HF 2128

as introduced - 92nd Legislature (2021 - 2022) Posted on 03/11/2021 02:44pm

A bill for an act
relating to health; modifying provisions governing health care, human services,
and licensing and background studies; establishing a budget for health and human
services; making technical and conforming changes; transferring money;
appropriating money; amending Minnesota Statutes 2020, sections 62J.495,
subdivisions 1, 2, 3, 4; 62J.498; 62J.4981; 62J.4982; 62V.05, by adding a
subdivision; 122A.18, subdivision 8; 144.1205, subdivisions 2, 4, 8, 9, by adding
a subdivision; 144.125, subdivision 1; 145.901; 174.30, subdivision 3; 245A.10,
subdivision 4; 245C.02, by adding subdivisions; 245C.03; 245C.05, subdivisions
1, 2, 2a, 2b, 4; 245C.08, by adding subdivisions; 245C.10, subdivision 15, by
adding subdivisions; 245C.13, subdivision 2; 245C.14, by adding a subdivision;
245C.16, subdivisions 1, 2; 245C.17, subdivision 1, by adding a subdivision;
245C.18; 256.9695, subdivision 1; 256.983; 256B.04, subdivisions 12, 14;
256B.057, subdivision 3; 256B.0622, subdivision 7a; 256B.0625, subdivisions
3b, 9, 13, 13e, 17, 17b, 18, 18b, 58; 256B.0947, subdivision 6; 256B.0949,
subdivision 13, by adding a subdivision; 256B.69, subdivision 6d; 256B.75;
256B.76, subdivisions 2, 4; 256B.766; 256B.767; 256B.79, subdivisions 1, 3;
256L.01, subdivision 5; 256L.04, subdivision 7b; 256L.05, subdivision 3a; 256L.11,
subdivision 7; 326.71, subdivision 4; 326.75, subdivisions 1, 2, 3; Laws 2017,
chapter 13, article 1, section 15, as amended; Laws 2019, First Special Session
chapter 9, article 14, section 3, as amended; proposing coding for new law in
Minnesota Statutes, chapters 145; 245C; 256B; repealing Minnesota Statutes 2020,
sections 245C.10, subdivisions 2, 2a, 3, 4, 5, 6, 7, 8, 9, 9a, 10, 11, 12, 13, 14, 16;
256B.0625, subdivisions 18c, 18d, 18e, 18h; 256L.11, subdivision 6a.

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

ARTICLE 1

HEALTH CARE

Section 1.

Minnesota Statutes 2020, section 256.9695, subdivision 1, is amended to read:

Subdivision 1.

Appeals.

A hospital may appeal a decision arising from the application
of standards or methods under section 256.9685, 256.9686, or 256.969, if an appeal would
result in a change to the hospital's payment rate or payments. Both overpayments and
underpayments that result from the submission of appeals shall be implemented. Regardless
of any appeal outcome, relative values, Medicare wage indexes, Medicare cost-to-charge
ratios, and policy adjusters shall not be changed. The appeal shall be heard by an
administrative law judge according to sections 14.57 to 14.62, or upon agreement by both
parties, according to a modified appeals procedure established by the commissioner and the
Office of Administrative Hearings. In any proceeding under this section, the appealing party
must demonstrate by a preponderance of the evidence that the commissioner's determination
is incorrect or not according to law.

To appeal a payment rate or payment determination or a determination made from base
year information, the hospital shall file a written appeal request to the commissioner within
60 days of the date the preliminary payment rate determination was mailed. The appeal
request shall specify: (i) the disputed items; (ii) the authority in federal or state statute or
rule upon which the hospital relies for each disputed item; and (iii) the name and address
of the person to contact regarding the appeal. Facts to be considered in any appeal of base
year information are limited to those in existence deleted text begin 12 deleted text end new text begin 18 new text end months after the last day of the
calendar year that is the base year for the payment rates in dispute.

Sec. 2.

Minnesota Statutes 2020, section 256B.057, subdivision 3, is amended to read:

Subd. 3.

Qualified Medicare beneficiaries.

new text begin (a) new text end A person deleted text begin who is entitled to Part A
Medicare benefits, whose income is equal to or less than 100 percent of the federal poverty
guidelines, and whose assets are no more than $10,000 for a single individual and $18,000
for a married couple or family of two or more, deleted text end is eligible for medical assistance
reimbursement of new text begin Medicare new text end Part A and Part B premiums, Part A and Part B coinsurance
and deductibles, and cost-effective premiums for enrollment with a health maintenance
organization or a competitive medical plan under section 1876 of the Social Security Act deleted text begin . deleted text end new text begin
if:
new text end

new text begin (1) the person is entitled to Medicare Part A benefits;
new text end

new text begin (2) the person's income is equal to or less than 100 percent of the federal poverty
guidelines; and
new text end

new text begin (3) the person's assets are no more than (i) $10,000 for a single individual, or (ii) $18,000
for a married couple or family of two or more; or, when the resource limits for eligibility
for the Medicare Part D extra help low income subsidy (LIS) exceed either amount in item
(i) or (ii), the person's assets are no more than the LIS resource limit in United States Code,
title 42, section 1396d, subsection (p).
new text end

new text begin (b) new text end Reimbursement of the Medicare coinsurance and deductibles, when added to the
amount paid by Medicare, must not exceed the total rate the provider would have received
for the same service or services if the person were a medical assistance recipient with
Medicare coverage. Increases in benefits under Title II of the Social Security Act shall not
be counted as income for purposes of this subdivision until July 1 of each year.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 3.

Minnesota Statutes 2020, section 256B.0622, subdivision 7a, is amended to read:

Subd. 7a.

Assertive community treatment team staff requirements and roles.

(a)
The required treatment staff qualifications and roles for an ACT team are:

(1) the team leader:

(i) shall be a licensed mental health professional who is qualified under Minnesota Rules,
part 9505.0371, subpart 5, item A. Individuals who are not licensed but who are eligible
for licensure and are otherwise qualified may also fulfill this role but must obtain full
licensure within 24 months of assuming the role of team leader;

(ii) must be an active member of the ACT team and provide some direct services to
clients;

(iii) must be a single full-time staff member, dedicated to the ACT team, who is
responsible for overseeing the administrative operations of the team, providing clinical
oversight of services in conjunction with the psychiatrist or psychiatric care provider, and
supervising team members to ensure delivery of best and ethical practices; and

(iv) must be available to provide overall clinical oversight to the ACT team after regular
business hours and on weekends and holidays. The team leader may delegate this duty to
another qualified member of the ACT team;

(2) the psychiatric care provider:

(i) must be a licensed psychiatrist certified by the American Board of Psychiatry and
Neurology or eligible for board certification or certified by the American Osteopathic Board
of Neurology and Psychiatry or eligible for board certification, or a psychiatric nurse who
is qualified under Minnesota Rules, part 9505.0371, subpart 5, item A. The psychiatric care
provider must have demonstrated clinical experience working with individuals with serious
and persistent mental illness;

(ii) shall collaborate with the team leader in sharing overall clinical responsibility for
screening and admitting clients; monitoring clients' treatment and team member service
delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects,
and health-related conditions; actively collaborating with nurses; and helping provide clinical
supervision to the team;

(iii) shall fulfill the following functions for assertive community treatment clients:
provide assessment and treatment of clients' symptoms and response to medications, including
side effects; provide brief therapy to clients; provide diagnostic and medication education
to clients, with medication decisions based on shared decision making; monitor clients'
nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and
community visits;

(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized
for mental health treatment and shall communicate directly with the client's inpatient
psychiatric care providers to ensure continuity of care;

(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per
50 clients. Part-time psychiatric care providers shall have designated hours to work on the
team, with sufficient blocks of time on consistent days to carry out the provider's clinical,
supervisory, and administrative responsibilities. No more than two psychiatric care providers
may share this role;

(vi) may deleted text begin not provide specific roles and responsibilities by telemedicine unless approved
by the commissioner deleted text end new text begin provide services by telemedicine when necessary to ensure the
continuation of psychiatric and medication services availability for clients and to maintain
statutory requirements for psychiatric care provider staffing levels new text end ; and

(vii) shall provide psychiatric backup to the program after regular business hours and
on weekends and holidays. The psychiatric care provider may delegate this duty to another
qualified psychiatric provider;

(3) the nursing staff:

(i) shall consist of one to three registered nurses or advanced practice registered nurses,
of whom at least one has a minimum of one-year experience working with adults with
serious mental illness and a working knowledge of psychiatric medications. No more than
two individuals can share a full-time equivalent position;

(ii) are responsible for managing medication, administering and documenting medication
treatment, and managing a secure medication room; and

(iii) shall develop strategies, in collaboration with clients, to maximize taking medications
as prescribed; screen and monitor clients' mental and physical health conditions and
medication side effects; engage in health promotion, prevention, and education activities;
communicate and coordinate services with other medical providers; facilitate the development
of the individual treatment plan for clients assigned; and educate the ACT team in monitoring
psychiatric and physical health symptoms and medication side effects;

(4) the co-occurring disorder specialist:

(i) shall be a full-time equivalent co-occurring disorder specialist who has received
specific training on co-occurring disorders that is consistent with national evidence-based
practices. The training must include practical knowledge of common substances and how
they affect mental illnesses, the ability to assess substance use disorders and the client's
stage of treatment, motivational interviewing, and skills necessary to provide counseling to
clients at all different stages of change and treatment. The co-occurring disorder specialist
may also be an individual who is a licensed alcohol and drug counselor as described in
section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience,
and other requirements in section 245G.11, subdivision 5. No more than two co-occurring
disorder specialists may occupy this role; and

(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients.
The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT
team members on co-occurring disorders;

(5) the vocational specialist:

(i) shall be a full-time vocational specialist who has at least one-year experience providing
employment services or advanced education that involved field training in vocational services
to individuals with mental illness. An individual who does not meet these qualifications
may also serve as the vocational specialist upon completing a training plan approved by the
commissioner;

(ii) shall provide or facilitate the provision of vocational services to clients. The vocational
specialist serves as a consultant and educator to fellow ACT team members on these services;
and

(iii) should not refer individuals to receive any type of vocational services or linkage by
providers outside of the ACT team;

(6) the mental health certified peer specialist:

(i) shall be a full-time equivalent mental health certified peer specialist as defined in
section 256B.0615. No more than two individuals can share this position. The mental health
certified peer specialist is a fully integrated team member who provides highly individualized
services in the community and promotes the self-determination and shared decision-making
abilities of clients. This requirement may be waived due to workforce shortages upon
approval of the commissioner;

(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery,
self-advocacy, and self-direction, promote wellness management strategies, and assist clients
in developing advance directives; and

(iii) must model recovery values, attitudes, beliefs, and personal action to encourage
wellness and resilience, provide consultation to team members, promote a culture where
the clients' points of view and preferences are recognized, understood, respected, and
integrated into treatment, and serve in a manner equivalent to other team members;

(7) the program administrative assistant shall be a full-time office-based program
administrative assistant position assigned to solely work with the ACT team, providing a
range of supports to the team, clients, and families; and

(8) additional staff:

(i) shall be based on team size. Additional treatment team staff may include licensed
mental health professionals as defined in Minnesota Rules, part 9505.0371, subpart 5, item
A; mental health practitioners as defined in section 245.462, subdivision 17; a mental health
practitioner working as a clinical trainee according to Minnesota Rules, part 9505.0371,
subpart 5, item C; or mental health rehabilitation workers as defined in section 256B.0623,
subdivision 5, paragraph (a), clause (4). These individuals shall have the knowledge, skills,
and abilities required by the population served to carry out rehabilitation and support
functions; and

(ii) shall be selected based on specific program needs or the population served.

(b) Each ACT team must clearly document schedules for all ACT team members.

(c) Each ACT team member must serve as a primary team member for clients assigned
by the team leader and are responsible for facilitating the individual treatment plan process
for those clients. The primary team member for a client is the responsible team member
knowledgeable about the client's life and circumstances and writes the individual treatment
plan. The primary team member provides individual supportive therapy or counseling, and
provides primary support and education to the client's family and support system.

(d) Members of the ACT team must have strong clinical skills, professional qualifications,
experience, and competency to provide a full breadth of rehabilitation services. Each staff
member shall be proficient in their respective discipline and be able to work collaboratively
as a member of a multidisciplinary team to deliver the majority of the treatment,
rehabilitation, and support services clients require to fully benefit from receiving assertive
community treatment.

(e) Each ACT team member must fulfill training requirements established by the
commissioner.

Sec. 4.

Minnesota Statutes 2020, section 256B.0625, subdivision 3b, is amended to read:

Subd. 3b.

Telemedicine services.

(a) Medical assistance covers medically necessary
services and consultations delivered by a licensed health care provider via telemedicine in
the same manner as if the service or consultation was delivered in person. deleted text begin Coverage is
limited to three telemedicine services per enrollee per calendar week, except as provided
in paragraph (f). deleted text end Telemedicine services shall be paid at the full allowable rate.

(b) The commissioner shall establish criteria that a health care provider must attest to
in order to demonstrate the safety or efficacy of delivering a particular service via
telemedicine. The attestation may include that the health care provider:

(1) has identified the categories or types of services the health care provider will provide
via telemedicine;

(2) has written policies and procedures specific to telemedicine services that are regularly
reviewed and updated;

(3) has policies and procedures that adequately address patient safety before, during,
and after the telemedicine service is rendered;

(4) has established protocols addressing how and when to discontinue telemedicine
services; and

(5) has an established quality assurance process related to telemedicine services.

(c) As a condition of payment, a licensed health care provider must document each
occurrence of a health service provided by telemedicine to a medical assistance enrollee.
Health care service records for services provided by telemedicine must meet the requirements
set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:

(1) the type of service provided by telemedicine;

(2) the time the service began and the time the service ended, including an a.m. and p.m.
designation;

(3) the licensed health care provider's basis for determining that telemedicine is an
appropriate and effective means for delivering the service to the enrollee;

(4) the mode of transmission of the telemedicine service and records evidencing that a
particular mode of transmission was utilized;

(5) the location of the originating site and the distant site;

(6) if the claim for payment is based on a physician's telemedicine consultation with
another physician, the written opinion from the consulting physician providing the
telemedicine consultation; and

(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).

(d) For purposes of this subdivision, unless otherwise covered under this chapter,
"telemedicine" is defined as the delivery of health care services or consultations while the
patient is at an originating site new text begin , including the patient's home, new text end and the licensed health care
provider is at a distant site. A communication between licensed health care providers, or a
licensed health care provider and a patient that consists solely of a telephone conversation,
e-mail, or facsimile transmission does not constitute telemedicine consultations or services.
Telemedicine may be provided by means of real-time two-way, interactive audio and visual
communications, including the application of secure video conferencing or store-and-forward
technology to provide or support health care delivery, which facilitate the assessment,
diagnosis, consultation, treatment, education, and care management of a patient's health
care.

(e) For purposes of this section, "licensed health care provider" means a licensed health
care provider under section 62A.671, subdivision 6 deleted text begin , deleted text end new text begin ; new text end a community paramedic as defined
under section 144E.001, subdivision 5f deleted text begin , or deleted text end new text begin ; new text end a mental health practitioner defined under section
245.462, subdivision 17, or 245.4871, subdivision 26 deleted text begin , working under the general supervision
of a mental health professional, and deleted text end new text begin ; new text end a community health worker who meets the criteria
under subdivision 49, paragraph (a) new text begin ; a mental health certified peer specialist under section
256B.0615, subdivision 5; a mental health certified family peer specialist under section
256B.0616, subdivision 5; a mental health rehabilitation worker under section 256B.0623,
subdivision 5, paragraph (a), clause (4), and paragraph (b); a mental health behavioral aide
under section 256B.0943, subdivision 7, paragraph (b), clause (3); an alcohol and drug
counselor under section 245G.11, subdivision 5; a treatment coordinator under section
245G.11, subdivision 7; or a recovery peer under section 245G.11, subdivision 8 new text end ; "health
care provider" is defined under section 62A.671, subdivision 3; and "originating site" is
defined under section 62A.671, subdivision 7.

deleted text begin (f) The limit on coverage of three telemedicine services per enrollee per calendar week
does not apply if:
deleted text end

deleted text begin (1) the telemedicine services provided by the licensed health care provider are for the
treatment and control of tuberculosis; and
deleted text end

deleted text begin (2) the services are provided in a manner consistent with the recommendations and best
practices specified by the Centers for Disease Control and Prevention and the commissioner
of health.
deleted text end

new text begin (f) Telemedicine visits, as described in this section, can be used to satisfy the face-to-face
requirement for consideration of reimbursement under the payment methods that apply to
a federally qualified health center, rural health clinic, Indian health service, 638 tribal clinic,
and certified community behavioral health clinic, if the service would have otherwise
qualified for payment if performed in person.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval.
new text end

Sec. 5.

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 commissioner deleted text begin . deleted text end new text begin or the drug appears on the 90-day supply list
published by the commissioner. The 90-day supply list shall be published by the
commissioner on the department's website. The commissioner may add to, delete from, and
otherwise modify the 90-day supply list after providing public notice and the opportunity
for a 15-day public comment period. The 90-day supply list may include cost-effective
generic drugs and shall not include controlled substances.
new text end

(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
ingredient" is defined as a substance that is represented for use in a drug and when used in
the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
excipients which are included in the medical assistance formulary. Medical assistance covers
selected active pharmaceutical ingredients and excipients used in compounded prescriptions
when the compounded combination is specifically approved by the commissioner or when
a commercially available product:

(1) is not a therapeutic option for the patient;

(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and

(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
prescription.

(d) Medical assistance covers the following over-the-counter drugs when prescribed by
a licensed practitioner or by a licensed pharmacist who meets standards established by the
commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
with documented vitamin deficiencies, vitamins for children under the age of seven and
pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions, or
disorders, and this determination shall not be subject to the requirements of chapter 14. A
pharmacist may prescribe over-the-counter medications as provided under this paragraph
for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for potential adverse interactions,
and make referrals as needed to other health care professionals.

(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
individuals, medical assistance may cover drugs from the drug classes listed in United States
Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
not be covered.

(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under common
ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.

(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. 6.

Minnesota Statutes 2020, section 256B.0625, subdivision 13e, is amended to read:

Subd. 13e.

Payment rates.

(a) The basis for determining the amount of payment shall
be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the
usual and customary price charged to the public. The usual and customary price means the
lowest price charged by the provider to a patient who pays for the prescription by cash,
check, or charge account and includes prices the pharmacy charges to a patient enrolled in
a prescription savings club or prescription discount club administered by the pharmacy or
pharmacy chain. The amount of payment basis must be reduced to reflect all discount
amounts applied to the charge by any third-party provider/insurer agreement or contract for
submitted charges to medical assistance programs. The net submitted charge may not be
greater than the patient liability for the service. The professional dispensing fee shall be
deleted text begin $10.48 deleted text end new text begin $9.91 new text end for prescriptions filled with legend drugs meeting the definition of "covered
outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The
dispensing fee for intravenous solutions that must be compounded by the pharmacist shall
be deleted text begin $10.48 deleted text end new text begin $9.91 new text end per deleted text begin bag deleted text end new text begin claim new text end . The professional dispensing fee for prescriptions filled with
over-the-counter drugs meeting the definition of covered outpatient drugs shall be deleted text begin $10.48 deleted text end new text begin
$9.91 new text end for dispensed quantities equal to or greater than the number of units contained in the
manufacturer's original package. The professional dispensing fee shall be prorated based
on the percentage of the package dispensed when the pharmacy dispenses a quantity less
than the number of units contained in the manufacturer's original package. The pharmacy
dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered
outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units
contained in the manufacturer's original package and shall be prorated based on the
percentage of the package dispensed when the pharmacy dispenses a quantity less than the
number of units contained in the manufacturer's original package. The National Average
Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug.
For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient
cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for
a provider participating in the federal 340B Drug Pricing Program shall be either the 340B
Drug Pricing Program ceiling price established by the Health Resources and Services
Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as
the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in
the United States, not including prompt pay or other discounts, rebates, or reductions in
price, for the most recent month for which information is available, as reported in wholesale
price guides or other publications of drug or biological pricing data. The maximum allowable
cost of a multisource drug may be set by the commissioner and it shall be comparable to
the actual acquisition cost of the drug product and no higher than the NADAC of the generic
product. Establishment of the amount of payment for drugs shall not be subject to the
requirements of the Administrative Procedure Act.

(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
an automated drug distribution system meeting the requirements of section 151.58, or a
packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents. A
retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.

(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota
Rules, part 6800.2700, is required to credit the department for the actual acquisition cost
of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective
billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that
is less than a 30-day supply.

(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC
of the generic product or the maximum allowable cost established by the commissioner
unless prior authorization for the brand name product has been granted according to the
criteria established by the Drug Formulary Committee as required by subdivision 13f,
paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in
a manner consistent with section 151.21, subdivision 2.

(e) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
set by the commissioner. If average sales price is unavailable, the amount of payment must
be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
The commissioner shall discount the payment rate for drugs obtained through the federal
340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an
outpatient setting shall be made to the administering facility or practitioner. A retail or
specialty pharmacy dispensing a drug for administration in an outpatient setting is not
eligible for direct reimbursement.

(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy
products that are lower than the ingredient cost formulas specified in paragraph (a). The
commissioner may require individuals enrolled in the health care programs administered
by the department to obtain specialty pharmacy products from providers with whom the
commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are
defined as those used by a small number of recipients or recipients with complex and chronic
diseases that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C,
growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of
cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that
require complex care. The commissioner shall consult with the Formulary Committee to
develop a list of specialty pharmacy products subject to maximum allowable cost
reimbursement. In consulting with the Formulary Committee in developing this list, the
commissioner shall take into consideration the population served by specialty pharmacy
products, the current delivery system and standard of care in the state, and access to care
issues. The commissioner shall have the discretion to adjust the maximum allowable cost
to prevent access to care issues.

(g) Home infusion therapy services provided by home infusion therapy pharmacies must
be paid at rates according to subdivision 8d.

(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey
for all pharmacies that are physically located in the state of Minnesota that dispense outpatient
drugs under medical assistance. The commissioner shall ensure that the vendor has prior
experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the
department to dispense outpatient prescription drugs to fee-for-service members must
respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under
section 256B.064 for failure to respond. The commissioner shall require the vendor to
measure a single statewide cost of dispensing for all responding pharmacies to measure the
mean, mean weighted by total prescription volume, mean weighted by medical assistance
prescription volume, median, median weighted by total prescription volume, and median
weighted by total medical assistance prescription volume. The commissioner shall post a
copy of the final cost of dispensing survey report on the department's website. The initial
survey must be completed no later than January 1, 2021, and repeated every three years.
The commissioner shall provide a summary of the results of each cost of dispensing survey
and provide recommendations for any changes to the dispensing fee to the chairs and ranking
members of the legislative committees with jurisdiction over medical assistance pharmacy
reimbursement.

(i) The commissioner shall increase the ingredient cost reimbursement calculated in
paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to
the wholesale drug distributor tax under section 295.52.

Sec. 7.

Minnesota Statutes 2020, section 256B.0625, subdivision 18, is amended to read:

Subd. 18.

deleted text begin Bus deleted text end new text begin Public transit new text end or taxicab transportation.

new text begin (a) new text end To the extent authorized
by rule of the state agency, medical assistance covers the most appropriate and cost-effective
form of transportation incurred by any ambulatory eligible person for obtaining
nonemergency medical care.

new text begin (b) The commissioner may provide a monthly public transit pass to recipients who are
well-served by public transit for the recipient's nonemergency medical transportation needs.
Any recipient who is eligible for one public transit trip for a medically necessary covered
service may select to receive a transit pass for that month. Recipients who do not have any
transportation needs for a medically necessary service in any given month 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. 8.

Minnesota Statutes 2020, section 256B.0625, subdivision 58, is amended to read:

Subd. 58.

Early and periodic screening, diagnosis, and treatment services.

new text begin (a) new text end Medical
assistance covers early and periodic screening, diagnosis, and treatment services (EPSDT).
The payment amount for a complete EPSDT screening shall not include charges for health
care services and products that are available at no cost to the provider and shall not exceed
the rate established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

new text begin (b) 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 EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022.
new text end

Sec. 9.

Minnesota Statutes 2020, section 256B.0947, subdivision 6, is amended to read:

Subd. 6.

Service standards.

The standards in this subdivision apply to intensive
nonresidential rehabilitative mental health services.

(a) The treatment team must use team treatment, not an individual treatment model.

(b) Services must be available at times that meet client needs.

(c) Services must be age-appropriate and meet the specific needs of the client.

(d) The initial functional assessment must be completed within ten days of intake and
updated at least every six months or prior to discharge from the service, whichever comes
first.

