as introduced - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to health; repealing MinnesotaCare provider 1.3 tax; expanding the eligibility for single adults and 1.4 households with no children for the MinnesotaCare 1.5 program; repealing the premium tax for health plan 1.6 companies and nonprofit health service plan 1.7 corporations; repealing the health care access fund; 1.8 amending Minnesota Statutes 1998, sections 60A.15, 1.9 subdivision 1; 62J.041, subdivision 1; 62Q.095, 1.10 subdivision 6; 144.1494, subdivision 1; 144.1495, 1.11 subdivision 2; 144.1496, subdivision 1; 214.16, 1.12 subdivisions 2 and 3; 256L.02, subdivisions 3 and 4; 1.13 256L.04, subdivision 7; 256L.07, subdivision 1; 1.14 270B.01, subdivision 8; 270B.14, subdivision 1; 1.15 295.52, subdivision 7; repealing Minnesota Statutes 1.16 1998, sections 13.99, subdivision 86b; 16A.724; 1.17 16A.76; 62T.10; 144.1484, subdivision 2; 295.50; 1.18 295.51; 295.52; 295.53, subdivisions 1, 2, 3, 4, and 1.19 4a; 295.54; 295.55; 295.56; 295.57; 295.58; 295.581; 1.20 295.582; and 295.59. 1.21 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.22 Section 1. Minnesota Statutes 1998, section 60A.15, 1.23 subdivision 1, is amended to read: 1.24 Subdivision 1. [DOMESTIC AND FOREIGN COMPANIES.] (a) On or 1.25 before April 1, June 1, and December 1 of each year, every 1.26 domestic and foreign company, including town and farmers' mutual 1.27 insurance companies, domestic mutual insurance companies, and 1.28 marine insurance companies,health maintenance organizations,1.29community integrated service networks, and nonprofit health1.30service plan corporations,shall pay to the commissioner of 1.31 revenue installments equal to one-third of the insurer's total 1.32 estimated tax for the current year. Except as provided in 1.33paragraphsparagraph (d),(e), (h), and (i),installments must 2.1 be based on a sum equal to two percent of the premiums described 2.2 in paragraph (b). 2.3 (b) Installments under paragraph (a),or (d), or (e)are 2.4 percentages of gross premiums less return premiums on all direct 2.5 business received by the insurer in this state, or by its agents 2.6 for it, in cash or otherwise, during such year. 2.7 (c) Failure of a company to make payments of at least 2.8 one-third of either (1) the total tax paid during the previous 2.9 calendar year or (2) 80 percent of the actual tax for the 2.10 current calendar year shall subject the company to the penalty 2.11 and interest provided in this section, unless the total tax for 2.12 the current tax year is $500 or less. 2.13 (d)For health maintenance organizations, nonprofit health2.14service plan corporations, and community integrated service2.15networks, the installments must be based on an amount determined2.16under paragraph (h) or (i).2.17(e)For purposes of computing installments for town and 2.18 farmers' mutual insurance companies and for mutual property 2.19 casualty companies with total assets on December 31, 1989, of 2.20 $1,600,000,000 or less, the following rates apply: 2.21 (1) for all life insurance, two percent; 2.22 (2) for town and farmers' mutual insurance companies and 2.23 for mutual property and casualty companies with total assets of 2.24 $5,000,000 or less, on all other coverages, one percent; and 2.25 (3) for mutual property and casualty companies with total 2.26 assets on December 31, 1989, of $1,600,000,000 or less, on all 2.27 other coverages, 1.26 percent. 2.28(f)(e) If the aggregate amount of premium tax payments 2.29 under this section and the fire marshal tax payments under 2.30 section 299F.21 made during a calendar year is equal to or 2.31 exceeds $120,000, all tax payments in the subsequent calendar 2.32 year must be paid by means of a funds transfer as defined in 2.33 section 336.4A-104, paragraph (a). The funds transfer payment 2.34 date, as defined in section 336.4A-401, must be on or before the 2.35 date the payment is due. If the date the payment is due is not 2.36 a funds transfer business day, as defined in section 336.4A-105, 3.1 paragraph (a), clause (4), the payment date must be on or before 3.2 the funds transfer business day next following the date the 3.3 payment is due. 3.4(g)(f) Premiums under medical assistance, general 3.5 assistance medical care, the MinnesotaCare program, and the 3.6 Minnesota comprehensive health insurance plan and all payments, 3.7 revenues, and reimbursements received from the federal 3.8 government for Medicare-related coverage as defined in section 3.9 62A.31, subdivision 3, paragraph (e), are not subject to tax 3.10 under this section. 