HF 5

5th Engrossment - 90th Legislature (2017 - 2018) Posted on 02/20/2018 12:11pm

A bill for an act
relating to insurance; health; creating the Minnesota premium security plan;
providing funding; establishing a legislative working group; regulating health care
provider system access; modifying premium subsidy program provisions;
appropriating money; amending Minnesota Statutes 2016, sections 62E.10,
subdivision 2; 62K.10, by adding a subdivision; Laws 2013, chapter 9, section 15;
Laws 2017, chapter 2, article 1, sections 1, subdivision 3; 2, subdivision 4, by
adding a subdivision; 3; article 2, section 13; proposing coding for new law in
Minnesota Statutes, chapter 62E.

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

ARTICLE 1

MINNESOTA PREMIUM SECURITY PLAN

Section 1.

Minnesota Statutes 2016, section 62E.10, subdivision 2, is amended to read:

Subd. 2.

Board of directors; organization.

The board of directors of the association
shall be made up of eleven 13 members as follows: six directors selected by contributing
members, subject to approval by the commissioner, one of which must be a health actuary;
two directors selected by the commissioner of human services, one of whom must represent
hospitals and one of whom must represent health care providers; five public directors selected
by the commissioner, at least two of whom must be plan enrollees, two of whom are covered
under an individual plan subject to assessment under section 62E.11 or group plan offered
by an employer subject to assessment under section 62E.11, enrollees in the individual
market and one of whom must be a licensed insurance agent. At least two of the public
directors must reside outside of the seven-county metropolitan area. In determining voting
rights at members' meetings, each member shall be entitled to vote in person or proxy. The
vote shall be a weighted vote based upon the member's cost of self-insurance, accident and
health insurance premium, subscriber contract charges, health maintenance contract payment,
or community integrated service network payment derived from or on behalf of Minnesota
residents in the previous calendar year, as determined by the commissioner. In approving
directors of the board, the commissioner shall consider, among other things, whether all
types of members are fairly represented. Directors selected by contributing members may
be reimbursed from the money of the association for expenses incurred by them as directors,
but shall not otherwise be compensated by the association for their services. The costs of
conducting meetings of the association and its board of directors shall be borne by members
of the association.

Sec. 2.

[62E.21] DEFINITIONS.

Subdivision 1.

Application.

For the purposes of sections 62E.21 to 62E.25, the terms
defined in this section have the meanings given them.

Subd. 2.

Affordable Care Act.

"Affordable Care Act" means the federal act as defined
in section 62A.011, subdivision 1a.

Subd. 3.

Attachment point.

"Attachment point" means an amount as provided in section
62E.23, subdivision 2, paragraph (b).

Subd. 4.

Benefit year.

"Benefit year" means the calendar year for which an eligible
health carrier provides coverage through an individual health plan.

Subd. 5.

Board.

"Board" means the board of directors of the Minnesota Comprehensive
Health Association created under section 62E.10.

Subd. 6.

Coinsurance rate.

"Coinsurance rate" means the rate as provided in section
62E.23, subdivision 2, paragraph (c).

Subd. 7.

Commissioner.

"Commissioner" means the commissioner of commerce.

Subd. 8.

Eligible health carrier.

"Eligible health carrier" means all of the following
that offer individual health plans and incur claims costs for an individual enrollee's covered
benefits in the applicable benefit year:

(1) 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;

(2) a nonprofit health service plan corporation operating under chapter 62C; or

(3) a health maintenance organization operating under chapter 62D.

Subd. 9.

Individual health plan.

"Individual health plan" means a health plan as defined
in section 62A.011, subdivision 4, that is not a grandfathered plan as defined in section
62A.011, subdivision 1b.

Subd. 10.

Individual market.

"Individual market" has the meaning given in section
62A.011, subdivision 5.

Subd. 11.

Minnesota Comprehensive Health Association or association.

"Minnesota
Comprehensive Health Association" or "association" has the meaning given in section
62E.02, subdivision 14.

