3rd Engrossment - 92nd Legislature (2021 - 2022) Posted on 04/21/2021 12:36pm
A bill for an act
relating to state government; modifying provisions governing health, health care,
human services, human services licensing and background studies, health-related
licensing boards, prescription drugs, health insurance, telehealth, children and
family services, behavioral health, direct care and treatment, disability services
and continuing care for older adults, community supports, and chemical and mental
health services; establishing a budget for health and human services; making
forecast adjustments; making technical and conforming changes; requiring reports;
transferring money; appropriating money; amending Minnesota Statutes 2020,
sections 62A.04, subdivision 2; 62A.10, by adding a subdivision; 62A.15,
subdivision 4, by adding a subdivision; 62A.152, subdivision 3; 62A.3094,
subdivision 1; 62A.65, subdivision 1, by adding a subdivision; 62C.01, by adding
a subdivision; 62D.01, by adding a subdivision; 62D.095, subdivisions 2, 3, 4, 5;
62J.495, subdivisions 1, 2, 3, 4; 62J.497, subdivisions 1, 3; 62J.498; 62J.4981;
62J.4982; 62J.63, subdivisions 1, 2; 62Q.01, subdivision 2a; 62Q.02; 62Q.096;
62Q.46; 62Q.677, by adding a subdivision; 62Q.81; 62U.04, subdivisions 4, 5,
11; 62V.05, by adding a subdivision; 62W.11; 103H.201, subdivision 1; 119B.011,
subdivision 15; 119B.025, subdivision 4; 119B.03, subdivisions 4, 6; 119B.09,
subdivision 4; 119B.11, subdivision 2a; 119B.125, subdivision 1; 119B.13,
subdivisions 1, 1a, 6, 7; 119B.25, subdivision 3; 122A.18, subdivision 8; 136A.128,
subdivisions 2, 4; 144.0724, subdivisions 1, 2, 3a, 4, 5, 7, 8, 9, 12; 144.1205,
subdivisions 2, 4, 8, 9, by adding a subdivision; 144.125, subdivision 1; 144.1481,
subdivision 1; 144.1501, subdivisions 1, 2, 3; 144.1911, subdivision 6; 144.212,
by adding a subdivision; 144.225, subdivisions 2, 7; 144.226, by adding
subdivisions; 144.55, subdivisions 4, 6; 144.551, subdivision 1, by adding a
subdivision; 144.555; 144.651, subdivision 2; 144.9501, subdivision 17; 144.9502,
subdivision 3; 144.9504, subdivisions 2, 5; 144D.01, subdivision 4; 144G.08,
subdivision 7, as amended; 144G.54, subdivision 3; 144G.84; 145.893, subdivision
1; 145.894; 145.897; 145.899; 145.901, subdivisions 2, 4; 147.033; 148.90,
subdivision 2; 148.911; 148B.30, subdivision 1; 148B.31; 148B.51; 148B.5301,
subdivision 2; 148B.54, subdivision 2; 148E.010, by adding a subdivision;
148E.120, subdivision 2; 148E.130, subdivision 1, by adding a subdivision;
148F.11, subdivision 1; 151.01, by adding subdivisions; 151.071, subdivisions 1,
2; 151.37, subdivision 2; 151.555, subdivisions 1, 7, 11, by adding a subdivision;
152.01, subdivision 23; 152.02, subdivisions 2, 3; 152.11, subdivision 1a, by
adding a subdivision; 152.12, by adding a subdivision; 152.125, subdivision 3;
152.22, subdivisions 6, 11, by adding subdivisions; 152.23; 152.25, by adding a
subdivision; 152.26; 152.27, subdivisions 3, 4, 6; 152.28, subdivision 1; 152.29,
subdivisions 1, 3, by adding subdivisions; 152.31; 152.32, subdivision 3; 156.12,
