HF 3697

1st Engrossment - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to government operations; making changes to health and human services
programs; modifying human service policy; modifying health policy; modifying
health care cost containment provisions; changing provisions for federal
health care compliance; changing provisions in state health care programs;
modifying long-term care and mental health provisions; establishing community
electronic health collaboratives; requiring a description of annuities for medical
assistance payments for long-term care; amending the assisted living bill of
rights; establishing the pharmacy payment reform advisory committee; requiring
certain abortion notification data; providing penalties; prohibiting pharmacists
from refusing to dispense a prescription drug; modifying provisions of the
Women's Right to Know Act; prohibiting the use of state funds for abortions;
requiring reports; appropriating money; making forecast adjustments; amending
Minnesota Statutes 2004, sections 13.3806, by adding a subdivision; 62A.045;
62D.02, subdivision 4, by adding a subdivision; 62D.03, subdivision 1; 62D.05,
subdivision 1; 62D.095, subdivisions 3, 4, by adding a subdivision; 62E.11,
subdivision 13; 62J.81, subdivision 1; 62S.05, by adding a subdivision; 62S.08,
subdivision 3; 62S.081, subdivision 4; 62S.10, subdivision 2; 62S.13, by
adding a subdivision; 62S.14, subdivision 2; 62S.15; 62S.20, subdivision 1;
62S.24, subdivisions 1, 3, 4, by adding subdivisions; 62S.25, subdivision 6,
by adding a subdivision; 62S.26; 62S.266, subdivision 2; 62S.29, subdivision
1; 62S.30; 72A.20, by adding a subdivision; 123A.21, subdivision 7; 144.0724,
subdivision 4; 144.6501, subdivision 6; 144.698, by adding a subdivision;
144A.071, subdivisions 4a, 4c; 144A.4605; 144D.01, by adding a subdivision;
144D.015; 144D.02; 144D.03, subdivision 2, by adding a subdivision; 144D.04;
144D.05; 144D.065; 145.4241, by adding subdivisions; 151.214, subdivision
1; 256.01, subdivision 18, by adding a subdivision; 256B.02, subdivision 9;
256B.056, subdivision 2, by adding subdivisions; 256B.0595, subdivisions 1,
3, 4; 256B.431, by adding a subdivision; 256B.434, by adding a subdivision;
256B.438, subdivision 4; 256B.69, subdivision 9, by adding a subdivision;
256B.692, subdivision 6; 256B.76; 256D.03, by adding a subdivision; 256L.04,
subdivision 10; 256L.17, subdivision 3; 295.52, by adding a subdivision;
Minnesota Statutes 2005 Supplement, sections 62J.052; 145.4242; 157.16,
subdivision 3a; 214.071; 256B.0571; 256B.0595, subdivision 2; 256B.06,
subdivision 4; 256B.434, subdivision 4; 256B.69, subdivision 23; 256D.03,
subdivision 3; 256L.05, subdivision 2; Laws 2003, First Special Session chapter
14, article 12, section 93, as amended; Laws 2005, First Special Session chapter
4, article 8, section 84; proposing coding for new law in Minnesota Statutes,
chapters 62J; 62M; 62Q; 62S; 144; 144A; 144D; 145; 151; 214; 245; 256B;
proposing coding for new law as Minnesota Statutes, chapter 144G; repealing
Minnesota Statutes 2004, sections 62J.17; 62J.694; 144.395; 256B.692,
subdivision 10; Minnesota Statutes 2005 Supplement, sections 62Q.251;
256B.0571, subdivisions 2, 5, 11; Minnesota Rules, part 4668.0215.

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

ARTICLE 1

LONG-TERM CARE AND MENTAL HEALTH

Section 1.

Minnesota Statutes 2004, section 144.0724, subdivision 4, is amended to
read:

Subd. 4.

Resident assessment schedule.

(a) A facility must conduct and
electronically submit to the commissioner of health case mix assessments that conform
with the assessment schedule defined by Code of Federal Regulations, title 42, section
483.20, and published by the United States Department of Health and Human Services,
Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made
in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0,
August 1996. The commissioner of health may substitute successor manuals or question
and answer documents published by the United States Department of Health and Human
Services, Centers for Medicare and Medicaid Services, to replace or supplement the
current version of the manual or document.

(b) The assessments used to determine a case mix classification for reimbursement
include the following:

(1) a new admission assessment must be completed by day 14 following admission;

(2) an annual assessment must be completed within 366 days of the last
comprehensive assessment;

(3) a significant change assessment must be completed within 14 days of the
identification of a significant change; and

(4) the new text begin first, new text end second new text begin , and third new text end quarterly assessment following either a new admission
assessment, an annual assessment, or a significant change assessment. Each quarterly
assessment must be completed within 92 days of the previous assessment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2006.
new text end

Sec. 2.

Minnesota Statutes 2004, section 144A.071, subdivision 4a, is amended to read:

Subd. 4a.

Exceptions for replacement beds.

It is in the best interest of the state
to ensure that nursing homes and boarding care homes continue to meet the physical
plant licensing and certification requirements by permitting certain construction projects.
Facilities should be maintained in condition to satisfy the physical and emotional needs
of residents while allowing the state to maintain control over nursing home expenditure
growth.

The commissioner of health in coordination with the commissioner of human
services, may approve the renovation, replacement, upgrading, or relocation of a nursing
home or boarding care home, under the following conditions:

(a) to license or certify beds in a new facility constructed to replace a facility or to
make repairs in an existing facility that was destroyed or damaged after June 30, 1987, by
fire, lightning, or other hazard provided:

(i) destruction was not caused by the intentional act of or at the direction of a
controlling person of the facility;

(ii) at the time the facility was destroyed or damaged the controlling persons of the
facility maintained insurance coverage for the type of hazard that occurred in an amount
that a reasonable person would conclude was adequate;

(iii) the net proceeds from an insurance settlement for the damages caused by the
hazard are applied to the cost of the new facility or repairs;

(iv) the new facility is constructed on the same site as the destroyed facility or on
another site subject to the restrictions in section 144A.073, subdivision 5;

(v) the number of licensed and certified beds in the new facility does not exceed the
number of licensed and certified beds in the destroyed facility; and

(vi) the commissioner determines that the replacement beds are needed to prevent an
inadequate supply of beds.

Project construction costs incurred for repairs authorized under this clause shall not be
considered in the dollar threshold amount defined in subdivision 2;

(b) to license or certify beds that are moved from one location to another within a
nursing home facility, provided the total costs of remodeling performed in conjunction
with the relocation of beds does not exceed $1,000,000;

(c) to license or certify beds in a project recommended for approval under section
144A.073;

(d) to license or certify beds that are moved from an existing state nursing home to
a different state facility, provided there is no net increase in the number of state nursing
home beds;

(e) to certify and license as nursing home beds boarding care beds in a certified
boarding care facility if the beds meet the standards for nursing home licensure, or in a
facility that was granted an exception to the moratorium under section 144A.073, and if
the cost of any remodeling of the facility does not exceed $1,000,000. If boarding care
beds are licensed as nursing home beds, the number of boarding care beds in the facility
must not increase beyond the number remaining at the time of the upgrade in licensure.
The provisions contained in section 144A.073 regarding the upgrading of the facilities
do not apply to facilities that satisfy these requirements;

(f) to license and certify up to 40 beds transferred from an existing facility owned and
operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the
same location as the existing facility that will serve persons with Alzheimer's disease and
other related disorders. The transfer of beds may occur gradually or in stages, provided
the total number of beds transferred does not exceed 40. At the time of licensure and
certification of a bed or beds in the new unit, the commissioner of health shall delicense
and decertify the same number of beds in the existing facility. As a condition of receiving
a license or certification under this clause, the facility must make a written commitment
to the commissioner of human services that it will not seek to receive an increase in its
property-related payment rate as a result of the transfers allowed under this paragraph;

(g) to license and certify nursing home beds to replace currently licensed and certified
boarding care beds which may be located either in a remodeled or renovated boarding care
or nursing home facility or in a remodeled, renovated, newly constructed, or replacement
nursing home facility within the identifiable complex of health care facilities in which the
currently licensed boarding care beds are presently located, provided that the number of
boarding care beds in the facility or complex are decreased by the number to be licensed
as nursing home beds and further provided that, if the total costs of new construction,
replacement, remodeling, or renovation exceed ten percent of the appraised value of
the facility or $200,000, whichever is less, the facility makes a written commitment to
the commissioner of human services that it will not seek to receive an increase in its
property-related payment rate by reason of the new construction, replacement, remodeling,
or renovation. The provisions contained in section 144A.073 regarding the upgrading of
facilities do not apply to facilities that satisfy these requirements;

(h) to license as a nursing home and certify as a nursing facility a facility that is
licensed as a boarding care facility but not certified under the medical assistance program,
but only if the commissioner of human services certifies to the commissioner of health that
licensing the facility as a nursing home and certifying the facility as a nursing facility will
result in a net annual savings to the state general fund of $200,000 or more;

(i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing
home beds in a facility that was licensed and in operation prior to January 1, 1992;

(j) to license and certify new nursing home beds to replace beds in a facility acquired
by the Minneapolis Community Development Agency as part of redevelopment activities
in a city of the first class, provided the new facility is located within three miles of the site
of the old facility. Operating and property costs for the new facility must be determined
and allowed under section 256B.431 or 256B.434;

(k) to license and certify up to 20 new nursing home beds in a community-operated
hospital and attached convalescent and nursing care facility with 40 beds on April 21,
1991, that suspended operation of the hospital in April 1986. The commissioner of human
services shall provide the facility with the same per diem property-related payment rate
for each additional licensed and certified bed as it will receive for its existing 40 beds;

(l) to license or certify beds in renovation, replacement, or upgrading projects as
defined in section 144A.073, subdivision 1, so long as the cumulative total costs of the
facility's remodeling projects do not exceed $1,000,000;

(m) to license and certify beds that are moved from one location to another for the
purposes of converting up to five four-bed wards to single or double occupancy rooms
in a nursing home that, as of January 1, 1993, was county-owned and had a licensed
capacity of 115 beds;

(n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified
nursing facility located in Minneapolis to layaway all of its licensed and certified nursing
home beds. These beds may be relicensed and recertified in a newly constructed teaching
nursing home facility affiliated with a teaching hospital upon approval by the legislature.
The proposal must be developed in consultation with the interagency committee on
long-term care planning. The beds on layaway status shall have the same status as
voluntarily delicensed and decertified beds, except that beds on layaway status remain
subject to the surcharge in section 256.9657. This layaway provision expires July 1, 1998;

(o) to allow a project which will be completed in conjunction with an approved
moratorium exception project for a nursing home in southern Cass County and which is
directly related to that portion of the facility that must be repaired, renovated, or replaced,
to correct an emergency plumbing problem for which a state correction order has been
issued and which must be corrected by August 31, 1993;

(p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified
nursing facility located in Minneapolis to layaway, upon 30 days prior written notice to
the commissioner, up to 30 of the facility's licensed and certified beds by converting
three-bed wards to single or double occupancy. Beds on layaway status shall have the
same status as voluntarily delicensed and decertified beds except that beds on layaway
status remain subject to the surcharge in section 256.9657, remain subject to the license
application and renewal fees under section 144A.07 and shall be subject to a $100 per bed
reactivation fee. In addition, at any time within three years of the effective date of the
layaway, the beds on layaway status may be:

(1) relicensed and recertified upon relocation and reactivation of some or all of
the beds to an existing licensed and certified facility or facilities located in Pine River,
Brainerd, or International Falls; provided that the total project construction costs related to
the relocation of beds from layaway status for any facility receiving relocated beds may
not exceed the dollar threshold provided in subdivision 2 unless the construction project
has been approved through the moratorium exception process under section 144A.073;

(2) relicensed and recertified, upon reactivation of some or all of the beds within the
facility which placed the beds in layaway status, if the commissioner has determined a
need for the reactivation of the beds on layaway status.

The property-related payment rate of a facility placing beds on layaway status
must be adjusted by the incremental change in its rental per diem after recalculating the
rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The
property-related payment rate for a facility relicensing and recertifying beds from layaway
status must be adjusted by the incremental change in its rental per diem after recalculating
its rental per diem using the number of beds after the relicensing to establish the facility's
capacity day divisor, which shall be effective the first day of the month following the
month in which the relicensing and recertification became effective. Any beds remaining
on layaway status more than three years after the date the layaway status became effective
must be removed from layaway status and immediately delicensed and decertified;

(q) to license and certify beds in a renovation and remodeling project to convert 12
four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing
home that, as of January 1, 1994, met the following conditions: the nursing home was
located in Ramsey County; had a licensed capacity of 154 beds; and had been ranked
among the top 15 applicants by the 1993 moratorium exceptions advisory review panel.
The total project construction cost estimate for this project must not exceed the cost
estimate submitted in connection with the 1993 moratorium exception process;

(r) to license and certify up to 117 beds that are relocated from a licensed and
certified 138-bed nursing facility located in St. Paul to a hospital with 130 licensed
hospital beds located in South St. Paul, provided that the nursing facility and hospital are
owned by the same or a related organization and that prior to the date the relocation is
completed the hospital ceases operation of its inpatient hospital services at that hospital.
After relocation, the nursing facility's status under section 256B.431, subdivision 2j, shall
be the same as it was prior to relocation. The nursing facility's property-related payment
rate resulting from the project authorized in this paragraph shall become effective no
earlier than April 1, 1996. For purposes of calculating the incremental change in the
facility's rental per diem resulting from this project, the allowable appraised value of
the nursing facility portion of the existing health care facility physical plant prior to the
renovation and relocation may not exceed $2,490,000;

(s) to license and certify two beds in a facility to replace beds that were voluntarily
delicensed and decertified on June 28, 1991;

(t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed
nursing home and 21-bed boarding care home facility in Minneapolis, notwithstanding
the licensure and certification after July 1, 1995, of the Minneapolis facility as a 147-bed
nursing home facility after completion of a construction project approved in 1993 under
section 144A.073, to be laid away upon 30 days' prior written notice to the commissioner.
Beds on layaway status shall have the same status as voluntarily delicensed or decertified
beds except that they shall remain subject to the surcharge in section 256.9657. The
16 beds on layaway status may be relicensed as nursing home beds and recertified at
any time within five years of the effective date of the layaway upon relocation of some
or all of the beds to a licensed and certified facility located in Watertown, provided that
the total project construction costs related to the relocation of beds from layaway status
for the Watertown facility may not exceed the dollar threshold provided in subdivision
2 unless the construction project has been approved through the moratorium exception
process under section 144A.073.

The property-related payment rate of the facility placing beds on layaway status
must be adjusted by the incremental change in its rental per diem after recalculating the
rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The
property-related payment rate for the facility relicensing and recertifying beds from
layaway status must be adjusted by the incremental change in its rental per diem after
recalculating its rental per diem using the number of beds after the relicensing to establish
the facility's capacity day divisor, which shall be effective the first day of the month
following the month in which the relicensing and recertification became effective. Any
beds remaining on layaway status more than five years after the date the layaway status
became effective must be removed from layaway status and immediately delicensed
and decertified;

(u) to license and certify beds that are moved within an existing area of a facility or
to a newly constructed addition which is built for the purpose of eliminating three- and
four-bed rooms and adding space for dining, lounge areas, bathing rooms, and ancillary
service areas in a nursing home that, as of January 1, 1995, was located in Fridley and had
a licensed capacity of 129 beds;

(v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County
to a 160-bed facility in Crow Wing County, provided all the affected beds are under
common ownership;

(w) to license and certify a total replacement project of up to 49 beds located in
Norman County that are relocated from a nursing home destroyed by flood and whose
residents were relocated to other nursing homes. The operating cost payment rates for
the new nursing facility shall be determined based on the interim and settle-up payment
provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of
section 256B.431, except that subdivision 26, paragraphs (a) and (b), shall not apply until
the second rate year after the settle-up cost report is filed. Property-related reimbursement
rates shall be determined under section 256B.431, taking into account any federal or state
flood-related loans or grants provided to the facility;

(x) to license and certify a total replacement project of up to 129 beds located
in Polk County that are relocated from a nursing home destroyed by flood and whose
residents were relocated to other nursing homes. The operating cost payment rates for
the new nursing facility shall be determined based on the interim and settle-up payment
provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of
section 256B.431, except that subdivision 26, paragraphs (a) and (b), shall not apply until
the second rate year after the settle-up cost report is filed. Property-related reimbursement
rates shall be determined under section 256B.431, taking into account any federal or state
flood-related loans or grants provided to the facility;

(y) to license and certify beds in a renovation and remodeling project to convert 13
three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and
add improvements in a nursing home that, as of January 1, 1994, met the following
conditions: the nursing home was located in Ramsey County, was not owned by a hospital
corporation, had a licensed capacity of 64 beds, and had been ranked among the top 15
applicants by the 1993 moratorium exceptions advisory review panel. The total project
construction cost estimate for this project must not exceed the cost estimate submitted in
connection with the 1993 moratorium exception process;

(z) to license and certify up to 150 nursing home beds to replace an existing 285
bed nursing facility located in St. Paul. The replacement project shall include both the
renovation of existing buildings and the construction of new facilities at the existing
site. The reduction in the licensed capacity of the existing facility shall occur during the
construction project as beds are taken out of service due to the construction process. Prior
to the start of the construction process, the facility shall provide written information to the
commissioner of health describing the process for bed reduction, plans for the relocation
of residents, and the estimated construction schedule. The relocation of residents shall be
in accordance with the provisions of law and rule;

(aa) to allow the commissioner of human services to license an additional 36 beds to
provide residential services for the physically handicapped under Minnesota Rules, parts
9570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that
the total number of licensed and certified beds at the facility does not increase;

(bb) to license and certify a new facility in St. Louis county with 44 beds constructed
to replace an existing facility in St. Louis County with 31 beds, which has resident rooms
on two separate floors and an antiquated elevator that creates safety concerns for residents
and prevents nonambulatory residents from residing on the second floor. The project shall
include the elimination of three- and four-bed rooms;

(cc) to license and certify four beds in a 16-bed certified boarding care home in
Minneapolis to replace beds that were voluntarily delicensed and decertified on or
before March 31, 1992. The licensure and certification is conditional upon the facility
periodically assessing and adjusting its resident mix and other factors which may
contribute to a potential institution for mental disease declaration. The commissioner of
human services shall retain the authority to audit the facility at any time and shall require
the facility to comply with any requirements necessary to prevent an institution for mental
disease declaration, including delicensure and decertification of beds, if necessary;

(dd) to license and certify 72 beds in an existing facility in Mille Lacs County with
80 beds as part of a renovation project. The renovation must include construction of
an addition to accommodate ten residents with beginning and midstage dementia in a
self-contained living unit; creation of three resident households where dining, activities,
and support spaces are located near resident living quarters; designation of four beds
for rehabilitation in a self-contained area; designation of 30 private rooms; and other
improvements;

(ee) to license and certify beds in a facility that has undergone replacement or
remodeling as part of a planned closure under section 256B.437;

(ff) to license and certify a total replacement project of up to 124 beds located
in Wilkin County that are in need of relocation from a nursing home significantly
damaged by flood. The operating cost payment rates for the new nursing facility shall
be determined based on the interim and settle-up payment provisions of Minnesota
Rules, part 9549.0057, and the reimbursement provisions of section 256B.431, except
that section 256B.431, subdivision 26, paragraphs (a) and (b), shall not apply until the
second rate year after the settle-up cost report is filed. Property-related reimbursement
rates shall be determined under section 256B.431, taking into account any federal or state
flood-related loans or grants provided to the facility;

(gg) to allow the commissioner of human services to license an additional nine beds
to provide residential services for the physically handicapped under Minnesota Rules,
parts 9570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that
the total number of licensed and certified beds at the facility does not increase;

(hh) to license and certify up to 120 new nursing facility beds to replace beds in a
facility in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the
new facility is located within four miles of the existing facility and is in Anoka County.
Operating and property rates shall be determined and allowed under section 256B.431 and
Minnesota Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 256B.435. The
provisions of section 256B.431, subdivision 26, paragraphs (a) and (b), do not apply until
the second rate year following settle-up; or

(ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County
that, as of March 25, 2001, is in the active process of closing, to a 122-licensed bed
nonprofit nursing facility located in the city of Columbia Heights or its affiliate. The
transfer is effective when the receiving facility notifies the commissioner in writing of the
number of beds accepted. The commissioner shall place all transferred beds on layaway
status held in the name of the receiving facility. The layaway adjustment provisions of
section 256B.431, subdivision 30, do not apply to this layaway. The receiving facility
may only remove the beds from layaway for recertification and relicensure at the receiving
facility's current site, or at a newly constructed facility located in Anoka County. The
receiving facility must receive statutory authorization before removing these beds from
layaway status new text begin , or may remove these beds from layaway status if removal from layaway
status is part of a moratorium exception project approved by the commissioner under
section 144A.073 new text end .

Sec. 3.

Minnesota Statutes 2004, section 144A.071, subdivision 4c, is amended to read:

Subd. 4c.

Exceptions for replacement beds after June 30, 2003.

(a) The
commissioner of health, in coordination with the commissioner of human services, may
approve the renovation, replacement, upgrading, or relocation of a nursing home or
boarding care home, under the following conditions:

(1) to license and certify an 80-bed city-owned facility in Nicollet County to be
constructed on the site of a new city-owned hospital to replace an existing 85-bed facility
attached to a hospital that is also being replaced. The threshold allowed for this project
under section 144A.073 shall be the maximum amount available to pay the additional
medical assistance costs of the new facility;

(2) to license and certify 29 beds to be added to an existing 69-bed facility in St.
Louis County, provided that the 29 beds must be transferred from active or layaway status
at an existing facility in St. Louis County that had 235 beds on April 1, 2003.

The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment
rate at that facility shall not be adjusted as a result of this transfer. The operating payment
rate of the facility adding beds after completion of this project shall be the same as it was
on the day prior to the day the beds are licensed and certified. This project shall not
proceed unless it is approved and financed under the provisions of section 144A.073; deleted text begin and deleted text end

(3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of
the new beds are transferred from a 45-bed facility in Austin under common ownership
that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea
under common ownership; (ii) the commissioner of human services is authorized by the
2004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii)
money is available from planned closures of facilities under common ownership to make
implementation of this clause budget-neutral to the state. The bed capacity of the Albert
Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the
new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's
disease or related dementias deleted text begin . deleted text end new text begin ; and
new text end

new text begin (4) to license and certify up to 80 beds transferred from an existing state-owned
nursing facility in Cass County to a new facility located on the grounds of the
Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be
determined based on the interim and settle-up payment provisions of Minnesota Rules,
part 9549.0057, and the reimbursement provisions of section 256B.431. The property
payment rate for the first three years of operation shall be $35 per day. For subsequent
years, the property payment rate of $35 per day shall be adjusted for inflation as provided
in section 256B.434, subdivision 4, paragraph (c), as long as the facility has a contract
under section 256B.434.
new text end

(b) Projects approved under this subdivision shall be treated in a manner equivalent
to projects approved under subdivision 4a.

Sec. 4.

new text begin [245.4682] MENTAL HEALTH SERVICE DELIVERY AND FINANCE
REFORM.
new text end

new text begin Subdivision 1. new text end

new text begin Policy. new text end

new text begin The commissioner of human services shall study and report
on reforms to improve the underlying structural, financing, and organizational problems
in Minnesota's mental health system with the goal of improving the availability, quality,
and accountability of mental health care within the state.
new text end

new text begin Subd. 2. new text end

new text begin General provisions. new text end

new text begin In the design and implementation of reforms to the
mental health system, the commissioner shall:
new text end

new text begin (1) consult with consumers, families, counties, tribes, advocates, providers, and
other stakeholders;
new text end

new text begin (2) report to the legislature and the state Mental Health Advisory Council by
December 15, 2006, and shall include recommendations on the following:
new text end

new text begin (a) updating the role of counties and health plans;
new text end

new text begin (b) ensuring continuity of care for persons affected by these reforms including:
new text end

new text begin (c) ensuring client choice of provider by requiring broad provider networks;
new text end

new text begin (d) allowing clients options to maintain previously established therapeutic
relationships;
new text end

new text begin (e) developing mechanisms to facilitate a smooth transition of service
responsibilities;
new text end

new text begin (f) providing accountability for the efficient and effective use of public and private
resources in achieving positive outcomes for consumers; and
new text end

new text begin (g) ensuring client access to applicable protections and appeals.
new text end

Sec. 5.

Minnesota Statutes 2004, section 256B.431, is amended by adding a
subdivision to read:

new text begin Subd. 43. new text end

new text begin Rate increase for facilities in Stearns, Sherburne, and Benton
Counties. new text end

new text begin Effective July 1, 2006, operating payment rates of nursing facilities in Stearns,
Sherburne, and Benton Counties that are reimbursed under this section, section 256B.434,
or section 256B.441 shall be increased to be equal, for a RUG's rate with a weight of 1.00,
to the geographic group III median rate for the same RUG's weight. The percentage of
the operating payment rate for each facility to be case-mix adjusted shall be equal to the
percentage that is case-mix adjusted in that facility's June 30, 2006, operating payment
rate. This subdivision shall apply only if it results in a rate increase. Increases provided
by this subdivision shall be added to the rate determined under any new reimbursement
system established under section 256B.440.
new text end

Sec. 6.

Minnesota Statutes 2005 Supplement, section 256B.434, subdivision 4, is
amended to read:

Subd. 4.

Alternate rates for nursing facilities.

(a) For nursing facilities which
have their payment rates determined under this section rather than section 256B.431, the
commissioner shall establish a rate under this subdivision. The nursing facility must enter
into a written contract with the commissioner.

(b) A nursing facility's case mix payment rate for the first rate year of a facility's
contract under this section is the payment rate the facility would have received under
section 256B.431.

(c) A nursing facility's case mix payment rates for the second and subsequent years
of a facility's contract under this section are the previous rate year's contract payment
rates plus an inflation adjustment and, for facilities reimbursed under this section or
section 256B.431, an adjustment to include the cost of any increase in Health Department
licensing fees for the facility taking effect on or after July 1, 2001. The index for the
inflation adjustment must be based on the change in the Consumer Price Index-All Items
(United States City average) (CPI-U) forecasted by the commissioner of finance's national
economic consultant, as forecasted in the fourth quarter of the calendar year preceding
the rate year. The inflation adjustment must be based on the 12-month period from the
midpoint of the previous rate year to the midpoint of the rate year for which the rate is
being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001,
July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, and July
1, 2008, this paragraph shall apply only to the property-related payment rate, except
that adjustments to include the cost of any increase in Health Department licensing fees
taking effect on or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to
the property payment rate under this section and section 256B.431 shall be effective on
October 1. In determining the amount of the property-related payment rate adjustment
under this paragraph, the commissioner shall determine the proportion of the facility's
rates that are property-related based on the facility's most recent cost report. Beginning
October 1, 2006, facilities reimbursed under this section shall be allowed to receive a
property rate adjustment for building projects under section 144A.071, subdivision 2.

new text begin (d) The commissioner shall develop additional incentive-based payments of up to
five percent above a facility's operating payment rate for achieving outcomes specified
in a contract. The commissioner may solicit contract amendments and implement those
which, on a competitive basis, best meet the state's policy objectives. The commissioner
shall limit the amount of any incentive payment and the number of contract amendments
under this paragraph to operate the incentive payments within funds appropriated for this
purpose. The contract amendments may specify various levels of payment for various
levels of performance. Incentive payments to facilities under this paragraph may be in
the form of time-limited rate adjustments or supplemental payments. In establishing the
specified outcomes and related criteria, the commissioner shall consider the following
state policy objectives:
new text end

new text begin (1) successful diversion or discharge of residents to the residents' prior home or
other community-based alternatives;
new text end

new text begin (2) adoption of new technology to improve quality or efficiency;
new text end

new text begin (3) improved quality as measured in the Nursing Home Report Card;
new text end

new text begin (4) reduced acute care costs; and
new text end

new text begin (5) any additional outcomes proposed by a nursing facility that the commissioner
finds desirable.
new text end

Sec. 7.

Minnesota Statutes 2004, section 256B.434, is amended by adding a
subdivision to read:

new text begin Subd. 4f. new text end

new text begin Facility rate increase effective July 1, 2006. new text end

new text begin For the rate year beginning
July 1, 2006, a nursing facility in Otter Tail County that was licensed for 55 beds as of
January 1, 2006, shall receive a rate increase to increase its operating rate to the 60th
percentile of the operating rates of all other Otter Tail County skilled nursing facilities.
The commissioner shall determine the 60th percentile of the case mix portion of the
operating rates of all other Otter Tail County skilled nursing facilities and then apply the
case mix weights. The 60th percentile of the other facilities operating per diem for all
other Otter Tail County facilities will be added to the above-determined weighted case
mix amount to compute the 60th percentile operating rate. The nonoperating components
of the facility's rates will not be adjusted under this subdivision.
new text end

Sec. 8.

Minnesota Statutes 2004, section 256B.438, subdivision 4, is amended to read:

Subd. 4.

Resident assessment schedule.

(a) Nursing facilities shall conduct and
submit case mix assessments according to the schedule established by the commissioner
of health under section 144.0724, subdivisions 4 and 5.

(b) The resident reimbursement classifications established under section 144.0724,
subdivision 3, shall be effective the day of admission for new admission assessments. The
effective date for significant change assessments shall be the assessment reference date.
The effective date for annual and deleted text begin second deleted text end new text begin all new text end quarterly assessments shall be the first day of
the month following assessment reference date.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2006.
new text end

Sec. 9.

Minnesota Statutes 2004, section 256B.69, subdivision 9, is amended to read:

Subd. 9.

Reporting.

new text begin (a) new text end Each demonstration provider shall submit information as
required by the commissioner, including data required for assessing client satisfaction,
quality of care, cost, and utilization of services for purposes of project evaluation. The
commissioner shall also develop methods of data new text begin reporting and new text end collection deleted text begin from county
advocacy activities deleted text end in order to provide aggregate enrollee information on encounters
and outcomes to determine access and quality assurance. Required information shall be
specified before the commissioner contracts with a demonstration provider.

new text begin (b) Aggregate nonpersonally identifiable health plan encounter data, aggregate
spending data for major categories of service as reported to the commissioners of health
and commerce under section 62D.08, subdivision 3, paragraph (a), and criteria for
service authorization and service use are public data that the commissioner shall make
available and use in public reports. The commissioner shall require each health plan and
county-based purchasing plan to provide:
new text end

new text begin (1) encounter data for each service provided, using standard codes and unit of
service definitions set by the commissioner, in a form that the commissioner can report by
age, eligibility groups, and health plan; and
new text end

new text begin (2) criteria, written policies, and procedures required to be disclosed under section
62M.10, subdivision 7, and Code of Federal Regulations, title 42, part 438.210(b)(1), used
for each type of service for which authorization is required.
new text end

Sec. 10.

Minnesota Statutes 2005 Supplement, section 256B.69, subdivision 23,
is amended to read:

Subd. 23.

Alternative services; elderly and disabled persons.

