SF 20

1st Engrossment - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; creating a children's health security account;
establishing the children's health security program; specifying eligibility criteria,
covered services, and administrative procedures; increasing the tax on tobacco
products; appropriating money; amending Minnesota Statutes 2004, sections
297F.05, subdivisions 1, 3, 4; 297F.10, as amended; proposing coding for
new law in Minnesota Statutes, chapter 16A; proposing coding for new law
as Minnesota Statutes, chapter 256N.

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

Section 1.

new text begin [16A.726] CHILDREN'S HEALTH SECURITY ACCOUNT.
new text end

new text begin A children's health security account is created in the state treasury. The account is a
direct appropriated special revenue account. The commissioner shall deposit to the credit
of the account money made available to the account. Notwithstanding section 11A.20,
all investment income and all investment losses attributable to the investment of the
children's health security account not currently needed shall be credited to the children's
health security account.
new text end

Sec. 2.

new text begin [256N.01] CITATION.
new text end

new text begin This chapter may be cited as the Children's Health Security Act.
new text end

Sec. 3.

new text begin [256N.02] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin The terms used in this chapter have the following
meanings unless otherwise provided for by text.
new text end

new text begin Subd. 2. new text end

new text begin Child. new text end

new text begin "Child" means an individual under age 19 or an unmarried child
who is a full-time student under the age of 25 years who is financially dependent upon a
parent, grandparent, foster parent, relative caretaker, or legal guardian.
new text end

new text begin Subd. 3. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of human
services.
new text end

Sec. 4.

new text begin [256N.03] ESTABLISHMENT.
new text end

new text begin The commissioner shall establish the children's health security program. The
commissioner shall begin implementation of the program on July 1, 2008.
new text end

Sec. 5.

new text begin [256N.05] ELIGIBILITY.
new text end

new text begin Subdivision 1. new text end

new text begin General requirements. new text end

new text begin Children meeting the eligibility
requirements of this section are eligible for the children's health security program.
new text end

new text begin Subd. 2. new text end

new text begin Phase-in of eligible groups. new text end

new text begin (a) Children in families with income equal to
or less than 300 percent of the federal poverty guidelines are eligible to enroll effective
July 1, 2008, or upon federal approval, whichever is later.
new text end

new text begin (b) Effective July 1, 2010, eligibility is expanded to include all children, regardless of
household income or assets, who are not eligible for medical assistance or MinnesotaCare.
new text end

new text begin Subd. 3. new text end

new text begin Residency. new text end

new text begin (a) To be eligible for health coverage under the children's
health security program, children must be permanent residents of Minnesota. For purposes
of this requirement, a permanent Minnesota resident is a person who has demonstrated,
through persuasive and objective evidence, that the person is domiciled in the state and
intends to live in the state permanently.
new text end

new text begin (b) To be eligible as a permanent resident, an applicant, or the applicant's parent
or guardian as applicable, must demonstrate the requisite intent to live in the state
permanently by:
new text end

new text begin (1) showing that the applicant, or the applicant's parent or guardian as applicable,
maintains a residence at a verified address, through the use of evidence of residence
described in paragraph (c); and
new text end

new text begin (2) signing an affidavit declaring that the applicant currently resides in the state and
intends to reside in the state permanently, and the applicant did not come to the state for
the primary purpose of obtaining medical coverage or treatment.
new text end

new text begin (c) An applicant, or a parent or guardian of an applicant, may verify a residence
address by presenting a valid state driver's license, a state identification card, a voter
registration card, a rent receipt, a statement by the landlord, apartment or emergency
shelter manager, or homeowner verifying that the individual is residing at the address, or
other form of verification approved by the commissioner.
new text end

new text begin (d) A child who is temporarily absent from the state does not lose eligibility for the
children's health security program. "Temporarily absent from the state" means the person
is out of the state for a temporary purpose and intends to return when the purpose of the
absence has been accomplished. A person is not temporarily absent from the state if
another state has determined that the person is a resident for any purpose. If temporarily
absent from the state, the person must follow the requirements of the health plan in which
the person is enrolled to receive services.
new text end

new text begin (e) A child who moved to Minnesota primarily to obtain medical treatment or health
coverage for a preexisting condition is not a permanent resident.
new text end

new text begin Subd. 4. new text end

new text begin Enrollment voluntary. new text end

new text begin Enrollment in the children's health security
program is voluntary. Parents or guardians may retain private sector or Medicare coverage
for a child as the sole source of coverage. Parents or guardians who have private sector or
Medicare coverage for children may also enroll children in the children's health security
program. If private sector or Medicare coverage is available, coverage under the children's
health security program is secondary to the private sector or Medicare coverage.
new text end