Subd. 12.

Minnesota premium security plan or plan.

"Minnesota premium security
plan" or "plan" means the state-based reinsurance program authorized under section 62E.23.

Subd. 13.

Payment parameters.

"Payment parameters" means the attachment point,
reinsurance cap, and coinsurance rate for the plan.

Subd. 14.

Reinsurance cap.

"Reinsurance cap" means the threshold amount as provided
in section 62E.23, subdivision 2, paragraph (d).

Subd. 15.

Reinsurance payments.

"Reinsurance payments" means an amount paid by
the association to an eligible health carrier under the plan.

Sec. 3.

[62E.22] DUTIES OF COMMISSIONER.

The commissioner shall require eligible health carriers to calculate the premium amount
the eligible health carrier would have charged for the benefit year if the Minnesota premium
security plan had not been established. The eligible health carrier must submit this
information as part of its rate filing. The commissioner must consider this information as
part of the rate review.

Sec. 4.

[62E.23] MINNESOTA PREMIUM SECURITY PLAN.

Subdivision 1.

Administration of plan.

(a) The association is Minnesota's reinsurance
entity to administer the state-based reinsurance program referred to as the Minnesota premium
security plan.

(b) The association may apply for any available federal funding for the plan. All funds
received by or appropriated to the association shall be deposited in the premium security
plan account in section 62E.25, subdivision 1. The association shall notify the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services and insurance within ten days of receiving any federal funds.

(c) The association must collect or access data from an eligible health carrier that are
necessary to determine reinsurance payments, according to the data requirements under
subdivision 5, paragraph (c).

(d) The board must not use any funds allocated to the plan for staff retreats, promotional
giveaways, excessive executive compensation, or promotion of federal or state legislative
or regulatory changes.

(e) For each applicable benefit year, the association must notify eligible health carriers
of reinsurance payments to be made for the applicable benefit year no later than June 30 of
the year following the applicable benefit year.

(f) On a quarterly basis during the applicable benefit year, the association must provide
each eligible health carrier with the calculation of total reinsurance payment requests.

(g) By August 15 of the year following the applicable benefit year, the association must
disburse all applicable reinsurance payments to an eligible health carrier.

Subd. 2.

Payment parameters.

(a) The board must design and adjust the payment
parameters to ensure the payment parameters:

(1) will stabilize or reduce premium rates in the individual market;

(2) will increase participation in the individual market;

(3) will improve access to health care providers and services for those in the individual
market;

(4) mitigate the impact high-risk individuals have on premium rates in the individual
market;

(5) take into account any federal funding available for the plan; and

(6) take into account the total amount available to fund the plan.

(b) The attachment point for the plan is the threshold amount for claims costs incurred
by an eligible health carrier for an enrolled individual's covered benefits in a benefit year,
beyond which the claims costs for benefits are eligible for reinsurance payments. The
attachment point shall be set by the board at $50,000 or more, but not exceeding the
reinsurance cap.

(c) The coinsurance rate for the plan is the rate at which the association will reimburse
an eligible health carrier for claims incurred for an enrolled individual's covered benefits
in a benefit year above the attachment point and below the reinsurance cap. The coinsurance
rate shall be set by the board at a rate between 50 and 80 percent.

(d) The reinsurance cap is the threshold amount for claims costs incurred by an eligible
health carrier for an enrolled individual's covered benefits, after which the claims costs for
benefits are no longer eligible for reinsurance payments. The reinsurance cap shall be set
by the board at $250,000 or less.

(e) The board may adjust the payment parameters to the extent necessary to secure
federal approval of the state innovation waiver request in article 1, section 8.

Subd. 3.

Operation.

(a) The board shall propose to the commissioner the payment
parameters for the next benefit year by January 15 of the year before the applicable benefit
year. The commissioner shall approve or reject the payment parameters no later than 14
days following the board's proposal. If the commissioner fails to approve or reject the
payment parameters within 14 days following the board's proposal, the proposed payment
parameters are final and effective.