(a) The
commissioner may implement demonstration projects to create alternative integrated
delivery systems for acute and long-term care services to elderly persons and persons
with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
coordination, improve access to quality services, and mitigate future cost increases.
The commissioner may seek federal authority to combine Medicare and Medicaid
capitation payments for the purpose of such demonstrations new text begin and may contract with
Medicare-approved special needs plans to provide Medicaid services new text end . Medicare funds
and services shall be administered according to the terms and conditions of the federal
deleted text begin waiver deleted text end new text begin contract new text end and demonstration provisions. For the purpose of administering medical
assistance funds, demonstrations under this subdivision are subject to subdivisions 1 to
22. The provisions of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these
demonstrations, with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457,
subpart 1, items B and C, which do not apply to persons enrolling in demonstrations
under this section. An initial open enrollment period may be provided. Persons who
disenroll from demonstrations under this subdivision remain subject to Minnesota Rules,
parts 9500.1450 to 9500.1464. When a person is enrolled in a health plan under these
demonstrations and the health plan's participation is subsequently terminated for any
reason, the person shall be provided an opportunity to select a new health plan and shall
have the right to change health plans within the first 60 days of enrollment in the second
health plan. Persons required to participate in health plans under this section who fail
to make a choice of health plan shall not be randomly assigned to health plans under
these demonstrations. Notwithstanding section 256L.12, subdivision 5, and Minnesota
Rules, part 9505.5220, subpart 1, item A, if adopted, for the purpose of demonstrations
under this subdivision, the commissioner may contract with managed care organizations,
including counties, to serve only elderly persons eligible for medical assistance, elderly
and disabled persons, or disabled persons only. For persons with primary diagnoses of
mental retardation or a related condition, serious and persistent mental illness, or serious
emotional disturbance, the commissioner must ensure that the county authority has
approved the demonstration and contracting design. Enrollment in these projects for
persons with disabilities shall be voluntary. The commissioner shall not implement any
demonstration project under this subdivision for persons with primary diagnoses of
mental retardation or a related condition, serious and persistent mental illness, or serious
emotional disturbance, without approval of the county board of the county in which the
demonstration is being implemented.

(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
under this section projects for persons with developmental disabilities. The commissioner
may capitate payments for ICF/MR services, waivered services for mental retardation or
related conditions, including case management services, day training and habilitation and
alternative active treatment services, and other services as approved by the state and by the
federal government. Case management and active treatment must be individualized and
developed in accordance with a person-centered plan. Costs under these projects may not
exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003,
and until two years after the pilot project implementation date, subcontractor participation
in the long-term care developmental disability pilot is limited to a nonprofit long-term
care system providing ICF/MR services, home and community-based waiver services,
and in-home services to no more than 120 consumers with developmental disabilities in
Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature
prior to expansion of the developmental disability pilot project. This paragraph expires
two years after the implementation date of the pilot project.

(c) Before implementation of a demonstration project for disabled persons, the
commissioner must provide information to appropriate committees of the house of
representatives and senate and must involve representatives of affected disability groups
in the design of the demonstration projects.

(d) A nursing facility reimbursed under the alternative reimbursement methodology
in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
provide services under paragraph (a). The commissioner shall amend the state plan and
seek any federal waivers necessary to implement this paragraph.

(e) The commissioner, in consultation with the commissioners of commerce and
health, may approve and implement programs for all-inclusive care for the elderly (PACE)
according to federal laws and regulations governing that program and state laws or rules
applicable to participating providers. The process for approval of these programs shall
begin only after the commissioner receives grant money in an amount sufficient to cover
the state share of the administrative and actuarial costs to implement the programs during
state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
account in the special revenue fund and are appropriated to the commissioner to be used
solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
not required to be licensed or certified as a health plan company as defined in section
62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county
and found to be eligible for services under the elderly waiver or community alternatives
for disabled individuals or who are already eligible for Medicaid but meet level of
care criteria for receipt of waiver services may choose to enroll in the PACE program.
Medicare and Medicaid services will be provided according to this subdivision and
federal Medicare and Medicaid requirements governing PACE providers and programs.
PACE enrollees will receive Medicaid home and community-based services through the
PACE provider as an alternative to services for which they would otherwise be eligible
through home and community-based waiver programs and Medicaid State Plan Services.
The commissioner shall establish Medicaid rates for PACE providers that do not exceed
costs that would have been incurred under fee-for-service or other relevant managed care
programs operated by the state.

(f) The commissioner shall seek federal approval to expand the Minnesota disability
health options (MnDHO) program established under this subdivision in stages, first to
regional population centers outside the seven-county metro area and then to all areas
of the state. new text begin Until January 1, 2008, expansion for MnDHO projects that include home
and community-based services is limited to the two projects and service areas in effect
on March 1, 2006. Enrollment in integrated MnDHO programs that include home and
community-based services shall remain voluntary. Costs for home and community-based
services included under MnDHO must not exceed costs that would have been incurred
under the fee-for-service program. In developing program specifications for expansion of
integrated programs, the commissioner shall involve and consult the state-level stakeholder
group established in subdivision 28, paragraph (d), including consultation on whether and
how to include home and community-based waiver programs. Plans for further expansion
of MnDHO projects shall be presented to the chairs of the house and senate committees
with jurisdiction over health and human services policy and finance by February 1, 2007.
new text end

(g) Notwithstanding section 256B.0261, health plans providing services under this
section are responsible for home care targeted case management and relocation targeted
case management. Services must be provided according to the terms of the waivers and
contracts approved by the federal government.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 11.

Minnesota Statutes 2004, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 28. new text end

new text begin Medicare special needs plans and medical assistance basic health
care for persons with disabilities. new text end

new text begin (a) The commissioner may contract with qualified
Medicare-approved special needs plans to provide medical assistance basic health care
services to persons with disabilities, including those with developmental disabilities.
Basic health care services include:
new text end

new text begin (1) those services covered by the medical assistance state plan except for ICF/MR
services, home and community-based waiver services, case management for persons with
developmental disabilities under section 256B.0625, subdivision 20a, and personal care
and certain home care services defined by the commissioner in consultation with the
stakeholder group established under paragraph (d);
new text end

new text begin (2) basic health care services may also include risk for up to 100 days of nursing
facility services for persons who reside in a noninstitutional setting and home health
services related to rehabilitation as defined by the commissioner after consultation with
the stakeholder group; and
new text end

new text begin (3) the commissioner may exclude other medical assistance services from the basic
health care benefit set. Enrollees in these plans can access any excluded services on the
same basis as other medical assistance recipients who have not enrolled.
new text end

new text begin Unless a person is otherwise required to enroll in managed care, enrollment in these
plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
enrollment with an option to opt out is not voluntary enrollment.
new text end

new text begin (b) Beginning January 1, 2007, the commissioner may contract with qualified
Medicare special needs plans to provide basic health care services under medical
assistance to persons who are dually eligible for both Medicare and Medicaid and those
Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
The commissioner shall consult with the stakeholder group under paragraph (d) in
developing program specifications for these services. The commissioner shall report to
the chairs of the house and senate committees with jurisdiction over health and human
services policy and finance by February 1, 2007, on implementation of these programs and
the need for increased funding for the ombudsman for managed care and other consumer
assistance and protections needed due to enrollment in managed care of persons with
disabilities. Payment for Medicaid services provided under this subdivision for the months
of May and June will be made no earlier than July 1 of the same calendar year.
new text end

new text begin (c) Beginning January 1, 2008, the commissioner may expand contracting under this
subdivision to all persons with disabilities not otherwise required to enroll in managed
care.
new text end

new text begin (d) The commissioner shall establish a state-level stakeholder group to provide
advice on managed care programs for persons with disabilities, including both MnDHO
and contracts with special needs plans that provide basic health care services as described
in paragraphs (a) and (b). The stakeholder group shall provide advice on program
expansions under this subdivision and subdivision 23, including:
new text end

new text begin (1) implementation efforts;
new text end

new text begin (2) consumer protections; and
new text end

new text begin (3) program specifications such as quality assurance measures, data collection and
reporting, and evaluation of costs, quality, and results.
new text end

new text begin (e) Each plan under contract to provide medical assistance basic health care services
shall establish a local or regional stakeholder group, including representatives of the
counties covered by the plan, members, consumer advocates, and providers, for advice on
issues that arise in the local or regional area.
new text end

Sec. 12. new text begin STAKEHOLDER PARTICIPATION.
new text end

new text begin The commissioner of human services shall confer with one or more stakeholder
groups of interested persons, including representatives of recipients, advocacy groups,
counties, providers, and health plans to provide information and advice on the development
of any substantial proposals for changes in the medical assistance program authorized by
the federal Deficit Reduction Act of 2005, Public Law 109-171. In addition, for any
substantial Deficit Reduction Act-related medical assistance change that affects recipients
and that is proposed outside of the legislative or rulemaking process, the commissioner
shall convene a stakeholder meeting and provide a 30-day comment period before the
change becomes effective. If the time frame required to comply with a federal mandate
precludes the 30-day advance notice, notice shall be given to the stakeholder group as
soon as possible.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 13. new text begin ICF/MR PLAN.
new text end

new text begin The commissioner of human services shall consult with ICF/MR providers,
advocates, counties, and consumer families to develop a stakeholder plan and legislation
concerning the future services provided to people served in ICFs/MR. The plan shall be
reported to the house and senate committees with jurisdiction over health and human
services policy and finance issues by December 15, 2007. In preparing the plan, the
commissioner shall consider:
new text end

new text begin (1) consumer choice of services;
new text end

new text begin (2) consumers' service needs, including, but not limited to, active treatment;
new text end

new text begin (3) the total cost of providing services in ICFs/MR and alternative delivery systems
for individuals currently residing in ICFs/MR;
new text end

new text begin (4) the impact of the payment shift to counties for ICFs/MR with more than six beds;
new text end

new text begin (5) whether it is the policy of the state to maintain an ICF/MR system and, if so,
the plan shall:
new text end

new text begin (i) define the purpose, types of services, and intended recipients of ICF/MR services;
new text end

new text begin (ii) define the capacity needed to maintain ICF/MR services for designated
populations;
new text end

new text begin (iii) evaluate incentives for counties to maintain ICF/MR services;
new text end

new text begin (iv) assure that mechanisms are provided to adequately fund the transition to the
defined services, maintain the designated capacity, and are adjustable to meet increased
service demands; and
new text end

new text begin (v) address the extent to which there is consensus among stakeholders; and
new text end

new text begin (6) if alternative services are recommended to support the people now receiving
services in an ICF/MR, the plan shall provide for transition planning and ensure adequate
state and federal financial resources are available to meet the needs of ICF/MR recipients.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

ARTICLE 2

STATE HEALTH CARE PROGRAMS

Section 1.

Minnesota Statutes 2004, section 256.01, subdivision 18, is amended to read:

Subd. 18.

Immigration status verifications.

(a) Notwithstanding any waiver of
this requirement by the secretary of the United States Department of Health and Human
Services, effective July 1, 2001, the commissioner shall utilize the Systematic Alien
Verification for Entitlements (SAVE) program to conduct immigration status verifications:

(1) as required under United States Code, title 8, section 1642;

(2) for all applicants for food assistance benefits, whether under the federal food
stamp program, the MFIP or work first program, or the Minnesota food assistance program;

(3) for all applicants for general assistance medical care, except assistance for an
emergency medical condition, for immunization with respect to an immunizable disease,
or for testing and treatment of symptoms of a communicable disease new text begin , and nonfederally
funded MinnesotaCare new text end ; and

(4) for all applicants for general assistance, Minnesota supplemental aid, new text begin medical
assistance, federally funded new text end MinnesotaCare, or group residential housing, when the
benefits provided by these programs would fall under the definition of "federal public
benefit" under United States Code, title 8, section 1642, if federal funds were used to
pay for all or part of the benefits.

(b) The commissioner shall comply with the reporting requirements under United
States Code, title 42, section 611a, and any federal regulation or guidance adopted under
that law.

Sec. 2.

Minnesota Statutes 2004, section 256.01, is amended by adding a subdivision
to read:

new text begin Subd. 18a. new text end

new text begin Reporting undocumented immigrants. new text end

new text begin The commissioner shall
require all employees of the state and counties to make a written report to the United States
Citizenship and Immigration Service (USCIS) for any violation of federal immigration law
by any applicant for medical assistance under chapter 256B, general assistance medical
care under chapter 256D, or MinnesotaCare under chapter 256L, that is discovered by the
employee. Employees do not need an applicant's written authorization to contact USCIS.
new text end

Sec. 3.

Minnesota Statutes 2004, section 256B.692, subdivision 6, is amended to read:

Subd. 6.

Commissioner's authority.

The commissioner may:

(1) reject any preliminary or final proposal that substantially fails to meet the
requirements of this section, or that the commissioner determines would substantially
impair the state's ability to purchase health care services in other areas of the state,
or would substantially impair an enrollee's choice of deleted text begin care systems deleted text end new text begin managed care
organizations new text end when reasonable choice is possible, or would substantially impair the
implementation and operation of the Minnesota senior health options demonstration
project authorized under section 256B.69, subdivision 23; and

(2) assume operation of a county's purchasing of health care for enrollees in medical
assistance and general assistance medical care in the event that the contract with the
county is terminated.

Sec. 4.

Minnesota Statutes 2004, section 256B.76, is amended to read:

256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.

(a) Effective for services rendered on or after October 1, 1992, the commissioner
shall make payments for physician services as follows:

(1) payment for level one Centers for Medicare and Medicaid Services' common
procedural coding system codes titled "office and other outpatient services," "preventive
medicine new and established patient," "delivery, antepartum, and postpartum care,"
"critical care," cesarean delivery and pharmacologic management provided to psychiatric
patients, and level three codes for enhanced services for prenatal high risk, shall be paid
at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
30, 1992. If the rate on any procedure code within these categories is different than the
rate that would have been paid under the methodology in section 256B.74, subdivision 2,
then the larger rate shall be paid;

(2) payments for all other services shall be paid at the lower of (i) submitted charges,
or (ii) 15.4 percent above the rate in effect on June 30, 1992;

(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases
except that payment rates for home health agency services shall be the rates in effect
on September 30, 1992;

(4) effective for services rendered on or after January 1, 2000, payment rates for
physician and professional services shall be increased by three percent over the rates in
effect on December 31, 1999, except for home health agency and family planning agency
services; and

(5) the increases in clause (4) shall be implemented January 1, 2000, for managed
care.

(b) Effective for services rendered on or after October 1, 1992, the commissioner
shall make payments for dental services as follows:

(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
percent above the rate in effect on June 30, 1992;

(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases;

(3) effective for services rendered on or after January 1, 2000, payment rates for
dental services shall be increased by three percent over the rates in effect on December
31, 1999;

(4) the commissioner shall award grants to community clinics or other nonprofit
community organizations, political subdivisions, professional associations, or other
organizations that demonstrate the ability to provide dental services effectively to public
program recipients. Grants may be used to fund the costs related to coordinating access for
recipients, developing and implementing patient care criteria, upgrading or establishing
new facilities, acquiring furnishings or equipment, recruiting new providers, or other
development costs that will improve access to dental care in a region. In awarding grants,
the commissioner shall give priority to applicants that plan to serve areas of the state in
which the number of dental providers is not currently sufficient to meet the needs of
recipients of public programs or uninsured individuals. The commissioner shall consider
the following in awarding the grants:

(i) potential to successfully increase access to an underserved population;

(ii) the ability to raise matching funds;

(iii) the long-term viability of the project to improve access beyond the period
of initial funding;

(iv) the efficiency in the use of the funding; and

(v) the experience of the proposers in providing services to the target population.

The commissioner shall monitor the grants and may terminate a grant if the grantee
does not increase dental access for public program recipients. The commissioner shall
consider grants for the following:

(i) implementation of new programs or continued expansion of current access
programs that have demonstrated success in providing dental services in underserved
areas;

(ii) a pilot program for utilizing hygienists outside of a traditional dental office to
provide dental hygiene services; and

(iii) a program that organizes a network of volunteer dentists, establishes a system to
refer eligible individuals to volunteer dentists, and through that network provides donated
dental care services to public program recipients or uninsured individuals;

(5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;

(6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000,
for managed care; and

(7) effective for services provided on or after January 1, 2002, payment for
diagnostic examinations and dental x-rays provided to children under age 21 shall be the
lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.

(c) Effective for dental services rendered on or after January 1, 2002, the
commissioner may, within the limits of available appropriation, increase reimbursements
to dentists and dental clinics deemed by the commissioner to be critical access dental
providers. Reimbursement to a critical access dental provider may be increased by not
more than 50 percent above the reimbursement rate that would otherwise be paid to
the provider. Payments to health plan companies shall be adjusted to reflect increased
reimbursements to critical access dental providers as approved by the commissioner.
In determining which dentists and dental clinics shall be deemed critical access dental
providers, the commissioner shall review:

(1) the utilization rate in the service area in which the dentist or dental clinic operates
for dental services to patients covered by medical assistance, general assistance medical
care, or MinnesotaCare as their primary source of coverage;

(2) the level of services provided by the dentist or dental clinic to patients covered
by medical assistance, general assistance medical care, or MinnesotaCare as their primary
source of coverage; and

(3) whether the level of services provided by the dentist or dental clinic is critical to
maintaining adequate levels of patient access within the service area.

In the absence of a critical access dental provider in a service area, the commissioner may
designate a dentist or dental clinic as a critical access dental provider if the dentist or
dental clinic is willing to provide care to patients covered by medical assistance, general
assistance medical care, or MinnesotaCare at a level which significantly increases access
to dental care in the service area.

new text begin The commissioner shall annually establish a reimbursement schedule for critical
access dental providers and provider-specific limits on total reimbursement received
under the reimbursement schedule, and shall notify each critical access dental provider
of the schedule and limit.
new text end

(d) An entity that operates both a Medicare certified comprehensive outpatient
rehabilitation facility and a facility which was certified prior to January 1, 1993, that is
licensed under Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33
percent of the clients receiving rehabilitation services in the most recent calendar year are
medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation
services at rates that are 38 percent greater than the maximum reimbursement rate
allowed under paragraph (a), clause (2), when those services are (1) provided within the
comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing
facilities owned by the entity.

(e) Effective for services rendered on or after January 1, 2007, the commissioner
shall make payments for physician and professional services based on the Medicare
relative value units (RVUs). This change shall be budget neutral and the cost of
implementing RVUs will be incorporated in the established conversion factor.

Sec. 5.

Minnesota Statutes 2004, section 256D.03, is amended by adding a subdivision
to read:

new text begin Subd. 3c. new text end

new text begin General assistance medical care; eligibility verification. new text end

new text begin The
commissioner shall verify assets and income for all applicants, and for all recipients
upon renewal.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007, or upon the
implementation of HealthMatch, whichever is later.
new text end

Sec. 6.

Minnesota Statutes 2005 Supplement, section 256L.05, subdivision 2, is
amended to read:

Subd. 2.

Commissioner's duties.

(a) The commissioner or county agency shall
use electronic verification as the primary method of income verification. If there is a
discrepancy between reported income and electronically verified income, an individual
may be required to submit additional verification. In addition, the commissioner shall
perform random audits to verify reported income and eligibility. The commissioner
may execute data sharing arrangements with the Department of Revenue and any other
governmental agency in order to perform income verification related to eligibility and
premium payment under the MinnesotaCare program.

(b) In determining eligibility for MinnesotaCare, the commissioner shall require
applicants and enrollees seeking renewal of eligibility to verify both earned and unearned
income. new text begin The commissioner shall require applicants and enrollees seeking renewal of
eligibility to verify assets, if they are subject to the asset requirement under section
256L.17. new text end The commissioner shall also require applicants and enrollees to submit the
names of their employers and a contact name with a telephone number for each employer
for purposes of verifying whether the applicant or enrollee, and any dependents, are
eligible for employer-subsidized coverage. Data collected is nonpublic data as defined
in section 13.02, subdivision 9.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007, or upon the
implementation of HealthMatch, whichever is later.
new text end

Sec. 7.

Minnesota Statutes 2004, section 256L.17, subdivision 3, is amended to read:

Subd. 3.

Documentation.

(a) The commissioner of human services shall require
individuals and families, at the time of application or renewal, to indicate on a checkoff
form developed by the commissioner whether they satisfy the MinnesotaCare asset
requirement. This form must include the following or similar language: "To be eligible for
MinnesotaCare, individuals and families must not own net assets in excess of $30,000
for a household of two or more persons or $15,000 for a household of one person, not
including a homestead, household goods and personal effects, assets owned by children,
vehicles used for employment, court-ordered settlements up to $10,000, individual
retirement accounts, and capital and operating assets of a trade or business up to $200,000.
Do you and your household own net assets in excess of these limits?"

(b) new text begin The commissioner shall require applicants and enrollees seeking renewal of
eligibility to verify assets. new text end The commissioner may require individuals and families to
provide any information the commissioner determines necessary to verify compliance
with the asset requirement, if the commissioner determines that there is reason to believe
that an individual or family has assets that exceed the program limit.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007, or upon the
implementation of HealthMatch, whichever is later.
new text end

Sec. 8.

Minnesota Statutes 2004, section 295.52, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Contingent reduction in tax rate. new text end

new text begin On September 1 of each odd-numbered
year, beginning September 1, 2007, the commissioner of finance shall determine the
projected balance of the health care access fund as of the end of the current biennium,
based on the most recent February forecast adjusted for any legislative session changes.
If the commissioner projects a surplus in the health care access fund as of the end of the
current biennium, the commissioner of finance, in consultation with the commissioner of
revenue, shall reduce the tax rates specified in subdivisions 1, 1a, 2, 3, and 4 in one-tenth
of one percent increments, making the largest reduction in tax rates consistent with
ensuring that the health care access fund retains a surplus as of the end of the current
biennium. The reduced tax rates shall take effect on the January 1 that immediately
follows the September 1 on which the commissioner determines the projected balance
and shall remain in effect for two tax years. The tax rates specified in subdivisions 1, 1a,
2, 3, and 4 shall apply for subsequent tax years, unless the commissioner, based on a
determination of the projected balance of the health care access fund made on September
1 of an odd-numbered year, reduces the tax rates. If the commissioner does not project a
surplus in the health care access fund as of the end of the current biennium, the tax rates
specified in subdivisions 1, 1a, 2, 3, and 4 shall continue to apply. The commissioner of
finance shall publish in the State Register by October 1 of each odd-numbered year the
amount of tax to be imposed for the next two calendar years.
new text end

Sec. 9.

Laws 2003, First Special Session chapter 14, article 12, section 93, as amended
by Laws 2005, First Special Session chapter 4, article 8, section 80, is amended to read:

Sec. 93. REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY
CRITERIA AND POTENTIAL COST SAVINGS.

The commissioner of human services, in consultation with the commissioner of
transportation and special transportation service providers, shall review eligibility criteria
for medical assistance special transportation services and shall evaluate whether the level
of special transportation services provided should be based on the degree of impairment of
the client, as well as the medical diagnosis. The commissioner shall also evaluate methods
for reducing the cost of special transportation services, including, but not limited to:

(1) requiring providers to maintain a daily log book confirming delivery of clients to
medical facilities;

(2) requiring providers to implement commercially available computer mapping
programs to calculate mileage for purposes of reimbursement;

(3) restricting special transportation service from being provided solely for trips
to pharmacies;

(4) modifying eligibility for special transportation;

(5) expanding alternatives to the use of special transportation services;

(6) improving the process of certifying persons as eligible for special transportation
services; and

(7) examining the feasibility and benefits of licensing special transportation
providers.

The commissioner shall present recommendations for changes in the eligibility
criteria and potential cost-savings for special transportation services to the chairs and
ranking minority members of the house and senate committees having jurisdiction
over health and human services spending by January 15, 2004. The commissioner
is prohibited from using a broker or coordinator to manage special transportation
services until July 1, 2006, except for the purposes of checking for recipient eligibility,
authorizing recipients for appropriate level of transportation, and monitoring provider
compliance with Minnesota Statutes, section 256B.0625, subdivision 17 new text begin , and except
that the commissioner shall extend this prohibition on using a broker or coordinator to
manage special transportation services until July 1, 2007, if this extension can be done on
a budget-neutral basis new text end . The commissioner shall not amend the initial contract to broker or
manage nonemergency medical transportation to extend beyond two consecutive years.
The commissioner shall not enter into a broker or management contract for transportation
services which denies a medical assistance recipient the free choice of health service
provider, including a special transportation provider, as specified in Code of Federal
Regulations, title 42, section 431.51. This prohibition does not apply to the purchase or
management of common carrier transportation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 10.

Laws 2005, First Special Session chapter 4, article 8, section 84, is amended
to read:

Sec. 84. deleted text begin SOLE-SOURCE OR deleted text end SINGLE-PLAN MANAGED CARE
CONTRACT.

Notwithstanding Minnesota Statutes, section 256B.692, subdivision 6, the
commissioner of human services shall deleted text begin not reject deleted text end new text begin consider new text end a county-based purchasing
health plan proposal that requires county-based purchasing on a deleted text begin sole-source or deleted text end single-plan
basis if the implementation of the deleted text begin sole-source or deleted text end single-plan purchasing proposal does
not limit an enrollee's provider choice or access to services. deleted text begin The commissioner shall
request federal approval, if necessary, to permit or maintain a sole-source or single-plan
purchasing option even if choice is available in the area. deleted text end

Sec. 11. new text begin PHARMACY PAYMENT REFORM ADVISORY COMMITTEE.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For purposes of this section, the following words, terms,
and phrases have the following meanings:
new text end

new text begin (a) "Department" means the Department of Human Services.
new text end

new text begin (b) "Commissioner" means the commissioner of the Department of Human Services.
new text end

new text begin (c) "Cost of dispensing" includes, but is not limited to, operational and overhead
costs; professional counseling as required under the Omnibus Budget Reconciliation Act
of 1990, excluding medication management services under Minnesota Statutes, section
256B.0625, subdivision 13h; salaries; and other associated administrative costs, as well
as a reasonable return on investment. In addition, cost of dispensing includes expenses
transferred by wholesale drug distributors to pharmacies as a result of the wholesale drug
distributor tax under Minnesota Statutes, sections 295.52 to 295.582.
new text end

new text begin (d) "Additional costs" include, but are not limited to, costs relating to coordination of
benefits, bad debt, uncollected co-pays, payment lag times, and high rate of rejected claims.
new text end

new text begin (e) "Advisory committee" means the Pharmacy Payment Reform Advisory
Committee established by this section.
new text end

new text begin Subd. 2. new text end

new text begin Advisory committee. new text end

new text begin The Pharmacy Payment Reform Advisory
Committee is established under the direction of the commissioner of human services.
The commissioner, after receiving recommendations from the Minnesota Pharmacists
Association, the Minnesota Retailers Association, the Minnesota Hospital Association,
and the Minnesota Wholesale Druggists Association, shall convene a pharmacy payment
reform advisory committee to advise the commissioner and make recommendations to the
legislature on implementation of pharmacy reforms contained in title VI, chapter IV, of
the Deficit Reduction Act of 2005. The committee shall be comprised of three licensed
pharmacists representing both independent and chain pharmacy entities, one of whom
must have expertise in pharmacoeconomics, two individuals representing hospitals with
outpatient pharmacies, and two individuals with expertise in wholesale drug distribution.
The committee shall be staffed by an employee of the department who shall serve as an ex
officio nonvoting member of the committee. The department's pharmacy program manager
shall also serve as an ex officio, nonvoting member of the committee. The committee is
governed by Minnesota Statutes, section 15.059, except that committee members do not
receive compensation or reimbursement for expenses. The advisory committee members
shall serve a two-year term and the advisory committee will expire on January 31, 2008.
new text end

new text begin Subd. 3. new text end

new text begin Cost of dispensing study. new text end

new text begin The department shall conduct a prescription
drug cost of dispensing study to determine the average cost of dispensing Medicaid
prescriptions in Minnesota. The department shall contract with an independent third
party in the state that has experience conducting business cost allocation studies, such as
an academic institution, to conduct a prescription drug cost of dispensing study. If no
independent third-party entity exists in the state, the department may contract with an
out-of-state entity. The cost of dispensing study shall be completed by an independent
third party no later than October 1, 2006, and reported to the department and the advisory
committee upon completion.
new text end

new text begin Subd. 4. new text end

new text begin Content of study. new text end

new text begin The study shall determine the cost of dispensing
the average prescription and any additional costs that might be incurred for dispensing
Medicaid prescriptions. The study shall include the current level of dispensing fees paid
to providers and an estimate of revenues required to adequately adjust reimbursement
to cover the cost to pharmacies.
new text end

new text begin Subd. 5. new text end

new text begin Methodology of study and publishing requirement. new text end

new text begin The independent
third-party entity performing the cost of dispensing research shall submit to the advisory
committee the entity's proposed research methodology and shall publish the collected data
to allow other independent researchers to validate the study results. The data shall be
published in a manner that does not identify the source of the data.
new text end

new text begin Subd. 6. new text end

new text begin Recommendations. new text end

new text begin The advisory committee shall use the information
from the cost of dispensing study and make recommendations to the commissioner on
implementation of pharmacy reforms contained in title VI, chapter IV, of the Deficit
Reduction Act of 2005. The commissioner shall report the findings of the study and
the recommendations of the advisory committee to the legislature by January 15, 2007.
The department shall conduct a cost of dispensing study every three years following the
initial report. The commissioner, in consultation with the advisory committee, shall make
recommendations to the legislature on how to adequately adjust reimbursement rates to
pharmacies to cover the costs of dispensing and additional costs to pharmacies. Reports
shall include the current level of dispensing fees paid to providers and an estimate of
revenues required to adequately adjust reimbursement to ensure that:
new text end

new text begin (1) reimbursement is sufficient to enlist an adequate number of participating
pharmacy providers so that pharmacy services are as available for Medicaid recipients
under the program as for the state's general population;
new text end

new text begin (2) Medicaid dispensing fees are adequate to reimburse pharmacy providers for the
costs of dispensing prescriptions under the Medicaid program;
new text end

new text begin (3) Medicaid pharmacy reimbursement for multiple-source drugs included on the
federal upper reimbursement limit is set at the level established by the federal government
under United States Code, title 42, section 1396r-8(e)(5);
new text end

new text begin (4) the combined Medicaid program reimbursement for prescription drug product
and the dispensing fee provides a return adequate to provide a reasonable profit for the
participating pharmacy; and
new text end

new text begin (5) the new payment system does not create disincentives for pharmacists to
dispense generic drugs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 12. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2004, section 256B.692, subdivision 10, new text end new text begin is repealed.
new text end

ARTICLE 3

HEALTH CARE FEDERAL COMPLIANCE

Section 1.

Minnesota Statutes 2004, section 62A.045, is amended to read:

62A.045 PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT
HEALTH PROGRAMS.

