HF 2755

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

  1.1                          A bill for an act 
  1.2             relating to health; providing cost containment goals 
  1.3             for health care; amending Minnesota Statutes 1994, 
  1.4             section 62J.04, subdivision 1; Minnesota Statutes 1995 
  1.5             Supplement, section 62J.04, subdivisions 1a and 3; 
  1.6             repealing Minnesota Statutes 1995 Supplement, sections 
  1.7             62J.041, subdivision 7; and 62J.042, subdivision 4. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 1994, section 62J.04, 
  1.10  subdivision 1, is amended to read: 
  1.11     Subdivision 1.  [LIMITS ON THE RATE OF GROWTH COST 
  1.12  CONTAINMENT GOALS.] (a) The commissioner of health shall set 
  1.13  annual limits on the rate of growth of cost containment goals 
  1.14  for public and private spending on health care services for 
  1.15  Minnesota residents, as provided in paragraph (b).  The limits 
  1.16  on growth cost containment goals must be set at levels the 
  1.17  commissioner determines to be realistic and achievable but that 
  1.18  will reduce the rate of growth in health care spending by at 
  1.19  least ten percent per year for the next five years.  The 
  1.20  commissioner shall set limits on growth cost containment goals 
  1.21  based on available data on spending and growth trends, including 
  1.22  data from group purchasers, national data on public and private 
  1.23  sector health care spending and cost trends, and trend 
  1.24  information from other states. 
  1.25     (b) The commissioner shall set the following annual limits 
  1.26  on the rate of growth of cost containment goals for public and 
  2.1   private spending on health care services for Minnesota residents:
  2.2      (1) for calendar year 1994, the rate of growth must not 
  2.3   exceed the change in the regional consumer price index for urban 
  2.4   consumers for calendar year 1993 plus 6.5 percentage points; 
  2.5      (2) for calendar year 1995, the rate of growth must not 
  2.6   exceed the change in the regional consumer price index for urban 
  2.7   consumers for calendar year 1994 plus 5.3 percentage points; 
  2.8      (3) for calendar year 1996, the rate of growth cost 
  2.9   containment goals must not exceed the change in the regional 
  2.10  consumer price index for urban consumers for calendar year 1995 
  2.11  plus 4.3 percentage points; 
  2.12     (4) for calendar year 1997, the rate of growth cost 
  2.13  containment goals must not exceed the change in the regional 
  2.14  consumer price index for urban consumers for calendar year 1996 
  2.15  plus 3.4 percentage points; and 
  2.16     (5) for calendar year 1998, the rate of growth cost 
  2.17  containment goals must not exceed the change in the regional 
  2.18  consumer price index for urban consumers for calendar year 1997 
  2.19  plus 2.6 percentage points. 
  2.20     The commissioner shall adjust the growth limit set for 
  2.21  calendar year 1995 to recover savings in health care spending 
  2.22  required for the period July 1, 1993, to December 31, 1993. 
  2.23     (c) The commissioner shall publish: 
  2.24     (1) the projected limits cost containment goals in the 
  2.25  State Register by April 15 of the year immediately preceding the 
  2.26  year in which the limit cost containment goal will be effective 
  2.27  except for the year 1993, in which the limit shall be published 
  2.28  by July 1, 1993; 
  2.29     (2) the quarterly change in the regional consumer price 
  2.30  index for urban consumers; and 
  2.31     (3) the health care financing administration forecast for 
  2.32  total growth in the national health care expenditures.  In 
  2.33  setting an annual limit the cost containment goals, the 
  2.34  commissioner is exempt from the rulemaking requirements of 
  2.35  chapter 14.  The commissioner's decision on an annual limit the 
  2.36  cost containment goal is not appealable. 
  3.1      Sec. 2.  Minnesota Statutes 1995 Supplement, section 
  3.2   62J.04, subdivision 1a, is amended to read: 
  3.3      Subd. 1a.  [ADJUSTED GROWTH LIMITS AND ENFORCEMENT COST 
  3.4   CONTAINMENT GOALS.] (a) The commissioner shall publish the final 
  3.5   adjusted growth limit cost containment goal in the State 
  3.6   Register by January 31 of the year that the expenditure limit is 
  3.7   to be in effect.  The adjusted limit cost containment goal must 
  3.8   reflect the actual regional consumer price index for urban 
  3.9   consumers for the previous calendar year, and may deviate from 
  3.10  the previously published projected growth limits to reflect 
  3.11  differences between the actual regional consumer price index for 
  3.12  urban consumers and the projected Consumer Price Index for urban 
  3.13  consumers.  The commissioner shall report to the legislature by 
  3.14  February 15 of each year on the implementation of the growth 
  3.15  limits cost containment goals.  This annual report shall 
  3.16  describe the differences between the projected increase in 
  3.17  health care expenditures, the actual expenditures based on data 
  3.18  collected, and the impact and validity of growth limits within 
  3.19  the overall health care reform strategy. 
