SF 947

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; establishing eligibility
requirements related to nonuse of tobacco products and
tobacco use cessation for state health care programs
and MFIP; amending Minnesota Statutes 2004, sections
256D.03, subdivision 3; 256L.07, by adding a
subdivision; proposing coding for new law in Minnesota
Statutes, chapters 256B; 256J.

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

Section 1.

new text begin [256B.0565] ELIGIBILITY; TOBACCO USE
CESSATION.
new text end

new text begin Subdivision 1. new text end

new text begin Requirement for adult recipients. new text end

new text begin In
order to be eligible for medical assistance, an adult recipient,
within 30 days of initial enrollment, must sign a statement
developed by the commissioner that states that the recipient:
new text end

new text begin (1) does not use tobacco products; or
new text end

new text begin (2) is currently enrolled in a tobacco use cessation
program approved by the commissioner, or agrees to enroll in and
complete a tobacco use cessation program that is approved by the
commissioner.
new text end

new text begin If the recipient under clause (2) does not complete a tobacco
use cessation program within six months of initial enrollment,
the recipient is subject to twice the level of cost-sharing
required under section 256B.0631, and a $40 per month maximum
for prescription drug co-payments, until the recipient completes
the program. For purposes of this higher cost-sharing
requirement, the exemption for pregnant women under section
256B.0631, subdivision 2, clause (2), does not apply.
new text end

new text begin Subd. 2. new text end

new text begin Renewal of eligibility. new text end

new text begin The commissioner shall
apply the requirements of subdivision 1 to randomly selected
adult recipients who renew their eligibility for medical
assistance. The commissioner shall apply all requirements of
subdivision 1 to the selected recipients, with the timeline for
compliance beginning with the date of renewal of eligibility
rather than the date of initial enrollment.
new text end

new text begin Subd. 3. new text end

new text begin Coordination. new text end

new text begin The commissioner shall coordinate
the approval of tobacco use cessation programs with the
commissioner of health, the Minnesota Partnership for Action
Against Tobacco, and other public and private sector entities
and partnerships, in order to ensure the availability of
effective and affordable programs and minimize state medical
assistance costs. The commissioner shall only approve tobacco
use cessation programs that participate in the medical
assistance program or that offer services without charge to
medical assistance recipients.
new text end

new text begin Subd. 4. new text end

new text begin Federal approval; other law. new text end

new text begin The commissioner
shall seek any federal waivers and law changes necessary to
implement this section. The commissioner shall implement this
section notwithstanding any state law to the contrary.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2005,
or upon receipt of any necessary federal approvals, whichever is
later, and applies to initial applications and renewals
submitted on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2004, section 256D.03,
subdivision 3, is amended to read:

Subd. 3.

General assistance medical care; eligibility.

(a) General assistance medical care may be paid for any person
who is not eligible for medical assistance under chapter 256B,
including eligibility for medical assistance based on a
spenddown of excess income according to section 256B.056,
subdivision 5, or MinnesotaCare as defined in paragraph (b),
except as provided in paragraph (c), new text begin is in compliance with
paragraph (m), new text end and:

(1) who is receiving assistance under section 256D.05,
except for families with children who are eligible under
Minnesota family investment program (MFIP), or who is having a
payment made on the person's behalf under sections 256I.01 to
256I.06; or

(2) who is a resident of Minnesota; and

(i) who has gross countable income not in excess of 75
percent of the federal poverty guidelines for the family size,
using a six-month budget period and whose equity in assets is
not in excess of $1,000 per assistance unit. Exempt assets, the
reduction of excess assets, and the waiver of excess assets must
conform to the medical assistance program in section 256B.056,
subdivision 3, with the following exception: the maximum amount
of undistributed funds in a trust that could be distributed to
or on behalf of the beneficiary by the trustee, assuming the
full exercise of the trustee's discretion under the terms of the
trust, must be applied toward the asset maximum; or

(ii) who has gross countable income above 75 percent of the
federal poverty guidelines but not in excess of 175 percent of
the federal poverty guidelines for the family size, using a
six-month budget period, whose equity in assets is not in excess
of the limits in section 256B.056, subdivision 3c, and who
applies during an inpatient hospitalization.

(b) General assistance medical care may not be paid for
applicants or recipients who meet all eligibility requirements
of MinnesotaCare as defined in sections 256L.01 to 256L.16, and
are adults with dependent children under 21 whose gross family
income is equal to or less than 275 percent of the federal
poverty guidelines.

(c) For applications received on or after October 1, 2003,
eligibility may begin no earlier than the date of application.
For individuals eligible under paragraph (a), clause (2), item
(i), a redetermination of eligibility must occur every 12
months. Individuals are eligible under paragraph (a), clause
(2), item (ii), only during inpatient hospitalization but may
reapply if there is a subsequent period of inpatient
hospitalization. Beginning January 1, 2000, Minnesota health
care program applications completed by recipients and applicants
who are persons described in paragraph (b), may be returned to
the county agency to be forwarded to the Department of Human
Services or sent directly to the Department of Human Services
for enrollment in MinnesotaCare. If all other eligibility
requirements of this subdivision are met, eligibility for
general assistance medical care shall be available in any month
during which a MinnesotaCare eligibility determination and
enrollment are pending. Upon notification of eligibility for
MinnesotaCare, notice of termination for eligibility for general
assistance medical care shall be sent to an applicant or
recipient. If all other eligibility requirements of this
subdivision are met, eligibility for general assistance medical
care shall be available until enrollment in MinnesotaCare
subject to the provisions of paragraph (e).

