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Capital IconMinnesota Legislature

HF 4571

1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 04/26/2024 12:30pm

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - 1st Engrossment

Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 2.42 2.43 2.44 2.45 2.46 2.47 2.48 2.49 3.1
3.2 3.3
3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22
3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25
7.26
7.27 7.28 7.29 7.30 7.31 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12
8.13 8.14 8.15
8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15
12.16 12.17 12.18
12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 15.1 15.2 15.3 15.4 15.5 15.6
15.7 15.8 15.9
15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22
15.23 15.24
15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 16.34 16.35 16.36 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 17.34 17.35 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 18.33 18.34 18.35
19.1
19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29
19.30 19.31 19.32 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 21.1 21.2 21.3 21.4 21.5 21.6
21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15
21.16 21.17
21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28
21.29
22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16
22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 22.33 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19
23.20
23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19
24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31
25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29
25.30
26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 28.1 28.2 28.3 28.4 28.5 28.6 28.7
28.8
28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26
28.27 28.28 28.29 28.30 28.31 28.32 29.1 29.2 29.3 29.4 29.5 29.6 29.7
29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 29.33 29.34 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 30.32 30.33 30.34 30.35 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 31.33 31.34 31.35 31.36 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 32.33 32.34 32.35 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22
33.23 33.24
33.25 33.26 33.27 33.28 33.29 33.30 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27
35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14
35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24
35.25 35.26 35.27 35.28 35.29 35.30 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23
36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12
37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30
38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18
39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11
40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 41.1 41.2 41.3 41.4 41.5
41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9
43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 43.33 43.34 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14
44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 44.32 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14
45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25
45.26 45.27 45.28 45.29 45.30 45.31 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14
46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 47.1 47.2 47.3
47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 47.32 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25
48.26
48.27 48.28 48.29 48.30 48.31 48.32 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 50.1 50.2
50.3
50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20
51.21
51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31
52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9
52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21
52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 53.33 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24
54.25 54.26 54.27 54.28
54.29 54.30 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26
55.27 55.28 55.29 55.30 55.31 55.32
56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10
56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31
57.1 57.2 57.3
57.4
57.5 57.6
57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21
57.22 57.23
57.24 57.25 57.26 57.27 57.28 57.29 57.30 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 59.33 60.1 60.2 60.3
60.4 60.5
60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14
60.15 60.16
60.17 60.18 60.19
60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27
60.28 60.29 60.30 61.1 61.2 61.3 61.4 61.5 61.6
61.7 61.8
61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18
61.19 61.20 61.21 61.22
61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13
62.14 62.15 62.16 62.17 62.18 62.19 62.20
62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 62.32 63.1 63.2 63.3 63.4 63.5 63.6 63.7
63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19
63.20 63.21
63.22 63.23 63.24 63.25 63.26 63.27
63.28 63.29
64.1 64.2 64.3 64.4
64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31
65.1 65.2 65.3
65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15
65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23
65.24
65.25 65.26 65.27 65.28 65.29 65.30 66.1 66.2
66.3 66.4 66.5 66.6 66.7
66.8 66.9 66.10 66.11 66.12 66.13 66.14
66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 67.1 67.2 67.3
67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29
67.30 67.31 67.32 67.33 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11
68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24
69.25
69.26 69.27 69.28 69.29 69.30 69.31 69.32 69.33 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24
70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 70.33 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12
71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22
71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30 71.31 71.32 71.33 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11
72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 72.33 73.1 73.2
73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 73.33 73.34
74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28
75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9
75.10 75.11
75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21
75.22 75.23
75.24 75.25 75.26 75.27 75.28 75.29 75.30 76.1 76.2 76.3 76.4
76.5 76.6
76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19
76.20 76.21 76.22 76.23 76.24 76.25 76.26
76.27 76.28 76.29 76.30 76.31 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23
78.24 78.25
78.26 78.27 78.28 78.29 78.30
79.1 79.2
79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28
79.29 79.30
80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16
80.17 80.18
80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12
81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32 84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19
84.20 84.21
84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 84.32 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25
85.26 85.27
85.28 85.29 85.30 85.31 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31 86.32 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 87.33 88.1 88.2 88.3 88.4 88.5 88.6
88.7 88.8
88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23
88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 89.1 89.2 89.3 89.4 89.5 89.6 89.7
89.8
89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24
89.25 89.26 89.27
89.28 89.29 89.30 89.31 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 90.32 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30
93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 93.32 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 95.1 95.2 95.3 95.4 95.5
95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25
95.26 95.27 95.28 95.29 95.30 95.31 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16
97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 97.32 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 99.1 99.2 99.3 99.4 99.5 99.6 99.7
99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21
100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29
100.30 100.31 100.32 100.33 101.1 101.2 101.3 101.4 101.5 101.6
101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15
101.16 101.17 101.18 101.19 101.20 101.21 101.22
101.23 101.24 101.25
101.26 101.27 101.28 101.29 101.30 101.31
102.1 102.2 102.3
102.4 102.5 102.6 102.7 102.8 102.9 102.10
102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22
102.23
102.24 102.25 102.26 102.27
102.28 102.29 102.30
103.1 103.2 103.3 103.4 103.5 103.6
103.7
103.8 103.9 103.10 103.11 103.12 103.13 103.14
103.15
103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 105.1 105.2 105.3 105.4
105.5 105.6 105.7
105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30
106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19
106.20 106.21 106.22 106.23
106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8
107.9 107.10 107.11 107.12
107.13 107.14
107.15 107.16
107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29
108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 109.1 109.2 109.3 109.4 109.5 109.6
109.7
109.8 109.9 109.10 109.11 109.12 109.13
109.14
109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30
110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 111.1 111.2 111.3 111.4 111.5 111.6
111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17
111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 111.33 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14
112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30
113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23
113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 115.1 115.2 115.3 115.4 115.5
115.6 115.7 115.8 115.9
115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21
115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 116.1 116.2 116.3 116.4 116.5
116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13
116.14 116.15 116.16
116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25
116.26 116.27 116.28 116.29 116.30
117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 118.1 118.2 118.3 118.4 118.5 118.6 118.7
118.8 118.9 118.10 118.11 118.12
118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23
118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 119.33 120.1 120.2 120.3
120.4 120.5 120.6 120.7 120.8 120.9 120.10
120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 121.1 121.2 121.3 121.4 121.5 121.6 121.7
121.8
121.9 121.10 121.11 121.12 121.13
121.14 121.15 121.16 121.17
121.18 121.19 121.20 121.21 121.22
121.23 121.24 121.25 121.26 121.27
122.1 122.2 122.3 122.4 122.5
122.6 122.7 122.8 122.9 122.10
122.11 122.12 122.13 122.14 122.15
122.16 122.17 122.18 122.19 122.20
122.21 122.22 122.23 122.24 122.25
122.26 122.27 122.28 122.29 123.1 123.2
123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10
123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13
124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 125.34 126.1 126.2 126.3 126.4 126.5 126.6
126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 126.33 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23
127.24 127.25 127.26 127.27 127.28
127.29 127.30 127.31 127.32 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14
128.15 128.16 128.17 128.18 128.19 128.20
128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 128.32 128.33 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10
129.11 129.12 129.13 129.14 129.15 129.16 129.17
129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 132.32 132.33 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 133.33 133.34 133.35 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15
134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30
134.31 134.32 134.33 135.1 135.2 135.3
135.4 135.5 135.6 135.7 135.8 135.9 135.10
135.11 135.12 135.13 135.14 135.15 135.16
135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29
136.1 136.2 136.3 136.4 136.5
136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19
136.20 136.21 136.22 136.23 136.24 136.25
136.26 136.27 136.28 136.29 136.30 136.31
137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 139.33 139.34 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 140.33 140.34 140.35 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.18 141.17 141.20 141.19 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 141.32 141.33 141.34 141.35 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 143.33 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22
144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11
145.12 145.13
145.14 145.15
145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27
147.28 147.29 147.30 147.31 147.32 147.33 148.1 148.2 148.3 148.4 148.5 148.6 148.7
148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26
148.27
148.28 148.29 148.30 148.31 148.32
149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28
149.29 149.30 149.31 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28
150.29 150.30 150.31 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16
151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 151.32 151.33 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 153.1 153.2 153.3 153.4 153.5 153.6 153.7
153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25
153.26 153.27 153.28 153.29 153.30 153.31 153.32 153.33 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9
154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18
156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8
158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14
159.15 159.16 159.17 159.18 159.19 159.20 159.21
159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22
160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 161.1 161.2
161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23
161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29
162.30 162.31 162.32 163.1 163.2 163.3 163.4
163.5
163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13
163.14 163.15
163.16 163.17 163.18 163.19
163.20 163.21
163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 164.1 164.2 164.3
164.4 164.5
164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23
164.24 164.25
164.26 164.27 164.28 164.29 165.1 165.2 165.3 165.4 165.5
165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17
165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32 167.33 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 169.33 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 170.34 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30
172.1 172.2 172.3 172.4 172.5
172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 172.33 172.34 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 173.33
174.1
174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17
174.18
174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27
174.28
175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 175.32 175.33 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32 177.1 177.2 177.3
177.4 177.5 177.6 177.7 177.8
177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25
179.26 179.27 179.28 179.29 179.30 179.31
180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16
180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10
181.11 181.12 181.13 181.14 181.15 181.16 181.17
181.18 181.19 181.20 181.21 181.22 181.23 181.24
181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 182.1 182.2 182.3 182.4
182.5 182.6 182.7 182.8 182.9 182.10
182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 183.1 183.2 183.3 183.4 183.5 183.6
183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28
184.1 184.2 184.3
184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25
184.26 184.27 184.28 184.29 185.1 185.2 185.3
185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12
185.13 185.14 185.15
185.16 185.17
185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27
187.1
187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32
188.1
188.2 188.3 188.4 188.5 188.6 188.7
188.8
188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26
188.27 188.28 188.29 188.30
188.31
189.1 189.2 189.3
189.4
189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14
190.15
190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23
190.24
190.25 190.26 190.27 190.28 190.29 190.30 190.31 190.32 191.1 191.2
191.3
191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12
191.13
191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 192.32 193.1 193.2
193.3
193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 194.1 194.2 194.3
194.4
194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 195.1 195.2 195.3 195.4
195.5
195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8
196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32
197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25
198.26 198.27 198.28 198.29 198.30 198.31 198.32 198.33 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11
199.12
199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10
200.11
200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28
201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17
202.18
202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 204.1 204.2 204.3
204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32 204.33 205.1 205.2 205.3
205.4 205.5 205.6 205.7 205.8 205.9 205.10
205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28
206.29
206.30 206.31 206.32 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27
207.28
207.29 207.30 207.31 207.32 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16
208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24
209.25 209.26 209.27 209.28 209.29 209.30 209.31 210.1 210.2
210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20
210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21
211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 212.1 212.2 212.3 212.4 212.5 212.6
212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 212.31 212.32 212.33 213.1 213.2 213.3 213.4 213.5
213.6
213.7 213.8 213.9 213.10 213.11 213.12 213.13
213.14
213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 213.31 214.1 214.2
214.3
214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 214.32 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 215.32 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 216.31 216.32 216.33 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32 218.33 218.34 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15
219.16
219.17 219.18 219.19 219.20 219.21 219.22 219.23
219.24
219.25 219.26 219.27 219.28 219.29 219.30 219.31 220.1 220.2
220.3
220.4 220.5 220.6 220.7 220.8 220.9
220.10
220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20
220.21
220.22 220.23 220.24 220.25 220.26 220.27 220.28
220.29
221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9
221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21
221.22 221.23 221.24 221.25 221.26 221.27 221.28 222.1 222.2 222.3
222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22
222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13
223.14 223.15 223.16 223.17
223.18
223.19 223.20
223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 224.33 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18
225.19 225.20
225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 225.33
226.1
226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 227.32 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 228.32 228.33 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23
229.24 229.25
229.26 229.27 229.28 229.29 229.30 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31
230.32 230.33
231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 232.33 233.1 233.2 233.3 233.4
233.5
233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16
233.17 233.18 233.19
233.20 233.21
233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 234.1 234.2 234.3 234.4 234.5 234.6 234.7
234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20
234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16 236.17
236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25
236.26 236.27 236.28 236.29 236.30 236.31 237.1 237.2
237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19
237.20 237.21 237.22 237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20
238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 239.1 239.2
239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19
239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12
240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 240.32 240.33 241.1 241.2 241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10 241.11
241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 242.1 242.2 242.3 242.4 242.5 242.6
242.7 242.8
242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 242.32 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29 244.1 244.2 244.3 244.4 244.5
244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31
245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23 245.24 245.25 245.26 245.27 245.28 245.29 245.30 245.31 245.32 245.33 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 246.33 247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22
248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 248.32 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 249.32 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 250.31 250.32 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14
251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 251.33 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11 252.12 252.13 252.14 252.15 252.16 252.17 252.18 252.19 252.20 252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28 252.29 252.30 252.31 252.32 252.33 252.34 253.1 253.2 253.3 253.4 253.5 253.6 253.7 253.8 253.9
253.10 253.11 253.12 253.13 253.14 253.15 253.16 253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29 253.30 253.31 253.32 254.1 254.2 254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 254.31 254.32 255.1 255.2 255.3 255.4 255.5 255.6 255.7 255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26
255.27 255.28 255.29 255.30 255.31 255.32 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9
256.10 256.11
256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29 256.30 256.31 256.32 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19 257.20 257.21 257.22 257.23 257.24 257.25 257.26 257.27 257.28 257.29 257.30 257.31 257.32 257.33 257.34 258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30 258.31 258.32 258.33 259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14 259.15 259.16 259.17
259.18 259.19 259.20 259.21 259.22 259.23 259.24 259.25 259.26 259.27 259.28 259.29 259.30 259.31 259.32 259.33 260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25 260.26 260.27 260.28 260.29 260.30 260.31 260.32 260.33 260.34 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25 261.26 261.27 261.28 261.29 261.30 261.31 262.1 262.2 262.3 262.4 262.5 262.6
262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 262.31 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9
263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23 263.24 263.25 263.26 263.27 263.28 263.29 263.30 263.31 264.1 264.2 264.3 264.4
264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14 264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29 264.30 264.31 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20
266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 266.31 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17
267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 268.1 268.2 268.3 268.4 268.5 268.6 268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19 268.20 268.21 268.22 268.23 268.24 268.25
268.26
268.27 268.28 268.29 268.30 268.31 268.32 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 270.1 270.2 270.3 270.4 270.5 270.6 270.7
270.8
270.9 270.10 270.11 270.12 270.13 270.14 270.15 270.16 270.17 270.18
270.19
270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27
270.28 270.29 270.30 270.31 271.1 271.2 271.3
271.4 271.5 271.6 271.7 271.8 271.9 271.10
271.11 271.12
271.13 271.14
271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 272.32 272.33 272.34 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 273.31 273.32 273.33 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9 274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29 274.30 274.31 274.32 274.33 274.34 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13
275.14
275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 275.32 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18
277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 278.1 278.2 278.3
278.4
278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22
278.23
278.24 278.25 278.26 278.27 278.28 278.29 278.30 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 279.33 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13
280.14
280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 280.31 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10 281.11 281.12 281.13
281.14
281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 282.1 282.2 282.3 282.4 282.5 282.6 282.7 282.8
282.9
282.10 282.11 282.12 282.13 282.14
282.15
282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 282.30 282.31 282.32 282.33 283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13
283.14
283.15 283.16 283.17 283.18 283.19 283.20 283.21 283.22 283.23 283.24 283.25 283.26 283.27 283.28 283.29 283.30 283.31 283.32 284.1 284.2
284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13 284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 284.33
285.1
285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9
286.10
286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19
286.20
286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 286.31 286.32 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13
287.14
287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24
287.25 287.26 287.27 287.28 287.29 287.30 287.31 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17
288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32 289.1 289.2 289.3
289.4 289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23
289.24
289.25 289.26 289.27 289.28 289.29 289.30 289.31 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28
290.29 290.30 290.31 290.32 290.33 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25 291.26 291.27 291.28 291.29 291.30 291.31 291.32 291.33 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30 292.31 292.32 292.33 293.1 293.2 293.3 293.4
293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24
293.25 293.26 293.27 293.28 293.29 293.30 293.31 294.1 294.2 294.3 294.4 294.5
294.6 294.7 294.8 294.9 294.10 294.11
294.12 294.13 294.14 294.15 294.16 294.17
294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30
296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 296.33 296.34 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10
297.11 297.12 297.13 297.14 297.15 297.16
297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28
298.1 298.2 298.3 298.4 298.5 298.6
298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30
299.31
300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11
300.12
300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24
300.25
300.26 300.27 300.28 300.29 300.30 300.31 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 301.32 301.33 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21
302.22
302.23 302.24 302.25 302.26 302.27 302.28 302.29 302.30 302.31 302.32 302.33 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11 303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 303.31 303.32 304.1 304.2 304.3 304.4 304.5
304.6
304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14 304.15 304.16 304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24
304.25
304.26 304.27 304.28 304.29 304.30 305.1 305.2 305.3 305.4 305.5 305.6 305.7
305.8
305.9 305.10 305.11 305.12 305.13 305.14 305.15 305.16 305.17 305.18 305.19 305.20 305.21 305.22 305.23 305.24 305.25 305.26 305.27 305.28 305.29 305.30 305.31 305.32 306.1 306.2 306.3 306.4 306.5
306.6
306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15 306.16 306.17 306.18 306.19 306.20 306.21 306.22 306.23 306.24 306.25 306.26 306.27 306.28 306.29 306.30 306.31 307.1 307.2 307.3 307.4
307.5
307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19 307.20 307.21 307.22 307.23 307.24 307.25 307.26 307.27 307.28 307.29 307.30
307.31
308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 308.32 308.33 308.34 309.1 309.2 309.3 309.4 309.5 309.6 309.7
309.8
309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21 309.22 309.23 309.24 309.25 309.26 309.27 309.28 309.29 309.30 309.31 309.32 309.33 310.1 310.2 310.3 310.4 310.5 310.6 310.7 310.8 310.9 310.10 310.11 310.12 310.13 310.14 310.15 310.16
310.17
310.18 310.19 310.20 310.21 310.22 310.23 310.24 310.25 310.26 310.27 310.28
311.1 311.2 311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 311.32
312.1 312.2 312.3 312.4 312.5 312.6 312.7 312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16 312.17 312.18
312.19
312.20 312.21 312.22 312.23 312.24 312.25 312.26 312.27 312.28 312.29 312.30 312.31 312.32 313.1 313.2 313.3 313.4 313.5 313.6 313.7 313.8 313.9 313.10 313.11 313.12 313.13 313.14 313.15 313.16 313.17 313.18 313.19 313.20 313.21 313.22 313.23 313.24 313.25 313.26 313.27 313.28 313.29 313.30 313.31 313.32 313.33 314.1 314.2
314.3
314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20 314.21 314.22 314.23 314.24 314.25 314.26 314.27 314.28 314.29 314.30 314.31 315.1
315.2
315.3 315.4 315.5 315.6 315.7
315.8
315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 315.30 315.31 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15
316.16
316.17 316.18 316.19 316.20 316.21 316.22 316.23 316.24 316.25 316.26 316.27 316.28 316.29 316.30 316.31 316.32 317.1 317.2 317.3 317.4
317.5 317.6 317.7 317.8 317.9
317.10 317.11
317.12 317.13 317.14 317.15 317.16 317.17 317.18 317.19 317.20 317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11 318.12 318.13 318.14 318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24 318.25 318.26 318.27 318.28
318.29 318.30 318.31 318.32 318.33 319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10 319.11 319.12 319.13 319.14 319.15 319.16 319.17 319.18 319.19
319.20 319.21
319.22 319.23
319.24 319.25 319.26 319.27 319.28 319.29 319.30 320.1 320.2 320.3 320.4 320.5 320.6 320.7 320.8 320.9 320.10
320.11 320.12 320.13 320.14 320.15 320.16 320.17
320.18 320.19 320.20 320.21 320.22 320.23 320.24 320.25 320.26 320.27 320.28 320.29 320.30 321.1 321.2 321.3 321.4 321.5 321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26 321.27 321.28 321.29 321.30 321.31 321.32 322.1 322.2 322.3 322.4 322.5 322.6
322.7 322.8 322.9
322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 322.32 322.33 322.34 323.1 323.2 323.3
323.4
323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16
323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17
324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 324.32 325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10 325.11 325.12 325.13 325.14
325.15 325.16 325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26 325.27 325.28 325.29 325.30 325.31 325.32 326.1 326.2 326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14 326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30 326.31
327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11
327.12 327.13 327.14
327.15 327.16 327.17
327.18
327.19 327.20
327.21 327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 328.1 328.2
328.3 328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13 328.14 328.15 328.16 328.17 328.18 328.19 328.20 328.21 328.22 328.23 328.24 328.25
328.26 328.27
328.28 328.29
328.30 329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15
329.16 329.17 329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30 329.31 329.32 329.33 329.34 330.1 330.2 330.3 330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25 330.26 330.27 330.28 330.29 330.30 330.31 330.32 330.33 330.34 331.1 331.2
331.3
331.4 331.5 331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 331.32 331.33 331.34 332.1 332.2 332.3 332.4 332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18
332.19
332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31 332.32 332.33 333.1 333.2 333.3 333.4 333.5 333.6 333.7 333.8
333.9
333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17
333.18 333.19 333.20 333.21 333.22 333.23 333.24
333.25 333.26 333.27 333.28 333.29 333.30 333.31 333.32 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18
334.19
334.20 334.21 334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 334.30 334.31 334.32 334.33 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 335.32 335.33 335.34 336.1 336.2 336.3 336.4 336.5
336.6
336.7 336.8 336.9 336.10 336.12 336.11 336.13 336.14 336.15 336.16 336.17 336.18 336.19 336.20 336.21 336.22 336.23 336.24 336.25 336.26 336.27 336.28 336.29 336.30 336.31 336.32 336.33 336.34 337.1 337.2 337.3 337.4 337.5 337.6 337.7 337.8 337.9 337.10 337.11 337.12
337.13
337.14 337.15 337.16 337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26 337.27 337.28 337.29 337.30 337.31 337.32 337.33 337.34 338.1 338.2 338.3 338.4 338.5 338.6 338.7 338.8 338.9 338.10 338.11 338.12 338.13 338.14 338.15 338.16 338.17 338.18 338.19 338.20 338.21 338.22 338.23 338.24 338.25 338.26 338.27 338.28 338.29 338.30 338.31 338.32 338.33 338.34 338.35 339.1 339.2 339.3 339.4 339.5 339.6
339.7 339.8 339.9 339.10 339.11 339.12 339.13 339.14 339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 339.30 339.31 339.32 339.33 339.34 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27 340.28 340.29 340.30 340.31 340.32 340.33 340.34 340.35 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 341.32 341.33 341.34 342.1 342.2 342.3 342.4 342.5 342.6 342.7 342.8 342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 342.32 342.33 343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28 343.29 343.30 343.31 343.32 343.33 343.34 344.1 344.2 344.3 344.4 344.5 344.6 344.7 344.8 344.9 344.10 344.11 344.12 344.13 344.14 344.15 344.16 344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31 344.32 344.33 344.34 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8 345.9 345.10 345.11 345.12 345.13 345.14 345.15 345.16 345.17 345.18 345.19 345.20 345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30 345.31 345.32 345.33 345.34 346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20 346.21 346.22 346.23 346.24 346.25 346.26 346.27 346.28 346.29 346.30 346.31 346.32 346.33 346.34 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11 347.12 347.13 347.14 347.15 347.16 347.17 347.18 347.19 347.20 347.21 347.22 347.23 347.24 347.25 347.26 347.27 347.28 347.29 347.30 347.31 347.32 347.33 347.34 348.1 348.2 348.3 348.4 348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16 348.17 348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 348.30 348.31 348.32 348.33 348.34 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31 349.32 349.33 349.34 349.35 350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 350.30 350.31 350.32 350.33 350.34 351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 351.32 351.33 351.34 352.1 352.2 352.3 352.4 352.5 352.6 352.7 352.8 352.9 352.10 352.11 352.12 352.13 352.14 352.15 352.16 352.17 352.18
352.19 352.20
352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30 352.31 352.32 352.33 353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21
353.22 353.23 353.24
353.25 353.26 353.27
353.28 353.29 353.30 353.31
354.1