Sec. 6.

new text begin [256N.07] COVERED SERVICES.
new text end

new text begin Covered services under the children's health security program consist of all services
reimbursed under chapter 256B.
new text end

Sec. 7.

new text begin [256N.09] NO ENROLLEE PREMIUMS OR COST SHARING.
new text end

new text begin In order to ensure broad access to coverage, the children's health security program
has no enrollee premium or cost-sharing requirements.
new text end

Sec. 8.

new text begin [256N.11] APPLICATION PROCEDURES.
new text end

new text begin Subdivision 1. new text end

new text begin Application procedure. new text end

new text begin Applications for the program must be made
available to provider offices, local human services agencies, school districts, schools,
community health offices, and other sites willing to cooperate in program outreach. These
sites may accept applications and forward applications to the commissioner. Applicants
may also apply directly to the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Eligibility determination. new text end

new text begin The commissioner shall determine an
applicant's eligibility for the program within 30 days of the date the application is received
by the Department of Human Services. The effective date of coverage is the day upon
which eligibility is approved, except in cases of persons applying under presumptive
eligibility.
new text end

new text begin Subd. 3. new text end

new text begin Presumptive eligibility. new text end

new text begin Coverage under the program is available during a
presumptive eligibility period. The presumptive eligibility period begins on the date a
health care provider or other entity designated by the commissioner determines, based
on preliminary information, that the person meets the criteria in section 256N.05. The
presumptive eligibility period ends on the day on which a determination is made as to
the person's eligibility, except that if an application is not submitted by the last day of
the month following the month during which the determination based on preliminary
information is made, the presumptive eligibility period ends on the last day of the month.
new text end

Sec. 9.

new text begin [256N.13] SERVICE DELIVERY.
new text end

new text begin (a) The commissioner may contract with health maintenance organizations licensed
under chapter 62D, community integrated service networks licensed under chapter 62N,
and accountable provider networks licensed under chapter 62T to provide health care
services to program enrollees. Health plan companies under contract are responsible for
coordinating health care services provided to eligible individuals. Health plan companies
under contract:
new text end

new text begin (1) shall authorize and arrange for the provision of all needed health services
reimbursed under chapter 256B, with the exception of services available only under a
medical assistance home and community-based waiver, in order to ensure appropriate
health care is delivered to enrollees;
new text end

new text begin (2) shall accept the prospective, per capita payment from the commissioner in return
for the provision of comprehensive and coordinated health care services for enrollees;
new text end

new text begin (3) may contract with health care and social service providers to provide services to
enrollees; and
new text end

new text begin (4) shall institute enrollee grievance procedures according to the method established
by the commissioner, utilizing applicable requirements of chapter 62D. Disputes not
resolved through this process may be appealed to the commissioner using the procedures
in section 256.045.
new text end

new text begin (b) The commissioner may contract with a private sector entity to administer and
manage contracts with health plan companies under paragraph (a).
new text end

new text begin (c) The commissioner shall contract with health care and social service providers,
on a fee-for-service basis, to provide program enrollees with services available only
under a medical assistance home and community-based waiver. The commissioner shall
determine eligibility for home and community-based waiver services using the criteria and
procedures in chapter 256B. Disputes related to services provided on a fee-for-service
basis may be appealed to the commissioner using the procedures in section 256.045.
new text end

Sec. 10.

new text begin [256N.15] PAYMENT RATES.
new text end

new text begin The commissioner, in consultation with a health care actuary, shall establish the
method and amount of payments for services. The commissioner shall annually contract
with eligible entities to provide services to program enrollees. The commissioner, in
consultation with the risk adjustment association established under section 62Q.03,
subdivision 6, shall develop and implement a risk adjustment system for the program.
new text end

Sec. 11.