(d) The date of an initial Minnesota health care program
application necessary to begin a determination of eligibility
shall be the date the applicant has provided a name, address,
and Social Security number, signed and dated, to the county
agency or the Department of Human Services. If the applicant is
unable to provide a name, address, Social Security number, and
signature when health care is delivered due to a medical
condition or disability, a health care provider may act on an
applicant's behalf to establish the date of an initial Minnesota
health care program application by providing the county agency
or Department of Human Services with provider identification and
a temporary unique identifier for the applicant. The applicant
must complete the remainder of the application and provide
necessary verification before eligibility can be determined.
The county agency must assist the applicant in obtaining
verification if necessary.

(e) County agencies are authorized to use all automated
databases containing information regarding recipients' or
applicants' income in order to determine eligibility for general
assistance medical care or MinnesotaCare. Such use shall be
considered sufficient in order to determine eligibility and
premium payments by the county agency.

(f) General assistance medical care is not available for a
person in a correctional facility unless the person is detained
by law for less than one year in a county correctional or
detention facility as a person accused or convicted of a crime,
or admitted as an inpatient to a hospital on a criminal hold
order, and the person is a recipient of general assistance
medical care at the time the person is detained by law or
admitted on a criminal hold order and as long as the person
continues to meet other eligibility requirements of this
subdivision.

(g) General assistance medical care is not available for
applicants or recipients who do not cooperate with the county
agency to meet the requirements of medical assistance.

(h) In determining the amount of assets of an individual
eligible under paragraph (a), clause (2), item (i), there shall
be included any asset or interest in an asset, including an
asset excluded under paragraph (a), that was given away, sold,
or disposed of for less than fair market value within the 60
months preceding application for general assistance medical care
or during the period of eligibility. Any transfer described in
this paragraph shall be presumed to have been for the purpose of
establishing eligibility for general assistance medical care,
unless the individual furnishes convincing evidence to establish
that the transaction was exclusively for another purpose. For
purposes of this paragraph, the value of the asset or interest
shall be the fair market value at the time it was given away,
sold, or disposed of, less the amount of compensation received.
For any uncompensated transfer, the number of months of
ineligibility, including partial months, shall be calculated by
dividing the uncompensated transfer amount by the average
monthly per person payment made by the medical assistance
program to skilled nursing facilities for the previous calendar
year. The individual shall remain ineligible until this fixed
period has expired. The period of ineligibility may exceed 30
months, and a reapplication for benefits after 30 months from
the date of the transfer shall not result in eligibility unless
and until the period of ineligibility has expired. The period
of ineligibility begins in the month the transfer was reported
to the county agency, or if the transfer was not reported, the
month in which the county agency discovered the transfer,
whichever comes first. For applicants, the period of
ineligibility begins on the date of the first approved
application.

(i) When determining eligibility for any state benefits
under this subdivision, the income and resources of all
noncitizens shall be deemed to include their sponsor's income
and resources as defined in the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996, title IV, Public Law
104-193, sections 421 and 422, and subsequently set out in
federal rules.

(j) Undocumented noncitizens and nonimmigrants are
ineligible for general assistance medical care. For purposes of
this subdivision, a nonimmigrant is an individual in one or more
of the classes listed in United States Code, title 8, section
1101(a)(15), and an undocumented noncitizen is an individual who
resides in the United States without the approval or
acquiescence of the Immigration and Naturalization Service.

(k) Notwithstanding any other provision of law, a
noncitizen who is ineligible for medical assistance due to the
deeming of a sponsor's income and resources, is ineligible for
general assistance medical care.

(l) Effective July 1, 2003, general assistance medical care
emergency services end.

new text begin (m) In order to be eligible for general assistance medical
care, an adult recipient, within 30 days of initial enrollment,
must sign a statement developed by the commissioner that states
that the recipient:
new text end

new text begin (1) does not use tobacco products; or
new text end

new text begin (2) is currently enrolled in a tobacco use cessation
program approved by the commissioner, or agrees to enroll in and
complete a tobacco use cessation program approved by the
commissioner.
new text end

new text begin If the recipient under clause (2) does not complete a tobacco
use cessation program within six months of initial enrollment,
the recipient is subject to twice the level of cost-sharing
required under subdivision 4, paragraph (d), clauses (1) to (5),
and a $40 per month maximum for prescription drug co-payments,
until the recipient completes the program. The commissioner
shall apply the requirements of this paragraph to randomly
selected adult recipients who renew their eligibility for
general assistance medical care. The commissioner shall apply
all requirements of this paragraph to the selected recipients,
with the timeline for compliance beginning with the date of
renewal of eligibility rather than the date of initial
enrollment. The commissioner shall coordinate the approval of
tobacco use cessation programs with the commissioner of health,
the Minnesota Partnership for Action Against Tobacco, and other
public and private sector entities and partnerships in order to
ensure the availability of effective and affordable programs and
minimize general assistance medical care costs. The
commissioner shall only approve tobacco use cessation programs
that participate in the general assistance medical care program
or that offer services without charge to general assistance
medical care recipients. Notwithstanding any state law to the
contrary, the commissioner shall implement this paragraph.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2005,
and applies to initial applications and renewals submitted on or
after that date.
new text end

