HF 2680

as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 11:32pm

A bill for an act
relating to health care; establishing mental health urgent care and consultation
services; modifying the general assistance medical care program; appropriating
money; amending Minnesota Statutes 2008, sections 256.9657, subdivisions 2,
3; 256.969, subdivisions 21, 26, 27; 256B.0625, subdivisions 13f, 20, by adding
a subdivision; 256B.69, by adding a subdivision; 256L.05, subdivisions 1b, 3,
3a; 256L.07, subdivision 6; 256L.15, subdivision 4; 256L.17, subdivision 7;
Minnesota Statutes 2009 Supplement, sections 256.969, subdivisions 2b, 3a, 30;
256B.195, subdivision 3; 256D.03, subdivision 3; proposing coding for new law
in Minnesota Statutes, chapters 245; 256D.

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

Section 1.

new text begin [245.4862] MENTAL HEALTH URGENT CARE AND PSYCHIATRIC
CONSULTATION.
new text end

new text begin Subdivision 1. new text end

new text begin Mental health urgent care and psychiatric consultation. new text end

new text begin The
commissioner shall include mental health urgent care and psychiatric consultation
services as part of, but not limited to, the redesign of six community-based behavioral
health hospitals and the Anoka-Metro Regional Treatment Center. These services must
not duplicate existing services in the region, and must be implemented as specified in
subdivisions 3 to 8.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin For purposes of this section:
new text end

new text begin (a) Mental health urgent care includes:
new text end

new text begin (1) initial mental health screening;
new text end

new text begin (2) mobile crisis assessment and intervention;
new text end

new text begin (3) rapid access to psychiatry, including psychiatric evaluation, initial treatment,
and short-term psychiatry;
new text end

new text begin (4) nonhospital crisis stabilization residential beds;
new text end

new text begin (5) necessary psychiatric prescriptions from a qualified individual and assistance
in obtaining psychiatric medications; and
new text end

new text begin (6) health care navigator services which include, but are not limited to, assisting
uninsured individuals in obtaining health care coverage.
new text end

new text begin (b) Psychiatric consultation services includes psychiatric consultation to primary
care practitioners.
new text end

new text begin Subd. 3. new text end

new text begin Rapid access to psychiatry. new text end

new text begin The commissioner shall develop rapid access
to psychiatric services based on the following criteria:
new text end

new text begin (1) the individuals who receive the psychiatric services must be at risk of
hospitalization and otherwise unable to receive timely services;
new text end

new text begin (2) where clinically appropriate, the service may be provided via interactive video
where the service is provided in conjunction with a local primary care or behavioral
care practitioner; and
new text end

new text begin (3) the commissioner may integrate rapid access to psychiatry with the psychiatric
consultation services in subdivision 5.
new text end

new text begin Subd. 4. new text end

new text begin Psychiatric medications. new text end

new text begin The commissioner may develop a grant
program to assist adults who are uninsured or otherwise unable to receive the psychiatric
medications that they need, based on the following criteria:
new text end

new text begin (1) the individuals who are assisted must be at risk of publicly funded hospitalization;
new text end

new text begin (2) assistance with medications is for a limited time and must be transitioned to
health care coverage as soon as possible; and
new text end

new text begin (3) the program may include co-pays based on the individual's ability to pay.
new text end

new text begin Subd. 5. new text end

new text begin Collaborative psychiatric consultation. new text end

new text begin The commissioner shall establish
a collaborative psychiatric consultation service based on the following criteria:
new text end

new text begin (1) the service may be available via telephone, interactive video, e-mail, or other
means of communication to emergency rooms, local crisis services, and primary care
practitioners, including pediatricians;
new text end

new text begin (2) the service shall include child and adolescent psychiatrists and adult psychiatrists;
new text end

new text begin (3) the first priority for this service is to provide the consultations required under
section 256B.0625, subdivision 13j; and
new text end

new text begin (4) the service must encourage use of cognitive and behavioral therapies and other
evidence-based treatments in addition to or in place of medication, where appropriate.
new text end

new text begin Subd. 6. new text end

new text begin Phased availability. new text end

new text begin (a) The commissioner may phase in the availability
of mental health urgent care services based on the limits of appropriations and the
commissioner's determination of level of need and cost-effectiveness.
new text end

new text begin (b) For subdivisions 3 and 5, the first phase must focus on adults in Hennepin
and Ramsey Counties and children statewide who are affected by section 256B.0625,
subdivision 13j, and must include tracking of costs for the services provided and
associated impacts on utilization of inpatient, emergency room, and other services.
new text end

new text begin Subd. 7. new text end

new text begin Limited appropriations. new text end

new text begin The commissioner shall maximize use
of available health care coverage for the services provided under this section. The
commissioner's responsibility to provide these services for individuals without health care
coverage must not exceed the appropriations for this section.
new text end

new text begin Subd. 8. new text end

new text begin Flexible implementation. new text end

new text begin To implement this section, the commissioner
shall select the structure and funding method that is the most cost-effective for each county
or group of counties. This may include grants, contracts, direct provision by state-operated
services, and public-private partnerships. Where feasible, the commissioner shall make
any grants under this section a part of the integrated adult mental health initiative grants
under section 245.4661.
new text end

Sec. 2.

Minnesota Statutes 2008, section 256.9657, subdivision 2, is amended to read:

Subd. 2.

Hospital surcharge.

(a) Effective October 1, 1992, each Minnesota
hospital except facilities of the federal Indian Health Service and regional treatment
centers shall pay to the medical assistance account a surcharge equal to 1.4 percent of net
patient revenues excluding net Medicare revenues reported by that provider to the health
care cost information system according to the schedule in subdivision 4.

(b) Effective July 1, 1994, the surcharge under paragraph (a) is increased to 1.56
percent.

(c) new text begin Effective March 1, 2010, to September 30, 2010, the surcharge under paragraph
(b) is increased to 3.95 percent. Effective October 1, 2010, to June 30, 2011, the surcharge
under paragraph (b) is increased to 3.06 percent. Notwithstanding section 256.9656,
money collected under this paragraph in excess of the amount collected under paragraph
(b) shall be deposited in the account established in section 256D.032.
new text end

new text begin (d) new text end Notwithstanding the Medicare cost finding and allowable cost principles, the
hospital surcharge is not an allowable cost for purposes of rate setting under sections
256.9685 to 256.9695.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 3.

Minnesota Statutes 2008, section 256.9657, subdivision 3, is amended to read:

Subd. 3.

Surcharge on HMOs and community integrated service networks.

(a)
Effective October 1, 1992, each health maintenance organization with a certificate of
authority issued by the commissioner of health under chapter 62D and each community
integrated service network licensed by the commissioner under chapter 62N shall pay to
the commissioner of human services a surcharge equal to six-tenths of one percent of the
total premium revenues of the health maintenance organization or community integrated
service network as reported to the commissioner of health according to the schedule in
subdivision 4.

(b) new text begin Effective March 1, 2010, to June 30, 2011: (1) the surcharge under paragraph (a)
is increased to 4.0 percent; and (2) each county-based purchasing plan authorized under
section 256B.692 shall pay to the commissioner a surcharge equal to 3.4 percent of the
total premium revenues of the plan, as reported to the commissioner of health, according
to the payment schedule in subdivision 4. Notwithstanding section 256.9656, money
collected under this paragraph in excess of the amount collected under paragraph (a) shall
be deposited in the account established in section 256D.032.
new text end

new text begin (c) new text end For purposes of this subdivision, total premium revenue means:

(1) premium revenue recognized on a prepaid basis from individuals and groups
for provision of a specified range of health services over a defined period of time which
is normally one month, excluding premiums paid to a health maintenance organization
or community integrated service network from the Federal Employees Health Benefit
Program;

(2) premiums from Medicare wrap-around subscribers for health benefits which
supplement Medicare coverage;

(3) Medicare revenue, as a result of an arrangement between a health maintenance
organization or a community integrated service network and the Centers for Medicare
and Medicaid Services of the federal Department of Health and Human Services, for
services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited
from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social
Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and
1395w-24, respectively, as they may be amended from time to time; and

(4) medical assistance revenue, as a result of an arrangement between a health
maintenance organization or community integrated service network and a Medicaid state
agency, for services to a medical assistance beneficiary.

If advance payments are made under clause (1) or (2) to the health maintenance
organization or community integrated service network for more than one reporting period,
the portion of the payment that has not yet been earned must be treated as a liability.

deleted text begin (c) deleted text end new text begin (d) new text end When a health maintenance organization or community integrated service
network merges or consolidates with or is acquired by another health maintenance
organization or community integrated service network, the surviving corporation or the
new corporation shall be responsible for the annual surcharge originally imposed on
each of the entities or corporations subject to the merger, consolidation, or acquisition,
regardless of whether one of the entities or corporations does not retain a certificate of
authority under chapter 62D or a license under chapter 62N.

deleted text begin (d) deleted text end new text begin (e) new text end Effective July 1 of each year, the surviving corporation's or the new
corporation's surcharge shall be based on the revenues earned in the second previous
calendar year by all of the entities or corporations subject to the merger, consolidation,
or acquisition regardless of whether one of the entities or corporations does not retain a
certificate of authority under chapter 62D or a license under chapter 62N until the total
premium revenues of the surviving corporation include the total premium revenues of all
the merged entities as reported to the commissioner of health.

deleted text begin (e) deleted text end new text begin (f) new text end When a health maintenance organization or community integrated service
network, which is subject to liability for the surcharge under this chapter, transfers,
assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability
for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer
of the health maintenance organization or community integrated service network.

deleted text begin (f) deleted text end new text begin (g) new text end In the event a health maintenance organization or community integrated
service network converts its licensure to a different type of entity subject to liability
for the surcharge under this chapter, but survives in the same or substantially similar
form, the surviving entity remains liable for the surcharge regardless of whether one of
the entities or corporations does not retain a certificate of authority under chapter 62D
or a license under chapter 62N.

deleted text begin (g) deleted text end new text begin (h) new text end The surcharge assessed to a health maintenance organization or community
integrated service network ends when the entity ceases providing services for premiums
and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 4.