(e) An individual treatment plan must:

(1) be based on the information in the client's diagnostic assessment and baselines;

(2) identify goals and objectives of treatment, a treatment strategy, a schedule for
accomplishing treatment goals and objectives, and the individuals responsible for providing
treatment services and supports;

(3) be developed after completion of the client's diagnostic assessment by a mental health
professional or clinical trainee and before the provision of children's therapeutic services
and supports;

(4) be developed through a child-centered, family-driven, culturally appropriate planning
process, including allowing parents and guardians to observe or participate in individual
and family treatment services, assessments, and treatment planning;

(5) be reviewed at least once every six months and revised to document treatment progress
on each treatment objective and next goals or, if progress is not documented, to document
changes in treatment;

(6) be signed by the clinical supervisor and by the client or by the client's parent or other
person authorized by statute to consent to mental health services for the client. A client's
parent may approve the client's individual treatment plan by secure electronic signature or
by documented oral approval that is later verified by written signature;

(7) be completed in consultation with the client's current therapist and key providers and
provide for ongoing consultation with the client's current therapist to ensure therapeutic
continuity and to facilitate the client's return to the community. For clients under the age of
18, the treatment team must consult with parents and guardians in developing the treatment
plan;

(8) if a need for substance use disorder treatment is indicated by validated assessment:

(i) identify goals, objectives, and strategies of substance use disorder treatment; develop
a schedule for accomplishing treatment goals and objectives; and identify the individuals
responsible for providing treatment services and supports;

(ii) be reviewed at least once every 90 days and revised, if necessary;

(9) be signed by the clinical supervisor and by the client and, if the client is a minor, by
the client's parent or other person authorized by statute to consent to mental health treatment
and substance use disorder treatment for the client; and

(10) provide for the client's transition out of intensive nonresidential rehabilitative mental
health services by defining the team's actions to assist the client and subsequent providers
in the transition to less intensive or "stepped down" services.

(f) The treatment team shall actively and assertively engage the client's family members
and significant others by establishing communication and collaboration with the family and
significant others and educating the family and significant others about the client's mental
illness, symptom management, and the family's role in treatment, unless the team knows or
has reason to suspect that the client has suffered or faces a threat of suffering any physical
or mental injury, abuse, or neglect from a family member or significant other.

(g) For a client age 18 or older, the treatment team may disclose to a family member,
other relative, or a close personal friend of the client, or other person identified by the client,
the protected health information directly relevant to such person's involvement with the
client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the
client is present, the treatment team shall obtain the client's agreement, provide the client
with an opportunity to object, or reasonably infer from the circumstances, based on the
exercise of professional judgment, that the client does not object. If the client is not present
or is unable, by incapacity or emergency circumstances, to agree or object, the treatment
team may, in the exercise of professional judgment, determine whether the disclosure is in
the best interests of the client and, if so, disclose only the protected health information that
is directly relevant to the family member's, relative's, friend's, or client-identified person's
involvement with the client's health care. The client may orally agree or object to the
disclosure and may prohibit or restrict disclosure to specific individuals.

(h) The treatment team shall provide interventions to promote positive interpersonal
relationships.

new text begin (i) The services and responsibilities of the psychiatric provider may be provided through
telemedicine when necessary to prevent disruption in client services or to maintain the
required psychiatric staffing level.
new text end

Sec. 10.

Minnesota Statutes 2020, section 256B.0949, subdivision 13, is amended to read:

Subd. 13.

Covered services.

(a) The services described in paragraphs (b) to (l) are
eligible for reimbursement by medical assistance under this section. Services must be
provided by a qualified EIDBI provider and supervised by a QSP. An EIDBI service must
address the person's medically necessary treatment goals and must be targeted to develop,
enhance, or maintain the individual developmental skills of a person with ASD or a related
condition to improve functional communication, including nonverbal or social
communication, social or interpersonal interaction, restrictive or repetitive behaviors,
hyperreactivity or hyporeactivity to sensory input, behavioral challenges and self-regulation,
cognition, learning and play, self-care, and safety.

(b) EIDBI treatment must be delivered consistent with the standards of an approved
modality, as published by the commissioner. EIDBI modalities include:

(1) applied behavior analysis (ABA);

(2) developmental individual-difference relationship-based model (DIR/Floortime);

(3) early start Denver model (ESDM);

(4) PLAY project;

(5) relationship development intervention (RDI); or

(6) additional modalities not listed in clauses (1) to (5) upon approval by the
commissioner.

(c) An EIDBI provider may use one or more of the EIDBI modalities in paragraph (b),
clauses (1) to (5), as the primary modality for treatment as a covered service, or several
EIDBI modalities in combination as the primary modality of treatment, as approved by the
commissioner. An EIDBI provider that identifies and provides assurance of qualifications
for a single specific treatment modality must document the required qualifications to meet
fidelity to the specific model.

(d) Each qualified EIDBI provider must identify and provide assurance of qualifications
for professional licensure certification, or training in evidence-based treatment methods,
and must document the required qualifications outlined in subdivision 15 in a manner
determined by the commissioner.

(e) CMDE is a comprehensive evaluation of the person's developmental status to
determine medical necessity for EIDBI services and meets the requirements of subdivision
5. The services must be provided by a qualified CMDE provider.

(f) EIDBI intervention observation and direction is the clinical direction and oversight
of EIDBI services by the QSP, level I treatment provider, or level II treatment provider,
including developmental and behavioral techniques, progress measurement, data collection,
function of behaviors, and generalization of acquired skills for the direct benefit of a person.
EIDBI intervention observation and direction informs any modification of the current
treatment protocol to support the outcomes outlined in the ITP.

(g) Intervention is medically necessary direct treatment provided to a person with ASD
or a related condition as outlined in their ITP. All intervention services must be provided
under the direction of a QSP. Intervention may take place across multiple settings. The
frequency and intensity of intervention services are provided based on the number of
treatment goals, person and family or caregiver preferences, and other factors. Intervention
services may be provided individually or in a group. Intervention with a higher provider
ratio may occur when deemed medically necessary through the person's ITP.

(1) Individual intervention is treatment by protocol administered by a single qualified
EIDBI provider delivered deleted text begin face-to-face deleted text end to one person.

(2) Group intervention is treatment by protocol provided by one or more qualified EIDBI
providers, delivered to at least two people who receive EIDBI services.

(h) ITP development and ITP progress monitoring is development of the initial, annual,
and progress monitoring of an ITP. ITP development and ITP progress monitoring documents
provide oversight and ongoing evaluation of a person's treatment and progress on targeted
goals and objectives and integrate and coordinate the person's and the person's legal
representative's information from the CMDE and ITP progress monitoring. This service
must be reviewed and completed by the QSP, and may include input from a level I provider
or a level II provider.

(i) Family caregiver training and counseling is specialized training and education for a
family or primary caregiver to understand the person's developmental status and help with
the person's needs and development. This service must be provided by the QSP, level I
provider, or level II provider.

(j) A coordinated care conference is a voluntary deleted text begin face-to-face deleted text end meeting with the person
and the person's family to review the CMDE or ITP progress monitoring and to integrate
and coordinate services across providers and service-delivery systems to develop the ITP.
This service must be provided by the QSP and may include the CMDE provider or a level
I provider or a level II provider.

(k) Travel time is allowable billing for traveling to and from the person's home, school,
a community setting, or place of service outside of an EIDBI center, clinic, or office from
a specified location to provide deleted text begin face-to-face deleted text end new text begin in-person new text end EIDBI intervention, observation and
direction, or family caregiver training and counseling. The person's ITP must specify the
reasons the provider must travel to the person.

(l) Medical assistance covers medically necessary EIDBI services and consultations
delivered by a licensed health care provider via telemedicine, as defined under section
256B.0625, subdivision 3b, in the same manner as if the service or consultation was delivered
in person.

Sec. 11.

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) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory
surgery hospital facility fee services for critical access hospitals designated under section
144.1483, clause (9), shall be paid on a cost-based payment system that is based on the
cost-finding methods and allowable costs of the Medicare program. Effective for services
provided on or after July 1, 2015, rates established for critical access hospitals under this
paragraph for the applicable payment year shall be the final payment and shall not be settled
to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal
year ending in 2017, the rate for outpatient hospital services shall be computed using
information from each hospital's Medicare cost report as filed with Medicare for the year
that is two years before the year that the rate is being computed. Rates shall be computed
using information from Worksheet C series until the department finalizes the medical
assistance cost reporting process for critical access hospitals. After the cost reporting process
is finalized, rates shall be computed using information from Title XIX Worksheet D series.
The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs
related to rural health clinics and federally qualified health clinics, divided by ancillary
charges plus outpatient charges, excluding charges related to rural health clinics and federally
qualified health clinics.

(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. 12.

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 areas deleted text end new text begin communities new text end identified by the commissioner as being at above-average
risk for adverse outcomes.

Sec. 13.

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
collaborative deleted 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. 14.

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 end new text begin projected annual income for the applicable tax year 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. 15.

Minnesota Statutes 2020, section 256L.04, subdivision 7b, is amended to read:

Subd. 7b.

Annual income limits adjustment.

The commissioner shall adjust the income
limits under this section annually deleted text begin each July 1 deleted text end new text begin on January 1 new text end as deleted text begin described in section 256B.056,
subdivision 1c deleted text end new text begin provided in Code of Federal Regulations, title 26, section 1.36B-1(h) new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 16.

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 basis deleted 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

ARTICLE 2

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 chapter 245C 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 must initiate the background studies required by paragraph (a) using the
online NETStudy 2.0 system operated by the commissioner of human services.
new text end

new text begin (c) The board shall not permit any individual to provide any service or function listed
in paragraph (a) until the board has received notification from the commissioner of human
services indicating that the individual:
new text end

new text begin (1) is not disqualified under chapter 245C; or
new text end

new text begin (2) is disqualified, but has received a set aside from the board of that disqualification
according to sections 245C.22 and 245C.23.
new text end

new text begin (d) The board or its delegate shall review a reconsideration request of an individual in
paragraph (a), including granting a set aside, according to the procedures and criteria in
chapter 245C. The board shall notify the individual and the Department of Human Services
of the board's decision.
new text end

Sec. 2.

Minnesota Statutes 2020, section 122A.18, subdivision 8, is amended to read:

Subd. 8.

Background deleted text begin checks deleted text end new text begin studies new text end .

(a) The Professional Educator Licensing and
Standards Board and the Board of School Administrators must deleted text begin obtain a deleted text end new text begin initiate new text end criminal
history background deleted text begin check on deleted text end new text begin studies of new text end all first-time deleted text begin teaching deleted text end applicants for new text begin educator new text end licenses
under their jurisdiction. Applicants must include with their licensure applications:

(1) an executed criminal history consent form, including fingerprints; and

(2) payment to conduct the background check. 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
checks on applicants for licensure.

(b) The background check 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. The superintendent shall recover the cost to the bureau of a
background check through the fee charged to the applicant under paragraph (a).

(c) The Professional Educator Licensing and Standards Board deleted text begin must contract with deleted text end new 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 end to deleted text begin conduct background checks and deleted text end obtain background check
data required under this chapter.

Sec. 3.

Minnesota Statutes 2020, section 245A.10, subdivision 4, is amended to read:

Subd. 4.

License or certification fee for certain programs.

(a) Child care centers shall
pay an annual nonrefundable license fee based on the following schedule:

	Licensed Capacity	Child Care Center License Fee
	1 to 24 persons	$200
	25 to 49 persons	$300
	50 to 74 persons	$400
	75 to 99 persons	$500
	100 to 124 persons	$600
	125 to 149 persons	$700
	150 to 174 persons	$800
	175 to 199 persons	$900
	200 to 224 persons	$1,000
	225 or more persons	$1,100

(b)(1) A program licensed to provide one or more of the home and community-based
services and supports identified under chapter 245D to persons with disabilities or age 65
and older, shall pay an annual nonrefundable license fee based on revenues derived from
the provision of services that would require licensure under chapter 245D during the calendar
year immediately preceding the year in which the license fee is paid, according to the
following schedule:

License Holder Annual Revenue		License Fee
less than or equal to $10,000		$200
greater than $10,000 but less than or equal to $25,000		$300
greater than $25,000 but less than or equal to $50,000		$400
greater than $50,000 but less than or equal to $100,000		$500
greater than $100,000 but less than or equal to $150,000		$600
greater than $150,000 but less than or equal to $200,000		$800
greater than $200,000 but less than or equal to $250,000		$1,000
greater than $250,000 but less than or equal to $300,000		$1,200
greater than $300,000 but less than or equal to $350,000		$1,400
greater than $350,000 but less than or equal to $400,000		$1,600
greater than $400,000 but less than or equal to $450,000		$1,800
greater than $450,000 but less than or equal to $500,000		$2,000
greater than $500,000 but less than or equal to $600,000		$2,250
greater than $600,000 but less than or equal to $700,000		$2,500
greater than $700,000 but less than or equal to $800,000		$2,750
greater than $800,000 but less than or equal to $900,000		$3,000
greater than $900,000 but less than or equal to $1,000,000		$3,250
greater than $1,000,000 but less than or equal to $1,250,000		$3,500
greater than $1,250,000 but less than or equal to $1,500,000		$3,750
greater than $1,500,000 but less than or equal to $1,750,000		$4,000
greater than $1,750,000 but less than or equal to $2,000,000		$4,250
greater than $2,000,000 but less than or equal to $2,500,000		$4,500
greater than $2,500,000 but less than or equal to $3,000,000		$4,750
greater than $3,000,000 but less than or equal to $3,500,000		$5,000
greater than $3,500,000 but less than or equal to $4,000,000		$5,500
greater than $4,000,000 but less than or equal to $4,500,000		$6,000
greater than $4,500,000 but less than or equal to $5,000,000		$6,500
greater than $5,000,000 but less than or equal to $7,500,000		$7,000
greater than $7,500,000 but less than or equal to $10,000,000		$8,500
greater than $10,000,000 but less than or equal to $12,500,000		$10,000
greater than $12,500,000 but less than or equal to $15,000,000		$14,000
greater than $15,000,000		$18,000

(2) If requested, the license holder shall provide the commissioner information to verify
the license holder's annual revenues or other information as needed, including copies of
documents submitted to the Department of Revenue.

(3) At each annual renewal, a license holder may elect to pay the highest renewal fee,
and not provide annual revenue information to the commissioner.

(4) A license holder that knowingly provides the commissioner incorrect revenue amounts
for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount
of double the fee the provider should have paid.

(5) Notwithstanding clause (1), a license holder providing services under one or more
licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license
fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license
holder for all licenses held under chapter 245B for calendar year 2013. For calendar year
2017 and thereafter, the license holder shall pay an annual license fee according to clause
(1).

(c) A chemical dependency treatment program licensed under chapter 245G, to provide
chemical dependency treatment shall pay an annual nonrefundable license fee based on the
following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$600
	25 to 49 persons	$800
	50 to 74 persons	$1,000
	75 to 99 persons	$1,200
	100 or more persons	$1,400

(d) A deleted text begin chemical dependency deleted text end new text begin detoxification new text end program licensed under Minnesota Rules,
parts 9530.6510 to 9530.6590, deleted text begin to provide detoxification services deleted text end new 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. 4.

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 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. 5.

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 or organization initiating a background
study.
new text end

Sec. 6.

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. 7.

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 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, 4, 6a, 9, and 9a.
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 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 assistant
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 Minnesota Statutes,
section 256B.0659, subdivision 11, notwithstanding paragraph (a), clause (3).
new text end

new text begin Subd. 3b. 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. 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

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 of health shall contract with the commissioner
of human services to 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 section 245C.03, subdivision 1, 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
understudy 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 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 providing
services in secure and nonsecure residential facilities and detention facilities who have direct
contact, as defined under section 245C.02, subdivision 11, with persons served in the
facilities.
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 with all criminal conviction data available from local, state,
and national 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
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's decision. The
commissioner's 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.

The commissioner shall conduct background
studies deleted text begin on deleted text end new text begin of new text end any individual deleted text begin required under section 256B.4912 to have a background study
completed under this chapter deleted text end new text begin who provides direct contact, as defined in section 245C.02,
subdivision 11, for services specified in the federally approved home and community-based
waiver plans under section 256B.4712 and the individual studied must meet the requirements
of this chapter prior to providing waiver services and as part of ongoing enrollment. Upon
federal approval, this requirement applies to consumer-directed community supports new text end .

Subd. 6a.

Legal nonlicensed and certified child care programs.

The commissioner
shall conduct background studies deleted text begin on an individual deleted text end new text begin of the following individuals as new text end required
deleted text begin under deleted text end new text begin by new text end sections 119B.125 and 245H.10 deleted text begin to complete a background study under this chapter. deleted text end new text begin :
new text end

new text begin (1) every individual who applies for certification;
new text end

new text begin (2) every member of a provider's household who is age 13 and older; and
new text end

new text begin (3) an individual who is at least ten years of age and under 13 years of age and lives in
the household where the nonlicensed child care will be provided when the county has
reasonable cause as defined under section 245C.02, subdivision 15.
new text end

Subd. 7.

Children's therapeutic services and supports providers.

The commissioner
shall conduct background studies deleted text begin according to this chapter when initiated by a children's
therapeutic services and supports provider deleted text end new text begin of all direct service providers and volunteers for
children's therapeutic services and supports providers new text end under section 256B.0943.

Subd. 8.

Self-initiated background studies.

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.

Subd. 9.

Community first services and supports organizations.

deleted text begin The commissioner
shall conduct background studies on any individual required under section 256B.85 to have
a background study completed under this chapter. deleted text end new text begin Individuals affiliated with Community
First Services and Supports (CFSS) agency-providers and Financial Management Services
(FMS) providers enrolled to provide CFSS services under the medical assistance program
must meet the following requirements:
new text end

new text begin (1) owners who have a five percent interest or more and all managing employees are
subject to a background study under this chapter. This requirement applies to currently
enrolled providers and agencies seeking enrollment. "Managing employee" has the meaning
given in Code of Federal Regulations, title 42, section 455.101. An organization is barred
from enrollment if:
new text end

new text begin (i) the organization has not initiated background studies of owners and managing
employees; or
new text end

new text begin (ii) the organization has initiated background studies of owners and managing employees
and the commissioner has sent the organization a notice that an owner or managing employee
of the organization has been disqualified under section 245C.14 and the owner or managing
employee has not received a set aside of the disqualification under section 245C.22;
new text end

new text begin (2) a background study must be initiated and completed for all staff who will have direct
contact with the participant to provide worker training and development; and
new text end

new text begin (3) a background study must be initiated and completed for all support workers.
new text end

new text begin Subd. 9a. new text end

new text begin Exception to support worker requirements for continuity of services. new text end

new text begin The
support worker for a participant may enroll with a different Community First Services and
Supports (CFSS) agency-provider or Financial Management Services (FMS) provider upon
initiation, rather than completion, of a new background study according to this chapter if:
new text end

new text begin (1) the commissioner determines that the support worker's change in enrollment or
affiliation is necessary to ensure continuity of services and to protect the health and safety
of the participant;
new text end

new text begin (2) the chosen agency-provider or FMS provider has been continuously enrolled as a
CFSS agency-provider or FMS provider for at least two years or since the inception of the
CFSS program, whichever is shorter;
new text end

new text begin (3) the participant served by the support worker chooses to transfer to the CFSS
agency-provider or the FMS provider to which the support worker is transferring;
new text end

new text begin (4) the support worker has been continuously enrolled with the former CFSS
agency-provider or FMS provider since the support worker's last background study was
completed; and
new text end

new text begin (5) the support worker continues to meet the requirements of section 256B.85, subdivision
16, notwithstanding paragraph (a), clause (1).
new text end

Subd. 10.

Providers of group residential housing or supplementary services.

new text begin (a) new text end The
commissioner shall conduct background studies deleted text begin on any individual required under section
256I.04 to have a background study completed under this chapter. deleted text end new text begin of the following individuals
who provide services under section 256I.04:
new text end

new text begin (1) controlling individuals as defined in section 245A.02;
new text end

new text begin (2) managerial officials as defined in section 245A.02; and
new text end

new text begin (3) all employees and volunteers of the establishment who have direct contact with
recipients or who have unsupervised access to recipients, recipients' personal property, or
recipients' private data.
new text end

new text begin (b) The provider of housing support must comply with all requirements for entities
initiating background studies under this chapter.
new text end

new text begin (c) A provider of housing support must demonstrate that all individuals who are required
to have a background study according to paragraph (a) have a notice stating that:
new text end

new text begin (1) the individual is not disqualified under section 245C.14; or
new text end

new text begin (2) the individual is disqualified and the individual has been issued a set aside of the
disqualification for the setting under section 245C.22.
new text end

deleted text begin Subd. 11. deleted text end

deleted text begin Child protection workers or social services staff having responsibility for
child protective duties. deleted text end

deleted text begin (a) The commissioner must complete background studies, according
to paragraph (b) and section 245C.04, subdivision 10, when initiated by a county social
services agency or by a local welfare agency according to section 626.559, subdivision 1b.
deleted text end

deleted text begin (b) For background studies completed by the commissioner under this subdivision, the
commissioner shall not make a disqualification decision, but shall provide the background
study information received to the county that initiated the study.
deleted text end

Subd. 12.

Providers of special transportation service.

new text begin (a) new text end The commissioner shall
conduct background studies deleted text begin on any individual required under section 174.30 to have a
background study completed under this chapter. deleted text end new text begin of the following individuals who provide
special transportation services under section 174.30:
new text end

new text begin (1) each person with a direct or indirect ownership interest of five percent or higher in
a transportation service provider;
new text end

new text begin (2) each controlling individual as defined under section 245A.02;
new text end

new text begin (3) a managerial official as defined in section 245A.02;
new text end

new text begin (4) each driver employed by the transportation service provider;
new text end

new text begin (5) each individual employed by the transportation service provider to assist a passenger
during transport; and
new text end

new text begin (6) each employee of the transportation service agency who provides administrative
support, including an employee who:
new text end

new text begin (i) may have face-to-face contact with or access to passengers, passengers' personal
property, or passengers' private data;
new text end

new text begin (ii) performs any scheduling or dispatching tasks; or
new text end

new text begin (iii) performs any billing activities.
new text end

new text begin (b) When a local or contracted agency is authorizing a ride under section 256B.0625,
subdivision 17, by a volunteer driver, and the agency authorizing the ride has a reason to
believe that the volunteer driver has a history that would disqualify the volunteer driver or
that may pose a risk to the health or safety of passengers, the agency may initiate a
background study that shall be completed according to this chapter using the commissioner
of human services' online NETStudy system, or by contacting the Department of Human
Services background study division for assistance. The agency that initiates the background
study under this paragraph shall be responsible for providing the volunteer driver with the
privacy notice required by section 245C.05, subdivision 2c, and with the payment for the
background study required by section 245C.10 before the background study is completed.
new text end

Subd. 13.

Providers of housing support services.

The commissioner shall conduct
background studies deleted text begin on deleted text end new text begin of new text end any deleted text begin individual deleted text end new text begin provider of housing support services new text end required deleted text begin under deleted text end new 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
according to section 245C.32.
new text end

Sec. 8.

Minnesota Statutes 2020, section 245C.03, is amended by adding a subdivision to
read:

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 the day following final enactment.
new text end

Sec. 9.