(b) If the amount in the premium security plan account in section 62E.25, subdivision
1, is not anticipated to be adequate to fully fund the approved payment parameters as of
July 1 of the year before the applicable benefit year, the board, in consultation with the
commissioner and the commissioner of management and budget, shall propose payment
parameters within the available appropriations. The commissioner must permit an eligible
health carrier to revise an applicable rate filing based on the final payment parameters for
the next benefit year.

Subd. 4.

Calculation of reinsurance payments.

(a) Each reinsurance payment must be
calculated with respect to an eligible health carrier's incurred claims costs for an individual
enrollee's covered benefits in the applicable benefit year. If the claims costs do not exceed
the attachment point, the reinsurance payment is $0. If the claims costs exceed the attachment
point, the reinsurance payment shall be calculated as the product of the coinsurance rate
and the lesser of:

(1) the claims costs minus the attachment point; or

(2) the reinsurance cap minus the attachment point.

(b) The board must ensure that reinsurance payments made to eligible health carriers do
not exceed the total amount paid by the eligible health carrier for any eligible claim. "Total
amount paid of an eligible claim" means the amount paid by the eligible health carrier based
upon the allowed amount less any deductible, coinsurance, or co-payment, as of the time
the data are submitted or made accessible under subdivision 5, paragraph (c).

Subd. 5.

Eligible carrier requests for reinsurance payments.

(a) An eligible health
carrier may request reinsurance payments from the association when the eligible health
carrier meets the requirements of this subdivision and subdivision 4.

(b) An eligible health carrier must make requests for reinsurance payments in accordance
with any requirements established by the board.

(c) An eligible health carrier must provide the association with access to the data within
the dedicated data environment established by the eligible health carrier under the federal
risk adjustment program under United States Code, title 42, section 18063. Eligible health
carriers must submit an attestation to the board asserting compliance with the dedicated
data environments, data requirements, establishment and usage of masked enrollee
identification numbers, and data submission deadlines.

(d) An eligible health carrier must provide the access described in paragraph (c) for the
applicable benefit year by April 30 of each year of the year following the end of the
applicable benefit year.

(e) An eligible health carrier must maintain documents and records, whether paper,
electronic, or in other media, sufficient to substantiate the requests for reinsurance payments
made pursuant to this section for a period of at least six years. An eligible health carrier
must also make those documents and records available upon request from the commissioner
for purposes of verification, investigation, audit, or other review of reinsurance payment
requests.

(f) An eligible health carrier may follow the appeals procedure under section 62E.10,
subdivision 2a.

(g) The association may have an eligible health carrier audited to assess the health
carrier's compliance with the requirements of this section. The eligible health carrier must
ensure that its contractors, subcontractors, or agents cooperate with any audit under this
section. If an audit results in a proposed finding of material weakness or significant deficiency
with respect to compliance with any requirement of this section, the eligible health carrier
may provide a response to the proposed finding within 30 days. Within 30 days of the
issuance of a final audit report that includes a finding of material weakness or significant
deficiency, the eligible health carrier must:

(1) provide a written corrective action plan to the association for approval;

(2) implement the approved plan; and

(3) provide the association with written documentation of the corrective action once
taken.

Subd. 6.

Data.

Government data of the association under this section are private data
on individuals, or nonpublic data, as defined under section 13.02, subdivisions 9 or 12.

Sec. 5.

[62E.24] ACCOUNTING, REPORTS, AND AUDITS OF THE
ASSOCIATION.

Subdivision 1.

Accounting.

The board must keep an accounting for each benefit year
of all:

(1) funds appropriated for reinsurance payments and administrative and operational
expenses;

(2) requests for reinsurance payments received from eligible health carriers;

(3) reinsurance payments made to eligible health carriers; and

(4) administrative and operational expenses incurred for the plan.

Subd. 2.

Reports.

