision, the term "secure and nonsecure residential facility
and detention facility" includes programs licensed or certified under section 241.021,
subdivision 2.
new text end
new text begin
(d) If an individual is disqualified, the Department of Human Services shall notify the
disqualified individual and the facility in which the disqualified individual provides services
of the disqualification and shall inform the disqualified individual of the right to request a
reconsideration of the disqualification by submitting the request to the Department of
Corrections.
new text end
new text begin
(e) The commissioner of corrections shall review and make decisions regarding
reconsideration requests, including whether to grant variances, according to the procedures
and criteria in this chapter. The commissioner of corrections shall inform the requesting
individual and the Department of Human Services of the commissioner of corrections'
decision regarding the reconsideration. The commissioner of corrections' decision to grant
or deny a reconsideration of a disqualification is the final administrative agency action.
new text end
Subd. 6.
Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities.
new text begin (a) new text end The commissioner shall conduct background
studies deleted text begin ondeleted text end new text begin ofnew text end any individual deleted text begin required under section 256B.4912 to have a background study
completed under this chapterdeleted text end new text begin who provides direct contact, as defined in section 245C.02,
subdivision 11, for services specified in the federally approved home and community-based
waiver plans under section 256B.4912. The individual studied must meet the requirements
of this chapter prior to providing waiver services and as part of ongoing enrollment.
new text end
new text begin (b) The requirements in paragraph (a) apply to consumer-directed community supports
under section 256B.4911new text end .
Subd. 6a.
Legal nonlicensed and certified child care programs.
The commissioner
shall conduct background studies deleted text begin on an individualdeleted text end new text begin of the following individuals asnew text end required
deleted text begin underdeleted text end new text begin bynew text end sections 119B.125 and 245H.10 deleted text begin to complete a background study under this chapter.deleted text end new text begin :
new text end
new text begin
(1) every individual who applies for certification;
new text end
new text begin
(2) every member of a provider's household who is age 13 and older and lives in the
household where nonlicensed child care is provided; and
new text end
new text begin
(3) an individual who is at least ten years of age and under 13 years of age and lives in
the household where the nonlicensed child care will be provided when the county has
reasonable cause as defined under section 245C.02, subdivision 15.
new text end
Subd. 7.
Children's therapeutic services and supports providers.
The commissioner
shall conduct background studies deleted text begin according to this chapter when initiated by a children's
therapeutic services and supports providerdeleted text end new text begin of all direct service providers and volunteers for
children's therapeutic services and supports providersnew text end under section 256B.0943.
deleted text begin Subd. 8. deleted text end
deleted text begin Self-initiated background studies. deleted text end
deleted text begin
Upon implementation of NETStudy 2.0,
the commissioner shall conduct background studies according to this chapter when initiated
by an individual who is not on the master roster. A subject under this subdivision who is
not disqualified must be placed on the inactive roster.
deleted text end
Subd. 9.
Community first services and supports new text begin and financial management services
new text end organizations.
deleted text begin
The commissioner shall conduct background studies on any individual
required under section 256B.85 to have a background study completed under this chapter.
deleted text end
new text begin
Individuals affiliated with Community First Services and Supports (CFSS) agency-providers
and Financial Management Services (FMS) providers enrolled to provide CFSS services
under the medical assistance program must meet the following requirements:
new text end
new text begin
(1) owners who have a five percent interest or more and all managing employees are
subject to a background study under this chapter. This requirement applies to currently
enrolled providers and agencies seeking enrollment. "Managing employee" has the meaning
given in Code of Federal Regulations, title 42, section 455.101. An organization is barred
from enrollment if:
new text end
new text begin
(i) the organization has not initiated background studies of owners and managing
employees; or
new text end
new text begin
(ii) the organization has initiated background studies of owners and managing employees
and the commissioner has sent the organization a notice that an owner or managing employee
of the organization has been disqualified under section 245C.14 and the owner or managing
employee has not received a set aside of the disqualification under section 245C.22;
new text end
new text begin
(2) a background study must be initiated and completed for all staff who will have direct
contact with the participant to provide worker training and development; and
new text end
new text begin
(3) a background study must be initiated and completed for all support workers.
new text end
new text begin Subd. 9a. new text end
new text begin Exception to support worker requirements for continuity of services. new text end
new text begin
The
support worker for a participant may enroll with a different Community First Services and
Supports (CFSS) agency-provider or Financial Management Services (FMS) provider upon
initiation, rather than completion, of a new background study according to this chapter if:
new text end
new text begin
(1) the commissioner determines that the support worker's change in enrollment or
affiliation is necessary to ensure continuity of services and to protect the health and safety
of the participant;
new text end
new text begin
(2) the chosen agency-provider or FMS provider has been continuously enrolled as a
CFSS agency-provider or FMS provider for at least two years or since the inception of the
CFSS program, whichever is shorter;
new text end
new text begin
(3) the participant served by the support worker chooses to transfer to the CFSS
agency-provider or the FMS provider to which the support worker is transferring;
new text end
new text begin
(4) the support worker has been continuously enrolled with the former CFSS
agency-provider or FMS provider since the support worker's last background study was
completed; and
new text end
new text begin
(5) the support worker continues to meet the requirements of section 256B.85, subdivision
16, notwithstanding paragraph (a), clause (1).
new text end
Subd. 10.
Providers of group residential housing or supplementary services.
new text begin (a) new text end The
commissioner shall conduct background studies deleted text begin on any individual required under section
256I.04 to have a background study completed under this chapter.deleted text end new text begin of the following individuals
who provide services under section 256I.04:
new text end
new text begin
(1) controlling individuals as defined in section 245A.02;
new text end
new text begin
(2) managerial officials as defined in section 245A.02; and
new text end
new text begin
(3) all employees and volunteers of the establishment who have direct contact with
recipients or who have unsupervised access to recipients, recipients' personal property, or
recipients' private data.
new text end
new text begin
(b) The provider of housing support must comply with all requirements for entities
initiating background studies under this chapter.
new text end
new text begin
(c) A provider of housing support must demonstrate that all individuals who are required
to have a background study according to paragraph (a) have a notice stating that:
new text end
new text begin
(1) the individual is not disqualified under section 245C.14; or
new text end
new text begin
(2) the individual is disqualified and the individual has been issued a set aside of the
disqualification for the setting under section 245C.22.
new text end
deleted text begin Subd. 11. deleted text end
deleted text begin
Child protection workers or social services staff having responsibility for
child protective duties.
deleted text end
deleted text begin
(a) The commissioner must complete background studies, according
to paragraph (b) and section 245C.04, subdivision 10, when initiated by a county social
services agency or by a local welfare agency according to section 626.559, subdivision 1b.
deleted text end
deleted text begin
(b) For background studies completed by the commissioner under this subdivision, the
commissioner shall not make a disqualification decision, but shall provide the background
study information received to the county that initiated the study.
deleted text end
Subd. 12.
Providers of special transportation service.
new text begin (a) new text end The commissioner shall
conduct background studies deleted text begin on any individual required under section 174.30 to have a
background study completed under this chapter.deleted text end new text begin of the following individuals who provide
special transportation services under section 174.30:
new text end
new text begin
(1) each person with a direct or indirect ownership interest of five percent or higher in
a transportation service provider;
new text end
new text begin
(2) each controlling individual as defined under section 245A.02;
new text end
new text begin
(3) a managerial official as defined in section 245A.02;
new text end
new text begin
(4) each driver employed by the transportation service provider;
new text end
new text begin
(5) each individual employed by the transportation service provider to assist a passenger
during transport; and
new text end
new text begin
(6) each employee of the transportation service agency who provides administrative
support, including an employee who:
new text end
new text begin
(i) may have face-to-face contact with or access to passengers, passengers' personal
property, or passengers' private data;
new text end
new text begin
(ii) performs any scheduling or dispatching tasks; or
new text end
new text begin
(iii) performs any billing activities.
new text end
new text begin
(b) When a local or contracted agency is authorizing a ride under section 256B.0625,
subdivision 17, by a volunteer driver, and the agency authorizing the ride has a reason to
believe that the volunteer driver has a history that would disqualify the volunteer driver or
that may pose a risk to the health or safety of passengers, the agency may initiate a
background study that shall be completed according to this chapter using the commissioner
of human services' online NETStudy system, or by contacting the Department of Human
Services background study division for assistance. The agency that initiates the background
study under this paragraph shall be responsible for providing the volunteer driver with the
privacy notice required by section 245C.05, subdivision 2c, and with the payment for the
background study required by section 245C.10 before the background study is completed.
new text end
Subd. 13.
Providers of housing support services.
The commissioner shall conduct
background studies deleted text begin ondeleted text end new text begin ofnew text end any deleted text begin individualdeleted text end new text begin provider of housing support servicesnew text end required deleted text begin underdeleted text end new text begin
bynew text end section 256B.051 to have a background study completed under this chapter.
new text begin Subd. 14. new text end
new text begin Tribal nursing facilities. new text end
new text begin
For completed background studies to comply with
a Tribal organization's licensing requirements for individuals affiliated with a tribally licensed
nursing facility, the commissioner shall obtain state and national criminal history data.
new text end
new text begin Subd. 15. new text end
new text begin Early intensive developmental and behavioral intervention providers. new text end
new text begin
The
commissioner shall conduct background studies according to this chapter when initiated by
an early intensive developmental and behavioral intervention provider under section
256B.0949.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2021, except subdivision 6,
paragraph (b), is effective upon federal approval and subdivision 15 is effective the day
following final enactment. The commissioner of human services shall notify the revisor of
statutes when federal approval is obtained.
new text end
Sec. 13.
new text begin
[245C.031] BACKGROUND STUDY; ALTERNATIVE BACKGROUND
STUDIES.
new text end
new text begin Subdivision 1. new text end
new text begin Alternative background studies. new text end
new text begin
(a) The commissioner shall conduct
an alternative background study of individuals listed in this section.
new text end
new text begin
(b) Notwithstanding other sections of this chapter, all alternative background studies
except subdivision 12 shall be conducted according to this section and with section 299C.60
to 299C.64.
new text end
new text begin
(c) All terms in this section shall have the definitions provided in section 245C.02.
new text end
new text begin
(d) The entity that submits an alternative background study request under this section
shall submit the request to the commissioner according to section 245C.05.
new text end
new text begin
(e) The commissioner shall comply with the destruction requirements in section 245C.051.
new text end
new text begin
(f) Background studies conducted under this section are subject to the provisions of
section 245C.32.
new text end
new text begin
(g) The commissioner shall forward all information that the commissioner receives under
section 245C.08 to the entity that submitted the alternative background study request under
subdivision 2. The commissioner shall not make any eligibility determinations regarding
background studies conducted under this section.
new text end
new text begin Subd. 2. new text end
new text begin Access to information. new text end
new text begin
Each entity that submits an alternative background
study request shall enter into an agreement with the commissioner before submitting requests
for alternative background studies under this section. As a part of the agreement, the entity
must agree to comply with state and federal law.
new text end
new text begin Subd. 3. new text end
new text begin
Child protection workers or social services staff having responsibility for
child protective duties.
new text end
new text begin
The commissioner shall conduct an alternative background study
of any person who has responsibility for child protection duties when the background study
is initiated by a county social services agency or by a local welfare agency according to
section 260E.36, subdivision 3.
new text end
new text begin Subd. 4. new text end
new text begin
Applicants, licensees, and other occupations regulated by the commissioner
of health.
new text end
new text begin
The commissioner shall conduct an alternative background study, including a
check of state data, and a national criminal history records check of the following individuals.
For studies under this section, the following persons shall complete a consent form:
new text end
new text begin
(1) an applicant for initial licensure, temporary licensure, or relicensure after a lapse in
licensure as an audiologist or speech-language pathologist or an applicant for initial
certification as a hearing instrument dispenser who must submit to a background study
under section 144.0572.
new text end
new text begin
(2) an applicant for a renewal license or certificate as an audiologist, speech-language
pathologist, or hearing instrument dispenser who was licensed or obtained a certificate
before January 1, 2018.
new text end
new text begin Subd. 5. new text end
new text begin Guardians and conservators. new text end
new text begin
(a) The commissioner shall conduct an alternative
background study of:
new text end
new text begin
(1) every court-appointed guardian and conservator, unless a background study has been
completed of the person under this section within the previous five years. The alternative
background study shall be completed prior to the appointment of the guardian or conservator,
unless a court determines that it would be in the best interests of the ward or protected person
to appoint a guardian or conservator before the alternative background study can be
completed. If the court appoints the guardian or conservator while the alternative background
study is pending, the alternative background study must be completed as soon as reasonably
possible after the guardian or conservator's appointment and no later than 30 days after the
guardian or conservator's appointment; and
new text end
new text begin
(2) a guardian and a conservator once every five years after the guardian or conservator's
appointment if the person continues to serve as a guardian or conservator.
new text end
new text begin
(b) An alternative background study is not required if the guardian or conservator is:
new text end
new text begin
(1) a state agency or county;
new text end
new text begin
(2) a parent or guardian of a proposed ward or protected person who has a developmental
disability if the parent or guardian has raised the proposed ward or protected person in the
family home until the time that the petition is filed, unless counsel appointed for the proposed
ward or protected person under section 524.5-205, paragraph (d); 524.5-304, paragraph (b);
524.5-405, paragraph (a); or 524.5-406, paragraph (b), recommends a background study;
or
new text end
new text begin
(3) a bank with trust powers, a bank and trust company, or a trust company, organized
under the laws of any state or of the United States and regulated by the commissioner of
commerce or a federal regulator.
new text end
new text begin Subd. 6. new text end
new text begin Guardians and conservators; required checks. new text end
new text begin
(a) An alternative background
study for a guardian or conservator pursuant to subdivision 5 shall include:
new text end
new text begin
(1) criminal history data from the Bureau of Criminal Apprehension and other criminal
history data obtained by the commissioner of human services;
new text end
new text begin
(2) data regarding whether the person has been a perpetrator of substantiated maltreatment
of a vulnerable adult under section 626.557 or a minor under chapter 260E. If the subject
of the study has been the perpetrator of substantiated maltreatment of a vulnerable adult or
a minor, the commissioner must include a copy of the public portion of the investigation
memorandum under section 626.557, subdivision 12b, or the public portion of the
investigation memorandum under section 260E.30. The commissioner shall provide the
court with information from a review of information according to subdivision 7 if the study
subject provided information that the study subject has a current or prior affiliation with a
state licensing agency;
new text end
new text begin
(3) criminal history data from a national criminal history record check as defined in
section 245C.02, subdivision 13c; and
new text end
new text begin
(4) state licensing agency data if a search of the database or databases of the agencies
listed in subdivision 7 shows that the proposed guardian or conservator has held a
professional license directly related to the responsibilities of a professional fiduciary from
an agency listed in subdivision 7 that was conditioned, suspended, revoked, or canceled.
new text end
new text begin
(b) If the guardian or conservator is not an individual, the background study must be
completed of all individuals who are currently employed by the proposed guardian or
conservator who are responsible for exercising powers and duties under the guardianship
or conservatorship.
new text end
new text begin Subd. 7. new text end
new text begin Guardians and conservators; state licensing data. new text end
new text begin
(a) Within 25 working
days of receiving the request for an alternative background study of a guardian or conservator,
the commissioner shall provide the court with licensing agency data for licenses directly
related to the responsibilities of a guardian or conservator if the study subject has a current
or prior affiliation with the:
new text end
new text begin
(1) Lawyers Responsibility Board;
new text end
new text begin
(2) State Board of Accountancy;
new text end
new text begin
(3) Board of Social Work;
new text end
new text begin
(4) Board of Psychology;
new text end
new text begin
(5) Board or Nursing;
new text end
new text begin
(6) Board of Medical Practice;
new text end
new text begin
(7) Department of Education;
new text end
new text begin
(8) Department of Commerce;
new text end
new text begin
(9) Board of Chiropractic Examiners;
new text end
new text begin
(10) Board of Dentistry;
new text end
new text begin
(11) Board of Marriage and Family Therapy;
new text end
new text begin
(12) Department of Human Services;
new text end
new text begin
(13) Peace Officer Standards and Training (POST) Board; and
new text end
new text begin
(14) Professional Educator Licensing and Standards Board.
new text end
new text begin
(b) The commissioner and each of the agencies listed above, except for the Department
of Human Services, shall enter into a written agreement to provide the commissioner with
electronic access to the relevant licensing data and to provide the commissioner with a
quarterly list of new sanctions issued by the agency.
new text end
new text begin
(c) The commissioner shall provide to the court the electronically available data
maintained in the agency's database, including whether the proposed guardian or conservator
is or has been licensed by the agency and whether a disciplinary action or a sanction against
the individual's license, including a condition, suspension, revocation, or cancellation, is in
the licensing agency's database.
new text end
new text begin
(d) If the proposed guardian or conservator has resided in a state other than Minnesota
during the previous ten years, licensing agency data under this section shall also include
licensing agency data from any other state where the proposed guardian or conservator
reported to have resided during the previous ten years if the study subject has a current or
prior affiliation to the licensing agency. If the proposed guardian or conservator has or has
had a professional license in another state that is directly related to the responsibilities of a
guardian or conservator from one of the agencies listed under paragraph (a), state licensing
agency data shall also include data from the relevant licensing agency of the other state.
new text end
new text begin
(e) The commissioner is not required to repeat a search for Minnesota or out-of-state
licensing data on an individual if the commissioner has provided this information to the
court within the prior five years.
new text end
new text begin
(f) The commissioner shall review the information in paragraph (c) at least once every
four months to determine whether an individual who has been studied within the previous
five years:
new text end
new text begin
(1) has any new disciplinary action or sanction against the individual's license; or
new text end
new text begin
(2) did not disclose a prior or current affiliation with a Minnesota licensing agency.
new text end
new text begin
(g) If the commissioner's review in paragraph (f) identifies new information, the
commissioner shall provide any new information to the court.
new text end
new text begin Subd. 8. new text end
new text begin Guardians ad litem. new text end
new text begin
The commissioner shall conduct an alternative background
study of:
new text end
new text begin
(1) a guardian ad litem appointed under section 518.165 if a background study of the
guardian ad litem has not been completed within the past three years. The background study
of the guardian ad litem must be completed before the court appoints the guardian ad litem,
unless the court determines that it is in the best interests of the child to appoint the guardian
ad litem before a background study is completed by the commissioner.
new text end
new text begin
(2) a guardian ad litem once every three years after the guardian has been appointed, as
long as the individual continues to serve as a guardian ad litem.
new text end
new text begin Subd. 9. new text end
new text begin Guardians ad litem; required checks. new text end
new text begin
(a) An alternative background study
for a guardian ad litem under subdivision 8 must include:
new text end
new text begin
(1) criminal history data from the Bureau of Criminal Apprehension and other criminal
history data obtained by the commissioner of human services; and
new text end
new text begin
(2) data regarding whether the person has been a perpetrator of substantiated maltreatment
of a minor or a vulnerable adult. If the study subject has been determined by the Department
of Human Services or the Department of Health to be the perpetrator of substantiated
maltreatment of a minor or a vulnerable adult in a licensed facility, the response must include
a copy of the public portion of the investigation memorandum under section 260E.30 or the
public portion of the investigation memorandum under section 626.557, subdivision 12b.
When the background study shows that the subject has been determined by a county adult
protection or child protection agency to have been responsible for maltreatment, the court
shall be informed of the county, the date of the finding, and the nature of the maltreatment
that was substantiated.
new text end
new text begin
(b) For checks of records under paragraph (a), clauses (1) and (2), the commissioner
shall provide the records within 15 working days of receiving the request. The information
obtained under sections 245C.05 and 245C.08 from a national criminal history records
check shall be provided within three working days of the commissioner's receipt of the data.
new text end
new text begin
(c) Notwithstanding section 260E.30 or 626.557, subdivision 12b, if the commissioner
or county lead agency or lead investigative agency has information that a person of whom
a background study was previously completed under this section has been determined to
be a perpetrator of maltreatment of a minor or vulnerable adult, the commissioner or the
county may provide this information to the court that requested the background study.
new text end
new text begin Subd. 10. new text end
new text begin
First-time applicants for educator licenses with the Professional Educator
Licensing and Standards Board.
new text end
new text begin
The Professional Educator Licensing and Standards
Board shall make all eligibility determinations for alternative background studies conducted
under this section for the Professional Educator Licensing and Standards Board. The
commissioner may conduct an alternative background study of all first-time applicants for
educator licenses pursuant to section 122A.18, subdivision 8. The alternative background
study for all first-time applicants for educator licenses must include a review of information
from the Bureau of Criminal Apprehension, including criminal history data as defined in
section 13.87, and must also include a review of the national criminal records repository.
new text end
new text begin Subd. 11. new text end
new text begin
First-time applicants for administrator licenses with the Board of School
Administrators.
new text end
new text begin
The Board of School Administrators shall make all eligibility determinations
for alternative background studies conducted under this section for the Board of School
Administrators. The commissioner may conduct an alternative background study of all
first-time applicants for administrator licenses pursuant to section 122A.18, subdivision 8.
The alternative background study for all first-time applicants for administrator licenses must
include a review of information from the Bureau of Criminal Apprehension, including
criminal history data as defined in section 13.87, and must also include a review of the
national criminal records repository.
new text end
new text begin Subd. 12. new text end
new text begin Occupations regulated by MNsure. new text end
new text begin
(a) The commissioner shall conduct a
background study of any individual required under section 62V.05 to have a background
study completed under this chapter. Notwithstanding subdivision 1, paragraph (g), the
commissioner shall conduct a background study only based on Minnesota criminal records
of:
new text end
new text begin
(1) each navigator;
new text end
new text begin
(2) each in-person assister; and
new text end
new text begin
(3) each certified application counselor.
new text end
new text begin
(b) The MNsure board of directors may initiate background studies required by paragraph
(a) using the online NETStudy 2.0 system operated by the commissioner.
new text end
new text begin
(c) The commissioner shall review information that the commissioner receives to
determine if the study subject has potentially disqualifying offenses. The commissioner
shall send a letter to the subject indicating any of the subject's potential disqualifications as
well as any relevant records. The commissioner shall send a copy of the letter indicating
any of the subject's potential disqualifications to the MNsure board.
new text end
new text begin
(d) The MNsure board or its delegate shall review a reconsideration request of an
individual in paragraph (a), including granting a set aside, according to the procedures and
criteria in chapter 245C. The board shall notify the individual and the Department of Human
Services of the board's decision.
new text end
Sec. 14.
Minnesota Statutes 2020, section 245C.05, subdivision 1, is amended to read:
Subdivision 1.
Individual studied.
(a) The individual who is the subject of the
background study must provide the applicant, license holder, or other entity under section
245C.04 with sufficient information to ensure an accurate study, including:
(1) the individual's first, middle, and last name and all other names by which the
individual has been known;
(2) current home address, city, and state of residence;
(3) current zip code;
(4) sex;
(5) date of birth;
(6) driver's license number or state identification number; and
(7) upon implementation of NETStudy 2.0, the home address, city, county, and state of
residence for the past five years.
(b) Every subject of a background study conducted or initiated by counties or private
agencies under this chapter must also provide the home address, city, county, and state of
residence for the past five years.
(c) Every subject of a background study related to private agency adoptions or related
to child foster care licensed through a private agency, who is 18 years of age or older, shall
also provide the commissioner a signed consent for the release of any information received
from national crime information databases to the private agency that initiated the background
study.
(d) The subject of a background study shall provide fingerprints and a photograph as
required in subdivision 5.
new text begin
(e) The subject of a background study shall submit a completed criminal and maltreatment
history records check consent form for applicable national and state level record checks.
new text end
Sec. 15.
Minnesota Statutes 2020, section 245C.05, subdivision 2, is amended to read:
Subd. 2.
Applicant, license holder, or other entity.
(a) The applicant, license holder,
or other deleted text begin entitiesdeleted text end new text begin entity initiating the background studynew text end as provided in this chapter shall verify
that the information collected under subdivision 1 about an individual who is the subject of
the background study is correct and must provide the information on forms or in a format
prescribed by the commissioner.
(b) The information collected under subdivision 1 about an individual who is the subject
of a completed background study may only be viewable by an entity that initiates a
subsequent background study on that individual under NETStudy 2.0 after the entity has
paid the applicable fee for the study and has provided the individual with the privacy notice
in subdivision 2c.
Sec. 16.
Minnesota Statutes 2020, section 245C.05, subdivision 2a, is amended to read:
Subd. 2a.
County or private agency.
For background studies related to child foster care
when the applicant or license holder resides in the home where child foster care services
are provided, county and private agencies new text begin initiating the background study new text end must collect the
information under subdivision 1 and forward it to the commissioner.
Sec. 17.
Minnesota Statutes 2020, section 245C.05, subdivision 2b, is amended to read:
Subd. 2b.
County agency to collect and forward information to commissioner.
(a)
For background studies related to all family adult day services and to adult foster care when
the adult foster care license holder resides in the adult foster care residence, the county
agency new text begin or private agency initiating the background study new text end must collect the information
required under subdivision 1 and forward it to the commissioner.
(b) Upon implementation of NETStudy 2.0, for background studies related to family
child care and legal nonlicensed child care authorized under chapter 119B, the county agency
new text begin initiating the background study new text end must collect the information required under subdivision 1
and provide the information to the commissioner.
Sec. 18.
Minnesota Statutes 2020, section 245C.05, subdivision 2c, is amended to read:
Subd. 2c.
Privacy notice to background study subject.
(a) Prior to initiating each
background study, the entity initiating the study must provide the commissioner's privacy
notice to the background study subject required under section 13.04, subdivision 2. The
notice must be available through the commissioner's electronic NETStudy and NETStudy
2.0 systems and shall include the information in paragraphs (b) and (c).
(b) The background study subject shall be informed that any previous background studies
that received a set-aside will be reviewed, and without further contact with the background
study subject, the commissioner may notify the agency that initiated the subsequent
background study:
(1) that the individual has a disqualification that has been set aside for the program or
agency that initiated the study;
(2) the reason for the disqualification; and
(3) that information about the decision to set aside the disqualification will be available
to the license holder upon request without the consent of the background study subject.
(c) The background study subject must also be informed that:
(1) the subject's fingerprints collected for purposes of completing the background study
under this chapter must not be retained by the Department of Public Safety, Bureau of
Criminal Apprehension, or by the commissioner. The Federal Bureau of Investigation will
deleted text begin only retain fingerprints of subjects with a criminal historydeleted text end new text begin not retain background study
subjects' fingerprintsnew text end ;
(2) effective upon implementation of NETStudy 2.0, the subject's photographic image
will be retained by the commissioner, and if the subject has provided the subject's Social
Security number for purposes of the background study, the photographic image will be
available to prospective employers and agencies initiating background studies under this
chapter to verify the identity of the subject of the background study;
(3) the commissioner's authorized fingerprint collection vendornew text begin or vendorsnew text end shall, for
purposes of verifying the identity of the background study subject, be able to view the
identifying information entered into NETStudy 2.0 by the entity that initiated the background
study, but shall not retain the subject's fingerprints, photograph, or information from
NETStudy 2.0. The authorized fingerprint collection vendornew text begin or vendorsnew text end shall retain no more
than the subject's name and the date and time the subject's fingerprints were recorded and
sent, only as necessary for auditing and billing activities;
(4) the commissioner shall provide the subject notice, as required in section 245C.17,
subdivision 1, paragraph (a), when an entity initiates a background study on the individual;
(5) the subject may request in writing a report listing the entities that initiated a
background study on the individual as provided in section 245C.17, subdivision 1, paragraph
(b);
(6) the subject may request in writing that information used to complete the individual's
background study in NETStudy 2.0 be destroyed if the requirements of section 245C.051,
paragraph (a), are met; and
(7) notwithstanding clause (6), the commissioner shall destroy:
(i) the subject's photograph after a period of two years when the requirements of section
245C.051, paragraph (c), are met; and
(ii) any data collected on a subject under this chapter after a period of two years following
the individual's death as provided in section 245C.051, paragraph (d).
Sec. 19.
Minnesota Statutes 2020, section 245C.05, subdivision 2d, is amended to read:
Subd. 2d.
Fingerprint data notification.
The commissioner of human services shall
notify all background study subjects under this chapter that the Department of Human
Services, Department of Public Safety, and the Bureau of Criminal Apprehension do not
retain fingerprint data after a background study is completed, and that the Federal Bureau
of Investigation deleted text begin only retains the fingerprints of subjects who have a criminal historydeleted text end new text begin does
not retain background study subjects' fingerprintsnew text end .
Sec. 20.
Minnesota Statutes 2020, section 245C.05, subdivision 4, is amended to read:
Subd. 4.
Electronic transmission.
(a) For background studies conducted by the
Department of Human Services, the commissioner shall implement a secure system for the
electronic transmission of:
(1) background study information to the commissioner;
(2) background study results to the license holder;
(3) background study deleted text begin resultsdeleted text end new text begin information obtained under this section and section 245C.08new text end
to countiesnew text begin and private agenciesnew text end for background studies conducted by the commissioner for
child foster carenew text begin , including a summary of nondisqualifying results, except as prohibited by
lawnew text end ; and
(4) background study results to county agencies for background studies conducted by
the commissioner for adult foster care and family adult day services and, upon
implementation of NETStudy 2.0, family child care and legal nonlicensed child care
authorized under chapter 119B.
(b) Unless the commissioner has granted a hardship variance under paragraph (c), a
license holder or an applicant must use the electronic transmission system known as
NETStudy or NETStudy 2.0 to submit all requests for background studies to the
commissioner as required by this chapter.
(c) A license holder or applicant whose program is located in an area in which high-speed
Internet is inaccessible may request the commissioner to grant a variance to the electronic
transmission requirement.
(d) Section 245C.08, subdivision 3, paragraph (c), applies to results transmitted under
this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2022.
new text end
Sec. 21.
Minnesota Statutes 2020, section 245C.08, subdivision 3, is amended to read:
Subd. 3.
Arrest and investigative information.
(a) For any background study completed
under this section, if the commissioner has reasonable cause to believe the information is
pertinent to the disqualification of an individual, the commissioner also may review arrest
and investigative information from:
(1) the Bureau of Criminal Apprehension;
(2) the commissioners of health and human services;
(3) a county attorney;
(4) a county sheriff;
(5) a county agency;
(6) a local chief of police;
(7) other states;
(8) the courts;
(9) the Federal Bureau of Investigation;
(10) the National Criminal Records Repository; and
(11) criminal records from other states.
(b) Except when specifically required by law, the commissioner is not required to conduct
more than one review of a subject's records from the Federal Bureau of Investigation if a
review of the subject's criminal history with the Federal Bureau of Investigation has already
been completed by the commissioner and there has been no break in the subject's affiliation
with the entity that initiated the background study.
(c) If the commissioner conducts a national criminal history record check when required
by law and uses the information from the national criminal history record check to make a
disqualification determination, the data obtained is private data and cannot be shared with
deleted text begin county agencies,deleted text end private agenciesdeleted text begin ,deleted text end or prospective employers of the background study subject.
(d) If the commissioner conducts a national criminal history record check when required
by law and uses the information from the national criminal history record check to make a
disqualification determination, the license holder or entity that submitted the study is not
required to obtain a copy of the background study subject's disqualification letter under
section 245C.17, subdivision 3.
Sec. 22.
Minnesota Statutes 2020, section 245C.08, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Authorization. new text end
new text begin
The commissioner of human services shall be authorized to
receive information under this chapter.
new text end
Sec. 23.
Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:
new text begin Subd. 1b. new text end
new text begin Background study fees. new text end
new text begin
(a) The commissioner shall recover the cost of
background studies. Except as otherwise provided in subdivisions 1c and 1d, the fees
collected under this section shall be appropriated to the commissioner for the purpose of
conducting background studies under this chapter. Fees under this section are charges under
section 16A.1283, paragraph (b), clause (3).
new text end
new text begin
(b) Background study fees may include:
new text end
new text begin
(1) a fee to compensate the commissioner's authorized fingerprint collection vendor or
vendors for obtaining and processing a background study subject's classifiable fingerprints
and photograph pursuant to subdivision 1c; and
new text end
new text begin
(2) a separate fee under subdivision 1c to complete a review of background-study-related
records as authorized under this chapter.
new text end
new text begin
(c) Fees charged under paragraph (b) may be paid in whole or part when authorized by
law by a state agency or board; by state court administration; by a service provider, employer,
license holder, or other organization that initiates the background study; by the commissioner
or other organization with duly appropriated funds; by a background study subject; or by
some combination of these sources.
new text end
Sec. 24.
Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:
new text begin Subd. 1c. new text end
new text begin Fingerprint and photograph processing fees. new text end
new text begin
The commissioner shall enter
into a contract with a qualified vendor or vendors to obtain and process a background study
subject's classifiable fingerprints and photograph as required by section 245C.05. The
commissioner may, at their discretion, directly collect fees and reimburse the commissioner's
authorized fingerprint collection vendor for the vendor's services or require the vendor to
collect the fees. The authorized vendor is responsible for reimbursing the vendor's
subcontractors at a rate specified in the contract with the commissioner.
new text end
Sec. 25.
Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:
new text begin Subd. 1d. new text end
new text begin Background studies fee schedule. new text end
new text begin
(a) By March 1 each year, the commissioner
shall publish a schedule of fees sufficient to administer and conduct background studies
under this chapter. The published schedule of fees shall be effective on July 1 each year.
new text end
new text begin
(b) Fees shall be based on the actual costs of administering and conducting background
studies, including payments to external agencies, department indirect cost payments under
section 16A.127, processing fees, and costs related to due process.
new text end
new text begin
(c) The commissioner shall publish a notice of fees by posting fee amounts on the
department website. The notice shall specify the actual costs that comprise the fees including
the categories described in paragraph (b).
new text end
new text begin
(d) The published schedule of fees shall remain in effect from July 1 to June 30 each
year.
new text end
new text begin
(e) The fees collected under this subdivision are appropriated to the commissioner for
the purpose of conducting background studies, alternative background studies, and criminal
background checks.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2021. The commissioner of human
services shall publish the initial fee schedule on the Department of Human Services website
on July 1, 2021, and the initial fee schedule is effective September 1, 2021.
new text end
Sec. 26.
Minnesota Statutes 2020, section 245C.10, subdivision 15, is amended to read:
Subd. 15.
Guardians and conservators.
The deleted text begin commissioner shall recover the cost of
conducting background studies for guardians and conservators under section 524.5-118
through a fee of no more than $110 per study. The fees collected under this subdivision are
appropriated to the commissioner for the purpose of conducting background studies.deleted text end new text begin fee
for conducting an alternative background study for appointment of a professional guardian
or conservator must be paid by the guardian or conservator. In other cases, the fee must be
paid as follows:
new text end
new text begin
(1) if the matter is proceeding in forma pauperis, the fee must be paid as an expense for
purposes of section 524.5-502, paragraph (a);
new text end
new text begin
(2) if there is an estate of the ward or protected person, the fee must be paid from the
estate; or
new text end
new text begin
(3) in the case of a guardianship or conservatorship of a person that is not proceeding
in forma pauperis, the fee must be paid by the guardian, conservator, or the court.
new text end
Sec. 27.
Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:
new text begin Subd. 17. new text end
new text begin Early intensive developmental and behavioral intervention providers. new text end
new text begin
The
commissioner shall recover the cost of background studies required under section 245C.03,
subdivision 15, for the purposes of early intensive developmental and behavioral intervention
under section 256B.0949, through a fee of no more than $20 per study charged to the enrolled
agency. The fees collected under this subdivision are appropriated to the commissioner for
the purpose of conducting background studies.
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. 28.
Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:
new text begin Subd. 18. new text end
new text begin
Applicants, licensees, and other occupations regulated by commissioner
of health.
new text end
new text begin
The applicant or license holder is responsible for paying to the Department of
Human Services all fees associated with the preparation of the fingerprints, the criminal
records check consent form, and the criminal background check.
new text end
Sec. 29.
Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:
new text begin Subd. 19. new text end
new text begin Occupations regulated by MNsure. new text end
new text begin
The commissioner shall set fees to
recover the cost of background studies and criminal background checks initiated by MNsure
under sections 62V.05 and 245C.031. The fee amount shall be established through
interagency agreement between the commissioner and the board of MNsure or its designee.
The fees collected under this subdivision shall be deposited in the special revenue fund and
are appropriated to the commissioner for the purpose of conducting background studies and
criminal background checks.
new text end
Sec. 30.
Minnesota Statutes 2020, section 245C.13, subdivision 2, is amended to read:
Subd. 2.
Activities pending completion of background study.
The subject of a
background study may not perform any activity requiring a background study under
paragraph (c) until the commissioner has issued one of the notices under paragraph (a).
(a) Notices from the commissioner required prior to activity under paragraph (c) include:
(1) a notice of the study results under section 245C.17 stating that:
(i) the individual is not disqualified; or
(ii) more time is needed to complete the study but the individual is not required to be
removed from direct contact or access to people receiving services prior to completion of
the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice
that more time is needed to complete the study must also indicate whether the individual is
required to be under continuous direct supervision prior to completion of the background
study. When more time is necessary to complete a background study of an individual
affiliated with a Title IV-E eligible children's residential facility or foster residence setting,
the individual may not work in the facility or setting regardless of whether or not the
individual is supervised;
(2) a notice that a disqualification has been set aside under section 245C.23; or
(3) a notice that a variance has been granted related to the individual under section
245C.30.
(b) For a background study affiliated with a licensed child care center or certified
license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii),
must require the individual to be under continuous direct supervision prior to completion
of the background study except as permitted in subdivision 3.
(c) Activities prohibited prior to receipt of notice under paragraph (a) include:
(1) being issued a license;
(2) living in the household where the licensed program will be provided;
(3) providing direct contact services to persons served by a program unless the subject
is under continuous direct supervision;
(4) having access to persons receiving services if the background study was completed
under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2),
(5), or (6), unless the subject is under continuous direct supervision;
(5) for licensed child care centers and certified license-exempt child care centers,
providing direct contact services to persons served by the program; deleted text begin or
deleted text end
(6) for children's residential facilities or foster residence settings, working in the facility
or settingdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(7) for background studies affiliated with a personal care provider organization, except
as provided in section 245C.03, subdivision 3b, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study of
the personal care assistant under this chapter and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:
new text end
new text begin
(i) not disqualified under section 245C.14; or
new text end
new text begin
(ii) disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22.
new text end
Sec. 31.
Minnesota Statutes 2020, section 245C.14, subdivision 1, is amended to read:
Subdivision 1.
Disqualification from direct contact.
(a) The commissioner shall
disqualify an individual who is the subject of a background study from any position allowing
direct contact with persons receiving services from the license holder or entity identified in
section 245C.03, upon receipt of information showing, or when a background study
completed under this chapter shows any of the following:
(1) a conviction of, admission to, or Alford plea to one or more crimes listed in section
245C.15, regardless of whether the conviction or admission is a felony, gross misdemeanor,
or misdemeanor level crime;
(2) a preponderance of the evidence indicates the individual has committed an act or
acts that meet the definition of any of the crimes listed in section 245C.15, regardless of
whether the preponderance of the evidence is for a felony, gross misdemeanor, or
misdemeanor level crime; or
(3) an investigation results in an administrative determination listed under section
245C.15, subdivision 4, paragraph (b).
(b) No individual who is disqualified following a background study under section
245C.03, subdivisions 1 and 2, may be retained in a position involving direct contact with
persons served by a program or entity identified in section 245C.03, unless the commissioner
has provided written notice under section 245C.17 stating that:
(1) the individual may remain in direct contact during the period in which the individual
may request reconsideration as provided in section 245C.21, subdivision 2;
(2) the commissioner has set aside the individual's disqualification for that program or
entity identified in section 245C.03, as provided in section 245C.22, subdivision 4; or
(3) the license holder has been granted a variance for the disqualified individual under
section 245C.30.
new text begin
(c) Notwithstanding paragraph (a), for the purposes of a background study affiliated
with a licensed family foster setting, the commissioner shall disqualify an individual who
is the subject of a background study from any position allowing direct contact with persons
receiving services from the license holder or entity identified in section 245C.03, upon
receipt of information showing or when a background study completed under this chapter
shows reason for disqualification under section 245C.15, subdivision 4a.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2022.
new text end
Sec. 32.
Minnesota Statutes 2020, section 245C.14, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin
Disqualification from working in licensed child care centers or certified
license-exempt child care centers.
new text end
new text begin
(a) For a background study affiliated with a licensed
child care center or certified license-exempt child care center, if an individual is disqualified
from direct contact under subdivision 1, the commissioner must also disqualify the individual
from working in any position regardless of whether the individual would have direct contact
with or access to children served in the licensed child care center or certified license-exempt
child care center and from having access to a person receiving services from the center.
new text end
new text begin
(b) Notwithstanding any other requirement of this chapter, for a background study
affiliated with a licensed child care center or a certified license-exempt child care center, if
an individual is disqualified, the individual may not work in the child care center until the
commissioner has issued a notice stating that:
new text end
new text begin
(1) the individual is not disqualified;
new text end
new text begin
(2) a disqualification has been set aside under section 245C.23; or
new text end
new text begin
(3) a variance has been granted related to the individual under section 245C.30.
new text end
Sec. 33.
Minnesota Statutes 2020, section 245C.15, is amended by adding a subdivision
to read:
new text begin Subd. 4a. new text end
new text begin Licensed family foster setting disqualifications. new text end
new text begin
(a) Notwithstanding
subdivisions 1 to 4, for a background study affiliated with a licensed family foster setting,
regardless of how much time has passed, an individual is disqualified under section 245C.14
if the individual committed an act that resulted in a felony-level conviction for sections:
609.185 (murder in the first degree); 609.19 (murder in the second degree); 609.195 (murder
in the third degree); 609.20 (manslaughter in the first degree); 609.205 (manslaughter in
the second degree); 609.2112 (criminal vehicular homicide); 609.221 (assault in the first
degree); 609.223, subdivision 2 (assault in the third degree, past pattern of child abuse);
609.223, subdivision 3 (assault in the third degree, victim under four); a felony offense
under sections 609.2242 and 609.2243 (domestic assault, spousal abuse, child abuse or
neglect, or a crime against children); 609.2247 (domestic assault by strangulation); 609.2325
(criminal abuse of a vulnerable adult resulting in the death of a vulnerable adult); 609.245
(aggravated robbery); 609.25 (kidnapping); 609.255 (false imprisonment); 609.2661 (murder
of an unborn child in the first degree); 609.2662 (murder of an unborn child in the second
degree); 609.2663 (murder of an unborn child in the third degree); 609.2664 (manslaughter
of an unborn child in the first degree); 609.2665 (manslaughter of an unborn child in the
second degree); 609.267 (assault of an unborn child in the first degree); 609.2671 (assault
of an unborn child in the second degree); 609.268 (injury or death of an unborn child in the
commission of a crime); 609.322, subdivision 1 (solicitation, inducement, and promotion
of prostitution; sex trafficking in the first degree); 609.324, subdivision 1 (other prohibited
acts; engaging in, hiring, or agreeing to hire minor to engage in prostitution); 609.342
(criminal sexual conduct in the first degree); 609.343 (criminal sexual conduct in the second
degree); 609.344 (criminal sexual conduct in the third degree); 609.345 (criminal sexual
conduct in the fourth degree); 609.3451 (criminal sexual conduct in the fifth degree);
609.3453 (criminal sexual predatory conduct); 609.352 (solicitation of children to engage
in sexual conduct); 609.377 (malicious punishment of a child); 609.378 (neglect or
endangerment of a child); 609.561 (arson in the first degree); 609.582, subdivision 1 (burglary
in the first degree); 609.746 (interference with privacy); 617.23 (indecent exposure); 617.246
(use of minors in sexual performance prohibited); or 617.247 (possession of pictorial
representations of minors).
new text end
new text begin
(b) Notwithstanding subdivisions 1 to 4, for the purposes of a background study affiliated
with a licensed family foster setting, an individual is disqualified under section 245C.14,
regardless of how much time has passed, if the individual:
new text end
new text begin
(1) committed an action under paragraph (d) that resulted in death or involved sexual
abuse, as defined in section 260E.03, subdivision 20;
new text end
new text begin
(2) committed an act that resulted in a gross misdemeanor-level conviction for section
609.3451 (criminal sexual conduct in the fifth degree);
new text end
new text begin
(3) committed an act against or involving a minor that resulted in a felony-level conviction
for: section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the
third degree); 609.2231 (assault in the fourth degree); or 609.224 (assault in the fifth degree);
or
new text end
new text begin
(4) committed an act that resulted in a misdemeanor or gross misdemeanor-level
conviction for section 617.293 (dissemination and display of harmful materials to minors).
new text end
new text begin
(c) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed
family foster setting, an individual is disqualified under section 245C.14 if less than 20
years have passed since the termination of the individual's parental rights under section
260C.301, subdivision 1, paragraph (b), or if the individual consented to a termination of
parental rights under section 260C.301, subdivision 1, paragraph (a), to settle a petition to
involuntarily terminate parental rights. An individual is disqualified under section 245C.14
if less than 20 years have passed since the termination of the individual's parental rights in
any other state or country, where the conditions for the individual's termination of parental
rights are substantially similar to the conditions in section 260C.301, subdivision 1, paragraph
(b).
new text end
new text begin
(d) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed
family foster setting, an individual is disqualified under section 245C.14 if less than five
years have passed since a felony-level violation for sections: 152.021 (controlled substance
crime in the first degree); 152.022 (controlled substance crime in the second degree); 152.023
(controlled substance crime in the third degree); 152.024 (controlled substance crime in the
fourth degree); 152.025 (controlled substance crime in the fifth degree); 152.0261 (importing
controlled substances across state borders); 152.0262, subdivision 1, paragraph (b)
(possession of substance with intent to manufacture methamphetamine); 152.027, subdivision
6, paragraph (c) (sale or possession of synthetic cannabinoids); 152.096 (conspiracies
prohibited); 152.097 (simulated controlled substances); 152.136 (anhydrous ammonia;
prohibited conduct; criminal penalties; civil liabilities); 152.137 (methamphetamine-related
crimes involving children or vulnerable adults); 169A.24 (felony first-degree driving while
impaired); 243.166 (violation of predatory offender registration requirements); 609.2113
(criminal vehicular operation; bodily harm); 609.2114 (criminal vehicular operation; unborn
child); 609.228 (great bodily harm caused by distribution of drugs); 609.2325 (criminal
abuse of a vulnerable adult not resulting in the death of a vulnerable adult); 609.233 (criminal
neglect); 609.235 (use of drugs to injure or facilitate a crime); 609.24 (simple robbery);
609.322, subdivision 1a (solicitation, inducement, and promotion of prostitution; sex
trafficking in the second degree); 609.498, subdivision 1 (tampering with a witness in the
first degree); 609.498, subdivision 1b (aggravated first-degree witness tampering); 609.562
(arson in the second degree); 609.563 (arson in the third degree); 609.582, subdivision 2
(burglary in the second degree); 609.66 (felony dangerous weapons); 609.687 (adulteration);
609.713 (terroristic threats); 609.749, subdivision 3, 4, or 5 (felony-level harassment or
stalking); 609.855, subdivision 5 (shooting at or in a public transit vehicle or facility); or
624.713 (certain people not to possess firearms).
new text end
new text begin
(e) Notwithstanding subdivisions 1 to 4, except as provided in paragraph (a), for a
background study affiliated with a licensed family child foster care license, an individual
is disqualified under section 245C.14 if less than five years have passed since:
new text end
new text begin
(1) a felony-level violation for an act not against or involving a minor that constitutes:
section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the third
degree); 609.2231 (assault in the fourth degree); or 609.224, subdivision 4 (assault in the
fifth degree);
new text end
new text begin
(2) a violation of an order for protection under section 518B.01, subdivision 14;
new text end
new text begin
(3) a determination or disposition of the individual's failure to make required reports
under section 260E.06 or 626.557, subdivision 3, for incidents in which the final disposition
under chapter 260E or section 626.557 was substantiated maltreatment and the maltreatment
was recurring or serious;
new text end
new text begin
(4) a determination or disposition of the individual's substantiated serious or recurring
maltreatment of a minor under chapter 260E, a vulnerable adult under section 626.557, or
serious or recurring maltreatment in any other state, the elements of which are substantially
similar to the elements of maltreatment under chapter 260E or section 626.557 and meet
the definition of serious maltreatment or recurring maltreatment;
new text end
new text begin
(5) a gross misdemeanor-level violation for sections: 609.224, subdivision 2 (assault in
the fifth degree); 609.2242 and 609.2243 (domestic assault); 609.233 (criminal neglect);
609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of a child);
609.746 (interference with privacy); 609.749 (stalking); or 617.23 (indecent exposure); or
new text end
new text begin
(6) committing an act against or involving a minor that resulted in a misdemeanor-level
violation of section 609.224, subdivision 1 (assault in the fifth degree).
new text end
new text begin
(f) For purposes of this subdivision, the disqualification begins from:
new text end
new text begin
(1) the date of the alleged violation, if the individual was not convicted;
new text end
new text begin
(2) the date of conviction, if the individual was convicted of the violation but not
committed to the custody of the commissioner of corrections; or
new text end
new text begin
(3) the date of release from prison, if the individual was convicted of the violation and
committed to the custody of the commissioner of corrections.
new text end
new text begin
Notwithstanding clause (3), if the individual is subsequently reincarcerated for a violation
of the individual's supervised release, the disqualification begins from the date of release
from the subsequent incarceration.
new text end
new text begin
(g) An individual's aiding and abetting, attempt, or conspiracy to commit any of the
offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota
Statutes, permanently disqualifies the individual under section 245C.14. An individual is
disqualified under section 245C.14 if less than five years have passed since the individual's
aiding and abetting, attempt, or conspiracy to commit any of the offenses listed in paragraphs
(d) and (e).
new text end
new text begin
(h) An individual's offense in any other state or country, where the elements of the
offense are substantially similar to any of the offenses listed in paragraphs (a) and (b),
permanently disqualifies the individual under section 245C.14. An individual is disqualified
under section 245C.14 if less than five years has passed since an offense in any other state
or country, the elements of which are substantially similar to the elements of any offense
listed in paragraphs (d) and (e).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2022.
new text end
Sec. 34.
Minnesota Statutes 2020, section 245C.16, subdivision 1, is amended to read:
Subdivision 1.
Determining immediate risk of harm.
(a) If the commissioner determines
that the individual studied has a disqualifying characteristic, the commissioner shall review
the information immediately available and make a determination as to the subject's immediate
risk of harm to persons served by the program where the individual studied will have direct
contact with, or access to, people receiving services.
(b) The commissioner shall consider all relevant information available, including the
following factors in determining the immediate risk of harm:
(1) the recency of the disqualifying characteristic;
(2) the recency of discharge from probation for the crimes;
(3) the number of disqualifying characteristics;
(4) the intrusiveness or violence of the disqualifying characteristic;
(5) the vulnerability of the victim involved in the disqualifying characteristic;
(6) the similarity of the victim to the persons served by the program where the individual
studied will have direct contact;
(7) whether the individual has a disqualification from a previous background study that
has not been set aside; deleted text begin and
deleted text end
(8) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 1, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense in
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with, or access to, persons receiving services from
the program and from working in a children's residential facility or foster residence settingdeleted text begin .deleted text end new text begin ;
and
new text end
new text begin
(9) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 2, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense during
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with or access to persons receiving services from
the center and from working in a licensed child care center or certified license-exempt child
care center.
new text end
(c) This section does not apply when the subject of a background study is regulated by
a health-related licensing board as defined in chapter 214, and the subject is determined to
be responsible for substantiated maltreatment under section 626.557 or chapter 260E.
(d) This section does not apply to a background study related to an initial application
for a child foster family setting license.
(e) Except for paragraph (f), this section does not apply to a background study that is
also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a
personal care assistant or a qualified professional as defined in section 256B.0659,
subdivision 1.
(f) If the commissioner has reason to believe, based on arrest information or an active
maltreatment investigation, that an individual poses an imminent risk of harm to persons
receiving services, the commissioner may order that the person be continuously supervised
or immediately removed pending the conclusion of the maltreatment investigation or criminal
proceedings.
Sec. 35.
Minnesota Statutes 2020, section 245C.16, subdivision 2, is amended to read:
Subd. 2.
Findings.
(a) After evaluating the information immediately available under
subdivision 1, the commissioner may have reason to believe one of the following:
(1) the individual poses an imminent risk of harm to persons served by the program
where the individual studied will have direct contact or access to persons served by the
program or where the individual studied will work;
(2) the individual poses a risk of harm requiring continuous, direct supervision while
providing direct contact services during the period in which the subject may request a
reconsideration; or
(3) the individual does not pose an imminent risk of harm or a risk of harm requiring
continuous, direct supervision while providing direct contact services during the period in
which the subject may request a reconsideration.
(b) After determining an individual's risk of harm under this section, the commissioner
must notify the subject of the background study and the applicant or license holder as
required under section 245C.17.
(c) For Title IV-E eligible children's residential facilities and foster residence settings,
the commissioner is prohibited from making the findings in paragraph (a), clause (2) or (3).
new text begin
(d) For licensed child care centers or certified license-exempt child care centers, the
commissioner is prohibited from making the findings in paragraph (a), clause (2) or (3).
new text end
Sec. 36.
Minnesota Statutes 2020, section 245C.17, subdivision 1, is amended to read:
Subdivision 1.
Time frame for notice of study results and auditing system access.
(a)
Within three working days after the commissioner's receipt of a request for a background
study submitted through the commissioner's NETStudy or NETStudy 2.0 system, the
commissioner shall notify the background study subject and the license holder or other
entity as provided in this chapter in writing or by electronic transmission of the results of
the study or that more time is needed to complete the study. The notice to the individual
shall include the identity of the entity that initiated the background study.
(b) Before being provided access to NETStudy 2.0, the license holder or other entity
under section 245C.04 shall sign an acknowledgment of responsibilities form developed
by the commissioner that includes identifying the sensitive background study information
person, who must be an employee of the license holder or entity. All queries to NETStudy
2.0 are electronically recorded and subject to audit by the commissioner. The electronic
record shall identify the specific user. A background study subject may request in writing
to the commissioner a report listing the entities that initiated a background study on the
individual.
(c) When the commissioner has completed a prior background study on an individual
that resulted in an order for immediate removal and more time is necessary to complete a
subsequent study, the notice that more time is needed that is issued under paragraph (a)
shall include an order for immediate removal of the individual from any position allowing
direct contact with or access to people receiving services and from working in a children's
residential facility deleted text begin ordeleted text end new text begin ,new text end foster residence settingnew text begin , child care center, or certified license-exempt
child care centernew text end pending completion of the background study.
Sec. 37.
Minnesota Statutes 2020, section 245C.17, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin
Disqualification notice to child care centers and certified license-exempt
child care centers.
new text end
new text begin
(a) For child care centers and certified license-exempt child care centers,
all notices under this section that order the license holder to immediately remove the
individual studied from any position allowing direct contact with, or access to a person
served by the center, must also order the license holder to immediately remove the individual
studied from working in any position regardless of whether the individual would have direct
contact with or access to children served in the center.
new text end
new text begin
(b) For child care centers and certified license-exempt child care centers, notices under
this section must not allow an individual to work in the center.
new text end
Sec. 38.
Minnesota Statutes 2020, section 245C.18, is amended to read:
245C.18 OBLIGATION TO REMOVE DISQUALIFIED INDIVIDUAL FROM
DIRECT CONTACT AND FROM WORKING IN A PROGRAM, FACILITY, deleted text begin ORdeleted text end
SETTINGnew text begin , OR CENTERnew text end .
(a) Upon receipt of notice from the commissioner, the license holder must remove a
disqualified individual from direct contact with persons served by the licensed program if:
(1) the individual does not request reconsideration under section 245C.21 within the
prescribed time;
(2) the individual submits a timely request for reconsideration, the commissioner does
not set aside the disqualification under section 245C.22, subdivision 4, and the individual
does not submit a timely request for a hearing under sections 245C.27 and 256.045, or
245C.28 and chapter 14; or
(3) the individual submits a timely request for a hearing under sections 245C.27 and
256.045, or 245C.28 and chapter 14, and the commissioner does not set aside or rescind the
disqualification under section 245A.08, subdivision 5, or 256.045.
(b) For children's residential facility and foster residence setting license holders, upon
receipt of notice from the commissioner under paragraph (a), the license holder must also
remove the disqualified individual from working in the program, facility, or setting and
from access to persons served by the licensed program.
(c) For Title IV-E eligible children's residential facility and foster residence setting
license holders, upon receipt of notice from the commissioner under paragraph (a), the
license holder must also remove the disqualified individual from working in the program
and from access to persons served by the program and must not allow the individual to work
in the facility or setting until the commissioner has issued a notice stating that:
(1) the individual is not disqualified;
(2) a disqualification has been set aside under section 245C.23; or
(3) a variance has been granted related to the individual under section 245C.30.
new text begin
(d) For licensed child care center and certified license-exempt child care center license
holders, upon receipt of notice from the commissioner under paragraph (a), the license
holder must remove the disqualified individual from working in any position regardless of
whether the individual would have direct contact with or access to children served in the
center and from having access to persons served by the center and must not allow the
individual to work in the center until the commissioner has issued a notice stating that:
new text end
new text begin
(1) the individual is not disqualified;
new text end
new text begin
(2) a disqualification has been set aside under section 245C.23; or
new text end
new text begin
(3) a variance has been granted related to the individual under section 245C.30.
new text end
Sec. 39.
Minnesota Statutes 2020, section 245C.24, subdivision 2, is amended to read:
Subd. 2.
Permanent bar to set aside a disqualification.
(a) Except as provided in
paragraphs (b) to deleted text begin (e)deleted text end new text begin (f)new text end , the commissioner may not set aside the disqualification of any
individual disqualified pursuant to this chapter, regardless of how much time has passed,
if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision
1.
(b) For an individual in the chemical dependency or corrections field who was disqualified
for a crime or conduct listed under section 245C.15, subdivision 1, and whose disqualification
was set aside prior to July 1, 2005, the commissioner must consider granting a variance
pursuant to section 245C.30 for the license holder for a program dealing primarily with
adults. A request for reconsideration evaluated under this paragraph must include a letter
of recommendation from the license holder that was subject to the prior set-aside decision
addressing the individual's quality of care to children or vulnerable adults and the
circumstances of the individual's departure from that service.
(c) If an individual who requires a background study for nonemergency medical
transportation services under section 245C.03, subdivision 12, was disqualified for a crime
or conduct listed under section 245C.15, subdivision 1, and if more than 40 years have
passed since the discharge of the sentence imposed, the commissioner may consider granting
a set-aside pursuant to section 245C.22. A request for reconsideration evaluated under this
paragraph must include a letter of recommendation from the employer. This paragraph does
not apply to a person disqualified based on a violation of sections 243.166; 609.185 to
609.205; 609.25; 609.342 to 609.3453; 609.352; 617.23, subdivision 2, clause (1), or 3,
clause (1); 617.246; or 617.247.
(d) When a licensed foster care provider adopts an individual who had received foster
care services from the provider for over six months, and the adopted individual is required
to receive a background study under section 245C.03, subdivision 1, paragraph (a), clause
(2) or (6), the commissioner may grant a variance to the license holder under section 245C.30
to permit the adopted individual with a permanent disqualification to remain affiliated with
the license holder under the conditions of the variance when the variance is recommended
by the county of responsibility for each of the remaining individuals in placement in the
home and the licensing agency for the home.
new text begin
(e) For an individual 18 years of age or older affiliated with a licensed family foster
setting, the commissioner must not set aside or grant a variance for the disqualification of
any individual disqualified pursuant to this chapter, regardless of how much time has passed,
if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision
4a, paragraphs (a) and (b).
new text end
new text begin
(f) In connection with a family foster setting license, the commissioner may grant a
variance to the disqualification for an individual who is under 18 years of age at the time
the background study is submitted.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2022.
new text end
Sec. 40.
Minnesota Statutes 2020, section 245C.24, subdivision 3, is amended to read:
Subd. 3.
Ten-year bar to set aside disqualification.
(a) The commissioner may not set
aside the disqualification of an individual in connection with a license to provide family
child care for childrendeleted text begin , foster care for children in the provider's home,deleted text end or foster care or day
care services for adults in the provider's home if: (1) less than ten years has passed since
the discharge of the sentence imposed, if any, for the offense; or (2) when disqualified based
on a preponderance of evidence determination under section 245C.14, subdivision 1,
paragraph (a), clause (2), or an admission under section 245C.14, subdivision 1, paragraph
(a), clause (1), and less than ten years has passed since the individual committed the act or
admitted to committing the act, whichever is later; and (3) the individual has committed a
violation of any of the following offenses: sections 609.165 (felon ineligible to possess
firearm); criminal vehicular homicide or criminal vehicular operation causing death under
609.2112, 609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.215 (aiding
suicide or aiding attempted suicide); felony violations under 609.223 or 609.2231 (assault
in the third or fourth degree); 609.229 (crimes committed for benefit of a gang); 609.713
(terroristic threats); 609.235 (use of drugs to injure or to facilitate crime); 609.24 (simple
robbery); 609.255 (false imprisonment); 609.562 (arson in the second degree); 609.71 (riot);
609.498, subdivision 1 or 1b (aggravated first-degree or first-degree tampering with a
witness); burglary in the first or second degree under 609.582 (burglary); 609.66 (dangerous
weapon); 609.665 (spring guns); 609.67 (machine guns and short-barreled shotguns);
609.749, subdivision 2 (gross misdemeanor harassment); 152.021 or 152.022 (controlled
substance crime in the first or second degree); 152.023, subdivision 1, clause (3) or (4) or
subdivision 2, clause (4) (controlled substance crime in the third degree); 152.024,
subdivision 1, clause (2), (3), or (4) (controlled substance crime in the fourth degree);
609.224, subdivision 2, paragraph (c) (fifth-degree assault by a caregiver against a vulnerable
adult); 609.23 (mistreatment of persons confined); 609.231 (mistreatment of residents or
patients); 609.2325 (criminal abuse of a vulnerable adult); 609.233 (criminal neglect of a
vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 609.234 (failure
to report); 609.265 (abduction); 609.2664 to 609.2665 (manslaughter of an unborn child in
the first or second degree); 609.267 to 609.2672 (assault of an unborn child in the first,
second, or third degree); 609.268 (injury or death of an unborn child in the commission of
a crime); repeat offenses under 617.23 (indecent exposure); 617.293 (disseminating or
displaying harmful material to minors); a felony-level conviction involving alcohol or drug
use, a gross misdemeanor offense under 609.324, subdivision 1 (other prohibited acts); a
gross misdemeanor offense under 609.378 (neglect or endangerment of a child); a gross
misdemeanor offense under 609.377 (malicious punishment of a child); 609.72, subdivision
3 (disorderly conduct against a vulnerable adult); or 624.713 (certain persons not to possess
firearms); or Minnesota Statutes 2012, section 609.21.
(b) The commissioner may not set aside the disqualification of an individual if less than
ten years have passed since the individual's aiding and abetting, attempt, or conspiracy to
commit any of the offenses listed in paragraph (a) as each of these offenses is defined in
Minnesota Statutes.
(c) The commissioner may not set aside the disqualification of an individual if less than
ten years have passed since the discharge of the sentence imposed for an offense in any
other state or country, the elements of which are substantially similar to the elements of any
of the offenses listed in paragraph (a).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2022.
new text end
Sec. 41.
Minnesota Statutes 2020, section 245C.24, subdivision 4, is amended to read:
Subd. 4.
Seven-year bar to set aside disqualification.
The commissioner may not set
aside the disqualification of an individual in connection with a license to provide family
child care for childrendeleted text begin , foster care for children in the provider's home,deleted text end or foster care or day
care services for adults in the provider's home if within seven years preceding the study:
(1) the individual committed an act that constitutes maltreatment of a child under sections
260E.24, subdivisions 1, 2, and 3, and 260E.30, subdivisions 1, 2, and 4, and the maltreatment
resulted in substantial bodily harm as defined in section 609.02, subdivision 7a, or substantial
mental or emotional harm as supported by competent psychological or psychiatric evidence;
or
(2) the individual was determined under section 626.557 to be the perpetrator of a
substantiated incident of maltreatment of a vulnerable adult that resulted in substantial
bodily harm as defined in section 609.02, subdivision 7a, or substantial mental or emotional
harm as supported by competent psychological or psychiatric evidence.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2022.
new text end
Sec. 42.
Minnesota Statutes 2020, section 245C.24, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Five-year bar to set aside disqualification; family foster setting. new text end
new text begin
(a) The
commissioner shall not set aside or grant a variance for the disqualification of an individual
18 years of age or older in connection with a foster family setting license if within five years
preceding the study the individual is convicted of a felony in section 245C.15, subdivision
4a, paragraph (d).
new text end
new text begin
(b) In connection with a foster family setting license, the commissioner may set aside
or grant a variance to the disqualification for an individual who is under 18 years of age at
the time the background study is submitted.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2022.
new text end
Sec. 43.
Minnesota Statutes 2020, section 245C.32, subdivision 1a, is amended to read:
Subd. 1a.
NETStudy 2.0 system.
(a) The commissioner shall design, develop, and test
the NETStudy 2.0 system and implement it no later than September 1, 2015.
(b) The NETStudy 2.0 system developed and implemented by the commissioner shall
incorporate and meet all applicable data security standards and policies required by the
Federal Bureau of Investigation (FBI), Department of Public Safety, Bureau of Criminal
Apprehension, and the Office of MN.IT Services. The system shall meet all required
standards for encryption of data at the database level as well as encryption of data that
travels electronically among agencies initiating background studies, the commissioner's
authorized fingerprint collection vendornew text begin or vendorsnew text end , the commissioner, the Bureau of Criminal
Apprehension, and in cases involving national criminal record checks, the FBI.
(c) The data system developed and implemented by the commissioner shall incorporate
a system of data security that allows the commissioner to control access to the data field
level by the commissioner's employees. The commissioner shall establish that employees
have access to the minimum amount of private data on any individual as is necessary to
perform their duties under this chapter.
(d) The commissioner shall oversee regular quality and compliance audits of the
authorized fingerprint collection vendornew text begin or vendorsnew text end .
Sec. 44.
Minnesota Statutes 2020, section 256B.0949, is amended by adding a subdivision
to read:
new text begin Subd. 16a. new text end
new text begin Background studies. new text end
new text begin
The requirements for background studies under this
section shall be met by an early intensive developmental and behavioral intervention services
agency through the commissioner's NETStudy system as provided under sections 245C.03,
subdivision 15, and 245C.10, subdivision 17.
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. 45.
Minnesota Statutes 2020, section 260C.215, subdivision 4, is amended to read:
Subd. 4.
Duties of commissioner.
The commissioner of human services shall:
(1) provide practice guidance to responsible social services agencies and licensed
child-placing agencies that reflect federal and state laws and policy direction on placement
of children;
(2) develop criteria for determining whether a prospective adoptive or foster family has
the ability to understand and validate the child's cultural background;
(3) provide a standardized training curriculum for adoption and foster care workers and
administrators who work with children. Training must address the following objectives:
(i) developing and maintaining sensitivity to all cultures;
(ii) assessing values and their cultural implications;
(iii) making individualized placement decisions that advance the best interests of a
particular child under section 260C.212, subdivision 2; and
(iv) issues related to cross-cultural placement;
(4) provide a training curriculum for all prospective adoptive and foster families that
prepares them to care for the needs of adoptive and foster children taking into consideration
the needs of children outlined in section 260C.212, subdivision 2, paragraph (b), and, as
necessary, preparation is continued after placement of the child and includes the knowledge
and skills related to reasonable and prudent parenting standards for the participation of the
child in age or developmentally appropriate activities, according to section 260C.212,
subdivision 14;
(5) develop and provide to responsible social services agencies and licensed child-placing
agencies a home study format to assess the capacities and needs of prospective adoptive
and foster families. The format must address problem-solving skills; parenting skills; evaluate
the degree to which the prospective family has the ability to understand and validate the
child's cultural background, and other issues needed to provide sufficient information for
agencies to make an individualized placement decision consistent with section 260C.212,
subdivision 2. For a study of a prospective foster parent, the format must also address the
capacity of the prospective foster parent to provide a safe, healthy, smoke-free home
environment. If a prospective adoptive parent has also been a foster parent, any update
necessary to a home study for the purpose of adoption may be completed by the licensing
authority responsible for the foster parent's license. If a prospective adoptive parent with
an approved adoptive home study also applies for a foster care license, the license application
may be made with the same agency which provided the adoptive home study; deleted text begin and
deleted text end
(6) consult with representatives reflecting diverse populations from the councils
established under sections 3.922 and 15.0145, and other state, local, and community
organizationsdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(7) establish family foster setting licensing guidelines for county agencies and private
agencies designated or licensed by the commissioner to perform licensing functions and
activities under section 245A.04. Guidelines that the commissioner establishes under this
clause shall be considered directives of the commissioner under section 245A.16.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023.
new text end
Sec. 46.
Laws 2020, First Special Session chapter 7, section 1, as amended by Laws 2020,
Third Special Session chapter 1, section 3, is amended by adding a subdivision to read:
new text begin Subd. 5. new text end
new text begin Waivers and modifications; extension for 180 days. new text end
new text begin
When the peacetime
emergency declared by the governor in response to the COVID-19 outbreak expires, is
terminated, or is rescinded by the proper authority, waiver CV23: modifying background
study requirements, issued by the commissioner of human services pursuant to Executive
Orders 20-11 and 20-12, including any amendments to the modification issued before the
peacetime emergency expires, shall remain in effect for 180 days after the peacetime
emergency ends.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment or
retroactively from the date the peacetime emergency declared by the governor in response
to the COVID-19 outbreak ends, whichever is earlier.
new text end
Sec. 47. new text begin CHILD FOSTER CARE LICENSING GUIDELINES.
new text end
new text begin
By July 1, 2023, the commissioner of human services shall, in consultation with
stakeholders with expertise in child protection and children's behavioral health, develop
family foster setting licensing guidelines for county agencies and private agencies that
perform licensing functions. Stakeholders include but are not limited to child advocates,
representatives from community organizations, representatives of the state ethnic councils,
the ombudsperson for families, family foster setting providers, youth who have experienced
family foster setting placements, county child protection staff, and representatives of county
and private licensing agencies.
new text end
Sec. 48. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall renumber Minnesota Statutes, section 245C.02, so that the
subdivisions are alphabetical. The revisor shall correct any cross-references that arise as a
result of the renumbering.
new text end
Sec. 49. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2020, section 245C.10, subdivisions 2, 2a, 3, 4, 5, 6, 7, 8, 9, 9a, 10,
11, 12, 13, 14, and 16,
new text end
new text begin
are repealed.
new text end
ARTICLE 3
HEALTH DEPARTMENT
Section 1.
Minnesota Statutes 2020, section 62J.495, subdivision 1, is amended to read:
Subdivision 1.
Implementation.
The commissioner of health, in consultation with the
e-Health Advisory Committee, shall develop uniform standards to be used for the
interoperable electronic health records system for sharing and synchronizing patient data
across systems. The standards must be compatible with federal efforts. The uniform standards
must be developed by January 1, 2009, and updated on an ongoing basis. deleted text begin The commissioner
shall include an update on standards development as part of an annual report to the legislature.deleted text end
Individual health care providers in private practice with no other providers and health care
providers that do not accept reimbursement from a group purchaser, as defined in section
62J.03, subdivision 6, are excluded from the requirements of this section.
Sec. 2.
Minnesota Statutes 2020, section 62J.495, subdivision 2, is amended to read:
Subd. 2.
E-Health Advisory Committee.
