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HF 521

as introduced - 92nd Legislature (2021 - 2022) Posted on 04/06/2021 12:50pm

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to human services; extending medical assistance postpartum coverage;
amending Minnesota Statutes 2020, sections 256B.055, subdivision 6; 256B.056,
subdivision 10; 256B.06, subdivision 4.

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

Section 1.

Minnesota Statutes 2020, section 256B.055, subdivision 6, is amended to read:


Subd. 6.

Pregnant women; needy unborn child.

Medical assistance may be paid for
a pregnant woman who meets the other eligibility criteria of this section and whose unborn
child would be eligible as a needy child under subdivision 10 if born and living with the
woman. In accordance with Code of Federal Regulations, title 42, section 435.956, the
commissioner must accept self-attestation of pregnancy unless the agency has information
that is not reasonably compatible with such attestation. For purposes of this subdivision, a
woman is considered pregnant for deleted text begin 60deleted text end new text begin 365new text end days postpartum.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval has been obtained.
new text end

Sec. 2.

Minnesota Statutes 2020, 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 deleted text begin 60-daydeleted text end new text begin
365-day
new text end 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 identify unreported accounts 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 identify unreported accounts 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval has been obtained.
new text end

Sec. 3.

Minnesota Statutes 2020, section 256B.06, subdivision 4, is amended to read:


Subd. 4.

Citizenship requirements.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Beginning July 1, 2010, children and pregnant women who are noncitizens described
in paragraph (b) or who are lawfully present in the United States as defined in Code of
Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements
of this chapter, are eligible for medical assistance with federal financial participation as
provided by the federal Children's Health Insurance Program Reauthorization Act of 2009,
Public Law 111-3.

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

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

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

(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment of
an emergency medical condition are limited to the following:

(i) services delivered in an emergency room or by an ambulance service licensed under
chapter 144E that are directly related to the treatment of an emergency medical condition;

(ii) services delivered in an inpatient hospital setting following admission from an
emergency room or clinic for an acute emergency condition; and

(iii) follow-up services that are directly related to the original service provided to treat
the emergency medical condition and are covered by the global payment made to the
provider.

(2) Services for the treatment of emergency medical conditions do not include:

(i) services delivered in an emergency room or inpatient setting to treat a nonemergency
condition;

(ii) organ transplants, stem cell transplants, and related care;

(iii) services for routine prenatal care;

(iv) continuing care, including long-term care, nursing facility services, home health
care, adult day care, day training, or supportive living services;

(v) elective surgery;

(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part
of an emergency room visit;

(vii) preventative health care and family planning services;

(viii) rehabilitation services;

(ix) physical, occupational, or speech therapy;

(x) transportation services;

(xi) case management;

(xii) prosthetics, orthotics, durable medical equipment, or medical supplies;

(xiii) dental services;

(xiv) hospice care;

(xv) audiology services and hearing aids;

(xvi) podiatry services;

(xvii) chiropractic services;

(xviii) immunizations;

(xix) vision services and eyeglasses;

(xx) waiver services;

(xxi) individualized education programs; or

(xxii) chemical dependency treatment.

(i) Pregnant noncitizens who are ineligible for federally funded medical assistance
because of immigration status, are not covered by a group health plan or health insurance
coverage according to Code of Federal Regulations, title 42, section 457.310, and who
otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance
through the period of pregnancy, including labor and delivery, and deleted text begin 60deleted text end new text begin 365new text end days postpartum,
to the extent federal funds are available under title XXI of the Social Security Act, and the
state children's health insurance program.

(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation services
from a nonprofit center established to serve victims of torture and are otherwise ineligible
for medical assistance under this chapter are eligible for medical assistance without federal
financial participation. These individuals are eligible only for the period during which they
are receiving services from the center. Individuals eligible under this paragraph shall not
be required to participate in prepaid medical assistance. The nonprofit center referenced
under this paragraph may establish itself as a provider of mental health targeted case
management services through a county contract under section 256.0112, subdivision 6. If
the nonprofit center is unable to secure a contract with a lead county in its service area, then,
notwithstanding the requirements of section 256B.0625, subdivision 20, the commissioner
may negotiate a contract with the nonprofit center for provision of mental health targeted
case management services. When serving clients who are not the financial responsibility
of their contracted lead county, the nonprofit center must gain the concurrence of the county
of financial responsibility prior to providing mental health targeted case management services
for those clients.

(k) Notwithstanding paragraph (h), clause (2), the following services are covered as
emergency medical conditions under paragraph (f) except where coverage is prohibited
under federal law for services under clauses (1) and (2):

(1) dialysis services provided in a hospital or freestanding dialysis facility;

(2) surgery and the administration of chemotherapy, radiation, and related services
necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission and
requires surgery, chemotherapy, or radiation treatment; and

(3) kidney transplant if the person has been diagnosed with end stage renal disease, is
currently receiving dialysis services, and is a potential candidate for a kidney transplant.

(l) Effective July 1, 2013, recipients of emergency medical assistance under this
subdivision are eligible for coverage of the elderly waiver services provided under chapter
256S, and coverage of rehabilitative services provided in a nursing facility. The age limit
for elderly waiver services does not apply. In order to qualify for coverage, a recipient of
emergency medical assistance is subject to the assessment and reassessment requirements
of section 256B.0911. Initial and continued enrollment under this paragraph is subject to
the limits of available funding.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval has been obtained.
new text end

Sec. 4. new text begin FEDERAL APPROVAL; EXTENSION OF POSTPARTUM COVERAGE.
new text end

new text begin The commissioner of human services shall seek all necessary federal waivers and
approvals necessary to extend medical assistance postpartum coverage, as provided in
Minnesota Statutes, section 256B.055, subdivision 6.
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