(a) new text begin As a condition of doing business in Minnesota, each health insurer shall comply
with the requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171,
including any federal regulations adopted under that act, to the extent that it imposes a
requirement that applies in this state and that is not also required by the laws of this state.
This section does not require compliance with any provision of the federal act prior to
the effective date provided for that provision in the federal act. The commissioner shall
enforce this section.
new text end

new text begin "Health insurer" for the purpose of this section includes self-insured plans, group
health plans (as defined in section 607(1) of the Employee Retirement Income Security
Act of 1974), service benefit plans, managed care organizations, pharmacy benefit
managers, or other parties that are by contract legally responsible to pay a claim for a
healthcare item or service for an individual receiving benefits under paragraph (b).
new text end

new text begin (b) new text end No health plan issued or renewed to provide coverage to a Minnesota resident
shall contain any provision denying or reducing benefits because services are rendered to a
person who is eligible for or receiving medical benefits pursuant to title XIX of the Social
Security Act (Medicaid) in this or any other state; chapter 256; 256B; or 256D or services
pursuant to section 252.27; 256L.01 to 256L.10; 260B.331, subdivision 2; 260C.331,
subdivision 2; or 393.07, subdivision 1 or 2. No health carrier providing benefits under
plans covered by this section shall use eligibility for medical programs named in this
section as an underwriting guideline or reason for nonacceptance of the risk.

deleted text begin (b) deleted text end new text begin (c) new text end If payment for covered expenses has been made under state medical programs
for health care items or services provided to an individual, and a third party has a legal
liability to make payments, the rights of payment and appeal of an adverse coverage
decision for the individual, or in the case of a child their responsible relative or caretaker,
will be subrogated to the state agency. The state agency may assert its rights under this
section within three years of the date the service was rendered. For purposes of this
section, "state agency" includes prepaid health plans under contract with the commissioner
according to sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12;
children's mental health collaboratives under section 245.493; demonstration projects for
persons with disabilities under section 256B.77; nursing homes under the alternative
payment demonstration project under section 256B.434; and county-based purchasing
entities under section 256B.692.

deleted text begin (c) deleted text end new text begin (d) new text end Notwithstanding any law to the contrary, when a person covered by a health
plan receives medical benefits according to any statute listed in this section, payment for
covered services or notice of denial for services billed by the provider must be issued
directly to the provider. If a person was receiving medical benefits through the Department
of Human Services at the time a service was provided, the provider must indicate this
benefit coverage on any claim forms submitted by the provider to the health carrier for
those services. If the commissioner of human services notifies the health carrier that
the commissioner has made payments to the provider, payment for benefits or notices
of denials issued by the health carrier must be issued directly to the commissioner.
Submission by the department to the health carrier of the claim on a Department of
Human Services claim form is proper notice and shall be considered proof of payment of
the claim to the provider and supersedes any contract requirements of the health carrier
relating to the form of submission. Liability to the insured for coverage is satisfied to the
extent that payments for those benefits are made by the health carrier to the provider or the
commissioner as required by this section.

deleted text begin (d) deleted text end new text begin (e) new text end When a state agency has acquired the rights of an individual eligible for
medical programs named in this section and has health benefits coverage through a
health carrier, the health carrier shall not impose requirements that are different from
requirements applicable to an agent or assignee of any other individual covered.

deleted text begin (e) deleted text end new text begin (f) new text end For the purpose of this section, health plan includes coverage offered by
community integrated service networks, any plan governed under the federal Employee
Retirement Income Security Act of 1974 (ERISA), United States Code, title 29, sections
1001 to 1461, and coverage offered under the exclusions listed in section 62A.011,
subdivision 3, clauses (2), (6), (9), (10), and (12).

Sec. 2.

Minnesota Statutes 2004, section 62S.05, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Extension of limitation periods. new text end

new text begin The commissioner may extend the
limitation periods set forth in subdivisions 1 and 2 as to specific age group categories in
specific policy forms upon finding that the extension is in the best interest of the public.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 3.

Minnesota Statutes 2004, section 62S.08, subdivision 3, is amended to read:

Subd. 3.

Mandatory format.

The following standard format outline of coverage
must be used, unless otherwise specifically indicated:

COMPANY NAME

ADDRESS - CITY AND STATE

TELEPHONE NUMBER

LONG-TERM CARE INSURANCE

OUTLINE OF COVERAGE

Policy Number or Group Master Policy and Certificate Number

(Except for policies or certificates which are guaranteed issue, the following caution
statement, or language substantially similar, must appear as follows in the outline of
coverage.)

CAUTION: The issuance of this long-term care insurance (policy) (certificate)
is based upon your responses to the questions on your application. A copy of your
(application) (enrollment form) (is enclosed) (was retained by you when you applied).
If your answers are incorrect or untrue, the company has the right to deny benefits or
rescind your policy. The best time to clear up any questions is now, before a claim
arises. If, for any reason, any of your answers are incorrect, contact the company at this
address: (insert address).

(1) This policy is (an individual policy of insurance) (a group policy) which was
issued in the (indicate jurisdiction in which group policy was issued).

(2) PURPOSE OF OUTLINE OF COVERAGE. This outline of coverage provides
a very brief description of the important features of the policy. You should compare
this outline of coverage to outlines of coverage for other policies available to you. This
is not an insurance contract, but only a summary of coverage. Only the individual or
group policy contains governing contractual provisions. This means that the policy or
group policy sets forth in detail the rights and obligations of both you and the insurance
company. Therefore, if you purchase this coverage, or any other coverage, it is important
that you READ YOUR POLICY (OR CERTIFICATE) CAREFULLY.

(3) THIS PLAN IS INTENDED TO BE A QUALIFIED LONG-TERM CARE
INSURANCE CONTRACT AS DEFINED UNDER SECTION 7702(B)(b) OF THE
INTERNAL REVENUE CODE OF 1986.

(4) new text begin TERMS UNDER WHICH THE POLICY OR CERTIFICATE MAY BE
CONTINUED IN FORCE OR DISCONTINUED.
new text end

new text begin (a) (For long-term care health insurance policies or certificates describe one of the
following permissible policy renewability provisions:
new text end

new text begin (1) Policies and certificates that are guaranteed renewable shall contain the following
statement:) RENEWABILITY: THIS POLICY (CERTIFICATE) IS GUARANTEED
RENEWABLE. This means you have the right, subject to the terms of your policy,
(certificate) to continue this policy as long as you pay your premiums on time. (company
name) cannot change any of the terms of your policy on its own, except that, in the future,
IT MAY INCREASE THE PREMIUM YOU PAY.
new text end

new text begin (2) (Policies and certificates that are noncancelable shall contain the following
statement:) RENEWABILITY: THIS POLICY (CERTIFICATE) IS NONCANCELABLE.
This means that you have the right, subject to the terms of your policy, to continue this
policy as long as you pay your premiums on time. (company name) cannot change any
of the terms of your policy on its own and cannot change the premium you currently
pay. However, if your policy contains an inflation protection feature where you choose
to increase your benefits, (company name) may increase your premium at that time for
those additional benefits.
new text end

new text begin (b) (For group coverage, specifically describe continuation/conversion provisions
applicable to the certificate and group policy.)
new text end

new text begin (c) (Describe waiver of premium provisions or state that there are not such
provisions.)
new text end

new text begin (5) TERMS UNDER WHICH THE COMPANY MAY CHANGE PREMIUMS.
new text end

new text begin (In bold type larger than the maximum type required to be used for the other
provisions of the outline of coverage, state whether or not the company has a right to
change the premium and, if a right exists, describe clearly and concisely each circumstance
under which the premium may change.)
new text end

new text begin (6) new text end TERMS UNDER WHICH THE POLICY OR CERTIFICATE MAY BE
RETURNED AND PREMIUM REFUNDED.

(a) (Provide a brief description of the right to return -- "free look" provision of
the policy.)

(b) (Include a statement that the policy either does or does not contain provisions
providing for a refund or partial refund of premium upon the death of an insured or
surrender of the policy or certificate. If the policy contains such provisions, include a
description of them.)

deleted text begin (5) deleted text end new text begin (7) new text end THIS IS NOT MEDICARE SUPPLEMENT COVERAGE. If you are
eligible for Medicare, review the Medicare Supplement Buyer's Guide available from
the insurance company.

(a) (For agents) neither (insert company name) nor its agents represent Medicare, the
federal government, or any state government.

(b) (For direct response) (insert company name) is not representing Medicare, the
federal government, or any state government.

deleted text begin (6) deleted text end new text begin (8) new text end LONG-TERM CARE COVERAGE. Policies of this category are designed to
provide coverage for one or more necessary or medically necessary diagnostic, preventive,
therapeutic, rehabilitative, maintenance, or personal care services, provided in a setting
other than an acute care unit of a hospital, such as in a nursing home, in the community,
or in the home.

This policy provides coverage in the form of a fixed dollar indemnity benefit for
covered long-term care expenses, subject to policy (limitations), (waiting periods), and
(coinsurance) requirements. (Modify this paragraph if the policy is not an indemnity
policy.)

deleted text begin (7) deleted text end new text begin (9) new text end BENEFITS PROVIDED BY THIS POLICY.

(a) (Covered services, related deductible(s), waiting periods, elimination periods,
and benefit maximums.)

(b) (Institutional benefits, by skill level.)

(c) (Noninstitutional benefits, by skill level.)

new text begin (d) (Eligibility for payment of benefits.)
new text end

new text begin (Activities of daily living and cognitive impairment shall be used to measure an
insured's need for long-term care and must be defined and described as part of the outline
of coverage.)
new text end

(Any benefit screens must be explained in this section. If these screens differ for
different benefits, explanation of the screen should accompany each benefit description. If
an attending physician or other specified person must certify a certain level of functional
dependency in order to be eligible for benefits, this too must be specified. If activities of
daily living (ADLs) are used to measure an insured's need for long-term care, then these
qualifying criteria or screens must be explained.)

deleted text begin (8) deleted text end new text begin (10) new text end LIMITATIONS AND EXCLUSIONS:

Describe:

(a) preexisting conditions;

(b) noneligible facilities/provider;

(c) noneligible levels of care (e.g., unlicensed providers, care or treatment provided
by a family member, etc.);

(d) exclusions/exceptions; and

(e) limitations.

(This section should provide a brief specific description of any policy provisions
which limit, exclude, restrict, reduce, delay, or in any other manner operate to qualify
payment of the benefits described in paragraph deleted text begin (6) deleted text end new text begin (8) new text end .)

THIS POLICY MAY NOT COVER ALL THE EXPENSES ASSOCIATED WITH
YOUR LONG-TERM CARE NEEDS.

deleted text begin (9) deleted text end new text begin (11) new text end RELATIONSHIP OF COST OF CARE AND BENEFITS. Because the costs
of long-term care services will likely increase over time, you should consider whether and
how the benefits of this plan may be adjusted. As applicable, indicate the following:

(a) that the benefit level will not increase over time;

(b) any automatic benefit adjustment provisions;

(c) whether the insured will be guaranteed the option to buy additional benefits and
the basis upon which benefits will be increased over time if not by a specified amount
or percentage;

(d) if there is such a guarantee, include whether additional underwriting or health
screening will be required, the frequency and amounts of the upgrade options, and any
significant restrictions or limitations; and

(e) whether there will be any additional premium charge imposed and how that
is to be calculated.

deleted text begin (10) deleted text end new text begin (12) new text end ALZHEIMER'S DISEASE AND OTHER ORGANIC BRAIN
DISORDERS. (State that the policy provides coverage for insureds clinically diagnosed as
having Alzheimer's disease or related degenerative and dementing illnesses. Specifically,
describe each benefit screen or other policy provision which provides preconditions to the
availability of policy benefits for such an insured.)

deleted text begin (11) deleted text end new text begin (13) new text end PREMIUM.

(a) State the total annual premium for the policy.

(b) If the premium varies with an applicant's choice among benefit options, indicate
the portion of annual premium which corresponds to each benefit option.

deleted text begin (12) deleted text end new text begin (14) new text end ADDITIONAL FEATURES.

(a) Indicate if medical underwriting is used.

(b) Describe other important features.

new text begin (15) CONTACT THE STATE DEPARTMENT OF COMMERCE OR SENIOR
LINKAGE LINE IF YOU HAVE GENERAL QUESTIONS REGARDING LONG-TERM
CARE INSURANCE. CONTACT THE INSURANCE COMPANY IF YOU HAVE
SPECIFIC QUESTIONS REGARDING YOUR LONG-TERM CARE INSURANCE
POLICY OR CERTIFICATE.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 4.

Minnesota Statutes 2004, section 62S.081, subdivision 4, is amended to read:

Subd. 4.

Forms.

An insurer shall use the forms in Appendices B new text begin (Personal
Worksheet) new text end and F new text begin (Potential Rate Increase Disclosure Form) new text end of the Long-term Care
Insurance Model Regulation adopted by the National Association of Insurance
Commissioners to comply with the requirements of subdivisions 1 and 2.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 5.

Minnesota Statutes 2004, section 62S.10, subdivision 2, is amended to read:

Subd. 2.

Contents.

The summary must include the following information:

(1) an explanation of how the long-term care benefit interacts with other components
of the policy, including deductions from death benefits;

(2) an illustration of the amount of benefits, the length of benefits, and the guaranteed
lifetime benefits, if any, for each covered person; deleted text begin and
deleted text end

(3) any exclusions, reductions, and limitations on benefits of long-term care new text begin ; and
new text end

new text begin (4) a statement that any long-term care inflation protection option required by section
62S.23 is not available under this policy new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 6.

Minnesota Statutes 2004, section 62S.13, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Death of insured. new text end

new text begin In the event of the death of the insured, this section shall
not apply to the remaining death benefit of a life insurance policy that accelerates benefits
for long-term care. In this situation, the remaining death benefits under these policies shall
be governed by section 61A.03, subdivision 1, paragraph (c). In all other situations, this
section shall apply to life insurance policies that accelerate benefits for long-term care.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 7.

Minnesota Statutes 2004, section 62S.14, subdivision 2, is amended to read:

Subd. 2.

Terms.

The terms "guaranteed renewable" and "noncancelable" may not
be used in an individual long-term care insurance policy without further explanatory
language that complies with the disclosure requirements of section 62S.20. new text begin The term
"level premium" may only be used when the insurer does not have the right to change
the premium. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006
new text end

Sec. 8.

Minnesota Statutes 2004, section 62S.15, is amended to read:

62S.15 AUTHORIZED LIMITATIONS AND EXCLUSIONS.

No policy may be delivered or issued for delivery in this state as long-term care
insurance if the policy limits or excludes coverage by type of illness, treatment, medical
condition, or accident, except as follows:

(1) preexisting conditions or diseases;

(2) mental or nervous disorders; except that the exclusion or limitation of benefits on
the basis of Alzheimer's disease is prohibited;

(3) alcoholism and drug addiction;

(4) illness, treatment, or medical condition arising out of war or act of war;
participation in a felony, riot, or insurrection; service in the armed forces or auxiliary
units; suicide, attempted suicide, or intentionally self-inflicted injury; or non-fare-paying
aviation; deleted text begin and
deleted text end

(5) treatment provided in a government facility unless otherwise required by
law, services for which benefits are available under Medicare or other government
program except Medicaid, state or federal workers' compensation, employer's liability
or occupational disease law, motor vehicle no-fault law; services provided by a member
of the covered person's immediate family; and services for which no charge is normally
made in the absence of insurance new text begin ; and
new text end

new text begin (6) expenses for services or items available or paid under another long-term care
insurance or health insurance policy new text end .

This subdivision does not prohibit exclusions and limitations by type of provider or
territorial limitations.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 9.

Minnesota Statutes 2004, section 62S.20, subdivision 1, is amended to read:

Subdivision 1.

Renewability.

new text begin (a) new text end Individual long-term care insurance policies
must contain a renewability provision that is appropriately captioned, appears on the first
page of the policy, and clearly states deleted text begin the duration, where limited, of renewability and the
duration of the term of coverage for which the policy is issued and for which it may be
renewed deleted text end new text begin that the coverage is guaranteed renewable or noncancelable new text end . This subdivision
does not apply to policies which are part of or combined with life insurance policies
which do not contain a renewability provision and under which the right to nonrenew is
reserved solely to the policyholder.

new text begin (b) A long-term care insurance policy or certificate, other than one where the insurer
does not have the right to change the premium, shall include a statement that premium
rates may change.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 10.

Minnesota Statutes 2004, section 62S.24, subdivision 1, is amended to read:

Subdivision 1.

Required questions.

An application form must include the following
questions designed to elicit information as to whether, as of the date of the application, the
applicant has another long-term care insurance policy or certificate in force or whether a
long-term care policy or certificate is intended to replace any other new text begin accident and sickness
or new text end long-term care policy or certificate presently in force. A supplementary application
or other form to be signed by the applicant and agent, except where the coverage is sold
without an agent, containing the following questions may be used. If a replacement policy
is issued to a group as defined under section 62S.01, subdivision 15, clause (1), the
following questions may be modified only to the extent necessary to elicit information
about long-term care insurance policies other than the group policy being replaced;
provided, however, that the certificate holder has been notified of the replacement:

(1) do you have another long-term care insurance policy or certificate in force new text begin
(including health care service contract or health maintenance organization contract) new text end ?;

(2) did you have another long-term care insurance policy or certificate in force
during the last 12 months?;

(i) if so, with which company?; and

(ii) if that policy lapsed, when did it lapse?; deleted text begin and
deleted text end

(3) are you covered by Medicaid? new text begin ; and
new text end

new text begin (4) do you intend to replace any of your medical or health insurance coverage with
this policy (certificate)?
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 11.

Minnesota Statutes 2004, section 62S.24, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Other health insurance policies sold by agent. new text end

new text begin Agents shall list all other
health insurance policies they have sold to the applicant that are still in force or were sold
in the past five years and are no longer in force.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 12.

Minnesota Statutes 2004, section 62S.24, subdivision 3, is amended to read:

Subd. 3.

Solicitations other than direct response.

After determining that a
sale will involve replacement, an insurer, other than an insurer using direct response
solicitation methods or its agent, shall furnish the applicant, before issuance or delivery of
the individual long-term care insurance policy, a notice regarding replacement of accident
and sickness or long-term care coverage. One copy of the notice must be retained by the
applicant and an additional copy signed by the applicant must be retained by the insurer.
The required notice must be provided in the following manner:

NOTICE TO APPLICANT REGARDING REPLACEMENT OF

INDIVIDUAL ACCIDENT AND SICKNESS OR LONG-TERM
CARE INSURANCE

(Insurance company's name and address)

SAVE THIS NOTICE! IT MAY BE IMPORTANT TO YOU IN THE FUTURE.

According to (your application) (information you have furnished), you intend to
lapse or otherwise terminate existing new text begin accident and sickness or new text end long-term care insurance
and replace it with an individual long-term care insurance policy to be issued by (company
name) insurance company. Your new policy provides 30 days within which you may
decide, without cost, whether you desire to keep the policy. For your own information and
protection, you should be aware of and seriously consider certain factors which may affect
the insurance protection available to you under the new policy.

You should review this new coverage carefully, comparing it with all new text begin accident
and sickness or new text end long-term care insurance coverage you now have, and terminate your
present policy only if, after due consideration, you find that purchase of this long-term
care coverage is a wise decision.

STATEMENT TO APPLICANT BY AGENT

(BROKER OR OTHER REPRESENTATIVE):

(Use additional sheets, as necessary.)

I have reviewed your current new text begin medical health new text end insurance coverage. I believe the
replacement of insurance involved in this transaction materially improves your position.
My conclusion has taken into account the following considerations, which I call to your
attention:

(a) Health conditions which you presently have (preexisting conditions) may not
be immediately or fully covered under the new policy. This could result in denial or
delay in payment of benefits under the new policy, whereas a similar claim might have
been payable under your present policy.

(b) State law provides that your replacement policy or certificate may not contain
new preexisting conditions or probationary periods. The insurer will waive any time
periods applicable to preexisting conditions or probationary periods in the new policy (or
coverage) for similar benefits to the extent such time was spent (depleted) under the
original policy.

(c) If you are replacing existing long-term care insurance coverage, you may wish to
secure the advice of your present insurer or its agent regarding the proposed replacement of
your present policy. This is not only your right, but it is also in your best interest to make
sure you understand all the relevant factors involved in replacing your present coverage.

(d) If, after due consideration, you still wish to terminate your present policy and
replace it with new coverage, be certain to truthfully and completely answer all questions
on the application concerning your medical health history. Failure to include all material
medical information on an application may provide a basis for the company to deny any
future claims and to refund your premium as though your policy had never been in force.
After the application has been completed and before you sign it, reread it carefully to be
certain that all information has been properly recorded.

.

(Signature of Agent, Broker, or Other Representative)

(Typed Name and Address of Agency or Broker)

The above "Notice to Applicant" was delivered to me on:

	.
	(Date)
	.
	(Applicant's Signature)

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 13.

Minnesota Statutes 2004, section 62S.24, subdivision 4, is amended to read:

Subd. 4.

Direct response solicitations.

Insurers using direct response solicitation
methods shall deliver a notice regarding replacement of long-term care coverage to
the applicant upon issuance of the policy. The required notice must be provided in the
following manner:

NOTICE TO APPLICANT REGARDING REPLACEMENT OF new text begin
ACCIDENT AND SICKNESS OR
new text end

LONG-TERM CARE INSURANCE

(Insurance company's name and address)

SAVE THIS NOTICE! IT MAY BE

IMPORTANT TO YOU IN THE FUTURE.

According to (your application) (information you have furnished), you intend to
lapse or otherwise terminate existing new text begin accident and sickness or new text end long-term care insurance
and replace it with the long-term care insurance policy delivered herewith issued by
(company name) insurance company.

Your new policy provides 30 days within which you may decide, without cost,
whether you desire to keep the policy. For your own information and protection, you
should be aware of and seriously consider certain factors which may affect the insurance
protection available to you under the new policy.

You should review this new coverage carefully, comparing it with all long-term care
insurance coverage you now have, and terminate your present policy only if, after due
consideration, you find that purchase of this long-term care coverage is a wise decision.

(a) Health conditions which you presently have (preexisting conditions) may not
be immediately or fully covered under the new policy. This could result in denial or
delay in payment of benefits under the new policy, whereas a similar claim might have
been payable under your present policy.

(b) State law provides that your replacement policy or certificate may not contain
new preexisting conditions or probationary periods. Your insurer will waive any time
periods applicable to preexisting conditions or probationary periods in the new policy (or
coverage) for similar benefits to the extent such time was spent (depleted) under the
original policy.

(c) If you are replacing existing long-term care insurance coverage, you may wish to
secure the advice of your present insurer or its agent regarding the proposed replacement of
your present policy. This is not only your right, but it is also in your best interest to make
sure you understand all the relevant factors involved in replacing your present coverage.

(d) (To be included only if the application is attached to the policy.)

If, after due consideration, you still wish to terminate your present policy and replace
it with new coverage, read the copy of the application attached to your new policy and be
sure that all questions are answered fully and correctly. Omissions or misstatements in
the application could cause an otherwise valid claim to be denied. Carefully check the
application and write to (company name and address) within 30 days if any information is
not correct and complete, or if any past medical history has been left out of the application.

	.
	(Company Name)

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 14.

Minnesota Statutes 2004, section 62S.24, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Life insurance policies. new text end

new text begin Life insurance policies that accelerate benefits for
long-term care shall comply with this section if the policy being replaced is a long-term
care insurance policy. If the policy being replaced is a life insurance policy, the insurer
shall comply with the replacement requirements of sections 61A.53 to 61A.60. If a
life insurance policy that accelerates benefits for long-term care is replaced by another
such policy, the replacing insurer shall comply with both the long-term care and the life
insurance replacement requirements.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 15.

Minnesota Statutes 2004, section 62S.24, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Exchange for long-term care partnership policy; addition of policy
rider. new text end

new text begin (a) If federal law is amended or a federal waiver is granted with respect to the
long-term care partnership program referenced in section 256B.0571, issuers of long-term
care policies may voluntarily exchange a current long-term care insurance policy for a
long-term care partnership policy that meets the requirements of Public Law 109-171,
section 6021, after the effective date of the state plan amendment implementing the
partnership program in this state.
new text end

new text begin (b) If federal law is amended or a federal waiver is granted with respect to the
long-term care partnership program referenced in section 256B.0571 allowing an existing
long-term care insurance policy to qualify as a partnership policy by addition of a policy
rider, the issuer of the policy is authorized to add the rider to the policy after the effective
date of the state plan amendment implementing the partnership program in this state.
new text end

new text begin (c) The commissioner, in cooperation with the commissioner of human services,
shall pursue any federal law changes or waivers necessary to allow the implementation
of paragraphs (a) and (b).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 16.

Minnesota Statutes 2004, section 62S.25, subdivision 6, is amended to read:

Subd. 6.

Claims denied.

Each insurer shall report annually by June 30 the number
of claims denied new text begin for any reason new text end during the reporting period for each class of business,
expressed as a percentage of claims denied, other than claims denied for failure to meet
the waiting period or because of any applicable preexisting condition. new text begin For purposes of
this subdivision, "claim" means a request for payment of benefits under an in-force policy
regardless of whether the benefit claimed is covered under the policy or any terms or
conditions of the policy have been met.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 17.

Minnesota Statutes 2004, section 62S.25, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Reports. new text end

new text begin Reports under this section shall be done on a statewide basis and
filed with the commissioner. They shall include, at a minimum, the information in the
format contained in Appendix E (Claim Denial Reporting Form) and in Appendix G
(Replacement and Lapse Reporting Form) of the Long-Term Care Model Regulation
adopted by the National Association of Insurance Commissioners.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 18.

Minnesota Statutes 2004, section 62S.26, is amended to read:

62S.26 LOSS RATIO.

new text begin Subdivision 1. new text end

new text begin Minimum loss ratio. new text end

deleted text begin (a) deleted text end The minimum loss ratio must be at least 60
percent, calculated in a manner which provides for adequate reserving of the long-term
care insurance risk. In evaluating the expected loss ratio, the commissioner shall give
consideration to all relevant factors, including:

(1) statistical credibility of incurred claims experience and earned premiums;

(2) the period for which rates are computed to provide coverage;

(3) experienced and projected trends;

(4) concentration of experience within early policy duration;

(5) expected claim fluctuation;

(6) experience refunds, adjustments, or dividends;

(7) renewability features;

(8) all appropriate expense factors;

(9) interest;

(10) experimental nature of the coverage;

(11) policy reserves;

(12) mix of business by risk classification; and

(13) product features such as long elimination periods, high deductibles, and high
maximum limits.

new text begin Subd. 2. new text end

new text begin Life insurance policies. new text end

new text begin Subdivision 1 shall not apply to life insurance
policies that accelerate benefits for long-term care. A life insurance policy that funds
long-term care benefits entirely by accelerating the death benefit is considered to provide
reasonable benefits in relation to premiums paid, if the policy complies with all of the
following provisions:
new text end

new text begin (1) the interest credited internally to determine cash value accumulations, including
long-term care, if any, are guaranteed not to be less than the minimum guaranteed interest
rate for cash value accumulations without long-term care set forth in the policy;
new text end

new text begin (2) the portion of the policy that provides life insurance benefits meets the
nonforfeiture requirements of section 61A.24;
new text end

new text begin (3) the policy meets the disclosure requirements of sections 62S.09, 62S.10, and
62S.11; and
new text end

new text begin (4) an actuarial memorandum is filed with the insurance department that includes:
new text end

new text begin (i) a description of the basis on which the long-term care rates were determined;
new text end

new text begin (ii) a description of the basis for the reserves;
new text end

new text begin (iii) a summary of the type of policy, benefits, renewability, general marketing
method, and limits on ages of issuance;
new text end

new text begin (iv) a description and a table of each actuarial assumption used. For expenses,
an insurer must include percentage of premium dollars per policy and dollars per unit
of benefits, if any;
new text end

new text begin (v) a description and a table of the anticipated policy reserves and additional reserves
to be held in each future year for active lives;
new text end

new text begin (vi) the estimated average annual premium per policy and the average issue age;
new text end

new text begin (vii) a statement as to whether underwriting is performed at the time of application.
The statement shall indicate whether underwriting is used and, if used, the statement
shall include a description of the type or types of underwriting used, such as medical
underwriting or functional assessment underwriting. Concerning a group policy, the
statement shall indicate whether the enrollee or any dependent will be underwritten and
when underwriting occurs; and
new text end

new text begin (viii) a description of the effect of the long-term care policy provision on the required
premiums, nonforfeiture values, and reserves on the underlying life insurance policy, both
for active lives and those in long-term care claim status.
new text end

new text begin Subd. 3. new text end

new text begin Nonapplication. new text end

deleted text begin (b) deleted text end This section does not apply to policies or certificates
that are subject to sections 62S.021, 62S.081, and 62S.265, and that comply with those
sections.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 19.

Minnesota Statutes 2004, section 62S.266, subdivision 2, is amended to read:

Subd. 2.

Requirement.

new text begin (a) new text end An insurer must offer each prospective policyholder a
nonforfeiture benefit in compliance with the following requirements:

(1) a policy or certificate offered with nonforfeiture benefits must have coverage
elements, eligibility, benefit triggers, and benefit length that are the same as coverage to be
issued without nonforfeiture benefits. The nonforfeiture benefit included in the offer must
be the benefit described in subdivision 5; and

(2) the offer must be in writing if the nonforfeiture benefit is not otherwise described
in the outline of coverage or other materials given to the prospective policyholder.

new text begin (b) When a group long-term care insurance policy is issued, the offer required in
paragraph (a) shall be made to the group policy holder. However, if the policy is issued as
group long-term care insurance as defined in section 62S.01, subdivision 15, clause (4),
other than to a continuing care retirement community or other similar entity, the offering
shall be made to each proposed certificate holder.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 20.

Minnesota Statutes 2004, section 62S.29, subdivision 1, is amended to read:

Subdivision 1.

Requirements.

An insurer or other entity marketing long-term care
insurance coverage in this state, directly or through its producers, shall:

(1) establish marketing procedures new text begin and agent training requirements new text end to assure that deleted text begin a
deleted text end new text begin any marketing activities, including any new text end comparison of policies by its agents or other
producers new text begin , new text end are fair and accurate;

(2) establish marketing procedures to assure excessive insurance is not sold or issued;

(3) display prominently by type, stamp, or other appropriate means, on the first page
of the outline of coverage and policy, the following:

"Notice to buyer: This policy may not cover all of the costs associated with
long-term care incurred by the buyer during the period of coverage. The buyer is advised
to review carefully all policy limitations.";

(4) new text begin provide copies of the disclosure forms required in section 62S.081, subdivision
4, to the applicant;
new text end

new text begin (5) new text end inquire and otherwise make every reasonable effort to identify whether a
prospective applicant or enrollee for long-term care insurance already has long-term care
insurance and the types and amounts of the insurance;

deleted text begin (5) deleted text end new text begin (6) new text end establish auditable procedures for verifying compliance with this subdivision;
deleted text begin and
deleted text end

deleted text begin (6) deleted text end new text begin (7) new text end if applicable, provide written notice to the prospective policyholder and
certificate holder, at solicitation, that a senior insurance counseling program approved
by the commissioner is available and the name, address, and telephone number of the
program new text begin ;
new text end

new text begin (8) use the terms "noncancelable" or "level premium" only when the policy or
certificate conforms to section 62S.14; and
new text end

new text begin (9) provide an explanation of contingent benefit upon lapse provided for in section
62S.266 new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 21.