(a) The commissioner shall establish an
e-Health Advisory Committee governed by section 15.059 to advise the commissioner on
the following matters:
(1) assessment of the adoption and effective use of health information technology by
the state, licensed health care providers and facilities, and local public health agencies;
(2) recommendations for implementing a statewide interoperable health information
infrastructure, to include estimates of necessary resources, and for determining standards
for clinical data exchange, clinical support programs, patient privacy requirements, and
maintenance of the security and confidentiality of individual patient data;
(3) recommendations for encouraging use of innovative health care applications using
information technology and systems to improve patient care and reduce the cost of care,
including applications relating to disease management and personal health management
that enable remote monitoring of patients' conditions, especially those with chronic
conditions; and
(4) other related issues as requested by the commissioner.
(b) The members of the e-Health Advisory Committee shall include the commissioners,
or commissioners' designees, of health, human services, administration, and commerce and
additional members to be appointed by the commissioner to include persons representing
Minnesota's local public health agencies, licensed hospitals and other licensed facilities and
providers, private purchasers, the medical and nursing professions, health insurers and health
plans, the state quality improvement organization, academic and research institutions,
consumer advisory organizations with an interest and expertise in health information
technology, and other stakeholders as identified by the commissioner to fulfill the
requirements of section 3013, paragraph (g), of the HITECH Act.
(c) deleted text begin The commissioner shall prepare and issue an annual report not later than January 30
of each year outlining progress to date in implementing a statewide health information
infrastructure and recommending action on policy and necessary resources to continue the
promotion of adoption and effective use of health information technology.
deleted text end
deleted text begin (d)deleted text end This subdivision expires June 30, deleted text begin 2021deleted text end new text begin 2031new 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.
Minnesota Statutes 2020, section 62J.495, subdivision 3, is amended to read:
Subd. 3.
Interoperable electronic health record requirements.
(a) Hospitals and health
care providers must meet the following criteria when implementing an interoperable
electronic health records system within their hospital system or clinical practice setting.
(b) The electronic health record must be a qualified electronic health record.
(c) The electronic health record must be certified by the Office of the National
Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and health
care providers if a certified electronic health record product for the provider's particular
practice setting is available. This criterion shall be considered met if a hospital or health
care provider is using an electronic health records system that has been certified within the
last three years, even if a more current version of the system has been certified within the
three-year period.
(d) The electronic health record must meet the standards established according to section
3004 of the HITECH Act as applicable.
(e) The electronic health record must have the ability to generate information on clinical
quality measures and other measures reported under sections 4101, 4102, and 4201 of the
HITECH Act.
(f) The electronic health record system must be connected to a state-certified health
information organization either directly or through a connection facilitated by a deleted text begin state-certifieddeleted text end
health data intermediary as defined in section 62J.498.
(g) A health care provider who is a prescriber or dispenser of legend drugs must have
an electronic health record system that meets the requirements of section 62J.497.
Sec. 4.
Minnesota Statutes 2020, section 62J.495, subdivision 4, is amended to read:
Subd. 4.
Coordination with national HIT activities.
(a) The commissioner, in
consultation with the e-Health Advisory Committee, shall update the statewide
implementation plan required under subdivision 2 and released June 2008, to be consistent
with the updated federal deleted text begin HIT Strategic Plan released by the Office of the National Coordinator
in accordance with section 3001 of the HITECH Act. The statewide plan shall meet the
requirements for a plan required under section 3013 of the HITECH Actdeleted text end new text begin plansnew text end .
(b) The commissioner, in consultation with the e-Health Advisory Committee, shall
work to ensure coordination between state, regional, and national efforts to support and
accelerate efforts to effectively use health information technology to improve the quality
and coordination of health care and the continuity of patient care among health care providers,
to reduce medical errors, to improve population health, to reduce health disparities, and to
reduce chronic disease. The commissioner's coordination efforts shall include but not be
limited to:
deleted text begin
(1) assisting in the development and support of health information technology regional
extension centers established under section 3012(c) of the HITECH Act to provide technical
assistance and disseminate best practices;
deleted text end
deleted text begin
(2) providing supplemental information to the best practices gathered by regional centers
to ensure that the information is relayed in a meaningful way to the Minnesota health care
community;
deleted text end
deleted text begin (3)deleted text end new text begin (1)new text end providing financial and technical support to Minnesota health care providers to
encourage implementation of admission, discharge and transfer alerts, and care summary
document exchange transactions and to evaluate the impact of health information technology
on cost and quality of care. Communications about available financial and technical support
shall include clear information about the interoperable health record requirements in
subdivision 1, including a separate statement in bold-face type clarifying the exceptions to
those requirements;
deleted text begin (4)deleted text end new text begin (2)new text end providing educational resources and technical assistance to health care providers
and patients related to state and national privacy, security, and consent laws governing
clinical health information, including the requirements in sections 144.291 to 144.298. In
carrying out these activities, the commissioner's technical assistance does not constitute
legal advice;
deleted text begin (5)deleted text end new text begin (3)new text end assessing Minnesota's legal, financial, and regulatory framework for health
information exchange, including the requirements in sections 144.291 to 144.298, and
making recommendations for modifications that would strengthen the ability of Minnesota
health care providers to securely exchange data in compliance with patient preferences and
in a way that is efficient and financially sustainable; and
deleted text begin (6)deleted text end new text begin (4)new text end seeking public input on both patient impact and costs associated with requirements
related to patient consent for release of health records for the purposes of treatment, payment,
and health care operations, as required in section 144.293, subdivision 2. The commissioner
shall provide a report to the legislature on the findings of this public input process no later
than February 1, 2017.
(c) The commissioner, in consultation with the e-Health Advisory Committee, shall
monitor national activity related to health information technology and shall coordinate
statewide input on policy development. The commissioner shall coordinate statewide
responses to proposed federal health information technology regulations in order to ensure
that the needs of the Minnesota health care community are adequately and efficiently
addressed in the proposed regulations. The commissioner's responses may include, but are
not limited to:
(1) reviewing and evaluating any standard, implementation specification, or certification
criteria proposed by the national HIT standards deleted text begin committeedeleted text end new text begin committeesnew text end ;
(2) reviewing and evaluating policy proposed by deleted text begin thedeleted text end national HIT policy deleted text begin committeedeleted text end new text begin
committeesnew text end relating to the implementation of a nationwide health information technology
infrastructure;new text begin and
new text end
(3) deleted text begin monitoring and responding to activity related to the development of quality measures
and other measures as required by section 4101 of the HITECH Act. Any response related
to quality measures shall consider and address the quality efforts required under chapter
62U; and
deleted text end
deleted text begin (4)deleted text end monitoring and responding to national activity related to privacy, security, and data
stewardship of electronic health information and individually identifiable health information.
(d) To the extent that the state is either required or allowed to apply, or designate an
entity to apply for or carry out activities and programs deleted text begin under section 3013 of the HITECH
Actdeleted text end , the commissioner of health, in consultation with the e-Health Advisory Committee
and the commissioner of human services, shall be the lead applicant or sole designating
authority. The commissioner shall make such designations consistent with the goals and
objectives of sections 62J.495 to 62J.497 and 62J.50 to 62J.61.
(e) The commissioner of human services shall apply for funding necessary to administer
the incentive payments to providers authorized under title IV of the American Recovery
and Reinvestment Act.
deleted text begin
(f) The commissioner shall include in the report to the legislature information on the
activities of this subdivision and provide recommendations on any relevant policy changes
that should be considered in Minnesota.
deleted text end
Sec. 5.
Minnesota Statutes 2020, section 62J.497, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For the purposes of this section, the following terms have
the meanings given.
deleted text begin
(b) "Backward compatible" means that the newer version of a data transmission standard
deleted text end
deleted text begin
would retain, at a minimum, the full functionality of the versions previously adopted, and
deleted text end
deleted text begin
would permit the successful completion of the applicable transactions with entities that
deleted text end
deleted text begin
continue to use the older versions.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision
30. Dispensing does not include the direct administering of a controlled substance to a
patient by a licensed health care professional.
deleted text begin (d)deleted text end new text begin (c)new text end "Dispenser" means a person authorized by law to dispense a controlled substance,
pursuant to a valid prescription.
deleted text begin (e)deleted text end new text begin (d)new text end "Electronic media" has the meaning given under Code of Federal Regulations,
title 45, part 160.103.
deleted text begin (f)deleted text end new text begin (e)new text end "E-prescribing" means the transmission using electronic media of prescription or
prescription-related information between a prescriber, dispenser, pharmacy benefit manager,
or group purchaser, either directly or through an intermediary, including an e-prescribing
network. E-prescribing includes, but is not limited to, two-way transmissions between the
point of care and the dispenser and two-way transmissions related to eligibility, formulary,
and medication history information.
deleted text begin (g)deleted text end new text begin (f)new text end "Electronic prescription drug program" means a program that provides for
e-prescribing.
deleted text begin (h)deleted text end new text begin (g)new text end "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
deleted text begin (i)deleted text end new text begin (h)new text end "HL7 messages" means a standard approved by the standards development
organization known as Health Level Seven.
deleted text begin (j)deleted text end new text begin (i)new text end "National Provider Identifier" or "NPI" means the identifier described under Code
of Federal Regulations, title 45, part 162.406.
deleted text begin (k)deleted text end new text begin (j)new text end "NCPDP" means the National Council for Prescription Drug Programs, Inc.
deleted text begin (l)deleted text end new text begin (k)new text end "NCPDP Formulary and Benefits Standard" means thenew text begin most recent version of thenew text end
National Council for Prescription Drug Programs Formulary and Benefits Standarddeleted text begin ,
Implementation Guide, Version 1, Release 0, October 2005deleted text end new text begin or the most recent standard
adopted by the Centers for Medicare and Medicaid Services for e-prescribing under Medicare
Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act and regulations
adopted under it. The standards shall be implemented according to the Centers for Medicare
and Medicaid Services schedule for compliancenew text end .
deleted text begin (m)deleted text end new text begin (l)new text end "NCPDP SCRIPT Standard" means thenew text begin most recent version of thenew text end National
Council for Prescription Drug Programs deleted text begin Prescriber/Pharmacist Interfacedeleted text end SCRIPT Standard,
deleted text begin Implementation Guide Version 8, Release 1 (Version 8.1), October 2005,deleted text end or the most recent
standard adopted by the Centers for Medicare and Medicaid Services for e-prescribing under
Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and
regulations adopted under it. The standards shall be implemented according to the Centers
for Medicare and Medicaid Services schedule for compliance. deleted text begin Subsequently released versions
of the NCPDP SCRIPT Standard may be used, provided that the new version of the standard
is backward compatible to the current version adopted by the Centers for Medicare and
Medicaid Services.
deleted text end
deleted text begin (n)deleted text end new text begin (m)new text end "Pharmacy" has the meaning given in section 151.01, subdivision 2.
deleted text begin (o)deleted text end new text begin (n)new text end "Prescriber" means a licensed health care practitioner, other than a veterinarian,
as defined in section 151.01, subdivision 23.
deleted text begin (p)deleted text end new text begin (o)new text end "Prescription-related information" means information regarding eligibility for
drug benefits, medication history, or related health or drug information.
deleted text begin (q)deleted text end new text begin (p)new text end "Provider" or "health care provider" has the meaning given in section 62J.03,
subdivision 8.
Sec. 6.
Minnesota Statutes 2020, section 62J.497, subdivision 3, is amended to read:
Subd. 3.
Standards for electronic prescribing.
(a) Prescribers and dispensers must use
the NCPDP SCRIPT Standard for the communication of a prescription or prescription-related
information. deleted text begin The NCPDP SCRIPT Standard shall be used to conduct the following
transactions:
deleted text end
deleted text begin
(1) get message transaction;
deleted text end
deleted text begin
(2) status response transaction;
deleted text end
deleted text begin
(3) error response transaction;
deleted text end
deleted text begin
(4) new prescription transaction;
deleted text end
deleted text begin
(5) prescription change request transaction;
deleted text end
deleted text begin
(6) prescription change response transaction;
deleted text end
deleted text begin
(7) refill prescription request transaction;
deleted text end
deleted text begin
(8) refill prescription response transaction;
deleted text end
deleted text begin
(9) verification transaction;
deleted text end
deleted text begin
(10) password change transaction;
deleted text end
deleted text begin
(11) cancel prescription request transaction; and
deleted text end
deleted text begin
(12) cancel prescription response transaction.
deleted text end
(b) Providers, group purchasers, prescribers, and dispensers must use the NCPDP SCRIPT
Standard for communicating and transmitting medication history information.
(c) Providers, group purchasers, prescribers, and dispensers must use the NCPDP
Formulary and Benefits Standard for communicating and transmitting formulary and benefit
information.
(d) Providers, group purchasers, prescribers, and dispensers must use the national provider
identifier to identify a health care provider in e-prescribing or prescription-related transactions
when a health care provider's identifier is required.
(e) Providers, group purchasers, prescribers, and dispensers must communicate eligibility
information and conduct health care eligibility benefit inquiry and response transactions
according to the requirements of section 62J.536.
Sec. 7.
Minnesota Statutes 2020, section 62J.498, is amended to read:
62J.498 HEALTH INFORMATION EXCHANGE.
Subdivision 1.
Definitions.
(a) The following definitions apply to sections 62J.498 to
62J.4982:
(b) "Clinical data repository" means a real time database that consolidates data from a
variety of clinical sources to present a unified view of a single patient and is used by a
deleted text begin state-certifieddeleted text end health information exchange service provider to enable health information
exchange among health care providers that are not related health care entities as defined in
section 144.291, subdivision 2, paragraph (k). This does not include clinical data that are
submitted to the commissioner for public health purposes required or permitted by law,
including any rules adopted by the commissioner.
(c) "Clinical transaction" means any meaningful use transaction or other health
information exchange transaction that is not covered by section 62J.536.
(d) "Commissioner" means the commissioner of health.
(e) "Health care provider" or "provider" means a health care provider or provider as
defined in section 62J.03, subdivision 8.
(f) "Health data intermediary" means an entity that provides the technical capabilities
or related products and services to enable health information exchange among health care
providers that are not related health care entities as defined in section 144.291, subdivision
2, paragraph (k). This includes but is not limited to health information service providers
(HISP), electronic health record vendors, and pharmaceutical electronic data intermediaries
as defined in section 62J.495.
(g) "Health information exchange" means the electronic transmission of health-related
information between organizations according to nationally recognized standards.
(h) "Health information exchange service provider" means a health data intermediary
or health information organization.
(i) "Health information organization" means an organization that oversees, governs, and
facilitates health information exchange among health care providers that are not related
health care entities as defined in section 144.291, subdivision 2, paragraph (k), to improve
coordination of patient care and the efficiency of health care delivery.
deleted text begin
(j) "HITECH Act" means the Health Information Technology for Economic and Clinical
Health Act as defined in section 62J.495.
deleted text end
deleted text begin (k)deleted text end new text begin (j)new text end "Major participating entity" means:
(1) a participating entity that receives compensation for services that is greater than 30
percent of the health information organization's gross annual revenues from the health
information exchange service provider;
(2) a participating entity providing administrative, financial, or management services to
the health information organization, if the total payment for all services provided by the
participating entity exceeds three percent of the gross revenue of the health information
organization; and
(3) a participating entity that nominates or appoints 30 percent or more of the board of
directors or equivalent governing body of the health information organization.
deleted text begin (l)deleted text end new text begin (k)new text end "Master patient index" means an electronic database that holds unique identifiers
of patients registered at a care facility and is used by a deleted text begin state-certifieddeleted text end health information
exchange service provider to enable health information exchange among health care providers
that are not related health care entities as defined in section 144.291, subdivision 2, paragraph
(k). This does not include data that are submitted to the commissioner for public health
purposes required or permitted by law, including any rules adopted by the commissioner.
deleted text begin
(m) "Meaningful use" means use of certified electronic health record technology to
improve quality, safety, and efficiency and reduce health disparities; engage patients and
families; improve care coordination and population and public health; and maintain privacy
and security of patient health information as established by the Centers for Medicare and
Medicaid Services and the Minnesota Department of Human Services pursuant to sections
4101, 4102, and 4201 of the HITECH Act.
deleted text end
deleted text begin
(n) "Meaningful use transaction" means an electronic transaction that a health care
provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare
penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
deleted text end
deleted text begin (o)deleted text end new text begin (l)new text end "Participating entity" means any of the following persons, health care providers,
companies, or other organizations with which a health information organization deleted text begin or health
data intermediarydeleted text end has contracts or other agreements for the provision of health information
exchange services:
(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home
licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise
licensed under the laws of this state or registered with the commissioner;
(2) a health care provider, and any other health care professional otherwise licensed
under the laws of this state or registered with the commissioner;
(3) a group, professional corporation, or other organization that provides the services of
individuals or entities identified in clause (2), including but not limited to a medical clinic,
a medical group, a home health care agency, an urgent care center, and an emergent care
center;
(4) a health plan as defined in section 62A.011, subdivision 3; and
(5) a state agency as defined in section 13.02, subdivision 17.
deleted text begin (p)deleted text end new text begin (m)new text end "Reciprocal agreement" means an arrangement in which two or more health
information exchange service providers agree to share in-kind services and resources to
allow for the pass-through of clinical transactions.
deleted text begin
(q) "State-certified health data intermediary" means a health data intermediary that has
been issued a certificate of authority to operate in Minnesota.
deleted text end
deleted text begin (r)deleted text end new text begin (n)new text end "State-certified health information organization" means a health information
organization that has been issued a certificate of authority to operate in Minnesota.
Subd. 2.
Health information exchange oversight.
(a) The commissioner shall protect
the public interest on matters pertaining to health information exchange. The commissioner
shall:
(1) review and act on applications from deleted text begin health data intermediaries anddeleted text end health information
organizations for certificates of authority to operate in Minnesota;
new text begin
(2) require information to be provided as needed from health information exchange
service providers in order to meet requirements established under sections 62J.498 to
62J.4982;
new text end
deleted text begin (2)deleted text end new text begin (3)new text end provide ongoing monitoring to ensure compliance with criteria established under
sections 62J.498 to 62J.4982;
deleted text begin (3)deleted text end new text begin (4)new text end respond to public complaints related to health information exchange services;
deleted text begin (4)deleted text end new text begin (5)new text end take enforcement actions as necessary, including the imposition of fines,
suspension, or revocation of certificates of authority as outlined in section 62J.4982;
deleted text begin (5)deleted text end new text begin (6)new text end provide a biennial report on the status of health information exchange services
that includes but is not limited to:
(i) recommendations on actions necessary to ensure that health information exchange
services are adequate to meet the needs of Minnesota citizens and providers statewide;
(ii) recommendations on enforcement actions to ensure that health information exchange
service providers act in the public interest without causing disruption in health information
exchange services;
(iii) recommendations on updates to criteria for obtaining certificates of authority under
this section; and
(iv) recommendations on standard operating procedures for health information exchange,
including but not limited to the management of consumer preferences; and
deleted text begin (6)deleted text end new text begin (7)new text end other duties necessary to protect the public interest.
(b) As part of the application review process for certification under paragraph (a), prior
to issuing a certificate of authority, the commissioner shall:
(1) make all portions of the application classified as public data available to the public
for at least ten days while an application is under consideration. At the request of the
commissioner, the applicant shall participate in a public hearing by presenting an overview
of their application and responding to questions from interested parties; and
(2) consult with hospitals, physicians, and other providers prior to issuing a certificate
of authority.
(c) When the commissioner is actively considering a suspension or revocation of a
certificate of authority as described in section 62J.4982, subdivision 3, all investigatory data
that are collected, created, or maintained related to the suspension or revocation are classified
as confidential data on individuals and as protected nonpublic data in the case of data not
on individuals.
(d) The commissioner may disclose data classified as protected nonpublic or confidential
under paragraph (c) if disclosing the data will protect the health or safety of patients.
(e) After the commissioner makes a final determination regarding a suspension or
revocation of a certificate of authority, all minutes, orders for hearing, findings of fact,
conclusions of law, and the specification of the final disciplinary action, are classified as
public data.
Sec. 8.
Minnesota Statutes 2020, section 62J.4981, is amended to read:
62J.4981 CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH
INFORMATION EXCHANGE SERVICES.
Subdivision 1.
Authority to require organizations to apply.
The commissioner shall
require deleted text begin a health data intermediary ordeleted text end a health information organization to apply for a
certificate of authority under this section. An applicant may continue to operate until the
commissioner acts on the application. If the application is denied, the applicant is considered
a health information exchange service provider whose certificate of authority has been
revoked under section 62J.4982, subdivision 2, paragraph (d).
deleted text begin Subd. 2. deleted text end
deleted text begin Certificate of authority for health data intermediaries. deleted text end
deleted text begin
(a) A health data
intermediary must be certified by the state and comply with requirements established in this
section.
deleted text end
deleted text begin
(b) Notwithstanding any law to the contrary, any corporation organized to do so may
apply to the commissioner for a certificate of authority to establish and operate as a health
data intermediary in compliance with this section. No person shall establish or operate a
health data intermediary in this state, nor sell or offer to sell, or solicit offers to purchase
or receive advance or periodic consideration in conjunction with a health data intermediary
contract unless the organization has a certificate of authority or has an application under
active consideration under this section.
deleted text end
deleted text begin
(c) In issuing the certificate of authority, the commissioner shall determine whether the
applicant for the certificate of authority has demonstrated that the applicant meets the
following minimum criteria:
deleted text end
deleted text begin
(1) hold reciprocal agreements with at least one state-certified health information
organization to access patient data, and for the transmission and receipt of clinical
transactions. Reciprocal agreements must meet the requirements established in subdivision
5; and
deleted text end
deleted text begin
(2) participate in statewide shared health information exchange services as defined by
the commissioner to support interoperability between state-certified health information
organizations and state-certified health data intermediaries.
deleted text end
Subd. 3.
Certificate of authority for health information organizations.
(a) A health
information organization must obtain a certificate of authority from the commissioner and
demonstrate compliance with the criteria in paragraph (c).
(b) Notwithstanding any law to the contrary, an organization may apply for a certificate
of authority to establish and operate a health information organization under this section.
No person shall establish or operate a health information organization in this state, nor sell
or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in
conjunction with a health information organization or health information contract unless
the organization has a certificate of authority under this section.
(c) In issuing the certificate of authority, the commissioner shall determine whether the
applicant for the certificate of authority has demonstrated that the applicant meets the
following minimum criteria:
(1) the entity is a legally established organization;
(2) appropriate insurance, including liability insurance, for the operation of the health
information organization is in place and sufficient to protect the interest of the public and
participating entities;
(3) strategic and operational plans address governance, technical infrastructure, legal
and policy issues, finance, and business operations in regard to how the organization will
expand to support providers in achieving health information exchange goals over time;
(4) the entity addresses the parameters to be used with participating entities and other
health information exchange service providers for clinical transactions, compliance with
Minnesota law, and interstate health information exchange trust agreements;
(5) the entity's board of directors or equivalent governing body is composed of members
that broadly represent the health information organization's participating entities and
consumers;
(6) the entity maintains a professional staff responsible to the board of directors or
equivalent governing body with the capacity to ensure accountability to the organization's
mission;
(7) the organization is compliant with national certification and accreditation programs
designated by the commissioner;
(8) the entity maintains the capability to query for patient information based on national
standards. The query capability may utilize a master patient index, clinical data repository,
or record locator service as defined in section 144.291, subdivision 2, paragraph (j). The
entity must be compliant with the requirements of section 144.293, subdivision 8, when
conducting clinical transactions;
(9) the organization demonstrates interoperability with all other state-certified health
information organizations using nationally recognized standards;
(10) the organization demonstrates compliance with all privacy and security requirements
required by state and federal law; and
(11) the organization uses financial policies and procedures consistent with generally
accepted accounting principles and has an independent audit of the organization's financials
on an annual basis.
(d) Health information organizations that have obtained a certificate of authority must:
(1) meet the requirements established for connecting to the National eHealth Exchange;
(2) annually submit strategic and operational plans for review by the commissioner that
address:
(i) progress in achieving objectives included in previously submitted strategic and
operational plans across the following domains: business and technical operations, technical
infrastructure, legal and policy issues, finance, and organizational governance;
(ii) plans for ensuring the necessary capacity to support clinical transactions;
(iii) approach for attaining financial sustainability, including public and private financing
strategies, and rate structures;
(iv) rates of adoption, utilization, and transaction volume, and mechanisms to support
health information exchange; and
(v) an explanation of methods employed to address the needs of community clinics,
critical access hospitals, and free clinics in accessing health information exchange services;
(3) enter into reciprocal agreements with all other state-certified health information
organizations deleted text begin and state-certified health data intermediariesdeleted text end to enable access to patient data,
and for the transmission and receipt of clinical transactions. Reciprocal agreements must
meet the requirements in subdivision 5;
(4) participate in statewide shared health information exchange services as defined by
the commissioner to support interoperability deleted text begin between state-certified health information
organizations and state-certified health data intermediariesdeleted text end ; and
(5) comply with additional requirements for the certification or recertification of health
information organizations that may be established by the commissioner.
Subd. 4.
Application for certificate of authority for health information deleted text begin exchange
service providersdeleted text end new text begin organizationsnew text end .
(a) Each application for a certificate of authority shall
be in a form prescribed by the commissioner and verified by an officer or authorized
representative of the applicant. Each application shall include the following in addition to
information described in the criteria in deleted text begin subdivisions 2 anddeleted text end new text begin subdivisionnew text end 3:
(1) deleted text begin for health information organizations only,deleted text end a copy of the basic organizational document,
if any, of the applicant and of each major participating entity, such as the articles of
incorporation, or other applicable documents, and all amendments to it;
(2) deleted text begin for health information organizations only,deleted text end a list of the names, addresses, and official
positions of the following:
(i) all members of the board of directors or equivalent governing body, and the principal
officers and, if applicable, shareholders of the applicant organization; and
(ii) all members of the board of directors or equivalent governing body, and the principal
officers of each major participating entity and, if applicable, each shareholder beneficially
owning more than ten percent of any voting stock of the major participating entity;
(3) deleted text begin for health information organizations only,deleted text end the name and address of each participating
entity and the agreed-upon duration of each contract or agreement if applicable;
(4) a copy of each standard agreement or contract intended to bind the participating
entities and the health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end . Contractual
provisions shall be consistent with the purposes of this section, in regard to the services to
be performed under the standard agreement or contract, the manner in which payment for
services is determined, the nature and extent of responsibilities to be retained by the health
information organization, and contractual termination provisions;
(5) a statement generally describing the health information deleted text begin exchange service providerdeleted text end new text begin
organizationnew text end , its health information exchange contracts, facilities, and personnel, including
a statement describing the manner in which the applicant proposes to provide participants
with comprehensive health information exchange services;
(6) a statement reasonably describing the geographic area or areas to be served and the
type or types of participants to be served;
(7) a description of the complaint procedures to be used as required under this section;
(8) a description of the mechanism by which participating entities will have an opportunity
to participate in matters of policy and operation;
(9) a copy of any pertinent agreements between the health information organization and
insurers, including liability insurers, demonstrating coverage is in place;
(10) a copy of the conflict of interest policy that applies to all members of the board of
directors or equivalent governing body and the principal officers of the health information
organization; and
(11) other information as the commissioner may reasonably require to be provided.
(b) Within 45 days after the receipt of the application for a certificate of authority, the
commissioner shall determine whether or not the application submitted meets the
requirements for completion in paragraph (a), and notify the applicant of any further
information required for the application to be processed.
(c) Within 90 days after the receipt of a complete application for a certificate of authority,
the commissioner shall issue a certificate of authority to the applicant if the commissioner
determines that the applicant meets the minimum criteria requirements of deleted text begin subdivision 2 for
health data intermediaries ordeleted text end subdivision 3 deleted text begin for health information organizationsdeleted text end . If the
commissioner determines that the applicant is not qualified, the commissioner shall notify
the applicant and specify the reasons for disqualification.
(d) Upon being granted a certificate of authority to operate as a state-certified health
information organization deleted text begin or state-certified health data intermediarydeleted text end , the organization must
operate in compliance with the provisions of this section. Noncompliance may result in the
imposition of a fine or the suspension or revocation of the certificate of authority according
to section 62J.4982.
Subd. 5.
Reciprocal agreements between health information deleted text begin exchange entitiesdeleted text end new text begin
organizationsnew text end .
(a) Reciprocal agreements between two health information organizations
deleted text begin or between a health information organization and a health data intermediarydeleted text end must include
a fair and equitable model for charges between the entities that:
(1) does not impede the secure transmission of clinical transactions;
(2) does not charge a fee for the exchange of deleted text begin meaningful usedeleted text end transactions transmitted
according to nationally recognized standards where no additional value-added service is
rendered to the sending or receiving health information organization deleted text begin or health data
intermediarydeleted text end either directly or on behalf of the client;
(3) is consistent with fair market value and proportionately reflects the value-added
services accessed as a result of the agreement; and
(4) prevents health care stakeholders from being charged multiple times for the same
service.
(b) Reciprocal agreements must include comparable quality of service standards that
ensure equitable levels of services.
(c) Reciprocal agreements are subject to review and approval by the commissioner.
(d) Nothing in this section precludes a state-certified health information organization deleted text begin or
state-certified health data intermediarydeleted text end from entering into contractual agreements for the
provision of value-added services deleted text begin beyond meaningful use transactionsdeleted text end .
Sec. 9.
Minnesota Statutes 2020, section 62J.4982, is amended to read:
62J.4982 ENFORCEMENT AUTHORITY; COMPLIANCE.
Subdivision 1.
Penalties and enforcement.
(a) The commissioner may, for any violation
of statute or rule applicable to a health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end ,
levy an administrative penalty in an amount up to $25,000 for each violation. In determining
the level of an administrative penalty, the commissioner shall consider the following factors:
(1) the number of participating entities affected by the violation;
(2) the effect of the violation on participating entities' access to health information
exchange services;
(3) if only one participating entity is affected, the effect of the violation on the patients
of that entity;
(4) whether the violation is an isolated incident or part of a pattern of violations;
(5) the economic benefits derived by the health information organization deleted text begin or a health data
intermediarydeleted text end by virtue of the violation;
(6) whether the violation hindered or facilitated an individual's ability to obtain health
care;
(7) whether the violation was intentional;
(8) whether the violation was beyond the direct control of the health information deleted text begin exchange
service providerdeleted text end new text begin organizationnew text end ;
(9) any history of prior compliance with the provisions of this section, including
violations;
(10) whether and to what extent the health information deleted text begin exchange service providerdeleted text end new text begin
organizationnew text end attempted to correct previous violations;
(11) how the health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end responded to
technical assistance from the commissioner provided in the context of a compliance effort;
and
(12) the financial condition of the health information deleted text begin exchange service providerdeleted text end new text begin
organizationnew text end includingdeleted text begin ,deleted text end but not limited todeleted text begin ,deleted text end whether the health information deleted text begin exchange service
providerdeleted text end new text begin organizationnew text end had financial difficulties that affected its ability to comply or whether
the imposition of an administrative monetary penalty would jeopardize the ability of the
health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end to continue to deliver health
information exchange services.
The commissioner shall give reasonable notice in writing to the health information
deleted text begin exchange service providerdeleted text end new text begin organizationnew text end of the intent to levy the penalty and the reasons for
it. A health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end may have 15 days within
which to contest whether the facts found constitute a violation of sections 62J.4981 and
62J.4982, according to the contested case and judicial review provisions of sections 14.57
to 14.69.
(b) If the commissioner has reason to believe that a violation of section 62J.4981 or
62J.4982 has occurred or is likely, the commissioner may confer with the persons involved
before commencing action under subdivision 2. The commissioner may notify the health
information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end and the representatives, or other persons
who appear to be involved in the suspected violation, to arrange a voluntary conference
with the alleged violators or their authorized representatives. The purpose of the conference
is to attempt to learn the facts about the suspected violation and, if it appears that a violation
has occurred or is threatened, to find a way to correct or prevent it. The conference is not
governed by any formal procedural requirements, and may be conducted as the commissioner
considers appropriate.
(c) The commissioner may issue an order directing a health information deleted text begin exchange service
providerdeleted text end new text begin organizationnew text end or a representative of a health information deleted text begin exchange service providerdeleted text end new text begin
organizationnew text end to cease and desist from engaging in any act or practice in violation of sections
62J.4981 and 62J.4982.
(d) Within 20 days after service of the order to cease and desist, a health information
deleted text begin exchange service providerdeleted text end new text begin organizationnew text end may contest whether the facts found constitute a
violation of sections 62J.4981 and 62J.4982 according to the contested case and judicial
review provisions of sections 14.57 to 14.69.
(e) In the event of noncompliance with a cease and desist order issued under this
subdivision, the commissioner may institute a proceeding to obtain injunctive relief or other
appropriate relief in Ramsey County District Court.
Subd. 2.
Suspension or revocation of certificates of authority.
(a) The commissioner
may suspend or revoke a certificate of authority issued to a deleted text begin health data intermediary ordeleted text end
health information organization under section 62J.4981 if the commissioner finds that:
(1) the health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end is operating
significantly in contravention of its basic organizational document, or in a manner contrary
to that described in and reasonably inferred from any other information submitted under
section 62J.4981, unless amendments to the submissions have been filed with and approved
by the commissioner;
(2) the health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end is unable to fulfill its
obligations to furnish comprehensive health information exchange services as required
under its health information exchange contract;
(3) the health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end is no longer financially
solvent or may not reasonably be expected to meet its obligations to participating entities;
(4) the health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end has failed to implement
the complaint system in a manner designed to reasonably resolve valid complaints;
(5) the health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end , or any person acting
with its sanction, has advertised or merchandised its services in an untrue, misleading,
deceptive, or unfair manner;
(6) the continued operation of the health information deleted text begin exchange service providerdeleted text end new text begin
organizationnew text end would be hazardous to its participating entities or the patients served by the
participating entities; or
(7) the health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end has otherwise failed
to substantially comply with section 62J.4981 or with any other statute or administrative
rule applicable to health information exchange service providers, or has submitted false
information in any report required under sections 62J.498 to 62J.4982.
(b) A certificate of authority shall be suspended or revoked only after meeting the
requirements of subdivision 3.
(c) If the certificate of authority of a health information deleted text begin exchange service providerdeleted text end new text begin
organizationnew text end is suspended, the health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end
shall not, during the period of suspension, enroll any additional participating entities, and
shall not engage in any advertising or solicitation.
(d) If the certificate of authority of a health information deleted text begin exchange service providerdeleted text end new text begin
organizationnew text end is revoked, the organization shall proceed, immediately following the effective
date of the order of revocation, to wind up its affairs, and shall conduct no further business
except as necessary to the orderly conclusion of the affairs of the organization. The
organization shall engage in no further advertising or solicitation. The commissioner may,
by written order, permit further operation of the organization as the commissioner finds to
be in the best interest of participating entities, to the end that participating entities will be
given the greatest practical opportunity to access continuing health information exchange
services.
Subd. 3.
Denial, suspension, and revocation; administrative procedures.
(a) When
the commissioner has cause to believe that grounds for the denial, suspension, or revocation
of a certificate of authority exist, the commissioner shall notify the health information
deleted text begin exchange service providerdeleted text end new text begin organizationnew text end in writing stating the grounds for denial, suspension,
or revocation and setting a time within 20 days for a hearing on the matter.
(b) After a hearing before the commissioner at which the health information deleted text begin exchange
service providerdeleted text end new text begin organizationnew text end may respond to the grounds for denial, suspension, or
revocation, or upon the failure of the health information deleted text begin exchange service providerdeleted text end new text begin
organizationnew text end to appear at the hearing, the commissioner shall take action as deemed necessary
and shall issue written findings and mail them to the health information deleted text begin exchange service
providerdeleted text end new text begin organizationnew text end .
(c) If suspension, revocation, or administrative penalty is proposed according to this
section, the commissioner must deliver, or send by certified mail with return receipt
requested, to the health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end written notice
of the commissioner's intent to impose a penalty. This notice of proposed determination
must include:
(1) a reference to the statutory basis for the penalty;
(2) a description of the findings of fact regarding the violations with respect to which
the penalty is proposed;
(3) the nature and amount of the proposed penalty;
(4) any circumstances described in subdivision 1, paragraph (a), that were considered
in determining the amount of the proposed penalty;
(5) instructions for responding to the notice, including a statement of the health
information deleted text begin exchange service provider'sdeleted text end new text begin organization'snew text end right to a contested case proceeding
and a statement that failure to request a contested case proceeding within 30 calendar days
permits the imposition of the proposed penalty; and
(6) the address to which the contested case proceeding request must be sent.
Subd. 4.
Coordination.
The commissioner shall, to the extent possible, seek the advice
of the Minnesota e-Health Advisory Committee, in the review and update of criteria for the
certification and recertification of health information deleted text begin exchange service providersdeleted text end new text begin
organizationsnew text end when implementing sections 62J.498 to 62J.4982.
Subd. 5.
Fees and monetary penalties.
(a) The commissioner shall assess fees on every
health information deleted text begin exchange service providerdeleted text end new text begin organizationnew text end subject to sections 62J.4981 and
62J.4982 as follows:
(1) filing an application for certificate of authority to operate as a health information
organization, $7,000;new text begin and
new text end
(2) deleted text begin filing an application for certificate of authority to operate as a health data intermediary,
$7,000;
deleted text end
deleted text begin (3)deleted text end annual health information organization certificate fee, $7,000deleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(4) annual health data intermediary certificate fee, $7,000.
deleted text end
(b) Fees collected under this section shall be deposited in the state treasury and credited
to the state government special revenue fund.
(c) Administrative monetary penalties imposed under this subdivision shall be credited
to an account in the special revenue fund and are appropriated to the commissioner for the
purposes of sections 62J.498 to 62J.4982.
Sec. 10.
Minnesota Statutes 2020, section 62J.63, subdivision 1, is amended to read:
Subdivision 1.
deleted text begin Establishment; administrationdeleted text end new text begin Support for state health care
purchasing and performance measurementnew text end .
The commissioner of health shall deleted text begin establish
and administer the Center for Health Care Purchasing Improvement as an administrative
unit within the Department of Health. The Center for Health Care Purchasing Improvement
shalldeleted text end support the state in its efforts to be a more prudent and efficient purchaser of quality
health care servicesdeleted text begin . The center shalldeleted text end new text begin ,new text end aid the state in developing and using more common
strategies and approaches for health care performance measurement and health care
purchasingdeleted text begin . The common strategies and approaches shalldeleted text end new text begin ,new text end promote greater transparency of
health care costs and qualitydeleted text begin ,deleted text end and greater accountability for health care results and
improvementdeleted text begin . The center shall alsodeleted text end new text begin , andnew text end identify barriers to more efficient, effective, quality
health care and options for overcoming the barriers.
Sec. 11.
Minnesota Statutes 2020, section 62J.63, subdivision 2, is amended to read:
Subd. 2.
deleted text begin Staffing;deleted text end Duties; scope.
deleted text begin (a)deleted text end The commissioner of health may deleted text begin appoint a director,
and up to three additional senior-level staff or codirectors, and other staff as needed who
are under the direction of the commissioner. The staff of the center are in the unclassified
service.deleted text end new text begin :
new text end
deleted text begin
(b) With the authorization of the commissioner of health, and in consultation or
interagency agreement with the appropriate commissioners of state agencies, the director,
or codirectors, may:
deleted text end
deleted text begin
(1) initiate projects to develop plan designs for state health care purchasing;
deleted text end
deleted text begin (2)deleted text end new text begin (1)new text end require reports or surveys to evaluate the performance of current health care
purchasingnew text begin or administrative simplificationnew text end strategies;
deleted text begin (3)deleted text end new text begin (2)new text end calculate fiscal impacts, including net savings and return on investment, of health
care purchasing strategies and initiatives;
deleted text begin
(4) conduct policy audits of state programs to measure conformity to state statute or
other purchasing initiatives or objectives;
deleted text end
deleted text begin (5)deleted text end new text begin (3)new text end support the Administrative Uniformity Committee under deleted text begin sectiondeleted text end new text begin sectionsnew text end 62J.50
new text begin and 62J.536 new text end and other relevant groups or activities to advance agreement on health care
administrative process streamlining;
deleted text begin
(6) consult with the Health Economics Unit of the Department of Health regarding
reports and assessments of the health care marketplace;
deleted text end
deleted text begin
(7) consult with the Department of Commerce regarding health care regulatory issues
and legislative initiatives;
deleted text end
deleted text begin
(8) work with appropriate Department of Human Services staff and the Centers for
Medicare and Medicaid Services to address federal requirements and conformity issues for
health care purchasing;
deleted text end
deleted text begin
(9) assist the Minnesota Comprehensive Health Association in health care purchasing
strategies;
deleted text end
deleted text begin
(10) convene medical directors of agencies engaged in health care purchasing for advice,
collaboration, and exploring possible synergies;
deleted text end
deleted text begin (11)deleted text end new text begin (4)new text end contact and participate with other relevant health care task forces, study activities,
and similar efforts with regard to health care performance measurement and
performance-based purchasing; and
deleted text begin (12)deleted text end new text begin (5)new text end assist in seeking external funding through appropriate grants or other funding
opportunities and may administer grants and externally funded projects.
Sec. 12.
Minnesota Statutes 2020, section 62U.04, subdivision 4, is amended to read:
Subd. 4.
Encounter data.
(a) deleted text begin Beginning July 1, 2009, and every six months thereafter,deleted text end
All health plan companies and third-party administrators shall submit encounter datanew text begin on a
monthly basisnew text end to a private entity designated by the commissioner of health. The data shall
be submitted in a form and manner specified by the commissioner subject to the following
requirements:
(1) the data must be de-identified data as described under the Code of Federal Regulations,
title 45, section 164.514;
(2) the data for each encounter must include an identifier for the patient's health care
home if the patient has selected a health care home and, for claims incurred on or after
January 1, 2019, data deemed necessary by the commissioner to uniquely identify claims
in the individual health insurance market; and
(3) except for the identifier described in clause (2), the data must not include information
that is not included in a health care claim or equivalent encounter information transaction
that is required under section 62J.536.
(b) The commissioner or the commissioner's designee shall only use the data submitted
under paragraph (a) to carry out the commissioner's responsibilities in this section, including
supplying the data to providers so they can verify their results of the peer grouping process
consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d),
and adopted by the commissioner and, if necessary, submit comments to the commissioner
or initiate an appeal.
(c) Data on providers collected under this subdivision are private data on individuals or
nonpublic data, as defined in section 13.02. new text begin Notwithstanding the data classifications in this
paragraph, data on providers collected under this subdivision may be released or published
as authorized in subdivision 11. new text end Notwithstanding the definition of summary data in section
13.02, subdivision 19, summary data prepared under this subdivision may be derived from
nonpublic data. The commissioner or the commissioner's designee shall establish procedures
and safeguards to protect the integrity and confidentiality of any data that it maintains.
(d) The commissioner or the commissioner's designee shall not publish analyses or
reports that identify, or could potentially identify, individual patients.
(e) The commissioner shall compile summary information on the data submitted under
this subdivision. The commissioner shall work with its vendors to assess the data submitted
in terms of compliance with the data submission requirements and the completeness of the
data submitted by comparing the data with summary information compiled by the
commissioner and with established and emerging data quality standards to ensure data
quality.
Sec. 13.
Minnesota Statutes 2020, section 62U.04, subdivision 5, is amended to read:
Subd. 5.
Pricing data.
(a) Beginning July 1, 2009, and annually on January 1 thereafter,
all health plan companies and third-party administrators shall submit data on their contracted
prices with health care providers to a private entity designated by the commissioner of health
for the purposes of performing the analyses required under this subdivision. The data shall
be submitted in the form and manner specified by the commissioner of health.
(b) The commissioner or the commissioner's designee shall only use the data submitted
under this subdivision to carry out the commissioner's responsibilities under this section,
including supplying the data to providers so they can verify their results of the peer grouping
process consistent with the recommendations developed pursuant to subdivision 3c, paragraph
(d), and adopted by the commissioner and, if necessary, submit comments to the
commissioner or initiate an appeal.
(c) Data collected under this subdivision are nonpublic data as defined in section 13.02.
new text begin Notwithstanding the data classification in this paragraph, data collected under this subdivision
may be released or published as authorized in subdivision 11. new text end Notwithstanding the definition
of summary data in section 13.02, subdivision 19, summary data prepared under this section
may be derived from nonpublic data. The commissioner shall establish procedures and
safeguards to protect the integrity and confidentiality of any data that it maintains.
Sec. 14.
Minnesota Statutes 2020, section 62U.04, subdivision 11, is amended to read:
Subd. 11.
Restricted uses of the all-payer claims data.
(a) Notwithstanding subdivision
4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the commissioner's
designee shall only use the data submitted under subdivisions 4 and 5 for the following
purposes:
(1) to evaluate the performance of the health care home program as authorized under
section 62U.03, subdivision 7;
(2) to study, in collaboration with the reducing avoidable readmissions effectively
(RARE) campaign, hospital readmission trends and rates;
(3) to analyze variations in health care costs, quality, utilization, and illness burden based
on geographical areas or populations;
(4) to evaluate the state innovation model (SIM) testing grant received by the Departments
of Health and Human Services, including the analysis of health care cost, quality, and
utilization baseline and trend information for targeted populations and communities; and
(5) to compile one or more public use files of summary data or tables that must:
(i) be available to the public for no or minimal cost by March 1, 2016, and available by
web-based electronic data download by June 30, 2019;
(ii) not identify individual patientsdeleted text begin ,deleted text end new text begin ornew text end payersdeleted text begin , or providersdeleted text end new text begin but that may identify the
rendering or billing hospital, clinic, or medical practicenew text end ;
(iii) be updated by the commissioner, at least annually, with the most current data
available;
(iv) contain clear and conspicuous explanations of the characteristics of the data, such
as the dates of the data contained in the files, the absence of costs of care for uninsured
patients or nonresidents, and other disclaimers that provide appropriate context; and
(v) not lead to the collection of additional data elements beyond what is authorized under
this section as of June 30, 2015.
(b) The commissioner may publish the results of the authorized uses identified in
paragraph (a) deleted text begin so long as the data released publicly do not contain information or descriptions
in which the identity of individual hospitals, clinics, or other providers may be discerneddeleted text end .new text begin
The data published under this paragraph may identify hospitals, clinics, and medical practices
so long as no individual health professionals are identified and the commissioner finds the
data to be accurate, valid, and suitable for publication for such use.
new text end
(c) Nothing in this subdivision shall be construed to prohibit the commissioner from
using the data collected under subdivision 4 to complete the state-based risk adjustment
system assessment due to the legislature on October 1, 2015.
(d) The commissioner or the commissioner's designee may use the data submitted under
subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until July 1,
2023.
(e) The commissioner shall consult with the all-payer claims database work group
established under subdivision 12 regarding the technical considerations necessary to create
the public use files of summary data described in paragraph (a), clause (5).
Sec. 15.
Minnesota Statutes 2020, section 103H.201, subdivision 1, is amended to read:
Subdivision 1.
Procedure.
(a) If groundwater quality monitoring results show that there
is a degradation of groundwater, the commissioner of health may promulgate health risk
limits under subdivision 2 for substances degrading the groundwater.
(b) Health risk limits shall be determined by two methods depending on their toxicological
end point.
(c) For systemic toxicants that are not carcinogens, the adopted health risk limits shall
be derived using United States Environmental Protection Agency risk assessment methods
using a reference dose, a drinking water equivalent, and a relative source contribution factor.
(d) For toxicants that are known or probable carcinogens, the adopted health risk limits
shall be derived from a quantitative estimate of the chemical's carcinogenic potency published
by the United States Environmental Protection Agency deleted text begin anddeleted text end new text begin ornew text end determined by the
commissioner to have undergone thorough scientific review.
Sec. 16.
new text begin
[144.066] DISTRIBUTION OF COVID-19 VACCINES.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) The terms defined in this subdivision apply to this section
and sections 144.0661 to 144.0663.
new text end
new text begin
(b) "Commissioner" means the commissioner of health.
new text end
new text begin
(c) "COVID-19 vaccine" means a vaccine against severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2).
new text end
new text begin
(d) "Department" means the Department of Health.
new text end
new text begin
(e) "Disproportionately impacted community" means a community or population that
has been disproportionately and negatively impacted by the COVID-19 pandemic.
new text end
new text begin
(f) "Local health department" has the meaning given in section 145A.02, subdivision
8b.
new text end
new text begin
(g) "Mobile vaccination vehicle" means a vehicle-mounted unit that is either motorized
or trailered, that is readily movable without disassembling, and at which vaccines are
provided in more than one geographic location.
new text end
new text begin Subd. 2. new text end
new text begin Distribution. new text end
new text begin
The commissioner shall establish and maintain partnerships or
agreements with local health departments; local health care providers, including community
health centers and primary care providers; and local pharmacies to administer COVID-19
vaccines throughout the state. COVID-19 vaccines may also be administered via mobile
vaccination vehicles authorized under section 144.0662.
new text end
new text begin Subd. 3. new text end
new text begin Second dose or booster. new text end
new text begin
For all COVID-19 vaccines for which a second dose
or booster is required, during the first vaccine appointment the registered vaccine provider
should be directed by the department during the vaccine provider registration process to
assist vaccine recipients with scheduling an appointment for the second dose or booster.
This assistance may be provided during the observation period following vaccine
administration.
new text end
new text begin Subd. 4. new text end
new text begin Nondiscrimination. new text end
new text begin
Nothing in sections 144.066 to 144.0663 shall be construed
to allow or require the denial of any benefit or opportunity on the basis of race, color, creed,
marital status, status with regard to public assistance, disability, genetic information, sexual
orientation, age, religion, national origin, sex, or membership in a local human rights
commission.
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. 17.
new text begin
[144.0661] EQUITABLE COVID-19 VACCINE DISTRIBUTION.
new text end
new text begin Subdivision 1. new text end
new text begin COVID-19 vaccination equity and outreach. new text end
new text begin
The commissioner shall
establish positions to continue the department's COVID-19 vaccination equity and outreach
activities and to plan and implement actions and programs to overcome disparities in
COVID-19 vaccination rates that are rooted in historic and current racism; biases based on
ethnicity, income, primary language, immigration status, or disability; geography; or
transportation access, language access, or Internet access. This work shall be managed by
a director who shall serve in a leadership role in the department's COVID-19 response.
new text end
new text begin Subd. 2. new text end
new text begin
Vaccine education and outreach campaign; direct delivery of
information.
new text end
new text begin
(a) The commissioner shall administer a COVID-19 vaccine education and
outreach campaign that engages in direct delivery of information to members of
disproportionately impacted communities. In this campaign, the commissioner shall contract
with community-based organizations including community faith-based organizations, tribal
governments, local health departments, and local health care providers, including community
health centers and primary care providers, to deliver the following information in a culturally
relevant and linguistically appropriate manner:
new text end
new text begin
(1) medically and scientifically accurate information on the safety, efficacy, science,
and benefits of vaccines generally and COVID-19 vaccines in particular;
new text end
new text begin
(2) information on how members of disproportionately impacted communities may
obtain a COVID-19 vaccine including, if applicable, obtaining a vaccine from a mobile
vaccination vehicle; and
new text end
new text begin
(3) measures to prevent transmission of COVID-19, including adequate indoor ventilation,
wearing face coverings, and physical distancing from individuals outside the household.
new text end
new text begin
(b) This information must be delivered directly by methods that include phone calls,
text messages, physically distanced door-to-door and street canvassing, and digital
event-based communication involving live and interactive messengers. For purposes of this
subdivision, direct delivery shall not include delivery by television, radio, newspaper, or
other forms of mass media.
new text end
new text begin Subd. 3. new text end
new text begin Vaccine education and outreach campaign; mass media. new text end
new text begin
The commissioner
shall administer a mass media campaign to provide COVID-19 vaccine education and
outreach to members of disproportionately impacted communities. In this campaign, the
commissioner shall contract with media vendors to provide the following information to
members of disproportionately impacted communities in a manner that is culturally relevant
and linguistically appropriate:
new text end
new text begin
(1) medically and scientifically accurate information on the safety, efficacy, science,
and benefits of COVID-19 vaccines; and
new text end
new text begin
(2) information on how members of disproportionately impacted communities may
obtain a COVID-19 vaccine.
new text end
new text begin Subd. 4. new text end
new text begin Community assistance. new text end
new text begin
The commissioner shall administer a program to help
members of disproportionately impacted communities arrange for and prepare to obtain a
COVID-19 vaccine and to support transportation-limited members of these communities
with transportation to vaccination appointments or otherwise arrange for vaccine providers
to reach members of these communities.
new text end
new text begin Subd. 5. new text end
new text begin Equitable distribution of COVID-19 vaccines. new text end
new text begin
The commissioner shall
establish a set of metrics to measure the equitable distribution of COVID-19 vaccines in
the state, and shall set and periodically update goals for COVID-19 vaccine distribution in
the state that are focused on equity.
new text end
new text begin Subd. 6. new text end
new text begin Expiration of programs. new text end
new text begin
The vaccine education and outreach programs in
subdivisions 2 and 3 and the community assistance program in subdivision 4 shall operate
until a sufficient percentage of individuals in each county or census tract have received the
full series of COVID-19 vaccines to protect individuals in each county or census tract from
COVID-19.
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. 18.
new text begin
[144.0662] MOBILE VACCINATION PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Administration. new text end
new text begin
The commissioner, in partnership with local health
departments and the regional health care coalitions, shall administer a mobile vaccination
program in which mobile vaccination vehicles are deployed to communities around the state
to provide COVID-19 vaccines to individuals. The commissioner shall deploy mobile
vaccination vehicles to communities to improve access to vaccines based on factors that
include but are not limited to vulnerability, likelihood of exposure, limits to transportation
access, rate of vaccine uptake, and limited access to vaccines or barriers to obtaining vaccines.
new text end
new text begin Subd. 2. new text end
new text begin Eligibility. new text end
new text begin
Notwithstanding the phases and priorities of the state's COVID-19
allocation and prioritization plan or guidance, all individuals in a community to which a
mobile vaccination vehicle is deployed shall be eligible to receive COVID-19 vaccines from
the vehicle.
new text end
new text begin Subd. 3. new text end
new text begin Staffing. new text end
new text begin
Each mobile vaccination vehicle must be staffed in accordance with
Centers for Disease Control and Prevention guidelines and may be staffed with additional
support staff based on needs determined by local request. Additional support staff may
include but are not limited to community partners and translators.
new text end
new text begin Subd. 4. new text end
new text begin Second doses. new text end
new text begin
For vaccine recipients who receive a first dose of a COVID-19
vaccine from a mobile vaccination vehicle, vehicle staff shall provide assistance in scheduling
an appointment with a mobile vaccination vehicle or with another vaccine provider for any
needed second dose or booster. The commissioner shall, to the extent possible, deploy
mobile vaccination vehicles in a manner that allows vaccine recipients to receive second
doses or boosters from a mobile vaccination vehicle.
new text end
new text begin Subd. 5. new text end
new text begin Expiration. new text end
new text begin
The commissioner shall administer the mobile vaccination vehicle
program until a sufficient percentage of individuals in each county or census tract have
received the full series of COVID-19 vaccines to protect individuals in each county or
census tract from the spread of COVID-19.
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. 19.
new text begin
[144.0663] COVID-19 VACCINATION PLAN AND DATA; REPORTS.
new text end
new text begin Subdivision 1. new text end
new text begin COVID-19 vaccination plan; implementation protocols. new text end
new text begin
The
commissioner shall:
new text end
new text begin
(1) publish the set of metrics and goals for equitable COVID-19 vaccine distribution
established by the commissioner under section 144.0661, subdivision 5; and
new text end
new text begin
(2) publish implementation protocols to address the disparities in COVID-19 vaccination
rates in certain communities and ensure that members of disproportionately impacted
communities are given adequate access to COVID-19 vaccines.
new text end
new text begin Subd. 2. new text end
new text begin Data on COVID-19 vaccines. new text end
new text begin
On at least a weekly basis, the commissioner
shall publish on the department website:
new text end
new text begin
(1) data measuring compliance with the set of metrics and goals for equitable COVID-19
vaccine distribution established by the commissioner under section 144.0661, subdivision
5; and
new text end
new text begin
(2) summary data on individuals who have received one or two doses of a COVID-19
vaccine, broken out by race, gender, ethnicity, age within an age range, and zip code.
new text end
new text begin Subd. 3. new text end
new text begin Quarterly reports. new text end
new text begin
On a quarterly basis while funds are available, the
commissioner shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over finance, ways and means, and health care:
new text end
new text begin
(1) funds distributed to local health departments for COVID-19 activities and the sources
of the funds; and
new text end
new text begin
(2) funds expended to implement sections 144.066 to 144.0663.
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. 20.
Minnesota Statutes 2020, section 144.0724, subdivision 1, is amended to read:
Subdivision 1.
Resident reimbursement case mix classifications.
The commissioner
of health shall establish resident reimbursementnew text begin case mixnew text end classifications based upon the
assessments of residents of nursing homes and boarding care homes conducted under this
section and according to section 256R.17.
Sec. 21.
Minnesota Statutes 2020, section 144.0724, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For purposes of this section, the following terms have the meanings
given.
(a) "Assessment reference date" or "ARD" means the specific end point for look-back
periods in the MDS assessment process. This look-back period is also called the observation
or assessment period.
(b) "Case mix index" means the weighting factors assigned to the RUG-IV classifications.
(c) "Index maximization" means classifying a resident who could be assigned to more
than one category, to the category with the highest case mix index.
(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment,
and functional status elements, that include common definitions and coding categories
specified by the Centers for Medicare and Medicaid Services and designated by the
deleted text begin Minnesotadeleted text end Department of Health.
(e) "Representative" means a person who is the resident's guardian or conservator, the
person authorized to pay the nursing home expenses of the resident, a representative of the
Office of Ombudsman for Long-Term Care whose assistance has been requested, or any
other individual designated by the resident.
(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing
facility's residents according to their clinical and functional status identified in data supplied
by the facility's Minimum Data Set.
(g) "Activities of daily living" deleted text begin means grooming,deleted text end new text begin includes personal hygiene,new text end dressing,
bathing, transferring,new text begin bednew text end mobility, deleted text begin positioning,deleted text end new text begin locomotion,new text end eating, and toileting.
(h) "Nursing facility level of care determination" means the assessment process that
results in a determination of a resident's or prospective resident's need for nursing facility
level of care as established in subdivision 11 for purposes of medical assistance payment
of long-term care services for:
(1) nursing facility services under section 256B.434 or chapter 256R;
(2) elderly waiver services under chapter 256S;
(3) CADI and BI waiver services under section 256B.49; and
(4) state payment of alternative care services under section 256B.0913.
Sec. 22.
Minnesota Statutes 2020, section 144.0724, subdivision 3a, is amended to read:
Subd. 3a.
Resident reimbursementnew text begin case mixnew text end classifications beginning January 1,
2012.
(a) Beginning January 1, 2012, resident reimbursementnew text begin case mixnew text end classifications shall
be based on the Minimum Data Set, version 3.0 assessment instrument, or its successor
version mandated by the Centers for Medicare and Medicaid Services that nursing facilities
are required to complete for all residents. The commissioner of health shall establish resident
classifications according to the RUG-IV, 48 group, resource utilization groups. Resident
classification must be established based on the individual items on the Minimum Data Set,
which must be completed according to the Long Term Care Facility Resident Assessment
Instrument User's Manual Version 3.0 or its successor issued by the Centers for Medicare
and Medicaid Services.
(b) Each resident must be classified based on the information from the Minimum Data
Set according to general categories deleted text begin as defined in the Case Mix Classification Manual for
Nursing Facilitiesdeleted text end issued by the Minnesota Department of Health.
Sec. 23.
Minnesota Statutes 2020, section 144.0724, subdivision 5, is amended to read:
Subd. 5.
Short stays.
(a) A facility must submit to the commissioner of health an
admission assessment for all residents who stay in the facility 14 days or lessdeleted text begin .deleted text end new text begin , unless the
resident is admitted and discharged from the facility on the same day, in which case the
admission assessment is not required. When an admission assessment is not submitted, the
case mix classification shall be the rate with a case mix index of 1.0.
new text end
(b) Notwithstanding the admission assessment requirements of paragraph (a), a facility
may elect to accept a short stay rate with a case mix index of 1.0 for all facility residents
who stay 14 days or less in lieu of submitting an admission assessment. Facilities shall make
this election annually.
(c) Nursing facilities must elect one of the options described in paragraphs (a) and (b)
by reporting to the commissioner of health, as prescribed by the commissioner. The election
is effective on July 1 each year.
Sec. 24.
Minnesota Statutes 2020, section 144.0724, subdivision 7, is amended to read:
Subd. 7.
Notice of resident reimbursementnew text begin case mixnew text end classification.
(a) The
commissioner of health shall provide to a nursing facility a notice for each resident of the
deleted text begin reimbursementdeleted text end classification established under subdivision 1. The notice must inform the
resident of thenew text begin case mixnew text end classification deleted text begin that wasdeleted text end assigned, the opportunity to review the
documentation supporting the classification, the opportunity to obtain clarification from the
commissioner, and the opportunity to request a reconsideration of the classification and the
address and telephone number of the Office of Ombudsman for Long-Term Care. The
commissioner must transmit the notice of resident classification by electronic means to the
nursing facility. deleted text begin Adeleted text end new text begin Thenew text end nursing facility is responsible for the distribution of the notice to
each residentdeleted text begin , to the person responsible for the payment of the resident's nursing home
expenses, or to another person designated by the residentdeleted text end new text begin or the resident's representativenew text end .
This notice must be distributed within three deleted text begin workingdeleted text end new text begin businessnew text end days after the facility's receipt
deleted text begin of the electronic file of notice of case mix classifications from the commissioner of healthdeleted text end .
(b) If a facility submits a deleted text begin modification to the most recent assessment used to establish
a case mix classification conducted under subdivision 3 that resultsdeleted text end new text begin modifying assessment
resultingnew text end in a change innew text begin thenew text end case mix classification, the facility deleted text begin shall givedeleted text end new text begin must provide anew text end
written notice to the resident or the resident's representative deleted text begin aboutdeleted text end new text begin regardingnew text end the itemnew text begin or
itemsnew text end that deleted text begin wasdeleted text end new text begin werenew text end modified and the reason for the deleted text begin modificationdeleted text end new text begin modificationsnew text end . The notice
deleted text begin of modified assessment maydeleted text end new text begin mustnew text end be provided deleted text begin at the same time that the resident or resident's
representative is provided the resident's modified notice of classificationdeleted text end new text begin within three business
days after distribution of the resident case mix classification noticenew text end .
Sec. 25.
Minnesota Statutes 2020, section 144.0724, subdivision 8, is amended to read:
Subd. 8.
Request for reconsideration of resident classifications.
(a) The resident, or
resident's representative, or the nursing facility or boarding care home may request that the
commissioner of health reconsider the assigned reimbursementnew text begin case mixnew text end classificationnew text begin and
any item or items changed during the audit processnew text end . The request for reconsideration must
be submitted in writing to the commissioner deleted text begin within 30 days of the day the resident or the
resident's representative receives the resident classification noticedeleted text end new text begin of healthnew text end .
new text begin
(b) For reconsideration requests initiated by the resident or the resident's representative:
new text end
new text begin (1) The resident or the resident's representative must submit in writing a reconsideration
request to the facility administrator within 30 days of receipt of the resident classification
notice.new text end Thenew text begin writtennew text end request deleted text begin for reconsiderationdeleted text end must include the deleted text begin name of the resident, the
name and address of the facility in which the resident resides, thedeleted text end reasons for the
reconsiderationdeleted text begin , and documentation supporting thedeleted text end request. deleted text begin The documentation accompanying
the reconsideration request is limited to a copy of the MDS that determined the classification
and other documents that would support or change the MDS findings.
deleted text end
new text begin
(2) Within three business days of receiving the reconsideration request, the nursing
facility must submit to the commissioner of health a completed reconsideration request
form, a copy of the resident's or resident's representative's written request, and all supporting
documentation used to complete the assessment being considered. If the facility fails to
provide the required information, the reconsideration will be completed with the information
submitted and the facility cannot make further reconsideration requests on this classification.
new text end
deleted text begin (b)deleted text end new text begin (3)new text end Uponnew text begin writtennew text end requestnew text begin and within three business daysnew text end , the nursing facility must
give the resident or the resident's representative a copy of the assessment deleted text begin formdeleted text end new text begin being
reconsiderednew text end and deleted text begin the otherdeleted text end new text begin all supportingnew text end documentation deleted text begin that was given to the commissioner
of healthdeleted text end new text begin usednew text end to deleted text begin supportdeleted text end new text begin completenew text end the assessment deleted text begin findingsdeleted text end . deleted text begin The nursing facility shall also
provide access to and a copy of other information from the resident's record that has been
requested by or on behalf of the resident to support a resident's reconsideration request. A
copy of any requested material must be provided within three working days of receipt of a
written request for the information.deleted text end Notwithstanding any law to the contrary, the facility
may not charge a fee for providing copies of the requested documentation. If a facility fails
to provide the deleted text begin materialdeleted text end new text begin required documentsnew text end within this time, it is subject to the issuance of
a correction order and penalty assessment under sections 144.653 and 144A.10.
Notwithstanding those sections, any correction order issued under this subdivision must
require that the nursing facility immediately comply with the request for informationnew text begin ,new text end and
deleted text begin thatdeleted text end as of the date of the issuance of the correction order, the facility shall forfeit to the state
a $100 fine for the first day of noncompliance, and an increase in the $100 fine by $50
increments for each day the noncompliance continues.
(c) deleted text begin in addition to the information required under paragraphs (a) and (b), a reconsideration
request from a nursing facility must contain the following information: (i) the date the
reimbursement classification notices were received by the facility; (ii) the date the
deleted text end deleted text begin classification notices were distributed to the resident or the resident's representative; and
(iii)deleted text end new text begin For reconsideration requests initiated by the facility:
new text end
new text begin
(1) The facility is required to inform the resident or the resident's representative in writing
that a reconsideration of the resident's case mix classification is being requested. The notice
must inform the resident or the resident's representative:
new text end
new text begin
(i) of the date and reason for the reconsideration request;
new text end
new text begin
(ii) of the potential for a classification and subsequent rate change;
new text end
new text begin
(iii) of the extent of the potential rate change;
new text end
new text begin
(iv) that copies of the request and supporting documentation are available for review;
and
new text end
new text begin
(v) that the resident or the resident's representative has the right to request a
reconsideration.
new text end
new text begin (2) Within 30 days of receipt of the audit exit report or resident classification notice, the
facility must submit to the commissioner of health a completed reconsideration request
form, all supporting documentation used to complete the assessment being reconsidered,
andnew text end a copy of deleted text begin adeleted text end new text begin thenew text end notice deleted text begin sent todeleted text end new text begin informingnew text end the resident or deleted text begin todeleted text end the resident's representativedeleted text begin .
This notice must inform the resident or the resident's representativedeleted text end that a reconsideration
of the resident's classification is being requesteddeleted text begin , the reason for the request, that the resident's
rate will change if the request is approved by the commissioner, the extent of the change,
that copies of the facility's request and supporting documentation are available for review,
and that the resident also has the right to request a reconsiderationdeleted text end .
new text begin (3)new text end If the facility fails to provide the required information deleted text begin listed in item (iii) with the
reconsideration request, the commissioner may request that the facility provide the
information within 14 calendar days.deleted text end new text begin ,new text end the reconsideration request deleted text begin mustdeleted text end new text begin maynew text end be denied deleted text begin if the
information is then not provided,deleted text end and the facility may not make further reconsideration
requests on deleted text begin that specific reimbursementdeleted text end new text begin thisnew text end classification.
(d) Reconsideration by the commissioner must be made by individuals not involved in
reviewing the assessment, audit, or reconsideration that established the disputed classification.
The reconsideration must be based upon the assessment that determined the classification
and upon the information provided to the commissionernew text begin of healthnew text end under paragraphs (a) deleted text begin and
(b)deleted text end new text begin to (c)new text end . If necessary for evaluating the reconsideration request, the commissioner may
conduct on-site reviews. Within 15 deleted text begin workingdeleted text end new text begin businessnew text end days of receiving the request for
reconsideration, the commissioner shall affirm or modify the original resident classification.
The original classification must be modified if the commissioner determines that the
assessment resulting in the classification did not accurately reflect characteristics of the
resident at the time of the assessment. deleted text begin The resident and the nursing facility or boarding care
home shall be notified within five working days after the decision is made.deleted text end new text begin The commissioner
must transmit the reconsideration classification notice by electronic means to the nursing
facility. The nursing facility is responsible for the distribution of the notice to the resident
or the resident's representative. The notice must be distributed by the nursing facility within
three business days after receipt.new text end A decision by the commissioner under this subdivision is
the final administrative decision of the agency for the party requesting reconsideration.
(e) The deleted text begin residentdeleted text end new text begin case mixnew text end classification established by the commissioner shall be the
classification deleted text begin thatdeleted text end new text begin whichnew text end applies to the resident while the request for reconsideration is
pending. If a request for reconsideration applies to an assessment used to determine nursing
facility level of care under subdivision 4, paragraph (c), the resident shall continue to be
eligible for nursing facility level of care while the request for reconsideration is pending.
(f) The commissioner may request additional documentation regarding a reconsideration
necessary to make an accurate reconsideration determination.
Sec. 26.
Minnesota Statutes 2020, section 144.0724, subdivision 9, is amended to read:
Subd. 9.
Audit authority.
(a) The commissioner shall audit the accuracy of resident
assessments performed under section 256R.17 through any of the following: desk audits;
on-site review of residents and their records; and interviews with staff, residents, or residents'
families. The commissioner shall reclassify a resident if the commissioner determines that
the resident was incorrectly classified.
(b) The commissioner is authorized to conduct on-site audits on an unannounced basis.
(c) A facility must grant the commissioner access to examine the medical records relating
to the resident assessments selected for audit under this subdivision. The commissioner may
also observe and speak to facility staff and residents.
(d) The commissioner shall consider documentation under the time frames for coding
items on the minimum data set as set out in the Long-Term Care Facility Resident Assessment
Instrument User's Manual published by the Centers for Medicare and Medicaid Services.
(e) The commissioner shall develop an audit selection procedure that includes the
following factors:
(1) Each facility shall be audited annually. If a facility has two successive audits in which
the percentage of change is five percent or less and the facility has not been the subject of
a special audit in the past 36 months, the facility may be audited biannually. A stratified
sample of 15 percent, with a minimum of ten assessments, of the most current assessments
shall be selected for audit. If more than 20 percent of the RUG-IV classifications are changed
as a result of the audit, the audit shall be expanded to a second 15 percent sample, with a
minimum of ten assessments. If the total change between the first and second samples is
35 percent or greater, the commissioner may expand the audit to all of the remaining
assessments.
(2) If a facility qualifies for an expanded audit, the commissioner may audit the facility
again within six months. If a facility has two expanded audits within a 24-month period,
that facility will be audited at least every six months for the next 18 months.
(3) The commissioner may conduct special audits if the commissioner determines that
circumstances exist that could alter or affect the validity of case mix classifications of
residents. These circumstances include, but are not limited to, the following:
(i) frequent changes in the administration or management of the facility;
(ii) an unusually high percentage of residents in a specific case mix classification;
(iii) a high frequency in the number of reconsideration requests received from a facility;
(iv) frequent adjustments of case mix classifications as the result of reconsiderations or
audits;
(v) a criminal indictment alleging provider fraud;
(vi) other similar factors that relate to a facility's ability to conduct accurate assessments;
(vii) an atypical pattern of scoring minimum data set items;
(viii) nonsubmission of assessments;
(ix) late submission of assessments; or
(x) a previous history of audit changes of 35 percent or greater.
