HF 3325

as introduced - 90th Legislature (2017 - 2018) Posted on 03/05/2018 03:06pm

A bill for an act
relating to human services; establishing requirements for integrated health
partnership administrative services provided by the commissioner; amending
Minnesota Statutes 2016, section 256B.0755, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2016, section 256B.0755, is amended by adding a subdivision
to read:

new text begin Subd. 9. new text end

new text begin Administrative services. new text end

new text begin If the commissioner requires an integrated health
partnership to purchase administrative services from the commissioner or contract for the
provision of administrative services with the commissioner, or gives an integrated health
partnership the option to purchase or contract for administrative services, the commissioner
shall charge or assess the integrated health partnership for the full cost of providing the
administrative services. For purposes of this subdivision, "administrative services" includes
but is not limited to: claims payments; customer service; member materials and enrollee
notices related to benefit determination and formulary changes; enrollment of providers;
initial enrollee screening and health risk assessment; utilization review, including prior
authorization, utilization limits, and provider standards; required reporting; program integrity;
grievance and appeals; and the provision of data on cost, quality, and prescribing patterns.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for integrated health partnership initial
contracts and contract renewals effective on or after January 1, 2019.
new text end