subdivision 2; 171.07, by adding a subdivision; 174.30, subdivision 3; 245.462,
subdivisions 1, 6, 8, 9, 14, 16, 17, 18, 21, 23, by adding a subdivision; 245.4661,
subdivision 5; 245.4662, subdivision 1; 245.467, subdivisions 2, 3; 245.469,
subdivisions 1, 2; 245.470, subdivision 1; 245.4712, subdivision 2; 245.472,
subdivision 2; 245.4863; 245.4871, subdivisions 9a, 10, 11a, 17, 21, 26, 27, 29,
31, 32, 34, by adding a subdivision; 245.4876, subdivisions 2, 3; 245.4879,
subdivision 1; 245.488, subdivision 1; 245.4882, subdivisions 1, 3; 245.4885,
subdivision 1; 245.4889, subdivision 1; 245.4901, subdivision 2; 245.62,
subdivision 2; 245.735, subdivisions 3, 5, by adding a subdivision; 245A.02, by
adding subdivisions; 245A.03, subdivision 7; 245A.04, subdivision 5; 245A.041,
by adding a subdivision; 245A.043, subdivision 3; 245A.05; 245A.07, subdivision
1; 245A.10, subdivision 4; 245A.14, subdivision 4; 245A.16, by adding a
subdivision; 245A.50, subdivisions 7, 9; 245A.65, subdivision 2; 245C.02,
subdivisions 4a, 5, by adding subdivisions; 245C.03; 245C.05, subdivisions 1, 2,
2a, 2b, 2c, 2d, 4; 245C.08, subdivision 3, by adding a subdivision; 245C.10,
subdivision 15, by adding subdivisions; 245C.13, subdivision 2; 245C.14,
subdivision 1, by adding a subdivision; 245C.15, by adding a subdivision; 245C.16,
subdivisions 1, 2; 245C.17, subdivision 1, by adding a subdivision; 245C.18;
245C.24, subdivisions 2, 3, 4, by adding a subdivision; 245C.32, subdivision 1a;
245D.02, subdivision 20; 245F.04, subdivision 2; 245G.01, subdivisions 13, 26;
245G.03, subdivision 2; 245G.06, subdivision 1; 246.54, subdivision 1b; 254A.19,
subdivision 5; 254B.01, subdivision 4a, by adding a subdivision; 254B.05,
subdivision 5; 254B.12, by adding a subdivision; 256.01, subdivisions 14b, 28;
256.0112, subdivision 6; 256.041; 256.042, subdivisions 2, 4; 256.043, subdivision
3; 256.969, subdivisions 2b, 9, by adding a subdivision; 256.9695, subdivision 1;
256.9741, subdivision 1; 256.98, subdivision 1; 256.983; 256B.04, subdivisions
12, 14; 256B.055, subdivision 6; 256B.056, subdivision 10; 256B.057, subdivision
3; 256B.06, subdivision 4; 256B.0615, subdivisions 1, 5; 256B.0616, subdivisions
1, 3, 5; 256B.0621, subdivision 10; 256B.0622, subdivisions 1, 2, 3a, 4, 7, 7a, 7b,
7d; 256B.0623, subdivisions 1, 2, 3, 4, 5, 6, 9, 12; 256B.0624; 256B.0625,
subdivisions 3b, 3c, 3d, 3e, 5, 5m, 9, 10, 13, 13c, 13d, 13e, 13h, 17, 17b, 18, 18b,
19c, 20, 20b, 28a, 30, 31, 42, 46, 48, 49, 52, 56a, 58, by adding subdivisions;
256B.0631, subdivision 1; 256B.0638, subdivisions 3, 5, 6; 256B.0659, subdivision
13; 256B.0757, subdivision 4c; 256B.0759, subdivisions 2, 4, by adding
subdivisions; 256B.0911, subdivisions 1a, 3a, 3f, 4d; 256B.092, subdivisions 4,
5, 12; 256B.0924, subdivision 6; 256B.094, subdivision 6; 256B.0941, subdivision
1; 256B.0943, subdivisions 1, 2, 3, 4, 5, 5a, 6, 7, 9, 11; 256B.0946, subdivisions
1, 1a, 2, 3, 4, 6; 256B.0947, subdivisions 1, 2, 3, 3a, 5, 6, 7; 256B.0949,
subdivisions 2, 4, 5a, by adding a subdivision; 256B.097, by adding subdivisions;
256B.196, subdivision 2; 256B.25, subdivision 3; 256B.439, by adding