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 9 shall be conducted according to this section and with section 299C.60
to 299C.64.
new text end

new text begin (c) All terms in this section shall have the definitions provided in section 245C.02.
new text end

new text begin (d) The entity that submits an alternative background study request under this section
shall submit the request to the commissioner according to section 245C.05.
new text end

new text begin (e) The commissioner shall comply with the destruction requirements in section 245C.051.
new text end

new text begin (f) Background studies conducted under this section are subject to the provisions of
section 245C.32.
new text end

new text begin (g) The commissioner shall forward all information that the commissioner receives under
section 245C.08 to the entity that submitted the alternative background study request under
subdivision 2. The commissioner shall not make any eligibility determinations regarding
background studies conducted under this section.
new text end

new text begin Subd. 2. new text end

new text begin Access to information. new text end

new text begin Each entity that submits an alternative background
study request shall enter into an agreement with the commissioner before submitting requests
for alternative background studies under this section. As a part of the agreement, the entity
must agree to comply with state and federal law.
new text end

new text begin Subd. 3. new text end

new text begin Child protection workers or social services staff having responsibility for
child protective duties. new text end

new text begin The commissioner shall conduct an alternative background study
of any person who has responsibility for child protection duties when the background study
is initiated by a county social services agency or by a local welfare agency according to
section 260E.36, subdivision 3.
new text end

new text begin Subd. 4. new text end

new text begin Applicants, licensees, and other occupations regulated by the commissioner
of health. new text end

new text begin The commissioner shall conduct an alternative background study, including a
check of state data, and a national criminal history records check of the following individuals.
The check must be structured so that any new crimes that an applicant or licensee or
certificate holder commits after the initial background check are flagged in the Bureau of
Criminal Apprehension's or Federal Bureau of Investigation's database and reported to the
commissioner of human services. For studies under this section, the following persons shall
complete a consent form:
new text end

new text begin (1) an applicant for initial licensure, temporary licensure, or relicensure after a lapse in
licensure as an audiologist or speech-language pathologist or an applicant for initial
certification as a hearing instrument dispenser who must submit to a background study
under section 144.0572.
new text end

new text begin (2) an applicant for a renewal license or certificate as an audiologist, speech-language
pathologist, or hearing instrument dispenser who was licensed or obtained a certificate
before January 1, 2018.
new text end

new text begin Subd. 5. new text end

new text begin Guardians and conservators. new text end

new text begin (a) The commissioner shall conduct an alternative
background study of:
new text end

new text begin (1) every court-appointed guardian and conservator, unless a background study has been
completed of the person under this section within the previous five years. The alternative
background study shall be completed prior to the appointment of the guardian or conservator,
unless a court determines that it would be in the best interests of the ward or protected person
to appoint a guardian or conservator before the alternative background study can be
completed. If the court appoints the guardian or conservator while the alternative background
study is pending, the alternative background study must be completed as soon as reasonably
possible after the guardian or conservator's appointment and no later than 30 days after the
guardian or conservator's appointment; and
new text end

new text begin (2) a guardian and a conservator once every five years after the guardian or conservator's
appointment if the person continues to serve as a guardian or conservator.
new text end

new text begin (b) An alternative background study is not required if the guardian or conservator is:
new text end

new text begin (1) a state agency or county;
new text end

new text begin (2) a parent or guardian of a proposed ward or protected person who has a developmental
disability if the parent or guardian has raised the proposed ward or protected person in the
family home until the time that the petition is filed, unless counsel appointed for the proposed
ward or protected person under section 524.5-205, paragraph (d); 524.5-304, paragraph (b);
524.5-405, paragraph (a); or 524.5-406, paragraph (b), recommends a background study;
or
new text end

new text begin (3) a bank with trust powers, a bank and trust company, or a trust company, organized
under the laws of any state or of the United States and regulated by the commissioner of
commerce or a federal regulator.
new text end

new text begin Subd. 6. new text end

new text begin Required checks. new text end

new text begin (a) An alternative background study pursuant to subdivision
5 shall include:
new text end

new text begin (1) criminal history data from the Bureau of Criminal Apprehension and other criminal
history data held by the commissioner of human services;
new text end

new text begin (2) data regarding whether the person has been a perpetrator of substantiated maltreatment
of a vulnerable adult under section 626.557 or a minor under chapter 260E. If the subject
of the study has been the perpetrator of substantiated maltreatment of a vulnerable adult or
a minor, the commissioner must include a copy of the public portion of the investigation
memorandum under section 626.557, subdivision 12b, or the public portion of the
investigation memorandum under section 260E.30. The commissioner shall provide the
court with information from a review of information according to subdivision 7 if the study
subject provided information that the study subject has a current or prior affiliation with a
state licensing agency;
new text end

new text begin (3) criminal history data from a national criminal history record check as defined in
section 245C.02, subdivision 13c; and
new text end

new text begin (4) state licensing agency data if a search of the database or databases of the agencies
listed in subdivision 7 shows that the proposed guardian or conservator has held a
professional license directly related to the responsibilities of a professional fiduciary from
an agency listed in subdivision 7 that was conditioned, suspended, revoked, or canceled.
new text end

new text begin (b) If the guardian or conservator is not an individual, the background study must be
completed of all individuals who are currently employed by the proposed guardian or
conservator who are responsible for exercising powers and duties under the guardianship
or conservatorship.
new text end

new text begin Subd. 7. new text end

new text begin State licensing data. new text end

new text begin (a) Within 25 working days of receiving the request, the
commissioner shall provide the court with licensing agency data for licenses directly related
to the responsibilities of a professional fiduciary if the study subject has a current or prior
affiliation with the:
new text end

new text begin (1) Lawyers Responsibility Board;
new text end

new text begin (2) State Board of Accountancy;
new text end

new text begin (3) Board of Social Work;
new text end

new text begin (4) Board of Psychology;
new text end

new text begin (5) Board or Nursing;
new text end

new text begin (6) Board of Medical Practice;
new text end

new text begin (7) Department of Education;
new text end

new text begin (8) Department of Commerce;
new text end

new text begin (9) Board of Chiropractic Examiners;
new text end

new text begin (10) Board of Dentistry;
new text end

new text begin (11) Board of Marriage and Family Therapy;
new text end

new text begin (12) Department of Human Services;
new text end

new text begin (13) Peace Officer Standards and Training (POST) Board; and
new text end

new text begin (14) Professional Educator Licensing and Standards Board.
new text end

new text begin (b) The commissioner and each of the agencies listed above, except for the Department
of Human Services, shall enter into a written agreement to provide the commissioner with
electronic access to the relevant licensing data and to provide the commissioner with a
quarterly list of new sanctions issued by the agency.
new text end

new text begin (c) The commissioner shall provide to the court the electronically available data
maintained in the agency's database, including whether the proposed guardian or conservator
is or has been licensed by the agency, and whether a disciplinary action or a sanction against
the individual's license, including a condition, suspension, revocation, or cancellation is in
the licensing agency's database.
new text end

new text begin (d) If the proposed guardian or conservator has resided in a state other than Minnesota
during the previous ten years, licensing agency data under this section shall also include
licensing agency data from any other state where the proposed guardian or conservator
reported to have resided during the previous ten years if the study subject has a current or
prior affiliation to the licensing agency. If the proposed guardian or conservator has or has
had a professional license in another state that is directly related to the responsibilities of a
professional fiduciary from one of the agencies listed under paragraph (a), state licensing
agency data shall also include data from the relevant licensing agency of the other state.
new text end

new text begin (e) The commissioner is not required to repeat a search for Minnesota or out-of-state
licensing data on an individual if the commissioner has provided this information to the
court within the prior five years.
new text end

new text begin (f) The commissioner shall review the information in paragraph (c) at least once every
four months to determine whether an individual who has been studied within the previous
five years:
new text end

new text begin (1) has any new disciplinary action or sanction against the individual's license; or
new text end

new text begin (2) did not disclose a prior or current affiliation with a Minnesota licensing agency.
new text end

new text begin (g) If the commissioner's review in paragraph (f) identifies new information, the
commissioner shall provide any new information to the court.
new text end

new text begin Subd. 8. new text end

new text begin Guardians ad litem. new text end

new text begin The commissioner shall conduct an alternative background
study of:
new text end

new text begin (1) a guardian ad litem appointed under section 518.165 if a background study of the
guardian ad litem has not been completed within the past three years. The background study
of the guardian ad litem must be completed before the court appoints the guardian ad litem,
unless the court determines that it is in the best interests of the child to appoint the guardian
ad litem before a background study is completed by the commissioner.
new text end

new text begin (2) a guardian ad litem once every three years after the guardian has been appointed, as
long as the individual continues to serve as a guardian ad litem.
new text end

new text begin Subd. 9. new text end

new text begin Required checks. new text end

new text begin (a) An alternative background study under subdivision 5
must include:
new text end

new text begin (1) criminal history data from the Bureau of Criminal Apprehension and other criminal
history data held by the commissioner of human services;
new text end

new text begin (2) data regarding whether the person has been a perpetrator of substantiated maltreatment
of a minor or a vulnerable adult. If the study subject has been determined by the Department
of Human Services or the Department of Health to be the perpetrator of substantiated
maltreatment of a minor or a vulnerable adult in a licensed facility, the response must include
a copy of the public portion of the investigation memorandum under section 260E.30 or the
public portion of the investigation memorandum under section 626.557, subdivision 12b.
When the background study shows that the subject has been determined by a county adult
protection or child protection agency to have been responsible for maltreatment, the court
shall be informed of the county, the date of the finding, and the nature of the maltreatment
that was substantiated;
new text end

new text begin (3) when the information from the Bureau of Criminal Apprehension indicates that the
study subject is a multistate offender or that the subject's multistate offender status is
undetermined, the court shall require a national criminal history records check, and shall
provide the commissioner with a set of classifiable fingerprints of the study subject.
new text end

new text begin (b) For checks of records under paragraph (a), clauses (1) and (2), the commissioner
shall provide the investigating information within 15 working days of receiving the request.
The information obtained under sections 245C.05 and 245C.08 from a national criminal
history records check shall be provided within three working days of the commissioner's
receipt of the data.
new text end

new text begin (c) Notwithstanding section 260E.30 or 626.557, subdivision 12b, if the commissioner
or county lead agency or lead investigative agency has information that a person of whom
a background study was previously completed under this section has been determined to
be a perpetrator of maltreatment of a minor or vulnerable adult, the commissioner or the
county may provide this information to the court that requested the background study.
new text end

new text begin Subd. 10. new text end

new text begin First-time applicants for educator licenses with the Professional Educator
Licensing and Standards Board. new text end

new text begin The Professional Educator Licensing and Standards
Board shall make all eligibility determinations for alternative background studies conducted
under this section for the Professional Educator Licensing and Standards Board. The
commissioner may conduct an alternative background study of all first-time applicants for
educator licenses pursuant to section 122A.18, subdivision 8. The alternative background
study for all first-time applicants for educator licenses must include a review of information
from the Bureau of Criminal Apprehension, including criminal history data as defined in
section 13.87, and must also include a review of the national criminal records repository.
new text end

new text begin Subd. 11. new text end

new text begin First-time applicants for administrator licenses with the Board of School
Administrators. new text end

new text begin The Board of School Administrators shall make all eligibility determinations
for alternative background studies conducted under this section for the Board of School
Administrators. The commissioner may conduct an alternative background study of all
first-time applicants for administrator licenses pursuant to section 122A.18, subdivision 8.
The alternative background study for all first-time applicants for administrator licenses must
include a review of information from the Bureau of Criminal Apprehension, including
criminal history data as defined in section 13.87, and must also include a review of the
national criminal records repository.
new text end

new text begin Subd. 12. new text end

new text begin MNsure. new text end

new text begin The commissioner shall conduct a background study of any individual
required under section 62V.05 to have a background study completed under this chapter.
new text end

Sec. 10.

Minnesota Statutes 2020, section 245C.05, subdivision 1, is amended to read:

Subdivision 1.

Individual studied.

(a) The individual who is the subject of the
background study must provide the applicant, license holder, or other entity under section
245C.04 with sufficient information to ensure an accurate study, including:

(1) the individual's first, middle, and last name and all other names by which the
individual has been known;

(2) current home address, city, and state of residence;

(3) current zip code;

(4) sex;

(5) date of birth;

(6) driver's license number or state identification number; and

(7) upon implementation of NETStudy 2.0, the home address, city, county, and state of
residence for the past five years.

(b) Every subject of a background study conducted or initiated by counties or deleted text begin private
agencies deleted text end new text begin commissioner's delegates new text end under this chapter must also provide the home address,
city, county, and state of residence for the past five years.

(c) Every subject of a background study related to private agency adoptions or related
to child foster care licensed through a private agency, who is 18 years of age or older, shall
also provide the commissioner a signed consent for the release of any information received
from national crime information databases to the private agency that initiated the background
study.

(d) The subject of a background study shall provide fingerprints and a photograph as
required in subdivision 5.

new text begin (e) The subject of a background study shall submit a completed criminal and maltreatment
history records check consent form for applicable national and state level record checks.
new text end

Sec. 11.

Minnesota Statutes 2020, section 245C.05, subdivision 2, is amended to read:

Subd. 2.

Applicant, license holder, or other entity.

(a) The applicant, license holder,
or other deleted text begin entities deleted text end new text begin entity initiating the background study new text end as provided in this chapter shall verify
that the information collected under subdivision 1 about an individual who is the subject of
the background study is correct and must provide the information on forms or in a format
prescribed by the commissioner.

(b) The information collected under subdivision 1 about an individual who is the subject
of a completed background study may only be viewable by an entity that initiates a
subsequent background study on that individual under NETStudy 2.0 after the entity has
paid the applicable fee for the study and has provided the individual with the privacy notice
in subdivision 2c.

Sec. 12.

Minnesota Statutes 2020, section 245C.05, subdivision 2a, is amended to read:

Subd. 2a.

County or private agency.

For background studies related to child foster care
when the applicant or license holder resides in the home where child foster care services
are provided, county and private agencies new text begin initiating the background study new text end must collect the
information under subdivision 1 and forward it to the commissioner.

Sec. 13.

Minnesota Statutes 2020, section 245C.05, subdivision 2b, is amended to read:

Subd. 2b.

County agency to collect and forward information to commissioner.

(a)
For background studies related to all family adult day services and to adult foster care when
the adult foster care license holder resides in the adult foster care residence, the county
agency new text begin or private agency initiating the background study new text end must collect the information
required under subdivision 1 and forward it to the commissioner.

(b) Upon implementation of NETStudy 2.0, for background studies related to family
child care and legal nonlicensed child care authorized under chapter 119B, the county agency
new text begin initiating the background study new text end must collect the information required under subdivision 1
and provide the information to the commissioner.

Sec. 14.

Minnesota Statutes 2020, section 245C.05, subdivision 4, is amended to read:

Subd. 4.

Electronic transmission.

(a) For background studies conducted by the
Department of Human Services, the commissioner shall implement a secure system for the
electronic transmission of:

(1) background study information to the commissioner;

(2) background study results to the license holder;

(3) background study deleted text begin results deleted text end new text begin information obtained under this section and section 245C.08 new text end
to counties new text begin and private agencies new text end for background studies conducted by the commissioner for
child foster care; and

(4) background study results to county agencies for background studies conducted by
the commissioner for adult foster care and family adult day services and, upon
implementation of NETStudy 2.0, family child care and legal nonlicensed child care
authorized under chapter 119B.

(b) Unless the commissioner has granted a hardship variance under paragraph (c), a
license holder or an applicant must use the electronic transmission system known as
NETStudy or NETStudy 2.0 to submit all requests for background studies to the
commissioner as required by this chapter.

(c) A license holder or applicant whose program is located in an area in which high-speed
Internet is inaccessible may request the commissioner to grant a variance to the electronic
transmission requirement.

(d) Section 245C.08, subdivision 3, paragraph (c), applies to results transmitted under
this subdivision.

new text begin (e) Information obtained under this section and section 245C.08 applies to state and
tribal agencies for alternative studies under section 245C.031.
new text end

Sec. 15.

Minnesota Statutes 2020, section 245C.08, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Authorized recipient. new text end

new text begin The commissioner of human services shall be the
authorized recipient of information and records received under this chapter.
new text end

Sec. 16.

Minnesota Statutes 2020, section 245C.08, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Bureau of Criminal Apprehension background check crimes. new text end

new text begin When
applicable, all background studies conducted under this chapter shall comply with the
requirements of sections 299C.60 to 299C.64.
new text end

Sec. 17.

Minnesota Statutes 2020, section 245C.10, subdivision 15, is amended to read:

Subd. 15.

Guardians and conservators.

The deleted text begin commissioner shall recover the cost of
conducting background studies for guardians and conservators under section 524.5-118
through a fee of no more than $110 per study. The fees collected under this subdivision are
appropriated to the commissioner for the purpose of conducting background studies. deleted text end new text begin fee
for conducting an alternative background study for appointment of a professional guardian
or conservator must be paid by the guardian or conservator. In other cases, the fee must be
paid as follows:
new text end

new text begin (1) if the matter is proceeding in forma pauperis, the fee must be paid as an expense for
purposes of section 524.5-502, paragraph (a);
new text end

new text begin (2) if there is an estate of the ward or protected person, the fee must be paid from the
estate; or
new text end

new text begin (3) in the case of a guardianship or conservatorship of a person that is not proceeding
in forma pauperis, the fee must be paid by the guardian, conservator, or the court.
new text end

Sec. 18.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 17. new text end

new text begin Early intensive developmental and behavioral intervention providers. new text end

new text begin The
commissioner shall recover the cost of background studies required under section 245C.03,
subdivision 15, for the purposes of early intensive developmental and behavioral intervention
under section 256B.0949, through a fee of no more than $20 per study charged to the enrolled
agency. The fees collected under this subdivision are appropriated to the commissioner for
the purpose of conducting background studies.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 19.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 18. new text end

new text begin Applicants, licensees, and other occupations regulated by commissioner
of health. new text end

new text begin The applicant or license holder is responsible for paying to the Department of
Human Services all fees associated with the preparation of the fingerprints, the criminal
records check consent form, and the criminal background check.
new text end

Sec. 20.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 19. new text end

new text begin Guardians ad litem. new text end

new text begin The Minnesota Supreme Court shall pay the commissioner
a fee for conducting an alternative background study.
new text end

Sec. 21.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 20. new text end

new text begin Occupations regulated by MNsure. new text end

new text begin The commissioner shall set fees to
recover the cost of background studies and criminal background checks initiated by MNsure
under sections 62V.05 and 245C.03. The fee amount shall be established through interagency
agreement between the commissioner and the board of MNsure or its designee. The fees
collected under this subdivision shall be deposited in the special revenue fund and are
appropriated to the commissioner for the purpose of conducting background studies and
criminal background checks.
new text end

Sec. 22.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 21. new text end

new text begin Professional Educators Licensing Standards Board. new text end

new text begin The commissioner
shall recover the cost of background studies initiated by the Professional Educators Licensing
Standards Board through a fee of no more than $51 per study. Fees collected under this
subdivision are appropriated to the commissioner for purposes of conducting background
studies.
new text end

Sec. 23.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 22. new text end

new text begin Board of School Administrators. new text end

new text begin The commissioner shall recover the cost
of background studies initiated by the Board of School Administrators through a fee of no
more than $51 per study. Fees collected under this subdivision are appropriated to the
commissioner for purposes of conducting background studies.
new text end

Sec. 24.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 23. new text end

new text begin Background studies fee schedule. new text end

new text begin (a) By March 1 each year, the commissioner
shall publish a schedule of fees sufficient to administer and conduct background studies
under this chapter. The published schedule of fees shall be effective on July 1 each year.
new text end

new text begin (b) Fees shall be based on the actual costs of administering and conducting background
studies, including payments to external agencies, department indirect cost payments under
section 16A.127, processing fees, and costs related to due process.
new text end

new text begin (c) The commissioner shall publish notice of fees by posting fee amounts on the
department website. The notice shall specify the actual costs that comprise the fees, including
the categories described in paragraph (b).
new text end

new text begin (d) The published schedule of fees shall remain in effect from July 1 to June 30 each
year.
new text end

new text begin (e) The fees collected under this subdivision are appropriated to the commissioner for
the purpose of conducting background studies.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021. The commissioner of human
services shall publish the initial fee schedule on the Department of Human Services' website
on July 1, 2021, and the initial fee schedule is effective September 1, 2021
new text end

Sec. 25.

Minnesota Statutes 2020, section 245C.13, subdivision 2, is amended to read:

Subd. 2.

Activities pending completion of background study.

The subject of a
background study may not perform any activity requiring a background study under
paragraph (c) until the commissioner has issued one of the notices under paragraph (a).

(a) Notices from the commissioner required prior to activity under paragraph (c) include:

(1) a notice of the study results under section 245C.17 stating that:

(i) the individual is not disqualified; or

(ii) more time is needed to complete the study but the individual is not required to be
removed from direct contact or access to people receiving services prior to completion of
the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice
that more time is needed to complete the study must also indicate whether the individual is
required to be under continuous direct supervision prior to completion of the background
study. When more time is necessary to complete a background study of an individual
affiliated with a Title IV-E eligible children's residential facility or foster residence setting,
the individual may not work in the facility or setting regardless of whether or not the
individual is supervised;

(2) a notice that a disqualification has been set aside under section 245C.23; or

(3) a notice that a variance has been granted related to the individual under section
245C.30.

(b) For a background study affiliated with a licensed child care center or certified
license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii),
must require the individual to be under continuous direct supervision prior to completion
of the background study except as permitted in subdivision 3.

(c) Activities prohibited prior to receipt of notice under paragraph (a) include:

(1) being issued a license;

(2) living in the household where the licensed program will be provided;

(3) providing direct contact services to persons served by a program unless the subject
is under continuous direct supervision;

(4) having access to persons receiving services if the background study was completed
under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2),
(5), or (6), unless the subject is under continuous direct supervision;

new text begin (i) not disqualified under section 245C.14; or
new text end

new text begin (ii) disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22;
new text end

(5) for licensed child care centers and certified license-exempt child care centers,
providing direct contact services to persons served by the program; deleted text begin or
deleted text end

(6) for children's residential facilities or foster residence settings, working in the facility
or setting deleted text begin . deleted text end new text begin ; or
new text end

new text begin (7) for background studies affiliated with a personal care provider organization, except
as provided in section 245C.03, subdivision 3a, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study of
the personal care assistant under this chapter and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:
new text end

new text begin (i) not disqualified under section 245C.14; or
new text end

new text begin (ii) disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22.
new text end

Sec. 26.

Minnesota Statutes 2020, section 245C.14, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Disqualification from working in licensed child care centers or certified
license-exempt child care centers. new text end

new text begin (a) For a background study affiliated with a licensed
child care center or certified license-exempt child care center, if an individual is disqualified
from direct contact under subdivision 1, the commissioner must also disqualify the individual
from working in any position regardless of whether the individual would have direct contact
with or access to children served in the licensed child care center or certified license-exempt
child care center and from having access to a person receiving services from the center.
new text end

new text begin (b) Notwithstanding any other requirement of this chapter, for a background study
affiliated with a licensed child care center or a certified license-exempt child care center, if
an individual is disqualified, the individual may not work in the child care center until the
commissioner has issued a notice stating that:
new text end

new text begin (1) the individual is not disqualified;
new text end

new text begin (2) a disqualification has been set aside under section 245C.23; or
new text end

new text begin (3) a variance has been granted related to the individual under section 245C.30.
new text end

Sec. 27.

Minnesota Statutes 2020, section 245C.16, subdivision 1, is amended to read:

Subdivision 1.

Determining immediate risk of harm.

(a) If the commissioner determines
that the individual studied has a disqualifying characteristic, the commissioner shall review
the information immediately available and make a determination as to the subject's immediate
risk of harm to persons served by the program where the individual studied will have direct
contact with, or access to, people receiving services.

(b) The commissioner shall consider all relevant information available, including the
following factors in determining the immediate risk of harm:

(1) the recency of the disqualifying characteristic;

(2) the recency of discharge from probation for the crimes;

(3) the number of disqualifying characteristics;

(4) the intrusiveness or violence of the disqualifying characteristic;

(5) the vulnerability of the victim involved in the disqualifying characteristic;

(6) the similarity of the victim to the persons served by the program where the individual
studied will have direct contact;

(7) whether the individual has a disqualification from a previous background study that
has not been set aside; deleted text begin and
deleted text end

(8) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 1, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense in
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with, or access to, persons receiving services from
the program and from working in a children's residential facility or foster residence setting deleted text begin . deleted text end new text begin ;
and
new text end

new text begin (9) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 2, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense during
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with or access to persons receiving services from
the center and from working in a licensed child care center or certified license-exempt child
care center.
new text end

(c) This section does not apply when the subject of a background study is regulated by
a health-related licensing board as defined in chapter 214, and the subject is determined to
be responsible for substantiated maltreatment under section 626.557 or chapter 260E.

(d) This section does not apply to a background study related to an initial application
for a child foster family setting license.

(e) Except for paragraph (f), this section does not apply to a background study that is
also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a
personal care assistant or a qualified professional as defined in section 256B.0659,
subdivision 1.

(f) If the commissioner has reason to believe, based on arrest information or an active
maltreatment investigation, that an individual poses an imminent risk of harm to persons
receiving services, the commissioner may order that the person be continuously supervised
or immediately removed pending the conclusion of the maltreatment investigation or criminal
proceedings.

Sec. 28.

Minnesota Statutes 2020, section 245C.16, subdivision 2, is amended to read:

Subd. 2.

Findings.

(a) After evaluating the information immediately available under
subdivision 1, the commissioner may have reason to believe one of the following:

(1) the individual poses an imminent risk of harm to persons served by the program
where the individual studied will have direct contact or access to persons served by the
program or where the individual studied will work;

(2) the individual poses a risk of harm requiring continuous, direct supervision while
providing direct contact services during the period in which the subject may request a
reconsideration; or

(3) the individual does not pose an imminent risk of harm or a risk of harm requiring
continuous, direct supervision while providing direct contact services during the period in
which the subject may request a reconsideration.

