HF 635

as introduced - 89th Legislature (2015 - 2016) Posted on 02/05/2015 01:55pm

A bill for an act
relating to human services; requiring the commissioner of human services
to develop and implement a new health care delivery system; requiring a
report; prohibiting renewal of managed care purchasing contracts beyond 2016;
appropriating money; proposing coding for new law in Minnesota Statutes,
chapter 256B.

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

Section 1.

new text begin [256B.0758] HEALTH CARE DELIVERY SYSTEM REDESIGN.
new text end

new text begin Subdivision 1. new text end

new text begin Development of new health care delivery system. new text end

new text begin The
commissioner, in consultation with the advisory committee established under this section,
shall develop and implement a new system to deliver health care services to Minnesota
health care program enrollees. The new health care delivery system must make payments
directly to health care providers and must not include contracts with or payments to
managed care organizations, unless the commissioner does not include county-based
purchasing plans under subdivision 7.
new text end

new text begin Subd. 2. new text end

new text begin Criteria for new system. new text end

new text begin The new system must:
new text end

new text begin (1) replace the delivery of health care services through managed care plans under
section 256B.69, through participating entities under section 256L.121, and through
county-based purchasing plans under section 256B.692, if the commissioner includes
county-based purchasing plans according to subdivision 7;
new text end

new text begin (2) provide services to medical assistance recipients required to enroll in a managed
care plan under section 256B.69, including those eligibility groups allowed to opt out of
enrollment, to MinnesotaCare recipients under chapter 256L, and to medical assistance
recipients required to enroll in a county-based purchasing plan under section 256B.692, if
the commissioner includes county-based purchasing plans according to subdivision 7;
new text end

new text begin (3) provide enrollees with all services required to be provided under sections
256B.69 and 256B.692;
new text end

new text begin (4) make payment directly to health care providers, using a payment methodology
based on total cost of care, risk and gain sharing, and quality measurement and incentives;
new text end

new text begin (5) incorporate the principles of, and findings from, the health care delivery system
demonstration project under section 256B.0755 and the county integrated health care
delivery network program under section 256B.0756;
new text end

new text begin (6) be compatible with and build upon initiatives implemented and funded through
the state innovation model (SIM) grant and the Minnesota accountable health model;
new text end

new text begin (7) incorporate health care homes certified under section 256B.0751 and other
methods of care coordination;
new text end

new text begin (8) allow participation by:
new text end

new text begin (i) health care delivery systems and accountable care organizations participating
under, or meeting the general criteria established in, section 256B.0755;
new text end

new text begin (ii) an entity operating a county integrated health care delivery network authorized
under section 256B.0756;
new text end

new text begin (iii) health care provider networks established by county boards that meet the
general criteria specified in section 256B.692, if the commissioner includes county-based
purchasing plans according to subdivision 7; and
new text end

new text begin (iv) networks of health care providers established to offer services to MinnesotaCare
enrollees under chapter 256L;
new text end

new text begin (9) provide technical assistance that allows small, independent health care providers
to participate in the new health care delivery system; and
new text end

new text begin (10) comply with other requirements specified in this section.
new text end

new text begin Subd. 3. new text end

new text begin Contracts. new text end

new text begin (a) The commissioner may contract with a health care policy
consultant or other entity to provide technical services related to design and development
of the new health care delivery system.
new text end

new text begin (b) The commissioner may contract with a health plan company, third-party
administrator, or other entity for administrative services related to implementation and
operation of the new health care delivery system.
new text end

new text begin (c) The commissioner shall contract with a health plan company, third-party
administrator, or other entity to provide technical assistance that will enable small,
independent health care providers to participate in the new health care delivery system.
new text end

new text begin Subd. 4. new text end

new text begin Infrastructure development grants. new text end

new text begin The commissioner shall award grants
to assist small, independent health care providers in developing the data infrastructure
necessary for participation in the new health care delivery system.
new text end

new text begin Subd. 5. new text end

new text begin Nonrenewal of contracts. new text end

new text begin For contracts signed after December 31, 2014,
the commissioner of human services shall not enter into or extend managed care contracts
under section 256B.69, contracts with participating entities under section 256L.121, and
county-based purchasing contracts under section 256B.692, if the commissioner includes
county-based purchasing plans under subdivision 7, beyond December 31, 2016.
new text end

new text begin Subd. 6. new text end

new text begin Advisory committee. new text end

new text begin The commissioner shall establish an advisory
committee to assist the commissioner in developing the new health care delivery system.
The commissioner shall appoint to the advisory committee representatives of the following
stakeholder groups: state health care program enrollees, health care delivery systems,
health care providers, and county boards. The advisory committee is governed by section
15.059, except that members shall not receive per diem compensation.
new text end

new text begin Subd. 7. new text end

new text begin County-based purchasing. new text end

new text begin The commissioner shall determine whether to
include county-based purchasing plans established under section 256B.692 in the health
care delivery system established under this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin The health care delivery system developed under this section
shall be implemented January 1, 2017, or upon federal approval, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 2.

new text begin REPORT TO LEGISLATURE.
new text end

new text begin The commissioner shall present a report on the new delivery system to the legislature
by December 15, 2015. The report must include criteria for the new delivery system
established according to Minnesota Statutes, section 256B.0758, an implementation plan
and schedule, and draft legislation. The report must also include recommendations on
whether medical assistance services not required to be provided under Minnesota Statutes,
sections 256B.69 and 256B.692, should be delivered through the new health care delivery
system.
new text end

Sec. 3. new text begin FEDERAL WAIVER OR APPROVAL.
new text end

new text begin The commissioner of human services shall seek all federal waivers or approvals
necessary to implement a new health care delivery system under Minnesota Statutes,
section 256B.0758.
new text end

Sec. 4. new text begin APPROPRIATION.
new text end

new text begin $....... is appropriated in fiscal year 2016 from the general fund to the commissioner
of human services to develop and implement the new health care delivery system under
Minnesota Statutes, section 256B.0758.
new text end