A bill for an act
relating to state government; modifying provisions for human services health care
finance, human services health care policy, health care generally, health insurance,
Department of Health finance, Department of Health policy, emergency medical
services, pharmacy practice, mental health, Department of Human Services Office
of Inspector General; substance use disorder treatment licensing; imposing
penalties; making forecast adjustments; requiring reports; appropriating money;
amending Minnesota Statutes 2022, sections 62A.28, subdivision 2; 62D.02,
subdivisions 4, 7; 62D.03, subdivision 1; 62D.05, subdivision 1; 62D.06,
subdivision 1; 62D.12, subdivision 19; 62D.14, subdivision 1; 62D.19; 62D.20,
subdivision 1; 62D.22, subdivision 5, by adding a subdivision; 62E.02, subdivision
3; 62J.49, subdivision 1; 62J.61, subdivision 5; 62M.01, subdivision 3; 62M.02,
subdivisions 1a, 5, 11, 12, 21, by adding a subdivision; 62M.04, subdivision 1;
62M.05, subdivision 3a; 62M.07, subdivisions 2, 4, by adding a subdivision;
62M.10, subdivisions 7, 8; 62M.17, subdivision 2; 62Q.14; 62Q.1841, subdivision
2; 62Q.19, subdivisions 3, 5, by adding a subdivision; 62Q.73, subdivision 2;
62V.05, subdivision 12; 62V.08; 62V.11, subdivision 4; 103I.621, subdivisions
1, 2; 144.05, subdivisions 6, 7; 144.058; 144.0724, subdivisions 2, 3a, 4, 6, 7, 8,
9, 11; 144.1464, subdivisions 1, 2, 3; 144.1501, subdivision 5; 144.1911,
subdivision 2; 144.292, subdivision 6; 144.293, subdivisions 2, 4, 9, 10; 144.493,
by adding a subdivision; 144.494, subdivision 2; 144.551, subdivision 1; 144.555,
subdivisions 1a, 1b, 2, by adding subdivisions; 144.605, by adding a subdivision;
144.7067, subdivision 2; 144A.10, subdivisions 15, 16; 144A.44, subdivision 1;
144A.471, by adding a subdivision; 144A.474, subdivision 13; 144A.70,
subdivisions 3, 5, 6, 7; 144A.71, subdivision 2, by adding a subdivision; 144A.72,
subdivision 1; 144A.73; 144E.001, subdivision 3a, by adding subdivisions;
144E.101, by adding a subdivision; 144E.16, subdivisions 5, 7; 144E.19,
subdivision 3; 144E.27, subdivisions 3, 5, 6; 144E.28, subdivisions 3, 5, 6, 8;
144E.285, subdivisions 1, 2, 4, 6, by adding subdivisions; 144E.287; 144E.305,
subdivision 3; 144G.08, subdivision 29; 144G.10, by adding a subdivision;
144G.16, subdivision 6; 146B.03, subdivision 7a; 146B.10, subdivisions 1, 3;
148F.025, subdivision 2; 149A.02, subdivisions 3, 16, 26a, 27, 35, 37c, by adding
subdivisions; 149A.03; 149A.65; 149A.70, subdivisions 1, 2, 3, 5; 149A.71,
subdivisions 2, 4; 149A.72, subdivisions 3, 9; 149A.73, subdivision 1; 149A.74,
subdivision 1; 149A.93, subdivision 3; 149A.94, subdivisions 1, 3, 4; 151.01,
subdivisions 23, 27; 151.37, by adding a subdivision; 151.74, subdivision 6;
214.025; 214.04, subdivision 2a; 214.29; 214.31; 214.355; 245.462, subdivision
6; 245.4663, subdivision 2; 245A.04, by adding a subdivision; 245A.043,
subdivisions 2, 4, by adding subdivisions; 245A.07, subdivision 6; 245A.52,
subdivision 2; 245C.05, subdivision 5; 245C.08, subdivision 4; 245C.10,
subdivision 18; 245C.14, by adding a subdivision; 245C.22, subdivision 4; 245C.24,
subdivisions 2, 5, 6; 245C.30, by adding a subdivision; 245F.09, subdivision 2;
245F.14, by adding a subdivision; 245F.17; 245G.07, subdivision 4; 245G.08,
subdivisions 5, 6; 245G.10, by adding a subdivision; 245G.11, subdivisions 5, 7;
245G.22, subdivisions 6, 7; 245I.02, subdivisions 17, 19; 245I.04, subdivision 6;
245I.10, subdivision 9; 245I.11, subdivision 1, by adding a subdivision; 245I.20,
subdivision 4; 245I.23, subdivision 14; 256.9657, subdivision 8, by adding a
subdivision; 256.969, by adding subdivisions; 256B.056, subdivisions 1a, 10;
256B.0622, subdivisions 2a, 3a, 7a, 7d; 256B.0623, subdivision 5; 256B.0625,
subdivisions 12, 20, 32, by adding subdivisions; 256B.0757, subdivisions 4a, 4d;
256B.0943, subdivision 12; 256B.0947, subdivision 5; 256B.69, by adding a
subdivision; 256I.04, subdivision 2f; 256R.02, subdivision 20; 260E.33, subdivision
2, as amended; 317A.811, subdivision 1; 334.01, by adding a subdivision; 519.05;
524.3-801, as amended; Minnesota Statutes 2023 Supplement, sections 13.46,
subdivision 4, as amended; 15A.0815, subdivision 2; 43A.08, subdivision 1a;
62Q.46, subdivision 1; 62Q.522, subdivision 1; 62Q.523, subdivision 1; 144.0526,
subdivision 1; 144.1501, subdivision 2; 144.1505, subdivision 2; 144.587,
subdivisions 1, 4; 144A.4791, subdivision 10; 144E.101, subdivisions 6, 7, as
amended; 145.561, subdivision 4; 145D.01, subdivision 1; 151.555, subdivisions
1, 4, 5, 6, 7, 8, 9, 11, 12; 151.74, subdivision 3; 152.126, subdivision 6; 245.4889,
subdivision 1; 245.991, subdivision 1; 245A.03, subdivision 2, as amended;
245A.043, subdivision 3; 245A.07, subdivision 1, as amended; 245A.11,
subdivision 7; 245A.16, subdivision 1, as amended; 245A.211, subdivision 4;
245A.242, subdivision 2; 245C.02, subdivision 13e; 245C.033, subdivision 3;
245C.08, subdivision 1; 245C.10, subdivision 15; 245G.22, subdivisions 2, 17;
254B.04, subdivision 1a; 256.046, subdivision 3; 256.0471, subdivision 1, as
amended; 256.9631; 256.969, subdivision 2b; 256B.0622, subdivisions 7b, 8;
256B.0625, subdivisions 5m, 13e, as amended, 13f, 16; 256B.064, subdivision 4;
256B.0671, subdivision 5; 256B.0701, subdivision 6; 256B.0947, subdivision 7;
256B.764; 256D.01, subdivision 1a; 256I.05, subdivisions 1a, 11; 256L.03,
subdivision 1; 270A.03, subdivision 2; 342.06; 342.63, by adding a subdivision;
Laws 2020, chapter 73, section 8; Laws 2023, chapter 22, section 4, subdivision
2; Laws 2023, chapter 70, article 20, sections 2, subdivisions 5, 7, 29; 3, subdivision
2; 12, as amended; Laws 2024, chapter 80, article 2, sections 6, subdivisions 2, 3,
by adding subdivisions; 10, subdivisions 1, 6; proposing coding for new law in
Minnesota Statutes, chapters 62A; 62C; 62D; 62J; 62M; 62Q; 62V; 144; 144A;
144E; 145D; 149A; 151; 245C; 256B; 332; proposing coding for new law as
Minnesota Statutes, chapter 332C; repealing Minnesota Statutes 2022, sections
62A.041, subdivision 3; 144.497; 144E.001, subdivision 5; 144E.01; 144E.123,
subdivision 5; 144E.27, subdivisions 1, 1a; 144E.50, subdivision 3; 151.74,
subdivision 16; 245C.125; 256D.19, subdivisions 1, 2; 256D.20, subdivisions 1,
2, 3, 4; 256D.23, subdivisions 1, 2, 3; 256R.02, subdivision 46; Minnesota Statutes
2023 Supplement, sections 62J.312, subdivision 6; 62Q.522, subdivisions 3, 4;
144.0528, subdivision 5; 245C.08, subdivision 2; Laws 2023, chapter 70, article
20, section 2, subdivision 31, as amended; Laws 2023, chapter 75, section 10;
Laws 2024, chapter 80, article 2, section 6, subdivision 4; Minnesota Rules, parts
2960.0620, subpart 3; 9502.0425, subpart 5.

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

ARTICLE 1

DEPARTMENT OF HUMAN SERVICES HEALTH CARE FINANCE

Section 1.

new text begin [62V.12] STATE-FUNDED COST-SHARING REDUCTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin (a) The board must develop and administer a state-funded
cost-sharing reduction program for eligible persons who enroll in a silver level qualified
health plan through MNsure. The board must implement the cost-sharing reduction program
for plan years beginning on or after January 1, 2027.
new text end

new text begin (b) For purposes of this section, an "eligible person" is an individual who meets the
eligibility criteria to receive a cost-sharing reduction under Code of Federal Regulations,
title 45, section 155.305(g).
new text end

new text begin Subd. 2. new text end

new text begin Reduction in cost-sharing. new text end

new text begin The cost-sharing reduction program must use state
money to reduce enrollee cost-sharing by increasing the actuarial value of silver level health
plans for eligible persons beyond the 73 percent value established in Code of Federal
Regulations, title 45, section 156.420(a)(3)(ii), to an actuarial value of 87 percent.
new text end

new text begin Subd. 3. new text end

new text begin Administration. new text end

new text begin The board, when administering the program, must:
new text end

new text begin (1) allow eligible persons to enroll in a silver level health plan with a state-funded
cost-sharing reduction;
new text end

new text begin (2) modify the MNsure shopping tool to display the total cost-sharing reduction benefit
available to individuals eligible under this section; and
new text end

new text begin (3) reimburse health carriers on a quarterly basis for the cost to the health plan providing
the state-funded cost-sharing reductions.
new text end

Sec. 2.

Minnesota Statutes 2023 Supplement, section 256.9631, is amended to read:


256.9631 deleted text begin DIRECT PAYMENT SYSTEMdeleted text end new text begin ALTERNATIVE CARE DELIVERY
MODELS
new text end FOR MEDICAL ASSISTANCE AND MINNESOTACARE.

Subdivision 1.

Direction to the commissioner.

(a) The commissionernew text begin , in order to deliver
services to eligible individuals, achieve better health outcomes, and reduce the cost of health
care for the state,
new text end shall develop deleted text begin andeleted text end implementation deleted text begin plandeleted text end new text begin plansnew text end for deleted text begin a direct payment system
to deliver services to eligible individuals in order to achieve better health outcomes and
reduce the cost of health care for the state. Under this system,
deleted text end new text begin at least three care delivery
models that:
new text end

new text begin (1) are alternatives to the use of commercial managed care plans to deliver health care
to Minnesota health care program enrollees; and
new text end

new text begin (2) do not shift financial risk to nongovernmental entities.
new text end

new text begin (b) One of the alternative models must be a direct payment system under whichnew text end eligible
individuals deleted text begin mustdeleted text end receive services through the deleted text begin medical assistancedeleted text end fee-for-service system,
county-based purchasing plans, deleted text begin ordeleted text end new text begin andnew text end county-owned health maintenance organizations. new text begin At
least one additional model must include county-based purchasing plans and county-owned
health maintenance organizations in their design, and must allow these entities to deliver
care in geographic areas on a single plan basis, if:
new text end

new text begin (1) these entities contract with all providers that agree to contract terms for network
participation; and
new text end

new text begin (2) the commissioner of human services determines that an entity's provider network is
adequate to ensure enrollee access and choice.
new text end

new text begin (c) Before determining the alternative models for which implementation plans will be
developed, the commissioner shall consult with the chairs and ranking minority members
of the legislative committees with jurisdiction over health care finance and policy.
new text end

new text begin (d) new text end The commissioner shall present deleted text begin andeleted text end implementation deleted text begin plandeleted text end new text begin plansnew text end for the deleted text begin direct payment
system
deleted text end new text begin selected modelsnew text end to the chairs and ranking minority members of the legislative
committees with jurisdiction over health care finance and policy by January 15, 2026. The
commissioner may contract for technical assistance in developing the implementation deleted text begin plandeleted text end new text begin
plans
new text end and conducting related studies and analyses.

deleted text begin (b) For the purposes of the direct payment system, the commissioner shall make the
following assumptions:
deleted text end

deleted text begin (1) health care providers are reimbursed directly for all medical assistance covered
services provided to eligible individuals, using the fee-for-service payment methods specified
in chapters
deleted text end deleted text begin 256 deleted text end deleted text begin , deleted text end deleted text begin 256B deleted text end deleted text begin , deleted text end deleted text begin 256R deleted text end deleted text begin , and deleted text end deleted text begin 256S deleted text end deleted text begin ;
deleted text end

deleted text begin (2) payments to a qualified hospital provider are equivalent to the payments that would
have been received based on managed care direct payment arrangements. If necessary, a
qualified hospital provider may use a county-owned health maintenance organization to
receive direct payments as described in section 256B.1973; and
deleted text end

deleted text begin (3) county-based purchasing plans and county-owned health maintenance organizations
must be reimbursed at the capitation rate determined under sections 256B.69 and 256B.692.
deleted text end

Subd. 2.

Definitions.

(a) For purposes of this section, the following terms have the
meanings given.

(b) "Eligible individuals" means deleted text begin qualifieddeleted text end new text begin allnew text end medical assistance deleted text begin enrollees, defined as
persons eligible for medical assistance as families and children and adults without children
deleted text end new text begin
and MinnesotaCare enrollees
new text end .

new text begin (c) "Minnesota health care programs" means the medical assistance and MinnesotaCare
programs.
new text end

deleted text begin (c)deleted text end new text begin (d)new text end "Qualified hospital provider" means a nonstate government teaching hospital
with high medical assistance utilization and a level 1 trauma center, and all of the hospital's
owned or affiliated health care professionals, ambulance services, sites, and clinics.

Subd. 3.

Implementation deleted text begin plandeleted text end new text begin plansnew text end .

(a) deleted text begin Thedeleted text end new text begin Eachnew text end implementation plan must include:

(1) a timeline for the development and recommended implementation date of the deleted text begin direct
payment system
deleted text end new text begin alternative modelnew text end . In recommending a timeline, the commissioner must
consider:

(i) timelines required by the existing contracts with managed care plans and county-based
purchasing plans to sunset existing delivery models;

(ii) in counties that choose to operate a county-based purchasing plan under section
256B.692, timelines for any new procurements required for those counties to establish a
new county-based purchasing plan or participate in an existing county-based purchasing
plan;

(iii) in counties that choose to operate a county-owned health maintenance organization
under section 256B.69, timelines for any new procurements required for those counties to
establish a new county-owned health maintenance organization or to continue serving
enrollees through an existing county-owned health maintenance organization; and

(iv) a recommendation on whether the commissioner should contract with a third-party
administrator to administer the deleted text begin direct payment systemdeleted text end new text begin alternative model,new text end and the timeline
needed for procuring an administrator;

(2) the procedures to be used to ensure continuity of care for enrollees who transition
from managed care to fee-for-service and any administrative resources needed to carry out
these procedures;

(3) recommended quality measures for health care service delivery;

(4) any changes to fee-for-service payment rates that the commissioner determines are
necessary to ensure provider access and high-quality care and to reduce health disparities;

(5) recommendations on ensuring effective care coordination under the deleted text begin direct payment
system
deleted text end new text begin alternative modelnew text end , especially for enrollees whonew text begin :
new text end

new text begin (i) are age 65 or older, blind, or have disabilities;
new text end

new text begin (ii)new text end have complex medical conditionsdeleted text begin , whodeleted text end new text begin ;
new text end

new text begin (iii)new text end face socioeconomic barriers to receiving caredeleted text begin , or whodeleted text end new text begin ; or
new text end

new text begin (iv)new text end are from underserved populations that experience health disparities;

(6) recommendations on deleted text begin whether the direct payment system should provide supplemental
payments
deleted text end new text begin payment arrangementsnew text end for care coordination, including:

(i) the provider types eligible for deleted text begin supplementaldeleted text end new text begin care coordinationnew text end payments;

(ii) procedures to coordinate deleted text begin supplementaldeleted text end new text begin care coordinationnew text end payments with existing
supplemental or cost-based payment methods or to replace these existing methods; and

(iii) procedures to align care coordination initiatives funded deleted text begin through supplemental
payments
deleted text end under deleted text begin this sectiondeleted text end new text begin the alternative modelnew text end with existing care coordination initiatives;

(7) recommendations on whether the deleted text begin direct payment systemdeleted text end new text begin alternative modelnew text end should
include funding to providers for outreach initiatives to patients who, because of mental
illness, homelessness, or other circumstances, are unlikely to obtain needed care and
treatment;

(8) recommendations for a supplemental payment to qualified hospital providers to offset
any potential revenue losses resulting from the shift from managed care payments;new text begin and
new text end

deleted text begin (9) recommendations on whether and how the direct payment system should be expanded
to deliver services and care coordination to medical assistance enrollees who are age 65 or
older, are blind, or have a disability and to persons enrolled in MinnesotaCare; and
deleted text end

deleted text begin (10)deleted text end new text begin (9)new text end recommendations for statutory changes necessary to implement the deleted text begin direct
payment system
deleted text end new text begin alternative modelnew text end .

(b) In developing deleted text begin thedeleted text end new text begin eachnew text end implementation plan, the commissioner shall:

(1) calculate the projected cost of deleted text begin a direct payment systemdeleted text end new text begin the alternative modelnew text end relative
to the cost of the current system;

(2) assess gaps in care coordination under the current medical assistance and
MinnesotaCare programs;

(3) evaluate the effectiveness of approaches other states have taken to coordinate care
under a fee-for-service system, including the coordination of care provided to persons who
new text begin are age 65 or older, new text end are blindnew text begin ,new text end or have disabilities;

(4) estimate the loss of revenue and cost savings from other payment enhancements
based on managed care plan directed payments and pass-throughs;

(5) estimate cost trends under deleted text begin a direct payment systemdeleted text end new text begin the alternative modelnew text end for managed
care payments to county-based purchasing plans and county-owned health maintenance
organizations;

(6) estimate the impact of deleted text begin a direct payment systemdeleted text end new text begin the alternative modelnew text end on other revenue,
including taxes, surcharges, or other federally approved in lieu of services and on other
arrangements allowed under managed care;

(7) consider allowing eligible individuals to opt out of managed care as an alternative
approach;

deleted text begin (8) assess the feasibility of a medical assistance outpatient prescription drug benefit
carve-out under section 256B.69, subdivision 6d, and in consultation with the commissioners
of commerce and health, assess the feasibility of including MinnesotaCare enrollees and
private sector enrollees of health plan companies in the drug benefit carve-out. The
assessment of feasibility must address and include recommendations related to the process
and terms by which the commissioner would contract with health plan companies to
administer prescription drug benefits and develop and manage a drug formulary, and the
impact of the drug-benefit carve-out on health care providers, including small pharmacies;
deleted text end

deleted text begin (9)deleted text end new text begin (8)new text end consult with the commissioners of health and commerce and the contractor or
contractors analyzing the Minnesota Health Plan deleted text begin under section 19deleted text end and other health reform
models on plan design and assumptions; and

deleted text begin (10)deleted text end new text begin (9)new text end conduct other analyses necessary to develop the implementation plan.

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

Minnesota Statutes 2022, section 256.9657, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Teaching hospital surcharge. new text end

new text begin (a) Each teaching hospital shall pay to the
medical assistance account a surcharge equal to 0.01 percent of net non-Medicare patient
care revenue. The initial surcharge must be paid 60 days after both this subdivision and
section 256.969, subdivision 2g, have received federal approval, and subsequent surcharge
payments must be made annually in the form and manner specified by the commissioner.
new text end

new text begin (b) The commissioner shall use revenue from the surcharge only to pay the nonfederal
share of the medical assistance supplemental payments described in section 256.969,
subdivision 2g, and to supplement, and not supplant, medical assistance reimbursement to
teaching hospitals. The surcharge must comply with Code of Federal Regulations, title 42,
section 433.63.
new text end

new text begin (c) For purposes of this subdivision, "teaching hospital" means any Minnesota hospital,
except facilities of the federal Indian Health Service and regional treatment centers, with a
Centers for Medicare and Medicaid Services designation of "teaching hospital" as reported
on form CMS-2552-10, worksheet S-2, line 56, that is eligible for reimbursement under
section 256.969, subdivision 2g.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the later of January 1, 2025, or federal
approval of this section and sections 4 and 5. The commissioner of human services shall
notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 4.

Minnesota Statutes 2023 Supplement, section 256.969, subdivision 2b, is amended
to read:


Subd. 2b.

Hospital payment rates.

(a) For discharges occurring on or after November
1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according
to the following:

(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
methodology;

(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology
under subdivision 25;

(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
distinct parts as defined by Medicare shall be paid according to the methodology under
subdivision 12; and

(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.

(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not
be rebased, except that a Minnesota long-term hospital shall be rebased effective January
1, 2011, based on its most recent Medicare cost report ending on or before September 1,
2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on
December 31, 2010. For rate setting periods after November 1, 2014, in which the base
years are updated, a Minnesota long-term hospital's base year shall remain within the same
period as other hospitals.

(c) Effective for discharges occurring on and after November 1, 2014, payment rates
for hospital inpatient services provided by hospitals located in Minnesota or the local trade
area, except for the hospitals paid under the methodologies described in paragraph (a),
clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
manner similar to Medicare. The base year or years for the rates effective November 1,
2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral,
ensuring that the total aggregate payments under the rebased system are equal to the total
aggregate payments that were made for the same number and types of services in the base
year. Separate budget neutrality calculations shall be determined for payments made to
critical access hospitals and payments made to hospitals paid under the DRG system. Only
the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being
rebased during the entire base period shall be incorporated into the budget neutrality
calculation.

(d) For discharges occurring on or after November 1, 2014, through the next rebasing
that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph
(a), clause (4), shall include adjustments to the projected rates that result in no greater than
a five percent increase or decrease from the base year payments for any hospital. Any
adjustments to the rates made by the commissioner under this paragraph and paragraph (e)
shall maintain budget neutrality as described in paragraph (c).

(e) For discharges occurring on or after November 1, 2014, the commissioner may make
additional adjustments to the rebased rates, and when evaluating whether additional
adjustments should be made, the commissioner shall consider the impact of the rates on the
following:

(1) pediatric services;

(2) behavioral health services;

(3) trauma services as defined by the National Uniform Billing Committee;

(4) transplant services;

(5) obstetric services, newborn services, and behavioral health services provided by
hospitals outside the seven-county metropolitan area;

(6) outlier admissions;

(7) low-volume providers; and

(8) services provided by small rural hospitals that are not critical access hospitals.

(f) Hospital payment rates established under paragraph (c) must incorporate the following:

(1) for hospitals paid under the DRG methodology, the base year payment rate per
admission is standardized by the applicable Medicare wage index and adjusted by the
hospital's disproportionate population adjustment;

(2) for critical access hospitals, payment rates for discharges between November 1, 2014,
and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
October 31, 2014;

(3) the cost and charge data used to establish hospital payment rates must only reflect
inpatient services covered by medical assistance; and

(4) in determining hospital payment rates for discharges occurring on or after the rate
year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per
discharge shall be based on the cost-finding methods and allowable costs of the Medicare
program in effect during the base year or years. In determining hospital payment rates for
discharges in subsequent base years, the per discharge rates shall be based on the cost-finding
methods and allowable costs of the Medicare program in effect during the base year or
years.

(g) The commissioner shall validate the rates effective November 1, 2014, by applying
the rates established under paragraph (c), and any adjustments made to the rates under
paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the
total aggregate payments for the same number and types of services under the rebased rates
are equal to the total aggregate payments made during calendar year 2013.

(h) Effective for discharges occurring on or after July 1, 2017, and every two years
thereafter, payment rates under this section shall be rebased to reflect only those changes
in hospital costs between the existing base year or years and the next base year or years. In
any year that inpatient claims volume falls below the threshold required to ensure a
statistically valid sample of claims, the commissioner may combine claims data from two
consecutive years to serve as the base year. Years in which inpatient claims volume is
reduced or altered due to a pandemic or other public health emergency shall not be used as
a base year or part of a base year if the base year includes more than one year. Changes in
costs between base years shall be measured using the lower of the hospital cost index defined
in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per
claim. The commissioner shall establish the base year for each rebasing period considering
the most recent year or years for which filed Medicare cost reports are available, except
that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019.
The estimated change in the average payment per hospital discharge resulting from a
scheduled rebasing must be calculated and made available to the legislature by January 15
of each year in which rebasing is scheduled to occur, and must include by hospital the
differential in payment rates compared to the individual hospital's costs.

(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates
for critical access hospitals located in Minnesota or the local trade area shall be determined
using a new cost-based methodology. The commissioner shall establish within the
methodology tiers of payment designed to promote efficiency and cost-effectiveness.
Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
the total cost for critical access hospitals as reflected in base year cost reports. Until the
next rebasing that occurs, the new methodology shall result in no greater than a five percent
decrease from the base year payments for any hospital, except a hospital that had payments
that were greater than 100 percent of the hospital's costs in the base year shall have their
rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and
after July 1, 2016, covered under this paragraph shall be increased by the inflation factor
in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not
be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the
following criteria:

(1) hospitals that had payments at or below 80 percent of their costs in the base year
shall have a rate set that equals 85 percent of their base year costs;

(2) hospitals that had payments that were above 80 percent, up to and including 90
percent of their costs in the base year shall have a rate set that equals 95 percent of their
base year costs; and

(3) hospitals that had payments that were above 90 percent of their costs in the base year
shall have a rate set that equals 100 percent of their base year costs.

(j) The commissioner may refine the payment tiers and criteria for critical access hospitals
to coincide with the next rebasing under paragraph (h). The factors used to develop the new
methodology may include, but are not limited to:

(1) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's charges to the medical assistance program;

(2) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;

(3) the ratio between the hospital's charges to the medical assistance program and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;

(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);

(5) the proportion of that hospital's costs that are administrative and trends in
administrative costs; and

(6) geographic location.

(k) new text begin Subject to section 256.969, subdivision 2g, paragraph (i), new text end effective for discharges
occurring on or after January 1, 2024, the rates paid to hospitals described in paragraph (a),
clauses (2) to (4), must include a rate factor specific to each hospital that qualifies for a
medical education and research cost distribution under section 62J.692, subdivision 4,
paragraph (a).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the later of January 1, 2025, or federal
approval of this section and sections 3 and 5. The commissioner of human services shall
notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 5.

Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to
read:


new text begin Subd. 2g. new text end

new text begin Annual supplemental payments; direct and indirect physician graduate
medical education.
new text end

new text begin (a) For discharges occurring on or after January 1, 2025, the
commissioner shall determine and pay annual supplemental payments to all eligible hospitals
as provided in this subdivision for direct and indirect physician graduate medical education
cost reimbursement. A hospital must be an eligible hospital to receive an annual supplemental
payment under this subdivision.
new text end

new text begin (b) The commissioner must use the following information to calculate the total cost of
direct graduate medical education incurred by each eligible hospital:
new text end

new text begin (1) the total allowable direct graduate medical education cost, as calculated by adding
form CMS-2552-10, worksheet B, part 1, columns 21 and 22, line 202; and
new text end

new text begin (2) the Medicaid share of total allowable direct graduate medical education cost
percentage, representing the allocation of total graduate medical education costs to Medicaid
based on the share of all Medicaid inpatient days, as reported on form CMS-2552-10,
worksheets S-2 and S-3, divided by the hospital's total inpatient days, as reported on
worksheet S-3.
new text end

new text begin (c) The commissioner may obtain the information in paragraph (b) from an eligible
hospital upon request by the commissioner or from the eligible hospital's most recently filed
form CMS-2552-10.
new text end

new text begin (d) The commissioner must use the following information to calculate the total allowable
indirect cost of graduate medical education incurred by each eligible hospital:
new text end

new text begin (1) for eligible hospitals that are not children's hospitals, the indirect graduate medical
education amount attributable to Medicaid, calculated based on form CMS-2552-10,
worksheet E, part A, including:
new text end

new text begin (i) the Medicare indirect medical education formula, using Medicaid variables;
new text end

new text begin (ii) Medicaid payments for inpatient services under fee-for-service and managed care,
as determined by the commissioner in consultation with each eligible hospital;
new text end

new text begin (iii) total inpatient beds available, as reported on form CMS-2552-10, worksheet E, part
A, line 4; and
new text end

new text begin (iv) full-time employees, as determined by adding form CMS-2552-10, worksheet E,
part A, lines 10 and 11; and
new text end

new text begin (2) for eligible hospitals that are children's hospitals:
new text end

new text begin (i) the Medicare indirect medical education formula, using Medicaid variables;
new text end

new text begin (ii) Medicaid payments for inpatient services under fee-for-service and managed care,
as determined by the commissioner in consultation with each eligible hospital;
new text end

new text begin (iii) total inpatient beds available, as reported on form CMS-2552-10, worksheet S-3,
part 1; and
new text end

new text begin (iv) full-time equivalent interns and residents, as determined by adding form
CMS-2552-10, worksheet E-4, lines 6, 10.01, and 15.01.
new text end

new text begin (e) The commissioner shall determine each eligible hospital's maximum allowable
Medicaid direct graduate medical education supplemental payment amount by calculating
the sum of:
new text end

new text begin (1) the total allowable direct graduate medical education costs determined under paragraph
(b), clause (1), multiplied by the Medicaid share of total allowable direct graduate medical
education cost percentage in paragraph (b), clause (2); and
new text end

new text begin (2) the total allowable direct graduate medical education costs determined under paragraph
(b), clause (1), multiplied by the most recently updated Medicaid utilization percentage
from form CMS-2552-10, as submitted to Medicare by each eligible hospital.
new text end

new text begin (f) The commissioner shall determine each eligible hospital's indirect graduate medical
education supplemental payment amount by multiplying the total allowable indirect cost
of graduate medical education amount calculated in paragraph (d) by:
new text end

new text begin (1) 0.95 for prospective payment system, for hospitals that are not children's hospitals
and have fewer than 50 full-time equivalent trainees;
new text end

new text begin (2) 1.0 for prospective payment system, for hospitals that are not children's hospitals
and have equal to or greater than 50 full-time equivalent trainees; and
new text end

new text begin (3) 1.05 for children's hospitals.
new text end

new text begin (g) An eligible hospital's annual supplemental payment under this subdivision equals
the sum of the amount calculated for the eligible hospital under paragraph (e) and the amount
calculated for the eligible hospital under paragraph (f).
new text end

new text begin (h) The annual supplemental payments under this subdivision are contingent upon federal
approval and must conform with the requirements for permissible supplemental payments
for direct and indirect graduate medical education under all applicable federal laws.
new text end

new text begin (i) An eligible hospital is only eligible for reimbursement under section 62J.692 for
nonphysician graduate medical education training costs that are not accounted for in the
calculation of an annual supplemental payment under this section. An eligible hospital must
not accept reimbursement under section 62J.692 for physician graduate medical education
training costs that are accounted for in the calculation of an annual supplemental payment
under this section.
new text end

new text begin (j) For purposes of this subdivision, "children's hospital" means a Minnesota hospital
designated as a children's hospital under Medicare.
new text end

new text begin (k) For purposes of this subdivision, "eligible hospital" means a hospital located in
Minnesota:
new text end

new text begin (1) participating in Minnesota's medical assistance program;
new text end

new text begin (2) that has received fee-for-service medical assistance payments in the payment year;
and
new text end

new text begin (3) that is either:
new text end

new text begin (i) eligible to receive graduate medical education payments from the Medicare program
under Code of Federal Regulations, title 42, section 413.75; or
new text end

new text begin (ii) a children's hospital.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the later of January 1, 2025, or federal
approval of this section and sections 3 and 4. The commissioner of human services shall
notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 6.

Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to
read:


new text begin Subd. 2h. new text end

new text begin Alternate inpatient payment rate for a discharge. new text end

new text begin (a) Effective retroactively
from January 1, 2024, in any rate year in which a children's hospital discharge is included
in the federally required disproportionate share hospital payment audit where the patient
discharged had resided in a children's hospital for over 20 years, the commissioner shall
compute an alternate inpatient rate for the children's hospital. The alternate payment rate
must be the rate computed under this section excluding the disproportionate share hospital
payment under subdivision 9, paragraph (d), clause (1), increased by an amount equal to
99 percent of what the disproportionate share hospital payment would have been under
subdivision 9, paragraph (d), clause (1), had the discharge been excluded.
new text end

new text begin (b) In any rate year in which payment to a children's hospital is made using this alternate
payment rate, payments must not be made to the hospital under subdivisions 2e, 2f, and 9.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 7.

Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13e, as
amended by Laws 2024, chapter 85, section 66, is amended to read:


Subd. 13e.

Payment rates.

(a) The basis for determining the amount of payment shall
be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the
usual and customary price charged to the public. The usual and customary price means the
lowest price charged by the provider to a patient who pays for the prescription by cash,
check, or charge account and includes prices the pharmacy charges to a patient enrolled in
a prescription savings club or prescription discount club administered by the pharmacy or
pharmacy chain. The amount of payment basis must be reduced to reflect all discount
amounts applied to the charge by any third-party provider/insurer agreement or contract for
submitted charges to medical assistance programs. The net submitted charge may not be
greater than the patient liability for the service. The professional dispensing fee shall be
deleted text begin $10.77deleted text end new text begin $11.55new text end for prescriptions filled with legend drugs meeting the definition of "covered
outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The
dispensing fee for intravenous solutions that must be compounded by the pharmacist shall
be deleted text begin $10.77deleted text end new text begin $11.55new text end per claim. The professional dispensing fee for prescriptions filled with
over-the-counter drugs meeting the definition of covered outpatient drugs shall be deleted text begin $10.77deleted text end new text begin
$11.55
new text end for dispensed quantities equal to or greater than the number of units contained in
the manufacturer's original package. The professional dispensing fee shall be prorated based
on the percentage of the package dispensed when the pharmacy dispenses a quantity less
than the number of units contained in the manufacturer's original package. The pharmacy
dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered
outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units
contained in the manufacturer's original package and shall be prorated based on the
percentage of the package dispensed when the pharmacy dispenses a quantity less than the
number of units contained in the manufacturer's original package. The National Average
Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug.
For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient
cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for
a provider participating in the federal 340B Drug Pricing Program shall be either the 340B
Drug Pricing Program ceiling price established by the Health Resources and Services
Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as
the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in
the United States, not including prompt pay or other discounts, rebates, or reductions in
price, for the most recent month for which information is available, as reported in wholesale
price guides or other publications of drug or biological pricing data. The maximum allowable
cost of a multisource drug may be set by the commissioner and it shall be comparable to
the actual acquisition cost of the drug product and no higher than the NADAC of the generic
product. Establishment of the amount of payment for drugs shall not be subject to the
requirements of the Administrative Procedure Act.

(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
an automated drug distribution system meeting the requirements of section 151.58, or a
packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents. A
retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.

(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota
Rules, part 6800.2700, is required to credit the department for the actual acquisition cost
of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective
billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that
is less than a 30-day supply.

(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC
of the generic product or the maximum allowable cost established by the commissioner
unless prior authorization for the brand name product has been granted according to the
criteria established by the Drug Formulary Committee as required by subdivision 13f,
paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in
a manner consistent with section 151.21, subdivision 2.

(e) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
set by the commissioner. If average sales price is unavailable, the amount of payment must
be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
The commissioner shall discount the payment rate for drugs obtained through the federal
340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an
outpatient setting shall be made to the administering facility or practitioner. A retail or
specialty pharmacy dispensing a drug for administration in an outpatient setting is not
eligible for direct reimbursement.

(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy
products that are lower than the ingredient cost formulas specified in paragraph (a). The
commissioner may require individuals enrolled in the health care programs administered
by the department to obtain specialty pharmacy products from providers with whom the
commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are
defined as those used by a small number of recipients or recipients with complex and chronic
diseases that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C,
growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of
cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that
require complex care. The commissioner shall consult with the Formulary Committee to
develop a list of specialty pharmacy products subject to maximum allowable cost
reimbursement. In consulting with the Formulary Committee in developing this list, the
commissioner shall take into consideration the population served by specialty pharmacy
products, the current delivery system and standard of care in the state, and access to care
issues. The commissioner shall have the discretion to adjust the maximum allowable cost
to prevent access to care issues.

(g) Home infusion therapy services provided by home infusion therapy pharmacies must
be paid at rates according to subdivision 8d.

(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey
for all pharmacies that are physically located in the state of Minnesota that dispense outpatient
drugs under medical assistance. The commissioner shall ensure that the vendor has prior
experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the
department to dispense outpatient prescription drugs to fee-for-service members must
respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under
section 256B.064 for failure to respond. The commissioner shall require the vendor to
measure a single statewide cost of dispensing for specialty prescription drugs and a single
statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies
to measure the mean, mean weighted by total prescription volume, mean weighted by
medical assistance prescription volume, median, median weighted by total prescription
volume, and median weighted by total medical assistance prescription volume. The
commissioner shall post a copy of the final cost of dispensing survey report on the
department's website. The initial survey must be completed no later than January 1, 2021,
and repeated every three years. The commissioner shall provide a summary of the results
of each cost of dispensing survey and provide recommendations for any changes to the
dispensing fee to the chairs and ranking minority members of the legislative committees
with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section
256.01, subdivision 42, this paragraph does not expire.

(i) The commissioner shall increase the ingredient cost reimbursement calculated in
paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to
the wholesale drug distributor tax under section 295.52.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024.
new text end

Sec. 8.

Minnesota Statutes 2022, section 256B.69, is amended by adding a subdivision to
read:


new text begin Subd. 38. new text end

new text begin Reimbursement of network providers. new text end

new text begin (a) A managed care plan that is a
staff model health plan company, when reimbursing network providers for services provided
to medical assistance and MinnesotaCare enrollees, must not reimburse network providers
who are employees at a higher rate than network providers who provide services under
contract for each separate service or grouping of services. This requirement does not apply
to reimbursement:
new text end

new text begin (1) of network providers when participating in value-based purchasing models that are
intended to recognize value or outcomes over volume of services, including:
new text end

new text begin (i) total cost of care and risk/gain sharing arrangements under section 256B.0755; and
new text end

new text begin (ii) other pay-for-performance arrangements or service payments, as long as the terms
and conditions of the value-based purchasing model are applied uniformly to all participating
network providers; and
new text end

new text begin (2) for services furnished by providers who are out-of-network.
new text end

new text begin (b) Any contract or agreement between a managed care plan and a network administrator,
for purposes of delivering services to medical assistance and MinnesotaCare enrollees, must
require the network administrator to comply with the requirements that apply to a managed
care plan that is a staff model health plan company under paragraph (a) when reimbursing
providers who are employees of the network administrator and providers who provide
services under contract with the network administrator. This provision applies whether or
not the managed care plan, network administrator, and providers are under the same corporate
ownership.
new text end

new text begin (c) For purposes of this subdivision, "network provider" has the meaning specified in
subdivision 37. For purposes of this subdivision, "network administrator" means any entity
that furnishes a provider network for a managed care plan company, or furnishes individual
health care providers or provider groups to a managed care plan for inclusion in the managed
care plan's provider network.
new text end

Sec. 9. new text begin COUNTY-ADMINISTERED MEDICAL ASSISTANCE MODEL.
new text end

new text begin Subdivision 1. new text end

new text begin Model development. new text end

new text begin (a) The commissioner of human services, in
collaboration with the Association of Minnesota Counties and county-based purchasing
plans, shall develop a county-administered medical assistance (CAMA) model and a detailed
plan for implementing the CAMA model.
new text end

new text begin (b) The CAMA model must be designed to achieve the following objectives:
new text end

new text begin (1) provide a distinct county owned and administered alternative to the prepaid medical
assistance program;
new text end

new text begin (2) facilitate greater integration of health care and social services to address social
determinants of health in rural and nonrural communities, with the degree of integration of
social services varying with each county's needs and resources;
new text end

new text begin (3) account for differences between counties in the number of medical assistance enrollees
and locally available providers of behavioral health, oral health, specialty and tertiary care,
nonemergency medical transportation, and other health care services in rural communities;
and
new text end

new text begin (4) promote greater accountability for health outcomes, health equity, customer service,
community outreach, and cost of care.
new text end

new text begin Subd. 2. new text end

new text begin County participation. new text end

new text begin (a) The CAMA model must give each rural and nonrural
county the option of applying to participate in the CAMA model as an alternative to
participation in the prepaid medical assistance program. The CAMA model must include a
process for the commissioner to determine whether and how a county can participate.
new text end

new text begin (b) The CAMA model may allow a county-administered managed care organization to
deliver care on a single-plan basis to all medical assistance enrollees residing in a county
if:
new text end

new text begin (1) the managed care organization contracts with all health care providers that agree to
accept the contract terms for network participation; and
new text end

new text begin (2) the commissioner determines that the health care provider network of the managed
care organization is adequate to ensure enrollee access to care and enrollee choice of
providers.
new text end

new text begin Subd. 3. new text end

new text begin Report to the legislature. new text end

new text begin (a) The commissioner shall report recommendations
and an implementation plan for the CAMA model to the chairs and ranking minority members
of the legislative committees with jurisdiction over health care policy and finance by January
15, 2025. The CAMA model and implementation plan must address the issues and consider
the recommendations identified in the document titled "Recommendations Not Contingent
on Outcome(s) of Current Litigation," attached to the September 13, 2022, e-filing to the
Second Judicial District Court (Correspondence for Judicial Approval Index #102), that
relates to the final contract decisions of the commissioner of human services regarding
South Country Health Alliance v. Minnesota Department of Human Services, No.
62-CV-22-907 (Ramsey Cnty. Dist. Ct. 2022).
new text end

new text begin (b) The report must also identify the clarifications, approvals, and waivers that are needed
from the Centers for Medicare and Medicaid Services and include any draft legislation
necessary to implement the CAMA model.
new text end

Sec. 10. new text begin REVISOR INSTRUCTION.
new text end

new text begin When the proposed rule published at Federal Register, volume 88, page 25313, becomes
effective, the revisor of statutes must change: (1) the reference in Minnesota Statutes, section
256B.06, subdivision 4, paragraph (d), from Code of Federal Regulations, title 8, section
103.12, to Code of Federal Regulations, title 42, section 435.4; and (2) the reference in
Minnesota Statutes, section 256L.04, subdivision 10, paragraph (a), from Code of Federal
Regulations, title 8, section 103.12, to Code of Federal Regulations, title 45, section 155.20.
The commissioner of human services shall notify the revisor of statutes when the proposed
rule published at Federal Register, volume 88, page 25313, becomes effective.
new text end

ARTICLE 2

DEPARTMENT OF HUMAN SERVICES HEALTH CARE POLICY

Section 1.

Minnesota Statutes 2023 Supplement, section 256.0471, subdivision 1, as
amended by Laws 2024, chapter 80, article 1, section 76, is amended to read:


Subdivision 1.

Qualifying overpayment.

Any overpayment fornew text begin state-funded medicalnew text end
assistancenew text begin under chapter 256B and state-funded MinnesotaCare under chapter 256Lnew text end granted
pursuant to section 256.045, subdivision 10; deleted text begin chapter 256B for state-funded medical
assistance;
deleted text end and chapters 256D, 256I, 256K, and 256L for state-funded MinnesotaCare except
agency error claims, become a judgment by operation of law 90 days after the notice of
overpayment is personally served upon the recipient in a manner that is sufficient under
rule 4.03(a)
of the Rules of Civil Procedure for district courts, or by certified mail, return
receipt requested. This judgment shall be entitled to full faith and credit in this and any
other state.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024.
new text end

Sec. 2.

Minnesota Statutes 2022, section 256.9657, subdivision 8, is amended to read:


Subd. 8.

Commissioner's duties.

deleted text begin (a) Beginning October 1, 2023, the commissioner of
human services shall annually report to the chairs and ranking minority members of the
legislative committees with jurisdiction over health care policy and finance regarding the
provider surcharge program. The report shall include information on total billings, total
collections, and administrative expenditures for the previous fiscal year. This paragraph
expires January 1, 2032.
deleted text end

deleted text begin (b)deleted text end new text begin (a)new text end The surcharge shall be adjusted by inflationary and caseload changes in future
bienniums to maintain reimbursement of health care providers in accordance with the
requirements of the state and federal laws governing the medical assistance program,
including the requirements of the Medicaid moratorium amendments of 1991 found in
Public Law No. 102-234.

deleted text begin (c)deleted text end new text begin (b)new text end The commissioner shall request the Minnesota congressional delegation to support
a change in federal law that would prohibit federal disallowances for any state that makes
a good faith effort to comply with Public Law 102-234 by enacting conforming legislation
prior to the issuance of federal implementing regulations.

Sec. 3.

Minnesota Statutes 2022, section 256B.056, subdivision 1a, is amended to read:


Subd. 1a.

Income and assets generally.

(a)(1) Unless specifically required by state law
or rule or federal law or regulation, the methodologies used in counting income and assets
to determine eligibility for medical assistance for persons whose eligibility category is based
on blindness, disability, or age of 65 or more years, the methodologies for the Supplemental
Security Income program shall be used, except as provided deleted text begin underdeleted text end new text begin in clause (2) andnew text end
subdivision 3, paragraph (a), clause (6).

new text begin (2) State tax credits, rebates, and refunds must not be counted as income. State tax credits,
rebates, and refunds must not be counted as assets for a period of 12 months after the month
of receipt.
new text end

deleted text begin (2)deleted text end new text begin (3)new text end Increases in benefits under title II of the Social Security Act shall not be counted
as income for purposes of this subdivision until July 1 of each year. Effective upon federal
approval, for children eligible under section 256B.055, subdivision 12, or for home and
community-based waiver services whose eligibility for medical assistance is determined
without regard to parental income, child support payments, including any payments made
by an obligor in satisfaction of or in addition to a temporary or permanent order for child
support, and Social Security payments are not counted as income.

(b)(1) The modified adjusted gross income methodology as defined in United States
Code, title 42, section 1396a(e)(14), shall be used for eligibility categories based on:

(i) children under age 19 and their parents and relative caretakers as defined in section
256B.055, subdivision 3a;

(ii) children ages 19 to 20 as defined in section 256B.055, subdivision 16;

(iii) pregnant women as defined in section 256B.055, subdivision 6;

(iv) infants as defined in sections 256B.055, subdivision 10, and 256B.057, subdivision
1; and

(v) adults without children as defined in section 256B.055, subdivision 15.

For these purposes, a "methodology" does not include an asset or income standard, or
accounting method, or method of determining effective dates.

(2) For individuals whose income eligibility is determined using the modified adjusted
gross income methodology in clause (1):

(i) the commissioner shall subtract from the individual's modified adjusted gross income
an amount equivalent to five percent of the federal poverty guidelines; and

(ii) the individual's current monthly income and household size is used to determine
eligibility for the 12-month eligibility period. If an individual's income is expected to vary
month to month, eligibility is determined based on the income predicted for the 12-month
eligibility period.

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2022, section 256B.056, subdivision 10, is amended to read:


Subd. 10.

Eligibility verification.

(a) The commissioner shall require women who are
applying for the continuation of medical assistance coverage following the end of the
12-month postpartum period to update their income and asset information and to submit
any required income or asset verification.

(b) The commissioner shall determine the eligibility of private-sector health care coverage
for infants less than one year of age eligible under section 256B.055, subdivision 10, or
256B.057, subdivision 1, paragraph (c), and shall pay for private-sector coverage if this is
determined to be cost-effective.

(c) The commissioner shall verify assets and income for all applicants, and for all
recipients upon renewal.

(d) The commissioner shall utilize information obtained through the electronic service
established by the secretary of the United States Department of Health and Human Services
and other available electronic data sources in Code of Federal Regulations, title 42, sections
435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish
standards to define when information obtained electronically is reasonably compatible with
information provided by applicants and enrollees, including use of self-attestation, to
accomplish real-time eligibility determinations and maintain program integrity.

(e) Each person applying for or receiving medical assistance under section 256B.055,
subdivision 7, and any other person whose resources are required by law to be disclosed to
determine the applicant's or recipient's eligibility must authorize the commissioner to obtain
information from financial institutions to deleted text begin identify unreported accountsdeleted text end new text begin verify assetsnew text end as
required in section 256.01, subdivision 18f. If a person refuses or revokes the authorization,
the commissioner may determine that the applicant or recipient is ineligible for medical
assistance. For purposes of this paragraph, an authorization to deleted text begin identify unreported accountsdeleted text end new text begin
verify assets
new text end meets the requirements of the Right to Financial Privacy Act, United States
Code, title 12, chapter 35, and need not be furnished to the financial institution.

(f) County and tribal agencies shall comply with the standards established by the
commissioner for appropriate use of the asset verification system specified in section 256.01,
subdivision 18f.

Sec. 5.

Minnesota Statutes 2023 Supplement, section 256B.0701, subdivision 6, is amended
to read:


Subd. 6.

Recuperative care facility rate.

(a) The recuperative care facility rate is for
facility costs and must be paid from state money in an amount equal to the deleted text begin medical assistance
room and board
deleted text end new text begin MSA equivalentnew text end rate new text begin as defined in section 256I.03, subdivision 11a, new text end at the
time the recuperative care services were provided. The eligibility standards in chapter 256I
do not apply to the recuperative care facility rate. The recuperative care facility rate is only
paid when the recuperative care services rate is paid to a provider. Providers may opt to
only receive the recuperative care services rate.

(b) Before a recipient is discharged from a recuperative care setting, the provider must
ensure that the recipient's medical condition is stabilized or that the recipient is being
discharged to a setting that is able to meet that recipient's needs.

Sec. 6.

Minnesota Statutes 2022, section 256B.0757, subdivision 4a, is amended to read:


Subd. 4a.

Behavioral health home services provider requirements.

A behavioral
health home services provider must:

(1) be an enrolled Minnesota Health Care Programs provider;

(2) provide a medical assistance covered primary care or behavioral health service;

(3) utilize an electronic health record;

(4) utilize an electronic patient registry that contains data elements required by the
commissioner;

(5) demonstrate the organization's capacity to administer screenings approved by the
commissioner for substance use disorder or alcohol and tobacco use;

(6) demonstrate the organization's capacity to refer an individual to resources appropriate
to the individual's screening results;

(7) have policies and procedures to track referrals to ensure that the referral met the
individual's needs;

(8) conduct a brief needs assessment when an individual begins receiving behavioral
health home services. The brief needs assessment must be completed with input from the
individual and the individual's identified supports. The brief needs assessment must address
the individual's immediate safety and transportation needs and potential barriers to
participating in behavioral health home services;

(9) conduct a health wellness assessment within 60 days after intake that contains all
required elements identified by the commissioner;

(10) conduct a health action plan that contains all required elements identified by the
commissioner. The plan must be completed within 90 days after intake and must be updated
at least once every six months, or more frequently if significant changes to an individual's
needs or goals occur;

(11) agree to cooperate with and participate in the state's monitoring and evaluation of
behavioral health home services; and

(12) obtain the individual's deleted text begin writtendeleted text end consent to begin receiving behavioral health home
services using a form approved by the commissioner.

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2022, section 256B.0757, subdivision 4d, is amended to read:


Subd. 4d.

Behavioral health home services delivery standards.

(a) A behavioral health
home services provider must meet the following service delivery standards:

(1) establish and maintain processes to support the coordination of an individual's primary
care, behavioral health, and dental care;

(2) maintain a team-based model of care, including regular coordination and
communication between behavioral health home services team members;

(3) use evidence-based practices that recognize and are tailored to the medical, social,
economic, behavioral health, functional impairment, cultural, and environmental factors
affecting the individual's health and health care choices;

(4) use person-centered planning practices to ensure the individual's health action plan
accurately reflects the individual's preferences, goals, resources, and optimal outcomes for
the individual and the individual's identified supports;

(5) use the patient registry to identify individuals and population subgroups requiring
specific levels or types of care and provide or refer the individual to needed treatment,
intervention, or services;

(6) deleted text begin utilize the Department of Human Services Partner Portal todeleted text end identify past and current
treatment or services and identify potential gaps in carenew text begin using a tool approved by the
commissioner
new text end ;

(7) deliver services consistent with the standards for frequency and face-to-face contact
required by the commissioner;

(8) ensure that a diagnostic assessment is completed for each individual receiving
behavioral health home services within six months of the start of behavioral health home
services;

(9) deliver services in locations and settings that meet the needs of the individual;

(10) provide a central point of contact to ensure that individuals and the individual's
identified supports can successfully navigate the array of services that impact the individual's
health and well-being;

(11) have capacity to assess an individual's readiness for change and the individual's
capacity to integrate new health care or community supports into the individual's life;

(12) offer or facilitate the provision of wellness and prevention education on
evidenced-based curriculums specific to the prevention and management of common chronic
conditions;

(13) help an individual set up and prepare for medical, behavioral health, social service,
or community support appointments, including accompanying the individual to appointments
as appropriate, and providing follow-up with the individual after these appointments;

(14) offer or facilitate the provision of health coaching related to chronic disease
management and how to navigate complex systems of care to the individual, the individual's
family, and identified supports;

(15) connect an individual, the individual's family, and identified supports to appropriate
support services that help the individual overcome access or service barriers, increase
self-sufficiency skills, and improve overall health;

(16) provide effective referrals and timely access to services; and

(17) establish a continuous quality improvement process for providing behavioral health
home services.

(b) The behavioral health home services provider must also create a plan, in partnership
with the individual and the individual's identified supports, to support the individual after
discharge from a hospital, residential treatment program, or other setting. The plan must
include protocols for:

(1) maintaining contact between the behavioral health home services team member, the
individual, and the individual's identified supports during and after discharge;

(2) linking the individual to new resources as needed;

(3) reestablishing the individual's existing services and community and social supports;
and

(4) following up with appropriate entities to transfer or obtain the individual's service
records as necessary for continued care.

(c) If the individual is enrolled in a managed care plan, a behavioral health home services
provider must:

(1) notify the behavioral health home services contact designated by the managed care
plan within 30 days of when the individual begins behavioral health home services; and

(2) adhere to the managed care plan communication and coordination requirements
described in the behavioral health home services manual.

(d) Before terminating behavioral health home services, the behavioral health home
services provider must:

(1) provide a 60-day notice of termination of behavioral health home services to all
individuals receiving behavioral health home services, the commissioner, and managed care
plans, if applicable; and

(2) refer individuals receiving behavioral health home services to a new behavioral
health home services provider.

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2023 Supplement, section 256B.764, is amended to read:


256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.

(a) Effective for services rendered on or after July 1, 2007, payment rates for family
planning services shall be increased by 25 percent over the rates in effect June 30, 2007,
when these services are provided by a community clinic as defined in section 145.9268,
subdivision 1.

(b) Effective for services rendered on or after July 1, 2013, payment rates for family
planning services shall be increased by 20 percent over the rates in effect June 30, 2013,
when these services are provided by a community clinic as defined in section 145.9268,
subdivision 1
. The commissioner shall adjust capitation rates to managed care and
county-based purchasing plans to reflect this increase, and shall require plans to pass on the
full amount of the rate increase to eligible community clinics, in the form of higher payment
rates for family planning services.

(c) Effective for services provided on or after January 1, 2024, payment rates for family
planningnew text begin , when such services are provided by an eligible community clinic as defined in
section 145.9268, subdivision 1,
new text end and abortion services shall be increased by 20 percent.
This increase does not apply to federally qualified health centers, rural health centers, or
Indian health services.

Sec. 9.

Minnesota Statutes 2023 Supplement, section 256L.03, subdivision 1, is amended
to read:


Subdivision 1.

Covered health services.

(a) "Covered health services" means the health
services reimbursed under chapter 256B, with the exception of special education services,
home care nursing services, deleted text begin adult dental care services other than services covered under
section 256B.0625, subdivision 9, orthodontic services,
deleted text end nonemergency medical transportation
services, personal care assistance and case management services, community first services
and supports under section 256B.85, behavioral health home services under section
256B.0757, housing stabilization services under section 256B.051, and nursing home or
intermediate care facilities services.

(b) Covered health services shall be expanded as provided in this section.

(c) For the purposes of covered health services under this section, "child" means an
individual younger than 19 years of age.

Sec. 10.

Minnesota Statutes 2022, section 524.3-801, as amended by Laws 2024, chapter
79, article 9, section 20, is amended to read:


524.3-801 NOTICE TO CREDITORS.

(a) Unless notice has already been given under this section, upon appointment of a
general personal representative in informal proceedings or upon the filing of a petition for
formal appointment of a general personal representative, notice thereof, in the form prescribed
by court rule, shall be given under the direction of the court administrator by publication
once a week for two successive weeks in a legal newspaper in the county wherein the
proceedings are pending giving the name and address of the general personal representative
and notifying creditors of the estate to present their claims within four months after the date
of the court administrator's notice which is subsequently published or be forever barred,
unless they are entitled to further service of notice under paragraph (b) or (c).

(b) The personal representative shall, within three months after the date of the first
publication of the notice, serve a copy of the notice upon each then known and identified
creditor in the manner provided in paragraph (c). If the decedent or a predeceased spouse
of the decedent received assistance for which a claim could be filed under section 246.53,
256B.15, 256D.16, or 261.04, notice to the commissioner of human services or direct care
and treatment executive board, as applicable, must be given under paragraph (d) instead of
under this paragraph or paragraph (c). A creditor is "known" if: (i) the personal representative
knows that the creditor has asserted a claim that arose during the decedent's life against
either the decedent or the decedent's estate; (ii) the creditor has asserted a claim that arose
during the decedent's life and the fact is clearly disclosed in accessible financial records
known and available to the personal representative; or (iii) the claim of the creditor would
be revealed by a reasonably diligent search for creditors of the decedent in accessible
financial records known and available to the personal representative. Under this section, a
creditor is "identified" if the personal representative's knowledge of the name and address
of the creditor will permit service of notice to be made under paragraph (c).

(c) Unless the claim has already been presented to the personal representative or paid,
the personal representative shall serve a copy of the notice required by paragraph (b) upon
each creditor of the decedent who is then known to the personal representative and identified
either by delivery of a copy of the required notice to the creditor, or by mailing a copy of
the notice to the creditor by certified, registered, or ordinary first class mail addressed to
the creditor at the creditor's office or place of residence.

(d)(1) Effective for decedents dying on or after July 1, 1997, if the decedent or a
predeceased spouse of the decedent received assistance for which a claim could be filed
under section 246.53, 256B.15, 256D.16, or 261.04, the personal representative or the
attorney for the personal representative shall serve the commissioner or executive board,
as applicable, with notice in the manner prescribed in paragraph (c)new text begin , or electronically in a
manner prescribed by the commissioner,
new text end as soon as practicable after the appointment of the
personal representative. The notice must state the decedent's full name, date of birth, and
Social Security number and, to the extent then known after making a reasonably diligent
inquiry, the full name, date of birth, and Social Security number for each of the decedent's
predeceased spouses. The notice may also contain a statement that, after making a reasonably
diligent inquiry, the personal representative has determined that the decedent did not have
any predeceased spouses or that the personal representative has been unable to determine
one or more of the previous items of information for a predeceased spouse of the decedent.
A copy of the notice to creditors must be attached to and be a part of the notice to the
commissioner or executive board.

(2) Notwithstanding a will or other instrument or law to the contrary, except as allowed
in this paragraph, no property subject to administration by the estate may be distributed by
the estate or the personal representative until 70 days after the date the notice is served on
the commissioner or executive board as provided in paragraph (c), unless the local agency
consents as provided for in clause (6). This restriction on distribution does not apply to the
personal representative's sale of real or personal property, but does apply to the net proceeds
the estate receives from these sales. The personal representative, or any person with personal
knowledge of the facts, may provide an affidavit containing the description of any real or
personal property affected by this paragraph and stating facts showing compliance with this
paragraph. If the affidavit describes real property, it may be filed or recorded in the office
of the county recorder or registrar of titles for the county where the real property is located.
This paragraph does not apply to proceedings under sections 524.3-1203 and 525.31, or
when a duly authorized agent of a county is acting as the personal representative of the
estate.