3.11(h) For calendar years 1997, 1998, and 1999, the3.12installments for health maintenance organizations, community3.13integrated service networks, and nonprofit health service plan3.14corporations must be based on an amount equal to one percent of3.15premiums described under paragraph (b). Health maintenance3.16organizations, community integrated service networks, and3.17nonprofit health service plan corporations that have met the3.18cost containment goals established under section 62J.04 in the3.19individual and small employer market for calendar year 1996 are3.20exempt from payment of the tax imposed under this section for3.21premiums paid after March 30, 1997, and before April 1, 1998.3.22Health maintenance organizations, community integrated service3.23networks, and nonprofit health service plan corporations that3.24have met the cost containment goals established under section3.2562J.04 in the individual and small employer market for calendar3.26year 1997 are exempt from payment of the tax imposed under this3.27section for premiums paid after March 30, 1998, and before April3.281, 1999. Health maintenance organizations, community integrated3.29service networks, and nonprofit health service plan corporations3.30that have met the cost containment goals established under3.31section 62J.04 in the individual and small employer market for3.32calendar year 1998 are exempt from payment of the tax imposed3.33under this section for premiums paid after March 30, 1999, and3.34before January 1, 2000.3.35(i) For calendar years after 1999, the commissioner of3.36finance shall determine the balance of the health care access4.1fund on September 1 of each year beginning September 1, 1999.4.2If the commissioner determines that there is no structural4.3deficit for the next fiscal year, no tax shall be imposed under4.4paragraph (d) for the following calendar year. If the4.5commissioner determines that there will be a structural deficit4.6in the fund for the following fiscal year, then the4.7commissioner, in consultation with the commissioner of revenue,4.8shall determine the amount needed to eliminate the structural4.9deficit and a tax shall be imposed under paragraph (d) for the4.10following calendar year. The commissioner shall determine the4.11rate of the tax as either one-quarter of one percent, one-half4.12of one percent, three-quarters of one percent, or one percent of4.13premiums described in paragraph (b), whichever is the lowest of4.14those rates that the commissioner determines will produce4.15sufficient revenue to eliminate the projected structural4.16deficit. The commissioner of finance shall publish in the State4.17Register by October 1 of each year the amount of tax to be4.18imposed for the following calendar year. In determining the4.19structural balance of the health care access fund for fiscal4.20years 2000 and 2001, the commissioner shall disregard the4.21transfer amount from the health care access fund to the general4.22fund for expenditures associated with the services provided to4.23pregnant women and children under the age of two enrolled in the4.24MinnesotaCare program.4.25(j) In approving the premium rates as required in sections4.2662L.08, subdivision 8, and 62A.65, subdivision 3, the4.27commissioners of health and commerce shall ensure that any4.28exemption from the tax as described in paragraphs (h) and (i) is4.29reflected in the premium rate.4.30 Sec. 2. Minnesota Statutes 1998, section 62J.041, 4.31 subdivision 1, is amended to read: 4.32 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 4.33 section, the following definitions apply. 4.34 (b) "Health plan company" has the definition provided in 4.35 section 62Q.01. 4.36 (c) "Total expenditures" means incurred claims or 5.1 expenditures on health care services, administrative expenses, 5.2 charitable contributions, and all other payments made by health 5.3 plan companies out of premium revenues. 