(b) After determining an individual's risk of harm under this section, the commissioner
must notify the subject of the background study and the applicant or license holder as
required under section 245C.17.

(c) For Title IV-E eligible children's residential facilities and foster residence settings,
the commissioner is prohibited from making the findings in paragraph (a), clause (2) or (3).

new text begin (d) For licensed child care centers or certified license-exempt child care centers, the
commissioner is prohibited from making the findings in paragraph (a), clause (2) or (3).
new text end

Sec. 29.

Minnesota Statutes 2020, section 245C.17, subdivision 1, is amended to read:

Subdivision 1.

Time frame for notice of study results and auditing system access.

(a)
Within three working days after the commissioner's receipt of a request for a background
study submitted through the commissioner's NETStudy or NETStudy 2.0 system, the
commissioner shall notify the background study subject and the license holder or other
entity as provided in this chapter in writing or by electronic transmission of the results of
the study or that more time is needed to complete the study. The notice to the individual
shall include the identity of the entity that initiated the background study.

(b) Before being provided access to NETStudy 2.0, the license holder or other entity
under section 245C.04 shall sign an acknowledgment of responsibilities form developed
by the commissioner that includes identifying the sensitive background study information
person, who must be an employee of the license holder or entity. All queries to NETStudy
2.0 are electronically recorded and subject to audit by the commissioner. The electronic
record shall identify the specific user. A background study subject may request in writing
to the commissioner a report listing the entities that initiated a background study on the
individual.

(c) When the commissioner has completed a prior background study on an individual
that resulted in an order for immediate removal and more time is necessary to complete a
subsequent study, the notice that more time is needed that is issued under paragraph (a)
shall include an order for immediate removal of the individual from any position allowing
direct contact with or access to people receiving services and from working in a children's
residential facility deleted text begin or deleted text end new text begin , new text end foster residence setting new text begin , child care center, or certified license-exempt
child care center new text end pending completion of the background study.

Sec. 30.

Minnesota Statutes 2020, section 245C.17, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Disqualification notice to child care centers and certified license-exempt
child care centers. new text end

new text begin (a) For child care centers and certified license-exempt child care centers,
all notices under this section that order the license holder to immediately remove the
individual studied from any position allowing direct contact with, or access to a person
served by the center, must also order the license holder to immediately remove the individual
studied from working in any position regardless of whether the individual would have direct
contact with or access to children served in the center.
new text end

new text begin (b) For child care centers and certified license-exempt child care centers, notices under
this section must not allow an individual to work in the center.
new text end

Sec. 31.

Minnesota Statutes 2020, section 245C.18, is amended to read:

245C.18 OBLIGATION TO REMOVE DISQUALIFIED INDIVIDUAL FROM
DIRECT CONTACT AND FROM WORKING IN A PROGRAM, FACILITY, deleted text begin OR deleted text end
SETTING new text begin , OR CENTER new text end .

(a) Upon receipt of notice from the commissioner, the license holder must remove a
disqualified individual from direct contact with persons served by the licensed program if:

(1) the individual does not request reconsideration under section 245C.21 within the
prescribed time;

(2) the individual submits a timely request for reconsideration, the commissioner does
not set aside the disqualification under section 245C.22, subdivision 4, and the individual
does not submit a timely request for a hearing under sections 245C.27 and 256.045, or
245C.28 and chapter 14; or

(3) the individual submits a timely request for a hearing under sections 245C.27 and
256.045, or 245C.28 and chapter 14, and the commissioner does not set aside or rescind the
disqualification under section 245A.08, subdivision 5, or 256.045.

(b) For children's residential facility and foster residence setting license holders, upon
receipt of notice from the commissioner under paragraph (a), the license holder must also
remove the disqualified individual from working in the program, facility, or setting and
from access to persons served by the licensed program.

(c) For Title IV-E eligible children's residential facility and foster residence setting
license holders, upon receipt of notice from the commissioner under paragraph (a), the
license holder must also remove the disqualified individual from working in the program
and from access to persons served by the program and must not allow the individual to work
in the facility or setting until the commissioner has issued a notice stating that:

(1) the individual is not disqualified;

(2) a disqualification has been set aside under section 245C.23; or

(3) a variance has been granted related to the individual under section 245C.30.

new text begin (d) For licensed child care center and certified license-exempt child care center license
holders, upon receipt of notice from the commissioner under paragraph (a), the license
holder must remove the disqualified individual from working in any position regardless of
whether the individual would have direct contact with or access to children served in the
center and from having access to persons served by the center and must not allow the
individual to work in the center until the commissioner has issued a notice stating that:
new text end

new text begin (1) the individual is not disqualified;
new text end

new text begin (2) a disqualification has been set aside under section 245C.23; or
new text end

new text begin (3) a variance has been granted related to the individual under section 245C.30.
new text end

Sec. 32.

Minnesota Statutes 2020, section 256B.0949, is amended by adding a subdivision
to read:

new text begin Subd. 16a. new text end

new text begin Background studies. new text end

new text begin The requirements for background studies under this
section shall be met by an early intensive developmental and behavioral intervention services
agency through the commissioner's NETStudy system as provided under sections 245C.03,
subdivision 15, and 245C.10, subdivision 17.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 33. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber Minnesota Statutes, section 245C.02, so that the
subdivisions are alphabetical. The revisor shall correct any cross-references that arise as a
result of the renumbering.
new text end

Sec. 34. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, section 245C.10, subdivisions 2, 2a, 3, 4, 5, 6, 7, 8, 9, 9a, 10,
11, 12, 13, 14, and 16, new text end new text begin are repealed.
new text end

ARTICLE 3

BLUE RIBBON COMMISSION

Section 1.

Minnesota Statutes 2020, section 174.30, subdivision 3, is amended to read:

Subd. 3.

Other standards; wheelchair securement; protected transport.

(a) A special
transportation service that transports individuals occupying wheelchairs is subject to the
provisions of sections 299A.11 to 299A.17 concerning wheelchair securement devices. The
commissioners of transportation and public safety shall cooperate in the enforcement of
this section and sections 299A.11 to 299A.17 so that a single inspection is sufficient to
ascertain compliance with sections 299A.11 to 299A.17 and with the standards adopted
under this section. Representatives of the Department of Transportation may inspect
wheelchair securement devices in vehicles operated by special transportation service
providers to determine compliance with sections 299A.11 to 299A.17 and to issue certificates
under section 299A.14, subdivision 4.

(b) In place of a certificate issued under section 299A.14, the commissioner may issue
a decal under subdivision 4 for a vehicle equipped with a wheelchair securement device if
the device complies with sections 299A.11 to 299A.17 and the decal displays the information
in section 299A.14, subdivision 4.

(c) For vehicles designated as protected transport under section 256B.0625, subdivision
17, paragraph deleted text begin (h) deleted text end new text begin (g) new text end , the commissioner of transportation, during the commissioner's
inspection, shall check to ensure the safety provisions contained in that paragraph are in
working order.

Sec. 2.

Minnesota Statutes 2020, section 256.983, is amended to read:

256.983 FRAUD PREVENTION INVESTIGATIONS.

Subdivision 1.

Programs established.

Within the limits of available appropriations, the
commissioner of human services shall require the maintenance of budget neutral fraud
prevention investigation programs in the counties new text begin or tribal agencies new text end participating in the
fraud prevention investigation project established under this section. If funds are sufficient,
the commissioner may also extend fraud prevention investigation programs to other counties
new text begin or tribal agencies new text end provided the expansion is budget neutral to the state. Under any expansion,
the commissioner has the final authority in decisions regarding the creation and realignment
of individual county new text begin , tribal agency, new text end or regional operations.

Subd. 2.

County new text begin and tribal agency new text end proposals.

Each participating county new text begin and tribal
new text end agency shall develop and submit an annual staffing and funding proposal to the commissioner
no later than April 30 of each year. Each proposal shall include, but not be limited to, the
staffing and funding of the fraud prevention investigation program, a job description for
investigators involved in the fraud prevention investigation program, and the organizational
structure of the county new text begin or tribal new text end agency unit, training programs for case workers, and the
operational requirements which may be directed by the commissioner. The proposal shall
be approved, to include any changes directed or negotiated by the commissioner, no later
than June 30 of each year.

Subd. 3.

Department responsibilities.

The commissioner shall establish training
programs which shall be attended by all investigative and supervisory staff of the involved
county new text begin and tribal new text end agencies. The commissioner shall also develop the necessary operational
guidelines, forms, and reporting mechanisms, which shall be used by the involved county new 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 begin and tribal new text end agency reimbursement shall be made through
the settlement provisions applicable to the Supplemental Nutrition Assistance Program
(SNAP), MFIP, child care assistance programs, the medical assistance program, and other
federal and state-funded programs.

(b) The commissioner will maintain program compliance if for any three consecutive
month period, a county new text begin or tribal new text end agency fails to comply with fraud prevention investigation
program guidelines, or fails to meet the cost-effectiveness standards developed by the
commissioner. This result is contingent on the commissioner providing written notice,
including an offer of technical assistance, within 30 days of the end of the third or subsequent
month of noncompliance. The county new text begin or tribal new text end agency shall be required to submit a corrective
action plan to the commissioner within 30 days of receipt of a notice of noncompliance.
Failure to submit a corrective action plan or, continued deviation from standards of more
than ten percent after submission of a corrective action plan, will result in denial of funding
for each subsequent month, or billing the county new text begin or tribal new text end agency for fraud prevention
investigation (FPI) service provided by the commissioner, or reallocation of program grant
funds, or investigative resources, or both, to other counties new text begin or tribal agencies new text end . The denial of
funding shall apply to the general settlement received by the county new text begin or tribal new text end agency on a
quarterly basis and shall not reduce the grant amount applicable to the FPI project.

Subd. 5.

Child care providers; financial misconduct.

(a) A county or tribal agency
may conduct investigations of financial misconduct by child care providers as described in
chapter 245E. Prior to opening an investigation, a county or tribal agency must contact the
commissioner to determine whether an investigation under this chapter may compromise
an ongoing investigation.

(b) If, upon investigation, a preponderance of evidence shows a provider committed an
intentional program violation, intentionally gave the county or tribe materially false
information on the provider's billing forms, provided false attendance records to a county,
tribe, or the commissioner, or committed financial misconduct as described in section
245E.01, subdivision 8, the county or tribal agency may suspend a provider's payment
pursuant to chapter 245E, or deny or revoke a provider's authorization pursuant to section
119B.13, subdivision 6, paragraph (d), clause (2), prior to pursuing other available remedies.
The county new text begin or tribe new 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. 3.

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 up to two dental
administrators to administer dental services for all recipients of medical assistance and
MinnesotaCare, including the administration of dental services for those enrolled in managed
care under 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 review for medical necessity of dental services;
new text end

new text begin (4) dental claims processing;
new text end

new text begin (5) coordination with other services;
new text end

new text begin (6) management of fraud and abuse;
new text end

new text begin (7) monitoring of access to dental services;
new text end

new text begin (8) performance measurement;
new text end

new text begin (9) quality improvement and evaluation requirements; 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. 4.

Minnesota Statutes 2020, section 256B.04, subdivision 12, is amended to read:

Subd. 12.

Limitation on services.

deleted text begin (a) deleted text end Place limits on the types of services covered by
medical assistance, the frequency with which the same or similar services may be covered
by medical assistance for an individual recipient, and the amount paid for each covered
service. deleted text begin The state agency shall promulgate rules establishing maximum reimbursement rates
for emergency and nonemergency transportation.
deleted text end

deleted text begin The rules shall provide:
deleted text end

deleted text begin (1) an opportunity for all recognized transportation providers to be reimbursed for
nonemergency transportation consistent with the maximum rates established by the agency;
and
deleted text end

deleted text begin (2) reimbursement of public and private nonprofit providers serving the population with
a disability generally at reasonable maximum rates that reflect the cost of providing the
service regardless of the fare that might be charged by the provider for similar services to
individuals other than those receiving medical assistance or medical care under this chapter.
deleted text end

deleted text begin (b) The commissioner shall encourage providers reimbursed under this chapter to
coordinate their operation with similar services that are operating in the same community.
To the extent practicable, the commissioner shall encourage eligible individuals to utilize
less expensive providers capable of serving their needs.
deleted text end

deleted text begin (c) For the purpose of this subdivision and section 256B.02, subdivision 8, and effective
on January 1, 1981, "recognized provider of transportation services" means an operator of
special transportation service as defined in section 174.29 that has been issued a current
certificate of compliance with operating standards of the commissioner of transportation
or, if those standards do not apply to the operator, that the agency finds is able to provide
the required transportation in a safe and reliable manner. Until January 1, 1981, "recognized
transportation provider" includes an operator of special transportation service that the agency
finds is able to provide the required transportation in a safe and reliable manner.
deleted text end

Sec. 5.

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; and

(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;

(5) nonemergency medical transportation deleted text begin level of need determinations, disbursement of
public transportation passes and tokens, and volunteer and recipient mileage and parking
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 begin special transportation services or deleted text end
incontinence products and related supplies.

Sec. 6.

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 those enrolled in managed
care under 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; and

(15) full-mouth debridement, limited to one every five years.

(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 January 1, 2023.
new text end

Sec. 7.

Minnesota Statutes 2020, section 256B.0625, subdivision 17, is amended to read:

Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transit, as defined in section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers.

(c) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.

(d) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(e) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner deleted text begin in consultation with the
Nonemergency Medical Transportation Advisory 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 mode deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.
deleted text end

deleted text begin (f) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
deleted text end

deleted text begin (g) deleted text end new text begin (f) new text end The commissioner may use an order by the recipient's attending physician,
advanced practice registered nurse, or a medical or mental health professional to certify that
the recipient requires nonemergency medical transportation services. Nonemergency medical
transportation providers shall perform driver-assisted services for eligible individuals, when
appropriate. Driver-assisted service includes passenger pickup at and return to the individual's
residence or place of business, assistance with admittance of the individual to the medical
facility, and assistance in passenger securement or in securing of wheelchairs, child seats,
or stretchers in the vehicle.

Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the deleted text begin local agency deleted text end new text begin administrator new text end .

Nonemergency medical transportation providers may not bill for separate base rates for
the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

deleted text begin (h) deleted text end new text begin (g) new text end The administrative agency shall use the level of service process established by
the commissioner deleted text begin in consultation with the Nonemergency Medical Transportation Advisory
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 end new text begin (h) new text end The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

deleted text begin (j) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
commissioner has developed, made available, and funded the web-based single administrative
structure, assessment tool, and level of need assessment under subdivision 18e. The local
agency's financial obligation is limited to funds provided by the state or federal government.
deleted text end

deleted text begin (k) deleted text end new text begin (i) new text end The commissioner shall:

(1) deleted text begin in consultation with the Nonemergency Medical Transportation Advisory Committee, deleted text end
verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

deleted text begin (l) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
deleted text end

deleted text begin (m) deleted text end new text begin (j) new text end Payments for nonemergency medical transportation must be paid based on the
client's assessed mode under paragraph deleted text begin (h) deleted text end new text begin (g) new text end , not the type of vehicle used to provide the
service. deleted text begin The medical assistance reimbursement rates for nonemergency medical transportation
services that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:
deleted text end

deleted text begin (1) $0.22 per mile for client reimbursement;
deleted text end

deleted text begin (2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;
deleted text end

deleted text begin (3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
medical transportation provider;
deleted text end

deleted text begin (4) $13 for the base rate and $1.30 per mile for assisted transport;
deleted text end

deleted text begin (5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
deleted text end

deleted text begin (6) $75 for the base rate and $2.40 per mile for protected transport; and
deleted text end

deleted text begin (7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.
deleted text end

deleted text begin (n) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:
deleted text end

deleted text begin (1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7); and
deleted text end

deleted text begin (2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7).
deleted text end

deleted text begin (o) For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) and (n), the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.
deleted text end

deleted text begin (p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.
deleted text end

deleted text begin (q) deleted text end new text begin (k) new text end The commissioner, when determining reimbursement rates for nonemergency
medical transportation deleted text begin under paragraphs (m) and (n) deleted text end , shall exempt all modes of transportation
listed under paragraph deleted text begin (i) deleted text end new text begin (h) new text end from Minnesota Rules, part 9505.0445, item R, subitem (2).

Sec. 8.

Minnesota Statutes 2020, section 256B.0625, subdivision 17b, is amended to read:

Subd. 17b.

Documentation required.

(a) As a condition for payment, nonemergency
medical transportation providers must document each occurrence of a service provided to
a recipient according to this subdivision. Providers must maintain odometer and other records
sufficient to distinguish individual trips with specific vehicles and drivers. The documentation
may be collected and maintained using electronic systems or software or in paper form but
must be made available and produced upon request. Program funds paid for transportation
that is not documented according to this subdivision shall be recovered by the new text begin nonemergency
medical transportation vendor or new text end department.

(b) A nonemergency medical transportation provider must compile transportation records
that meet the following requirements:

(1) the record must be in English and must be legible according to the standard of a
reasonable person;

(2) the recipient's name must be on each page of the record; and

(3) each entry in the record must document:

(i) the date on which the entry is made;

(ii) the date or dates the service is provided;

(iii) the printed last name, first name, and middle initial of the driver;

(iv) the signature of the driver attesting to the following: "I certify that I have accurately
reported in this record the trip miles I actually drove and the dates and times I actually drove
them. I understand that misreporting the miles driven and hours worked is fraud for which
I could face criminal prosecution or civil proceedings.";

(v) the signature of the recipient or authorized party attesting to the following: "I certify
that I received the reported transportation service.", or the signature of the provider of
medical services certifying that the recipient was delivered to the provider;

(vi) the address, or the description if the address is not available, of both the origin and
destination, and the mileage for the most direct route from the origin to the destination;

(vii) the mode of transportation in which the service is provided;

(viii) the license plate number of the vehicle used to transport the recipient;

(ix) whether the service was ambulatory or nonambulatory;

(x) the time of the pickup and the time of the drop-off with "a.m." and "p.m."
designations;

(xi) the name of the extra attendant when an extra attendant is used to provide special
transportation service; and

(xii) the electronic source documentation used to calculate driving directions and mileage.

Sec. 9.

Minnesota Statutes 2020, section 256B.0625, subdivision 18b, is amended to read:

Subd. 18b.

deleted text begin Broker dispatching prohibition deleted text end new 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

Sec. 10.

Minnesota Statutes 2020, section 256B.69, subdivision 6d, is amended to read:

Subd. 6d.

Prescription drugs.

The commissioner deleted text begin may deleted text end new text begin shall new text end exclude deleted text begin or modify deleted text end coverage
for new text begin outpatient new text end prescription drugs new text begin dispensed by a pharmacy to a member eligible for medical
assistance under this chapter new text end from the prepaid managed care contracts entered into under
this section deleted text begin in order to increase savings to the state by collecting additional prescription
drug rebates. The contracts must maintain incentives for the managed care plan to manage
drug costs and utilization and may require that the managed care plans maintain an open
drug formulary. In order to manage drug costs and utilization, the contracts may authorize
the managed care plans to use preferred drug lists and prior authorization. This subdivision
is contingent on federal approval of the managed care contract changes and the collection
of additional prescription drug rebates deleted text end . new text begin The commissioner may include, exclude, or modify
coverage for outpatient prescription drugs dispensed by a pharmacy to a member eligible
for MinnesotaCare under chapter 256L and prescription drugs administered to a medical
assistance member or MinnesotaCare member from the prepaid managed care contracts
entered into under this section.
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. 11.

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, 1992, 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, 1999, 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, 2000, 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, 2002, 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).

(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).

(j) Effective for services rendered on or after January 1, 2014, 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.

(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.

(l) Effective for services provided on or after January 1, 2017, new 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.

(m) Effective for services provided on or after July 1, 2017, new 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 (n) Effective for dental services provided on or after January 1, 2023, the commissioner
shall increase payment rates by 54 percent. This rate increase must not apply to state-operated
dental clinics in paragraph (f), federally qualified health centers, rural health centers, or
Indian health centers.
new text end

Sec. 12.

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, 2016, new 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, 2016, new text begin through December 31, 2022,
new 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. 13.

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 bidding new 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 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.
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. 14.

Minnesota Statutes 2020, section 256B.767, is amended to read:

256B.767 MEDICARE PAYMENT LIMIT.

(a) Effective for services rendered on or after July 1, 2010, fee-for-service payment rates
for physician and professional services under section 256B.76, subdivision 1, and basic care
services subject to the rate reduction specified in section 256B.766, shall not exceed the
Medicare payment rate for the applicable service, as adjusted for any changes in Medicare
payment rates after July 1, 2010. The commissioner shall implement this section after any
other rate adjustment that is effective July 1, 2010, and shall reduce rates under this section
by first reducing or eliminating provider rate add-ons.

(b) This section does not apply to services provided by advanced practice certified nurse
midwives licensed under chapter 148 or traditional midwives licensed under chapter 147D.
Notwithstanding this exemption, medical assistance fee-for-service payment rates for
advanced practice certified nurse midwives and licensed traditional midwives shall equal
and shall not exceed the medical assistance payment rate to physicians for the applicable
service.

(c) This section does not apply to mental health services or physician services billed by
a psychiatrist or an advanced practice registered nurse with a specialty in mental health.

deleted text begin (d) Effective July 1, 2015, this section shall not apply to durable medical equipment,
prosthetics, orthotics, or supplies.
deleted text end

deleted text begin (e) deleted text end new text begin (d) new text end This section does not apply to physical therapy, occupational therapy, speech
pathology and related services, and basic care services provided by a hospital meeting the
criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4).

Sec. 15.