The board must submit to the commissioner and make available to
the public a report summarizing the plan operations for each benefit year by posting the
summary on the Minnesota Comprehensive Health Association Web site and making the
summary otherwise available by November 1 of the year following the applicable benefit
year or 60 calendar days following the final disbursement of reinsurance payments for the
applicable benefit year, whichever is later.

Subd. 3.

Legislative auditor.

The Minnesota premium security plan is subject to audit
by the legislative auditor. The board must ensure that its contractors, subcontractors, or
agents cooperate with the audit.

Subd. 4.

Independent external audit.

(a) The board must engage and cooperate with
an independent certified public accountant or CPA firm licensed or permitted under chapter
326A to perform an audit for each benefit year of the plan, in accordance with generally
accepted auditing standards. The audit must at a minimum:

(1) assess compliance with the requirements of sections 62E.21 to 62E.25; and

(2) identify any material weaknesses or significant deficiencies and address manners in
which to correct any such material weaknesses or deficiencies.

(b) The board, after receiving the completed audit, must:

(1) provide the commissioner the results of the audit;

(2) identify to the commissioner any material weakness or significant deficiency identified
in the audit and address in writing to the commissioner how the board intends to correct
any such material weakness or significant deficiency in compliance with subdivision 5; and

(3) make public the results of the audit, to the extent the audit contains government data
that is public, including any material weakness or significant deficiency and how the board
intends to correct the material weakness or significant deficiency, by posting the audit results
on the Minnesota Comprehensive Health Association Web site and making the audit results
otherwise available.

Subd. 5.

Actions on audit findings.

(a) If an audit results in a finding of material
weakness or significant deficiency with respect to compliance by the association with any
requirement under sections 62E.21 to 62E.25, the board must:

(1) provide a written corrective action plan to the commissioner for approval within 60
days of the completed audit;

(2) implement the corrective action plan; and

(3) provide the commissioner with written documentation of the corrective actions taken.

(b) By December 1 of each year, the board must submit a report to the standing
committees of the legislature having jurisdiction over health and human services and
insurance regarding any finding of material weakness or significant deficiency found in an
audit.

Sec. 6.

[62E.25] ACCOUNTS.

Subdivision 1.

Premium security plan account.

The premium security plan account is
created in the special revenue fund of the state treasury. Funds in the account are appropriated
annually to the commissioner of commerce for grants to the Minnesota Comprehensive
Health Association for the operational and administrative costs and reinsurance payments
relating to the start-up and operation of the Minnesota premium security plan.
Notwithstanding section 11A.20, all investment income and all investment losses attributable
to the investment of the premium security plan account shall be credited to the premium
security plan account.

Subd. 2.

Deposits.

Except as provided in subdivision 3, funds received by the
commissioner of commerce or other state agency pursuant to the state innovation waiver
request in article 1, section 8, shall be deposited in the premium security plan account in
subdivision 1.

Subd. 3.

Basic health plan trust account.

Funds received by the commissioner of
commerce or other state agency pursuant to the state innovation waiver request in article 1,
section 8, that are attributable to the basic health program shall be deposited in the basic
health plan trust account in the federal fund.

Sec. 7.

Laws 2013, chapter 9, section 15, is amended to read:

Sec. 15. MINNESOTA COMPREHENSIVE HEALTH ASSOCIATION
TERMINATION.

(a) The commissioner of commerce, in consultation with the board of directors of the
Minnesota Comprehensive Health Association, has the authority to develop and implement
the phase-out and eventual appropriate termination of coverage provided by the Minnesota
Comprehensive Health Association under Minnesota Statutes, chapter 62E. The phase-out
of coverage shall begin no sooner than January 1, 2014, or upon the effective date of the
operation of the Minnesota Insurance Marketplace and the ability to purchase qualified
health plans through the Minnesota Insurance Marketplace, whichever is later, and shall,
to the extent practicable, ensure the least amount of disruption to the enrollees' health care
coverage. The member assessments established under Minnesota Statutes, section 62E.11,
shall take into consideration any phase-out of coverage implemented under this section.