(f) deleted text begin Within 15 working days of completing the audit process, the commissioner shall
make available electronically the results of the audit to the facility. If the results of the audit
reflect a change in the resident's case mix classification, a case mix classification notice
will be made available electronically to the facility, using the procedure in subdivision 7,
paragraph (a). The notice must contain the resident's classification and a statement informing
the resident, the resident's authorized representative, and the facility of their right to review
the commissioner's documents supporting the classification and to request a reconsideration
of the classification. This notice must also include the address and telephone number of the
Office of Ombudsman for Long-Term Care.deleted text end new text begin If the audit results in a case mix classification
change, the commissioner must transmit the audit classification notice by electronic means
to the nursing facility within 15 business days of completing an audit. The nursing facility
is responsible for distribution of the notice to each resident or the resident's representative.
This notice must be distributed by the nursing facility within three business days after
receipt. The notice must inform the resident of the case mix classification assigned, the
opportunity to review the documentation supporting the classification, the opportunity to
obtain clarification from the commissioner, the opportunity to request a reconsideration of
the classification, and the address and telephone number of the Office of Ombudsman for
Long-Term Care.
new text end
Sec. 27.
Minnesota Statutes 2020, section 144.0724, subdivision 12, is amended to read:
Subd. 12.
Appeal of nursing facility level of care determination.
(a) A resident or
prospective resident whose level of care determination results in a denial of long-term care
services can appeal the determination as outlined in section 256B.0911, subdivision 3a,
paragraph (h), clause (9).
(b) The commissioner of human services shall ensure that notice of changes in eligibility
due to a nursing facility level of care determination is provided to each affected recipient
or the recipient's guardian at least 30 days before the effective date of the change. The notice
shall include the following information:
(1) how to obtain further information on the changes;
(2) how to receive assistance in obtaining other services;
(3) a list of community resources; and
(4) appeal rights.
deleted text begin
A recipient who meets the criteria in section 256B.0922, subdivision 2, paragraph (a), clauses
(1) and (2), may request continued services pending appeal within the time period allowed
to request an appeal under section 256.045, subdivision 3, paragraph (i). This paragraph is
in effect for appeals filed between January 1, 2015, and December 31, 2016.
deleted text end
Sec. 28.
Minnesota Statutes 2020, section 144.1205, subdivision 2, is amended to read:
Subd. 2.
new text begin Initial and new text end annual fee.
new text begin
(a) A licensee must pay an initial fee that is equivalent
to the annual fee upon issuance of the initial license.
new text end
new text begin (b) new text end A licensee must pay an annual fee at least 60 days before the anniversary date of the
issuance of the license. The annual fee is as follows:
| TYPE |
deleted text begin ANNUALdeleted text end new text begin LICENSEnew text end FEE |
||
| Academic broad scope - type Anew text begin , B, or C new text end |
deleted text begin
$19,920
deleted text end
new text begin
$25,896 new text end |
||
|
deleted text begin
Academic broad scope - type B deleted text end |
deleted text begin
19,920 deleted text end |
||
|
deleted text begin
Academic broad scope - type C deleted text end |
deleted text begin
19,920 deleted text end |
||
|
new text begin
Academic broad scope - type A, B, or C (4-8 locations) new text end |
new text begin
$31,075 new text end |
||
|
new text begin
Academic broad scope - type A, B, or C (9 or more locations) new text end |
new text begin
$36,254 new text end |
||
| Medical broad scope - type A |
deleted text begin
19,920
deleted text end
new text begin
$25,896 new text end |
||
|
new text begin
Medical broad scope- type A (4-8 locations) new text end |
new text begin
$31,075 new text end |
||
|
new text begin
Medical broad scope- type A (9 or more locations) new text end |
new text begin
$36,254 new text end |
||
|
deleted text begin
Medical institution - diagnostic and therapeutic deleted text end |
deleted text begin
3,680 deleted text end |
||
|
new text begin
Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies new text end |
new text begin
$4,784 new text end |
||
|
new text begin
Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies (4-8 locations) new text end |
new text begin
$5,740 new text end |
||
|
new text begin
Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies (9 or more locations) new text end |
new text begin
$6,697 new text end |
||
|
deleted text begin
Medical institution - diagnostic (no written directives) deleted text end |
deleted text begin
3,680 deleted text end |
||
|
deleted text begin
Medical private practice - diagnostic and therapeutic deleted text end |
deleted text begin
3,680 deleted text end |
||
|
deleted text begin
Medical private practice - diagnostic (no written directives) deleted text end |
deleted text begin
3,680 deleted text end |
||
|
deleted text begin
Eye applicators deleted text end |
deleted text begin
3,680 deleted text end |
||
|
deleted text begin
Nuclear medical vans deleted text end |
deleted text begin
3,680 deleted text end |
||
|
deleted text begin
High dose rate afterloader deleted text end |
deleted text begin
3,680 deleted text end |
||
|
deleted text begin
Mobile high dose rate afterloader deleted text end |
deleted text begin
3,680 deleted text end |
||
|
deleted text begin
Medical therapy - other emerging technology deleted text end |
deleted text begin
3,680 deleted text end |
||
| Teletherapy |
deleted text begin
8,960
deleted text end
new text begin
$11,648 new text end |
||
| Gamma knife |
deleted text begin
8,960
deleted text end
new text begin
$11,648 new text end |
||
| Veterinary medicine |
deleted text begin
2,000
deleted text end
new text begin
$2,600 new text end |
||
| In vitro testing lab |
deleted text begin
2,000
deleted text end
new text begin
$2,600 new text end |
||
| Nuclear pharmacy |
deleted text begin
8,800
deleted text end
new text begin
$11,440 new text end |
||
|
new text begin
Nuclear pharmacy (5 or more locations) new text end |
new text begin
$13,728 new text end |
||
| Radiopharmaceutical distribution (10 CFR 32.72) |
deleted text begin
3,840
deleted text end
new text begin
$4,992 new text end |
||
| Radiopharmaceutical processing and distribution (10 CFR 32.72) |
deleted text begin
8,800
deleted text end
new text begin
$11,440 new text end |
||
|
new text begin
Radiopharmaceutical processing and distribution (10 CFR 32.72) (5 or more locations) new text end |
new text begin
$13,728 new text end |
||
| Medical sealed sources - distribution (10 CFR 32.74) |
deleted text begin
3,840
deleted text end
new text begin
$4,992 new text end |
||
| Medical sealed sources - processing and distribution (10 CFR 32.74) |
deleted text begin
8,800
deleted text end
new text begin
$11,440 new text end |
||
|
new text begin
Medical sealed sources - processing and distribution (10 CFR 32.74) (5 or more locations) new text end |
new text begin
$13,728 new text end |
||
| Well logging - sealed sources |
deleted text begin
3,760
deleted text end
new text begin
$4,888 new text end |
||
| Measuring systems - new text begin (new text end fixed gaugenew text begin , portable gauge, gas chromatograph, other) new text end |
deleted text begin
2,000
deleted text end
new text begin
$2,600 new text end |
||
|
deleted text begin
Measuring systems - portable gauge deleted text end |
deleted text begin
2,000 deleted text end |
||
|
new text begin
Measuring systems - (fixed gauge, portable gauge, gas chromatograph, other) (4-8 locations) new text end |
new text begin
$3,120 new text end |
||
|
new text begin
Measuring systems - (fixed gauge, portable gauge, gas chromatograph, other) (9 or more locations) new text end |
new text begin
$3,640 new text end |
||
| X-ray fluorescent analyzer |
deleted text begin
1,520
deleted text end
new text begin
$1,976 new text end |
||
|
deleted text begin
Measuring systems - gas chromatograph deleted text end |
deleted text begin
2,000 deleted text end |
||
|
deleted text begin
Measuring systems - other deleted text end |
deleted text begin
2,000 deleted text end |
||
| deleted text begin Broad scopedeleted text end Manufacturing and distribution - type Anew text begin broad scope new text end |
deleted text begin
19,920
deleted text end
new text begin
$25,896 new text end |
||
|
new text begin
Manufacturing and distribution - type A broad scope (4-8 locations) new text end |
new text begin
$31,075 new text end |
||
|
new text begin
Manufacturing and distribution - type A broad scope (9 or more locations) new text end |
new text begin
$36,254 new text end |
||
| deleted text begin Broad scopedeleted text end Manufacturing and distribution - type Bnew text begin or C broad scope new text end |
deleted text begin
17,600
deleted text end
new text begin
$22,880 new text end |
||
|
deleted text begin
Broad scope Manufacturing and distribution - type C deleted text end |
deleted text begin
17,600 deleted text end |
||
|
new text begin
Manufacturing and distribution - type B or C broad scope (4-8 locations) new text end |
new text begin
$27,456 new text end |
||
|
new text begin
Manufacturing and distribution - type B or C broad scope (9 or more locations) new text end |
new text begin
$32,032 new text end |
||
| Manufacturing and distribution - other |
deleted text begin
5,280
deleted text end
new text begin
$6,864 new text end |
||
|
new text begin
Manufacturing and distribution - other (4-8 locations) new text end |
new text begin
$8,236 new text end |
||
|
new text begin
Manufacturing and distribution - other (9 or more locations) new text end |
new text begin
$9,609 new text end |
||
| Nuclear laundry |
deleted text begin
18,640
deleted text end
new text begin
$24,232 new text end |
||
| Decontamination services |
deleted text begin
4,960
deleted text end
new text begin
$6,448 new text end |
||
| Leak test services only |
deleted text begin
2,000
deleted text end
new text begin
$2,600 new text end |
||
| Instrument calibration service onlydeleted text begin , less than 100 curies deleted text end |
deleted text begin
2,000
deleted text end
new text begin
$2,600 new text end |
||
|
deleted text begin
Instrument calibration service only, 100 curies or more deleted text end |
deleted text begin
2,000 deleted text end |
||
| Service, maintenance, installation, source changes, etc. |
deleted text begin
4,960
deleted text end
new text begin
$6,448 new text end |
||
| Waste disposal service, prepackaged only |
deleted text begin
6,000
deleted text end
new text begin
$7,800 new text end |
||
| Waste disposal |
deleted text begin
8,320
deleted text end
new text begin
$10,816 new text end |
||
| Distribution - general licensed devices (sealed sources) |
deleted text begin
1,760
deleted text end
new text begin
$2,288 new text end |
||
| Distribution - general licensed material (unsealed sources) |
deleted text begin
1,120
deleted text end
new text begin
$1,456 new text end |
||
| Industrial radiography - fixednew text begin or temporarynew text end location |
deleted text begin
9,840
deleted text end
new text begin
$12,792 new text end |
||
|
deleted text begin
Industrial radiography - temporary job sites deleted text end |
deleted text begin
9,840 deleted text end |
||
|
new text begin
Industrial radiography - fixed or temporary location (5 or more locations) new text end |
new text begin
$16,629 new text end |
||
| Irradiators, self-shieldingdeleted text begin , less than 10,000 curies deleted text end |
deleted text begin
2,880
deleted text end
new text begin
$3,744 new text end |
||
| Irradiators, other, less than 10,000 curies |
deleted text begin
5,360
deleted text end
new text begin
$6,968 new text end |
||
|
deleted text begin
Irradiators, self-shielding, 10,000 curies or more deleted text end |
deleted text begin
2,880 deleted text end |
||
| Research and development - type Anew text begin , B, or Cnew text end broad scope |
deleted text begin
9,520
deleted text end
new text begin
$12,376 new text end |
||
|
deleted text begin
Research and development - type B broad scope deleted text end |
deleted text begin
9,520 deleted text end |
||
|
deleted text begin
Research and development - type C broad scope deleted text end |
deleted text begin
9,520 deleted text end |
||
|
new text begin
Research and development - type A, B, or C broad scope (4-8 locations) new text end |
new text begin
$14,851 new text end |
||
|
new text begin
Research and development - type A, B, or C broad scope (9 or more locations) new text end |
new text begin
$17,326 new text end |
||
| Research and development - other |
deleted text begin
4,480
deleted text end
new text begin
$5,824 new text end |
||
| Storage - no operations |
deleted text begin
2,000
deleted text end
new text begin
$2,600 new text end |
||
| Source material - shielding |
deleted text begin
584
deleted text end
new text begin
$759 new text end |
||
| Special nuclear material plutonium - neutron source in device |
deleted text begin
3,680
deleted text end
new text begin
$4,784 new text end |
||
| Pacemaker by-product and/or special nuclear material - medical (institution) |
deleted text begin
3,680
deleted text end
new text begin
$4,784 new text end |
||
| Pacemaker by-product and/or special nuclear material - manufacturing and distribution |
deleted text begin
5,280
deleted text end
new text begin
$6,864 new text end |
||
| Accelerator-produced radioactive material |
deleted text begin
3,840
deleted text end
new text begin
$4,992 new text end |
||
| Nonprofit educational institutions |
deleted text begin
300
deleted text end
new text begin
$500 new text end |
||
|
deleted text begin
General license registration deleted text end |
deleted text begin
150 deleted text end |
||
Sec. 29.
Minnesota Statutes 2020, section 144.1205, subdivision 4, is amended to read:
Subd. 4.
new text begin Initial and renewal new text end application fee.
A licensee must pay an new text begin initial and a
renewal new text end application fee deleted text begin as follows:deleted text end new text begin according to this subdivision.
new text end
| TYPE |
APPLICATION FEE |
||
| Academic broad scope - type Anew text begin , B, or C new text end |
deleted text begin
$ 5,920
deleted text end
new text begin
$6,808 new text end |
||
|
deleted text begin
Academic broad scope - type B deleted text end |
deleted text begin
5,920 deleted text end |
||
|
deleted text begin
Academic broad scope - type C deleted text end |
deleted text begin
5,920 deleted text end |
||
| Medical broad scope - type A |
deleted text begin
3,920
deleted text end
new text begin
$4,508 new text end |
||
|
new text begin
Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies new text end |
new text begin
$1,748 new text end |
||
|
deleted text begin
Medical institution - diagnostic and therapeutic deleted text end |
deleted text begin
1,520 deleted text end |
||
|
deleted text begin
Medical institution - diagnostic (no written directives) deleted text end |
deleted text begin
1,520 deleted text end |
||
|
deleted text begin
Medical private practice - diagnostic and therapeutic deleted text end |
deleted text begin
1,520 deleted text end |
||
|
deleted text begin
Medical private practice - diagnostic (no written directives) deleted text end |
deleted text begin
1,520 deleted text end |
||
|
deleted text begin
Eye applicators deleted text end |
deleted text begin
1,520 deleted text end |
||
|
deleted text begin
Nuclear medical vans deleted text end |
deleted text begin
1,520 deleted text end |
||
|
deleted text begin
High dose rate afterloader deleted text end |
deleted text begin
1,520 deleted text end |
||
|
deleted text begin
Mobile high dose rate afterloader deleted text end |
deleted text begin
1,520 deleted text end |
||
|
deleted text begin
Medical therapy - other emerging technology deleted text end |
deleted text begin
1,520 deleted text end |
||
| Teletherapy |
deleted text begin
5,520
deleted text end
new text begin
$6,348 new text end |
||
| Gamma knife |
deleted text begin
5,520
deleted text end
new text begin
$6,348 new text end |
||
| Veterinary medicine |
deleted text begin
960
deleted text end
new text begin
$1,104 new text end |
||
| In vitro testing lab |
deleted text begin
960
deleted text end
new text begin
$1,104 new text end |
||
| Nuclear pharmacy |
deleted text begin
4,880
deleted text end
new text begin
$5,612 new text end |
||
| Radiopharmaceutical distribution (10 CFR 32.72) |
deleted text begin
2,160
deleted text end
new text begin
$2,484 new text end |
||
| Radiopharmaceutical processing and distribution (10 CFR 32.72) |
deleted text begin
4,880
deleted text end
new text begin
$5,612 new text end |
||
| Medical sealed sources - distribution (10 CFR 32.74) |
deleted text begin
2,160
deleted text end
new text begin
$2,484 new text end |
||
| Medical sealed sources - processing and distribution (10 CFR 32.74) |
deleted text begin
4,880
deleted text end
new text begin
$5,612 new text end |
||
| Well logging - sealed sources |
deleted text begin
1,600
deleted text end
new text begin
$1,840 new text end |
||
| Measuring systems - new text begin (new text end fixed gaugenew text begin , portable gauge, gas chromatograph, other) new text end |
deleted text begin
960
deleted text end
new text begin
$1,104 new text end |
||
|
deleted text begin
Measuring systems - portable gauge deleted text end |
deleted text begin
960 deleted text end |
||
| X-ray fluorescent analyzer |
deleted text begin
584
deleted text end
new text begin
$671 new text end |
||
|
deleted text begin
Measuring systems - gas chromatograph deleted text end |
deleted text begin
960 deleted text end |
||
|
deleted text begin
Measuring systems - other deleted text end |
deleted text begin
960 deleted text end |
||
| deleted text begin Broad scopedeleted text end Manufacturing and distribution - type Anew text begin , B, and C broad scope new text end |
deleted text begin
5,920
deleted text end
new text begin
$6,854 new text end |
||
|
deleted text begin
Broad scope manufacturing and distribution - type B deleted text end |
deleted text begin
5,920 deleted text end |
||
|
deleted text begin
Broad scope manufacturing and distribution - type C deleted text end |
deleted text begin
5,920 deleted text end |
||
| Manufacturing and distribution - other |
deleted text begin
2,320
deleted text end
new text begin
$2,668 new text end |
||
| Nuclear laundry |
deleted text begin
10,080
deleted text end
new text begin
$11,592 new text end |
||
| Decontamination services |
deleted text begin
2,640
deleted text end
new text begin
$3,036 new text end |
||
| Leak test services only |
deleted text begin
960
deleted text end
new text begin
$1,104 new text end |
||
| Instrument calibration service onlydeleted text begin , less than 100 curies deleted text end |
deleted text begin
960
deleted text end
new text begin
$1,104 new text end |
||
|
deleted text begin
Instrument calibration service only, 100 curies or more deleted text end |
deleted text begin
960 deleted text end |
||
| Service, maintenance, installation, source changes, etc. |
deleted text begin
2,640
deleted text end
new text begin
$3,036 new text end |
||
| Waste disposal service, prepackaged only |
deleted text begin
2,240
deleted text end
new text begin
$2,576 new text end |
||
| Waste disposal |
deleted text begin
1,520
deleted text end
new text begin
$1,748 new text end |
||
| Distribution - general licensed devices (sealed sources) |
deleted text begin
880
deleted text end
new text begin
$1,012 new text end |
||
| Distribution - general licensed material (unsealed sources) |
deleted text begin
520
deleted text end
new text begin
$598 new text end |
||
| Industrial radiography - fixed new text begin or temporary new text end location |
deleted text begin
2,640
deleted text end
new text begin
$3,036 new text end |
||
|
deleted text begin
Industrial radiography - temporary job sites deleted text end |
deleted text begin
2,640 deleted text end |
||
| Irradiators, self-shieldingdeleted text begin , less than 10,000 curies deleted text end |
deleted text begin
1,440
deleted text end
new text begin
$1,656 new text end |
||
| Irradiators, other, less than 10,000 curies |
deleted text begin
2,960
deleted text end
new text begin
$3,404 new text end |
||
|
deleted text begin
Irradiators, self-shielding, 10,000 curies or more deleted text end |
deleted text begin
1,440 deleted text end |
||
| Research and development - type Anew text begin , B, or Cnew text end broad scope |
deleted text begin
4,960
deleted text end
new text begin
$5,704 new text end |
||
|
deleted text begin
Research and development - type B broad scope deleted text end |
deleted text begin
4,960 deleted text end |
||
|
deleted text begin
Research and development - type C broad scope deleted text end |
deleted text begin
4,960 deleted text end |
||
| Research and development - other |
deleted text begin
2,400
deleted text end
new text begin
$2,760 new text end |
||
| Storage - no operations |
deleted text begin
960
deleted text end
new text begin
$1,104 new text end |
||
| Source material - shielding |
deleted text begin
136
deleted text end
new text begin
$156 new text end |
||
| Special nuclear material plutonium - neutron source in device |
deleted text begin
1,200
deleted text end
new text begin
$1,380 new text end |
||
| Pacemaker by-product and/or special nuclear material - medical (institution) |
deleted text begin
1,200
deleted text end
new text begin
$1,380 new text end |
||
| Pacemaker by-product and/or special nuclear material - manufacturing and distribution |
deleted text begin
2,320
deleted text end
new text begin
$2,668 new text end |
||
| Accelerator-produced radioactive material |
deleted text begin
4,100
deleted text end
new text begin
$4,715 new text end |
||
| Nonprofit educational institutions |
deleted text begin
300
deleted text end
new text begin
$345 new text end |
||
|
deleted text begin
General license registration deleted text end |
deleted text begin
0 deleted text end |
||
|
deleted text begin
Industrial radiographer certification deleted text end |
deleted text begin
150 deleted text end |
||
Sec. 30.
Minnesota Statutes 2020, section 144.1205, subdivision 8, is amended to read:
Subd. 8.
Reciprocity fee.
A licensee submitting an application for reciprocal recognition
of a materials license issued by another agreement state or the United States Nuclear
Regulatory Commission for a period of 180 days or less during a calendar year must pay
deleted text begin $1,200deleted text end new text begin $2,400new text end . For a period of 181 days or more, the licensee must obtain a license under
subdivision 4.
Sec. 31.
Minnesota Statutes 2020, section 144.1205, subdivision 9, is amended to read:
Subd. 9.
Fees for license amendments.
A licensee must pay a fee of deleted text begin $300deleted text end new text begin $600new text end to
amend a license as follows:
(1) to amend a license requiring review including, but not limited to, addition of isotopes,
procedure changes, new authorized users, or a new radiation safety officer; deleted text begin anddeleted text end new text begin or
new text end
(2) to amend a license requiring review and a site visit including, but not limited to,
facility move or addition of processes.
Sec. 32.
Minnesota Statutes 2020, section 144.1205, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Fees for general license registrations. new text end
new text begin
A person required to register generally
licensed devices according to Minnesota Rules, part 4731.3215, must pay an annual
registration fee of $450.
new text end
Sec. 33.
Minnesota Statutes 2020, section 144.125, subdivision 1, is amended to read:
Subdivision 1.
Duty to perform testing.
(a) It is the duty of (1) the administrative officer
or other person in charge of each institution caring for infants 28 days or less of age, (2) the
person required in pursuance of the provisions of section 144.215, to register the birth of a
child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have
administered to every infant or child in its care tests for heritable and congenital disorders
according to subdivision 2 and rules prescribed by the state commissioner of health.
(b) Testing, recording of test results, reporting of test results, and follow-up of infants
with heritable congenital disorders, including hearing loss detected through the early hearing
detection and intervention program in section 144.966, shall be performed at the times and
in the manner prescribed by the commissioner of health.
(c) The fee to support the newborn screening program, including tests administered
under this section and section 144.966, shall be deleted text begin $135deleted text end new text begin $177new text end per specimen. This fee amount
shall be deposited in the state treasury and credited to the state government special revenue
fund.
(d) The fee to offset the cost of the support services provided under section 144.966,
subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
and credited to the general fund.
Sec. 34.
new text begin
[144.1461] DIGNITY IN PREGNANCY AND CHILDBIRTH.
new text end
new text begin Subdivision 1. new text end
new text begin Citation. new text end
new text begin
This section may be cited as the "Dignity in Pregnancy and
Childbirth Act."
new text end
new text begin Subd. 2. new text end
new text begin Continuing education requirement. new text end
new text begin
(a) Hospitals with obstetric care and birth
centers must provide continuing education on anti-racism training and implicit bias. The
continuing education must be evidence-based and must include at a minimum the following
criteria:
new text end
new text begin
(1) education aimed at identifying personal, interpersonal, institutional, structural, and
cultural barriers to inclusion;
new text end
new text begin
(2) identifying and implementing corrective measures to promote anti-racism practices
and decrease implicit bias at the interpersonal and institutional levels, including the
institution's ongoing policies and practices;
new text end
new text begin
(3) providing information on the ongoing effects of historical and contemporary exclusion
and oppression of Black and Indigenous communities with the greatest health disparities
related to maternal and infant mortality and morbidity;
new text end
new text begin
(4) providing information and discussion of health disparities in the perinatal health care
field including how systemic racism and implicit bias have different impacts on health
outcomes for different racial and ethnic communities; and
new text end
new text begin
(5) soliciting perspectives of diverse, local constituency groups and experts on racial,
identity, cultural, and provider-community relationship issues.
new text end
new text begin
(b) In addition to the initial continuing educational requirement in paragraph (a), hospitals
with obstetric care and birth centers must provide an annual refresher course that reflects
current trends on race, culture, identity, and anti-racism principles and institutional implicit
bias.
new text end
new text begin
(c) Hospitals with obstetric care and birth centers must develop continuing education
materials on anti-racism and implicit bias that must be provided and updated annually for
direct care employees and contractors who routinely care for patients who are pregnant or
postpartum.
new text end
new text begin
(d) Hospitals with obstetric care and birth centers shall coordinate with health-related
licensing boards to obtain continuing education credits for the trainings and materials
required in this section. The commissioner of health shall monitor compliance with this
section. Initial training for the continuing education requirements in this subdivision must
be completed by December 31, 2022. The commissioner may inspect the training records
or require reports on the continuing education materials in this section from hospitals with
obstetric care and birth centers.
new text end
new text begin
(e) A facility described in paragraph (d) must provide a certificate of training completion
to another facility or a training attendee upon request. A facility may accept the training
certificate from another facility for a health care provider that works in more than one
facility.
new text end
Sec. 35.
Minnesota Statutes 2020, section 144.1481, subdivision 1, is amended to read:
Subdivision 1.
Establishment; membership.
The commissioner of health shall establish
a deleted text begin 15-memberdeleted text end new text begin 16-membernew text end Rural Health Advisory Committee. The committee shall consist
of the following members, all of whom must reside outside the seven-county metropolitan
area, as defined in section 473.121, subdivision 2:
(1) two members from the house of representatives of the state of Minnesota, one from
the majority party and one from the minority party;
(2) two members from the senate of the state of Minnesota, one from the majority party
and one from the minority party;
(3) a volunteer member of an ambulance service based outside the seven-county
metropolitan area;
(4) a representative of a hospital located outside the seven-county metropolitan area;
(5) a representative of a nursing home located outside the seven-county metropolitan
area;
(6) a medical doctor or doctor of osteopathic medicine licensed under chapter 147;
(7) new text begin a dentist licensed under chapter 150A;
new text end
new text begin (8) new text end a midlevel practitioner;
deleted text begin (8)deleted text end new text begin (9)new text end a registered nurse or licensed practical nurse;
deleted text begin (9)deleted text end new text begin (10)new text end a licensed health care professional from an occupation not otherwise represented
on the committee;
deleted text begin (10)deleted text end new text begin (11)new text end a representative of an institution of higher education located outside the
seven-county metropolitan area that provides training for rural health care providers; and
deleted text begin (11)deleted text end new text begin (12)new text end three consumers, at least one of whom must be an advocate for persons who
are mentally ill or developmentally disabled.
The commissioner will make recommendations for committee membership. Committee
members will be appointed by the governor. In making appointments, the governor shall
ensure that appointments provide geographic balance among those areas of the state outside
the seven-county metropolitan area. The chair of the committee shall be elected by the
members. The advisory committee is governed by section 15.059, except that the members
do not receive per diem compensation.
Sec. 36.
Minnesota Statutes 2020, section 144.1911, subdivision 6, is amended to read:
Subd. 6.
International medical graduate primary care residency grant program
and revolving account.
(a) The commissioner shall award grants to support primary care
residency positions designated for Minnesota immigrant physicians who are willing to serve
in rural or underserved areas of the state. No grant shall exceed $150,000 per residency
position per year. Eligible primary care residency grant recipients include accredited family
medicine, new text begin general surgery, new text end internal medicine, obstetrics and gynecology, psychiatry, and
pediatric residency programs. Eligible primary care residency programs shall apply to the
commissioner. Applications must include the number of anticipated residents to be funded
using grant funds and a budget. Notwithstanding any law to the contrary, funds awarded to
grantees in a grant agreement do not lapse until the grant agreement expires. Before any
funds are distributed, a grant recipient shall provide the commissioner with the following:
(1) a copy of the signed contract between the primary care residency program and the
participating international medical graduate;
(2) certification that the participating international medical graduate has lived in
Minnesota for at least two years and is certified by the Educational Commission on Foreign
Medical Graduates. Residency programs may also require that participating international
medical graduates hold a Minnesota certificate of clinical readiness for residency, once the
certificates become available; and
(3) verification that the participating international medical graduate has executed a
participant agreement pursuant to paragraph (b).
(b) Upon acceptance by a participating residency program, international medical graduates
shall enter into an agreement with the commissioner to provide primary care for at least
five years in a rural or underserved area of Minnesota after graduating from the residency
program and make payments to the revolving international medical graduate residency
account for five years beginning in their second year of postresidency employment.
Participants shall pay $15,000 or ten percent of their annual compensation each year,
whichever is less.
(c) A revolving international medical graduate residency account is established as an
account in the special revenue fund in the state treasury. The commissioner of management
and budget shall credit to the account appropriations, payments, and transfers to the account.
Earnings, such as interest, dividends, and any other earnings arising from fund assets, must
be credited to the account. Funds in the account are appropriated annually to the
commissioner to award grants and administer the grant program established in paragraph
(a). Notwithstanding any law to the contrary, any funds deposited in the account do not
expire. The commissioner may accept contributions to the account from private sector
entities subject to the following provisions:
(1) the contributing entity may not specify the recipient or recipients of any grant issued
under this subdivision;
(2) the commissioner shall make public the identity of any private contributor to the
account, as well as the amount of the contribution provided; and
(3) a contributing entity may not specify that the recipient or recipients of any funds use
specific products or services, nor may the contributing entity imply that a contribution is
an endorsement of any specific product or service.
Sec. 37.
Minnesota Statutes 2020, section 144.212, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Homeless youth. new text end
new text begin
"Homeless youth" has the meaning given in section 256K.45,
subdivision 1a.
new text end
Sec. 38.
Minnesota Statutes 2020, section 144.225, subdivision 2, is amended to read:
Subd. 2.
Data about births.
(a) Except as otherwise provided in this subdivision, data
pertaining to the birth of a child to a woman who was not married to the child's father when
the child was conceived nor when the child was born, including the original record of birth
and the certified vital record, are confidential data. At the time of the birth of a child to a
woman who was not married to the child's father when the child was conceived nor when
the child was born, the mother may designate demographic data pertaining to the birth as
public. Notwithstanding the designation of the data as confidential, it may be disclosed:
(1) to a parent or guardian of the child;
(2) to the child when the child is 16 years of age or oldernew text begin , except as provided in clause
(3)new text end ;
new text begin
(3) to the child if the child is a homeless youth;
new text end
deleted text begin (3)deleted text end new text begin (4)new text end under paragraph (b), (e), or (f); or
deleted text begin (4)deleted text end new text begin (5)new text end pursuant to a court order. For purposes of this section, a subpoena does not
constitute a court order.
(b) Unless the child is adopted, data pertaining to the birth of a child that are not accessible
to the public become public data if 100 years have elapsed since the birth of the child who
is the subject of the data, or as provided under section 13.10, whichever occurs first.
(c) If a child is adopted, data pertaining to the child's birth are governed by the provisions
relating to adoption records, including sections 13.10, subdivision 5; 144.218, subdivision
1; 144.2252; and 259.89.
(d) The name and address of a mother under paragraph (a) and the child's date of birth
may be disclosed to the county social services, tribal health department, or public health
member of a family services collaborative for purposes of providing services under section
124D.23.
(e) The commissioner of human services shall have access to birth records for:
(1) the purposes of administering medical assistance and the MinnesotaCare program;
(2) child support enforcement purposes; and
(3) other public health purposes as determined by the commissioner of health.
(f) Tribal child support programs shall have access to birth records for child support
enforcement purposes.
Sec. 39.
Minnesota Statutes 2020, section 144.225, subdivision 7, is amended to read:
Subd. 7.
Certified birth or death record.
(a) The state registrar or local issuance office
shall issue a certified birth or death record or a statement of no vital record found to an
individual upon the individual's proper completion of an attestation provided by the
commissioner andnew text begin , except as provided in section 144.2255,new text end payment of the required fee:
(1) to a person who deleted text begin has a tangible interest in the requested vital record. A person who
has a tangible interestdeleted text end is:
(i) the subject of the vital record;
(ii) a child of the subject;
(iii) the spouse of the subject;
(iv) a parent of the subject;
(v) the grandparent or grandchild of the subject;
(vi) if the requested record is a death record, a sibling of the subject;
deleted text begin
(vii) the party responsible for filing the vital record;
deleted text end
deleted text begin (viii)deleted text end new text begin (vii)new text end the legal custodian, guardian or conservator, or health care agent of the subject;
deleted text begin (ix)deleted text end new text begin (viii)new text end a personal representative, by sworn affidavit of the fact that the certified copy
is required for administration of the estate;
deleted text begin (x)deleted text end new text begin (ix)new text end a successor of the subject, as defined in section 524.1-201, if the subject is
deceased, by sworn affidavit of the fact that the certified copy is required for administration
of the estate;
deleted text begin (xi)deleted text end new text begin (x)new text end if the requested record is a death record, a trustee of a trust by sworn affidavit
of the fact that the certified copy is needed for the proper administration of the trust;
deleted text begin (xii)deleted text end new text begin (xi)new text end a person or entity who demonstrates that a certified vital record is necessary
for the determination or protection of a personal or property right, pursuant to rules adopted
by the commissioner; or
deleted text begin (xiii)deleted text end new text begin (xii)new text end an adoption agency in order to complete confidential postadoption searches
as required by section 259.83;
(2) to any local, state, tribal, or federal governmental agency upon request if the certified
vital record is necessary for the governmental agency to perform its authorized duties;
(3) to an attorney new text begin representing the subject of the vital record or another person listed in
clause (1), new text end upon evidence of the attorney's license;
(4) pursuant to a court order issued by a court of competent jurisdiction. For purposes
of this section, a subpoena does not constitute a court order; or
(5) to a representative authorized by a person under clauses (1) to (4).
(b) The state registrar or local issuance office shall also issue a certified death record to
an individual described in paragraph (a), clause (1), items (ii) to deleted text begin (viii)deleted text end new text begin (xi)new text end , if, on behalf of
the individual, a licensed mortician furnishes the registrar with a properly completed
attestation in the form provided by the commissioner within 180 days of the time of death
of the subject of the death record. This paragraph is not subject to the requirements specified
in Minnesota Rules, part 4601.2600, subpart 5, item B.
Sec. 40.
new text begin
[144.2255] CERTIFIED BIRTH RECORD FOR HOMELESS YOUTH.
new text end
new text begin Subdivision 1. new text end
new text begin Application; certified birth record. new text end
new text begin
A subject of a birth record who is
a homeless youth in Minnesota or another state may apply to the state registrar or a local
issuance office for a certified birth record according to this section. The state registrar or
local issuance office shall issue a certified birth record or statement of no vital record found
to a subject of a birth record who submits:
new text end
new text begin
(1) a completed application signed by the subject of the birth record;
new text end
new text begin
(2) a statement that the subject of the birth record is a homeless youth, signed by the
subject of the birth record; and
new text end
new text begin
(3) one of the following:
new text end
new text begin
(i) a document of identity listed in Minnesota Rules, part 4601.2600, subpart 8, or, at
the discretion of the state registrar or local issuance office, Minnesota Rules, part 4601.2600,
subpart 9;
new text end
new text begin
(ii) a statement that complies with Minnesota Rules, part 4601.2600, subparts 6 and 7;
or
new text end
new text begin
(iii) a statement verifying that the subject of the birth record is a homeless youth that
complies with the requirements in subdivision 2 and is from an employee of a human services
agency that receives public funding to provide services to homeless youth, runaway youth,
youth with mental illness, or youth with substance use disorders; a school staff person who
provides services to homeless youth; or a school social worker.
new text end
new text begin Subd. 2. new text end
new text begin Statement verifying subject is a homeless youth. new text end
new text begin
A statement verifying that
a subject of a birth record is a homeless youth must include:
new text end
new text begin
(1) the following information regarding the individual providing the statement: first
name, middle name, if any, and last name; home or business address; telephone number, if
any; and e-mail address, if any;
new text end
new text begin
(2) the first name, middle name, if any, and last name of the subject of the birth record;
and
new text end
new text begin
(3) a statement specifying the relationship of the individual providing the statement to
the subject of the birth record and verifying that the subject of the birth record is a homeless
youth.
new text end
new text begin
The individual providing the statement must also provide a copy of the individual's
employment identification.
new text end
new text begin Subd. 3. new text end
new text begin Expiration; reissuance. new text end
new text begin
If a subject of a birth record obtains a certified birth
record under this section using the statement specified in subdivision 1, clause (3), item
(iii), the certified birth record issued shall expire six months after the date of issuance. Upon
expiration of the certified birth record, the subject of the birth record may surrender the
expired birth record to the state registrar or a local issuance office and obtain another birth
record. Each certified birth record obtained under this subdivision shall expire six months
after the date of issuance. If the subject of the birth record does not surrender the expired
birth record, the subject may apply for a certified birth record using the process in subdivision
1.
new text end
new text begin Subd. 4. new text end
new text begin Fees waived. new text end
new text begin
The state registrar or local issuance office shall not charge any
fee for issuance of a certified birth record or statement of no vital record found under this
section.
new text end
new text begin Subd. 5. new text end
new text begin Data practices. new text end
new text begin
Data listed under subdivision 1, clauses (2) and (3), item (iii),
are private data on individuals.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment for
applications for and the issuance of certified birth records on or after January 1, 2022.
new text end
Sec. 41.
Minnesota Statutes 2020, section 144.226, is amended by adding a subdivision
to read:
new text begin Subd. 7. new text end
new text begin Transaction fees. new text end
new text begin
The state registrar may charge and permit agents to charge
a convenience fee and a transaction fee for electronic transactions and transactions by
telephone or Internet, as well as the fees established under subdivisions 1 to 4. The
convenience fee may not exceed three percent of the cost of the charges for payment. The
state registrar may permit agents to charge and retain a transaction fee as payment agreed
upon under contract. When an electronic convenience fee or transaction fee is charged, the
agent charging the fee is required to post information on their web page informing individuals
of the fee. The information must be near the point of payment, clearly visible, include the
amount of the fee, and state: "This contracted agent is allowed by state law to charge a
convenience fee and transaction fee for this electronic transaction."
new text end
Sec. 42.
Minnesota Statutes 2020, section 144.226, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Birth record fees waived for homeless youth. new text end
new text begin
A subject of a birth record who
is a homeless youth shall not be charged any of the fees specified in subdivisions 1 and 3
to 6 for a certified birth record or statement of no vital record found under section 144.2255.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment for
applications for and the issuance of certified birth records on or after January 1, 2022.
new text end
Sec. 43.
Minnesota Statutes 2020, section 144.55, subdivision 4, is amended to read:
Subd. 4.
Routine inspections; presumption.
Any hospital surveyed and accredited
under the standards of the hospital accreditation program of an approved accrediting
organization that submits to the commissioner within a reasonable time copies of (a) its
currently valid accreditation certificate and accreditation letter, together with accompanying
recommendations and comments and (b) any further recommendations, progress reports
and correspondence directly related to the accreditation is presumed to comply with
application requirements of subdivision 1 and the standards requirements of subdivision 3
and no further routine inspections or accreditation information shall be required by the
commissioner to determine compliance. Notwithstanding the provisions of sections 144.54
and 144.653, subdivisions 2 and 4, hospitals shall be inspected only as provided in this
section. The provisions of section 144.653 relating to the assessment and collection of fines
shall not apply to any hospital. The commissioner of health shall annually conduct, with
notice, validation inspections of a selected sample of the number of hospitals accredited by
an approved accrediting organization, not to exceed ten percent of accredited hospitals, for
the purpose of determining compliance with the provisions of subdivision 3. If a validation
survey discloses a failure to comply with subdivision 3, the provisions of section 144.653
relating to correction orders, reinspections, and notices of noncompliance shall apply. The
commissioner shall also conduct any inspection necessary to determine whether hospital
construction, addition, or remodeling projects comply with standards for construction
promulgated in rules pursuant to subdivision 3. new text begin The commissioner shall also conduct any
inspections necessary to determine whether a hospital or hospital corporate system continues
to satisfy the conditions on which a hospital construction moratorium exception was granted
under section 144.551. new text end Pursuant to section 144.653, the commissioner shall inspect any
hospital that does not have a currently valid hospital accreditation certificate from an
approved accrediting organization. Nothing in this subdivision shall be construed to limit
the investigative powers of the Office of Health Facility Complaints as established in sections
144A.51 to 144A.54.
Sec. 44.
Minnesota Statutes 2020, section 144.55, subdivision 6, is amended to read:
Subd. 6.
Suspension, revocation, and refusal to renew.
(a) The commissioner may
refuse to grant or renew, or may suspend or revoke, a license on any of the following grounds:
(1) violation of any of the provisions of sections 144.50 to 144.56 or the rules or standards
issued pursuant thereto, or Minnesota Rules, chapters 4650 and 4675;
(2) permitting, aiding, or abetting the commission of any illegal act in the institution;
(3) conduct or practices detrimental to the welfare of the patient; or
(4) obtaining or attempting to obtain a license by fraud or misrepresentation; or
(5) with respect to hospitals and outpatient surgical centers, if the commissioner
determines that there is a pattern of conduct that one or more physicians or advanced practice
registered nurses who have a "financial or economic interest," as defined in section 144.6521,
subdivision 3, in the hospital or outpatient surgical center, have not provided the notice and
disclosure of the financial or economic interest required by section 144.6521.
(b) The commissioner shall not renew a license for a boarding care bed in a resident
room with more than four beds.
new text begin
(c) The commissioner shall not renew licenses for hospital beds issued to a hospital or
hospital corporate system pursuant to a hospital construction moratorium exception under
section 144.551 if the commissioner determines the hospital or hospital corporate system
is not satisfying the conditions on which the exception was granted.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for license renewals occurring on or after
July 1, 2021.
new text end
Sec. 45.
Minnesota Statutes 2020, section 144.551, subdivision 1, is amended to read:
Subdivision 1.
Restricted construction or modification.
(a) The following construction
or modification may not be commenced:
(1) any erection, building, alteration, reconstruction, modernization, improvement,
extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
to another, or otherwise results in an increase or redistribution of hospital beds within the
state; and
(2) the establishment of a new hospital.
(b) This section does not apply to:
(1) construction or relocation within a county by a hospital, clinic, or other health care
facility that is a national referral center engaged in substantial programs of patient care,
medical research, and medical education meeting state and national needs that receives more
than 40 percent of its patients from outside the state of Minnesota;
(2) a project for construction or modification for which a health care facility held an
approved certificate of need on May 1, 1984, regardless of the date of expiration of the
certificate;
(3) a project for which a certificate of need was denied before July 1, 1990, if a timely
appeal results in an order reversing the denial;
(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200,
section 2;
(5) a project involving consolidation of pediatric specialty hospital services within the
Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number
of pediatric specialty hospital beds among the hospitals being consolidated;
(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to
an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
the number of hospital beds. Upon completion of the reconstruction, the licenses of both
hospitals must be reinstated at the capacity that existed on each site before the relocation;
(7) the relocation or redistribution of hospital beds within a hospital building or
identifiable complex of buildings provided the relocation or redistribution does not result
in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from
one physical site or complex to another; or (iii) redistribution of hospital beds within the
state or a region of the state;
(8) relocation or redistribution of hospital beds within a hospital corporate system that
involves the transfer of beds from a closed facility site or complex to an existing site or
complex provided that: (i) no more than 50 percent of the capacity of the closed facility is
transferred; (ii) the capacity of the site or complex to which the beds are transferred does
not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal
health systems agency boundary in place on July 1, 1983; deleted text begin anddeleted text end (iv) the relocation or
redistribution does not involve the construction of a new hospital buildingnew text begin ; and (v) the
transferred beds are used first to replace within the hospital corporate system the total number
of beds previously used in the closed facility site or complex for mental health services and
substance use disorder services. Only after the hospital corporate system has fulfilled the
requirements of this item may the remainder of the available capacity of the closed facility
site or complex be transferred for any other purposenew text end ;
(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice
County that primarily serves adolescents and that receives more than 70 percent of its
patients from outside the state of Minnesota;
(10) a project to replace a hospital or hospitals with a combined licensed capacity of
130 beds or less if: (i) the new hospital site is located within five miles of the current site;
and (ii) the total licensed capacity of the replacement hospital, either at the time of
construction of the initial building or as the result of future expansion, will not exceed 70
licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
(11) the relocation of licensed hospital beds from an existing state facility operated by
the commissioner of human services to a new or existing facility, building, or complex
operated by the commissioner of human services; from one regional treatment center site
to another; or from one building or site to a new or existing building or site on the same
campus;
(12) the construction or relocation of hospital beds operated by a hospital having a
statutory obligation to provide hospital and medical services for the indigent that does not
result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
beds, of which 12 serve mental health needs, may be transferred from Hennepin County
Medical Center to Regions Hospital under this clause;
(13) a construction project involving the addition of up to 31 new beds in an existing
nonfederal hospital in Beltrami County;
(14) a construction project involving the addition of up to eight new beds in an existing
nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
(15) a construction project involving the addition of 20 new hospital beds in an existing
hospital in Carver County serving the southwest suburban metropolitan area;
(16) a project for the construction or relocation of up to 20 hospital beds for the operation
of up to two psychiatric facilities or units for children provided that the operation of the
facilities or units have received the approval of the commissioner of human services;
(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation
services in an existing hospital in Itasca County;
(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County
that closed 20 rehabilitation beds in 2002, provided that the beds are used only for
rehabilitation in the hospital's current rehabilitation building. If the beds are used for another
purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
(19) a critical access hospital established under section 144.1483, clause (9), and section
1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that
delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33,
to the extent that the critical access hospital does not seek to exceed the maximum number
of beds permitted such hospital under federal law;
(20) notwithstanding section 144.552, a project for the construction of a new hospital
in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
(i) the project, including each hospital or health system that will own or control the entity
that will hold the new hospital license, is approved by a resolution of the Maple Grove City
Council as of March 1, 2006;
(ii) the entity that will hold the new hospital license will be owned or controlled by one
or more not-for-profit hospitals or health systems that have previously submitted a plan or
plans for a project in Maple Grove as required under section 144.552, and the plan or plans
have been found to be in the public interest by the commissioner of health as of April 1,
2005;
(iii) the new hospital's initial inpatient services must include, but are not limited to,
medical and surgical services, obstetrical and gynecological services, intensive care services,
orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health
services, and emergency room services;
(iv) the new hospital:
(A) will have the ability to provide and staff sufficient new beds to meet the growing
needs of the Maple Grove service area and the surrounding communities currently being
served by the hospital or health system that will own or control the entity that will hold the
new hospital license;
(B) will provide uncompensated care;
(C) will provide mental health services, including inpatient beds;
(D) will be a site for workforce development for a broad spectrum of health-care-related
occupations and have a commitment to providing clinical training programs for physicians
and other health care providers;
(E) will demonstrate a commitment to quality care and patient safety;
(F) will have an electronic medical records system, including physician order entry;
(G) will provide a broad range of senior services;
(H) will provide emergency medical services that will coordinate care with regional
providers of trauma services and licensed emergency ambulance services in order to enhance
the continuity of care for emergency medical patients; and
(I) will be completed by December 31, 2009, unless delayed by circumstances beyond
the control of the entity holding the new hospital license; and
(v) as of 30 days following submission of a written plan, the commissioner of health
has not determined that the hospitals or health systems that will own or control the entity
that will hold the new hospital license are unable to meet the criteria of this clause;
(21) a project approved under section 144.553;
(22) a project for the construction of a hospital with up to 25 beds in Cass County within
a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder
is approved by the Cass County Board;
(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity
from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing
a separately licensed 13-bed skilled nursing facility;
(24) notwithstanding section 144.552, a project for the construction and expansion of a
specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients
who are under 21 years of age on the date of admission. The commissioner conducted a
public interest review of the mental health needs of Minnesota and the Twin Cities
metropolitan area in 2008. No further public interest review shall be conducted for the
construction or expansion project under this clause;
(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the
commissioner finds the project is in the public interest after the public interest review
conducted under section 144.552 is complete;
(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city
of Maple Grove, exclusively for patients who are under 21 years of age on the date of
admission, if the commissioner finds the project is in the public interest after the public
interest review conducted under section 144.552 is complete;
(ii) this project shall serve patients in the continuing care benefit program under section
256.9693. The project may also serve patients not in the continuing care benefit program;
and
(iii) if the project ceases to participate in the continuing care benefit program, the
commissioner must complete a subsequent public interest review under section 144.552. If
the project is found not to be in the public interest, the license must be terminated six months
from the date of that finding. If the commissioner of human services terminates the contract
without cause or reduces per diem payment rates for patients under the continuing care
benefit program below the rates in effect for services provided on December 31, 2015, the
project may cease to participate in the continuing care benefit program and continue to
operate without a subsequent public interest review;
(27) a project involving the addition of 21 new beds in an existing psychiatric hospital
in Hennepin County that is exclusively for patients who are under 21 years of age on the
date of admission; deleted text begin or
deleted text end
(28) a project to add 55 licensed beds in an existing safety net, level I trauma center
hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which
15 beds are to be used for inpatient mental health and 40 are to be used for other services.
In addition, five unlicensed observation mental health beds shall be addeddeleted text begin .deleted text end new text begin ;
new text end
new text begin
(29) notwithstanding section 144.552, a project to add 45 licensed beds in an existing
safety net, level I trauma center hospital in Ramsey County as designated under section
383A.91, subdivision 5. The commissioner conducted a public interest review of the
construction and expansion of this hospital in 2018. No further public interest review shall
be conducted for the project under this clause; or
new text end
new text begin
(30) the addition of licensed beds in a hospital or hospital corporate system to primarily
provide mental health services or substance use disorder services. In order to add beds under
this clause, a hospital must have an emergency department and must not be a hospital that
solely provides treatment to adults for mental illnesses or substance use disorders. Beds
added under this clause must be available to serve medical assistance and MinnesotaCare
enrollees. Notwithstanding section 144.552, public interest review shall not be required for
an addition of beds under this clause.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
(a) Paragraph (b), clause (29), is effective the day following final
enactment, contingent upon:
new text end
new text begin
(1) the addition of the 15 inpatient mental health beds specified in paragraph (b), clause
(28), to the Ramsey County level I trauma center's bed capacity;
new text end
new text begin
(2) five of the 45 additional beds authorized in paragraph (b), clause (29), being
designated for use for inpatient mental health and added to the hospital's bed capacity before
the remaining 40 beds authorized under that clause are added; and
new text end
new text begin
(3) the Ramsey County level I trauma center's agreement to not participate in the Revenue
Recapture Act under Minnesota Statutes, chapter 270, and Minnesota Statutes, section
270C.41.
new text end
new text begin
(b) The amendment to paragraph (b), clause (8), and paragraph (b), clause (30), are
effective the day following final enactment.
new text end
Sec. 46.
Minnesota Statutes 2020, section 144.551, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Monitoring. new text end
new text begin
The commissioner shall monitor the implementation of exceptions
under this section. Each hospital or hospital corporate system granted an exception under
this section shall submit to the commissioner each year a report on how the hospital or
hospital corporate system continues to satisfy the conditions on which the exception was
granted.
new text end
Sec. 47.
Minnesota Statutes 2020, section 144.555, is amended to read:
144.555 deleted text begin HOSPITALdeleted text end new text begin FACILITY OR CAMPUSnew text end CLOSINGSnew text begin , RELOCATING
SERVICES, OR CEASING TO OFFER CERTAIN SERVICESnew text end ; PATIENT
RELOCATIONS.
Subdivision 1.
Notice of closing or curtailing deleted text begin servicedeleted text end new text begin operations; facilities other than
hospitalsnew text end .
If a facility licensed under sections 144.50 to 144.56new text begin , other than a hospital,new text end
voluntarily plans to cease operations or to curtail operations to the extent that patients or
residents must be relocated, the controlling persons of the facility must notify the
commissioner of health at least 90 days before the scheduled cessation or curtailment. The
commissioner shall cooperate with the controlling persons and advise them about relocating
the patients or residents.
new text begin Subd. 1a. new text end
new text begin
Notice of closing, curtailing operations, relocating services, or ceasing to
offer certain services; hospitals.
new text end
new text begin
(a) The controlling persons of a hospital licensed under
sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health at
least nine months before a scheduled action if the hospital or hospital campus voluntarily
plans to:
new text end
new text begin
(1) cease operations;
new text end
new text begin
(2) curtail operations to the extent that patients must be relocated;
new text end
new text begin
(3) relocate the provision of health services to another hospital or another hospital
campus; or
new text end
new text begin
(4) cease offering maternity care and newborn care services, intensive care unit services,
inpatient mental health services, or inpatient substance use disorder treatment services.
new text end
new text begin
(b) The commissioner shall cooperate with the controlling persons and advise them
about relocating the patients. The controlling persons of the hospital or hospital campus
must comply with section 144.556.
new text end
new text begin Subd. 1b. new text end
new text begin Public hearing. new text end
new text begin
Upon receiving notice under subdivision 1a, the commissioner
shall conduct a public hearing on the scheduled cessation of operations, curtailment of
operations, relocation of health services, or cessation in offering health services. The
commissioner must provide adequate public notice of the hearing in a time and manner
determined by the commissioner. The public hearing must be held in the community where
the hospital or hospital campus is located at least six months before the scheduled cessation
or curtailment of operations, relocation of health services, or cessation in offering health
services. The controlling persons of the hospital or hospital campus must participate in the
public hearing. The public hearing must include:
new text end
new text begin
(1) an explanation by the controlling persons of the reasons for ceasing or curtailing
operations, relocating health services, or ceasing to offer any of the listed health services;
new text end
new text begin
(2) a description of the actions that controlling persons will take to ensure that residents
in the hospital's or campus's service area have continued access to the health services being
eliminated, curtailed, or relocated;
new text end
new text begin
(3) an opportunity for public testimony on the scheduled cessation or curtailment of
operations, relocation of health services, or cessation in offering any of the listed health
services, and on the hospital's or campus's plan to ensure continued access to those health
services being eliminated, curtailed, or relocated; and
new text end
new text begin
(4) an opportunity for the controlling persons to respond to questions from interested
persons.
new text end
Subd. 2.
Penalty.
Failure to notify the commissioner under subdivision 1 new text begin or 1a or failure
to participate in a public hearing under subdivision 1b new text end may result in issuance of a correction
order under section 144.653, subdivision 5.
Sec. 48.
new text begin
[144.556] RIGHT OF FIRST REFUSAL FOR HOSPITAL OR HOSPITAL
CAMPUS.
new text end
new text begin Subdivision 1. new text end
new text begin
Prerequisite before sale, conveyance, or ceasing operations of hospital
or hospital campus.
new text end
new text begin
The controlling persons of a hospital licensed under sections 144.50
to 144.56 shall not sell or convey the hospital or a campus of the hospital, offer to sell or
convey the hospital or hospital campus, or voluntarily cease operations of the hospital or
hospital campus unless the controlling persons have first made a good faith offer to sell or
convey the hospital or hospital campus to the home rule charter or statutory city, county,
town, or hospital district in which the hospital or hospital campus is located.
new text end
new text begin Subd. 2. new text end
new text begin Offer. new text end
new text begin
The offer to sell or convey the hospital or hospital campus must be at a
price that does not exceed the current fair market value of the hospital or hospital campus.
A party to whom an offer is made under subdivision 1 must accept or decline the offer
within 60 days after receipt. If the party fails to respond within 60 days after receipt, the
offer is deemed declined.
new text end
Sec. 49.
Minnesota Statutes 2020, section 144.9501, subdivision 17, is amended to read:
Subd. 17.
Lead hazard reduction.
"Lead hazard reduction" means abatement or interim
controls undertaken to make a residence, child care facility, school, deleted text begin ordeleted text end playgroundnew text begin , or other
location where lead hazards are identifiednew text end lead-safe by complying with the lead standards
and methods adopted under section 144.9508.
Sec. 50.
Minnesota Statutes 2020, section 144.9502, subdivision 3, is amended to read:
Subd. 3.
Reports of blood lead analysis required.
(a) Every hospital, medical clinic,
medical laboratory, other facility, or individual performing blood lead analysis shall report
the results after the analysis of each specimen analyzed, for both capillary and venous
specimens, and epidemiologic information required in this section to the commissioner of
health, within the time frames set forth in clauses (1) and (2):
(1) within two working days by telephone, fax, or electronic transmissionnew text begin as prescribed
by the commissionernew text end , with written or electronic confirmation within one monthnew text begin as prescribed
by the commissionernew text end , for a venous blood lead level equal to or greater than 15 micrograms
of lead per deciliter of whole blood; or
(2) within one month in writing or by electronic transmissionnew text begin as prescribed by the
commissionernew text end , for any capillary result or for a venous blood lead level less than 15
micrograms of lead per deciliter of whole blood.
(b) If a blood lead analysis is performed outside of Minnesota and the facility performing
the analysis does not report the blood lead analysis results and epidemiological information
required in this section to the commissioner, the provider who collected the blood specimen
must satisfy the reporting requirements of this section. For purposes of this section, "provider"
has the meaning given in section 62D.02, subdivision 9.
(c) The commissioner shall coordinate with hospitals, medical clinics, medical
laboratories, and other facilities performing blood lead analysis to develop a universal
reporting form and mechanism.
Sec. 51.
Minnesota Statutes 2020, section 144.9504, subdivision 2, is amended to read:
Subd. 2.
Lead risk assessment.
(a) new text begin Notwithstanding section 144.9501, subdivision 6a,
for purposes of this subdivision, "child" means an individual under 18 years of age.
new text end
new text begin (b) new text end An assessing agency shall conduct a lead risk assessment of a residencenew text begin , residential
or commercial child care facility, playground, school, or other location where lead hazards
are suspectednew text end according to the venous blood lead level and time frame set forth in clauses
(1) to (4) for purposes of secondary prevention:
(1) within 48 hours of a child or pregnant female in the residencenew text begin , residential or
commercial child care facility, playground, school, or other location where lead hazards are
suspectednew text end being identified to the agency as having a venous blood lead level equal to or
greater than 60 micrograms of lead per deciliter of whole blood;
(2) within five working days of a child or pregnant female in the residencenew text begin , residential
or commercial child care facility, playground, school, or other location where lead hazards
are suspectednew text end being identified to the agency as having a venous blood lead level equal to
or greater than 45 micrograms of lead per deciliter of whole blood;
deleted text begin
(3) within ten working days of a child in the residence being identified to the agency as
having a venous blood lead level equal to or greater than 15 micrograms of lead per deciliter
of whole blood; or
deleted text end
deleted text begin (4)deleted text end new text begin (3)new text end within ten working days of a new text begin child or new text end pregnant female in the residencenew text begin , residential
or commercial child care facility, playground, school, or other location where lead hazards
are suspectednew text end being identified to the agency as having a venous blood lead level equal to
or greater than ten micrograms of lead per deciliter of whole blooddeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(4) within 20 working days of a child or pregnant female in the residence, residential or
commercial child care facility, playground, school, or other location where lead hazards are
suspected being identified to the agency as having a venous blood lead level equal to or
greater than five micrograms per deciliter of whole blood.
new text end
new text begin
An assessing agency may refer investigations at sites other than the child's or pregnant
female's residence to the commissioner.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end Within the limits of available local, state, and federal appropriations, an assessing
agency may also conduct a lead risk assessment for children with any elevated blood lead
level.
deleted text begin (c)deleted text end new text begin (d)new text end In a building with two or more dwelling units, an assessing agency shall assess
the individual unit in which the conditions of this section are met and shall inspect all
common areas accessible to a child. If a child visits one or more other sites such as another
residence, or a residential or commercial child care facility, playground, or school, the
assessing agency shall also inspect the other sites. The assessing agency shall have one
additional day added to the time frame set forth in this subdivision to complete the lead risk
assessment for each additional site.
deleted text begin (d)deleted text end new text begin (e)new text end Within the limits of appropriations, the assessing agency shall identify the known
addresses for the previous 12 months of the child or pregnant female with venous blood
lead levels of at least 15 micrograms per deciliter for the child or at least ten micrograms
per deciliter for the pregnant female; notify the property owners, landlords, and tenants at
those addresses that an elevated blood lead level was found in a person who resided at the
property; and give them primary prevention information. Within the limits of appropriations,
the assessing agency may perform a risk assessment and issue corrective orders in the
properties, if it is likely that the previous address contributed to the child's or pregnant
female's blood lead level. The assessing agency shall provide the notice required by this
subdivision without identifying the child or pregnant female with the elevated blood lead
level. The assessing agency is not required to obtain the consent of the child's parent or
guardian or the consent of the pregnant female for purposes of this subdivision. This
information shall be classified as private data on individuals as defined under section 13.02,
subdivision 12.
deleted text begin (e)deleted text end new text begin (f)new text end The assessing agency shall conduct the lead risk assessment according to rules
adopted by the commissioner under section 144.9508. An assessing agency shall have lead
risk assessments performed by lead risk assessors licensed by the commissioner according
to rules adopted under section 144.9508. If a property owner refuses to allow a lead risk
assessment, the assessing agency shall begin legal proceedings to gain entry to the property
and the time frame for conducting a lead risk assessment set forth in this subdivision no
longer applies. A lead risk assessor or assessing agency may observe the performance of
lead hazard reduction in progress and shall enforce the provisions of this section under
section 144.9509. Deteriorated painted surfaces, bare soil, and dust must be tested with
appropriate analytical equipment to determine the lead content, except that deteriorated
painted surfaces or bare soil need not be tested if the property owner agrees to engage in
lead hazard reduction on those surfaces. The lead content of drinking water must be measured
if another probable source of lead exposure is not identified. Within a standard metropolitan
statistical area, an assessing agency may order lead hazard reduction of bare soil without
measuring the lead content of the bare soil if the property is in a census tract in which soil
sampling has been performed according to rules established by the commissioner and at
least 25 percent of the soil samples contain lead concentrations above the standard in section
144.9508.
deleted text begin (f)deleted text end new text begin (g)new text end Each assessing agency shall establish an administrative appeal procedure which
allows a property owner to contest the nature and conditions of any lead order issued by
the assessing agency. Assessing agencies must consider appeals that propose lower cost
methods that make the residence lead safe. The commissioner shall use the authority and
appeal procedure granted under sections 144.989 to 144.993.
deleted text begin (g)deleted text end new text begin (h)new text end Sections 144.9501 to 144.9512 neither authorize nor prohibit an assessing agency
from charging a property owner for the cost of a lead risk assessment.
Sec. 52.
Minnesota Statutes 2020, section 144.9504, subdivision 5, is amended to read:
Subd. 5.
Lead orders.
(a) An assessing agency, after conducting a lead risk assessment,
shall order a property owner to perform lead hazard reduction on all lead sources that exceed
a standard adopted according to section 144.9508. If lead risk assessments and lead orders
are conducted at times when weather or soil conditions do not permit the lead risk assessment
or lead hazard reduction, external surfaces and soil lead shall be assessed, and lead orders
complied with, if necessary, at the first opportunity that weather and soil conditions allow.
new text begin
(b) If, after conducting a lead risk assessment, an assessing agency determines that the
property owner's lead hazard originated from another source location, the assessing agency
may order the responsible person of the source location to:
new text end
new text begin
(1) perform lead hazard reduction at the site where the assessing agency conducted the
lead risk assessment; and
new text end
new text begin
(2) remediate the conditions at the source location that allowed the lead hazard, pollutant,
or contaminant to migrate from the source location.
new text end
new text begin
(c) For purposes of this subdivision, "pollutant or contaminant" has the meaning given
in section 115B.02, subdivision 13, and "responsible person" has the meaning given in
section 115B.03.
new text end
deleted text begin (b)deleted text end new text begin (d)new text end If the paint standard under section 144.9508 is violated, but the paint is intact,
the assessing agency shall not order the paint to be removed unless the intact paint is a
known source of actual lead exposure to a specific person. Before the assessing agency may
order the intact paint to be removed, a reasonable effort must be made to protect the child
and preserve the intact paint by the use of guards or other protective devices and methods.
deleted text begin (c)deleted text end new text begin (e)new text end Whenever windows and doors or other components covered with deteriorated
lead-based paint have sound substrate or are not rotting, those components should be repaired,
sent out for stripping or planed down to remove deteriorated lead-based paint, or covered
with protective guards instead of being replaced, provided that such an activity is the least
cost method. However, a property owner who has been ordered to perform lead hazard
reduction may choose any method to address deteriorated lead-based paint on windows,
doors, or other components, provided that the method is approved in rules adopted under
section 144.9508 and that it is appropriate to the specific property.
deleted text begin (d)deleted text end new text begin (f)new text end Lead orders must require that any source of damage, such as leaking roofs,
plumbing, and windows, be repaired or replaced, as needed, to prevent damage to
lead-containing interior surfaces.
deleted text begin (e)deleted text end new text begin (g)new text end The assessing agency is not required to pay for lead hazard reduction. The
assessing agency shall enforce the lead orders issued to a property owner under this section.
Sec. 53.
Minnesota Statutes 2020, section 144G.08, subdivision 7, as amended by Laws
2020, Seventh Special Session chapter 1, article 6, section 5, is amended to read:
Subd. 7.
Assisted living facility.
"Assisted living facility" means deleted text begin a facility thatdeleted text end new text begin an
establishment where an operating person or legal entity, either directly or through contract,
business relationship, or common ownership with another person or entity,new text end provides sleeping
accommodations and assisted living services to one or more adultsnew text begin in the facilitynew text end . Assisted
living facility includes assisted living facility with dementia care, and does not include:
(1) emergency shelter, transitional housing, or any other residential units serving
exclusively or primarily homeless individuals, as defined under section 116L.361;
(2) a nursing home licensed under chapter 144A;
(3) a hospital, certified boarding care, or supervised living facility licensed under sections
144.50 to 144.56;
(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts
9520.0500 to 9520.0670, or under chapter 245D or 245G;
(5) services and residential settings licensed under chapter 245A, including adult foster
care and services and settings governed under the standards in chapter 245D;
(6) a private home in which the residents are related by kinship, law, or affinity with the
provider of services;
(7) a duly organized condominium, cooperative, and common interest community, or
owners' association of the condominium, cooperative, and common interest community
where at least 80 percent of the units that comprise the condominium, cooperative, or
common interest community are occupied by individuals who are the owners, members, or
shareholders of the units;
(8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593;
(9) a setting offering services conducted by and for the adherents of any recognized
church or religious denomination for its members exclusively through spiritual means or
by prayer for healing;
(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with
low-income housing tax credits pursuant to United States Code, title 26, section 42, and
units financed by the Minnesota Housing Finance Agency that are intended to serve
individuals with disabilities or individuals who are homeless, except for those developments
that market or hold themselves out as assisted living facilities and provide assisted living
services;
(11) rental housing developed under United States Code, title 42, section 1437, or United
States Code, title 12, section 1701q;
(12) rental housing designated for occupancy by only elderly or elderly and disabled
residents under United States Code, title 42, section 1437e, or rental housing for qualifying
families under Code of Federal Regulations, title 24, section 983.56;
(13) rental housing funded under United States Code, title 42, chapter 89, or United
States Code, title 42, section 8011;
deleted text begin (14) a covered setting as defined in section 325F.721, subdivision 1, paragraph (b);deleted text end or
deleted text begin (15)deleted text end new text begin (14)new text end any establishment that exclusively or primarily serves as a shelter or temporary
shelter for victims of domestic or any other form of violence.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 54.
Minnesota Statutes 2020, section 144G.84, is amended to read:
144G.84 SERVICES FOR RESIDENTS WITH DEMENTIA.
(a) In addition to the minimum services required in section 144G.41, an assisted living
facility with dementia care must also provide the following services:
(1) assistance with activities of daily living that address the needs of each resident with
dementia due to cognitive or physical limitations. These services must meet or be in addition
to the requirements in the licensing rules for the facility. Services must be provided in a
person-centered manner that promotes resident choice, dignity, and sustains the resident's
abilities;
(2) nonpharmacological practices that are person-centered and evidence-informed;
(3) services to prepare and educate persons living with dementia and their legal and
designated representatives about transitions in care and ensuring complete, timely
communication between, across, and within settings; and
(4) services that provide residents with choices for meaningful engagement with other
facility residents and the broader community.
(b) Each resident must be evaluated for activities according to the licensing rules of the
facility. In addition, the evaluation must address the following:
(1) past and current interests;
(2) current abilities and skills;
(3) emotional and social needs and patterns;
(4) physical abilities and limitations;
(5) adaptations necessary for the resident to participate; and
(6) identification of activities for behavioral interventions.
(c) An individualized activity plan must be developed for each resident based on their
activity evaluation. The plan must reflect the resident's activity preferences and needs.
(d) A selection of daily structured and non-structured activities must be provided and
included on the resident's activity service or care plan as appropriate. Daily activity options
based on resident evaluation may include but are not limited to:
(1) occupation or chore related tasks;
(2) scheduled and planned events such as entertainment or outings;
(3) spontaneous activities for enjoyment or those that may help defuse a behavior;
(4) one-to-one activities that encourage positive relationships between residents and
staff such as telling a life story, reminiscing, or playing music;
(5) spiritual, creative, and intellectual activities;
(6) sensory stimulation activities;
(7) physical activities that enhance or maintain a resident's ability to ambulate or move;
and
(8) new text begin a resident's individualized activity plan for regular new text end outdoor deleted text begin activitiesdeleted text end new text begin activitynew text end .
(e) Behavioral symptoms that negatively impact the resident and others in the assisted
living facility with dementia care must be evaluated and included on the service or care
plan. The staff must initiate and coordinate outside consultation or acute care when indicated.
(f) Support must be offered to family and other significant relationships on a regularly
scheduled basis but not less than quarterly.
(g) deleted text begin Access to secured outdoor space and walkways that allow residents to enter and
return without staff assistance must be provided.deleted text end new text begin Existing housing with services
establishments registered under chapter 144D prior to August 1, 2021, that obtain an assisted
living facility license must provide residents with regular access to outdoor space. A licensee
with new construction on or after August 1, 2021, or a new licensee that was not previously
registered under chapter 144D prior to August 1, 2021, must provide regular access to
secured outdoor space on the premises of the facility. A resident's access to outdoor space
must be in accordance with the resident's documented care plan.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 55.
new text begin
[145.87] HOME VISITING FOR PREGNANT WOMEN AND FAMILIES
WITH YOUNG CHILDREN.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) The terms defined in this subdivision apply to this section
and have the meanings given them.
new text end
new text begin
(b) "Evidence-based home visiting program" means a program that:
new text end
new text begin
(1) is based on a clear, consistent program or model that is research-based and grounded
in relevant, empirically based knowledge;
new text end
new text begin
(2) is linked to program-determined outcomes and is associated with a national
organization, institution of higher education, or national or state public health institute;
new text end
new text begin
(3) has comprehensive home visitation standards that ensure high-quality service delivery
and continuous quality improvement;
new text end
new text begin
(4) has demonstrated significant, sustained positive outcomes; and
new text end
new text begin
(5) either:
new text end
new text begin
(i) has been evaluated using rigorous randomized controlled research designs and the
evaluation results have been published in a peer-reviewed journal; or
new text end
new text begin
(ii) is based on quasi-experimental research using two or more separate, comparable
client samples.
new text end
new text begin
(c) "Evidence-informed home visiting program" means a program that:
new text end
new text begin
(1) has data or evidence demonstrating effectiveness at achieving positive outcomes for
pregnant women and young children; and
new text end
new text begin
(2) either:
new text end
new text begin
(i) has an active evaluation of the program; or
new text end
new text begin
(ii) has a plan and timeline for an active evaluation of the program to be conducted.
new text end
new text begin
(d) "Health equity" means every individual has a fair opportunity to attain the individual's
full health potential and no individual is disadvantaged from achieving this potential.
new text end
new text begin
(e) "Promising practice home visiting program" means a program that has shown
improvement toward achieving positive outcomes for pregnant women or young children.
new text end
new text begin Subd. 2. new text end
new text begin Grants for home visiting programs. new text end
new text begin
(a) The commissioner of health shall
award grants to community health boards, nonprofit organizations, and tribal nations to start
up or expand voluntary home visiting programs serving pregnant women and families with
young children. Home visiting programs supported under this section shall provide voluntary
home visits by early childhood professionals or health professionals, including but not
limited to nurses, social workers, early childhood educators, and trained paraprofessionals.
