SF 1281

as introduced - 88th Legislature (2013 - 2014) Posted on 03/12/2013 09:06am

A bill for an act
relating to human services; modifying hospital, nursing home, ICF/DD, and
health maintenance organization provider surcharges; providing a medical
assistance rate increase; amending Minnesota Statutes 2012, sections 256.9657,
subdivisions 1, 2, 3, 3a; 256.9685, subdivision 2; 256.969, subdivisions 3a, 21,
30, by adding subdivisions; 256B.441, subdivision 53; 256B.5012, by adding a
subdivision; 256B.69, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2012, section 256.9657, subdivision 1, is amended to read:

Subdivision 1.

Nursing home license surcharge.

(a) Effective July 1, 1993,
each non-state-operated nursing home licensed under chapter 144A shall pay to the
commissioner an annual surcharge according to the schedule in subdivision 4. The
surcharge shall be calculated as $620 per licensed bed. If the number of licensed beds is
deleted text begin reduced deleted text end new text begin changed new text end , the surcharge shall be based on the number of remaining licensed beds
the second month following the receipt of timely notice by the commissioner of human
services that new text begin the number of new text end beds deleted text begin have been delicensed deleted text end new text begin has been changed new text end . The nursing home
must notify the commissioner of health in writing when new text begin the number of new text end beds deleted text begin are delicensed
deleted text end new text begin is changed new text end . The commissioner of health must notify the commissioner of human services
within ten working days after receiving written notification. If the notification is received
by the commissioner of human services by the deleted text begin 15th deleted text end new text begin third new text end of the month, the invoice for the
second following month must be deleted text begin reduced deleted text end new text begin changed new text end to recognize the deleted text begin delicensing deleted text end new text begin change
in the number new text end of beds. deleted text begin Beds on layaway status continue to be subject to the surcharge.
deleted text end The commissioner of human services must acknowledge a medical care surcharge appeal
within 30 days of receipt of the written appeal from the provider.

(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.

(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased
to $990.

(d) Effective July 15, 2003, the surcharge under paragraph (c) shall be increased
to $2,815.

(e) new text begin Effective July 15, 2013, the surcharge under paragraph (d) shall be increased
to $........
new text end

new text begin (f) new text end The commissioner may reduce, and may subsequently restore, the surcharge under
paragraph deleted text begin (d) deleted text end new text begin (e) new text end based on the commissioner's determination of a permissible surcharge.

deleted text begin (f) deleted text end new text begin (g) new text end Between deleted text begin April 1, 2002, and August 15, 2004 deleted text end new text begin July 1, 2013, and June 30, 2014 new text end ,
a facility governed by this subdivision may elect to assume full participation in the medical
assistance program by agreeing to comply with all of the requirements of the medical
assistance program, including the rate equalization law in section 256B.48, subdivision 1,
paragraph (a), and all other requirements established in law or rule, and to begin intake
of new medical assistance recipients. Rates will be determined under Minnesota Rules,
parts 9549.0010 to 9549.0080. Rate calculations will be subject to limits as prescribed
in rule and law. Other than the adjustments in sections 256B.431, subdivisions 30 and
32; 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 9549.0057, and any
other applicable legislation enacted prior to the finalization of rates, facilities assuming
full participation in medical assistance under this paragraph are not eligible for any rate
adjustments until the July 1 following their settle-up period.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 2.

Minnesota Statutes 2012, section 256.9657, subdivision 2, is amended to read:

Subd. 2.

Hospital surcharge.

(a) Effective October 1, 1992, each Minnesota
hospital except facilities of the federal Indian Health Service and regional treatment
centers shall pay to the medical assistance account a surcharge equal to 1.4 percent of net
patient revenues excluding net Medicare revenues reported by that provider to the health
care cost information system according to the schedule in subdivision 4.

(b) Effective July 1, 1994, the surcharge under paragraph (a) is increased to 1.56
percent.

(c) new text begin Effective July 1, 2013, the surcharge under paragraph (b) is increased to ...
percent for all nongovernment-owned hospitals.
new text end

new text begin (d) new text end Notwithstanding the Medicare cost finding and allowable cost principles, the
hospital surcharge is not an allowable cost for purposes of rate setting under sections
256.9685 to 256.9695.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 3.

Minnesota Statutes 2012, section 256.9657, subdivision 3, is amended to read:

Subd. 3.

Surcharge on HMOs and community integrated service networks.