Minnesota Statutes 2009 Supplement, section 256.969, subdivision 2b, is
amended to read:

Subd. 2b.

Operating payment rates.

In determining operating payment rates for
admissions occurring on or after the rate year beginning January 1, 1991, and every two
years after, or more frequently as determined by the commissioner, the commissioner shall
obtain operating data from an updated base year and establish operating payment rates
per admission for each hospital based on the cost-finding methods and allowable costs of
the Medicare program in effect during the base year. Rates under the general assistance
medical care, medical assistance, and MinnesotaCare programs shall not be rebased to
more current data on January 1, 1997, January 1, 2005, for the first 24 months of the
rebased period beginning January 1, 2009. For the first deleted text begin three deleted text end new text begin six new text end months of the rebased
period beginning January 1, 2011, rates shall new text begin not new text end be rebased deleted text begin at 74.25 percent of the full
value of the rebasing percentage change deleted text end . From deleted text begin April deleted text end new text begin July new text end 1, 2011, to March 31, 2012,
rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change.
Effective April 1, 2012, rates shall be rebased at full value. The base year operating
payment rate per admission is standardized by the case mix index and adjusted by the
hospital cost index, relative values, and disproportionate population adjustment. The
cost and charge data used to establish operating rates shall only reflect inpatient services
covered by medical assistance and shall not include property cost information and costs
recognized in outlier payments.

Sec. 5.

Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is
amended to read:

Subd. 3a.

Payments.

(a) Acute care hospital billings under the medical
assistance program must not be submitted until the recipient is discharged. However,
the commissioner shall establish monthly interim payments for inpatient hospitals that
have individual patient lengths of stay over 30 days regardless of diagnostic category.
Except as provided in section 256.9693, medical assistance reimbursement for treatment
of mental illness shall be reimbursed based on diagnostic classifications. Individual
hospital payments established under this section and sections 256.9685, 256.9686, and
256.9695, in addition to third party and recipient liability, for discharges occurring during
the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
inpatient services paid for the same period of time to the hospital. This payment limitation
shall be calculated separately for medical assistance and general assistance medical
care services. The limitation on general assistance medical care shall be effective for
admissions occurring on or after July 1, 1991. Services that have rates established under
subdivision 11 or 12, must be limited separately from other services. After consulting with
the affected hospitals, the commissioner may consider related hospitals one entity and
may merge the payment rates while maintaining separate provider numbers. The operating
and property base rates per admission or per day shall be derived from the best Medicare
and claims data available when rates are established. The commissioner shall determine
the best Medicare and claims data, taking into consideration variables of recency of the
data, audit disposition, settlement status, and the ability to set rates in a timely manner.
The commissioner shall notify hospitals of payment rates by December 1 of the year
preceding the rate year. The rate setting data must reflect the admissions data used to
establish relative values. Base year changes from 1981 to the base year established for the
rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
1. The commissioner may adjust base year cost, relative value, and case mix index data
to exclude the costs of services that have been discontinued by the October 1 of the year
preceding the rate year or that are paid separately from inpatient services. Inpatient stays
that encompass portions of two or more rate years shall have payments established based
on payment rates in effect at the time of admission unless the date of admission preceded
the rate year in effect by six months or more. In this case, operating payment rates for
services rendered during the rate year in effect and established based on the date of
admission shall be adjusted to the rate year in effect by the hospital cost index.

(b) For fee-for-service admissions occurring on or after July 1, 2002, the total
payment, before third-party liability and spenddown, made to hospitals for inpatient
services is reduced by .5 percent from the current statutory rates.

(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Mental health services within diagnosis related groups 424 to 432, and
facilities defined under subdivision 16 are excluded from this paragraph.

(d) In addition to the reduction in paragraphs (b) and (c), the total payment for
fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 6.0 percent
from the current statutory rates. Mental health services within diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
assistance does not include general assistance medical care. Payments made to managed
care plans shall be reduced for services provided on or after January 1, 2006, to reflect
this reduction.

(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
3.46 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care plans shall be reduced for services provided
on or after January 1, 2009, through June 30, 2009, to reflect this reduction.

(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2009, through June 30, deleted text begin 2010 deleted text end new text begin 2011 new text end ,
made to hospitals for inpatient services before third-party liability and spenddown, is
reduced 1.9 percent from the current statutory rates. Mental health services with diagnosis
related groups 424 to 432 and facilities defined under subdivision 16 are excluded from
this paragraph. Payments made to managed care plans shall be reduced for services
provided on or after July 1, 2009, through June 30, deleted text begin 2010 deleted text end new text begin 2011 new text end , to reflect this reduction.

(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
for fee-for-service admissions occurring on or after July 1, deleted text begin 2010 deleted text end new text begin 2011 new text end , made to hospitals
for inpatient services before third-party liability and spenddown, is reduced 1.79 percent
from the current statutory rates. Mental health services with diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Payments made to managed care plans shall be reduced for services provided on or after
July 1, deleted text begin 2010 deleted text end new text begin 2011 new text end , to reflect this reduction.

(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
payment for fee-for-service admissions occurring on or after July 1, 2009, made to
hospitals for inpatient services before third-party liability and spenddown, is reduced
one percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments made to managed care plans shall be reduced for
services provided on or after October 1, 2009, to reflect this reduction.

new text begin (i) In order to offset the ratable reductions provided for in this subdivision, the
base payment rate prior to case mix adjustments for fee-for-service admissions occurring
from March 1, 2010, to June 30, 2011, made to hospitals for inpatient services before
third-party liability and spenddown, shall be increased by 15 percent from the current
statutory rates. For purposes of this paragraph, medical assistance does not include
general assistance medical care. This increase shall be paid from the account established
in section 256D.032. The commissioner shall not adjust rates paid to a prepaid health plan
under contract with the commissioner to reflect payments provided in this paragraph. The
commissioner may utilize a settlement process to adjust rates in excess of the Medicare
upper limits on payments. The commissioner may ratably reduce payments under this
paragraph in order to comply with section 256B.195, subdivision 3, paragraph (f).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 6.

Minnesota Statutes 2008, section 256.969, subdivision 21, is amended to read:

Subd. 21.

Mental health or chemical dependency admissions; rates.

new text begin (a)
new text end Admissions under the general assistance medical care program occurring on or after
July 1, 1990, and admissions under medical assistance, excluding general assistance
medical care, occurring on or after July 1, 1990, and on or before September 30, 1992,
that are classified to a diagnostic category of mental health or chemical dependency
shall have rates established according to the methods of subdivision 14, except the per
day rate shall be multiplied by a factor of 2, provided that the total of the per day rates
shall not exceed the per admission rate. This methodology shall also apply when a hold
or commitment is ordered by the court for the days that inpatient hospital services are
medically necessary. Stays which are medically necessary for inpatient hospital services
and covered by medical assistance shall not be billable to any other governmental entity.
Medical necessity shall be determined under criteria established to meet the requirements
of section 256B.04, subdivision 15, or 256D.03, subdivision 7, paragraph (b).

new text begin (b) In order to ensure adequate access for the provision of mental health services
and to encourage broader delivery of these services outside the nonstate governmental
hospital setting, payment rates for medical assistance admissions, excluding general
assistance medical care admissions, occurring from March 1, 2010, to June 30, 2011,
at a private, not-for-profit hospital above the 75th percentile of all Minnesota private,
nonprofit hospitals in terms of mental health admissions paid by medical assistance,
shall be increased for diagnosis-related groups 424 to 432 and 521 to 523 at a percentage
calculated to cost not more than a total of $50,000,000, including state and federal shares.
This increase shall be paid from the account established in section 256D.032. The
commissioner shall not adjust rates paid to a prepaid health plan under contract with
the commissioner to reflect payments provided in this paragraph. The commissioner
may utilize a settlement process to adjust rates in excess of the Medicare upper limits on
payments. The commissioner may ratably reduce payments under this paragraph in order
to comply with section 256B.195, subdivision 3, paragraph (f).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 7.

Minnesota Statutes 2008, section 256.969, subdivision 26, is amended to read:

Subd. 26.

Greater Minnesota payment adjustment after June 30, 2001.

