SF 1252

as introduced - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act
  1.2             relating to human services; increasing medical 
  1.3             assistance reimbursement rates for dental services; 
  1.4             amending Minnesota Statutes 1996, section 256B.76. 
  1.5   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.6      Section 1.  Minnesota Statutes 1996, section 256B.76, is 
  1.7   amended to read: 
  1.8      256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
  1.9      (a) The physician reimbursement increase provided in 
  1.10  section 256B.74, subdivision 2, shall not be implemented.  
  1.11  Effective for services rendered on or after October 1, 1992, the 
  1.12  commissioner shall make payments for physician services as 
  1.13  follows: 
  1.14     (1) payment for level one Health Care Finance 
  1.15  Administration's common procedural coding system (HCPCS) codes 
  1.16  titled "office and other outpatient services," "preventive 
  1.17  medicine new and established patient," "delivery, antepartum, 
  1.18  and postpartum care," "critical care," Caesarean delivery and 
  1.19  pharmacologic management provided to psychiatric patients, and 
  1.20  HCPCS level three codes for enhanced services for prenatal high 
  1.21  risk, shall be paid at the lower of (i) submitted charges, or 
  1.22  (ii) 25 percent above the rate in effect on June 30, 1992.  If 
  1.23  the rate on any procedure code within these categories is 
  1.24  different than the rate that would have been paid under the 
  1.25  methodology in section 256B.74, subdivision 2, then the larger 
  2.1   rate shall be paid; 
  2.2      (2) payments for all other services shall be paid at the 
  2.3   lower of (i) submitted charges, or (ii) 15.4 percent above the 
  2.4   rate in effect on June 30, 1992; and 
  2.5      (3) all physician rates shall be converted from the 50th 
  2.6   percentile of 1982 to the 50th percentile of 1989, less the 
  2.7   percent in aggregate necessary to equal the above increases 
  2.8   except that payment rates for home health agency services shall 
  2.9   be the rates in effect on September 30, 1992. 
  2.10     (b) The dental reimbursement increase provided in section 
  2.11  256B.74, subdivision 5, shall not be implemented.  Effective for 
  2.12  services rendered on or after October 1, 1992, the commissioner 
  2.13  shall make payments for dental services as follows: 
  2.14     (1) dental services shall be paid at the lower of (i) 
  2.15  submitted charges, or (ii) 25 percent above the rate in effect 
  2.16  on June 30, 1992; and 
  2.17     (2) dental rates shall be converted from the 50th 
  2.18  percentile of 1982 to the 50th percentile of 1989, less the 
  2.19  percent in aggregate necessary to equal the above increases. 
  2.20     (c) An entity that operates both a Medicare certified 
  2.21  comprehensive outpatient rehabilitation facility and a facility 
  2.22  which was certified prior to January 1, 1993, that is licensed 
  2.23  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
  2.24  whom at least 33 percent of the clients receiving rehabilitation 
  2.25  services in the most recent calendar year are medical assistance 
  2.26  recipients, shall be reimbursed by the commissioner for 
  2.27  rehabilitation services at rates that are 38 percent greater 
  2.28  than the maximum reimbursement rate allowed under paragraph (a), 
  2.29  clause (2), when those services are (1) provided within the 
  2.30  comprehensive outpatient rehabilitation facility and (2) 
  2.31  provided to residents of nursing facilities owned by the entity. 
  2.32     (d) Effective for services provided on or after July 1, 
  2.33  1997, the medical assistance reimbursement rate for a covered 
  2.34  dental service shall be 80 percent of the median statewide 
  2.35  charge for that service for the most recent calendar year for 
  2.36  which the information is available.  Capitation payments to 
  3.1   dental plans that have contracts with the commissioner to 
  3.2   provide dental services under section 256B.037 shall be adjusted 
  3.3   to reflect the rate increase provided in this paragraph, for 
  3.4   contracts effective on or after January 1, 1998.