(a)
Effective October 1, 1992, each health maintenance organization with a certificate of
authority issued by the commissioner of health under chapter 62D and each community
integrated service network licensed by the commissioner under chapter 62N shall pay to
the commissioner of human services a surcharge equal to six-tenths of one percent of the
total premium revenues of the health maintenance organization or community integrated
service network as reported to the commissioner of health according to the schedule in
subdivision 4.

(b) new text begin Effective July 1, 2013:
new text end

new text begin (1) the surcharge under paragraph (a) is increased to ... percent; and
new text end

new text begin (2) each county-based purchasing plan authorized under section 256B.692 shall pay
to the commissioner a surcharge equal to ... percent of the total premium revenues of the
plan, as reported to the commissioner of health, according to the payment schedule in
subdivision 4.
new text end

new text begin (c) new text end For purposes of this subdivision, total premium revenue means:

(1) premium revenue recognized on a prepaid basis from individuals and groups
for provision of a specified range of health services over a defined period of time which
is normally one month, excluding premiums paid to a health maintenance organization
or community integrated service network from the Federal Employees Health Benefit
Program;

(2) premiums from Medicare wraparound subscribers for health benefits which
supplement Medicare coverage;

(3) Medicare revenue, as a result of an arrangement between a health maintenance
organization or a community integrated service network and the Centers for Medicare
and Medicaid Services of the federal Department of Health and Human Services, for
services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited
from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social
Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and
1395w-24, respectively, as they may be amended from time to time; and

(4) medical assistance revenue, as a result of an arrangement between a health
maintenance organization or community integrated service network and a Medicaid state
agency, for services to a medical assistance beneficiary.

If advance payments are made under clause (1) or (2) to the health maintenance
organization or community integrated service network for more than one reporting period,
the portion of the payment that has not yet been earned must be treated as a liability.

deleted text begin (c) deleted text end new text begin (d) new text end When a health maintenance organization or community integrated service
network merges or consolidates with or is acquired by another health maintenance
organization or community integrated service network, the surviving corporation or the
new corporation shall be responsible for the annual surcharge originally imposed on
each of the entities or corporations subject to the merger, consolidation, or acquisition,
regardless of whether one of the entities or corporations does not retain a certificate of
authority under chapter 62D or a license under chapter 62N.

deleted text begin (d) deleted text end new text begin (e) new text end Effective July 1 of each year, the surviving corporation's or the new
corporation's surcharge shall be based on the revenues earned in the second previous
calendar year by all of the entities or corporations subject to the merger, consolidation,
or acquisition regardless of whether one of the entities or corporations does not retain a
certificate of authority under chapter 62D or a license under chapter 62N until the total
premium revenues of the surviving corporation include the total premium revenues of all
the merged entities as reported to the commissioner of health.

deleted text begin (e) deleted text end new text begin (f) new text end When a health maintenance organization or community integrated service
network, which is subject to liability for the surcharge under this chapter, transfers,
assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability
for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer
of the health maintenance organization or community integrated service network.

deleted text begin (f) deleted text end new text begin (g) new text end In the event a health maintenance organization or community integrated
service network converts its licensure to a different type of entity subject to liability
for the surcharge under this chapter, but survives in the same or substantially similar
form, the surviving entity remains liable for the surcharge regardless of whether one of
the entities or corporations does not retain a certificate of authority under chapter 62D
or a license under chapter 62N.

deleted text begin (g) deleted text end new text begin (h) new text end The surcharge assessed to a health maintenance organization or community
integrated service network ends when the entity ceases providing services for premiums
and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 4.

Minnesota Statutes 2012, section 256.9657, subdivision 3a, is amended to read:

Subd. 3a.

deleted text begin ICF/MR deleted text end new text begin ICF/DD new text end license surcharge.

new text begin (a) new text end Effective July 1, 2003, each
non-state-operated facility as defined under section 256B.501, subdivision 1, shall pay
to the commissioner an annual surcharge according to the schedule in subdivision 4,
paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of
licensed beds is reduced, the surcharge shall be based on the number of remaining licensed
beds the second month following the receipt of timely notice by the commissioner of
human services that beds have been delicensed. The facility must notify the commissioner
of health in writing when beds are delicensed. The commissioner of health must notify
the commissioner of human services within ten working days after receiving written
notification. If the notification is received by the commissioner of human services by
the 15th of the month, the invoice for the second following month must be reduced to
recognize the delicensing of beds. The commissioner may reduce, and may subsequently
restore, the surcharge under this subdivision based on the commissioner's determination of
a permissible surcharge.

new text begin (b) Effective July 1, 2013, the surcharge under paragraph (a) is increased to $.......
per licensed bed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 5.