subdivisions; 256B.49, subdivisions 11, 11a, 14, 17, by adding a subdivision;
256B.4914, subdivisions 5, 6, 7, 8, 9, by adding a subdivision; 256B.69,
subdivisions 5a, 6, 6d, by adding subdivisions; 256B.6928, subdivision 5; 256B.75;
256B.76, subdivisions 2, 4; 256B.761; 256B.763; 256B.79, subdivisions 1, 3;
256B.85, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11b, 12, 12b, 13, 13a, 15,
17a, 18a, 20b, 23, 23a, by adding subdivisions; 256D.03, by adding a subdivision;
256D.051, by adding subdivisions; 256D.0515; 256D.0516, subdivision 2; 256E.34,
subdivision 1; 256I.03, subdivision 13; 256I.04, subdivision 3; 256I.05, subdivisions
1a, 1c, 11; 256I.06, subdivisions 6, 8; 256J.08, subdivisions 15, 71, 79; 256J.09,
subdivision 3; 256J.10; 256J.21, subdivisions 3, 4, 5; 256J.24, subdivision 5;
256J.30, subdivision 8; 256J.33, subdivisions 1, 2, 4; 256J.37, subdivisions 1, 1b,
3, 3a; 256J.45, subdivision 1; 256J.626, subdivision 1; 256J.95, subdivision 9;
256L.01, subdivision 5; 256L.03, subdivision 5; 256L.04, subdivision 7b; 256L.05,
subdivision 3a; 256L.07, subdivision 2; 256L.11, subdivisions 6a, 7; 256L.15,
subdivision 2; 256N.25, subdivisions 2, 3; 256N.26, subdivisions 11, 13; 256P.01,
subdivisions 3, 6a, by adding a subdivision; 256P.04, subdivisions 4, 8; 256P.06,
subdivisions 2, 3; 256P.07; 256S.05, subdivision 2; 256S.18, subdivision 7;
256S.20, subdivision 1; 257.0755, subdivision 1; 257.076, subdivisions 3, 5;
257.0768, subdivisions 1, 6; 257.0769; 260.761, subdivision 2; 260C.007,
subdivisions 6, 14, 26c, 31; 260C.157, subdivision 3; 260C.212, subdivisions 1a,
13; 260C.215, subdivision 4; 260C.4412; 260C.452; 260C.704; 260C.706;
260C.708; 260C.71; 260C.712; 260C.714; 260D.01; 260D.05; 260D.06, subdivision
2; 260D.07; 260D.08; 260D.14; 260E.01; 260E.02, subdivision 1; 260E.03,
subdivision 22, by adding subdivisions; 260E.06, subdivision 1; 260E.14,
subdivisions 2, 5; 260E.17, subdivision 1; 260E.18; 260E.20, subdivision 2;
260E.24, subdivisions 2, 7; 260E.31, subdivision 1; 260E.33, subdivision 1, by
adding a subdivision; 260E.35, subdivision 6; 260E.36, by adding a subdivision;
295.50, subdivision 9b; 295.53, subdivision 1; 325F.721, subdivision 1; 326.71,
subdivision 4; 326.75, subdivisions 1, 2, 3; Laws 2019, First Special Session
chapter 9, article 14, section 3, as amended; Laws 2020, First Special Session
chapter 7, section 1, subdivision 2, as amended; Laws 2020, Fifth Special Session
chapter 3, article 10, section 3; Laws 2020, Seventh Special Session chapter 1,
article 6, section 12, subdivision 4; proposing coding for new law in Minnesota
Statutes, chapters 3; 62A; 62J; 62Q; 62W; 119B; 144; 145; 151; 245; 245A; 245C;
254B; 256B; 256P; 256S; proposing coding for new law as Minnesota Statutes,
chapter 245I; repealing Minnesota Statutes 2020, sections 16A.724, subdivision
2; 62A.67; 62A.671; 62A.672; 62J.63, subdivision 3; 119B.125, subdivision 5;
144.0721, subdivision 1; 144.0722; 144.0724, subdivision 10; 144.693; 245.462,
subdivision 4a; 245.4871, subdivision 32a; 245.4879, subdivision 2; 245.62,
