HF 2419

as introduced - 89th Legislature (2015 - 2016) Posted on 03/08/2016 04:25pm

A bill for an act
relating to human services; modifying medical assistance reimbursement rates
for certain services; amending Minnesota Statutes 2014, section 256B.0625,
subdivision 31a; Minnesota Statutes 2015 Supplement, section 256B.0625,
subdivision 31.

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

Section 1.

Minnesota Statutes 2015 Supplement, section 256B.0625, subdivision 31,
is amended to read:

Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall
be made for wheelchairs and wheelchair accessories for recipients who are residents
of intermediate care facilities for the developmentally disabled. Reimbursement for
wheelchairs and wheelchair accessories for ICF/DD recipients shall be subject to the same
conditions and limitations as coverage for recipients who do not reside in institutions. A
wheelchair purchased outside of the facility's payment rate is the property of the recipient.

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics,
orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
enrollment requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic,
orthotic, or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or
similar durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with
the Medicare program's supplier and quality standards and the vendor serves primarily
pediatric patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical
condition or is generally used primarily for a medical purpose.

(e) Electronic tablets may be considered durable medical equipment if the electronic
tablet will be used as an augmentative and alternative communication system as defined
under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
must be locked in order to prevent use not related to communication.

(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must
be locked to prevent use not as an augmentative communication device, a recipient of
waiver services may use an electronic tablet for a use not related to communication when
the recipient has been authorized under the waiver to receive one or more additional
applications that can be loaded onto the electronic tablet, such that allowing the additional
use prevents the purchase of a separate electronic tablet with waiver funds.

new text begin (g) The medical assistance fee-for-service reimbursement rate for repair or
nonroutine service for durable medical equipment is the lesser of:
new text end

new text begin (1) the submitted charge; or
new text end

new text begin (2) $23.75 per 15 minutes of service.
new text end

Sec. 2.

Minnesota Statutes 2014, section 256B.0625, subdivision 31a, is amended to
read:

Subd. 31a.

Augmentative and alternative communication systems.

(a) Medical
assistance covers augmentative and alternative communication systems consisting of
electronic or nonelectronic devices and the related components necessary to enable a
person with severe expressive communication limitations to produce or transmit messages
or symbols in a manner that compensates for that disability.

(b) Augmentative and alternative communication systems must be paid the lower
of the:

(1) submitted charge; or

(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are
manufacturers of augmentative and alternative communication systems; or

(ii) manufacturer's invoice charge plus deleted text begin 20 deleted text end new text begin 25 new text end percent for providers that are not
manufacturers of augmentative and alternative communication systems.

(c) Reimbursement rates established by this purchasing program are not subject to
Minnesota Rules, part 9505.0445, item S or T.