(3) At any time before an order or decree is entered under section 524.3-1001 or
524.3-1002, or a closing statement is filed under section 524.3-1003, the personal
representative or the attorney for the personal representative may serve an amended notice
on the commissioner or executive board to add variations or other names of the decedent
or a predeceased spouse named in the notice, the name of a predeceased spouse omitted
from the notice, to add or correct the date of birth or Social Security number of a decedent
or predeceased spouse named in the notice, or to correct any other deficiency in a prior
notice. The amended notice must state the decedent's name, date of birth, and Social Security
number, the case name, case number, and district court in which the estate is pending, and
the date the notice being amended was served on the commissioner or executive board. If
the amendment adds the name of a predeceased spouse omitted from the notice, it must also
state that spouse's full name, date of birth, and Social Security number. The amended notice
must be served on the commissioner or executive board in the same manner as the original
notice. Upon service, the amended notice relates back to and is effective from the date the
notice it amends was served, and the time for filing claims arising under section 246.53,
256B.15, 256D.16 or 261.04 is extended by 60 days from the date of service of the amended
notice. Claims filed during the 60-day period are undischarged and unbarred claims, may
be prosecuted by the entities entitled to file those claims in accordance with section
524.3-1004, and the limitations in section 524.3-1006 do not apply. The personal
representative or any person with personal knowledge of the facts may provide and file or
record an affidavit in the same manner as provided for in clause (1).

(4) Within one year after the date an order or decree is entered under section 524.3-1001
or 524.3-1002 or a closing statement is filed under section 524.3-1003, any person who has
an interest in property that was subject to administration by the estate may serve an amended
notice on the commissioner or executive board to add variations or other names of the
decedent or a predeceased spouse named in the notice, the name of a predeceased spouse
omitted from the notice, to add or correct the date of birth or Social Security number of a
decedent or predeceased spouse named in the notice, or to correct any other deficiency in
a prior notice. The amended notice must be served on the commissioner or executive board
in the same manner as the original notice and must contain the information required for
amendments under clause (3). If the amendment adds the name of a predeceased spouse
omitted from the notice, it must also state that spouse's full name, date of birth, and Social
Security number. Upon service, the amended notice relates back to and is effective from
the date the notice it amends was served. If the amended notice adds the name of an omitted
predeceased spouse or adds or corrects the Social Security number or date of birth of the
decedent or a predeceased spouse already named in the notice, then, notwithstanding any
other laws to the contrary, claims against the decedent's estate on account of those persons
resulting from the amendment and arising under section 246.53, 256B.15, 256D.16, or
261.04 are undischarged and unbarred claims, may be prosecuted by the entities entitled to
file those claims in accordance with section 524.3-1004, and the limitations in section
524.3-1006 do not apply. The person filing the amendment or any other person with personal
knowledge of the facts may provide and file or record an affidavit describing affected real
or personal property in the same manner as clause (1).

(5) After one year from the date an order or decree is entered under section 524.3-1001
or 524.3-1002, or a closing statement is filed under section 524.3-1003, no error, omission,
or defect of any kind in the notice to the commissioner or executive board required under
this paragraph or in the process of service of the notice on the commissioner or executive
board, or the failure to serve the commissioner or executive board with notice as required
by this paragraph, makes any distribution of property by a personal representative void or
voidable. The distributee's title to the distributed property shall be free of any claims based
upon a failure to comply with this paragraph.

(6) The local agency may consent to a personal representative's request to distribute
property subject to administration by the estate to distributees during the 70-day period after
service of notice on the commissioner or executive board. The local agency may grant or
deny the request in whole or in part and may attach conditions to its consent as it deems
appropriate. When the local agency consents to a distribution, it shall give the estate a written
certificate evidencing its consent to the early distribution of assets at no cost. The certificate
must include the name, case number, and district court in which the estate is pending, the
name of the local agency, describe the specific real or personal property to which the consent
applies, state that the local agency consents to the distribution of the specific property
described in the consent during the 70-day period following service of the notice on the
commissioner or executive board, state that the consent is unconditional or list all of the
terms and conditions of the consent, be dated, and may include other contents as may be
appropriate. The certificate must be signed by the director of the local agency or the director's
designees and is effective as of the date it is dated unless it provides otherwise. The signature
of the director or the director's designee does not require any acknowledgment. The certificate
shall be prima facie evidence of the facts it states, may be attached to or combined with a
deed or any other instrument of conveyance and, when so attached or combined, shall
constitute a single instrument. If the certificate describes real property, it shall be accepted
for recording or filing by the county recorder or registrar of titles in the county in which the
property is located. If the certificate describes real property and is not attached to or combined
with a deed or other instrument of conveyance, it shall be accepted for recording or filing
by the county recorder or registrar of titles in the county in which the property is located.
The certificate constitutes a waiver of the 70-day period provided for in clause (2) with
respect to the property it describes and is prima facie evidence of service of notice on the
commissioner or executive board. The certificate is not a waiver or relinquishment of any
claims arising under section 246.53, 256B.15, 256D.16, or 261.04, and does not otherwise
constitute a waiver of any of the personal representative's duties under this paragraph.
Distributees who receive property pursuant to a consent to an early distribution shall remain
liable to creditors of the estate as provided for by law.

(7) All affidavits provided for under this paragraph:

(i) shall be provided by persons who have personal knowledge of the facts stated in the
affidavit;

(ii) may be filed or recorded in the office of the county recorder or registrar of titles in
the county in which the real property they describe is located for the purpose of establishing
compliance with the requirements of this paragraph; and

(iii) are prima facie evidence of the facts stated in the affidavit.

(8) This paragraph applies to the estates of decedents dying on or after July 1, 1997.
Clause (5) also applies with respect to all notices served on the commissioner of human
services before July 1, 1997, under Laws 1996, chapter 451, article 2, section 55. All notices
served on the commissioner before July 1, 1997, pursuant to Laws 1996, chapter 451, article
2, section 55, shall be deemed to be legally sufficient for the purposes for which they were
intended, notwithstanding any errors, omissions or other defects.

ARTICLE 3

HEALTH CARE

Section 1.

new text begin [62J.805] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin For purposes of sections 62J.805 to 62J.808, the following
terms have the meanings given.
new text end

new text begin Subd. 2. new text end

new text begin Group practice. new text end

new text begin "Group practice" has the meaning given to health care provider
group practice in section 145D.01, subdivision 1.
new text end

new text begin Subd. 3. new text end

new text begin Health care provider. new text end

new text begin "Health care provider" means:
new text end

new text begin (1) a health professional who is licensed or registered by the state to provide health
treatments and services within the professional's scope of practice and in accordance with
state law;
new text end

new text begin (2) a group practice; or
new text end

new text begin (3) a hospital.
new text end

new text begin Subd. 4. new text end

new text begin Health plan. new text end

new text begin "Health plan" has the meaning given in section 62A.011,
subdivision 3.
new text end

new text begin Subd. 5. new text end

new text begin Hospital. new text end

new text begin "Hospital" means a health care facility licensed as a hospital under
sections 144.50 to 144.56.
new text end

new text begin Subd. 6. new text end

new text begin Medically necessary. new text end

new text begin "Medically necessary" means:
new text end

new text begin (1) safe and effective;
new text end

new text begin (2) not experimental or investigational, except as provided in Code of Federal Regulations,
title 42, section 411.15(o);
new text end

new text begin (3) furnished in accordance with acceptable medical standards of medical practice for
the diagnosis or treatment of the patient's condition or to improve the function of a malformed
body member;
new text end

new text begin (4) furnished in a setting appropriate to the patient's medical need and condition;
new text end

new text begin (5) ordered and furnished by qualified personnel;
new text end

new text begin (6) meets, but does not exceed, the patient's medical need; and
new text end

new text begin (7) is at least as beneficial as an existing and available medically appropriate alternative.
new text end

new text begin Subd. 7. new text end

new text begin Miscode. new text end

new text begin "Miscode" means a health care provider or a health care provider's
designee, using a coding system and for billing purposes, assigns a numeric or alphanumeric
code to a health treatment or service provided to a patient and the code assigned does not
accurately reflect the health treatment or service provided based on factors that include the
patient's diagnosis and the complexity of the patient's condition.
new text end

new text begin Subd. 8. new text end

new text begin Payment. new text end

new text begin "Payment" includes co-payments and coinsurance and deductible
payments made by a patient.
new text end

Sec. 2.

new text begin [62J.806] POLICY FOR COLLECTION OF MEDICAL DEBT.
new text end

new text begin Subdivision 1. new text end

new text begin Requirement. new text end

new text begin Each health care provider must make available to the
public the health care provider's policy for the collection of medical debt from patients. This
policy must be made available by:
new text end

new text begin (1) clearly posting it on the health care provider's website or, for health professionals,
on the website of the health clinic, group practice, or hospital at which the health professional
is employed or under contract; and
new text end

new text begin (2) providing a copy of the policy to any individual who requests it.
new text end

new text begin Subd. 2. new text end

new text begin Content. new text end

new text begin A policy made available under this section must at least specify the
procedures followed by the health care provider for:
new text end

new text begin (1) communicating with patients about the medical debt owed and collecting medical
debt;
new text end

new text begin (2) referring medical debt to a collection agency or law firm for collection; and
new text end

new text begin (3) identifying medical debt as uncollectible or satisfied, and ending collection activities.
new text end

Sec. 3.

new text begin [62J.807] DENIAL OF HEALTH TREATMENTS OR SERVICES DUE TO
OUTSTANDING MEDICAL DEBT.
new text end

new text begin (a) A health care provider must not deny medically necessary health treatments or services
to a patient or any member of the patient's family or household because of outstanding
medical debt owed by the patient or any member of the patient's family or household to the
health care provider, regardless of whether the health treatment or service may be available
from another health care provider.
new text end

new text begin (b) As a condition of providing medically necessary health treatments or services in the
circumstances described in paragraph (a), a health care provider may require the patient to
enroll in a payment plan for the outstanding medical debt owed to the health care provider.
new text end

Sec. 4.

new text begin [62J.808] BILLING AND PAYMENT FOR MISCODED HEALTH
TREATMENTS AND SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Participation and cooperation required. new text end

new text begin Each health care provider
must participate in, and cooperate with, all processes and investigations to identify, review,
and correct the coding of health treatments and services that are miscoded by the health
care provider or a designee.
new text end

new text begin Subd. 2. new text end

new text begin Notice; billing and payment during review. new text end

new text begin (a) When a health care provider
receives notice, other than notice from a health plan company as provided in paragraph (b),
or otherwise determines that a health treatment or service may have been miscoded, the
health care provider must notify the health plan company administering the patient's health
plan in a timely manner of the potentially miscoded health treatment or service.
new text end

new text begin (b) When a health plan company receives notice, other than notice from a health care
provider as provided in paragraph (a), or otherwise determines that a health treatment or
service may have been miscoded, the health plan company must notify the health care
provider who provided the health treatment or service of the potentially miscoded health
treatment or service.
new text end

new text begin (c) When a review of a potentially miscoded health treatment or service is commenced,
the health care provider and health plan company must notify the patient that a miscoding
review is being conducted and that the patient will not be billed for any health treatment or
service subject to the review and is not required to submit payments for any health treatment
or service subject to the review until the review is complete and any miscoded health
treatments or services are correctly coded.
new text end

new text begin (d) While a review of a potentially miscoded health treatment or service is being
conducted, the health care provider and health plan company must not bill the patient for,
or accept payment from the patient for, any health treatment or service subject to the review.
new text end

new text begin Subd. 3. new text end

new text begin Billing and payment after completion of review. new text end

new text begin The health care provider
and health plan company may bill the patient for, and accept payment from the patient for,
the health treatment or service that was subject to the miscoding review only after the review
is complete and any miscoded health treatments or services have been correctly coded.
new text end

Sec. 5.

Minnesota Statutes 2023 Supplement, section 144.587, subdivision 1, is amended
to read:


Subdivision 1.

Definitions.

(a) The terms defined in this subdivision apply to this section
and sections 144.588 to 144.589.

(b) "Charity care" means the provision of free or discounted care to a patient according
to a hospital's financial assistance policies.

(c) "Hospital" means a private, nonprofit, or municipal hospital licensed under sections
144.50 to 144.56.

(d) "Insurance affordability program" has the meaning given in section 256B.02,
subdivision 19.

(e) "Navigator" has the meaning given in section 62V.02, subdivision 9.

(f) "Presumptive eligibility" has the meaning given in section 256B.057, subdivision
12.

deleted text begin (g) "Revenue recapture" means the use of the procedures in chapter deleted text end deleted text begin 270A deleted text end deleted text begin to collect debt.
deleted text end

deleted text begin (h)deleted text end new text begin (g)new text end "Uninsured service or treatment" means any service or treatment that is not
covered by:

(1) a health plan, contract, or policy that provides health coverage to a patient; or

(2) any other type of insurance coverage, including but not limited to no-fault automobile
coverage, workers' compensation coverage, or liability coverage.

deleted text begin (i)deleted text end new text begin (h)new text end "Unreasonable burden" includes requiring a patient to apply for enrollment in a
state or federal program for which the patient is obviously or categorically ineligible or has
been found to be ineligible in the previous 12 months.

Sec. 6.

Minnesota Statutes 2023 Supplement, section 144.587, subdivision 4, is amended
to read:


Subd. 4.

Prohibited actions.

new text begin (a) new text end A hospital must not initiate one or more of the following
actions until the hospital determines that the patient is ineligible for charity care or denies
an application for charity care:

(1) offering to enroll or enrolling the patient in a payment plan;

(2) changing the terms of a patient's payment plan;

(3) offering the patient a loan or line of credit, application materials for a loan or line of
credit, or assistance with applying for a loan or line of credit, for the payment of medical
debt;

(4) referring a patient's debt for collections, including in-house collections, third-party
collections, deleted text begin revenue recapture,deleted text end or any other process for the collection of debt;new text begin or
new text end

deleted text begin (5) denying health care services to the patient or any member of the patient's household
because of outstanding medical debt, regardless of whether the services are deemed necessary
or may be available from another provider; or
deleted text end

deleted text begin (6)deleted text end new text begin (5)new text end accepting a credit card payment of over $500 for the medical debt owed to the
hospital.

new text begin (b) A hospital is subject to section 62J.807.
new text end

Sec. 7.

Minnesota Statutes 2023 Supplement, section 151.555, subdivision 1, is amended
to read:


Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.

(b) "Central repository" means a wholesale distributor that meets the requirements under
subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this
section.

(c) "Distribute" means to deliver, other than by administering or dispensing.

(d) "Donor" means:

(1) deleted text begin a health care facility as defined in this subdivisiondeleted text end new text begin an individual at least 18 years of
age, provided that the drug or medical supply that is donated was obtained legally and meets
the requirements of this section for donation
new text end ;new text begin or
new text end

(2) deleted text begin a skilled nursing facility licensed under chapter deleted text end deleted text begin 144Adeleted text end deleted text begin ;deleted text end new text begin any entity legally authorized
to possess medicine with a license or permit in good standing in the state in which it is
located, without further restrictions, including but not limited to a health care facility, skilled
nursing facility, assisted living facility, pharmacy, wholesaler, and drug manufacturer.
new text end

deleted text begin (3) an assisted living facility licensed under chapter deleted text end deleted text begin 144G deleted text end deleted text begin ;
deleted text end

deleted text begin (4) a pharmacy licensed under section 151.19, and located either in the state or outside
the state;
deleted text end

deleted text begin (5) a drug wholesaler licensed under section 151.47;
deleted text end

deleted text begin (6) a drug manufacturer licensed under section 151.252; or
deleted text end

deleted text begin (7) an individual at least 18 years of age, provided that the drug or medical supply that
is donated was obtained legally and meets the requirements of this section for donation.
deleted text end

(e) "Drug" means any prescription drug that has been approved for medical use in the
United States, is listed in the United States Pharmacopoeia or National Formulary, and
meets the criteria established under this section for donation; or any over-the-counter
medication that meets the criteria established under this section for donation. This definition
includes cancer drugs and antirejection drugs, but does not include controlled substances,
as defined in section 152.01, subdivision 4, or a prescription drug that can only be dispensed
to a patient registered with the drug's manufacturer in accordance with federal Food and
Drug Administration requirements.

(f) "Health care facility" means:

(1) a physician's office or health care clinic where licensed practitioners provide health
care to patients;

(2) a hospital licensed under section 144.50;

(3) a pharmacy licensed under section 151.19 and located in Minnesota; or

(4) a nonprofit community clinic, including a federally qualified health center; a rural
health clinic; public health clinic; or other community clinic that provides health care utilizing
a sliding fee scale to patients who are low-income, uninsured, or underinsured.

(g) "Local repository" means a health care facility that elects to accept donated drugs
and medical supplies and meets the requirements of subdivision 4.

(h) "Medical supplies" or "supplies" means any prescription or nonprescription medical
supplies needed to administer a drug.

(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is
sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or
unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose
packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules,
part 6800.3750.

(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that
it does not include a veterinarian.

Sec. 8.

Minnesota Statutes 2023 Supplement, section 151.555, subdivision 4, is amended
to read:


Subd. 4.

Local repository requirements.

(a) To be eligible for participation in the
medication repository program, a health care facility must agree to comply with all applicable
federal and state laws, rules, and regulations pertaining to the medication repository program,
drug storage, and dispensing. The facility must also agree to maintain in good standing any
required state license or registration that may apply to the facility.

(b) A local repository may elect to participate in the program by submitting the following
information to the central repository on a form developed by the board and made available
on the board's website:

(1) the name, street address, and telephone number of the health care facility and any
state-issued license or registration number issued to the facility, including the issuing state
agency;

(2) the name and telephone number of a responsible pharmacist or practitioner who is
employed by or under contract with the health care facility; and

(3) a statement signed and dated by the responsible pharmacist or practitioner indicating
that the health care facility meets the eligibility requirements under this section and agrees
to comply with this section.

(c) Participation in the medication repository program is voluntary. A local repository
may withdraw from participation in the medication repository program at any time by
providing written notice to the central repository on a form developed by the board and
made available on the board's website. deleted text begin The central repository shall provide the board with
a copy of the withdrawal notice within ten business days from the date of receipt of the
withdrawal notice.
deleted text end

Sec. 9.

Minnesota Statutes 2023 Supplement, section 151.555, subdivision 5, is amended
to read:


Subd. 5.

Individual eligibility and application requirements.

(a) deleted text begin To be eligible for
the medication repository program
deleted text end new text begin At the time of or before receiving donated drugs or
supplies as a new eligible patient
new text end , an individual must submit to a local repository an new text begin electronic
or physical
new text end intake application form that is signed by the individual and attests that the
individual:

(1) is a resident of Minnesota;

(2) is uninsured deleted text begin and is not enrolled in the medical assistance program under chapter
deleted text end deleted text begin 256Bdeleted text end deleted text begin or the MinnesotaCare program under chapter deleted text end deleted text begin 256Ldeleted text end , has no prescription drug coverage,
or is underinsured;

(3) acknowledges that the drugs or medical supplies to be received through the program
may have been donated; and

(4) consents to a waiver of the child-resistant packaging requirements of the federal
Poison Prevention Packaging Act.

deleted text begin (b) Upon determining that an individual is eligible for the program, the local repository
shall furnish the individual with an identification card. The card shall be valid for one year
from the date of issuance and may be used at any local repository. A new identification card
may be issued upon expiration once the individual submits a new application form.
deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end The local repository shall send a copy of the intake application form to the central
repository by regular mail, facsimile, or secured email within ten days from the date the
application is approved by the local repository.

deleted text begin (d)deleted text end new text begin (c)new text end The board shall develop and make available on the board's website an application
form deleted text begin and the format for the identification carddeleted text end .

Sec. 10.

Minnesota Statutes 2023 Supplement, section 151.555, subdivision 6, is amended
to read:


Subd. 6.

Standards and procedures for accepting donations of drugs and supplies.

(a)
new text begin Notwithstanding any other law or rule, new text end a donor may donate drugs or medical supplies to
the central repository or a local repository if the drug or supply meets the requirements of
this section as determined by a pharmacist or practitioner who is employed by or under
contract with the central repository or a local repository.

(b) A drug is eligible for donation under the medication repository program if the
following requirements are met:

deleted text begin (1) the donation is accompanied by a medication repository donor form described under
paragraph (d) that is signed by an individual who is authorized by the donor to attest to the
donor's knowledge in accordance with paragraph (d);
deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end the drug's expiration date is at least six months after the date the drug was donated.
If a donated drug bears an expiration date that is less than six months from the donation
date, the drug may be accepted and distributed if the drug is in high demand and can be
dispensed for use by a patient before the drug's expiration date;

deleted text begin (3)deleted text end new text begin (2)new text end the drug is in its original, sealed, unopened, tamper-evident packaging that includes
the expiration date. Single-unit-dose drugs may be accepted if the single-unit-dose packaging
is unopened;

deleted text begin (4)deleted text end new text begin (3)new text end the drug or the packaging does not have any physical signs of tampering,
misbranding, deterioration, compromised integrity, or adulteration;

deleted text begin (5)deleted text end new text begin (4)new text end the drug does not require storage temperatures other than normal room temperature
as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being
donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located
in Minnesota; and

deleted text begin (6)deleted text end new text begin (5)new text end the drug is not a controlled substance.

(c) A medical supply is eligible for donation under the medication repository program
if the following requirements are met:

(1) the supply has no physical signs of tampering, misbranding, or alteration and there
is no reason to believe it has been adulterated, tampered with, or misbranded;

(2) the supply is in its original, unopened, sealed packaging;new text begin and
new text end

deleted text begin (3) the donation is accompanied by a medication repository donor form described under
paragraph (d) that is signed by an individual who is authorized by the donor to attest to the
donor's knowledge in accordance with paragraph (d); and
deleted text end

deleted text begin (4)deleted text end new text begin (3)new text end if the supply bears an expiration date, the date is at least six months later than
the date the supply was donated. If the donated supply bears an expiration date that is less
than six months from the date the supply was donated, the supply may be accepted and
distributed if the supply is in high demand and can be dispensed for use by a patient before
the supply's expiration date.

(d) The board shall develop the medication repository donor form and make it available
on the board's website. deleted text begin The form must state that to the best of the donor's knowledge the
donated drug or supply has been properly stored under appropriate temperature and humidity
conditions and that the drug or supply has never been opened, used, tampered with,
adulterated, or misbranded.
deleted text end new text begin Prior to the first donation from a new donor, a central repository
or local repository shall verify and record the following information on the donor form:
new text end

new text begin (1) the donor's name, address, phone number, and license number, if applicable;
new text end

new text begin (2) that the donor will only make donations in accordance with the program;
new text end

new text begin (3) to the best of the donor's knowledge, only drugs or supplies that have been properly
stored under appropriate temperature and humidity conditions will be donated; and
new text end

new text begin (4) to the best of the donor's knowledge, only drugs or supplies that have never been
opened, used, tampered with, adulterated, or misbranded will be donated.
new text end

(e) new text begin Notwithstanding any other law or rule, a central repository or a local repository may
receive donated drugs from donors.
new text end Donated drugs and supplies may be shipped or delivered
to the premises of the central repository or a local repository, and shall be inspected by a
pharmacist or an authorized practitioner who is employed by or under contract with the
repository and who has been designated by the repository deleted text begin to accept donationsdeleted text end new text begin prior to
dispensing
new text end . A drop box must not be used to deliver or accept donations.

(f) The central repository and local repository shall new text begin maintain a written or electronic
new text end inventory new text begin of new text end all drugs and supplies donated to the repositorynew text begin upon acceptance of each drug
or supply
new text end . For each drug, the inventory must include the drug's name, strength, quantity,
manufacturer, expiration date, and the date the drug was donated. For each medical supply,
the inventory must include a description of the supply, its manufacturer, the date the supply
was donated, and, if applicable, the supply's brand name and expiration date.new text begin The board
may waive the requirement under this paragraph if an entity is under common ownership
or control with a central repository or local repository and either the entity or the repository
maintains an inventory containing all the information required under this paragraph.
new text end

Sec. 11.

Minnesota Statutes 2023 Supplement, section 151.555, subdivision 7, is amended
to read:


Subd. 7.

Standards and procedures for inspecting and storing donated drugs and
supplies.

(a) A pharmacist or authorized practitioner who is employed by or under contract
with the central repository or a local repository shall inspect all donated drugs and supplies
before the drug or supply is dispensed to determine, to the extent reasonably possible in the
professional judgment of the pharmacist or practitioner, that the drug or supply is not
adulterated or misbranded, has not been tampered with, is safe and suitable for dispensing,
has not been subject to a recall, and meets the requirements for donation. deleted text begin The pharmacist
or practitioner who inspects the drugs or supplies shall sign an inspection record stating that
the requirements for donation have been met.
deleted text end If a local repository receives drugs and supplies
from the central repository, the local repository does not need to reinspect the drugs and
supplies.

(b) The central repository and local repositories shall store donated drugs and supplies
in a secure storage area under environmental conditions appropriate for the drug or supply
being stored. Donated drugs and supplies may not be stored with nondonated inventory.

(c) The central repository and local repositories shall dispose of all drugs and medical
supplies that are not suitable for donation in compliance with applicable federal and state
statutes, regulations, and rules concerning hazardous waste.

(d) In the event that controlled substances or drugs that can only be dispensed to a patient
registered with the drug's manufacturer are shipped or delivered to a central or local repository
for donation, the shipment delivery must be documented by the repository and returned
immediately to the donor or the donor's representative that provided the drugs.

(e) Each repository must develop drug and medical supply recall policies and procedures.
If a repository receives a recall notification, the repository shall destroy all of the drug or
medical supply in its inventory that is the subject of the recall and complete a record of
destruction form in accordance with paragraph (f). If a drug or medical supply that is the
subject of a Class I or Class II recall has been dispensed, the repository shall immediately
notify the recipient of the recalled drug or medical supply. A drug that potentially is subject
to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug
is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.

(f) A record of destruction of donated drugs and supplies that are not dispensed under
subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation
shall be maintained by the repository for at least two years. For each drug or supply destroyed,
the record shall include the following information:

(1) the date of destruction;

(2) the name, strength, and quantity of the drug destroyed; and

(3) the name of the person or firm that destroyed the drug.

new text begin No other record of destruction is required.
new text end

Sec. 12.

Minnesota Statutes 2023 Supplement, section 151.555, subdivision 8, is amended
to read:


Subd. 8.

Dispensing requirements.

(a) Donated new text begin prescription new text end drugs and supplies may
be dispensed if the drugs or supplies are prescribed by a practitioner for use by an eligible
individual and are dispensed by a pharmacist or practitioner. A repository shall dispense
drugs and supplies to eligible individuals in the following priority order: (1) individuals
who are uninsured; (2) individuals with no prescription drug coverage; and (3) individuals
who are underinsured. A repository shall dispense donated drugs in compliance with
applicable federal and state laws and regulations for dispensing drugs, including all
requirements relating to packaging, labeling, record keeping, drug utilization review, and
patient counseling.

(b) Before dispensing or administering a drug or supply, the pharmacist or practitioner
shall visually inspect the drug or supply for adulteration, misbranding, tampering, and date
of expiration. Drugs or supplies that have expired or appear upon visual inspection to be
adulterated, misbranded, or tampered with in any way must not be dispensed or administered.

(c) Before deleted text begin adeleted text end new text begin the firstnew text end drug or supply is dispensed or administered to an individual, the
individual must sign deleted text begin adeleted text end new text begin an electronic or physicalnew text end drug repository recipient form acknowledging
that the individual understands deleted text begin the information stated on the form. The board shall develop
the form and make it available on the board's website. The form must include the following
information
deleted text end :

(1) that the drug or supply being dispensed or administered has been donated and may
have been previously dispensed;

(2) that a visual inspection has been conducted by the pharmacist or practitioner to ensure
that the drug or supply has not expired, has not been adulterated or misbranded, and is in
its original, unopened packaging; and

(3) that the dispensing pharmacist, the dispensing or administering practitioner, the
central repository or local repository, the Board of Pharmacy, and any other participant of
the medication repository program cannot guarantee the safety of the drug or medical supply
being dispensed or administered and that the pharmacist or practitioner has determined that
the drug or supply is safe to dispense or administer based on the accuracy of the donor's
form submitted with the donated drug or medical supply and the visual inspection required
to be performed by the pharmacist or practitioner before dispensing or administering.

Sec. 13.

Minnesota Statutes 2023 Supplement, section 151.555, subdivision 9, is amended
to read:


Subd. 9.

Handling fees.