Grant money shall be used to:
new text end
new text begin
(1) establish or expand evidence-based, evidence-informed, or promising practice home
visiting programs that address health equity and utilize community-driven health strategies;
new text end
new text begin
(2) serve families with young children or pregnant women who have high needs or are
high-risk, including but not limited to a family with low income, a parent or pregnant woman
with a mental illness or a substance use disorder, or a parent or pregnant woman experiencing
housing instability or domestic abuse; and
new text end
new text begin
(3) improve program outcomes in two or more of the following areas:
new text end
new text begin
(i) maternal and newborn health;
new text end
new text begin
(ii) school readiness and achievement;
new text end
new text begin
(iii) family economic self-sufficiency;
new text end
new text begin
(iv) coordination and referral for other community resources and supports;
new text end
new text begin
(v) reduction in child injuries, abuse, or neglect; or
new text end
new text begin
(vi) reduction in crime or domestic violence.
new text end
new text begin
(b) Grants awarded to evidence-informed and promising practice home visiting programs
must include money to evaluate program outcomes for up to four of the areas listed in
paragraph (a), clause (3).
new text end
new text begin Subd. 3. new text end
new text begin Grant prioritization. new text end
new text begin
(a) In awarding grants, the commissioner shall give
priority to community health boards, nonprofit organizations, and tribal nations seeking to
expand home visiting services with community or regional partnerships.
new text end
new text begin
(b) The commissioner shall allocate at least 75 percent of the grant money awarded each
grant cycle to evidence-based home visiting programs that address health equity and up to
25 percent of the grant money awarded each grant cycle to evidence-informed or promising
practice home visiting programs that address health equity and utilize community-driven
health strategies.
new text end
new text begin Subd. 4. new text end
new text begin Administrative costs. new text end
new text begin
The commissioner may use up to seven percent of the
annual appropriation under this section to provide training and technical assistance and to
administer and evaluate the program. The commissioner may contract for training,
capacity-building support for grantees or potential grantees, technical assistance, and
evaluation support.
new text end
new text begin Subd. 5. new text end
new text begin Use of state general fund appropriations. new text end
new text begin
Appropriations dedicated to
establishing or expanding evidence-based home visiting programs shall, for grants awarded
on or after July 1, 2021, be awarded according to this section. This section shall not govern
grant awards of federal funds for home visiting programs and shall not govern grant awards
using state general fund appropriations dedicated to establishing or expanding nurse-family
partnership home visiting programs.
new text end
Sec. 56.
Minnesota Statutes 2020, section 145.893, subdivision 1, is amended to read:
Subdivision 1.
deleted text begin Vouchersdeleted text end new text begin Food benefitsnew text end .
An eligible individual shall receive deleted text begin vouchersdeleted text end new text begin
food benefitsnew text end for the purchase of specified nutritional supplements in type and quantity
approved by the commissioner. Alternate forms of delivery may be developed by the
commissioner in appropriate cases.
Sec. 57.
Minnesota Statutes 2020, section 145.894, is amended to read:
145.894 STATE COMMISSIONER OF HEALTH; DUTIES, RESPONSIBILITIES.
The commissioner of health shall:
(1) develop a comprehensive state plan for the delivery of nutritional supplements to
pregnant and lactating women, infants, and children;
(2) contract with existing local public or private nonprofit organizations for the
administration of the nutritional supplement program;
(3) develop and implement a public education program promoting the provisions of
sections 145.891 to 145.897, and provide for the delivery of individual and family nutrition
education and counseling at project sites. The education programs must include a campaign
to promote breast feeding;
(4) develop in cooperation with other agencies and vendors a uniform state deleted text begin voucherdeleted text end new text begin food
benefitnew text end system for the delivery of nutritional supplements;
(5) authorize local health agencies to issue deleted text begin vouchers bimonthlydeleted text end new text begin food benefits trimonthlynew text end
to some or all eligible individuals served by the agency, provided the agency demonstrates
that the federal minimum requirements for providing nutrition education will continue to
be met and that the quality of nutrition education and health services provided by the agency
will not be adversely impacted;
(6) investigate and implement a system to reduce the cost of nutritional supplements
and maintain ongoing negotiations with nonparticipating manufacturers and suppliers to
maximize cost savings;
(7) develop, analyze, and evaluate the health aspects of the nutritional supplement
program and establish nutritional guidelines for the program;
(8) apply for, administer, and annually expend at least 99 percent of available federal
or private funds;
(9) aggressively market services to eligible individuals by conducting ongoing outreach
activities and by coordinating with and providing marketing materials and technical assistance
to local human services and community service agencies and nonprofit service providers;
(10) determine, on July 1 of each year, the number of pregnant women participating in
each special supplemental food program for women, infants, and children (WIC) deleted text begin and, in
1986, 1987, and 1988, at the commissioner's discretion, designate a different food program
deliverer if the current deliverer fails to increase the participation of pregnant women in the
program by at least ten percent over the previous year's participation ratedeleted text end ;
(11) promulgate all rules necessary to carry out the provisions of sections 145.891 to
145.897; and
(12) ensure that any state appropriation to supplement the federal program is spent
consistent with federal requirements.
Sec. 58.
Minnesota Statutes 2020, section 145.897, is amended to read:
145.897 deleted text begin VOUCHERSdeleted text end new text begin FOOD BENEFITSnew text end .
deleted text begin Vouchersdeleted text end new text begin Food benefitsnew text end issued pursuant to sections 145.891 to 145.897 shall be only
for the purchase of those foods determined by the deleted text begin commissionerdeleted text end new text begin United States Department
of Agriculturenew text end to be desirable nutritional supplements for pregnant and lactating women,
infants and children. deleted text begin These foods shall include, but not be limited to, iron fortified infant
formula, vegetable or fruit juices, cereal, milk, cheese, and eggs.
deleted text end
Sec. 59.
Minnesota Statutes 2020, section 145.899, is amended to read:
145.899 WIC deleted text begin VOUCHERSdeleted text end new text begin FOOD BENEFITSnew text end FOR ORGANICS.
deleted text begin Vouchersdeleted text end new text begin Food benefitsnew text end for the special supplemental nutrition program for women,
infants, and children (WIC) may be used to purchase cost-neutral organic WIC allowable
food. The commissioner of health shall regularly evaluate the list of WIC allowable food
in accordance with federal requirements and shall add to the list any organic WIC allowable
foods determined to be cost-neutral.
Sec. 60.
Minnesota Statutes 2020, section 145.901, subdivision 2, is amended to read:
Subd. 2.
Access to data.
(a) The commissioner of health has access to medical data as
defined in section 13.384, subdivision 1, paragraph (b), medical examiner data as defined
in section 13.83, subdivision 1, and health records created, maintained, or stored by providers
deleted text begin as defined in section 144.291, subdivision 2, paragraph (i),deleted text end without the consent of the subject
of the data, and without the consent of the parent, spouse, other guardian, or legal
representative of the subject of the data, when the subject of the data is a woman who died
during a pregnancy or within 12 months of a fetal death, a live birth, or other termination
of a pregnancy.
The commissioner has access only to medical data and health records related to deaths
that occur on or after July 1, 2000new text begin , including the names of the providers, clinics, or other
health services such as family home visiting programs; the women, infants, and children
(WIC) program; prescription monitoring programs; and behavioral health services, where
care was received before, during, or related to the pregnancy or death. The commissioner
has access to records maintained by a medical examiner, a coroner, or hospitals or to hospital
discharge data, for the purpose of providing the name and location of any pre-pregnancy,
prenatal, or other care received by the subject of the data up to one year after the end of the
pregnancynew text end .
(b) The provider or responsible authority that creates, maintains, or stores the data shall
furnish the data upon the request of the commissioner. The provider or responsible authority
may charge a fee for providing the data, not to exceed the actual cost of retrieving and
duplicating the data.
(c) The commissioner shall make a good faith reasonable effort to notify the parent,
spouse, other guardian, or legal representative of the subject of the data before collecting
data on the subject. For purposes of this paragraph, "reasonable effort" means one notice
is sent by certified mail to the last known address of the parent, spouse, guardian, or legal
representative informing the recipient of the data collection and offering a public health
nurse support visit if desired.
(d) The commissioner does not have access to coroner or medical examiner data that
are part of an active investigation as described in section 13.83.
new text begin
(e) The commissioner may request and receive from a coroner or medical examiner the
name of the health care provider that provided prenatal, postpartum, or other health services
to the subject of the data.
new text end
new text begin
(f) The commissioner may access Department of Human Services data to identify sources
of care and services to assist with the evaluation of welfare systems, including housing, to
reduce preventable maternal deaths.
new text end
new text begin
(g) The commissioner may request and receive law enforcement reports or incident
reports related to the subject of the data.
new text end
Sec. 61.
Minnesota Statutes 2020, section 145.901, subdivision 4, is amended to read:
Subd. 4.
Classification of data.
(a) Data provided to the commissioner from source
records under subdivision 2, including identifying information on individual providers, data
subjects, or their children, and data derived by the commissioner under subdivision 3 for
the purpose of carrying out maternal death studies, are classified as confidential data on
individuals or confidential data on decedents, as defined in sections 13.02, subdivision 3,
and 13.10, subdivision 1, paragraph (a).
(b) Information classified under paragraph (a) shall not be subject to discovery or
introduction into evidence in any administrative, civil, or criminal proceeding. Such
information otherwise available from an original source shall not be immune from discovery
or barred from introduction into evidence merely because it was utilized by the commissioner
in carrying out maternal death studies.
(c) Summary data on maternal death studies created by the commissioner, which does
not identify individual data subjects or individual providers, shall be public in accordance
with section 13.05, subdivision 7.
new text begin
(d) Data provided by the commissioner of human services to the commissioner of health
under this section retain the same classification the data held when retained by the
commissioner of human services, as required under section 13.03, subdivision 4, paragraph
(c).
new text end
Sec. 62.
new text begin
[145.9013] SEVERE MATERNAL MORBIDITY STUDIES.
new text end
new text begin Subdivision 1. new text end
new text begin Purpose. new text end
new text begin
(a) The commissioner of health may conduct maternal morbidity
studies to assist the planning, implementation, and evaluation of medical, health, and welfare
service systems and to reduce the numbers of preventable adverse maternal outcomes in
Minnesota.
new text end
new text begin
(b) For purposes of this section, "maternal morbidity" has the meaning given to severe
maternal morbidity by the Centers for Disease Control and Prevention and includes an
unexpected outcome of labor or delivery that results in significant short- or long-term
consequences to a woman's health.
new text end
new text begin Subd. 2. new text end
new text begin Access to data. new text end
new text begin
(a) The commissioner has access to medical data as defined in
section 13.384, subdivision 1, paragraph (b), and health records created, maintained, or
stored by providers when the subject of the data experienced one or more maternal
morbidities during a pregnancy or within 12 months of the end of a pregnancy. The
commissioner has access only to medical data and health records related to maternal
morbidities that occur on or after January 1, 2015, including the names of providers and
clinics where care was received before, during, or related to the pregnancy. The commissioner
has access to records maintained by family home visiting programs; the women, infants,
and children (WIC) program; prescription monitoring programs; behavioral health services
programs; substance use disorder treatment facilities; and hospitals for the purpose of
providing the name and location of any pre-pregnancy, prenatal, or other care received by
the subject of the data up to one year following the end of the pregnancy.
new text end
new text begin
(b) The provider or responsible authority that creates, maintains, or stores the data under
paragraph (a) shall provide the commissioner with access to information on each maternal
morbidity case in the manner and at times that the commissioner designates. The provider
or responsible authority may charge a fee for providing the data, not to exceed the actual
cost of retrieving and duplicating the data.
new text end
new text begin
(c) Once the commissioner has determined that the subject of the data meets the criteria
in paragraph (a) for a maternal morbidity review, the commissioner must inform the subject
of the data about the collection of the subject's data under this section. At any time during
the maternal morbidity review process, the subject of the data may request in writing, using
a form prescribed by the commissioner, that the commissioner remove the subject of the
data's personal identifying information from data obtained by the commissioner under this
section. The commissioner must comply with such requests. For purposes of this paragraph,
"inform the subject of the data about the collection of the subject's data" means one notice
sent by certified mail to the last known address of the subject of the data.
new text end
new text begin
(d) The subject of the data may voluntarily participate in an informant interview with
staff on behalf of the commissioner related to the maternal experience. If the subject of the
data agrees to the interview, the commissioner may compensate the subject of the data for
time and other expenses related to the interview.
new text end
new text begin
(e) The commissioner may access Department of Human Services data to identify sources
of care and services to assist with the evaluation of welfare systems to reduce preventable
maternal morbidities.
new text end
new text begin Subd. 3. new text end
new text begin Management of records. new text end
new text begin
After the commissioner has collected all data about
a subject of a maternal morbidity study needed to perform the study, the data from source
records obtained under subdivision 2, other than data identifying the subject, must be
transferred to separate records to be maintained by the commissioner. Notwithstanding
section 138.17, after the data has been transferred, all source records obtained under
subdivision 2 possessed by the commissioner must be destroyed.
new text end
new text begin Subd. 4. new text end
new text begin Classification of data. new text end
new text begin
(a) Data provided to the commissioner from source
records under subdivision 2, including identifying information on individual providers, data
subjects, or their children, and data derived by the commissioner under subdivision 3 for
the purpose of carrying out maternal morbidity studies, are classified as confidential data
on individuals or confidential data on decedents, as defined in sections 13.02, subdivision
3, and 13.10, subdivision 1, paragraph (a).
new text end
new text begin
(b) Information classified under paragraph (a) shall not be subject to discovery or
introduction into evidence in any administrative, civil, or criminal proceeding. Such
information otherwise available from an original source shall not be immune from discovery
or barred from introduction into evidence merely because the information was utilized by
the commissioner in carrying out maternal morbidity studies.
new text end
new text begin
(c) Summary data on maternal morbidity studies created by the commissioner, which
does not identify individual data subjects or individual providers, shall be public in
accordance with section 13.05, subdivision 7.
new text end
new text begin
(d) Data provided by the commissioner of human services to the commissioner of health
under this section retains the same classification the data held when retained by the
commissioner of human services, as required under section 13.03, subdivision 4, paragraph
(c).
new text end
Sec. 63.
Minnesota Statutes 2020, section 152.01, subdivision 23, is amended to read:
Subd. 23.
Analog.
(a) Except as provided in paragraph (b), "analog" means a substance,
the chemical structure of which is substantially similar to the chemical structure of a
controlled substance in Schedule I or II:
(1) that has a stimulant, depressant, or hallucinogenic effect on the central nervous system
that is substantially similar to or greater than the stimulant, depressant, or hallucinogenic
effect on the central nervous system of a controlled substance in Schedule I or II; or
(2) with respect to a particular person, if the person represents or intends that the substance
have a stimulant, depressant, or hallucinogenic effect on the central nervous system that is
substantially similar to or greater than the stimulant, depressant, or hallucinogenic effect
on the central nervous system of a controlled substance in Schedule I or II.
(b) "Analog" does not include:
(1) a controlled substance;
(2) any substance for which there is an approved new drug application under the Federal
Food, Drug, and Cosmetic Act; deleted text begin or
deleted text end
(3) with respect to a particular person, any substance, if an exemption is in effect for
investigational use, for that person, as provided by United States Code, title 21, section 355,
and the person is registered as a controlled substance researcher as required under section
152.12, subdivision 3, to the extent conduct with respect to the substance is pursuant to the
exemption and registrationnew text begin ; or
new text end
new text begin (4) marijuana or tetrahydrocannabinols naturally contained in a plant of the genus
cannabis or in the resinous extractives of the plantnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021, and applies to crimes
committed on or after that date.
new text end
Sec. 64.
Minnesota Statutes 2020, section 152.02, subdivision 2, is amended to read:
Subd. 2.
Schedule I.
(a) Schedule I consists of the substances listed in this subdivision.
(b) Opiates. Unless specifically excepted or unless listed in another schedule, any of the
following substances, including their analogs, isomers, esters, ethers, salts, and salts of
isomers, esters, and ethers, whenever the existence of the analogs, isomers, esters, ethers,
and salts is possible:
(1) acetylmethadol;
(2) allylprodine;
(3) alphacetylmethadol (except levo-alphacetylmethadol, also known as levomethadyl
acetate);
(4) alphameprodine;
(5) alphamethadol;
(6) alpha-methylfentanyl benzethidine;
(7) betacetylmethadol;
(8) betameprodine;
(9) betamethadol;
(10) betaprodine;
(11) clonitazene;
(12) dextromoramide;
(13) diampromide;
(14) diethyliambutene;
(15) difenoxin;
(16) dimenoxadol;
(17) dimepheptanol;
(18) dimethyliambutene;
(19) dioxaphetyl butyrate;
(20) dipipanone;
(21) ethylmethylthiambutene;
(22) etonitazene;
(23) etoxeridine;
(24) furethidine;
(25) hydroxypethidine;
(26) ketobemidone;
(27) levomoramide;
(28) levophenacylmorphan;
(29) 3-methylfentanyl;
(30) acetyl-alpha-methylfentanyl;
(31) alpha-methylthiofentanyl;
(32) benzylfentanyl beta-hydroxyfentanyl;
(33) beta-hydroxy-3-methylfentanyl;
(34) 3-methylthiofentanyl;
(35) thenylfentanyl;
(36) thiofentanyl;
(37) para-fluorofentanyl;
(38) morpheridine;
(39) 1-methyl-4-phenyl-4-propionoxypiperidine;
(40) noracymethadol;
(41) norlevorphanol;
(42) normethadone;
(43) norpipanone;
(44) 1-(2-phenylethyl)-4-phenyl-4-acetoxypiperidine (PEPAP);
(45) phenadoxone;
(46) phenampromide;
(47) phenomorphan;
(48) phenoperidine;
(49) piritramide;
(50) proheptazine;
(51) properidine;
(52) propiram;
(53) racemoramide;
(54) tilidine;
(55) trimeperidine;
(56) N-(1-Phenethylpiperidin-4-yl)-N-phenylacetamide (acetyl fentanyl);
(57) 3,4-dichloro-N-[(1R,2R)-2-(dimethylamino)cyclohexyl]-N-
methylbenzamide(U47700);
(58) N-phenyl-N-[1-(2-phenylethyl)piperidin-4-yl]furan-2-carboxamide(furanylfentanyl);
(59) 4-(4-bromophenyl)-4-dimethylamino-1-phenethylcyclohexanol (bromadol);
(60) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopropanecarboxamide (Cyclopropryl
fentanyl);
(61) N-(1-phenethylpiperidin-4-yl)-N-phenylbutanamide) (butyryl fentanyl);
(62) 1-cyclohexyl-4-(1,2-diphenylethyl)piperazine) (MT-45);
(63) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopentanecarboxamide (cyclopentyl
fentanyl);
(64) N-(1-phenethylpiperidin-4-yl)-N-phenylisobutyramide (isobutyryl fentanyl);
(65) N-(1-phenethylpiperidin-4-yl)-N-phenylpentanamide (valeryl fentanyl);
(66) N-(4-chlorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide
(para-chloroisobutyryl fentanyl);
(67) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)butyramide (para-fluorobutyryl
fentanyl);
(68) N-(4-methoxyphenyl)-N-(1-phenethylpiperidin-4-yl)butyramide
(para-methoxybutyryl fentanyl);
(69) N-(2-fluorophenyl)-2-methoxy-N-(1-phenethylpiperidin-4-yl)acetamide (ocfentanil);
(70) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide (4-fluoroisobutyryl
fentanyl or para-fluoroisobutyryl fentanyl);
(71) N-(1-phenethylpiperidin-4-yl)-N-phenylacrylamide (acryl fentanyl or
acryloylfentanyl);
(72) 2-methoxy-N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide (methoxyacetyl
fentanyl);
(73) N-(2-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)propionamide (ortho-fluorofentanyl
or 2-fluorofentanyl);
(74) N-(1-phenethylpiperidin-4-yl)-N-phenyltetrahydrofuran-2-carboxamide
(tetrahydrofuranyl fentanyl); and
(75) Fentanyl-related substances, their isomers, esters, ethers, salts and salts of isomers,
esters and ethers, meaning any substance not otherwise listed under another federal
Administration Controlled Substance Code Number or not otherwise listed in this section,
and for which no exemption or approval is in effect under section 505 of the Federal Food,
Drug, and Cosmetic Act, United States Code , title 21, section 355, that is structurally related
to fentanyl by one or more of the following modifications:
(i) replacement of the phenyl portion of the phenethyl group by any monocycle, whether
or not further substituted in or on the monocycle;
(ii) substitution in or on the phenethyl group with alkyl, alkenyl, alkoxyl, hydroxyl, halo,
haloalkyl, amino, or nitro groups;
(iii) substitution in or on the piperidine ring with alkyl, alkenyl, alkoxyl, ester, ether,
hydroxyl, halo, haloalkyl, amino, or nitro groups;
(iv) replacement of the aniline ring with any aromatic monocycle whether or not further
substituted in or on the aromatic monocycle; or
(v) replacement of the N-propionyl group by another acyl group.
(c) Opium derivatives. Any of the following substances, their analogs, salts, isomers,
and salts of isomers, unless specifically excepted or unless listed in another schedule,
whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:
(1) acetorphine;
(2) acetyldihydrocodeine;
(3) benzylmorphine;
(4) codeine methylbromide;
(5) codeine-n-oxide;
(6) cyprenorphine;
(7) desomorphine;
(8) dihydromorphine;
(9) drotebanol;
(10) etorphine;
(11) heroin;
(12) hydromorphinol;
(13) methyldesorphine;
(14) methyldihydromorphine;
(15) morphine methylbromide;
(16) morphine methylsulfonate;
(17) morphine-n-oxide;
(18) myrophine;
(19) nicocodeine;
(20) nicomorphine;
(21) normorphine;
(22) pholcodine; and
(23) thebacon.
(d) Hallucinogens. Any material, compound, mixture or preparation which contains any
quantity of the following substances, their analogs, salts, isomers (whether optical, positional,
or geometric), and salts of isomers, unless specifically excepted or unless listed in another
schedule, whenever the existence of the analogs, salts, isomers, and salts of isomers is
possible:
(1) methylenedioxy amphetamine;
(2) methylenedioxymethamphetamine;
(3) methylenedioxy-N-ethylamphetamine (MDEA);
(4) n-hydroxy-methylenedioxyamphetamine;
(5) 4-bromo-2,5-dimethoxyamphetamine (DOB);
(6) 2,5-dimethoxyamphetamine (2,5-DMA);
(7) 4-methoxyamphetamine;
(8) 5-methoxy-3, 4-methylenedioxyamphetamine;
(9) alpha-ethyltryptamine;
(10) bufotenine;
(11) diethyltryptamine;
(12) dimethyltryptamine;
(13) 3,4,5-trimethoxyamphetamine;
(14) 4-methyl-2, 5-dimethoxyamphetamine (DOM);
(15) ibogaine;
(16) lysergic acid diethylamide (LSD);
(17) mescaline;
(18) parahexyl;
(19) N-ethyl-3-piperidyl benzilate;
(20) N-methyl-3-piperidyl benzilate;
(21) psilocybin;
(22) psilocyn;
(23) tenocyclidine (TPCP or TCP);
(24) N-ethyl-1-phenyl-cyclohexylamine (PCE);
(25) 1-(1-phenylcyclohexyl) pyrrolidine (PCPy);
(26) 1-[1-(2-thienyl)cyclohexyl]-pyrrolidine (TCPy);
(27) 4-chloro-2,5-dimethoxyamphetamine (DOC);
(28) 4-ethyl-2,5-dimethoxyamphetamine (DOET);
(29) 4-iodo-2,5-dimethoxyamphetamine (DOI);
(30) 4-bromo-2,5-dimethoxyphenethylamine (2C-B);
(31) 4-chloro-2,5-dimethoxyphenethylamine (2C-C);
(32) 4-methyl-2,5-dimethoxyphenethylamine (2C-D);
(33) 4-ethyl-2,5-dimethoxyphenethylamine (2C-E);
(34) 4-iodo-2,5-dimethoxyphenethylamine (2C-I);
(35) 4-propyl-2,5-dimethoxyphenethylamine (2C-P);
(36) 4-isopropylthio-2,5-dimethoxyphenethylamine (2C-T-4);
(37) 4-propylthio-2,5-dimethoxyphenethylamine (2C-T-7);
(38) 2-(8-bromo-2,3,6,7-tetrahydrofuro [2,3-f][1]benzofuran-4-yl)ethanamine
(2-CB-FLY);
(39) bromo-benzodifuranyl-isopropylamine (Bromo-DragonFLY);
(40) alpha-methyltryptamine (AMT);
(41) N,N-diisopropyltryptamine (DiPT);
(42) 4-acetoxy-N,N-dimethyltryptamine (4-AcO-DMT);
(43) 4-acetoxy-N,N-diethyltryptamine (4-AcO-DET);
(44) 4-hydroxy-N-methyl-N-propyltryptamine (4-HO-MPT);
(45) 4-hydroxy-N,N-dipropyltryptamine (4-HO-DPT);
(46) 4-hydroxy-N,N-diallyltryptamine (4-HO-DALT);
(47) 4-hydroxy-N,N-diisopropyltryptamine (4-HO-DiPT);
(48) 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DiPT);
(49) 5-methoxy-α-methyltryptamine (5-MeO-AMT);
(50) 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT);
(51) 5-methylthio-N,N-dimethyltryptamine (5-MeS-DMT);
(52) 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT);
(53) 5-methoxy-α-ethyltryptamine (5-MeO-AET);
(54) 5-methoxy-N,N-dipropyltryptamine (5-MeO-DPT);
(55) 5-methoxy-N,N-diethyltryptamine (5-MeO-DET);
(56) 5-methoxy-N,N-diallyltryptamine (5-MeO-DALT);
(57) methoxetamine (MXE);
(58) 5-iodo-2-aminoindane (5-IAI);
(59) 5,6-methylenedioxy-2-aminoindane (MDAI);
(60) 2-(4-bromo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25B-NBOMe);
(61) 2-(4-chloro-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25C-NBOMe);
(62) 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25I-NBOMe);
(63) 2-(2,5-Dimethoxyphenyl)ethanamine (2C-H);
(64) 2-(4-Ethylthio-2,5-dimethoxyphenyl)ethanamine (2C-T-2);
(65) N,N-Dipropyltryptamine (DPT);
(66) 3-[1-(Piperidin-1-yl)cyclohexyl]phenol (3-HO-PCP);
(67) N-ethyl-1-(3-methoxyphenyl)cyclohexanamine (3-MeO-PCE);
(68) 4-[1-(3-methoxyphenyl)cyclohexyl]morpholine (3-MeO-PCMo);
(69) 1-[1-(4-methoxyphenyl)cyclohexyl]-piperidine (methoxydine, 4-MeO-PCP);
(70) 2-(2-Chlorophenyl)-2-(ethylamino)cyclohexan-1-one (N-Ethylnorketamine,
ethketamine, NENK);
(71) methylenedioxy-N,N-dimethylamphetamine (MDDMA);
(72) 3-(2-Ethyl(methyl)aminoethyl)-1H-indol-4-yl (4-AcO-MET); and
(73) 2-Phenyl-2-(methylamino)cyclohexanone (deschloroketamine).
(e) Peyote. All parts of the plant presently classified botanically as Lophophora williamsii
Lemaire, whether growing or not, the seeds thereof, any extract from any part of the plant,
and every compound, manufacture, salts, derivative, mixture, or preparation of the plant,
its seeds or extracts. The listing of peyote as a controlled substance in Schedule I does not
apply to the nondrug use of peyote in bona fide religious ceremonies of the American Indian
Church, and members of the American Indian Church are exempt from registration. Any
person who manufactures peyote for or distributes peyote to the American Indian Church,
however, is required to obtain federal registration annually and to comply with all other
requirements of law.
(f) Central nervous system depressants. Unless specifically excepted or unless listed in
another schedule, any material compound, mixture, or preparation which contains any
quantity of the following substances, their analogs, salts, isomers, and salts of isomers
whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:
(1) mecloqualone;
(2) methaqualone;
(3) gamma-hydroxybutyric acid (GHB), including its esters and ethers;
(4) flunitrazepam;
(5) 2-(2-Methoxyphenyl)-2-(methylamino)cyclohexanone (2-MeO-2-deschloroketamine,
methoxyketamine);
(6) tianeptine;
(7) clonazolam;
(8) etizolam;
(9) flubromazolam; and
(10) flubromazepam.
(g) Stimulants. Unless specifically excepted or unless listed in another schedule, any
material compound, mixture, or preparation which contains any quantity of the following
substances, their analogs, salts, isomers, and salts of isomers whenever the existence of the
analogs, salts, isomers, and salts of isomers is possible:
(1) aminorex;
(2) cathinone;
(3) fenethylline;
(4) methcathinone;
(5) methylaminorex;
(6) N,N-dimethylamphetamine;
(7) N-benzylpiperazine (BZP);
(8) methylmethcathinone (mephedrone);
(9) 3,4-methylenedioxy-N-methylcathinone (methylone);
(10) methoxymethcathinone (methedrone);
(11) methylenedioxypyrovalerone (MDPV);
(12) 3-fluoro-N-methylcathinone (3-FMC);
(13) methylethcathinone (MEC);
(14) 1-benzofuran-6-ylpropan-2-amine (6-APB);
(15) dimethylmethcathinone (DMMC);
(16) fluoroamphetamine;
(17) fluoromethamphetamine;
(18) α-methylaminobutyrophenone (MABP or buphedrone);
(19) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)butan-1-one (butylone);
(20) 2-(methylamino)-1-(4-methylphenyl)butan-1-one (4-MEMABP or BZ-6378);
(21) 1-(naphthalen-2-yl)-2-(pyrrolidin-1-yl) pentan-1-one (naphthylpyrovalerone or
naphyrone);
(22) (alpha-pyrrolidinopentiophenone (alpha-PVP);
(23) (RS)-1-(4-methylphenyl)-2-(1-pyrrolidinyl)-1-hexanone (4-Me-PHP or MPHP);
(24) 2-(1-pyrrolidinyl)-hexanophenone (Alpha-PHP);
(25) 4-methyl-N-ethylcathinone (4-MEC);
(26) 4-methyl-alpha-pyrrolidinopropiophenone (4-MePPP);
(27) 2-(methylamino)-1-phenylpentan-1-one (pentedrone);
(28) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)pentan-1-one (pentylone);
(29) 4-fluoro-N-methylcathinone (4-FMC);
(30) 3,4-methylenedioxy-N-ethylcathinone (ethylone);
(31) alpha-pyrrolidinobutiophenone (α-PBP);
(32) 5-(2-Aminopropyl)-2,3-dihydrobenzofuran (5-APDB);
(33) 1-phenyl-2-(1-pyrrolidinyl)-1-heptanone (PV8);
(34) 6-(2-Aminopropyl)-2,3-dihydrobenzofuran (6-APDB);
(35) 4-methyl-alpha-ethylaminopentiophenone (4-MEAPP);
(36) 4'-chloro-alpha-pyrrolidinopropiophenone (4'-chloro-PPP);
(37) 1-(1,3-Benzodioxol-5-yl)-2-(dimethylamino)butan-1-one (dibutylone, bk-DMBDB);
(38) 1-(3-chlorophenyl) piperazine (meta-chlorophenylpiperazine or mCPP);
(39) 1-(1,3-benzodioxol-5-yl)-2-(ethylamino)-pentan-1-one (N-ethylpentylone, ephylone);
and
(40) any other substance, except bupropion or compounds listed under a different
schedule, that is structurally derived from 2-aminopropan-1-one by substitution at the
1-position with either phenyl, naphthyl, or thiophene ring systems, whether or not the
compound is further modified in any of the following ways:
(i) by substitution in the ring system to any extent with alkyl, alkylenedioxy, alkoxy,
haloalkyl, hydroxyl, or halide substituents, whether or not further substituted in the ring
system by one or more other univalent substituents;
(ii) by substitution at the 3-position with an acyclic alkyl substituent;
(iii) by substitution at the 2-amino nitrogen atom with alkyl, dialkyl, benzyl, or
methoxybenzyl groups; or
(iv) by inclusion of the 2-amino nitrogen atom in a cyclic structure.
(h) deleted text begin Marijuana,deleted text end new text begin Syntheticnew text end tetrahydrocannabinolsdeleted text begin ,deleted text end and synthetic cannabinoids. Unless
specifically excepted or unless listed in another schedule, any deleted text begin natural ordeleted text end synthetic material,
compound, mixture, or preparation that contains any quantity of the following substances,
their analogs, isomers, esters, ethers, salts, and salts of isomers, esters, and ethers, whenever
the existence of the isomers, esters, ethers, or salts is possible:
deleted text begin
(1) marijuana;
deleted text end
deleted text begin (2)deleted text end new text begin (1) syntheticnew text end tetrahydrocannabinols deleted text begin naturally contained in a plant of the genus
Cannabis,deleted text end new text begin that are thenew text end synthetic equivalents of the substances contained in the cannabis
plant or in the resinous extractives of the plant, or synthetic substances with similar chemical
structure and pharmacological activity to those substances contained in the plant or resinous
extract, including, but not limited to, 1 cis or trans tetrahydrocannabinol, 6 cis or trans
tetrahydrocannabinol, and 3,4 cis or trans tetrahydrocannabinol;
deleted text begin (3)deleted text end new text begin (2)new text end synthetic cannabinoids, including the following substances:
(i) Naphthoylindoles, which are any compounds containing a 3-(1-napthoyl)indole
structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl,
alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group, whether or not further substituted in the indole ring to any
extent and whether or not substituted in the naphthyl ring to any extent. Examples of
naphthoylindoles include, but are not limited to:
(A) 1-Pentyl-3-(1-naphthoyl)indole (JWH-018 and AM-678);
(B) 1-Butyl-3-(1-naphthoyl)indole (JWH-073);
(C) 1-Pentyl-3-(4-methoxy-1-naphthoyl)indole (JWH-081);
(D) 1-[2-(4-morpholinyl)ethyl]-3-(1-naphthoyl)indole (JWH-200);
(E) 1-Propyl-2-methyl-3-(1-naphthoyl)indole (JWH-015);
(F) 1-Hexyl-3-(1-naphthoyl)indole (JWH-019);
(G) 1-Pentyl-3-(4-methyl-1-naphthoyl)indole (JWH-122);
(H) 1-Pentyl-3-(4-ethyl-1-naphthoyl)indole (JWH-210);
(I) 1-Pentyl-3-(4-chloro-1-naphthoyl)indole (JWH-398);
(J) 1-(5-fluoropentyl)-3-(1-naphthoyl)indole (AM-2201).
(ii) Napthylmethylindoles, which are any compounds containing a
1H-indol-3-yl-(1-naphthyl)methane structure with substitution at the nitrogen atom of the
indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl,
1-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group, whether or not further
substituted in the indole ring to any extent and whether or not substituted in the naphthyl
ring to any extent. Examples of naphthylmethylindoles include, but are not limited to:
(A) 1-Pentyl-1H-indol-3-yl-(1-naphthyl)methane (JWH-175);
(B) 1-Pentyl-1H-indol-3-yl-(4-methyl-1-naphthyl)methane (JWH-184).
(iii) Naphthoylpyrroles, which are any compounds containing a 3-(1-naphthoyl)pyrrole
structure with substitution at the nitrogen atom of the pyrrole ring by an alkyl, haloalkyl,
alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the pyrrole ring to any
extent, whether or not substituted in the naphthyl ring to any extent. Examples of
naphthoylpyrroles include, but are not limited to,
(5-(2-fluorophenyl)-1-pentylpyrrol-3-yl)-naphthalen-1-ylmethanone (JWH-307).
(iv) Naphthylmethylindenes, which are any compounds containing a naphthylideneindene
structure with substitution at the 3-position of the indene ring by an alkyl, haloalkyl, alkenyl,
cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the indene ring to any
extent, whether or not substituted in the naphthyl ring to any extent. Examples of
naphthylemethylindenes include, but are not limited to,
E-1-[1-(1-naphthalenylmethylene)-1H-inden-3-yl]pentane (JWH-176).
(v) Phenylacetylindoles, which are any compounds containing a 3-phenylacetylindole
structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl,
alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any
extent, whether or not substituted in the phenyl ring to any extent. Examples of
phenylacetylindoles include, but are not limited to:
(A) 1-(2-cyclohexylethyl)-3-(2-methoxyphenylacetyl)indole (RCS-8);
(B) 1-pentyl-3-(2-methoxyphenylacetyl)indole (JWH-250);
(C) 1-pentyl-3-(2-methylphenylacetyl)indole (JWH-251);
(D) 1-pentyl-3-(2-chlorophenylacetyl)indole (JWH-203).
(vi) Cyclohexylphenols, which are compounds containing a
2-(3-hydroxycyclohexyl)phenol structure with substitution at the 5-position of the phenolic
ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl,
1-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group whether or not substituted
in the cyclohexyl ring to any extent. Examples of cyclohexylphenols include, but are not
limited to:
(A) 5-(1,1-dimethylheptyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol (CP 47,497);
(B) 5-(1,1-dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol
(Cannabicyclohexanol or CP 47,497 C8 homologue);
(C) 5-(1,1-dimethylheptyl)-2-[(1R,2R)-5-hydroxy-2-(3-hydroxypropyl)cyclohexyl]
-phenol (CP 55,940).
(vii) Benzoylindoles, which are any compounds containing a 3-(benzoyl)indole structure
with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl,
cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any
extent and whether or not substituted in the phenyl ring to any extent. Examples of
benzoylindoles include, but are not limited to:
(A) 1-Pentyl-3-(4-methoxybenzoyl)indole (RCS-4);
(B) 1-(5-fluoropentyl)-3-(2-iodobenzoyl)indole (AM-694);
(C) (4-methoxyphenyl-[2-methyl-1-(2-(4-morpholinyl)ethyl)indol-3-yl]methanone (WIN
48,098 or Pravadoline).
(viii) Others specifically named:
(A) (6aR,10aR)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)
-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (HU-210);
(B) (6aS,10aS)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)
-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (Dexanabinol or HU-211);
(C) 2,3-dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo[1,2,3-de]
-1,4-benzoxazin-6-yl-1-naphthalenylmethanone (WIN 55,212-2);
(D) (1-pentylindol-3-yl)-(2,2,3,3-tetramethylcyclopropyl)methanone (UR-144);
(E) (1-(5-fluoropentyl)-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl)methanone
(XLR-11);
(F) 1-pentyl-N-tricyclo[3.3.1.13,7]dec-1-yl-1H-indazole-3-carboxamide
(AKB-48(APINACA));
(G) N-((3s,5s,7s)-adamantan-1-yl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide
(5-Fluoro-AKB-48);
(H) 1-pentyl-8-quinolinyl ester-1H-indole-3-carboxylic acid (PB-22);
(I) 8-quinolinyl ester-1-(5-fluoropentyl)-1H-indole-3-carboxylic acid (5-Fluoro PB-22);
(J) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-pentyl-1H-indazole- 3-carboxamide
(AB-PINACA);
(K) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-[(4-fluorophenyl)methyl]-
1H-indazole-3-carboxamide (AB-FUBINACA);
(L) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-(cyclohexylmethyl)-1H-
indazole-3-carboxamide(AB-CHMINACA);
(M) (S)-methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3- methylbutanoate
(5-fluoro-AMB);
(N) [1-(5-fluoropentyl)-1H-indazol-3-yl](naphthalen-1-yl) methanone (THJ-2201);
(O) (1-(5-fluoropentyl)-1H-benzo[d]imidazol-2-yl)(naphthalen-1-yl)methanone)
(FUBIMINA);
(P) (7-methoxy-1-(2-morpholinoethyl)-N-((1S,2S,4R)-1,3,3-trimethylbicyclo
[2.2.1]heptan-2-yl)-1H-indole-3-carboxamide (MN-25 or UR-12);
(Q) (S)-N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)
-1H-indole-3-carboxamide (5-fluoro-ABICA);
(R) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl)
-1H-indole-3-carboxamide;
(S) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl)
-1H-indazole-3-carboxamide;
(T) methyl 2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido) -3,3-dimethylbutanoate;
(U) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1(cyclohexylmethyl)-1
H-indazole-3-carboxamide (MAB-CHMINACA);
(V) N-(1-Amino-3,3-dimethyl-1-oxo-2-butanyl)-1-pentyl-1H-indazole-3-carboxamide
(ADB-PINACA);
(W) methyl (1-(4-fluorobenzyl)-1H-indazole-3-carbonyl)-L-valinate (FUB-AMB);
(X) N-[(1S)-2-amino-2-oxo-1-(phenylmethyl)ethyl]-1-(cyclohexylmethyl)-1H-Indazole-
3-carboxamide. (APP-CHMINACA);
(Y) quinolin-8-yl 1-(4-fluorobenzyl)-1H-indole-3-carboxylate (FUB-PB-22); and
(Z) methyl N-[1-(cyclohexylmethyl)-1H-indole-3-carbonyl]valinate (MMB-CHMICA).
(ix) Additional substances specifically named:
(A) 1-(5-fluoropentyl)-N-(2-phenylpropan-2-yl)-1
H-pyrrolo[2,3-B]pyridine-3-carboxamide (5F-CUMYL-P7AICA);
(B) 1-(4-cyanobutyl)-N-(2- phenylpropan-2-yl)-1 H-indazole-3-carboxamide
(4-CN-Cumyl-Butinaca);
(C) naphthalen-1-yl-1-(5-fluoropentyl)-1-H-indole-3-carboxylate (NM2201; CBL2201);
(D) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)-1
H-indazole-3-carboxamide (5F-ABPINACA);
(E) methyl-2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3,3-dimethylbutanoate
(MDMB CHMICA);
(F) methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate
(5F-ADB; 5F-MDMB-PINACA); and
(G) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)
1H-indazole-3-carboxamide (ADB-FUBINACA).
(i) A controlled substance analog, to the extent that it is implicitly or explicitly intended
for human consumption.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021, and applies to crimes
committed on or after that date.
new text end
Sec. 65.
Minnesota Statutes 2020, section 152.02, subdivision 3, is amended to read:
Subd. 3.
Schedule II.
(a) Schedule II consists of the substances listed in this subdivision.
(b) Unless specifically excepted or unless listed in another schedule, any of the following
substances whether produced directly or indirectly by extraction from substances of vegetable
origin or independently by means of chemical synthesis, or by a combination of extraction
and chemical synthesis:
(1) Opium and opiate, and any salt, compound, derivative, or preparation of opium or
opiate.
(i) Excluding:
(A) apomorphine;
(B) thebaine-derived butorphanol;
(C) dextrophan;
(D) nalbuphine;
(E) nalmefene;
(F) naloxegol;
(G) naloxone;
(H) naltrexone; and
(I) their respective salts;
(ii) but including the following:
(A) opium, in all forms and extracts;
(B) codeine;
(C) dihydroetorphine;
(D) ethylmorphine;
(E) etorphine hydrochloride;
(F) hydrocodone;
(G) hydromorphone;
(H) metopon;
(I) morphine;
(J) oxycodone;
(K) oxymorphone;
(L) thebaine;
(M) oripavine;
(2) any salt, compound, derivative, or preparation thereof which is chemically equivalent
or identical with any of the substances referred to in clause (1), except that these substances
shall not include the isoquinoline alkaloids of opium;
(3) opium poppy and poppy straw;
(4) coca leaves and any salt, cocaine compound, derivative, or preparation of coca leaves
(including cocaine and ecgonine and their salts, isomers, derivatives, and salts of isomers
and derivatives), and any salt, compound, derivative, or preparation thereof which is
chemically equivalent or identical with any of these substances, except that the substances
shall not include decocainized coca leaves or extraction of coca leaves, which extractions
do not contain cocaine or ecgonine;
(5) concentrate of poppy straw (the crude extract of poppy straw in either liquid, solid,
or powder form which contains the phenanthrene alkaloids of the opium poppy).
(c) Any of the following opiates, including their isomers, esters, ethers, salts, and salts
of isomers, esters and ethers, unless specifically excepted, or unless listed in another schedule,
whenever the existence of such isomers, esters, ethers and salts is possible within the specific
chemical designation:
(1) alfentanil;
(2) alphaprodine;
(3) anileridine;
(4) bezitramide;
(5) bulk dextropropoxyphene (nondosage forms);
(6) carfentanil;
(7) dihydrocodeine;
(8) dihydromorphinone;
(9) diphenoxylate;
(10) fentanyl;
(11) isomethadone;
(12) levo-alpha-acetylmethadol (LAAM);
(13) levomethorphan;
(14) levorphanol;
(15) metazocine;
(16) methadone;
(17) methadone - intermediate, 4-cyano-2-dimethylamino-4, 4-diphenylbutane;
(18) moramide - intermediate, 2-methyl-3-morpholino-1, 1-diphenyl-propane-carboxylic
acid;
(19) pethidine;
(20) pethidine - intermediate - a, 4-cyano-1-methyl-4-phenylpiperidine;
(21) pethidine - intermediate - b, ethyl-4-phenylpiperidine-4-carboxylate;
(22) pethidine - intermediate - c, 1-methyl-4-phenylpiperidine-4-carboxylic acid;
(23) phenazocine;
(24) piminodine;
(25) racemethorphan;
(26) racemorphan;
(27) remifentanil;
(28) sufentanil;
(29) tapentadol;
(30) 4-Anilino-N-phenethylpiperidine.
(d) Unless specifically excepted or unless listed in another schedule, any material,
compound, mixture, or preparation which contains any quantity of the following substances
having a stimulant effect on the central nervous system:
(1) amphetamine, its salts, optical isomers, and salts of its optical isomers;
(2) methamphetamine, its salts, isomers, and salts of its isomers;
(3) phenmetrazine and its salts;
(4) methylphenidate;
(5) lisdexamfetamine.
(e) Unless specifically excepted or unless listed in another schedule, any material,
compound, mixture, or preparation which contains any quantity of the following substances
having a depressant effect on the central nervous system, including its salts, isomers, and
salts of isomers whenever the existence of such salts, isomers, and salts of isomers is possible
within the specific chemical designation:
(1) amobarbital;
(2) glutethimide;
(3) secobarbital;
(4) pentobarbital;
(5) phencyclidine;
(6) phencyclidine immediate precursors:
(i) 1-phenylcyclohexylamine;
(ii) 1-piperidinocyclohexanecarbonitrile;
(7) phenylacetone.
(f) new text begin Cannabis and new text end cannabinoids:
(1) nabilone;
new text begin
(2) unless specifically excepted or unless listed in another schedule, any natural material,
compound, mixture, or preparation that contains any quantity of the following substances,
their analogs, isomers, esters, ethers, salts, and salts of isomers, esters, and ethers, whenever
the existence of the isomers, esters, ethers, or salts is possible:
new text end
new text begin
(i) marijuana; and
new text end
new text begin
(ii) tetrahydrocannabinols naturally contained in a plant of the genus cannabis or in the
resinous extractives of the plant; and
new text end
deleted text begin (2)deleted text end new text begin (3)new text end dronabinol [(-)-delta-9-trans-tetrahydrocannabinol (delta-9-THC)] in an oral
solution in a drug product approved for marketing by the United States Food and Drug
Administration.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021, and applies to crimes
committed on or after that date.
new text end
Sec. 66.
Minnesota Statutes 2020, section 152.11, subdivision 1a, is amended to read:
Subd. 1a.
Prescription requirements for Schedule II controlled substances.
new text begin Except
as allowed under section 152.29, new text end no person may dispense a controlled substance included
in Schedule II of section 152.02 without a prescription issued by a doctor of medicine, a
doctor of osteopathic medicine licensed to practice medicine, a doctor of dental surgery, a
doctor of dental medicine, a doctor of podiatry, or a doctor of veterinary medicine, lawfully
licensed to prescribe in this state or by a practitioner licensed to prescribe controlled
substances by the state in which the prescription is issued, and having a current federal Drug
Enforcement Administration registration number. The prescription must either be printed
or written in ink and contain the handwritten signature of the prescriber or be transmitted
electronically or by facsimile as permitted under subdivision 1. Provided that in emergency
situations, as authorized by federal law, such drug may be dispensed upon oral prescription
reduced promptly to writing and filed by the pharmacist. Such prescriptions shall be retained
in conformity with section 152.101. No prescription for a Schedule II substance may be
refilled.
Sec. 67.
Minnesota Statutes 2020, section 152.11, is amended by adding a subdivision to
read:
new text begin Subd. 5. new text end
new text begin Exception. new text end
new text begin
References in this section to Schedule II controlled substances do
not extend to marijuana or tetrahydrocannabinols.
new text end
Sec. 68.
Minnesota Statutes 2020, section 152.12, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin Exception. new text end
new text begin
References in this section to Schedule II controlled substances do
not extend to marijuana or tetrahydrocannabinols.
new text end
Sec. 69.
Minnesota Statutes 2020, section 152.125, subdivision 3, is amended to read:
Subd. 3.
Limits on applicability.
This section does not apply to:
(1) a physician's treatment of an individual for chemical dependency resulting from the
use of controlled substances in Schedules II to V of section 152.02;
(2) the prescription or administration of controlled substances in Schedules II to V of
section 152.02 to an individual whom the physician knows to be using the controlled
substances for nontherapeutic purposes;
(3) the prescription or administration of controlled substances in Schedules II to V of
section 152.02 for the purpose of terminating the life of an individual having intractable
pain; deleted text begin or
deleted text end
(4) the prescription or administration of a controlled substance in Schedules II to V of
section 152.02 that is not a controlled substance approved by the United States Food and
Drug Administration for pain reliefnew text begin ; or
new text end
new text begin (5) the administration of medical cannabis under sections 152.22 to 152.37new text end .
Sec. 70.
Minnesota Statutes 2020, section 152.22, is amended by adding a subdivision to
read:
new text begin Subd. 5c. new text end
new text begin Hemp processor. new text end
new text begin
"Hemp processor" means a person or business licensed by
the commissioner of agriculture under chapter 18K to convert raw hemp into a product.
new text end
Sec. 71.
Minnesota Statutes 2020, section 152.22, subdivision 6, is amended to read:
Subd. 6.
Medical cannabis.
(a) "Medical cannabis" means any species of the genus
cannabis plant, or any mixture or preparation of them, including whole plant extracts and
resins, and is delivered in the form of:
(1) liquid, including, but not limited to, oil;
(2) pill;
(3) vaporized delivery method with use of liquid or oil deleted text begin but which does not require the
use of dried leaves or plant form; ordeleted text end new text begin ;
new text end
new text begin
(4) combustion with use of dried raw cannabis; or
new text end
deleted text begin (4)deleted text end new text begin (5)new text end any other methoddeleted text begin , excluding smoking,deleted text end approved by the commissioner.
(b) This definition includes any part of the genus cannabis plant prior to being processed
into a form allowed under paragraph (a), that is possessed by a person while that person is
engaged in employment duties necessary to carry out a requirement under sections 152.22
to 152.37 for a registered manufacturer or a laboratory under contract with a registered
manufacturer. This definition also includes any hemp acquired by a manufacturer by a hemp
grower as permitted under section 152.29, subdivision 1, paragraph (b).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the earlier of (1) March 1, 2022, or (2)
a date, as determined by the commissioner of health, by which (i) the rules adopted or
amended under Minnesota Statutes, section 152.26, paragraph (b), are in effect and (ii) the
independent laboratories under contract with the manufacturers have the necessary procedures
and equipment in place to perform the required testing of dried raw cannabis. If this section
is effective before March 1, 2022, the commissioner shall provide notice of that effective
date to the public.
new text end
Sec. 72.
Minnesota Statutes 2020, section 152.22, subdivision 11, is amended to read:
Subd. 11.
Registered designated caregiver.
"Registered designated caregiver" means
a person who:
(1) is at least 18 years old;
(2) does not have a conviction for a disqualifying felony offense;
(3) has been approved by the commissioner to assist a patient who deleted text begin has been identified
by a health care practitioner as developmentally or physically disabled and thereforedeleted text end requires
assistance in administering medical cannabis or obtaining medical cannabis from a
distribution facility deleted text begin due to the disabilitydeleted text end ; and
(4) is authorized by the commissioner to assist the patient with the use of medical
cannabis.
Sec. 73.
Minnesota Statutes 2020, section 152.22, is amended by adding a subdivision to
read:
new text begin Subd. 13a. new text end
new text begin Tribal medical cannabis program. new text end
new text begin
"Tribal medical cannabis program"
means a medical cannabis program operated by a federally recognized Indian Tribe located
within the state that has been recognized by the commissioner of health in accordance with
section 152.25, subdivision 5.
new text end
Sec. 74.
Minnesota Statutes 2020, section 152.23, is amended to read:
152.23 LIMITATIONS.
(a) Nothing in sections 152.22 to 152.37 permits any person to engage in and does not
prevent the imposition of any civil, criminal, or other penalties for:
(1) undertaking any task under the influence of medical cannabis that would constitute
negligence or professional malpractice;
(2) possessing or engaging in the use of medical cannabis:
(i) on a school bus or van;
(ii) on the grounds of any preschool or primary or secondary school;
(iii) in any correctional facility; or
(iv) on the grounds of any child care facility or home day care;
(3) vaporizing new text begin or combusting new text end medical cannabis pursuant to section 152.22, subdivision
6:
(i) on any form of public transportation;
(ii) where the vapor would be inhaled by a nonpatient minor childnew text begin or where the smoke
would be inhaled by a minor childnew text end ; or
(iii) in any public place, including any indoor or outdoor area used by or open to the
general public or a place of employment as defined under section 144.413, subdivision 1b;
and
(4) operating, navigating, or being in actual physical control of any motor vehicle,
aircraft, train, or motorboat, or working on transportation property, equipment, or facilities
while under the influence of medical cannabis.
(b) Nothing in sections 152.22 to 152.37 require the medical assistance and
MinnesotaCare programs to reimburse an enrollee or a provider for costs associated with
the medical use of cannabis. Medical assistance and MinnesotaCare shall continue to provide
coverage for all services related to treatment of an enrollee's qualifying medical condition
if the service is covered under chapter 256B or 256L.
Sec. 75.
Minnesota Statutes 2020, section 152.25, is amended by adding a subdivision to
read:
new text begin Subd. 5. new text end
new text begin Tribal medical cannabis programs. new text end
new text begin
Upon the request of an Indian Tribe
operating a Tribal medical cannabis program, the commissioner shall determine if the
standards for the Tribal medical cannabis program meet or exceed the standards required
under sections 152.22 to 152.37 in terms of qualifying for the medical cannabis program,
allowable forms of medical cannabis, production and distribution requirements, product
safety and testing, and security measures. If the commissioner determines that the Tribal
medical cannabis program meets or exceeds the standards in sections 152.22 to 152.37, the
commissioner shall recognize the Tribal medical cannabis program and shall post the Tribal
medical cannabis programs that have been recognized by the commissioner on the
Department of Health's website.
new text end
Sec. 76.
Minnesota Statutes 2020, section 152.26, is amended to read:
152.26 RULEMAKING.
new text begin (a) new text end The commissioner may adopt rules to implement sections 152.22 to 152.37. Rules
for which notice is published in the State Register before January 1, 2015, may be adopted
using the process in section 14.389.
new text begin
(b) The commissioner may adopt or amend rules, using the procedure in section 14.386,
paragraph (a), to implement the addition of dried raw cannabis as an allowable form of
medical cannabis under section 152.22, subdivision 6, paragraph (a), clause (4). Section
14.386, paragraph (b), does not apply to these rules.
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. 77.
Minnesota Statutes 2020, section 152.27, subdivision 3, is amended to read:
Subd. 3.
Patient application.
(a) The commissioner shall develop a patient application
for enrollment into the registry program. The application shall be available to the patient
and given to health care practitioners in the state who are eligible to serve as health care
practitioners. The application must include:
(1) the name, mailing address, and date of birth of the patient;
(2) the name, mailing address, and telephone number of the patient's health care
practitioner;
(3) the name, mailing address, and date of birth of the patient's designated caregiver, if
any, or the patient's parent, legal guardian, or spouse if the parent, legal guardian, or spouse
will be acting as a caregiver;
(4) a copy of the certification from the patient's health care practitioner that is dated
within 90 days prior to submitting the application which certifies that the patient has been
diagnosed with a qualifying medical condition deleted text begin and, if applicable, that, in the health care
practitioner's medical opinion, the patient is developmentally or physically disabled and,
as a result of that disability, the patient requires assistance in administering medical cannabis
or obtaining medical cannabis from a distribution facilitydeleted text end ; and
(5) all other signed affidavits and enrollment forms required by the commissioner under
sections 152.22 to 152.37, including, but not limited to, the disclosure form required under
paragraph (c).
(b) The commissioner shall require a patient to resubmit a copy of the certification from
the patient's health care practitioner on a yearly basis and shall require that the recertification
be dated within 90 days of submission.
(c) The commissioner shall develop a disclosure form and require, as a condition of
enrollment, all patients to sign a copy of the disclosure. The disclosure must include:
(1) a statement that, notwithstanding any law to the contrary, the commissioner, or an
employee of any state agency, may not be held civilly or criminally liable for any injury,
loss of property, personal injury, or death caused by any act or omission while acting within
the scope of office or employment under sections 152.22 to 152.37; and
(2) the patient's acknowledgment that enrollment in the patient registry program is
conditional on the patient's agreement to meet all of the requirements of sections 152.22 to
152.37.
Sec. 78.
Minnesota Statutes 2020, section 152.27, subdivision 4, is amended to read:
Subd. 4.
Registered designated caregiver.
(a) The commissioner shall register a
designated caregiver for a patient if deleted text begin the patient's health care practitioner has certified that
the patient, in the health care practitioner's medical opinion, is developmentally or physically
disabled and, as a result of that disability,deleted text end the patient requires assistance in administering
medical cannabis or obtaining medical cannabis from a distribution facility and the caregiver
has agreed, in writing, to be the patient's designated caregiver. As a condition of registration
as a designated caregiver, the commissioner shall require the person to:
(1) be at least 18 years of age;
(2) agree to only possess the patient's medical cannabis for purposes of assisting the
patient; and
(3) agree that if the application is approved, the person will not be a registered designated
caregiver for more than deleted text begin one patient, unless thedeleted text end new text begin six registered patients at one time.new text end Patients
new text begin who new text end reside in the same residencenew text begin shall count as one patientnew text end .
(b) The commissioner shall conduct a criminal background check on the designated
caregiver prior to registration to ensure that the person does not have a conviction for a
disqualifying felony offense. Any cost of the background check shall be paid by the person
seeking registration as a designated caregiver. A designated caregiver must have the criminal
background check renewed every two years.
(c) Nothing in sections 152.22 to 152.37 shall be construed to prevent a person registered
as a designated caregiver from also being enrolled in the registry program as a patient and
possessing and using medical cannabis as a patient.
Sec. 79.
Minnesota Statutes 2020, section 152.27, subdivision 6, is amended to read:
Subd. 6.
Patient enrollment.
(a) After receipt of a patient's application, application fees,
and signed disclosure, the commissioner shall enroll the patient in the registry program and
issue the patient and patient's registered designated caregiver or parent, legal guardian, or
spouse, if applicable, a registry verification. The commissioner shall approve or deny a
patient's application for participation in the registry program within 30 days after the
commissioner receives the patient's application and application fee. deleted text begin The commissioner may
approve applications up to 60 days after the receipt of a patient's application and application
fees until January 1, 2016.deleted text end A patient's enrollment in the registry program shall only be
denied if the patient:
(1) does not have certification from a health care practitioner that the patient has been
diagnosed with a qualifying medical condition;
(2) has not signed and returned the disclosure form required under subdivision 3,
paragraph (c), to the commissioner;
(3) does not provide the information required;new text begin or
new text end
deleted text begin
(4) has previously been removed from the registry program for violations of section
152.30 or 152.33; or
deleted text end
deleted text begin (5)deleted text end new text begin (4)new text end provides false information.
(b) The commissioner shall give written notice to a patient of the reason for denying
enrollment in the registry program.
(c) Denial of enrollment into the registry program is considered a final decision of the
commissioner and is subject to judicial review under the Administrative Procedure Act
pursuant to chapter 14.
(d) A patient's enrollment in the registry program may only be revoked upon the death
of the patient or if a patient violates a requirement under section 152.30 or 152.33.new text begin If a
patient's enrollment in the registry program has been revoked due to a violation of section
152.30 or 152.33, the patient may reapply for enrollment 12 months from the date the
patient's enrollment was revoked. The commissioner shall process the application in
accordance with this section.
new text end
(e) The commissioner shall develop a registry verification to provide to the patient, the
health care practitioner identified in the patient's application, and to the manufacturer. The
registry verification shall include:
(1) the patient's name and date of birth;
(2) the patient registry number assigned to the patient; and
(3) the name and date of birth of the patient's registered designated caregiver, if any, or
the name of the patient's parent, legal guardian, or spouse if the parent, legal guardian, or
spouse will be acting as a caregiver.
new text begin
(f) The commissioner shall not deny a patient's application for participation in the registry
program or revoke a patient's enrollment in the registry program solely because the patient
is also enrolled in a Tribal medical cannabis program.
new text end
Sec. 80.
Minnesota Statutes 2020, section 152.28, subdivision 1, is amended to read:
Subdivision 1.
Health care practitioner duties.
(a) Prior to a patient's enrollment in
the registry program, a health care practitioner shall:
(1) determine, in the health care practitioner's medical judgment, whether a patient suffers
from a qualifying medical condition, and, if so determined, provide the patient with a
certification of that diagnosis;
(2) deleted text begin determine whether a patient is developmentally or physically disabled and, as a result
of that disability, the patient requires assistance in administering medical cannabis or
obtaining medical cannabis from a distribution facility, and, if so determined, include that
determination on the patient's certification of diagnosis;
deleted text end
deleted text begin (3)deleted text end advise patients, registered designated caregivers, and parents, legal guardians, or
spouses who are acting as caregivers of the existence of any nonprofit patient support groups
or organizations;
deleted text begin (4)deleted text end new text begin (3)new text end provide explanatory information from the commissioner to patients with qualifying
medical conditions, including disclosure to all patients about the experimental nature of
therapeutic use of medical cannabis; the possible risks, benefits, and side effects of the
proposed treatment; the application and other materials from the commissioner; and provide
patients with the Tennessen warning as required by section 13.04, subdivision 2; and
deleted text begin (5)deleted text end new text begin (4)new text end agree to continue treatment of the patient's qualifying medical condition and
report medical findings to the commissioner.
(b) Upon notification from the commissioner of the patient's enrollment in the registry
program, the health care practitioner shall:
(1) participate in the patient registry reporting system under the guidance and supervision
of the commissioner;
(2) report health records of the patient throughout the ongoing treatment of the patient
to the commissioner in a manner determined by the commissioner and in accordance with
subdivision 2;
(3) determine, on a yearly basis, if the patient continues to suffer from a qualifying
medical condition and, if so, issue the patient a new certification of that diagnosis; and
(4) otherwise comply with all requirements developed by the commissioner.
(c) A health care practitioner may conduct a patient assessment to issue a recertification
as required under paragraph (b), clause (3), via telemedicine as defined under section
62A.671, subdivision 9.
(d) Nothing in this section requires a health care practitioner to participate in the registry
program.
Sec. 81.
Minnesota Statutes 2020, section 152.29, subdivision 1, is amended to read:
Subdivision 1.
Manufacturer; requirements.
(a) A manufacturer may operate eight
distribution facilities, which may include the manufacturer's single location for cultivation,
harvesting, manufacturing, packaging, and processing but is not required to include that
location. The commissioner shall designate the geographical service areas to be served by
each manufacturer based on geographical need throughout the state to improve patient
access. A manufacturer shall not have more than two distribution facilities in each
geographical service area assigned to the manufacturer by the commissioner. A manufacturer
shall operate only one location where all cultivation, harvesting, manufacturing, packaging,
and processing of medical cannabis shall be conducted. This location may be one of the
manufacturer's distribution facility sites. The additional distribution facilities may dispense
medical cannabis and medical cannabis products but may not contain any medical cannabis
in a form other than those forms allowed under section 152.22, subdivision 6, and the
manufacturer shall not conduct any cultivation, harvesting, manufacturing, packaging, or
processing at the other distribution facility sites. Any distribution facility operated by the
manufacturer is subject to all of the requirements applying to the manufacturer under sections
152.22 to 152.37, including, but not limited to, security and distribution requirements.
(b) A manufacturer may acquire hemp grown in this state from a hemp growernew text begin , and may
acquire hemp products produced by a hemp processornew text end . A manufacturer may manufacture
or process hemp new text begin and hemp products new text end into an allowable form of medical cannabis under
section 152.22, subdivision 6. Hemp new text begin and hemp products new text end acquired by a manufacturer under
this paragraph deleted text begin isdeleted text end new text begin arenew text end subject to the same quality control program, security and testing
requirements, and other requirements that apply to medical cannabis under sections 152.22
to 152.37 and Minnesota Rules, chapter 4770.
(c) A medical cannabis manufacturer shall contract with a laboratory approved by the
commissioner, subject to any additional requirements set by the commissioner, for purposes
of testing medical cannabis manufactured or hemp new text begin or hemp products new text end acquired by the medical
cannabis manufacturer as to content, contamination, and consistency to verify the medical
cannabis meets the requirements of section 152.22, subdivision 6. The cost of laboratory
testing shall be paid by the manufacturer.
(d) The operating documents of a manufacturer must include:
(1) procedures for the oversight of the manufacturer and procedures to ensure accurate
record keeping;
(2) procedures for the implementation of appropriate security measures to deter and
prevent the theft of medical cannabis and unauthorized entrance into areas containing medical
cannabis; and
(3) procedures for the delivery and transportation of hemp between hemp growers and
manufacturersnew text begin and for the delivery and transportation of hemp products between hemp
processors and manufacturersnew text end .
(e) A manufacturer shall implement security requirements, including requirements for
the delivery and transportation of hempnew text begin and hemp productsnew text end , protection of each location by
a fully operational security alarm system, facility access controls, perimeter intrusion
detection systems, and a personnel identification system.
(f) A manufacturer shall not share office space with, refer patients to a health care
practitioner, or have any financial relationship with a health care practitioner.
(g) A manufacturer shall not permit any person to consume medical cannabis on the
property of the manufacturer.
(h) A manufacturer is subject to reasonable inspection by the commissioner.
(i) For purposes of sections 152.22 to 152.37, a medical cannabis manufacturer is not
subject to the Board of Pharmacy licensure or regulatory requirements under chapter 151.
(j) A medical cannabis manufacturer may not employ any person who is under 21 years
of age or who has been convicted of a disqualifying felony offense. An employee of a
medical cannabis manufacturer must submit a completed criminal history records check
consent form, a full set of classifiable fingerprints, and the required fees for submission to
the Bureau of Criminal Apprehension before an employee may begin working with the
manufacturer. The bureau must conduct a Minnesota criminal history records check and
the superintendent is authorized to exchange the fingerprints with the Federal Bureau of
Investigation to obtain the applicant's national criminal history record information. The
bureau shall return the results of the Minnesota and federal criminal history records checks
to the commissioner.
(k) A manufacturer may not operate in any location, whether for distribution or
cultivation, harvesting, manufacturing, packaging, or processing, within 1,000 feet of a
public or private school existing before the date of the manufacturer's registration with the
commissioner.
(l) A manufacturer shall comply with reasonable restrictions set by the commissioner
relating to signage, marketing, display, and advertising of medical cannabis.
(m) Before a manufacturer acquires hemp from a hemp growernew text begin or hemp products from
a hemp processornew text end , the manufacturer must verify that the hemp grower new text begin or hemp processor
new text end has a valid license issued by the commissioner of agriculture under chapter 18K.
(n) Until a state-centralized, seed-to-sale system is implemented that can track a specific
medical cannabis plant from cultivation through testing and point of sale, the commissioner
shall conduct at least one unannounced inspection per year of each manufacturer that includes
inspection of:
(1) business operations;
(2) physical locations of the manufacturer's manufacturing facility and distribution
facilities;
(3) financial information and inventory documentation, including laboratory testing
results; and
(4) physical and electronic security alarm systems.
Sec. 82.
Minnesota Statutes 2020, section 152.29, subdivision 3, is amended to read:
Subd. 3.
Manufacturer; distribution.
(a) A manufacturer shall require that employees
licensed as pharmacists pursuant to chapter 151 be the only employees to give final approval
for the distribution of medical cannabis to a patient. A manufacturer may transport medical
cannabis or medical cannabis products that have been cultivated, harvested, manufactured,
packaged, and processed by that manufacturer to another registered manufacturer for the
other manufacturer to distribute.
(b) A manufacturer may distribute medical cannabis products, whether or not the products
have been manufactured by that manufacturer.
(c) Prior to distribution of any medical cannabis, the manufacturer shall:
(1) verify that the manufacturer has received the registry verification from the
commissioner for that individual patient;
(2) verify that the person requesting the distribution of medical cannabis is the patient,
the patient's registered designated caregiver, or the patient's parent, legal guardian, or spouse
listed in the registry verification using the procedures described in section 152.11, subdivision
2d;
(3) assign a tracking number to any medical cannabis distributed from the manufacturer;
(4) ensure that any employee of the manufacturer licensed as a pharmacist pursuant to
chapter 151 has consulted with the patient to determine the proper dosage for the individual
patient after reviewing the ranges of chemical compositions of the medical cannabis and
the ranges of proper dosages reported by the commissioner. For purposes of this clause, a
consultation may be conducted remotely deleted text begin using adeleted text end new text begin by securenew text end videoconferencenew text begin , telephone, or
other remote meansnew text end , so long as the employee providing the consultation is able to confirm
the identity of the patientdeleted text begin , the consultation occurs while the patient is at a distribution facility,deleted text end
and the consultation adheres to patient privacy requirements that apply to health care services
delivered through telemedicinenew text begin . A pharmacist consultation under this clause is not required
when a manufacturer is distributing medical cannabis to a patient according to a
patient-specific dosage plan established with that manufacturer and is not modifying the
dosage or product being distributed under that plan and the medical cannabis is distributed
by a pharmacy techniciannew text end ;
(5) properly package medical cannabis in compliance with the United States Poison
Prevention Packing Act regarding child-resistant packaging and exemptions for packaging
for elderly patients, and label distributed medical cannabis with a list of all active ingredients
and individually identifying information, including:
(i) the patient's name and date of birth;
(ii) the name and date of birth of the patient's registered designated caregiver or, if listed
on the registry verification, the name of the patient's parent or legal guardian, if applicable;
(iii) the patient's registry identification number;
(iv) the chemical composition of the medical cannabis; and
(v) the dosage; and
(6) ensure that the medical cannabis distributed contains a maximum of a 90-day supply
of the dosage determined for that patient.