(a) For
admissions occurring after June 30, 2001, the commissioner shall pay fee-for-service
inpatient admissions for the diagnosis-related groups specified in paragraph (b) at hospitals
located outside of the seven-county metropolitan area at the higher of:

(1) the hospital's current payment rate for the diagnostic category to which the
diagnosis-related group belongs, exclusive of disproportionate population adjustments
received under subdivision 9 and hospital payment adjustments received under subdivision
23; or

(2) 90 percent of the average payment rate for that diagnostic category for hospitals
located within the seven-county metropolitan area, exclusive of disproportionate
population adjustments received under subdivision 9 and hospital payment adjustments
received under subdivisions 20 and 23.

(b) The payment increases provided in paragraph (a) apply to the following
diagnosis-related groups, as they fall within the diagnostic categories:

(1) 370 cesarean section with complicating diagnosis;

(2) 371 cesarean section without complicating diagnosis;

(3) 372 vaginal delivery with complicating diagnosis;

(4) 373 vaginal delivery without complicating diagnosis;

(5) 386 extreme immaturity and respiratory distress syndrome, neonate;

(6) 388 full-term neonates with other problems;

(7) 390 prematurity without major problems;

(8) 391 normal newborn;

(9) 385 neonate, died or transferred to another acute care facility;

(10) 425 acute adjustment reaction and psychosocial dysfunction;

(11) 430 psychoses;

(12) 431 childhood mental disorders; and

(13) 164-167 appendectomy.

new text begin (c) For admissions occurring from March 1, 2010, to June 30, 2011, the payment
rate under paragraph (a), clause (2), shall be increased to 100 percent from 90 percent,
after application of the rate increase in subdivision 3a, paragraph (i). This increase shall
be paid from the account established in section 256D.032. The commissioner shall not
adjust rates paid to a prepaid health plan under contract with the commissioner to reflect
payments provided in this paragraph. The commissioner may utilize a settlement process
to adjust rates in excess of the Medicare upper limits on payments. The commissioner may
ratably reduce payments under this paragraph in order to comply with section 256B.195,
subdivision 3, paragraph (f).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 8.

Minnesota Statutes 2008, section 256.969, subdivision 27, is amended to read:

Subd. 27.

Quarterly payment adjustment.

(a) In addition to any other payment
under this section, the commissioner shall make the following payments effective July
1, 2007:

(1) for a hospital located in Minnesota and not eligible for payments under
subdivision 20, with a medical assistance inpatient utilization rate greater than 17.8
percent of total patient days as of the base year in effect on July 1, 2005, a payment equal
to 13 percent of the total of the operating and property payment rates;

(2) for a hospital located in Minnesota in a specified urban area outside of the
seven-county metropolitan area and not eligible for payments under subdivision 20, with
a medical assistance inpatient utilization rate less than or equal to 17.8 percent of total
patient days as of the base year in effect on July 1, 2005, a payment equal to ten percent
of the total of the operating and property payment rates. For purposes of this clause, the
following cities are specified urban areas: Detroit Lakes, Rochester, Willmar, Alexandria,
Austin, Cambridge, Brainerd, Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids,
Wyoming, Fergus Falls, Albert Lea, Winona, Virginia, Thief River Falls, and Wadena;

(3) for a hospital located in Minnesota but not located in a specified urban area
under clause (2), with a medical assistance inpatient utilization rate less than or equal to
17.8 percent of total patient days as of the base year in effect on July 1, 2005, a payment
equal to four percent of the total of the operating and property payment rates. A hospital
located in Woodbury and not in existence during the base year shall be reimbursed under
this clause; and

(4) in addition to any payments under clauses (1) to (3), for a hospital located in
Minnesota and not eligible for payments under subdivision 20 with a medical assistance
inpatient utilization rate of 17.9 percent of total patient days as of the base year in effect
on July 1, 2005, a payment equal to eight percent of the total of the operating and property
payment rates, and for a hospital located in Minnesota and not eligible for payments
under subdivision 20 with a medical assistance inpatient utilization rate of 59.6 percent
of total patient days as of the base year in effect on July 1, 2005, a payment equal to
nine percent of the total of the operating and property payment rates. After making any
ratable adjustments required under paragraph (b), the commissioner shall proportionately
reduce payments under clauses (2) and (3) by an amount needed to make payments under
this clause.

(b) The state share of payments under paragraph (a) shall be equal to federal
reimbursements to the commissioner to reimburse expenditures reported under section
256B.199. The commissioner shall ratably reduce or increase payments under this
subdivision in order to ensure that these payments equal the amount of reimbursement
received by the commissioner under section 256B.199, except that payments shall be
ratably reduced by an amount equivalent to the state share of a four percent reduction in
MinnesotaCare and medical assistance payments for inpatient hospital services. Effective
July 1, 2009, the ratable reduction shall be equivalent to the state share of a three percent
reduction in these payments. new text begin Effective for federal disproportionate share hospital funds
earned on general assistance medical care payments for services rendered March 1, 2010,
to June 30, 2011, the amount of the three percent ratable reduction required under this
paragraph shall be deposited in the account established in section 256D.032.
new text end

(c) The payments under paragraph (a) shall be paid quarterly based on each hospital's
operating and property payments from the second previous quarter, beginning on July
15, 2007, or upon federal approval of federal reimbursements under section 256B.199,
whichever occurs later.

(d) The commissioner shall not adjust rates paid to a prepaid health plan under
contract with the commissioner to reflect payments provided in paragraph (a).

(e) The commissioner shall maximize the use of available federal money for
disproportionate share hospital payments and shall maximize payments to qualifying
hospitals. In order to accomplish these purposes, the commissioner may, in consultation
with the nonstate entities identified in section 256B.199, adjust, on a pro rata basis
if feasible, the amounts reported by nonstate entities under section 256B.199 when
application for reimbursement is made to the federal government, and otherwise adjust
the provisions of this subdivision. The commissioner shall utilize a settlement process
based on finalized data to maximize revenue under section 256B.199 and payments
under this section.

(f) For purposes of this subdivision, medical assistance does not include general
assistance medical care.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for services rendered on or after
March 1, 2010.
new text end

Sec. 9.

Minnesota Statutes 2009 Supplement, section 256.969, subdivision 30, is
amended to read:

Subd. 30.

Payment rates for births.

(a) For admissions occurring on or after
October 1, 2009, the total operating and property payment rate, excluding disproportionate
population adjustment, for the following diagnosis-related groups, as they fall within
the diagnostic categories: (1) 371 cesarean section without complicating diagnosis; (2)
372 vaginal delivery with complicating diagnosis; and (3) 373 vaginal delivery without
complicating diagnosis, shall be no greater than $3,528.

(b) The rates described in this subdivision do not include newborn care.

(c) Payments to managed care and county-based purchasing plans under section
256B.69, 256B.692, or 256L.12 shall be reduced for services provided on or after October
1, 2009, to reflect the adjustments in paragraph (a).

(d) Prior authorization shall not be required before reimbursement is paid for a
cesarean section delivery.

new text begin (e) In order to ensure adequate access for the provision of maternity services and
to encourage broader delivery of these services outside the nonstate governmental
hospital setting, payment rates for medical assistance admissions, excluding general
assistance medical care admissions, occurring from March 1, 2010, to June 30, 2011,
at a private, not-for-profit hospital above the 65th percentile of all Minnesota private,
nonprofit hospitals in terms of deliveries paid by medical assistance, shall be increased for
diagnosis-related groups 370 to 373, 388, 390, and 391 at a percentage calculated to cost
not more than a total of $42,000,000, including state and federal shares. This increase shall
be paid from the account established in section 256D.032. The commissioner shall not
adjust rates paid to a prepaid health plan under contract with the commissioner to reflect
payments provided in this paragraph. The commissioner may utilize a settlement process
to adjust rates in excess of the Medicare upper limits on payments. The commissioner may
ratably reduce payments under this paragraph in order to comply with section 256B.195,
subdivision 3, paragraph (f).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 10.

Minnesota Statutes 2008, section 256B.0625, subdivision 13f, is amended to
read:

Subd. 13f.

Prior authorization.

(a) The Formulary Committee shall review and
recommend drugs which require prior authorization. The Formulary Committee shall
establish general criteria to be used for the prior authorization of brand-name drugs for
which generically equivalent drugs are available, but the committee is not required to
review each brand-name drug for which a generically equivalent drug is available.

(b) Prior authorization may be required by the commissioner before certain
formulary drugs are eligible for payment. The Formulary Committee may recommend
drugs for prior authorization directly to the commissioner. The commissioner may also
request that the Formulary Committee review a drug for prior authorization. Before the
commissioner may require prior authorization for a drug:

(1) the commissioner must provide information to the Formulary Committee on the
impact that placing the drug on prior authorization may have on the quality of patient care
and on program costs, information regarding whether the drug is subject to clinical abuse
or misuse, and relevant data from the state Medicaid program if such data is available;

(2) the Formulary Committee must review the drug, taking into account medical and
clinical data and the information provided by the commissioner; and

(3) the Formulary Committee must hold a public forum and receive public comment
for an additional 15 days.

The commissioner must provide a 15-day notice period before implementing the prior
authorization.

(c) new text begin Except as provided in subdivision 13j, new text end prior authorization shall not be required or
utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness if:

(1) there is no generically equivalent drug available; and

(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or

(3) the drug is part of the recipient's current course of treatment.