  3.20     (b) The commissioner, in consultation with the Minnesota 
  3.21  health care commission, shall research and include in the annual 
  3.22  report required in paragraph (a) for 1996, recommendations 
  3.23  regarding the implementation of growth limits for health plan 
  3.24  companies and providers.  The commissioner shall: 
  3.25     (1) consider both spending and revenue approaches and 
  3.26  report on the implementation of the interim limits as defined in 
  3.27  sections 62J.041 and 62J.042; 
  3.28     (2) make recommendations regarding the enforcement 
  3.29  mechanism and consider mechanisms to adjust future growth limits 
  3.30  as well as mechanisms to establish financial penalties for 
  3.31  noncompliance; 
  3.32     (3) address the feasibility of systemwide limits imposed on 
  3.33  all integrated service networks; and 
  3.34     (4) make recommendations on the most effective way to 
  3.35  implement growth limits on the fee-for-service system in the 
  3.36  absence of a regulated all-payer system. 
  4.1      (c) The commissioner shall enforce limits on growth in 
  4.2   spending for health plan companies and revenues for providers.  
  4.3   If the commissioner determines that artificial inflation or 
  4.4   padding of costs or prices has occurred in anticipation of the 
  4.5   implementation of growth limits, the commissioner may adjust the 
  4.6   base year spending totals or growth limits or take other action 
  4.7   to reverse the effect of the artificial inflation or padding. 
  4.8      (d) The commissioner shall impose and enforce set overall 
  4.9   limits on growth in cost containment goals for spending for 
  4.10  health plan companies, with adjustments for changes in 
  4.11  enrollment, benefits, severity, and risks.  If a health plan 
  4.12  company exceeds the growth limits, the commissioner may impose 
  4.13  financial penalties up to the amount exceeding the applicable 
  4.14  growth limit. 
  4.15     Sec. 3.  Minnesota Statutes 1995 Supplement, section 
  4.16  62J.04, subdivision 3, is amended to read: 
  4.17     Subd. 3.  [COST CONTAINMENT DUTIES.] After obtaining the 
  4.18  advice and recommendations of the Minnesota health care 
  4.19  commission, the commissioner shall: 
  4.20     (1) establish statewide and regional limits on growth in 
  4.21  cost containment goals for total health care spending under this 
  4.22  section, and collect data as described in sections 62J.37 to 
  4.23  62J.41 to monitor statewide compliance with the spending limits, 
  4.24  and take action to achieve compliance to the extent authorized 
  4.25  by the legislature achievement of the cost containment goals; 
  4.26     (2) divide the state into no fewer than four regions, with 
  4.27  one of those regions being the Minneapolis/St. Paul metropolitan 
  4.28  statistical area but excluding Chisago, Isanti, Wright, and 
  4.29  Sherburne counties, for purposes of fostering the development of 
  4.30  regional health planning and coordination of health care 
  4.31  delivery among regional health care systems and working to 
  4.32  achieve spending limits the cost containment goals; 
  4.33     (3) provide technical assistance to regional coordinating 
  4.34  boards; 
  4.35     (4) monitor the quality of health care throughout the state 
  4.36  and take action as necessary to ensure an appropriate level of 
  5.1   quality; 
  5.2      (5) issue recommendations regarding uniform billing forms, 
  5.3   uniform electronic billing procedures and data interchanges, 
  5.4   patient identification cards, and other uniform claims and 
  5.5   administrative procedures for health care providers and private 
  5.6   and public sector payers.  In developing the recommendations, 
  5.7   the commissioner shall review the work of the work group on 
  5.8   electronic data interchange (WEDI) and the American National 
  5.9   Standards Institute (ANSI) at the national level, and the work 
  5.10  being done at the state and local level.  The commissioner may 
  5.11  adopt rules requiring the use of the Uniform Bill 82/92 form, 
  5.12  the National Council of Prescription Drug Providers (NCPDP) 3.2 
  5.13  electronic version, the Health Care Financing Administration 
  5.14  1500 form, or other standardized forms or procedures; 
  5.15     (6) undertake health planning responsibilities as provided 
  5.16  in section 62J.15; 
  5.17     (7) authorize, fund, or promote research and 
  5.18  experimentation on new technologies and health care procedures; 
  5.19     (8) within the limits of appropriations for these purposes, 
  5.20  administer or contract for statewide consumer education and 
  5.21  wellness programs that will improve the health of Minnesotans 
  5.22  and increase individual responsibility relating to personal 
  5.23  health and the delivery of health care services, undertake 
  5.24  prevention programs including initiatives to improve birth 
  5.25  outcomes, expand childhood immunization efforts, and provide 
  5.26  start-up grants for worksite wellness programs; and 
  5.27     (9) undertake other activities to monitor and oversee the 
  5.28  delivery of health care services in Minnesota with the goal of 
  5.29  improving affordability, quality, and accessibility of health 
  5.30  care for all Minnesotans. 
  5.31     Sec. 4.  [REPEALER.] 
  5.32     Minnesota Statutes 1995 Supplement, sections 62J.041, 
  5.33  subdivision 7; and 62J.042, subdivision 4, are repealed.