subdivisions 3, 4; 245.69, subdivision 2; 245.735, subdivisions 1, 2, 4; 245C.10,
subdivisions 2, 2a, 3, 4, 5, 6, 7, 8, 9, 9a, 10, 11, 12, 13, 14, 16; 256B.0596;
256B.0615, subdivision 2; 256B.0616, subdivision 2; 256B.0622, subdivisions 3,
5a; 256B.0623, subdivisions 7, 8, 10, 11; 256B.0625, subdivisions 5l, 18c, 18d,
18e, 18h, 35a, 35b, 61, 62, 65; 256B.0916, subdivisions 2, 3, 4, 5, 8, 11, 12;
256B.0924, subdivision 4a; 256B.0943, subdivisions 8, 10; 256B.0944; 256B.0946,
subdivision 5; 256B.097, subdivisions 1, 2, 3, 4, 5, 6; 256B.49, subdivisions 26,
27; 256D.051, subdivisions 1, 1a, 2, 2a, 3, 3a, 3b, 6b, 6c, 7, 8, 9, 18; 256D.052,
subdivision 3; 256J.08, subdivisions 10, 53, 61, 62, 81, 83; 256J.21, subdivisions
1, 2; 256J.30, subdivisions 5, 7, 8; 256J.33, subdivisions 3, 4, 5; 256J.34,
subdivisions 1, 2, 3, 4; 256J.37, subdivision 10; 256S.20, subdivision 2; Minnesota
Rules, parts 9505.0275; 9505.0370; 9505.0371; 9505.0372; 9505.1693; 9505.1696,
subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22;
9505.1699; 9505.1701; 9505.1703; 9505.1706; 9505.1712; 9505.1715; 9505.1718;
9505.1724; 9505.1727; 9505.1730; 9505.1733; 9505.1736; 9505.1739; 9505.1742;
9505.1745; 9505.1748; 9520.0010; 9520.0020; 9520.0030; 9520.0040; 9520.0050;
9520.0060; 9520.0070; 9520.0080; 9520.0090; 9520.0100; 9520.0110; 9520.0120;
9520.0130; 9520.0140; 9520.0150; 9520.0160; 9520.0170; 9520.0180; 9520.0190;
9520.0200; 9520.0210; 9520.0230; 9520.0750; 9520.0760; 9520.0770; 9520.0780;
9520.0790; 9520.0800; 9520.0810; 9520.0820; 9520.0830; 9520.0840; 9520.0850;
9520.0860; 9520.0870; 9530.6800; 9530.6810.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
new text begin
Any benefit or coverage mandate included in this chapter does not apply to managed
care plans or county-based purchasing plans when the plan is providing coverage to state
public health care program enrollees under chapter 256B or 256L.
new text end
Minnesota Statutes 2020, section 62C.01, is amended by adding a subdivision to
read:
new text begin
Any benefit or coverage mandate included in this chapter does
not apply to managed care plans or county-based purchasing plans when the plan is providing
coverage to state public health care program enrollees under chapter 256B or 256L.
new text end
Minnesota Statutes 2020, section 62D.01, is amended by adding a subdivision to
read:
new text begin
Any benefit or coverage mandate included in this chapter does
not apply to managed care plans or county-based purchasing plans when the plan is providing
coverage to state public health care program enrollees under chapter 256B or 256L.
new text end
new text begin
Any benefit or coverage mandate included in this chapter does not apply to managed
care plans or county-based purchasing plans when the plan is providing coverage to state
public health care program enrollees under chapter 256B or 256L.
new text end
Minnesota Statutes 2020, section 62Q.02, is amended to read:
(a) This chapter applies only to health plans, as defined in section 62Q.01, and not to
other types of insurance issued or renewed by health plan companies, unless otherwise
specified.