This paragraph applies to any multistate preferred drug list or supplemental drug rebate
program established or administered by the commissioner. Prior authorization shall
automatically be granted for 60 days for brand name drugs prescribed for treatment of
mental illness within 60 days of when a generically equivalent drug becomes available,
provided that the brand name drug was part of the recipient's course of treatment at the
time the generically equivalent drug became available.

(d) Prior authorization shall not be required or utilized for any antihemophilic factor
drug prescribed for the treatment of hemophilia and blood disorders where there is no
generically equivalent drug available if the prior authorization is used in conjunction with
any supplemental drug rebate program or multistate preferred drug list established or
administered by the commissioner.

(e) The commissioner may require prior authorization for brand name drugs
whenever a generically equivalent product is available, even if the prescriber specifically
indicates "dispense as written-brand necessary" on the prescription as required by section
151.21, subdivision 2.

(f) Notwithstanding this subdivision, the commissioner may automatically require
prior authorization, for a period not to exceed 180 days, for any drug that is approved by
the United States Food and Drug Administration on or after July 1, 2005. The 180-day
period begins no later than the first day that a drug is available for shipment to pharmacies
within the state. The Formulary Committee shall recommend to the commissioner general
criteria to be used for the prior authorization of the drugs, but the committee is not
required to review each individual drug. In order to continue prior authorizations for a
drug after the 180-day period has expired, the commissioner must follow the provisions
of this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 11.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 13j. new text end

new text begin Antipsychotic and attention deficit disorder and attention deficit
hyperactivity disorder medications. new text end

new text begin (a) The commissioner, in consultation with the
Drug Utilization Review Board established in subdivision 13i and actively practicing
pediatric mental health professionals, must:
new text end

new text begin (1) identify recommended pediatric dose ranges for atypical antipsychotic drugs
and drugs used for attention deficit disorder or attention deficit hyperactivity disorder
based on available medical, clinical, and safety data and research. The commissioner
shall periodically review the list of medications and pediatric dose ranges and update
the medications and doses listed as needed after consultation with the Drug Utilization
Review Board;
new text end

new text begin (2) identify situations where a collaborative psychiatric consultation and prior
authorization should be required before the initiation or continuation of drug therapy
in pediatric patients including, but not limited to, high-dose regimens, off-label use of
prescription medication, a patient's young age, and lack of coordination among multiple
prescribing providers; and
new text end

new text begin (3) track prescriptive practices and the use of psychotropic medications in children
with the goal of reducing the use of medication, where appropriate.
new text end

new text begin (b) Effective July 1, 2011, the commissioner shall require prior authorization and
a collaborative psychiatric consultation before the atypical antipsychotic and attention
deficit disorder and attention deficit hyperactivity disorder medications meeting the
criteria identified in paragraph (a), clause (2), are eligible for payment. A collaborative
psychiatric consultation must be completed before the identified medications are eligible
for payment unless:
new text end

new text begin (1) the patient has already been stabilized on the medication regimen; or
new text end

new text begin (2) the prescriber indicates that the child is in crisis.
new text end

new text begin If clause (1) or (2) applies, the collaborative psychiatric consultation must be completed
within 90 days for payment to continue.
new text end

new text begin (c) For purposes of this subdivision, a collaborative psychiatric consultation must
meet the criteria described in section 245.4862, subdivision 5.
new text end

Sec. 12.

Minnesota Statutes 2008, section 256B.0625, subdivision 20, is amended to
read:

Subd. 20.

Mental health case management.

(a) To the extent authorized by rule
of the state agency, medical assistance covers case management services to persons with
serious and persistent mental illness and children with severe emotional disturbance.
Services provided under this section must meet the relevant standards in sections 245.461
to 245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota
Rules, parts 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.

(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe
emotional disturbance when these services meet the program standards in Minnesota
Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.

(c) Medical assistance and MinnesotaCare payment for mental health case
management shall be made on a monthly basis. In order to receive payment for an eligible
child, the provider must document at least a face-to-face contact with the child, the child's
parents, or the child's legal representative. To receive payment for an eligible adult, the
provider must document:

(1) at least a face-to-face contact with the adult or the adult's legal representative; or

(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact with the adult or the adult's legal representative within
the preceding two months.

(d) Payment for mental health case management provided by county or state staff
shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
paragraph (b), with separate rates calculated for child welfare and mental health, and
within mental health, separate rates for children and adults.

(e) Payment for mental health case management provided by Indian health services
or by agencies operated by Indian tribes may be made according to this section or other
relevant federally approved rate setting methodology.

(f) Payment for mental health case management provided by vendors who contract
with a county or Indian tribe shall be based on a monthly rate negotiated by the host county
or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the
county or tribe may negotiate a team rate with a vendor who is a member of the team. The
team shall determine how to distribute the rate among its members. No reimbursement
received by contracted vendors shall be returned to the county or tribe, except to reimburse
the county or tribe for advance funding provided by the county or tribe to the vendor.

(g) If the service is provided by a team which includes contracted vendors, tribal
staff, and county or state staff, the costs for county or state staff participation in the team
shall be included in the rate for county-provided services. In this case, the contracted
vendor, the tribal agency, and the county may each receive separate payment for services
provided by each entity in the same month. In order to prevent duplication of services,
each entity must document, in the recipient's file, the need for team case management and
a description of the roles of the team members.

(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs
for mental health case management shall be provided by the recipient's county of
responsibility, as defined in sections 256G.01 to 256G.12, from sources other than federal
funds or funds used to match other federal funds. If the service is provided by a tribal
agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this
service is paid by the state without a federal share through fee-for-service, 50 percent of
the cost shall be provided by the recipient's county of responsibility new text begin , unless the service
is provided under the general assistance medical care program established in section
256D.031 new text end .

(i) Notwithstanding any administrative rule to the contrary, prepaid medical
assistance, general assistance medical care, and MinnesotaCare include mental health case
management. When the service is provided through prepaid capitation, the nonfederal
share is paid by the state and the county pays no share.

(j) The commissioner may suspend, reduce, or terminate the reimbursement to a
provider that does not meet the reporting or other requirements of this section. The county
of responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal
agency, is responsible for any federal disallowances. The county or tribe may share this
responsibility with its contracted vendors.

(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, clause (15). The repayment is limited to:

(1) the costs of developing and implementing this section; and

(2) programming the information systems.

(l) Payments to counties and tribal agencies for case management expenditures
under this section shall only be made from federal earnings from services provided
under this section. When this service is paid by the state without a federal share through
fee-for-service, 50 percent of the cost shall be provided by the state. Payments to
county-contracted vendors shall include the federal earnings, the state share, and the
county share.

(m) Case management services under this subdivision do not include therapy,
treatment, legal, or outreach services.

(n) If the recipient is a resident of a nursing facility, intermediate care facility, or
hospital, and the recipient's institutional care is paid by medical assistance, payment for
case management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility and may not exceed
more than six months in a calendar year; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 13.

Minnesota Statutes 2009 Supplement, section 256B.195, subdivision 3,
is amended to read:

Subd. 3.

Payments to certain safety net providers.

(a) Effective July 15, 2001, the
commissioner shall make the following payments to the hospitals indicated annually:

(1) to Hennepin County Medical Center, any federal matching funds available to
match the payments received by the medical center under subdivision 2, to increase
payments for medical assistance admissions and to recognize higher medical assistance
costs in institutions that provide high levels of charity care; and

(2) to Regions Hospital, any federal matching funds available to match the payments
received by the hospital under subdivision 2, to increase payments for medical assistance
admissions and to recognize higher medical assistance costs in institutions that provide
high levels of charity care.

(b) Effective July 15, 2001, the following percentages of the transfers under
subdivision 2 shall be retained by the commissioner for deposit each month into the
general fund:

(1) 18 percent, plus any federal matching funds, shall be allocated for the following
purposes:

(i) during the fiscal year beginning July 1, 2001, of the amount available under
this clause, 39.7 percent shall be allocated to make increased hospital payments under
section 256.969, subdivision 26; 34.2 percent shall be allocated to fund the amounts
due from small rural hospitals, as defined in section 144.148, for overpayments under
section 256.969, subdivision 5a, resulting from a determination that medical assistance
and general assistance payments exceeded the charge limit during the period from 1994 to
1997; and 26.1 percent shall be allocated to the commissioner of health for rural hospital
capital improvement grants under section 144.148; and

(ii) during fiscal years beginning on or after July 1, 2002, of the amount available
under this clause, 55 percent shall be allocated to make increased hospital payments under
section 256.969, subdivision 26, and 45 percent shall be allocated to the commissioner of
health for rural hospital capital improvement grants under section 144.148; and

(2) 11 percent shall be allocated to the commissioner of health to fund community
clinic grants under section 145.9268.

(c) This subdivision shall apply to fee-for-service payments only and shall not
increase capitation payments or payments made based on average rates. The allocation in
paragraph (b), clause (1), item (ii), to increase hospital payments under section 256.969,
subdivision 26, shall not limit payments under that section.

(d) Medical assistance rate or payment changes, including those required to obtain
federal financial participation under section 62J.692, subdivision 8, shall precede the
determination of intergovernmental transfer amounts determined in this subdivision.
Participation in the intergovernmental transfer program shall not result in the offset of
any health care provider's receipt of medical assistance payment increases other than
limits resulting from hospital-specific charge limits and limits on disproportionate share
hospital payments.

