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HF 2736

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

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to human services; modifying MinnesotaCare coverage for certain single
adults and households without children; amending Minnesota Statutes 2008,
sections 256D.03, by adding a subdivision; 256L.05, subdivision 3; 256L.15,
subdivision 4; proposing coding for new law in Minnesota Statutes, chapter 256L.

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

Section 1.

Minnesota Statutes 2008, section 256D.03, is amended by adding a
subdivision to read:


new text begin Subd. 3c. new text end

new text begin Enrollee characteristics; eligibility criteria. new text end

new text begin The commissioner of
human services shall study the demographic characteristics, health care needs, and health
care service utilization of individuals enrolled in general assistance medical care for all or
part of the period January 1, 2006, through December 31, 2009. The commissioner, by
September 1, 2010, shall identify the characteristics of enrollees who can be effectively
served under the standard MinnesotaCare program and the characteristics of enrollees who
cannot be effectively served under the standard MinnesotaCare program but can be served
effectively under modified MinnesotaCare coverage for single adults and households
without children. Based upon this analysis, the commissioner shall establish eligibility
criteria under which individuals would qualify for modified MinnesotaCare coverage for
single adults and households without children.
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. 2.

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, is the first day of the month following the
last day of general assistance medical care coverage.

new text begin (f) Effective for applications submitted March 1, 2010, through June 30, 2011, the
effective date of coverage for persons formerly enrolled in general assistance medical
care and enrolled in MinnesotaCare according to section 256D.03, subdivision 3, shall
be no earlier than the date of application for general assistance medical care. Effective
for applications submitted on or after July 1, 2011, the effective date of coverage
provisions in this paragraph apply only if the person also meets the criteria established by
the commissioner under section 256D.03, subdivision 3c, for modified MinnesotaCare
coverage for single adults and households without children. The effective date of coverage
for persons who do not meet these criteria shall be the first day of the month following
approval of eligibility.
new text end

new text begin (g) Effective for applications submitted March 1, 2010, through June 30, 2011, the
effective date of coverage for applicants who are single adults and households without
children under section 256L.04, subdivision 7, with gross family incomes that do not
exceed 100 percent of the federal poverty guidelines, shall be no earlier than the date
of application for MinnesotaCare. Effective for applications submitted on or after July
1, 2011, the effective date of coverage provisions in this paragraph apply only if the
person also meets the criteria established by the commissioner under section 256D.03,
subdivision 3c, for modified MinnesotaCare coverage for single adults and households
without children. The effective date of coverage for persons who do not meet these criteria
shall be the first day of the month following approval of eligibility.
new text end

new text begin (h) MinnesotaCare coverage for persons whose effective date of coverage is
determined under paragraph (f) or (g) shall be provided on a fee-for-service basis for three
months, or until the person is enrolled in a managed care plan, whichever is earlier. If
a person has not enrolled in a managed care plan within three months, MinnesotaCare
coverage ends and will resume only upon enrollment in a managed care plan.
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. 3.

new text begin [256L.121] HEALTH CARE HOME PROGRAM FOR CERTAIN
SINGLE ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; contract with commissioner. new text end

new text begin (a) new text end new text begin The commissioner
shall develop and implement, by July 1, 2011, a county-based, health care home program
for those individuals identified by the commissioner under section 256D.03, subdivision
3c, as being more effectively served under modified MinnesotaCare coverage for single
adults and households without children.
new text end

new text begin (b) Participation by counties in the program is voluntary and subject to approval by,
and entering into a contract with, the commissioner. Contract requirements must include:
new text end

new text begin (1) criteria and procedures for county participation, and withdrawal from, the health
care home program;
new text end

new text begin (2) care coordination, quality of care, and other requirements for participating health
care homes, and county oversight requirements for health care homes;
new text end

new text begin (3) consumer protection, provider protection, and fiscal solvency standards; and
new text end

new text begin (4) procedures for addressing fiscal insolvency of county health care home programs
and ensuring continuity of care.
new text end

new text begin Subd. 2. new text end

new text begin County requirements related to health care homes. new text end

new text begin Each county
participating in the health care home program shall contract with providers certified
as health care homes under section 256B.0751 to provide services to MinnesotaCare
enrollees meeting the criteria developed by the commissioner under section 256D.03,
subdivision 3c. Each participating county shall require enrollees residing in the county to
designate as a health care home a provider certified under section 256B.0751 and shall
assign enrollees who do not make a designation to a health care home.
new text end

new text begin Subd. 3. new text end

new text begin County payment. new text end

new text begin The commissioner shall pay counties that are providing
health care under this section a per capita payment for all MinnesotaCare enrollees
that does not exceed the payment that would otherwise be paid to a managed care plan
under section 256L.12. A county is not required to obtain a certificate of authority under
chapter 62D, but must meet consumer protection, provider protection, and fiscal solvency
standards established by the commissioner. The state and the commissioner shall not be
liable for any costs incurred by a county that exceed the payments to the county made
under this section.
new text end

new text begin Subd. 4. new text end

new text begin Nonparticipating counties. new text end

new text begin The commissioner shall continue to provide
MinnesotaCare services using managed care and county-based purchasing plans under
sections 256B.69 and 256B.692 in counties that chose not to participate in, or withdraw
from, the health care program.
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. 4.

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


Subd. 4.

Exception for deleted text begintransitioneddeleted text endnew text begin certainnew text end adults.

new text begin(a) new text endCounty agencies shall
paynew text begin the enrollee share ofnew text end premiums fornew text begin: (1)new text end single adults and households with no children
formerly enrolled in general assistance medical care and enrolled in MinnesotaCare
according to section 256D.03, subdivision 3deleted text begin, until six-month renewal. The county agency
has the option of continuing to pay premiums for these enrollees
deleted text endnew text begin; and (2) single adults and
households without children enrolled under section 256L.04, subdivision 7, with gross
family incomes not exceeding 100 percent of the federal poverty guidelines
new text end.

new text begin (b) Counties that do not participate in the health care program established under
section 256L.121 shall pay both the enrollee and state share of MinnesotaCare premiums
for individuals meeting the criteria developed for modified MinnesotaCare coverage by
the commissioner under section 256D.03, subdivision 3c.
new text end

new text begin EFFECTIVE DATE. new text end

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