Minnesota Statutes 2012, section 256.9685, subdivision 2, is amended to read:

Subd. 2.

Federal requirements.

new text begin (a) new text end If it is determined that a provision of this
section or section 256.9686, 256.969, or 256.9695 conflicts with existing or future
requirements of the United States government with respect to federal financial participation
in medical assistance, the federal requirements prevail. The commissioner may, deleted text begin in the
aggregate, deleted text end prospectively new text begin and retrospectively, new text end reduce payment rates new text begin and payments new text end to avoid
reduced federal financial participation resulting from rates new text begin and payments determined by
the commissioner new text end that are in excess of the Medicare new text begin upper payment new text end limitations.

new text begin (b) For rates and payments determined by the commissioner to be in excess of the
Medicare upper payment limits for the nongovernment-owned limit category, rates and
payments shall be reduced to the limits according to clauses (1) to (4):
new text end

new text begin (1) rates and payments under section 256.969, subdivisions 3a, paragraph (j); 21,
paragraph (b); 30, paragraph (e); 31; and 32, shall be reduced proportionately;
new text end

new text begin (2) if rates and payments remain above the limit, medical education payments under
section 62J.692, subdivision 8, shall be the first reduction for the government-owned
limit category;
new text end

new text begin (3) if rates and payments remain above the limit, rates and payments not included
under clause (1) shall be reduced in total; and
new text end

new text begin (4) the state share of payments under clauses (1) and (2) shall be returned to the
hospital.
new text end

Sec. 6.

Minnesota Statutes 2012, section 256.969, subdivision 3a, is amended to read:

Subd. 3a.

Payments.

(a) Acute care hospital billings under the medical
assistance program must not be submitted until the recipient is discharged. However,
the commissioner shall establish monthly interim payments for inpatient hospitals that
have individual patient lengths of stay over 30 days regardless of diagnostic category.
Except as provided in section 256.9693, medical assistance reimbursement for treatment
of mental illness shall be reimbursed based on diagnostic classifications. Individual
hospital payments established under this section and sections 256.9685, 256.9686, and
256.9695, in addition to third-party and recipient liability, for discharges occurring during
the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
inpatient services paid for the same period of time to the hospital. deleted text begin This payment limitation
shall be calculated separately for medical assistance and general assistance medical
care services. The limitation on general assistance medical care shall be effective for
admissions occurring on or after July 1, 1991. deleted text end Services that have rates established under
subdivision 11 or 12, must be limited separately from other services. After consulting with
the affected hospitals, the commissioner may consider related hospitals one entity and
may merge the payment rates while maintaining separate provider numbers. The operating
and property base rates per admission or per day shall be derived from the best Medicare
and claims data available when rates are established. The commissioner shall determine
the best Medicare and claims data, taking into consideration variables of recency of the
data, audit disposition, settlement status, and the ability to set rates in a timely manner.
The commissioner shall notify hospitals of payment rates by December 1 of the year
preceding the rate year. The rate setting data must reflect the admissions data used to
establish relative values. Base year changes from 1981 to the base year established for the
rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
1. The commissioner may adjust base year cost, relative value, and case mix index data
to exclude the costs of services that have been discontinued by the October 1 of the year
preceding the rate year or that are paid separately from inpatient services. Inpatient stays
that encompass portions of two or more rate years shall have payments established based
on payment rates in effect at the time of admission unless the date of admission preceded
the rate year in effect by six months or more. In this case, operating payment rates for
services rendered during the rate year in effect and established based on the date of
admission shall be adjusted to the rate year in effect by the hospital cost index.

(b) For fee-for-service admissions occurring on or after July 1, 2002, the total
payment, before third-party liability and spenddown, made to hospitals for inpatient
services is reduced by .5 percent from the current statutory rates.

(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Mental health services within diagnosis related groups 424 to 432, and
facilities defined under subdivision 16 are excluded from this paragraph.

(d) In addition to the reduction in paragraphs (b) and (c), the total payment for
fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 6.0 percent
from the current statutory rates. Mental health services within diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
deleted text begin Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
assistance does not include general assistance medical care. deleted text end Payments made to managed
care plans shall be reduced for services provided on or after January 1, 2006, to reflect
this reduction.

(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
3.46 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care plans shall be reduced for services provided
on or after January 1, 2009, through June 30, 2009, to reflect this reduction.

(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
1.9 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care plans shall be reduced for services provided
on or after July 1, 2009, through June 30, 2011, to reflect this reduction.

(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 1.79 percent
from the current statutory rates. Mental health services with diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Payments made to managed care plans shall be reduced for services provided on or after
July 1, 2011, to reflect this reduction.