(e) Effective July 1, 2003, if the amount available for allocation under paragraph
(b) is greater than the amounts available during March 2003, after any increase in
intergovernmental transfers and payments that result from section 256.969, subdivision
3a, paragraph (c), are paid to the general fund, any additional amounts available under this
subdivision after reimbursement of the transfers under subdivision 2 shall be allocated to
increase medical assistance payments, subject to hospital-specific charge limits and limits
on disproportionate share hospital payments, as follows:

(1) if the payments under subdivision 5 are approved, the amount shall be paid to
the largest ten percent of hospitals as measured by 2001 payments for medical assistance,
general assistance medical care, and MinnesotaCare in the nonstate government hospital
category. Payments shall be allocated according to each hospital's proportionate share
of the 2001 payments; or

(2) if the payments under subdivision 5 are not approved, the amount shall be paid to
the largest ten percent of hospitals as measured by 2001 payments for medical assistance,
general assistance medical care, and MinnesotaCare in the nonstate government category
and to the largest ten percent of hospitals as measured by payments for medical assistance,
general assistance medical care, and MinnesotaCare in the nongovernment hospital
category. Payments shall be allocated according to each hospital's proportionate
share of the 2001 payments in their respective category of nonstate government and
nongovernment. The commissioner shall determine which hospitals are in the nonstate
government and nongovernment hospital categories.

new text begin (f) For federal fiscal years 2010 and 2011, payments under this subdivision shall
be made at no less than the federal fiscal year 2009 level.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 14.

Minnesota Statutes 2008, section 256B.69, is amended by adding a
subdivision to read:

new text begin Subd. 5k. new text end

new text begin Temporary rate modifications. new text end

new text begin For services rendered effective May 1,
2010, to June 30, 2011, the total payment made to managed care plans under the medical
assistance program shall be increased by 5.14 percent. This increase shall be paid from the
account established in section 256D.032.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 15.

Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, is
amended to read:

Subd. 3.

General assistance medical care; eligibility.

(a) General assistance
medical care may be paid for any person who is not eligible for medical assistance under
chapter 256B, including eligibility for medical assistance based on a spenddown of excess
income according to section 256B.056, subdivision 5, or MinnesotaCare for applicants
and recipients defined in paragraph (c), except as provided in paragraph (d), and:

(1) who is receiving assistance under section 256D.05, except for families with
children who are eligible under Minnesota family investment program (MFIP), or who is
having a payment made on the person's behalf under sections 256I.01 to 256I.06; or

(2) who is a resident of Minnesota; and

(i) who has gross countable income not in excess of 75 percent of the federal poverty
guidelines for the family size, using a six-month budget period and whose equity in assets
is not in excess of $1,000 per assistance unit. General assistance medical care is not
available for applicants or enrollees who are otherwise eligible for medical assistance but
fail to verify their assets. Enrollees who become eligible for medical assistance shall be
terminated and transferred to medical assistance. Exempt assets, the reduction of excess
assets, and the waiver of excess assets must conform to the medical assistance program in
section 256B.056, subdivisions 3 and 3d, with the following exception: the maximum
amount of undistributed funds in a trust that could be distributed to or on behalf of the
beneficiary by the trustee, assuming the full exercise of the trustee's discretion under the
terms of the trust, must be applied toward the asset maximum; or

(ii) who has gross countable income above 75 percent of the federal poverty
guidelines but not in excess of 175 percent of the federal poverty guidelines for the family
size, using a six-month budget period, whose equity in assets is not in excess of the limits
in section 256B.056, subdivision 3c, and who applies during an inpatient hospitalization.

(b) The commissioner shall adjust the income standards under this section each July
1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.

(c) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may not be paid for applicants or recipients who are adults
with dependent children under 21 whose gross family income is equal to or less than 275
percent of the federal poverty guidelines who are not described in paragraph (f).

(d) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may be paid for applicants and recipients who meet all
eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
beginning the date of application. Immediately following approval of general assistance
medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
subdivision 7, with covered services as provided in section 256L.03 for the rest of the
six-month general assistance medical care eligibility period, until their six-month renewal.

(e) To be eligible for general assistance medical care following enrollment in
MinnesotaCare as required by paragraph (d), an individual must complete a new
application.

(f) Applicants and recipients eligible under paragraph (a), clause (2), item (i), are
exempt from the MinnesotaCare enrollment requirements in this subdivision if they:

(1) have applied for and are awaiting a determination of blindness or disability by
the state medical review team or a determination of eligibility for Supplemental Security
Income or Social Security Disability Insurance by the Social Security Administration;

(2) fail to meet the requirements of section 256L.09, subdivision 2;

(3) are homeless as defined by United States Code, title 42, section 11301, et seq.;

(4) are classified as end-stage renal disease beneficiaries in the Medicare program;

(5) are enrolled in private health care coverage as defined in section 256B.02,
subdivision 9;

(6) are eligible under paragraph (k);

(7) receive treatment funded pursuant to section 254B.02; or

(8) reside in the Minnesota sex offender program defined in chapter 246B.

(g) For applications received on or after October 1, 2003, eligibility may begin no
earlier than the date of application. For individuals eligible under paragraph (a), clause
(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
may reapply if there is a subsequent period of inpatient hospitalization.

(h) Beginning September 1, 2006, Minnesota health care program applications and
renewals completed by recipients and applicants who are persons described in paragraph
(d) and submitted to the county agency shall be determined for MinnesotaCare eligibility
by the county agency. If all other eligibility requirements of this subdivision are met,
eligibility for general assistance medical care shall be available in any month during which
MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
notice of termination for eligibility for general assistance medical care shall be sent to
an applicant or recipient. If all other eligibility requirements of this subdivision are
met, eligibility for general assistance medical care shall be available until enrollment in
MinnesotaCare subject to the provisions of paragraphs (d), (f), and (g).

(i) The date of an initial Minnesota health care program application necessary to
begin a determination of eligibility shall be the date the applicant has provided a name,
address, and Social Security number, signed and dated, to the county agency or the
Department of Human Services. If the applicant is unable to provide a name, address,
Social Security number, and signature when health care is delivered due to a medical
condition or disability, a health care provider may act on an applicant's behalf to establish
the date of an initial Minnesota health care program application by providing the county
agency or Department of Human Services with provider identification and a temporary
unique identifier for the applicant. The applicant must complete the remainder of the
application and provide necessary verification before eligibility can be determined. The
applicant must complete the application within the time periods required under the
medical assistance program as specified in Minnesota Rules, parts 9505.0015, subpart
5, and 9505.0090, subpart 2. The county agency must assist the applicant in obtaining
verification if necessary.

(j) County agencies are authorized to use all automated databases containing
information regarding recipients' or applicants' income in order to determine eligibility for
general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
in order to determine eligibility and premium payments by the county agency.

(k) General assistance medical care is not available for a person in a correctional
facility unless the person is detained by law for less than one year in a county correctional
or detention facility as a person accused or convicted of a crime, or admitted as an
inpatient to a hospital on a criminal hold order, and the person is a recipient of general
assistance medical care at the time the person is detained by law or admitted on a criminal
hold order and as long as the person continues to meet other eligibility requirements
of this subdivision.

(l) General assistance medical care is not available for applicants or recipients who
do not cooperate with the county agency to meet the requirements of medical assistance.

(m) In determining the amount of assets of an individual eligible under paragraph
(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
an asset excluded under paragraph (a), that was given away, sold, or disposed of for
less than fair market value within the 60 months preceding application for general
assistance medical care or during the period of eligibility. Any transfer described in this
paragraph shall be presumed to have been for the purpose of establishing eligibility for
general assistance medical care, unless the individual furnishes convincing evidence to
establish that the transaction was exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair market value at the time it
was given away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial months,
shall be calculated by dividing the uncompensated transfer amount by the average monthly
per person payment made by the medical assistance program to skilled nursing facilities
for the previous calendar year. The individual shall remain ineligible until this fixed period
has expired. The period of ineligibility may exceed 30 months, and a reapplication for
benefits after 30 months from the date of the transfer shall not result in eligibility unless
and until the period of ineligibility has expired. The period of ineligibility begins in the
month the transfer was reported to the county agency, or if the transfer was not reported,
the month in which the county agency discovered the transfer, whichever comes first. For
applicants, the period of ineligibility begins on the date of the first approved application.

(n) When determining eligibility for any state benefits under this subdivision,
the income and resources of all noncitizens shall be deemed to include their sponsor's
income and resources as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
subsequently set out in federal rules.

(o) Undocumented noncitizens and nonimmigrants are ineligible for general
assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
in one or more of the classes listed in United States Code, title 8, section 1101, subsection
(a), paragraph (15), and an undocumented noncitizen is an individual who resides in
the United States without the approval or acquiescence of the United States Citizenship
and Immigration Services.

(p) Notwithstanding any other provision of law, a noncitizen who is ineligible for
medical assistance due to the deeming of a sponsor's income and resources, is ineligible
for general assistance medical care.