(a) The central or local repository may charge the individual
receiving a drug or supply a handling fee of no more than 250 percent of the medical
assistance program dispensing fee for each drug or medical supply dispensed or administered
by that repository.

(b) A repository that dispenses or administers a drug or medical supply through the
medication repository program shall not receive reimbursement under the medical assistance
program or the MinnesotaCare program for that dispensed or administered drug or supply.

new text begin (c) A supply or handling fee must not be charged to an individual enrolled in the medical
assistance or MinnesotaCare program.
new text end

Sec. 14.

Minnesota Statutes 2023 Supplement, section 151.555, subdivision 11, is amended
to read:


Subd. 11.

Forms and record-keeping requirements.

(a) The following forms developed
for the administration of this program deleted text begin shall be utilized by the participants of the program
and
deleted text end shall be available on the board's website:

(1) intake application form described under subdivision 5;

(2) local repository participation form described under subdivision 4;

(3) local repository withdrawal form described under subdivision 4;

(4) medication repository donor form described under subdivision 6;

(5) record of destruction form described under subdivision 7; and

(6) medication repository recipient form described under subdivision 8.

new text begin Participants may use substantively similar electronic or physical forms.
new text end

(b) All records, including drug inventorydeleted text begin , inspection,deleted text end and disposal of donated drugs and
medical supplies, must be maintained by a repository for a minimum of two years. Records
required as part of this program must be maintained pursuant to all applicable practice acts.

(c) Data collected by the medication repository program from all local repositories shall
be submitted quarterly or upon request to the central repository. Data collected may consist
of the information, records, and forms required to be collected under this section.

(d) The central repository shall submit reports to the board as required by the contract
or upon request of the board.

Sec. 15.

Minnesota Statutes 2023 Supplement, section 151.555, subdivision 12, is amended
to read:


Subd. 12.

Liability.

(a) The manufacturer of a drug or supply is not subject to criminal
or civil liability for injury, death, or loss to a person or to property for causes of action
described in clauses (1) and (2). A manufacturer is not liable for:

(1) the intentional or unintentional alteration of the drug or supply by a party not under
the control of the manufacturer; or

(2) the failure of a party not under the control of the manufacturer to transfer or
communicate product or consumer information or the expiration date of the donated drug
or supply.

(b) A health care facility participating in the program, a pharmacist dispensing a drug
or supply pursuant to the program, a practitioner dispensing or administering a drug or
supply pursuant to the program, deleted text begin ordeleted text end a donor of a drug or medical supplynew text begin , or a person or entity
that facilitates any of the above
new text end is immune from civil liability for an act or omission that
causes injury to or the death of an individual to whom the drug or supply is dispensed and
no disciplinary action by a health-related licensing board shall be taken against a deleted text begin pharmacist
or practitioner
deleted text end new text begin person or entitynew text end so long as the drug or supply is donated, accepted, distributed,
and dispensed according to the requirements of this section. This immunity does not apply
if the act or omission involves reckless, wanton, or intentional misconduct, or malpractice
unrelated to the quality of the drug or medical supply.

Sec. 16.

Minnesota Statutes 2023 Supplement, section 151.74, subdivision 3, is amended
to read:


Subd. 3.

Access to urgent-need insulin.

(a) MNsure shall develop an application form
to be used by an individual who is in urgent need of insulin. The application must ask the
individual to attest to the eligibility requirements described in subdivision 2. The form shall
be accessible through MNsure's website. MNsure shall also make the form available to
pharmacies and health care providers who prescribe or dispense insulin, hospital emergency
departments, urgent care clinics, and community health clinics. By submitting a completed,
signed, and dated application to a pharmacy, the individual attests that the information
contained in the application is correct.

(b) If the individual is in urgent need of insulin, the individual may present a completed,
signed, and dated application form to a pharmacy. The individual must also:

(1) have a valid insulin prescription; and

(2) present the pharmacist with identification indicating Minnesota residency in the form
of a valid Minnesota identification card, driver's license or permit, individual taxpayer
identification number, or Tribal identification card as defined in section 171.072, paragraph
(b). If the individual in urgent need of insulin is under the age of 18, the individual's parent
or legal guardian must provide the pharmacist with proof of residency.

(c) Upon receipt of a completed and signed application, the pharmacist shall dispense
the prescribed insulin in an amount that will provide the individual with a 30-day supply.
The pharmacy must notify the health care practitioner who issued the prescription order no
later than 72 hours after the insulin is dispensed.

(d) The pharmacy may submit to the manufacturer of the dispensed insulin product or
to the manufacturer's vendor a claim for payment that is in accordance with the National
Council for Prescription Drug Program standards for electronic claims processing, unless
the manufacturer agrees to send to the pharmacy a replacement supply of the same insulin
as dispensed in the amount dispensed. If the pharmacy submits an electronic claim to the
manufacturer or the manufacturer's vendor, the manufacturer or vendor shall reimburse the
pharmacy in an amount that covers the pharmacy's acquisition cost.

(e) The pharmacy may collect an insulin co-payment from the individual to cover the
pharmacy's costs of processing and dispensing in an amount not to exceed $35 for the 30-day
supply of insulin dispensed.

(f) The pharmacy shall also provide each eligible individual with the information sheet
described in subdivision 7 and a list of trained navigators provided by the Board of Pharmacy
for the individual to contact if the individual deleted text begin is in need of accessingdeleted text end new text begin needs to accessnew text end ongoing
insulin coverage options, including assistance in:

(1) applying for medical assistance or MinnesotaCare;

(2) applying for a qualified health plan offered through MNsure, subject to open and
special enrollment periods;

(3) accessing information on providers who participate in prescription drug discount
programs, including providers who are authorized to participate in the 340B program under
section 340b of the federal Public Health Services Act, United States Code, title 42, section
256b; and

(4) accessing insulin manufacturers' patient assistance programs, co-payment assistance
programs, and other foundation-based programs.

(g) The pharmacist shall retain a copy of the application form submitted by the individual
to the pharmacy for reporting and auditing purposes.

new text begin (h) A manufacturer may submit to the commissioner of administration a request for
reimbursement in an amount not to exceed $35 for each 30-day supply of insulin the
manufacturer provides under paragraph (d). The commissioner of administration shall
determine the manner and format for submitting and processing requests for reimbursement.
After receiving a reimbursement request, the commissioner of administration shall reimburse
the manufacturer in an amount not to exceed $35 for each 30-day supply of insulin the
manufacturer provided under paragraph (d).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024.
new text end

Sec. 17.

Minnesota Statutes 2022, section 151.74, subdivision 6, is amended to read:


Subd. 6.

Continuing safety net program; process.

(a) The individual shall submit to
a pharmacy the statement of eligibility provided by the manufacturer under subdivision 5,
paragraph (b). Upon receipt of an individual's eligibility status, the pharmacy shall submit
an order containing the name of the insulin product and the daily dosage amount as contained
in a valid prescription to the product's manufacturer.

(b) The pharmacy must include with the order to the manufacturer the following
information:

(1) the pharmacy's name and shipping address;

(2) the pharmacy's office telephone number, fax number, email address, and contact
name; and

(3) any specific days or times when deliveries are not accepted by the pharmacy.

(c) Upon receipt of an order from a pharmacy and the information described in paragraph
(b), the manufacturer shall send to the pharmacy a 90-day supply of insulin as ordered,
unless a lesser amount is requested in the order, at no charge to the individual or pharmacy.

(d) Except as authorized under paragraph (e), the pharmacy shall provide the insulin to
the individual at no charge to the individual. The pharmacy shall not provide insulin received
from the manufacturer to any individual other than the individual associated with the specific
order. The pharmacy shall not seek reimbursement for the insulin received from the
manufacturer or from any third-party payer.

(e) The pharmacy may collect a co-payment from the individual to cover the pharmacy's
costs for processing and dispensing in an amount not to exceed $50 for each 90-day supply
if the insulin is sent to the pharmacy.

(f) The pharmacy may submit to a manufacturer a reorder for an individual if the
individual's eligibility statement has not expired. Upon receipt of a reorder from a pharmacy,
the manufacturer must send to the pharmacy an additional 90-day supply of the product,
unless a lesser amount is requested, at no charge to the individual or pharmacy if the
individual's eligibility statement has not expired.

(g) Notwithstanding paragraph (c), a manufacturer may send the insulin as ordered
directly to the individual if the manufacturer provides a mail order service option.

new text begin (h) A manufacturer may submit to the commissioner of administration a request for
reimbursement in an amount not to exceed $105 for each 90-day supply of insulin the
manufacturer provides under paragraphs (c) and (f). The commissioner of administration
shall determine the manner and format for submitting and processing requests for
reimbursement. After receiving a reimbursement request, the commissioner of administration
shall reimburse the manufacturer in an amount not to exceed $105 for each 90-day supply
of insulin the manufacturer provided under paragraphs (c) and (f). If the manufacturer
provides less than a 90-day supply of insulin under paragraphs (c) and (f), the manufacturer
may submit a request for reimbursement not to exceed $35 for each 30-day supply of insulin
provided.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024.
new text end

Sec. 18.

new text begin [151.741] INSULIN MANUFACTURER REGISTRATION FEE.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Board" means the Minnesota Board of Pharmacy under section 151.02.
new text end

new text begin (c) "Manufacturer" means a manufacturer licensed under section 151.252 and engaged
in the manufacturing of prescription insulin.
new text end

new text begin Subd. 2. new text end

new text begin Assessment of registration fee. new text end

new text begin (a) The board shall assess each manufacturer
an annual registration fee of $100,000, except as provided in paragraph (b). The board shall
notify each manufacturer of this requirement beginning November 1, 2024, and each
November 1 thereafter.
new text end

new text begin (b) A manufacturer may request an exemption from the annual registration fee. The
board shall exempt a manufacturer from the annual registration fee if the manufacturer can
demonstrate to the board, in the form and manner specified by the board, that sales of
prescription insulin produced by that manufacturer and sold or delivered within or into the
state totaled $2,000,000 or less in the previous calendar year.
new text end

new text begin Subd. 3. new text end

new text begin Payment of the registration fee; deposit of fee. new text end

new text begin (a) Each manufacturer must
pay the registration fee by March 1, 2025, and by each March 1 thereafter. In the event of
a change in ownership of the manufacturer, the new owner must pay the registration fee
that the original owner would have been assessed had the original owner retained ownership.
The board may assess a late fee of ten percent per month or any portion of a month that the
registration fee is paid after the due date.
new text end

new text begin (b) The registration fee, including any late fees, must be deposited in the insulin safety
net program account.
new text end

new text begin Subd. 4. new text end

new text begin Insulin safety net program account. new text end

new text begin The insulin safety net program account
is established in the special revenue fund in the state treasury. Money in the account is
appropriated each fiscal year to:
new text end

new text begin (1) the MNsure board in an amount sufficient to carry out assigned duties under section
151.74, subdivision 7; and
new text end

new text begin (2) the Board of Pharmacy in an amount sufficient to cover costs incurred by the board
in assessing and collecting the registration fee under this section and in administering the
insulin safety net program under section 151.74.
new text end

new text begin Subd. 5. new text end

new text begin Insulin repayment account; annual transfer from health care access fund. new text end

new text begin (a)
The insulin repayment account is established in the special revenue fund in the state treasury.
Money in the account is appropriated each fiscal year to the commissioner of administration
in an amount sufficient for the commissioner to reimburse manufacturers for insulin dispensed
under the insulin safety net program in section 151.74, in accordance with section 151.74,
subdivisions 3, paragraph (h), and 6, paragraph (h), and to cover costs incurred by the
commissioner in providing these reimbursement payments.
new text end

new text begin (b) The commissioner of management and budget shall transfer from the health care
access fund to the insulin repayment account, beginning July 1, 2025, and each July 1
thereafter, an amount sufficient for the commissioner of administration to implement
paragraph (a).
new text end

new text begin Subd. 6. new text end

new text begin Contingent transfer by commissioner. new text end

new text begin If subdivisions 2 and 3, or the
application of subdivisions 2 and 3 to any person or circumstance, are held invalid for any
reason in a court of competent jurisdiction, the validity of subdivisions 2 and 3 does not
affect other provisions of this act, and the commissioner of management and budget shall
annually transfer from the health care access fund to the insulin safety net program account
an amount sufficient to implement subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024.
new text end

Sec. 19.

Minnesota Statutes 2023 Supplement, section 270A.03, subdivision 2, is amended
to read:


Subd. 2.

Claimant agency.

"Claimant agency" means any state agency, as defined by
section 14.02, subdivision 2, the regents of the University of Minnesota, any district court
of the state, any county, any statutory or home rule charter city, including a city that is
presenting a claim for deleted text begin a municipal hospital ordeleted text end a public library deleted text begin or a municipal ambulance
service, a hospital district, any ambulance service licensed under chapter 144E
deleted text end , any public
agency responsible for child support enforcement, any public agency responsible for the
collection of court-ordered restitution, and any public agency established by general or
special law that is responsible for the administration of a low-income housing program.

Sec. 20.

new text begin [332.371] MEDICAL DEBT CREDIT REPORTING PROHIBITED.
new text end

new text begin (a) A consumer reporting agency is prohibited from making a consumer report containing
an item of information that the consumer reporting agency knows or should know concerns
(1) medical information; or (2) debt arising from: (i) the provision of medical care, treatment,
services, devices, or medicines; or (ii) procedures to maintain, diagnose, or treat a person's
physical or mental health.
new text end

new text begin (b) For purposes of this section, "consumer report," "consumer reporting agency," and
"medical information" have the meanings given in the Fair Credit Reporting Act, United
States Code, title 15, section 1681a.
new text end

Sec. 21.

new text begin [332C.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin For purposes of this chapter, the following terms have the
meanings given.
new text end

new text begin Subd. 2. new text end

new text begin Collecting party. new text end

new text begin "Collecting party" means a party engaged in the collection
of medical debt for any account, bill, or other indebtedness, except as hereinafter provided.
new text end

new text begin Subd. 3. new text end

new text begin Debtor. new text end

new text begin "Debtor" means a person obligated or alleged to be obligated to pay
any debt.
new text end

new text begin Subd. 4. new text end

new text begin Medical debt. new text end

new text begin "Medical debt" means debt incurred primarily for necessary
medical care and related services. Medical debt does not include debt charged to a credit
card unless the credit card is issued under a credit plan offered solely for the payment of
health care treatment or services.
new text end

new text begin Subd. 5. new text end

new text begin Person. new text end

new text begin "Person" means any individual, partnership, association, or corporation.
new text end

Sec. 22.

new text begin [332C.02] PROHIBITED PRACTICES.
new text end

new text begin No collecting party shall:
new text end

new text begin (1) in a collection letter, publication, invoice, or any oral or written communication,
threaten wage garnishment or legal suit by a particular lawyer, unless the collecting party
has actually retained the lawyer to do so;
new text end

new text begin (2) use or employ sheriffs or any other officer authorized to serve legal papers in
connection with the collection of a claim, except when performing their legally authorized
duties;
new text end

new text begin (3) use or threaten to use methods of collection which violate Minnesota law;
new text end

new text begin (4) furnish legal advice to debtors or represent that the collecting party is competent or
able to furnish legal advice to debtors;
new text end

new text begin (5) communicate with debtors in a misleading or deceptive manner by falsely using the
stationery of a lawyer, forms or instruments which only lawyers are authorized to prepare,
or instruments which simulate the form and appearance of judicial process;
new text end

new text begin (6) publish or cause to be published any list of debtors, use shame cards or shame
automobiles, advertise or threaten to advertise for sale any claim as a means of forcing
payment thereof, or use similar devices or methods of intimidation;
new text end

new text begin (7) operate under a name or in a manner which falsely implies the collecting party is a
branch of or associated with any department of federal, state, county, or local government
or an agency thereof;
new text end

new text begin (8) transact business or hold itself out as a debt settlement company, debt management
company, debt adjuster, or any person who settles, adjusts, prorates, pools, liquidates, or
pays the indebtedness of a debtor, unless there is no charge to the debtor, or the pooling or
liquidation is done pursuant to court order or under the supervision of a creditor's committee;
new text end

new text begin (9) unless an exemption in the law exists, violate Code of Federal Regulations, title 12,
part 1006, while attempting to collect on any account, bill, or other indebtedness. For
purposes of this section, Public Law 95-109 and Code of Federal Regulations, title 12, part
1006, apply to collecting parties;
new text end

new text begin (10) communicate with a debtor by use of an automatic telephone dialing system or an
artificial or prerecorded voice after the debtor expressly informs the collecting party to cease
communication utilizing an automatic telephone dialing system or an artificial or prerecorded
voice. For purposes of this clause, an automatic telephone dialing system or an artificial or
prerecorded voice includes but is not limited to (i) artificial intelligence chat bots, and (ii)
the usage of the term under the Telephone Consumer Protection Act, United States Code,
title 47, section 227(b)(1)(A);
new text end

new text begin (11) in collection letters or publications, or in any oral or written communication, imply
or suggest that medically necessary health treatment or services will be denied as a result
of a medical debt;
new text end

new text begin (12) when a debtor has a listed telephone number, enlist the aid of a neighbor or third
party to request that the debtor contact the collecting party, except a person who resides
with the debtor or a third party with whom the debtor has authorized with the collecting
party to place the request. This clause does not apply to a call back message left at the
debtor's place of employment which is limited solely to the collecting party's telephone
number and name;
new text end

new text begin (13) when attempting to collect a medical debt, fail to provide the debtor with the full
name of the collecting party, as registered with the secretary of state;
new text end

new text begin (14) fail to return any amount of overpayment from a debtor to the debtor or to the state
of Minnesota pursuant to the requirements of chapter 345;
new text end

new text begin (15) accept currency or coin as payment for a medical debt without issuing an original
receipt to the debtor and maintaining a duplicate receipt in the debtor's payment records;
new text end

new text begin (16) attempt to collect any amount, including any interest, fee, charge, or expense
incidental to the charge-off obligation, from a debtor unless the amount is expressly
authorized by the agreement creating the medical debt or is otherwise permitted by law;
new text end

new text begin (17) falsify any documents with the intent to deceive;
new text end

new text begin (18) when initially contacting a Minnesota debtor by mail to collect a medical debt, fail
to include a disclosure on the contact notice, in a type size or font which is equal to or larger
than the largest other type of type size or font used in the text of the notice, that includes
and identifies the Office of the Minnesota Attorney General's general telephone number,
and states: "You have the right to hire your own attorney to represent you in this matter.";
new text end

new text begin (19) commence legal action to collect a medical debt outside the limitations period set
forth in section 541.053;
new text end

new text begin (20) report to a credit reporting agency any medical debt which the collecting party
knows or should know is or was originally owed to a health care provider, as defined in
section 62J.805, subdivision 2; or
new text end

new text begin (21) challenge a debtor's claim of exemption to garnishment or levy in a manner that is
baseless, frivolous, or otherwise in bad faith.
new text end

Sec. 23.

new text begin [332C.04] DEFENDING MEDICAL DEBT CASES.
new text end

new text begin A debtor who successfully defends against a claim for payment of medical debt that is
alleged by a collecting party must be awarded the debtor's costs, including a reasonable
attorney fee, incurred in defending against the collecting party's claim for debt payment.
new text end

Sec. 24.

new text begin [332C.05] ENFORCEMENT.
new text end

new text begin (a) The attorney general may enforce this chapter under section 8.31.
new text end

new text begin (b) A collecting party that violates this chapter is strictly liable to the debtor in question
for the sum of:
new text end

new text begin (1) actual damage sustained by the debtor as a result of the violation;
new text end

new text begin (2) additional damages as the court may allow, but not exceeding $1,000 per violation;
and
new text end

new text begin (3) in the case of any successful action to enforce the foregoing, the costs of the action,
together with a reasonable attorney fee as determined by the court.
new text end

new text begin (c) A collecting party that willfully and maliciously violates this chapter is strictly liable
to the debtor for three times the sums allowable under paragraph (b), clauses (1) and (2).
new text end

new text begin (d) The dollar amount limit under paragraph (b), clause (2), changes on July 1 of each
even-numbered year in an amount equal to changes made in the Consumer Price Index,
compiled by the United States Bureau of Labor Statistics. The Consumer Price Index for
December 2024 is the reference base index. If the Consumer Price Index is revised, the
percentage of change made under this section must be calculated on the basis of the revised
Consumer Price Index. If a Consumer Price Index revision changes the reference base index,
a revised reference base index must be determined by multiplying the reference base index
that is effective at the time by the rebasing factor furnished by the Bureau of Labor Statistics.
new text end

new text begin (e) If the Consumer Price Index is superseded, the Consumer Price Index referred to in
this section is the Consumer Price Index represented by the Bureau of Labor Statistics as
most accurately reflecting changes in the prices paid by consumers for consumer goods and
services.
new text end

new text begin (f) The attorney general must publish the base reference index under paragraph (c) in
the State Register no later than September 1, 2024. The attorney general must calculate and
then publish the revised Consumer Price Index under paragraph (c) in the State Register no
later than September 1 each even-numbered year.
new text end

new text begin (g) An action brought under this section benefits the public.
new text end

Sec. 25.

Minnesota Statutes 2022, section 334.01, is amended by adding a subdivision to
read:


new text begin Subd. 4. new text end

new text begin Contracts for medical care. new text end

new text begin Interest for any debt owed to a health care provider
incurred in exchange for care, treatment, services, devices, medicines, or procedures to
maintain, diagnose, or treat a person's physical or mental health shall be at a rate of $4 upon
$100 for a year.
new text end

Sec. 26.

Minnesota Statutes 2022, section 519.05, is amended to read:


519.05 LIABILITY OF deleted text begin HUSBAND AND WIFEdeleted text end new text begin SPOUSESnew text end .

(a) A spouse is not liable to a creditor for any debts of the other spouse. deleted text begin Where husband
and wife are living together, they
deleted text end new text begin Spousesnew text end shall be jointly and severally liable for deleted text begin necessary
medical services that have been furnished to either spouse, including
deleted text end any claims arising
under section deleted text begin 246.53,deleted text end 256B.15deleted text begin , 256D.16, or 261.04, and necessary household articles and
supplies furnished to and used by the family
deleted text end . Notwithstanding this paragraph, in a proceeding
under chapter 518 the court may apportion such debt between the spouses.

(b) Either spouse may close a credit card account or other unsecured consumer line of
credit on which both spouses are contractually liable, by giving written notice to the creditor.

Sec. 27.

Laws 2020, chapter 73, section 8, is amended to read:


Sec. 8. APPROPRIATIONS.

(a) $297,000 is appropriated in fiscal year 2020 from the health care access fund to the
Board of Directors of MNsure deleted text begin to train navigators to assist individuals and provide
compensation as required
deleted text end new text begin for the insulin safety net programnew text end under Minnesota Statutes,
section 151.74deleted text begin , subdivision 7deleted text end . deleted text begin Of this appropriation, $108,000 is for implementing the
training requirements for navigators and $189,000 is for application assistance bonus
payments.
deleted text end This is a onetime appropriation and is available until deleted text begin December 31, 2024deleted text end new text begin June
30, 2027
new text end .

(b) $250,000 is appropriated in fiscal year 2020 from the health care access fund to the
Board of Directors of MNsure for a public awareness campaign for the insulin safety net
program established under Minnesota Statutes, section 151.74. This is a onetime appropriation
and is available until December 31, 2024.

(c) $76,000 is appropriated in fiscal year 2021 from the health care access fund to the
Board of Pharmacy to implement Minnesota Statutes, section 151.74. The base for this
appropriation is $76,000 in fiscal year 2022; $76,000 in fiscal year 2023; $76,000 in fiscal
year 2024; $38,000 in fiscal year 2025; and $0 in fiscal year 2026.

(d) $136,000 in fiscal year 2021 is appropriated from the health care access fund to the
commissioner of health to implement the survey to assess program satisfaction in Minnesota
Statutes, section 151.74, subdivision 12. The base for this appropriation is $80,000 in fiscal
year 2022 and $0 in fiscal year 2023. This is a onetime appropriation.

Sec. 28. new text begin REPEALER; SUNSET FOR THE LONG-TERM SAFETY NET INSULIN
PROGRAM.
new text end

new text begin Minnesota Statutes 2022, section 151.74, subdivision 16, new text end new text begin is 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 4

HEALTH INSURANCE

Section 1.

Minnesota Statutes 2022, section 62A.28, subdivision 2, is amended to read:


Subd. 2.

Required coverage.

new text begin (a) new text end Every policy, plan, certificate, or contract referred to
in subdivision 1 deleted text begin issued or renewed after August 1, 1987,deleted text end must provide coverage for scalp
hair prosthesesnew text begin , including all equipment and accessories necessary of regular use of scalp
hair prostheses,
new text end worn for hair loss suffered as a result of new text begin a health condition, including, but
not limited to,
new text end alopecia areatanew text begin or the treatment for cancer, unless there is a clinical basis for
limitation
new text end .

new text begin (b) new text end The coverage required by this section is subject to the co-payment, coinsurance,
deductible, and other enrollee cost-sharing requirements that apply to similar types of items
under the policy, plan, certificate, or contract and may be limited to one prosthesis per
benefit year.

new text begin (c) The coverage required by this section for scalp hair prostheses is limited to $1,000
per benefit year.
new text end

new text begin (d) A scalp hair prostheses must be prescribed by a doctor to be covered under this
section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to all policies,
plans, certificates, and contracts offered, issued, or renewed on or after that date.
new text end

Sec. 2.

new text begin [62A.3098] RAPID WHOLE GENOME SEQUENCING; COVERAGE.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "rapid whole genome sequencing"
or "rWGS" means an investigation of the entire human genome, including coding and
noncoding regions and mitochondrial deoxyribonucleic acid, to identify disease-causing
genetic changes that returns the final results in 14 days. Rapid whole genome sequencing
includes patient-only whole genome sequencing and duo and trio whole genome sequencing
of the patient and the patient's biological parent or parents.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage. new text end

new text begin A health plan that provides coverage to Minnesota residents
must cover rWGS testing if the enrollee:
new text end

new text begin (1) is 21 years of age or younger;
new text end

new text begin (2) has a complex or acute illness of unknown etiology that is not confirmed to have
been caused by an environmental exposure, toxic ingestion, an infection with a normal
response to therapy, or trauma; and
new text end

new text begin (3) is receiving inpatient hospital services in an intensive care unit or a neonatal or high
acuity pediatric care unit.
new text end

new text begin Subd. 3. new text end

new text begin Coverage criteria. new text end

new text begin Coverage may be based on the following medical necessity
criteria:
new text end

new text begin (1) the enrollee has symptoms that suggest a broad differential diagnosis that would
require an evaluation by multiple genetic tests if rWGS testing is not performed;
new text end

new text begin (2) timely identification of a molecular diagnosis is necessary in order to guide clinical
decision making, and the rWGS testing may aid in guiding the treatment or management
of the enrollee's condition; and
new text end

new text begin (3) the enrollee's complex or acute illness of unknown etiology includes at least one of
the following conditions:
new text end

new text begin (i) congenital anomalies involving at least two organ systems, or complex or multiple
congenital anomalies in one organ system;
new text end

new text begin (ii) specific organ malformations that are highly suggestive of a genetic etiology;
new text end

new text begin (iii) abnormal laboratory tests or abnormal chemistry profiles suggesting the presence
of a genetic disease, complex metabolic disorder, or inborn error of metabolism;
new text end

new text begin (iv) refractory or severe hypoglycemia or hyperglycemia;
new text end

new text begin (v) abnormal response to therapy related to an underlying medical condition affecting
vital organs or bodily systems;
new text end

new text begin (vi) severe muscle weakness, rigidity, or spasticity;
new text end

new text begin (vii) refractory seizures;
new text end

new text begin (viii) a high-risk stratification on evaluation for a brief resolved unexplained event with
any of the following features:
new text end

new text begin (A) a recurrent event without respiratory infection;
new text end

new text begin (B) a recurrent seizure-like event; or
new text end

new text begin (C) a recurrent cardiopulmonary resuscitation;
new text end

new text begin (ix) abnormal cardiac diagnostic testing results that are suggestive of possible
channelopathies, arrhythmias, cardiomyopathies, myocarditis, or structural heart disease;
new text end

new text begin (x) abnormal diagnostic imaging studies that are suggestive of underlying genetic
condition;
new text end

new text begin (xi) abnormal physiologic function studies that are suggestive of an underlying genetic
etiology; or
new text end

new text begin (xii) family genetic history related to the patient's condition.
new text end

new text begin Subd. 4. new text end

new text begin Cost sharing. new text end

new text begin Coverage provided in this section is subject to the enrollee's
health plan cost-sharing requirements, including any deductibles, co-payments, or coinsurance
requirements that apply to diagnostic testing services.
new text end

new text begin Subd. 5. new text end

new text begin Payment for services provided. new text end

new text begin If the enrollee's health plan uses a capitated
or bundled payment arrangement to reimburse a provider for services provided in an inpatient
setting, reimbursement for services covered under this section must be paid separately and
in addition to any reimbursement otherwise payable to the provider under the capitated or
bundled payment arrangement, unless the health carrier and the provider have negotiated
an increased capitated or bundled payment rate that includes the services covered under this
section.
new text end

new text begin Subd. 6. new text end

new text begin Genetic data. new text end

new text begin Genetic data generated as a result of performing rWGS and
covered under this section: (1) must be used for the primary purpose of assisting the ordering
provider and treating care team to diagnose and treat the patient; (2) is protected health
information as set forth under the Health Insurance Portability and Accountability Act
(HIPAA), the Health Information Technology for Economic and Clinical Health Act, and
any promulgated regulations, including but not limited to Code of Federal Regulations, title
45, parts 160 and 164, subparts A and E; and (3) is a protected health record under sections
144.291 to 144.298.
new text end

new text begin Subd. 7. new text end

new text begin Reimbursement. new text end

new text begin The commissioner of commerce must reimburse health
carriers for coverage under this section. Reimbursement is available only for coverage that
would not have been provided by the health carrier without the requirements of this section.
Each fiscal year, an amount necessary to make payments to health carriers to defray the
cost of providing coverage under this section is appropriated to the commissioner of
commerce. Health carriers must report to the commissioner quantified costs attributable to
the additional benefit under this section in a format developed by the commissioner. The
commissioner must evaluate submissions and make payments to health carriers as provided
in Code of Federal Regulations, title 45, section 155.170.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to a health
plan offered, issued, or sold on or after that date.
new text end

Sec. 3.

new text begin [62A.59] COVERAGE OF SERVICE; PRIOR AUTHORIZATION.
new text end

new text begin Subdivision 1. new text end

new text begin Service for which prior authorization not required. new text end

new text begin A health carrier
must not retrospectively deny or limit coverage of a health care service for which prior
authorization was not required by the health carrier, unless there is evidence that the health
care service was provided based on fraud or misinformation.
new text end

new text begin Subd. 2. new text end

new text begin Service for which prior authorization required but not obtained. new text end

new text begin A health
carrier must not deny or limit coverage of a health care service which the enrollee has already
received solely on the basis of lack of prior authorization if the service would otherwise
have been covered had the prior authorization been obtained.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 4.

new text begin [62C.045] APPLICATION OF OTHER LAW.
new text end

new text begin Sections 145D.30 to 145D.37 apply to service plan corporations operating under this
chapter.
new text end

Sec. 5.