5.4 (d) "Net expenditures" means total expenditures minus 5.5 exempted taxes and assessments and payments or allocations made 5.6 to establish or maintain reserves. 5.7 (e) "Exempted taxes and assessments" means direct payments 5.8 for taxes to government agencies, contributions to the Minnesota 5.9 comprehensive health association, the medical assistance 5.10 provider's surcharge under section 256.9657, the MinnesotaCare 5.11 provider tax under Minnesota Statutes 1998, section 295.52, 5.12 assessments by the health coverage reinsurance association, 5.13 assessments by the Minnesota life and health insurance guaranty 5.14 association, assessments by the Minnesota risk adjustment 5.15 association, and any new assessments imposed by federal or state 5.16 law. 5.17 (f) "Consumer cost-sharing or subscriber liability" means 5.18 enrollee coinsurance, copayment, deductible payments, and 5.19 amounts in excess of benefit plan maximums. 5.20 Sec. 3. Minnesota Statutes 1998, section 62Q.095, 5.21 subdivision 6, is amended to read: 5.22 Subd. 6. [EXEMPTION.] A health plan company, to the extent 5.23 that it operates as a staff model health plan companyas defined5.24in section 295.50, subdivision 12b,by employing allied 5.25 independent health care providers to deliver health care 5.26 services to enrollees, is exempt from this section. For 5.27 purposes of this subdivision, "staff model health plan company" 5.28 means a health plan company as defined in section 62Q.01, 5.29 subdivision 4, that employs one or more types of health care 5.30 provider to deliver health care services to the health plan 5.31 company's enrollees. 5.32 Sec. 4. Minnesota Statutes 1998, section 144.1494, 5.33 subdivision 1, is amended to read: 5.34 Subdivision 1. [CREATION OF ACCOUNT.] A rural physician 5.35 education account is established in thehealth care5.36accessgeneral fund. The commissioner shall use money from the 6.1 account to establish a loan forgiveness program for medical 6.2 residents agreeing to practice in designated rural areas, as 6.3 defined by the commissioner. Appropriations made to this 6.4 account do not cancel and are available until expended, except 6.5 that at the end of each biennium the commissioner shall cancel 6.6 to the health care access fund any remaining unobligated balance 6.7 in this account. 6.8 Sec. 5. Minnesota Statutes 1998, section 144.1495, 6.9 subdivision 2, is amended to read: 6.10 Subd. 2. [CREATION OF ACCOUNT.] A midlevel practitioner 6.11 education account is established in thehealth care6.12accessgeneral fund. The commissioner shall use money from the 6.13 account to establish a loan forgiveness program for midlevel 6.14 practitioners agreeing to practice in designated rural areas. 6.15 Sec. 6. Minnesota Statutes 1998, section 144.1496, 6.16 subdivision 1, is amended to read: 6.17 Subdivision 1. [CREATION OF THE ACCOUNT.] An education 6.18 account in thehealth care accessgeneral fund is established 6.19 for a loan forgiveness program for nurses who agree to practice 6.20 nursing in a nursing home or intermediate care facility for 6.21 persons with mental retardation or related conditions. The 6.22 account consists of money appropriated by the legislature and 6.23 repayments and penalties collected under subdivision 4. Money 6.24 from the account must be used for a loan forgiveness program. 6.25 Sec. 7. Minnesota Statutes 1998, section 214.16, 6.26 subdivision 2, is amended to read: 6.27 Subd. 2. [BOARD COOPERATION REQUIRED.] The board shall 6.28 assist the commissioner of health in data collection activities 6.29 required under Laws 1992, chapter 549, article 7, and shall6.30assist the commissioner of revenue in activities related to6.31collection of the health care provider tax required under Laws6.321992, chapter 549, article 9. Upon the request of the 6.33 commissioneror the commissioner of revenue, the board shall 6.34 make available names and addresses of current licensees and 6.35 provide other information or assistance as needed. 