HF 3837

as introduced - 86th Legislature (2009 - 2010) Posted on 05/10/2010 09:02am

A bill for an act
relating to human services; modifying coverage and payment rates for
rehabilitative services and medical supplies and equipment; amending Minnesota
Statutes 2008, sections 256B.04, subdivision 14; 256B.0625, subdivisions 8, 8a,
8b, 31, by adding a subdivision; Minnesota Statutes 2009 Supplement, section
256B.0653, subdivision 5.

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

Section 1.

Minnesota Statutes 2008, section 256B.04, subdivision 14, is amended to
read:

Subd. 14.

Competitive bidding.

(a) When determined to be effective, economical,
and feasible, the commissioner may utilize volume purchase through competitive bidding
and negotiation under the provisions of chapter 16C, to provide items under the medical
assistance program including but not limited to the following:

(1) eyeglasses;

(2) oxygen. The commissioner shall provide for oxygen needed in an emergency
situation on a short-term basis, until the vendor can obtain the necessary supply from
the contract dealer;

(3) hearing aids and supplies; deleted text begin and
deleted text end

(4) durable medical equipment, including but not limited to:

(i) hospital beds;

(ii) commodes;

(iii) glide-about chairs;

(iv) patient lift apparatus;

(v) wheelchairs and accessories;

(vi) oxygen administration equipment;

(vii) respiratory therapy equipment;

(viii) electronic diagnostic, therapeutic and life-support systems;

(5) nonemergency medical transportation level of need determinations, disbursement
of public transportation passes and tokens, and volunteer and recipient mileage and
parking reimbursements; deleted text begin and
deleted text end

(6) drugs new text begin ; and
new text end

new text begin (7) medical supplies new text end .

(b) Rate changes under this chapter and chapters 256D and 256L do not affect
contract payments under this subdivision unless specifically identified.

(c) The commissioner may not utilize volume purchase through competitive bidding
and negotiation for special transportation services under the provisions of chapter 16C.

Sec. 2.

Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to read:

Subd. 8.

Physical therapy.

Medical assistance covers physical therapy and related
services deleted text begin , including specialized maintenance therapy deleted text end . new text begin Authorization by the commissioner
is required to provide services to a recipient beyond any of the following onetime service
thresholds: (1) 80 units of any approved CPT code other than modalities; (2) 20 modality
sessions; and (3) three evaluations or re-evaluations. new text end Services provided by a physical
therapy assistant shall be reimbursed at the same rate as services performed by a physical
therapist when the services of the physical therapy assistant are provided under the
direction of a physical therapist who is on the premises. Services provided by a physical
therapy assistant that are provided under the direction of a physical therapist who is not on
the premises shall be reimbursed at 65 percent of the physical therapist rate.

Sec. 3.

Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to
read:

Subd. 8a.

Occupational therapy.

Medical assistance covers occupational therapy
and related services deleted text begin , including specialized maintenance therapy deleted text end . new text begin Authorization by the
commissioner is required to provide services to a recipient beyond any of the following
onetime service thresholds: (1) 120 units of any combination of approved CPT codes;
and (2) two evaluations or re-evaluations. new text end Services provided by an occupational therapy
assistant shall be reimbursed at the same rate as services performed by an occupational
therapist when the services of the occupational therapy assistant are provided under the
direction of the occupational therapist who is on the premises. Services provided by an
occupational therapy assistant that are provided under the direction of an occupational
therapist who is not on the premises shall be reimbursed at 65 percent of the occupational
therapist rate.

Sec. 4.

Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to
read:

Subd. 8b.

Speech language pathology and audiology services.

Medical assistance
covers speech language pathology and related services deleted text begin , including specialized maintenance
therapy deleted text end . new text begin Authorization by the commissioner is required to provide services to a recipient
beyond any of the following onetime service thresholds: (1) 50 treatment sessions with
any combination of approved CPT codes; and (2) one evaluation. new text end Medical assistance
covers audiology services and related services. Services provided by a person who has
been issued a temporary registration under section 148.5161 shall be reimbursed at the
same rate as services performed by a speech language pathologist or audiologist as long as
the requirements of section 148.5161, subdivision 3, are met.

Sec. 5.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 8d. new text end

new text begin Chiropractic services. new text end

new text begin Payment for chiropractic services is limited to
one annual evaluation and 12 visits per year unless prior authorization of a greater number
of visits is obtained.
new text end

Sec. 6.

Minnesota Statutes 2008, section 256B.0625, subdivision 31, is amended to
read:

Subd. 31.

Medical supplies and equipment.

Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall
be made for wheelchairs and wheelchair accessories for recipients who are residents
of intermediate care facilities for the developmentally disabled. Reimbursement for
wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
conditions and limitations as coverage for recipients who do not reside in institutions. A
wheelchair purchased outside of the facility's payment rate is the property of the recipient. new text begin
The commissioner may set reimbursement rates for specified categories of medical
supplies at levels below the Medicare payment rate.
new text end

Sec. 7.

Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 5,
is amended to read:

Subd. 5.

Home care therapies.

(a) Home care therapies include the following:
physical therapy, occupational therapy, respiratory therapy, and speech and language
pathology therapy services.

(b) Home care therapies must be:

(1) provided in the recipient's residence after it has been determined the recipient is
unable to access outpatient therapy;

(2) prescribed, ordered, or referred by a physician and documented in a plan of care
and reviewed, according to Minnesota Rules, part 9505.0390;

(3) assessed by an appropriate therapist; and

(4) provided by a Medicare-certified home health agency enrolled as a Medicaid
provider agency.

(c) Restorative deleted text begin and specialized maintenance deleted text end therapies must be provided according to
Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be
used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.

(d) For both physical and occupational therapies, the therapist and the therapist's
assistant may not both bill for services provided to a recipient on the same day.