(b) Nothing in paragraph (a) applies to the Minnesota premium security plan, as defined
in Minnesota Statutes, section 62E.21, subdivision 12.

Sec. 8. STATE INNOVATION WAIVER.

Subdivision 1.

Submission of waiver application.

The commissioner of commerce
shall apply to the secretary of health and human services under United States Code, title
42, section 18052, for a state innovation waiver to implement the Minnesota premium
security plan for benefit years beginning January 1, 2018, and future years, to maximize
federal funding. The waiver application must clearly state that operation of the Minnesota
premium security plan is contingent on approval of the waiver request.

Subd. 2.

Consultation.

In developing the waiver application, the commissioner shall
consult with the commissioner of human services, the commissioner of health, and the
MNsure board.

Subd. 3.

Application timelines; notification.

The commissioner shall submit the waiver
application to the secretary of health and human services on or before June 15, 2017. The
commissioner shall make a draft application available for public review and comment by
May 15, 2017. The commissioner shall notify the chairs and ranking minority members of
the legislative committees with jurisdiction over health and human services and insurance,
and the board of directors of the Minnesota Comprehensive Health Association of any
federal actions regarding the waiver request.

Sec. 9. COSTS RELATED TO IMPLEMENTATION OF THIS ACT.

A state agency that incurs administrative costs to implement any provision of this act
and does not receive an appropriation for administrative costs of this act must implement
the act within the limits of existing appropriations.

Sec. 10. PREMIUM SECURITY PLAN CONTINGENT ON FEDERAL WAIVER.

If the state innovation waiver request in article 1, section 8, is not approved, the Minnesota
Comprehensive Health Association and its board of directors shall not administer the
Minnesota premium security plan and provide reinsurance payments to eligible health
carriers.

Sec. 11. PAYMENT PARAMETERS FOR 2018.

(a) Notwithstanding Minnesota Statutes, section 62E.23, and subject to paragraph (b),
the Minnesota premium security plan payment parameters for benefit year 2018 are:

(1) an attachment point of $50,000;

(2) a coinsurance rate of 80 percent; and

(3) a reinsurance cap of $250,000.

(b) The board of directors of the Minnesota Comprehensive Health Association may
alter the payment parameters to the extent necessary to secure federal approval of the state
innovation waiver request in article 1, section 8.

Sec. 12. DEPOSIT OF FUNDS.

(a) Within ten days of the effective date of this section, the Minnesota Comprehensive
Health Association, as defined in Minnesota Statutes, section 62E.02, subdivision 14, shall
deposit all money, including monetary reserves, the association holds into the premium
security plan account in Minnesota Statutes, section 62E.25, subdivision 1.

(b) Notwithstanding paragraph (a), the Minnesota Comprehensive Health Association
may retain funds necessary to fulfill medical needs and contractual obligations in place for
former Minnesota Comprehensive Health Association enrollees until December 31, 2018.

Sec. 13. DISPOSITION AND SETTLEMENTS.

Notwithstanding Minnesota Statutes, section 62E.09, and any other law to the contrary,
the board of directors of the Minnesota Comprehensive Health Association, as defined in
Minnesota Statutes, section 62E.02, subdivision 14, shall have authority:

(1) over the disposition and settlement of all funds held by the association, including
prior assessments, to the extent funds have not been transferred pursuant to article 1, section
12; and

(2) to settle and make determinations regarding litigation pending on the effective date
of this act, including litigation that impacts funds held by the association.

Sec. 14. LEGISLATIVE WORKING GROUP.

A legislative working group is established consisting of the chairs and ranking minority
members of the senate committees with jurisdiction over commerce, health and human
services finance and policy, and human services reform finance and policy and the chairs
and ranking minority members of the house of representatives committees with jurisdiction
over commerce and regulatory reform, health and human services finance, and health and
human services reform. The purpose of the working group is to advise the board of the
Minnesota Comprehensive Health Association on the adoption of payment parameters and
other elements of a reinsurance plan for benefit year 2019. The commissioner of commerce
must provide technical assistance for the working group, and must review and monitor the
following to serve as a resource for the working group:

(1) the effectiveness of reinsurance models adopted in Alaska and other states in
stabilizing premiums in the individual market and the related costs thereof;

(2) the effect of federal health reform legislation on the Minnesota premium security
plan, including but not limited to funding for the plan; and

(3) the status of the health care access fund, and issues relating to its potential continued
use as a source of funding for the Minnesota premium security plan.