6.36 Sec. 8. Minnesota Statutes 1998, section 214.16, 7.1 subdivision 3, is amended to read: 7.2 Subd. 3. [GROUNDS FOR DISCIPLINARY ACTION.] The board 7.3 shall take disciplinary action, which may include license 7.4 revocation, against a regulated person for: 7.5 (1) intentional failure to provide the commissioner of 7.6 health with the data required under chapter 62J; 7.7(2) intentional failure to provide the commissioner of7.8revenue with data on gross revenue and other information7.9required for the commissioner to implement sections 295.50 to7.10295.58;7.11(3) intentional failure to pay the health care provider tax7.12required under section 295.52;and 7.13(4)(2) entering into a contract or arrangement that is 7.14 prohibited under sections 62J.70 to 62J.73. 7.15 Sec. 9. Minnesota Statutes 1998, section 256L.02, 7.16 subdivision 3, is amended to read: 7.17 Subd. 3. [FINANCIAL MANAGEMENT.] (a)The commissioner7.18shall manage spending for the MinnesotaCare program in a manner7.19that maintains a minimum reserve in accordance with section7.2016A.76.As part of each state revenue and expenditure forecast, 7.21 the commissioner must make an assessment of the expected 7.22 expenditures for the services coveredservicesunder the 7.23 MinnesotaCare program for the remainder of the current biennium 7.24 and for the following biennium.The estimated expenditure,7.25including the reserve requirements described in section 16A.76,7.26shall be compared to an estimate of the revenues that will be7.27available in the health care access fund. Based on this7.28comparison, andAfter consulting with the chairs of the house 7.29 ways and means committee and the senate finance committee, and 7.30 the legislative commission on health care access, the 7.31 commissioner shall, as necessary, make the adjustments specified 7.32 in paragraph (b) to ensure that expenditures remain within the 7.33 limits of the availablerevenues for the remainder of the7.34current biennium and for the following bienniumappropriations. 7.35 The commissioner shall not hire additional staff using 7.36 appropriations from thehealth care accessgeneral fund until 8.1 the commissioner of finance makes a determination that the 8.2 adjustments implemented under paragraph (b) are sufficient to 8.3 allow MinnesotaCare expenditures to remain within the limits of 8.4 availablerevenues for the remainder of the current biennium and8.5for the following bienniumappropriations. 8.6 (b) The adjustments the commissioner shall use must be 8.7 implemented in this order: first, stop enrollment of single 8.8 adults and households without children; second, upon 45 days' 8.9 notice, stop coverage of single adults and households without 8.10 children already enrolled in the MinnesotaCare program; third, 8.11 upon 90 days' notice, decrease the premium subsidy amounts by 8.12 ten percent for families with gross annual income above 200 8.13 percent of the federal poverty guidelines; fourth, upon 90 days' 8.14 notice, decrease the premium subsidy amounts by ten percent for 8.15 families with gross annual income at or below 200 percent; and 8.16 fifth, require applicants to be uninsured for at least six 8.17 months prior to eligibility in the MinnesotaCare program. If 8.18 these measures are insufficient to limit the expenditures to the 8.19estimated amount of revenueavailable appropriations, the 8.20 commissioner shall further limit enrollment or decrease premium 8.21 subsidies. 8.22 Sec. 10. Minnesota Statutes 1998, section 256L.02, 8.23 subdivision 4, is amended to read: 8.24 Subd. 4. [FUNDING FOR PREGNANT WOMEN AND CHILDREN UNDER 8.25 AGE TWO.] For fiscal years beginning on or after July 1, 1999, 8.26 the state cost of health care services provided to MinnesotaCare 8.27 enrollees who are pregnant women or children under age two shall 8.28 be paid out of the general fundrather than the health care8.29access fund. If the commissioner of finance decides to pay for 8.30 these costs using a source other than the general fund, the 8.31 commissioner shall include the change as a budget initiative in 8.32 the biennial or supplemental budget, and shall not change the 8.33 funding source through a forecast modification. 8.34 Sec. 11. Minnesota Statutes 1998, section 256L.04, 8.35 subdivision 7, is amended to read: 8.36 Subd. 7. [SINGLE ADULTS AND HOUSEHOLDS WITH NO CHILDREN.] 9.1 The definition of eligible persons includes all individuals and 9.2 households with no children who have gross family incomes that 9.3 are equal to or less than175275 percent of the federal poverty 9.4 guidelines. 