(d) A manufacturer shall require any employee of the manufacturer who is transporting
medical cannabis or medical cannabis products to a distribution facility or to another
registered manufacturer to carry identification showing that the person is an employee of
the manufacturer.
new text begin
(e) A manufacturer shall distribute medical cannabis in dried raw cannabis form only
to a patient age 21 or older, or to the registered designated caregiver, parent, legal guardian,
or spouse of a patient age 21 or older.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Paragraph (e) is effective the earlier of (1) March 1, 2022, or (2)
a date, as determined by the commissioner of health, by which (i) the rules adopted or
amended under Minnesota Statutes, section 152.26, paragraph (b), are in effect and (ii) the
independent laboratories under contract with the manufacturers have the necessary procedures
and equipment in place to perform the required testing of dried raw cannabis. If this section
is effective before March 1, 2022, the commissioner shall provide notice of that effective
date to the public.
new text end
Sec. 83.
Minnesota Statutes 2020, section 152.29, is amended by adding a subdivision to
read:
new text begin Subd. 3b. new text end
new text begin Distribution to recipient in a motor vehicle. new text end
new text begin
A manufacturer may distribute
medical cannabis to a patient, registered designated caregiver, or parent, legal guardian, or
spouse of a patient who is at the distribution facility but remains in a motor vehicle, provided:
new text end
new text begin
(1) distribution facility staff receive payment and distribute medical cannabis in a
designated zone that is as close as feasible to the front door of the distribution facility;
new text end
new text begin
(2) the manufacturer ensures that the receipt of payment and distribution of medical
cannabis are visually recorded by a closed-circuit television surveillance camera at the
distribution facility and provides any other necessary security safeguards;
new text end
new text begin
(3) the manufacturer does not store medical cannabis outside a restricted access area at
the distribution facility, and distribution facility staff transport medical cannabis from a
restricted access area at the distribution facility to the designated zone for distribution only
after confirming that the patient, designated caregiver, or parent, guardian, or spouse has
arrived in the designated zone;
new text end
new text begin
(4) the payment and distribution of medical cannabis take place only after a pharmacist
consultation takes place, if required under subdivision 3, paragraph (c), clause (4);
new text end
new text begin
(5) immediately following distribution of medical cannabis, distribution facility staff
enter the transaction in the state medical cannabis registry information technology database;
and
new text end
new text begin
(6) immediately following distribution of medical cannabis, distribution facility staff
take the payment received into the distribution facility.
new text end
Sec. 84.
Minnesota Statutes 2020, section 152.29, is amended by adding a subdivision to
read:
new text begin Subd. 3c. new text end
new text begin Disposal of medical cannabis plant root balls. new text end
new text begin
Notwithstanding Minnesota
Rules, part 4770.1200, subpart 2, item C, a manufacturer is not required to grind root balls
of medical cannabis plants or incorporate them with a greater quantity of nonconsumable
solid waste before transporting root balls to another location for disposal. For purposes of
this subdivision, "root ball" means a compact mass of roots formed by a plant and any
attached growing medium.
new text end
Sec. 85.
Minnesota Statutes 2020, section 152.31, is amended to read:
152.31 DATA PRACTICES.
(a) Government data in patient files maintained by the commissioner and the health care
practitioner, and data submitted to or by a medical cannabis manufacturer, are private data
on individuals, as defined in section 13.02, subdivision 12, or nonpublic data, as defined in
section 13.02, subdivision 9, but may be used for purposes of complying with chapter 13
and complying with a request from the legislative auditor or the state auditor in the
performance of official duties. The provisions of section 13.05, subdivision 11, apply to a
registration agreement entered between the commissioner and a medical cannabis
manufacturer under section 152.25.
(b) Not public data maintained by the commissioner may not be used for any purpose
not provided for in sections 152.22 to 152.37, and may not be combined or linked in any
manner with any other list, dataset, or database.
(c) The commissioner may execute data sharing arrangements with the commissioner
of agriculture to verify licensing, inspection, and compliance information related to hemp
growers new text begin and hemp processors new text end under chapter 18K.
Sec. 86.
Minnesota Statutes 2020, section 152.32, subdivision 3, is amended to read:
Subd. 3.
Discrimination prohibited.
(a) No school or landlord may refuse to enroll or
lease to and may not otherwise penalize a person solely for the person's status as a patient
enrolled in the registry program under sections 152.22 to 152.37, unless failing to do so
would violate federal law or regulations or cause the school or landlord to lose a monetary
or licensing-related benefit under federal law or regulations.
(b) For the purposes of medical care, including organ transplants, a registry program
enrollee's use of medical cannabis under sections 152.22 to 152.37 is considered the
equivalent of the authorized use of any other medication used at the discretion of a physician
or advanced practice registered nurse and does not constitute the use of an illicit substance
or otherwise disqualify a patient from needed medical care.
(c) Unless a failure to do so would violate federal law or regulations or cause an employer
to lose a monetary or licensing-related benefit under federal law or regulations, an employer
may not discriminate against a person in hiring, termination, or any term or condition of
employment, or otherwise penalize a person, if the discrimination is based upon either of
the following:
(1) the person's status as a patient enrolled in the registry program under sections 152.22
to 152.37; or
(2) a patient's positive drug test for cannabis components or metabolites, unless the
patient used, possessed, or was impaired by medical cannabis on the premises of the place
of employment or during the hours of employment.
(d) An employee who is required to undergo employer drug testing pursuant to section
181.953 may present verification of enrollment in the patient registry as part of the employee's
explanation under section 181.953, subdivision 6.
(e) A person shall not be denied custody of a minor child or visitation rights or parenting
time with a minor child solely based on the person's status as a patient enrolled in the registry
program under sections 152.22 to 152.37. There shall be no presumption of neglect or child
endangerment for conduct allowed under sections 152.22 to 152.37, unless the person's
behavior is such that it creates an unreasonable danger to the safety of the minor as
established by clear and convincing evidence.
new text begin
(f) This subdivision applies to any person enrolled in a Tribal medical cannabis program
to the same extent as if the person was enrolled in the registry program under sections 152.22
to 152.37.
new text end
Sec. 87.
Minnesota Statutes 2020, section 171.07, is amended by adding a subdivision to
read:
new text begin Subd. 3b. new text end
new text begin Identification card for homeless youth. new text end
new text begin
(a) A homeless youth, as defined in
section 256K.45, subdivision 1a, who meets the requirements of this subdivision may obtain
a noncompliant identification card, notwithstanding section 171.06, subdivision 3.
new text end
new text begin
(b) An applicant under this subdivision must:
new text end
new text begin
(1) provide the applicant's full name, date of birth, and sex;
new text end
new text begin
(2) provide the applicant's height in feet and inches, weight in pounds, and eye color;
new text end
new text begin
(3) submit a certified copy of a birth certificate issued by a government bureau of vital
statistics or equivalent agency in the applicant's state of birth, which must bear the raised
or authorized seal of the issuing government entity; and
new text end
new text begin
(4) submit a statement verifying that the applicant is a homeless youth who resides in
Minnesota that is signed by:
new text end
new text begin
(i) an employee of a human services agency receiving public funding to provide services
to homeless youth, runaway youth, youth with mental illness, or youth with substance use
disorders; or
new text end
new text begin
(ii) staff at a school who provide services to homeless youth or a school social worker.
new text end
new text begin
(c) For a noncompliant identification card under this subdivision:
new text end
new text begin
(1) the commissioner must not impose a fee, surcharge, or filing fee under section 171.06,
subdivision 2; and
new text end
new text begin
(2) a driver's license agent must not impose a filing fee under section 171.061, subdivision
4.
new text end
new text begin
(d) Minnesota Rules, parts 7410.0400 and 7410.0410, or successor rules, do not apply
for an identification card under this subdivision.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment for
application and issuance of Minnesota identification cards on and after January 1, 2022.
new text end
Sec. 88.
Minnesota Statutes 2020, section 256.98, subdivision 1, is amended to read:
Subdivision 1.
Wrongfully obtaining assistance.
new text begin (a) new text end A person who commits any of the
following acts or omissions with intent to defeat the purposes of sections 145.891 to 145.897,
the MFIP program formerly codified in sections 256.031 to 256.0361, the AFDC program
formerly codified in sections 256.72 to 256.871, chapter 256B, 256D, 256I, 256J, 256K, or
256L, child care assistance programs, and emergency assistance programs under section
256D.06, is guilty of theft and shall be sentenced under section 609.52, subdivision 3, clauses
(1) to (5):
(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a
willfully false statement or representation, by intentional concealment of any material fact,
or by impersonation or other fraudulent device, assistance or the continued receipt of
assistance, to include child care assistance or deleted text begin vouchersdeleted text end new text begin food benefitsnew text end produced according
to sections 145.891 to 145.897 and MinnesotaCare services according to sections 256.9365,
256.94, and 256L.01 to 256L.15, to which the person is not entitled or assistance greater
than that to which the person is entitled;
(2) knowingly aids or abets in buying or in any way disposing of the property of a
recipient or applicant of assistance without the consent of the county agency; or
(3) obtains or attempts to obtain, alone or in collusion with others, the receipt of payments
to which the individual is not entitled as a provider of subsidized child care, or by furnishing
or concurring in a willfully false claim for child care assistance.
new text begin (b) new text end The continued receipt of assistance to which the person is not entitled or greater than
that to which the person is entitled as a result of any of the acts, failure to act, or concealment
described in this subdivision shall be deemed to be continuing offenses from the date that
the first act or failure to act occurred.
Sec. 89.
Minnesota Statutes 2020, section 256B.0625, subdivision 52, is amended to read:
Subd. 52.
Lead risk assessments.
(a) Effective October 1, 2007, or six months after
federal approval, whichever is later, medical assistance covers lead risk assessments provided
by a lead risk assessor who is licensed by the commissioner of health under section 144.9505
and employed by an assessing agency as defined in section 144.9501. Medical assistance
covers a onetime on-site investigation of a recipient's home or primary residence to determine
the existence of lead so long as the recipient is under the age of 21 and has a venous blood
lead level specified in section 144.9504, subdivision 2, paragraph deleted text begin (a)deleted text end new text begin (b)new text end .
(b) Medical assistance reimbursement covers the lead risk assessor's time to complete
the following activities:
(1) gathering samples;
(2) interviewing family members;
(3) gathering data, including meter readings; and
(4) providing a report with the results of the investigation and options for reducing
lead-based paint hazards.
Medical assistance coverage of lead risk assessment does not include testing of
environmental substances such as water, paint, or soil or any other laboratory services.
Medical assistance coverage of lead risk assessments is not included in the capitated services
for children enrolled in health plans through the prepaid medical assistance program and
the MinnesotaCare program.
(c) Payment for lead risk assessment must be cost-based and must meet the criteria for
federal financial participation under the Medicaid program. The rate must be based on
allowable expenditures from cost information gathered. Under section 144.9507, subdivision
5, federal medical assistance funds may not replace existing funding for lead-related activities.
The nonfederal share of costs for services provided under this subdivision must be from
state or local funds and is the responsibility of the agency providing the risk assessment.
When the risk assessment is conducted by the commissioner of health, the state share must
be from appropriations to the commissioner of health for this purpose. Eligible expenditures
for the nonfederal share of costs may not be made from federal funds or funds used to match
other federal funds. Any federal disallowances are the responsibility of the agency providing
risk assessment services.
Sec. 90.
Minnesota Statutes 2020, section 326.71, subdivision 4, is amended to read:
Subd. 4.
Asbestos-related work.
"Asbestos-related work" means the enclosure, removal,
or encapsulation of asbestos-containing material in a quantity that meets or exceeds 260
linear feet of friable asbestos-containing material on pipes, 160 square feet of friable
asbestos-containing material on other facility components, or, if linear feet or square feet
cannot be measured, a total of 35 cubic feet of friable asbestos-containing material on or
off all facility components in one facility. In the case of single or multifamily residences,
"asbestos-related work" also means the enclosure, removal, or encapsulation of greater than
ten but less than 260 linear feet of friable asbestos-containing material on pipes, greater
than six but less than 160 square feet of friable asbestos-containing material on other facility
components, or, if linear feet or square feet cannot be measured, greater than one cubic foot
but less than 35 cubic feet of friable asbestos-containing material on or off all facility
components in one facility. deleted text begin This provision excludes asbestos-containing floor tiles and
sheeting, roofing materials, siding, and all ceilings with asbestos-containing material in
single family residences and buildings with no more than four dwelling units.deleted text end
Asbestos-related work includes asbestos abatement area preparation; enclosure, removal,
or encapsulation operations; and an air quality monitoring specified in rule to assure that
the abatement and adjacent areas are not contaminated with asbestos fibers during the project
and after completion.
For purposes of this subdivision, the quantity of deleted text begin asbestos containingdeleted text end new text begin asbestos-containingnew text end
material applies separately for every project.
Sec. 91.
Minnesota Statutes 2020, section 326.75, subdivision 1, is amended to read:
Subdivision 1.
Licensing fee.
A person required to be licensed under section 326.72
shall, before receipt of the license and before causing asbestos-related work to be performed,
pay the commissioner an annual license fee of deleted text begin $100deleted text end new text begin $105new text end .
Sec. 92.
Minnesota Statutes 2020, section 326.75, subdivision 2, is amended to read:
Subd. 2.
Certification fee.
An individual required to be certified new text begin as an asbestos worker
or asbestos site supervisor new text end under section 326.73, subdivision 1, shall pay the commissioner
a certification fee of deleted text begin $50deleted text end new text begin $52.50new text end before the issuance of the certificate. deleted text begin The commissioner
may establish by rule fees required before the issuance ofdeleted text end new text begin An individual required to be
certified as annew text end asbestos inspector, asbestos management planner, and asbestos project
designer deleted text begin certificates requireddeleted text end under section 326.73, subdivisions 2, 3, and 4new text begin , shall pay the
commissioner a certification fee of $105 before the issuance of the certificatenew text end .
Sec. 93.
Minnesota Statutes 2020, section 326.75, subdivision 3, is amended to read:
Subd. 3.
Permit fee.
Five calendar days before beginning asbestos-related work, a person
shall pay a project permit fee to the commissioner equal to deleted text begin onedeleted text end new text begin twonew text end percent of the total costs
of the asbestos-related work. For asbestos-related work performed in single or multifamily
residences, of greater than ten but less than 260 linear feet of asbestos-containing material
on pipes, or greater than six but less than 160 square feet of asbestos-containing material
on other facility components, a person shall pay a project permit fee of $35 to the
commissioner.
Sec. 94.
Laws 2020, Seventh Special Session chapter 1, article 6, section 12, subdivision
4, is amended to read:
Subd. 4.
Housing with services establishment registration; conversion to an assisted
living facility license.
(a) Housing with services establishments registered under chapter
144D, providing home care services according to chapter 144A to at least one resident, and
intending to provide assisted living services on or after August 1, 2021, must submit an
application for an assisted living facility license in accordance with section 144G.12 no
later than June 1, 2021. The commissioner shall consider the application in accordance with
section deleted text begin 144G.16deleted text end new text begin 144G.15new text end .
(b) Notwithstanding the housing with services contract requirements identified in section
144D.04, any existing housing with services establishment registered under chapter 144D
that does not intend to convert its registration to an assisted living facility license under this
chapter must provide written notice to its residents at least 60 days before the expiration of
its registration, or no later than May 31, 2021, whichever is earlier. The notice must:
(1) state that the housing with services establishment does not intend to convert to an
assisted living facility;
(2) include the date when the housing with services establishment will no longer provide
housing with services;
(3) include the name, e-mail address, and phone number of the individual associated
with the housing with services establishment that the recipient of home care services may
contact to discuss the notice;
(4) include the contact information consisting of the phone number, e-mail address,
mailing address, and website for the Office of Ombudsman for Long-Term Care and the
Office of Ombudsman for Mental Health and Developmental Disabilities; and
(5) for residents who receive home and community-based waiver services under section
256B.49 and chapter 256S, also be provided to the resident's case manager at the same time
that it is provided to the resident.
(c) A housing with services registrant that obtains an assisted living facility license, but
does so under a different business name as a result of reincorporation, and continues to
provide services to the recipient, is not subject to the 60-day notice required under paragraph
(b). However, the provider must otherwise provide notice to the recipient as required under
sections 144D.04 and 144D.045, as applicable, and section 144D.09.
(d) All registered housing with services establishments providing assisted living under
sections 144G.01 to 144G.07 prior to August 1, 2021, must have an assisted living facility
license under this chapter.
(e) Effective August 1, 2021, any housing with services establishment registered under
chapter 144D that has not converted its registration to an assisted living facility license
under this chapter is prohibited from providing assisted living services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective retroactively from December 17, 2020.
new text end
Sec. 95. new text begin ADDITIONAL MEMBER TO COVID-19 VACCINE ALLOCATION
ADVISORY GROUP.
new text end
new text begin
The commissioner of health shall appoint an individual who is an expert on vaccine
disinformation to the state COVID-19 Vaccine Allocation Advisory Group no later than
.......
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. 96. new text begin FEDERAL SCHEDULE I EXEMPTION APPLICATION FOR MEDICAL
USE OF CANNABIS.
new text end
new text begin
By September 1, 2021, the commissioner of health shall apply to the Drug Enforcement
Administration's Office of Diversion Control for an exception under Code of Federal
Regulations, title 21, section 1307.03, and request formal written acknowledgment that the
listing of marijuana, marijuana extract, and tetrahydrocannabinols as controlled substances
in federal Schedule I does not apply to the protected activities in Minnesota Statutes, section
152.32, subdivision 2, pursuant to the medical cannabis program established under Minnesota
Statutes, sections 152.22 to 152.37. The application shall include the list of presumptions
in Minnesota Statutes, section 152.32, subdivision 1.
new text end
Sec. 97. new text begin RECOMMENDATIONS; EXPANDED ACCESS TO DATA FROM
ALL-PAYER CLAIMS DATABASE.
new text end
new text begin
The commissioner of health shall develop recommendations to expand access to data
in the all-payer claims database under Minnesota Statutes, section 62U.04, to additional
outside entities for public health or research purposes. In the recommendations, the
commissioner must address an application process for outside entities to access the data,
how the department will exercise ongoing oversight over data use by outside entities,
purposes for which the data may be used by outside entities, establishment of a data access
committee to advise the department on selecting outside entities that may access the data,
and steps outside entities must take to protect data held by those entities from unauthorized
use. Following development of these recommendations, an outside entity that accesses data
in compliance with these recommendations may publish results that identify hospitals,
clinics, and medical practices so long as no individual health professionals are identified
and the commissioner finds the data to be accurate, valid, and suitable for publication for
such use. The commissioner shall submit these recommendations by December 15, 2021,
to the chairs and ranking minority members of the legislative committees with jurisdiction
over health policy and civil law.
new text end
Sec. 98. new text begin SKIN LIGHTENING PRODUCTS PUBLIC AWARENESS AND
EDUCATION GRANT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment; purpose. new text end
new text begin
The commissioner of health shall develop a
grant program for the purpose of increasing public awareness and education on the health
dangers associated with using skin lightening creams and products that contain mercury
that are manufactured in other countries and brought into this country and sold illegally
online or in stores.
new text end
new text begin Subd. 2. new text end
new text begin Grants authorized. new text end
new text begin
The commissioner shall award grants through a request
for proposal process to community-based, nonprofit organizations that serve ethnic
communities and that focus on public health outreach to Black, Indigenous, and people of
color communities on the issue of skin lightening products and chemical exposure from
these products. Priority in awarding grants shall be given to organizations that have
historically provided services to ethnic communities on the skin lightening and chemical
exposure issue for the past three years.
new text end
new text begin Subd. 3. new text end
new text begin Grant allocation. new text end
new text begin
(a) Grantees must use the funds to conduct public awareness
and education activities that are culturally specific and community-based and focus on:
new text end
new text begin
(1) the dangers of exposure to mercury through dermal absorption, inhalation,
hand-to-mouth contact, and through contact with individuals who have used these skin
lightening products;
new text end
new text begin
(2) the signs and symptoms of mercury poisoning;
new text end
new text begin
(3) the health effects of mercury poisoning, including the permanent effects on the central
nervous system and kidneys;
new text end
new text begin
(4) the dangers of using these products or being exposed to these products during
pregnancy and breastfeeding to the mother and to the infant;
new text end
new text begin
(5) knowing how to identify products that contain mercury; and
new text end
new text begin
(6) proper disposal of the product if the product contains mercury.
new text end
new text begin
(b) The grant application must include:
new text end
new text begin
(1) a description of the purpose or project for which the grant funds will be used;
new text end
new text begin
(2) a description of the objectives, a work plan, and a timeline for implementation; and
new text end
new text begin
(3) the community or group the grant proposes to focus on.
new text end
Sec. 99. new text begin TRAUMA-INFORMED GUN VIOLENCE REDUCTION; PILOT
PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Pilot program. new text end
new text begin
(a) The commissioner of health shall establish a pilot
program to aid in the reduction of trauma resulting from gun violence and address the root
causes of gun violence by making the following resources available to professionals and
organizations in health care, public health, mental health, social service, law enforcement,
and victim advocacy and other professionals who are most likely to encounter individuals
who have been victims, witnesses, or perpetrators of gun violence occurring in a community,
or in a domestic or other setting:
new text end
new text begin
(1) training on recognizing trauma as both a result and a cause of gun violence;
new text end
new text begin
(2) developing skills to address the effects of trauma on individuals and family members;
new text end
new text begin
(3) investments in community-based organizations to enable high-quality, targeted
services to individuals in need. This may include resources for additional training, hiring
of specialized staff needed to address trauma-related issues, management information
systems to facilitate data collection, and expansion of existing programming;
new text end
new text begin
(4) replication and expansion of effective community-based gun violence prevention
initiatives, such as Project Life, the Minneapolis Group Violence Intervention initiative, to
connect at-risk individuals to mental health services, job readiness programs, and employment
opportunities; and
new text end
new text begin
(5) education campaigns and outreach materials to educate communities, organizations,
and the public about the relationship between trauma and gun violence.
new text end
new text begin
(b) The pilot program shall address the traumatic effects of gun violence exposure using
a holistic treatment modality.
new text end
new text begin Subd. 2. new text end
new text begin Program guidelines and protocols. new text end
new text begin
(a) The commissioner, with advice from
an advisory panel knowledgeable about gun violence and its traumatic impact, shall develop
protocols and program guidelines that address resources and training to be used by
professionals who encounter individuals who have perpetrated or been impacted by gun
violence. Educational, training, and outreach material must be culturally appropriate for the
community and provided in multiple languages for those with limited English language
proficiency. The materials developed must address necessary responses by local, state, and
other governmental entities tasked with addressing gun violence. The protocols must include
a method of informing affected communities and local governments representing those
communities on effective strategies to target community, domestic, and other forms of gun
violence.
new text end
new text begin
(b) The commissioner may enter into contractual agreements with community-based
organizations or experts in the field to perform any of the activities under this section.
new text end
new text begin Subd. 3. new text end
new text begin Report. new text end
new text begin
By November 15, 2021, the commissioner shall submit a report on the
progress of the pilot program to the chairs and ranking minority members of the committees
with jurisdiction over health and public safety.
new text end
Sec. 100. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall amend the section headnote for Minnesota Statutes, section
62J.63, to read "HEALTH CARE PURCHASING AND PERFORMANCE
MEASUREMENT."
new text end
Sec. 101. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2020, sections 62J.63, subdivision 3; 144.0721, subdivision 1;
144.0722; 144.0724, subdivision 10; and 144.693,
new text end
new text begin
are repealed.
new text end
ARTICLE 4
HEALTH-RELATED LICENSING BOARDS
Section 1.
Minnesota Statutes 2020, section 156.12, subdivision 2, is amended to read:
Subd. 2.
Authorized activities.
No provision of this chapter shall be construed to prohibit:
(a) a person from rendering necessary gratuitous assistance in the treatment of any animal
when the assistance does not amount to prescribing, testing for, or diagnosing, operating,
or vaccinating and when the attendance of a licensed veterinarian cannot be procured;
(b) a person who is a regular student in an accredited or approved college of veterinary
medicine from performing duties or actions assigned by instructors or preceptors or working
under the direct supervision of a licensed veterinarian;
(c) a veterinarian regularly licensed in another jurisdiction from consulting with a licensed
veterinarian in this state;
(d) the owner of an animal and the owner's regular employee from caring for and
administering to the animal belonging to the owner, except where the ownership of the
animal was transferred for purposes of circumventing this chapter;
(e) veterinarians who are in compliance with subdivision 6 and who are employed by
the University of Minnesota from performing their duties with the College of Veterinary
Medicine, College of Agriculture, Agricultural Experiment Station, Agricultural Extension
Service, Medical School, School of Public Health, or other unit within the university; or a
person from lecturing or giving instructions or demonstrations at the university or in
connection with a continuing education course or seminar to veterinarians or pathologists
at the University of Minnesota Veterinary Diagnostic Laboratory;
(f) any person from selling or applying any pesticide, insecticide or herbicide;
(g) any person from engaging in bona fide scientific research or investigations which
reasonably requires experimentation involving animals;
(h) any employee of a licensed veterinarian from performing duties other than diagnosis,
prescription or surgical correction under the direction and supervision of the veterinarian,
who shall be responsible for the performance of the employee;
(i) a graduate of a foreign college of veterinary medicine from working under the direct
personal instruction, control, or supervision of a veterinarian faculty member of the College
of Veterinary Medicine, University of Minnesota in order to complete the requirements
necessary to obtain an ECFVG or PAVE certificate;
(j) a licensed chiropractor registered under section 148.01, subdivision 1a, from practicing
animal chiropracticdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(k) a person certified by the Emergency Medical Services Regulatory Board under
chapter 144E from providing emergency medical care to a police dog wounded in the line
of duty.
new text end
ARTICLE 5
PRESCRIPTION DRUGS
Section 1.
new text begin
[62J.841] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
For purposes of sections 62J.841 to 62J.845, the following
definitions apply.
new text end
new text begin Subd. 2. new text end
new text begin Consumer Price Index. new text end
new text begin
"Consumer Price Index" means the Consumer Price
Index, Annual Average, for All Urban Consumers, CPI-U: U.S. City Average, All Items,
reported by the United States Department of Labor, Bureau of Labor Statistics, or its
successor or, if the index is discontinued, an equivalent index reported by a federal authority
or, if no such index is reported, "Consumer Price Index" means a comparable index chosen
by the Bureau of Labor Statistics.
new text end
new text begin Subd. 3. new text end
new text begin Generic or off-patent drug. new text end
new text begin
"Generic or off-patent drug" means any prescription
drug for which any exclusive marketing rights granted under the Federal Food, Drug, and
Cosmetic Act, section 351 of the federal Public Health Service Act, and federal patent law
have expired, including any drug-device combination product for the delivery of a generic
drug.
new text end
new text begin Subd. 4. new text end
new text begin Manufacturer. new text end
new text begin
"Manufacturer" has the meaning provided in section 151.01,
subdivision 14a.
new text end
new text begin Subd. 5. new text end
new text begin Prescription drug. new text end
new text begin
"Prescription drug" means a drug for human use subject
to United States Code, title 21, section 353(b)(1).
new text end
new text begin Subd. 6. new text end
new text begin Wholesale acquisition cost. new text end
new text begin
"Wholesale acquisition cost" has the meaning
provided in United States Code, title 42, section 1395w-3a.
new text end
new text begin Subd. 7. new text end
new text begin Wholesale distributor. new text end
new text begin
"Wholesale distributor" has the meaning provided in
section 151.441, subdivision 14.
new text end
Sec. 2.
new text begin
[62J.842] EXCESSIVE PRICE INCREASES PROHIBITED.
new text end
new text begin Subdivision 1. new text end
new text begin Prohibition. new text end
new text begin
No manufacturer shall impose, or cause to be imposed, an
excessive price increase, whether directly or through a wholesale distributor, pharmacy, or
similar intermediary, on the sale of any generic or off-patent drug sold, dispensed, or
delivered to any consumer in the state.
new text end
new text begin Subd. 2. new text end
new text begin Excessive price increase. new text end
new text begin
A price increase is excessive for purposes of this
section when:
new text end
new text begin
(1) the price increase, adjusted for inflation utilizing the Consumer Price Index, exceeds:
new text end
new text begin
(i) 15 percent of the wholesale acquisition cost over the immediately preceding calendar
year; or
new text end
new text begin
(ii) 40 percent of the wholesale acquisition cost over the immediately preceding three
calendar years; and
new text end
new text begin
(2) the price increase, adjusted for inflation utilizing the Consumer Price Index, exceeds
$30 for:
new text end
new text begin
(i) a 30-day supply of the drug; or
new text end
new text begin
(ii) a course of treatment lasting less than 30 days.
new text end
new text begin Subd. 3. new text end
new text begin Exemption. new text end
new text begin
It is not a violation of this section for a wholesale distributor or
pharmacy to increase the price of a generic or off-patent drug if the price increase is directly
attributable to additional costs for the drug imposed on the wholesale distributor or pharmacy
by the manufacturer of the drug.
new text end
Sec. 3.
new text begin
[62J.843] REGISTERED AGENT AND OFFICE WITHIN THE STATE.
new text end
new text begin
Any manufacturer that sells, distributes, delivers, or offers for sale any generic or
off-patent drug in the state is required to maintain a registered agent and office within the
state.
new text end
Sec. 4.
new text begin
[62J.844] ENFORCEMENT.
new text end
new text begin Subdivision 1. new text end
new text begin Notification. new text end
new text begin
The commissioner of management and budget and any
other state agency that provides or purchases a pharmacy benefit except the Department of
Human Services, and any entity under contract with a state agency to provide a pharmacy
benefit other than an entity under contract with the Department of Human Services, shall
notify the manufacturer of a generic or off-patent drug, the attorney general, and the Board
of Pharmacy of any price increase that is in violation of section 62J.842.
new text end
new text begin Subd. 2. new text end
new text begin
Submission of drug cost statement and other information by manufacturer;
investigation by attorney general.
new text end
new text begin
(a) Within 45 days of receiving a notice under subdivision
1, the manufacturer of the generic or off-patent drug shall submit a drug cost statement to
the attorney general. The statement must:
new text end
new text begin
(1) itemize the cost components related to production of the drug;
new text end
new text begin
(2) identify the circumstances and timing of any increase in materials or manufacturing
costs that caused any increase during the preceding calendar year, or preceding three calendar
years as applicable, in the price of the drug; and
new text end
new text begin
(3) provide any other information that the manufacturer believes to be relevant to a
determination of whether a violation of section 62J.842 has occurred.
new text end
new text begin
(b) The attorney general may investigate whether a violation of section 62J.842 has
occurred, is occurring, or is about to occur, in accordance with section 8.31, subdivision 2.
new text end
new text begin Subd. 3. new text end
new text begin Petition to court. new text end
new text begin
(a) On petition of the attorney general, a court may issue an
order:
new text end
new text begin
(1) compelling the manufacturer of a generic or off-patent drug to:
new text end
new text begin
(i) provide the drug cost statement required under subdivision 2, paragraph (a); and
new text end
new text begin
(ii) answer interrogatories, produce records or documents, or be examined under oath,
as required by the attorney general under subdivision 2, paragraph (b);
new text end
new text begin
(2) restraining or enjoining a violation of sections 62J.841 to 62J.845, including issuing
an order requiring that drug prices be restored to levels that comply with section 62J.842;
new text end
new text begin
(3) requiring the manufacturer to provide an accounting to the attorney general of all
revenues resulting from a violation of section 62J.842;
new text end
new text begin
(4) requiring the manufacturer to repay to all consumers, including any third-party payers,
any money acquired as a result of a price increase that violates section 62J.842;
new text end
new text begin
(5) notwithstanding section 16A.151, requiring that all revenues generated from a
violation of section 62J.842 be remitted to the state and deposited into a special fund, to be
used for initiatives to reduce the cost to consumers of acquiring prescription drugs, if a
manufacturer is unable to determine the individual transactions necessary to provide the
repayments described in clause (4);
new text end
new text begin
(6) imposing a civil penalty of up to $10,000 per day for each violation of section 62J.842;
new text end
new text begin
(7) providing for the attorney general's recovery of its costs and disbursements incurred
in bringing an action against a manufacturer found in violation of section 62J.842, including
the costs of investigation and reasonable attorney's fees; and
new text end
new text begin
(8) providing any other appropriate relief, including any other equitable relief as
determined by the court.
new text end
new text begin
(b) For purposes of paragraph (a), clause (6), every individual transaction in violation
of section 62J.842 shall be considered a separate violation.
new text end
new text begin Subd. 4. new text end
new text begin Private right of action. new text end
new text begin
Any action brought pursuant to section 8.31, subdivision
3a, by a person injured by a violation of this section is for the benefit of the public.
new text end
Sec. 5.
new text begin
[62J.845] PROHIBITION ON WITHDRAWAL OF GENERIC OR
OFF-PATENT DRUGS FOR SALE.
new text end
new text begin Subdivision 1. new text end
new text begin Prohibition. new text end
new text begin
A manufacturer of a generic or off-patent drug is prohibited
from withdrawing that drug from sale or distribution within this state for the purpose of
avoiding the prohibition on excessive price increases under section 62J.842.
new text end
new text begin Subd. 2. new text end
new text begin Notice to board and attorney general. new text end
new text begin
Any manufacturer that intends to
withdraw a generic or off-patent drug from sale or distribution within the state shall provide
a written notice of withdrawal to the Board of Pharmacy and the attorney general, at least
180 days prior to the withdrawal.
new text end
new text begin Subd. 3. new text end
new text begin Financial penalty. new text end
new text begin
The attorney general shall assess a penalty of $500,000 on
any manufacturer of a generic or off-patent drug that it determines has failed to comply
with the requirements of this section.
new text end
Sec. 6.
new text begin
[62J.846] SEVERABILITY.
new text end
new text begin
If any provision of sections 62J.841 to 62J.845 or the application thereof to any person
or circumstance is held invalid for any reason in a court of competent jurisdiction, the
invalidity does not affect other provisions or any other application of sections 62J.841 to
62J.845 that can be given effect without the invalid provision or application.
new text end
Sec. 7.
Minnesota Statutes 2020, section 62Q.81, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin Prescription drug benefits. new text end
new text begin
(a) A health plan company that offers individual
health plans must ensure that no fewer than 25 percent of the individual health plans the
company offers in each geographic area that the health plan company services at each level
of coverage described in subdivision 1, paragraph (b), clause (3), applies a predeductible,
flat-dollar amount co-payment structure to the entire drug benefit, including all tiers.
new text end
new text begin
(b) A health plan company that offers small group health plans must ensure that no fewer
than 25 percent of small group health plans the company offers in each geographic area that
the health plan company services at each level of coverage described in subdivision 1,
paragraph (b), clause (3), applies a predeductible, flat-dollar amount co-payment structure
to the entire drug benefit, including all tiers.
new text end
new text begin
(c) The highest allowable co-payment for the highest cost drug tier for health plans
offered pursuant to this subdivision must be no greater than 1/12 of the plan's out-of-pocket
maximum for an individual.
new text end
new text begin
(d) The flat-dollar amount co-payment tier structure for prescription drugs under this
subdivision must be graduated and proportionate.
new text end
new text begin
(e) All individual and small group health plans offered pursuant to this subdivision must
be:
new text end
new text begin
(1) clearly and appropriately named to aid the purchaser in the selection process;
new text end
new text begin
(2) marketed in the same manner as other health plans offered by the health plan company;
and
new text end
new text begin
(3) offered for purchase to any individual or small group.
new text end
new text begin
(f) This subdivision does not apply to catastrophic plans, grandfathered plans, large
group health plans, health savings accounts (HSAs), qualified high deductible health benefit
plans, limited health benefit plans, or short-term limited-duration health insurance policies.
new text end
new text begin
(g) Health plan companies must meet the requirements in this subdivision separately for
plans offered through MNsure under chapter 62V and plans offered outside of MNsure.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, and applies to individual
and small group health plans offered, issued, or renewed on or after that date.
new text end
Sec. 8.
new text begin
[62Q.83] PRESCRIPTION DRUG BENEFIT TRANSPARENCY AND
MANAGEMENT.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For the purposes of this section, the following terms have
the meanings given.
new text end
new text begin
(b) "Drug" has the meaning given in section 151.01, subdivision 5.
new text end
new text begin
(c) "Enrollee contract term" means the 12-month term during which benefits associated
with health plan company products are in effect. For managed care plans and county-based
purchasing plans under section 256B.69 and chapter 256L, enrollee contract term means a
single calendar quarter.
new text end
new text begin
(d) "Formulary" means a list of prescription drugs that have been developed by clinical
and pharmacy experts and represents the health plan company's medically appropriate and
cost-effective prescription drugs approved for use.
new text end
new text begin
(e) "Health plan company" has the meaning given in section 62Q.01, subdivision 4, and
includes an entity that performs pharmacy benefits management for the health plan company.
new text end
new text begin
(f) "Pharmacy benefits management" means the administration or management of
prescription drug benefits provided by the health plan company for the benefit of its enrollees
and may include but is not limited to procurement of prescription drugs, clinical formulary
development and management services, claims processing, and rebate contracting and
administration.
new text end
new text begin
(g) "Prescription" has the meaning given in section 151.01, subdivision 16a.
new text end
new text begin Subd. 2. new text end
new text begin Prescription drug benefit disclosure. new text end
new text begin
(a) A health plan company that provides
prescription drug benefit coverage and uses a formulary must make its formulary and related
benefit information available by electronic means and, upon request, in writing at least 30
days prior to annual renewal dates.
new text end
new text begin
(b) Formularies must be organized and disclosed consistent with the most recent version
of the United States Pharmacopeia's Model Guidelines.
new text end
new text begin
(c) For each item or category of items on the formulary, the specific enrollee benefit
terms must be identified, including enrollee cost-sharing and expected out-of-pocket costs.
new text end
new text begin Subd. 3. new text end
new text begin Formulary changes. new text end
new text begin
(a) Once a formulary has been established, a health plan
company may, at any time during the enrollee's contract term:
new text end
new text begin
(1) expand its formulary by adding drugs to the formulary;
new text end
new text begin
(2) reduce co-payments or coinsurance; or
new text end
new text begin
(3) move a drug to a benefit category that reduces an enrollee's cost.
new text end
new text begin
(b) A health plan company may remove a brand name drug from its formulary or place
a brand name drug in a benefit category that increases an enrollee's cost only upon the
addition to the formulary of a generic or multisource brand name drug rated as therapeutically
equivalent according to the Food and Drug Administration (FDA) Orange Book or a biologic
drug rated as interchangeable according to the FDA Purple Book at a lower cost to the
enrollee and upon at least a 60-day notice to prescribers, pharmacists, and affected enrollees.
new text end
new text begin
(c) A health plan company may change utilization review requirements or move drugs
to a benefit category that increases an enrollee's cost during the enrollee's contract term
upon at least a 60-day notice to prescribers, pharmacists, and affected enrollees, provided
that these changes do not apply to enrollees who are currently taking the drugs affected by
these changes for the duration of the enrollee's contract term.
new text end
new text begin
(d) A health plan company may remove any drugs from its formulary that have been
deemed unsafe by the FDA; that have been withdrawn by either the FDA or the product
manufacturer; or when an independent source of research, clinical guidelines, or
evidence-based standards has issued drug-specific warnings or recommended changes in
drug usage.
new text end
Sec. 9.
new text begin
[62W.0751] ALTERNATIVE BIOLOGICAL PRODUCTS.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For the purposes of this section, the following definitions
have the meanings given.
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new text begin
(b) "Biological product" has the meaning given in section 151.01, subdivision 40.
new text end
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(c) "Biosimilar" or "biosimilar product" has the meaning given in section 151.01,
subdivision 43.
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new text begin
(d) "Interchangeable biological product" has the meaning given in section 151.01,
subdivision 41.
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new text begin
(e) "Reference biological product" has the meaning given in section 151.01, subdivision
44.
new text end
new text begin Subd. 2. new text end
new text begin
Pharmacy and provider choice related to dispensing reference biological
products, interchangeable biological products, or biosimilar products.
new text end
new text begin
(a) A pharmacy
benefit manager or health carrier must not require or demonstrate a preference for a pharmacy
or health care provider to prescribe or dispense a single biological product for which there
is a United States Food and Drug Administration-approved biosimilar or interchangeable
biological product relative to a reference biological product, except as provided in paragraph
(b).
new text end
new text begin
(b) If a pharmacy benefit manager or health carrier elects coverage of a product listed
in paragraph (a), it must also elect equivalent coverage for at least three reference, biosimilar,
or interchangeable biological products, or the total number of products that have been
approved by the United States Food and Drug Administration relative to the reference
product if less than three, for which the wholesale acquisition cost is less than the wholesale
acquisition cost of the product listed in paragraph (a).
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new text begin
(c) A pharmacy benefit manager or health carrier must not impose limits on access to a
product required to be covered under paragraph (b) that are more restrictive than limits
imposed on access to a product listed in paragraph (a), or that otherwise have the same
effect as giving preferred status to a product listed in paragraph (a) over the product required
to be covered under paragraph (b).
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new text begin
(d) This section does not apply to coverage provided through a public health care program
under chapter 256B or 256L, or health plan coverage through the State Employee Group
Insurance Plan (SEGIP) under chapter 43A.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
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Sec. 10.
Minnesota Statutes 2020, section 62W.11, is amended to read:
62W.11 GAG CLAUSE PROHIBITION.
(a) No contract between a pharmacy benefit manager or health carrier and a pharmacy
or pharmacist shall prohibit, restrict, or penalize a pharmacy or pharmacist from disclosing
to an enrollee any health care information that the pharmacy or pharmacist deems appropriate
regarding the nature of treatment; the risks or alternatives; the availability of alternative
therapies, consultations, or tests; the decision of utilization reviewers or similar persons to
authorize or deny services; the process that is used to authorize or deny health care services
or benefits; or information on financial incentives and structures used by the health carrier
or pharmacy benefit manager.
(b) A pharmacy or pharmacist must provide to an enrollee information regarding the
enrollee's total cost for each prescription drug dispensed where part or all of the cost of the
prescription is being paid or reimbursed by the employer-sponsored plan or by a health
carrier or pharmacy benefit manager, in accordance with section 151.214, subdivision 1.
(c) A pharmacy benefit manager or health carrier must not prohibit a pharmacist or
pharmacy from discussing information regarding the total cost for pharmacy services for a
prescription drug, including the patient's co-payment amount deleted text begin anddeleted text end new text begin ,new text end the pharmacy's own usual
and customary price deleted text begin ofdeleted text end new text begin fornew text end the prescriptionnew text begin drug, the pharmacy's acquisition cost for the
prescription drug, and the amount the pharmacy is being reimbursed by the pharmacy benefit
manager or health carrier for the prescription drugnew text end .
new text begin
(d) A pharmacy benefit manager must not prohibit a pharmacist or pharmacy from
discussing with a health carrier the amount the pharmacy is being paid or reimbursed for a
prescription drug by the pharmacy benefit manager or the pharmacy's acquisition cost for
a prescription drug.
new text end
deleted text begin (d)deleted text end new text begin (e)new text end A pharmacy benefit manager or health carrier must not prohibit a pharmacist or
pharmacy from discussing the availability of any therapeutically equivalent alternative
prescription drugs or alternative methods for purchasing the prescription drug, including
but not limited to paying out-of-pocket the pharmacy's usual and customary price when that
amount is less expensive to the enrollee than the amount the enrollee is required to pay for
the prescription drug under the enrollee's health plan.
Sec. 11.
Minnesota Statutes 2020, section 62W.12, is amended to read:
62W.12 POINT OF SALE.
new text begin (a) new text end No pharmacy benefit manager or health carrier shall require an enrollee to make a
payment at the point of sale for a covered prescription drug in an amount greater than the
lesser of:
(1) the applicable co-payment for the prescription drug;
(2) the allowable claim amount for the prescription drug; deleted text begin or
deleted text end
(3) the amount an enrollee would pay for the prescription drug if the enrollee purchased
the prescription drug without using a health plan or any other source of prescription drug
benefits or discountsdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(4) the net price of the prescription drug plus the dispensing fee.
new text end
new text begin
(b) For purposes of this section, "net price" means the pharmacy benefit manager's or
health carrier's cost for a prescription drug after applying any rebates or discounts received
by or accrued directly or indirectly to the pharmacy benefit manager or health carrier from
a drug manufacturer.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for health plans offered, issued, or
renewed on or after January 1, 2022.
new text end
Sec. 12.
Minnesota Statutes 2020, section 151.01, is amended by adding a subdivision to
read:
new text begin Subd. 43. new text end
new text begin Biosimilar product. new text end
new text begin
"Biosimilar" or "interchangeable biological product"
means a biological product that the United States Food and Drug Administration has licensed,
and determined to be "biosimilar" under United States Code, title 42, section 262(i)(2).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 13.
Minnesota Statutes 2020, section 151.01, is amended by adding a subdivision to
read:
new text begin Subd. 44. new text end
new text begin Reference biological product. new text end
new text begin
"Reference biological product" means the
single biological product for which the United States Food and Drug Administration has
approved an initial biological product license application, against which other biological
products are evaluated for licensure as biosimilar products or interchangeable biological
products.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 14.
Minnesota Statutes 2020, section 151.071, subdivision 1, is amended to read:
Subdivision 1.
Forms of disciplinary action.
When the board finds that a licensee,
registrant, or applicant has engaged in conduct prohibited under subdivision 2, it may do
one or more of the following:
(1) deny the issuance of a license or registration;
(2) refuse to renew a license or registration;
(3) revoke the license or registration;
(4) suspend the license or registration;
(5) impose limitations, conditions, or both on the license or registration, including but
not limited to: the limitation of practice to designated settings; the limitation of the scope
of practice within designated settings; the imposition of retraining or rehabilitation
requirements; the requirement of practice under supervision; the requirement of participation
in a diversion program such as that established pursuant to section 214.31 or the conditioning
of continued practice on demonstration of knowledge or skills by appropriate examination
or other review of skill and competence;
(6) impose a civil penalty not exceeding $10,000 for each separate violation,new text begin except that
a civil penalty not exceeding $25,000 may be imposed for each separate violation of section
62J.842,new text end the amount of the civil penalty to be fixed so as to deprive a licensee or registrant
of any economic advantage gained by reason of the violation, to discourage similar violations
by the licensee or registrant or any other licensee or registrant, or to reimburse the board
for the cost of the investigation and proceeding, including but not limited to, fees paid for
services provided by the Office of Administrative Hearings, legal and investigative services
provided by the Office of the Attorney General, court reporters, witnesses, reproduction of
records, board members' per diem compensation, board staff time, and travel costs and
expenses incurred by board staff and board members; and
(7) reprimand the licensee or registrant.
Sec. 15.
Minnesota Statutes 2020, section 151.071, subdivision 2, is amended to read:
Subd. 2.
Grounds for disciplinary action.
The following conduct is prohibited and is
grounds for disciplinary action:
(1) failure to demonstrate the qualifications or satisfy the requirements for a license or
registration contained in this chapter or the rules of the board. The burden of proof is on
the applicant to demonstrate such qualifications or satisfaction of such requirements;
(2) obtaining a license by fraud or by misleading the board in any way during the
application process or obtaining a license by cheating, or attempting to subvert the licensing
examination process. Conduct that subverts or attempts to subvert the licensing examination
process includes, but is not limited to: (i) conduct that violates the security of the examination
materials, such as removing examination materials from the examination room or having
unauthorized possession of any portion of a future, current, or previously administered
licensing examination; (ii) conduct that violates the standard of test administration, such as
communicating with another examinee during administration of the examination, copying
another examinee's answers, permitting another examinee to copy one's answers, or
possessing unauthorized materials; or (iii) impersonating an examinee or permitting an
impersonator to take the examination on one's own behalf;
(3) for a pharmacist, pharmacy technician, pharmacist intern, applicant for a pharmacist
or pharmacy license, or applicant for a pharmacy technician or pharmacist intern registration,
conviction of a felony reasonably related to the practice of pharmacy. Conviction as used
in this subdivision includes a conviction of an offense that if committed in this state would
be deemed a felony without regard to its designation elsewhere, or a criminal proceeding
where a finding or verdict of guilt is made or returned but the adjudication of guilt is either
withheld or not entered thereon. The board may delay the issuance of a new license or
registration if the applicant has been charged with a felony until the matter has been
adjudicated;
(4) for a facility, other than a pharmacy, licensed or registered by the board, if an owner
or applicant is convicted of a felony reasonably related to the operation of the facility. The
board may delay the issuance of a new license or registration if the owner or applicant has
been charged with a felony until the matter has been adjudicated;
(5) for a controlled substance researcher, conviction of a felony reasonably related to
controlled substances or to the practice of the researcher's profession. The board may delay
the issuance of a registration if the applicant has been charged with a felony until the matter
has been adjudicated;
(6) disciplinary action taken by another state or by one of this state's health licensing
agencies:
(i) revocation, suspension, restriction, limitation, or other disciplinary action against a
license or registration in another state or jurisdiction, failure to report to the board that
charges or allegations regarding the person's license or registration have been brought in
another state or jurisdiction, or having been refused a license or registration by any other
state or jurisdiction. The board may delay the issuance of a new license or registration if an
investigation or disciplinary action is pending in another state or jurisdiction until the
investigation or action has been dismissed or otherwise resolved; and
(ii) revocation, suspension, restriction, limitation, or other disciplinary action against a
license or registration issued by another of this state's health licensing agencies, failure to
report to the board that charges regarding the person's license or registration have been
brought by another of this state's health licensing agencies, or having been refused a license
or registration by another of this state's health licensing agencies. The board may delay the
issuance of a new license or registration if a disciplinary action is pending before another
of this state's health licensing agencies until the action has been dismissed or otherwise
resolved;
(7) for a pharmacist, pharmacy, pharmacy technician, or pharmacist intern, violation of
any order of the board, of any of the provisions of this chapter or any rules of the board or
violation of any federal, state, or local law or rule reasonably pertaining to the practice of
pharmacy;
(8) for a facility, other than a pharmacy, licensed by the board, violations of any order
of the board, of any of the provisions of this chapter or the rules of the board or violation
of any federal, state, or local law relating to the operation of the facility;
(9) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the
public, or demonstrating a willful or careless disregard for the health, welfare, or safety of
a patient; or pharmacy practice that is professionally incompetent, in that it may create
unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of
actual injury need not be established;
(10) aiding or abetting an unlicensed person in the practice of pharmacy, except that it
is not a violation of this clause for a pharmacist to supervise a properly registered pharmacy
technician or pharmacist intern if that person is performing duties allowed by this chapter
or the rules of the board;
(11) for an individual licensed or registered by the board, adjudication as mentally ill
or developmentally disabled, or as a chemically dependent person, a person dangerous to
the public, a sexually dangerous person, or a person who has a sexual psychopathic
personality, by a court of competent jurisdiction, within or without this state. Such
adjudication shall automatically suspend a license for the duration thereof unless the board
orders otherwise;
(12) for a pharmacist or pharmacy intern, engaging in unprofessional conduct as specified
in the board's rules. In the case of a pharmacy technician, engaging in conduct specified in
board rules that would be unprofessional if it were engaged in by a pharmacist or pharmacist
intern or performing duties specifically reserved for pharmacists under this chapter or the
rules of the board;
(13) for a pharmacy, operation of the pharmacy without a pharmacist present and on
duty except as allowed by a variance approved by the board;
(14) for a pharmacist, the inability to practice pharmacy with reasonable skill and safety
to patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type
of material or as a result of any mental or physical condition, including deterioration through
the aging process or loss of motor skills. In the case of registered pharmacy technicians,
pharmacist interns, or controlled substance researchers, the inability to carry out duties
allowed under this chapter or the rules of the board with reasonable skill and safety to
patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type
of material or as a result of any mental or physical condition, including deterioration through
the aging process or loss of motor skills;
(15) for a pharmacist, pharmacy, pharmacist intern, pharmacy technician, medical gas
dispenser, or controlled substance researcher, revealing a privileged communication from
or relating to a patient except when otherwise required or permitted by law;
(16) for a pharmacist or pharmacy, improper management of patient records, including
failure to maintain adequate patient records, to comply with a patient's request made pursuant
to sections 144.291 to 144.298, or to furnish a patient record or report required by law;
(17) fee splitting, including without limitation:
(i) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate,
kickback, or other form of remuneration, directly or indirectly, for the referral of patients;
(ii) referring a patient to any health care provider as defined in sections 144.291 to
144.298 in which the licensee or registrant has a financial or economic interest as defined
in section 144.6521, subdivision 3, unless the licensee or registrant has disclosed the
licensee's or registrant's financial or economic interest in accordance with section 144.6521;
and
(iii) any arrangement through which a pharmacy, in which the prescribing practitioner
does not have a significant ownership interest, fills a prescription drug order and the
prescribing practitioner is involved in any manner, directly or indirectly, in setting the price
for the filled prescription that is charged to the patient, the patient's insurer or pharmacy
benefit manager, or other person paying for the prescription or, in the case of veterinary
patients, the price for the filled prescription that is charged to the client or other person
paying for the prescription, except that a veterinarian and a pharmacy may enter into such
an arrangement provided that the client or other person paying for the prescription is notified,
in writing and with each prescription dispensed, about the arrangement, unless such
arrangement involves pharmacy services provided for livestock, poultry, and agricultural
production systems, in which case client notification would not be required;
(18) engaging in abusive or fraudulent billing practices, including violations of the
federal Medicare and Medicaid laws or state medical assistance laws or rules;
(19) engaging in conduct with a patient that is sexual or may reasonably be interpreted
by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning
to a patient;
(20) failure to make reports as required by section 151.072 or to cooperate with an
investigation of the board as required by section 151.074;
(21) knowingly providing false or misleading information that is directly related to the
care of a patient unless done for an accepted therapeutic purpose such as the dispensing and
administration of a placebo;
(22) aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:
(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation
of section 609.215, subdivision 1 or 2;
(ii) a copy of the record of a judgment of contempt of court for violating an injunction
issued under section 609.215, subdivision 4;
(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5; or
(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.
The board must investigate any complaint of a violation of section 609.215, subdivision 1
or 2;
(23) for a pharmacist, practice of pharmacy under a lapsed or nonrenewed license. For
a pharmacist intern, pharmacy technician, or controlled substance researcher, performing
duties permitted to such individuals by this chapter or the rules of the board under a lapsed
or nonrenewed registration. For a facility required to be licensed under this chapter, operation
of the facility under a lapsed or nonrenewed license or registration; deleted text begin and
deleted text end
(24) for a pharmacist, pharmacist intern, or pharmacy technician, termination or discharge
from the health professionals services program for reasons other than the satisfactory
completion of the programdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(25) for a manufacturer, a violation of section 62J.842 or section 62J.845.
new text end
Sec. 16.
new text begin
[151.335] DELIVERY THROUGH COMMON CARRIER; COMPLIANCE
WITH TEMPERATURE REQUIREMENTS.
new text end
new text begin
In addition to complying with the requirements of Minnesota Rules, part 6800.3000, a
mail order or specialty pharmacy that employs the United States Postal Service or other
common carrier to deliver a filled prescription directly to a patient must ensure that the drug
is delivered in compliance with temperature requirements established by the manufacturer
of the drug. The pharmacy must develop written policies and procedures that are consistent
with United States Pharmacopeia, chapters 1079 and 1118, and with nationally recognized
standards issued by standard-setting or accreditation organizations recognized by the board
through guidance. The policies and procedures must be provided to the board upon request.
new text end
Sec. 17.
Minnesota Statutes 2020, section 151.555, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.
(b) "Central repository" means a wholesale distributor that meets the requirements under
subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this
section.
(c) "Distribute" means to deliver, other than by administering or dispensing.
(d) "Donor" means:
(1) a health care facility as defined in this subdivision;
(2) a skilled nursing facility licensed under chapter 144A;
(3) an assisted living facility registered under chapter 144D where there is centralized
storage of drugs and 24-hour on-site licensed nursing coverage provided seven days a week;
(4) a pharmacy licensed under section 151.19, and located either in the state or outside
the state;
(5) a drug wholesaler licensed under section 151.47;
(6) a drug manufacturer licensed under section 151.252; or
(7) an individual at least 18 years of age, provided that the drug or medical supply that
is donated was obtained legally and meets the requirements of this section for donation.
(e) "Drug" means any prescription drug that has been approved for medical use in the
United States, is listed in the United States Pharmacopoeia or National Formulary, and
meets the criteria established under this section for donationnew text begin ; or any over-the-counter
medication that meets the criteria established under this section for donationnew text end . This definition
includes cancer drugs and antirejection drugs, but does not include controlled substances,
as defined in section 152.01, subdivision 4, or a prescription drug that can only be dispensed
to a patient registered with the drug's manufacturer in accordance with federal Food and
Drug Administration requirements.
(f) "Health care facility" means:
(1) a physician's office or health care clinic where licensed practitioners provide health
care to patients;
(2) a hospital licensed under section 144.50;
(3) a pharmacy licensed under section 151.19 and located in Minnesota; or
(4) a nonprofit community clinic, including a federally qualified health center; a rural
health clinic; public health clinic; or other community clinic that provides health care utilizing
a sliding fee scale to patients who are low-income, uninsured, or underinsured.
(g) "Local repository" means a health care facility that elects to accept donated drugs
and medical supplies and meets the requirements of subdivision 4.
(h) "Medical supplies" or "supplies" means any prescription and nonprescription medical
supplies needed to administer a prescription drug.
(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is
sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or
unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose
packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules,
part 6800.3750.
(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that
it does not include a veterinarian.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 18.
Minnesota Statutes 2020, section 151.555, subdivision 7, is amended to read:
Subd. 7.
Standards and procedures for inspecting and storing donated prescription
drugs and supplies.
(a) A pharmacist or authorized practitioner who is employed by or
under contract with the central repository or a local repository shall inspect all donated
prescription drugs and supplies before the drug or supply is dispensed to determine, to the
extent reasonably possible in the professional judgment of the pharmacist or practitioner,
that the drug or supply is not adulterated or misbranded, has not been tampered with, is safe
and suitable for dispensing, has not been subject to a recall, and meets the requirements for
donation. The pharmacist or practitioner who inspects the drugs or supplies shall sign an
inspection record stating that the requirements for donation have been met. If a local
repository receives drugs and supplies from the central repository, the local repository does
not need to reinspect the drugs and supplies.
(b) The central repository and local repositories shall store donated drugs and supplies
in a secure storage area under environmental conditions appropriate for the drug or supply
being stored. Donated drugs and supplies may not be stored with nondonated inventory. deleted text begin If
donated drugs or supplies are not inspected immediately upon receipt, a repository must
quarantine the donated drugs or supplies separately from all dispensing stock until the
donated drugs or supplies have been inspected and (1) approved for dispensing under the
program; (2) disposed of pursuant to paragraph (c); or (3) returned to the donor pursuant to
paragraph (d).
deleted text end
(c) The central repository and local repositories shall dispose of all prescription drugs
and medical supplies that are not suitable for donation in compliance with applicable federal
and state statutes, regulations, and rules concerning hazardous waste.
(d) In the event that controlled substances or prescription drugs that can only be dispensed
to a patient registered with the drug's manufacturer are shipped or delivered to a central or
local repository for donation, the shipment delivery must be documented by the repository
and returned immediately to the donor or the donor's representative that provided the drugs.
(e) Each repository must develop drug and medical supply recall policies and procedures.
If a repository receives a recall notification, the repository shall destroy all of the drug or
medical supply in its inventory that is the subject of the recall and complete a record of
destruction form in accordance with paragraph (f). If a drug or medical supply that is the
subject of a Class I or Class II recall has been dispensed, the repository shall immediately
notify the recipient of the recalled drug or medical supply. A drug that potentially is subject
to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug
is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.
(f) A record of destruction of donated drugs and supplies that are not dispensed under
subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation
shall be maintained by the repository for at least deleted text begin fivedeleted text end new text begin twonew text end years. For each drug or supply
destroyed, the record shall include the following information:
(1) the date of destruction;
(2) the name, strength, and quantity of the drug destroyed; and
(3) the name of the person or firm that destroyed the drug.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 19.
Minnesota Statutes 2020, section 151.555, subdivision 11, is amended to read:
Subd. 11.
Forms and record-keeping requirements.
(a) The following forms developed
for the administration of this program shall be utilized by the participants of the program
and shall be available on the board's website:
(1) intake application form described under subdivision 5;
(2) local repository participation form described under subdivision 4;
(3) local repository withdrawal form described under subdivision 4;
(4) drug repository donor form described under subdivision 6;
(5) record of destruction form described under subdivision 7; and
(6) drug repository recipient form described under subdivision 8.
(b) All records, including drug inventory, inspection, and disposal of donated prescription
drugs and medical supplies, must be maintained by a repository for a minimum of deleted text begin fivedeleted text end new text begin twonew text end
years. Records required as part of this program must be maintained pursuant to all applicable
practice acts.
(c) Data collected by the drug repository program from all local repositories shall be
submitted quarterly or upon request to the central repository. Data collected may consist of
the information, records, and forms required to be collected under this section.
(d) The central repository shall submit reports to the board as required by the contract
or upon request of the board.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 20.
Minnesota Statutes 2020, section 151.555, is amended by adding a subdivision
to read:
new text begin Subd. 14. new text end
new text begin Cooperation. new text end
new text begin
The central repository, as approved by the Board of Pharmacy,
may enter into an agreement with another state that has an established drug repository or
drug donation program if the other state's program includes regulations to ensure the purity,
integrity, and safety of the drugs and supplies donated, to permit the central repository to
offer to another state program inventory that is not needed by a Minnesota resident and to
accept inventory from another state program to be distributed to local repositories and
dispensed to Minnesota residents in accordance with this program.
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. 21.
Minnesota Statutes 2020, section 256B.69, subdivision 6, is amended to read:
Subd. 6.
Service delivery.
(a) Each demonstration provider shall be responsible for the
health care coordination for eligible individuals. Demonstration providers:
(1) shall authorize and arrange for the provision of all needed health services including
but not limited to the full range of services listed in sections 256B.02, subdivision 8, and
256B.0625 in order to ensure appropriate health care is delivered to enrollees.
Notwithstanding section 256B.0621, demonstration providers that provide nursing home
and community-based services under this section shall provide relocation service coordination
to enrolled persons age 65 and over;
(2) shall accept the prospective, per capita payment from the commissioner in return for
the provision of comprehensive and coordinated health care services for eligible individuals
enrolled in the program;
(3) may contract with other health care and social service practitioners to provide services
to enrollees; and
(4) shall institute recipient grievance procedures according to the method established
by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved
through this process shall be appealable to the commissioner as provided in subdivision 11.
(b) Demonstration providers must comply with the standards for claims settlement under
section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health care and
social service practitioners to provide services to enrollees. A demonstration provider must
pay a clean claim, as defined in Code of Federal Regulations, title 42, section 447.45(b),
within 30 business days of the date of acceptance of the claim.
new text begin
(c) Managed care plans and county-based purchasing plans must comply with section
62Q.83.
new text end
Sec. 22. new text begin STUDY OF PHARMACY AND PROVIDER CHOICE OF BIOLOGICAL
PRODUCTS.
new text end
new text begin
The commissioner of health, within the limits of existing resources, shall analyze the
effect of Minnesota Statutes, section 62W.0751, on the net price for different payors of
biological products, interchangeable biological products, and biosimilar products. The
commissioner of health shall report findings to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services policy and
finance, and insurance, by December 15, 2023.
new text end
Sec. 23. new text begin STUDY OF TEMPERATURE MONITORING.
new text end
new text begin
The Board of Pharmacy shall conduct a study to determine the appropriateness and
feasibility of requiring mail order and specialty pharmacies to enclose in each medication's
packaging a method by which the patient can easily detect improper storage or temperature
variations that may have occurred during the delivery of a medication. The board shall
report the results of the study by January 15, 2022, to the chairs and ranking minority
members of the legislative committees with jurisdiction over health finance and policy.
new text end
ARTICLE 6
HEALTH INSURANCE
Section 1.
Minnesota Statutes 2020, section 62A.04, subdivision 2, is amended to read:
Subd. 2.
Required provisions.
Except as provided in subdivision 4 each such policy
delivered or issued for delivery to any person in this state shall contain the provisions
specified in this subdivision in the words in which the same appear in this section. The
insurer may, at its option, substitute for one or more of such provisions corresponding
provisions of different wording approved by the commissioner which are in each instance
not less favorable in any respect to the insured or the beneficiary. Such provisions shall be
preceded individually by the caption appearing in this subdivision or, at the option of the
insurer, by such appropriate individual or group captions or subcaptions as the commissioner
may approve.
(1) A provision as follows:
ENTIRE CONTRACT; CHANGES: This policy, including the endorsements and the
attached papers, if any, constitutes the entire contract of insurance. No change in this policy
shall be valid until approved by an executive officer of the insurer and unless such approval
be endorsed hereon or attached hereto. No agent has authority to change this policy or to
waive any of its provisions.
(2) A provision as follows:
TIME LIMIT ON CERTAIN DEFENSES: (a) After two years from the date of issue of
this policy no misstatements, except fraudulent misstatements, made by the applicant in the
application for such policy shall be used to void the policy or to deny a claim for loss incurred
or disability (as defined in the policy) commencing after the expiration of such two year
period.
The foregoing policy provision shall not be so construed as to affect any legal requirement
for avoidance of a policy or denial of a claim during such initial two year period, nor to
limit the application of clauses (1), (2), (3), (4) and (5), in the event of misstatement with
respect to age or occupation or other insurance. A policy which the insured has the right to
continue in force subject to its terms by the timely payment of premium (1) until at least
age 50 or, (2) in the case of a policy issued after age 44, for at least five years from its date
of issue, may contain in lieu of the foregoing the following provisions (from which the
clause in parentheses may be omitted at the insurer's option) under the caption
"INCONTESTABLE":
After this policy has been in force for a period of two years during the lifetime of the
insured (excluding any period during which the insured is disabled), it shall become
incontestable as to the statements contained in the application.
(b) No claim for loss incurred or disability (as defined in the policy) commencing after
two years from the date of issue of this policy shall be reduced or denied on the ground that
a disease or physical condition not excluded from coverage by name or specific description
effective on the date of loss had existed prior to the effective date of coverage of this policy.
(3)(a) Except as required for qualified health plans sold through MNsure to individuals
receiving advance payments of the premium tax credit, a provision as follows:
GRACE PERIOD: A grace period of ..... (insert a number not less than "7" for weekly
premium policies, "10" for monthly premium policies and "31" for all other policies) days
will be granted for the payment of each premium falling due after the first premium, during
which grace period the policy shall continue in force.
A policy which contains a cancellation provision may add, at the end of the above
provision,
subject to the right of the insurer to cancel in accordance with the cancellation provision
hereof.
A policy in which the insurer reserves the right to refuse any renewal shall have, at the
beginning of the above provision,
Unless not less than five days prior to the premium due date the insurer has delivered
to the insured or has mailed to the insured's last address as shown by the records of the
insurer written notice of its intention not to renew this policy beyond the period for which
the premium has been accepted.
(b) For deleted text begin qualifieddeleted text end new text begin individual and small groupnew text end health plans deleted text begin sold through MNsure to
individuals receiving advance payments of the premium tax creditdeleted text end , a grace period provision
must be included that complies with deleted text begin the Affordable Care Act and is no less restrictive than
the grace period required by the Affordable Care Actdeleted text end new text begin section 62A.65, subdivision 2anew text end .
(4) A provision as follows:
REINSTATEMENT: If any renewal premium be not paid within the time granted the
insured for payment, a subsequent acceptance of premium by the insurer or by any agent
duly authorized by the insurer to accept such premium, without requiring in connection
therewith an application for reinstatement, shall reinstate the policy. If the insurer or such
agent requires an application for reinstatement and issues a conditional receipt for the
premium tendered, the policy will be reinstated upon approval of such application by the
insurer or, lacking such approval, upon the forty-fifth day following the date of such
conditional receipt unless the insurer has previously notified the insured in writing of its
disapproval of such application. For health plans described in section 62A.011, subdivision
3, clause (10), an insurer must accept payment of a renewal premium and reinstate the
policy, if the insured applies for reinstatement no later than 60 days after the due date for
the premium payment, unless:
(1) the insured has in the interim left the state or the insurer's service area; or
(2) the insured has applied for reinstatement on two or more prior occasions.
The reinstated policy shall cover only loss resulting from such accidental injury as may
be sustained after the date of reinstatement and loss due to such sickness as may begin more
than ten days after such date. In all other respects the insured and insurer shall have the
same rights thereunder as they had under the policy immediately before the due date of the
defaulted premium, subject to any provisions endorsed hereon or attached hereto in
connection with the reinstatement. Any premium accepted in connection with a reinstatement
shall be applied to a period for which premium has not been previously paid, but not to any
period more than 60 days prior to the date of reinstatement. The last sentence of the above
provision may be omitted from any policy which the insured has the right to continue in
force subject to its terms by the timely payment of premiums (1) until at least age 50, or,
(2) in the case of a policy issued after age 44, for at least five years from its date of issue.
(5) A provision as follows:
NOTICE OF CLAIM: Written notice of claim must be given to the insurer within 20
days after the occurrence or commencement of any loss covered by the policy, or as soon
thereafter as is reasonably possible. Notice given by or on behalf of the insured or the
beneficiary to the insurer at ..... (insert the location of such office as the insurer may designate
for the purpose), or to any authorized agent of the insurer, with information sufficient to
identify the insured, shall be deemed notice to the insurer.
In a policy providing a loss-of-time benefit which may be payable for at least two years,
an insurer may at its option insert the following between the first and second sentences of
the above provision:
Subject to the qualifications set forth below, if the insured suffers loss of time on account
of disability for which indemnity may be payable for at least two years, the insured shall,
at least once in every six months after having given notice of claim, give to the insurer
notice of continuance of said disability, except in the event of legal incapacity. The period
of six months following any filing of proof by the insured or any payment by the insurer
on account of such claim or any denial of liability in whole or in part by the insurer shall
be excluded in applying this provision. Delay in the giving of such notice shall not impair
the insured's right to any indemnity which would otherwise have accrued during the period
of six months preceding the date on which such notice is actually given.
(6) A provision as follows:
CLAIM FORMS: The insurer, upon receipt of a notice of claim, will furnish to the
claimant such forms as are usually furnished by it for filing proofs of loss. If such forms
are not furnished within 15 days after the giving of such notice the claimant shall be deemed
to have complied with the requirements of this policy as to proof of loss upon submitting,
within the time fixed in the policy for filing proofs of loss, written proof covering the
occurrence, the character and the extent of the loss for which claim is made.
(7) A provision as follows:
PROOFS OF LOSS: Written proof of loss must be furnished to the insurer at its said
office in case of claim for loss for which this policy provides any periodic payment contingent
upon continuing loss within 90 days after the termination of the period for which the insurer
is liable and in case of claim for any other loss within 90 days after the date of such loss.
Failure to furnish such proof within the time required shall not invalidate nor reduce any
claim if it was not reasonably possible to give proof within such time, provided such proof
is furnished as soon as reasonably possible and in no event, except in the absence of legal
capacity, later than one year from the time proof is otherwise required.
(8) A provision as follows:
TIME OF PAYMENT OF CLAIMS: Indemnities payable under this policy for any loss
other than loss for which this policy provides periodic payment will be paid immediately
upon receipt of due written proof of such loss. Subject to due written proof of loss, all
accrued indemnities for loss for which this policy provides periodic payment will be paid
..... (insert period for payment which must not be less frequently than monthly) and any
balance remaining unpaid upon the termination of liability will be paid immediately upon
receipt of due written proof.
