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Capital IconMinnesota Legislature

HF 2128

1st Engrossment - 92nd Legislature (2021 - 2022) Posted on 04/12/2021 04:55pm

KEY: stricken = removed, old language.
underscored = added, new language.
Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27
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 endnew 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 beginor to develop and operate an encounter alerting
service
new text endthat 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 beginfrom the fee-for-service
program
deleted 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 endnew 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 endnew 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 beginor if the hospital qualifies for the alternative payment rate described in
subdivision 2e,
new text endthe 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 endnew text begin
$9,000,000
new 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 begin12deleted text endnew 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 beginor tribal agencies new text endparticipating 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 endprovided 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 beginand tribal agency new text endproposals.

Each participating county new text beginand 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 beginor tribal new text endagency 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 beginand tribal new text endagencies. The commissioner shall also develop the necessary operational
guidelines, forms, and reporting mechanisms, which shall be used by the involved countynew text begin
or tribal
new 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 beginand tribal new text endagency 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 beginor tribal new text endagency 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 beginor tribal new text endagency 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 beginor tribal new text endagency 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 beginor tribal new text endagency 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 beginThe 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 beginand
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 beginlevel of need determinations, disbursement of
public transportation passes and tokens, and volunteer and recipient mileage and parking
reimbursements
deleted 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 beginspecial 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 begin60 daysdeleted text end new text beginsix 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 begin60-daydeleted text endnew text begin
six-month
new 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 endA person deleted text beginwho 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 beginMedicare new text endPart 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 endnew 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 begin60 daysdeleted text end new text beginsix monthsnew text end
postpartumdeleted text begin, deleted text enddeleted text beginto the extent federal funds are available under title XXI of the Social Security
Act, and the
deleted text enddeleted text beginstate 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 beginPolicy Committeedeleted text endnew 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 begin13-memberdeleted text endnew text begin 14-membernew text end Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory
Council
new text end, which consists of deleted text begin12deleted text endnew text begin 13new text end voting members and one nonvoting member. The Health
Services deleted text beginPolicy Committeedeleted text endnew 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 beginthe
medical assistance and MinnesotaCare programs
deleted text endnew 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 commissioner
new text end. The Health Services
deleted text begin Policy Committeedeleted text endnew text begin Advisory Councilnew text end shall meet at least quarterly. The Health Services deleted text beginPolicy
Committee
deleted text endnew text begin Advisory Councilnew text end shall annually deleted text beginelectdeleted text endnew text begin selectnew text end a deleted text beginphysiciandeleted 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 beginPolicy Committee shall alsodeleted text endnew text begin Advisory
Council may
new 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 beginsubcommitteedeleted text endnew text begin subcouncilnew text end to operate under
the Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end. The dental deleted text beginsubcommitteedeleted text endnew text begin
subcouncil
new 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 endnew 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 endnew text begin (c)new text end The Health Services deleted text beginPolicy Committee shalldeleted text endnew text begin Advisory Council maynew text end monitor and
track the practice patterns of deleted text beginphysicians providing services to medical assistance and
MinnesotaCare enrollees
deleted text endnew text begin health care providers who serve MHCP recipientsnew text end under
fee-for-service, managed care, and county-based purchasing. The deleted text begincommitteedeleted text endnew text begin monitoring
and tracking
new text end shall focus on services or specialties for which there is a high variation in
utilization new text beginor quality new text endacross deleted text beginphysiciansdeleted text endnew text begin providersnew text end, or which are associated with high medical
costs. The commissioner, based upon the findings of the deleted text begincommitteedeleted text endnew text begin Health Services Advisory
Council
new text end, deleted text beginshall regularlydeleted text endnew text begin maynew text end notify deleted text beginphysiciansdeleted text endnew text begin providersnew text end whose practice patterns indicate
new text begin below average quality or new text endhigher 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 beginthisdeleted text endnew text begin thesenew text end
data available to the deleted text begincommitteedeleted text endnew 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 beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end members.

(a) The
Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end consists of:

(1) deleted text beginsevendeleted text endnew text begin sixnew text end voting members who are licensed physicians actively engaged in the practice
of medicine in Minnesota, deleted text beginone of whom must be actively engaged in the treatment of persons
with mental illness, and
deleted text end three of whom must represent health plans currently under contract
to serve deleted text beginmedical assistancedeleted text endnew text begin MHCPnew text end recipients;

(2) two voting members who are new text beginlicensed new text endphysician 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 endnew text begin (5) two consumersnew text end who shall serve as deleted text beginadeleted text end voting deleted text beginmemberdeleted text endnew text begin membersnew text end; and

deleted text begin (5)deleted text endnew 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 beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end shall not be
employed by the deleted text beginDepartment of Human Servicesdeleted text endnew 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 beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end terms and
compensation.

deleted text beginCommitteedeleted 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 beginPolicy
Committee
deleted text endnew 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 begincommitteedeleted text endnew text begin councilnew text end member
in attendance except the medical director. The Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory
Council
new 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 beginand
deleted text end

(15) full-mouth debridement, limited to one every five yearsdeleted text begin.deleted text endnew 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.12
deleted 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 endnew 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 beginThe Formulary Committee expires June 30, 2022.deleted text endnew 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 endnew 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 endnew 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 endnew 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 endnew 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 beginin consultation with the
Nonemergency Medical Transportation Advisory Committee
deleted 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 endnew 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 endnew 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 beginlocal agencydeleted text endnew 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 endThe administrative agency shall use the level of service process established by
the commissioner deleted text beginin consultation with the Nonemergency Medical Transportation Advisory
Committee
deleted 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 endnew 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 endnew text begin (i)new text end The commissioner shall:

(1) deleted text beginin 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 endPayments for nonemergency medical transportation must be paid based on the
client's assessed mode under paragraph deleted text begin(h)deleted text endnew text begin (g)new text end, not the type of vehicle used to provide the
service. deleted text beginThe 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 endnew text begin (k)new text end The commissioner, when determining reimbursement rates for nonemergency
medical transportation deleted text beginunder paragraphs (m) and (n)deleted text end, shall exempt all modes of transportation
listed under paragraph deleted text begin(i)deleted text endnew 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 beginnonemergency
medical transportation vendor or
new text enddepartment.