(b) This chapter applies to a health plan company only with respect to health plans, as
defined in section 62Q.01, issued or renewed by the health plan company, unless otherwise
specified.
(c) If a health plan company issues or renews health plans in other states, this chapter
applies only to health plans issued or renewed in this state for Minnesota residents, or to
cover a resident of the state, unless otherwise specified.
new text begin
(d) Any benefit or coverage mandate included in this chapter does not apply to managed
care plans or county-based purchasing plans when the plan is providing coverage to state
public health care program enrollees under chapter 256B or 256L.
new text end
Minnesota Statutes 2020, section 174.30, subdivision 3, is amended to read:
(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.
Minnesota Statutes 2020, section 256.01, subdivision 28, is amended to read:
(a) The commissioner has the
authority to join and participate as a member in a legal entity developing and operating a
statewide health information exchange new text begin or to develop and operate an encounter alerting
service new text end that shall meet the following criteria:
(1) the legal entity must meet all constitutional and statutory requirements to allow the
commissioner to participate; and
(2) the commissioner or the commissioner's designated representative must have the
right to participate in the governance of the legal entity under the same terms and conditions
and subject to the same requirements as any other member in the legal entity and in that
role shall act to advance state interests and lessen the burdens of government.
(b) Notwithstanding chapter 16C, the commissioner may pay the state's prorated share
of development-related expenses of the legal entity retroactively from October 29, 2007,
regardless of the date the commissioner joins the legal entity as a member.
Minnesota Statutes 2020, section 256.969, subdivision 2b, is amended to read:
(a) For discharges occurring on or after November
1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according
to the following:
(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
methodology;
(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology
under subdivision 25;
(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
distinct parts as defined by Medicare shall be paid according to the methodology under
subdivision 12; and
(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not
be rebased, except that a Minnesota long-term hospital shall be rebased effective January
1, 2011, based on its most recent Medicare cost report ending on or before September 1,
2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on
December 31, 2010. For rate setting periods after November 1, 2014, in which the base
years are updated, a Minnesota long-term hospital's base year shall remain within the same
period as other hospitals.
(c) Effective for discharges occurring on and after November 1, 2014, payment rates
for hospital inpatient services provided by hospitals located in Minnesota or the local trade
area, except for the hospitals paid under the methodologies described in paragraph (a),
clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
manner similar to Medicare. The base yearnew text begin or yearsnew text end for the rates effective November 1,
2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral,
ensuring that the total aggregate payments under the rebased system are equal to the total
aggregate payments that were made for the same number and types of services in the base
year. Separate budget neutrality calculations shall be determined for payments made to
critical access hospitals and payments made to hospitals paid under the DRG system. Only
the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being
rebased during the entire base period shall be incorporated into the budget neutrality
calculation.
(d) For discharges occurring on or after November 1, 2014, through the next rebasing
that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph
(a), clause (4), shall include adjustments to the projected rates that result in no greater than
a five percent increase or decrease from the base year payments for any hospital. Any
adjustments to the rates made by the commissioner under this paragraph and paragraph (e)
shall maintain budget neutrality as described in paragraph (c).