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, 2017, new text begin through December 31, 2022, new 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. 16. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, sections 256B.0625, subdivisions 18c, 18d, 18e, and 18h; and
256L.11, subdivision 6a, new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

ARTICLE 4

HEALTH AND HEALTH-BOARD APPROPRIATIONS

Section 1. new text begin APPROPRIATIONS. new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the agencies
and for the purposes specified in this article. The appropriations are from the general fund,
or another named fund, and are available for the fiscal years indicated for each purpose.
The figures "2022" and "2023" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2022, or June 30, 2023, respectively.
"The first year" is fiscal year 2022. "The second year" is fiscal year 2023. "The biennium"
is fiscal years 2022 and 2023.
new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2022 new text end		new text begin 2023 new text end

Sec. 2. new text begin COMMISSIONER OF HEALTH new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin 250,023,000 new text end

new text begin $ new text end

new text begin 249,704,000 new text end

new text begin Appropriations by Fund new text end
	new text begin 2022 new text end	new text begin 2023 new text end
new text begin General new text end	new text begin 132,347,000 new text end	new text begin 132,324,000 new text end
new text begin State Government Special Revenue new text end	new text begin 68,451,000 new text end	new text begin 68,835,000 new text end
new text begin Health Care Access new text end	new text begin 37,512,000 new text end	new text begin 36,832,000 new text end
new text begin Federal TANF new text end	new text begin 11,713,000 new text end	new text begin 11,713,000 new text end

new text begin The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end

new text begin Subd. 2. new text end new text begin Health Improvement new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 95,690,000 new text end	new text begin 95,877,000 new text end
new text begin State Government Special Revenue new text end	new text begin 9,140,000 new text end	new text begin 9,140,000 new text end
new text begin Health Care Access new text end	new text begin 37,512,000 new text end	new text begin 36,832,000 new text end
new text begin Federal TANF new text end	new text begin 11,713,000 new text end	new text begin 11,713,000 new text end

new text begin (a) TANF Appropriations. (1) $3,579,000 in
fiscal year 2022 and $3,579,000 in fiscal year
2023 are from the TANF fund for home
visiting and nutritional services listed under
Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7). Funds must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1;
new text end

new text begin (2) $2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;
new text end

new text begin (3) $4,978,000 in fiscal year 2022 and
$4,978,000 in fiscal year 2023 are from the
TANF fund for the family home visiting grant
program according to Minnesota Statutes,
section 145A.17. $4,000,000 of the funding
in each fiscal year must be distributed to
community health boards according to
Minnesota Statutes, section 145A.131,
subdivision 1. $978,000 of the funding in each
fiscal year must be distributed to tribal
governments according to Minnesota Statutes,
section 145A.14, subdivision 2a;
new text end

new text begin (4) $1,156,000 in fiscal year 2022 and
$1,156,000 in fiscal year 2023 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and
new text end

new text begin (5) the commissioner may use up to 6.23
percent of the funds appropriated from the
TANF fund each fiscal year to conduct the
ongoing evaluations required under Minnesota
Statutes, section 145A.17, subdivision 7, and
training and technical assistance as required
under Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
new text end

new text begin (b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.
new text end

new text begin (c) new text begin Fetal and Infant Mortality Review. new text end
$311,000 in fiscal year 2022 and $311,000 in
fiscal year 2023 are appropriated from the
general fund to the commissioner of health to
be used to conduct fetal and infant mortality
reviews under Minnesota Statutes, section
145.9011.
new text end

new text begin (d) Maternal Morbidity and Death Studies.
$198,000 in fiscal year 2022 and $198,000 in
fiscal year 2023 are appropriated from the
general fund to the commissioner of health to
be used to conduct maternal morbidity and
death studies under Minnesota Statutes,
section 145.901.
new text end

new text begin (e) Transfer. The $77,000 transfer each year
from the state government special revenue
fund to the general fund as required by Laws
2008, chapter 364, section 17, paragraph (b),
is canceled effective June 30, 2021.
new text end

new text begin (f) MERC Program. The general fund
appropriation for distribution via the Medical
Education and Research Cost formula under
Minnesota Statutes, section 62J.692,
subdivision 4, is $0 in fiscal years 2022 and
2023.
new text end

new text begin (g) Base Level Adjustments. The general
fund base is $94,877,000 in fiscal year 2024
and $94,877,000 in fiscal year 2025. The state
government special revenue fund base is
$9,140,000 in fiscal year 2024 and $9,140,000
in fiscal year 2025. The health care access
fund base is $37,432,000 in fiscal year 2024
and $36,832,000 in fiscal year 2025.
new text end

new text begin Subd. 3. new text end new text begin Health Protection new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 25,087,000 new text end	new text begin 24,868,000 new text end
new text begin State Government Special Revenue new text end	new text begin 59,311,000 new text end	new text begin 59,695,000 new text end

new text begin Base Level Adjustments. The general fund
base is $24,868,000 in fiscal year 2024 and
$24,868,000 in fiscal year 2025. The state
government special revenue fund base is
$59,695,000 in fiscal year 2024 and
$59,695,000 in fiscal year 2025.
new text end

new text begin Subd. 4. new text end new text begin Health Operations new text end

new text begin 11,570,000 new text end

new text begin 11,579,000 new text end

Sec. 3. new text begin HEALTH-RELATED BOARDS new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin 27,507,000 new text end

new text begin $ new text end

new text begin 26,943,000 new text end

new text begin Appropriations by Fund new text end
new text begin State Government Special Revenue new text end	new text begin 27,431,000 new text end	new text begin 26,867,000 new text end
new text begin Health Care Access new text end	new text begin 76,000 new text end	new text begin 76,000 new text end

new text begin This appropriation is from the state
government special revenue fund unless
specified otherwise. The amounts that may be
spent for each purpose are specified in the
following subdivisions.
new text end

new text begin Subd. 2. new text end new text begin Board of Chiropractic Examiners new text end

new text begin 666,000 new text end

new text begin 666,000 new text end

new text begin Subd. 3. new text end new text begin Board of Dentistry new text end

new text begin 4,228,000 new text end

new text begin 3,753,000 new text end

new text begin (a) Administrative Services Unit - Operating
Costs. Of this appropriation, $2,738,000 in
fiscal year 2022 and $2,263,000 in fiscal year
2023 are for operating costs of the
administrative services unit. The
administrative services unit may receive and
expend reimbursements for services it
performs for other agencies.
new text end

new text begin (b) Administrative Services Unit - Volunteer
Health Care Provider Program. Of this
appropriation, $150,000 in fiscal year 2022
and $150,000 in fiscal year 2023 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end

new text begin (c) Administrative Services Unit -
Retirement Costs. Of this appropriation,
$475,000 in fiscal year 2022 is a onetime
appropriation to the administrative services
unit to pay for the retirement costs of
health-related board employees. This funding
may be transferred to the health board
incurring retirement costs. Any board that has
an unexpended balance for an amount
transferred under this paragraph shall transfer
the unexpended amount to the administrative
services unit. These funds are available either
year of the biennium.
new text end

new text begin (d) Administrative Services Unit - Contested
Cases and Other Legal Proceedings. Of this
appropriation, $200,000 in fiscal year 2022
and $200,000 in fiscal year 2023 are for costs
of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards funded under
this section. Upon certification by a
health-related board to the administrative
services unit that costs will be incurred and
that there is insufficient money available to
pay for the costs out of money currently
available to that board, the administrative
services unit is authorized to transfer money
from this appropriation to the board for
payment of those costs with the approval of
the commissioner of management and budget.
The commissioner of management and budget
must require any board that has an unexpended
balance for an amount transferred under this
paragraph to transfer the unexpended amount
to the administrative services unit to be
deposited in the state government special
revenue fund.
new text end

new text begin Subd. 4. new text end new text begin Board of Dietetics and Nutrition Practice new text end

new text begin 164,000 new text end

new text begin 164,000 new text end

new text begin Subd. 5. new text end new text begin Board of Marriage and Family Therapy new text end

new text begin 406,000 new text end

new text begin 406,000 new text end

new text begin Subd. 6. new text end new text begin Board of Medical Practice new text end

new text begin 5,912,000 new text end

new text begin 5,868,000 new text end

new text begin Health Professional Services Program. This
appropriation includes $1,002,000 in fiscal
year 2022 and $1,002,000 in fiscal year 2023
for the health professional services program.
new text end

new text begin Subd. 7. new text end new text begin Board of Nursing new text end

new text begin 5,345,000 new text end

new text begin 5,355,000 new text end

new text begin Subd. 8. new text end new text begin Board of Executives for Long Term Services and Supports new text end

new text begin 693,000 new text end

new text begin 635,000 new text end

new text begin Subd. 9. new text end new text begin Board of Optometry new text end

new text begin 238,000 new text end

new text begin 238,000 new text end

new text begin Subd. 10. new text end new text begin Board of Pharmacy new text end

new text begin 4,479,000 new text end

new text begin 4,479,000 new text end

new text begin Appropriations by Fund new text end
new text begin State Government Special Revenue new text end	new text begin 4,403,000 new text end	new text begin 4,403,000 new text end
new text begin Health Care Access new text end	new text begin 76,000 new text end	new text begin 76,000 new text end

new text begin The base for this appropriation in the health
care access fund is $76,000 in fiscal year 2024,
$38,000 in fiscal year 2025, and $0 in fiscal
year 2026.
new text end

new text begin Subd. 11. new text end new text begin Board of Physical Therapy new text end

new text begin 564,000 new text end

new text begin 564,000 new text end

new text begin Subd. 12. new text end new text begin Board of Podiatric Medicine new text end

new text begin 214,000 new text end

new text begin 214,000 new text end

new text begin Subd. 13. new text end new text begin Board of Psychology new text end

new text begin 1,355,000 new text end

new text begin 1,355,000 new text end

new text begin Subd. 14. new text end new text begin Board of Social Work new text end

new text begin 1,556,000 new text end

new text begin 1,559,000 new text end

new text begin Subd. 15. new text end new text begin Board of Veterinary Medicine new text end

new text begin 363,000 new text end

new text begin 363,000 new text end

new text begin Subd. 16. new text end new text begin Board of Behavioral Health and Therapy new text end

new text begin 868,000 new text end

new text begin 868,000 new text end

new text begin Subd. 17. new text end new text begin Board of Occupational Therapy Practice new text end

new text begin 456,000 new text end

new text begin 456,000 new text end

Sec. 4. new text begin EMERGENCY MEDICAL SERVICES REGULATORY BOARD new text end

new text begin $ new text end

new text begin 3,803,000 new text end

new text begin $ new text end

new text begin 3,829,000 new text end

new text begin (a) Cooper/Sams Volunteer Ambulance
Program. $950,000 in fiscal year 2022 and
$950,000 in fiscal year 2023 are for the
Cooper/Sams volunteer ambulance program
under Minnesota Statutes, section 144E.40.
new text end

new text begin (1) Of this amount, $861,000 in fiscal year
2022 and $861,000 in fiscal year 2023 are for
the ambulance service personnel longevity
award and incentive program under Minnesota
Statutes, section 144E.40.
new text end

new text begin (2) Of this amount, $89,000 in fiscal year 2022
and $89,000 in fiscal year 2023 are for the
operations of the ambulance service personnel
longevity award and incentive program under
Minnesota Statutes, section 144E.40.
new text end

new text begin (b) EMSRB Operations. $1,880,000 in fiscal
year 2022 and $1,880,000 in fiscal year 2023
are for board operations.
new text end

new text begin (c) Regional Grants. $585,000 in fiscal year
2022 and $585,000 in fiscal year 2023 are for
regional emergency medical services
programs, to be distributed equally to the eight
emergency medical service regions under
Minnesota Statutes, section 144E.52.
new text end

new text begin (d) Ambulance Training Grant. $361,000
in fiscal year 2022 and $361,000 in fiscal year
2023 are for training grants under Minnesota
Statutes, section 144E.35.
new text end

Sec. 5. new text begin COUNCIL ON DISABILITY new text end

new text begin $ new text end

new text begin 1,022,000 new text end

new text begin $ new text end

new text begin 1,038,000 new text end

Sec. 6. new text begin OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES new text end

new text begin $ new text end

new text begin 2,487,000 new text end

new text begin $ new text end

new text begin 2,536,000 new text end

new text begin Department of Psychiatry Monitoring.
$100,000 in fiscal year 2022 and $100,000 in
fiscal year 2023 are for monitoring the
Department of Psychiatry at the University of
Minnesota.
new text end

Sec. 7. new text begin OMBUDSPERSONS FOR FAMILIES new text end

new text begin $ new text end

new text begin 733,000 new text end

new text begin $ new text end

new text begin 744,000 new text end

Sec. 8.

Laws 2019, First Special Session chapter 9, article 14, section 3, as amended by
Laws 2019, First Special Session chapter 12, section 6, is amended to read:

Sec. 3. COMMISSIONER OF HEALTH

Subdivision 1. Total Appropriation

$

231,829,000

$

deleted text begin 236,188,000 deleted text end new text begin 233,979,000 new text end

Appropriations by Fund
	2020	2021
General	124,381,000	126,276,000
State Government Special Revenue	58,450,000	deleted text begin 61,367,000 deleted text end new text begin 59,158,000 new text end
Health Care Access	37,285,000	36,832,000
Federal TANF	11,713,000	11,713,000

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2. Health Improvement

Appropriations by Fund
General	94,980,000	96,117,000
State Government Special Revenue	7,614,000	deleted text begin 7,558,000 deleted text end new text begin 6,924,000 new text end
Health Care Access	37,285,000	36,832,000
Federal TANF	11,713,000	11,713,000

(a) TANF Appropriations. (1) $3,579,000 in
fiscal year 2020 and $3,579,000 in fiscal year
2021 are from the TANF fund for home
visiting and nutritional services under
Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7). Funds must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1;

(2) $2,000,000 in fiscal year 2020 and
$2,000,000 in fiscal year 2021 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;

(3) $4,978,000 in fiscal year 2020 and
$4,978,000 in fiscal year 2021 are from the
TANF fund for the family home visiting grant
program under Minnesota Statutes, section
145A.17. $4,000,000 of the funding in each
fiscal year must be distributed to community
health boards according to Minnesota Statutes,
section 145A.131, subdivision 1. $978,000 of
the funding in each fiscal year must be
distributed to tribal governments according to
Minnesota Statutes, section 145A.14,
subdivision 2a;

(4) $1,156,000 in fiscal year 2020 and
$1,156,000 in fiscal year 2021 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and

(5) The commissioner may use up to 6.23
percent of the amounts appropriated from the
TANF fund each year to conduct the ongoing
evaluations required under Minnesota Statutes,
section 145A.17, subdivision 7, and training
and technical assistance as required under
Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.

(b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.

(c) Comprehensive Suicide Prevention.
$2,730,000 in fiscal year 2020 and $2,730,000
in fiscal year 2021 are from the general fund
for a comprehensive, community-based suicide
prevention strategy. The funds are allocated
as follows:

(1) $955,000 in fiscal year 2020 and $955,000
in fiscal year 2021 are for community-based
suicide prevention grants authorized in
Minnesota Statutes, section 145.56,
subdivision 2. Specific emphasis must be
placed on those communities with the greatest
disparities. The base for this appropriation is
$1,291,000 in fiscal year 2022 and $1,291,000
in fiscal year 2023;

(2) $683,000 in fiscal year 2020 and $683,000
in fiscal year 2021 are to support
evidence-based training for educators and
school staff and purchase suicide prevention
curriculum for student use statewide, as
authorized in Minnesota Statutes, section
145.56, subdivision 2. The base for this
appropriation is $913,000 in fiscal year 2022
and $913,000 in fiscal year 2023;

(3) $137,000 in fiscal year 2020 and $137,000
in fiscal year 2021 are to implement the Zero
Suicide framework with up to 20 behavioral
and health care organizations each year to treat
individuals at risk for suicide and support
those individuals across systems of care upon
discharge. The base for this appropriation is
$205,000 in fiscal year 2022 and $205,000 in
fiscal year 2023;

(4) $955,000 in fiscal year 2020 and $955,000
in fiscal year 2021 are to develop and fund a
Minnesota-based network of National Suicide
Prevention Lifeline, providing statewide
coverage. The base for this appropriation is
$1,321,000 in fiscal year 2022 and $1,321,000
in fiscal year 2023; and

(5) the commissioner may retain up to 18.23
percent of the appropriation under this
paragraph to administer the comprehensive
suicide prevention strategy.

(d) Statewide Tobacco Cessation. $1,598,000
in fiscal year 2020 and $2,748,000 in fiscal
year 2021 are from the general fund for
statewide tobacco cessation services under
Minnesota Statutes, section 144.397. The base
for this appropriation is $2,878,000 in fiscal
year 2022 and $2,878,000 in fiscal year 2023.

(e) Health Care Access Survey. $225,000 in
fiscal year 2020 and $225,000 in fiscal year
2021 are from the health care access fund to
continue and improve the Minnesota Health
Care Access Survey. These appropriations
may be used in either year of the biennium.

(f) Community Solutions for Healthy Child
Development Grant Program. $1,000,000
in fiscal year 2020 and $1,000,000 in fiscal
year 2021 are for the community solutions for
healthy child development grant program to
promote health and racial equity for young
children and their families under article 11,
section 107. The commissioner may use up to
23.5 percent of the total appropriation for
administration. The base for this appropriation
is $1,000,000 in fiscal year 2022, $1,000,000
in fiscal year 2023, and $0 in fiscal year 2024.

(g) Domestic Violence and Sexual Assault
Prevention Program. $375,000 in fiscal year
2020 and $375,000 in fiscal year 2021 are
from the general fund for the domestic
violence and sexual assault prevention
program under article 11, section 108. This is
a onetime appropriation.

(h) Skin Lightening Products Public
Awareness Grant Program. $100,000 in
fiscal year 2020 and $100,000 in fiscal year
2021 are from the general fund for a skin
lightening products public awareness and
education grant program. This is a onetime
appropriation.

(i) Cannabinoid Products Workgroup.
$8,000 in fiscal year 2020 is from the state
government special revenue fund for the
cannabinoid products workgroup. This is a
onetime appropriation.

(j) Base Level Adjustments. The general fund
base is $96,742,000 in fiscal year 2022 and
$96,742,000 in fiscal year 2023. The health
care access fund base is $37,432,000 in fiscal
year 2022 and $36,832,000 in fiscal year 2023.

Subd. 3. Health Protection

Appropriations by Fund
General	18,803,000	19,774,000
State Government Special Revenue	50,836,000	deleted text begin 53,809,000 deleted text end new text begin 52,234,000 new text end

(a) Public Health Laboratory Equipment.
$840,000 in fiscal year 2020 and $655,000 in
fiscal year 2021 are from the general fund for
equipment for the public health laboratory.
This is a onetime appropriation and is
available until June 30, 2023.

(b) Base Level Adjustment. The general fund
base is $19,119,000 in fiscal year 2022 and
$19,119,000 in fiscal year 2023. The state
government special revenue fund base is
$53,782,000 in fiscal year 2022 and
$53,782,000 in fiscal year 2023.

Subd. 4. Health Operations

10,598,000

10,385,000

Base Level Adjustment. The general fund
base is $10,912,000 in fiscal year 2022 and
$10,912,000 in fiscal year 2023.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment and
the reductions in subdivisions 1 to 3 are onetime reductions.
new text end

Sec. 9. new text begin TRANSFERS; HEALTH.
new text end

new text begin Positions, salary money, and nonsalary administrative money may be transferred within
the Department of Health as the commissioner considers necessary, with the advance
approval of the commissioner of management and budget. The commissioner shall inform
the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services finance quarterly about transfers made under this section.
new text end

Sec. 10. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end

new text begin The commissioner of health shall not use indirect cost allocations to pay for the
operational costs of any program for which they are responsible.
new text end

Sec. 11. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2023, unless a
different expiration date is explicit.
new text end

Sec. 12. new text begin EFFECTIVE DATE.
new text end

new text begin This article is effective July 1, 2021, unless a different effective date is specified.
new text end

ARTICLE 5

HEALTH POLICY

Section 1.

Minnesota Statutes 2020, section 62J.495, subdivision 1, is amended to read:

Subdivision 1.

Implementation.

The commissioner of health, in consultation with the
e-Health Advisory Committee, shall develop uniform standards to be used for the
interoperable electronic health records system for sharing and synchronizing patient data
across systems. The standards must be compatible with federal efforts. The uniform standards
must be developed by January 1, 2009, and updated on an ongoing basis. deleted text begin The commissioner
shall include an update on standards development as part of an annual report to the legislature. deleted text end
Individual health care providers in private practice with no other providers and health care
providers that do not accept reimbursement from a group purchaser, as defined in section
62J.03, subdivision 6, are excluded from the requirements of this section.

Sec. 2.

Minnesota Statutes 2020, section 62J.495, subdivision 2, is amended to read:

Subd. 2.

E-Health Advisory Committee.

(a) The commissioner shall establish an
e-Health Advisory Committee governed by section 15.059 to advise the commissioner on
the following matters:

(1) assessment of the adoption and effective use of health information technology by
the state, licensed health care providers and facilities, and local public health agencies;

(2) recommendations for implementing a statewide interoperable health information
infrastructure, to include estimates of necessary resources, and for determining standards
for clinical data exchange, clinical support programs, patient privacy requirements, and
maintenance of the security and confidentiality of individual patient data;

(3) recommendations for encouraging use of innovative health care applications using
information technology and systems to improve patient care and reduce the cost of care,
including applications relating to disease management and personal health management
that enable remote monitoring of patients' conditions, especially those with chronic
conditions; and

(4) other related issues as requested by the commissioner.

(b) The members of the e-Health Advisory Committee shall include the commissioners,
or commissioners' designees, of health, human services, administration, and commerce and
additional members to be appointed by the commissioner to include persons representing
Minnesota's local public health agencies, licensed hospitals and other licensed facilities and
providers, private purchasers, the medical and nursing professions, health insurers and health
plans, the state quality improvement organization, academic and research institutions,
consumer advisory organizations with an interest and expertise in health information
technology, and other stakeholders as identified by the commissioner to fulfill the
requirements of section 3013, paragraph (g), of the HITECH Act.

(c) deleted text begin The commissioner shall prepare and issue an annual report not later than January 30
of each year outlining progress to date in implementing a statewide health information
infrastructure and recommending action on policy and necessary resources to continue the
promotion of adoption and effective use of health information technology.
deleted text end

deleted text begin (d) deleted text end This subdivision expires June 30, 2021.

Sec. 3.

Minnesota Statutes 2020, section 62J.495, subdivision 3, is amended to read:

Subd. 3.

Interoperable electronic health record requirements.

(a) Hospitals and health
care providers must meet the following criteria when implementing an interoperable
electronic health records system within their hospital system or clinical practice setting.

(b) The electronic health record must be a qualified electronic health record.

(c) The electronic health record must be certified by the Office of the National
Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and health
care providers if a certified electronic health record product for the provider's particular
practice setting is available. This criterion shall be considered met if a hospital or health
care provider is using an electronic health records system that has been certified within the
last three years, even if a more current version of the system has been certified within the
three-year period.

(d) The electronic health record must meet the standards established according to section
3004 of the HITECH Act as applicable.

(e) The electronic health record must have the ability to generate information on clinical
quality measures and other measures reported under sections 4101, 4102, and 4201 of the
HITECH Act.

(f) The electronic health record system must be connected to a state-certified health
information organization either directly or through a connection facilitated by a deleted text begin state-certified deleted text end
health data intermediary as defined in section 62J.498.

(g) A health care provider who is a prescriber or dispenser of legend drugs must have
an electronic health record system that meets the requirements of section 62J.497.

Sec. 4.

Minnesota Statutes 2020, section 62J.495, subdivision 4, is amended to read:

Subd. 4.

Coordination with national HIT activities.

(a) The commissioner, in
consultation with the e-Health Advisory Committee, shall update the statewide
implementation plan required under subdivision 2 and released June 2008, to be consistent
with the updated federal deleted text begin HIT Strategic Plan released by the Office of the National Coordinator
in accordance with section 3001 of the HITECH Act. The statewide plan shall meet the
requirements for a plan required under section 3013 of the HITECH Act deleted text end new text begin plans new text end .

(b) The commissioner, in consultation with the e-Health Advisory Committee, shall
work to ensure coordination between state, regional, and national efforts to support and
accelerate efforts to effectively use health information technology to improve the quality
and coordination of health care and the continuity of patient care among health care providers,
to reduce medical errors, to improve population health, to reduce health disparities, and to
reduce chronic disease. The commissioner's coordination efforts shall include but not be
limited to:

deleted text begin (1) assisting in the development and support of health information technology regional
extension centers established under section 3012(c) of the HITECH Act to provide technical
assistance and disseminate best practices;
deleted text end

deleted text begin (2) providing supplemental information to the best practices gathered by regional centers
to ensure that the information is relayed in a meaningful way to the Minnesota health care
community;
deleted text end

deleted text begin (3) deleted text end new text begin (1) new text end providing financial and technical support to Minnesota health care providers to
encourage implementation of admission, discharge and transfer alerts, and care summary
document exchange transactions and to evaluate the impact of health information technology
on cost and quality of care. Communications about available financial and technical support
shall include clear information about the interoperable health record requirements in
subdivision 1, including a separate statement in bold-face type clarifying the exceptions to
those requirements;

deleted text begin (4) deleted text end new text begin (2) new text end providing educational resources and technical assistance to health care providers
and patients related to state and national privacy, security, and consent laws governing
clinical health information, including the requirements in sections 144.291 to 144.298. In
carrying out these activities, the commissioner's technical assistance does not constitute
legal advice;

deleted text begin (5) deleted text end new text begin (3) new text end assessing Minnesota's legal, financial, and regulatory framework for health
information exchange, including the requirements in sections 144.291 to 144.298, and
making recommendations for modifications that would strengthen the ability of Minnesota
health care providers to securely exchange data in compliance with patient preferences and
in a way that is efficient and financially sustainable; and

deleted text begin (6) deleted text end new text begin (4) new text end seeking public input on both patient impact and costs associated with requirements
related to patient consent for release of health records for the purposes of treatment, payment,
and health care operations, as required in section 144.293, subdivision 2. The commissioner
shall provide a report to the legislature on the findings of this public input process no later
than February 1, 2017.

(c) The commissioner, in consultation with the e-Health Advisory Committee, shall
monitor national activity related to health information technology and shall coordinate
statewide input on policy development. The commissioner shall coordinate statewide
responses to proposed federal health information technology regulations in order to ensure
that the needs of the Minnesota health care community are adequately and efficiently
addressed in the proposed regulations. The commissioner's responses may include, but are
not limited to:

(1) reviewing and evaluating any standard, implementation specification, or certification
criteria proposed by the national HIT standards deleted text begin committee deleted text end new text begin committees new text end ;

(2) reviewing and evaluating policy proposed by deleted text begin the deleted text end national HIT policy deleted text begin committee deleted text end new text begin
committees new text end relating to the implementation of a nationwide health information technology
infrastructure; new text begin and
new text end

(3) deleted text begin monitoring and responding to activity related to the development of quality measures
and other measures as required by section 4101 of the HITECH Act. Any response related
to quality measures shall consider and address the quality efforts required under chapter
62U; and
deleted text end

deleted text begin (4) deleted text end monitoring and responding to national activity related to privacy, security, and data
stewardship of electronic health information and individually identifiable health information.

(d) To the extent that the state is either required or allowed to apply, or designate an
entity to apply for or carry out activities and programs deleted text begin under section 3013 of the HITECH
Act deleted text end , the commissioner of health, in consultation with the e-Health Advisory Committee
and the commissioner of human services, shall be the lead applicant or sole designating
authority. The commissioner shall make such designations consistent with the goals and
objectives of sections 62J.495 to 62J.497 and 62J.50 to 62J.61.