(q) Effective July 1, 2003, general assistance medical care emergency services end.

new text begin (r) For the period beginning March 1, 2010, and ending July 1, 2011, the general
assistance medical care program shall be administered according to section 256D.031,
unless otherwise stated.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 16.

new text begin [256D.031] GENERAL ASSISTANCE MEDICAL CARE.
new text end

new text begin Subdivision 1. new text end

new text begin Eligibility. new text end

new text begin (a) Except as provided under subdivision 2, general
assistance medical care may be paid for any individual who is not eligible for medical
assistance under chapter 256B, including eligibility for medical assistance based on a
spenddown of excess income according to section 256B.056, subdivision 5, and who:
new text end

new text begin (1) is receiving assistance under section 256D.05, except for families with children
who are eligible under the Minnesota family investment program (MFIP), or who is
having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
new text end

new text begin (2) is a resident of Minnesota and has gross countable income not in excess of 75
percent of federal poverty guidelines for the family size, using a six-month budget period,
and whose equity in assets is not in excess of $1,000 per assistance unit.
new text end

new text begin Exempt assets, the reduction of excess assets, and the waiver of excess assets must
conform to the medical assistance program in section 256B.056, subdivisions 3 and 3d,
except that the maximum amount of undistributed funds in a trust that could be distributed
to or on behalf of the beneficiary by the trustee, assuming the full exercise of the trustee's
discretion under the terms of the trust, must be applied toward the asset maximum.
new text end

new text begin (b) The commissioner shall adjust the income standards under this section each July
1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.
new text end

new text begin Subd. 2. new text end

new text begin Ineligible groups. new text end

new text begin (a) General assistance medical care may not be paid for
an applicant or a recipient who:
new text end

new text begin (1) is otherwise eligible for medical assistance but fails to verify their assets;
new text end

new text begin (2) is an adult in a family with children as defined in section 256L.01, subdivision 3a;
new text end

new text begin (3) is enrolled in private health coverage as defined in section 256B.02, subdivision
9;
new text end

new text begin (4) is in a correctional facility, including an individual in a county correctional or
detention facility as an individual accused or convicted of a crime, or admitted as an
inpatient to a hospital on a criminal hold order;
new text end

new text begin (5) resides in the Minnesota sex offender program defined in chapter 246B;
new text end

new text begin (6) does not cooperate with the county agency to meet the requirements of medical
assistance;
new text end

new text begin (7) does not cooperate with a county or state agency or the state medical review team
in determining a disability or for determining eligibility for Supplemental Security Income
or Social Security Disability Insurance by the Social Security Administration; or
new text end

new text begin (8) fails to meet the requirements of section 256L.09, subdivision 2.
new text end

new text begin (b) Undocumented noncitizens and nonimmigrants are ineligible for general
assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
in one or more of the classes listed in United States Code, title 8, section 1101, subsection
(a), paragraph (15), and an undocumented noncitizen is an individual who resides in the
United States without approval or acquiescence of the United States Citizenship and
Immigration Services.
new text end

new text begin (c) Notwithstanding any other provision of law, a noncitizen who is ineligible for
medical assistance due to the deeming of a sponsor's income and resources is ineligible for
general assistance medical care.
new text end

new text begin (d) General assistance medical care recipients who become eligible for medical
assistance shall be terminated from general assistance medical care and transferred to
medical assistance.
new text end

new text begin Subd. 3. new text end

new text begin Transitional MinnesotaCare. new text end

new text begin (a) Except as provided in paragraph (c),
effective March 1, 2010, all applicants and recipients who meet the eligibility requirements
in subdivision 1, paragraph (a), clause (2), and who are not described in subdivision 2
shall be enrolled in MinnesotaCare under section 256L.04, subdivision 7, immediately
following approval of general assistance medical care.
new text end

new text begin (b) If all other eligibility requirements of this subdivision are met, general assistance
medical care may be paid for individuals identified in paragraph (a) for a temporary
period beginning the date of application. Eligibility for general assistance medical care
shall continue until enrollment in MinnesotaCare is completed. Upon notification of
eligibility for MinnesotaCare, notice of termination for eligibility for general assistance
medical care shall be sent to the applicant or recipient. Once enrolled in MinnesotaCare,
the MinnesotaCare-covered services as described in section 256L.03 shall apply for the
remainder of the six-month general assistance medical care eligibility period until their
six-month renewal.
new text end

new text begin (c) This subdivision does not apply if the applicant or recipient:
new text end

new text begin (1) has applied for and is awaiting a determination of blindness or disability by the
state medical review team or a determination of eligibility for Supplemental Security
Income or Social Security Disability Insurance by the Social Security Administration;
new text end

new text begin (2) is homeless as defined by United States Code, title 42, section 11301, et seq.;
new text end

new text begin (3) is classified as an end-stage renal disease beneficiary in the Medicare program; or
new text end

new text begin (4) receives treatment funded in section 254B.02.
new text end

new text begin Applicants and recipients who meet any one of these criteria shall remain eligible for
general assistance medical care and shall not be required to enroll in MinnesotaCare.
new text end

new text begin (d) To be eligible for general assistance medical care following enrollment
in MinnesotaCare as required in paragraph (a), an individual must complete a new
application.
new text end

new text begin Subd. 4. new text end

new text begin Eligibility and enrollment procedures. new text end

new text begin (a) Eligibility for general
assistance medical care shall begin no earlier than the date of application. The date of
application shall be the date the applicant has provided a name, address, and Social
Security number, signed and dated, to the county agency or the Department of Human
Services. If the applicant is unable to provide a name, address, Social Security number,
and signature when health care is delivered due to a medical condition or disability, a
health care provider may act on an applicant's behalf to establish the date of an application
by providing the county agency or Department of Human Services with provider
identification and a temporary unique identifier for the applicant. The applicant must
complete the remainder of the application and provide necessary verification before
eligibility can be determined. The applicant must complete the application within the time
periods required under the medical assistance program as specified in Minnesota Rules,
parts 9505.0015, subpart 5; and 9505.0090, subpart 2. The county agency must assist the
applicant in obtaining verification if necessary.
new text end

new text begin (b) County agencies are authorized to use all automated databases containing
information regarding recipients' or applicants' income in order to determine eligibility for
general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
in order to determine eligibility and premium payments by the county agency.
new text end

new text begin (c) In determining the amount of assets of an individual eligible under subdivision 1,
paragraph (a), clause (2), there shall be included any asset or interest in an asset, including
an asset excluded under subdivision 1, paragraph (a), that was given away, sold, or
disposed of for less than fair market value within the 60 months preceding application for
general assistance medical care or during the period of eligibility. Any transfer described
in this paragraph shall be presumed to have been for the purpose of establishing eligibility
for general assistance medical care, unless the individual furnishes convincing evidence to
establish that the transaction was exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair market value at the time it
was given away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial months,
shall be calculated by dividing the uncompensated transfer amount by the average monthly
per person payment made by the medical assistance program to skilled nursing facilities
for the previous calendar year. The individual shall remain ineligible until this fixed period
has expired. The period of ineligibility may exceed 30 months, and a reapplication for
benefits after 30 months from the date of the transfer shall not result in eligibility unless
and until the period of ineligibility has expired. The period of ineligibility begins in the
month the transfer was reported to the county agency, or if the transfer was not reported,
the month in which the county agency discovered the transfer, whichever comes first. For
applicants, the period of ineligibility begins on the date of the first approved application.
new text end

new text begin (d) When determining eligibility for any state benefits under this subdivision,
the income and resources of all noncitizens shall be deemed to include their sponsor's
income and resources as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
subsequently set out in federal rules.
new text end

new text begin Subd. 5. new text end

new text begin General assistance medical care; services. new text end

new text begin (a) General assistance
medical care covers:
new text end

new text begin (1) inpatient hospital services within the limitations described in subdivision 10;
new text end

new text begin (2) outpatient hospital services;
new text end

new text begin (3) services provided by Medicare-certified rehabilitation agencies;
new text end

new text begin (4) prescription drugs and other products recommended through the process
established in section 256B.0625, subdivision 13;
new text end

new text begin (5) equipment necessary to administer insulin and diagnostic supplies and equipment
for diabetics to monitor blood sugar level;
new text end

new text begin (6) eyeglasses and eye examinations provided by a physician or optometrist;
new text end

new text begin (7) hearing aids;
new text end

new text begin (8) prosthetic devices;
new text end

new text begin (9) laboratory and x-ray services;
new text end

new text begin (10) physicians' services;
new text end

new text begin (11) medical transportation except special transportation;
new text end

new text begin (12) chiropractic services as covered under the medical assistance program;
new text end

new text begin (13) podiatric services;
new text end

new text begin (14) dental services as covered under the medical assistance program;
new text end

new text begin (15) mental health services covered under chapter 256B;
new text end

new text begin (16) prescribed medications for persons who have been diagnosed as mentally ill as
necessary to prevent more restrictive institutionalization;
new text end

new text begin (17) medical supplies and equipment, and Medicare premiums, coinsurance, and
deductible payments;
new text end

new text begin (18) medical equipment not specifically listed in this paragraph when the use of
the equipment will prevent the need for costlier services that are reimbursable under
this subdivision;
new text end

new text begin (19) services performed by a certified pediatric nurse practitioner, a certified family
nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
practitioner in independent practice, if (1) the service is otherwise covered under this
chapter as a physician service, (2) the service provided on an inpatient basis is not included
as part of the cost for inpatient services included in the operating payment rate, and (3) the
service is within the scope of practice of the nurse practitioner's license as a registered
nurse, as defined in section 148.171;
new text end