new text begin [256N.17] CONSUMER ASSISTANCE.
new text end

new text begin Subdivision 1. new text end

new text begin Assistance to applicants. new text end

new text begin The commissioner shall assist applicants
in choosing a health plan company by:
new text end

new text begin (1) establishing a Web site to provide information about health plan companies
and to allow on-line enrollment;
new text end

new text begin (2) make information on health plan companies available at the sites specified in
section 256N.11, subdivision 1;
new text end

new text begin (3) make applications and information on health plan companies available in
Spanish, Hmong, Laotian, Russian, Somali, Vietnamese, and Cambodian, and provide
language interpreter services as necessary to assist applicants in choosing a health plan
company; and
new text end

new text begin (4) make benefit educators available to assist applicants in choosing a health plan
company.
new text end

new text begin Subd. 2. new text end

new text begin Ombudsperson. new text end

new text begin The commissioner shall designate an ombudsperson
to advocate for children enrolled in the children's health security program. The
ombudsperson shall assist enrollees in understanding and making use of complaint and
appeal procedures and ensure that necessary medical services are provided to enrollees. At
the time of enrollment, the commissioner shall inform enrollees about: the ombudsperson
program; the right to a resolution of the enrollee's complaint by the health plan company
if the enrollee experiences a problem with the health plan company or its providers; and
appeal rights under section 256.045.
new text end

Sec. 12.

new text begin [256N.19] MONITORING AND EVALUATION OF QUALITY AND
COSTS.
new text end

new text begin The commissioner, as a condition of contract, shall require each participating health
plan company and participating provider to submit, in the form and manner specified by
the commissioner, data required for assessing enrollee satisfaction, quality of care, cost,
and utilization of services. The commissioner shall evaluate this data, in order to:
new text end

new text begin (1) make summary information on the quality of care across health plan companies,
medical clinics, and providers available to consumers;
new text end

new text begin (2) require health plan companies and providers, as a condition of contract, to
implement quality improvement plans; and
new text end

new text begin (3) compare the cost and quality of services under the program to the cost and
quality of services provided to private sector enrollees.
new text end

Sec. 13.

Minnesota Statutes 2004, section 297F.05, subdivision 1, is amended to read:

Subdivision 1.

Rates; cigarettes.

A tax is imposed upon the sale of cigarettes in
this state, upon having cigarettes in possession in this state with intent to sell, upon any
person engaged in business as a distributor, and upon the use or storage by consumers, at
the following rates:

(1) on cigarettes weighing not more than three pounds per thousand, deleted text begin 24 deleted text end new text begin 74 new text end mills on
each such cigarette; and

(2) on cigarettes weighing more than three pounds per thousand, deleted text begin 48 deleted text end new text begin 148 new text end mills on
each such cigarette.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 14.

Minnesota Statutes 2004, section 297F.05, subdivision 3, is amended to read:

Subd. 3.

Rates; tobacco products.

A tax is imposed upon all tobacco products
in this state and upon any person engaged in business as a distributor, at the rate of deleted text begin 35
deleted text end new text begin 108 new text end percent of the wholesale sales price of the tobacco products. The tax is imposed at
the time the distributor:

(1) brings, or causes to be brought, into this state from outside the state tobacco
products for sale;

(2) makes, manufactures, or fabricates tobacco products in this state for sale in
this state; or

(3) ships or transports tobacco products to retailers in this state, to be sold by those
retailers.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 15.

Minnesota Statutes 2004, section 297F.05, subdivision 4, is amended to read:

Subd. 4.

Use tax; tobacco products.

A tax is imposed upon the use or storage by
consumers of tobacco products in this state, and upon such consumers, at the rate of deleted text begin 35
deleted text end new text begin 108 new text end percent of the cost to the consumer of the tobacco products.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 16.

Minnesota Statutes 2004, section 297F.10, as amended by Laws 2005, First
Special Session chapter 3, article 6, section 14, is amended to read:

297F.10 DEPOSIT OF PROCEEDS.

Subdivision 1.

Tax and use tax on cigarettes.

Revenue received from cigarette
taxes, as well as related penalties, interest, license fees, and miscellaneous sources of
revenue shall be deposited by the commissioner in the state treasury and credited as
follows:

(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each
year thereafter must be credited to the Academic Health Center special revenue fund
hereby created and is annually appropriated to the Board of Regents at the University of
Minnesota for Academic Health Center funding at the University of Minnesota; and

(2) $8,553,000 for fiscal year 2006 and $8,550,000 for fiscal year 2007 and each year
thereafter must be credited to the medical education and research costs account hereby
created in the special revenue fund and is annually appropriated to the commissioner of
health for distribution under section 62J.692, subdivision 4; and

(3) the balance of the revenues derived from taxes, penalties, and interest (under this
chapter) and from license fees and miscellaneous sources of revenue shall be credited to
the general fund new text begin , except that the portion of tax revenue resulting from the increase in the
tax on cigarettes weighing not more than three pounds per thousand from 24 to 74 mills
and the increase in the tax on cigarettes weighing more than three pounds per thousand
from 48 to 148 mills shall be deposited in the children's health security account new text end .