Minnesota Statutes 2004, section 62S.30, is amended to read:

62S.30 deleted text begin APPROPRIATENESS OF RECOMMENDED PURCHASE deleted text end new text begin
SUITABILITY new text end .

deleted text begin In recommending the purchase or replacement of a long-term care insurance policy
or certificate, an agent shall comply with section 60K.46, subdivision 4.
deleted text end new text begin new text end

new text begin Subdivision 1. new text end

new text begin Standards. new text end

new text begin Every insurer or other entity marketing long-term care
insurance shall:
new text end

new text begin (1) develop and use suitability standards to determine whether the purchase or
replacement of long-term care insurance is appropriate for the needs of the applicant;
new text end

new text begin (2) train its agents in the use of its suitability standards; and
new text end

new text begin (3) maintain a copy of its suitability standards and make them available for
inspection upon request by the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Procedures. new text end

new text begin (a) To determine whether the applicant meets the standards
developed by the insurer or other entity marketing long-term care insurance, the agent
and insurer or other entity marketing long-term care insurance shall develop procedures
that take the following into consideration:
new text end

new text begin (1) the ability to pay for the proposed coverage and other pertinent financial
information related to the purchase of the coverage;
new text end

new text begin (2) the applicant's goals or needs with respect to long-term care and the advantages
and disadvantages of insurance to meet those goals or needs; and
new text end

new text begin (3) the values, benefits, and costs of the applicant's existing insurance, if any, when
compared to the values, benefits, and costs of the recommended purchase or replacement.
new text end

new text begin (b) The insurer or other entity marketing long-term care insurance, and where an
agent is involved, the agent, shall make reasonable efforts to obtain the information set
forth in paragraph (a). The efforts shall include presentation to the applicant, at or prior
to application, of the "Long-Term Care Insurance Personal Worksheet." The personal
worksheet used by the insurer or other entity marketing long-term care insurance shall
contain, at a minimum, the information in the format contained in Appendix B of the
Long-Term Care Model Regulation adopted by the National Association of Insurance
Commissioners, in not less than 12-point type. The insurer or other entity marketing
long-term care insurance may request the applicant to provide additional information to
comply with its suitability standards. The insurer or other entity marketing long-term care
insurance shall file a copy of its personal worksheet with the commissioner.
new text end

new text begin (c) A completed personal worksheet shall be returned to the insurer or other entity
marketing long-term care insurance prior to consideration of the applicant for coverage,
except the personal worksheet need not be returned for sales of employer group long-term
care insurance to employees and their spouses. The sale or dissemination by the insurer
or other entity marketing long-term care insurance, or the agent, of information obtained
through the personal worksheet, is prohibited.
new text end

new text begin (d) The insurer or other entity marketing long-term care insurance shall use the
suitability standards it has developed under this section in determining whether issuing
long-term care insurance coverage to an applicant is appropriate. Agents shall use the
suitability standards developed by the insurer or other entity marketing long-term care
insurance in marketing long-term care insurance.
new text end

new text begin (e) At the same time as the personal worksheet is provided to the applicant, the
disclosure form entitled "Things You Should Know Before You Buy Long-Term Care
Insurance" shall be provided. The form shall be in the format contained in Appendix C of
the Long-Term Care Insurance Model Regulation adopted by the National Association of
Insurance Commissioners in not less than 12-point type.
new text end

new text begin (f) If the insurer or other entity marketing long-term care insurance determines
that the applicant does not meet its financial suitability standards, or if the applicant has
declined to provide the information, the insurer or other entity marketing long-term
care insurance may reject the application. In the alternative, the insurer or other entity
marketing long-term care insurance shall send the applicant a letter similar to Appendix D
of the Long-Term Care Insurance Model Regulation adopted by the National Association
of Insurance Commissioners. However, if the applicant has declined to provide financial
information, the insurer or other entity marketing long-term care insurance may use some
other method to verify the applicant's intent. The applicant's returned letter or a record of
the alternative method of verification shall be made part of the applicant's file.
new text end

new text begin Subd. 3. new text end

new text begin Reports. new text end

new text begin The insurer or other entity marketing long-term care insurance
shall report annually to the commissioner the total number of applications received from
residents of this state, the number of those who declined to provide information on the
personal worksheet, the number of applicants who did not meet the suitability standards,
and the number of those who chose to confirm after receiving a suitability letter.
new text end

new text begin Subd. 4. new text end

new text begin Application. new text end

new text begin This section shall not apply to life insurance policies that
accelerate benefits for long-term care.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 22.

new text begin [62S.315] PRODUCER TRAINING.
new text end

new text begin The commissioner shall approve producer training requirements in accordance with
the NAIC Long-Term Care Insurance Model Act provisions. The commissioner of the
Department of Human Services shall provide technical assistance and information to the
commissioner in accordance with Public Law 109-171, section 6021.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 23.

Minnesota Statutes 2004, section 144.6501, subdivision 6, is amended to read:

Subd. 6.

Medical assistance payment.

(a) An admission contract for a facility that
is certified for participation in the medical assistance program must state that neither the
prospective resident, nor anyone on the resident's behalf, is required to pay privately any
amount for which the resident's care at the facility has been approved for payment by
medical assistance or to make any kind of donation, voluntary or otherwise. new text begin Except as
permitted under section 6015 of the Deficit Reduction Act of 2005, Public Law 109-171,
new text end an admission contract must state that the facility does not require as a condition of
admission, either in its admission contract or by oral promise before signing the admission
contract, that residents remain in private pay status for any period of time.

(b) The admission contract must state that upon presentation of proof of eligibility,
the facility will submit a medical assistance claim for reimbursement and will return any
and all payments made by the resident, or by any person on the resident's behalf, for
services covered by medical assistance, upon receipt of medical assistance payment.

(c) A facility that participates in the medical assistance program shall not charge for
the day of the resident's discharge from the facility or subsequent days.

(d) If a facility's charges incurred by the resident are delinquent for 30 days, and
no person has agreed to apply for medical assistance for the resident, the facility may
petition the court under chapter 525 to appoint a representative for the resident in order to
apply for medical assistance for the resident.

(e) The remedy provided in this subdivision does not preclude a facility from seeking
any other remedy available under other laws of this state.

Sec. 24.

Minnesota Statutes 2004, section 256B.02, subdivision 9, is amended to read:

Subd. 9.

Private health care coverage.

"Private health care coverage" means any
plan regulated by chapter 62A, 62C or 64B. Private health care coverage also includes
any deleted text begin self-insurance deleted text end new text begin self-insured new text end plan providing health care benefits new text begin , pharmacy benefit
manager, service benefit plan, managed care organization, and other parties that are by
contract legally responsible for payment of a claim for a health care item or service for an
individual receiving medical benefits under chapter 256B, 256D, or 256L new text end .

Sec. 25.

Minnesota Statutes 2004, section 256B.056, subdivision 2, is amended to read:

Subd. 2.

Homestead deleted text begin ; deleted text end exclusion new text begin and homestead equity limit new text end for institutionalized
persons.

new text begin (a) new text end The homestead shall be excluded for the first six calendar months of a
person's stay in a long-term care facility and shall continue to be excluded for as long as
the recipient can be reasonably expected to return to the homestead. For purposes of
this subdivision, "reasonably expected to return to the homestead" means the recipient's
attending physician has certified that the expectation is reasonable, and the recipient can
show that the cost of care upon returning home will be met through medical assistance
or other sources. The homestead shall continue to be excluded for persons residing in
a long-term care facility if it is used as a primary residence by one of the following
individuals:

deleted text begin (a) deleted text end new text begin (1) new text end the spouse;

deleted text begin (b) deleted text end new text begin (2) new text end a child under age 21;

deleted text begin (c) deleted text end new text begin (3) new text end a child of any age who is blind or permanently and totally disabled as defined
in the supplemental security income program;

deleted text begin (d) deleted text end new text begin (4) new text end a sibling who has equity interest in the home and who resided in the home for
at least one year immediately before the date of the person's admission to the facility; or

deleted text begin (e) deleted text end new text begin (5) new text end a child of any age, or, subject to federal approval, a grandchild of any age,
who resided in the home for at least two years immediately before the date of the person's
admission to the facility, and who provided care to the person that permitted the person to
reside at home rather than in an institution.

new text begin (b) Effective for applications filed on or after July 1, 2006, and for renewals after
July 1, 2006, for persons who first applied for payment of long-term care services on
or after January 2, 2006, the equity interest in the homestead of an individual whose
eligibility for long-term care services is determined on or after January 1, 2006, shall not
exceed $500,000, unless it is the lawful residence of the individual's spouse or child
who is under age 21, blind, or disabled. The amount specified in this paragraph shall be
increased beginning in year 2011, from year-to-year based on the percentage increase in
the Consumer Price Index for all urban consumers (all items; United States city average),
rounded to the nearest $1,000. This provision may be waived in the case of demonstrated
hardship by a process to be determined by the secretary of health and human services
pursuant to section 6014 of the Deficit Reduction Act of 2005, Public Law 109-171.
new text end

Sec. 26.

Minnesota Statutes 2004, section 256B.056, is amended by adding a
subdivision to read:

new text begin Subd. 3e. new text end

new text begin Treatment of continuing care retirement and life care community
entrance fees. new text end

new text begin An entrance fee paid by an individual to a continuing care retirement or
life care community shall be treated as an available asset to the extent that:
new text end

new text begin (1) the individual has the ability to use the entrance fee, or the contract provides that
the entrance fee may be used, to pay for care should other resources or income of the
individual be insufficient to pay for care;
new text end

new text begin (2) the individual is eligible for a refund of any remaining entrance fees when
the individual dies or terminates the continuing care retirement or life care community
contract and leaves the community; and
new text end

new text begin (3) the entrance fee does not confer an ownership interest in the continuing care
retirement or life care community.
new text end

Sec. 27.

Minnesota Statutes 2004, section 256B.056, is amended by adding a
subdivision to read:

new text begin Subd. 11. new text end

new text begin Treatment of annuities. new text end

new text begin (a) Any individual applying for or seeking
recertification of eligibility for medical assistance payment of long-term care services
shall provide a complete description of any interest either the individual or the individual's
spouse has in annuities. The individual and the individual's spouse shall furnish the
agency responsible for determining eligibility with complete current copies of their
annuities and related documents for review as part of the application process on disclosure
forms provided by the department as part of their application.
new text end

new text begin (b) The disclosure form shall include a statement that the department becomes the
remainder beneficiary under the annuity or similar financial instrument by virtue of the
receipt of medical assistance. The disclosure form shall include a notice to the issuer of
the department's right under this section as a preferred remainder beneficiary under the
annuity or similar financial instrument for medical assistance furnished to the individual
or the individual's spouse, and require the issuer to provide confirmation that a remainder
beneficiary designation has been made and to notify the county agency when there is a
change in the amount of the income or principal being withdrawn from the annuity or
other similar financial instrument at the time of the most recent disclosure required under
this section. The individual and the individual's spouse shall execute separate disclosure
forms for each annuity or similar financial instrument that they are required to disclose
under this section and in which they have an interest.
new text end

new text begin (c) An issuer of an annuity or similar financial instrument who receives notice on a
disclosure form as described in paragraph (b) shall provide confirmation to the requesting
agency that a remainder beneficiary designating the state has been made and shall notify
the county agency when there is a change in the amount of income or principal being
withdrawn from the annuity or other similar financial instrument. The county agency shall
provide the issuer with the name, address, and telephone number of a unit within the
department that the insurer can contact to comply with this paragraph.
new text end

Sec. 28.

Minnesota Statutes 2005 Supplement, section 256B.0571, is amended to read:

256B.0571 LONG-TERM CARE PARTNERSHIP new text begin PROGRAM new text end .

Subdivision 1.

Definitions.

For purposes of this section, the following terms have
the meanings given them.

deleted text begin Subd. 2. deleted text end

deleted text begin Home care service. deleted text end

deleted text begin "Home care service" means care described in section
.
deleted text end

Subd. 3.

Long-term care insurance.

"Long-term care insurance" means a policy
described in section 62S.01.

Subd. 4.

Medical assistance.

"Medical assistance" means the program of medical
assistance established under section 256B.01.

deleted text begin Subd. 5. deleted text end

deleted text begin Nursing home. deleted text end

deleted text begin "Nursing home" means a nursing home as described
in section .
deleted text end

Subd. 6.

Partnership policy.

"Partnership policy" means a long-term care insurance
policy that meets the requirements under subdivision 10 deleted text begin or 11, regardless of when the
policy deleted text end new text begin and new text end was deleted text begin first deleted text end issued new text begin on or after the effective date of the state plan amendment new text end .

Subd. 7.

Partnership program.

"Partnership program" means the Minnesota
partnership for long-term care program established under this section.

new text begin Subd. 7a. new text end

new text begin Protected assets. new text end

new text begin "Protected assets" means assets or proceeds of assets
that are protected from recovery under subdivisions 13 and 15.
new text end

Subd. 8.

Program established.

(a) The commissioner, in cooperation with the
commissioner of commerce, shall establish the Minnesota partnership for long-term care
program to provide for the financing of long-term care through a combination of private
insurance and medical assistance.

(b) An individual who meets the requirements in this paragraph is eligible to
participate in the partnership program. The individual must:

(1) be a Minnesota resident new text begin at the time coverage first became effective under the
partnership policy new text end ;

(2) deleted text begin purchase a partnership policy that is delivered, issued for delivery, or renewed on
or after the effective date of Laws 2005, First Special Session chapter 4, article 7, section
5, and maintain the partnership policy in effect throughout the period of participation in
the partnership program deleted text end new text begin be a beneficiary of a partnership policy that (i) is issued on or
after the effective date of the state plan amendment implementing the partnership program
in Minnesota, or (ii) qualifies as a partnership policy under the provisions of section
62S.24, subdivision 8 new text end ; and

(3) deleted text begin exhaust the minimum deleted text end new text begin have exhausted all of the new text end benefits under the partnership
policy as described in this section. Benefits received under a long-term care insurance
policy before deleted text begin the effective date of Laws 2005, First Special Session chapter 4, article 7,
section 5 deleted text end new text begin July 1, 2006 new text end , do not count toward the exhaustion of benefits required in this
subdivision.

Subd. 9.

Medical assistance eligibility.

(a) Upon application deleted text begin of deleted text end new text begin for medical
assistance program payment of long-term care services by new text end an individual who meets the
requirements described in subdivision 8, the commissioner shall determine the individual's
eligibility for medical assistance according to paragraphs (b) deleted text begin and (c) deleted text end new text begin to (i) new text end .

(b) After deleted text begin disregarding financial deleted text end new text begin determining new text end assets deleted text begin exempted under medical
assistance eligibility requirements deleted text end new text begin subject to the asset limit under section 256B.056,
subdivision 3 or 3c, or section 256B.057, subdivision 9 or 10 new text end , the commissioner shall
deleted text begin disregard an additional amount of financial assets equal deleted text end new text begin allow the individual to designate
assets to be protected from recovery under subdivisions 13 and 15 of this section up
new text end to the dollar amount of deleted text begin coverage deleted text end new text begin the benefits new text end utilized under the partnership policy. new text begin
Designated assets shall be disregarded for purposes of determining eligibility for payment
of long-term care services.
new text end

(c) deleted text begin The commissioner shall consider the individual's income according to medical
assistance eligibility requirements. deleted text end new text begin The individual shall identify the designated assets and
the full fair market value of those assets and designate them as assets to be protected at
the time of initial application for medical assistance. The full fair market value of real
property or interests in real property shall be based on the most recent full assessed value
for property tax purposes for the real property, unless the individual provides a complete
professional appraisal by a licensed appraiser to establish the full fair market value. The
extent of a life estate in real property shall be determined using the life estate table in the
health care program's manual. Ownership of any asset in joint tenancy shall be treated as
ownership as tenants in common for purposes of its designation as a disregarded asset.
The unprotected value of any protected asset is subject to estate recovery according to
subdivisions 13 and 15.
new text end

new text begin (d) The right to designate assets to be protected is personal to the individual and
ends when the individual dies, except as otherwise provided in subdivisions 13 and
15. It does not include the increase in the value of the protected asset and the income,
dividends, or profits from the asset. It may be exercised by the individual or by anyone
with the legal authority to do so on the individual's behalf. It shall not be sold, assigned,
transferred, or given away.
new text end

new text begin (e) If the dollar amount of the benefits utilized under a partnership policy is greater
than the full fair market value of all assets protected at the time of the application for
medical assistance long-term care services, the individual may designate additional assets
that become available during the individual's lifetime for protection under this section.
The individual must make the designation in writing to the county agency no later than
the last date on which the individual must report a change in circumstances to the county
agency, as provided for under the medical assistance program. Any excess used for this
purpose shall not be available to the individual's estate to protect assets in the estate from
recovery under section 256B.15, 524.3-1202, or otherwise.
new text end

new text begin (f) This section applies only to estate recovery under United States Code, title 42,
section 1396p, subsections (a) and (b), and does not apply to recovery authorized by other
provisions of federal law, including, but not limited to, recovery from trusts under United
States Code, title 42, section 1396p, subsection (d)(4)(A) and (C), or to recovery from
annuities, or similar legal instruments, subject to section 6012, subsections (a) and (b), of
the Deficit Reduction Act of 2005, Public Law 109-171.
new text end

new text begin (g) An individual's protected assets owned by the individual's spouse who applies
for payment of medical assistance long-term care services shall not be protected assets or
disregarded for purposes of eligibility of the individual's spouse solely because they were
protected assets of the individual.
new text end

new text begin (h) Assets designated under this subdivision shall not be subject to penalty under
section 256B.0595.
new text end

new text begin (i) The commissioner shall otherwise determine the individual's eligibility
for payment of long-term care services according to medical assistance eligibility
requirements.
new text end

Subd. 10.

deleted text begin Dollar-for-dollar asset protection policies deleted text end new text begin Inflation protection new text end .

deleted text begin (a) A
dollar-for-dollar asset protection policy must meet all of the requirements in paragraphs
(b) to (e).
deleted text end

deleted text begin (b) The policy must satisfy the requirements of chapter 62S.
deleted text end

deleted text begin (c) The policy must offer an elimination period of not more than 180 days for an
adjusted premium.
deleted text end

deleted text begin (d) The policy must satisfy the requirements established by the commissioner of
human services under subdivision 14.
deleted text end

deleted text begin (e) Minimum daily benefits shall be $130 for nursing home care or $65 for home
care, with inflation protection provided in the policy as described in section deleted text begin 62S.23,
subdivision 1 deleted text end , clause (1). These minimum daily benefit amounts shall be adjusted by the
commissioner on October 1 of each year by a percentage equal to the inflation protection
feature described in section deleted text begin 62S.23, subdivision 1 deleted text end , clause (1), for purposes of setting
minimum requirements that a policy must meet in future years in order to initially qualify
as an approved policy under this subdivision. Adjusted minimum daily benefit amounts
shall be rounded to the nearest whole dollar.
deleted text end

new text begin A long-term care partnership policy must provide the inflation protection described
in this paragraph. If the policy is sold to an individual who:
new text end

new text begin (1) has not attained age 61 as of the date of purchase, the policy provides compound
annual inflation protection;
new text end

new text begin (2) has attained age 61, but has not attained age 76 as of such date, the policy
provides some level of inflation protection; and
new text end

new text begin (3) has attained age 76 as of such date, the policy may, but is not required to, provide
some level of inflation protection.
new text end

deleted text begin Subd. 11. deleted text end

deleted text begin Total asset protection policies. deleted text end

deleted text begin (a) A total asset protection policy must
meet all of the requirements in subdivision 10, paragraphs (b) to (d), and this subdivision.
deleted text end

deleted text begin (b) Minimum coverage shall be for a period of not less than three years and for a
dollar amount equal to 36 months of nursing home care at the minimum daily benefit rate
determined and adjusted under paragraph (c).
deleted text end

deleted text begin (c) Minimum daily benefits shall be $150 for nursing home care or $75 for home
care, with inflation protection provided in the policy as described in section deleted text begin 62S.23,
subdivision 1 deleted text end , clause (1). These minimum daily benefit amounts shall also be adjusted
by the commissioner on October 1 of each year by a percentage equal to the inflation
protection feature described in section deleted text begin 62S.23, subdivision 1 deleted text end , clause (1), for purposes of
setting minimum requirements that a policy must meet in future years in order to initially
qualify as an approved policy under this subdivision. Adjusted minimum daily benefit
amounts shall be rounded to the nearest whole dollar.
deleted text end

deleted text begin (d) The policy must cover all of the following services:
deleted text end

deleted text begin (1) nursing home stay;
deleted text end

deleted text begin (2) home care service; and
deleted text end

deleted text begin (3) care management.
deleted text end

Subd. 12.

Compliance with federal law.

An issuer of a partnership policy must
comply with deleted text begin any federal law authorizing partnership policies in Minnesota deleted text end new text begin Public Law
109-171, section 6021 new text end , including any federal regulations, as amended, adopted under that
law. deleted text begin This subdivision does not require compliance with any provision of this federal
law until the date upon which the law requires compliance with the provision. The
commissioner has authority to enforce this subdivision.
deleted text end

Subd. 13.

Limitations on estate recovery.

(a) deleted text begin For an individual who exhausts the
minimum benefits of a deleted text end deleted text begin dollar-for-dollar asset protection deleted text end deleted text begin policy under subdivision 10, and
is determined eligible for medical assistance under subdivision 9, the state shall limit
recovery under the provisions of section 256B.15 against the estate of the individual or
individual's spouse for medical assistance benefits received by that individual to an amount
that exceeds the dollar amount of coverage utilized under the partnership policy. deleted text end new text begin Protected
assets of the individual shall not be subject to recovery under section 256B.15 or section
524.3-1201 for medical assistance or alternative care paid on behalf of the individual.
Protected assets of the individual in the estate of the individual's surviving spouse shall
not be liable to pay a claim for recovery of medical assistance paid for the predeceased
individual that is filed in the estate of the surviving spouse under section 256B.15.
Protected assets of the individual shall not be protected assets in the surviving spouse's
estate by reason of the preceding sentence and shall be subject to recovery under section
256B.15 or 524.3-1201 for medical assistance paid on behalf of the surviving spouse.
new text end

(b) deleted text begin For an individual who exhausts the minimum benefits of a total asset protection
policy under subdivision 11, and is determined eligible for medical assistance under
subdivision 9, the state shall not seek recovery under the provisions of section 256B.15
against the estate of the individual or individual's spouse for medical assistance benefits
received by that individual. deleted text end new text begin The personal representative may protect the full fair market
value of an individual's unprotected assets in the individual's estate in an amount equal
to the unused amount of asset protection the individual had on the date of death. The
personal representative shall apply the asset protection so that the full fair market value of
any unprotected asset in the estate is protected. When or if the asset protection available
to the personal representative is or becomes less than the full fair market value of any
remaining unprotected asset, it shall be applied to partially protect one unprotected asset.
new text end

new text begin (c) The asset protection described in paragraph (a) terminates with respect to an asset
includable in the individual's estate under chapter 524 or section 256B.15:
new text end

new text begin (1) when the estate distributes the asset; or
new text end

new text begin (2) if the estate of the individual has not been probated within one year from the
date of death.
new text end

new text begin (d) If an individual owns a protected asset on the date of death and the estate is
opened for probate more than one year after death, the state or a county agency may file
and collect claims in the estate under section 256B.15, and no statute of limitations in
chapter 524 that would otherwise limit or bar the claim shall apply.
new text end

new text begin (e) Except as otherwise provided, nothing in this section shall limit or prevent
recovery of medical assistance.
new text end

Subd. 14.

Implementation.

deleted text begin (a) If federal law is amended or a federal waiver is
granted to permit implementation of this section, the commissioner, in consultation with
the commissioner of commerce, may alter the requirements of subdivisions 10 and 11,
and may establish additional requirements for approved policies in order to conform with
federal law or waiver authority. In establishing these requirements, the commissioner shall
seek to maximize purchase of qualifying policies by Minnesota residents while controlling
medical assistance costs.
deleted text end

deleted text begin (b) The commissioner is authorized to suspend implementation of this section
until the next session of the legislature if the commissioner, in consultation with the
commissioner of commerce, determines that the federal legislation or federal waiver
authorizing a partnership program in Minnesota is likely to impose substantial unforeseen
costs on the state budget.
deleted text end

deleted text begin (c) The commissioner must take action under paragraph (a) or (b) within 45 days of
final federal action authorizing a partnership policy in Minnesota.
deleted text end

deleted text begin (d) The commissioner must notify the appropriate legislative committees of
action taken under this subdivision within 50 days of final federal action authorizing a
partnership policy in Minnesota.
deleted text end

deleted text begin (e) The commissioner must publish a notice in the State Register of implementation
decisions made under this subdivision as soon as practicable. deleted text end new text begin The commissioner shall
submit a state plan amendment to the federal government to implement the long-term care
partnership program in accordance with this section.
new text end

new text begin Subd. 15. new text end

new text begin Limitation on liens. new text end

new text begin (a) An individual's interest in real property shall not
be subject to a medical assistance lien or a notice of potential claim while it is protected
under subdivision 9, to the extent it is protected.
new text end

new text begin (b) Medical assistance liens or liens arising under notices of potential claims against
an individual's interests in real property in their estate that are designated as protected
under subdivision 13, paragraph (b), shall be released to the extent of the dollar value
of the protection applied to the interest.
new text end

new text begin (c) If an interest in real property is protected from a lien for recovery of medical
assistance paid on behalf of the individual under paragraph (a) or (b), no such lien for
recovery of medical assistance paid on behalf of that individual shall be filed against the
protected interest in real property after it is distributed to the individual's heirs or devisees.
new text end

new text begin Subd. 16. new text end

new text begin Burden of proof. new text end

new text begin Any individual or the personal representative of the
individual's estate who asserts that an asset is a disregarded or protected asset under
this section in connection with any determination of eligibility for benefits under the
medical assistance program or any appeal, case, controversy, or other proceedings, shall
have the initial burden of:
new text end

new text begin (1) documenting and proving by convincing evidence that the asset or source of
funds for the asset in question was designated as disregarded or protected;
new text end

new text begin (2) tracing the asset and the proceeds of the asset from that time forward; and
new text end

new text begin (3) documenting that the asset or proceeds of the asset remained disregarded or
protected at all relevant times.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 29.

new text begin [256B.0594] PAYMENT OF BENEFITS FROM AN ANNUITY.
new text end

new text begin When payment becomes due under an annuity that names the department a
remainder beneficiary as described in section 256B.056, subdivision 11, the issuer shall
request and the department shall, within 45 days after receipt of the request, provide a
written statement of the total amount of the medical assistance paid. Upon timely receipt
of the written statement of the amount of medical assistance paid, the issuer shall pay the
department an amount equal to the lesser of the amount due the department under the
annuity or the total amount of medical assistance paid on behalf of the individual or the
individual's spouse. Any amounts remaining after the issuer's payment to the department
shall be payable according to the terms of the annuity or similar financial instrument. The
county agency or the department shall provide the issuer with the name, address, and
telephone number of a unit within the department the issuer can contact to comply with this
section. The requirements of section 72A.201, subdivision 4, clause (3), shall not apply to
payments made under this section until the issuer has received final payment information
from the department, if the issuer has notified the beneficiary of the requirements of this
section at the time it initially requests payment information from the department.
new text end

Sec. 30.

Minnesota Statutes 2004, section 256B.0595, subdivision 1, is amended to
read:

Subdivision 1.

Prohibited transfers.

(a) For transfers of assets made on or before
August 10, 1993, if a person or the person's spouse has given away, sold, or disposed of,
for less than fair market value, any asset or interest therein, except assets other than the
homestead that are excluded under the supplemental security program, within 30 months
before or any time after the date of institutionalization if the person has been determined
eligible for medical assistance, or within 30 months before or any time after the date of the
first approved application for medical assistance if the person has not yet been determined
eligible for medical assistance, the person is ineligible for long-term care services for the
period of time determined under subdivision 2.

(b) Effective for transfers made after August 10, 1993, a person, a person's spouse,
or any person, court, or administrative body with legal authority to act in place of, on
behalf of, at the direction of, or upon the request of the person or person's spouse, may not
give away, sell, or dispose of, for less than fair market value, any asset or interest therein,
except assets other than the homestead that are excluded under the supplemental security
income program, for the purpose of establishing or maintaining medical assistance
eligibility. This applies to all transfers, including those made by a community spouse
after the month in which the institutionalized spouse is determined eligible for medical
assistance. For purposes of determining eligibility for long-term care services, any transfer
of such assets within 36 months before or any time after an institutionalized person applies
for medical assistance, or 36 months before or any time after a medical assistance recipient
becomes institutionalized, for less than fair market value may be considered. Any such
transfer is presumed to have been made for the purpose of establishing or maintaining
medical assistance eligibility and the person is ineligible for long-term care services for
the period of time determined under subdivision 2, unless the person furnishes convincing
evidence to establish that the transaction was exclusively for another purpose, or unless
the transfer is permitted under subdivision 3 or 4. deleted text begin Notwithstanding the provisions of this
paragraph, deleted text end In the case of payments from a trust or portions of a trust that are considered
transfers of assets under federal law, new text begin or in the case of any other disposal of assets made on
or after February 8, 2006, new text end any transfers made within 60 months before or any time after an
institutionalized person applies for medical assistance and within 60 months before or any
time after a medical assistance recipient becomes institutionalized, may be considered.

(c) This section applies to transfers, for less than fair market value, of income
or assets, including assets that are considered income in the month received, such as
inheritances, court settlements, and retroactive benefit payments or income to which the
person or the person's spouse is entitled but does not receive due to action by the person,
the person's spouse, or any person, court, or administrative body with legal authority
to act in place of, on behalf of, at the direction of, or upon the request of the person or
the person's spouse.

(d) This section applies to payments for care or personal services provided by a
relative, unless the compensation was stipulated in a notarized, written agreement which
was in existence when the service was performed, the care or services directly benefited
the person, and the payments made represented reasonable compensation for the care
or services provided. A notarized written agreement is not required if payment for the
services was made within 60 days after the service was provided.

(e) This section applies to the portion of any asset or interest that a person, a person's
spouse, or any person, court, or administrative body with legal authority to act in place of,
on behalf of, at the direction of, or upon the request of the person or the person's spouse,
transfers to any annuity that exceeds the value of the benefit likely to be returned to the
person or spouse while alive, based on estimated life expectancy using the life expectancy
tables employed by the supplemental security income program to determine the value
of an agreement for services for life. The commissioner may adopt rules reducing life
expectancies based on the need for long-term care. This section applies to an annuity
described in this paragraph purchased on or after March 1, 2002, that:

(1) is not purchased from an insurance company or financial institution that is
subject to licensing or regulation by the Minnesota Department of Commerce or a similar
regulatory agency of another state;

(2) does not pay out principal and interest in equal monthly installments; or

(3) does not begin payment at the earliest possible date after annuitization.

new text begin (f) Effective for transactions, including the purchase of an annuity, occurring on or
after February 8, 2006, the purchase of an annuity by or on behalf of an individual who
has applied for or is receiving long-term care services or the individual's spouse shall be
treated as the disposal of an asset for less than fair market value unless:
new text end

new text begin (1) the department is named as the remainder beneficiary in first position for an
amount equal to at least the total amount of medical assistance paid on behalf of the
individual or the individual's spouse; or the department is named as the remainder
beneficiary in second position for an amount equal to at least the total amount of medical
assistance paid on behalf of the individual or the individual's spouse after the individual's
community spouse or minor or disabled child and is named as the remainder beneficiary in
the first position if the community spouse or a representative of the minor or disabled child
disposes of the remainder for less than fair market value. Any subsequent change to the
designation of the department as a remainder beneficiary shall result in the annuity being
treated as a disposal of assets for less than fair market value. The amount of such transfer
shall be the maximum amount the individual or the individual's spouse could receive from
the annuity or similar financial instrument. Any change in the amount of the income or
principal being withdrawn from the annuity or other similar financial instrument at the
time of the most recent disclosure shall be deemed to be a transfer of assets for less than
fair market value unless the individual or the individual's spouse demonstrates that the
transaction was for fair market value; and
new text end

new text begin (2) the purchase of an annuity by or on behalf of an individual applying for or
receiving long-term care services shall be treated as a disposal of assets for less than fair
market value unless it is:
new text end

new text begin (i) an annuity described in subsection (b) or (q) of section 408 of the Internal
Revenue Code of 1986; or
new text end

new text begin (ii) purchased with proceeds from:
new text end

new text begin (A) an account or trust described in subsection (a), (c), or (p) of section 408 of the
Internal Revenue Code;
new text end

new text begin (B) a simplified employee pension within the meaning of section 408(k) of the
Internal Revenue Code; or
new text end

new text begin (C) a Roth IRA described in section 408A of the Internal Revenue Code; or
new text end

new text begin (iii) an annuity that is irrevocable and nonassignable; is actuarially sound as
determined in accordance with actuarial publications of the Office of the Chief Actuary of
the Social Security Administration; and provides for payments in equal amounts during
the term of the annuity, with no deferral and no balloon payments made.
new text end

deleted text begin (f) deleted text end new text begin (g) new text end For purposes of this section, long-term care services include services in a
nursing facility, services that are eligible for payment according to section 256B.0625,
subdivision 2, because they are provided in a swing bed, intermediate care facility for
persons with mental retardation, and home and community-based services provided
pursuant to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision
and subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an
inpatient in a nursing facility or in a swing bed, or intermediate care facility for persons
with mental retardation or who is receiving home and community-based services under
sections 256B.0915, 256B.092, and 256B.49.

new text begin (h) This section applies to funds used to purchase a promissory note, loan, or
mortgage unless the note, loan, or mortgage:
new text end

new text begin (1) has a repayment term that is actuarially sound;
new text end

new text begin (2) provides for payments to be made in equal amounts during the term of the loan,
with no deferral and no balloon payments made; and
new text end

new text begin (3) prohibits the cancellation of the balance upon the death of the lender.
new text end

new text begin In the case of a promissory note, loan, or mortgage that does not meet an exception
in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding
balance due as of the date of the individual's application for long-term care services.
new text end

new text begin (i) This section applies to the purchase of a life estate interest in another individual's
home unless the purchaser resides in the home for a period of at least one year after the
date of purchase.
new text end

Sec. 31.