(e) For discharges occurring on or after November 1, 2014, the commissioner may make
additional adjustments to the rebased rates, and when evaluating whether additional
adjustments should be made, the commissioner shall consider the impact of the rates on the
following:
(1) pediatric services;
(2) behavioral health services;
(3) trauma services as defined by the National Uniform Billing Committee;
(4) transplant services;
(5) obstetric services, newborn services, and behavioral health services provided by
hospitals outside the seven-county metropolitan area;
(6) outlier admissions;
(7) low-volume providers; and
(8) services provided by small rural hospitals that are not critical access hospitals.
(f) Hospital payment rates established under paragraph (c) must incorporate the following:
(1) for hospitals paid under the DRG methodology, the base year payment rate per
admission is standardized by the applicable Medicare wage index and adjusted by the
hospital's disproportionate population adjustment;
(2) for critical access hospitals, payment rates for discharges between November 1, 2014,
and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
October 31, 2014;
(3) the cost and charge data used to establish hospital payment rates must only reflect
inpatient services covered by medical assistance; and
(4) in determining hospital payment rates for discharges occurring on or after the rate
year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per
discharge shall be based on the cost-finding methods and allowable costs of the Medicare
program in effect during the base year or years. In determining hospital payment rates for
discharges in subsequent base years, the per discharge rates shall be based on the cost-finding
methods and allowable costs of the Medicare program in effect during the base year or
years.
(g) The commissioner shall validate the rates effective November 1, 2014, by applying
the rates established under paragraph (c), and any adjustments made to the rates under
paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the
total aggregate payments for the same number and types of services under the rebased rates
are equal to the total aggregate payments made during calendar year 2013.
(h) Effective for discharges occurring on or after July 1, 2017, and every two years
thereafter, payment rates under this section shall be rebased to reflect only those changes
in hospital costs between the existing base yearnew text begin or yearsnew text end and the next base yearnew text begin or yearsnew text end .new text begin In
any year that inpatient claims volume falls below the threshold required to ensure a statically
valid sample of claims, the commissioner may combine claims data from two consecutive
years to serve as the base year. Years in which inpatient claims volume is reduced or altered
due to a pandemic or other public health emergency shall not be used as a base year or part
of a base year if the base year includes more than one year.new text end Changes in costs between base
years shall be measured using the lower of the hospital cost index defined in subdivision 1,
paragraph (a), or the percentage change in the case mix adjusted cost per claim. The
commissioner shall establish the base year for each rebasing period considering the most
recent yearnew text begin or yearsnew text end for which filed Medicare cost reports are available. The estimated
change in the average payment per hospital discharge resulting from a scheduled rebasing
must be calculated and made available to the legislature by January 15 of each year in which
rebasing is scheduled to occur, and must include by hospital the differential in payment
rates compared to the individual hospital's costs.
(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates
for critical access hospitals located in Minnesota or the local trade area shall be determined
using a new cost-based methodology. The commissioner shall establish within the
methodology tiers of payment designed to promote efficiency and cost-effectiveness.
Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
the total cost for critical access hospitals as reflected in base year cost reports. Until the
next rebasing that occurs, the new methodology shall result in no greater than a five percent
decrease from the base year payments for any hospital, except a hospital that had payments
that were greater than 100 percent of the hospital's costs in the base year shall have their
rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and
after July 1, 2016, covered under this paragraph shall be increased by the inflation factor
in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not
be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the
following criteria:
(1) hospitals that had payments at or below 80 percent of their costs in the base year
shall have a rate set that equals 85 percent of their base year costs;
(2) hospitals that had payments that were above 80 percent, up to and including 90
percent of their costs in the base year shall have a rate set that equals 95 percent of their
base year costs; and
(3) hospitals that had payments that were above 90 percent of their costs in the base year
shall have a rate set that equals 100 percent of their base year costs.
(j) The commissioner may refine the payment tiers and criteria for critical access hospitals
to coincide with the next rebasing under paragraph (h). The factors used to develop the new
methodology may include, but are not limited to:
(1) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's charges to the medical assistance program;
(2) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;
(3) the ratio between the hospital's charges to the medical assistance program and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;
(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);