9.5 Sec. 12. Minnesota Statutes 1998, section 256L.07, 9.6 subdivision 1, is amended to read: 9.7 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 9.8 enrolled in the original children's health plan as of September 9.9 30, 1992, children who enrolled in the MinnesotaCare program 9.10 after September 30, 1992, pursuant to Laws 1992, chapter 549, 9.11 article 4, section 17, and children who have family gross 9.12 incomes that are equal to or less than 150 percent of the 9.13 federal poverty guidelines are eligible for subsidized premium 9.14 payments without meeting the requirements of subdivision 2, as 9.15 long as they maintain continuous coverage in the MinnesotaCare 9.16 program or medical assistance. Children who apply for 9.17 MinnesotaCare on or after the implementation date of the 9.18 employer-subsidized health coverage program as described in Laws 9.19 1998, chapter 407, article 5, section 45, who have family gross 9.20 incomes that are equal to or less than 150 percent of the 9.21 federal poverty guidelines, must meet the requirements of 9.22 subdivision 2 to be eligible for MinnesotaCare. 9.23 (b) Families and individuals enrolled in MinnesotaCare 9.24 under section 256L.04, subdivision 1 or 7, whose income 9.25 increases above 275 percent of the federal poverty guidelines, 9.26 are no longer eligible for the program and shall be disenrolled 9.27 by the commissioner.Individuals enrolled in MinnesotaCare9.28under section 256L.04, subdivision 7, whose income increases9.29above 175 percent of the federal poverty guidelines are no9.30longer eligible for the program and shall be disenrolled by the9.31commissioner.For persons disenrolled under this subdivision, 9.32 MinnesotaCare coverage terminates the last day of the calendar 9.33 month following the month in which the commissioner determines 9.34 that the income of a family or individual, determined over a 9.35 four-month period as required by section 256L.15, subdivision 2, 9.36 exceeds program income limits. 10.1 (c) Notwithstanding paragraph (b), individuals and families 10.2 may remain enrolled in MinnesotaCare if ten percent of their 10.3 annual income is less than the annual premium for a policy with 10.4 a $500 deductible available through the Minnesota comprehensive 10.5 health association. Individuals and families who are no longer 10.6 eligible for MinnesotaCare under this subdivision shall be given 10.7 an 18-month notice period from the date that ineligibility is 10.8 determined before disenrollment. 10.9 Sec. 13. Minnesota Statutes 1998, section 270B.01, 10.10 subdivision 8, is amended to read: 10.11 Subd. 8. [MINNESOTA TAX LAWS.] For purposes of this 10.12 chapter only, unless expressly stated otherwise, "Minnesota tax 10.13 laws" means the taxes, refunds, and fees administered by or paid 10.14 to the commissioner under chapters 115B (except taxes imposed 10.15 under sections 115B.21 to 115B.24), 289A (except taxes imposed 10.16 under sections 298.01, 298.015, and 298.24), 290, 290A, 291, 10.17 297A, and 297Hand sections 295.50 to 295.59, or any similar 10.18 Indian tribal tax administered by the commissioner pursuant to 10.19 any tax agreement between the state and the Indian tribal 10.20 government, and includes any laws for the assessment, 10.21 collection, and enforcement of those taxes, refunds, and fees. 10.22 Sec. 14. Minnesota Statutes 1998, section 270B.14, 10.23 subdivision 1, is amended to read: 10.24 Subdivision 1. [DISCLOSURE TO COMMISSIONER OF HUMAN 10.25 SERVICES.] (a) On the request of the commissioner of human 10.26 services, the commissioner shall disclose return information 10.27 regarding taxes imposed by chapter 290, and claims for refunds 10.28 under chapter 290A, to the extent provided in paragraph (b) and 10.29 for the purposes set forth in paragraph (c). 10.30 (b) Data that may be disclosed are limited to data relating 10.31 to the identity, whereabouts, employment, income, and property 10.32 of a person owing or alleged to be owing an obligation of child 10.33 support. 