Minnesota Statutes 2005 Supplement, section 256B.0595, subdivision 2,
is amended to read:

Subd. 2.

Period of ineligibility.

(a) For any uncompensated transfer occurring on or
before August 10, 1993, the number of months of ineligibility for long-term care services
shall be the lesser of 30 months, or the uncompensated transfer amount divided by the
average medical assistance rate for nursing facility services in the state in effect on the
date of application. The amount used to calculate the average medical assistance payment
rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year.
The period of ineligibility begins with the month in which the assets were transferred.
If the transfer was not reported to the local agency at the time of application, and the
applicant received long-term care services during what would have been the period of
ineligibility if the transfer had been reported, a cause of action exists against the transferee
for the cost of long-term care services provided during the period of ineligibility, or for the
uncompensated amount of the transfer, whichever is less. The action may be brought by
the state or the local agency responsible for providing medical assistance under chapter
256G. The uncompensated transfer amount is the fair market value of the asset at the time
it was given away, sold, or disposed of, less the amount of compensation received.

(b) For uncompensated transfers made after August 10, 1993, the number of months
of ineligibility for long-term care services shall be the total uncompensated value of the
resources transferred divided by the average medical assistance rate for nursing facility
services in the state in effect on the date of application. The amount used to calculate the
average medical assistance payment rate shall be adjusted each July 1 to reflect payment
rates for the previous calendar year. The period of ineligibility begins with the first day
of the month after the month in which the assets were transferred except that if one or
more uncompensated transfers are made during a period of ineligibility, the total assets
transferred during the ineligibility period shall be combined and a penalty period calculated
to begin on the first day of the month after the month in which the first uncompensated
transfer was made. If the transfer was reported to the local agency after the date that
advance notice of a period of ineligibility that affects the next month could be provided to
the recipient and the recipient received medical assistance services or the transfer was not
reported to the local agency, and the applicant or recipient received medical assistance
services during what would have been the period of ineligibility if the transfer had been
reported, a cause of action exists against the transferee for the cost of medical assistance
services provided during the period of ineligibility, or for the uncompensated amount of
the transfer, whichever is less. The action may be brought by the state or the local agency
responsible for providing medical assistance under chapter 256G. The uncompensated
transfer amount is the fair market value of the asset at the time it was given away, sold, or
disposed of, less the amount of compensation received. Effective for transfers made on or
after March 1, 1996, involving persons who apply for medical assistance on or after April
13, 1996, no cause of action exists for a transfer unless:

(1) the transferee knew or should have known that the transfer was being made by a
person who was a resident of a long-term care facility or was receiving that level of care in
the community at the time of the transfer;

(2) the transferee knew or should have known that the transfer was being made to
assist the person to qualify for or retain medical assistance eligibility; or

(3) the transferee actively solicited the transfer with intent to assist the person to
qualify for or retain eligibility for medical assistance.

(c) new text begin For uncompensated transfers made on or after February 8, 2006, the period of
ineligibility begins on the first day of the month in which advance notice can be given
following the month in which assets have been transferred for less than fair market value,
or the date on which the individual is eligible for medical assistance under the Medicaid
state plan and would otherwise be receiving long-term care services based on an approved
application for such care but for the application of the penalty period, whichever is later,
and which does not occur during any other period of ineligibility.
new text end

new text begin (d) new text end If a calculation of a penalty period results in a partial month, payments for
long-term care services shall be reduced in an amount equal to the fraction deleted text begin , deleted text end new text begin . new text end deleted text begin except that in
calculating the value of uncompensated transfers, if the total value of all uncompensated
transfers made in a month not included in an existing penalty period does not exceed $200,
then such transfers shall be disregarded for each month prior to the month of application
for or during receipt of medical assistance.
deleted text end

new text begin (e) In the case of multiple fractional transfers of assets in more than one month for
less than fair market value on or after February 8, 2006, the period of ineligibility is
calculated by treating the total, cumulative uncompensated value of all assets transferred
during all months on or after February 8, 2006, as one transfer.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Amendments to this section are effective for applications on
or after July 1, 2006, and for renewals and reports of transfers on or after July 1, 2006.
new text end

Sec. 32.

Minnesota Statutes 2004, section 256B.0595, subdivision 3, is amended to
read:

Subd. 3.

Homestead exception to transfer prohibition.

(a) An institutionalized
person is not ineligible for long-term care services due to a transfer of assets for less than
fair market value if the asset transferred was a homestead and:

(1) title to the homestead was transferred to the individual's new text begin :
new text end

(i) spouse;

(ii) child who is under age 21;

(iii) blind or permanently and totally disabled child as defined in the supplemental
security income program;

(iv) sibling who has equity interest in the home and who was residing in the home
for a period of at least one year immediately before the date of the individual's admission
to the facility; or

(v) son or daughter who was residing in the individual's home for a period of at least
two years immediately before the date of the individual's admission to the facility, and who
provided care to the individual that, as certified by the individual's attending physician,
permitted the individual to reside at home rather than in an institution or facility;

(2) a satisfactory showing is made that the individual intended to dispose of the
homestead at fair market value or for other valuable consideration; or

(3) the local agency grants a waiver of a penalty resulting from a transfer for less
than fair market value because denial of eligibility would cause undue hardship for the
individual, based on imminent threat to the individual's health and well-being. Whenever
an applicant or recipient is denied eligibility because of a transfer for less than fair market
value, the local agency shall notify the applicant or recipient that the applicant or recipient
may request a waiver of the penalty if the denial of eligibility will cause undue hardship.
new text begin With the written consent of the individual or the personal representative of the individual,
a long-term care facility in which an individual is residing may file an undue hardship
waiver request, on behalf of the individual who is denied eligibility for long-term care
services on or after July 1, 2006, due to a period of ineligibility resulting from a transfer on
or after February 8, 2006. new text end In evaluating a waiver, the local agency shall take into account
whether the individual was the victim of financial exploitation, whether the individual has
made reasonable efforts to recover the transferred property or resource, and other factors
relevant to a determination of hardship. If the local agency does not approve a hardship
waiver, the local agency shall issue a written notice to the individual stating the reasons
for the denial and the process for appealing the local agency's decision.

(b) When a waiver is granted under paragraph (a), clause (3), a cause of action exists
against the person to whom the homestead was transferred for that portion of long-term
care services granted within:

(1) 30 months of a transfer made on or before August 10, 1993;

(2) 60 months if the homestead was transferred after August 10, 1993, to a trust or
portion of a trust that is considered a transfer of assets under federal law; deleted text begin or
deleted text end

(3) 36 months if transferred in any other manner after August 10, 1993, new text begin but prior
to February 8, 2006; or
new text end

new text begin (4) 60 months if the homestead was transferred on or after February 8, 2006,
new text end

or the amount of the uncompensated transfer, whichever is less, together with the
costs incurred due to the action. The action shall be brought by the state unless the
state delegates this responsibility to the local agency responsible for providing medical
assistance under chapter 256G.

Sec. 33.

Minnesota Statutes 2004, section 256B.0595, subdivision 4, is amended to
read:

Subd. 4.

Other exceptions to transfer prohibition.

An institutionalized person
who has made, or whose spouse has made a transfer prohibited by subdivision 1, is not
ineligible for long-term care services if one of the following conditions applies:

(1) the assets were transferred to the individual's spouse or to another for the sole
benefit of the spouse; or

(2) the institutionalized spouse, prior to being institutionalized, transferred assets
to a spouse, provided that the spouse to whom the assets were transferred does not then
transfer those assets to another person for less than fair market value. (At the time when
one spouse is institutionalized, assets must be allocated between the spouses as provided
under section 256B.059); or

(3) the assets were transferred to the individual's child who is blind or permanently
and totally disabled as determined in the supplemental security income program; or

(4) a satisfactory showing is made that the individual intended to dispose of the
assets either at fair market value or for other valuable consideration; or

(5) the local agency determines that denial of eligibility for long-term care services
would work an undue hardship and grants a waiver of a penalty resulting from a transfer
for less than fair market value based on an imminent threat to the individual's health
and well-being. Whenever an applicant or recipient is denied eligibility because of a
transfer for less than fair market value, the local agency shall notify the applicant or
recipient that the applicant or recipient may request a waiver of the penalty if the denial of
eligibility will cause undue hardship. new text begin With the written consent of the individual or the
personal representative of the individual, a long-term care facility in which an individual
is residing may file an undue hardship waiver request, on behalf of the individual who
is denied eligibility for long-term care services on or after July 1, 2006, due to a period
of ineligibility resulting from a transfer on or after February 8, 2006. new text end In evaluating a
waiver, the local agency shall take into account whether the individual was the victim of
financial exploitation, whether the individual has made reasonable efforts to recover the
transferred property or resource, new text begin whether the individual has taken any action to prevent
the designation of the department as a remainder beneficiary on an annuity as described
in section 256B.056, subdivision 11, new text end and other factors relevant to a determination of
hardship. If the local agency does not approve a hardship waiver, the local agency shall
issue a written notice to the individual stating the reasons for the denial and the process for
appealing the local agency's decision. When a waiver is granted, a cause of action exists
against the person to whom the assets were transferred for that portion of long-term care
services granted within:

(i) 30 months of a transfer made on or before August 10, 1993;

(ii) 60 months of a transfer if the assets were transferred after August 30, 1993, to a
trust or portion of a trust that is considered a transfer of assets under federal law; deleted text begin or
deleted text end

(iii) 36 months of a transfer if transferred in any other manner after August 10, 1993, new text begin
but prior to February 8, 2006; or
new text end

new text begin (iv) 60 months of any transfer made on or after February 8, 2006,
new text end

or the amount of the uncompensated transfer, whichever is less, together with the
costs incurred due to the action. The action shall be brought by the state unless the
state delegates this responsibility to the local agency responsible for providing medical
assistance under this chapter; or

(6) for transfers occurring after August 10, 1993, the assets were transferred by
the person or person's spouse: (i) into a trust established for the sole benefit of a son or
daughter of any age who is blind or disabled as defined by the Supplemental Security
Income program; or (ii) into a trust established for the sole benefit of an individual who is
under 65 years of age who is disabled as defined by the Supplemental Security Income
program.

"For the sole benefit of" has the meaning found in section 256B.059, subdivision 1.

Sec. 34.

Minnesota Statutes 2005 Supplement, section 256B.06, subdivision 4, is
amended to read:

Subd. 4.

Citizenship requirements.

(a) Eligibility for medical assistance is limited
to citizens of the United States, qualified noncitizens as defined in this subdivision, and
other persons residing lawfully in the United States. new text begin Citizens or nationals of the United
States must cooperate in obtaining satisfactory documentary evidence of citizenship or
nationality as required by the federal Deficit Reduction Act of 2005, Public Law 109-171.
new text end

(b) "Qualified noncitizen" means a person who meets one of the following
immigration criteria:

(1) admitted for lawful permanent residence according to United States Code, title 8;

(2) admitted to the United States as a refugee according to United States Code,
title 8, section 1157;

(3) granted asylum according to United States Code, title 8, section 1158;

(4) granted withholding of deportation according to United States Code, title 8,
section 1253(h);

(5) paroled for a period of at least one year according to United States Code, title 8,
section 1182(d)(5);

(6) granted conditional entrant status according to United States Code, title 8,
section 1153(a)(7);

(7) determined to be a battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;

(8) is a child of a noncitizen determined to be a battered noncitizen by the United
States Attorney General according to the Illegal Immigration Reform and Immigrant
Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
Public Law 104-200; or

(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
Law 96-422, the Refugee Education Assistance Act of 1980.

(c) All qualified noncitizens who were residing in the United States before August
22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance with federal financial participation.

(d) All qualified noncitizens who entered the United States on or after August 22,
1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance with federal financial participation through November 30, 1996.

Beginning December 1, 1996, qualified noncitizens who entered the United States
on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
chapter are eligible for medical assistance with federal participation for five years if they
meet one of the following criteria:

(i) refugees admitted to the United States according to United States Code, title 8,
section 1157;

(ii) persons granted asylum according to United States Code, title 8, section 1158;

(iii) persons granted withholding of deportation according to United States Code,
title 8, section 1253(h);

(iv) veterans of the United States armed forces with an honorable discharge for
a reason other than noncitizen status, their spouses and unmarried minor dependent
children; or

(v) persons on active duty in the United States armed forces, other than for training,
their spouses and unmarried minor dependent children.

Beginning December 1, 1996, qualified noncitizens who do not meet one of the
criteria in items (i) to (v) are eligible for medical assistance without federal financial
participation as described in paragraph (j).

(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b),
who are lawfully residing in the United States and who otherwise meet the eligibility
requirements of this chapter, are eligible for medical assistance under clauses (1) to (3).
These individuals must cooperate with the Immigration and Naturalization Service to
pursue any applicable immigration status, including citizenship, that would qualify them
for medical assistance with federal financial participation.

(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
for medical assistance with federal financial participation through December 31, 1996.

(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
medical assistance without federal financial participation as described in paragraph (j).

(3) Beginning December 1, 1996, persons residing in the United States prior to
August 22, 1996, who were not receiving medical assistance and persons who arrived on
or after August 22, 1996, are eligible for medical assistance without federal financial
participation as described in paragraph (j).

(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this
subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
Code, title 8, section 1101(a)(15).

(g) Payment shall also be made for care and services that are furnished to noncitizens,
regardless of immigration status, who otherwise meet the eligibility requirements of
this chapter, if such care and services are necessary for the treatment of an emergency
medical condition, except for organ transplants and related care and services and routine
prenatal care.

(h) For purposes of this subdivision, the term "emergency medical condition" means
a medical condition that meets the requirements of United States Code, title 42, section
1396b(v).

(i) Pregnant noncitizens who are undocumented, nonimmigrants, or eligible for
medical assistance as described in paragraph (j), and who are not covered by a group
health plan or health insurance coverage according to Code of Federal Regulations, title
42, section 457.310, and who otherwise meet the eligibility requirements of this chapter,
are eligible for medical assistance through the period of pregnancy, including labor and
delivery, to the extent federal funds are available under title XXI of the Social Security
Act, and the state children's health insurance program, followed by 60 days postpartum
without federal financial participation.

(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
lawfully residing in the United States as described in paragraph (e), who are ineligible
for medical assistance with federal financial participation and who otherwise meet the
eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
assistance without federal financial participation. Qualified noncitizens as described
in paragraph (d) are only eligible for medical assistance without federal financial
participation for five years from their date of entry into the United States.

(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation
services from a nonprofit center established to serve victims of torture and are otherwise
ineligible for medical assistance under this chapter are eligible for medical assistance
without federal financial participation. These individuals are eligible only for the period
during which they are receiving services from the center. Individuals eligible under this
paragraph shall not be required to participate in prepaid medical assistance.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 35.

Minnesota Statutes 2005 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 as defined in
paragraph (b), except as provided in paragraph (c), 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. Exempt assets, the reduction of excess
assets, and the waiver of excess assets must conform to the medical assistance program in
section 256B.056, subdivision 3, 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;

(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; or

(iii) 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.

(b) 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 (e).

(c) 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 eligibility period, until their six-month renewal.

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

(e) Applicants and recipients eligible under paragraph (a), clause (1) deleted text begin , deleted text end deleted text begin or deleted text end new text begin ; new text end who 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 deleted text begin , deleted text end deleted text begin or deleted text end new text begin ; new text end who fail to meet
the requirements of section 256L.09, subdivision 2, are exempt from the MinnesotaCare
enrollment requirements of this subdivision.

(f) 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.

(g) Beginning September 1, 2006, Minnesota health care program applications and
renewals completed by recipients and applicants who are persons described in paragraph
(c) 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 (c), (e), and (f).

(h) 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
county agency must assist the applicant in obtaining verification if necessary.

(i) 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.

(j) 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.

(k) 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.

(l) 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.

(m) 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.

(n) 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(a)(15), and
an undocumented noncitizen is an individual who resides in the United States without the
approval or acquiescence of the Immigration and Naturalization Service.

(o) 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.

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

new text begin (q) Citizens or nationals of the United States must cooperate in obtaining satisfactory
documentary evidence of citizenship or nationality as required by the federal Deficit
Reduction Act of 2005, Public Law 109-171.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 36.

Minnesota Statutes 2004, section 256L.04, subdivision 10, is amended to read:

Subd. 10.

Citizenship requirements.

Eligibility for MinnesotaCare is limited
to citizens new text begin or nationals new text end of the United States, qualified noncitizens, and other persons
residing lawfully in the United States as described in section 256B.06, subdivision 4,
paragraphs (a) to (e) and (j). Undocumented noncitizens and nonimmigrants are ineligible
for MinnesotaCare. 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(a)(15), and
an undocumented noncitizen is an individual who resides in the United States without
the approval or acquiescence of the Immigration and Naturalization Service. new text begin Citizens
or nationals of the United States must cooperate in obtaining satisfactory documentary
evidence of citizenship or nationality as required by the federal Deficit Reduction Act of
2005, Public Law 109-171.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 37. new text begin DESIGNATION OF ASSETS AS CONTINGENTLY EXEMPT UNDER
LONG-TERM CARE PARTNERSHIP PROGRAM.
new text end

new text begin The commissioner of human services shall develop and present to the legislature
by December 15, 2006, a plan and draft legislation to allow individuals participating in
the long-term care partnership program established under Minnesota Statutes, section
256B.0571, to designate, at the time of initial application for medical assistance, assets
as contingently exempt. The full fair market value of assets designated as contingently
exempt must not exceed a percentage, specified by the commissioner, of the full fair market
value of assets designated as protected under Minnesota Statutes, section 256B.0571,
subdivision 9. The commissioner may specify different percentages for different categories
of protected assets. Assets designated as contingently exempt shall be disregarded for
purposes of determining eligibility for payment of long-term care services. If the dollar
amount of benefits utilized under a partnership policy is greater than the full fair market
value of all assets protected due to a decrease in the value of the protected assets, the plan
and draft legislation must allow the individual or the personal representative to designate
assets that are contingently exempt as protected, up to the amount of the decrease in value
of the protected assets. The plan and draft legislation must provide that any contingently
exempt asset that is not designated as protected be subject to recovery.
new text end

Sec. 38. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2005 Supplement, section 256B.0571, subdivisions 2, 5, and
11, new text end new text begin are repealed.
new text end

ARTICLE 4

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2004, section 13.3806, is amended by adding a
subdivision to read:

new text begin Subd. 21. new text end

new text begin Abortion notification data. new text end

new text begin Classification of data in abortion notification
reports is governed by section 144.3431.
new text end

Sec. 2.

new text begin [144.2251] COPY OF BIRTH RECORD IN EVENT OF A CHILD'S
DEATH.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For the purposes of this section, "clean copy" means a
certified copy of a deceased child's birth record without the word DECEASED, the date of
death, or other similar reference appearing on the document.
new text end

new text begin Subd. 2. new text end

new text begin Duties of state registrar. new text end

new text begin (a) Notwithstanding Minnesota Rules, part
4601.2525, subpart 3, the state registrar shall provide one clean copy of a birth record, if
requested, provided:
new text end

new text begin (1) no other clean copy of the record has been issued;
new text end

new text begin (2) the person requesting the clean copy of a birth record is listed as the child's
mother or father on the birth record;
new text end

new text begin (3) the request is made no later than six years from the date of the child's birth; and
new text end

new text begin (4) the child was born on or after January 1, 2002.
new text end

new text begin (b) The state registrar shall prescribe the form of and information to be included in
the request and implement a process for meeting the requirements of this section. The
process developed and implemented under this section shall require that only the state
registrar, and not a local registrar, may issue a clean copy.
new text end

new text begin Subd. 3. new text end

new text begin Information to parents. new text end

new text begin The state and local registrars shall inform parents
who request a certified copy of their deceased child's birth record that they may be eligible
to receive a clean copy of the record. The state or a local registrar shall provide parents
who would like to request a clean copy with information on how to obtain one from the
state registrar and any additional information or forms required under subdivision 2,
paragraph (b).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 3.

new text begin [144.3431] ABORTION NOTIFICATION DATA.
new text end

new text begin Subdivision 1. new text end

new text begin Reporting form. new text end

new text begin (a) Within 90 days of the effective date of this
section, the commissioner of health shall prepare a reporting form for use by physicians
and facilities performing abortions under the circumstances specified in paragraph (b).
new text end

new text begin (b) The form shall require the following information:
new text end

new text begin (1) the number of minors or women for whom a guardian has been appointed under
sections 524.5-301 to 524.5-317 because of a finding of incompetency for whom the
physician or an agent of the physician provided the notice described in section 144.343,
subdivision 2; of that number, the number of notices provided personally as described in
section 144.343, subdivision 2, paragraph (a), and the number of notices provided by
mail as described in section 144.343, subdivision 2, paragraph (b); and of each of those
numbers, the number who, to the best of the reporting physician's or reporting facility's
information and belief, went on to obtain the abortion from the reporting physician or
reporting physician's facility, or from the reporting facility;
new text end

new text begin (2) the number of minors or women for whom a guardian has been appointed under
sections 524.5-301 to 524.5-317 because of a finding of incompetency upon whom
the physician performed an abortion without providing the notice described in section
144.343, subdivision 2; and of that number, the number who were emancipated minors,
and the number for whom section 144.343, subdivision 4, was applicable, itemized by
each of the limitations identified in paragraphs (a), (b), and (c) of that subdivision;
new text end

new text begin (3) the number of abortions performed by the physician for which judicial
authorization was received and for which the notification described in section 144.343,
subdivision 2, was not provided;
new text end

new text begin (4) the county the female resides in; the county where the abortion was performed, if
different from the female's residence; and, if a judicial bypass was obtained, the judicial
district it was obtained in;
new text end

new text begin (5) the age of the female;
new text end

new text begin (6) the race of the female;
new text end

new text begin (7) the process the physician or the physician's agent used to inform the minor
female, or a woman for whom a guardian has been appointed under sections 524.5-301
to 524.5-317 because of a finding of incompetency, of the judicial bypass; whether court
forms were provided to her; and whether the physician or the physician's agent made
the court arrangement for the minor female, or a woman for whom a guardian has been
appointed under sections 524.5-301 to 524.5-317 because of a finding of incompetency;
and
new text end

new text begin (8) how soon after visiting the abortion facility the minor female, or a woman for
whom a guardian has been appointed under section 524.5-301 to 524.5-317 because of a
finding of incompetency, went to court to obtain a judicial bypass.
new text end

new text begin Subd. 2. new text end

new text begin Forms to physicians and facilities. new text end

new text begin Physicians and facilities required to
report under subdivision 3 shall obtain reporting forms from the commissioner.
new text end

new text begin Subd. 3. new text end

new text begin Submission. new text end

new text begin (a) The following physicians or facilities must submit the
forms to the commissioner no later than April 1 for abortions performed on minors or
women for whom a guardian has been appointed in the previous calendar year:
new text end

new text begin (1) a physician who provides, or whose agent provides, the notice described in
section 144.343, subdivision 2, or the facility at which the notice is provided; and
new text end

new text begin (2) a physician who knowingly performs an abortion upon a minor, or a woman for
whom a guardian has been appointed under sections 524.5-301 to 524.5-317 because of a
finding of incompetency, or a facility at which such an abortion is performed.
new text end

new text begin (b) The commissioner shall maintain as confidential data which alone or in
combination may constitute information that would reasonably lead, using epidemiologic
principles, to the identification of:
new text end

new text begin (1) an individual who has had an abortion, who has received judicial authorization
for an abortion, or to whom the notice described in section 144.343, subdivision 2, has
been provided; or
new text end

new text begin (2) a physician or facility required to report under paragraph (a).
new text end

new text begin Subd. 4. new text end

new text begin Failure to report as required. new text end

new text begin (a) Reports that are not submitted more
than 30 days following the due date shall be subject to a late fee of $500 for each
additional 30-day period or portion of a 30-day period overdue. If a physician or facility
required to report under this section has not submitted a report, or has submitted only
an incomplete report, more than one year following the due date, the commissioner of
health shall bring an action in a court of competent jurisdiction for an order directing the
physician or facility to submit a complete report within a period stated by court order or be
subject to sanctions. If the commissioner brings such an action for an order directing a
physician or facility to submit a complete report, the court may assess reasonable attorney
fees and costs against the noncomplying party.
new text end

new text begin (b) Notwithstanding section 13.39, data related to actions taken by the commissioner
to enforce any provision of this section is private data if the data, alone or in combination,
may constitute information that would reasonably lead, using epidemiologic principles, to
the identification of:
new text end

new text begin (1) an individual who has had an abortion, who has received judicial authorization
for an abortion, or to whom the notice described in section 144.343, subdivision 2, has
been provided; or
new text end

new text begin (2) a physician or facility required to report under subdivision 3.
new text end

new text begin Subd. 5. new text end

new text begin Public records. new text end

new text begin (a) By September 30 of each year, the commissioner of
health shall issue a public report providing statistics for each item listed in subdivision 1
for the previous calendar year compiled from reports submitted according to this section.
The report shall also include statistics, which shall be obtained from court administrators,
that include:
new text end

new text begin (1) the total number of petitions or motions filed under section 144.343, subdivision
6, paragraph (c), clause (i);
new text end

new text begin (2) the number of cases in which the court appointed a guardian ad litem;
new text end

new text begin (3) the number of cases in which the court appointed counsel;
new text end

new text begin (4) the number of cases in which the judge issued an order authorizing an abortion
without notification, including:
new text end

new text begin (i) the number of petitions or motions granted by the court because of a finding of
maturity and the basis for that finding; and
new text end

new text begin (ii) the number of petitions or motions granted because of a finding that the abortion
would be in the best interest of the minor and the basis for that finding;
new text end

new text begin (5) the number of denials from which an appeal was filed;
new text end

new text begin (6) the number of appeals that resulted in a denial being affirmed; and
new text end

new text begin (7) the number of appeals that resulted in reversal of a denial.
new text end

new text begin (b) The report shall provide the statistics for all previous calendar years for which a
public report was required to be issued, adjusted to reflect any additional information from
late or corrected reports.
new text end

new text begin (c) The commissioner shall ensure that all statistical information included in the
public reports are presented so that the data cannot reasonably lead, using epidemiologic
principles, to the identification of:
new text end

new text begin (1) an individual who has had an abortion, who has received judicial authorization
for an abortion, or to whom the notice described in section 144.343, subdivision 2, has
been provided; or
new text end

new text begin (2) a physician or facility who has submitted a form to the commissioner under
subdivision 3.
new text end

new text begin Subd. 6. new text end

new text begin Modification of requirements. new text end

new text begin The commissioner of health may, by
administrative rule, alter the dates established in subdivisions 3 and 5, consolidate the
forms created according to subdivision 1 with the reporting form created according
to section 145.4131, or consolidate reports to achieve administrative convenience or
fiscal savings, to allow physicians and facilities to submit all information collected by
the commissioner regarding abortions at one time, or to reduce the burden of the data
collection, so long as the report described in subdivision 5 is issued at least once a year.
new text end

new text begin Subd. 7. new text end

new text begin Suit to compel statistical report. new text end

new text begin If the commissioner of health fails to
issue the public report required under subdivision 5, any group of ten or more citizens
of the state may seek an injunction in a court of competent jurisdiction against the
commissioner, requiring that a complete report be issued within a period stated by court
order. Failure to abide by the injunction shall subject the commissioner to sanctions
for civil contempt.
new text end

new text begin Subd. 8. new text end

new text begin Attorney fees. new text end

new text begin If judgment is rendered in favor of the plaintiff in any
action described in this section, the court shall also render judgment for a reasonable
attorney fee in favor of the plaintiff against the defendant. If the judgment is rendered in
favor of the defendant and the court finds that plaintiff's suit was frivolous and brought
in bad faith, the court shall render judgment for a reasonable attorney fee in favor of
the defendant against the plaintiff.
new text end

new text begin Subd. 9. new text end

new text begin Severability. new text end

new text begin If any one or more provision, section, subdivision,
sentence, clause, phrase, or word of this section or the application thereof to any person
or circumstance is found to be unconstitutional, the same is hereby declared to be
severable and the balance of this section shall remain effective notwithstanding such
unconstitutionality. The legislature intends that it would have passed this section, and each
provision, section, subdivision, sentence, clause, phrase, or word thereof irrespective of
the fact that any one provision, section, subdivision, sentence, clause, phrase, or word be
declared unconstitutional. new text end

new text begin Subd. 10. new text end

new text begin Supreme Court jurisdiction. new text end

new text begin The Minnesota Supreme Court has original
jurisdiction over an action challenging the constitutionality of this section and shall
expedite the resolution of the action.
new text end

Sec. 4.

new text begin [144.388] LIMITATION.
new text end

new text begin Cross-connection control devices shall be limited in use according to the respective
standard, unless otherwise permitted under sections 144.381 to 144.387. The use of a hose
connection backflow preventer and a hose connection vacuum breaker in a continuous
pressure situation shall be limited to campgrounds that are not connected to a municipal
water system.
new text end

Sec. 5.

new text begin [144A.441] ASSISTED LIVING BILL OF RIGHTS ADDENDUM.
new text end

new text begin Assisted living clients, as defined in section 144G.01, subdivision 3, shall be
provided with the home care bill of rights required by section 144A.44, except that the
home care bill of rights provided to these clients must include the following provision in
place of the provision in section 144A.44, subdivision 1, clause (16):
new text end

new text begin "(16) the right to reasonable, advance notice of changes in services or charges,
including at least 30 days' advance notice of the termination of a service by a provider,
except in cases where:
new text end

new text begin (i) the recipient of services engages in conduct that alters the conditions of
employment as specified in the employment contract between the home care provider
and the individual providing home care services, or creates an abusive or unsafe work
environment for the individual providing home care services;
new text end

new text begin (ii) an emergency for the informal caregiver or a significant change in the recipient's
condition has resulted in service needs that exceed the current service provider agreement
and that cannot be safely met by the home care provider; or
new text end

new text begin (iii) the provider has not received payment for services, for which at least ten days'
advance notice of the termination of a service shall be provided."
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 6.

new text begin [144A.442] TERMINATION OF HOME CARE SERVICES FOR
ASSISTED LIVING CLIENTS.
new text end

new text begin If an arranged home care provider, as defined in section 144D.01, subdivision 2a,
who is not also Medicare certified terminates a service agreement or service plan with
an assisted living client, as defined in section 144G.01, subdivision 3, the home care
provider shall provide the assisted living client and the legal or designated representatives
of the client, if any, with a written notice of termination which includes the following
information:
new text end

new text begin (1) the effective date of termination;
new text end

new text begin (2) the reason for termination;
new text end

new text begin (3) without extending the termination notice period, an affirmative offer to meet with
the assisted living client or client representatives within no more than five business days of
the date of the termination notice to discuss the termination;
new text end

new text begin (4) contact information for a reasonable number of other home care providers in
the geographic area of the assisted living client, as required by Minnesota Rules, part
4668.0050;
new text end

new text begin (5) a statement that the provider will participate in a coordinated transfer of the care
of the client to another provider or caregiver, as required by section 144A.44, subdivision
1, clause (17);
new text end

new text begin (6) the name and contact information of a representative of the home care provider
with whom the client may discuss the notice of termination;
new text end

new text begin (7) a copy of the home care bill of rights; and
new text end

new text begin (8) a statement that the notice of termination of home care services by the home care
provider does not constitute notice of termination of the housing with services contract
with a housing with services establishment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 7.