(9) A provision as follows:
PAYMENT OF CLAIMS: Indemnity for loss of life will be payable in accordance with
the beneficiary designation and the provisions respecting such payment which may be
prescribed herein and effective at the time of payment. If no such designation or provision
is then effective, such indemnity shall be payable to the estate of the insured. Any other
accrued indemnities unpaid at the insured's death may, at the option of the insurer, be paid
either to such beneficiary or to such estate. All other indemnities will be payable to the
insured.
The following provisions, or either of them, may be included with the foregoing provision
at the option of the insurer:
If any indemnity of this policy shall be payable to the estate of the insured, or to an
insured or beneficiary who is a minor or otherwise not competent to give a valid release,
the insurer may pay such indemnity, up to an amount not exceeding $..... (insert an amount
which shall not exceed $1,000), to any relative by blood or connection by marriage of the
insured or beneficiary who is deemed by the insurer to be equitably entitled thereto. Any
payment made by the insurer in good faith pursuant to this provision shall fully discharge
the insurer to the extent of such payment.
Subject to any written direction of the insured in the application or otherwise all or a
portion of any indemnities provided by this policy on account of hospital, nursing, medical,
or surgical services may, at the insurer's option and unless the insured requests otherwise
in writing not later than the time of filing proofs of such loss, be paid directly to the hospital
or person rendering such services; but it is not required that the service be rendered by a
particular hospital or person.
(10) A provision as follows:
PHYSICAL EXAMINATIONS AND AUTOPSY: The insurer at its own expense shall
have the right and opportunity to examine the person of the insured when and as often as it
may reasonably require during the pendency of a claim hereunder and to make an autopsy
in case of death where it is not forbidden by law.
(11) A provision as follows:
LEGAL ACTIONS: No action at law or in equity shall be brought to recover on this
policy prior to the expiration of 60 days after written proof of loss has been furnished in
accordance with the requirements of this policy. No such action shall be brought after the
expiration of three years after the time written proof of loss is required to be furnished.
(12) A provision as follows:
CHANGE OF BENEFICIARY: Unless the insured makes an irrevocable designation
of beneficiary, the right to change of beneficiary is reserved to the insured and the consent
of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of this
policy or to any change of beneficiary or beneficiaries, or to any other changes in this policy.
The first clause of this provision, relating to the irrevocable designation of beneficiary, may
be omitted at the insurer's option.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2020, section 62A.10, is amended by adding a subdivision to
read:
new text begin Subd. 5. new text end
new text begin Prohibition on waiting periods that exceed 90 days. new text end
new text begin
(a) For purposes of this
subdivision, "waiting period" means the period that must pass before coverage becomes
effective for an individual who is otherwise eligible to enroll under the terms of a group
health plan.
new text end
new text begin
(b) A health carrier offering a group health plan must not apply a waiting period that
exceeds 90 days, with exceptions for the circumstances described in paragraphs (c) to (e).
A health carrier does not violate this subdivision solely because an individual is permitted
to take additional time to elect coverage beyond the end of the 90-day waiting period.
new text end
new text begin
(c) If a group health plan conditions eligibility on an employee working full time or
regularly having a specified number of service hours per period, and the plan is unable to
determine whether a newly hired employee is full time or reasonably expected to regularly
work the specific number of hours per period, the plan may take a reasonable period of
time, not to exceed 12 months beginning on any date between the employee's start date and
the first day of the first calendar month after the employee's start date, to determine whether
the employee meets the plan's eligibility condition.
new text end
new text begin
(d) If a group health plan conditions eligibility on an employee having completed a
cumulative number of service hours, the cumulative hours-of-service requirement must not
exceed 1,200 hours.
new text end
new text begin
(e) An orientation period may be added to the 90-day waiting period if the orientation
period is one month or less. The one-month period is determined by adding one calendar
month and subtracting one calendar day, measured from an employee's start date in a position
that is otherwise eligible for coverage.
new text end
new text begin
(f) A group health plan may treat an employee whose employment has terminated and
is later rehired as newly eligible upon rehire and require the rehired employee to meet the
plan's eligibility criteria and waiting period again, if doing so is reasonable under the
circumstances. Treating an employee as rehired is reasonable if the employee has a break
in service of at least 13 weeks, or at least 26 weeks if the employer is an educational
institution.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 3.
Minnesota Statutes 2020, section 62A.65, subdivision 1, is amended to read:
Subdivision 1.
Applicability.
No health carrier, as defined in section 62A.011, shall
offer, sell, issue, or renew any individual health plan, as defined in section 62A.011, to a
Minnesota resident except in compliance with this section. deleted text begin This section does not apply to
the Comprehensive Health Association established in section 62E.10.deleted text end new text begin A health carrier must
only offer, sell, issue, or renew individual health plans on a guaranteed issue basis and at a
premium rate that does not vary based on the health status of the individual.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 4.
Minnesota Statutes 2020, section 62A.65, is amended by adding a subdivision to
read:
new text begin Subd. 2a. new text end
new text begin Grace period for nonpayment of premium. new text end
new text begin
(a) Notwithstanding any other
law to the contrary, an individual health plan may be canceled for nonpayment of premiums,
but must include a grace period as described in this subdivision.
new text end
new text begin
(b) The grace period must be three consecutive months. During the grace period, the
health carrier must:
new text end
new text begin
(1) pay all claims for services that would have been covered if the premium had been
paid, which are provided to the enrollee during the first month of the grace period, and may
pend claims for services provided to an enrollee in the second and third months of the grace
period; and
new text end
new text begin
(2) notify health care providers of the possibility of denied claims when an enrollee is
in the second and third month of the grace period.
new text end
new text begin
(c) In order to stop a cancellation, an enrollee must pay all outstanding premiums before
the end of the grace period.
new text end
new text begin
(d) If a health plan is canceled under this subdivision, the final day of the enrollment is
the last day of the first month of the three-month grace period.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 5.
Minnesota Statutes 2020, section 62D.095, subdivision 2, is amended to read:
Subd. 2.
Co-payments.
A health maintenance contract may impose a co-payment and
coinsurance consistent with deleted text begin the provisions of the Affordable Care Act as defined under
section 62A.011, subdivision 1adeleted text end new text begin state and federal lawnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 6.
Minnesota Statutes 2020, section 62D.095, subdivision 3, is amended to read:
Subd. 3.
Deductibles.
A health maintenance contract may impose a deductible consistent
with deleted text begin the provisions of the Affordable Care Act as defined under section 62A.011, subdivision
1adeleted text end new text begin state and federal lawnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 7.
Minnesota Statutes 2020, section 62D.095, subdivision 4, is amended to read:
Subd. 4.
Annual out-of-pocket maximums.
A health maintenance contract may impose
an annual out-of-pocket maximum consistent with the provisions of deleted text begin the Affordable Care
Act as defined under section 62A.011, subdivision 1adeleted text end new text begin section 62Q.677, subdivision 6anew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 8.
Minnesota Statutes 2020, section 62D.095, subdivision 5, is amended to read:
Subd. 5.
Exceptions.
No co-payments or deductibles may be imposed on preventive
deleted text begin health caredeleted text end new text begin items andnew text end services deleted text begin consistent with the provisions of the Affordable Care Act as
defined under section 62A.011, subdivision 1adeleted text end new text begin , as defined in section 62Q.46, subdivision
1new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 9.
Minnesota Statutes 2020, section 62Q.01, subdivision 2a, is amended to read:
Subd. 2a.
Dependent child to the limiting age.
"Dependent child to the limiting age"
or "dependent children to the limiting age" means those individuals who are eligible and
covered as a dependent child under the terms of a health plan who have not yet attained 26
years of age. A health plan company must not deny or restrict eligibility for a dependent
child to the limiting age based on financial dependency, residency, marital status, or student
status. For coverage under plans offered by the Minnesota Comprehensive Health
Association, dependent to the limiting age means dependent as defined in section 62A.302,
subdivision 3. Notwithstanding the provisions in this subdivision, a health plan may include:
(1) eligibility requirements regarding the absence of other health plan coverage deleted text begin as
permitted by the Affordable Care Actdeleted text end for grandfathered plan coverage; or
(2) an age greater than 26 in its policy, contract, or certificate of coverage.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 10.
new text begin
[62Q.097] REQUIREMENTS FOR TIMELY PROVIDER
CREDENTIALING.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) The definitions in this subdivision apply to this section.
new text end
new text begin
(b) "Clean application for provider credentialing" or "clean application" means an
application for provider credentialing submitted by a health care provider to a health plan
company that is complete, is in the format required by the health plan company, and includes
all information and substantiation required by the health plan company and does not require
evaluation of any identified potential quality or safety concern.
new text end
new text begin
(c) "Provider credentialing" means the process undertaken by a health plan company to
evaluate and approve a health care provider's education, training, residency, licenses,
certifications, and history of significant quality or safety concerns in order to approve the
health care provider to provide health care services to patients at a clinic or facility.
new text end
new text begin Subd. 2. new text end
new text begin Time limit for credentialing determination. new text end
new text begin
A health plan company that
receives an application for provider credentialing must:
new text end
new text begin
(1) if the application is determined to be a clean application for provider credentialing
and if the health care provider submitting the application or the clinic or facility at which
the health care provider provides services requests the information, affirm that the health
care provider's application is a clean application and notify the health care provider or clinic
or facility of the date by which the health plan company will make a determination on the
health care provider's application;
new text end
new text begin
(2) if the application is determined not to be a clean application, inform the health care
provider of the application's deficiencies or missing information or substantiation within
three business days after the health plan company determines the application is not a clean
application; and
new text end
new text begin
(3) make a determination on the health care provider's clean application within 45 days
after receiving the clean application unless the health plan company identifies a substantive
quality or safety concern in the course of provider credentialing that requires further
investigation. Upon notice to the health care provider, clinic, or facility, the health plan
company is allowed 30 additional days to investigate any quality or safety concerns.
new text end
new text begin EFFECTIVE DATE; APPLICATION. new text end
new text begin
This section applies to applications for provider
credentialing submitted to a health plan company on or after January 1, 2022.
new text end
Sec. 11.
Minnesota Statutes 2020, section 62Q.46, is amended to read:
62Q.46 PREVENTIVE ITEMS AND SERVICES.
Subdivision 1.
Coverage for preventive items and services.
(a) "Preventive items and
services" deleted text begin has the meaning specified in the Affordable Care Actdeleted text end new text begin means the items and services
categorized as preventive under subdivision 1anew text end .
(b) A health plan company must provide coverage for preventive items and services at
a participating provider without imposing cost-sharing requirements, including a deductible,
coinsurance, or co-payment. Nothing in this section prohibits a health plan company that
has a network of providers from excluding coverage or imposing cost-sharing requirements
for preventive items or services that are delivered by an out-of-network provider.
(c) A health plan company is not required to provide coverage for any items or services
specified in any recommendation or guideline described in paragraph (a) if the
recommendation or guideline is no longer included as a preventive item or service as defined
in paragraph (a). Annually, a health plan company must determine whether any additional
items or services must be covered without cost-sharing requirements or whether any items
or services are no longer required to be covered.
(d) Nothing in this section prevents a health plan company from using reasonable medical
management techniques to determine the frequency, method, treatment, or setting for a
preventive item or service to the extent not specified in the recommendation or guideline.
(e) This section does not apply to grandfathered plans.
(f) This section does not apply to plans offered by the Minnesota Comprehensive Health
Association.
new text begin Subd. 1a. new text end
new text begin Preventive items and services. new text end
new text begin
The commissioner of commerce must provide
health plan companies with information regarding which items and services must be
categorized as preventive.
new text end
Subd. 2.
Coverage for office visits in conjunction with preventive items and
services.
(a) A health plan company may impose cost-sharing requirements with respect to
an office visit if a preventive item or service is billed separately or is tracked separately as
individual encounter data from the office visit.
(b) A health plan company must not impose cost-sharing requirements with respect to
an office visit if a preventive item or service is not billed separately or is not tracked
separately as individual encounter data from the office visit and the primary purpose of the
office visit is the delivery of the preventive item or service.
(c) A health plan company may impose cost-sharing requirements with respect to an
office visit if a preventive item or service is not billed separately or is not tracked separately
as individual encounter data from the office visit and the primary purpose of the office visit
is not the delivery of the preventive item or service.
Subd. 3.
Additional services not prohibited.
Nothing in this section prohibits a health
plan company from providing coverage for preventive items and services in addition to
those specified in deleted text begin the Affordable Care Actdeleted text end new text begin subdivision 1anew text end , or from denying coverage for
preventive items and services that are not recommended as preventive items and services
under deleted text begin the Affordable Care Actdeleted text end new text begin subdivision 1anew text end . A health plan company may impose
cost-sharing requirements for a treatment not described in deleted text begin the Affordable Care Actdeleted text end new text begin
subdivision 1anew text end even if the treatment results from a preventive item or service described in
deleted text begin the Affordable Care Actdeleted text end new text begin subdivision 1anew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 12.
new text begin
[62Q.472] SCREENING AND TESTING FOR OPIOIDS.
new text end
new text begin
(a) A health plan company shall not place a lifetime or annual limit on screenings and
urinalysis testing for opioids for an enrollee in an inpatient or outpatient substance use
disorder treatment program when ordered by a health care provider and performed by an
accredited clinical laboratory. A health plan company is not prohibited from conducting a
medical necessity review when screenings or urinalysis testing for an enrollee exceeds 24
tests in any 12-month period.
new text end
new text begin
(b) This section does not apply to managed care plans or county-based purchasing plans
when the plan is providing coverage to public health care program enrollees under chapter
256B or 256L.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, and applies to health
plans offered, issued, or renewed on or after that date.
new text end
Sec. 13.
new text begin
[62Q.521] COVERAGE OF CONTRACEPTIVES AND CONTRACEPTIVE
SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) The definitions in this subdivision apply to this section.
new text end
new text begin
(b) "Closely held for-profit entity" means an entity that:
new text end
new text begin
(1) is not a nonprofit entity;
new text end
new text begin
(2) has more than 50 percent of the value of its ownership interest owned directly or
indirectly by five or fewer individuals, or has an ownership structure that is substantially
similar; and
new text end
new text begin
(3) has no publicly traded ownership interest, having any class of common equity
securities required to be registered under United States Code, title 15, section 781.
new text end
new text begin
For purposes of this paragraph:
new text end
new text begin
(i) ownership interests owned by a corporation, partnership, estate, or trust are considered
owned proportionately by that entity's shareholders, partners, or beneficiaries;
new text end
new text begin
(ii) ownership interests owned by a nonprofit entity are considered owned by a single
owner;
new text end
new text begin
(iii) ownership interests owned by an individual are considered owned, directly or
indirectly, by or for the individual's family. For purposes of this item, "family" means
brothers and sisters, including half-brothers and half-sisters, a spouse, ancestors, and lineal
descendants; and
new text end
new text begin
(iv) if an individual or entity holds an option to purchase an ownership interest, the
individual or entity is considered to be the owner of those ownership interests.
new text end
new text begin
(c) "Contraceptive" means a drug, device, or other product approved by the Food and
Drug Administration to prevent unintended pregnancy.
new text end
new text begin
(d) "Contraceptive service" means consultation, examination, procedure, and medical
service related to the prevention of unintended pregnancy. This includes but is not limited
to voluntary sterilization procedures, patient education, counseling on contraceptives, and
follow-up services related to contraceptives or contraceptive services, management of side
effects, counseling for continued adherence, and device insertion or removal.
new text end
new text begin
(e) "Eligible organization" means an organization that opposes providing coverage for
some or all contraceptives or contraceptive services on account of religious objections and
that is:
new text end
new text begin
(1) organized as a nonprofit entity and holds itself as a religious employer; or
new text end
new text begin
(2) organized and operates as a closely held for-profit entity, and the organization's
highest governing body has adopted, under the organization's applicable rules of governance
and consistent with state law, a resolution or similar action establishing that it objects to
covering some or all contraceptives or contraceptive services on account of the owners'
sincerely held religious beliefs.
new text end
new text begin
(f) "Medical necessity" includes but is not limited to considerations such as severity of
side effects, difference in permanence and reversibility of a contraceptive or contraceptive
service, and ability to adhere to the appropriate use of the contraceptive method or service,
as determined by the attending provider.
new text end
new text begin
(g) "Religious employer" means an organization that is organized and operates as a
nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal
Revenue Code of 1986, as amended.
new text end
new text begin
(h) "Therapeutic equivalent version" means a drug, device, or product that can be expected
to have the same clinical effect and safety profile when administered to a patient under the
conditions specified in the labeling, and that:
new text end
new text begin
(1) is approved as safe and effective;
new text end
new text begin
(2) is a pharmaceutical equivalent, (i) containing identical amounts of the same active
drug ingredient in the same dosage form and route of administration, and (ii) meeting
compendial or other applicable standards of strength, quality, purity, and identity;
new text end
new text begin
(3) is bioequivalent in that:
new text end
new text begin
(i) the drug, device, or product does not present a known or potential bioequivalence
problem and meets an acceptable in vitro standard; or
new text end
new text begin
(ii) if the drug, device, or product does present a known or potential bioequivalence
problem, it is shown to meet an appropriate bioequivalence standard;
new text end
new text begin
(4) is adequately labeled; and
new text end
new text begin
(5) is manufactured in compliance with current manufacturing practice regulations.
new text end
new text begin Subd. 2. new text end
new text begin Required coverage; cost-sharing prohibited. new text end
new text begin
(a) A health plan must provide
coverage for all prescription contraceptives and contraceptive services.
new text end
new text begin
(b) A health plan company must not impose cost-sharing requirements, including co-pays,
deductibles, or co-insurance, for contraceptives or contraceptive services.
new text end
new text begin
(c) Notwithstanding paragraph (b), a health plan that is a high-deductible health plan in
conjunction with a health savings account must include cost-sharing for contraceptives and
contraceptive services at the minimum level necessary to preserve the enrollee's ability to
make tax exempt contributions and withdrawals from the health savings account, as provided
by section 223 of the Internal Revenue Code of 1986, as amended.
new text end
new text begin
(d) A health plan company must not impose any referral requirements, restrictions, or
delays for contraceptives or contraceptive services.
new text end
new text begin
(e) If more than one therapeutic equivalent version of a contraceptive is approved by
the FDA, a health plan must cover at least one therapeutic equivalent version, but is not
required to cover all therapeutic equivalent versions.
new text end
new text begin
(f) For each health plan, a health plan company must list the contraceptives and
contraceptive services that are covered without cost-sharing in a manner that is easily
accessible to enrollees, health care providers, and representatives of health care providers.
The list for each health plan must be promptly updated to reflect changes to the coverage.
new text end
new text begin
(g) If an enrollee's attending provider recommends a particular contraceptive or
contraceptive service based on a determination of medical necessity for that enrollee, the
health plan must cover that contraceptive or contraceptive service without cost-sharing. The
health plan company issuing the health plan must defer to the attending provider's
determination that the particular contraceptive or contraceptive service is medically necessary
for the enrollee.
new text end
new text begin Subd. 3. new text end
new text begin Religious employers; exempt. new text end
new text begin
(a) A religious employer is not required to cover
contraceptives or contraceptive services if the employer has religious objections to the
coverage. A religious employer that chooses not to provide coverage for some or all
contraceptives and contraceptive services must notify employees as part of the hiring process
and all employees at least 30 days before:
new text end
new text begin
(1) an employee enrolls in the health plan; or
new text end
new text begin
(2) the effective date of the health plan, whichever occurs first.
new text end
new text begin
(b) If the religious employer provides coverage for some contraceptives or contraceptive
services, the notice must provide a list of the contraceptives or contraceptive services the
employer refuses to cover.
new text end
new text begin Subd. 4. new text end
new text begin Accommodation for eligible organizations. new text end
new text begin
(a) A health plan established or
maintained by an eligible organization complies with the requirements of subdivision 2 to
provide coverage of contraceptives and contraceptive services if the eligible organization
provides notice to any health plan company the eligible organization contracts with that it
is an eligible organization and that the eligible organization has a religious objection to
coverage for all or a subset of contraceptives or contraceptive services.
new text end
new text begin
(b) The notice from an eligible organization to a health plan company under paragraph
(a) must include the name of the eligible organization, a statement that it objects to coverage
for some or all of contraceptives or contraceptive services, including a list of the contraceptive
services the eligible organization objects to, if applicable, and the health plan name. The
notice must be executed by a person authorized to provide notice on behalf of the eligible
organization.
new text end
new text begin
(c) An eligible organization must provide a copy of the notice under paragraph (b) to
prospective employees as part of the hiring process and to all employees at least 30 days
before:
new text end
new text begin
(1) an employee enrolls in the health plan; or
new text end
new text begin
(2) the effective date of the health plan, whichever occurs first.
new text end
new text begin
(d) A health plan company that receives a copy of the notice under paragraph (a) with
respect to a health plan established or maintained by an eligible organization must:
new text end
new text begin
(1) expressly exclude coverage for some or all contraceptives or contraceptive services
from the health plan and provide separate payments for any contraceptive or contraceptive
service required to be covered under subdivision 2 for enrollees as long as the enrollee
remains enrolled in the health plan; or
new text end
new text begin
(2) arrange for an issuer or other entity to provide payments for contraceptive services
for plan participants and beneficiaries without imposing any cost-sharing requirements, or
imposing a premium fee or other charge, or any portion thereof directly or indirectly, on
the eligible organization, the group health plan, or plan participants or beneficiaries.
new text end
new text begin
(e) The health plan company must not impose any cost-sharing requirements, including
co-pays, deductibles, or co-insurance, or directly or indirectly impose any premium, fee, or
other charge for contraceptive services or contraceptives on the eligible organization, health
plan, or enrollee.
new text end
new text begin
(f) On January 1, 2022, and every year thereafter a health plan company must notify the
commissioner, in a manner to be determined by the commissioner, regarding the number
of eligible organizations granted an accommodation under this subdivision.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, and applies to coverage
offered, sold, issued, or renewed on or after that date.
new text end
Sec. 14.
new text begin
[62Q.522] COVERAGE FOR PRESCRIPTION CONTRACEPTIVES;
SUPPLY REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Scope of coverage. new text end
new text begin
Except as otherwise provided in section 62Q.521,
subdivision 3, all health plans that provide prescription coverage must comply with the
requirements of this section.
new text end
new text begin Subd. 2. new text end
new text begin Definition. new text end
new text begin
For purposes of this section, "prescription contraceptive" means
any drug or device that requires a prescription and is approved by the Food and Drug
Administration to prevent pregnancy. Prescription contraceptive does not include an
emergency contraceptive drug that prevents pregnancy when administered after sexual
contact.
new text end
new text begin Subd. 3. new text end
new text begin Required coverage. new text end
new text begin
(a) Health plan coverage for a prescription contraceptive
must provide a 12-month supply for any prescription contraceptive, regardless of whether
the enrollee was covered by the health plan at the time of the first dispensing.
new text end
new text begin
(b) The prescribing health care provider must determine the appropriate number of
months to prescribe the prescription contraceptives for, up to 12 months.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, and applies to coverage
offered, sold, issued, or renewed on or after that date.
new text end
Sec. 15.
Minnesota Statutes 2020, section 62Q.677, is amended by adding a subdivision
to read:
new text begin Subd. 6a. new text end
new text begin Out-of-pocket annual maximum. new text end
new text begin
By October of each year, the commissioner
of commerce must determine the maximum annual out-of-pocket limits applicable to
individual health plans and small group health plans.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 16.
Minnesota Statutes 2020, section 62Q.81, is amended to read:
62Q.81 ESSENTIAL HEALTH BENEFIT PACKAGE REQUIREMENTS.
Subdivision 1.
Essential health benefits package.
(a) Health plan companies offering
individual and small group health plans must include the essential health benefits package
deleted text begin required under section 1302(a) of the Affordable Care Act and asdeleted text end described in this
subdivision.
(b) The essential health benefits package means new text begin insurance new text end coverage that:
(1) provides new text begin the new text end essential health benefits deleted text begin as outlined in the Affordable Care Actdeleted text end new text begin described
in subdivision 4new text end ;
(2) limits cost-sharing for deleted text begin suchdeleted text end new text begin thenew text end coverage deleted text begin in accordance with the Affordable Care
Actdeleted text end , as described in subdivision 2; and
(3) deleted text begin subject to subdivision 3,deleted text end provides bronze, silver, gold, or platinum level of coverage
deleted text begin in accordance with the Affordable Care Actdeleted text end new text begin , as described in subdivision 3new text end .
Subd. 2.
new text begin Cost-sharing; new text end coverage for enrollees under the age of 21.
new text begin
(a) Cost-sharing
includes (1) deductibles, coinsurance, co-payments, or similar charges, and (2) qualified
medical expenses, as defined in section 223(d)(2) of the Internal Revenue Code of 1986,
as amended. Cost-sharing does not include premiums, balance billing from non-network
providers, or spending for noncovered services.
new text end
new text begin
(b) Cost-sharing per year for individual health plans is limited to the amount allowed
under section 223(c)(2)(A)(ii) of the Internal Revenue Code of 1986, as amended, increased
by an amount equal to the product of that amount and the premium adjustment percentage.
The premium adjustment percentage is the percentage that the average per capita premium
for health insurance coverage in the United States for the preceding calendar year exceeds
the average per capita premium for 2017. If the amount of the increase is not a multiple of
$50, the increases must be rounded to the next lowest multiple of $50.
new text end
new text begin
(c) Cost-sharing per year for small group health plans is limited to twice the amount
allowed under paragraph (b).
new text end
new text begin (d) new text end If a health plan company offers health plans in any level of coverage deleted text begin specified under
section 1302(d) of the Affordable Care Act, asdeleted text end described in subdivision deleted text begin 1, paragraph (b),
clause (3)deleted text end new text begin 3new text end , the health plan company shall also offer coverage in that level to individuals
who have not attained 21 years of age as of the beginning of a policy year.
Subd. 3.
new text begin Levels of coverage; new text end alternative compliance for catastrophic plans.
new text begin
(a) A
health plan in the bronze level must provide a level of coverage designed to provide benefits
that are actuarially equivalent to 60 percent of the full actuarial value of the benefits provided
under the plan.
new text end
new text begin
(b) A health plan in the silver level must provide a level of coverage designed to provide
benefits that are actuarially equivalent to 70 percent of the full actuarial value of the benefits
provided under the plan.
new text end
new text begin
(c) A health plan in the gold level must provide a level of coverage designed to provide
benefits that are actuarially equivalent to 80 percent of the full actuarial value of the benefits
provided under the plan.
new text end
new text begin
(d) A health plan in the platinum level must provide a level of coverage designed to
provide benefits that are actuarially equivalent to 90 percent of the full actuarial value of
the benefits provided under the plan.
new text end
new text begin (e) new text end A health plan company that does not provide an individual or small group health
plan in the bronze, silver, gold, or platinum level of coveragedeleted text begin , as described in subdivision
1, paragraph (b), clause (3), shall be treated as meetingdeleted text end new text begin meetsnew text end the requirements ofnew text begin thisnew text end section
deleted text begin 1302(d) of the Affordable Care Actdeleted text end with respect to any deleted text begin policydeleted text end new text begin plannew text end year if the health plan
company provides a catastrophic plan that meets thenew text begin followingnew text end requirements deleted text begin of section
1302(e) of the Affordable Care Act.deleted text end new text begin :
new text end
new text begin
(1) enrollment in the health plan is limited only to individuals that:
new text end
new text begin
(i) have not attained age 30 before the beginning of the plan year;
new text end
new text begin
(ii) are unable to access affordable coverage; or
new text end
new text begin
(iii) are experiencing a hardship in reference to the individual's capability to access
coverage; and
new text end
new text begin
(2) the health plan provides:
new text end
new text begin
(i) essential health benefits, except that the plan does not provide benefits for any plan
year until the individual has incurred cost-sharing expenses in an amount equal to the
limitation in effect under subdivision 2; and
new text end
new text begin
(ii) coverage for at least three primary care visits.
new text end
Subd. 4.
Essential health benefits; definition.
new text begin (a) new text end For purposes of this section, "essential
health benefits" deleted text begin has the meaning given under section 1302(b) of the Affordable Care Act
and includesdeleted text end new text begin meansnew text end :
(1) ambulatory patient services;
(2) emergency services;
(3) hospitalization;
(4) laboratory services;
(5) maternity and newborn care;
(6) mental health and substance use disorder services, including behavioral health
treatment;
(7) pediatric services, including oral and vision care;
(8) prescription drugs;
(9) preventive and wellness services and chronic disease management;
(10) rehabilitative and habilitative services and devices; and
(11) additional essential health benefits included in the deleted text begin EHB-benchmark plan, as defined
under the Affordable Care Actdeleted text end new text begin health plan described in paragraph (c)new text end .
new text begin
(b) If a service provider does not have a contractual relationship with the health plan to
provide services, emergency services must be provided without imposing any prior
authorization requirement or limitation on coverage that is more restrictive than the
requirements or limitations that apply to emergency services received from providers who
have a contractual relationship with the health plan. If services are provided out-of-network,
the cost-sharing must be equivalent to services provided in-network.
new text end
new text begin
(c) The scope of essential health benefits under paragraph (a) must be equal to the scope
of benefits provided under a typical employer plan.
new text end
new text begin
(d) Essential health benefits must:
new text end
new text begin
(1) reflect an appropriate balance among the categories to ensure benefits are not unduly
weighted toward any category;
new text end
new text begin
(2) not make coverage decisions, determine reimbursement rates, establish incentive
programs, or design benefits in a manner that discriminates against individuals on the basis
of age, disability, or expected length of life;
new text end
new text begin
(3) account for the health care needs of diverse segments of the population, including
women, children, persons with disabilities, and other groups; and
new text end
new text begin
(4) ensure that health benefits established as essential are not subject to denial against
the individual's wishes on the basis of the individual's age or expected length of life or of
the individual's present or predicted disability, degree of medical dependency, or quality of
life.
new text end
Subd. 5.
Exception.
This section does not apply to a dental plan deleted text begin described in section
1311(d)(2)(B)(ii) of the Affordable Care Actdeleted text end new text begin that is limited in scope and provides pediatric
dental benefitsnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, for health plans offered,
sold, issued, or renewed on or after that date.
new text end
Sec. 17.
Minnesota Statutes 2020, section 256B.0625, subdivision 10, is amended to read:
Subd. 10.
Laboratory deleted text begin anddeleted text end new text begin ,new text end x-raynew text begin , and opioid screeningnew text end services.
new text begin (a) new text end Medical assistance
covers laboratory and x-ray services.
new text begin
(b) Medical assistance covers screening and urinalysis tests for opioids without lifetime
or annual limits.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 18.
Minnesota Statutes 2020, section 256B.0625, subdivision 13, is amended to read:
Subd. 13.
Drugs.
(a) Medical assistance covers drugs, except for fertility drugs when
specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
dispensing physician, or by a physician, a physician assistant, or an advanced practice
registered nurse employed by or under contract with a community health board as defined
in section 145A.02, subdivision 5, for the purposes of communicable disease control.
(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
unless authorized by the commissionernew text begin or as provided in paragraph (h)new text end .
(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
ingredient" is defined as a substance that is represented for use in a drug and when used in
the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
excipients which are included in the medical assistance formulary. Medical assistance covers
selected active pharmaceutical ingredients and excipients used in compounded prescriptions
when the compounded combination is specifically approved by the commissioner or when
a commercially available product:
(1) is not a therapeutic option for the patient;
(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and
(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
prescription.
(d) Medical assistance covers the following over-the-counter drugs when prescribed by
a licensed practitioner or by a licensed pharmacist who meets standards established by the
commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
with documented vitamin deficiencies, vitamins for children under the age of seven and
pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions, or
disorders, and this determination shall not be subject to the requirements of chapter 14. A
pharmacist may prescribe over-the-counter medications as provided under this paragraph
for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for potential adverse interactions,
and make referrals as needed to other health care professionals.
(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
individuals, medical assistance may cover drugs from the drug classes listed in United States
Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
not be covered.
(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under common
ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.
(g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal
contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section
151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a
licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists
used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed
pharmacist in accordance with section 151.37, subdivision 16.
new text begin
(h) Medical assistance coverage for a prescription contraceptive must provide a 12-month
supply for any prescription contraceptive. The prescribing health care provider must
determine the appropriate number of months to prescribe the prescription contraceptives,
up to 12 months. For the purposes of this paragraph, "prescription contraceptive" means
any drug or device that requires a prescription and is approved by the Food and Drug
Administration to prevent pregnancy. Prescription contraceptive does not include an
emergency contraceptive drug approved to prevent pregnancy when administered after
sexual contact.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section applies to medical assistance and MinnesotaCare
coverage effective January 1, 2022.
new text end
Sec. 19. new text begin COMMISSIONER OF COMMERCE; DETERMINATION OF
PREVENTIVE ITEMS AND SERVICES.
new text end
new text begin
The commissioner of commerce must determine the items and services that are preventive
under Minnesota Statutes, section 62Q.46, subdivision 1a. Items and services that are
preventive must include:
new text end
new text begin
(1) evidence-based items or services that have in effect a rating of A or B pursuant to
the recommendations of the United States Preventive Services Task Force in effect January
1, 2021, and with respect to the individual involved;
new text end
new text begin
(2) immunizations for routine use in children, adolescents, and adults that have in effect
a recommendation from the Advisory Committee on Immunization Practices of the Centers
for Disease Control and Prevention with respect to the individual involved. For the purposes
of this clause, a recommendation from the Advisory Committee on Immunization Practices
of the Centers for Disease Control and Prevention is considered in effect after it has been
adopted by the Director of the Centers for Disease Control and Prevention and a
recommendation is considered to be for routine use if it is listed on the Immunization
Schedules of the Centers for Disease Control and Prevention;
new text end
new text begin
(3) with respect to infants, children, and adolescents, evidence-informed preventive care
and screenings provided for in comprehensive guidelines supported by the Health Resources
and Services Administration; and
new text end
new text begin
(4) with respect to women, additional preventive care and screenings not described in
clause (1), as provided for in comprehensive guidelines supported by the Health Resources
and Services Administration.
new text end
ARTICLE 7
TELEHEALTH
Section 1.
new text begin
[62A.673] COVERAGE OF SERVICES PROVIDED THROUGH
TELEHEALTH.
new text end
new text begin Subdivision 1. new text end
new text begin Citation. new text end
new text begin
This section may be cited as the "Minnesota Telehealth Act."
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.
new text end
new text begin
(b) "Distant site" means a site at which a health care provider is located while providing
health care services or consultations by means of telehealth.
new text end
new text begin
(c) "Health care provider" means a health care professional who is licensed or registered
by the state to perform health care services within the provider's scope of practice and in
accordance with state law. A health care provider includes a mental health professional as
defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; a mental health
practitioner as defined under section 245.462, subdivision 17, or 245.4871, subdivision 26;
a treatment coordinator under section 245G.11, subdivision 7; an alcohol and drug counselor
under section 245G.11, subdivision 5; and a recovery peer under section 245G.11, subdivision
8.
new text end
new text begin
(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
new text end
new text begin
(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan
includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental
plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed
to pay benefits directly to the policy holder.
new text end
new text begin
(f) "Originating site" means a site at which a patient is located at the time health care
services are provided to the patient by means of telehealth. For purposes of store-and-forward
transfer, the originating site also means the location at which a health care provider transfers
or transmits information to the distant site.
new text end
new text begin
(g) "Store-and-forward transfer" means the asynchronous electronic transfer of a patient's
medical information or data from an originating site to a distant site for the purposes of
diagnostic and therapeutic assistance in the care of a patient.
new text end
new text begin
(h) "Telehealth" means the delivery of health care services or consultations through the
use of real-time, two-way interactive audio and visual or audio-only communications to
provide or support health care delivery and facilitate the assessment, diagnosis, consultation,
treatment, education, and care management of a patient's health care. Telehealth includes
the application of secure video conferencing, store-and-forward transfers, and synchronous
interactions between a patient located at an originating site and a health care provider located
at a distant site. Telehealth includes audio-only communication between a health care
provider and a patient if the communication is a scheduled appointment and the standard
of care for the service can be met through the use of audio-only communication. Telehealth
does not include communication between health care providers or between a health care
provider and a patient that consists solely of an e-mail or facsimile transmission. Telehealth
does not include communication between health care providers that consists solely of a
telephone conversation.
new text end
new text begin
(i) "Telemonitoring services" means the remote monitoring of clinical data related to
the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits
the data electronically to a health care provider for analysis. Telemonitoring is intended to
collect an enrollee's health-related data for the purpose of assisting a health care provider
in assessing and monitoring the enrollee's medical condition or status.
new text end
new text begin Subd. 3. new text end
new text begin Coverage of telehealth. new text end
new text begin
(a) A health plan sold, issued, or renewed by a health
carrier in Minnesota must (1) cover benefits delivered through telehealth in the same manner
as any other benefits covered under the health plan, and (2) comply with this section.
new text end
new text begin
(b) Coverage for services delivered through telehealth must not be limited on the basis
of geography, location, or distance for travel.
new text end
new text begin
(c) A health carrier must not create a separate provider network or provide incentives
to enrollees to use a separate provider network to deliver services through telehealth that
does not include network providers who provide in-person care to patients for the same
service.
new text end
new text begin
(d) A health carrier may require a deductible, co-payment, or coinsurance payment for
a health care service provided through telehealth, provided that the deductible, co-payment,
or coinsurance payment is not in addition to, and does not exceed, the deductible, co-payment,
or coinsurance applicable for the same service provided through in-person contact.
new text end
new text begin
(e) Nothing in this section:
new text end
new text begin
(1) requires a health carrier to provide coverage for services that are not medically
necessary or are not covered under the enrollee's health plan; or
new text end
new text begin
(2) prohibits a health carrier from:
new text end
new text begin
(i) establishing criteria that a health care provider must meet to demonstrate the safety
or efficacy of delivering a particular service through telehealth for which the health carrier
does not already reimburse other health care providers for delivering the service through
telehealth;
new text end
new text begin
(ii) establishing reasonable medical management techniques, provided the criteria or
techniques are not unduly burdensome or unreasonable for the particular service; or
new text end
new text begin
(iii) requiring documentation or billing practices designed to protect the health carrier
or patient from fraudulent claims, provided the practices are not unduly burdensome or
unreasonable for the particular service.
new text end
new text begin
(f) Nothing in this section requires the use of telehealth when a health care provider
determines that the delivery of a health care service through telehealth is not appropriate or
when an enrollee chooses not to receive a health care service through telehealth.
new text end
new text begin Subd. 4. new text end
new text begin Parity between telehealth and in-person services. new text end
new text begin
(a) A health carrier must
not restrict or deny coverage of a health care service that is covered under a health plan
solely:
new text end
new text begin
(1) because the health care service provided by the health care provider through telehealth
is not provided through in-person contact; or
new text end
new text begin
(2) based on the communication technology or application used to deliver the health
care service through telehealth, provided the technology or application complies with this
section and is appropriate for the particular service.
new text end
new text begin
(b) Prior authorization may be required for health care services delivered through
telehealth only if prior authorization is required before the delivery of the same service
through in-person contact.
new text end
new text begin
(c) A health carrier may require a utilization review for services delivered through
telehealth, provided the utilization review is conducted in the same manner and uses the
same clinical review criteria as a utilization review for the same services delivered through
in-person contact.
new text end
new text begin Subd. 5. new text end
new text begin Reimbursement for services delivered through telehealth. new text end
new text begin
(a) A health carrier
must reimburse the health care provider for services delivered through telehealth on the
same basis and at the same rate as the health carrier would apply to those services if the
services had been delivered by the health care provider through in-person contact.
new text end
new text begin
(b) A health carrier must not deny or limit reimbursement based solely on a health care
provider delivering the service or consultation through telehealth instead of through in-person
contact.
new text end
new text begin
(c) A health carrier must not deny or limit reimbursement based solely on the technology
and equipment used by the health care provider to deliver the health care service or
consultation through telehealth, provided the technology and equipment used by the provider
meets the requirements of this section and is appropriate for the particular service.
new text end
new text begin Subd. 6. new text end
new text begin Telehealth equipment. new text end
new text begin
(a) A health carrier must not require a health care
provider to use specific telecommunications technology and equipment as a condition of
coverage under this section, provided the health care provider uses telecommunications
technology and equipment that complies with current industry interoperable standards and
complies with standards required under the federal Health Insurance Portability and
Accountability Act of 1996, Public Law 104-191, and regulations promulgated under that
Act, unless authorized under this section.
new text end
new text begin
(b) A health carrier must provide coverage for health care services delivered through
telehealth by means of the use of audio-only telephone communication if the communication
is a scheduled appointment and the standard of care for that particular service can be met
through the use of audio-only communication.
new text end
new text begin Subd. 7. new text end
new text begin Telemonitoring services. new text end
new text begin
A health carrier must provide coverage for
telemonitoring services if:
new text end
new text begin
(1) the telemonitoring service is medically appropriate based on the enrollee's medical
condition or status;
new text end
new text begin
(2) the enrollee is cognitively and physically capable of operating the monitoring device
or equipment, or the enrollee has a caregiver who is willing and able to assist with the
monitoring device or equipment; and
new text end
new text begin
(3) the enrollee resides in a setting that is suitable for telemonitoring and not in a setting
that has health care staff on site.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 2.
Minnesota Statutes 2020, section 147.033, is amended to read:
147.033 PRACTICE OF deleted text begin TELEMEDICINEdeleted text end new text begin TELEHEALTHnew text end .
Subdivision 1.
Definition.
For the purposes of this section, deleted text begin "telemedicine" means the
delivery of health care services or consultations while the patient is at an originating site
and the licensed health care provider is at a distant site. A communication between licensed
health care providers that consists solely of a telephone conversation, e-mail, or facsimile
transmission does not constitute telemedicine consultations or services. A communication
between a licensed health care provider and a patient that consists solely of an e-mail or
facsimile transmission does not constitute telemedicine consultations or services.
Telemedicine may be provided by means of real-time two-way interactive audio, and visual
communications, including the application of secure video conferencing or store-and-forward
technology to provide or support health care delivery, that facilitate the assessment, diagnosis,
consultation, treatment, education, and care management of a patient's health care.deleted text end new text begin
"telehealth" has the meaning given in section 62A.673, subdivision 2, paragraph (h).
new text end
Subd. 2.
Physician-patient relationship.
A physician-patient relationship may be
established through deleted text begin telemedicinedeleted text end new text begin telehealthnew text end .
Subd. 3.
Standards of practice and conduct.
A physician providing health care services
by deleted text begin telemedicinedeleted text end new text begin telehealthnew text end in this state shall be held to the same standards of practice and
conduct as provided in this chapter for in-person health care services.
Sec. 3.
Minnesota Statutes 2020, section 151.37, subdivision 2, is amended to read:
Subd. 2.
Prescribing and filing.
(a) A licensed practitioner in the course of professional
practice only, may prescribe, administer, and dispense a legend drug, and may cause the
same to be administered by a nurse, a physician assistant, or medical student or resident
under the practitioner's direction and supervision, and may cause a person who is an
appropriately certified, registered, or licensed health care professional to prescribe, dispense,
and administer the same within the expressed legal scope of the person's practice as defined
in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, without reference
to a specific patient, by directing a licensed dietitian or licensed nutritionist, pursuant to
section 148.634; a nurse, pursuant to section 148.235, subdivisions 8 and 9; physician
assistant; medical student or resident; or pharmacist according to section 151.01, subdivision
27, to adhere to a particular practice guideline or protocol when treating patients whose
condition falls within such guideline or protocol, and when such guideline or protocol
specifies the circumstances under which the legend drug is to be prescribed and administered.
An individual who verbally, electronically, or otherwise transmits a written, oral, or electronic
order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug.
This paragraph applies to a physician assistant only if the physician assistant meets the
requirements of deleted text begin section 147A.18deleted text end new text begin sections 147A.02 and 147A.09new text end .
(b) The commissioner of health, if a licensed practitioner, or a person designated by the
commissioner who is a licensed practitioner, may prescribe a legend drug to an individual
or by protocol for mass dispensing purposes where the commissioner finds that the conditions
triggering section 144.4197 or 144.4198, subdivision 2, paragraph (b), exist. The
commissioner, if a licensed practitioner, or a designated licensed practitioner, may prescribe,
dispense, or administer a legend drug or other substance listed in subdivision 10 to control
tuberculosis and other communicable diseases. The commissioner may modify state drug
labeling requirements, and medical screening criteria and documentation, where time is
critical and limited labeling and screening are most likely to ensure legend drugs reach the
maximum number of persons in a timely fashion so as to reduce morbidity and mortality.
(c) A licensed practitioner that dispenses for profit a legend drug that is to be administered
orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must file with the
practitioner's licensing board a statement indicating that the practitioner dispenses legend
drugs for profit, the general circumstances under which the practitioner dispenses for profit,
and the types of legend drugs generally dispensed. It is unlawful to dispense legend drugs
for profit after July 31, 1990, unless the statement has been filed with the appropriate
licensing board. For purposes of this paragraph, "profit" means (1) any amount received by
the practitioner in excess of the acquisition cost of a legend drug for legend drugs that are
purchased in prepackaged form, or (2) any amount received by the practitioner in excess
of the acquisition cost of a legend drug plus the cost of making the drug available if the
legend drug requires compounding, packaging, or other treatment. The statement filed under
this paragraph is public data under section 13.03. This paragraph does not apply to a licensed
doctor of veterinary medicine or a registered pharmacist. Any person other than a licensed
practitioner with the authority to prescribe, dispense, and administer a legend drug under
paragraph (a) shall not dispense for profit. To dispense for profit does not include dispensing
by a community health clinic when the profit from dispensing is used to meet operating
expenses.
(d) A prescription drug order for the following drugs is not valid, unless it can be
established that the prescription drug order was based on a documented patient evaluation,
including an examination, adequate to establish a diagnosis and identify underlying conditions
and contraindications to treatment:
(1) controlled substance drugs listed in section 152.02, subdivisions 3 to 5;
(2) drugs defined by the Board of Pharmacy as controlled substances under section
152.02, subdivisions 7, 8, and 12;
(3) muscle relaxants;
(4) centrally acting analgesics with opioid activity;
(5) drugs containing butalbital; or
(6) phosphodiesterase type 5 inhibitors when used to treat erectile dysfunction.
deleted text begin
For purposes of prescribing drugs listed in clause (6), the requirement for a documented
patient evaluation, including an examination, may be met through the use of telemedicine,
as defined in section 147.033, subdivision 1.
deleted text end
(e) For the purposes of paragraph (d), the requirement for an examination shall be met
ifnew text begin :
new text end
new text begin (1)new text end an in-person examination has been completed in any of the following circumstances:
deleted text begin (1)deleted text end new text begin (i)new text end the prescribing practitioner examines the patient at the time the prescription or
drug order is issued;
deleted text begin (2)deleted text end new text begin (ii)new text end the prescribing practitioner has performed a prior examination of the patient;
deleted text begin (3)deleted text end new text begin (iii)new text end another prescribing practitioner practicing within the same group or clinic as
the prescribing practitioner has examined the patient;
deleted text begin (4)deleted text end new text begin (iv)new text end a consulting practitioner to whom the prescribing practitioner has referred the
patient has examined the patient; or
deleted text begin (5)deleted text end new text begin (v)new text end the referring practitioner has performed an examination in the case of a consultant
practitioner issuing a prescription or drug order when providing services by means of
telemedicinedeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(2) the prescription order is for a drug listed in paragraph (d), clause (6), or for medication
assisted therapy for a substance use disorder, and the prescribing practitioner has completed
an examination of the patient via telehealth as defined in section 62A.673, subdivision 2,
paragraph (h).
new text end
(f) Nothing in paragraph (d) or (e) prohibits a licensed practitioner from prescribing a
drug through the use of a guideline or protocol pursuant to paragraph (a).
(g) Nothing in this chapter prohibits a licensed practitioner from issuing a prescription
or dispensing a legend drug in accordance with the Expedited Partner Therapy in the
Management of Sexually Transmitted Diseases guidance document issued by the United
States Centers for Disease Control.
(h) Nothing in paragraph (d) or (e) limits prescription, administration, or dispensing of
legend drugs through a public health clinic or other distribution mechanism approved by
the commissioner of health or a community health board in order to prevent, mitigate, or
treat a pandemic illness, infectious disease outbreak, or intentional or accidental release of
a biological, chemical, or radiological agent.
(i) No pharmacist employed by, under contract to, or working for a pharmacy located
within the state and licensed under section 151.19, subdivision 1, may dispense a legend
drug based on a prescription that the pharmacist knows, or would reasonably be expected
to know, is not valid under paragraph (d).
(j) No pharmacist employed by, under contract to, or working for a pharmacy located
outside the state and licensed under section 151.19, subdivision 1, may dispense a legend
drug to a resident of this state based on a prescription that the pharmacist knows, or would
reasonably be expected to know, is not valid under paragraph (d).
(k) Nothing in this chapter prohibits the commissioner of health, if a licensed practitioner,
or, if not a licensed practitioner, a designee of the commissioner who is a licensed
practitioner, from prescribing legend drugs for field-delivered therapy in the treatment of
a communicable disease according to the Centers For Disease Control and Prevention Partner
Services Guidelines.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 4.
Minnesota Statutes 2020, section 245G.01, subdivision 13, is amended to read:
Subd. 13.
Face-to-face.
"Face-to-face" means two-way, real-time, interactive deleted text begin and visualdeleted text end
communication between a client and a treatment service provider and includes services
delivered in person or via deleted text begin telemedicinedeleted text end new text begin telehealth with priority being given to interactive
audio and visual communication, if availablenew text end . new text begin Meetings required by section 245G.22,
subdivision 4, must be conducted by interactive video and visual communication.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 5.
Minnesota Statutes 2020, section 245G.01, subdivision 26, is amended to read:
Subd. 26.
deleted text begin Telemedicinedeleted text end new text begin Telehealthnew text end .
deleted text begin "Telemedicine"deleted text end new text begin "Telehealth"new text end means the delivery
of a substance use disorder treatment service while the client is at an originating site and
the deleted text begin licenseddeleted text end health care provider is at a distant sitenew text begin via telehealth as defined in section
256B.0625, subdivision 3b, andnew text end as specified in section 254B.05, subdivision 5, paragraph
(f).
Sec. 6.
Minnesota Statutes 2020, section 245G.06, subdivision 1, is amended to read:
Subdivision 1.
General.
Each client must have a person-centered individual treatment
plan developed by an alcohol and drug counselor within ten days from the day of service
initiation for a residential program and within five calendar days on which a treatment
session has been provided from the day of service initiation for a client in a nonresidential
program. Opioid treatment programs must complete the individual treatment plan within
21 days from the day of service initiation. The individual treatment plan must be signed by
the client and the alcohol and drug counselor and document the client's involvement in the
development of the plan. The individual treatment plan is developed upon the qualified staff
member's dated signature. Treatment planning must include ongoing assessment of client
needs. An individual treatment plan must be updated based on new information gathered
about the client's condition, the client's level of participation, and on whether methods
identified have the intended effect. A change to the plan must be signed by the client and
the alcohol and drug counselor. If the client chooses to have family or others involved in
treatment services, the client's individual treatment plan must include how the family or
others will be involved in the client's treatment.new text begin If a client is receiving treatment services
or an assessment via telehealth and the license holder documents the reason the client's
signature cannot be obtained, the alcohol and drug counselor may document the client's
verbal approval or electronic written approval of the treatment plan or change to the treatment
plan in lieu of the client's signature.
new text end
Sec. 7.
Minnesota Statutes 2020, section 254A.19, subdivision 5, is amended to read:
Subd. 5.
Assessment via deleted text begin telemedicinedeleted text end new text begin telehealthnew text end .
Notwithstanding Minnesota Rules,
part 9530.6615, subpart 3, item A, a chemical use assessment may be conducted via
deleted text begin telemedicinedeleted text end new text begin telehealth as defined in section 256B.0625, subdivision 3bnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 8.
Minnesota Statutes 2020, section 254B.05, subdivision 5, is amended to read:
Subd. 5.
Rate requirements.
(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.
(b) Eligible substance use disorder treatment services include:
(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;
(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;
(3) care coordination services provided according to section 245G.07, subdivision 1,
paragraph (a), clause (5);
(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);
(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;
(6) medication-assisted therapy services that are licensed according to sections 245G.01
to 245G.17 and 245G.22, or applicable tribal license;
(7) medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause (6) and provide nine hours of clinical services each week;
(8) high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
provide, respectively, 30, 15, and five hours of clinical services each week;
(9) hospital-based treatment services that are licensed according to sections 245G.01 to
245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;
(10) adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable tribal license;
(11) high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of
clinical services each week provided by a state-operated vendor or to clients who have been
civilly committed to the commissioner, present the most complex and difficult care needs,
and are a potential threat to the community; and
(12) room and board facilities that meet the requirements of subdivision 1a.
(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:
(1) programs that serve parents with their children if the program:
(i) provides on-site child care during the hours of treatment activity that:
(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or
(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:
(A) a child care center under Minnesota Rules, chapter 9503; or
(B) a family child care home under Minnesota Rules, chapter 9502;
(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or
programs or subprograms serving special populations, if the program or subprogram meets
the following requirements:
(i) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;
(ii) is governed with significant input from individuals of that specific background; and
(iii) employs individuals to provide individual or group therapy, at least 50 percent of
whom are of that specific background, except when the common social background of the
individuals served is a traumatic brain injury or cognitive disability and the program employs
treatment staff who have the necessary professional training, as approved by the
commissioner, to serve clients with the specific disabilities that the program is designed to
serve;
(3) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; and
(4) programs that offer services to individuals with co-occurring mental health and
chemical dependency problems if:
(i) the program meets the co-occurring requirements in section 245G.20;
(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined
in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates
under the supervision of a licensed alcohol and drug counselor supervisor and licensed
mental health professional, except that no more than 50 percent of the mental health staff
may be students or licensing candidates with time documented to be directly related to
provisions of co-occurring services;
(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;
(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;
(v) family education is offered that addresses mental health and substance abuse disorders
and the interaction between the two; and
(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.
(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the chemical dependency facility of the child care provider's current licensure to provide
child care services. Programs that provide child care according to paragraph (c), clause (1),
must be deemed in compliance with the licensing requirements in section 245G.19.
(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).
(f) Subject to federal approval, chemical dependency services that are otherwise covered
as direct face-to-face services may be provided via deleted text begin two-way interactive videodeleted text end new text begin telehealth as
defined in section 256B.0625, subdivision 3bnew text end . The use of deleted text begin two-way interactive videodeleted text end new text begin telehealth
to deliver servicesnew text end must be medically appropriate to the condition and needs of the person
being served. Reimbursement shall be at the same rates and under the same conditions that
would otherwise apply to direct face-to-face services. deleted text begin The interactive video equipment and
connection must comply with Medicare standards in effect at the time the service is provided.
deleted text end
(g) For the purpose of reimbursement under this section, substance use disorder treatment
services provided in a group setting without a group participant maximum or maximum
client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
At least one of the attending staff must meet the qualifications as established under this
chapter for the type of treatment service provided. A recovery peer may not be included as
part of the staff ratio.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 9.
Minnesota Statutes 2020, section 256B.0621, subdivision 10, is amended to read:
Subd. 10.
Payment rates.
The commissioner shall set payment rates for targeted case
management under this subdivision. Case managers may bill according to the following
criteria:
(1) for relocation targeted case management, case managers may bill for direct case
management activities, including face-to-face contact, telephone contact, and interactive
video contact deleted text begin according to section 256B.0924, subdivision 4adeleted text end , in the lesser of:
(i) 180 days preceding an eligible recipient's discharge from an institution; or
(ii) the limits and conditions which apply to federal Medicaid funding for this service;
(2) for home care targeted case management, case managers may bill for direct case
management activities, including face-to-face and telephone contacts; and
(3) billings for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 10.
Minnesota Statutes 2020, section 256B.0625, subdivision 3b, is amended to read:
Subd. 3b.
deleted text begin Telemedicinedeleted text end new text begin Telehealthnew text end services.
(a) Medical assistance covers medically
necessary services and consultations delivered by a deleted text begin licenseddeleted text end health care provider deleted text begin via
telemedicinedeleted text end new text begin through telehealthnew text end in the same manner as if the service or consultation was
delivered deleted text begin in persondeleted text end new text begin through in-person contactnew text end . deleted text begin Coverage is limited to three telemedicine
services per enrollee per calendar week, except as provided in paragraph (f). Telemedicinedeleted text end
Services new text begin or consultations delivered through telehealth new text end shall be paid at the full allowable
rate.
(b) The commissioner deleted text begin shalldeleted text end new text begin maynew text end establish criteria that a health care provider must attest
to in order to demonstrate the safety or efficacy of delivering a particular service deleted text begin via
telemedicinedeleted text end new text begin through telehealthnew text end . The attestation may include that the health care provider:
(1) has identified the categories or types of services the health care provider will provide
deleted text begin via telemedicinedeleted text end new text begin through telehealthnew text end ;
(2) has written policies and procedures specific to deleted text begin telemedicinedeleted text end servicesnew text begin delivered through
telehealthnew text end that are regularly reviewed and updated;
(3) has policies and procedures that adequately address patient safety before, during,
and after the deleted text begin telemedicinedeleted text end service is deleted text begin rendereddeleted text end new text begin delivered through telehealthnew text end ;
(4) has established protocols addressing how and when to discontinue telemedicine
services; and
(5) has an established quality assurance process related to deleted text begin telemedicinedeleted text end new text begin deliveringnew text end servicesnew text begin
through telehealthnew text end .
(c) As a condition of payment, a licensed health care provider must document each
occurrence of a health service deleted text begin provided by telemedicinedeleted text end new text begin delivered through telehealthnew text end to a
medical assistance enrollee. Health care service records for services deleted text begin provided by telemedicinedeleted text end new text begin
delivered through telehealthnew text end must meet the requirements set forth in Minnesota Rules, part
9505.2175, subparts 1 and 2, and must document:
(1) the type of service deleted text begin provided by telemedicinedeleted text end new text begin delivered through telehealthnew text end ;
(2) the time the service began and the time the service ended, including an a.m. and p.m.
designation;
(3) the deleted text begin licenseddeleted text end health care provider's basis for determining that deleted text begin telemedicinedeleted text end new text begin telehealthnew text end
is an appropriate and effective means for delivering the service to the enrollee;
(4) the mode of transmission deleted text begin ofdeleted text end new text begin used to delivernew text end the deleted text begin telemedicinedeleted text end service new text begin through telehealth
new text end and records evidencing that a particular mode of transmission was utilized;
(5) the location of the originating site and the distant site;
(6) if the claim for payment is based on a physician's deleted text begin telemedicinedeleted text end consultation with
another physiciannew text begin through telehealthnew text end , the written opinion from the consulting physician
providing the deleted text begin telemedicinedeleted text end new text begin telehealthnew text end consultation; and
(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).
(d) For purposes of this subdivision, unless otherwise covered under this chapterdeleted text begin ,
"telemedicine" is defined as the delivery of health care services or consultations while the
patient is at an originating site and the licensed health care provider is at a distant site. A
communication between licensed health care providers, or a licensed health care provider
and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission
does not constitute telemedicine consultations or services. Telemedicine may be provided
by means of real-time two-way, interactive audio and visual communications, including the
application of secure video conferencing or store-and-forward technology to provide or
support health care delivery, which facilitate the assessment, diagnosis, consultation,
treatment, education, and care management of a patient's health care.deleted text end new text begin :
new text end
new text begin
(1) "telehealth" means the delivery of health care services or consultations through the
use of real-time, two-way interactive audio and visual or audio-only communications to
provide or support health care delivery and facilitate the assessment, diagnosis, consultation,
treatment, education, and care management of a patient's health care. Telehealth includes
the application of secure video conferencing, store-and-forward transfers, and synchronous
interactions between a patient located at an originating site and a health care provider located
at a distant site. Unless interactive visual and audio communication is specifically required,
telehealth includes audio-only communication between a health care provider and a patient,
if the communication is a scheduled appointment with the health care provider and the
standard of care for the service can be met through the use of audio-only communication.
Telehealth does not include communication between health care providers, or communication
between a health care provider and a patient that consists solely of an e-mail or facsimile
transmission;
new text end
deleted text begin (e) For purposes of this section, "licenseddeleted text end new text begin (2) "new text end health care provider" means a deleted text begin licenseddeleted text end
health care provider deleted text begin under section 62A.671, subdivision 6deleted text end new text begin as defined under section 62A.673new text end ,
a community paramedic as defined under section 144E.001, subdivision 5f, deleted text begin or a mental
health practitioner defined under section 245.462, subdivision 17, or 245.4871, subdivision
26, working under the general supervision of a mental health professional, anddeleted text end a community
health worker who meets the criteria under subdivision 49, paragraph (a)deleted text begin ; "health care
provider" is defined under section 62A.671, subdivision 3;deleted text end new text begin , a mental health certified peer
specialist under section 256B.0615, subdivision 5, a mental health certified family peer
specialist under section 256B.0616, subdivision 5, a mental health rehabilitation worker
under section 256B.0623, subdivision 5, paragraph (a), clause (4), and paragraph (b), a
mental health behavioral aide under section 256B.0943, subdivision 7, paragraph (b), clause
(3), a treatment coordinator under section 245G.11, subdivision 7, an alcohol and drug
counselor under section 245G.11, subdivision 5, a recovery peer under section 245G.11,
subdivision 8, and a mental health case manager under section 245.462, subdivision 4;new text end and
new text begin (3) new text end "originating site" deleted text begin is defined under section 62A.671, subdivision 7deleted text end new text begin , "distant site," and
"store-and-forward transfer" have the meanings given in section 62A.673, subdivision 2new text end .
deleted text begin
(f) The limit on coverage of three telemedicine services per enrollee per calendar week
does not apply if:
deleted text end
deleted text begin
(1) the telemedicine services provided by the licensed health care provider are for the
treatment and control of tuberculosis; and
deleted text end
deleted text begin
(2) the services are provided in a manner consistent with the recommendations and best
practices specified by the Centers for Disease Control and Prevention and the commissioner
of health.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 11.
Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 3h. new text end
new text begin Telemonitoring services. new text end
new text begin
(a) Medical assistance covers telemonitoring services
if a recipient:
new text end
new text begin
(1) has been diagnosed and is receiving services for at least one of the following chronic
conditions: hypertension, cancer, congestive heart failure, chronic obstructive pulmonary
disease, asthma, or diabetes;
new text end
new text begin
(2) requires at least five times per week monitoring to manage the chronic condition, as
ordered by the recipient's health care provider;
new text end
new text begin
(3) has had two or more emergency room or inpatient hospitalization stays within the
last 12 months due to the chronic condition or the recipient's health care provider has
identified that telemonitoring services would likely prevent the recipient's admission or
readmission to a hospital, emergency room, or nursing facility;
new text end
new text begin
(4) is cognitively and physically capable of operating the monitoring device or equipment,
or the recipient has a caregiver who is willing and able to assist with the monitoring device
or equipment; and
new text end
new text begin
(5) resides in a setting that is suitable for telemonitoring and not in a setting that has
health care staff on site.
new text end
new text begin
(b) For purposes of this subdivision, "telemonitoring services" means the remote
monitoring of data related to a recipient's vital signs or biometric data by a monitoring
device or equipment that transmits the data electronically to a provider for analysis. The
assessment and monitoring of the health data transmitted by telemonitoring must be
performed by one of the following licensed health care professionals: physician, podiatrist,
registered nurse, advanced practice registered nurse, physician assistant, respiratory therapist,
or licensed professional working under the supervision of a medical director.
new text end
Sec. 12.
Minnesota Statutes 2020, section 256B.0625, subdivision 13h, is amended to
read:
Subd. 13h.
Medication therapy management services.
(a) Medical assistance covers
medication therapy management services for a recipient taking prescriptions to treat or
prevent one or more chronic medical conditions. For purposes of this subdivision,
"medication therapy management" means the provision of the following pharmaceutical
care services by a licensed pharmacist to optimize the therapeutic outcomes of the patient's
medications:
(1) performing or obtaining necessary assessments of the patient's health status;
(2) formulating a medication treatment plan, which may include prescribing medications
or products in accordance with section 151.37, subdivision 14, 15, or 16;
(3) monitoring and evaluating the patient's response to therapy, including safety and
effectiveness;
(4) performing a comprehensive medication review to identify, resolve, and prevent
medication-related problems, including adverse drug events;
(5) documenting the care delivered and communicating essential information to the
patient's other primary care providers;
(6) providing verbal education and training designed to enhance patient understanding
and appropriate use of the patient's medications;
(7) providing information, support services, and resources designed to enhance patient
adherence with the patient's therapeutic regimens; and
(8) coordinating and integrating medication therapy management services within the
broader health care management services being provided to the patient.
Nothing in this subdivision shall be construed to expand or modify the scope of practice of
the pharmacist as defined in section 151.01, subdivision 27.
(b) To be eligible for reimbursement for services under this subdivision, a pharmacist
must meet the following requirements:
(1) have a valid license issued by the Board of Pharmacy of the state in which the
medication therapy management service is being performed;
(2) have graduated from an accredited college of pharmacy on or after May 1996, or
completed a structured and comprehensive education program approved by the Board of
Pharmacy and the American Council of Pharmaceutical Education for the provision and
documentation of pharmaceutical care management services that has both clinical and
didactic elements;new text begin and
new text end
deleted text begin
(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
have developed a structured patient care process that is offered in a private or semiprivate
patient care area that is separate from the commercial business that also occurs in the setting,
or in home settings, including long-term care settings, group homes, and facilities providing
assisted living services, but excluding skilled nursing facilities; and
deleted text end
deleted text begin (4)deleted text end new text begin (3)new text end make use of an electronic patient record system that meets state standards.
(c) For purposes of reimbursement for medication therapy management services, the
commissioner may enroll individual pharmacists as medical assistance providers. The
commissioner may also establish deleted text begin contact requirements between the pharmacist and recipient,
including limitingdeleted text end new text begin limits on new text end the number of reimbursable consultations per recipient.
(d) deleted text begin If there are no pharmacists who meet the requirements of paragraph (b) practicing
within a reasonable geographic distance of the patient, a pharmacist who meets the
requirements may provide Thedeleted text end new text begin Medication therapy managementnew text end services new text begin may be provided
new text end via deleted text begin two-way interactive videodeleted text end new text begin telehealth as defined in subdivision 3b and may be delivered
into a patient's residencenew text end . Reimbursement shall be at the same rates and under the same
conditions that would otherwise apply to the services provided. To qualify for reimbursement
under this paragraph, the pharmacist providing the services must meet the requirements of
paragraph (b)deleted text begin , and must be located within an ambulatory care setting that meets the
requirements of paragraph (b), clause (3). The patient must also be located within an
ambulatory care setting that meets the requirements of paragraph (b), clause (3). Services
provided under this paragraph may not be transmitted into the patient's residencedeleted text end .
deleted text begin
(e) Medication therapy management services may be delivered into a patient's residence
via secure interactive video if the medication therapy management services are performed
electronically during a covered home care visit by an enrolled provider. Reimbursement
shall be at the same rates and under the same conditions that would otherwise apply to the
services provided. To qualify for reimbursement under this paragraph, the pharmacist
providing the services must meet the requirements of paragraph (b) and must be located
within an ambulatory care setting that meets the requirements of paragraph (b), clause (3).
deleted text end
Sec. 13.
Minnesota Statutes 2020, section 256B.0625, subdivision 20, is amended to read:
Subd. 20.
Mental health case management.
(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illness and children with severe emotional disturbance. Services
provided under this section must meet the relevant standards in sections 245.461 to 245.4887,
the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts
9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules, parts
9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
(c) Medical assistance and MinnesotaCare payment for mental health case management
shall be made on a monthly basis. In order to receive payment for an eligible child, the
provider must document at least a face-to-face contact new text begin or a contact by interactive video that
meets the requirements of subdivision 20b new text end with the child, the child's parents, or the child's
legal representative. To receive payment for an eligible adult, the provider must document:
(1) at least a face-to-face contactnew text begin , or a contact by interactive video that meets the
requirements of subdivision 20b,new text end with the adult or the adult's legal representative or a contact
by interactive video that meets the requirements of subdivision 20b; or
(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact or a contact by interactive video that meets the requirements
of subdivision 20b with the adult or the adult's legal representative within the preceding
two months.
(d) Payment for mental health case management provided by county or state staff shall
be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental health, and within mental
health, separate rates for children and adults.
(e) Payment for mental health case management provided by Indian health services or
by agencies operated by Indian tribes may be made according to this section or other relevant
federally approved rate setting methodology.
(f) Payment for mental health case management provided by vendors who contract with
a county or Indian tribe shall be based on a monthly rate negotiated by the host county or
tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the county
or tribe may negotiate a team rate with a vendor who is a member of the team. The team
shall determine how to distribute the rate among its members. No reimbursement received
by contracted vendors shall be returned to the county or tribe, except to reimburse the county
or tribe for advance funding provided by the county or tribe to the vendor.
(g) If the service is provided by a team which includes contracted vendors, tribal staff,
and county or state staff, the costs for county or state staff participation in the team shall be
included in the rate for county-provided services. In this case, the contracted vendor, the
tribal agency, and the county may each receive separate payment for services provided by
each entity in the same month. In order to prevent duplication of services, each entity must
document, in the recipient's file, the need for team case management and a description of
the roles of the team members.
(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
mental health case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall be provided by
the recipient's county of responsibility.
(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.
(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency,
is responsible for any federal disallowances. The county or tribe may share this responsibility
with its contracted vendors.
(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
(1) the costs of developing and implementing this section; and
(2) programming the information systems.
(l) Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.
(m) Case management services under this subdivision do not include therapy, treatment,
legal, or outreach services.
(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the lesser of:
(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or
(2) the limits and conditions which apply to federal Medicaid funding for this service.
(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.
(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 14.
Minnesota Statutes 2020, section 256B.0625, subdivision 20b, is amended to
read:
Subd. 20b.
deleted text begin Mental healthdeleted text end Targeted case management new text begin face-to-face contactnew text end through
interactive video.
deleted text begin
(a) Subject to federal approval, contact made for targeted case management
by interactive video shall be eligible for payment if:
deleted text end
deleted text begin
(1) the person receiving targeted case management services is residing in:
deleted text end
deleted text begin
(i) a hospital;
deleted text end
deleted text begin
(ii) a nursing facility; or
deleted text end
deleted text begin
(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging
deleted text end
deleted text begin
establishment or lodging establishment that provides supportive services or health supervision
deleted text end
deleted text begin
services according to section
deleted text end
deleted text begin
that is staffed 24 hours a day, seven days a week;
deleted text end
deleted text begin
(2) interactive video is in the best interests of the person and is deemed appropriate by
deleted text end
deleted text begin
the person receiving targeted case management or the person's legal guardian, the case
deleted text end
deleted text begin
management provider, and the provider operating the setting where the person is residing;
deleted text end
deleted text begin
(3) the use of interactive video is approved as part of the person's written personal service
deleted text end
deleted text begin
or case plan, taking into consideration the person's vulnerability and active personal
deleted text end
deleted text begin
relationships; and
deleted text end
deleted text begin (4) interactive video is used for up to, but not more than, 50 percent of the minimum
required face-to-facedeleted text end deleted text begin contact.deleted text end new text begin (a) Minimum required face-to-face contacts for targeted case
management may be provided through interactive video if interactive video is in the best
interests of the person and is deemed appropriate by the person receiving targeted case
management or the person's legal guardian and the case management provider.
new text end
(b) The person receiving targeted case management or the person's legal guardian has
the right to choose and consent to the use of interactive video under this subdivision and
has the right to refuse the use of interactive video at any time.