(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 beginBusdeleted text endnew text begin Public transitnew text end or taxicab transportation.

new text begin(a) new text endTo 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 beginBroker dispatching prohibitiondeleted text endnew text begin Administration of nonemergency medical
transportation
new 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 endMedical
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 endThe 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 beginand
deleted text end

(12) one member representing Minnesota law enforcementdeleted text begin.deleted text endnew 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 beginand
deleted text end

(3) the medical director for the Department of Labor and Industrydeleted text begin.deleted text endnew 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 endnew 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 begina report identifying an
opioid prescriber who is subject to quality improvement activities
deleted text endnew 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 beginand enroll with the department as
a qualified professional after clearing
deleted text endnew text begin clearnew text end a background studynew text begin, and meet provider training
requirements
new 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 beginEffective 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 beginHennepin 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 beginfrom 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 beginHennepin 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 beginHennepin 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 beginHennepin
County Medical Center and
deleted 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 beginmaydeleted text endnew text begin shallnew text end exclude deleted text beginor modifydeleted text end coverage
for new text beginoutpatient new text endprescription drugs new text begindispensed by a pharmacy to a member eligible for medical
assistance under this chapter
new text endfrom the prepaid managed care contracts entered into under
this section deleted text beginin 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 rebates
deleted 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 beginindeleted text endnew text begin as permitted under Code of Federal Regulations, part 42, section 438.6(c). The
exception under this paragraph includes
new 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 endNotwithstanding 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,
2022
new 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,
2022
new 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 endnew text begin (i)new text end Effective for services rendered on or after January 1, 2014new text begin, through December 31,
2022
new 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 endnew text begin (j)new text end Effective for services provided on or after January 1, 2017new text begin, through December 31,
2022
new 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 endnew text begin (k)new text end Effective for services provided on or after July 1, 2017new text begin, through December 31,
2022
new 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, 2022
new 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,
2021
new 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 endnew 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 endnew 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, 2019
deleted 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 period
deleted text endnew 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 beginanddeleted text endnew 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 begineach July 1deleted text endnew text begin on January 1new text end as deleted text begindescribed in section 256B.056,
subdivision 1c
deleted text endnew 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 Services
deleted 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 beginordeleted text endnew text begin,new text end enhancednew text begin, or uniform adjustment factornew text end payments authorized under
section 256B.196 deleted text beginordeleted text endnew 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 beginCOURT 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 beginDELIVERY 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 beginDENTAL 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 beginDIRECTION 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 beginEXPANSION 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 beginFEDERAL 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 beginPROPOSAL 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 beginRESPONSE 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 beginREVISOR 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 beginREPEALER.
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 beginchecksdeleted text endnew text begin studiesnew text end.

(a) The Professional Educator Licensing and
Standards Board and the Board of School Administrators must deleted text beginobtain adeleted text endnew text begin initiatenew text end criminal
history background deleted text begincheck ondeleted text endnew text begin studies ofnew text end all first-time deleted text beginteachingdeleted text end applicants for new text begineducator new text endlicenses
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 begincheckdeleted text end new text beginstudynew 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 beginstudiesnew text end on applicants for licensure.

(b) The background deleted text begincheckdeleted text end new text beginstudynew 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 beginThe 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 beginmust contract withdeleted text endnew text begin may
initiate criminal history background studies through
new text end the commissioner of human services
new text begin according to section 245C.031 new text endto deleted text beginconduct background checks anddeleted text end obtain background deleted text begincheckdeleted 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 beginor
deleted text end

(10) is prohibited from holding a license according to section 245.095deleted text begin.deleted text endnew 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 children
new 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 beginchemical dependencydeleted text endnew text begin detoxificationnew text end program licensed under Minnesota Rules,
parts 9530.6510 to 9530.6590, deleted text beginto provide detoxification servicesdeleted text endnew text begin or a withdrawal management
program licensed under chapter 245F
new 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 endThe commissioner shall conduct background
studies deleted text beginondeleted text endnew text begin ofnew text end any individual deleted text beginrequired under section 256B.4912 to have a background study
completed under this chapter
deleted text endnew 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.4911
new text end.

Subd. 6a.

Legal nonlicensed and certified child care programs.

The commissioner
shall conduct background studies deleted text beginon an individualdeleted text endnew text begin of the following individuals asnew text end required
deleted text begin underdeleted text endnew text begin bynew text end sections 119B.125 and 245H.10 deleted text beginto complete a background study under this chapter.deleted text endnew 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 beginaccording to this chapter when initiated by a children's
therapeutic services and supports provider
deleted text endnew text begin of all direct service providers and volunteers for
children's therapeutic services and supports providers
new 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 beginand 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 endThe
commissioner shall conduct background studies deleted text beginon any individual required under section
256I.04 to have a background study completed under this chapter.
deleted text endnew 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 endThe commissioner shall
conduct background studies deleted text beginon any individual required under section 174.30 to have a
background study completed under this chapter.
deleted text endnew 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 beginondeleted text endnew text begin ofnew text end any deleted text beginindividualdeleted text endnew text begin provider of housing support servicesnew text end required deleted text beginunderdeleted text endnew text begin
by
new 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