Sec. 15. MINNESOTA PREMIUM SECURITY PLAN FUNDING.

(a) The Minnesota Comprehensive Health Association shall fund the operational and
administrative costs and reinsurance payments of the Minnesota security plan and association
using the following amounts deposited in the premium security plan account in Minnesota
Statutes, section 62E.25, subdivision 1, in the following order:

(1) any federal funding available;

(2) funds deposited under article 1, sections 12 and 13;

(3) any state funds from the health care access fund; and

(4) any state funds from the general fund.

(b) The association shall transfer from the premium security plan account any general
fund amount not used for the Minnesota premium security plan by June 30, 2021, to the
commissioner of commerce. Any amount transferred to the commissioner of commerce
shall be deposited in the general fund.

(c) The association shall transfer from the premium security plan account any health
care access fund amount not used for the Minnesota premium security plan by June 30,
2021, to the commissioner of commerce. Any amount transferred to the commissioner of
commerce shall be deposited in the health care access fund in Minnesota Statutes, section
16A.724.

(d) The Minnesota Comprehensive Health Association may not spend more than
$271,000,000 for benefit year 2018 and not more than $271,000,000 for benefit year 2019
for the operational and administrative costs of, and reinsurance payments under, the
Minnesota premium security plan.

Sec. 16. TRANSFERS.

(a) The commissioner of management and budget shall transfer $200,000,000 in fiscal
year 2018 and $200,000,000 in fiscal year 2019 from the health care access fund to the
premium security plan account in Minnesota Statutes, section 62E.25, subdivision 1. This
is a onetime transfer.

(b) The commissioner of management and budget shall transfer $71,000,000 in fiscal
year 2018 and $71,000,000 in fiscal year 2019 from the general fund to the premium security
plan account in Minnesota Statutes, section 62E.25, subdivision 1. This is a onetime transfer.

EFFECTIVE DATE.

This section is effective upon federal approval of the state
innovation request in article 1, section 8. The commissioner of commerce shall inform the
revisor of statutes when federal approval is obtained.

Sec. 17. TRANSFER; 2018.

The commissioner of management and budget shall transfer $750,000 in fiscal year 2018
from the health care access fund to the premium security plan account in Minnesota Statutes,
section 62E.25, subdivision 1. This is a onetime transfer.

Sec. 18. APPROPRIATION.

$155,000 in fiscal year 2018 is appropriated from the general fund to the commissioner
of commerce to prepare and submit the state innovation waiver in article 1, section 8.

Sec. 19. EFFECTIVE DATE.

Sections 1 to 15, 17, and 18 are effective the day following final enactment.

ARTICLE 2

HEALTH POLICY

Section 1.

Minnesota Statutes 2016, section 62K.10, is amended by adding a subdivision
to read:

Subd. 1a.

Health care provider system access.

For those counties in which a health
carrier actively markets an individual health plan, the health carrier must offer, in those
same counties, at least one individual health plan with a provider network that includes
in-network access to more than a single health care provider system. This subdivision is
applicable only for the year in which the health carrier actively markets an individual health
plan.

EFFECTIVE DATE.

This section is effective January 1, 2018, and applies to individual
health plans offered, issued, or renewed on or after that date.

Sec. 2.

Laws 2017, chapter 2, article 1, section 1, subdivision 3, is amended to read:

Subd. 3.

Eligible individual.