Minnesota Statutes 2004, section 144A.4605, is amended to read:

144A.4605 deleted text begin ASSISTED LIVING HOME CARE deleted text end new text begin CLASS F new text end PROVIDER.

Subdivision 1.

Definitions.

For purposes of this section, the term " deleted text begin assisted
living deleted text end new text begin class F new text end home care provider" means a home care provider who provides nursing
services, delegated nursing services, other services performed by unlicensed personnel, or
central storage of medications solely for residents of one or more housing with services
establishments registered under chapter 144D.

Subd. 2.

deleted text begin Assisted living deleted text end new text begin Class F new text end home care license established.

A home care
provider license category entitled deleted text begin assisted living deleted text end new text begin class F new text end home care provider is hereby
established. A home care provider may obtain deleted text begin an assisted living deleted text end new text begin a class F new text end license if the
program meets the following requirements:

(a) nursing services, delegated nursing services, other services performed by
unlicensed personnel, or central storage of medications under the deleted text begin assisted living deleted text end new text begin class
F new text end license are provided solely for residents of one or more housing with services
establishments registered under chapter 144D;

(b) unlicensed personnel perform home health aide and home care aide tasks
identified in Minnesota Rules, parts 4668.0100, subparts 1 and 2, and 4668.0110, subpart 1.
Qualifications to perform these tasks shall be established in accordance with subdivision 3;

(c) periodic supervision of unlicensed personnel is provided as required by rule;

(d) notwithstanding Minnesota Rules, part 4668.0160, subpart 6, item D, client
records shall include:

(1) daily records or a weekly summary of home care services provided;

(2) documentation each time medications are administered to a client; and

(3) documentation on the day of occurrence of any significant change in the client's
status or any significant incident, such as a fall or refusal to take medications.

All entries must be signed by the staff providing the services and entered into the
record no later than two weeks after the end of the service day, except as specified in
clauses (2) and (3);

(e) medication and treatment orders, if any, are included in the client record and
are renewed at least every 12 months, or more frequently when indicated by a clinical
assessment;

(f) the central storage of medications in a housing with services establishment
registered under chapter 144D is managed under a system that is established by a
registered nurse and addresses the control of medications, handling of medications,
medication containers, medication records, and disposition of medications; and

(g) in other respects meets the requirements established by rules adopted under
sections 144A.45 to 144A.47.

Subd. 3.

Training or competency evaluations required.

(a) Unlicensed personnel
must:

(1) satisfy the training or competency requirements established by rule under
sections 144A.45 to 144A.47; or

(2) be trained or determined competent by a registered nurse in each task identified
under Minnesota Rules, part 4668.0100, subparts 1 and 2, when offered to clients in a
housing with services establishment as described in paragraphs (b) to (e).

(b) Training for tasks identified under Minnesota Rules, part 4668.0100, subparts
1 and 2, shall use a curriculum which meets the requirements in Minnesota Rules, part
4668.0130.

(c) Competency evaluations for tasks identified under Minnesota Rules, part
4668.0100, subparts 1 and 2, must be completed and documented by a registered nurse.

(d) Unlicensed personnel performing tasks identified under Minnesota Rules, part
4668.0100, subparts 1 and 2, shall be trained or demonstrate competency in the following
topics:

(1) an overview of sections 144A.43 to 144A.47 and rules adopted thereunder;

(2) recognition and handling of emergencies and use of emergency services;

(3) reporting the maltreatment of vulnerable minors or adults under sections 626.556
and 626.557;

(4) home care bill of rights;

(5) handling of clients' complaints and reporting of complaints to the Office of
Health Facility Complaints;

(6) services of the ombudsman for older Minnesotans;

(7) observation, reporting, and documentation of client status and of the care or
services provided;

(8) basic infection control;

(9) maintenance of a clean, safe, and healthy environment;

(10) communication skills;

(11) basic elements of body functioning and changes in body function that must be
reported to an appropriate health care professional; and

(12) physical, emotional, and developmental needs of clients, and ways to work with
clients who have problems in these areas, including respect for the client, the client's
property, and the client's family.

(e) Unlicensed personnel who administer medications must comply with rules
relating to the administration of medications in Minnesota Rules, part 4668.0100, subpart
2, except that unlicensed personnel need not comply with the requirements of Minnesota
Rules, part 4668.0100, subpart 5.

Subd. 4.

License required.

(a) A housing with services establishment registered
under chapter 144D that is required to obtain a home care license must obtain deleted text begin an assisted
living deleted text end new text begin a class F new text end home care license according to this section or a class A or class deleted text begin E deleted text end new text begin B new text end license
according to rule. A housing with services establishment that obtains a class deleted text begin E deleted text end new text begin B new text end license
under this subdivision remains subject to the payment limitations in sections 256B.0913,
subdivision 5f, paragraph (b), and 256B.0915, subdivision 3d.

(b) A board and lodging establishment registered for special services as of December
31, 1996, and also registered as a housing with services establishment under chapter
144D, must deliver home care services according to sections 144A.43 to 144A.47, and
may apply for a waiver from requirements under Minnesota Rules, parts 4668.0002 to
4668.0240, to operate a licensed agency under the standards of section 157.17. Such
waivers as may be granted by the department will expire upon promulgation of home care
rules implementing section 144A.4605.

deleted text begin (c) An adult foster care provider licensed by the Department of Human Services and
registered under chapter 144D may continue to provide health-related services under its
foster care license until the promulgation of home care rules implementing this section.
deleted text end

deleted text begin (d) An assisted living deleted text end new text begin (c) A class F new text end home care provider licensed under this section
must comply with the disclosure provisions of section 325F.72 to the extent they are
applicable.

Subd. 5.

License fees.

The license fees for deleted text begin assisted living deleted text end new text begin class F new text end home care
providers shall be as follows:

(1) $125 annually for those providers serving a monthly average of 15 or fewer
clients, and for deleted text begin assisted living deleted text end new text begin class F new text end providers of all sizes during the first year of
operation;

(2) $200 annually for those providers serving a monthly average of 16 to 30 clients;

(3) $375 annually for those providers serving a monthly average of 31 to 50 clients;
and

(4) $625 annually for those providers serving a monthly average of 51 or more
clients.

Subd. 6.

Waiver.

Upon request of the home care provider, the commissioner may
waive the provisions of this section relating to registered nurse duties.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 8.

Minnesota Statutes 2004, section 144D.01, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Arranged home care provider. new text end

new text begin "Arranged home care provider" means a
home care provider licensed under Minnesota Rules, chapter 4668, that provides services
to some or all of the residents of a housing with services establishment and that is either
the establishment itself or another entity with which the establishment has an arrangement.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 9.

Minnesota Statutes 2004, section 144D.015, is amended to read:

144D.015 ASSISTED LIVING FACILITY new text begin OR ASSISTED LIVING
RESIDENCE new text end DEFINITION FOR PURPOSES OF LONG-TERM CARE
INSURANCE.

For purposes of consistency with terminology commonly used in long-term
care insurance policies new text begin and notwithstanding chapter 144G new text end , a housing with services
establishment that is registered under section 144D.03 and that holds, or deleted text begin contracts deleted text end new text begin makes
arrangements new text end with an individual or entity that holds deleted text begin , a deleted text end new text begin any type of new text end home care license and
all other licenses, permits, registrations, or other governmental approvals legally required
for delivery of the services the establishment offers or provides to its residents, constitutes
an "assisted living facility" or "assisted living residence."

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 10.

Minnesota Statutes 2004, section 144D.02, is amended to read:

144D.02 REGISTRATION REQUIRED.

No entity may establish, operate, conduct, or maintain deleted text begin an elderly deleted text end new text begin a new text end housing with
services establishment in this state without registering and operating as required in
sections 144D.01 to 144D.06.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 11.

Minnesota Statutes 2004, section 144D.03, is amended by adding a
subdivision to read:

new text begin Subd. 1a. new text end

new text begin Surcharge for injunctive relief actions. new text end

new text begin The commissioner shall assess
each housing with services establishment that offers or provides assisted living under
chapter 144G a surcharge on the annual registration fee paid under subdivision 1, to pay
for the commissioner's costs related to bringing actions for injunctive relief under section
144G.02, subdivision 2, paragraph (b), on or after July 1, 2007. The commissioner shall
assess surcharges using a sliding scale under which the surcharge amount increases with
the client capacity of an establishment. The commissioner shall adjust the surcharge as
necessary to recover the projected costs of bringing actions for injunctive relief. The
commissioner shall adjust the surcharge in accordance with section 16A.1285.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for annual registrations submitted
on or after July 1, 2007.
new text end

Sec. 12.

Minnesota Statutes 2004, section 144D.03, subdivision 2, is amended to read:

Subd. 2.

Registration information.

The establishment shall provide the following
information to the commissioner in order to be registered:

(1) the business name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners are not natural persons, identification of the type of business entity
of the owner or owners, and the names and addresses of the officers and members of the
governing body, or comparable persons for partnerships, limited liability corporations, or
other types of business organizations of the owner or owners;

(3) the name and mailing address of the managing agent, whether through
management agreement or lease agreement, of the establishment, if different from the
owner or owners, and the name of the on-site manager, if any;

(4) verification that the establishment has entered into deleted text begin an elderly deleted text end new text begin a new text end housing with
services contract, as required in section 144D.04, with each resident or resident's
representative;

(5) verification that the establishment is complying with the requirements of section
325F.72, if applicable;

(6) the name and address of at least one natural person who shall be responsible
for dealing with the commissioner on all matters provided for in sections 144D.01 to
144D.06, and on whom personal service of all notices and orders shall be made, and who
shall be authorized to accept service on behalf of the owner or owners and the managing
agent, if any; and

(7) the signature of the authorized representative of the owner or owners or, if
the owner or owners are not natural persons, signatures of at least two authorized
representatives of each owner, one of which shall be an officer of the owner.

Personal service on the person identified under clause (6) by the owner or owners in
the registration shall be considered service on the owner or owners, and it shall not be a
defense to any action that personal service was not made on each individual or entity. The
designation of one or more individuals under this subdivision shall not affect the legal
responsibility of the owner or owners under sections 144D.01 to 144D.06.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 13.

Minnesota Statutes 2004, section 144D.04, is amended to read:

144D.04 deleted text begin ELDERLY deleted text end HOUSING WITH SERVICES CONTRACTS.

Subdivision 1.

Contract required.

No deleted text begin elderly deleted text end housing with services establishment
may operate in this state unless a written deleted text begin elderly deleted text end housing with services contract, as defined
in subdivision 2, is executed between the establishment and each resident or resident's
representative and unless the establishment operates in accordance with the terms of the
contract. The resident or the resident's representative shall be given a complete copy of
the contract and all supporting documents and attachments and any changes whenever
changes are made.

Subd. 2.

Contents of contract.

deleted text begin An elderly deleted text end new text begin A new text end housing with services contract, which
need not be entitled as such to comply with this section, shall include at least the following
elements in itself or through supporting documents or attachments:

(1) new text begin the new text end name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners is not a natural person, identification of the type of business entity
of the owner or owners;

(3) the name and mailing address of the managing agent, through management
agreement or lease agreement, of the establishment, if different from the owner or owners;

(4) the name and address of at least one natural person who is authorized to accept
service new text begin of process new text end on behalf of the owner or owners and managing agent;

(5) new text begin a new text end statement describing the registration and licensure status of the establishment
and any provider providing health-related or supportive services under an arrangement
with the establishment;

(6) new text begin the new text end term of the contract;

(7) new text begin a new text end description of the services to be provided to the resident in the base rate to
be paid by resident;

(8) new text begin a new text end description of any additional services new text begin , including home care services, new text end available
for an additional fee from the establishment directly or through arrangements with the
establishment new text begin , and a schedule of fees charged for these services new text end ;

deleted text begin (9) fee schedules outlining the cost of any additional services;
deleted text end

deleted text begin (10) deleted text end new text begin (9) (a) new text end description of the process through which the contract may be modified,
amended, or terminated;

deleted text begin (11) deleted text end new text begin (10) new text end new text begin a new text end description of the establishment's complaint resolution process available
to residents including the toll-free complaint line for the Office of Ombudsman for Older
Minnesotans;

deleted text begin (12) deleted text end new text begin (11) new text end the resident's designated representative, if any;

deleted text begin (13) deleted text end new text begin (12) new text end the establishment's referral procedures if the contract is terminated;

deleted text begin (14) criteria deleted text end new text begin (13) requirements of residency new text end used by the establishment to determine
who may new text begin reside or new text end continue to reside in the deleted text begin elderly deleted text end housing with services establishment;

deleted text begin (15) deleted text end new text begin (14) new text end billing and payment procedures and requirements;

deleted text begin (16) deleted text end new text begin (15) new text end new text begin a new text end statement regarding the ability of residents to receive services from
service providers with whom the establishment does not have an arrangement; deleted text begin and
deleted text end

deleted text begin (17) deleted text end new text begin (16) new text end new text begin a new text end statement regarding the availability of public funds for payment for
residence or services in the establishment new text begin ; and
new text end

new text begin (17) a statement regarding the availability of and contact information for long-
term care consultation services under section 256B.0911 in the county in which the
establishment is located new text end .

Subd. 3.

Contracts in permanent files.

deleted text begin Elderly deleted text end Housing with services contracts
and related documents executed by each resident or resident's representative shall be
maintained by the establishment in files from the date of execution until three years after
the contract is terminated. The contracts and the written disclosures required under section
325F.72, if applicable, shall be made available for on-site inspection by the commissioner
upon request at any time.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 14.

new text begin [144D.045] INFORMATION CONCERNING ARRANGED HOME
CARE PROVIDERS.
new text end

new text begin If a housing with services establishment has one or more arranged home care
providers, the establishment shall arrange to have that arranged home care provider deliver
the following information in writing to a prospective resident, prior to the date on which
the prospective resident executes a contract with the establishment or the prospective
resident's move-in date, whichever is earlier:
new text end

new text begin (1) the name, mailing address, and telephone number of the arranged home care
provider;
new text end

new text begin (2) the name and mailing address of at least one natural person who is authorized to
accept service of process on behalf of the entity described in clause (1) ;
new text end

new text begin (3) a description of the process through which a home care service agreement or
service plan between a resident and the arranged home care provider, if any, may be
modified, amended, or terminated;
new text end

new text begin (4) the arranged home care provider's billing and payment procedures and
requirements; and
new text end

new text begin (5) any limits to the services available from the arranged provider.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 15.

Minnesota Statutes 2004, section 144D.05, is amended to read:

144D.05 AUTHORITY OF COMMISSIONER.

The commissioner shall, upon receipt of information which may indicate the failure
of the deleted text begin elderly deleted text end housing with services establishment, a resident, a resident's representative,
or a service provider to comply with a legal requirement to which one or more of them
may be subject, make appropriate referrals to other governmental agencies and entities
having jurisdiction over the subject matter. The commissioner may also make referrals
to any public or private agency the commissioner considers available for appropriate
assistance to those involved.

The commissioner shall have standing to bring an action for injunctive relief
in the district court in the district in which an establishment is located to compel the
deleted text begin elderly deleted text end housing with services establishment to meet the requirements of this chapter or
other requirements of the state or of any county or local governmental unit to which the
establishment is otherwise subject. Proceedings for securing an injunction may be brought
by the commissioner through the attorney general or through the appropriate county
attorney. The sanctions in this section do not restrict the availability of other sanctions.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 16.

Minnesota Statutes 2004, section 144D.065, is amended to read:

144D.065 ESTABLISHMENTS THAT SERVE PERSONS WITH
ALZHEIMER'S DISEASE OR RELATED DISORDERS.

(a) If a housing with services establishment registered under this chapter markets or
otherwise promotes services for persons with Alzheimer's disease or related disorders,
whether in a segregated or general unit, the deleted text begin facility's deleted text end new text begin establishment's new text end direct care staff and
their supervisors must be trained in dementia care.

(b) Areas of required training include:

(1) an explanation of Alzheimer's disease and related disorders;

(2) assistance with activities of daily living;

(3) problem solving with challenging behaviors; and

(4) communication skills.

(c) The establishment shall provide to consumers in written or electronic form a
description of the training program, the categories of employees trained, the frequency
of training, and the basic topics covered. This information satisfies the disclosure
requirements of section 325F.72, subdivision 2, clause (4).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 17.

new text begin [144G.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Scope; other definitions. new text end

new text begin For purposes of sections 144G.01 to
144G.05, the following definitions apply. In addition, the definitions provided in section
144D.01 also apply to sections 144G.01 to 144G.05.
new text end

new text begin Subd. 2. new text end

new text begin Assisted living. new text end

new text begin "Assisted living" means a service or package of services
advertised, marketed, or otherwise described, offered, or promoted using the phrase
"assisted living" either alone or in combination with other words, whether orally or in
writing, and which is subject to the requirements of this chapter.
new text end

new text begin Subd. 3. new text end

new text begin Assisted living client. new text end

new text begin "Assisted living client" or "client" means a housing
with services resident who receives assisted living that is subject to the requirements
of this chapter.
new text end

new text begin Subd. 4. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of health.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 18.

new text begin [144G.02] ASSISTED LIVING; PROTECTED TITLE; RESTRICTION
ON USE; REGULATORY FUNCTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Protected title; restriction on use. new text end

new text begin No person or entity may use the
phrase "assisted living," whether alone or in combination with other words and whether
orally or in writing, to advertise, market, or otherwise describe, offer, or promote itself, or
any housing, service, service package, or program that it provides within this state, unless
the person or entity is a housing with services establishment that meets the requirements of
this chapter, or is a person or entity that provides some or all components of assisted living
that meet the requirements of this chapter. A person or entity entitled to use the phrase
"assisted living" shall use the phrase only in the context of its participation in assisted
living that meets the requirements of this chapter. A housing with services establishment
offering or providing assisted living that is not made available to residents in all of its
housing units shall identify the number or location of the units in which assisted living
is available, and may not use the term "assisted living" in the name of the establishment
registered with the commissioner under chapter 144D, or in the name the establishment
uses to identify itself to residents or the public.
new text end

new text begin Subd. 2. new text end

new text begin Authority of commissioner. new text end

new text begin (a) The commissioner, upon receipt of
information that may indicate the failure of a housing with services establishment, the
arranged home care provider, an assisted living client, or an assisted living client's
representative to comply with a legal requirement to which one or more of the entities may
be subject, shall make appropriate referrals to other governmental agencies and entities
having jurisdiction over the subject matter. The commissioner may also make referrals
to any public or private agency the commissioner considers available for appropriate
assistance to those involved.
new text end

new text begin (b) In addition to the authority with respect to licensed home care providers under
sections 144A.45 and 144A.46 and with respect to housing with services establishments
under chapter 144D, the commissioner shall have standing to bring an action for injunctive
relief in the district court in the district in which a housing with services establishment
is located to compel the housing with services establishment or the arranged home care
provider to meet the requirements of this chapter or other requirements of the state or of
any county or local governmental unit to which the establishment or arranged home care
provider is otherwise subject. Proceedings for securing an injunction may be brought by
the commissioner through the attorney general or through the appropriate county attorney.
The sanctions in this section do not restrict the availability of other sanctions.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 19.

new text begin [144G.03] ASSISTED LIVING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Verification in annual registration. new text end

new text begin A registered housing with
services establishment using the phrase "assisted living," pursuant to section 144G.02,
subdivision 1, shall verify to the commissioner in its annual registration pursuant to chapter
144D that the establishment is complying with sections 144G.01 to 144G.05, as applicable.
new text end

new text begin Subd. 2. new text end

new text begin Minimum requirements for assisted living. new text end

new text begin (a) Assisted living shall
be provided or made available only to individuals residing in a registered housing with
services establishment. Except as expressly stated in this chapter, a person or entity
offering assisted living may define the available services and may offer assisted living to
all or some of the residents of a housing with services establishment. The services that
comprise assisted living may be provided or made available directly by a housing with
services establishment or by persons or entities with which the housing with services
establishment has made arrangements.
new text end

new text begin (b) A person or entity entitled to use the phrase "assisted living," according to
section 144G.02, subdivision 1, shall do so only with respect to a housing with services
establishment, or a service, service package, or program available within a housing with
services establishment that, at a minimum:
new text end

new text begin (1) provides or makes available health related services under a class A or class F
home care license. At a minimum, health related services must include:
new text end

new text begin (i) assistance with self-administration of medication as defined in Minnesota Rules,
part 4668.0003, subpart 2a, or medication administration as defined in Minnesota Rules,
part 4668.0003, subpart 21a; and
new text end

new text begin (ii) assistance with at least three of the following seven activities of daily living:
bathing, dressing, grooming, eating, transferring, continence care, and toileting.
new text end

new text begin All health related services shall be provided in a manner that complies with applicable
home care licensure requirements in chapter 144A and Minnesota Rules, chapter 4668,
and with sections 148.171 to 148.285;
new text end

new text begin (2) provides necessary assessments of the physical and cognitive needs of assisted
living clients by a registered nurse, as required by applicable home care licensure
requirements in chapter 144A and Minnesota Rules, chapter 4668, and by sections
148.171 to 148.285;
new text end

new text begin (3) has and maintains a system for delegation of health care activities to unlicensed
assistive health care personnel by a registered nurse, including supervision and evaluation
of the delegated activities as required by applicable home care licensure requirements in
chapter 144A and Minnesota Rules, chapter 4668, and by sections 148.171 to 148.285;
new text end

new text begin (4) provides staff access to an on-call registered nurse 24 hours per day, seven
days per week;
new text end

new text begin (5) has and maintains a system to check on each assisted living client at least daily;
new text end

new text begin (6) provides a means for assisted living clients to request assistance for health and
safety needs 24 hours per day, seven days per week, from the establishment or a person or
entity with which the establishment has made arrangements;
new text end

new text begin (7) has a person or persons available 24 hours per day, seven days per week, who
is responsible for responding to the requests of assisted living clients for assistance with
health or safety needs, who shall be:
new text end

new text begin (i) awake;
new text end

new text begin (ii) located in the same building, in an attached building, or on a contiguous campus
with the housing with services establishment in order to respond within a reasonable
amount of time;
new text end

new text begin (iii) capable of communicating with assisted living clients;
new text end

new text begin (iv) capable of recognizing the need for assistance;
new text end

new text begin (v) capable of providing either the assistance required or summoning the appropriate
assistance; and
new text end

new text begin (vi) capable of following directions;
new text end

new text begin (8) offers to provide or make available at least the following supportive services
to assisted living clients:
new text end

new text begin (i) two meals per day;
new text end

new text begin (ii) weekly housekeeping;
new text end

new text begin (iii) weekly laundry service;
new text end

new text begin (iv) upon the request of the client, reasonable assistance with arranging for
transportation to medical and social services appointments, and the name of or other
identifying information about the person or persons responsible for providing this
assistance;
new text end

new text begin (v) upon the request of the client, reasonable assistance with accessing community
resources and social services available in the community, and the name of or other
identifying information about the person or persons responsible for providing this
assistance; and
new text end

new text begin (vi) periodic opportunities for socialization; and
new text end

new text begin (9) makes available to all prospective and current assisted living clients information
consistent with the uniform format and the required components adopted by the
commissioner under section 144G.06. This information must be made available beginning
no later than six months after the commissioner makes the uniform format and required
components available to providers according to section 144G.06.
new text end

new text begin Subd. 3. new text end

new text begin Exemption from awake-staff requirement. new text end

new text begin (a) A housing with services
establishment that offers or provides assisted living is exempt from the requirement in
subdivision 2, paragraph (b), clause (7), item (i), that the person or persons available and
responsible for responding to requests for assistance must be awake, if the establishment
meets the following requirements:
new text end

new text begin (1) the establishment has a maximum capacity to serve 12 or fewer assisted living
clients;
new text end

new text begin (2) the person or persons available and responsible for responding to requests for
assistance are physically present within the housing with services establishment in which
the assisted living clients reside;
new text end

new text begin (3) the establishment has a system in place that is compatible with the health, safety,
and welfare of the establishment's assisted living clients;
new text end

new text begin (4) the establishment's housing with services contract, as required by section
144D.04, includes a statement disclosing the establishment's qualification for, and
intention to rely upon, this exemption;
new text end

new text begin (5) the establishment files with the commissioner, for purposes of public information
but not review or approval by the commissioner, a statement describing how the
establishment meets the conditions in clauses (1) to (4), and makes a copy of this statement
available to actual and prospective assisted living clients; and
new text end

new text begin (6) the establishment indicates on its housing with services registration, under
section 144D.02 or 144D.03, as applicable, that it qualifies for and intends to rely upon the
exemption under this subdivision.
new text end

new text begin Subd. 4. new text end

new text begin Nursing assessment. new text end

new text begin (a) A housing with services establishment offering or
providing assisted living shall:
new text end

new text begin (1) offer to have the arranged home care provider conduct a nursing assessment by
a registered nurse of the physical and cognitive needs of the prospective resident and
propose a service agreement or service plan prior to the date on which a prospective
resident executes a contract with a housing with services establishment or the date on
which a prospective resident moves in, whichever is earlier; and
new text end

new text begin (2) inform the prospective resident of the availability of and contact information for
long-term care consultation services under section 256B.0911, prior to the date on which a
prospective resident executes a contract with a housing with services establishment or the
date on which a prospective resident moves in, whichever is earlier.
new text end

new text begin (b) An arranged home care provider is not obligated to conduct a nursing assessment
by a registered nurse when requested by a prospective resident if either the geographic
distance between the prospective resident and the provider, or urgent or unexpected
circumstances, do not permit the assessment to be conducted prior to the date on which
the prospective resident executes a contract or moves in, whichever is earlier. When such
circumstances occur, the arranged home care provider shall offer to conduct a telephone
conference whenever reasonably possible.
new text end

new text begin (c) The arranged home care provider shall comply with applicable home care
licensure requirements in chapter 144A and Minnesota Rules, chapter 4668, and with
sections 148.171 to 148.285 with respect to the provision of a nursing assessment prior
to the delivery of nursing services and the execution of a home care service plan or
service agreement.
new text end

new text begin Subd. 5. new text end

new text begin Assistance with arranged home care provider. new text end

new text begin The housing with services
establishment shall provide each assisted living client with identifying information about a
person or persons reasonably available to assist the client with concerns the client may
have with respect to the services provided by the arranged home care provider. The
establishment shall keep each assisted living client reasonably informed of any changes in
the personnel referenced in this subdivision. Upon request of the assisted living client,
such personnel or designee shall provide reasonable assistance to the assisted living client
in addressing concerns regarding services provided by the arranged home care provider.
new text end

new text begin Subd. 6. new text end

new text begin Termination of housing with services contract. new text end

new text begin If a housing with
services establishment terminates a housing with services contract with an assisted living
client, the establishment shall provide the assisted living client, and the legal or designated
representative of the assisted living client, if any, with a written notice of termination
which includes the following information:
new text end

new text begin (1) the effective date of termination;
new text end

new text begin (2) the section of the contract that authorizes the termination;
new text end

new text begin (3) without extending the termination notice period, an affirmative offer to meet with
the assisted living client and, if applicable, client representatives, within no more than five
business days of the date of the termination notice to discuss the termination;
new text end

new text begin (4) an explanation that:
new text end

new text begin (i) the assisted living client must vacate the apartment, along with all personal
possessions, on or before the effective date of termination;
new text end

new text begin (ii) failure to vacate the apartment by the date of termination may result in the filing
of an eviction action in court by the establishment, and that the assisted living client may
present a defense, if any, to the court at that time; and
new text end

new text begin (iii) the assisted living client may seek legal counsel in connection with the notice
of termination;
new text end

new text begin (5) a statement that, with respect to the notice of termination, reasonable
accommodation is available for the disability of the assisted living client, if any; and
new text end

new text begin (6) the name and contact information of the representative of the establishment
with whom the assisted living client or client representatives may discuss the notice of
termination.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 20.

new text begin [144G.04] RESERVATION OF RIGHTS.
new text end

new text begin Subdivision 1. new text end

new text begin Use of services. new text end

new text begin Nothing in this chapter requires an assisted living
client to utilize any service provided or made available in assisted living.
new text end

new text begin Subd. 2. new text end

new text begin Housing with services contracts. new text end

new text begin Nothing in this chapter requires a
housing with services establishment to execute or refrain from terminating a housing with
services contract with a prospective or current resident who is unable or unwilling to meet
the requirements of residency, with or without assistance.
new text end

new text begin Subd. 3. new text end

new text begin Provision of services. new text end

new text begin Nothing in this chapter requires the arranged home
care provider to offer or continue to provide services under a service agreement or service
plan to a prospective or current resident of the establishment whose needs cannot be
met by the arranged home care provider.
new text end

new text begin Subd. 4. new text end

new text begin Altering operations; service packages. new text end

new text begin Nothing in this chapter requires
a housing with services establishment or arranged home care provider offering assisted
living to fundamentally alter the nature of the operations of the establishment or the
provider in order to accommodate the request or need for facilities or services by any
assisted living client, or to refrain from requiring, as a condition of residency, that an
assisted living client pay for a package of assisted living services even if the client does
not choose to utilize all or some of the services in the package.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 21.

new text begin [144G.05] REIMBURSEMENT UNDER ASSISTED LIVING SERVICE
PACKAGES.
new text end

new text begin Notwithstanding the provisions of this chapter, the requirements for the Elderly
Waiver program's assisted living payment rates under section 256B.0915, subdivision
3e, shall continue to be effective and providers who do not meet the requirements of
this chapter may continue to receive payment under section 256B.0915, subdivision 3e,
as long as they continue to meet the definitions and standards for assisted living and
assisted living plus set forth in the federally approved Elderly Home and Community
Based Services Waiver Program (Control Number 0025.91). Providers of assisted living
for the Community Alternatives for Disabled Individuals (CADI) and Traumatic Brain
Injury (TBI) waivers shall continue to receive payment as long as they continue to meet
the definitions and standards for assisted living and assisted living plus set forth in the
federally approved CADI and TBI waiver plans.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 22.

new text begin [144G.06] UNIFORM CONSUMER INFORMATION GUIDE.
new text end

new text begin (a) The commissioner of health shall establish an advisory committee consisting
of representatives of consumers, providers, county and state officials, and other
groups the commissioner considers appropriate. The advisory committee shall present
recommendations to the commissioner on:
new text end

new text begin (1) a format for a guide to be used by individual providers of assisted living, as
defined in Minnesota Statutes, section 144G.01, that includes information about services
offered by that provider, service costs, and other relevant provider-specific information, as
well as a statement of philosophy and values associated with assisted living, presented in
uniform categories that facilitate comparison with guides issued by other providers; and
new text end

new text begin (2) requirements for informing assisted living clients, as defined in Minnesota
Statutes, section 144G.01, of their applicable legal rights.
new text end

new text begin (b) The commissioner, after reviewing the recommendations of the advisory
committee, shall adopt a uniform format for the guide to be used by individual providers,
and the required components of materials to be used by providers to inform assisted
living clients of their legal rights, and shall make the uniform format and the required
components available to assisted living providers.
new text end

Sec. 23.

new text begin [145.4122] NON-HOSPITAL-PERFORMED ABORTIONS;
REQUIREMENT; MISDEMEANOR.
new text end

new text begin Subdivision 1. new text end

new text begin Physician requirement. new text end

new text begin A physician performing or inducing an
abortion who does not have clinical privileges at a hospital which offers obstetrical or
gynecological care within the state and within 20 miles of the location where the abortion
is performed or induced is guilty of a misdemeanor and is subject to the criminal penalties
provided by law. For purposes of this section, abortion has the meaning given in section
144.343, subdivision 3.
new text end

new text begin Subd. 2. new text end

new text begin Severability. new text end

new text begin If any one or more provision, section, subdivision,
sentence, clause, phrase, or word of this section or the application thereof to any person
or circumstance is found to be unconstitutional, the same is hereby declared to be
severable and the balance of this section shall remain effective notwithstanding such
unconstitutionality. The legislature intends that it would have passed this section, and each
provision, section, subdivision, sentence, clause, phrase, or word thereof irrespective of
the fact that any one provision, section, subdivision, sentence, clause, phrase, or word be
declared unconstitutional.
new text end

new text begin Subd. 3. new text end

new text begin Supreme Court jurisdiction. new text end

new text begin The Minnesota Supreme Court has original
jurisdiction over an action challenging the constitutionality of this section and shall
expedite the resolution of the action.
new text end

Sec. 24.