new text begin (20) services of a certified public health nurse or a registered nurse practicing in
a public health nursing clinic that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the scope of practice of the
public health nurse's license as a registered nurse, as defined in section 148.171;
new text end

new text begin (21) telemedicine consultations, to the extent they are covered under section
256B.0625, subdivision 3b;
new text end

new text begin (22) care coordination and patient education services provided by a community
health worker according to section 256B.0625, subdivision 49; and
new text end

new text begin (23) regardless of the number of employees that an enrolled health care provider
may have, sign language interpreter services when provided by an enrolled health care
provider during the course of providing a direct, person-to-person-covered health care
service to an enrolled recipient who has a hearing loss and uses interpreting services.
new text end

new text begin (b) Sex reassignment surgery is not covered under this section.
new text end

new text begin (c) Drug coverage is covered in accordance with section 256D.03, subdivision 4,
paragraph (d).
new text end

new text begin (d) The following co-payments shall apply for services provided:
new text end

new text begin (1) $25 for nonemergency visits to a hospital-based emergency room; and
new text end

new text begin (2) $3 per brand-name drug prescription, subject to a $7 per month maximum for
prescription drug co-payments. No co-payments shall apply to antipsychotic drugs when
used for the treatment of mental illness.
new text end

new text begin (e) Co-payments shall be limited to one per day per provider for nonemergency
visits to a hospital-based emergency room. Recipients of general assistance medical care
are responsible for all co-payments in this subdivision. Reimbursement for prescription
drugs shall be reduced by the amount of the co-payment until the recipient has reached the
$7 per month maximum for prescription drug co-payments. The provider shall collect
the co-payment from the recipient. Providers may not deny services to recipients who
are unable to pay the co-payment.
new text end

new text begin (f) Chemical dependency services that are reimbursed under chapter 254B shall not
be reimbursed under general assistance medical care.
new text end

new text begin (g) Inpatient hospital services that are provided in community behavioral health
hospitals operated by state-operated services shall not be reimbursed under general
assistance medical care.
new text end

new text begin Subd. 6. new text end

new text begin Temporary division of costs. new text end

new text begin (a) Beginning March 1, 2010, and ending
July 1, 2011, the county share of state expenditures for general assistance medical care
shall be ten percent. The county share of the state expenditures shall be assessed based
on the recipient's county of financial responsibility as defined in section 256G.02. To
implement this subdivision, the commissioner may select the most appropriate and
efficient billing and receipting methods.
new text end

new text begin (b) This subdivision is exempt from the limitations described in section 275.77.
new text end

new text begin Subd. 7. new text end

new text begin Coordinated care delivery option. new text end

new text begin (a) A county or group of counties may
elect to provide health care and supportive services to individuals who are eligible for
general assistance medical care under this section and who reside within the county or
counties through a coordinated care delivery option. The health care services provided
by the county must include the services described in subdivision 5 with the exception of
outpatient prescription drug coverage but including drugs administered in an outpatient
setting. Support services may include, but are not limited to, social services, outreach,
health care navigation, housing, and transportation. Counties that elect to provide health
care services through this option must ensure that the requirements of this subdivision
are met. Upon electing to provide services through this option, the county accepts the
financial risk of the delivery of the health care services described in this subdivision to
general assistance medical care recipients residing in the county for the period beginning
July 1, 2010, and ending July 1, 2011, for the fixed payments described in subdivision 10.
new text end

new text begin (b) A county that elects to provide services through this option must provide to
the commissioner the following:
new text end

new text begin (1) the names of the county or counties that are electing to provide services through
the county care delivery option; and
new text end

new text begin (2) the geographic area to be served.
new text end

new text begin (c) The county may contract with a managed care plan, an integrated delivery
system, a physician-hospital organization, or an academic health center to administer
the delivery of services through this option. Any county providing general assistance
medical care services through a county-based purchasing plan in accordance with section
256B.692 may continue to provide services through the county-based purchasing plan.
Payments to the county-based purchasing plan for the period beginning July 1, 2010, and
ending July 1, 2011, shall be paid according to subdivision 10.
new text end

new text begin (d) A county must demonstrate the ability to:
new text end

new text begin (1) provide the covered services required under this subdivision to recipients
residing within the county;
new text end

new text begin (2) provide a system for advocacy, consumer protection, and complaints and appeals
that is independent of care providers or other risk bearers and complies with section
256B.69;
new text end

new text begin (3) establish a process to ensure and improve the quality of care provided; and
new text end

new text begin (4) coordinate the delivery of health care services with existing homeless prevention,
supportive housing, and rent subsidy programs and funding administered by the Minnesota
Housing Finance Agency under chapter 462A.
new text end

new text begin (e) The commissioner may require the county to provide the commissioner with data
necessary for assessing quality of care, cost, and utilization of services.
new text end

new text begin (f) A county that elects to provide services through this option shall be considered to
be a prepaid health plan for purposes of section 256.045.
new text end

new text begin (g) The state shall not be liable for the payment of any cost or obligation incurred
by the county or a participating provider.
new text end

new text begin Subd. 8. new text end

new text begin Health care home designation. new text end

new text begin The commissioner or a county may
require a recipient to designate a primary care provider or a primary care clinic that is
certified as a health care home under section 256B.0751.
new text end

new text begin Subd. 9. new text end

new text begin Payments; fee-for-service rate for the period between March 1,
2010, and July 1, 2010. new text end

new text begin (a) Effective for services provided on or after March 1, 2010,
and before July 1, 2010, the payment rates for all covered services provided to general
assistance medical care recipients, with the exception of outpatient prescription drug
coverage, shall be 50 percent of the general assistance medical care payment rate in effect
on February 28, 2010.
new text end

new text begin (b) Outpatient prescription drug coverage provided on or after March 1, 2010, and
before July 1, 2010, shall be paid on a fee-for-service basis in accordance with section
256B.0625, subdivision 13e.
new text end

new text begin Subd. 10. new text end

new text begin Payments; fee-for-service rates for the period between July 1, 2010,
and July 1, 2011. new text end

new text begin (a) Effective for services provided on or after July 1, 2010, and before
July 1, 2011, to general assistance medical care recipients residing in counties that are
not served through the coordinated care delivery option, payments shall be made by the
commissioner to providers at rates described in this subdivision.
new text end

new text begin (b) For inpatient hospital admissions provided on or after July 1, 2010, and before
July 1, 2011, the payment rate shall be:
new text end

new text begin (1) 70 percent of the general assistance medical care rate in effect on February
28, 2010, if the inpatient hospital services were provided in a hospital where the
fee-for-service inpatient and outpatient hospital general assistance medical care payments
to the hospital for admissions provided in calendar year 2007 totaled $1,000,000 or more
or the hospital's fee-for-service inpatient and outpatient hospital general assistance medical
care payments received for calendar year 2007 admissions was one percent or more of the
hospital's net patient revenue received for services provided in calendar year 2007; or
new text end

new text begin (2) 40 percent of the general assistance medical care rate in effect on February 28,
2010, if the inpatient hospital services were provided by a hospital that does not meet the
criteria described in clause (1).
new text end

new text begin (c) Effective for services other than inpatient hospital services and outpatient
prescription drug coverage provided on or after July 1, 2010, and before July 1, 2011,
the payment rate shall begin at 50 percent of the general assistance medical care rate
in effect on February 28, 2010.
new text end

new text begin (d) Outpatient prescription drug coverage provided on or after July 1, 2010, and
before July 1, 2011, shall be paid on a fee-for-service basis in accordance with section
256B.0625, subdivision 13e.
new text end

new text begin (e) The commissioner may adjust the rates paid under paragraphs (b) and (c) on a
quarterly basis to ensure that the total aggregate amount paid out for services provided
on a fee-for-service basis beginning March 1, 2010, and ending June 30, 2011, does not
exceed the appropriation from the general assistance medical care account established in
section 256D.032 for the general assistance medical care program.
new text end

new text begin Subd. 11. new text end

new text begin Payments; rate setting for the coordinated care delivery option. new text end

new text begin (a)
Effective for general assistance medical care services, with the exception of outpatient
prescription drug coverage, provided on or after July 1, 2010, and before July 1, 2011,
to recipients residing in counties that have elected to provide services through the
coordinated delivery care option, the commissioner shall establish quarterly prospective
fixed payments to the county. The payments must not exceed 60 percent of the county's
general assistance medical care county allocation amount as determined in paragraph (b).
These payments must not be used by the county to pay MinnesotaCare premiums for
general assistance medical care recipients or MinnesotaCare enrollees.
new text end

new text begin (b) For each county that elects to provide services in accordance with subdivision
7, the commissioner shall determine a general assistance medical care county allocation
amount that equals the total general assistance medical care payments made for recipients
residing within the county in fiscal year 2009 for all covered general assistance medical
care services with the exception of outpatient prescription drug coverage.
new text end

new text begin (c) Outpatient prescription drug coverage provided on or after July 1, 2010,
and before July 1, 2011, shall be paid on a fee-for-service basis according to section
256B.0625, subdivision 13e.
new text end

new text begin Subd. 12. new text end

new text begin Unallotment. new text end

new text begin Appropriations for this program are not subject to section
16A.152, subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for services rendered on or after
March 1, 2010, and before July 1, 2011.
new text end

Sec. 17.

new text begin [256D.032] GENERAL ASSISTANCE MEDICAL CARE ACCOUNT.
new text end

new text begin The general assistance medical care account is created in the special revenue fund.
Money deposited into the account is subject to appropriation by the legislature.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 18.