Minnesota Statutes 2022, section 62D.02, subdivision 4, is amended to read:


Subd. 4.

Health maintenance organization.

"Health maintenance organization" means
a deleted text begin foreign or domesticdeleted text end new text begin nonprofitnew text end corporationnew text begin organized under chapter 317Anew text end , or a local
governmental unit as defined in subdivision 11, 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.

Sec. 6.

Minnesota Statutes 2022, section 62D.02, subdivision 7, is amended to read:


Subd. 7.

Comprehensive health maintenance services.

"Comprehensive health
maintenance services" means a set of comprehensive health services which the enrollees
might reasonably require to be maintained in good health including as a minimum, but not
limited to, emergency care, emergency ground ambulance transportation services, inpatient
hospital and physician care, outpatient health services and preventive health services.
deleted text begin Elective, induced abortion, except as medically necessary to prevent the death of the mother,
whether performed in a hospital, other abortion facility or the office of a physician, shall
not be mandatory for any health maintenance organization.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 7.

Minnesota Statutes 2022, section 62D.03, subdivision 1, is amended to read:


Subdivision 1.

Certificate of authority required.

Notwithstanding any law of this state
to the contrary, any deleted text begin foreign or domesticdeleted text end new text begin nonprofitnew text end corporation organized to do so or a local
governmental unit 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.

Sec. 8.

Minnesota Statutes 2022, section 62D.05, subdivision 1, is amended to read:


Subdivision 1.

Authority granted.

Any new text begin nonprofit new text end corporation or local governmental
unit may, upon obtaining a certificate of authority as required in sections 62D.01 to 62D.30,
operate as a health maintenance organization.

Sec. 9.

Minnesota Statutes 2022, section 62D.06, subdivision 1, is amended to read:


Subdivision 1.

Governing body composition; enrollee advisory body.

The governing
body of any health maintenance organization which is a new text begin nonprofit new text end corporation may include
enrollees, providers, or other individuals; provided, however, that after a health maintenance
organization which is a new text begin nonprofit new text end corporation has been authorized under sections 62D.01
to 62D.30 for one year, at least 40 percent of the governing body shall be composed of
enrollees and members elected by the enrollees and members from among the enrollees and
members. For purposes of this section, "member" means a consumer who receives health
care services through a self-insured contract that is administered by the health maintenance
organization or its related third-party administrator. The number of members elected to the
governing body shall not exceed the number of enrollees elected to the governing body. An
enrollee or member elected to the governing board may not be a person:

(1) whose occupation involves, or before retirement involved, the administration of
health activities or the provision of health services;

(2) who is or was employed by a health care facility as a licensed health professional;
or

(3) who has or had a direct substantial financial or managerial interest in the rendering
of a health service, other than the payment of a reasonable expense reimbursement or
compensation as a member of the board of a health maintenance organization.

After a health maintenance organization which is a local governmental unit has been
authorized under sections 62D.01 to 62D.30 for one year, an enrollee advisory body shall
be established. The enrollees who make up this advisory body shall be elected by the enrollees
from among the enrollees.

Sec. 10.

Minnesota Statutes 2022, section 62D.12, subdivision 19, is amended to read:


Subd. 19.

Coverage of service.

A health maintenance organization may not deny or
limit coverage of a service which the enrollee has already received solely on the basis of
lack of prior authorization or second opinion, to the extent that the service would otherwise
have been covered under the member's contract by the health maintenance organization had
prior authorization or second opinion been obtained.new text begin This subdivision expires December
31, 2025, for health plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 11.

Minnesota Statutes 2022, section 62D.19, is amended to read:


62D.19 UNREASONABLE EXPENSES.

No health maintenance organization shall incur or pay for any expense of any nature
which is unreasonably high in relation to the value of the service or goods provided. The
commissioner of health shall implement and enforce this section by rules adopted under
this section.

In an effort to achieve the stated purposes of sections 62D.01 to 62D.30new text begin , in order to
safeguard the underlying nonprofit status of health maintenance organizations,
new text end and new text begin in order
new text end to ensure that the payment of health maintenance organization money to major participating
entities results in a corresponding benefit to the health maintenance organization and its
enrollees, when determining whether an organization has incurred an unreasonable expense
in relation to a major participating entity, due consideration shall be given to, in addition
to any other appropriate factors, whether the officers and trustees of the health maintenance
organization have acted with good faith and in the best interests of the health maintenance
organization in entering into, and performing under, a contract under which the health
maintenance organization has incurred an expense. The commissioner has standing to sue,
on behalf of a health maintenance organization, officers or trustees of the health maintenance
organization who have breached their fiduciary duty in entering into and performing such
contracts.

Sec. 12.

Minnesota Statutes 2022, section 62D.20, subdivision 1, is amended to read:


Subdivision 1.

Rulemaking.

The commissioner of health may, pursuant to chapter 14,
promulgate such reasonable rules as are necessary or proper to carry out the provisions of
sections 62D.01 to 62D.30. Included among such rules shall be those which provide minimum
requirements for the provision of comprehensive health maintenance services, as defined
in section 62D.02, subdivision 7, and reasonable exclusions therefrom. deleted text begin Nothing in such
rules shall force or require a health maintenance organization to provide elective, induced
abortions, except as medically necessary to prevent the death of the mother, whether
performed in a hospital, other abortion facility, or the office of a physician; the rules shall
provide every health maintenance organization the option of excluding or including elective,
induced abortions, except as medically necessary to prevent the death of the mother, as part
of its comprehensive health maintenance services.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 13.

Minnesota Statutes 2022, section 62D.22, subdivision 5, is amended to read:


Subd. 5.

Other state law.

Except as otherwise provided in sections 62A.01 to 62A.42
and 62D.01 to 62D.30, deleted text begin and except as they eliminate elective, induced abortions, wherever
performed, from health or maternity benefits,
deleted text end provisions of the insurance laws and provisions
of nonprofit health service plan corporation laws shall not be applicable to any health
maintenance organization granted a certificate of authority under sections 62D.01 to 62D.30.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 14.

Minnesota Statutes 2022, section 62D.22, is amended by adding a subdivision to
read:


new text begin Subd. 5a. new text end

new text begin Application of other law. new text end

new text begin Sections 145D.30 to 145D.37 apply to nonprofit
health maintenance organizations operating under this chapter.
new text end

Sec. 15.

new text begin [62D.221] OVERSIGHT OF TRANSACTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Insurance provisions applicable to health maintenance
organizations.
new text end

new text begin (a) Health maintenance organizations are subject to sections 60A.135,
60A.136, 60A.137, 60A.16, 60A.161, 60D.17, 60D.18, and 60D.20 and must comply with
the provisions of these sections applicable to insurers. In applying these sections to health
maintenance organizations, "the commissioner" means the commissioner of health. Health
maintenance organizations are subject to Minnesota Rules, chapter 2720, as applicable to
sections 60D.17, 60D.18, and 60D.20, and must comply with those provisions of the chapter
applicable to insurers unless the commissioner of health adopts rules to implement this
subdivision.
new text end

new text begin (b) In addition to the conditions in section 60D.17, subdivision 1, subjecting a health
maintenance organization to filing requirements, no person other than the issuer shall acquire
all or substantially all of the assets of a domestic nonprofit health maintenance organization
through any means unless at the time the offer, request, or invitation is made or the agreement
is entered into the person has filed with the commissioner and has sent to the health
maintenance organization a statement containing the information required in section 60D.17
and the offer, request, invitation, agreement, or acquisition has been approved by the
commissioner of health in the manner prescribed in section 60D.17.
new text end

new text begin Subd. 2. new text end

new text begin Conversion transactions. new text end

new text begin If a health maintenance organization must notify or
report a transaction to the commissioner under subdivision 1, the health maintenance
organization must include information regarding the plan for a conversion benefit entity,
in the form and manner determined by the commissioner, if the reportable transaction
qualifies as a conversion transaction as defined in section 145D.30, subdivision 5. The
commissioner may consider information regarding the conversion transaction and the
conversion benefit entity plan in any actions taken under subdivision 1, including in decisions
to approve or disapprove transactions, and may extend time frames to a total of 90 days,
with notice to the parties to the transaction.
new text end

Sec. 16.

Minnesota Statutes 2022, section 62E.02, subdivision 3, is amended to read:


Subd. 3.

Health maintenance organization.

"Health maintenance organization" means
a new text begin nonprofit new text end corporation licensed and operated as provided in chapter 62D.

Sec. 17.

Minnesota Statutes 2022, section 62M.01, subdivision 3, is amended to read:


Subd. 3.

Scope.

(a) Nothing in this chapter applies to review of claims after submission
to determine eligibility for benefits under a health benefit plan. The appeal procedure
described in section 62M.06 applies to any complaint as defined under section 62Q.68,
subdivision 2
, that requires a medical determination in its resolution.

(b) new text begin Effective January 1, 2026, new text end this chapter deleted text begin does not applydeleted text end new text begin appliesnew text end to managed care plans
or county-based purchasing plans when the plan is providing coverage to state public health
care program enrollees under chapter 256B or 256L.

new text begin (c) Effective January 1, 2026, the following sections of this chapter apply to services
delivered through fee-for-service under chapters 256B and 256L: 62M.02, subdivisions 1
to 5, 7 to 12, 13, 14 to 18, and 21; 62M.04; 62M.05, subdivisions 1 to 4; 62M.06, subdivisions
1 to 3; 62M.07; 62M.072; 62M.09; 62M.10; 62M.12; and 62M.17, subdivision 2.
new text end

Sec. 18.

Minnesota Statutes 2022, section 62M.02, subdivision 1a, is amended to read:


Subd. 1a.

Adverse determination.

"Adverse determination" means a decision by a
utilization review organization relating to an admission, extension of stay, or health care
service that is partially or wholly adverse to the enrollee, includingnew text begin :
new text end

new text begin (1)new text end a decision to deny an admission, extension of stay, or health care service on the basis
that it is not medically necessarynew text begin ; or
new text end

new text begin (2) an authorization for a health care service that is less intensive than the health care
service specified in the original request for authorization
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. 19.

Minnesota Statutes 2022, section 62M.02, subdivision 5, is amended to read:


Subd. 5.

Authorization.

"Authorization" means a determination by a utilization review
organization that an admission, extension of stay, or other health care service has been
reviewed and that, based on the information provided, it satisfies the utilization review
requirements of the applicable health new text begin benefit new text end plan and the health plan company new text begin or
commissioner
new text end will then pay for the covered benefit, provided the preexisting limitation
provisions, the general exclusion provisions, and any deductible, co-payment, coinsurance,
or other policy requirements have been met.

Sec. 20.

Minnesota Statutes 2022, section 62M.02, is amended by adding a subdivision
to read:


new text begin Subd. 8a. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means, effective January 1, 2026, for the
sections specified in section 62M.01, subdivision 3, paragraph (c), the commissioner of
human services, unless otherwise specified.
new text end

Sec. 21.

Minnesota Statutes 2022, section 62M.02, subdivision 11, is amended to read:


Subd. 11.

Enrollee.

"Enrollee" meansnew text begin :
new text end

new text begin (1)new text end an individual covered by a health benefit plan and includes an insured policyholder,
subscriber, contract holder, member, covered person, or certificate holdernew text begin ; or
new text end

new text begin (2) effective January 1, 2026, for the sections specified in section 62M.01, subdivision
3, paragraph (c), a recipient receiving coverage through fee-for-service under chapters 256B
and 256L
new text end .

Sec. 22.

Minnesota Statutes 2022, section 62M.02, subdivision 12, is amended to read:


Subd. 12.

Health benefit plan.

new text begin (a) new text end "Health benefit plan" meansnew text begin :
new text end

new text begin (1)new text end a policy, contract, or certificate issued by a health plan company for the coverage of
medical, dental, or hospital benefitsnew text begin ; or
new text end

new text begin (2) effective January 1, 2026, for the sections specified in section 62M.01, subdivision
3, paragraph (c), coverage of medical, dental, or hospital benefits through fee-for-service
under chapters 256B and 256L, as specified by the commissioner on the agency's public
website or through other forms of recipient and provider guidance
new text end .

new text begin (b)new text end A health benefit plan does not include coverage that is:

(1) limited to disability or income protection coverage;

(2) automobile medical payment coverage;

(3) supplemental to liability insurance;

(4) designed solely to provide payments on a per diem, fixed indemnity, or nonexpense
incurred basis;

(5) credit accident and health insurance issued under chapter 62B;

(6) blanket accident and sickness insurance as defined in section 62A.11;

(7) accident only coverage issued by a licensed and tested insurance agent; or

(8) workers' compensation.

Sec. 23.

Minnesota Statutes 2022, section 62M.02, subdivision 21, is amended to read:


Subd. 21.

Utilization review organization.

"Utilization review organization" means an
entity including but not limited to an insurance company licensed under chapter 60A to
offer, sell, or issue a policy of accident and sickness insurance as defined in section 62A.01;
a prepaid limited health service organization issued a certificate of authority and operating
under sections 62A.451 to 62A.4528; a health service plan licensed under chapter 62C; a
health maintenance organization licensed under chapter 62D; a community integrated service
network licensed under chapter 62N; an accountable provider network operating under
chapter 62T; a fraternal benefit society operating under chapter 64B; a joint self-insurance
employee health plan operating under chapter 62H; a multiple employer welfare arrangement,
as defined in section 3 of the Employee Retirement Income Security Act of 1974 (ERISA),
United States Code, title 29, section 1103, as amended; a third-party administrator licensed
under section 60A.23, subdivision 8, which conducts utilization review and authorizes or
makes adverse determinations regarding an admission, extension of stay, or other health
care services for a Minnesota resident; new text begin effective January 1, 2026, for the sections specified
in section 62M.01, subdivision 3, paragraph (c), the commissioner of human services for
purposes of delivering services through fee-for-service under chapters 256B and 256L;
new text end any
other entity that provides, offers, or administers hospital, outpatient, medical, prescription
drug, or other health benefits to individuals treated by a health professional under a policy,
plan, or contract; or any entity performing utilization review that is affiliated with, under
contract with, or conducting utilization review on behalf of, a business entity in this state.
Utilization review organization does not include a clinic or health care system acting pursuant
to a written delegation agreement with an otherwise regulated utilization review organization
that contracts with the clinic or health care system. The regulated utilization review
organization is accountable for the delegated utilization review activities of the clinic or
health care system.

Sec. 24.

Minnesota Statutes 2022, section 62M.04, subdivision 1, is amended to read:


Subdivision 1.

Responsibility for obtaining authorization.

A health benefit plan that
includes utilization review requirements must specify the process for notifying the utilization
review organization in a timely manner and obtaining authorization for health care services.
Each health plan company must provide a clear and concise description of this process to
an enrollee as part of the policy, subscriber contract, or certificate of coverage. new text begin Effective
January 1, 2026, the commissioner must provide a clear and concise description of this
process to fee-for-service recipients receiving services under chapters 256B and 256L,
through the agency's public website or through other forms of recipient guidance.
new text end In addition
to the enrollee, the utilization review organization must allow any provider or provider's
designee, or responsible patient representative, including a family member, to fulfill the
obligations under the health new text begin benefit new text end plan.

A claims administrator that contracts directly with providers for the provision of health
care services to enrollees may, through contract, require the provider to notify the review
organization in a timely manner and obtain authorization for health care services.

Sec. 25.

Minnesota Statutes 2022, section 62M.05, subdivision 3a, is amended to read:


Subd. 3a.

Standard review determination.

(a) deleted text begin Notwithstanding subdivision 3b, a
standard review determination on all requests for utilization review must be communicated
to the provider and enrollee in accordance with this subdivision within five business days
after receiving the request if the request is received electronically, or within six business
days if received through nonelectronic means, provided that all information reasonably
necessary to make a determination on the request has been made available to the utilization
review organization. Effective January 1, 2022,
deleted text end A standard review determination on all
requests for utilization review must be communicated to the provider and enrollee in
accordance with this subdivision within five business days after receiving the request,
regardless of how the request was received, provided that all information reasonably
necessary to make a determination on the request has been made available to the utilization
review organization.

(b) When a determination is made to authorize, notification must be provided promptly
by telephone to the provider. The utilization review organization shall send written
notification to the provider or shall maintain an audit trail of the determination and telephone
notification. For purposes of this subdivision, "audit trail" includes documentation of the
telephone notification, including the date; the name of the person spoken to; the enrollee;
the service, procedure, or admission authorized; and the date of the service, procedure, or
admission. If the utilization review organization indicates authorization by use of a number,
the number must be called the "authorization number." For purposes of this subdivision,
notification may also be made by facsimile to a verified number or by electronic mail to a
secure electronic mailbox. These electronic forms of notification satisfy the "audit trail"
requirement of this paragraph.

(c) When an adverse determination is made, notification must be provided within the
time periods specified in paragraph (a) by telephone, by facsimile to a verified number, or
by electronic mail to a secure electronic mailbox to the attending health care professional
and hospital or physician office as applicable. Written notification must also be sent to the
hospital or physician office as applicable and attending health care professional if notification
occurred by telephone. For purposes of this subdivision, notification may be made by
facsimile to a verified number or by electronic mail to a secure electronic mailbox. Written
notification must be sent to the enrollee and may be sent by United States mail, facsimile
to a verified number, or by electronic mail to a secure mailbox. The written notification
must include all reasons relied on by the utilization review organization for the determination
and the process for initiating an appeal of the determination. Upon request, the utilization
review organization shall provide the provider or enrollee with the criteria used to determine
the necessity, appropriateness, and efficacy of the health care service and identify the
database, professional treatment parameter, or other basis for the criteria. Reasons for an
adverse determination may include, among other things, the lack of adequate information
to authorize after a reasonable attempt has been made to contact the provider or enrollee.

(d) When an adverse determination is made, the written notification must inform the
enrollee and the attending health care professional of the right to submit an appeal to the
internal appeal process described in section 62M.06 and the procedure for initiating the
internal appeal. The written notice shall be provided in a culturally and linguistically
appropriate manner consistent with the provisions of the Affordable Care Act as defined
under section 62A.011, subdivision 1a.

new text begin EFFECTIVE DATE. new text end

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

Sec. 26.

Minnesota Statutes 2022, section 62M.07, subdivision 2, is amended to read:


Subd. 2.

Prior authorization of deleted text begin emergencydeleted text end new text begin certainnew text end services prohibited.

No utilization
review organization, health plan company, or claims administrator may conduct or require
prior authorization ofnew text begin :
new text end

new text begin (1)new text end emergency confinement or an emergency service. The enrollee or the enrollee's
authorized representative may be required to notify the health plan company, claims
administrator, or utilization review organization as soon as reasonably possible after the
beginning of the emergency confinement or emergency servicedeleted text begin .deleted text end new text begin ;
new text end

new text begin (2) oral buprenorphine to treat a substance use disorder;
new text end

new text begin (3) outpatient mental health treatment or outpatient substance use disorder treatment,
except for treatment which is: (i) a medication; and (ii) not otherwise listed in this
subdivision. Prior authorizations required for medications used for outpatient mental health
treatment or outpatient substance use disorder treatment, and not otherwise listed in this
subdivision, must be processed according to section 62M.05, subdivision 3b, for initial
determinations, and according to section 62M.06, subdivision 2, for appeals;
new text end

new text begin (4) antineoplastic cancer treatment that is consistent with guidelines of the National
Comprehensive Cancer Network, except for treatment which is: (i) a medication; and (ii)
not otherwise listed in this subdivision. Prior authorizations required for medications used
for antineoplastic cancer treatment, and not otherwise listed in this subdivision, must be
processed according to section 62M.05, subdivision 3b, for initial determinations, and
according to section 62M.06, subdivision 2, for appeals;
new text end

new text begin (5) services that currently have a rating of A or B from the United States Preventive
Services Task Force, immunizations recommended by the Advisory Committee on
Immunization Practices of the Centers for Disease Control and Prevention, or preventive
services and screenings provided to women as described in Code of Federal Regulations,
title 45, section 147.130;
new text end

new text begin (6) pediatric hospice services provided by a hospice provider licensed under sections
144A.75 to 144A.755; and
new text end

new text begin (7) treatment delivered through a neonatal abstinence program operated by pediatric
pain or palliative care subspecialists.
new text end

new text begin Clauses (2) to (7) are effective January 1, 2026, and apply to health benefit plans offered,
sold, issued, or renewed on or after that date.
new text end

Sec. 27.

Minnesota Statutes 2022, section 62M.07, subdivision 4, is amended to read:


Subd. 4.

Submission of prior authorization requests.

new text begin (a) new text end If prior authorization for a
health care service is required, the utilization review organization, health plan company, or
claim administrator must allow providers to submit requests for prior authorization of the
health care services without unreasonable delay by telephone, facsimile, or voice mail or
through an electronic mechanism 24 hours a day, seven days a week. This subdivision does
not apply to dental service covered under MinnesotaCare or medical assistance.

new text begin (b) Effective January 1, 2027, for health benefit plans offered, sold, issued, or renewed
on or after that date, utilization review organizations, health plan companies, and claims
administrators must have and maintain a prior authorization application programming
interface (API) that automates the prior authorization process for health care services,
excluding prescription drugs and medications. The API must allow providers to determine
whether a prior authorization is required for health care services, identify prior authorization
information and documentation requirements, and facilitate the exchange of prior
authorization requests and determinations from provider electronic health records or practice
management systems. The API must use the Health Level Seven (HL7) Fast Healthcare
Interoperability Resources (FHIR) standard in accordance with Code of Federal Regulations,
title 45, section 170.215(a)(1), and the most recent standards and guidance adopted by the
United States Department of Health and Human Services to implement that section. Prior
authorization submission requests for prescription drugs and medications must comply with
the requirements of section 62J.497.
new text end

Sec. 28.

Minnesota Statutes 2022, section 62M.07, is amended by adding a subdivision
to read:


new text begin Subd. 5. new text end

new text begin Treatment of a chronic condition. new text end

new text begin This subdivision is effective January 1,
2026, and applies to health benefit plans offered, sold, issued, or renewed on or after that
date. An authorization for treatment of a chronic health condition does not expire unless
the standard of treatment for that health condition changes. A chronic health condition is a
condition that is expected to last one year or more and:
new text end

new text begin (1) requires ongoing medical attention to effectively manage the condition or prevent
an adverse health event; or
new text end

new text begin (2) limits one or more activities of daily living.
new text end

Sec. 29.

Minnesota Statutes 2022, section 62M.10, subdivision 7, is amended to read:


Subd. 7.

Availability of criteria.

(a) For utilization review determinations other than
prior authorization, a utilization review organization shall, upon request, provide to an
enrollee, a provider, and the commissioner of commerce the criteria used to determine the
medical necessity, appropriateness, and efficacy of a procedure or service and identify the
database, professional treatment guideline, or other basis for the criteria.

(b) For prior authorization determinations, a utilization review organization must submit
the organization's current prior authorization requirements and restrictions, including written,
evidence-based, clinical criteria used to make an authorization or adverse determination, to
all health plan companies for which the organization performs utilization review. A health
plan company must post on its public website the prior authorization requirements and
restrictions of any utilization review organization that performs utilization review for the
health plan company. These prior authorization requirements and restrictions must be detailed
and written in language that is easily understandable to providers.new text begin This paragraph does not
apply to the commissioner of human services when delivering services through fee-for-service
under chapters 256B and 256L.
new text end

new text begin (c) Effective January 1, 2026, the commissioner of human services must post on the
department's public website the prior authorization requirements and restrictions, including
written, evidence-based, clinical criteria used to make an authorization or adverse
determination, that apply to prior authorization determinations for fee-for-service under
chapters 256B and 256L. These prior authorization requirements and restrictions must be
detailed and written in language that is easily understandable to providers.
new text end

Sec. 30.

Minnesota Statutes 2022, section 62M.10, subdivision 8, is amended to read:


Subd. 8.

Notice; new prior authorization requirements or restrictions; change to
existing requirement or restriction.

(a) Before a utilization review organization may
implement a new prior authorization requirement or restriction or amend an existing prior
authorization requirement or restriction, the utilization review organization must submit the
new or amended requirement or restriction to all health plan companies for which the
organization performs utilization review. A health plan company must post on its website
the new or amended requirement or restriction.new text begin This paragraph does not apply to the
commissioner of human services when delivering services through fee-for-service under
chapters 256B and 256L.
new text end

(b) At least 45 days before a new prior authorization requirement or restriction or an
amended existing prior authorization requirement or restriction is implemented, the utilization
review organization, health plan company, or claims administrator must provide written or
electronic notice of the new or amended requirement or restriction to all Minnesota-based,
in-network attending health care professionals who are subject to the prior authorization
requirements and restrictions.new text begin This paragraph does not apply to the commissioner of human
services when delivering services through fee-for-service under chapters 256B and 256L.
new text end

new text begin (c) Effective January 1, 2026, before the commissioner of human services may implement
a new prior authorization requirement or restriction or amend an existing prior authorization
requirement or restriction, the commissioner, at least 45 days before the new or amended
requirement or restriction takes effect, must provide written or electronic notice of the new
or amended requirement or restriction, to all health care professionals participating as
fee-for-service providers under chapters 256B and 256L who are subject to the prior
authorization requirements and restrictions.
new text end

Sec. 31.

Minnesota Statutes 2022, section 62M.17, subdivision 2, is amended to read:


Subd. 2.

Effect of change in prior authorization clinical criteria.