(e) The commissioner of human services shall apply for funding necessary to administer
the incentive payments to providers authorized under title IV of the American Recovery
and Reinvestment Act.

deleted text begin (f) The commissioner shall include in the report to the legislature information on the
activities of this subdivision and provide recommendations on any relevant policy changes
that should be considered in Minnesota.
deleted text end

Sec. 5.

Minnesota Statutes 2020, section 62J.498, is amended to read:

62J.498 HEALTH INFORMATION EXCHANGE.

Subdivision 1.

Definitions.

(a) The following definitions apply to sections 62J.498 to
62J.4982:

(b) "Clinical data repository" means a real time database that consolidates data from a
variety of clinical sources to present a unified view of a single patient and is used by a
deleted text begin state-certified deleted text end health information exchange service provider to enable health information
exchange among health care providers that are not related health care entities as defined in
section 144.291, subdivision 2, paragraph (k). This does not include clinical data that are
submitted to the commissioner for public health purposes required or permitted by law,
including any rules adopted by the commissioner.

(c) "Clinical transaction" means any meaningful use transaction or other health
information exchange transaction that is not covered by section 62J.536.

(d) "Commissioner" means the commissioner of health.

(e) "Health care provider" or "provider" means a health care provider or provider as
defined in section 62J.03, subdivision 8.

(f) "Health data intermediary" means an entity that provides the technical capabilities
or related products and services to enable health information exchange among health care
providers that are not related health care entities as defined in section 144.291, subdivision
2, paragraph (k). This includes but is not limited to health information service providers
(HISP), electronic health record vendors, and pharmaceutical electronic data intermediaries
as defined in section 62J.495.

(g) "Health information exchange" means the electronic transmission of health-related
information between organizations according to nationally recognized standards.

(h) "Health information exchange service provider" means a health data intermediary
or health information organization.

(i) "Health information organization" means an organization that oversees, governs, and
facilitates health information exchange among health care providers that are not related
health care entities as defined in section 144.291, subdivision 2, paragraph (k), to improve
coordination of patient care and the efficiency of health care delivery.

deleted text begin (j) "HITECH Act" means the Health Information Technology for Economic and Clinical
Health Act as defined in section 62J.495.
deleted text end

deleted text begin (k) deleted text end new text begin (j) new text end "Major participating entity" means:

(1) a participating entity that receives compensation for services that is greater than 30
percent of the health information organization's gross annual revenues from the health
information exchange service provider;

(2) a participating entity providing administrative, financial, or management services to
the health information organization, if the total payment for all services provided by the
participating entity exceeds three percent of the gross revenue of the health information
organization; and

(3) a participating entity that nominates or appoints 30 percent or more of the board of
directors or equivalent governing body of the health information organization.

deleted text begin (l) deleted text end new text begin (k) new text end "Master patient index" means an electronic database that holds unique identifiers
of patients registered at a care facility and is used by a deleted text begin state-certified deleted text end health information
exchange service provider to enable health information exchange among health care providers
that are not related health care entities as defined in section 144.291, subdivision 2, paragraph
(k). This does not include data that are submitted to the commissioner for public health
purposes required or permitted by law, including any rules adopted by the commissioner.

deleted text begin (m) "Meaningful use" means use of certified electronic health record technology to
improve quality, safety, and efficiency and reduce health disparities; engage patients and
families; improve care coordination and population and public health; and maintain privacy
and security of patient health information as established by the Centers for Medicare and
Medicaid Services and the Minnesota Department of Human Services pursuant to sections
4101, 4102, and 4201 of the HITECH Act.
deleted text end

deleted text begin (n) "Meaningful use transaction" means an electronic transaction that a health care
provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare
penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
deleted text end

deleted text begin (o) deleted text end new text begin (l) new text end "Participating entity" means any of the following persons, health care providers,
companies, or other organizations with which a health information organization deleted text begin or health
data intermediary deleted text end has contracts or other agreements for the provision of health information
exchange services:

(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home
licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise
licensed under the laws of this state or registered with the commissioner;

(2) a health care provider, and any other health care professional otherwise licensed
under the laws of this state or registered with the commissioner;

(3) a group, professional corporation, or other organization that provides the services of
individuals or entities identified in clause (2), including but not limited to a medical clinic,
a medical group, a home health care agency, an urgent care center, and an emergent care
center;

(4) a health plan as defined in section 62A.011, subdivision 3; and

(5) a state agency as defined in section 13.02, subdivision 17.

deleted text begin (p) deleted text end new text begin (m) new text end "Reciprocal agreement" means an arrangement in which two or more health
information exchange service providers agree to share in-kind services and resources to
allow for the pass-through of clinical transactions.

deleted text begin (q) "State-certified health data intermediary" means a health data intermediary that has
been issued a certificate of authority to operate in Minnesota.
deleted text end

deleted text begin (r) deleted text end new text begin (n) new text end "State-certified health information organization" means a health information
organization that has been issued a certificate of authority to operate in Minnesota.

Subd. 2.

Health information exchange oversight.

(a) The commissioner shall protect
the public interest on matters pertaining to health information exchange. The commissioner
shall:

(1) review and act on applications from deleted text begin health data intermediaries and deleted text end health information
organizations for certificates of authority to operate in Minnesota;

new text begin (2) require information to be provided as needed from health information exchange
service providers in order to meet requirements established under sections 62J.498 to
62J.4982;
new text end

deleted text begin (2) deleted text end new text begin (3) new text end provide ongoing monitoring to ensure compliance with criteria established under
sections 62J.498 to 62J.4982;

deleted text begin (3) deleted text end new text begin (4) new text end respond to public complaints related to health information exchange services;

deleted text begin (4) deleted text end new text begin (5) new text end take enforcement actions as necessary, including the imposition of fines,
suspension, or revocation of certificates of authority as outlined in section 62J.4982;

deleted text begin (5) deleted text end new text begin (6) new text end provide a biennial report on the status of health information exchange services
that includes but is not limited to:

(i) recommendations on actions necessary to ensure that health information exchange
services are adequate to meet the needs of Minnesota citizens and providers statewide;

(ii) recommendations on enforcement actions to ensure that health information exchange
service providers act in the public interest without causing disruption in health information
exchange services;

(iii) recommendations on updates to criteria for obtaining certificates of authority under
this section; and

(iv) recommendations on standard operating procedures for health information exchange,
including but not limited to the management of consumer preferences; and

deleted text begin (6) deleted text end new text begin (7) new text end other duties necessary to protect the public interest.

(b) As part of the application review process for certification under paragraph (a), prior
to issuing a certificate of authority, the commissioner shall:

(1) make all portions of the application classified as public data available to the public
for at least ten days while an application is under consideration. At the request of the
commissioner, the applicant shall participate in a public hearing by presenting an overview
of their application and responding to questions from interested parties; and

(2) consult with hospitals, physicians, and other providers prior to issuing a certificate
of authority.

(c) When the commissioner is actively considering a suspension or revocation of a
certificate of authority as described in section 62J.4982, subdivision 3, all investigatory data
that are collected, created, or maintained related to the suspension or revocation are classified
as confidential data on individuals and as protected nonpublic data in the case of data not
on individuals.

(d) The commissioner may disclose data classified as protected nonpublic or confidential
under paragraph (c) if disclosing the data will protect the health or safety of patients.

(e) After the commissioner makes a final determination regarding a suspension or
revocation of a certificate of authority, all minutes, orders for hearing, findings of fact,
conclusions of law, and the specification of the final disciplinary action, are classified as
public data.

Sec. 6.

Minnesota Statutes 2020, section 62J.4981, is amended to read:

62J.4981 CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH
INFORMATION EXCHANGE SERVICES.

Subdivision 1.

Authority to require organizations to apply.

The commissioner shall
require deleted text begin a health data intermediary or deleted text end a health information organization to apply for a
certificate of authority under this section. An applicant may continue to operate until the
commissioner acts on the application. If the application is denied, the applicant is considered
a health information exchange service provider whose certificate of authority has been
revoked under section 62J.4982, subdivision 2, paragraph (d).

deleted text begin Subd. 2. deleted text end

deleted text begin Certificate of authority for health data intermediaries. deleted text end

deleted text begin (a) A health data
intermediary must be certified by the state and comply with requirements established in this
section.
deleted text end

deleted text begin (b) Notwithstanding any law to the contrary, any corporation organized to do so may
apply to the commissioner for a certificate of authority to establish and operate as a health
data intermediary in compliance with this section. No person shall establish or operate a
health data intermediary in this state, nor sell or offer to sell, or solicit offers to purchase
or receive advance or periodic consideration in conjunction with a health data intermediary
contract unless the organization has a certificate of authority or has an application under
active consideration under this section.
deleted text end

deleted text begin (c) In issuing the certificate of authority, the commissioner shall determine whether the
applicant for the certificate of authority has demonstrated that the applicant meets the
following minimum criteria:
deleted text end

deleted text begin (1) hold reciprocal agreements with at least one state-certified health information
organization to access patient data, and for the transmission and receipt of clinical
transactions. Reciprocal agreements must meet the requirements established in subdivision
5; and
deleted text end

deleted text begin (2) participate in statewide shared health information exchange services as defined by
the commissioner to support interoperability between state-certified health information
organizations and state-certified health data intermediaries.
deleted text end

Subd. 3.

Certificate of authority for health information organizations.

(a) A health
information organization must obtain a certificate of authority from the commissioner and
demonstrate compliance with the criteria in paragraph (c).

(b) Notwithstanding any law to the contrary, an organization may apply for a certificate
of authority to establish and operate a health information organization under this section.
No person shall establish or operate a health information organization in this state, nor sell
or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in
conjunction with a health information organization or health information contract unless
the organization has a certificate of authority under this section.

(c) In issuing the certificate of authority, the commissioner shall determine whether the
applicant for the certificate of authority has demonstrated that the applicant meets the
following minimum criteria:

(1) the entity is a legally established organization;

(2) appropriate insurance, including liability insurance, for the operation of the health
information organization is in place and sufficient to protect the interest of the public and
participating entities;

(3) strategic and operational plans address governance, technical infrastructure, legal
and policy issues, finance, and business operations in regard to how the organization will
expand to support providers in achieving health information exchange goals over time;

(4) the entity addresses the parameters to be used with participating entities and other
health information exchange service providers for clinical transactions, compliance with
Minnesota law, and interstate health information exchange trust agreements;

(5) the entity's board of directors or equivalent governing body is composed of members
that broadly represent the health information organization's participating entities and
consumers;

(6) the entity maintains a professional staff responsible to the board of directors or
equivalent governing body with the capacity to ensure accountability to the organization's
mission;

(7) the organization is compliant with national certification and accreditation programs
designated by the commissioner;

(8) the entity maintains the capability to query for patient information based on national
standards. The query capability may utilize a master patient index, clinical data repository,
or record locator service as defined in section 144.291, subdivision 2, paragraph (j). The
entity must be compliant with the requirements of section 144.293, subdivision 8, when
conducting clinical transactions;

(9) the organization demonstrates interoperability with all other state-certified health
information organizations using nationally recognized standards;

(10) the organization demonstrates compliance with all privacy and security requirements
required by state and federal law; and

(11) the organization uses financial policies and procedures consistent with generally
accepted accounting principles and has an independent audit of the organization's financials
on an annual basis.

(d) Health information organizations that have obtained a certificate of authority must:

(1) meet the requirements established for connecting to the National eHealth Exchange;

(2) annually submit strategic and operational plans for review by the commissioner that
address:

(i) progress in achieving objectives included in previously submitted strategic and
operational plans across the following domains: business and technical operations, technical
infrastructure, legal and policy issues, finance, and organizational governance;

(ii) plans for ensuring the necessary capacity to support clinical transactions;

(iii) approach for attaining financial sustainability, including public and private financing
strategies, and rate structures;

(iv) rates of adoption, utilization, and transaction volume, and mechanisms to support
health information exchange; and

(v) an explanation of methods employed to address the needs of community clinics,
critical access hospitals, and free clinics in accessing health information exchange services;

(3) enter into reciprocal agreements with all other state-certified health information
organizations deleted text begin and state-certified health data intermediaries deleted text end to enable access to patient data,
and for the transmission and receipt of clinical transactions. Reciprocal agreements must
meet the requirements in subdivision 5;

(4) participate in statewide shared health information exchange services as defined by
the commissioner to support interoperability deleted text begin between state-certified health information
organizations and state-certified health data intermediaries deleted text end ; and

(5) comply with additional requirements for the certification or recertification of health
information organizations that may be established by the commissioner.

Subd. 4.

Application for certificate of authority for health information deleted text begin exchange
service providers deleted text end new text begin organizations new text end .

(a) Each application for a certificate of authority shall
be in a form prescribed by the commissioner and verified by an officer or authorized
representative of the applicant. Each application shall include the following in addition to
information described in the criteria in deleted text begin subdivisions 2 and deleted text end new text begin subdivision new text end 3:

(1) deleted text begin for health information organizations only, deleted text end a copy of the basic organizational document,
if any, of the applicant and of each major participating entity, such as the articles of
incorporation, or other applicable documents, and all amendments to it;

(2) deleted text begin for health information organizations only, deleted text end a list of the names, addresses, and official
positions of the following:

(i) all members of the board of directors or equivalent governing body, and the principal
officers and, if applicable, shareholders of the applicant organization; and

(ii) all members of the board of directors or equivalent governing body, and the principal
officers of each major participating entity and, if applicable, each shareholder beneficially
owning more than ten percent of any voting stock of the major participating entity;

(3) deleted text begin for health information organizations only, deleted text end the name and address of each participating
entity and the agreed-upon duration of each contract or agreement if applicable;

(4) a copy of each standard agreement or contract intended to bind the participating
entities and the health information deleted text begin exchange service provider deleted text end new text begin organization new text end . Contractual
provisions shall be consistent with the purposes of this section, in regard to the services to
be performed under the standard agreement or contract, the manner in which payment for
services is determined, the nature and extent of responsibilities to be retained by the health
information organization, and contractual termination provisions;

(5) a statement generally describing the health information deleted text begin exchange service provider deleted text end new text begin
organization new text end , its health information exchange contracts, facilities, and personnel, including
a statement describing the manner in which the applicant proposes to provide participants
with comprehensive health information exchange services;

(6) a statement reasonably describing the geographic area or areas to be served and the
type or types of participants to be served;

(7) a description of the complaint procedures to be used as required under this section;

(8) a description of the mechanism by which participating entities will have an opportunity
to participate in matters of policy and operation;

(9) a copy of any pertinent agreements between the health information organization and
insurers, including liability insurers, demonstrating coverage is in place;

(10) a copy of the conflict of interest policy that applies to all members of the board of
directors or equivalent governing body and the principal officers of the health information
organization; and

(11) other information as the commissioner may reasonably require to be provided.

(b) Within 45 days after the receipt of the application for a certificate of authority, the
commissioner shall determine whether or not the application submitted meets the
requirements for completion in paragraph (a), and notify the applicant of any further
information required for the application to be processed.

(c) Within 90 days after the receipt of a complete application for a certificate of authority,
the commissioner shall issue a certificate of authority to the applicant if the commissioner
determines that the applicant meets the minimum criteria requirements of subdivision 2 deleted text begin for
health data intermediaries or subdivision 3 for health information organizations deleted text end . If the
commissioner determines that the applicant is not qualified, the commissioner shall notify
the applicant and specify the reasons for disqualification.

(d) Upon being granted a certificate of authority to operate as a state-certified health
information organization deleted text begin or state-certified health data intermediary deleted text end , the organization must
operate in compliance with the provisions of this section. Noncompliance may result in the
imposition of a fine or the suspension or revocation of the certificate of authority according
to section 62J.4982.

Subd. 5.

Reciprocal agreements between health information deleted text begin exchange entities deleted text end new text begin
organizations new text end .

(a) Reciprocal agreements between two health information organizations
deleted text begin or between a health information organization and a health data intermediary deleted text end must include
a fair and equitable model for charges between the entities that:

(1) does not impede the secure transmission of clinical transactions;

(2) does not charge a fee for the exchange of deleted text begin meaningful use deleted text end transactions transmitted
according to nationally recognized standards where no additional value-added service is
rendered to the sending or receiving health information organization deleted text begin or health data
intermediary deleted text end either directly or on behalf of the client;

(3) is consistent with fair market value and proportionately reflects the value-added
services accessed as a result of the agreement; and

(4) prevents health care stakeholders from being charged multiple times for the same
service.

(b) Reciprocal agreements must include comparable quality of service standards that
ensure equitable levels of services.

(c) Reciprocal agreements are subject to review and approval by the commissioner.

(d) Nothing in this section precludes a state-certified health information organization deleted text begin or
state-certified health data intermediary deleted text end from entering into contractual agreements for the
provision of value-added services deleted text begin beyond meaningful use transactions deleted text end .

Sec. 7.

Minnesota Statutes 2020, section 62J.4982, is amended to read:

62J.4982 ENFORCEMENT AUTHORITY; COMPLIANCE.

Subdivision 1.

Penalties and enforcement.

(a) The commissioner may, for any violation
of statute or rule applicable to a health information deleted text begin exchange service provider deleted text end new text begin organization new text end ,
levy an administrative penalty in an amount up to $25,000 for each violation. In determining
the level of an administrative penalty, the commissioner shall consider the following factors:

(1) the number of participating entities affected by the violation;

(2) the effect of the violation on participating entities' access to health information
exchange services;

(3) if only one participating entity is affected, the effect of the violation on the patients
of that entity;

(4) whether the violation is an isolated incident or part of a pattern of violations;

(5) the economic benefits derived by the health information organization deleted text begin or a health data
intermediary deleted text end by virtue of the violation;

(6) whether the violation hindered or facilitated an individual's ability to obtain health
care;

(7) whether the violation was intentional;

(8) whether the violation was beyond the direct control of the health information deleted text begin exchange
service provider deleted text end new text begin organization new text end ;

(9) any history of prior compliance with the provisions of this section, including
violations;

(10) whether and to what extent the health information deleted text begin exchange service provider deleted text end new text begin
organization new text end attempted to correct previous violations;

(11) how the health information deleted text begin exchange service provider deleted text end new text begin organization new text end responded to
technical assistance from the commissioner provided in the context of a compliance effort;
and

(12) the financial condition of the health information deleted text begin exchange service provider deleted text end new text begin
organization new text end including deleted text begin , deleted text end but not limited to deleted text begin , deleted text end whether the health information deleted text begin exchange service
provider deleted text end new text begin organization new text end had financial difficulties that affected its ability to comply or whether
the imposition of an administrative monetary penalty would jeopardize the ability of the
health information deleted text begin exchange service provider deleted text end new text begin organization new text end to continue to deliver health
information exchange services.

The commissioner shall give reasonable notice in writing to the health information
deleted text begin exchange service provider deleted text end new text begin organization new text end of the intent to levy the penalty and the reasons for
it. A health information deleted text begin exchange service provider deleted text end new text begin organization new text end may have 15 days within
which to contest whether the facts found constitute a violation of sections 62J.4981 and
62J.4982, according to the contested case and judicial review provisions of sections 14.57
to 14.69.

(b) If the commissioner has reason to believe that a violation of section 62J.4981 or
62J.4982 has occurred or is likely, the commissioner may confer with the persons involved
before commencing action under subdivision 2. The commissioner may notify the health
information deleted text begin exchange service provider deleted text end new text begin organization new text end and the representatives, or other persons
who appear to be involved in the suspected violation, to arrange a voluntary conference
with the alleged violators or their authorized representatives. The purpose of the conference
is to attempt to learn the facts about the suspected violation and, if it appears that a violation
has occurred or is threatened, to find a way to correct or prevent it. The conference is not
governed by any formal procedural requirements, and may be conducted as the commissioner
considers appropriate.

(c) The commissioner may issue an order directing a health information deleted text begin exchange service
provider deleted text end new text begin organization new text end or a representative of a health information deleted text begin exchange service provider deleted text end new text begin
organization new text end to cease and desist from engaging in any act or practice in violation of sections
62J.4981 and 62J.4982.

(d) Within 20 days after service of the order to cease and desist, a health information
deleted text begin exchange service provider deleted text end new text begin organization new text end may contest whether the facts found constitute a
violation of sections 62J.4981 and 62J.4982 according to the contested case and judicial
review provisions of sections 14.57 to 14.69.

(e) In the event of noncompliance with a cease and desist order issued under this
subdivision, the commissioner may institute a proceeding to obtain injunctive relief or other
appropriate relief in Ramsey County District Court.

Subd. 2.

Suspension or revocation of certificates of authority.

(a) The commissioner
may suspend or revoke a certificate of authority issued to a deleted text begin health data intermediary or deleted text end
health information organization under section 62J.4981 if the commissioner finds that:

(1) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end is operating
significantly in contravention of its basic organizational document, or in a manner contrary
to that described in and reasonably inferred from any other information submitted under
section 62J.4981, unless amendments to the submissions have been filed with and approved
by the commissioner;

(2) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end is unable to fulfill its
obligations to furnish comprehensive health information exchange services as required
under its health information exchange contract;

(3) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end is no longer financially
solvent or may not reasonably be expected to meet its obligations to participating entities;

(4) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end has failed to implement
the complaint system in a manner designed to reasonably resolve valid complaints;

(5) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end , or any person acting
with its sanction, has advertised or merchandised its services in an untrue, misleading,
deceptive, or unfair manner;

(6) the continued operation of the health information deleted text begin exchange service provider deleted text end new text begin
organization new text end would be hazardous to its participating entities or the patients served by the
participating entities; or

(7) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end has otherwise failed
to substantially comply with section 62J.4981 or with any other statute or administrative
rule applicable to health information exchange service providers, or has submitted false
information in any report required under sections 62J.498 to 62J.4982.

(b) A certificate of authority shall be suspended or revoked only after meeting the
requirements of subdivision 3.

(c) If the certificate of authority of a health information deleted text begin exchange service provider deleted text end new text begin
organization new text end is suspended, the health information deleted text begin exchange service provider deleted text end new text begin organization new text end
shall not, during the period of suspension, enroll any additional participating entities, and
shall not engage in any advertising or solicitation.

(d) If the certificate of authority of a health information deleted text begin exchange service provider deleted text end new text begin
organization new text end is revoked, the organization shall proceed, immediately following the effective
date of the order of revocation, to wind up its affairs, and shall conduct no further business
except as necessary to the orderly conclusion of the affairs of the organization. The
organization shall engage in no further advertising or solicitation. The commissioner may,
by written order, permit further operation of the organization as the commissioner finds to
be in the best interest of participating entities, to the end that participating entities will be
given the greatest practical opportunity to access continuing health information exchange
services.

Subd. 3.

Denial, suspension, and revocation; administrative procedures.

(a) When
the commissioner has cause to believe that grounds for the denial, suspension, or revocation
of a certificate of authority exist, the commissioner shall notify the health information
deleted text begin exchange service provider deleted text end new text begin organization new text end in writing stating the grounds for denial, suspension,
or revocation and setting a time within 20 days for a hearing on the matter.

(b) After a hearing before the commissioner at which the health information deleted text begin exchange
service provider deleted text end new text begin organization new text end may respond to the grounds for denial, suspension, or
revocation, or upon the failure of the health information exchange service provider to appear
at the hearing, the commissioner shall take action as deemed necessary and shall issue
written findings and mail them to the health information deleted text begin exchange service provider deleted text end new text begin
organization new text end .

(c) If suspension, revocation, or administrative penalty is proposed according to this
section, the commissioner must deliver, or send by certified mail with return receipt
requested, to the health information deleted text begin exchange service provider deleted text end new text begin organization new text end written notice
of the commissioner's intent to impose a penalty. This notice of proposed determination
must include:

(1) a reference to the statutory basis for the penalty;

(2) a description of the findings of fact regarding the violations with respect to which
the penalty is proposed;

(3) the nature and amount of the proposed penalty;

(4) any circumstances described in subdivision 1, paragraph (a), that were considered
in determining the amount of the proposed penalty;

(5) instructions for responding to the notice, including a statement of the health
information deleted text begin exchange service provider's deleted text end new text begin organization's new text end right to a contested case proceeding
and a statement that failure to request a contested case proceeding within 30 calendar days
permits the imposition of the proposed penalty; and

(6) the address to which the contested case proceeding request must be sent.

Subd. 4.

Coordination.

The commissioner shall, to the extent possible, seek the advice
of the Minnesota e-Health Advisory Committee, in the review and update of criteria for the
certification and recertification of health information deleted text begin exchange service providers deleted text end new text begin
organizations new text end when implementing sections 62J.498 to 62J.4982.

Subd. 5.

Fees and monetary penalties.