Minnesota Statutes 2008, section 256L.05, subdivision 1b, is amended to read:

Subd. 1b.

MinnesotaCare enrollment by county agencies.

Beginning September
1, 2006, county agencies shall enroll single adults and households with no children
formerly enrolled in general assistance medical care in MinnesotaCare according to
section 256D.03, subdivision 3 new text begin , or 256D.031 new text end . County agencies shall perform all duties
necessary to administer the MinnesotaCare program ongoing for these enrollees, including
the redetermination of MinnesotaCare eligibility at renewal.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 19.

Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:

Subd. 3.

Effective date of coverage.

(a) The effective date of coverage is the
first day of the month following the month in which eligibility is approved and the first
premium payment has been received. As provided in section 256B.057, coverage for
newborns is automatic from the date of birth and must be coordinated with other health
coverage. The effective date of coverage for eligible newly adoptive children added to a
family receiving covered health services is the month of placement. The effective date
of coverage for other new members added to the family is the first day of the month
following the month in which the change is reported. All eligibility criteria must be met
by the family at the time the new family member is added. The income of the new family
member is included with the family's gross income and the adjusted premium begins in
the month the new family member is added.

(b) The initial premium must be received by the last working day of the month for
coverage to begin the first day of the following month.

(c) Benefits are not available until the day following discharge if an enrollee is
hospitalized on the first day of coverage.

(d) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to
256L.18 are secondary to a plan of insurance or benefit program under which an eligible
person may have coverage and the commissioner shall use cost avoidance techniques to
ensure coordination of any other health coverage for eligible persons. The commissioner
shall identify eligible persons who may have coverage or benefits under other plans of
insurance or who become eligible for medical assistance.

(e) The effective date of coverage for single adults and households with no children
formerly enrolled in general assistance medical care and enrolled in MinnesotaCare
according to section 256D.03, subdivision 3, new text begin or 256D.031, new text end is the first day of the month
following the last day of general assistance medical care coverage.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 20.

Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:

Subd. 3a.

Renewal of eligibility.

(a) Beginning July 1, 2007, an enrollee's eligibility
must be renewed every 12 months. The 12-month period begins in the month after the
month the application is approved.

(b) Each new period of eligibility must take into account any changes in
circumstances that impact eligibility and premium amount. An enrollee must provide all
the information needed to redetermine eligibility by the first day of the month that ends
the eligibility period. If there is no change in circumstances, the enrollee may renew
eligibility at designated locations that include community clinics and health care providers'
offices. The designated sites shall forward the renewal forms to the commissioner. The
commissioner may establish criteria and timelines for sites to forward applications to the
commissioner or county agencies. The premium for the new period of eligibility must be
received as provided in section 256L.06 in order for eligibility to continue.

(c) For single adults and households with no children formerly enrolled in general
assistance medical care and enrolled in MinnesotaCare according to section 256D.03,
subdivision 3, new text begin or 256D.031, new text end the first period of eligibility begins the month the enrollee
submitted the application or renewal for general assistance medical care.

(d) An enrollee who fails to submit renewal forms and related documentation
necessary for verification of continued eligibility in a timely manner shall remain eligible
for one additional month beyond the end of the current eligibility period before being
disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the
additional month.

Sec. 21.

Minnesota Statutes 2008, section 256L.07, subdivision 6, is amended to read:

Subd. 6.

Exception for certain adults.

Single adults and households with
no children formerly enrolled in general assistance medical care and enrolled in
MinnesotaCare according to section 256D.03, subdivision 3, new text begin or 256D.031, new text end are eligible
without meeting the requirements of this section until renewal.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 22.

Minnesota Statutes 2008, section 256L.15, subdivision 4, is amended to read:

Subd. 4.

Exception for transitioned adults.

County agencies shall pay premiums
for single adults and households with no children formerly enrolled in general assistance
medical care and enrolled in MinnesotaCare according to section 256D.03, subdivision 3,
new text begin or 256D.031, new text end until six-month renewal. The county agency has the option of continuing to
pay premiums for these enrollees.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 23.

Minnesota Statutes 2008, section 256L.17, subdivision 7, is amended to read:

Subd. 7.

Exception for certain adults.

Single adults and households with
no children formerly enrolled in general assistance medical care and enrolled in
MinnesotaCare according to section 256D.03, subdivision 3, new text begin or 256D.031, new text end are exempt
from the requirements of this section until renewal.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 24. new text begin DRUG REBATE PROGRAM.
new text end

new text begin The commissioner of human services shall continue to administer a drug rebate
program for drugs purchased for persons eligible for the general assistance medical care
program in accordance with Minnesota Statutes, sections 256.01, subdivision 2, paragraph
(cc), and 256D.03. The rebate revenues collected under the drug rebate program for
persons eligible for the general assistance medical care program shall be deposited in the
general assistance medical care account in the special revenue fund established under
Minnesota Statutes, section 256D.032.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010, and expires June
30, 2011.
new text end

Sec. 25. new text begin TEMPORARY SUSPENSION.
new text end

new text begin (a) For the period beginning March 1, 2010, to June 30, 2011, the commissioner
of human services shall not implement or administer Minnesota Statutes 2008, section
256D.03, subdivisions 6 and 9; Minnesota Statutes 2009 Supplement, section 256D.03,
subdivision 4; or Minnesota Statutes 2008, section 256B.692; and Minnesota Statutes
2009 Supplement, section 256B.69, as they apply to the general assistance medical care
program unless specifically continued in Minnesota Statutes, section 256D.031.
new text end

new text begin (b) Notwithstanding paragraph (a), outpatient prescription drug coverage shall
continue to be provided under Minnesota Statutes, section 256D.03.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010, and expires July 1,
2011.
new text end

Sec. 26. new text begin MINNESOTA COMPREHENSIVE HEALTH ASSOCIATION
ASSESSMENT MODIFICATION; TRANSFER.
new text end

new text begin Subdivision 1. new text end

new text begin Minnesota Comprehensive Health Association assessment
modification. new text end

new text begin For the purpose of the annual assessment allocation required in Minnesota
Statutes, section 62E.11, the Minnesota Comprehensive Health Association shall credit
$....... to HealthPartners' assessment for calendar year 2010 and $....... to HealthPartners'
assessment for calendar year 2011, upon receipt by the association of the transfers
specified in subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Transfer. new text end

new text begin $....... shall be transferred in fiscal year 2011 and $....... in fiscal
year 2012 from the general assistance medical care account established in Minnesota
Statutes, section 256D.032, to the commissioner of commerce for disbursement upon
receipt to the Minnesota Comprehensive Health Association, to compensate for the loss in
the association's assessments created by the credits specified in subdivision 1.
new text end

Sec. 27. new text begin APPROPRIATION TRANSFERS.
new text end

new text begin (a) Of the general fund appropriation to the commissioner of human services for
health care management in Laws 2009, chapter 79, article 13, section 3, subdivision
7, as amended by Laws 2009, chapter 173, article 2, section 1, $3,300,000 for health
care administration and $4,100,000 for health care operations shall be transferred on
March 1, 2010, to the fund established in Minnesota Statutes, section 256D.032. These
amounts are appropriated to the commissioner for the administration and operation of the
general assistance medical care program under Minnesota Statutes, section 256D.031. For
purposes of consistent cost allocation and accounting, the commissioner may transfer the
amounts appropriated for program administration and operation to the general fund.
new text end

new text begin (b) Of the general fund appropriation to the commissioner of human services for
general assistance medical care grants in fiscal year 2010 in Laws 2009, chapter 79, article
13, section 3, subdivision 6, paragraph (d), as amended by Laws 2009, chapter 173, article
2, section 1, $26,000,000 shall be transferred on March 1, 2010, to the fund established
in Minnesota Statutes, section 256D.032.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 28. new text begin APPROPRIATIONS.
new text end

new text begin The following appropriations are from the account established in Minnesota
Statutes, section 256D.032, to the commissioner of human services for the time periods
and purposes indicated:
new text end

new text begin (1) $....... for the period from March 1, 2010, to June 30, 2010, and $....... for fiscal
year 2011 for the hospital rate increases under Minnesota Statutes, section 256.969. The
commissioner may transfer these appropriations to the medical assistance account in the
general fund and pay the rate increases from the medical assistance account;
new text end

new text begin (2) $....... for the period from March 1, 2010, to June 30, 2010, and $....... for
fiscal year 2011 for the managed care plan rate increase in Minnesota Statutes, section
256B.69, subdivision 5k. The commissioner may transfer these appropriations to the
medical assistance account in the general fund and pay the rate increases from the medical
assistance account; and
new text end

new text begin (3) $....... for the period from March 1, 2010, to June 30, 2010, and $....... for fiscal
year 2011 for the general assistance medical care program established in Minnesota
Statutes, section 256D.031.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end