(a) If, during a plan
year, a utilization review organization changes coverage terms for a health care service or
the clinical criteria used to conduct prior authorizations for a health care service, the change
in coverage terms or change in clinical criteria shall not apply until the next plan year for
any enrollee who received prior authorization for a health care service using the coverage
terms or clinical criteria in effect before the effective date of the change.

(b) Paragraph (a) does not apply if a utilization review organization changes coverage
terms for a drug or device that has been deemed unsafe by the United States Food and Drug
Administration (FDA); that has been withdrawn by either the FDA or the product
manufacturer; or when an independent source of research, clinical guidelines, or
evidence-based standards has issued drug- or device-specific warnings or recommended
changes in drug or device usage.

(c) Paragraph (a) does not apply if a utilization review organization changes coverage
terms for a service or the clinical criteria used to conduct prior authorizations for a service
when an independent source of research, clinical guidelines, or evidence-based standards
has recommended changes in usage of the service for reasons related to patient harm.new text begin This
paragraph expires December 31, 2025, for health benefit plans offered, sold, issued, or
renewed on or after that date.
new text end

new text begin (d) Effective January 1, 2026, and applicable to health benefit plans offered, sold, issued,
or renewed on or after that date, paragraph (a) does not apply if a utilization review
organization changes coverage terms for a service or the clinical criteria used to conduct
prior authorizations for a service when an independent source of research, clinical guidelines,
or evidence-based standards has recommended changes in usage of the service for reasons
related to previously unknown and imminent patient harm.
new text end

deleted text begin (d)deleted text end new text begin (e)new text end Paragraph (a) does not apply if a utilization review organization removes a brand
name drug from its formulary or places a brand name drug in a benefit category that increases
the enrollee's cost, provided the utilization review organization (1) adds to its formulary a
generic or multisource brand name drug rated as therapeutically equivalent according to
the FDA Orange Book, or a biologic drug rated as interchangeable according to the FDA
Purple Book, at a lower cost to the enrollee, and (2) provides at least a 60-day notice to
prescribers, pharmacists, and affected enrollees.

Sec. 32.

new text begin [62M.19] ANNUAL REPORT TO COMMISSIONER OF HEALTH; PRIOR
AUTHORIZATIONS.
new text end

new text begin On or before September 1 each year, each utilization review organization must report
to the commissioner of health, in a form and manner specified by the commissioner,
information on prior authorization requests for the previous calendar year. The report
submitted under this subdivision must include the following data:
new text end

new text begin (1) the total number of prior authorization requests received;
new text end

new text begin (2) the number of prior authorization requests for which an authorization was issued;
new text end

new text begin (3) the number of prior authorization requests for which an adverse determination was
issued;
new text end

new text begin (4) the number of adverse determinations reversed on appeal;
new text end

new text begin (5) the 25 codes with the highest number of prior authorization requests and the
percentage of authorizations for each of these codes;
new text end

new text begin (6) the 25 codes with the highest percentage of prior authorization requests for which
an authorization was issued and the total number of the requests;
new text end

new text begin (7) the 25 codes with the highest percentage of prior authorization requests for which
an adverse determination was issued but which was reversed on appeal and the total number
of the requests;
new text end

new text begin (8) the 25 codes with the highest percentage of prior authorization requests for which
an adverse determination was issued and the total number of the requests; and
new text end

new text begin (9) the reasons an adverse determination to a prior authorization request was issued,
expressed as a percentage of all adverse determinations. The reasons listed may include but
are not limited to:
new text end

new text begin (i) the patient did not meet prior authorization criteria;
new text end

new text begin (ii) incomplete information was submitted by the provider to the utilization review
organization;
new text end

new text begin (iii) the treatment program changed; and
new text end

new text begin (iv) the patient is no longer covered by the health benefit plan.
new text end

Sec. 33.

Minnesota Statutes 2022, section 62Q.14, is amended to read:


62Q.14 RESTRICTIONS ON ENROLLEE SERVICES.

No health plan company may restrict the choice of an enrollee as to where the enrollee
receives services related to:

(1) the voluntary planning of the conception and bearing of childrendeleted text begin , provided that this
clause does not refer to abortion services
deleted text end ;

(2) the diagnosis of infertility;

(3) the testing and treatment of a sexually transmitted disease; and

(4) the testing for AIDS or other HIV-related conditions.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 34.

Minnesota Statutes 2022, section 62Q.1841, subdivision 2, is amended to read:


Subd. 2.

Prohibition on use of new text begin prior authorization or new text end step therapy protocols.

A health
plan that provides coverage for the treatment of stage four advanced metastatic cancer or
associated conditions must not limit or exclude coverage for a drug approved by the United
States Food and Drug Administration deleted text begin that is on the health plan's prescription drug formularydeleted text end
by mandating that an enrollee with stage four advanced metastatic cancer or associated
conditions new text begin obtain a prior authorization or new text end follow a step therapy protocol if the use of the
approved drug is consistent with:

(1) a United States Food and Drug Administration-approved indication; and

(2) a clinical practice guideline published by the National Comprehensive Care Network.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 35.

Minnesota Statutes 2022, section 62Q.19, subdivision 3, is amended to read:


Subd. 3.

Health plan company affiliation.

A health plan company must offer a provider
contract to deleted text begin anydeleted text end new text begin allnew text end designated essential community deleted text begin providerdeleted text end new text begin providersnew text end located within the
area served by the health plan company. new text begin A health plan company must include all essential
community providers that have accepted a contract in each of the company's provider
networks.
new text end A health plan company shall not restrict enrollee access to services designated
to be provided by the essential community provider for the population that the essential
community provider is certified to serve. A health plan company may also make other
providers available for these services. A health plan company may require an essential
community provider to meet all data requirements, utilization review, and quality assurance
requirements on the same basis as other health plan providers.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, issued, or renewed on or after that date.
new text end

Sec. 36.

Minnesota Statutes 2022, section 62Q.19, is amended by adding a subdivision to
read:


new text begin Subd. 4a. new text end

new text begin Contract payment rates; private. new text end

new text begin An essential community provider and a
health plan company may negotiate the payment rate for covered services provided by the
essential community provider. This rate must be at least the same rate per unit of service
as is paid by the health plan company to the essential community provider under the provider
contract between the two with the highest number of enrollees receiving health care services
from the provider or, if there is no provider contract between the health plan company and
the essential community provider, the rate must be at least the same rate per unit of service
as is paid to other plan providers for the same or similar services. The provider contract
used to set the rate under this subdivision must be in relation to an individual, small group,
or large group health plan. This subdivision applies only to provider contracts in relation
to individual, small employer, and large group health plans.
new text end

Sec. 37.

Minnesota Statutes 2022, section 62Q.19, subdivision 5, is amended to read:


Subd. 5.

Contract payment ratesnew text begin ; publicnew text end .

An essential community provider and a
health plan company may negotiate the payment rate for covered services provided by the
essential community provider. This rate must be at least the same rate per unit of service
as is paid to other health plan providers for the same or similar services. new text begin This subdivision
applies only to provider contracts in relation to health plans offered through the State
Employee Group Insurance Program, medical assistance, and MinnesotaCare.
new text end

Sec. 38.

Minnesota Statutes 2023 Supplement, section 62Q.522, subdivision 1, is amended
to read:


Subdivision 1.

Definitions.

(a) The definitions in this subdivision apply to this section.

deleted text begin (b) "Closely held for-profit entity" means an entity that:
deleted text end

deleted text begin (1) is not a nonprofit entity;
deleted text end

deleted text begin (2) has more than 50 percent of the value of its ownership interest owned directly or
indirectly by five or fewer owners; and
deleted text end

deleted text begin (3) has no publicly traded ownership interest.
deleted text end

deleted text begin For purposes of this paragraph:
deleted text end

deleted text begin (i) ownership interests owned by a corporation, partnership, limited liability company,
estate, trust, or similar entity are considered owned by that entity's shareholders, partners,
members, or beneficiaries in proportion to their interest held in the corporation, partnership,
limited liability company, estate, trust, or similar entity;
deleted text end

deleted text begin (ii) ownership interests owned by a nonprofit entity are considered owned by a single
owner;
deleted text end

deleted text begin (iii) ownership interests owned by all individuals in a family are considered held by a
single owner. For purposes of this item, "family" means brothers and sisters, including
half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
deleted text end

deleted text begin (iv) if an individual or entity holds an option, warrant, or similar right to purchase an
ownership interest, the individual or entity is considered to be the owner of those ownership
interests.
deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end "Contraceptive method" means a drug, device, or other product approved by the
Food and Drug Administration to prevent unintended pregnancy.

deleted text begin (d)deleted text end new text begin (c)new text end "Contraceptive service" means consultation, examination, procedures, and medical
services related to the prevention of unintended pregnancy, excluding vasectomies. This
includes but is not limited to voluntary sterilization procedures, patient education, counseling
on contraceptives, and follow-up services related to contraceptive methods or services,
management of side effects, counseling for continued adherence, and device insertion or
removal.

deleted text begin (e) "Eligible organization" means an organization that opposes providing coverage for
some or all contraceptive methods or services on account of religious objections and that
is:
deleted text end

deleted text begin (1) organized as a nonprofit entity and holds itself out to be religious; or
deleted text end

deleted text begin (2) organized and operates as a closely held for-profit entity, and the organization's
owners or highest governing body has adopted, under the organization's applicable rules of
governance and consistent with state law, a resolution or similar action establishing that the
organization objects to covering some or all contraceptive methods or services on account
of the owners' sincerely held religious beliefs.
deleted text end

deleted text begin (f) "Exempt organization" means an organization that is organized and operates as a
nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal
Revenue Code of 1986, as amended.
deleted text end

deleted text begin (g)deleted text end new text begin (d)new text end "Medical necessity" includes but is not limited to considerations such as severity
of side effects, difference in permanence and reversibility of a contraceptive method or
service, and ability to adhere to the appropriate use of the contraceptive method or service,
as determined by the attending provider.

deleted text begin (h)deleted text end new text begin (e)new text end "Therapeutic equivalent version" means a drug, device, or product that can be
expected to have the same clinical effect and safety profile when administered to a patient
under the conditions specified in the labeling, and that:

(1) is approved as safe and effective;

(2) is a pharmaceutical equivalent: (i) containing identical amounts of the same active
drug ingredient in the same dosage form and route of administration; and (ii) meeting
compendial or other applicable standards of strength, quality, purity, and identity;

(3) is bioequivalent in that:

(i) the drug, device, or product does not present a known or potential bioequivalence
problem and meets an acceptable in vitro standard; or

(ii) if the drug, device, or product does present a known or potential bioequivalence
problem, it is shown to meet an appropriate bioequivalence standard;

(4) is adequately labeled; and

(5) is manufactured in compliance with current manufacturing practice regulations.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on of after that date.
new text end

Sec. 39.

Minnesota Statutes 2023 Supplement, section 62Q.523, subdivision 1, is amended
to read:


Subdivision 1.

Scope of coverage.

Except as otherwise provided in section deleted text begin 62Q.522deleted text end new text begin
62Q.679
new text end , subdivisions new text begin 2 and new text end 3 deleted text begin and 4deleted text end , all health plans that provide prescription coverage
must comply with the requirements of this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 40.

new text begin [62Q.524] COVERAGE OF ABORTIONS AND ABORTION-RELATED
SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "abortion" means any medical
treatment intended to induce the termination of a pregnancy with a purpose other than
producing a live birth.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage; cost-sharing. new text end

new text begin (a) A health plan must provide coverage
for abortions and abortion-related services, including preabortion services and follow-up
services.
new text end

new text begin (b) A health plan must not impose on the coverage under this section any co-payment,
coinsurance, deductible, or other enrollee cost-sharing that is greater than the cost-sharing
that applies to similar services covered under the health plan.
new text end

new text begin (c) A health plan must not impose any limitation on the coverage under this section,
including but not limited to any utilization review, prior authorization, referral requirements,
restrictions, or delays, that is not generally applicable to other coverages under the plan.
new text end

new text begin Subd. 3. new text end

new text begin Exclusion. new text end

new text begin This section does not apply to managed care organizations or
county-based purchasing plans when the plan provides coverage to public health care
program enrollees under chapter 256B or 256L.
new text end

new text begin Subd. 4. new text end

new text begin Reimbursement. new text end

new text begin The commissioner of commerce must reimburse health plan
companies for coverage under this section. Reimbursement is available only for coverage
that would not have been provided by the health plan company without the requirements
of this section. Each fiscal year, an amount necessary to make payments to health plan
companies to defray the cost of providing coverage under this section is appropriated to the
commissioner of commerce. Health plan companies must report to the commissioner
quantified costs attributable to the additional benefit under this section in a format developed
by the commissioner. The commissioner must evaluate submissions and make payments to
health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 41.

new text begin [62Q.531] AMINO ACID-BASED FORMULA COVERAGE.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin (a) For purposes of this section, the following term has the
meaning given.
new text end

new text begin (b) "Formula" means an amino acid-based elemental formula.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage. new text end

new text begin A health plan company must provide coverage for formula
when formula is medically necessary.
new text end

new text begin Subd. 3. new text end

new text begin Covered conditions. new text end

new text begin Conditions for which formula is medically necessary
include but are not limited to:
new text end

new text begin (1) cystic fibrosis;
new text end

new text begin (2) amino acid, organic acid, and fatty acid metabolic and malabsorption disorders;
new text end

new text begin (3) IgE mediated allergies to food proteins;
new text end

new text begin (4) food protein-induced enterocolitis syndrome;
new text end

new text begin (5) eosinophilic esophagitis;
new text end

new text begin (6) eosinophilic gastroenteritis;
new text end

new text begin (7) eosinophilic colitis; and
new text end

new text begin (8) mast cell activation syndrome.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, issued, or sold on or after that date.
new text end

Sec. 42.

new text begin [62Q.585] GENDER-AFFIRMING CARE COVERAGE; MEDICALLY
NECESSARY CARE.
new text end

new text begin Subdivision 1. new text end

new text begin Requirement. new text end

new text begin No health plan that covers physical or mental health
services may be offered, sold, issued, or renewed in this state that:
new text end

new text begin (1) excludes coverage for medically necessary gender-affirming care; or
new text end

new text begin (2) requires gender-affirming treatments to satisfy a definition of "medically necessary
care," "medical necessity," or any similar term that is more restrictive than the definition
provided in subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Minimum definition. new text end

new text begin "Medically necessary care" means health care services
appropriate in terms of type, frequency, level, setting, and duration to the enrollee's diagnosis
or condition and diagnostic testing and preventive services. Medically necessary care must
be consistent with generally accepted practice parameters as determined by health care
providers in the same or similar general specialty as typically manages the condition,
procedure, or treatment at issue and must:
new text end

new text begin (1) help restore or maintain the enrollee's health; or
new text end

new text begin (2) prevent deterioration of the enrollee's condition.
new text end

new text begin Subd. 3. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have the
meanings given.
new text end

new text begin (b) "Gender-affirming care" means all medical, surgical, counseling, or referral services,
including telehealth services, that an individual may receive to support and affirm the
individual's gender identity or gender expression and that are legal under the laws of this
state.
new text end

new text begin (c) "Health plan" has the meaning given in section 62Q.01, subdivision 3, but includes
the coverages listed in section 62A.011, subdivision 3, clauses (7) and (10).
new text end

Sec. 43.

new text begin [62Q.665] COVERAGE FOR ORTHOTIC AND PROSTHETIC DEVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Accredited facility" means any entity that is accredited to provide comprehensive
orthotic or prosthetic devices or services by a Centers for Medicare and Medicaid Services
approved accrediting agency.
new text end

new text begin (c) "Orthosis" means:
new text end

new text begin (1) an external medical device that is:
new text end

new text begin (i) custom-fabricated or custom-fitted to a specific patient based on the patient's unique
physical condition;
new text end

new text begin (ii) applied to a part of the body to correct a deformity, provide support and protection,
restrict motion, improve function, or relieve symptoms of a disease, syndrome, injury, or
postoperative condition; and
new text end

new text begin (iii) deemed medically necessary by a prescribing physician or licensed health care
provider who has authority in Minnesota to prescribe orthotic and prosthetic devices, supplies,
and services; and
new text end

new text begin (2) any provision, repair, or replacement of a device that is furnished or performed by:
new text end

new text begin (i) an accredited facility in comprehensive orthotic services; or
new text end

new text begin (ii) a health care provider licensed in Minnesota and operating within the provider's
scope of practice which allows the provider to provide orthotic or prosthetic devices, supplies,
or services.
new text end

new text begin (d) "Orthotics" means:
new text end

new text begin (1) the science and practice of evaluating, measuring, designing, fabricating, assembling,
fitting, adjusting, or servicing and providing the initial training necessary to accomplish the
fitting of an orthotic device for the support, correction, or alleviation of a neuromuscular
or musculoskeletal dysfunction, disease, injury, or deformity;
new text end

new text begin (2) evaluation, treatment, and consultation related to an orthotic device;
new text end

new text begin (3) basic observation of gait and postural analysis;
new text end

new text begin (4) assessing and designing orthosis to maximize function and provide support and
alignment necessary to prevent or correct a deformity or to improve the safety and efficiency
of mobility and locomotion;
new text end

new text begin (5) continuing patient care to assess the effect of an orthotic device on the patient's
tissues; and
new text end

new text begin (6) proper fit and function of the orthotic device by periodic evaluation.
new text end

new text begin (e) "Prosthesis" means:
new text end

new text begin (1) an external medical device that is:
new text end

new text begin (i) used to replace or restore a missing limb, appendage, or other external human body
part; and
new text end

new text begin (ii) deemed medically necessary by a prescribing physician or licensed health care
provider who has authority in Minnesota to prescribe orthotic and prosthetic devices, supplies,
and services; and
new text end

new text begin (2) any provision, repair, or replacement of a device that is furnished or performed by:
new text end

new text begin (i) an accredited facility in comprehensive prosthetic services; or
new text end

new text begin (ii) a health care provider licensed in Minnesota and operating within the provider's
scope of practice which allows the provider to provide orthotic or prosthetic devices, supplies,
or services.
new text end

new text begin (f) "Prosthetics" means:
new text end

new text begin (1) the science and practice of evaluating, measuring, designing, fabricating, assembling,
fitting, aligning, adjusting, or servicing, as well as providing the initial training necessary
to accomplish the fitting of, a prosthesis through the replacement of external parts of a
human body lost due to amputation or congenital deformities or absences;
new text end

new text begin (2) the generation of an image, form, or mold that replicates the patient's body segment
and that requires rectification of dimensions, contours, and volumes for use in the design
and fabrication of a socket to accept a residual anatomic limb to, in turn, create an artificial
appendage that is designed either to support body weight or to improve or restore function
or anatomical appearance, or both;
new text end

new text begin (3) observational gait analysis and clinical assessment of the requirements necessary to
refine and mechanically fix the relative position of various parts of the prosthesis to maximize
function, stability, and safety of the patient;
new text end

new text begin (4) providing and continuing patient care in order to assess the prosthetic device's effect
on the patient's tissues; and
new text end

new text begin (5) assuring proper fit and function of the prosthetic device by periodic evaluation.
new text end

new text begin Subd. 2. new text end

new text begin Coverage. new text end

new text begin (a) A health plan must provide coverage for orthotic and prosthetic
devices, supplies, and services, including repair and replacement, at least equal to the
coverage provided under federal law for health insurance for the aged and disabled under
sections 1832, 1833, and 1834 of the Social Security Act, United States Code, title 42,
sections 1395k, 1395l, and 1395m, but only to the extent consistent with this section.
new text end

new text begin (b) A health plan must not subject orthotic and prosthetic benefits to separate financial
requirements that apply only with respect to those benefits. A health plan may impose
co-payment and coinsurance amounts on those benefits, except that any financial
requirements that apply to such benefits must not be more restrictive than the financial
requirements that apply to the health plan's medical and surgical benefits, including those
for internal restorative devices.
new text end

new text begin (c) A health plan may limit the benefits for, or alter the financial requirements for,
out-of-network coverage of prosthetic and orthotic devices, except that the restrictions and
requirements that apply to those benefits must not be more restrictive than the financial
requirements that apply to the out-of-network coverage for the health plan's medical and
surgical benefits.
new text end

new text begin (d) A health plan must cover orthoses and prostheses when furnished under an order by
a prescribing physician or licensed health care prescriber who has authority in Minnesota
to prescribe orthoses and prostheses, and that coverage for orthotic and prosthetic devices,
supplies, accessories, and services must include those devices or device systems, supplies,
accessories, and services that are customized to the covered individual's needs.
new text end

new text begin (e) A health plan must cover orthoses and prostheses determined by the enrollee's provider
to be the most appropriate model that meets the medical needs of the enrollee for purposes
of performing physical activities, as applicable, including but not limited to running, biking,
and swimming, and maximizing the enrollee's limb function.
new text end

new text begin (f) A health plan must cover orthoses and prostheses for showering or bathing.
new text end

new text begin Subd. 3. new text end

new text begin Prior authorization. new text end

new text begin A health plan may require prior authorization for orthotic
and prosthetic devices, supplies, and services in the same manner and to the same extent as
prior authorization is required for any other covered benefit.
new text end

new text begin Subd. 4. new text end

new text begin Reimbursement. new text end

new text begin The commissioner of commerce must reimburse health plan
companies for coverage under this section. Reimbursement is available only for coverage
that would not have been provided by the health plan company without the requirements
of this section. Each fiscal year, an amount necessary to make payments to health plan
companies to defray the cost of providing coverage under this section is appropriated to the
commissioner of commerce. Health plan companies must report to the commissioner
quantified costs attributable to the additional benefit under this section in a format developed
by the commissioner. The commissioner must evaluate submissions and make payments to
health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to all health
plans offered, issued, or renewed on or after that date.
new text end

Sec. 44.

new text begin [62Q.666] MEDICAL NECESSITY AND NONDISCRIMINATION
STANDARDS FOR COVERAGE OF PROSTHETICS OR ORTHOTICS.
new text end

new text begin (a) When performing a utilization review for a request for coverage of prosthetic or
orthotic benefits, a health plan company shall apply the most recent version of evidence-based
treatment and fit criteria as recognized by relevant clinical specialists.
new text end

new text begin (b) A health plan company shall render utilization review determinations in a
nondiscriminatory manner and shall not deny coverage for habilitative or rehabilitative
benefits, including prosthetics or orthotics, solely on the basis of an enrollee's actual or
perceived disability.
new text end

new text begin (c) A health plan company shall not deny a prosthetic or orthotic benefit for an individual
with limb loss or absence that would otherwise be covered for a nondisabled person seeking
medical or surgical intervention to restore or maintain the ability to perform the same
physical activity.
new text end

new text begin (d) A health plan offered, issued, or renewed in Minnesota that offers coverage for
prosthetics and custom orthotic devices shall include language describing an enrollee's rights
pursuant to paragraphs (b) and (c) in its evidence of coverage and any benefit denial letters.
new text end

new text begin (e) A health plan that provides coverage for prosthetic or orthotic services shall ensure
access to medically necessary clinical care and to prosthetic and custom orthotic devices
and technology from not less than two distinct prosthetic and custom orthotic providers in
the plan's provider network located in Minnesota. In the event that medically necessary
covered orthotics and prosthetics are not available from an in-network provider, the health
plan company shall provide processes to refer a member to an out-of-network provider and
shall fully reimburse the out-of-network provider at a mutually agreed upon rate less member
cost sharing determined on an in-network basis.
new text end

new text begin (f) If coverage for prosthetic or custom orthotic devices is provided, payment shall be
made for the replacement of a prosthetic or custom orthotic device or for the replacement
of any part of the devices, without regard to continuous use or useful lifetime restrictions,
if an ordering health care provider determines that the provision of a replacement device,
or a replacement part of a device, is necessary because:
new text end

new text begin (1) of a change in the physiological condition of the patient;
new text end

new text begin (2) of an irreparable change in the condition of the device or in a part of the device; or
new text end

new text begin (3) the condition of the device, or the part of the device, requires repairs and the cost of
the repairs would be more than 60 percent of the cost of a replacement device or of the part
being replaced.
new text end

new text begin (g) Confirmation from a prescribing health care provider may be required if the prosthetic
or custom orthotic device or part being replaced is less than three years old.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to all health
plans offered, issued, or renewed on or after that date.
new text end

Sec. 45.

new text begin [62Q.679] RELIGIOUS OBJECTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) The definitions in this subdivision apply to this section.
new text end

new text begin (b) "Closely held for-profit entity" means an entity that is not a nonprofit entity, has
more than 50 percent of the value of its ownership interest owned directly or indirectly by
five or fewer owners, and has no publicly traded ownership interest. For purposes of this
paragraph:
new text end

new text begin (1) ownership interests owned by a corporation, partnership, limited liability company,
estate, trust, or similar entity are considered owned by that entity's shareholders, partners,
members, or beneficiaries in proportion to their interest held in the corporation, partnership,
limited liability company, estate, trust, or similar entity;
new text end

new text begin (2) ownership interests owned by a nonprofit entity are considered owned by a single
owner;
new text end

new text begin (3) ownership interests owned by all individuals in a family are considered held by a
single owner. For purposes of this clause, "family" means brothers and sisters, including
half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
new text end

new text begin (4) if an individual or entity holds an option, warrant, or similar right to purchase an
ownership interest, the individual or entity is considered to be the owner of those ownership
interests.
new text end

new text begin (c) "Eligible organization" means an organization that opposes covering some or all
health benefits under section 62Q.522, 62Q.524, or 62Q.585 on account of religious
objections and that is:
new text end

new text begin (1) organized as a nonprofit entity and holds itself out to be religious; or
new text end

new text begin (2) organized and operates as a closely held for-profit entity, and the organization's
owners or highest governing body has adopted, under the organization's applicable rules of
governance and consistent with state law, a resolution or similar action establishing that the
organization objects to covering some or all health benefits under section 62Q.522, 62Q.524,
or 62Q.585 on account of the owners' sincerely held religious beliefs.
new text end

new text begin (d) "Exempt organization" means an organization that is organized and operates as a
nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal
Revenue Code of 1986, as amended.
new text end

new text begin Subd. 2. new text end

new text begin Exemption. new text end

new text begin (a) An exempt organization is not required to provide coverage
under section 62Q.522, 62Q.524, or 62Q.585 if the exempt organization has religious
objections to the coverage. An exempt organization that chooses to not provide coverage
pursuant to this paragraph must notify employees as part of the hiring process and must
notify all employees at least 30 days before:
new text end

new text begin (1) an employee enrolls in the health plan; or
new text end

new text begin (2) the effective date of the health plan, whichever occurs first.
new text end

new text begin (b) If the exempt organization provides partial coverage under section 62Q.522, 62Q.524,
or 62Q.585, the notice required under paragraph (a) must provide a list of the portions of
such coverage which the organization refuses to cover.
new text end

new text begin Subd. 3. new text end

new text begin Accommodation for eligible organizations. new text end

new text begin (a) A health plan established or
maintained by an eligible organization complies with the coverage requirements of section
62Q.522, 62Q.524, or 62Q.585, with respect to the health benefits identified in the notice
under this paragraph, if the eligible organization provides notice to any health plan company
with which the eligible organization contracts that it is an eligible organization and that the
eligible organization has a religious objection to coverage for all or a subset of the health
benefits under section 62Q.522, 62Q.524, or 62Q.585.
new text end

new text begin (b) The notice from an eligible organization to a health plan company under paragraph
(a) must include: (1) the name of the eligible organization; (2) a statement that it objects to
coverage for some or all of the health benefits under section 62Q.522, 62Q.524, or 62Q.585,
including a list of the health benefits to which the eligible organization objects, if applicable;
and (3) the health plan name. The notice must be executed by a person authorized to provide
notice on behalf of the eligible organization.
new text end

new text begin (c) An eligible organization must provide a copy of the notice under paragraph (a) to
prospective employees as part of the hiring process and to all employees at least 30 days
before:
new text end

new text begin (1) an employee enrolls in the health plan; or
new text end

new text begin (2) the effective date of the health plan, whichever occurs first.
new text end

new text begin (d) A health plan company that receives a copy of the notice under paragraph (a) with
respect to a health plan established or maintained by an eligible organization must, for all
future enrollments in the health plan:
new text end

new text begin (1) expressly exclude coverage for those health benefits identified in the notice under
paragraph (a) from the health plan; and
new text end

new text begin (2) provide separate payments for any health benefits required to be covered under
section 62Q.522, 62Q.524, or 62Q.585 for enrollees as long as the enrollee remains enrolled
in the health plan.
new text end

new text begin (e) The health plan company must not impose any cost-sharing requirements, including
co-pays, deductibles, or coinsurance, or directly or indirectly impose any premium, fee, or
other charge for the health benefits under section 62Q.522 on the enrollee. The health plan
company must not directly or indirectly impose any premium, fee, or other charge for the
health benefits under section 62Q.522, 62Q.524, or 62Q.585 on the eligible organization
or health plan.
new text end

new text begin (f) On January 1, 2024, and every year thereafter a health plan company must notify the
commissioner, in a manner determined by the commissioner, of the number of eligible
organizations granted an accommodation under this subdivision.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 46.