(a) The commissioner shall assess fees on every
health information deleted text begin exchange service provider deleted text end new text begin organization new text end subject to sections 62J.4981 and
62J.4982 as follows:

(1) filing an application for certificate of authority to operate as a health information
organization, $7,000; new text begin and
new text end

(2) deleted text begin filing an application for certificate of authority to operate as a health data intermediary,
$7,000;
deleted text end

deleted text begin (3) deleted text end annual health information organization certificate fee, $7,000 deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (4) annual health data intermediary certificate fee, $7,000.
deleted text end

(b) Fees collected under this section shall be deposited in the state treasury and credited
to the state government special revenue fund.

(c) Administrative monetary penalties imposed under this subdivision shall be credited
to an account in the special revenue fund and are appropriated to the commissioner for the
purposes of sections 62J.498 to 62J.4982.

Sec. 8.

Minnesota Statutes 2020, section 144.1205, subdivision 2, is amended to read:

Subd. 2.

new text begin Initial and new text end annual fee.

new text begin (a) A licensee must pay an initial fee that is equivalent
to the annual fee upon issuance of the initial license.
new text end

new text begin (b) new text end A licensee must pay an annual fee at least 60 days before the anniversary date of the
issuance of the license. The annual fee is as follows:

TYPE		deleted text begin ANNUAL deleted text end new text begin LICENSE new text end FEE
Academic broad scope - type A new text begin , B, or C new text end		deleted text begin $19,920 deleted text end new text begin $25,896 new text end
deleted text begin Academic broad scope - type B deleted text end		deleted text begin 19,920 deleted text end
deleted text begin Academic broad scope - type C deleted text end		deleted text begin 19,920 deleted text end
new text begin Academic broad scope - type A, B, or C (4-8 locations) new text end		new text begin $31,075 new text end
new text begin Academic broad scope - type A, B, or C (9 or more locations) new text end		new text begin $36,254 new text end
Medical broad scope - type A		deleted text begin 19,920 deleted text end new text begin $25,896 new text end
new text begin Medical broad scope- type A (4-8 locations) new text end		new text begin $31,075 new text end
new text begin Medical broad scope- type A (9 or more locations) new text end		new text begin $36,254 new text end
deleted text begin Medical institution - diagnostic and therapeutic deleted text end		deleted text begin 3,680 deleted text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies new text end		new text begin $4,784 new text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies (4-8 locations) new text end		new text begin $5,740 new text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies (9 or more locations) new text end		new text begin $6,697 new text end
deleted text begin Medical institution - diagnostic (no written directives) deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Medical private practice - diagnostic and therapeutic deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Medical private practice - diagnostic (no written directives) deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Eye applicators deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Nuclear medical vans deleted text end		deleted text begin 3,680 deleted text end
deleted text begin High dose rate afterloader deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Mobile high dose rate afterloader deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Medical therapy - other emerging technology deleted text end		deleted text begin 3,680 deleted text end
Teletherapy		deleted text begin 8,960 deleted text end new text begin $11,648 new text end
Gamma knife		deleted text begin 8,960 deleted text end new text begin $11,648 new text end
Veterinary medicine		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
In vitro testing lab		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
Nuclear pharmacy		deleted text begin 8,800 deleted text end new text begin $11,440 new text end
new text begin Nuclear pharmacy (5 or more locations) new text end		new text begin $13,728 new text end
Radiopharmaceutical distribution (10 CFR 32.72)		deleted text begin 3,840 deleted text end new text begin $4,992 new text end
Radiopharmaceutical processing and distribution (10 CFR 32.72)		deleted text begin 8,800 deleted text end new text begin $11,440 new text end
new text begin Radiopharmaceutical processing and distribution (10 CFR 32.72) (5 or more locations) new text end		new text begin $13,728 new text end
Medical sealed sources - distribution (10 CFR 32.74)		deleted text begin 3,840 deleted text end new text begin $4,992 new text end
Medical sealed sources - processing and distribution (10 CFR 32.74)		deleted text begin 8,800 deleted text end new text begin $11,440 new text end
new text begin Medical sealed sources - processing and distribution (10 CFR 32.74) (5 or more locations) new text end		new text begin $13,728 new text end
Well logging - sealed sources		deleted text begin 3,760 deleted text end new text begin $4,888 new text end
Measuring systems - new text begin ( new text end fixed gauge new text begin , portable gauge, gas chromatograph, other) new text end		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
deleted text begin Measuring systems - portable gauge deleted text end		deleted text begin 2,000 deleted text end
new text begin Measuring systems - (fixed gauge, portable gauge, gas chromatograph, other) (4-8 locations) new text end		new text begin $3,120 new text end
new text begin Measuring systems - (fixed gauge, portable gauge, gas chromatograph, other) (9 or more locations) new text end		new text begin $3,640 new text end
X-ray fluorescent analyzer		deleted text begin 1,520 deleted text end new text begin $1,976 new text end
deleted text begin Measuring systems - gas chromatograph deleted text end		deleted text begin 2,000 deleted text end
deleted text begin Measuring systems - other deleted text end		deleted text begin 2,000 deleted text end
deleted text begin Broad scope deleted text end Manufacturing and distribution - type A new text begin broad scope new text end		deleted text begin 19,920 deleted text end new text begin $25,896 new text end
new text begin Manufacturing and distribution - type A broad scope (4-8 locations) new text end		new text begin $31,075 new text end
new text begin Manufacturing and distribution - type A broad scope (9 or more locations) new text end		new text begin $36,254 new text end
deleted text begin Broad scope deleted text end Manufacturing and distribution - type B new text begin or C broad scope new text end		deleted text begin 17,600 deleted text end new text begin $22,880 new text end
deleted text begin Broad scope Manufacturing and distribution - type C deleted text end		deleted text begin 17,600 deleted text end
new text begin Manufacturing and distribution - type B or C broad scope (4-8 locations) new text end		new text begin $27,456 new text end
new text begin Manufacturing and distribution - type B or C broad scope (9 or more locations) new text end		new text begin $32,032 new text end
Manufacturing and distribution - other		deleted text begin 5,280 deleted text end new text begin $6,864 new text end
new text begin Manufacturing and distribution - other (4-8 locations) new text end		new text begin $8,236 new text end
new text begin Manufacturing and distribution - other (9 or more locations) new text end		new text begin $9,609 new text end
Nuclear laundry		deleted text begin 18,640 deleted text end new text begin $24,232 new text end
Decontamination services		deleted text begin 4,960 deleted text end new text begin $6,448 new text end
Leak test services only		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
Instrument calibration service only deleted text begin , less than 100 curies deleted text end		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
deleted text begin Instrument calibration service only, 100 curies or more deleted text end		deleted text begin 2,000 deleted text end
Service, maintenance, installation, source changes, etc.		deleted text begin 4,960 deleted text end new text begin $6,448 new text end
Waste disposal service, prepackaged only		deleted text begin 6,000 deleted text end new text begin $7,800 new text end
Waste disposal		deleted text begin 8,320 deleted text end new text begin $10,816 new text end
Distribution - general licensed devices (sealed sources)		deleted text begin 1,760 deleted text end new text begin $2,288 new text end
Distribution - general licensed material (unsealed sources)		deleted text begin 1,120 deleted text end new text begin $1,456 new text end
Industrial radiography - fixed new text begin or temporary new text end location		deleted text begin 9,840 deleted text end new text begin $12,792 new text end
deleted text begin Industrial radiography - temporary job sites deleted text end		deleted text begin 9,840 deleted text end
new text begin Industrial radiography - fixed or temporary location (5 or more locations) new text end		new text begin $16,629 new text end
Irradiators, self-shielding deleted text begin , less than 10,000 curies deleted text end		deleted text begin 2,880 deleted text end new text begin $3,744 new text end
Irradiators, other, less than 10,000 curies		deleted text begin 5,360 deleted text end new text begin $6,968 new text end
deleted text begin Irradiators, self-shielding, 10,000 curies or more deleted text end		deleted text begin 2,880 deleted text end
Research and development - type A new text begin , B, or C new text end broad scope		deleted text begin 9,520 deleted text end new text begin $12,376 new text end
deleted text begin Research and development - type B broad scope deleted text end		deleted text begin 9,520 deleted text end
deleted text begin Research and development - type C broad scope deleted text end		deleted text begin 9,520 deleted text end
new text begin Research and development - type A, B, or C broad scope (4-8 locations) new text end		new text begin $14,851 new text end
new text begin Research and development - type A, B, or C broad scope (9 or more locations) new text end		new text begin $17,326 new text end
Research and development - other		deleted text begin 4,480 deleted text end new text begin $5,824 new text end
Storage - no operations		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
Source material - shielding		deleted text begin 584 deleted text end new text begin $759 new text end
Special nuclear material plutonium - neutron source in device		deleted text begin 3,680 deleted text end new text begin $4,784 new text end
Pacemaker by-product and/or special nuclear material - medical (institution)		deleted text begin 3,680 deleted text end new text begin $4,784 new text end
Pacemaker by-product and/or special nuclear material - manufacturing and distribution		deleted text begin 5,280 deleted text end new text begin $6,864 new text end
Accelerator-produced radioactive material		deleted text begin 3,840 deleted text end new text begin $4,992 new text end
Nonprofit educational institutions		deleted text begin 300 deleted text end new text begin $500 new text end
deleted text begin General license registration deleted text end		deleted text begin 150 deleted text end

Sec. 9.

Minnesota Statutes 2020, section 144.1205, subdivision 4, is amended to read:

Subd. 4.

new text begin Initial and renewal new text end application fee.

A licensee must pay an new text begin initial and a
renewal new text end application fee deleted text begin as follows: deleted text end new text begin according to this subdivision.
new text end

TYPE	APPLICATION FEE
Academic broad scope - type A new text begin , B, or C new text end		deleted text begin $ 5,920 deleted text end new text begin $6,808 new text end
deleted text begin Academic broad scope - type B deleted text end		deleted text begin 5,920 deleted text end
deleted text begin Academic broad scope - type C deleted text end		deleted text begin 5,920 deleted text end
Medical broad scope - type A		deleted text begin 3,920 deleted text end new text begin $4,508 new text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies new text end		new text begin $1,748 new text end
deleted text begin Medical institution - diagnostic and therapeutic deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Medical institution - diagnostic (no written directives) deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Medical private practice - diagnostic and therapeutic deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Medical private practice - diagnostic (no written directives) deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Eye applicators deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Nuclear medical vans deleted text end		deleted text begin 1,520 deleted text end
deleted text begin High dose rate afterloader deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Mobile high dose rate afterloader deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Medical therapy - other emerging technology deleted text end		deleted text begin 1,520 deleted text end
Teletherapy		deleted text begin 5,520 deleted text end new text begin $6,348 new text end
Gamma knife		deleted text begin 5,520 deleted text end new text begin $6,348 new text end
Veterinary medicine		deleted text begin 960 deleted text end new text begin $1,104 new text end
In vitro testing lab		deleted text begin 960 deleted text end new text begin $1,104 new text end
Nuclear pharmacy		deleted text begin 4,880 deleted text end new text begin $5,612 new text end
Radiopharmaceutical distribution (10 CFR 32.72)		deleted text begin 2,160 deleted text end new text begin $2,484 new text end
Radiopharmaceutical processing and distribution (10 CFR 32.72)		deleted text begin 4,880 deleted text end new text begin $5,612 new text end
Medical sealed sources - distribution (10 CFR 32.74)		deleted text begin 2,160 deleted text end new text begin $2,484 new text end
Medical sealed sources - processing and distribution (10 CFR 32.74)		deleted text begin 4,880 deleted text end new text begin $5,612 new text end
Well logging - sealed sources		deleted text begin 1,600 deleted text end new text begin $1,840 new text end
Measuring systems - new text begin ( new text end fixed gauge new text begin , portable gauge, gas chromatograph, other) new text end		deleted text begin 960 deleted text end new text begin $1,104 new text end
deleted text begin Measuring systems - portable gauge deleted text end		deleted text begin 960 deleted text end
X-ray fluorescent analyzer		deleted text begin 584 deleted text end new text begin $671 new text end
deleted text begin Measuring systems - gas chromatograph deleted text end		deleted text begin 960 deleted text end
deleted text begin Measuring systems - other deleted text end		deleted text begin 960 deleted text end
deleted text begin Broad scope deleted text end Manufacturing and distribution - type A new text begin , B, and C broad scope new text end		deleted text begin 5,920 deleted text end new text begin $6,854 new text end
deleted text begin Broad scope manufacturing and distribution - type B deleted text end		deleted text begin 5,920 deleted text end
deleted text begin Broad scope manufacturing and distribution - type C deleted text end		deleted text begin 5,920 deleted text end
Manufacturing and distribution - other		deleted text begin 2,320 deleted text end new text begin $2,668 new text end
Nuclear laundry		deleted text begin 10,080 deleted text end new text begin $11,592 new text end
Decontamination services		deleted text begin 2,640 deleted text end new text begin $3,036 new text end
Leak test services only		deleted text begin 960 deleted text end new text begin $1,104 new text end
Instrument calibration service only deleted text begin , less than 100 curies deleted text end		deleted text begin 960 deleted text end new text begin $1,104 new text end
deleted text begin Instrument calibration service only, 100 curies or more deleted text end		deleted text begin 960 deleted text end
Service, maintenance, installation, source changes, etc.		deleted text begin 2,640 deleted text end new text begin $3,036 new text end
Waste disposal service, prepackaged only		deleted text begin 2,240 deleted text end new text begin $2,576 new text end
Waste disposal		deleted text begin 1,520 deleted text end new text begin $1,748 new text end
Distribution - general licensed devices (sealed sources)		deleted text begin 880 deleted text end new text begin $1,012 new text end
Distribution - general licensed material (unsealed sources)		deleted text begin 520 deleted text end new text begin $598 new text end
Industrial radiography - fixed new text begin or temporary new text end location		deleted text begin 2,640 deleted text end new text begin $3,036 new text end
deleted text begin Industrial radiography - temporary job sites deleted text end		deleted text begin 2,640 deleted text end
Irradiators, self-shielding deleted text begin , less than 10,000 curies deleted text end		deleted text begin 1,440 deleted text end new text begin $1,656 new text end
Irradiators, other, less than 10,000 curies		deleted text begin 2,960 deleted text end new text begin $3,404 new text end
deleted text begin Irradiators, self-shielding, 10,000 curies or more deleted text end		deleted text begin 1,440 deleted text end
Research and development - type A new text begin , B, or C new text end broad scope		deleted text begin 4,960 deleted text end new text begin $5,704 new text end
deleted text begin Research and development - type B broad scope deleted text end		deleted text begin 4,960 deleted text end
deleted text begin Research and development - type C broad scope deleted text end		deleted text begin 4,960 deleted text end
Research and development - other		deleted text begin 2,400 deleted text end new text begin $2,760 new text end
Storage - no operations		deleted text begin 960 deleted text end new text begin $1,104 new text end
Source material - shielding		deleted text begin 136 deleted text end new text begin $156 new text end
Special nuclear material plutonium - neutron source in device		deleted text begin 1,200 deleted text end new text begin $1,380 new text end
Pacemaker by-product and/or special nuclear material - medical (institution)		deleted text begin 1,200 deleted text end new text begin $1,380 new text end
Pacemaker by-product and/or special nuclear material - manufacturing and distribution		deleted text begin 2,320 deleted text end new text begin $2,668 new text end
Accelerator-produced radioactive material		deleted text begin 4,100 deleted text end new text begin $4,715 new text end
Nonprofit educational institutions		deleted text begin 300 deleted text end new text begin $345 new text end
deleted text begin General license registration deleted text end		deleted text begin 0 deleted text end
deleted text begin Industrial radiographer certification deleted text end		deleted text begin 150 deleted text end

Sec. 10.

Minnesota Statutes 2020, section 144.1205, subdivision 8, is amended to read:

Subd. 8.

Reciprocity fee.

A licensee submitting an application for reciprocal recognition
of a materials license issued by another agreement state or the United States Nuclear
Regulatory Commission for a period of 180 days or less during a calendar year must pay
deleted text begin $1,200 deleted text end new text begin $2,400 new text end . For a period of 181 days or more, the licensee must obtain a license under
subdivision 4.

Sec. 11.

Minnesota Statutes 2020, section 144.1205, subdivision 9, is amended to read:

Subd. 9.

Fees for license amendments.

A licensee must pay a fee of deleted text begin $300 deleted text end new text begin $600 new text end to
amend a license as follows:

(1) to amend a license requiring review including, but not limited to, addition of isotopes,
procedure changes, new authorized users, or a new radiation safety officer; and

(2) to amend a license requiring review and a site visit including, but not limited to,
facility move or addition of processes.

Sec. 12.

Minnesota Statutes 2020, section 144.1205, is amended by adding a subdivision
to read:

new text begin Subd. 10. new text end

new text begin Fees for general license registrations. new text end

new text begin A person required to register generally
licensed devices according to Minnesota Rules, part 4731.3215, must pay an annual
registration fee of $450.
new text end

Sec. 13.

Minnesota Statutes 2020, section 144.125, subdivision 1, is amended to read:

Subdivision 1.

Duty to perform testing.

(a) It is the duty of (1) the administrative officer
or other person in charge of each institution caring for infants 28 days or less of age, (2) the
person required in pursuance of the provisions of section 144.215, to register the birth of a
child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have
administered to every infant or child in its care tests for heritable and congenital disorders
according to subdivision 2 and rules prescribed by the state commissioner of health.

(b) Testing, recording of test results, reporting of test results, and follow-up of infants
with heritable congenital disorders, including hearing loss detected through the early hearing
detection and intervention program in section 144.966, shall be performed at the times and
in the manner prescribed by the commissioner of health.

(c) The fee to support the newborn screening program, including tests administered
under this section and section 144.966, shall be deleted text begin $135 deleted text end new text begin $177 new text end per specimen. This fee amount
shall be deposited in the state treasury and credited to the state government special revenue
fund.

(d) The fee to offset the cost of the support services provided under section 144.966,
subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
and credited to the general fund.

Sec. 14.

Minnesota Statutes 2020, section 145.901, is amended to read:

145.901 MATERNAL new text begin MORBIDITY AND new text end DEATH STUDIES.

Subdivision 1.

Purpose.

The commissioner of health may conduct maternal new text begin morbidity
and new text end death studies to assist the planning, implementation, and evaluation of medical, health,
and welfare service systems and to reduce the numbers of preventable new text begin adverse new text end maternal
new text begin outcomes and new text end deaths in Minnesota.

Subd. 2.

Access to data.

(a) The commissioner of health has access to medical data as
defined in section 13.384, subdivision 1, paragraph (b), medical examiner data as defined
in section 13.83, subdivision 1, and health records created, maintained, or stored by providers
as defined in section 144.291, subdivision 2, paragraph (i), without the consent of the subject
of the data, and without the consent of the parent, spouse, other guardian, or legal
representative of the subject of the data, when the subject of the data is a woman who died
new text begin or experienced morbidities new text end during a pregnancy or within 12 months of a fetal death, a live
birth, or other termination of a pregnancy.

The commissioner has access only to medical data and health records related to new text begin maternal
morbidity and new text end deaths that occur on or after July 1, 2000 new text begin , including the names of the providers;
clinics; or other health services, such as family home visiting, WIC, prescription drug
monitoring programs, and behavioral health services, where care was received before,
during, or relating to the pregnancy or death. The commissioner has access to records
maintained by the medical examiner, coroner, or hospitals or hospital discharge data for the
purpose of providing the name and location of any pre-pregnancy, prenatal, or other care
up to one year after the end of the pregnancy received by the subject of the data new text end .

new text begin The subject of the data or the subject's parent, spouse, other guardian, or legal
representative may voluntarily participate in an informant interview with staff on behalf of
the commissioner related to the maternal experience. If the subject of the data or the subject's
parent, spouse, other guardian, or legal representative agrees to an interview, the
commissioner may compensate the interviewee for time and other expenses related to the
interview.
new text end

(b) The provider or responsible authority that creates, maintains, or stores the data shall
furnish the data upon the request of the commissioner. The provider or responsible authority
may charge a fee for providing the data, not to exceed the actual cost of retrieving and
duplicating the data.

(c) The commissioner shall make a good faith reasonable effort to notify the new text begin subject of
the data, or the subject's new text end parent, spouse, other guardian, or legal representative deleted text begin of the subject
of the data deleted text end before collecting data on the subject. For purposes of this paragraph, "reasonable
effort" means one notice is sent by certified mail to the last known address of the new text begin subject
of the data, or the subject's new text end parent, spouse, guardian, or legal representative informing the
recipient of the data collection and offering a public health nurse support visit if desired.

(d) The commissioner does not have access to coroner or medical examiner data that
are part of an active investigation as described in section 13.83.

new text begin (e) The commissioner may request and receive from a coroner or medical examiner the
name of the health care provider that provided prenatal, postpartum, and other health services
to the subject of the data.
new text end

new text begin (f) The commissioner may access Department of Human Services data to identify sources
of care and services to assist with the evaluation of welfare systems, including housing and
Healthy Start, to reduce preventable maternal deaths.
new text end

new text begin (g) The commissioner may request and receive law enforcement reports or incident
reports related to the subject of the data.
new text end

Subd. 3.

Management of records.

After the commissioner has collected all data about
a subject of a new text begin morbidity or new text end maternal death study needed to perform the study, the data from
source records obtained under subdivision 2, other than data identifying the subject, must
be transferred to separate records to be maintained by the commissioner. Notwithstanding
section 138.17, after the data have been transferred, all source records obtained under
subdivision 2 possessed by the commissioner must be destroyed.

Subd. 4.

Classification of data.

(a) Data provided to the commissioner from source
records under subdivision 2, including identifying information on individual providers, data
subjects, or their children, and data derived by the commissioner under subdivision 3 for
the purpose of carrying out maternal new text begin morbidity and new text end death studies, are classified as confidential
data on individuals or confidential data on decedents, as defined in sections 13.02, subdivision
3, and 13.10, subdivision 1, paragraph (a).

(b) Information classified under paragraph (a) shall not be subject to discovery or
introduction into evidence in any administrative, civil, or criminal proceeding. Such
information otherwise available from an original source shall not be immune from discovery
or barred from introduction into evidence merely because it was utilized by the commissioner
in carrying out maternal new text begin morbidity and new text end death studies.

