Minnesota Legislature
HF 2394
as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am
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A bill for an act
relating to health; making changes in MinnesotaCare
eligibility determination procedures and in program
eligibility criteria; establishing a MinnesotaCare
premium surcharge and enrollee accounts; amending
Minnesota Statutes 2004, sections 256L.01,
subdivisions 1a, 5; 256L.05, subdivision 2; 256L.06,
subdivision 3; 256L.15, subdivision 2, by adding a
subdivision; 256L.17, subdivision 3.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2004, section 256L.01,
subdivision 1a, is amended to read:
Subd. 1a.
Child.
"Child" means an individual under 21
years of age new text begin who is either not enrolled or is enrolled less than
half time in a program of study at a postsecondary education
institutionnew text end , including the unborn child of a pregnant woman, an
emancipated minor, and an emancipated minor's spouse. new text begin For an
individual enrolled more than half time in a program of study at
a postsecondary education institution, child means an individual
under 18 years of age, including an emancipated minor, and an
emancipated minor's spouse.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2005,
or upon federal approval, whichever is later.
new text end
Sec. 2.
Minnesota Statutes 2004, section 256L.01,
subdivision 5, is amended to read:
Subd. 5.
Income.
"Income" has the meaning given for
earned and unearned income for families and children in the
medical assistance program, according to the state's aid to
families with dependent children plan in effect as of July 16,
1996. The definition does not include medical assistance income
methodologies and deeming requirements. The earned income of
full-time and part-time students under age 19 is not counted as
incomenew text begin , unless the student is age 18 or older and enrolled on a
half time or greater basis in a program of study at a
postsecondary education institution. Household and family
income includes the earned and unearned income of all persons
residing in the household or family, including unrelated
personsnew text end . Public assistance payments and supplemental security
income are not excluded income.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2005,
except that the provision is effective July 1, 2005, or upon
federal approval, whichever is later, for MinnesotaCare
enrollees for whom a federal match is received.
new text end
Sec. 3.
Minnesota Statutes 2004, section 256L.05,
subdivision 2, is amended to read:
Subd. 2.
Commissioner's duties.
new text begin (a) new text end The commissioner or
county agency shall use electronic verification as the primary
method of income verification. If there is a discrepancy
between reported income and electronically verified income, an
individual may be required to submit additional verification.
In addition, the commissioner shall perform random audits to
verify reported income and eligibility. The commissioner may
execute data sharing arrangements with the Department of Revenue
and any other governmental agency in order to perform income
verification related to eligibility and premium payment under
the MinnesotaCare program.
new text begin
(b) In determining eligibility for MinnesotaCare, the
commissioner shall require applicants and enrollees seeking
renewal of eligibility to verify both earned and unearned
income. The commissioner shall also require applicants and
enrollees to submit to their employers, if employed, a form to
verify whether the applicant or enrollee, and any dependents,
are eligible for employer subsidized coverage.
new text end
Sec. 4.
Minnesota Statutes 2004, section 256L.06,
subdivision 3, is amended to read:
Subd. 3.
Commissioner's duties and payment.
(a) Premiums
are dedicated to the commissioner for MinnesotaCare.
(b) The commissioner shall develop and implement procedures
to: (1) require enrollees to report changes in income; (2)
adjust sliding scale premium payments, based upon deleted text begin changes deleted text end new text begin both
increases and decreases new text end in enrollee incomenew text begin , at the time the
change in income is reportednew text end ; and (3) disenroll enrollees from
MinnesotaCare for failure to pay required premiums. Failure to
pay includes payment with a dishonored check, a returned
automatic bank withdrawal, or a refused credit card or debit
card payment. The commissioner may demand a guaranteed form of
payment, including a cashier's check or a money order, as the
only means to replace a dishonored, returned, or refused payment.
(c) Premiums are calculated on a calendar month basis and
may be paid on a monthly, quarterly, or semiannual basis, with
the first payment due upon notice from the commissioner of the
premium amount required. The commissioner shall inform
applicants and enrollees of these premium payment options.
Premium payment is required before enrollment is complete and to
maintain eligibility in MinnesotaCare. Premium payments
received before noon are credited the same day. Premium
payments received after noon are credited on the next working
day.
(d) Nonpayment of the premium will result in disenrollment
from the plan effective for the calendar month for which the
premium was due. Persons disenrolled for nonpayment or who
voluntarily terminate coverage from the program may not reenroll
until four calendar months have elapsed. Persons disenrolled
for nonpayment who pay all past due premiums as well as current
premiums due, including premiums due for the period of
disenrollment, within 20 days of disenrollment, shall be
reenrolled retroactively to the first day of disenrollment.
Persons disenrolled for nonpayment or who voluntarily terminate
coverage from the program may not reenroll for four calendar
months unless the person demonstrates good cause for
nonpayment. Good cause does not exist if a person chooses to
pay other family expenses instead of the premium. The
commissioner shall define good cause in rule.
Sec. 5.
Minnesota Statutes 2004, section 256L.15,
subdivision 2, is amended to read:
Subd. 2.