(c) The commissioner deleted text begin shalldeleted text end new text begin maynew text end establish criteria that a targeted case management
provider must attest to in order to demonstrate the safety or efficacy of deleted text begin delivering the servicedeleted text end
new text begin meeting the minimum face-to-face contact requirements for targeted case managementnew text end via
interactive video. deleted text begin The attestation may include that the case management provider has:
deleted text end
deleted text begin
(1) written policies and procedures specific to interactive video services that are regularly
deleted text end
deleted text begin
reviewed and updated;
deleted text end
deleted text begin
(2) policies and procedures that adequately address client safety before, during, and after
deleted text end
deleted text begin
the interactive video services are rendered;
deleted text end
deleted text begin
(3) established protocols addressing how and when to discontinue interactive video
deleted text end
deleted text begin
services; and
deleted text end
deleted text begin
(4) established a quality assurance process related to interactive video services.
deleted text end
(d) As a condition of payment, the targeted case management provider must document
the following for each occurrence of targeted case management provided by interactive
video new text begin for the purpose of face-to-face contactnew text end :
(1) the time the deleted text begin servicedeleted text end new text begin contactnew text end began and the time the deleted text begin servicedeleted text end new text begin contactnew text end ended, including
an a.m. and p.m. designation;
(2) the basis for determining that interactive video is an appropriate and effective means
for deleted text begin delivering the service todeleted text end new text begin contactingnew text end the person receiving new text begin targetednew text end case management
services;
(3) the mode of transmission of the interactive video services and records evidencing
that a particular mode of transmission was utilized; new text begin and
new text end
(4) the location of the originating site and the distant sitedeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(5) compliance with the criteria attested to by the targeted case management provider
as provided in paragraph (c).
deleted text end
new text begin
(e) Interactive video must not be used to meet minimum face-to-face contact requirements
for children who are in out-of-home placement or receiving case management services for
child protection reasons.
new text end
new text begin
(f) For the purposes of this section, "interactive video" means real-time, two-way
interactive audio and visual communications.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 15.
Minnesota Statutes 2020, section 256B.0625, subdivision 46, is amended to read:
Subd. 46.
Mental health deleted text begin telemedicinedeleted text end new text begin telehealthnew text end .
deleted text begin Effective January 1, 2006, anddeleted text end Subject
to federal approval, mental health services that are otherwise covered by medical assistance
as direct face-to-face services may be provided via deleted text begin two-way interactive videodeleted text end new text begin telehealth as
defined in subdivision 3bnew text end . Use of deleted text begin two-way interactive videodeleted text end new text begin telehealth to deliver servicesnew text end
must be medically appropriate to the condition and needs of the person being served.
Reimbursement is at the same rates and under the same conditions that would otherwise
apply to the service. deleted text begin The interactive video equipment and connection must comply with
Medicare standards in effect at the time the service is provided.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 16.
Minnesota Statutes 2020, section 256B.0911, subdivision 1a, is amended to read:
Subd. 1a.
Definitions.
For purposes of this section, the following definitions apply:
(a) Until additional requirements apply under paragraph (b), "long-term care consultation
services" means:
(1) intake for and access to assistance in identifying services needed to maintain an
individual in the most inclusive environment;
(2) providing recommendations for and referrals to cost-effective community services
that are available to the individual;
(3) development of an individual's person-centered community support plan;
(4) providing information regarding eligibility for Minnesota health care programs;
(5) deleted text begin face-to-facedeleted text end long-term care consultation assessmentsnew text begin conducted according to
subdivision 3anew text end , which may be completed in a hospital, nursing facility, intermediate care
facility for persons with developmental disabilities (ICF/DDs), regional treatment centers,
or the person's current or planned residence;
(6) determination of home and community-based waiver and other service eligibility as
required under chapter 256S and sections 256B.0913, 256B.092, and 256B.49, including
level of care determination for individuals who need an institutional level of care as
determined under subdivision 4e, based on a long-term care consultation assessment and
community support plan development, appropriate referrals to obtain necessary diagnostic
information, and including an eligibility determination for consumer-directed community
supports;
(7) providing recommendations for institutional placement when there are no
cost-effective community services available;
(8) providing access to assistance to transition people back to community settings after
institutional admission;
(9) providing information about competitive employment, with or without supports, for
school-age youth and working-age adults and referrals to the Disability Hub and Disability
Benefits 101 to ensure that an informed choice about competitive employment can be made.
For the purposes of this subdivision, "competitive employment" means work in the
competitive labor market that is performed on a full-time or part-time basis in an integrated
setting, and for which an individual is compensated at or above the minimum wage, but not
less than the customary wage and level of benefits paid by the employer for the same or
similar work performed by individuals without disabilities;
(10) providing information about independent living to ensure that an informed choice
about independent living can be made; and
(11) providing information about self-directed services and supports, including
self-directed funding options, to ensure that an informed choice about self-directed options
can be made.
(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c,
and 3a, "long-term care consultation services" also means:
(1) service eligibility determination for the following state plan services:
(i) personal care assistance services under section 256B.0625, subdivisions 19a and 19c;
(ii) consumer support grants under section 256.476; or
(iii) community first services and supports under section 256B.85;
(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
gaining access to:
(i) relocation targeted case management services available under section 256B.0621,
subdivision 2, clause (4);
(ii) case management services targeted to vulnerable adults or developmental disabilities
under section 256B.0924; and
(iii) case management services targeted to people with developmental disabilities under
Minnesota Rules, part 9525.0016;
(3) determination of eligibility for semi-independent living services under section
252.275; and
(4) obtaining necessary diagnostic information to determine eligibility under clauses (2)
and (3).
(c) "Long-term care options counseling" means the services provided by sections 256.01,
subdivision 24, and 256.975, subdivision 7, and also includes telephone assistance and
follow up once a long-term care consultation assessment has been completed.
(d) "Minnesota health care programs" means the medical assistance program under this
chapter and the alternative care program under section 256B.0913.
(e) "Lead agencies" means counties administering or tribes and health plans under
contract with the commissioner to administer long-term care consultation services.
(f) "Person-centered planning" is a process that includes the active participation of a
person in the planning of the person's services, including in making meaningful and informed
choices about the person's own goals, talents, and objectives, as well as making meaningful
and informed choices about the services the person receives, the settings in which the person
receives the services, and the setting in which the person lives.
(g) "Informed choice" means a voluntary choice of services, settings, living arrangement,
and work by a person from all available service and setting options based on accurate and
complete information concerning all available service and setting options and concerning
the person's own preferences, abilities, goals, and objectives. In order for a person to make
an informed choice, all available options must be developed and presented to the person in
a way the person can understand to empower the person to make fully informed choices.
(h) "Available service and setting options" or "available options," with respect to the
home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49,
means all services and settings defined under the waiver plan for which a waiver applicant
or waiver participant is eligible.
(i) "Independent living" means living in a setting that is not controlled by a provider.
Sec. 17.
Minnesota Statutes 2020, section 256B.0911, subdivision 3a, is amended to read:
Subd. 3a.
Assessment and support planning.
(a) Persons requesting assessment, services
planning, or other assistance intended to support community-based living, including persons
who need assessment in order to determine waiver or alternative care program eligibility,
must be visited by a long-term care consultation team within 20 calendar days after the date
on which an assessment was requested or recommended. Upon statewide implementation
of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person
requesting personal care assistance services. The commissioner shall provide at least a
90-day notice to lead agencies prior to the effective date of this requirement. deleted text begin Face-to-facedeleted text end
Assessments must be conducted according to paragraphs (b) to deleted text begin (i)deleted text end new text begin (q)new text end .
(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
assessors to conduct the assessment. For a person with complex health care needs, a public
health or registered nurse from the team must be consulted.
(c) The MnCHOICES assessment provided by the commissioner to lead agencies must
be used to complete a comprehensive, conversation-based, person-centered assessment.
The assessment must include the health, psychological, functional, environmental, and
social needs of the individual necessary to develop a person-centered community support
plan that meets the individual's needs and preferences.
(d) new text begin Except as provided in paragraph (q), new text end the assessment must be conducted by a certified
assessor in a face-to-face conversational interview with the person being assessed. The
person's legal representative must provide input during the assessment process and may do
so remotely if requested. At the request of the person, other individuals may participate in
the assessment to provide information on the needs, strengths, and preferences of the person
necessary to develop a community support plan that ensures the person's health and safety.
Except for legal representatives or family members invited by the person, persons
participating in the assessment may not be a provider of service or have any financial interest
in the provision of services. For persons who are to be assessed for elderly waiver customized
living or adult day services under chapter 256S, with the permission of the person being
assessed or the person's designated or legal representative, the client's current or proposed
provider of services may submit a copy of the provider's nursing assessment or written
report outlining its recommendations regarding the client's care needs. The person conducting
the assessment must notify the provider of the date by which this information is to be
submitted. This information shall be provided to the person conducting the assessment prior
to the assessment. For a person who is to be assessed for waiver services under section
256B.092 or 256B.49, with the permission of the person being assessed or the person's
designated legal representative, the person's current provider of services may submit a
written report outlining recommendations regarding the person's care needs the person
completed in consultation with someone who is known to the person and has interaction
with the person on a regular basis. The provider must submit the report at least 60 days
before the end of the person's current service agreement. The certified assessor must consider
the content of the submitted report prior to finalizing the person's assessment or reassessment.
(e) The certified assessor and the individual responsible for developing the coordinated
service and support plan must complete the community support plan and the coordinated
service and support plan no more than 60 calendar days from the assessment visit. The
person or the person's legal representative must be provided with a written community
support plan within the timelines established by the commissioner, regardless of whether
the person is eligible for Minnesota health care programs.
(f) For a person being assessed for elderly waiver services under chapter 256S, a provider
who submitted information under paragraph (d) shall receive the final written community
support plan when available and the Residential Services Workbook.
(g) The written community support plan must include:
(1) a summary of assessed needs as defined in paragraphs (c) and (d);
(2) the individual's options and choices to meet identified needs, including:
(i) all available options for case management services and providers;
(ii) all available options for employment services, settings, and providers;
(iii) all available options for living arrangements;
(iv) all available options for self-directed services and supports, including self-directed
budget options; and
(v) service provided in a non-disability-specific setting;
(3) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;
(4) referral information; and
(5) informal caregiver supports, if applicable.
For a person determined eligible for state plan home care under subdivision 1a, paragraph
(b), clause (1), the person or person's representative must also receive a copy of the home
care service plan developed by the certified assessor.
(h) A person may request assistance in identifying community supports without
participating in a complete assessment. Upon a request for assistance identifying community
support, the person must be transferred or referred to long-term care options counseling
services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for
telephone assistance and follow up.
(i) The person has the right to make the final decision:
(1) between institutional placement and community placement after the recommendations
have been provided, except as provided in section 256.975, subdivision 7a, paragraph (d);
(2) between community placement in a setting controlled by a provider and living
independently in a setting not controlled by a provider;
(3) between day services and employment services; and
(4) regarding available options for self-directed services and supports, including
self-directed funding options.
(j) The lead agency must give the person receiving long-term care consultation services
or the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:
(1) written recommendations for community-based services and consumer-directed
options;
(2) documentation that the most cost-effective alternatives available were offered to the
individual. For purposes of this clause, "cost-effective" means community services and
living arrangements that cost the same as or less than institutional care. For an individual
found to meet eligibility criteria for home and community-based service programs under
chapter 256S or section 256B.49, "cost-effectiveness" has the meaning found in the federally
approved waiver plan for each program;
(3) the need for and purpose of preadmission screening conducted by long-term care
options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
nursing facility placement. If the individual selects nursing facility placement, the lead
agency shall forward information needed to complete the level of care determinations and
screening for developmental disability and mental illness collected during the assessment
to the long-term care options counselor using forms provided by the commissioner;
(4) the role of long-term care consultation assessment and support planning in eligibility
determination for waiver and alternative care programs, and state plan home care, case
management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
and (b);
(5) information about Minnesota health care programs;
(6) the person's freedom to accept or reject the recommendations of the team;
(7) the person's right to confidentiality under the Minnesota Government Data Practices
Act, chapter 13;
(8) the certified assessor's decision regarding the person's need for institutional level of
care as determined under criteria established in subdivision 4e and the certified assessor's
decision regarding eligibility for all services and programs as defined in subdivision 1a,
paragraphs (a), clause (6), and (b);
(9) the person's right to appeal the certified assessor's decision regarding eligibility for
all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
(8), and (b), and incorporating the decision regarding the need for institutional level of care
or the lead agency's final decisions regarding public programs eligibility according to section
256.045, subdivision 3. The certified assessor must verbally communicate this appeal right
to the person and must visually point out where in the document the right to appeal is stated;
and
(10) documentation that available options for employment services, independent living,
and self-directed services and supports were described to the individual.
(k) deleted text begin Face-to-facedeleted text end Assessment completed as part of an eligibility determination for multiple
programs for the alternative care, elderly waiver, developmental disabilities, community
access for disability inclusion, community alternative care, and brain injury waiver programs
under chapter 256S and sections 256B.0913, 256B.092, and 256B.49 is valid to establish
service eligibility for no more than 60 calendar days after the date of assessment.
(l) The effective eligibility start date for programs in paragraph (k) can never be prior
to the date of assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment and support
plan information must be updated and documented in the department's Medicaid Management
Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
state plan services, the effective date of eligibility for programs included in paragraph (k)
cannot be prior to the date the most recent updated assessment is completed.
(m) If an eligibility update is completed within 90 days of the previous deleted text begin face-to-facedeleted text end
assessment and documented in the department's Medicaid Management Information System
(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date
of the previous deleted text begin face-to-facedeleted text end assessment when all other eligibility requirements are met.
(n) At the time of reassessment, the certified assessor shall assess each person receiving
waiver residential supports and services currently residing in a community residential setting,
licensed adult foster care home that is either not the primary residence of the license holder
or in which the license holder is not the primary caregiver, family adult foster care residence,
customized living setting, or supervised living facility to determine if that person would
prefer to be served in a community-living setting as defined in section 256B.49, subdivision
23, in a setting not controlled by a provider, or to receive integrated community supports
as described in section 245D.03, subdivision 1, paragraph (c), clause (8). The certified
assessor shall offer the person, through a person-centered planning process, the option to
receive alternative housing and service options.
(o) At the time of reassessment, the certified assessor shall assess each person receiving
waiver day services to determine if that person would prefer to receive employment services
as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified
assessor shall describe to the person through a person-centered planning process the option
to receive employment services.
(p) At the time of reassessment, the certified assessor shall assess each person receiving
non-self-directed waiver services to determine if that person would prefer an available
service and setting option that would permit self-directed services and supports. The certified
assessor shall describe to the person through a person-centered planning process the option
to receive self-directed services and supports.
new text begin
(q) All assessments performed according to this subdivision must be face-to-face unless
the assessment is a reassessment meeting the requirements of this paragraph. Subject to
federal approval, remote reassessments conducted by interactive video or telephone may
substitute for face-to-face reassessments for services provided by alternative care under
section 256B.0913, the elderly waiver under chapter 256S, the developmental disabilities
waiver under section 256B.092, and the community access for disability inclusion,
community alternative care, and brain injury waiver programs under section 256B.49.
Remote reassessments may be substituted for two consecutive reassessments if followed
by a face-to-face reassessment. A remote reassessment is permitted only if the person being
reassessed, the person's legal representative, and the lead agency case manager all agree
that there is no change in the person's condition, there is no need for a change in service,
and that a remote reassessment is appropriate. The person being reassessed, or the person's
legal representative, has the right to refuse a remote reassessment at any time. During a
remote reassessment, if the certified assessor determines in the assessor's sole judgment
that a remote reassessment is inappropriate, the certified assessor shall suspend the remote
reassessment and schedule a face-to-face reassessment to complete the reassessment. All
other requirements of a face-to-face reassessment apply to a remote reassessment.
new text end
Sec. 18.
Minnesota Statutes 2020, section 256B.0911, subdivision 3f, is amended to read:
Subd. 3f.
Long-term care reassessments and community support plan updates.
(a)
Prior to a deleted text begin face-to-facedeleted text end reassessment, the certified assessor must review the person's most
recent assessment. Reassessments must be tailored using the professional judgment of the
assessor to the person's known needs, strengths, preferences, and circumstances.
Reassessments provide information to support the person's informed choice and opportunities
to express choice regarding activities that contribute to quality of life, as well as information
and opportunity to identify goals related to desired employment, community activities, and
preferred living environment. Reassessments require a review of the most recent assessment,
review of the current coordinated service and support plan's effectiveness, monitoring of
services, and the development of an updated person-centered community support plan.
Reassessments must verify continued eligibility, offer alternatives as warranted, and provide
an opportunity for quality assurance of service delivery. deleted text begin Face-to-facedeleted text end Reassessments must
be conducted annually or as required by federal and state laws and rules. For reassessments,
the certified assessor and the individual responsible for developing the coordinated service
and support plan must ensure the continuity of care for the person receiving services and
complete the updated community support plan and the updated coordinated service and
support plan no more than 60 days from the reassessment visit.
(b) The commissioner shall develop mechanisms for providers and case managers to
share information with the assessor to facilitate a reassessment and support planning process
tailored to the person's current needs and preferences.
Sec. 19.
Minnesota Statutes 2020, section 256B.0911, subdivision 4d, is amended to read:
Subd. 4d.
Preadmission screening of individuals under 65 years of age.
(a) It is the
policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness
are served in the most integrated setting appropriate to their needs and have the necessary
information to make informed choices about home and community-based service options.
(b) Individuals under 65 years of age who are admitted to a Medicaid-certified nursing
facility must be screened prior to admission according to the requirements outlined in section
256.975, subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as
required under section 256.975, subdivision 7.
(c) Individuals under 65 years of age who are admitted to nursing facilities with only a
telephone screening must receive a face-to-face assessment from the long-term care
consultation team member of the county in which the facility is located or from the recipient's
county case manager within the timeline established by the commissioner, based on review
of data.
(d) At the face-to-face assessment, the long-term care consultation team member or
county case manager must perform the activities required under subdivision 3b.
(e) For individuals under 21 years of age, a screening interview which recommends
nursing facility admission must be face-to-face and approved by the commissioner before
the individual is admitted to the nursing facility.
(f) In the event that an individual under 65 years of age is admitted to a nursing facility
on an emergency basis, the Senior LinkAge Line must be notified of the admission on the
next working day, and a face-to-face assessment as described in paragraph (c) must be
conducted within the timeline established by the commissioner, based on review of data.
(g) At the face-to-face assessment, the long-term care consultation team member or the
case manager must present information about home and community-based options, including
consumer-directed options, so the individual can make informed choices. If the individual
chooses home and community-based services, the long-term care consultation team member
or case manager must complete a written relocation plan within 20 working days of the
visit. The plan shall describe the services needed to move out of the facility and a time line
for the move which is designed to ensure a smooth transition to the individual's home and
community.
(h) An individual under 65 years of age residing in a nursing facility shall receive a
deleted text begin face-to-face assessmentdeleted text end new text begin reassessmentnew text end at least every 12 months to review the person's service
choices and available alternatives unless the individual indicates, in writing, that annual
visits are not desired. In this case, the individual must receive a deleted text begin face-to-face assessmentdeleted text end new text begin
reassessmentnew text end at least once every 36 months for the same purposes. new text begin A remote reassessment
is permitted only if the person being reassessed, the person's legal representative, and the
lead agency case manager all agree that there is no change in the person's condition, there
is no need for a change in service, and that a remote reassessment is appropriate. The person
being reassessed, or the person's legal representative, has the right to refuse a remote
reassessment at any time. During a remote reassessment, if the certified assessor determines
in the assessor's sole judgment that a remote reassessment is inappropriate, the certified
assessor shall suspend the remote reassessment and schedule a face-to-face reassessment
to complete the reassessment. All other requirements of a face-to-face reassessment apply
to a remote reassessment.
new text end
(i) Notwithstanding the provisions of subdivision 6, the commissioner may pay county
agencies directly for deleted text begin face-to-facedeleted text end assessments for individuals under 65 years of age who
are being considered for placement or residing in a nursing facility.
(j) Funding for preadmission screening follow-up shall be provided to the Disability
Hub for the under-60 population by the Department of Human Services to cover options
counseling salaries and expenses to provide the services described in subdivisions 7a to 7c.
The Disability Hub shall employ, or contract with other agencies to employ, within the
limits of available funding, sufficient personnel to provide preadmission screening follow-up
services and shall seek to maximize federal funding for the service as provided under section
256.01, subdivision 2, paragraph (aa).
Sec. 20.
Minnesota Statutes 2020, section 256B.0924, subdivision 6, is amended to read:
Subd. 6.
Payment for targeted case management.
(a) Medical assistance and
MinnesotaCare payment for targeted case management shall be made on a monthly basis.
In order to receive payment for an eligible adult, the provider must document at least one
contact per month and not more than two consecutive months without a face-to-face contact
new text begin or a contact by interactive video that meets the requirements of section 256B.0625,
subdivision 20b, new text end with the adult or the adult's legal representative, family, primary caregiver,
or other relevant persons identified as necessary to the development or implementation of
the goals of the personal service plan.
(b) Payment for targeted case management provided by county staff under this subdivision
shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
paragraph (b), calculated as one combined average rate together with adult mental health
case management under section 256B.0625, subdivision 20, except for calendar year 2002.
In calendar year 2002, the rate for case management under this section shall be the same as
the rate for adult mental health case management in effect as of December 31, 2001. Billing
and payment must identify the recipient's primary population group to allow tracking of
revenues.
(c) Payment for targeted case management provided by county-contracted vendors shall
be based on a monthly rate negotiated by the host county. The negotiated rate must not
exceed the rate charged by the vendor for the same service to other payers. If the service is
provided by a team of contracted vendors, the county may negotiate a team rate with a
vendor who is a member of the team. The team shall determine how to distribute the rate
among its members. No reimbursement received by contracted vendors shall be returned
to the county, except to reimburse the county for advance funding provided by the county
to the vendor.
(d) If the service is provided by a team that includes contracted vendors and county staff,
the costs for county staff participation on the team shall be included in the rate for
county-provided services. In this case, the contracted vendor and the county may each
receive separate payment for services provided by each entity in the same month. In order
to prevent duplication of services, the county must document, in the recipient's file, the need
for team targeted case management and a description of the different roles of the team
members.
(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
targeted case management shall be provided by the recipient's county of responsibility, as
defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds.
(f) The commissioner may suspend, reduce, or terminate reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal
disallowances. The county may share this responsibility with its contracted vendors.
(g) The commissioner shall set aside five percent of the federal funds received under
this section for use in reimbursing the state for costs of developing and implementing this
section.
(h) Payments to counties for targeted case management expenditures under this section
shall only be made from federal earnings from services provided under this section. Payments
to contracted vendors shall include both the federal earnings and the county share.
(i) Notwithstanding section 256B.041, county payments for the cost of case management
services provided by county staff shall not be made to the commissioner of management
and budget. For the purposes of targeted case management services provided by county
staff under this section, the centralized disbursement of payments to counties under section
256B.041 consists only of federal earnings from services provided under this section.
(j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for targeted case
management services under this subdivision is limited to the lesser of:
(1) the last 180 days of the recipient's residency in that facility; or
(2) the limits and conditions which apply to federal Medicaid funding for this service.
(k) Payment for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.
(l) Any growth in targeted case management services and cost increases under this
section shall be the responsibility of the counties.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 21.
Minnesota Statutes 2020, section 256B.094, subdivision 6, is amended to read:
Subd. 6.
Medical assistance reimbursement of case management services.
(a) Medical
assistance reimbursement for services under this section shall be made on a monthly basis.
Payment is based on face-to-facenew text begin , interactive video,new text end or telephone contacts between the case
manager and the client, client's family, primary caregiver, legal representative, or other
relevant person identified as necessary to the development or implementation of the goals
of the individual service plan regarding the status of the client, the individual service plan,
or the goals for the client. These contacts must meet the minimum standards in clauses (1)
and (2):
(1) there must be a face-to-face contactnew text begin , or a contact by interactive video that meets the
requirements of section 256B.0625, subdivision 20b,new text end at least once a month except as provided
in clause (2); and
(2) for a client placed outside of the county of financial responsibility, or a client served
by tribal social services placed outside the reservation, in an excluded time facility under
section 256G.02, subdivision 6, or through the Interstate Compact for the Placement of
Children, section 260.93, and the placement in either case is more than 60 miles beyond
the county or reservation boundaries, there must be at least one contact per month and not
more than two consecutive months without a face-to-face contact.
new text begin
Face-to-face contacts under this paragraph may be conducted using interactive video for
up to two consecutive contacts following each in-person contact.
new text end
(b) Except as provided under paragraph (c), the payment rate is established using time
study data on activities of provider service staff and reports required under sections 245.482
and 256.01, subdivision 2, paragraph (p).
(c) Payments for tribes may be made according to section 256B.0625 or other relevant
federally approved rate setting methodology for child welfare targeted case management
provided by Indian health services and facilities operated by a tribe or tribal organization.
(d) Payment for case management provided by county or tribal social services contracted
vendors shall be based on a monthly rate negotiated by the host county or tribal social
services. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the county
or tribal social services may negotiate a team rate with a vendor who is a member of the
team. The team shall determine how to distribute the rate among its members. No
reimbursement received by contracted vendors shall be returned to the county or tribal social
services, except to reimburse the county or tribal social services for advance funding provided
by the county or tribal social services to the vendor.
(e) If the service is provided by a team that includes contracted vendors and county or
tribal social services staff, the costs for county or tribal social services staff participation in
the team shall be included in the rate for county or tribal social services provided services.
In this case, the contracted vendor and the county or tribal social services may each receive
separate payment for services provided by each entity in the same month. To prevent
duplication of services, each entity must document, in the recipient's file, the need for team
case management and a description of the roles and services of the team members.
new text begin (f) new text end Separate payment rates may be established for different groups of providers to
maximize reimbursement as determined by the commissioner. The payment rate will be
reviewed annually and revised periodically to be consistent with the most recent time study
and other data. Payment for services will be made upon submission of a valid claim and
verification of proper documentation described in subdivision 7. Federal administrative
revenue earned through the time study, or under paragraph (c), shall be distributed according
to earnings, to counties, reservations, or groups of counties or reservations which have the
same payment rate under this subdivision, and to the group of counties or reservations which
are not certified providers under section 256F.10. The commissioner shall modify the
requirements set out in Minnesota Rules, parts 9550.0300 to 9550.0370, as necessary to
accomplish this.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 22.
Minnesota Statutes 2020, section 256B.49, subdivision 14, is amended to read:
Subd. 14.
Assessment and reassessment.
(a) Assessments and reassessments shall be
conducted by certified assessors according to section 256B.0911, subdivision 2b.
(b) There must be a determination that the client requires a hospital level of care or a
nursing facility level of care as defined in section 256B.0911, subdivision 4e, at initial and
subsequent assessments to initiate and maintain participation in the waiver program.
(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
appropriate to determine nursing facility level of care for purposes of medical assistance
payment for nursing facility services, only deleted text begin face-to-facedeleted text end assessments conducted according
to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
determination or a nursing facility level of care determination must be accepted for purposes
of initial and ongoing access to waiver services payment.
(d) Recipients who are found eligible for home and community-based services under
this section before their 65th birthday may remain eligible for these services after their 65th
birthday if they continue to meet all other eligibility factors.
Sec. 23.
Minnesota Statutes 2020, section 256J.09, subdivision 3, is amended to read:
Subd. 3.
Submitting application form.
(a) A county agency must offer, in person or
by mail, the application forms prescribed by the commissioner as soon as a person makes
a written or oral inquiry. At that time, the county agency must:
(1) inform the person that assistance begins deleted text begin withdeleted text end new text begin onnew text end the date new text begin that new text end the deleted text begin signeddeleted text end application
is received by the county agency new text begin either as a written application; an application submitted
by telephone; or an application submitted through Internet telepresence; new text end or new text begin on new text end the date new text begin that
new text end all eligibility criteria are met, whichever is later;
(2) new text begin inform a person that the person may submit the application by telephone or through
Internet telepresence;
new text end
new text begin
(3) inform a person that when the person submits the application by telephone or through
Internet telepresence, the county agency must receive a signed written application within
30 days of the date that the person submitted the application by telephone or through Internet
telepresence;
new text end
new text begin (4) new text end inform the person that any delay in submitting the application will reduce the amount
of assistance paid for the month of application;
deleted text begin (3)deleted text end new text begin (5)new text end inform a person that the person may submit the application before an interview;
deleted text begin (4)deleted text end new text begin (6)new text end explain the information that will be verified during the application process by
the county agency as provided in section 256J.32;
deleted text begin (5)deleted text end new text begin (7)new text end inform a person about the county agency's average application processing time
and explain how the application will be processed under subdivision 5;
deleted text begin (6)deleted text end new text begin (8)new text end explain how to contact the county agency if a person's application information
changes and how to withdraw the application;
deleted text begin (7)deleted text end new text begin (9)new text end inform a person that the next step in the application process is an interview and
what a person must do if the application is approved including, but not limited to, attending
orientation under section 256J.45 and complying with employment and training services
requirements in sections 256J.515 to 256J.57;
deleted text begin (8)deleted text end new text begin (10)new text end inform the person that deleted text begin thedeleted text end new text begin annew text end interview must be conductednew text begin . The interview may
be conductednew text end face-to-face in the county officenew text begin or at a location mutually agreed uponnew text end , through
Internet telepresence, or deleted text begin at a location mutually agreed upondeleted text end new text begin by telephonenew text end ;
deleted text begin
(9) inform a person who has received MFIP or DWP in the past 12 months of the option
to have a face-to-face, Internet telepresence, or telephone interview;
deleted text end
deleted text begin (10)deleted text end new text begin (11)new text end explain the child care and transportation services that are available under
paragraph (c) to enable caregivers to attend the interview, screening, and orientation; and
deleted text begin (11)deleted text end new text begin (12)new text end identify any language barriers and arrange for translation assistance during
appointments, including, but not limited to, screening under subdivision 3a, orientation
under section 256J.45, and assessment under section 256J.521.
(b) Upon receipt of a signed application, the county agency must stamp the date of receipt
on the face of the application. The county agency must process the application within the
time period required under subdivision 5. An applicant may withdraw the application at
any time by giving written or oral notice to the county agency. The county agency must
issue a written notice confirming the withdrawal. The notice must inform the applicant of
the county agency's understanding that the applicant has withdrawn the application and no
longer wants to pursue it. When, within ten days of the date of the agency's notice, an
applicant informs a county agency, in writing, that the applicant does not wish to withdraw
the application, the county agency must reinstate the application and finish processing the
application.
(c) Upon a participant's request, the county agency must arrange for transportation and
child care or reimburse the participant for transportation and child care expenses necessary
to enable participants to attend the screening under subdivision 3a and orientation under
section 256J.45.
Sec. 24.
Minnesota Statutes 2020, section 256J.45, subdivision 1, is amended to read:
Subdivision 1.
County agency to provide orientation.
A county agency must provide
deleted text begin a face-to-facedeleted text end new text begin annew text end orientation to each MFIP caregiver unless the caregiver is:
(1) a single parent, or one parent in a two-parent family, employed at least 35 hours per
week; or
(2) a second parent in a two-parent family who is employed for 20 or more hours per
week provided the first parent is employed at least 35 hours per week.
The county agency must inform caregivers who are not exempt under clause (1) or (2) that
failure to attend the orientation is considered an occurrence of noncompliance with program
requirements, and will result in the imposition of a sanction under section 256J.46. If the
client complies with the orientation requirement prior to the first day of the month in which
the grant reduction is proposed to occur, the orientation sanction shall be lifted.
Sec. 25.
Minnesota Statutes 2020, section 256S.05, subdivision 2, is amended to read:
Subd. 2.
Nursing facility level of care determination required.
Notwithstanding other
assessments identified in section 144.0724, subdivision 4, only deleted text begin face-to-facedeleted text end assessments
conducted according to section 256B.0911, subdivisions 3, 3a, and 3b, that result in a nursing
facility level of care determination at initial and subsequent assessments shall be accepted
for purposes of a participant's initial and ongoing participation in the elderly waiver and a
service provider's access to service payments under this chapter.
Sec. 26. new text begin STUDY OF TELEHEALTH.
new text end
new text begin
(a) The commissioner of health, in consultation with the commissioners of human services
and commerce, shall study the impact of telehealth payment methodologies and expansion
under the Minnesota Telehealth Act on the coverage and provision of health care services
under public health care programs and private health insurance. The study shall review and
make recommendations related to:
new text end
new text begin
(1) the impact of telehealth payment methodologies and expansion on access to health
care services, quality of care, and value-based payments and innovation in care delivery;
new text end
new text begin
(2) the short-term and long-term impacts of telehealth payment methodologies and
expansion in reducing health care disparities and providing equitable access for underserved
communities;
new text end
new text begin
(3) the use of audio-only communication in supporting equitable access to health care
services, including behavioral health services for the elderly, rural communities, and
communities of color, and eliminating barriers for vulnerable and underserved populations;
new text end
new text begin
(4) whether there is evidence to suggest that increased access to telehealth improves
health outcomes and, if so, for which services and populations; and
new text end
new text begin
(5) the effect of payment parity on public and private health care costs, health care
premiums, and health outcomes.
new text end
new text begin
(b) When conducting the study, the commissioner shall consult with stakeholders and
communities impacted by telehealth payment and expansion. The commissioner,
notwithstanding Minnesota Statutes, section 62U.04, subdivision 11, may use data available
under that section to conduct the study. The commissioner shall report findings to the chairs
and ranking minority members of the legislative committees with jurisdiction over health
care policy and finance and commerce, by February 15, 2023.
new text end
Sec. 27. new text begin EFFECTIVE DATE.
new text end
new text begin
The amendments in this article to, or establishing, the following provisions of Minnesota
Statutes are effective January 1, 2022: 245G.01, subdivision 26; 245G.06, subdivision 1;
256B.0596; and 256B.0625, subdivisions 3h and 13h.
new text end
Sec. 28. new text begin EXPIRATION DATE.
new text end
new text begin
(a) The amendments in this article to, or establishing, the following provisions of
Minnesota Statutes expire July 1, 2023: 245G.01, subdivision 13; 245G.01, subdivision 26;
245G.06, subdivision 1; 254A.19, subdivision 5; 254B.05, subdivision 5; 256B.0596; and
256B.0625, subdivisions 3b, 3h, 13h, and 46.
new text end
new text begin
(b) Notwithstanding paragraph (a), the definition of "originating site" in Minnesota
Statutes, section 256B.0625, subdivision 3b, paragraph (d), clause (3), shall not expire.
new text end
Sec. 29. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall substitute the term "telemedicine" with "telehealth" whenever
the term appears in Minnesota Statutes and substitute Minnesota Statutes, section 62A.673,
whenever references to Minnesota Statutes, sections 62A.67, 62A.671, and 62A.672, appear
in Minnesota Statutes.
new text end
Sec. 30. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2020, sections 62A.67; 62A.671; and 62A.672,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2020, sections 256B.0596; and 256B.0924, subdivision 4a,
new text end
new text begin
are
repealed upon federal approval. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
new text end
ARTICLE 8
APPROPRIATIONS
Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.
|
new text begin
The sums shown in the columns marked "Appropriations" are appropriated to the agencies
and for the purposes specified in this article. The appropriations are from the general fund,
or another named fund, and are available for the fiscal years indicated for each purpose.
The figures "2022" and "2023" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2022, or June 30, 2023, respectively.
"The first year" is fiscal year 2022. "The second year" is fiscal year 2023. "The biennium"
is fiscal years 2022 and 2023.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2022 new text end |
new text begin
2023 new text end |
|||||
Sec. 2. new text begin COMMISSIONER OF HUMAN
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
8,944,696,000 new text end |
new text begin
$ new text end |
new text begin
9,423,461,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2022 new text end |
new text begin
2023 new text end |
|
|
new text begin
General new text end |
new text begin
7,786,104,000 new text end |
new text begin
8,289,809,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,299,000 new text end |
new text begin
4,299,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
867,214,000 new text end |
new text begin
845,520,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
282,623,000 new text end |
new text begin
278,803,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
1,896,000 new text end |
new text begin
1,896,000 new text end |
|
new text begin
Opiate Epidemic Response new text end |
new text begin
2,560,000 new text end |
new text begin
2,560,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
TANF Maintenance of Effort
|
||||||
new text begin
(a) Nonfederal Expenditures. The
commissioner shall ensure that sufficient
qualified nonfederal expenditures are made
each year to meet the state's maintenance of
effort (MOE) requirements of the TANF block
grant specified under Code of Federal
Regulations, title 45, section 263.1. In order
to meet these basic TANF/MOE requirements,
the commissioner may report as TANF/MOE
expenditures only nonfederal money expended
for allowable activities listed in the following
clauses:
new text end
new text begin
(1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;
new text end
new text begin
(2) the child care assistance programs under
Minnesota Statutes, sections 119B.03 and
119B.05, and county child care administrative
costs under Minnesota Statutes, section
119B.15;
new text end
new text begin
(3) state and county MFIP administrative costs
under Minnesota Statutes, chapters 256J and
256K;
new text end
new text begin
(4) state, county, and tribal MFIP employment
services under Minnesota Statutes, chapters
256J and 256K;
new text end
new text begin
(5) expenditures made on behalf of legal
noncitizen MFIP recipients who qualify for
the MinnesotaCare program under Minnesota
Statutes, chapter 256L;
new text end
new text begin
(6) qualifying working family credit
expenditures under Minnesota Statutes, section
290.0671;
new text end
new text begin
(7) qualifying Minnesota education credit
expenditures under Minnesota Statutes, section
290.0674; and
new text end
new text begin
(8) qualifying Head Start expenditures under
Minnesota Statutes, section 119A.50.
new text end
new text begin
(b) Nonfederal Expenditures; Reporting.
For the activities listed in paragraph (a),
clauses (2) to (8), the commissioner may
report only expenditures that are excluded
from the definition of assistance under Code
of Federal Regulations, title 45, section
260.31.
new text end
new text begin
(c) Certain Expenditures Required. The
commissioner shall ensure that the MOE used
by the commissioner of management and
budget for the February and November
forecasts required under Minnesota Statutes,
section 16A.103, contains expenditures under
paragraph (a), clause (1), equal to at least 16
percent of the total required under Code of
Federal Regulations, title 45, section 263.1.
new text end
new text begin
(d) Limitation; Exceptions. The
commissioner must not claim an amount of
TANF/MOE in excess of the 75 percent
standard in Code of Federal Regulations, title
45, section 263.1(a)(2), except:
new text end
new text begin
(1) to the extent necessary to meet the 80
percent standard under Code of Federal
Regulations, title 45, section 263.1(a)(1), if it
is determined by the commissioner that the
state will not meet the TANF work
participation target rate for the current year;
new text end
new text begin
(2) to provide any additional amounts under
Code of Federal Regulations, title 45, section
264.5, that relate to replacement of TANF
funds due to the operation of TANF penalties;
and
new text end
new text begin
(3) to provide any additional amounts that may
contribute to avoiding or reducing TANF work
participation penalties through the operation
of the excess MOE provisions of Code of
Federal Regulations, title 45, section 261.43
(a)(2).
new text end
new text begin
(e) Supplemental Expenditures. For the
purposes of paragraph (d), the commissioner
may supplement the MOE claim with working
family credit expenditures or other qualified
expenditures to the extent such expenditures
are otherwise available after considering the
expenditures allowed in this subdivision.
new text end
new text begin
(f) Reduction of Appropriations; Exception.
The requirement in Minnesota Statutes, section
256.011, subdivision 3, that federal grants or
aids secured or obtained under that subdivision
be used to reduce any direct appropriations
provided by law, does not apply if the grants
or aids are federal TANF funds.
new text end
new text begin
(g) IT Appropriations Generally. This
appropriation includes funds for information
technology projects, services, and support.
Notwithstanding Minnesota Statutes, section
16E.0466, funding for information technology
project costs shall be incorporated into the
service level agreement and paid to the Office
of MN.IT Services by the Department of
Human Services under the rates and
mechanism specified in that agreement.
new text end
new text begin
(h) Receipts for Systems Project.
Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, ISDS, METS, and SSIS must
be deposited in the state systems account
authorized in Minnesota Statutes, section
256.014. Money appropriated for computer
projects approved by the commissioner of the
Office of MN.IT Services, funded by the
legislature, and approved by the commissioner
of management and budget may be transferred
from one project to another and from
development to operations as the
commissioner of human services considers
necessary. Any unexpended balance in the
appropriation for these projects does not
cancel and is available for ongoing
development and operations.
new text end
new text begin
(i) Federal SNAP Education and Training
Grants. Federal funds available during fiscal
years 2022 and 2023 for Supplemental
Nutrition Assistance Program Education and
Training and SNAP Quality Control
Performance Bonus grants are appropriated
to the commissioner of human services for the
purposes allowable under the terms of the
federal award. This paragraph is effective the
day following final enactment.
new text end
new text begin Subd. 3. new text end
new text begin
Information Technology
|
||||||
new text begin
(a) IT Appropriations Generally. This
appropriation includes funds for information
technology projects, services, and support.
Notwithstanding Minnesota Statutes, section
16E.0466, funding for information technology
project costs shall be incorporated into the
service level agreement and paid to the Office
of MN.IT Services by the Department of
Human Services under the rates and
mechanism specified in that agreement.
new text end
new text begin
(b) Receipts for Systems Project.
Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, ISDS, METS, and SSIS must
be deposited in the state systems account
authorized in Minnesota Statutes, section
256.014. Money appropriated for computer
projects approved by the commissioner of the
Office of MN.IT Services, funded by the
legislature, and approved by the commissioner
of management and budget may be transferred
from one project to another and from
development to operations as the
commissioner of human services considers
necessary. Any unexpended balance in the
appropriation for these projects does not
cancel and is available for ongoing
development and operations.
new text end
new text begin Subd. 4. new text end
new text begin
Central Office; Operations
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
174,080,000 new text end |
new text begin
167,456,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,174,000 new text end |
new text begin
4,174,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
16,966,000 new text end |
new text begin
16,966,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
100,000 new text end |
new text begin
100,000 new text end |
new text begin
(a) Administrative Recovery; Set-Aside. The
commissioner may invoice local entities
through the SWIFT accounting system as an
alternative means to recover the actual cost of
administering the following provisions:
new text end
new text begin
(1) Minnesota Statutes, section 125A.744,
subdivision 3;
new text end
new text begin
(2) Minnesota Statutes, section 245.495,
paragraph (b);
new text end
new text begin
(3) Minnesota Statutes, section 256B.0625,
subdivision 20, paragraph (k);
new text end
new text begin
(4) Minnesota Statutes, section 256B.0924,
subdivision 6, paragraph (g);
new text end
new text begin
(5) Minnesota Statutes, section 256B.0945,
subdivision 4, paragraph (d); and
new text end
new text begin
(6) Minnesota Statutes, section 256F.10,
subdivision 6, paragraph (b).
new text end
new text begin
(b) Background Studies. (1) $2,074,000 in
fiscal year 2022 is from the general fund to
provide a credit to providers who paid for
emergency background studies in NETStudy
2.0.
new text end
new text begin
(2) $2,061,000 in fiscal year 2022 is from the
general fund to cover the costs of reprocessing
emergency studies conducted under
interagency agreements with other agencies.
new text end
new text begin
(c) Personal Care Assistance Compensation
for Services Provided by a Parent or
Spouse. $349,000 in fiscal year 2022 is from
the general fund for compensation for personal
care assistance services provided by a parent
or spouse under Laws 2020, Fifth Special
Session chapter 3, article 10, section 3, as
amended.
new text end
new text begin
(d) Family Foster Setting Background
Studies. $338,000 in fiscal year 2022 and
$349,000 in fiscal year 2023 are from the
general fund for costs related to implementing
and administering licensed family foster
setting background study requirements.
new text end
new text begin
(e) Cultural and Ethnic Communities
Leadership Council. $18,000 in fiscal year
2022 and $62,000 in fiscal year 2023 are from
the general fund for the Cultural and Ethnic
Communities Leadership Council.
new text end
new text begin
(f) Base Level Adjustment. The general fund
base is $162,024,000 in fiscal year 2024 and
$162,255,000 in fiscal year 2025.
new text end
new text begin Subd. 5. new text end
new text begin
Central Office; Children and Families
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
18,382,000 new text end |
new text begin
18,407,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
2,582,000 new text end |
new text begin
2,582,000 new text end |
new text begin
(a) Financial Institution Data Match and
Payment of Fees. The commissioner is
authorized to allocate up to $310,000 each
year in fiscal year 2022 and fiscal year 2023
from the systems special revenue account to
make payments to financial institutions in
exchange for performing data matches
between account information held by financial
institutions and the public authority's database
of child support obligors as authorized by
Minnesota Statutes, section 13B.06,
subdivision 7.
new text end
new text begin
(b) Base Level Adjustment. The general fund
base is $18,692,000 in fiscal year 2024 and
$18,692,000 in fiscal year 2025.
new text end
new text begin Subd. 6. new text end
new text begin
Central Office; Health Care
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
26,005,000 new text end |
new text begin
23,992,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
28,168,000 new text end |
new text begin
28,168,000 new text end |
new text begin
(a) new text begin Case Management Benefit Study for
American Indians.new text end $200,000 in fiscal year
2022 is from the general fund for a contract
to conduct fiscal analysis and development of
standards for a targeted case management
benefit for American Indians. The
commissioner of human services must consult
the Minnesota Indian Affairs Council in the
development of any request for proposal and
in the evaluation of responses. This is a
onetime appropriation. Any unencumbered
balance remaining from the first year does not
cancel and is available for the second year of
the biennium.
new text end
new text begin
(b) Integrated Care for High-Risk Pregnant
Women Grant Program. $106,000 in fiscal
year 2022 and $122,000 in fiscal year 2023
are from the general fund for administration
of the integrated care for high-risk pregnant
women grant program under Minnesota
Statutes, section 256B.79.
new text end
new text begin
(c) Studies on Health Care Delivery.
$700,000 in fiscal year 2022 and $300,000 in
fiscal year 2023 are from the general fund for
the commissioner of human services to
develop a legislative proposal for a public
option program and to compare and report to
the legislature on delivery and payment system
models to deliver services to MinnesotaCare
enrollees and certain medical assistance
enrollees.
new text end
new text begin
(d) Base Level Adjustment. The general fund
base is $24,036,000 in fiscal year 2024 and
$24,004,000 in fiscal year 2025.
new text end
new text begin Subd. 7. new text end
new text begin
Central Office; Continuing Care for
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
18,873,000 new text end |
new text begin
18,900,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
125,000 new text end |
new text begin
125,000 new text end |
new text begin
(a) Assisted Living Survey. $2,593,000 in
fiscal year 2022 and $2,593,000 in fiscal year
2023 are from the general fund for
development and administration of a resident
experience survey and family survey for all
assisted living facilities according to
Minnesota Statutes, section 256B.439,
subdivision 3c. These appropriations are
available in either year of the biennium.
new text end
new text begin
(b) new text begin Base Level Adjustment.new text end The general fund
base is $18,830,000 in fiscal year 2024 and
$18,900,000 in fiscal year 2025.
new text end
new text begin Subd. 8. new text end
new text begin
Central Office; Community Supports
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
35,294,000 new text end |
new text begin
35,846,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
163,000 new text end |
new text begin
163,000 new text end |
|
new text begin
Opioid Epidemic Response new text end |
new text begin
60,000 new text end |
new text begin
60,000 new text end |
new text begin
(a) Study of Self Directed Tiered Wage
Structure. $25,000 in fiscal year 2022 is from
the general fund for a study of the feasibility
of a tiered wage structure for individual
providers. This is a onetime appropriation.
This appropriation is available only if the labor
agreement between the state of Minnesota and
the Service Employees International Union
Healthcare Minnesota under Minnesota
Statutes, section 179A.54, is approved under
Minnesota Statutes, section 3.855.
new text end
new text begin
(b) Substance Use Disorder Treatment
Paperwork Reduction. $234,000 in fiscal
year 2022 and $201,000 in fiscal year 2023
are from the general fund for a contract with
a vendor to develop, assess, and recommend
systems improvements to minimize regulatory
paperwork and improve systems for licensed
substance use disorder programs. This is a
onetime appropriation.
new text end
new text begin
(c) Case Management and Substance Use
Disorder Treatment Rate Methodology
Analysis. $500,000 in fiscal year 2022 and
$200,000 in fiscal year 2023 are from the
general fund for the fiscal analysis needed to
establish federally compliant payment
methodologies for all medical
assistance-funded case management services,
including substance use disorder treatment
rates. This is a onetime appropriation.
new text end
new text begin
(d) Substance Use Disorder Community of
Practice. $250,000 in fiscal year 2022 and
$250,000 in fiscal year 2023 are from the
general fund for the commissioner of human
services to establish and administer the
substance use disorder community of practice,
including providing compensation for
community of practice participants.
new text end
new text begin
(e) Sober Housing Program
Recommendations Development. $90,000
in fiscal year 2022 is from the general fund
for developing recommendations related to
sober housing programs and completing and
submitting a report on the recommendations
to the legislature.
new text end
new text begin
(f) new text begin Base Level Adjustment.new text end The general fund
base is $34,634,000 in fiscal year 2024 and
$34,666,000 in fiscal year 2025. The opiate
epidemic response fund base is $60,000 in
fiscal year 2024 and $0 in fiscal year 2025.
new text end
new text begin Subd. 9. new text end
new text begin
Forecasted Programs; MFIP/DWP
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
92,588,000 new text end |
new text begin
91,668,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
104,285,000 new text end |
new text begin
104,410,000 new text end |
new text begin Subd. 10. new text end
new text begin
Forecasted Programs; MFIP Child
|
new text begin
146,000 new text end |
new text begin
569,000 new text end |
||||
new text begin Subd. 11. new text end
new text begin
Forecasted Programs; General
|
new text begin
53,574,000 new text end |
new text begin
52,835,000 new text end |
||||
new text begin
(a) General Assistance Standard. The
commissioner shall set the monthly standard
of assistance for general assistance units
consisting of an adult recipient who is
childless and unmarried or living apart from
parents or a legal guardian at $203. The
commissioner may reduce this amount
according to Laws 1997, chapter 85, article 3,
section 54.
new text end
new text begin
(b) Emergency General Assistance Limit.
The amount appropriated for emergency
general assistance is limited to no more than
$6,729,812 in fiscal year 2022 and $6,729,812
in fiscal year 2023. Funds to counties shall be
allocated by the commissioner using the
allocation method under Minnesota Statutes,
section 256D.06.
new text end
new text begin Subd. 12. new text end
new text begin
Forecasted Programs; Minnesota
|
new text begin
51,779,000 new text end |
new text begin
52,486,000 new text end |
||||
new text begin Subd. 13. new text end
new text begin
Forecasted Programs; Housing
|
new text begin
184,005,000 new text end |
new text begin
191,966,000 new text end |
||||
new text begin Subd. 14. new text end
new text begin
Forecasted Programs; Northstar Care
|
new text begin
110,583,000 new text end |
new text begin
121,246,000 new text end |
||||
new text begin Subd. 15. new text end
new text begin
Forecasted Programs; MinnesotaCare
|
new text begin
207,437,000 new text end |
new text begin
184,822,000 new text end |
||||
new text begin
new text begin Generally.new text end This appropriation is from the
health care access fund.
new text end
new text begin Subd. 16. new text end
new text begin
Forecasted Programs; Medical
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
6,058,378,000 new text end |
new text begin
6,557,536,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
611,178,000 new text end |
new text begin
612,099,000 new text end |
new text begin
Behavioral Health Services. $1,000,000 in
fiscal year 2022 and $1,000,000 in fiscal year
2023 are for behavioral health services
provided by hospitals identified under
Minnesota Statutes, section 256.969,
subdivision 2b, paragraph (a), clause (4). The
increase in payments shall be made by
increasing the adjustment under Minnesota
Statutes, section 256.969, subdivision 2b,
paragraph (e), clause (2).
new text end
new text begin Subd. 17. new text end
new text begin
Forecasted Programs; Alternative
|
new text begin
45,669,000 new text end |
new text begin
45,656,000 new text end |
||||
new text begin
new text begin Alternative Care Transfer.new text end Any money
allocated to the alternative care program that
is not spent for the purposes indicated does
not cancel but must be transferred to the
medical assistance account.
new text end
new text begin Subd. 18. new text end
new text begin
Forecasted Programs; Behavioral
|
new text begin
132,377,000 new text end |
new text begin
116,706,000 new text end |
||||
new text begin
(a) Grants to Tribal Governments.
$28,873,377 in fiscal year 2022 is from the
general fund to satisfy the value of
overpayments owed by the Leech Lake Band
of Ojibwe and White Earth Band of Chippewa
to repay overpayments for medication-assisted
treatment services between fiscal year 2014
and fiscal year 2019. The grant to the Leech
Lake Band of Ojibwe shall be $14,666,122
and the grant to the White Earth Band of
Chippewa shall be $14,207,215. This is a
onetime appropriation.
new text end
new text begin
(b) Institutions for Mental Disease
Payments. $8,328,000 in fiscal year 2022 is
from the general fund for the commissioner
of human services to reimburse counties for
the amount identified by the commissioner for
the statewide county share of costs for which
federal funds were claimed, but were not
eligible for federal funding for substance use
disorder services provided in institutions for
mental disease, for claims paid between
January 1, 2014, and June 30, 2019. The
commissioner of human services shall allocate
this appropriation between counties in the
amount identified by the department that is
owed by each county. Prior to a county
receiving reimbursement, the county must pay
in full any unpaid consolidated chemical
dependency treatment fund invoiced county
share. This is a onetime appropriation.
new text end
new text begin Subd. 19. new text end
new text begin
Grant Programs; Support Services
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
8,715,000 new text end |
new text begin
8,715,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
96,312,000 new text end |
new text begin
96,311,000 new text end |
new text begin Subd. 20. new text end
new text begin
Grant Programs; BSF Child Care
|
new text begin
(17,000) new text end |
new text begin
(23,000) new text end |
||||
new text begin Subd. 21. new text end
new text begin
Grant Programs; Child Support
|
new text begin
50,000 new text end |
new text begin
50,000 new text end |
||||
new text begin Subd. 22. new text end
new text begin
Grant Programs; Children's Services
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
52,133,000 new text end |
new text begin
51,848,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
140,000 new text end |
new text begin
140,000 new text end |
new text begin
(a) new text begin Title IV-E Adoption Assistance.new text end The
commissioner shall allocate funds from the
Title IV-E reimbursement to the state from
the Fostering Connections to Success and
Increasing Adoptions Act for adoptive, foster,
and kinship families as required in Minnesota
Statutes, section 256N.261.
new text end
new text begin
(b) Indian Child Welfare Training.
$1,012,000 in fiscal year 2022 and $993,000
in fiscal year 2023 are from the general fund
for the establishment and operation of the
Tribal Training and Certification Partnership
at the University of Minnesota-Duluth to
provide training, establish federal Indian Child
Welfare Act and Minnesota Family
Preservation Act training requirements for
county child welfare workers, and develop
Indigenous child welfare training for American
Indian Tribes. The base for this appropriation
is $1,053,000 in fiscal year 2024 and
$1,053,000 in fiscal year 2025.
new text end
new text begin
(c) Parent Support for Better Outcomes
Grants. $150,000 in fiscal year 2022 and
$150,000 in fiscal year 2023 are from the
general fund for grants to Minnesota One-Stop
for Communities to provide mentoring,
guidance, and support services to parents
navigating the child welfare system in
Minnesota, in order to promote the
development of safe, stable, and healthy
families. Grant money may be used for parent
mentoring, peer-to-peer support groups,
housing support services, training, staffing,
and administrative costs.
new text end
new text begin Subd. 23. new text end
new text begin
Grant Programs; Children and
|
new text begin
60,251,000 new text end |
new text begin
60,856,000 new text end |
||||
new text begin Subd. 24. new text end
new text begin
Grant Programs; Children and
|
new text begin
34,240,000 new text end |
new text begin
34,240,000 new text end |
||||
new text begin
(a) Minnesota Food Assistance Program.
Unexpended funds for the Minnesota food
assistance program for fiscal year 2022 do not
cancel but are available for this purpose in
fiscal year 2023.
new text end
new text begin
(b) Emergency Shelters. $2,500,000 in fiscal
year 2022 and $2,500,000 in fiscal year 2023
are for short-term housing facilities to increase
the supply and improve the condition of
shelters for individuals and families without
a permanent residence. The commissioner
shall ensure that a portion of the funds are
expended to provide for short-term housing
facilities for tribes and shall ensure equitable
geographic distribution of funds. This
appropriation is available until June 30, 2026.
new text end
new text begin
(c) Emergency Services Grants. $9,000,000
in fiscal year 2022 and $9,000,000 in fiscal
year 2023 are to provide emergency services
grants under Minnesota Statutes, section
256E.36.
new text end
new text begin Subd. 25. new text end
new text begin
Grant Programs; Health Care Grants
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
4,811,000 new text end |
new text begin
4,811,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
3,465,000 new text end |
new text begin
3,465,000 new text end |
new text begin
Integrated Care for High Risk Pregnancies
Initiative. $1,100,000 in fiscal year 2022 and
$1,100,000 in fiscal year 2023 are from the
general fund for the commissioner of human
services to enter into a contract with the
Integrated Care for High Risk Pregnancies
(ICHRP) initiative to provide support to the
integrated care for high-risk pregnant women
grant program under Minnesota Statutes,
section 256B.79.
new text end
new text begin Subd. 26. new text end
new text begin
Grant Programs; Other Long-Term
|
new text begin
1,925,000 new text end |
new text begin
1,925,000 new text end |
||||
new text begin Subd. 27. new text end
new text begin
Grant Programs; Aging and Adult
|
new text begin
32,495,000 new text end |
new text begin
32,495,000 new text end |
||||
new text begin Subd. 28. new text end
new text begin
Grant Programs; Deaf and
|
new text begin
2,886,000 new text end |
new text begin
2,886,000 new text end |
||||
new text begin Subd. 29. new text end
new text begin
Grant Programs; Disabilities Grants
|
new text begin
20,251,000 new text end |
new text begin
18,863,000 new text end |
||||
new text begin
Training Stipends for Direct Support
Services Providers. $1,000,000 in fiscal year
2022 is from the general fund for stipends for
individual providers of direct support services
as defined in Minnesota Statutes, section
256B.0711, subdivision 1. These stipends are
available to individual providers who have
completed designated voluntary trainings
made available through the State-Provider
Cooperation Committee formed by the State
of Minnesota and the Service Employees
International Union Healthcare Minnesota.
Any unspent appropriation in fiscal year 2022
is available in fiscal year 2023. This is a
onetime appropriation. This appropriation is
available only if the labor agreement between
the state of Minnesota and the Service
Employees International Union Healthcare
Minnesota under Minnesota Statutes, section
179A.54, is approved under Minnesota
Statutes, section 3.855.
new text end
new text begin Subd. 30. new text end
new text begin
Grant Programs; Housing Support
|
new text begin
11,364,000 new text end |
new text begin
11,364,000 new text end |
||||
new text begin
Long-Term Homeless Supportive Services.
$1,000,000 in fiscal year 2022 and $1,000,000
in fiscal year 2023 are for long-term homeless
supportive services under Minnesota Statutes,
section 256K.26.
new text end
new text begin Subd. 31. new text end
new text begin
Grant Programs; Adult Mental Health
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
84,073,000 new text end |
new text begin
84,074,000 new text end |
|
new text begin
Opiate Epidemic Response new text end |
new text begin
2,000,000 new text end |
new text begin
2,000,000 new text end |
new text begin
(a) Culturally and Linguistically
Appropriate Services Implementation
Grants. $750,000 in fiscal year 2022 and
$750,000 in fiscal year 2023 are from the
general fund for grants to substance use
disorder treatment providers to implement
culturally and linguistically appropriate
services standards, according to the
implementation and transition plan developed
by the commissioner. This is a onetime
appropriation.
new text end
new text begin
(b) Base Level Adjustment. The general fund
base is $82,324,000 in fiscal year 2024 and
$82,324,000 in fiscal year 2025. The opiate
epidemic response fund base is $2,000,000 in
fiscal year 2024 and $0 in fiscal year 2025.
new text end
new text begin Subd. 32. new text end
new text begin
Grant Programs; Child Mental Health
|
new text begin
28,703,000 new text end |
new text begin
28,703,000 new text end |
||||
new text begin
(a) Children's Residential Facilities.
$3,000,000 in fiscal year 2022 and $3,000,000
in fiscal year 2023 are to reimburse counties
for a portion of the costs of treatment in
children's residential facilities. The
commissioner shall distribute the appropriation
on an annual basis to counties proportionally
based on a methodology developed by the
commissioner. Of this appropriation, $100,000
in fiscal year 2022 and $100,000 in fiscal year
2023 are available to the commissioner for
administrative expenses.
new text end
new text begin
(b) new text begin Base Level Adjustment.new text end The general fund
base is $28,726,000 in fiscal year 2024 and
$28,726,000 in fiscal year 2025.
new text end
new text begin Subd. 33. new text end
new text begin
Grant Programs; Chemical
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
2,846,000 new text end |
new text begin
2,845,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
1,733,000 new text end |
new text begin
1,733,000 new text end |
|
new text begin
Opiate Epidemic Response new text end |
new text begin
500,000 new text end |
new text begin
500,000 new text end |
new text begin
(a) Problem Gambling. $225,000 in fiscal
year 2022 and $225,000 in fiscal year 2023
are from the lottery prize fund for a grant to
the state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
and training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.
new text end
new text begin
(b) Recovery Community Organization
Grants. $573,000 in fiscal year 2022 and
$571,000 in fiscal year 2023 are from the
general fund for grants to recovery community
organizations, as defined in Minnesota
Statutes, section 254B.01, subdivision 8, to
provide for costs and community-based peer
recovery support services that are not
otherwise eligible for reimbursement under
Minnesota Statutes, section 254B.05, as part
of the continuum of care for substance use
disorders.
new text end
new text begin
(c) Base Level Adjustment. The general fund
base is $2,636,000 in fiscal year 2024 and
$2,636,000 in fiscal year 2025. The opiate
epidemic response fund base is $500,000 in
fiscal year 2024 and $0 in fiscal year 2025.
new text end
new text begin Subd. 34. new text end
new text begin
Direct Care and Treatment; Generally
|
||||||
new text begin
new text begin Transfer Authority.new text end Money appropriated to
budget activities under this subdivision and
subdivisions 35 to 39, may be transferred
between budget activities and between years
of the biennium with the approval of the
commissioner of management and budget.
new text end
new text begin Subd. 35. new text end
new text begin
Direct Care and Treatment; Mental
|
new text begin
139,946,000 new text end |
new text begin
144,103,000 new text end |
||||
new text begin
(a) Transfer Authority. Money appropriated
to support the continued operations of the
Community Addiction Recovery Enterprise
(C.A.R.E.) program may be transferred to the
enterprise fund for C.A.R.E.
new text end
new text begin
(b) Operating Adjustment. $2,307,000 in
fiscal year 2022 and $2,453,000 in fiscal year
2023 are for the Community Addiction
Recovery Enterprise program. The
commissioner may transfer $2,307,000 in
fiscal year 2022 and $2,453,000 in fiscal year
2023 to the enterprise fund for Community
Addiction Recovery Enterprise.
new text end
new text begin Subd. 36. new text end
new text begin
Direct Care and Treatment;
|
new text begin
18,771,000 new text end |
new text begin
19,752,000 new text end |
||||
new text begin
(a) Transfer Authority. Money appropriated
to support the continued operations of the
Minnesota State Operated Community
Services (MSOCS) program may be
transferred to the enterprise fund for MSOCS.
new text end
new text begin
(b) Operating Adjustment. $1,519,000 in
fiscal year 2022 and $2,541,000 in fiscal year
2023 are for the Minnesota State Operated
Community Services program. The
commissioner may transfer $1,519,000 in
fiscal year 2022 and $2,541,000 in fiscal year
2023 to the enterprise fund for Minnesota State
Operated Community Services.
new text end
new text begin Subd. 37. new text end
new text begin
Direct Care and Treatment; Forensic
|
new text begin
119,854,000 new text end |
new text begin
122,206,000 new text end |
||||
new text begin Subd. 38. new text end
new text begin
Direct Care and Treatment; Sex
|
new text begin
97,570,000 new text end |
new text begin
99,917,000 new text end |
||||
new text begin
new text begin Transfer Authority.new text end Money appropriated for
the Minnesota sex offender program may be
transferred between fiscal years of the
biennium with the approval of the
commissioner of management and budget.
new text end
new text begin Subd. 39. new text end
new text begin
Direct Care and Treatment;
|
new text begin
63,504,000 new text end |
new text begin
65,910,000 new text end |
||||
new text begin Subd. 40. new text end
new text begin
Technical Activities
|
new text begin
79,204,000 new text end |
new text begin
78,260,000 new text end |
||||
new text begin
(a) Generally. This appropriation is from the
federal TANF fund.
new text end
new text begin
(b) Base Level Adjustment. The TANF fund
base is $71,493,000 in fiscal year 2024 and
$71,493,000 in fiscal year 2025.
new text end
Sec. 3. new text begin COMMISSIONER OF HEALTH
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
258,989,000 new text end |
new text begin
$ new text end |
new text begin
251,881,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2022 new text end |
new text begin
2023 new text end |
|
|
new text begin
General new text end |
new text begin
155,953,000 new text end |
new text begin
150,554,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
54,465,000 new text end |
new text begin
53,356,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
36,858,000 new text end |
new text begin
36,258,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
11,713,000 new text end |
new text begin
11,713,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Health Improvement
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
113,697,000 new text end |
new text begin
112,692,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
9,103,000 new text end |
new text begin
7,777,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
36,858,000 new text end |
new text begin
36,258,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
11,713,000 new text end |
new text begin
11,713,000 new text end |
new text begin
(a) TANF Appropriations. (1) $3,579,000 in
fiscal year 2022 and $3,579,000 in fiscal year
2023 are from the TANF fund for home
visiting and nutritional services listed under
Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7). Funds must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1;
new text end
new text begin
(2) $2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;
new text end
new text begin
(3) $4,978,000 in fiscal year 2022 and
$4,978,000 in fiscal year 2023 are from the
TANF fund for the family home visiting grant
program according to Minnesota Statutes,
section 145A.17. $4,000,000 of the funding
in each fiscal year must be distributed to
community health boards according to
Minnesota Statutes, section 145A.131,
subdivision 1. $978,000 of the funding in each
fiscal year must be distributed to tribal
governments according to Minnesota Statutes,
section 145A.14, subdivision 2a;
new text end
new text begin
(4) $1,156,000 in fiscal year 2022 and
$1,156,000 in fiscal year 2023 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and
new text end
new text begin
(5) the commissioner may use up to 6.23
percent of the funds appropriated from the
TANF fund each fiscal year to conduct the
ongoing evaluations required under Minnesota
Statutes, section 145A.17, subdivision 7, and
training and technical assistance as required
under Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
new text end
new text begin
(b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.
new text end
new text begin
(c) Maternal Morbidity and Death Studies.
$198,000 in fiscal year 2022 and $198,000 in
fiscal year 2023 are from the general fund to
be used to conduct maternal morbidity and
death studies under Minnesota Statutes,
sections 145.901 and 145.9013.
new text end
new text begin
(d) Comprehensive Advanced Life Support
Educational Program. $100,000 in fiscal
year 2022 and $100,000 in fiscal year 2023
are from the general fund for the
comprehensive advanced life support
educational program under Minnesota Statutes,
section 144.6062. This is a onetime
appropriation.
new text end
new text begin
(e) Local Public Health Grants. $2,978,000
in fiscal year 2022 and $2,978,000 in fiscal
year 2023 are from the general fund for local
public health grants under Minnesota Statutes,
section 145A.131. The base for this
appropriation is $2,500,000 in fiscal year 2024
and $2,500,000 in fiscal year 2025.
new text end
new text begin
(f) Public Health Infrastructure and Health
Equity and Outreach. $5,000,000 in fiscal
year 2022 and $5,000,000 in fiscal year 2023
are from the general fund for purposes of
Minnesota Statutes, sections 144.0661 to
144.0663, and to build public health
infrastructure at the state and local levels to
address current and future public health
emergencies, conduct outreach to underserved
communities in the state experiencing health
disparities, and build systems at the state and
local levels with the goals of reducing and
eliminating health disparities in these
communities.
new text end
new text begin
(g) Mental Health Cultural Community
Continuing Education. $500,000 in fiscal
year 2022 and $500,000 in fiscal year 2023
are from the general fund for the mental health
cultural community continuing education grant
program.
new text end
new text begin
(h) Health Professional Education Loan
Forgiveness Program. $3,000,000 in fiscal
year 2022 and $3,000,000 in fiscal year 2023
are from the general fund for loan forgiveness
under the health professional education loan
forgiveness program under Minnesota Statutes,
section 144.1501, for individuals who: (1) are
eligible alcohol and drug counselors or eligible
mental health professionals, as defined in
Minnesota Statutes, section 144.1501,
subdivision 1; and (2) are Black, Indigenous,
or people of color, or members of an
underrepresented community as defined in
Minnesota Statutes, section 148E.010,
subdivision 20. Loan forgiveness shall be
provided according to this paragraph
notwithstanding the priorities and distribution
requirements for loan forgiveness in
Minnesota Statutes, section 144.1501.
new text end
new text begin
(i) Birth Records; Homeless Youth. $72,000
in fiscal year 2022 and $32,000 in fiscal year
2023 are from the general fund for
administration and issuance of certified birth
records and statements of no vital record found
to homeless youth under Minnesota Statutes,
section 144.2255.
new text end
new text begin
(j) Trauma-Informed Gun Violence
Reduction Pilot Program. $100,000 in fiscal
year 2022 is from the general fund for the
trauma-informed gun violence reduction pilot
program.
new text end
new text begin
(k) Home Visiting for Pregnant Women and
Families with Young Children. $2,500,000
in fiscal year 2022 and $2,500,000 in fiscal
year 2023 are from the general fund for grants
for home visiting services under Minnesota
Statutes, section 145.87.
new text end
new text begin
(l) Supporting Healthy Development of
Babies During Pregnancy and Postpartum.
$279,000 in fiscal year 2022 and $279,000 in
fiscal year 2023 are from the general fund for
a grant to the Amherst H. Wilder Foundation
for the African American Babies Coalition
initiative for community-driven training and
education on best practices to support healthy
development of babies during pregnancy and
postpartum. Grant funds must be used to build
capacity in, train, educate, or improve
practices among individuals, from youth to
elders, serving families with members who
are Black, Indigenous, or people of color,
during pregnancy and postpartum. Of this
appropriation, $19,000 in fiscal year 2022 and
$19,000 in fiscal year 2023 are for the
commissioner to use for administration. This
is a onetime appropriation. Any unexpended
balance in the first year of the biennium does
not cancel and is available in the second year
of the biennium.
new text end
new text begin
(m) Dignity in Pregnancy and Childbirth.