Minnesota Statutes 2004, section 145.4241, is amended by adding a
subdivision to read:

new text begin Subd. 3a. new text end

new text begin Fetal anomaly incompatible with life. new text end

new text begin "Fetal anomaly incompatible with
life" means an untreatable fetal anomaly diagnosed before birth that will with reasonable
certainty result in fetal or neonatal death. These conditions include anencephaly, trisomy
13 or 18, acardia, renal agenesis, and thanatophoric dwarfism.
new text end

Sec. 25.

Minnesota Statutes 2004, section 145.4241, is amended by adding a
subdivision to read:

new text begin Subd. 4a. new text end

new text begin Perinatal hospice. new text end

new text begin (a) "Perinatal hospice" means comprehensive support
to the female and her family that includes support from the time of diagnosis through the
time of birth and death of the infant and through the postpartum period. Supportive care
may include maternal-fetal medical specialists, obstetricians, neonatologists, anesthesia
specialists, family physicians, nurse midwives, clergy, social workers, and specialty nurses.
new text end

new text begin (b) The availability of perinatal hospice provides an alternative to families for whom
elective pregnancy termination is not chosen.
new text end

Sec. 26.

Minnesota Statutes 2005 Supplement, section 145.4242, is amended to read:

145.4242 INFORMED CONSENT.

(a) No abortion shall be performed in this state except with the voluntary and
informed consent of the female upon whom the abortion is to be performed. Except in
the case of a medical emergency new text begin or if the fetus has an anomaly incompatible with life,
and the female has declined perinatal hospice care new text end , consent to an abortion is voluntary
and informed only if:

(1) the female is told the following, by telephone or in person, by the physician who
is to perform the abortion or by a referring physician, at least 24 hours before the abortion:

(i) the particular medical risks associated with the particular abortion procedure to be
employed including, when medically accurate, the risks of infection, hemorrhage, breast
cancer, danger to subsequent pregnancies, and infertility;

(ii) the probable gestational age of the unborn child at the time the abortion is to
be performed;

(iii) the medical risks associated with carrying her child to term; and

(iv) for abortions after 20 weeks gestational, whether or not an anesthetic or
analgesic would eliminate or alleviate organic pain to the unborn child caused by the
particular method of abortion to be employed and the particular medical benefits and risks
associated with the particular anesthetic or analgesic.

The information required by this clause may be provided by telephone without
conducting a physical examination or tests of the patient, in which case the information
required to be provided may be based on facts supplied to the physician by the female and
whatever other relevant information is reasonably available to the physician. It may not be
provided by a tape recording, but must be provided during a consultation in which the
physician is able to ask questions of the female and the female is able to ask questions
of the physician. If a physical examination, tests, or the availability of other information
to the physician subsequently indicate, in the medical judgment of the physician, a
revision of the information previously supplied to the patient, that revised information
may be communicated to the patient at any time prior to the performance of the abortion.
Nothing in this section may be construed to preclude provision of required information in
a language understood by the patient through a translator;

(2) the female is informed, by telephone or in person, by the physician who is to
perform the abortion, by a referring physician, or by an agent of either physician at least
24 hours before the abortion:

(i) that medical assistance benefits may be available for prenatal care, childbirth,
and neonatal care;

(ii) that the father is liable to assist in the support of her child, even in instances
when the father has offered to pay for the abortion; and

(iii) that she has the right to review the printed materials described in section
145.4243, that these materials are available on a state-sponsored Web site, and what the
Web site address is. The physician or the physician's agent shall orally inform the female
that the materials have been provided by the state of Minnesota and that they describe the
unborn child, list agencies that offer alternatives to abortion, and contain information on
fetal pain. If the female chooses to view the materials other than on the Web site, they
shall either be given to her at least 24 hours before the abortion or mailed to her at least 72
hours before the abortion by certified mail, restricted delivery to addressee, which means
the postal employee can only deliver the mail to the addressee.

The information required by this clause may be provided by a tape recording if
provision is made to record or otherwise register specifically whether the female does or
does not choose to have the printed materials given or mailed to her;

(3) the female certifies in writing, prior to the abortion, that the information
described in clauses (1) and (2) has been furnished to her and that she has been informed
of her opportunity to review the information referred to in clause (2), subclause (iii); and

(4) prior to the performance of the abortion, the physician who is to perform the
abortion or the physician's agent obtains a copy of the written certification prescribed by
clause (3) and retains it on file with the female's medical record for at least three years
following the date of receipt.

(b) Prior to administering the anesthetic or analgesic as described in paragraph (a),
clause (1), item (iv), the physician must disclose to the woman any additional cost of the
procedure for the administration of the anesthetic or analgesic. If the woman consents
to the administration of the anesthetic or analgesic, the physician shall administer the
anesthetic or analgesic or arrange to have the anesthetic or analgesic administered.

new text begin (c) A female seeking an abortion of her unborn child diagnosed with a fetal anomaly
incompatible with life must be informed of available perinatal hospice services and offered
this care as an alternative to abortion. If perinatal hospice services are declined, voluntary
and informed consent by the female seeking an abortion is given if the female receives the
information required in paragraphs (a), clause (1) and (b). The female and the physician or
physician's agent must comply with the requirements in paragraph (a), clauses (3) and
(4), as they relate to paragraphs (a), clause (1), and (b).
new text end

Sec. 27.

new text begin [151.415] PROHIBITION AGAINST REFUSING TO DISPENSE A
LEGEND DRUG OR DEVICE.
new text end

new text begin Subdivision 1. new text end

new text begin Intent. new text end

new text begin It is the intent of the legislature that pharmacists dispense
legend drugs and devices in a timely way or provide appropriate referrals for patients to
obtain the necessary legend drugs and devices, despite the pharmacist's objection to
dispensing the drugs or devices on ethical, moral, or religious grounds.
new text end

new text begin Subd. 2. new text end

new text begin Prohibition. new text end

new text begin (a) No pharmacist shall obstruct a patient in obtaining a
legend drug or device that has been legally prescribed or ordered for that patient. A
violation of this section constitutes unprofessional conduct by the pharmacist and shall
subject the pharmacist to disciplinary or administrative action by the Board of Pharmacy.
new text end

new text begin (b) Notwithstanding any other provision of law, a pharmacist shall dispense drugs
and devices, as described in section 151.01, subdivision 30, pursuant to a lawful order or
prescription unless one of the following circumstances exists:
new text end

new text begin (1) based solely on the pharmacist's professional training and judgment dispensing
pursuant to the order or the prescription is contrary to law, or the pharmacist determines
that the prescribed drug or device would cause a harmful drug interaction or would
otherwise adversely affect the patient's medical condition;
new text end

new text begin (2) the legend drug or device is not in stock. If an order or prescription cannot be
dispensed because the drug or device is not in stock, the pharmacist shall take one of the
following actions:
new text end

new text begin (i) immediately notify the patient and arrange for the drug or device to be delivered
to the site or directly to the patient in a timely manner;
new text end

new text begin (ii) promptly transfer the prescription to another pharmacy known to stock the
legend drug or device to ensure the patient has timely access to the drug or device; or
new text end

new text begin (iii) return the prescription to the patient and refer the patient; or
new text end

new text begin (3) the pharmacist refuses on ethical, moral, or religious grounds to dispense a drug
or device pursuant to an order or prescription. A pharmacist may decline to dispense a
prescription drug or device on this basis if the employer has previously been notified by
the pharmacist, in writing, of the drug or class of drugs to which the pharmacist objects.
The pharmacist's employer shall establish protocols that ensure that the patient has timely
access to the prescribed drug or device despite the pharmacist's refusal to dispense the
prescription or order.
new text end

new text begin (c) For the purposes of this section, "legend drug or device" has the same meaning as
the definition in section 151.01, subdivision 17.
new text end

new text begin (d) Nothing in this section requires a pharmacy to stock any legend drug or device.
new text end

new text begin (e) This section imposes no duty on a pharmacist to dispense a drug or device
pursuant to a prescription or order without payment for the drug or device, including
payment directly by the patient or through a third-party payer accepted by the pharmacist
or payment of any required co-payment by the patient.
new text end

Sec. 28.

Minnesota Statutes 2005 Supplement, section 157.16, subdivision 3a, is
amended to read:

Subd. 3a.

Statewide hospitality fee.

Every person, firm, or corporation that operates
a licensed boarding establishment, food and beverage service establishment, seasonal
temporary or permanent food stand, special event food stand, mobile food unit, food cart,
resort, hotel, motel, or lodging establishment in Minnesota new text begin , except for a school, as defined
in section 120A.05, subdivisions 9, 11, and 13, new text end must submit to the commissioner a $35
annual statewide hospitality fee for each licensed activity. The fee for establishments
licensed by the Department of Health is required at the same time the licensure fee is due.
For establishments licensed by local governments, the fee is due by July 1 of each year.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 29. new text begin PROHIBITION ON USE OF STATE FUNDS.
new text end

new text begin Subdivision 1. new text end

new text begin Use of funds. new text end

new text begin Funding for state-sponsored health programs shall not
be used for funding abortions, except to the extent necessary for continued participation
in a federal program. For purposes of this section, abortion has the meaning given in
Minnesota Statutes, section 144.343, subdivision 3.
new text end

new text begin Subd. 2. new text end

new text begin Severability. new text end

new text begin If any one or more provision, section, subdivision,
sentence, clause, phrase, or word of this section or the application thereof to any person
or circumstance is found to be unconstitutional, the same is hereby declared to be
severable and the balance of this section shall remain effective notwithstanding such
unconstitutionality. The legislature intends that it would have passed this section, and each
provision, section, subdivision, sentence, clause, phrase, or word thereof irrespective of
the fact that any one provision, section, subdivision, sentence, clause, phrase, or word be
declared unconstitutional.
new text end

new text begin Subd. 3. new text end

new text begin Supreme Court jurisdiction. new text end

new text begin The Minnesota Supreme Court has original
jurisdiction over an action challenging the constitutionality of this section and shall
expedite the resolution of the action.
new text end

Sec. 30. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin (a) new text end

new text begin The revisor of statutes shall strike all references to the "Class E assisted living
home care programs license, "Class E license," and similar terms in Minnesota Rules,
chapters 4668 and 4669. In sections affected by this instruction, the revisor may make
changes necessary to correct the punctuation, grammar, or structure of the remaining text
and preserve its meaning.
new text end

new text begin (b) new text end

new text begin The revisor of statutes shall change the term "assisted living home care provider,"
"assisted living license," and similar terms to "Class F home care provider," "Class F
license," and similar terms to "Class F home care provider," "Class F license," and similar
terms, in Minnesota Rules, chapter 4668. In sections affected by this instruction, the
revisor may make changes necessary to correct the punctuation, grammar, or structure of
the remaining text and preserve its meaning.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 31. new text begin REPEALER.
new text end

new text begin Minnesota Rules, part 4668.0215, new text end new text begin is repealed effective January 1, 2007.
new text end

ARTICLE 5

HEALTH CARE COST-CONTAINMENT

Section 1.

Minnesota Statutes 2004, section 62D.02, is amended by adding a
subdivision to read:

new text begin Subd. 1a. new text end

new text begin Authorized entity. new text end

new text begin "Authorized entity" means a corporation organized
under chapter 302A, 317A, or the similar laws of another state; a limited liability company
organized under chapter 322B or the similar laws of another state; or a local government
unit as defined in subdivision 11.
new text end

Sec. 2.

Minnesota Statutes 2004, section 62D.02, subdivision 4, is amended to read:

Subd. 4.

Health maintenance organization.

(a) "Health maintenance organization"
means deleted text begin a nonprofit corporation organized under chapter 317A, or a local governmental unit
as defined in subdivision 11 deleted text end new text begin an authorized entity new text end , controlled and operated as provided in
sections 62D.01 to 62D.30, which provides, either directly or through arrangements with
providers or other persons, comprehensive health maintenance services, or arranges for
the provision of these services, to enrollees on the basis of a fixed prepaid sum without
regard to the frequency or extent of services furnished to any particular enrollee.

(b) (Expired)

Sec. 3.

Minnesota Statutes 2004, section 62D.03, subdivision 1, is amended to read:

Subdivision 1.

Certificate of authority required.

Notwithstanding any law of this
state to the contrary, deleted text begin any nonprofit corporation organized to do so or a local governmental
unit deleted text end new text begin an authorized entity new text end may apply to the commissioner of health for a certificate of
authority to establish and operate a health maintenance organization in compliance with
sections 62D.01 to 62D.30. No person shall establish or operate a health maintenance
organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive
advance or periodic consideration in conjunction with a health maintenance organization
or health maintenance contract unless the organization has a certificate of authority under
sections 62D.01 to 62D.30. new text begin An out-of-state corporation or out-of-state limited liability
company may qualify to apply for a certificate of authority under this chapter, subject to
obtaining a certificate of authority to do business in this state under section 303.08 or
322B.915, as appropriate, and compliance with this chapter and other applicable state laws.
new text end

Sec. 4.

Minnesota Statutes 2004, section 62D.05, subdivision 1, is amended to read:

Subdivision 1.

Authority granted.

Any deleted text begin nonprofit corporation or local governmental
unit deleted text end new text begin authorized entity new text end may, upon obtaining a certificate of authority as required in sections
62D.01 to 62D.30, operate as a health maintenance organization.

Sec. 5.

Minnesota Statutes 2004, section 62D.095, subdivision 3, is amended to read:

Subd. 3.

Deductibles.

deleted text begin (a) deleted text end A health maintenance contract issued by a health
maintenance organization deleted text begin that is assessed less than three percent of the total annual amount
assessed by the Minnesota comprehensive health association deleted text end may impose deductibles not
to exceed deleted text begin $3,000 deleted text end new text begin $5,000 new text end per person, per year and deleted text begin $6,000 deleted text end new text begin $10,000 new text end per family, per year. deleted text begin For
purposes of the percentage calculation, a health maintenance organization's assessments
include those of its affiliates.
deleted text end

deleted text begin (b) All other health maintenance contracts may impose deductibles not to exceed
$2,250 per person, per year and $4,500 per family, per year.
deleted text end

Sec. 6.

Minnesota Statutes 2004, section 62D.095, subdivision 4, is amended to read:

Subd. 4.

Annual out-of-pocket maximums.

deleted text begin (a) deleted text end A health maintenance contract
issued by a health maintenance organization deleted text begin that is assessed less than three percent of the
total annual amount assessed by the Minnesota comprehensive health association deleted text end must
include a limitation not to exceed deleted text begin $4,500 deleted text end new text begin $5,000 new text end per person and deleted text begin $7,500 deleted text end new text begin $10,000 new text end per
family on total annual out-of-pocket enrollee cost-sharing expenses. deleted text begin For purposes of the
percentage calculation, a health maintenance organization's assessments include those
of its affiliates.
deleted text end

deleted text begin (b) All other health maintenance contracts must include a limitation not to
exceed $3,000 per person and $6,000 per family on total annual out-of-pocket enrollee
cost-sharing expenses.
deleted text end

Sec. 7.

Minnesota Statutes 2004, section 62D.095, is amended by adding a subdivision
to read:

new text begin Subd. 5a. new text end

new text begin Lifetime maximum benefit. new text end

new text begin (a) A health maintenance contract issued
by a health maintenance organization may impose a lifetime maximum benefit no less
than $3,000,000. At no time shall a health maintenance organization impose a lifetime
maximum lower than the required lifetime maximum of the comprehensive health
insurance plan under section 62E.12.
new text end

new text begin (b) The comprehensive health insurance plan is available under section 62E.14,
subdivision 4c, paragraph (a), to those meeting the lifetime maximum benefit, without
providing evidence of rejection.
new text end

Sec. 8.

Minnesota Statutes 2004, section 62E.11, subdivision 13, is amended to read:

Subd. 13.

State funding; effect on premium rates of members.

new text begin (a) new text end In approving
the premium rates as required in sections 62A.65, subdivision 3; and 62L.08, subdivision
8, the commissioners of health and commerce shall ensure that any appropriation to
reduce the annual assessment made on the contributing members to cover the costs of the
Minnesota comprehensive health insurance plan as required under this section is reflected
in the premium rates charged by each contributing member.

new text begin (b) In any fiscal year, a positive balance in the health care access fund, not to
exceed $40,000,000, is appropriated to the commissioner of commerce for disbursement
to the Minnesota Comprehensive Health Association for the purpose of reducing or
eliminating its annual assessments on its contributing members, under subdivision 6. The
amount appropriated and disbursed must not exceed the total amount that the association
would otherwise assess on its contributing members for the calendar year in which the
disbursement is made.
new text end

new text begin (c) Notwithstanding the appropriation in paragraph (b), $87,500,000 in fiscal year
2007, $20,000,000 in fiscal year 2008, and $40,000,000 in fiscal year 2009 is appropriated
from the health care access fund to the commissioner of commerce for the purpose
stated in paragraph (b).
new text end

new text begin (d) The appropriations in this section are available only after the state prevails in
the appeal of the decision, filed December 20, 2005, by the Minnesota District Court,
Second Judicial District v. Philip Morris, Inc.
new text end

Sec. 9.

Minnesota Statutes 2005 Supplement, section 62J.052, is amended to read:

62J.052 PROVIDER COST DISCLOSURE.

new text begin Subdivision 1. new text end

new text begin Health care providers. new text end

(a) Each health care provider, as defined by
section 62J.03, subdivision 8, except hospitals and outpatient surgical centers new text begin subject to
the requirements of section 62J.823 new text end , shall provide the following information:

(1) the average allowable payment from private third-party payers for the 20 services
or procedures most commonly performed;

(2) the average payment rates for those services and procedures for medical
assistance;

(3) the average charge for those services and procedures for individuals who have no
applicable private or public coverage; and

(4) the average charge for those services and procedures, including all patients.

(b) This information shall be updated annually and be readily available at no cost to
the public on site.

new text begin Subd. 2. new text end

new text begin Pharmacies. new text end

new text begin (a) Each pharmacy, as defined in section 151.01, subdivision
2, shall provide the following information to a patient, upon request:
new text end

new text begin (1) the pharmacy's own usual and customary price for a prescription drug;
new text end

new text begin (2) a historical record, including all transactions on record with the pharmacy both
past and present, of all co-payments and other cost-sharing paid to the pharmacy by the
patient; and
new text end

new text begin (3) the total amount of all co-payments and other cost-sharing paid to the pharmacy
by the patient over the entire historical record.
new text end

Sec. 10.

new text begin [62J.431] EVIDENCE-BASED PRACTICE STANDARDS AND
GUIDELINES.
new text end

new text begin Subdivision 1. new text end

new text begin Health-related boards and provider organizations; practice
standards. new text end

new text begin The health-related boards, under chapter 148, or professional provider
organizations may establish practice standards for treating patients within their respective
scopes of practice. The boards or provider organizations may utilize the services of
appropriate public or private entities to facilitate the development or review of practice
standards and evidence-based guidelines. Each board or provider organization that has
established or ratified existing standards shall report these standards to the legislative
committees with jurisdiction over the public health occupations by January 15, 2007, and
shall report subsequent changes annually thereafter. If a board or provider organization
has existing standards, nothing in this section requires a board or provider organization to
establish new standards. Nothing in this section shall require a health plan company to
cover treatments, testing, or imaging, based on standards developed under this section.
new text end

new text begin Subd. 2. new text end

new text begin Criteria for evidence-based guidelines. new text end

new text begin Guidelines identified under this
section must meet the following criteria:
new text end

new text begin (1) the scope and application are clear;
new text end

new text begin (2) authorship is stated and any conflicts of interest disclosed;
new text end

new text begin (3) authors represent all pertinent clinical fields or other means of input have been
used;
new text end

new text begin (4) the development process is explicitly stated;
new text end

new text begin (5) the guideline is grounded in evidence;
new text end

new text begin (6) the evidence is cited and graded;
new text end

new text begin (7) the document itself is clear and practical;
new text end

new text begin (8) the document is flexible in use, with exceptions noted or provided for with
general statements;
new text end

new text begin (9) measures are included for use in systems improvement; and
new text end

new text begin (10) the guideline has scheduled reviews and updating.
new text end

Sec. 11.

new text begin [62J.62] ELECTRONIC BILLING ASSISTANCE.
new text end

new text begin The commissioner of human services shall, out of existing resources, encourage and
assist providers to adopt and use electronic billing for state programs, including but not
limited to the provision of training.
new text end

Sec. 12.

Minnesota Statutes 2004, section 62J.81, subdivision 1, is amended to read:

Subdivision 1.

Required disclosure of estimated payment.

new text begin (a) new text end A health care
provider, as defined in section 62J.03, subdivision 8, new text begin or the provider's designee as agreed
to by that designee, new text end shall, at the request of a consumer, provide that consumer with a good
faith estimate of the reimbursement the provider expects to receive from the health plan
company in which the consumer is enrolled. Health plan companies must allow contracted
providers new text begin , or their designee, new text end to release this information. A good faith estimate must also be
made available at the request of a consumer who is not enrolled in a health plan company.
Payment information provided by a provider new text begin , or by the provider's designee as agreed to
by that designee, new text end to a patient pursuant to this subdivision does not constitute a legally
binding estimate of the cost of services.

new text begin (b) A health plan company, as defined in section 62J.03, subdivision 10, shall,
at the request of an enrollee, provide that enrollee with a good faith estimate of the
reimbursement the health plan company would expect to pay to a specified provider within
the network for a health care service specified by the enrollee. An estimate provided to an
enrollee under this paragraph is not a legally binding estimate of the reimbursement.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (a) is effective the day following final enactment.
Paragraph (b) is effective January 1, 2007.
new text end

Sec. 13.

new text begin [62J.823] HOSPITAL PRICING TRANSPARENCY.
new text end

new text begin Subdivision 1. new text end

new text begin Short title. new text end

new text begin This section may be cited as the Hospital Pricing
Transparency Act.
new text end

new text begin Subd. 2. new text end

new text begin Definition. new text end

new text begin For the purposes of this section, "estimate" means any of
the following:
new text end

new text begin (1) the actual price expected to be charged to the individual based on the specific
diagnostic related group code or specific procedure code or codes reflecting any discounts
the individual would receive;
new text end

new text begin (2) the actual price expected to be charged to the individual based on the specific
diagnostic related group code or specific procedure code or codes to be performed without
taking into account any discounts the individual may receive;
new text end

new text begin (3) the average billed rate of all of the specific diagnostic related group code or
procedure code performed in the last six months;
new text end

new text begin (4) the average billed rate of the most recently performed services of the same
diagnostic related group code or procedure code; or
new text end

new text begin (5) any other estimate that will provide a patient with an accurate view of their
potential financial obligations if the services are performed by the hospital.
new text end

new text begin Subd. 3. new text end

new text begin Applicability and scope. new text end

new text begin Any hospital, as defined in section 144.696,
subdivision 3, and outpatient surgical center, as defined in section 144.696, subdivision 4,
shall provide a written estimate of the cost of a specific service or stay upon the request of
a patient, doctor, or the patient??A???a?sA???a?zA?s representative. The request must include:
new text end

new text begin (1) the specific diagnostic related group code;
new text end

new text begin (2) the name of the procedure or procedures to be performed;
new text end

new text begin (3) the type of treatment to be received; or
new text end

new text begin (4) any other information that will allow the hospital or outpatient surgical center to
determine the specific diagnostic related group or procedure code or codes.
new text end

new text begin Subd. 4. new text end

new text begin Estimate. new text end

new text begin (a) An estimate provided by the hospital or outpatient surgical
center must contain:
new text end

new text begin (1) the method used to calculate the estimate;
new text end

new text begin (2) the specific diagnostic related group or procedure code or codes used to calculate
the estimate;
new text end

new text begin (3) the name of any network or program that resulted in a discounted rate; and
new text end

new text begin (4) a statement indicating that the estimate, while accurate, may not reflect the
actual billed charges and that the final bill may be higher or lower depending on the
patient??A???a?sA???a?zA?s specific circumstances.
new text end

new text begin (b) The estimate may be provided in any method that meets the needs of the patient
and the hospital or outpatient surgical center, including electronically; however, a paper
copy must be provided if specifically requested.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 14.

new text begin [62J.83] REDUCED PAYMENT AMOUNTS PERMITTED.
new text end

new text begin (a) Notwithstanding any provision of chapter 148 or any other provision of law to
the contrary, a health care provider may provide care to a patient at a discounted payment
amount, including care provided for free.
new text end

new text begin (b) This section does not apply in a situation in which the discounted payment
amount is not permitted under federal law.
new text end

Sec. 15.

new text begin [62J.85] PROVISION OF INFORMATION ON PHARMACEUTICAL
ASSISTANCE PROGRAMS.
new text end

new text begin A medical clinic must make available to patients, in a public area of the clinic,
brochures on programs offered by pharmaceutical manufacturers that provide free or
discounted drugs or provide coverage for prescription drugs. This requirement applies
only to brochures that are made available to clinics free of charge by pharmaceutical
manufacturers. If a Web site is developed that provides this information, a public posting
describing the Web site complies with this requirement.
new text end

Sec. 16.

new text begin [62M.071] PRIOR AUTHORIZATION.
new text end

new text begin Health plan companies, in cooperation with health care providers, shall review prior
authorization procedures administered by utilization review organizations and health plan
companies, to ensure the cost-effective use of prior authorization and minimization of
provider, clinic, and central office administrative burden.
new text end

Sec. 17.

new text begin [62M.072] USE OF EVIDENCE-BASED STANDARDS.
new text end

new text begin If no independently developed evidence-based standards exist for a particular
treatment, testing, or imaging procedure, then an insurer or utilization review organization
shall not deny coverage of the treatment, testing, or imaging based solely on the grounds
that the treatment, testing, or imaging does not meet an evidence-based standard.
new text end

Sec. 18.

new text begin [62Q.645] DISTRIBUTION OF INFORMATION; ADMINISTRATIVE
EFFICIENCY AND COVERAGE OPTIONS.
new text end

new text begin (a) The commissioner may use reports submitted by health plan companies, service
cooperatives, and the public employee insurance program created in section 43A.316
to compile entity specific administrative efficiency reports; may make these reports
available on state agency Web sites, including minnesotahealthinfo.com; and may include
information on:
new text end

new text begin (1) number of covered lives;
new text end

new text begin (2) covered services;
new text end

new text begin (3) geographic availability;
new text end

new text begin (4) whom to contact to obtain current premium rates;
new text end

new text begin (5) administrative costs, using the definition of administrative costs developed under
section 62J.38;
new text end

new text begin (6) Internet links to information on the health plan, if available; and
new text end

new text begin (7) any other information about the health plan identified by the commissioner
as being useful for employers, consumers, providers, and others in evaluating health
plan options.
new text end

new text begin (b) This section does not apply to a health plan company unless its annual Minnesota
premiums exceed $50,000,000 based on the most recent assessment base of the Minnesota
Comprehensive Health Association. For purposes of this determination, the premiums of a
health plan company include those of its affiliates.
new text end

Sec. 19.

new text begin [62Q.80] SMALL HEALTH PLAN PURCHASING POOL.
new text end

new text begin (a) Health plan companies whose premium volume is less than ten percent of
total premiums in the Minnesota health plan market may create a purchasing pool for
group contracting for health care from health care providers for purposes of this section.
Membership by a health plan company is voluntary. For purposes of the ten percent
calculation, a health plan company's premiums include those of its affiliates.
new text end

new text begin (b) Members of the pool may use the contracted health care for purposes of meeting
their obligations to their enrollees under health plans.
new text end

new text begin (c) The pool or its members may offer and sell health care discount cards to persons
who have no public sector or private sector health coverage. The discount cards must
entitle the purchasers to discounted charges from health care providers that participate
in the program. The discount cards need not provide their purchasers with the same
discounted prices used under paragraph (b). The discount cards, and advertisements
regarding them, must clearly indicate that the discount card program is not insurance
or health maintenance coverage, and that the purchaser must check with a provider to
determine whether the provider accepts the card.
new text end

new text begin (d) The commissioner of commerce shall oversee and supervise this purchasing pool
to ensure that it promotes competition in the market for health plan coverage in this state
by enabling its members to participate in the health plan market in this state on a more
equal footing with their larger competitors.
new text end

Sec. 20.

Minnesota Statutes 2004, section 72A.20, is amended by adding a subdivision
to read:

new text begin Subd. 39. new text end

new text begin Discounted payments by health care providers; effect on use of
usual and customary payments. new text end

new text begin An insurer, including, but not limited to, a health plan
company as defined in section 62Q.01, subdivision 4; a reparation obligor as defined in
section 65B.43, subdivision 9; and a workers' compensation insurer shall not consider in
determining a health care provider's usual and customary payment, standard payment, or
allowable payment used as a basis for determining the provider's payment by the insurer,
the following discounted payment situations:
new text end

new text begin (1) care provided to relatives of the provider;
new text end

new text begin (2) care for which a discount or free care is given in hardship situations; and
new text end

new text begin (3) care for which a discount is given in exchange for cash payment.
new text end

new text begin For purposes of this subdivision, "health care provider" and "provider" have the
meaning given in section 62J.03, subdivision 8.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 21.