"Eligible individual" means a Minnesota resident who:

(1) is not receiving a an advance premium tax credit under Code of Federal Regulations,
title 26, section 1.36B-2, as of the date in a month in which their coverage is effectuated
effective;

(2) is not enrolled in public program coverage under Minnesota Statutes, section
256B.055, or 256L.04; and

(3) purchased an individual health plan from a health carrier in the individual market.

EFFECTIVE DATE.

This section is effective retroactively from January 27, 2017.

Sec. 3.

Laws 2017, chapter 2, article 1, section 2, subdivision 4, is amended to read:

Subd. 4.

Data practices.

(a) The definitions in Minnesota Statutes, section 13.02, apply
to this subdivision.

(b) Government data on an enrollee or health carrier under this section are private data
on individuals or nonpublic data, except that the total reimbursement requested by a health
carrier and the total state payment to the health carrier are public data.

(c) Notwithstanding Minnesota Statutes, section 138.17, not public government data on
an enrollee or health carrier under this section must be destroyed by June 30, 2018, or upon
completion by the legislative auditor of the audits required by section 3, whichever is later.
This paragraph does not apply to data maintained by the legislative auditor.

EFFECTIVE DATE.

This section is effective retroactively from January 27, 2017.

Sec. 4.

Laws 2017, chapter 2, article 1, section 2, is amended by adding a subdivision to
read:

Subd. 5.

Data sharing.

(a) Notwithstanding any law to the contrary, government entities
are permitted to share or disseminate data as follows:

(1) the commissioner of human services and the board of directors of MNsure must
share data on public program enrollment under Minnesota Statutes, sections 256B.055 and
256L.04, as well as data on an enrollee's receipt of a premium tax credit under Code of
Federal Regulations, title 26, section 1.36B-2, with the commissioner of management and
budget; and

(2) the commissioner of management and budget must disseminate data on an enrollee's
public program coverage enrollment under Minnesota Statutes, sections 256B.055 and
256L.04, to health carriers to the extent the commissioner determines is necessary for
determining the enrollee's eligibility for the premium subsidy program authorized by this
act.

(b) Data shared under this subdivision may be collected, stored, or used only for the
purposes of administration of the premium subsidy program authorized by this act and may
not be further shared or disseminated except as otherwise provided by law.

(c) By June 30, 2018, a health carrier must destroy any data it received pursuant to this
subdivision.

EFFECTIVE DATE.

This section is effective retroactively from January 27, 2017.

Sec. 5.

Laws 2017, chapter 2, article 1, section 3, is amended to read:

Sec. 3. AUDITS.

(a) The legislative auditor shall conduct audits of the health carriers' supporting data, as
prescribed by the commissioner, to determine whether payments align with criteria
established in sections 1 and 2. The commissioner of human services shall provide data as
necessary to the legislative auditor to complete the audit. The commissioner shall withhold
or charge back payments to the health carriers to the extent they do not align with the criteria
established in sections 1 and 2, as determined by the audit.

(b) The legislative auditor shall audit the extent to which health carriers provided premium
subsidies to persons meeting the residency and other eligibility requirements specified in
section 1, subdivision 3. The legislative auditor shall report to the commissioner the amount
of premium subsidies provided by each health carrier to persons not eligible for a premium
subsidy. The commissioner, in consultation with the commissioners of commerce and health
human services, shall develop and implement a process to recover from health carriers the
amount of premium subsidies received for enrollees determined to be ineligible for premium
subsidies by the legislative auditor. The legislative auditor, when conducting the required
audit, and the commissioner, when determining the amount of premium subsidy to be
recovered, may take into account the extent to which a health carrier makes use of the
Minnesota eligibility system, as defined in Minnesota Statutes, section 62V.055, subdivision
1.

EFFECTIVE DATE.

This section is effective retroactively from January 27, 2017.

Sec. 6.

Laws 2017, chapter 2, article 2, section 13, the effective date, is amended to read:

EFFECTIVE DATE.

This section is effective 90 days following final enactment January
1, 2018, and applies to provider services provided on or after that date.

EFFECTIVE DATE.

This section is effective retroactively from January 27, 2017.