HF 2702

as introduced - 79th Legislature (1995 - 1996) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to medical assistance; prohibiting expansion 
  1.3             of the prepayment program into additional counties 
  1.4             unless requested by the county board; authorizing 
  1.5             joint purchaser demonstration projects; amending 
  1.6             Minnesota Statutes 1995 Supplement, section 256B.69, 
  1.7             subdivisions 3a and 21. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 1995 Supplement, section 
  1.10  256B.69, subdivision 3a, is amended to read: 
  1.11     Subd. 3a.  [COUNTY AUTHORITY.] The commissioner, when 
  1.12  implementing the general assistance medical care or medical 
  1.13  assistance prepayment program within a county, must include the 
  1.14  county board in the process of development, approval, and 
  1.15  issuance of the request for proposals to provide services to 
  1.16  eligible individuals within the proposed county.  County boards 
  1.17  must be given reasonable opportunity to make recommendations 
  1.18  regarding the development, issuance, review of responses, and 
  1.19  changes needed in the request for proposals.  The commissioner 
  1.20  must provide county boards the opportunity to review each 
  1.21  proposal based on the identification of community needs under 
  1.22  chapters 145A and 256E and county advocacy activities.  If a 
  1.23  county board finds that a proposal does not address certain 
  1.24  community needs, the county board and commissioner shall 
  1.25  continue efforts for improving the proposal and network prior to 
  1.26  the approval of the contract.  The county board shall make 
  2.1   recommendations regarding the approval of local networks and 
  2.2   their operations to ensure adequate availability and access to 
  2.3   covered services.  The provider or health plan must respond 
  2.4   directly to county advocates and the state prepaid medical 
  2.5   assistance ombudsperson regarding service delivery and must be 
  2.6   accountable to the state regarding contracts with medical 
  2.7   assistance and general assistance medical care funds.  The 
  2.8   county board may recommend a maximum number of participating 
  2.9   health plans after considering the size of the enrolling 
  2.10  population; ensuring adequate access and capacity; considering 
  2.11  the client and county administrative complexity; and considering 
  2.12  the need to promote the viability of locally developed health 
  2.13  plans.  Prior to the development of the request for proposal, 
  2.14  there shall be established a mutually agreed upon timetable.  
  2.15  This process shall in no way delay the department's ability to 
  2.16  secure and finalize contracts for the medical assistance 
  2.17  prepayment program.  The medical assistance prepayment program 
  2.18  shall not be expanded to any of the additional 71 counties that 
  2.19  have not begun enrollment as of January 15, 1996, unless 
  2.20  expansion is requested by the county board. 
  2.21     Sec. 2.  Minnesota Statutes 1995 Supplement, section 
  2.22  256B.69, subdivision 21, is amended to read: 
  2.23     Subd. 21.  [PREPAYMENT COORDINATOR.] The local agency 
  2.24  county board shall designate a prepayment coordinator to assist 
  2.25  the state agency in implementing this section and section 
  2.26  256D.03, subdivision 4.  Assistance must include educating 
  2.27  recipients about available health care options, enrolling 
  2.28  recipients under subdivision 5, providing necessary eligibility 
  2.29  and enrollment information to health plans and the state agency, 
  2.30  and coordinating complaints and appeals with the ombudsman 
  2.31  established in subdivision 18. 
  2.32     Sec. 3.  [JOINT PURCHASER DEMONSTRATION PROJECTS.] 
  2.33     Subdivision 1.  [DEMONSTRATION PROJECTS.] A county or group 
  2.34  of counties may implement a county-based demonstration project, 
  2.35  including the option for direct contracting by counties with 
  2.36  local providers or provider networks, for services provided to 
  3.1   eligible individuals under medical assistance, general 
  3.2   assistance medical care, MinnesotaCare, state health and social 
  3.3   service grants, and county-funded programs for these or other 
  3.4   participants, including, at the county option, county employees. 
  3.5      Subd. 2.  [OBJECTIVES.] The objective of the demonstration 
  3.6   project is to promote the development of local provider 
  3.7   networks; further define the county and state role, authorities, 
  3.8   and functions in providing publicly reimbursed health and social 
  3.9   services, including services reimbursed by the county; provide 
  3.10  better coordination of services, increased competition, and 
  3.11  consumer choice and entry of providers into the marketplace; 
  3.12  identify mechanisms to ensure short-term and long-term control 
  3.13  of costs and avoidance of cost shifting; define adequate 
  3.14  financing within a capital allocation; and develop state-county 
  3.15  risk-sharing strategies, which may include stop-loss protection, 
  3.16  reinsurance, and retrospective risk adjustment.  The 
  3.17  demonstration projects shall also develop accountability 
  3.18  strategies such as mutually defined outcomes and reporting 
  3.19  requirements. 
  3.20     Subd. 3.  [PROJECT SCOPE.] Demonstration projects shall be 
  3.21  subject to definitions of eligibility, benefits, and appeal 
  3.22  processes under the medical assistance, general assistance 
  3.23  medical care, and MinnesotaCare programs.  County-based 
  3.24  demonstration projects shall report to the legislature by 
  3.25  January 15, 1997, with recommendations for county reporting, 
  3.26  financing, and risk-sharing methodologies.