Subd. 2.

Tax and use tax on tobacco products.

Revenue received from taxes on
tobacco products, as well as related penalties, interest, and license fees shall be deposited
by the commissioner in the state treasury and credited to the general fund new text begin , except that
the portion of tax revenue resulting from the increase in the tax on the wholesale sales
price of tobacco products from 35 to 108 percent shall be deposited in the children's
health security account new text end .

EFFECTIVE DATE.

new text begin This section is effective January 1, 2007.
new text end

Sec. 17. new text begin FLOOR STOCKS TAX.
new text end

new text begin Subdivision 1. new text end

new text begin Cigarettes. new text end

new text begin (a) A floor stocks tax is imposed on every person
engaged in business in this state as a distributor, retailer, subjobber, vendor, manufacturer,
or manufacturer's representative of cigarettes, on the stamped cigarettes and unaffixed
stamps in the person's possession or under the person's control at 12:01 a.m. on January 1,
2007. The tax is imposed at the following rates, subject to the discounts in Minnesota
Statutes, section 297F.08, subdivision 7:
new text end

new text begin (1) on cigarettes weighing not more than three pounds per thousand, 50 mills on
each cigarette; and
new text end

new text begin (2) on cigarettes weighing more than three pounds per thousand, 100 mills on each
cigarette.
new text end

new text begin (b) Each distributor, by January 8, 2007, shall file a report with the commissioner
of revenue, in the form the commissioner prescribes, showing the stamped cigarettes
and unaffixed stamps on hand at 12:01 a.m. on January 1, 2007, and the amount of tax
due on the cigarettes and unaffixed stamps. The tax imposed by this section is due and
payable by February 1, 2007, and after that date bears interest as provided in Minnesota
Statutes, section 270.75. Each retailer, subjobber, vendor, manufacturer, or manufacturer's
representative shall file a return with the commissioner, in the form the commissioner
prescribes, showing the cigarettes on hand at 12:01 a.m. on January 1, 2007, and pay the
tax due on the cigarettes by February 1, 2007. Tax not paid by the due date bears interest
as provided in Minnesota Statutes, section 270.75.
new text end

new text begin Subd. 2. new text end

new text begin Tobacco products. new text end

new text begin A floor stocks tax is imposed on every person engaged
in business in this state as a distributor of tobacco products, at the rate of 73 percent of
the wholesale sales price of each tobacco product in the person's possession or under the
person's control at 12:01 a.m. on January 1, 2007, and the amount of tax due on them.
The tax imposed by this section, less the discount provided in Minnesota Statutes, section
297F.09, subdivision 2, is due and payable by February 1, 2007, and thereafter bears
interest as provided in Minnesota Statutes, section 270.75.
new text end

new text begin Subd. 3. new text end

new text begin Audit and enforcement. new text end

new text begin The tax imposed by this section is subject to
the audit, assessment, and collection provisions applicable to the taxes imposed under
Minnesota Statutes, chapter 297F. The commissioner of revenue shall deposit the revenue
from the tax imposed under this section in the children's health security account in the
state treasury.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 18. new text begin IMPLEMENTATION PLAN.
new text end

new text begin The commissioner shall develop an implementation plan for the children's health
security coverage program and shall present this plan, any necessary draft legislation, and
a draft of proposed rules to the legislature by December 15, 2006. The commissioner shall
evaluate the provision of services under the program to children with disabilities and
shall present recommendations to the legislature by December 15, 2008, for any program
changes necessary to ensure the quality and continuity of care.
new text end

Sec. 19. new text begin FEDERAL APPROVAL.
new text end

new text begin The commissioner shall seek all federal waivers and approvals necessary to
implement this chapter including, but not limited to, waivers and approvals necessary to:
new text end

new text begin (1) merge medical assistance and MinnesotaCare coverage for children into the
children's health security program;
new text end

new text begin (2) use federal medical assistance and MinnesotaCare dollars to pay for health care
services under the children's health security program; and
new text end

new text begin (3) maximize receipt of the federal medical assistance match for covered children,
by increasing income standards through the use of more liberal income methodologies as
provided under United States Code, title 42, sections 1396a and 1396u-1.
new text end

Sec. 20. new text begin RULEMAKING.
new text end

new text begin The commissioner shall adopt rules to implement this act.
new text end

Sec. 21. new text begin APPROPRIATION.
new text end

new text begin $....... is appropriated from the children's health security account to the commissioner
of human services for the fiscal year ending June 30, 2007, to develop and implement the
Children's Health Security Act.
new text end