Minnesota Statutes 2022, section 62Q.73, subdivision 2, is amended to read:


Subd. 2.

Exception.

(a) This section does not apply to governmental programs except
as permitted under paragraph (b). For purposes of this subdivision, "governmental programs"
means the prepaid medical assistance programdeleted text begin ,deleted text end new text begin ;new text end new text begin effective January 1, 2026, the medical
assistance fee-for-service program;
new text end the MinnesotaCare programdeleted text begin ,deleted text end new text begin ;new text end the demonstration project
for people with disabilitiesdeleted text begin ,deleted text end new text begin ;new text end and the federal Medicare program.

(b) In the course of a recipient's appeal of a medical determination to the commissioner
of human services under section 256.045, the recipient may request an expert medical
opinion be arranged by the external review entity under contract to provide independent
external reviews under this section. If such a request is made, the cost of the review shall
be paid by the commissioner of human services. Any medical opinion obtained under this
paragraph shall only be used by a state human services judge as evidence in the recipient's
appeal to the commissioner of human services under section 256.045.

(c) Nothing in this subdivision shall be construed to limit or restrict the appeal rights
provided in section 256.045 for governmental program recipients.

Sec. 47.

Minnesota Statutes 2022, section 62V.05, subdivision 12, is amended to read:


Subd. 12.

Reports on interagency agreements and intra-agency transfers.

The
MNsure Board shall provide deleted text begin quarterly reports to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services policy and
finance on:
deleted text end new text begin legislative reports on interagency agreements and intra-agency transfers according
to section 15.0395.
new text end

deleted text begin (1) interagency agreements or service-level agreements and any renewals or extensions
of existing interagency or service-level agreements with a state department under section
15.01, state agency under section 15.012, or the Department of Information Technology
Services, with a value of more than $100,000, or related agreements with the same department
or agency with a cumulative value of more than $100,000; and
deleted text end

deleted text begin (2) transfers of appropriations of more than $100,000 between accounts within or between
agencies.
deleted text end

deleted text begin The report must include the statutory citation authorizing the agreement, transfer or dollar
amount, purpose, and effective date of the agreement, the duration of the agreement, and a
copy of the agreement.
deleted 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. 48.

Minnesota Statutes 2022, section 62V.08, is amended to read:


62V.08 REPORTS.

(a) MNsure shall submit a report to the legislature by deleted text begin January 15, 2015deleted text end new text begin March 31, 2025new text end ,
and each deleted text begin January 15deleted text end new text begin March 31new text end thereafter, on: (1) the performance of MNsure operations;
(2) meeting MNsure responsibilities; (3) an accounting of MNsure budget activities; (4)
practices and procedures that have been implemented to ensure compliance with data
practices laws, and a description of any violations of data practices laws or procedures; and
(5) the effectiveness of the outreach and implementation activities of MNsure in reducing
the rate of uninsurance.

(b) MNsure must publish its administrative and operational costs on a website to educate
consumers on those costs. The information published must include: (1) the amount of
premiums and federal premium subsidies collected; (2) the amount and source of revenue
received under section 62V.05, subdivision 1, paragraph (b), clause (3); (3) the amount and
source of any other fees collected for purposes of supporting operations; and (4) any misuse
of funds as identified in accordance with section 3.975. The website must be updated at
least annually.

Sec. 49.

Minnesota Statutes 2022, section 62V.11, subdivision 4, is amended to read:


Subd. 4.

Review of costs.

The board shall submit for review the annual budget of MNsure
for the next fiscal year by March deleted text begin 15deleted text end new text begin 31new text end of each year, beginning March deleted text begin 15, 2014deleted text end new text begin 31, 2025new text end .

Sec. 50.

Minnesota Statutes 2023 Supplement, section 145D.01, subdivision 1, is amended
to read:


Subdivision 1.

Definitions.

(a) For purposes of this deleted text begin chapterdeleted text end new text begin section and section 145D.02new text end ,
the following terms have the meanings given.

(b) "Captive professional entity" means a professional corporation, limited liability
company, or other entity formed to render professional services in which a beneficial owner
is a health care provider employed by, controlled by, or subject to the direction of a hospital
or hospital system.

(c) "Commissioner" means the commissioner of health.

(d) "Control," including the terms "controlling," "controlled by," and "under common
control with," means the possession, direct or indirect, of the power to direct or cause the
direction of the management and policies of a health care entity, whether through the
ownership of voting securities, membership in an entity formed under chapter 317A, by
contract other than a commercial contract for goods or nonmanagement services, or otherwise,
unless the power is the result of an official position with, corporate office held by, or court
appointment of, the person. Control is presumed to exist if any person, directly or indirectly,
owns, controls, holds with the power to vote, or holds proxies representing 40 percent or
more of the voting securities of any other person, or if any person, directly or indirectly,
constitutes 40 percent or more of the membership of an entity formed under chapter 317A.
The attorney general may determine that control exists in fact, notwithstanding the absence
of a presumption to that effect.

(e) "Health care entity" means:

(1) a hospital;

(2) a hospital system;

(3) a captive professional entity;

(4) a medical foundation;

(5) a health care provider group practice;

(6) an entity organized or controlled by an entity listed in clauses (1) to (5); or

(7) an entity that owns or exercises control over an entity listed in clauses (1) to (5).

(f) "Health care provider" means a physician licensed under chapter 147, a physician
assistant licensed under chapter 147A, or an advanced practice registered nurse as defined
in section 148.171, subdivision 3, who provides health care services, including but not
limited to medical care, consultation, diagnosis, or treatment.

(g) "Health care provider group practice" means two or more health care providers legally
organized in a partnership, professional corporation, limited liability company, medical
foundation, nonprofit corporation, faculty practice plan, or other similar entity:

(1) in which each health care provider who is a member of the group provides services
that a health care provider routinely provides, including but not limited to medical care,
consultation, diagnosis, and treatment, through the joint use of shared office space, facilities,
equipment, or personnel;

(2) for which substantially all services of the health care providers who are group
members are provided through the group and are billed in the name of the group practice
and amounts so received are treated as receipts of the group; or

(3) in which the overhead expenses of, and the income from, the group are distributed
in accordance with methods previously determined by members of the group.

An entity that otherwise meets the definition of health care provider group practice in this
paragraph shall be considered a health care provider group practice even if its shareholders,
partners, members, or owners include a professional corporation, limited liability company,
or other entity in which any beneficial owner is a health care provider and that is formed to
render professional services.

(h) "Hospital" means a health care facility licensed as a hospital under sections 144.50
to 144.56.

(i) "Medical foundation" means a nonprofit legal entity through which health care
providers perform research or provide medical services.

(j) "Transaction" means a single action, or a series of actions within a five-year period,
which occurs in part within the state of Minnesota or involves a health care entity formed
or licensed in Minnesota, that constitutes:

(1) a merger or exchange of a health care entity with another entity;

(2) the sale, lease, or transfer of 40 percent or more of the assets of a health care entity
to another entity;

(3) the granting of a security interest of 40 percent or more of the property and assets
of a health care entity to another entity;

(4) the transfer of 40 percent or more of the shares or other ownership of a health care
entity to another entity;

(5) an addition, removal, withdrawal, substitution, or other modification of one or more
members of the health care entity's governing body that transfers control, responsibility for,
or governance of the health care entity to another entity;

(6) the creation of a new health care entity;

(7) an agreement or series of agreements that results in the sharing of 40 percent or more
of the health care entity's revenues with another entity, including affiliates of such other
entity;

(8) an addition, removal, withdrawal, substitution, or other modification of the members
of a health care entity formed under chapter 317A that results in a change of 40 percent or
more of the membership of the health care entity; or

(9) any other transfer of control of a health care entity to, or acquisition of control of a
health care entity by, another entity.

(k) A transaction as defined in paragraph (j) does not include:

(1) an action or series of actions that meets one or more of the criteria set forth in
paragraph (j), clauses (1) to (9), if, immediately prior to all such actions, the health care
entity directly, or indirectly through one or more intermediaries, controls, is controlled by,
or is under common control with, all other parties to the action or series of actions;

(2) a mortgage or other secured loan for business improvement purposes entered into
by a health care entity that does not directly affect delivery of health care or governance of
the health care entity;

(3) a clinical affiliation of health care entities formed solely for the purpose of
collaborating on clinical trials or providing graduate medical education;

(4) the mere offer of employment to, or hiring of, a health care provider by a health care
entity;

(5) contracts between a health care entity and a health care provider primarily for clinical
services; or

(6) a single action or series of actions within a five-year period involving only entities
that operate solely as a nursing home licensed under chapter 144A; a boarding care home
licensed under sections 144.50 to 144.56; a supervised living facility licensed under sections
144.50 to 144.56; an assisted living facility licensed under chapter 144G; a foster care setting
licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, for a physical location that
is not the primary residence of the license holder; a community residential setting as defined
in section 245D.02, subdivision 4a; or a home care provider licensed under sections 144A.471
to 144A.483.

Sec. 51.

new text begin [145D.30] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin For purposes of sections 145D.30 to 145D.37, the following
terms have the meanings given unless the context clearly indicates otherwise.
new text end

new text begin Subd. 2. new text end

new text begin Commissioner new text end

new text begin "Commissioner" means the commissioner of commerce for a
nonprofit health coverage entity that is a nonprofit health service plan corporation operating
under chapter 62C or the commissioner of health for a nonprofit health coverage entity that
is a nonprofit health maintenance organization operating under chapter 62D.
new text end

new text begin Subd. 3. new text end

new text begin Control. new text end

new text begin "Control," including the terms "controlling," "controlled by," and
"under common control with," means the possession, direct or indirect, of the power to
direct or cause the direction of the management and policies of a nonprofit health coverage
entity, whether through the ownership of voting securities, through membership in an entity
formed under chapter 317A, by contract other than a commercial contract for goods or
nonmanagement services, or otherwise, unless the power is the result of an official position
with, corporate office held by, or court appointment of the person. Control is presumed to
exist if any person, directly or indirectly, owns, controls, holds with the power to vote, or
holds proxies representing 40 percent or more of the voting securities of any other person
or if any person, directly or indirectly, constitutes 40 percent or more of the membership
of an entity formed under chapter 317A. The attorney general may determine that control
exists in fact, notwithstanding the absence of a presumption to that effect.
new text end

new text begin Subd. 4. new text end

new text begin Conversion benefit entity. new text end

new text begin "Conversion benefit entity" means a foundation,
corporation, limited liability company, trust, partnership, or other entity that receives, in
connection with a conversion transaction, the value of any public benefit asset in accordance
with section 145D.32, subdivision 5.
new text end

new text begin Subd. 5. new text end

new text begin Conversion transaction. new text end

new text begin "Conversion transaction" means a transaction otherwise
permitted under applicable law in which a nonprofit health coverage entity:
new text end

new text begin (1) merges, consolidates, converts, or transfers all or substantially all of its assets to any
entity except a corporation that is exempt under United States Code, title 26, section
501(c)(3);
new text end

new text begin (2) makes a series of separate transfers within a 60-month period that in the aggregate
constitute a transfer of all or substantially all of the nonprofit health coverage entity's assets
to any entity except a corporation that is exempt under United States Code, title 26, section
501(c)(3); or
new text end

new text begin (3) adds or substitutes one or more directors or officers that effectively transfer the
control of, responsibility for, or governance of the nonprofit health coverage entity to any
entity except a corporation that is exempt under United States Code, title 26, section
501(c)(3).
new text end

new text begin Subd. 6. new text end

new text begin Corporation. new text end

new text begin "Corporation" has the meaning given in section 317A.011,
subdivision 6, and also includes a nonprofit limited liability company organized under
section 322C.1101.
new text end

new text begin Subd. 7. new text end

new text begin Director. new text end

new text begin "Director" has the meaning given in section 317A.011, subdivision
7.
new text end

new text begin Subd. 8. new text end

new text begin Family member. new text end

new text begin "Family member" means a spouse, parent, child, spouse of
a child, brother, sister, or spouse of a brother or sister.
new text end

new text begin Subd. 9. new text end

new text begin Full and fair value. new text end

new text begin "Full and fair value" means at least the amount that the
public benefit assets of the nonprofit health coverage entity would be worth if the assets
were equal to stock in the nonprofit health coverage entity, if the nonprofit health coverage
entity was a for-profit corporation and if the nonprofit health coverage entity had 100 percent
of its stock authorized by the corporation and available for purchase without transfer
restrictions. The valuation shall consider market value, investment or earning value, net
asset value, goodwill, amount of donations received, and control premium, if any.
new text end

new text begin Subd. 10. new text end

new text begin Key employee. new text end

new text begin "Key employee" means an individual, regardless of title, who:
new text end

new text begin (1) has responsibilities, power, or influence over an organization similar to those of an
officer or director;
new text end

new text begin (2) manages a discrete segment or activity of the organization that represents ten percent
or more of the activities, assets, income, or expenses of the organization, as compared to
the organization as a whole; or
new text end

new text begin (3) has or shares authority to control or determine ten percent or more of the organization's
capital expenditures, operating budget, or compensation for employees.
new text end

new text begin Subd. 11. new text end

new text begin Nonprofit health coverage entity. new text end

new text begin "Nonprofit health coverage entity" means
a nonprofit health service plan corporation operating under chapter 62C or a nonprofit health
maintenance organization operating under chapter 62D.
new text end

new text begin Subd. 12. new text end

new text begin Officer. new text end

new text begin "Officer" has the meaning given in section 317A.011, subdivision
15.
new text end

new text begin Subd. 13. new text end

new text begin Public benefit assets. new text end

new text begin "Public benefit assets" means the entirety of a nonprofit
health coverage entity's assets, whether tangible or intangible, including but not limited to
its goodwill and anticipated future revenue.
new text end

new text begin Subd. 14. new text end

new text begin Related organization. new text end

new text begin "Related organization" has the meaning given in section
317A.011, subdivision 18.
new text end

Sec. 52.

new text begin [145D.31] CERTAIN CONVERSION TRANSACTIONS PROHIBITED.
new text end

new text begin A nonprofit health coverage entity must not enter into a conversion transaction if:
new text end

new text begin (1) doing so would result in less than the full and fair market value of all public benefit
assets remaining dedicated to the public benefit; or
new text end

new text begin (2) an individual who has been an officer, director, or other executive of the nonprofit
health coverage entity or of a related organization, or a family member of such an individual:
new text end

new text begin (i) has held or will hold, whether guaranteed or contingent, an ownership stake, stock,
securities, investment, or other financial interest in an entity to which the nonprofit health
coverage entity transfers public benefit assets in connection with the conversion transaction;
new text end

new text begin (ii) has received or will receive any type of compensation or other financial benefit from
an entity to which the nonprofit health coverage entity transfers public benefit assets in
connection with the conversion transaction;
new text end

new text begin (iii) has held or will hold, whether guaranteed or contingent, an ownership stake, stock,
securities, investment, or other financial interest in an entity that has or will have a business
relationship with an entity to which the nonprofit health coverage entity transfers public
benefit assets in connection with the conversion transaction; or
new text end

new text begin (iv) has received or will receive any type of compensation or other financial benefit from
an entity that has or will have a business relationship with an entity to which the nonprofit
health coverage entity transfers public benefit assets in connection with the conversion
transaction.
new text end

Sec. 53.

new text begin [145D.32] REQUIREMENTS FOR NONPROFIT HEALTH COVERAGE
ENTITY CONVERSION TRANSACTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Notice. new text end

new text begin (a) Before entering into a conversion transaction, a nonprofit
health coverage entity must notify the attorney general according to section 317A.811. In
addition to the elements listed in section 317A.811, subdivision 1, the notice required by
this subdivision must also include: (1) an itemization of the nonprofit health coverage entity's
public benefit assets and an independent third-party valuation of the nonprofit health coverage
entity's public benefit assets; (2) a proposed plan to distribute the value of those public
benefit assets to a conversion benefit entity that meets the requirements of section 145D.33;
and (3) other information contained in forms provided by the attorney general.
new text end

new text begin (b) When the nonprofit health coverage entity provides the attorney general with the
notice and other information required under paragraph (a), the nonprofit health coverage
entity must also provide a copy of this notice and other information to the applicable
commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Nonprofit health coverage entity requirements. new text end

new text begin Before entering into a
conversion transaction, a nonprofit health coverage entity must ensure that:
new text end

new text begin (1) the proposed conversion transaction complies with chapters 317A and 501B and
other applicable laws;
new text end

new text begin (2) the proposed conversion transaction does not involve or constitute a breach of
charitable trust;
new text end

new text begin (3) the nonprofit health coverage entity shall receive full and fair value for its public
benefit assets;
new text end

new text begin (4) the value of the public benefit assets to be transferred has not been manipulated in
a manner that causes or caused the value of the assets to decrease;
new text end

new text begin (5) the proceeds of the proposed conversion transaction shall be used in a manner
consistent with the public benefit for which the assets are held by the nonprofit health
coverage entity;
new text end

new text begin (6) the proposed conversion transaction shall not result in a breach of fiduciary duty;
and
new text end

new text begin (7) the conversion benefit entity that receives the value of the nonprofit health coverage
entity's public benefit assets meets the requirements in section 145D.33.
new text end

new text begin Subd. 3. new text end

new text begin Listening sessions and public comment. new text end

new text begin The attorney general or the
commissioner may hold public listening sessions or forums and may solicit public comments
regarding the proposed conversion transaction, including on the formation of a conversion
benefit entity under section 145D.33.
new text end

new text begin Subd. 4. new text end

new text begin Waiting period. new text end

new text begin (a) Subject to paragraphs (b) and (c), a nonprofit health
coverage entity must not enter into a conversion transaction until 90 days after the nonprofit
health coverage entity has given written notice as required in subdivision 1.
new text end

new text begin (b) The attorney general may waive all or part of the waiting period or may extend the
waiting period for an additional 90 days by notifying the nonprofit health coverage entity
of the extension in writing.
new text end

new text begin (c) The time periods specified in this subdivision shall be suspended while an
investigation into the conversion transaction is pending or while a request from the attorney
general for additional information is outstanding.
new text end

new text begin Subd. 5. new text end

new text begin Transfer of value of assets required. new text end

new text begin As part of a conversion transaction for
which notice is provided under subdivision 1, the nonprofit health coverage entity must
transfer the entirety of the full and fair value of its public benefit assets to one or more
conversion benefit entities that meet the requirements in section 145D.33.
new text end

new text begin Subd. 6. new text end

new text begin Funds restricted for a particular purpose. new text end

new text begin Nothing in this section relieves a
nonprofit health coverage entity from complying with requirements for funds that are
restricted for a particular purpose. Funds restricted for a particular purpose must continue
to be used in accordance with the purpose for which they were restricted under sections
317A.671 and 501B.31. A nonprofit health coverage entity may not convert assets that
would conflict with their restricted purpose.
new text end

Sec. 54.

new text begin [145D.33] CONVERSION BENEFIT ENTITY REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Requirements. new text end

new text begin In order to receive the value of a nonprofit health coverage
entity's public benefit assets as part of a conversion transaction, a conversion benefit entity
must:
new text end

new text begin (1) be: (i) an existing or new domestic, nonprofit corporation operating under chapter
317A, a nonprofit limited liability company operating under chapter 322C, or a wholly
owned subsidiary thereof; and (ii) exempt under United States Code, title 26, section
501(c)(3);
new text end

new text begin (2) have in place procedures and policies to prohibit conflicts of interest, including but
not limited to conflicts of interest relating to any grant-making activities that may benefit:
new text end

new text begin (i) the officers, directors, or key employees of the conversion benefit entity;
new text end

new text begin (ii) any entity to which the nonprofit health coverage entity transfers public benefit assets
in connection with a conversion transaction; or
new text end

new text begin (iii) any officers, directors, or key employees of an entity to which the nonprofit health
coverage entity transfers public benefit assets in connection with a conversion transaction;
new text end

new text begin (3) operate to benefit the health of the people in this state;
new text end

new text begin (4) have in place procedures and policies that prohibit:
new text end

new text begin (i) an officer, director, or key employee of the nonprofit health coverage entity from
serving as an officer, director, or key employee of the conversion benefit entity for the
five-year period following the conversion transaction;
new text end

new text begin (ii) an officer, director, or key employee of the nonprofit health coverage entity or of
the conversion benefit entity from directly or indirectly benefiting from the conversion
transaction; and
new text end

new text begin (iii) elected or appointed public officials from serving as an officer, director, or key
employee of the conversion benefit entity;
new text end

new text begin (5) not make grants or payments or otherwise provide financial benefit to an entity to
which a nonprofit health coverage entity transfers public benefit assets as part of a conversion
transaction or to a related organization of the entity to which the nonprofit health coverage
entity transfers public benefit assets as part of a conversion transaction; and
new text end

new text begin (6) not have as an officer director, or key employee any individual who has been an
officer, director, or key employee of an entity that receives public benefit assets as part of
a conversion transaction.
new text end

new text begin Subd. 2. new text end

new text begin Review and approval. new text end

new text begin The commissioner must review and approve a conversion
benefit entity before the conversion benefit entity receives the value of public benefit assets
from a nonprofit health coverage entity. In order to be approved under this subdivision, the
conversion benefit entity's governance must be broadly based in the community served by
the nonprofit health coverage entity and must be independent of the entity to which the
nonprofit health coverage entity transfers public benefit assets as part of the conversion
transaction. As part of the review of the conversion benefit entity's governance, the
commissioner may hold a public hearing. The public hearing, if held by the commissioner
of health, may be held concurrently with the hearing authorized under section 62D.31. If
the commissioner finds it necessary, a portion of the value of the public benefit assets must
be used to develop a community-based plan for use by the conversion benefit entity.
new text end

new text begin Subd. 3. new text end

new text begin Community advisory committee. new text end

new text begin The commissioner must establish a
community advisory committee for a conversion benefit entity receiving the value of public
benefit assets. The members of the community advisory committee must be selected to
represent the diversity of the community previously served by the nonprofit health coverage
entity. The community advisory committee must:
new text end

new text begin (1) provide a slate of three nominees for each vacancy on the governing board of the
conversion benefit entity, from which the remaining board members must select new
members to the board;
new text end

new text begin (2) provide the conversion benefit entity's governing board with guidance on the health
needs of the community previously served by the nonprofit health coverage entity; and
new text end

new text begin (3) promote dialogue and information sharing between the conversion benefit entity and
the community previously served by the nonprofit health coverage entity.
new text end

Sec. 55.

new text begin [145D.34] ENFORCEMENT AND REMEDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Investigation. new text end

new text begin The attorney general has the powers in section 8.31.
Nothing in this subdivision limits the powers, remedies, or responsibilities of the attorney
general under this chapter; chapter 8, 309, 317A, or 501B; or any other chapter. For purposes
of this section, an approval by the commissioner for regulatory purposes does not impair
or inform the attorney general's authority.
new text end

new text begin Subd. 2. new text end

new text begin Enforcement and penalties. new text end

new text begin (a) The attorney general may bring an action in
district court to enjoin or unwind a conversion transaction or seek other equitable relief
necessary to protect the public interest if:
new text end

new text begin (1) a nonprofit health coverage entity or conversion transaction violates sections 145D.30
to 145D.33; or
new text end

new text begin (2) the conversion transaction is contrary to the public interest.
new text end

new text begin In seeking injunctive relief, the attorney general must not be required to establish irreparable
harm but must instead establish that a violation of sections 145D.30 to 145D.33 occurred
or that the requested order promotes the public interest.
new text end

new text begin (b) Factors informing whether a conversion transaction is contrary to the public interest
include but are not limited to whether:
new text end

new text begin (1) the conversion transaction shall result in increased health care costs for patients; and
new text end

new text begin (2) the conversion transaction shall adversely impact provider cost trends and containment
of total health care spending.
new text end

new text begin (c) The attorney general may enforce sections 145D.30 to 145D.33 under section 8.31.
new text end

new text begin (d) Failure of the entities involved in a conversion transaction to provide timely
information as required by the attorney general or the commissioner shall be an independent
and sufficient ground for a court to enjoin or unwind the transaction or provide other equitable
relief, provided the attorney general notifies the entities of the inadequacy of the information
provided and provides the entities with a reasonable opportunity to remedy the inadequacy.
new text end

new text begin (e) An officer, director, or other executive found to have violated sections 145D.30 to
145D.33 shall be subject to a civil penalty of up to $100,000 for each violation. A corporation
or other entity which is a party to or materially participated in a conversion transaction
found to have violated sections 145D.30 to 145D.33 shall be subject to a civil penalty of
up to $1,000,000. A court may also award reasonable attorney fees and costs of investigation
and litigation.
new text end

new text begin Subd. 3. new text end

new text begin Commissioner of health; data and research. new text end

new text begin The commissioner of health
must provide the attorney general, upon request, with data and research on broader market
trends, impacts on prices and outcomes, public health and population health considerations,
and health care access, for the attorney general to use when evaluating whether a conversion
transaction is contrary to public interest. The commissioner may share with the attorney
general, according to section 13.05, subdivision 9, any not public data, as defined in section
13.02, subdivision 8a, held by the commissioner to aid in the investigation and review of
the conversion transaction, and the attorney general must maintain this data with the same
classification according to section 13.03, subdivision 4, paragraph (c).
new text end

new text begin Subd. 4. new text end

new text begin Failure to take action. new text end

new text begin Failure by the attorney general to take action with
respect to a conversion transaction under this section does not constitute approval of the
conversion transaction or waiver, nor shall failure prevent the attorney general from taking
action in the same, similar, or subsequent circumstances.
new text end

Sec. 56.

new text begin [145D.35] DATA PRACTICES.
new text end

new text begin Section 13.65 applies to data provided by a nonprofit health coverage entity or the
commissioner to the attorney general under sections 145D.30 to 145D.33. Section 13.39
applies to data provided by a nonprofit health coverage entity to the commissioner under
sections 145D.30 to 145D.33. The attorney general or the commissioner may make any
data classified as confidential or protected nonpublic under this section accessible to any
civil or criminal law enforcement agency if the attorney general or commissioner determines
that the access aids the law enforcement process.
new text end

Sec. 57.

new text begin [145D.36] COMMISSIONER OF HEALTH; REPORTS AND ANALYSIS.
new text end

new text begin Notwithstanding any law to the contrary, the commissioner of health may use data or
information submitted under sections 60A.135 to 60A.137, 60A.17, 60D.18, 60D.20,
62D.221, and 145D.32 to conduct analyses of the aggregate impact of transactions within
nonprofit health coverage entities and organizations which include nonprofit health coverage
entities or their affiliates on access to or the cost of health care services, health care market
consolidation, and health care quality. The commissioner of health must issue periodic
public reports on the number and types of conversion transactions subject to sections 145D.30
to 145D.35 and on the aggregate impact of conversion transactions on health care costs,
quality, and competition in Minnesota.
new text end

Sec. 58.

new text begin [145D.37] RELATION TO OTHER LAW.
new text end

new text begin (a) Sections 145D.30 to 145D.36 are in addition to and do not affect or limit any power,
remedy, or responsibility of a health maintenance organization, a service plan corporation,
a conversion benefit entity, the attorney general, the commissioner of health, or the
commissioner of commerce under this chapter; chapter 8, 62C, 62D, 309, 317A, or 501B;
or other law.
new text end

new text begin (b) Nothing in sections 145D.03 to 145D.36 authorizes a nonprofit health coverage entity
to enter into a conversion transaction not otherwise permitted under chapter 317A or 501B
or other law.
new text end

Sec. 59.

Minnesota Statutes 2022, section 256B.0625, subdivision 12, is amended to read:


Subd. 12.

Eyeglassesdeleted text begin , dentures, and prosthetic and orthotic devicesdeleted text end .

deleted text begin (a)deleted text end Medical
assistance covers eyeglassesdeleted text begin , denture