Minnesota Statutes 2004, section 123A.21, subdivision 7, is amended to read:

Subd. 7.

Educational programs and services.

new text begin (a) new text end The board of directors of each
SC shall submit annually a plan to the members. The plan shall identify the programs and
services which are suggested for implementation by the SC during the following year and
shall contain components of long-range planning determined by the SC. These programs
and services may include, but are not limited to, the following areas:

(1) administrative services;

(2) curriculum development;

(3) data processing;

(4) distance learning and other telecommunication services;

(5) evaluation and research;

(6) staff development;

(7) media and technology centers;

(8) publication and dissemination of materials;

(9) pupil personnel services;

(10) planning;

(11) secondary, postsecondary, community, adult, and adult vocational education;

(12) teaching and learning services, including services for students with special
talents and special needs;

(13) employee personnel services;

(14) vocational rehabilitation;

(15) health, diagnostic, and child development services and centers;

(16) leadership or direction in early childhood and family education;

(17) community services;

(18) shared time programs;

(19) fiscal services and risk management programs;

(20) technology planning, training, and support services;

(21) health and safety services;

(22) student academic challenges; and

(23) cooperative purchasing services.

new text begin (b) A health coverage program provided by one or more service cooperatives:
new text end

new text begin (1) may provide coverage to nursing homes licensed under chapter 144A and
boarding care homes licensed under sections 144.50 to 144.56 and certified for
participation in the medical assistance program located in this state;
new text end

new text begin (2) must rebid contracts for insurance and third-party administration at least every
four years. The contracts may be regional or statewide in the discretion of the service
cooperative;
new text end

new text begin (3) must comply with section 72.20, subdivision 26, notwithstanding section 13.203,
and must also provide that same information to exclusive representatives of the employees
upon request. A service cooperative shall not terminate coverage, exclude an employer
from future coverage, or otherwise penalize an employer for seeking bids from other
sources of health coverage; and
new text end

new text begin (4) may determine premiums for its health coverage individually for specific
employers or may determine them on a pooled or other basis established by the service
cooperative.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 22.

new text begin [144.0506] AGENCY WEB SITES.
new text end

new text begin Subdivision 1. new text end

new text begin Information to be posted. new text end

new text begin The commissioner of health may post the
following information on agency Web sites, including minnesotahealthinfo.com:
new text end

new text begin (1) healthy lifestyle and preventive health care information, organized by sex and
age, with procedures and treatments categorized by level of effectiveness and reliability of
the supporting evidence on effectiveness;
new text end

new text begin (2) health plan company administrative efficiency report cards;
new text end

new text begin (3) health care provider charges for common procedures, based on information
available under section 62J.052;
new text end

new text begin (4) evidence-based medicine guidelines and related information for use as resources
by health care professionals, and summaries of the guidelines and related information for
use by patients and consumers;
new text end

new text begin (5) resources and Web links related to improving efficiency in medical clinics and
health care professional practices; and
new text end

new text begin (6) lists of nonprofit and charitable entities that accept donations of used medical
equipment and supplies, such as crutches and walkers.
new text end

new text begin Subd. 2. new text end

new text begin Other Internet resources. new text end

new text begin The commissioner of health, in implementing
subdivision 1, shall include relevant Web links and materials from private sector and other
government sources, in order to avoid duplication and reduce state administrative costs.
new text end

new text begin Subd. 3. new text end

new text begin Cooperation with commissioner of commerce. new text end

new text begin The commissioner of
health shall consult and work in cooperation with the commissioner of commerce when
posting on the Web site information collected from health plan companies regulated by
the commissioner of commerce.
new text end

Sec. 23.

Minnesota Statutes 2004, section 144.698, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Reporting on uncompensated care. new text end

new text begin (a) A report on the services provided
to benefit the community, as required under subdivision 1, clause (5), must report charity
care in compliance with the following requirements:
new text end

new text begin (1) For a facility to report amounts as charity care adjustments, the facility must:
new text end

new text begin (i) generate and record a charge;
new text end

new text begin (ii) have a policy on the provision of charity care that contains specific eligibility
criteria and is communicated or made available to patients;
new text end

new text begin (iii) have made a reasonable effort to identify a third-party payer, encourage the
patient to enroll in public programs, and, to the extent possible, aid the patient in the
enrollment process; and
new text end

new text begin (iv) ensure that the patient meets the charity care criteria of this subdivision.
new text end

new text begin (2) In determining whether to classify care as charity care, the facility must consider
the following:
new text end

new text begin (i) charity care may include services that the provider is obligated to render
independently of the ability to collect;
new text end

new text begin (ii) charity care may include care provided to patients who meet the facility's charity
care guidelines and have partial coverage, but who are unable to pay the remainder of their
medical bills, but this does not apply to that portion of the bill that has been determined to
be the patient's responsibility after a partial charity care classification by the facility;
new text end

new text begin (iii) charity care may include care provided to low-income patients who may qualify
for a public health insurance program and meet the facility's eligibility criteria for charity
care, but who do not complete the application process for public insurance despite the
facility's reasonable efforts;
new text end

new text begin (iv) charity care may include care to individuals whose eligibility for charity care
was determined through third-party services for information gathering purposes only;
new text end

new text begin (v) charity care does not include contractual allowances, which is the difference
between gross charges and payments received under contractual arrangements with
insurance companies and payers;
new text end

new text begin (vi) charity care does not include bad debt;
new text end

new text begin (vii) charity care does not include what may be perceived as underpayments for
operating public programs;
new text end

new text begin (viii) charity care does not include unreimbursed costs of basic or clinical research
or professional education and training;
new text end

new text begin (ix) charity care does not include professional courtesy discounts;
new text end

new text begin (x) charity care does not include community service or outreach activities; and
new text end

new text begin (xi) charity care does not include services for patients against whom collection
actions were taken that resulted in a financial obligation documented on a patient's credit
report with credit bureaus.
new text end

new text begin (3) When reporting charity care adjustments, the facility must report total dollar
amounts and the number of contacts between a patient and a health care provider during
which a service is provided for the following categories:
new text end

new text begin (i) care to patients with family incomes at or below 275 percent of the federal
poverty guideline;
new text end

new text begin (ii) care to patients with family incomes above 275 percent of the federal poverty
guideline; and
new text end

new text begin (iii) care to patients when the facility, with reasonable effort, is unable to determine
family incomes.
new text end

new text begin (b) For the report required under subdivision 1, clause (5), the facility must, in
determining whether to classify care as a bad debt expense:
new text end

new text begin (1) presume that a patient is able and willing to pay until and unless the facility has
reason to consider the care as a charity care case under its charity care policy and the
facility classifies the care as a charity care case; and
new text end

new text begin (2) include as a bad debt expense any unpaid deductibles, coinsurance, co-payments,
noncovered services, and other unpaid patient responsibilities.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for facility fiscal years ending on or
after December 31, 2006.
new text end

Sec. 24.

Minnesota Statutes 2004, section 151.214, subdivision 1, is amended to read:

Subdivision 1.

Explanation of pharmacy benefits.

A pharmacist licensed under
this chapter must provide to a patient, for each prescription dispensed where part or all
of the cost of the prescription is being paid or reimbursed by an employer-sponsored
plan or health plan company, or its contracted pharmacy benefit manager, the patient's
co-payment amount and the new text begin pharmacy's own new text end usual and customary price of the prescription
or the amount the pharmacy will be paid for the prescription drug by the patient's
employer-sponsored plan or health plan company, or its contracted pharmacy benefit
manager.

Sec. 25.

Minnesota Statutes 2005 Supplement, section 214.071, is amended to read:

214.071 HEALTH BOARDS; DIRECTORY OF LICENSEES.

new text begin By July 1, 2009, new text end each deleted text begin health deleted text end new text begin health-related licensing new text end board deleted text begin under chapters 147, 148,
148B, and 150A deleted text end new text begin , as defined in section 214.01, subdivision 2 new text end , shall establish a directory of
licensees that includes biographical data for each licensee.

Sec. 26.

new text begin [214.121] PRICE DISCLOSURE REMINDER.
new text end

new text begin Each health-related licensing board shall at least annually inform and remind its
licensees of the price disclosure requirements of section 62J.052 or 151.214, as applicable,
through the board's regular means of communicating with its licensees.
new text end

Sec. 27. new text begin REPORTING OF ACQUIRED INFECTIONS.
new text end

new text begin (a) The commissioner of health may consult with infection control specialists,
health care facility representatives, and consumers, for the purpose of obtaining
recommendations regarding a determination of the need for action to implement health
care associated infection control reporting in hospitals and nursing homes. If the outcome
of the determination warrants, the commissioner shall consult with the group regarding:
new text end

new text begin (1) the selection of reporting measures relating to health care associated infections;
new text end

new text begin (2) design, implementation, validation, and ongoing evaluation of the reporting
system; and
new text end

new text begin (3) ensuring that the reporting measures remain flexible and adaptable to changing
national standards.
new text end

new text begin (b) If the commissioner determines that there is a need for the action described in
paragraph (a), the commissioner shall make written recommendations to the legislature.
new text end

Sec. 28. new text begin COST-CONTAINMENT STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Alternative and complementary health care. new text end

new text begin The commissioner of
human services, through the medical director and in consultation with the health services
policy committee established under Minnesota Statutes, section 256B.0625, subdivision
3c, shall study the potential for improving quality and obtaining cost savings through
greater use of alternative and complementary treatment methods that are supported by the
findings of evidence-based research, and shall incorporate these methods into the medical
assistance, MinnesotaCare, and general assistance medical care programs as appropriate.
new text end

new text begin Subd. 2. new text end

new text begin Study related to access to care. new text end

new text begin The commissioners of human services
and health shall study the adequacy of the current system of community health care clinics
and centers both statewide, and in urban areas with significant disparities in health status
and access to services across racial and ethnic groups. The commissioners shall evaluate:
new text end

new text begin (1) methods to provide 24-hour availability of care through the clinics and centers;
new text end

new text begin (2) methods to expand the availability of care through the clinics and centers;
new text end

new text begin (3) the use of health care access fund grants to expand the number of clinics and
centers, the services provided, and the availability of care; and
new text end

new text begin (4) the extent to which increased use of physician assistants, nurse practitioners,
medical residents and interns, and other allied health professionals in clinics and centers
would increase the availability of services.
new text end

Sec. 29. new text begin MEDICAL MALPRACTICE INSURANCE REPORT.
new text end

new text begin (a) The commissioner of commerce shall provide to the legislature annually a brief
written report on the status of the market for medical malpractice insurance in Minnesota.
The report must summarize, interpret, explain, and analyze information on that subject
available to the commissioner, through annual statements filed by insurance companies,
information obtained under paragraph (c), and other sources.
new text end

new text begin (b) The annual report must consider, to the extent possible, using definitions
developed by the commissioner, Minnesota-specific data on market shares; premiums
received; amounts paid to settle claims that were not litigated, claims that were settled
after litigation began, and claims that were litigated to court judgment; amounts spent
on processing, investigation, litigation, and otherwise handling claims; other sales and
administrative costs; and the loss ratios of the insurers.
new text end

new text begin (c) Each insurance company that provides medical malpractice insurance in this state
shall, no later than June 1 each year, file with the commissioner of commerce, on a form
prescribed by the commissioner and using definitions developed by the commissioner,
the Minnesota-specific data referenced in paragraph (b), other than market share, for the
previous calendar year for that insurance company, shown separately for various categories
of coverages including, if possible, hospitals, medical clinics, nursing homes, physicians
who provide emergency medical care, obstetrician gynecologists, and ambulance services.
An insurance company need not comply with this paragraph if its direct premium that is
written in this state for the previous calendar year is less than $2,000,000.
new text end

Sec. 30. new text begin STUDY; PROVIDER PRICING FAIRNESS.
new text end

new text begin Subdivision 1. new text end

new text begin Proposal to be studied. new text end

new text begin The commissioners of commerce and health
shall jointly study the proposal that state law prohibit health care providers from varying
the amount that they accept as full payment for a health care service based upon the
identity of the payer, upon a contracted arrangement with a payer, upon the identity of the
patient, or upon whether the patient has coverage through a group purchaser, as defined
in Minnesota Statutes, section 62J.03, subdivision 6. The commissioners shall submit a
report to the legislature that includes the results of the study by July 1, 2007. The proposal
does not apply if the payer is a government entity, and the proposal does not prevent care
for a reduced price based upon financial hardship if otherwise permitted by law.
new text end

new text begin Subd. 2. new text end

new text begin Focus of study. new text end

new text begin The study described in subdivision 1 must focus primarily
upon how best to implement the proposal, taking into account its effects upon the health
care and health coverage markets, including any necessary related changes.
new text end

Sec. 31. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2004, section 62J.17, new text end new text begin and new text end new text begin Minnesota Statutes 2005 Supplement,
section 62Q.251, new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

ARTICLE 6

HUMAN SERVICES FORECAST ADJUSTMENTS

Section 1. new text begin DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT new text end

new text begin The dollar amounts shown are added to or, if shown in parentheses, are subtracted
from the appropriations in Laws 2005, First Special Session chapter 4, article 9, and
are appropriated from the general fund, or any other fund named, to the Department of
Human Services for the purposes specified in this article, to be available for the fiscal year
indicated for each purpose. The figures "2006" and "2007" used in this article means
that the appropriation or appropriations listed are available for the respective fiscal year
ending June 30, 2006 or June 30, 2007.
new text end

new text begin SUMMARY BY FUND new text end
				new text begin 2006 new text end		new text begin 2007 new text end
new text begin General Fund new text end			new text begin $ new text end	new text begin (58,333,000) new text end	new text begin $ new text end	new text begin (17,589,000) new text end
new text begin Health Care Access new text end				new text begin (44,511,000) new text end		new text begin (62,360,000) new text end
new text begin TANF new text end				new text begin (13,807,000) new text end		new text begin (3,866,000) new text end
new text begin TOTAL new text end			new text begin $ new text end	new text begin (116,651,000) new text end	new text begin $ new text end	new text begin (83,815,000) new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin (116,651,000) new text end

new text begin $ new text end

new text begin (83,815,000) new text end

new text begin Summary by Fund new text end
new text begin General new text end	new text begin (58,333,000) new text end	new text begin (17,589,000) new text end
new text begin Health Care Access new text end	new text begin (44,511,000) new text end	new text begin (62,360,000) new text end
new text begin TANF new text end	new text begin (13,807,000) new text end	new text begin (3,866,000) new text end

new text begin Subd. 2. new text end new text begin Revenue and Pass-Through new text end

new text begin TANF new text end

new text begin (1,446,000) new text end

new text begin (1,177,000) new text end

new text begin Subd. 3. new text end new text begin Children and Economic Assistance Grants new text end

new text begin General new text end				new text begin (4,469,000) new text end		new text begin 1,785,000 new text end
new text begin TANF new text end				new text begin (12,361,000) new text end		new text begin (2,689,000) new text end

new text begin The amount that may be spent from this
appropriation for each purpose is as follows:
new text end

new text begin (a) Minnesota Family Investment Program new text end

new text begin General new text end				new text begin 6,048,000 new text end		new text begin (393,000) new text end
new text begin TANF new text end				new text begin (12,361,000) new text end		new text begin (2,689,000) new text end

new text begin (b) MFIP Child Care Assistance Grants new text end
new text begin General Fund new text end				new text begin (5,090,000) new text end		new text begin 2,751,000 new text end

new text begin (c) General Assistance new text end

new text begin 2,540,000 new text end

new text begin 3,947,000 new text end

new text begin (d) Minnesota Supplemental Aid new text end				new text begin (285,000) new text end		new text begin 551,000 new text end
new text begin (e) Group Residential Housing new text end				new text begin (7,682,000) new text end		new text begin (5,071,000) new text end

new text begin Subd. 4. new text end new text begin Basic Health Care Grants new text end

new text begin General new text end				new text begin (19,022,000) new text end		new text begin 10,499,000 new text end
new text begin Health Care Access new text end				new text begin (44,511,000) new text end		new text begin (62,360,000) new text end

new text begin The amount that may be spent from this
appropriation for each purpose is as follows:
new text end

new text begin (a) MinnesotaCare new text end

new text begin Health Care Access new text end

new text begin (44,511,000) new text end

new text begin (62,360,000) new text end

new text begin (b) MA Basic Health Care - Families and Children new text end

new text begin General new text end

new text begin (29,882,000) new text end

new text begin (54,401,000) new text end

new text begin (c) MA Basic Health Care - Elderly and Disabled new text end

new text begin General new text end

new text begin (2,857,000) new text end

new text begin 33,179,000 new text end

new text begin (d) General Assistance Medical Care new text end

new text begin General new text end

new text begin 13,717,000 new text end

new text begin 31,721,000 new text end

new text begin Subd. 5. new text end new text begin Continuing Care Grants new text end

new text begin General new text end

new text begin (34,842,000) new text end

new text begin (29,873,000) new text end

new text begin The amount that may be spent from this
appropriation for each purpose is as follows:
new text end

new text begin (a) MA Long-Term Care Waivers new text end

new text begin General new text end

new text begin (23,368,000) new text end

new text begin (35,953,000) new text end

new text begin (b) MA Long-Term Care Facilities new text end

new text begin General new text end

new text begin (16,251,000) new text end

new text begin (5,202,000) new text end

new text begin (c) Chemical Dependency Entitlement Grants new text end

new text begin General new text end

new text begin 4,777,000 new text end

new text begin 11,282,000 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

ARTICLE 7

APPROPRIATIONS

Section 1. new text begin SUPPLEMENTAL APPROPRIATIONS. new text end

new text begin The appropriations in this article are added to or, if shown in parentheses, subtracted
from the appropriations enacted into law by the legislature in 2005, or other specified law,
to the named agencies and for the specified programs or activities. The sums shown are
appropriated from the general fund, or another named fund, to be available for the fiscal
years indicated: 2006 is the fiscal year ending June 30, 2006; 2007 is the fiscal year
ending June 30, 2007; and the biennium is fiscal years 2006 and 2007. Supplementary
appropriations and reductions to appropriations for the fiscal year ending June 30, 2006,
are effective the day following final enactment.
new text end

new text begin SUMMARY BY FUND new text end
		new text begin 2006 new text end		new text begin 2007 new text end		new text begin BIENNIAL TOTAL new text end
new text begin General new text end	new text begin $ new text end	new text begin 35,250,000 new text end	new text begin $ new text end	new text begin 53,402,000 new text end	new text begin $ new text end	new text begin 88,652,000 new text end
new text begin State Government Special Revenue Fund new text end		new text begin 514,000 new text end		new text begin 679,000 new text end		new text begin 1,193,000 new text end
new text begin Health Care Access Fund new text end		new text begin -0- new text end		new text begin 1,689,000 new text end		new text begin 1,689,000 new text end
new text begin TOTAL new text end	new text begin $ new text end	new text begin 35,764,000 new text end	new text begin $ new text end	new text begin 55,770,000 new text end	new text begin $ new text end	new text begin 91,534,000 new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2006 new text end		new text begin 2007 new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin 35,250,000 new text end

new text begin $ new text end

new text begin 53,256,000 new text end

new text begin Summary by Fund new text end
new text begin General new text end	new text begin 35,250,000 new text end	new text begin 51,527,000 new text end
new text begin Health Care Access new text end	new text begin -0- new text end	new text begin 1,729,000 new text end

new text begin Subd. 2. new text end new text begin Children and Economic Assistance Management new text end

new text begin Summary by Fund new text end
new text begin General new text end	new text begin -0- new text end	new text begin 8,000 new text end
new text begin (a) Children and Economic Assistance Operations new text end	new text begin -0- new text end	new text begin 8,000 new text end

new text begin CHILDREN AND ECONOMIC
ASSISTANCE OPERATIONS BASE
ADJUSTMENT. The general fund base for
children and economic assistance operations
shall be decreased by $8,000 in fiscal year
2008 and $8,000 in fiscal year 2009.
new text end

new text begin Subd. 3. new text end new text begin Health Care Grants new text end

new text begin Summary by Fund new text end
new text begin General new text end	new text begin -0- new text end	new text begin (2,950,000) new text end
new text begin Health Care Access new text end	new text begin -0- new text end	new text begin -0- new text end

new text begin (a) MinnesotaCare Grants Health Care Access new text end

new text begin -0- new text end

new text begin -0- new text end

new text begin (b) Medical Assistance Basic Health Care - Families and Children new text end
new text begin General new text end	new text begin -0- new text end	new text begin (2,625,000) new text end

new text begin (c) Medical Assistance Basic Health Care - Elderly and Disabled new text end
new text begin General new text end	new text begin -0- new text end	new text begin (325,000) new text end

new text begin (d) General Assistance Medical Care new text end
new text begin General new text end	new text begin -0- new text end	new text begin -0- new text end

new text begin Subd. 4. new text end new text begin Health Care Management new text end

new text begin Summary by Fund new text end
new text begin General new text end	new text begin -0- new text end	new text begin 2,120,000 new text end
new text begin Health Care Access new text end	new text begin -0- new text end	new text begin 1,729,000 new text end

new text begin (a) Health Care Administration new text end
new text begin General new text end	new text begin -0- new text end	new text begin 2,015,000 new text end

new text begin new text begin HEALTH CARE ADMINISTRATION
BASE ADJUSTMENT. new text end The general fund
base for health care administration shall be
decreased by $312,000 in fiscal year 2008
and decreased by $859,000 in fiscal year
2009.
new text end

new text begin INCREASED STAFF FOR ENROLLING
PERSONS WITH DISABILITIES
IN MANAGED CARE. $124,000 is
appropriated from the general fund to
the commissioner of human services in
fiscal year 2007 to increase staff for the
development and management of contract
requirements associated with enrolling
persons with disabilities in managed care.
new text end

new text begin (b) Health Care Operations new text end
new text begin General new text end	new text begin -0- new text end	new text begin 105,000 new text end
new text begin Health Care Access new text end	new text begin -0- new text end	new text begin 1,729,000 new text end

new text begin HEALTH CARE OPERATIONS BASE
ADJUSTMENT. The general fund base for
health care operations shall be decreased by
$81,000 in fiscal year 2008 and increased by
$7,000 in fiscal year 2009.
new text end

new text begin HEALTH CARE OPERATIONS BASE
ADJUSTMENT. The health care access
fund base for health care operations shall be
decreased by $1,094,000 in fiscal year 2008
and $1,094,000 in fiscal year 2009.
new text end

new text begin Subd. 5. new text end new text begin Continuing Care Grants new text end

new text begin Summary by Fund new text end
new text begin General new text end	new text begin 250,000 new text end	new text begin (573,000) new text end

new text begin (a) Medical Assistance Long-term Care Facilities new text end
new text begin General new text end	new text begin -0- new text end	new text begin (1,409,000) new text end

new text begin (b) Medical Assistance Long-term Care Waivers new text end
new text begin General new text end	new text begin -0- new text end	new text begin (414,000) new text end

new text begin ADDITIONAL WAIVER
ALLOCATIONS. Notwithstanding
the waiver growth limits in Laws 2005,
First Special Session chapter 4, article 9,
section 2, paragraph (d), the commissioner
may allocate an additional waiver allocation
under Minnesota Statutes, section 256B.49,
for a recipient of personal care assistant
services who is eligible for and chooses
waivered services and received personal care
assistant services from a provider who was
billing for a service delivery model for that
recipient other than individual or shared care
on March 1, 2006.
new text end

new text begin (c) Adult and Aging Services Grants new text end
new text begin General new text end	new text begin 250,000 new text end	new text begin 1,250,000 new text end

new text begin AGING AND ADULT SERVICES
GRANTS FOR MEDICARE PART D.
$250,000 in fiscal year 2006 and $1,250,000
in fiscal year 2007 is appropriated from
the general fund to the commissioner of
human services for grants awarded through
the Minnesota Board on Aging to area
Agencies on Aging to provide information
and enrollment assistance for the Medicare
Part D program.
new text end

new text begin MEDICARE PART D INFORMATION
AND ASSISTANCE REIMBURSEMENT.
Federal administrative reimbursement
obtained from information and assistance
services provided by the Senior Linkage or
Disability Linkage lines to people who are
identified as eligible for medical assistance
shall be appropriated to the commissioner
for this activity.
new text end

new text begin AGING AND ADULT SERVICES
GRANTS BASE ADJUSTMENT. The
general fund base for aging and adult services
grants is decreased by $250,000 in fiscal
year 2008 and $250,000 in fiscal year 2009
for information and assistance grants to
area agencies on aging for assisting with
Medicare Part D.
new text end

new text begin Subd. 6. new text end new text begin Continuing Care Management new text end

new text begin General new text end

new text begin -0- new text end

new text begin 113,000 new text end

new text begin CONTINUING CARE MANAGEMENT
BASE ADJUSTMENT. The general fund
base for continuing care management shall
be decreased by $30,000 in fiscal year 2009.
new text end

new text begin Subd. 7. new text end new text begin State-Operated Services new text end

new text begin General new text end

new text begin 35,508,000 new text end

new text begin 53,909,000 new text end

new text begin MINNESOTA SECURITY HOSPITAL.
For the purposes of enhancing the safety
of the public, improving supervision, and
enhancing community-based mental health
treatment, state-operated services may
establish additional community capacity
for providing treatment and supervision
of clients who have been ordered into a
less restrictive alternative of care from the
state-operated services transition services
program consistent with Minnesota Statutes,
section 246.014.
new text end

new text begin STATE-OPERATED SERVICES BASE
ADJUSTMENT. The general fund base
for state-operated services is increased by
$11,403,000 in fiscal year 2008 and increased
by $1,779,000 in fiscal year 2009.
new text end

Sec. 3. new text begin COMMISSIONER OF HEALTH new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin -0- new text end

new text begin 1,133,000 new text end

new text begin Summary by Fund new text end
new text begin General new text end	new text begin -0- new text end	new text begin 1,116,000 new text end
new text begin State Government Special Revenue new text end	new text begin -0- new text end	new text begin 57,000 new text end
new text begin Health Care Access new text end	new text begin -0- new text end	new text begin (40,000) new text end

new text begin Subd. 2. new text end new text begin Policy Quality and Compliance new text end

new text begin Summary by Fund new text end
new text begin General new text end	new text begin -0- new text end	new text begin 116,000 new text end
new text begin State Government Special Revenue new text end	new text begin -0- new text end	new text begin 140,000 new text end
new text begin Health Care Access new text end	new text begin -0- new text end	new text begin (40,000) new text end

new text begin POLICY QUALITY AND
COMPLIANCE BASE ADJUSTMENT.
The general fund base for Policy Quality
and Compliance is decreased by $20,000
in fiscal year 2009.
new text end

new text begin ASSISTED LIVING. (a) $140,000 is
appropriated from the state government
special revenue fund to the commissioner
of health for the biennium ending June 30,
2007, for costs related to bringing actions for
injunctive relief under Minnesota Statutes,
section 144G.02, subdivision 2, paragraph
(b).
new text end

new text begin (b) The state government special revenue
base is increased by $140,000 in fiscal year
2008 and $140,000 in fiscal year 2009.
new text end

new text begin Subd. 3. new text end new text begin Health Protection new text end

new text begin Summary by Fund new text end
new text begin General new text end	new text begin -0- new text end	new text begin 1,000,000 new text end
new text begin State Government Special Revenue new text end	new text begin -0- new text end	new text begin (83,000) new text end

new text begin PANDEMIC INFLUENZA
PREPAREDNESS. $1,000,000
from the general fund is for preparation,
planning, and response to an outbreak of
influenza. The base for this is $1,000,000 in
fiscal years 2008 and 2009 and $0 in 2010
and thereafter.
new text end

Sec. 4. new text begin VETERANS NURSING HOMES BOARD new text end

new text begin General new text end

new text begin -0- new text end

new text begin 759,000 new text end

new text begin This appropriation is added to appropriations
in Laws 2005, First Special Session chapter
4, article 9, section 4.
new text end

new text begin BASE ADJUSTMENT. The general fund
base is increased by $3,945,000 in fiscal year
2008 and $3,945,000 in fiscal year 2009 for
the Veterans Homes Board.
new text end

Sec. 5. new text begin HEALTH-RELATED BOARDS new text end

new text begin State Government Special Revenue new text end

new text begin 514,000 new text end

new text begin 572,000 new text end

new text begin Subdivision 1. new text end new text begin Board of Chiropractic Examiners new text end

new text begin 5,000 new text end

new text begin 5,000 new text end

new text begin BOARD OF CHIROPRACTIC
EXAMINERS APPROPRIATION
INCREASE. (a) This appropriation is
added to appropriations in Laws 2005,
First Special Session chapter 4, article 9,
section 5, subdivision 3. This is a onetime
appropriation.
new text end

new text begin (b) This increase is to correct programming
difficulties incurred during implementation
of payment processing changes.
new text end

new text begin Subd. 2. new text end new text begin Board of Dentistry new text end

new text begin -0- new text end

new text begin 67,000 new text end

new text begin BOARD OF DENTISTRY
APPROPRIATION INCREASE.
(a) This appropriation is added to
appropriations in Laws 2005, First Special
Session chapter 4, article 9, section 5,
subdivision 4.
new text end

new text begin (b) This increase is to retain a legal analyst
as part of the board staff.
new text end

new text begin Subd. 3. new text end new text begin Board of Medical Practice new text end

new text begin 500,000 new text end

new text begin 500,000 new text end

new text begin BOARD OF MEDICAL PRACTICE
INCREASE. (a) This appropriation is
added to appropriations in Laws 2005,
First Special Session chapter 4, article 9,
section 5, subdivision 7. This is a onetime
appropriation.
new text end

new text begin (b) This increase is to cover higher than
expected costs of investigation and legal
action.
new text end

new text begin Subd. 4. new text end new text begin Board of Physical Therapy new text end

new text begin 9,000 new text end

new text begin -0- new text end

new text begin BOARD OF PHYSICAL THERAPY
APPROPRIATION INCREASE. (a) This
appropriation is added to appropriations in
Laws 2005, First Special Session chapter 4,
article 9, section 5, subdivision 12. This is a
onetime appropriation.
new text end

new text begin (b) This increase is to correct programming
difficulties incurred during implementation
of payment processing changes.
new text end

Sec. 6. new text begin EMERGENCY MEDICAL SERVICES BOARD new text end

new text begin State Government Special Revenue new text end

new text begin -0- new text end

new text begin 50,000 new text end

new text begin EMERGENCY MEDICAL SERVICES
BOARD APPROPRIATION INCREASE.
(a) This appropriation is added to
appropriations in Laws 2005, First Special
Session chapter 4, article 9, section 5,
subdivision 12.
new text end

new text begin (b) This increase is to be spent by the health
professional service program from the state
government special revenue fund.
new text end

Sec. 7. new text begin TRANSFER.
new text end

new text begin On June 30, 2006, the commissioner of finance shall transfer the balances in the
tobacco use prevention and local public health endowment fund and the medical education
endowment fund to the general fund. These balances result from investment income
credited to the funds after the transfer of balances on July 1, 2003. The amount transferred
under this section is estimated to be $2,933,000.
new text end

Sec. 8. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes shall correct internal cross-references to sections that are
affected by section 9, the repealer section of this article. The revisor may make changes
necessary to correct the punctuation, grammar, or structure of the remaining text and
preserve its meaning.
new text end

Sec. 9. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2004, sections 62J.694; and 144.395, new text end new text begin are repealed.
new text end