Sliding fee scale to determine percentage of
gross individual or family income.
(a) The commissioner shall
establish a sliding fee scale to determine the percentage of
gross individual or family income that households at different
income levels must pay to obtain coverage through the
MinnesotaCare program. The sliding fee scale must be based on
the enrollee's gross individual or family income. The sliding
fee scale must contain separate tables based on enrollment of
one, two, or three or more persons. The sliding fee scale
begins with a premium of 1.5 percent of gross individual or
family income for individuals or families with incomes below the
limits for the medical assistance program for families and
children in effect on January 1, 1999, and proceeds through the
following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9,
7.4, and 8.8 percent. These percentages are matched to evenly
spaced income steps ranging from the medical assistance income
limit for families and children in effect on January 1, 1999, to
275 percent of the federal poverty guidelines for the applicable
family size, up to a family size of five. The sliding fee scale
for a family of five must be used for families of more than
five. Effective October 1, 2003, the commissioner shall
increase each percentage by 0.5 percentage points for enrollees
with income greater than 100 percent but not exceeding 200
percent of the federal poverty guidelines and shall increase
each percentage by 1.0 percentage points for families and
children with incomes greater than 200 percent of the federal
poverty guidelines. The sliding fee scale and percentages are
not subject to the provisions of chapter 14. If a family or
individual reports increased income after enrollment, premiums
shall deleted text begin not deleted text end be adjusted deleted text begin until eligibility renewal deleted text end new text begin at the time the
change in income is reportednew text end .
(b)(1) Enrolled families whose gross annual income
increases above 275 percent of the federal poverty guideline
shall pay the maximum premium. This clause expires effective
February 1, 2004.
(2) Effective February 1, 2004, children in families whose
gross income is above 275 percent of the federal poverty
guidelines shall pay the maximum premium.
(3) The maximum premium is defined as a base charge for
one, two, or three or more enrollees so that if all
MinnesotaCare cases paid the maximum premium, the total revenue
would equal the total cost of MinnesotaCare medical coverage and
administration. In this calculation, administrative costs shall
be assumed to equal ten percent of the total. The costs of
medical coverage for pregnant women and children under age two
and the enrollees in these groups shall be excluded from the
total. The maximum premium for two enrollees shall be twice the
maximum premium for one, and the maximum premium for three or
more enrollees shall be three times the maximum premium for one.
Sec. 6.
Minnesota Statutes 2004, section 256L.15, is
amended by adding a subdivision to read:
new text begin Subd. 4. new text end
new text begin Premium surcharge. new text end
new text begin
(a) Effective for premiums
due on or after July 1, 2005, the commissioner shall impose a
two percent surcharge on premiums calculated under subdivision
2. The commissioner shall establish a surcharge account for
each enrollee, and shall deposit into this account the amounts
collected through the surcharge from that enrollee. Amounts
deposited in the account shall accrue interest at the rate of
one percent.
new text end
new text begin
(b) The commissioner may use money in each enrollee's
surcharge account to pay for any premium amounts an enrollee may
owe due to failure to promptly report changes in income, and for
the cost of any MinnesotaCare services provided to an enrollee
when that enrollee was not eligible for services, but received
services due to a failure to report required information to the
commissioner.
new text end
new text begin
(c) The commissioner shall transfer any amounts remaining
in the account, and accrued interest, to individuals who
voluntarily terminate MinnesotaCare coverage, but is not
required to transfer amounts remaining and accrued interest to
persons who are disenrolled for nonpayment of premium.
new text end
Sec. 7.
Minnesota Statutes 2004, section 256L.17,
subdivision 3, is amended to read:
Subd. 3.
Documentation new text begin and verificationnew text end .
deleted text begin (a) deleted text end The
commissioner of human services shall deleted text begin require individuals and
families, at the time of application or renewal, to indicate on
a checkoff form developed by the commissioner whether they
satisfy the MinnesotaCare asset requirement. This form must
include the following or similar language: "To be eligible for
MinnesotaCare, individuals and families must not own net assets
in excess of $30,000 for a household of two or more persons or
$15,000 for a household of one person, not including a
homestead, household goods and personal effects, assets owned by
children, vehicles used for employment, court-ordered
settlements up to $10,000, individual retirement accounts, and
capital and operating assets of a trade or business up to
$200,000. Do you and your household own net assets in excess of
these limits?"
deleted text end
deleted text begin
(b) The commissioner may require individuals and families
to provide any information the commissioner determines necessary
to verify compliance with the asset requirement, if the
commissioner determines that there is reason to believe that an
individual or family has assets that exceed the program
limit deleted text end new text begin verify compliance with the asset requirement using the
asset verification procedure and documentation procedures of the
medical assistance programnew text end .
Sec. 8. new text begin FEDERAL APPROVAL.
new text end
new text begin
The commissioner shall seek federal approval to implement
the amendments to Minnesota Statutes, section 256L.01,
subdivision 1a, and to fully implement the amendments to
Minnesota Statutes, section 256L.01, subdivision 5.
new text end