$1,695,000 in fiscal year 2022 and $908,000
in fiscal year 2023 are from the general fund
for purposes of Minnesota Statutes, section
144.1461. Of this appropriation, $845,000 in
fiscal year 2022 is for a grant to the University
of Minnesota School of Public Health's Center
for Antiracism Research for Health Equity, to
develop a model curriculum on anti-racism
and implicit bias for use by hospitals with
obstetric care and birth centers to provide
continuing education to staff caring for
pregnant or postpartum women. The model
curriculum must be evidence-based and must
meet the criteria in Minnesota Statutes, section
144.1461, subdivision 2, paragraph (a). The
base for this appropriation is $907,000 in fiscal
year 2024 and $860,000 in fiscal year 2025.
new text end
new text begin
(n) Recommendations to Expand Access to
Data from the All-Payer Claims Database.
$55,000 in fiscal year 2022 is from the general
fund for the commissioner to develop
recommendations to expand access to data
from the all-payer claims database under
Minnesota Statutes, section 62U.04, to
additional outside entities for public health or
research purposes.
new text end
new text begin
(o) Base Level Adjustments. The general
fund base is $110,895,000 in fiscal year 2024
and $111,787,000 in fiscal year 2025. The
state government special revenue fund base is
$7,777,000 in fiscal year 2024 and $7,777,000
in fiscal year 2025. The health care access
fund base is $36,858,000 in fiscal year 2024
and $36,258,000 in fiscal year 2025.
new text end
new text begin Subd. 3. new text end
new text begin
Health Protection
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
30,686,000 new text end |
new text begin
26,283,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
45,362,000 new text end |
new text begin
45,579,000 new text end |
new text begin
(a) Lead Risk Assessments and Lead
Orders. $1,530,000 in fiscal year 2022 and
$1,314,000 in fiscal year 2023 are from the
general fund for implementation of the
requirements for conducting lead risk
assessments under Minnesota Statutes, section
144.9504, subdivision 2, and for issuance of
lead orders under Minnesota Statutes, section
144.9504, subdivision 5.
new text end
new text begin
(b) Hospital Closure or Curtailment of
Operations. $10,000 in fiscal year 2022 and
$1,000 in fiscal year 2023 are from the general
fund for purposes of Minnesota Statutes,
section 144.555, subdivisions 1a, 1b, and 2.
new text end
new text begin
(c) Transfer; Public Health Response
Contingency Account. The commissioner
shall transfer $500,000 in fiscal year 2022
from the general fund to the public health
response contingency account established in
Minnesota Statutes, section 144.4199. This is
a onetime transfer.
new text end
new text begin
(d) Skin Lightening Products Public
Awareness and Education Grant Program.
$100,000 in fiscal year 2022 and $100,000 in
fiscal year 2023 are from the general fund for
a skin lightening products public awareness
and education grant program. This is a onetime
appropriation.
new text end
new text begin
(e) Base Level Adjustments. The general
fund base is $26,183,000 in fiscal year 2024
and $26,183,000 in fiscal year 2025. The state
government special revenue fund base is
$45,579,000 in fiscal year 2024 and
$45,579,000 in fiscal year 2025.
new text end
new text begin Subd. 4. new text end
new text begin
Health Operations
|
new text begin
11,570,000 new text end |
new text begin
11,579,000 new text end |
||||
Sec. 4. new text begin HEALTH-RELATED BOARDS
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
27,535,000 new text end |
new text begin
$ new text end |
new text begin
26,960,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
State Government Special Revenue new text end |
new text begin
27,459,000 new text end |
new text begin
26,884,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
76,000 new text end |
new text begin
76,000 new text end |
new text begin
This appropriation is from the state
government special revenue fund unless
specified otherwise. The amounts that may be
spent for each purpose are specified in the
following subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Board of Behavioral Health and
|
new text begin
877,000 new text end |
new text begin
875,000 new text end |
||||
new text begin Subd. 3. new text end
new text begin
Board of Chiropractic Examiners
|
new text begin
666,000 new text end |
new text begin
666,000 new text end |
||||
new text begin Subd. 4. new text end
new text begin
Board of Dentistry
|
new text begin
4,228,000 new text end |
new text begin
3,753,000 new text end |
||||
new text begin
(a) Administrative Services Unit - Operating
Costs. Of this appropriation, $2,738,000 in
fiscal year 2022 and $2,263,000 in fiscal year
2023 are for operating costs of the
administrative services unit. The
administrative services unit may receive and
expend reimbursements for services it
performs for other agencies.
new text end
new text begin
(b) Administrative Services Unit - Volunteer
Health Care Provider Program. Of this
appropriation, $150,000 in fiscal year 2022
and $150,000 in fiscal year 2023 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end
new text begin
(c) Administrative Services Unit -
Retirement Costs. Of this appropriation,
$475,000 in fiscal year 2022 is a onetime
appropriation to the administrative services
unit to pay for the retirement costs of
health-related board employees. This funding
may be transferred to the health board
incurring retirement costs. Any board that has
an unexpended balance for an amount
transferred under this paragraph shall transfer
the unexpended amount to the administrative
services unit. These funds are available either
year of the biennium.
new text end
new text begin
(d) Administrative Services Unit - Contested
Cases and Other Legal Proceedings. Of this
appropriation, $200,000 in fiscal year 2022
and $200,000 in fiscal year 2023 are for costs
of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards funded under
this section. Upon certification by a
health-related board to the administrative
services unit that costs will be incurred and
that there is insufficient money available to
pay for the costs out of money currently
available to that board, the administrative
services unit is authorized to transfer money
from this appropriation to the board for
payment of those costs with the approval of
the commissioner of management and budget.
The commissioner of management and budget
must require any board that has an unexpended
balance for an amount transferred under this
paragraph to transfer the unexpended amount
to the administrative services unit to be
deposited in the state government special
revenue fund.
new text end
new text begin Subd. 5. new text end
new text begin
Board of Dietetics and Nutrition
|
new text begin
164,000 new text end |
new text begin
164,000 new text end |
||||
new text begin Subd. 6. new text end
new text begin
Board of Executives for Long Term
|
new text begin
693,000 new text end |
new text begin
635,000 new text end |
||||
new text begin Subd. 7. new text end
new text begin
Board of Marriage and Family Therapy
|
new text begin
413,000 new text end |
new text begin
410,000 new text end |
||||
new text begin Subd. 8. new text end
new text begin
Board of Medical Practice
|
new text begin
5,912,000 new text end |
new text begin
5,868,000 new text end |
||||
new text begin
Health Professional Services Program. This
appropriation includes $1,002,000 in fiscal
year 2022 and $1,002,000 in fiscal year 2023
for the health professional services program.
new text end
new text begin Subd. 9. new text end
new text begin
Board of Nursing
|
new text begin
5,345,000 new text end |
new text begin
5,355,000 new text end |
||||
new text begin Subd. 10. new text end
new text begin
Board of Occupational Therapy
|
new text begin
456,000 new text end |
new text begin
456,000 new text end |
||||
new text begin Subd. 11. new text end
new text begin
Board of Optometry
|
new text begin
238,000 new text end |
new text begin
238,000 new text end |
||||
new text begin Subd. 12. new text end
new text begin
Board of Pharmacy
|
new text begin
4,479,000 new text end |
new text begin
4,479,000 new text end |
||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
State Government Special Revenue new text end |
new text begin
4,403,000 new text end |
new text begin
4,403,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
76,000 new text end |
new text begin
76,000 new text end |
new text begin
Base Level Adjustment. The health care
access fund base is $76,000 in fiscal year
2024, $38,000 in fiscal year 2025, and $0 in
fiscal year 2026.
new text end
new text begin Subd. 13. new text end
new text begin
Board of Physical Therapy
|
new text begin
564,000 new text end |
new text begin
564,000 new text end |
||||
new text begin Subd. 14. new text end
new text begin
Board of Podiatric Medicine
|
new text begin
214,000 new text end |
new text begin
214,000 new text end |
||||
new text begin Subd. 15. new text end
new text begin
Board of Psychology
|
new text begin
1,362,000 new text end |
new text begin
1,360,000 new text end |
||||
new text begin Subd. 16. new text end
new text begin
Board of Social Work
|
new text begin
1,561,000 new text end |
new text begin
1,560,000 new text end |
||||
new text begin Subd. 17. new text end
new text begin
Board of Veterinary Medicine
|
new text begin
363,000 new text end |
new text begin
363,000 new text end |
||||
Sec. 5. new text begin EMERGENCY MEDICAL SERVICES
|
new text begin
$ new text end |
new text begin
4,453,000 new text end |
new text begin
$ new text end |
new text begin
3,829,000 new text end |
||
new text begin
(a) Cooper/Sams Volunteer Ambulance
Program. $950,000 in fiscal year 2022 and
$950,000 in fiscal year 2023 are for the
Cooper/Sams volunteer ambulance program
under Minnesota Statutes, section 144E.40.
new text end
new text begin
(1) Of this amount, $861,000 in fiscal year
2022 and $861,000 in fiscal year 2023 are for
the ambulance service personnel longevity
award and incentive program under Minnesota
Statutes, section 144E.40.
new text end
new text begin
(2) Of this amount, $89,000 in fiscal year 2022
and $89,000 in fiscal year 2023 are for the
operations of the ambulance service personnel
longevity award and incentive program under
Minnesota Statutes, section 144E.40.
new text end
new text begin
(b) EMSRB Operations. $1,880,000 in fiscal
year 2022 and $1,880,000 in fiscal year 2023
are for board operations.
new text end
new text begin
(c) Regional Grants. $585,000 in fiscal year
2022 and $585,000 in fiscal year 2023 are for
regional emergency medical services
programs, to be distributed equally to the eight
emergency medical service regions under
Minnesota Statutes, section 144E.52.
new text end
new text begin
(d) Ambulance Training Grant. $361,000
in fiscal year 2022 and $361,000 in fiscal year
2023 are for training grants under Minnesota
Statutes, section 144E.35.
new text end
new text begin
(e) Grants to Regional Emergency Medical
Services Programs. $650,000 in fiscal year
2022 is for grants to regional emergency
medical services programs, to be distributed
among the eight emergency medical services
regions according to Minnesota Statutes,
section 144E.50.
new text end
Sec. 6. new text begin COUNCIL ON DISABILITY
|
new text begin
$ new text end |
new text begin
1,022,000 new text end |
new text begin
$ new text end |
new text begin
1,038,000 new text end |
||
Sec. 7. new text begin OMBUDSMAN FOR MENTAL
|
new text begin
$ new text end |
new text begin
2,487,000 new text end |
new text begin
$ new text end |
new text begin
2,536,000 new text end |
||
new text begin
Department of Psychiatry Monitoring.
$100,000 in fiscal year 2022 and $100,000 in
fiscal year 2023 are for monitoring the
Department of Psychiatry at the University of
Minnesota.
new text end
Sec. 8. new text begin OMBUDSPERSONS FOR FAMILIES
|
new text begin
$ new text end |
new text begin
733,000 new text end |
new text begin
$ new text end |
new text begin
744,000 new text end |
||
Sec. 9. new text begin ATTORNEY GENERAL
|
new text begin
$ new text end |
new text begin
200,000 new text end |
new text begin
$ new text end |
new text begin
200,000 new text end |
||
new text begin
Excessive Drug Price Increases. This
appropriation is for costs of expert witnesses
and investigations under Minnesota Statutes,
section 62J.844. This is a onetime
appropriation.
new text end
Sec. 10.
Laws 2019, First Special Session chapter 9, article 14, section 3, as amended by
Laws 2019, First Special Session chapter 12, section 6, is amended to read:
Sec. 3. COMMISSIONER OF HEALTH
|
||||||
Subdivision 1.Total Appropriation
|
$ |
231,829,000 |
$ |
deleted text begin
236,188,000
deleted text end
new text begin
233,584,000 new text end |
||
| Appropriations by Fund |
||
| 2020 |
2021 |
|
| General |
124,381,000 |
deleted text begin 126,276,000deleted text end new text begin 125,881,000 new text end |
| State Government Special Revenue |
58,450,000 |
deleted text begin
61,367,000
deleted text end
new text begin
59,158,000 new text end |
| Health Care Access |
37,285,000 |
36,832,000 |
| Federal TANF |
11,713,000 |
11,713,000 |
The amounts that may be spent for each
purpose are specified in the following
subdivisions.
Subd. 2.Health Improvement
|
||||||
| Appropriations by Fund |
||
| General |
94,980,000 |
deleted text begin 96,117,000deleted text end new text begin 95,722,000 new text end |
| State Government Special Revenue |
7,614,000 |
deleted text begin
7,558,000
deleted text end
new text begin
6,924,000 new text end |
| Health Care Access |
37,285,000 |
36,832,000 |
| Federal TANF |
11,713,000 |
11,713,000 |
(a) TANF Appropriations. (1) $3,579,000 in
fiscal year 2020 and $3,579,000 in fiscal year
2021 are from the TANF fund for home
visiting and nutritional services under
Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7). Funds must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1;
(2) $2,000,000 in fiscal year 2020 and
$2,000,000 in fiscal year 2021 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;
(3) $4,978,000 in fiscal year 2020 and
$4,978,000 in fiscal year 2021 are from the
TANF fund for the family home visiting grant
program under Minnesota Statutes, section
145A.17. $4,000,000 of the funding in each
fiscal year must be distributed to community
health boards according to Minnesota Statutes,
section 145A.131, subdivision 1. $978,000 of
the funding in each fiscal year must be
distributed to tribal governments according to
Minnesota Statutes, section 145A.14,
subdivision 2a;
(4) $1,156,000 in fiscal year 2020 and
$1,156,000 in fiscal year 2021 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and
(5) The commissioner may use up to 6.23
percent of the amounts appropriated from the
TANF fund each year to conduct the ongoing
evaluations required under Minnesota Statutes,
section 145A.17, subdivision 7, and training
and technical assistance as required under
Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
(b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.
(c) Comprehensive Suicide Prevention.
$2,730,000 in fiscal year 2020 and $2,730,000
in fiscal year 2021 are from the general fund
for a comprehensive, community-based suicide
prevention strategy. The funds are allocated
as follows:
(1) $955,000 in fiscal year 2020 and $955,000
in fiscal year 2021 are for community-based
suicide prevention grants authorized in
Minnesota Statutes, section 145.56,
subdivision 2. Specific emphasis must be
placed on those communities with the greatest
disparities. The base for this appropriation is
$1,291,000 in fiscal year 2022 and $1,291,000
in fiscal year 2023;
(2) $683,000 in fiscal year 2020 and $683,000
in fiscal year 2021 are to support
evidence-based training for educators and
school staff and purchase suicide prevention
curriculum for student use statewide, as
authorized in Minnesota Statutes, section
145.56, subdivision 2. The base for this
appropriation is $913,000 in fiscal year 2022
and $913,000 in fiscal year 2023;
(3) $137,000 in fiscal year 2020 and $137,000
in fiscal year 2021 are to implement the Zero
Suicide framework with up to 20 behavioral
and health care organizations each year to treat
individuals at risk for suicide and support
those individuals across systems of care upon
discharge. The base for this appropriation is
$205,000 in fiscal year 2022 and $205,000 in
fiscal year 2023;
(4) $955,000 in fiscal year 2020 and $955,000
in fiscal year 2021 are to develop and fund a
Minnesota-based network of National Suicide
Prevention Lifeline, providing statewide
coverage. The base for this appropriation is
$1,321,000 in fiscal year 2022 and $1,321,000
in fiscal year 2023; and
(5) the commissioner may retain up to 18.23
percent of the appropriation under this
paragraph to administer the comprehensive
suicide prevention strategy.
(d) Statewide Tobacco Cessation. $1,598,000
in fiscal year 2020 and $2,748,000 in fiscal
year 2021 are from the general fund for
statewide tobacco cessation services under
Minnesota Statutes, section 144.397. The base
for this appropriation is $2,878,000 in fiscal
year 2022 and $2,878,000 in fiscal year 2023.
(e) Health Care Access Survey. $225,000 in
fiscal year 2020 and $225,000 in fiscal year
2021 are from the health care access fund to
continue and improve the Minnesota Health
Care Access Survey. These appropriations
may be used in either year of the biennium.
(f) Community Solutions for Healthy Child
Development Grant Program. $1,000,000
in fiscal year 2020 and $1,000,000 in fiscal
year 2021 are for the community solutions for
healthy child development grant program to
promote health and racial equity for young
children and their families under article 11,
section 107. The commissioner may use up to
23.5 percent of the total appropriation for
administration. The base for this appropriation
is $1,000,000 in fiscal year 2022, $1,000,000
in fiscal year 2023, and $0 in fiscal year 2024.
(g) Domestic Violence and Sexual Assault
Prevention Program. $375,000 in fiscal year
2020 and $375,000 in fiscal year 2021 are
from the general fund for the domestic
violence and sexual assault prevention
program under article 11, section 108. This is
a onetime appropriation.
(h) Skin Lightening Products Public
Awareness Grant Program. $100,000 in
fiscal year 2020 and $100,000 in fiscal year
2021 are from the general fund for a skin
lightening products public awareness and
education grant program. This is a onetime
appropriation.
(i) Cannabinoid Products Workgroup.
$8,000 in fiscal year 2020 is from the state
government special revenue fund for the
cannabinoid products workgroup. This is a
onetime appropriation.
(j) Base Level Adjustments. The general fund
base is $96,742,000 in fiscal year 2022 and
$96,742,000 in fiscal year 2023. The health
care access fund base is $37,432,000 in fiscal
year 2022 and $36,832,000 in fiscal year 2023.
Subd. 3.Health Protection
|
||||||
| Appropriations by Fund |
||
| General |
18,803,000 |
19,774,000 |
| State Government Special Revenue |
50,836,000 |
deleted text begin
53,809,000
deleted text end
new text begin
52,234,000 new text end |
(a) Public Health Laboratory Equipment.
$840,000 in fiscal year 2020 and $655,000 in
fiscal year 2021 are from the general fund for
equipment for the public health laboratory.
This is a onetime appropriation and is
available until June 30, 2023.
(b) Base Level Adjustment. The general fund
base is $19,119,000 in fiscal year 2022 and
$19,119,000 in fiscal year 2023. The state
government special revenue fund base is
$53,782,000 in fiscal year 2022 and
$53,782,000 in fiscal year 2023.
Subd. 4.Health Operations
|
10,598,000 |
10,385,000 |
||||
Base Level Adjustment. The general fund
base is $10,912,000 in fiscal year 2022 and
$10,912,000 in fiscal year 2023.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment and
the reductions in subdivisions 1 to 3 are onetime reductions.
new text end
Sec. 11. new text begin APPROPRIATION; MINNESOTA FAMILY INVESTMENT PROGRAM
SUPPLEMENTAL PAYMENT.
new text end
new text begin
$24,235,000 in fiscal year 2021 is appropriated from the TANF fund to the commissioner
of human services to provide a onetime cash benefit of up to $750 for each household
enrolled in the Minnesota family investment program or diversionary work program under
Minnesota Statutes, chapter 256J, at the time that the cash benefit is distributed. The
commissioner shall distribute these funds through existing systems and in a manner that
minimizes the burden to families. This is a onetime appropriation.
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. 12. new text begin APPROPRIATION; REFINANCING OF EMERGENCY CHILD CARE
GRANTS; CANCELLATION.
new text end
new text begin
$26,622,626 in fiscal year 2021 is appropriated from the coronavirus relief federal fund
to the commissioner of human services for fiscal year 2020 to replace a portion of the general
fund appropriation in Laws 2020, chapter 71, article 1, section 2, subdivision 9. The general
fund appropriation that is replaced by coronavirus relief funds under this section is canceled
to the general fund. This is a onetime appropriation.
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. 13. new text begin CANCELLATION; TRANSFER FROM STATE GOVERNMENT SPECIAL
REVENUE FUND TO GENERAL FUND.
new text end
new text begin
The $77,000 transfer each year from the state government special revenue fund to the
general fund under Laws 2008, chapter 364, section 17, paragraph (b), is canceled. This
section does not expire.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective June 30, 2021.
new text end
Sec. 14. new text begin FEDERAL FUNDS FOR VACCINE ACTIVITIES; APPROPRIATION.
new text end
new text begin
Federal funds made available to the commissioner of health for vaccine activities are
appropriated to the commissioner for that purpose and shall be used to support work under
Minnesota Statutes, sections 144.0661 to 144.0663.
new text end
Sec. 15. new text begin FEDERAL FUNDS REPLACEMENT; APPROPRIATION.
new text end
new text begin
Notwithstanding any law to the contrary, the commissioner of management and budget
must determine whether the expenditures authorized under this act are eligible uses of federal
funding received under the Coronavirus State Fiscal Recovery Fund or any other federal
funds received by the state under the American Rescue Plan Act, Public Law 117-2. If the
commissioner of management and budget determines an expenditure is eligible for funding
under Public Law 117-2, the amount of the eligible expenditure is appropriated from the
account where those amounts have been deposited and the corresponding general fund
amounts appropriated under this act are canceled to the general fund.
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. 16. new text begin TRANSFERS; HUMAN SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Grants. new text end
new text begin
The commissioner of human services, with the approval of the
commissioner of management and budget, may transfer unencumbered appropriation balances
for the biennium ending June 30, 2023, within fiscal years among the MFIP, general
assistance, medical assistance, MinnesotaCare, MFIP child care assistance under Minnesota
Statutes, section 119B.05, Minnesota supplemental aid program, group residential housing
program, the entitlement portion of Northstar Care for Children under Minnesota Statutes,
chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment
fund, and between fiscal years of the biennium. The commissioner shall inform the chairs
and ranking minority members of the senate Health and Human Services Finance Division
and the house of representatives Health Finance and Policy Committee and Human Services
Finance and Policy Committee quarterly about transfers made under this subdivision.
new text end
new text begin Subd. 2. new text end
new text begin Administration. new text end
new text begin
Positions, salary money, and nonsalary administrative money
may be transferred within the Department of Human Services as the commissioners consider
necessary, with the advance approval of the commissioner of management and budget. The
commissioner shall inform the chairs and ranking minority members of the senate Health
and Human Services Finance Division and the house of representatives Health Finance and
Policy Committee and Human Services Finance and Policy Committee quarterly about
transfers made under this subdivision.
new text end
Sec. 17. new text begin TRANSFERS; HEALTH.
new text end
new text begin
Positions, salary money, and nonsalary administrative money may be transferred within
the Department of Health as the commissioner considers necessary, with the advance
approval of the commissioner of management and budget. The commissioner shall inform
the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services finance quarterly about transfers made under this section.
new text end
Sec. 18. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end
new text begin
The commissioners of health and human services shall not use indirect cost allocations
to pay for the operational costs of any program for which they are responsible.
new text end
Sec. 19. new text begin APPROPRIATION ENACTED MORE THAN ONCE.
new text end
new text begin
If an appropriation in this act is enacted more than once in the 2021 legislative session,
the appropriation must be given effect only once.
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. 20. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2023, unless a
different expiration date is explicit.
new text end
Sec. 21. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2020, section 16A.724, subdivision 2,
new text end
new text begin
is repealed effective June 30,
2025.
new text end
Sec. 22. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective July 1, 2021, unless a different effective date is specified.
new text end
APPENDIX
Repealed Minnesota Statutes: H2128-1
16A.724 HEALTH CARE ACCESS FUND.
Subd. 2.
Transfers.
(a) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund, effective for the biennium beginning July 1, 2007, the commissioner of management and budget shall transfer the excess funds from the health care access fund to the general fund on June 30 of each year, provided that the amount transferred in fiscal year 2016 shall not exceed $48,000,000, the amount in fiscal year 2017 shall not exceed $122,000,000, and the amount in any fiscal biennium thereafter shall not exceed $244,000,000. The purpose of this transfer is to meet the rate increase required under section 256B.04, subdivision 25.
(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if necessary, the commissioner shall reduce these transfers from the health care access fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer sufficient funds from the general fund to the health care access fund to meet annual MinnesotaCare expenditures.
62A.67 SHORT TITLE.
Sections 62A.67 to 62A.672 may be cited as the "Minnesota Telemedicine Act."
62A.671 DEFINITIONS.
Subdivision 1.
Applicability.
For purposes of sections 62A.67 to 62A.672, the terms defined in this section have the meanings given.
Subd. 2.
Distant site.
"Distant site" means a site at which a licensed health care provider is located while providing health care services or consultations by means of telemedicine.
Subd. 3.
Health care provider.
"Health care provider" has the meaning provided in section 62A.63, subdivision 2.
Subd. 4.
Health carrier.
"Health carrier" has the meaning provided in section 62A.011, subdivision 2.
Subd. 5.
Health plan.
"Health plan" means a health plan as defined in section 62A.011, subdivision 3, and includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental plans that provide indemnity-based benefits, regardless of expenses incurred and are designed to pay benefits directly to the policyholder.
Subd. 6.
Licensed health care provider.
"Licensed health care provider" means a health care provider who is:
(1) licensed under chapter 147, 147A, 148, 148B, 148E, 148F, 150A, or 153; a mental health professional as defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; or vendor of medical care defined in section 256B.02, subdivision 7; and
(2) authorized within their respective scope of practice to provide the particular service with no supervision or under general supervision.
Subd. 7.
Originating site.
"Originating site" means a site including, but not limited to, a health care facility at which a patient is located at the time health care services are provided to the patient by means of telemedicine.
Subd. 8.
Store-and-forward technology.
"Store-and-forward technology" means the transmission of a patient's medical information from an originating site to a health care provider at a distant site without the patient being present, or the delivery of telemedicine that does not occur in real time via synchronous transmissions.
Subd. 9.
Telemedicine.
"Telemedicine" means the delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. A communication between licensed health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission does not constitute telemedicine consultations or services. A communication between a licensed health care provider and a patient that consists solely of an e-mail or facsimile transmission does not constitute telemedicine consultations or services. Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care.
62A.672 COVERAGE OF TELEMEDICINE SERVICES.
Subdivision 1.
Coverage of telemedicine.
(a) A health plan sold, issued, or renewed by a health carrier for which coverage of benefits begins on or after January 1, 2017, shall include coverage for telemedicine benefits in the same manner as any other benefits covered under the policy, plan, or contract, and shall comply with the regulations of this section.
(b) Nothing in this section shall be construed to:
(1) require a health carrier to provide coverage for services that are not medically necessary;
(2) prohibit a health carrier from establishing criteria that a health care provider must meet to demonstrate the safety or efficacy of delivering a particular service via telemedicine for which the health carrier does not already reimburse other health care providers for delivering via telemedicine, so long as the criteria are not unduly burdensome or unreasonable for the particular service; or
(3) prevent a health carrier from requiring a health care provider to agree to certain documentation or billing practices designed to protect the health carrier or patients from fraudulent claims so long as the practices are not unduly burdensome or unreasonable for the particular service.
Subd. 2.
Parity between telemedicine and in-person services.
A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient.
Subd. 3.
Reimbursement for telemedicine services.
(a) A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider.
(b) It is not a violation of this subdivision for a health carrier to include a deductible, co-payment, or coinsurance requirement for a health care service provided via telemedicine, provided that the deductible, co-payment, or coinsurance is not in addition to, and does not exceed, the deductible, co-payment, or coinsurance applicable if the same services were provided through in-person contact.
62J.63 CENTER FOR HEALTH CARE PURCHASING IMPROVEMENT.
Subd. 3.
Report.
The commissioner of health must report annually to the legislature and the governor on the operations, activities, and impacts of the center. The report must be posted on the Department of Health website and must be available to the public. The report must include a description of the state's efforts to develop and use more common strategies for health care performance measurement and health care purchasing. The report must also include an assessment of the impacts of these efforts, especially in promoting greater transparency of health care costs and quality, and greater accountability for health care results and improvement.
144.0721 ASSESSMENTS OF CARE AND SERVICES TO NURSING HOME RESIDENTS.
Subdivision 1.
Appropriateness and quality.
Until the date of implementation of the revised case mix system based on the minimum data set, the commissioner of health shall assess the appropriateness and quality of care and services furnished to private paying residents in nursing homes and boarding care homes that are certified for participation in the medical assistance program under United States Code, title 42, sections 1396-1396p. These assessments shall be conducted until the date of implementation of the revised case mix system with the exception of provisions requiring recommendations for changes in the level of care provided to the private paying residents.
144.0722 RESIDENT REIMBURSEMENT CLASSIFICATIONS.
Subdivision 1.
Resident reimbursement classifications.
The commissioner of health shall establish resident reimbursement classifications based upon the assessments of residents of nursing homes and boarding care homes conducted under section 144.0721, or under rules established by the commissioner of human services under chapter 256R. The reimbursement classifications established by the commissioner must conform to the rules established by the commissioner of human services.
Subd. 2.
Notice of resident reimbursement classification.
The commissioner of health shall notify each resident, and the nursing home or boarding care home in which the resident resides, of the reimbursement classification established under subdivision 1. The notice must inform the resident of the classification that was assigned, the opportunity to review the documentation supporting the classification, the opportunity to obtain clarification from the commissioner, and the opportunity to request a reconsideration of the classification. The notice of resident classification must be sent by first-class mail. The individual resident notices may be sent to the resident's nursing home or boarding care home for distribution to the resident. The nursing home or boarding care home is responsible for the distribution of the notice to each resident, to the person responsible for the payment of the resident's nursing home expenses, or to another person designated by the resident. This notice must be distributed within three working days after the facility's receipt of the notices from the department.
Subd. 2a.
Semiannual assessment by nursing facilities.
Notwithstanding Minnesota Rules, part 9549.0059, subpart 2, item B, the individual dependencies items 21 to 24 and 28 are required to be completed in accordance with the Facility Manual for Completing Case Mix Requests for Classification, July 1987, issued by the Minnesota Department of Health.
Subd. 3.
Request for reconsideration.
The resident or the nursing home or boarding care home may request that the commissioner reconsider the assigned reimbursement classification. The request for reconsideration must be submitted in writing to the commissioner within 30 days of the receipt of the notice of resident classification. For reconsideration requests submitted by or on behalf of the resident, the time period for submission of the request begins as of the date the resident or the resident's representative receives the classification notice. The request for reconsideration must include the name of the resident, the name and address of the facility in which the resident resides, the reasons for the reconsideration, the requested classification changes, and documentation supporting the requested classification. The documentation accompanying the reconsideration request is limited to documentation establishing that the needs of the resident at the time of the assessment resulting in the disputed classification justify a change of classification.
Subd. 3a.
Access to information.
Upon written request, the nursing home or boarding care home must give the resident or the resident's representative a copy of the assessment form and the other documentation that was given to the department to support the assessment findings. The nursing home or boarding care home shall also provide access to and a copy of other information from the resident's record that has been requested by or on behalf of the resident to support a resident's reconsideration request. A copy of any requested material must be provided within three working days of receipt of a written request for the information. If a facility fails to provide the material within this time, it is subject to the issuance of a correction order and penalty assessment under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order issued under this subdivision must require that the facility immediately comply with the request for information and that as of the date of the issuance of the correction order, the facility shall forfeit to the state a $100 fine the first day of noncompliance, and an increase in the $100 fine by $50 increments for each day the noncompliance continues. For the purposes of this section, "representative" includes the resident's guardian or conservator, the person authorized to pay the nursing home expenses of the resident, a representative of the nursing home ombudsman's office whose assistance has been requested, or any other individual designated by the resident.
Subd. 3b.
Facility's request for reconsideration.
In addition to the information required in subdivision 3, a reconsideration request from a nursing home or boarding care home must contain the following information: the date the resident reimbursement classification notices were received by the facility; the date the classification notices were distributed to the resident or the resident's representative; and a copy of a notice sent to the resident or to the resident's representative. This notice must tell the resident or the resident's representative that a reconsideration of the resident's classification is being requested, the reason for the request, that the resident's rate will change if the request is approved by the department and the extent of the change, that copies of the facility's request and supporting documentation are available for review, and that the resident also has the right to request a reconsideration. If the facility fails to provide this information with the reconsideration request, the request must be denied, and the facility may not make further reconsideration requests on that specific reimbursement classification.
Subd. 4.
Reconsideration.
The commissioner's reconsideration must be made by individuals not involved in reviewing the assessment that established the disputed classification. The reconsideration must be based upon the initial assessment and upon the information provided to the commissioner under subdivision 3. If necessary for evaluating the reconsideration request, the commissioner may conduct on-site reviews. In its discretion, the commissioner may review the reimbursement classifications assigned to all residents in the facility. Within 15 working days of receiving the request for reconsideration, the commissioner shall affirm or modify the original resident classification. The original classification must be modified if the commissioner determines that the assessment resulting in the classification did not accurately reflect the needs of the resident at the time of the assessment. The resident and the nursing home or boarding care home shall be notified within five working days after the decision is made. The commissioner's decision under this subdivision is the final administrative decision of the agency.
Subd. 5.
Audit authority.
The Department of Health may audit assessments of nursing home and boarding care home residents. These audits may be in addition to the assessments completed by the department under section 144.0721. The audits may be conducted at the facility, and the department may conduct the audits on an unannounced basis.
144.0724 RESIDENT REIMBURSEMENT CLASSIFICATION.
Subd. 10.
Transition.
After implementation of this section, reconsiderations requested for classifications made under section 144.0722, subdivision 1, shall be determined under section 144.0722, subdivision 3.
144.693 MEDICAL MALPRACTICE CLAIMS; REPORTS.
Subdivision 1.
Insurers' reports to commissioner.
On or before September 1, 1976, and on or before March 1 and September 1 of each year thereafter, each insurer providing professional liability insurance to one or more hospitals, outpatient surgery centers, or health maintenance organizations, shall submit to the state commissioner of health a report listing by facility or organization all claims which have been closed by or filed with the insurer during the period ending December 31 of the previous year or June 30 of the current year. The report shall contain, but not be limited to, the following information:
(1) the total number of claims made against each facility or organization which were filed or closed during the reporting period;
(2) the date each new claim was filed with the insurer;
(3) the allegations contained in each claim filed during the reporting period;
(4) the disposition and closing date of each claim closed during the reporting period;
(5) the dollar amount of the award or settlement for each claim closed during the reporting period; and
(6) any other information the commissioner of health may, by rule, require.
Any hospital, outpatient surgery center, or health maintenance organization which is self insured shall be considered to be an insurer for the purposes of this section and shall comply with the reporting provisions of this section.
A report from an insurer submitted pursuant to this section is private data, as defined in section 13.02, subdivision 12, accessible to the facility or organization which is the subject of the data, and to its authorized agents. Any data relating to patient records which is reported to the state commissioner of health pursuant to this section shall be reported in the form of summary data, as defined in section 13.02, subdivision 19.
Subd. 2.
Report to legislature.
The state commissioner of health shall collect and review the data reported pursuant to subdivision 1. On December 1, 1976, and on January 2 of each year thereafter, the state commissioner of health shall report to the legislature the findings related to the incidence and size of malpractice claims against hospitals, outpatient surgery centers, and health maintenance organizations, and shall make any appropriate recommendations to reduce the incidence and size of the claims. Data published by the state commissioner of health pursuant to this subdivision with respect to malpractice claims information shall be summary data within the meaning of section 13.02, subdivision 19.
Subd. 3.
Access to insurers' records.
The state commissioner of health shall have access to the records of any insurer relating to malpractice claims made against hospitals, outpatient surgery centers, and health maintenance organizations in years prior to 1976 if the commissioner determines the records are necessary to fulfill the duties of the commissioner under Laws 1976, chapter 325.
245C.10 BACKGROUND STUDY; FEES.
Subd. 2.
Supplemental nursing services agencies.
The commissioner shall recover the cost of the background studies initiated by supplemental nursing services agencies registered under section 144A.71, subdivision 1, through a fee of no more than $20 per study charged to the agency. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 2a.
Occupations regulated by commissioner of health.
The commissioner shall set fees to recover the cost of combined background studies and criminal background checks initiated by applicants, licensees, and certified practitioners regulated under sections 148.511 to 148.5198 and chapter 153A. The fees collected under this subdivision shall be deposited in the special revenue fund and are appropriated to the commissioner for the purpose of conducting background studies and criminal background checks.
Subd. 3.
Personal care provider organizations.
The commissioner shall recover the cost of background studies initiated by a personal care provider organization under sections 256B.0651 to 256B.0654 and 256B.0659 through a fee of no more than $20 per study charged to the organization responsible for submitting the background study form. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 4.
Temporary personnel agencies, educational programs, and professional services agencies.
The commissioner shall recover the cost of the background studies initiated by temporary personnel agencies, educational programs, and professional services agencies that initiate background studies under section 245C.03, subdivision 4, through a fee of no more than $20 per study charged to the agency. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 5.
Adult foster care and family adult day services.
The commissioner shall recover the cost of background studies required under section 245C.03, subdivision 1, for the purposes of adult foster care and family adult day services licensing, through a fee of no more than $20 per study charged to the license holder. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 6.
Unlicensed home and community-based waiver providers of service to seniors and individuals with disabilities.
The commissioner shall recover the cost of background studies initiated by unlicensed home and community-based waiver providers of service to seniors and individuals with disabilities under section 256B.4912 through a fee of no more than $20 per study.
Subd. 7.
Private agencies.
The commissioner shall recover the cost of conducting background studies under section 245C.33 for studies initiated by private agencies for the purpose of adoption through a fee of no more than $70 per study charged to the private agency. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 8.
Children's therapeutic services and supports providers.
The commissioner shall recover the cost of background studies required under section 245C.03, subdivision 7, for the purposes of children's therapeutic services and supports under section 256B.0943, through a fee of no more than $20 per study charged to the license holder. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 9.
Human services licensed programs.
The commissioner shall recover the cost of background studies required under section 245C.03, subdivision 1, for all programs that are licensed by the commissioner, except child foster care when the applicant or license holder resides in the home where child foster care services are provided, family child care, child care centers, certified license-exempt child care centers, and legal nonlicensed child care authorized under chapter 119B, through a fee of no more than $20 per study charged to the license holder. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 9a.
Child care programs.
The commissioner shall recover the cost of a background study required for family child care, certified license-exempt child care centers, licensed child care centers, and legal nonlicensed child care providers authorized under chapter 119B through a fee of no more than $40 per study charged to the license holder. A fee of no more than $20 per study shall be charged for studies conducted under section 245C.05, subdivision 5a, paragraph (a). The fees collected under this subdivision are appropriated to the commissioner to conduct background studies.
Subd. 10.
Community first services and supports organizations.
The commissioner shall recover the cost of background studies initiated by an agency-provider delivering services under section 256B.85, subdivision 11, or a financial management services provider providing service functions under section 256B.85, subdivision 13, through a fee of no more than $20 per study, charged to the organization responsible for submitting the background study form. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 11.
Providers of housing support.
The commissioner shall recover the cost of background studies initiated by providers of housing support under section 256I.04 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 12.
Child protection workers or social services staff having responsibility for child protective duties.
The commissioner shall recover the cost of background studies initiated by county social services agencies and local welfare agencies for individuals who are required to have a background study under section 626.559, subdivision 1b, through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 13.
Providers of special transportation service.
The commissioner shall recover the cost of background studies initiated by providers of special transportation service under section 174.30 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
Subd. 14.
Children's residential facilities.
The commissioner shall recover the cost of background studies initiated by a licensed children's residential facility through a fee of no more than $51 per study. Fees collected under this subdivision are appropriated to the commissioner for purposes of conducting background studies.
Subd. 16.
Providers of housing support services.
The commissioner shall recover the cost of background studies initiated by providers of housing support services under section 256B.051 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.
256B.0596 MENTAL HEALTH CASE MANAGEMENT.
Counties shall contract with eligible providers willing to provide mental health case management services under section 256B.0625, subdivision 20. In order to be eligible, in addition to general provider requirements under this chapter, the provider must:
(1) be willing to provide the mental health case management services; and
(2) have a minimum of at least one contact with the client per week. This section is not intended to limit the ability of a county to provide its own mental health case management services.
256B.0625 COVERED SERVICES.
Subd. 18c.
Nonemergency Medical Transportation Advisory Committee.
(a) The Nonemergency Medical Transportation Advisory Committee shall advise the commissioner on the administration of nonemergency medical transportation covered under medical assistance. The advisory committee shall meet at least quarterly the first year following January 1, 2015, and at least biannually thereafter and may meet more frequently as required by the commissioner. The advisory committee shall annually elect a chair from among its members, who shall work with the commissioner or the commissioner's designee to establish the agenda for each meeting. The commissioner, or the commissioner's designee, shall attend all advisory committee meetings.
(b) The Nonemergency Medical Transportation Advisory Committee shall advise and make recommendations to the commissioner on:
(1) updates to the nonemergency medical transportation policy manual;
(2) other aspects of the nonemergency medical transportation system, as requested by the commissioner; and
(3) other aspects of the nonemergency medical transportation system, as requested by:
(i) a committee member, who may request an item to be placed on the agenda for a future meeting. The request may be considered by the committee and voted upon. If the motion carries, the meeting agenda item may be developed for presentation to the committee; and
(ii) a member of the public, who may approach the committee by letter or e-mail requesting that an item be placed on a future meeting agenda. The request may be considered by the committee and voted upon. If the motion carries, the agenda item may be developed for presentation to the committee.
(c) The Nonemergency Medical Transportation Advisory Committee shall coordinate its activities with the Minnesota Council on Transportation Access established under section 174.285. The chair of the advisory committee, or the chair's designee, shall attend all meetings of the Minnesota Council on Transportation Access.
(d) The Nonemergency Medical Transportation Advisory Committee shall expire December 1, 2019.
Subd. 18d.
Advisory committee members.
(a) The Nonemergency Medical Transportation Advisory Committee consists of:
(1) four voting members who represent counties, utilizing the rural urban commuting area classification system. As defined in subdivision 17, these members shall be designated as follows:
(i) two counties within the 11-county metropolitan area;
(ii) one county representing the rural area of the state; and
(iii) one county representing the super rural area of the state.
The Association of Minnesota Counties shall appoint one county within the 11-county metropolitan area and one county representing the super rural area of the state. The Minnesota Inter-County Association shall appoint one county within the 11-county metropolitan area and one county representing the rural area of the state;
(2) three voting members who represent medical assistance recipients, including persons with physical and developmental disabilities, persons with mental illness, seniors, children, and low-income individuals;
(3) five voting members who represent providers that deliver nonemergency medical transportation services to medical assistance enrollees, one of whom is a taxicab owner or operator;
(4) two voting members of the house of representatives, one from the majority party and one from the minority party, appointed by the speaker of the house, and two voting members from the senate, one from the majority party and one from the minority party, appointed by the Subcommittee on Committees of the Committee on Rules and Administration;
(5) one voting member who represents demonstration providers as defined in section 256B.69, subdivision 2;
(6) one voting member who represents an organization that contracts with state or local governments to coordinate transportation services for medical assistance enrollees;
(7) one voting member who represents the Minnesota State Council on Disability;
(8) the commissioner of transportation or the commissioner's designee, who shall serve as a voting member;
(9) one voting member appointed by the Minnesota Ambulance Association; and
(10) one voting member appointed by the Minnesota Hospital Association.
(b) Members of the advisory committee shall not be employed by the Department of Human Services. Members of the advisory committee shall receive no compensation.
Subd. 18e.
Single administrative structure and delivery system.
The commissioner, in coordination with the commissioner of transportation, shall implement a single administrative structure and delivery system for nonemergency medical transportation, beginning the latter of the date the single administrative assessment tool required in this subdivision is available for use, as determined by the commissioner or by July 1, 2016.
In coordination with the Department of Transportation, the commissioner shall develop and authorize a web-based single administrative structure and assessment tool, which must operate 24 hours a day, seven days a week, to facilitate the enrollee assessment process for nonemergency medical transportation services. The web-based tool shall facilitate the transportation eligibility determination process initiated by clients and client advocates; shall include an accessible automated intake and assessment process and real-time identification of level of service eligibility; and shall authorize an appropriate and auditable mode of transportation authorization. The tool shall provide a single framework for reconciling trip information with claiming and collecting complaints regarding inappropriate level of need determinations, inappropriate transportation modes utilized, and interference with accessing nonemergency medical transportation. The web-based single administrative structure shall operate on a trial basis for one year from implementation and, if approved by the commissioner, shall be permanent thereafter. The commissioner shall seek input from the Nonemergency Medical Transportation Advisory Committee to ensure the software is effective and user-friendly and make recommendations regarding funding of the single administrative system.
Subd. 18h.
Managed care.
(a) The following subdivisions apply to managed care plans and county-based purchasing plans:
(1) subdivision 17, paragraphs (a), (b), (i), and (n);
(2) subdivision 18; and
(3) subdivision 18a.
(b) A nonemergency medical transportation provider must comply with the operating standards for special transportation service specified in sections 174.29 to 174.30 and Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire vehicles are exempt from the requirements in this paragraph.
256B.0924 TARGETED CASE MANAGEMENT SERVICES.
Subd. 4a.
Targeted case management through interactive video.
(a) Subject to federal approval, contact made for targeted case management by interactive video shall be eligible for payment under subdivision 6 if:
(1) the person receiving targeted case management services is residing in:
(i) a hospital;
(ii) a nursing facility; or
(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging establishment or lodging establishment that provides supportive services or health supervision services according to section 157.17 that is staffed 24 hours a day, seven days a week;
(2) interactive video is in the best interests of the person and is deemed appropriate by the person receiving targeted case management or the person's legal guardian, the case management provider, and the provider operating the setting where the person is residing;
(3) the use of interactive video is approved as part of the person's written personal service or case plan; and
(4) interactive video is used for up to, but not more than, 50 percent of the minimum required face-to-face contact.
(b) The person receiving targeted case management or the person's legal guardian has the right to choose and consent to the use of interactive video under this subdivision and has the right to refuse the use of interactive video at any time.
(c) The commissioner shall establish criteria that a targeted case management provider must attest to in order to demonstrate the safety or efficacy of delivering the service via interactive video. The attestation may include that the case management provider has:
(1) written policies and procedures specific to interactive video services that are regularly reviewed and updated;
(2) policies and procedures that adequately address client safety before, during, and after the interactive video services are rendered;
(3) established protocols addressing how and when to discontinue interactive video services; and
(4) established a quality assurance process related to interactive video services.
(d) As a condition of payment, the targeted case management provider must document the following for each occurrence of targeted case management provided by interactive video:
(1) the time the service began and the time the service ended, including an a.m. and p.m. designation;
(2) the basis for determining that interactive video is an appropriate and effective means for delivering the service to the person receiving case management services;
(3) the mode of transmission of the interactive video services and records evidencing that a particular mode of transmission was utilized;
(4) the location of the originating site and the distant site; and
(5) compliance with the criteria attested to by the targeted case management provider as provided in paragraph (c).
Repealed Minnesota Rule: H2128-1
9505.0275 EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT.
Subpart 1.
Definition.
"Early and periodic screening, diagnosis, and treatment service" means a service provided to a recipient under age 21 to identify a potentially disabling condition and to provide diagnosis and treatment for a condition identified according to the requirements of the Code of Federal Regulations, title 42, section 441.55 and parts 9505.1693 to 9505.1748.
9505.1693 SCOPE AND PURPOSE.
Parts 9505.1693 to 9505.1748 govern the early and periodic screening, diagnosis, and treatment (EPSDT) program.
Parts 9505.1693 to 9505.1748 must be read in conjunction with section 1905(a)(4)(B) of the Social Security Act, as amended through December 31, 1981, and the Code of Federal Regulations, title 42, part 441, subpart B, as amended through October 1, 1987, and section 6403 of the Omnibus Budget Reconciliation Act of 1989. The purpose of the EPSDT program is to identify potentially disabling conditions in children eligible for medical assistance, to provide diagnosis and treatment for conditions identified, and to encourage parents and their children to use health care services when necessary.
9505.1696 DEFINITIONS.
Subpart 1.
Applicability.
As used in parts 9505.1693 to 9505.1748, the following terms have the meanings given them.
Subp. 2.
Child.
"Child" means a person who is eligible for early and periodic screening, diagnosis, and treatment under part 9505.1699.
Subp. 3.
Community health clinic.
"Community health clinic" means a clinic that provides services by or under the supervision of a physician and that:
B.
is exempt from federal income tax under Internal Revenue Code of 1986, section 501(c)(3), as amended through December 31, 1987;
D.
has written clinic policies describing the services provided by the clinic and concerning (1) the medical management of health problems, including problems that require referral to physicians, (2) emergency health services, and (3) the maintenance and review of health records by the physician.
Subp. 5.
Diagnosis.
"Diagnosis" means the identification and determination of the nature or cause of a disease or abnormality through the use of a health history; physical, developmental, and psychological examination; and laboratory tests.
Subp. 6.
Early and periodic screening clinic or EPS clinic.
"Early and periodic screening clinic" or "EPS clinic" means an individual or facility that is approved by the Minnesota Department of Health under parts 4615.0900 to 4615.2000.
Subp. 7.
Early and periodic screening, diagnosis, and treatment program or EPSDT program.
"Early and periodic screening, diagnosis, and treatment program" or "EPSDT program" means the program that provides screening, diagnosis, and treatment under parts 9505.1693 to 9505.1748; Code of Federal Regulations, title 42, section 441.55, as amended through October 1, 1986; and Minnesota Statutes, section 256B.02, subdivision 8, paragraph (12).
Subp. 8.
EPSDT clinic.
"EPSDT clinic" means a facility supervised by a physician that provides screening according to parts 9505.1693 to 9505.1748 or an EPS clinic.
Subp. 9.
EPSDT provider agreement.
"EPSDT provider agreement" means the agreement required by part 9505.1703, subpart 2.
Subp. 11.
Follow-up.
"Follow-up" means efforts by a local agency to ensure that a screening requested for a child is provided to that child and that diagnosis and treatment indicated as necessary by a screening are also provided to that child.
Subp. 12.
Head Start agency.
"Head Start agency" refers to the child development program administered by the United States Department of Health and Human Services, Office of Administration for Children, Youth and Families.
Subp. 13.
Local agency.
"Local agency" means the county welfare board, multicounty welfare board, or human service agency established in Minnesota Statutes, section 256B.02, subdivision 6, and Minnesota Statutes, chapter 393.
Subp. 14.
Medical assistance.
"Medical assistance" means the program authorized by title XIX of the Social Security Act and Minnesota Statutes, chapters 256 and 256B.
Subp. 15.
Outreach.
"Outreach" means efforts by the department or a local agency to inform eligible persons about early and periodic screening, diagnosis, and treatment or to encourage persons to use the EPSDT program.
Subp. 17.
Physician.
"Physician" means a person who is licensed to provide health services within the scope of the person's profession under Minnesota Statutes, chapter 147.
Subp. 18.
Prepaid health plan.
"Prepaid health plan" means a health insurer licensed and operating under Minnesota Statutes, chapters 60A, 62A, and 62C, and a health maintenance organization licensed and operating under Minnesota Statutes, chapter 62D to provide health services to recipients of medical assistance entitlements.
Subp. 19.
Public health nursing service.
"Public health nursing service" means the nursing program provided by a community health board under Minnesota Statutes, section 145A.04, subdivisions 1 and 1a.
Subp. 20.
Screening.
"Screening" means the use of quick, simple procedures to separate apparently well children from those who need further examination for possible physical, developmental, or psychological problems.
Subp. 21.
Skilled professional medical personnel and supporting staff.
"Skilled professional medical personnel" and "supporting staff" means persons as defined by Code of Federal Regulations, title 42, section 432.2, as amended through October 1, 1987.
Subp. 22.
Treatment.
"Treatment" means the prevention, correction, or amelioration of a disease or abnormality identified by screening or diagnosis.
9505.1699 ELIGIBILITY TO BE SCREENED.
A person under age 21 who is eligible for medical assistance is eligible for the EPSDT program.
9505.1701 CHOICE OF PROVIDER.
Subpart 1.
Choice of screening provider.
Except as provided by subpart 3, a child or parent of a child who requests screening may choose any screening provider who has signed an EPSDT provider agreement and a medical assistance provider agreement.
Subp. 2.
Choice of diagnosis and treatment provider.
Except as provided by subpart 3, a child or parent of a child may choose any diagnosis and treatment provider as provided by part 9505.0190.
Subp. 3.
Exception to subparts 1 and 2.
A child who is enrolled in a prepaid health plan must receive screening, diagnosis, and treatment from that plan.
9505.1703 ELIGIBILITY TO PROVIDE SCREENING.
Subpart 1.
Providers.
An EPSDT clinic or a community health clinic shall be approved for medical assistance reimbursement for EPSDT services if it complies with the requirements of parts 9505.1693 to 9505.1748. A Head Start agency shall be approved as provided by subpart 2.
Subp. 2.
EPSDT provider agreement.
To be eligible to provide screening and receive reimbursement under the EPSDT program, an individual or facility must sign an EPSDT provider agreement provided by the department and a medical assistance provider agreement under part 9505.0195 or be a prepaid health plan.
Subp. 3.
Terms of EPSDT provider agreement.
The EPSDT provider agreement required by subpart 2 must state that the provider must:
9505.1706 REIMBURSEMENT.
Subp. 2.
Eligibility for reimbursement; Head Start agency.
A Head Start agency may complete all the screening components under part 9505.1718, subparts 2 to 14 or those components that have not been completed by another provider within the six months before completion of the screening components by the Head Start agency. A Head Start agency that completes the previously incomplete screening components must document on the EPSDT screening form that the other screening components of part 9505.1718, subparts 2 to 14, have been completed by another provider.
The department shall reimburse a Head Start agency for those screening components of part 9505.1718, subparts 2 to 14, that the Head Start agency has provided. The amount of reimbursement must be the same as a Head Start agency's usual and customary cost for each screening component or the maximum fee determined under subpart 1, whichever is lower.
Subp. 3.
Prepaid health plan.
A prepaid health plan is not eligible for a separate payment for screening. The early and periodic screening, diagnosis, and treatment screening must be a service included within the prepaid capitation rate specified in its contract with the department.
9505.1712 TRAINING.
The department must train the staff of an EPSDT clinic that is supervised by a physician on how to comply with the procedures required by part 9505.1718 if the EPSDT clinic requests the training.
9505.1715 COMPLIANCE WITH SURVEILLANCE AND UTILIZATION REVIEW.
A screening provider must comply with the surveillance and utilization review requirements of parts 9505.2160 to 9505.2245.
9505.1718 SCREENING STANDARDS FOR AN EPSDT CLINIC.
Subpart 1.
Requirement.
An early and periodic screening, diagnosis, and treatment screening must meet the requirements of subparts 2 to 15 except as provided by part 9505.1706, subpart 2.
Subp. 2.
Health and developmental history.
A history of a child's health and development must be obtained from the child, parent of the child, or an adult who is familiar with the child's health history. The history must include information on sexual development, lead and tuberculosis exposure, nutrition intake, chemical abuse, and social, emotional, and mental health status.
Subp. 3.
Assessment of physical growth.
The child's height or length and the child's weight must be measured and the results plotted on a growth grid based on data from the National Center for Health Statistics (NCHS). The head circumference of a child up to 36 months of age or a child whose growth in head circumference appears to deviate from the expected circumference for that child must be measured and plotted on an NCHS-based growth grid.
Subp. 4.
Physical examination.
The following must be checked according to accepted medical procedures: pulse; respiration; blood pressure; head; eyes; ears; nose; mouth; pharynx; neck; chest; heart; lungs; abdomen; spine; genitals; extremities; joints; muscle tone; skin; and neurological condition.
Subp. 5.
Vision.
A child must be checked for a family history of maternal and neonatal infection and ocular abnormalities. A child must be observed for pupillary reflex; the presence of nystagmus; and muscle balance, which includes an examination for esotropia, exotropia, phorias, and extraocular movements. The external parts of a child's eyes must be examined including the lids, conjunctiva, cornea, iris, and pupils. A child or parent of the child must be asked whether he or she has concerns about the child's vision.
Subp. 6.
Vision of a child age three or older.
In addition to the requirements of subpart 5, the visual acuity of a child age three years or older must be checked by use of the Screening Test for Young Children and Retardates (STYCAR) or the Snellen Alphabet Chart.
Subp. 7.
Hearing.
A child must be checked for a family history of hearing disability or loss, delay of language acquisition or history of such delay, the ability to determine the direction of a sound, and a history of repeated otitis media during early life. A child or parent of the child must be asked whether he or she has any concerns regarding the child's hearing.
Subp. 8.
Hearing of a child age three or older.
In addition to the requirements of subpart 7, a child age three or older must receive a pure tone audiometric test or referral for the test if the examination under subpart 7 indicates the test is needed.
Subp. 9.
Development.
A child must be screened for the following according to the screening provider's standard procedures: fine and gross motor development, speech and language development, social development, cognitive development, and self-help skills. Standardized tests that are used in screening must be culturally sensitive and have norms for the age range tested, written procedures for administration and for scoring and interpretation that are statistically reliable and valid. The provider must use a combination of the child's health and developmental history and standardized test or clinical judgment to determine the child's developmental status or need for further assessment.
Subp. 10.
Sexual development.
A child must be evaluated to determine whether the child's sexual development is consistent with the child's chronological age. A female must receive a breast examination and pelvic examination when indicated. A male must receive a testicular examination when indicated. If it is in the best interest of a child, counseling on normal sexual development, information on birth control and sexually transmitted diseases, and prescriptions and tests must be offered to a child. If it is in the best interest of a child, a screening provider may refer the child to other resources for counseling or a pelvic examination.
Subp. 11.
Nutrition.
When the assessment of a child's physical growth performed according to subpart 3 indicates a nutritional risk condition, the child must be referred for further assessment, receive nutritional counseling, or be referred to a nutrition program such as the Special Supplemental Food Program for Women, Infants, and Children; food stamps or food support; Expanded Food and Nutrition Education Program; or Head Start.
Subp. 12.
Immunizations.
The immunization status of a child must be compared to the "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition. Immunizations that the comparison shows are needed must be offered to the child and given to the child if the child or parent of the child accepts the offer. The "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition, is developed and distributed by the Minnesota Department of Health, 717 Delaware Street Southeast, Minneapolis, Minnesota 55440. The "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition, is incorporated by reference and is available at the State Law Library, Judicial Center, 25 Rev. Dr. Martin Luther King Jr. Blvd., Saint Paul, Minnesota 55155. It is subject to frequent change.
Subp. 13.
Laboratory tests.
Laboratory tests must be done according to items A to F.
A.
A Mantoux test must be administered yearly to a child whose health history indicates ongoing exposure to tuberculosis, unless the child has previously tested positive. A child who tests positive must be referred for diagnosis and treatment.
B.
A child aged one to five years must initially be screened for lead through the use of either an erythrocyte protoporphyrin (EP) test or a direct blood lead screening test until December 31, 1992. Beginning January 1, 1993, a child age one to five must initially be screened using a direct blood lead screening test. Either capillary or venous blood may be used as the specimen for the direct blood lead test. Blood tests must be performed at a minimum of once at 12 months of age and once at 24 months of age or whenever the history indicates that there are risk factors for lead poisoning. When the result of the EP or capillary blood test is greater than the maximum allowable level set by the Centers for Disease Control of the United States Public Health Service, the child must be referred for a venous blood lead test. A child with a venous blood lead level greater than the maximum allowable level set by the Centers for Disease Control must be referred for diagnosis and treatment.
C.
The urine of a child must be tested for the presence of glucose, ketones, protein, and other abnormalities. A female at or near the age of four and a female at or near the age of ten must be tested for bacteriuria.
D.
Either a microhematocrit determination or a hemoglobin concentration test for anemia must be done.
E.
A test for sickle cell or other hemoglobinopathy, or abnormal blood conditions must be offered to a child who is at risk of such abnormalities and who has not yet been tested. These tests must be provided if accepted or requested by the child or parent of the child. If the tests identify a hemoglobin abnormality or other abnormal blood condition, the child must be referred for genetic counseling.
F.
Other laboratory tests such as those for cervical cancer, sexually transmitted diseases, pregnancy, and parasites must be performed when indicated by a child's medical or family history.
Subp. 14.
Oral examination.
An oral examination of a child's mouth must be performed to detect deterioration of hard tissue, and inflammation or swelling of soft tissue. Counseling about the systemic use of fluoride must be given to a child when fluoride is not available through the community water supply or school programs.
Subp. 14a.
Health education and health counseling.
Health education and health counseling concerning the child's health must be offered to the child who is being screened and to the child's parent or representative. The health education and health counseling are for the purposes of assisting the child or the parent or representative of the child to understand the expected growth and development of the child and of informing the child or the parent or representative of the child about the benefits of healthy lifestyles and about practices to promote accident and disease prevention.
Subp. 15.
Schedule of age related screening standards.
An early and periodic screening, diagnosis, and treatment screening for a child at a specific age must include, at a minimum, the screening requirements of subparts 2 to 14 as provided by the following schedule:
Schedule of age related screening standards
A.
Infancy:
| Standards | Ages | |||||
| By 1 month | 2 months | 4 months | 6 months | 9 months | 12 months | |
| Health History | X | X | X | X | X | X |
| Assessment of Physical Growth: | ||||||
| Height | X | X | X | X | X | X |
| Weight | X | X | X | X | X | X |
| Head Circumference | X | X | X | X | X | X |
| Physical Examination | X | X | X | X | X | X |
| Vision | X | X | X | X | X | X |
| Hearing | X | X | X | X | X | X |
| Development | X | X | X | X | X | X |
| Health Education/Counseling | X | X | X | X | X | X |
| Sexual Development | X | X | X | X | X | X |
| Nutrition | X | X | X | X | X | X |
| Immunizations/Review | X | X | X | X | X | |
| Laboratory Tests: | ||||||
| Tuberculin | if history indicates | |||||
| Lead Absorption | if history indicates | X | ||||
| Urinalysis | ← | ← | ← | X | ← | ← |
| Hematocrit or Hemoglobin | ← | ← | ← | ← | X | X |
| Sickle Cell | at parent's or child's request | |||||
| Other Laboratory Tests | as indicated | |||||
| Oral Examination | X | X | X | X | X | X |
X = Procedure to be completed.
← = Procedure to be completed if not done at the previous visit, or on the first visit.
B.
Early Childhood:
| Standards | Ages | ||||
| 15 months | 18 months | 24 months | 3years | 4years | |
| Health History | X | X | X | X | X |
| Assessment of Physical Growth: | |||||
| Height | X | X | X | X | X |
| Weight | X | X | X | X | X |
| Head Circumference | X | X | X | X | X |
| Physical Examination | X | X | X | X | X |
| Vision | X | X | X | X | X |
| Hearing | X | X | X | X | X |
| Blood Pressure | X | X | |||
| Development | X | X | X | X | X |
| Health Education/Counseling | X | X | X | X | X |
| Sexual Development | X | X | X | X | X |
| Nutrition | X | X | X | X | X |
| Immunizations/Review | X | X | X | X | X |
| Laboratory Tests: | |||||
| Tuberculin | if history indicates | ||||
| Lead Absorption | if history indicates | X | if history indicates | ||
| Urinalysis | ← | ← | X | ← | ← |
| Bacteriuria (females) | X | ||||
| Hematocrit or Hemoglobin | ← | ← | ← | ← | ← |
| Sickle Cell | at parent's or child's request | ||||
| Other Laboratory Tests | as indicated | ||||
| Oral Examination | X | X | X | X | X |
X = Procedure to be completed.
← = Procedure to be completed if not done at the previous visit, or on the first visit.
C.
Late childhood:
| Standards | Ages | ||||
| 5 years | 6 years | 8 years | 10 years | 12 years | |
| Health History | X | X | X | X | X |
| Assessment of Physical Growth: | |||||
| Height | X | X | X | X | X |
| Weight | X | X | X | X | X |
| Physical Examination | X | X | X | X | X |
| Vision | X | X | X | X | X |
| Hearing | X | X | X | X | X |
| Blood Pressure | X | X | X | X | X |
| Development | X | X | X | X | X |
| Health Education/Counseling | X | X | X | X | X |
| Sexual Development | X | X | X | X | X |
| Nutrition | X | X | X | X | X |
| Immunizations/Review | X | X | X | X | X |
| Laboratory Tests: | |||||
| Tuberculin | if history indicates | ||||
| Lead Absorption | if history indicates | ||||
| Urinalysis | ← | ← | X | ← | ← |
| Bacteriuria (females) | ← | ← | X | ← | ← |
| Hemoglobin or Hematocrit | ← | ← | X | ← | |
| Sickle Cell | at parent's or child's request | ||||
| Other Laboratory Tests | as indicated | ||||
| Oral Examination | X | X | X | X | X |
X = Procedure to be completed.
← = Procedure to be completed if not done at the previous visit, or on the first visit.
D.
Adolescence:
| Standards | Ages | |||
| 14 years | 16 years | 18 years | 20 years | |
| Health History | X | X | X | X |
| Assessment of Physical Growth: | ||||
| Height | X | X | X | X |
| Weight | X | X | X | X |
| Physical Examination | X | X | X | X |
| Vision | X | X | X | X |
| Hearing | X | X | X | X |
| Blood Pressure | X | X | X | X |
| Development | X | X | X | X |
| Health Education/Counseling | X | X | X | X |
| Sexual Development | X | X | X | X |
| Nutrition | X | X | X | X |
| Immunizations/Review | X | X | X | X |
| Laboratory Tests: | ||||
| Tuberculin | if history indicates | |||
| Lead Absorption | if history indicates | |||
| Urinalysis | ← | X | ||
| Bacteriuria (females) | ← | ← | ||
| Hemoglobin or Hematocrit | ← | X | ||
| Sickle Cell | at parent's or child's request | |||
| Other Laboratory Tests | as indicated | |||
| Oral Examination | X | X | ||
X = Procedure to be completed.
← = Procedure to be completed if not done at the previous visit, or on the first visit.
Subp. 15a.
Additional screenings.
A child may have a partial or complete screening between the ages specified in the schedule under subpart 15 if the screening is medically necessary or a concern develops about the child's health or development.
9505.1724 PROVISION OF DIAGNOSIS AND TREATMENT.
Diagnosis and treatment identified as needed under part 9505.1718 shall be eligible for medical assistance payment subject to the provisions of parts 9505.0170 to 9505.0475.
9505.1727 INFORMING.
A local agency must inform each child or parent of a child about the EPSDT program no later than 60 days after the date the child is determined to be eligible for medical assistance. The information about the EPSDT program must be given orally and in writing, indicate the purpose and benefits of the EPSDT program, indicate that the EPSDT program is without cost to the child or parent of the child while the child is eligible for medical assistance, state the types of medical and dental services available under the EPSDT program, and state that the transportation and appointment scheduling assistance required under part 9505.1730 is available.
The department must send a written notice to a child or parent of a child who has been screened informing the child or parent that the child should be screened again. This notice must be sent at the following ages of the child: six months, nine months, one year, 18 months, two years, four years, and every three years after age four.
Each year, on the date the child was determined eligible for medical assistance entitlements, the department must send a written notice to a child or parent of a child who has never been screened informing the child or parent that the child is eligible to be screened.
9505.1730 ASSISTANCE WITH OBTAINING A SCREENING.
Within ten working days of receiving a request for screening from a child or parent of a child, a local agency must give or mail to the child or parent of the child:
9505.1733 ASSISTANCE WITH OBTAINING DIAGNOSIS AND TREATMENT.
An EPSDT clinic must notify a child or parent of a child who is referred for diagnosis and treatment that the local agency will provide names and addresses of diagnosis and treatment providers and will help with appointment scheduling and transportation to the diagnosis and treatment provider. The notice must be on a form provided by the department and must be given to the child or parent of the child on the day the child is screened.
If a child or parent of a child asks a local agency for assistance with obtaining diagnosis and treatment, the local agency must provide that assistance within ten working days of the date of the request.
9505.1736 SPECIAL NOTIFICATION REQUIREMENT.
A local agency must effectively inform an individual who is blind or deaf, or who cannot read or understand the English language, about the EPSDT program.
9505.1739 CHILDREN IN FOSTER CARE.
Subpart 1.
Dependent or neglected state wards.
The local agency must provide early and periodic screening, diagnosis, and treatment services for a child in foster care who is a dependent or neglected state ward under parts 9560.0410 to 9560.0470, and who is eligible for medical assistance unless the early and periodic screening, diagnosis, and treatment services are not in the best interest of the child.
Subp. 2.
Other children in foster care.
The local agency must discuss the EPSDT program with a parent of a child in foster care who is under the legal custody or protective supervision of the local agency or whose parent has entered into a voluntary placement agreement with the local agency. The local agency must help the parent decide whether to accept early and periodic screening, diagnosis, and treatment services for the child. If a parent cannot be consulted, the local agency must decide whether to accept early and periodic screening, diagnosis, and treatment services for the child and must document the reasons for the decision.
Subp. 3.
Assistance with appointment scheduling and transportation.
The local agency must help a child in foster care with appointment scheduling and transportation for screening, diagnosis, and treatment as provided by parts 9505.1730 to 9505.1733.
Subp. 4.
Notification.
The department must send a written notice to the local agency stating that a child in foster care who has been screened should be screened again. This notice must be sent at the following ages of the child: six months, nine months, one year, 18 months, two years, four years, and every three years thereafter.
Each year, by the anniversary of the date the child was determined eligible for medical assistance entitlements, the department must send a written notice to the local agency that a child in foster care who has never been screened is eligible to be screened.
If a written notice under this subpart pertains to a child who is a dependent or neglected state ward, the local agency must proceed according to subpart 1. The local agency must proceed according to subpart 2 if the written notice pertains to a child who is not a dependent or neglected state ward.
9505.1742 DOCUMENTATION.
The local agency must document compliance with parts 9505.1693 to 9505.1748 on forms provided by the department.
9505.1745 INTERAGENCY COORDINATION.
The local agency must coordinate the EPSDT program with other programs that provide health services to children as provided by Code of Federal Regulations, title 42, section 441.61(c), as amended through October 1, 1986. Examples of such agencies are a public health nursing service, a Head Start agency, and a school district.
9505.1748 CONTRACTS FOR ADMINISTRATIVE SERVICES.
Subpart 1.
Authority.
A local agency may contract with a county public health nursing service, a community health clinic, a Head Start agency, a community action agency, or a school district for early and periodic screening, diagnosis, and treatment administrative services. Early and periodic screening, diagnosis, and treatment administrative services include outreach; notification; appointment scheduling and transportation; follow-up; and documentation. For purposes of this subpart, "community action agency" means an entity defined in Minnesota Statutes, section 256E.31, subdivision 1, and "school district" means a school district as defined in Minnesota Statutes, section 120A.05, subdivisions 5, 10, and 14.
Subp. 2.
Federal financial participation.
The percent of federal financial participation for salaries, fringe benefits, and travel of skilled professional medical personnel and their supporting staff shall be paid as provided by Code of Federal Regulations, title 42, section 433.15(b)(5), as amended through October 1, 1986.
Subp. 3.
State reimbursement.
State reimbursement for contracts for EPSDT administrative services under this part shall be as provided by Minnesota Statutes, section 256B.19, subdivision 1, except for the provisions under subdivision 1 that pertain to a prepaid health plan.
Subp. 4.
Approval.
A contract for administrative services must be approved by the local agency and submitted to the department for approval by November 1 of the year before the beginning of the calendar year in which the contract will be effective. A contract must contain items A to L to be approved by the department for reimbursement:
D.
amount of the contract, budget breakdown, and a clause that stipulates that the department's procedures for certifying expenditures will be followed by the local agency;
F.
a clause that stipulates that the contract will be renegotiated if federal or state program regulations or federal financial reimbursement regulations change;
G.
a clause that stipulates that the contracting parties will provide program and fiscal records and maintain all nonpublic data required by the contract according to the Minnesota Government Data Practices Act and will cooperate with state and federal program reviews;
J.
signatures of the representatives of the contracting parties with the authority to obligate the parties by contract and dates of those signatures;
K.
a clause that stipulates that the services provided under contract must be performed by or under the supervision of skilled medical personnel; and
L.
a clause that stipulates that the contracting parties will comply with state and federal requirements for the receipt of medical assistance funds.