(c) Summary data on maternal new text begin morbidity and new text end death studies created by the commissioner,
which does not identify individual data subjects or individual providers, shall be public in
accordance with section 13.05, subdivision 7.

new text begin (d) Data provided by the commissioner of human services to the commissioner of health
under this section retains the same classification the data held when retained by the
commissioner of human services, as required under section 13.03, subdivision 4, paragraph
(c).
new text end

Sec. 15.

new text begin [145.9011] FETAL AND INFANT DEATH STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin The commissioner of health may conduct fetal and infant death
studies to assist the planning, implementation, and evaluation of medical, health, and welfare
service systems and to reduce the numbers of preventable fetal and infant deaths in
Minnesota.
new text end

new text begin Subd. 2. new text end

new text begin Access to data. new text end

new text begin (a) The commissioner of health has access to medical data as
defined in section 13.384, subdivision 1, paragraph (b), medical examiner data as defined
in section 13.83, subdivision 1, and health records created, maintained, or stored by providers
as defined in section 144.291, subdivision 2, paragraph (i), without the consent of the subject
of the data, and without the consent of the parent, other guardian, or legal representative of
the subject of the data, when the subject of the data is:
new text end

new text begin (1) a live-born infant that died within the first year of life;
new text end

new text begin (2) a fetal death which meets the criteria required for reporting as defined in section
144.222; or
new text end

new text begin (3) the biological mother of a fetus or infant as described in clause (1) or (2).
new text end

new text begin The commissioner has access only to medical data and health records related to fetal or
infant deaths that occur on or after July 1, 2000, including the names of the providers and
clinics where care was received before, during, or relating to the pregnancy or fetal death
or death of the infant. The commissioner has access to records maintained by the medical
examiner, coroner, or hospitals for the purpose of providing the name and location of any
pre-pregnancy, prenatal, postpartum, or pediatric care received by the subject of the data
and biological mother.
new text end

new text begin (b) The provider or responsible authority that creates, maintains, or stores the data shall
furnish the data upon the request of the commissioner. The provider or responsible authority
may charge a fee for providing the data, not to exceed the actual cost of retrieving and
duplicating the data.
new text end

new text begin (c) The commissioner shall make a good faith reasonable effort to notify the parent,
spouse, other guardian, or legal representative of the subject of the data before collecting
data on the subject. For purposes of this paragraph, "reasonable effort" means one notice
is sent by certified mail to the last-known address of the parent, guardian, or legal
representative informing the recipient of the data collection and offering a public health
nurse support visit if desired.
new text end

new text begin (d) The commissioner does not have access to coroner or medical examiner data that
are part of an active investigation as described in section 13.83.
new text end

new text begin (e) The commissioner may request and receive from the coroner or medical examiner
the name of the health care provider that provided prenatal, postpartum, pediatric, and other
health services to the subject of the data and biological mother.
new text end

new text begin (f) The commissioner shall have access to Department of Human Services data to identify
sources of care and services to assist with evaluation of welfare systems to reduce preventable
fetal and infant deaths.
new text end

new text begin Subd. 3. new text end

new text begin Management of records. new text end

new text begin After the commissioner has collected all data on a
subject of a fetal or infant death study that is needed to perform the study, the data from
source records obtained under subdivision 2, other than data identifying the subject, must
be transferred to separate records to be maintained by the commissioner. Notwithstanding
section 138.17, after the data have been transferred, all source records obtained under
subdivision 2 possessed by the commissioner must be destroyed.
new text end

new text begin Subd. 4. new text end

new text begin Classification of data. new text end

new text begin (a) Data provided to the commissioner from source
records under subdivision 2, including identifying information on individual providers, data
subjects, or their family, and data derived by the commissioner under subdivision 3 for the
purpose of carrying out fetal or infant death studies, are classified as confidential data on
individuals or confidential data on decedents, as defined in sections 13.02, subdivision 3;
and 13.10, subdivision 1, paragraph (a).
new text end

new text begin (b) Information classified under paragraph (a) shall not be subject to discovery or
introduction into evidence in any administrative, civil, or criminal proceeding. Such
information otherwise available from an original source shall not be immune from discovery
or barred from introduction into evidence merely because it was utilized by the commissioner
in carrying out fetal or infant death studies.
new text end

new text begin (c) Summary data on fetal and infant death studies created by the commissioner, which
do not identify individual data subjects or individual providers, shall be public in accordance
with section 13.05, subdivision 7.
new text end

new text begin (d) Data provided by the commissioner of human services to the commissioner of health
under this section retains the same classification the data held when retained by the
commissioner of human services, as required under section 13.03, subdivision 4, paragraph
(c).
new text end

new text begin Subd. 5. new text end

new text begin Fetal and infant mortality reviews. new text end

new text begin The commissioner of health shall convene
case review committees to conduct death study reviews, make recommendations, and
publicly share summary information, especially for racial and ethnic groups, including
American Indians and African Americans, that experience significantly disparate rates of
fetal and infant mortality. The case review committees may include but are not limited to
medical examiners or coroners, health care institutions that provide care to pregnant people
and infants, obstetric and pediatric practitioners, Medicaid representatives, state agency
women and infant program representatives, and individuals from the communities with
disparate rates and other subject matter experts as appropriate. The case review committees
shall review data from source records obtained under subdivision 2, other than data
identifying the subject or the provider. Every three years beginning December 1, 2022, the
case review committees shall provide findings and recommendations to the Maternal and
Child Health Advisory Task Force and the commissioner from review of fetal and infant
deaths and provide specific recommendations designed to reduce disparities in fetal and
infant deaths.
new text end

new text begin Subd. 6. new text end

new text begin Community action committees. new text end

new text begin (a) The commissioner shall convene
community action committees to implement the priority recommendations from the case
review committees.
new text end

new text begin (b) Members of the community action committees may include but are not limited to
local, tribal, and state government representatives; local hospital or health care administration;
local public health; nonprofit organizations serving the community's mothers, infants, and
fathers; state maternal and child health consultants; case review committee members;
representatives of communities disproportionately affected by fetal and infant death;
Minnesotans with lived experiences; and others based on recommendations.
new text end

Sec. 16.

Minnesota Statutes 2020, section 326.71, subdivision 4, is amended to read:

Subd. 4.

Asbestos-related work.

"Asbestos-related work" means the enclosure, removal,
or encapsulation of asbestos-containing material in a quantity that meets or exceeds 260
linear feet of friable asbestos-containing material on pipes, 160 square feet of friable
asbestos-containing material on other facility components, or, if linear feet or square feet
cannot be measured, a total of 35 cubic feet of friable asbestos-containing material on or
off all facility components in one facility. In the case of single or multifamily residences,
"asbestos-related work" also means the enclosure, removal, or encapsulation of greater than
ten but less than 260 linear feet of friable asbestos-containing material on pipes, greater
than six but less than 160 square feet of friable asbestos-containing material on other facility
components, or, if linear feet or square feet cannot be measured, greater than one cubic foot
but less than 35 cubic feet of friable asbestos-containing material on or off all facility
components in one facility. deleted text begin This provision excludes asbestos-containing floor tiles and
sheeting, roofing materials, siding, and all ceilings with asbestos-containing material in
single family residences and buildings with no more than four dwelling units. deleted text end
Asbestos-related work includes asbestos abatement area preparation; enclosure, removal,
or encapsulation operations; and an air quality monitoring specified in rule to assure that
the abatement and adjacent areas are not contaminated with asbestos fibers during the project
and after completion.

For purposes of this subdivision, the quantity of deleted text begin asbestos containing deleted text end material applies
separately for every project.

Sec. 17.

Minnesota Statutes 2020, section 326.75, subdivision 1, is amended to read:

Subdivision 1.

Licensing fee.

A person required to be licensed under section 326.72
shall, before receipt of the license and before causing asbestos-related work to be performed,
pay the commissioner an annual license fee of deleted text begin $100 deleted text end new text begin $105 new text end .

Sec. 18.

Minnesota Statutes 2020, section 326.75, subdivision 2, is amended to read:

Subd. 2.

Certification fee.

An individual required to be certified new text begin as an asbestos worker
or asbestos site supervisor new text end under section 326.73, subdivision 1, shall pay the commissioner
a certification fee of deleted text begin $50 deleted text end new text begin $52.50 new text end before the issuance of the certificate. deleted text begin The commissioner
may establish by rule fees required before the issuance of deleted text end new text begin An individual required to be
certified as an new text end asbestos inspector, asbestos management planner, and asbestos project
designer deleted text begin certificates required deleted text end under section 326.73, subdivisions 2, 3, and 4 new text begin , shall pay the
commissioner a certification fee of $105 before the issuance of the certificate new text end .

Sec. 19.

Minnesota Statutes 2020, section 326.75, subdivision 3, is amended to read:

Subd. 3.

Permit fee.

Five calendar days before beginning asbestos-related work, a person
shall pay a project permit fee to the commissioner equal to deleted text begin one deleted text end new text begin two new text end percent of the total costs
of the asbestos-related work. For asbestos-related work performed in single or multifamily
residences, of greater than ten but less than 260 linear feet of asbestos-containing material
on pipes, or greater than six but less than 160 square feet of asbestos-containing material
on other facility components, a person shall pay a project permit fee of $35 to the
commissioner.

ARTICLE 6

APPROPRIATIONS

Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS. new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the agencies
and for the purposes specified in this article. The appropriations are from the general fund,
or another named fund, and are available for the fiscal years indicated for each purpose.
The figures "2022" and "2023" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2022, or June 30, 2023, respectively.
"The first year" is fiscal year 2022. "The second year" is fiscal year 2023. "The biennium"
is fiscal years 2022 and 2023.
new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2022 new text end		new text begin 2023 new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin 4,232,594,000 new text end

new text begin $ new text end

new text begin 4,385,195,000 new text end

new text begin Appropriations by Fund new text end
	new text begin 2022 new text end	new text begin 2023 new text end
new text begin General new text end	new text begin 3,361,282,000 new text end	new text begin 3,535,836,000 new text end
new text begin State Government Special Revenue new text end	new text begin 4,174,000 new text end	new text begin 4,174,000 new text end
new text begin Health Care Access new text end	new text begin 867,038,000 new text end	new text begin 845,085,000 new text end
new text begin Federal TANF new text end	new text begin 100,000 new text end	new text begin 100,000 new text end

new text begin The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end

new text begin Subd. 2. new text end new text begin Information Technology new text end

new text begin (a) IT Appropriations Generally. This
appropriation includes funds for information
technology projects, services, and support.
Notwithstanding Minnesota Statutes, section
16E.0466, funding for information technology
project costs shall be incorporated into the
service level agreement and paid to the Office
of MN.IT Services by the Department of
Human Services under the rates and
mechanism specified in that agreement.
new text end

new text begin (b) Receipts for Systems Project.
Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, ISDS, METS, and SSIS must
be deposited in the state systems account
authorized in Minnesota Statutes, section
256.014. Money appropriated for computer
projects approved by the commissioner of the
Office of MN.IT Services, funded by the
legislature, and approved by the commissioner
of management and budget may be transferred
from one project to another and from
development to operations as the
commissioner of human services considers
necessary. Any unexpended balance in the
appropriation for these projects does not
cancel and is available for ongoing
development and operations.
new text end

new text begin Subd. 3. new text end new text begin Central Office; Operations new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 157,188,000 new text end	new text begin 161,099,000 new text end
new text begin State Government Special Revenue new text end	new text begin 4,174,000 new text end	new text begin 4,174,000 new text end
new text begin Health Care Access new text end	new text begin 20,709,000 new text end	new text begin 20,709,000 new text end
new text begin Federal TANF new text end	new text begin 100,000 new text end	new text begin 100,000 new text end

new text begin (a) Administrative Recovery; Set-Aside. The
commissioner may invoice local entities
through the SWIFT accounting system as an
alternative means to recover the actual cost of
administering the following provisions:
new text end

new text begin (1) Minnesota Statutes, section 125A.744,
subdivision 3;
new text end

new text begin (2) Minnesota Statutes, section 245.495,
paragraph (b);
new text end

new text begin (3) Minnesota Statutes, section 256B.0625,
subdivision 20, paragraph (k);
new text end

new text begin (4) Minnesota Statutes, section 256B.0924,
subdivision 6, paragraph (g);
new text end

new text begin (5) Minnesota Statutes, section 256B.0945,
subdivision 4, paragraph (d); and
new text end

new text begin (6) Minnesota Statutes, section 256F.10,
subdivision 6, paragraph (b).
new text end

new text begin (b) Base Level Adjustment. The general fund
base is $161,781,000 in fiscal year 2024 and
$161,934,000 in fiscal year 2025.
new text end

new text begin Subd. 4. new text end new text begin Central Office; Health Care new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 21,942,000 new text end	new text begin 22,360,000 new text end
new text begin Health Care Access new text end	new text begin 24,313,000 new text end	new text begin 24,313,000 new text end

new text begin (a) new text begin Case Management Benefit Study for
American Indians. new text end $200,000 in fiscal year
2022 is for a contract to conduct fiscal analysis
and development of standards for a targeted
case management benefit for American
Indians. The commissioner of human services
must consult the Minnesota Indian Affairs
Council in the development of any request for
proposal and in the evaluation of responses.
This is a onetime appropriation. Any
unencumbered balance remaining from the
first year does not cancel and is available for
the second year of the biennium.
new text end

new text begin (b) new text begin Base Level Adjustment. new text end The general fund
base is $23,453,000 in fiscal year 2024 and
$23,512,000 in fiscal year 2025.
new text end

new text begin Subd. 5. new text end new text begin Central Office; Community Supports new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 30,000 new text end	new text begin -0- new text end

new text begin Subd. 6. new text end new text begin Forecasted Programs; MinnesotaCare new text end

new text begin 207,373,000 new text end

new text begin 184,499,000 new text end

new text begin Generally. This appropriation is from the
health care access fund.
new text end

new text begin Subd. 7. new text end new text begin Forecasted Programs; Medical Assistance new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 3,173,949,000 new text end	new text begin 3,340,640,000 new text end
new text begin Health Care Access new text end	new text begin 611,178,000 new text end	new text begin 612,099,000 new text end

new text begin Behavioral Health Services. $1,000,000 in
fiscal year 2022 and $1,000,000 in fiscal year
2023 are for behavioral health services
provided by hospitals identified under
Minnesota Statutes, section 256.969,
subdivision 2b, paragraph (a), clause (4). The
increase in payments shall be made by
increasing the adjustment under Minnesota
Statutes, section 256.969, subdivision 2b,
paragraph (e), clause (2).
new text end

new text begin Subd. 8. new text end new text begin Grant Programs; Health Care Grants new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 4,811,000 new text end	new text begin 4,811,000 new text end
new text begin Health Care Access new text end	new text begin 3,465,000 new text end	new text begin 3,465,000 new text end

new text begin Integrated Care for High-Risk Pregnant
Women Grant Program. $1,100,000 in fiscal
year 2022 and $1,100,000 in fiscal year 2023
are for the integrated care for high-risk
pregnant women grant program under
Minnesota Statutes, section 256B.79.
new text end

new text begin Subd. 9. new text end new text begin Direct Care and Treatment - Operations new text end

new text begin 3,663,000 new text end

new text begin 7,326,000 new text end

Sec. 3.

Laws 2017, chapter 13, article 1, section 15, as amended by Laws 2017, First
Special Session chapter 6, article 5, section 10, and Laws 2019, First Special Session chapter
9, article 8, section 19, is amended to read:

Sec. 15. MINNESOTA PREMIUM SECURITY PLAN FUNDING.

(a) The Minnesota Comprehensive Health Association shall fund the operational and
administrative costs and reinsurance payments of the Minnesota security plan and association
using the following amounts deposited in the premium security plan account in Minnesota
Statutes, section 62E.25, subdivision 1, in the following order:

(1) any federal funding available;

(2) funds deposited under article 1, sections 12 and 13;

(3) any state funds from the health care access fund; and

(4) any state funds from the general fund.

(b) The association shall transfer from the premium security plan account any remaining
state funds not used for the Minnesota premium security plan by June 30, 2023, to the
commissioner of commerce. Any amount transferred to the commissioner of commerce
shall be deposited in the deleted text begin health care access fund in Minnesota Statutes, section 16A.724 deleted text end new text begin
general fund for the fiscal year starting on July 1, 2023 new text end .

(c) The Minnesota Comprehensive Health Association may not spend more than
$271,000,000 for benefit year 2018 and not more than $271,000,000 for benefit year 2019
for the operational and administrative costs of, and reinsurance payments under, the
Minnesota premium security plan.

Sec. 4. new text begin TRANSFERS; HUMAN SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Grants. new text end

new text begin The commissioner of human services, with the approval of the
commissioner of management and budget, may transfer unencumbered appropriation balances
for the biennium ending June 30, 2023, within fiscal years among the MFIP, general
assistance, medical assistance, MinnesotaCare, MFIP child care assistance under Minnesota
Statutes, section 119B.05, Minnesota supplemental aid program, group residential housing
program, the entitlement portion of Northstar Care for Children under Minnesota Statutes,
chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment
fund, and between fiscal years of the biennium. The commissioner shall inform the chairs
and ranking minority members of the senate Health and Human Services Finance Division
and the house of representatives Health and Human Services Finance Committee quarterly
about transfers made under this subdivision.
new text end

new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin Positions, salary money, and nonsalary administrative money
may be transferred within the Department of Human Services as the commissioners consider
necessary, with the advance approval of the commissioner of management and budget. The
commissioner shall inform the chairs and ranking minority members of the senate Health
and Human Services Finance Division and the house of representatives Health and Human
Services Finance Committee quarterly about transfers made under this subdivision.
new text end

Sec. 5. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end

new text begin The commissioners of health and human services shall not use indirect cost allocations
to pay for the operational costs of any program for which they are responsible.
new text end

Sec. 6. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2023, unless a
different expiration date is explicit.
new text end

Sec. 7. new text begin EFFECTIVE DATE.
new text end

new text begin This article is effective July 1, 2021, unless a different effective date is specified.
new text end

APPENDIX

Repealed Minnesota Statutes: 21-03536

245C.10 BACKGROUND STUDY; FEES.

Subd. 2.

Supplemental nursing services agencies.

The commissioner shall recover the cost of the background studies initiated by supplemental nursing services agencies registered under section 144A.71, subdivision 1, through a fee of no more than $20 per study charged to the agency. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 2a.

Occupations regulated by commissioner of health.

The commissioner shall set fees to recover the cost of combined background studies and criminal background checks initiated by applicants, licensees, and certified practitioners regulated under sections 148.511 to 148.5198 and chapter 153A. The fees collected under this subdivision shall be deposited in the special revenue fund and are appropriated to the commissioner for the purpose of conducting background studies and criminal background checks.

Subd. 3.

Personal care provider organizations.

The commissioner shall recover the cost of background studies initiated by a personal care provider organization under sections 256B.0651 to 256B.0654 and 256B.0659 through a fee of no more than $20 per study charged to the organization responsible for submitting the background study form. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 4.

Temporary personnel agencies, educational programs, and professional services agencies.

The commissioner shall recover the cost of the background studies initiated by temporary personnel agencies, educational programs, and professional services agencies that initiate background studies under section 245C.03, subdivision 4, through a fee of no more than $20 per study charged to the agency. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 5.

Adult foster care and family adult day services.

The commissioner shall recover the cost of background studies required under section 245C.03, subdivision 1, for the purposes of adult foster care and family adult day services licensing, through a fee of no more than $20 per study charged to the license holder. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 6.

Unlicensed home and community-based waiver providers of service to seniors and individuals with disabilities.

The commissioner shall recover the cost of background studies initiated by unlicensed home and community-based waiver providers of service to seniors and individuals with disabilities under section 256B.4912 through a fee of no more than $20 per study.

Subd. 7.

Private agencies.

The commissioner shall recover the cost of conducting background studies under section 245C.33 for studies initiated by private agencies for the purpose of adoption through a fee of no more than $70 per study charged to the private agency. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 8.

Children's therapeutic services and supports providers.

The commissioner shall recover the cost of background studies required under section 245C.03, subdivision 7, for the purposes of children's therapeutic services and supports under section 256B.0943, through a fee of no more than $20 per study charged to the license holder. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 9.

Human services licensed programs.

The commissioner shall recover the cost of background studies required under section 245C.03, subdivision 1, for all programs that are licensed by the commissioner, except child foster care when the applicant or license holder resides in the home where child foster care services are provided, family child care, child care centers, certified license-exempt child care centers, and legal nonlicensed child care authorized under chapter 119B, through a fee of no more than $20 per study charged to the license holder. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 9a.

Child care programs.

The commissioner shall recover the cost of a background study required for family child care, certified license-exempt child care centers, licensed child care centers, and legal nonlicensed child care providers authorized under chapter 119B through a fee of no more than $40 per study charged to the license holder. A fee of no more than $20 per study shall be charged for studies conducted under section 245C.05, subdivision 5a, paragraph (a). The fees collected under this subdivision are appropriated to the commissioner to conduct background studies.

Subd. 10.

Community first services and supports organizations.

The commissioner shall recover the cost of background studies initiated by an agency-provider delivering services under section 256B.85, subdivision 11, or a financial management services provider providing service functions under section 256B.85, subdivision 13, through a fee of no more than $20 per study, charged to the organization responsible for submitting the background study form. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 11.

Providers of housing support.

The commissioner shall recover the cost of background studies initiated by providers of housing support under section 256I.04 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 12.

Child protection workers or social services staff having responsibility for child protective duties.

The commissioner shall recover the cost of background studies initiated by county social services agencies and local welfare agencies for individuals who are required to have a background study under section 626.559, subdivision 1b, through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 13.

Providers of special transportation service.

The commissioner shall recover the cost of background studies initiated by providers of special transportation service under section 174.30 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

Subd. 14.

Children's residential facilities.

The commissioner shall recover the cost of background studies initiated by a licensed children's residential facility through a fee of no more than $51 per study. Fees collected under this subdivision are appropriated to the commissioner for purposes of conducting background studies.

Subd. 16.

Providers of housing support services.

The commissioner shall recover the cost of background studies initiated by providers of housing support services under section 256B.051 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

256B.0625 COVERED SERVICES.

Subd. 18c.

Nonemergency Medical Transportation Advisory Committee.

(a) The Nonemergency Medical Transportation Advisory Committee shall advise the commissioner on the administration of nonemergency medical transportation covered under medical assistance. The advisory committee shall meet at least quarterly the first year following January 1, 2015, and at least biannually thereafter and may meet more frequently as required by the commissioner. The advisory committee shall annually elect a chair from among its members, who shall work with the commissioner or the commissioner's designee to establish the agenda for each meeting. The commissioner, or the commissioner's designee, shall attend all advisory committee meetings.

(b) The Nonemergency Medical Transportation Advisory Committee shall advise and make recommendations to the commissioner on:

(1) updates to the nonemergency medical transportation policy manual;

(2) other aspects of the nonemergency medical transportation system, as requested by the commissioner; and

(3) other aspects of the nonemergency medical transportation system, as requested by:

(i) a committee member, who may request an item to be placed on the agenda for a future meeting. The request may be considered by the committee and voted upon. If the motion carries, the meeting agenda item may be developed for presentation to the committee; and

(ii) a member of the public, who may approach the committee by letter or e-mail requesting that an item be placed on a future meeting agenda. The request may be considered by the committee and voted upon. If the motion carries, the agenda item may be developed for presentation to the committee.

(c) The Nonemergency Medical Transportation Advisory Committee shall coordinate its activities with the Minnesota Council on Transportation Access established under section 174.285. The chair of the advisory committee, or the chair's designee, shall attend all meetings of the Minnesota Council on Transportation Access.

(d) The Nonemergency Medical Transportation Advisory Committee shall expire December 1, 2019.

Subd. 18d.

Advisory committee members.

(a) The Nonemergency Medical Transportation Advisory Committee consists of:

(1) four voting members who represent counties, utilizing the rural urban commuting area classification system. As defined in subdivision 17, these members shall be designated as follows:

(i) two counties within the 11-county metropolitan area;

(ii) one county representing the rural area of the state; and

(iii) one county representing the super rural area of the state.

The Association of Minnesota Counties shall appoint one county within the 11-county metropolitan area and one county representing the super rural area of the state. The Minnesota Inter-County Association shall appoint one county within the 11-county metropolitan area and one county representing the rural area of the state;

(2) three voting members who represent medical assistance recipients, including persons with physical and developmental disabilities, persons with mental illness, seniors, children, and low-income individuals;

(3) five voting members who represent providers that deliver nonemergency medical transportation services to medical assistance enrollees, one of whom is a taxicab owner or operator;

(4) two voting members of the house of representatives, one from the majority party and one from the minority party, appointed by the speaker of the house, and two voting members from the senate, one from the majority party and one from the minority party, appointed by the Subcommittee on Committees of the Committee on Rules and Administration;

(5) one voting member who represents demonstration providers as defined in section 256B.69, subdivision 2;

(6) one voting member who represents an organization that contracts with state or local governments to coordinate transportation services for medical assistance enrollees;

(7) one voting member who represents the Minnesota State Council on Disability;

(8) the commissioner of transportation or the commissioner's designee, who shall serve as a voting member;

(9) one voting member appointed by the Minnesota Ambulance Association; and

(10) one voting member appointed by the Minnesota Hospital Association.

(b) Members of the advisory committee shall not be employed by the Department of Human Services. Members of the advisory committee shall receive no compensation.

Subd. 18e.

Single administrative structure and delivery system.

The commissioner, in coordination with the commissioner of transportation, shall implement a single administrative structure and delivery system for nonemergency medical transportation, beginning the latter of the date the single administrative assessment tool required in this subdivision is available for use, as determined by the commissioner or by July 1, 2016.

In coordination with the Department of Transportation, the commissioner shall develop and authorize a web-based single administrative structure and assessment tool, which must operate 24 hours a day, seven days a week, to facilitate the enrollee assessment process for nonemergency medical transportation services. The web-based tool shall facilitate the transportation eligibility determination process initiated by clients and client advocates; shall include an accessible automated intake and assessment process and real-time identification of level of service eligibility; and shall authorize an appropriate and auditable mode of transportation authorization. The tool shall provide a single framework for reconciling trip information with claiming and collecting complaints regarding inappropriate level of need determinations, inappropriate transportation modes utilized, and interference with accessing nonemergency medical transportation. The web-based single administrative structure shall operate on a trial basis for one year from implementation and, if approved by the commissioner, shall be permanent thereafter. The commissioner shall seek input from the Nonemergency Medical Transportation Advisory Committee to ensure the software is effective and user-friendly and make recommendations regarding funding of the single administrative system.

Subd. 18h.

Managed care.

(a) The following subdivisions apply to managed care plans and county-based purchasing plans:

(1) subdivision 17, paragraphs (a), (b), (i), and (n);

(2) subdivision 18; and

(3) subdivision 18a.

(b) A nonemergency medical transportation provider must comply with the operating standards for special transportation service specified in sections 174.29 to 174.30 and Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire vehicles are exempt from the requirements in this paragraph.

256L.11 PROVIDER PAYMENT.

Subd. 6a.

Dental providers.

Effective for dental services provided to MinnesotaCare enrollees on or after January 1, 2018, 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.