10.34 (c) The commissioner of human services may request data 10.35 only for the purposes of carrying out the child support 10.36 enforcement program and to assist in the location of parents who 11.1 have, or appear to have, deserted their children. Data received 11.2 may be used only as set forth in section 256.978. 11.3 (d) The commissioner shall provide the records and 11.4 information necessary to administer the supplemental housing 11.5 allowance to the commissioner of human services. 11.6 (e) At the request of the commissioner of human services, 11.7 the commissioner of revenue shall electronically match the 11.8 social security numbers and names of participants in the 11.9 telephone assistance plan operated under sections 237.69 to 11.10 237.711, with those of property tax refund filers, and determine 11.11 whether each participant's household income is within the 11.12 eligibility standards for the telephone assistance plan. 11.13 (f) The commissioner may provide records and information 11.14 collected under Minnesota Statutes 1998, sections 295.50 to 11.15 295.59, to the commissioner of human services for purposes of 11.16 the Medicaid Voluntary Contribution and Provider-Specific Tax 11.17 Amendments of 1991, Public Law Number 102-234. Upon the written 11.18 agreement by the United States Department of Health and Human 11.19 Services to maintain the confidentiality of the data, the 11.20 commissioner may provide records and information collected under 11.21 Minnesota Statutes 1998, sections 295.50 to 295.59, to the 11.22 Health Care Financing Administration section of the United 11.23 States Department of Health and Human Services for purposes of 11.24 meeting federal reporting requirements. 11.25 (g) The commissioner may provide records and information to 11.26 the commissioner of human services as necessary to administer 11.27 the early refund of refundable tax credits. 11.28 (h) The commissioner may disclose information to the 11.29 commissioner of human services necessary to verify income for 11.30 eligibility and premium payment under the MinnesotaCare program, 11.31 under section 256L.05, subdivision 2. 11.32 Sec. 15. Minnesota Statutes 1998, section 295.52, 11.33 subdivision 7, is amended to read: 11.34 Subd. 7. [TAX REDUCTION.] Notwithstanding subdivisions 1, 11.35 1a, 2, 3, and 4, the tax imposed under this section for calendar 11.36 years 1998 and 1999 shall be equal to 1.5 percent of the gross 12.1 revenues received on or after January 1, 1998, and before 12.2 January 1, 2000.The commissioner shall extend the reduced tax12.3rate of 1.5 percent for gross revenues received on or after12.4January 1, 2000, and before January 1, 2002, if the commissioner12.5of finance determines that the health care access fund12.6structural balance projected for fiscal year 2001 will remain12.7positive, prior to any increase of the one percent premium tax12.8under section 60A.15, subdivision 1, paragraph (h), and prior to12.9any tax expenditures related to the increase in the maximum tax12.10credit for research expenses under section 295.53, subdivision12.114a, as amended by Laws 1997, chapter 225.For calendar year 12.12 2000, the tax imposed under this section shall be equal to .5 12.13 percent of the gross revenues received on or after January 1, 12.14 2000, and before July 1, 2000. 12.15 Sec. 16. [TRANSFER.] 12.16 The commissioner of finance shall transfer all funds 12.17 remaining in the health care access fund as of June 30, 2001, to 12.18 the general fund. 12.19 Sec. 17. [REPEALER.] 12.20 (a) Minnesota Statutes 1998, sections 13.99, subdivision 12.21 86b; 144.1484, subdivision 2; 295.50; 295.51; 295.52; 295.53, 12.22 subdivisions 1, 2, 3, and 4; 295.54; 295.55; 295.56; 295.57; 12.23 295.58; 295.582; and 295.59, are repealed. 12.24 (b) Sections 16A.724; 16A.76; and 295.581, are repealed. 12.25 (c) Section 62T.10, is repealed. 12.26 (d) Section 295.53, subdivision 4a, is repealed. 12.27 Sec. 18. [EFFECTIVE DATE.] 12.28 Sections 1 and 17, paragraph (c), are effective January 1, 12.29 2000. 12.30 Sections 2; 3; 7; 8; 13; 14; and 17, paragraph (a), are 12.31 effective July 1, 2000, and apply to gross revenue received on 12.32 or after that date. 12.33 Sections 10; 11; 12; 15; 16; and 17, paragraph (d), are 12.34 effective July 1, 1999. 12.35 Sections 4; 5; 6; 9; and 17, paragraph (b), are effective 12.36 July 1, 2001.