Sec. 3.

new text begin [256J.145] ELIGIBILITY; TOBACCO USE CESSATION.
new text end

new text begin Subdivision 1. new text end

new text begin Requirement. new text end

new text begin In order to be eligible for
MFIP, an adult recipient, within 30 days of initial enrollment,
must sign a statement developed by the commissioner that states
that the recipient:
new text end

new text begin (1) does not use tobacco products; or
new text end

new text begin (2) is currently enrolled in a tobacco use cessation
program approved by the commissioner or agrees to enroll in and
complete a tobacco use cessation program that is approved by the
commissioner.
new text end

new text begin If the recipient under clause (2) does not complete a tobacco
use cessation program within six months of initial enrollment,
the commissioner shall reduce the recipient's MFIP grant amount
by ten percent until the recipient completes the program.
new text end

new text begin Subd. 2. new text end

new text begin Renewal of eligibility. new text end

new text begin The commissioner shall
apply the requirements of subdivision 1 to randomly selected
adult recipients who renew their eligibility for MFIP. The
commissioner shall apply all requirements of subdivision 1 to
the selected recipients, with the timeline for compliance
beginning with the date of renewal of eligibility rather than
the date of initial enrollment.
new text end

new text begin Subd. 3. new text end

new text begin Coordination. new text end

new text begin The commissioner shall coordinate
the approval of tobacco use cessation programs with the
commissioner of health, the Minnesota Partnership for Action
Against Tobacco, and other public and private sector entities
and partnerships in order to ensure the availability of
effective and affordable programs and minimize state health care
program costs. The commissioner shall only approve tobacco use
cessation programs that participate in the medical assistance
program or that offer services without charge to MFIP enrollees.
new text end

new text begin Subd. 4. new text end

new text begin Federal approval. new text end

new text begin The commissioner shall seek
any federal waivers and law changes necessary to implement this
section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2005,
or upon receipt of any necessary federal approvals, whichever is
later, and applies to initial applications and renewals
submitted on or after that date.
new text end

Sec. 4.

Minnesota Statutes 2004, section 256L.07, is
amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Tobacco use cessation required for adult
enrollees. new text end

new text begin (a) In order to be eligible for MinnesotaCare, an
adult enrollee, within 30 days of initial enrollment, must sign
a statement developed by the commissioner that states that the
enrollee:
new text end

new text begin (1) does not use tobacco products; or
new text end

new text begin (2) is currently enrolled in a tobacco use cessation
program approved by the commissioner, or agrees to enroll in and
complete a tobacco use cessation program that is approved by the
commissioner.
new text end

new text begin If the enrollee under clause (2) does not complete a tobacco use
cessation program within six months of initial enrollment, the
enrollee is subject to twice the level of cost-sharing required
under section 256L.03, subdivision 5, paragraph (a), clauses (1)
to (4), and double the out-of-pocket maximums for inpatient
hospital services, or if applicable, twice the level of
cost-sharing required under section 256L.035 and a $2,000
out-of-pocket maximum for inpatient hospital services and a $40
per month maximum for prescription drug co-payments until the
enrollee completes the program. For purposes of this higher
cost-sharing requirement, the exemptions for parents, relative
caretakers, and pregnant women under section 256L.03,
subdivision 5, paragraphs (b) and (c), do not apply.
new text end

new text begin (b) The commissioner shall apply the requirements of
paragraph (a) to randomly selected adult enrollees who renew
their eligibility for MinnesotaCare. The commissioner shall
apply all requirements of paragraph (a) to the selected
enrollees with the timeline for compliance beginning with the
date of renewal of eligibility rather than the date of initial
enrollment.
new text end

new text begin (c) The commissioner shall coordinate the approval of
tobacco use cessation programs with the commissioner of health,
the Minnesota Partnership for Action Against Tobacco, and other
public and private sector entities and partnerships in order to
ensure the availability of effective and affordable programs and
minimize state MinnesotaCare costs. The commissioner shall only
approve tobacco use cessation programs that participate in the
MinnesotaCare program or that offer services without charge to
MinnesotaCare enrollees.
new text end

new text begin (d) The commissioner shall seek any federal waivers and law
changes necessary to implement this subdivision.
Notwithstanding any state law to the contrary, the commissioner
shall implement this subdivision for all enrollees for whom
federal approval is not necessary.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2005,
for all enrollees for whom federal approval is not necessary,
and is effective July 1, 2005, or upon receipt of any necessary
federal approvals, whichever is later, for all enrollees for
whom federal approval is necessary, and applies to initial
applications and renewals submitted on or after those dates.
new text end