(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
payment for fee-for-service admissions occurring on or after July 1, 2009, made to
hospitals for inpatient services before third-party liability and spenddown, is reduced
one percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments made to managed care plans shall be reduced for
services provided on or after October 1, 2009, to reflect this reduction.

(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total
payment for fee-for-service admissions occurring on or after July 1, 2011, made to
hospitals for inpatient services before third-party liability and spenddown, is reduced
1.96 percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments made to managed care plans shall be reduced for
services provided on or after January 1, 2011, to reflect this reduction.

new text begin (j) In order to offset the rateable reductions provided for in this subdivision, the total
payment rate for medical assistance admissions for nongovernment-owned hospitals
occurring on or after July 1, 2013, made to Minnesota hospitals for inpatient services
before third-party liability and spenddown, shall be increased by ... percent from the
current statutory rates. The commissioner shall not adjust rates paid to a prepaid health
plan under contract with the commissioner to reflect payments provided in this paragraph.
The commissioner shall adjust rates and payments in excess of the Medicare upper limits
on payments according to section 256.9685, subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 7.

Minnesota Statutes 2012, section 256.969, subdivision 21, is amended to read:

Subd. 21.

Mental health or chemical dependency admissions; rates.

new text begin (a)
new text end Admissions under deleted text begin the general assistance medical care program occurring on or after
July 1, 1990, and admissions under deleted text end medical assistance deleted text begin , excluding general assistance
medical care, deleted text end occurring on or after July 1, 1990, and on or before September 30, 1992,
that are classified to a diagnostic category of mental health or chemical dependency
shall have rates established according to the methods of subdivision 14, except the per
day rate shall be multiplied by a factor of 2, provided that the total of the per day rates
shall not exceed the per admission rate. This methodology shall also apply when a hold
or commitment is ordered by the court for the days that inpatient hospital services are
medically necessary. Stays which are medically necessary for inpatient hospital services
and covered by medical assistance shall not be billable to any other governmental entity.
Medical necessity shall be determined under criteria established to meet the requirements
of section 256B.04, subdivision 15, or 256D.03, subdivision 7, paragraph (b).

new text begin (b) In order to ensure adequate access for the provision of mental health services
and to encourage broader delivery of these services outside the nonstate governmental
hospital setting, payment rates for medical assistance admissions occurring on or after
July 1, 2013, at a Minnesota nongovernment-owned hospital above the 75th percentile
of all Minnesota private, nonprofit hospitals for diagnosis-related groups 424 to 432 and
521 to 523 admissions paid by medical assistance for admissions occurring in calendar
year 2010, shall be increased for these diagnosis-related groups at a percentage calculated
to cost an average of not more than $....... each year after rateable reductions under
subdivision 3a, including state and federal shares. The commissioner shall not adjust rates
paid to a prepaid health plan under contract with the commissioner to reflect payments
provided in this paragraph. The commissioner shall adjust rates and payments in excess of
the Medicare upper limits on payments according to section 256.9685, subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 8.

Minnesota Statutes 2012, section 256.969, subdivision 30, is amended to read:

Subd. 30.

Payment rates for births.

(a) For admissions occurring on or after
October 1, 2009, the total operating and property payment rate, excluding disproportionate
population adjustment, for the following diagnosis-related groups, as they fall within
the diagnostic categories: (1) 371 cesarean section without complicating diagnosis; (2)
372 vaginal delivery with complicating diagnosis; and (3) 373 vaginal delivery without
complicating diagnosis, shall be no greater than $3,528.

(b) The rates described in this subdivision do not include newborn care.

(c) Payments to managed care and county-based purchasing plans under section
256B.69, 256B.692, or 256L.12 shall be reduced for services provided on or after October
1, 2009, to reflect the adjustments in paragraph (a).

(d) Prior authorization shall not be required before reimbursement is paid for a
cesarean section delivery.

new text begin (e) Notwithstanding paragraph (a), for medical assistance admissions occurring on
or after July 1, 2013, the commissioner shall increase rates for inpatient hospital services
at Minnesota nongovernment-owned hospitals by a dollar amount for each admission
calculated not to exceed an average of $....... each year, after rateable reductions under
subdivision 3a, including state and federal shares. The commissioner shall not adjust rates
paid to a prepaid health plan under contract with the commissioner to reflect payments
provided in this subdivision. The commissioner shall adjust rates and payments in excess
of the Medicare upper limits on payments according to section 256.9685, subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 9.

Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision
to read:

new text begin Subd. 31. new text end

new text begin Critical access hospitals. new text end

new text begin As designated under section 144.1483, clause
(9), for medical assistance admissions to critical access hospitals occurring on or after July
1, 2013, the commissioner shall increase rates for inpatient hospital services at Minnesota
nongovernment-owned hospitals by a dollar amount for each admission calculated not
to exceed an average of $....... each year, after rateable reductions under subdivision 3a,
including state and federal shares.
new text end

new text begin The commissioner shall not adjust rates paid to a prepaid health plan under contract
with the commissioner to reflect payments provided in this subdivision. The commissioner
shall adjust rates and payments in excess of the Medicare upper limits on payments
according to section 256.9685, subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 10.

Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision
to read:

new text begin Subd. 32. new text end

new text begin Pediatric care. new text end

new text begin For medical assistance admissions occurring on or after
July 1, 2013, the commissioner shall increase rates at Minnesota nongovernment-owned
hospitals above the 85th percentile for patient days for patients under 18 years of age in
calendar year 2012 of all Minnesota private, nonprofit hospitals. The increase shall be a
percentage calculated to cost an average of not more than $....... each year.
new text end

new text begin The commissioner shall not adjust rates paid to a prepaid health plan under contract
with the commissioner to reflect payments provided in this subdivision. The commissioner
shall adjust rates and payments in excess of the Medicare upper limits on payments
according to section 256.9685, subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 11.

Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision
to read:

new text begin Subd. 33. new text end

new text begin Pediatric orthopedic care. new text end

new text begin For medical assistance admissions
occurring on or after July 1, 2013, the commissioner shall increase rates at Minnesota
nongovernment-owned hospitals above the 90th percentile for patient days for patients
under 18 years of age in calendar year 2011 of all Minnesota private, nonprofit hospitals
for diagnosis-related groups 453 to 517, 533 to 541, 906, and 956. The increase shall be a
percentage calculated to cost an average of not more than $....... each year.
new text end

new text begin The commissioner shall not adjust rates paid to a prepaid health plan under contract
with the commissioner to reflect payments provided in this subdivision. The commissioner
shall adjust rates and payments in excess of the Medicare upper limits on payments
according to section 256.9685, subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 12.

Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision
to read:

new text begin Subd. 34. new text end

new text begin Trauma-designated hospitals. new text end

new text begin For medical assistance admissions
occurring on or after July 1, 2013, the commissioner shall increase rates at Minnesota
nongovernment-owned hospitals verified by the American College of Surgeons as a Level
I trauma center. The increase shall be $....... each year for each nongovernment-owned
hospital with the Level I trauma center designation.
new text end

new text begin The commissioner shall not adjust rates paid to a prepaid health plan under contract
with the commissioner to reflect payments provided in this subdivision. The commissioner
shall adjust rates and payments in excess of the Medicare upper limits on payments
according to section 256.9685, subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 13.

Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision
to read:

new text begin Subd. 35. new text end

new text begin Medicare volume. new text end

new text begin For medical assistance admissions occurring
on or after July 1, 2013, the commissioner shall increase rates at Minnesota
nongovernment-owned hospitals that serve large Medicare populations. The increase shall
be based on the percentage-to-total of Medicare admissions for all Minnesota private,
nonprofit hospitals, calculated to cost an average of not more than $....... each year.
new text end

new text begin The commissioner shall not adjust rates paid to a prepaid health plan under contract
with the commissioner to reflect payments provided in this subdivision. The commissioner
shall adjust rates and payments in excess of the Medicare upper limits on payments
according to section 256.9685, subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 14.

Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:

Subd. 53.

Calculation of payment rate for external fixed costs.

The commissioner
shall calculate a payment rate for external fixed costs.

(a) For a facility licensed as a nursing home, the portion related to section 256.9657
shall be equal to deleted text begin $8.86 deleted text end new text begin $....... new text end . For a facility licensed as both a nursing home and a
boarding care home, the portion related to section 256.9657 shall be equal to deleted text begin $8.86 deleted text end new text begin $.......
new text end multiplied by the result of its number of nursing home beds divided by its total number of
licensed beds.

(b) The portion related to the licensure fee under section 144.122, paragraph (d),
shall be the amount of the fee divided by actual resident days.

(c) The portion related to scholarships shall be determined under section 256B.431,
subdivision 36.

(d) The portion related to long-term care consultation shall be determined according
to section 256B.0911, subdivision 6.

(e) The portion related to development and education of resident and family advisory
councils under section 144A.33 shall be $5 divided by 365.

(f) The portion related to planned closure rate adjustments shall be as determined
under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
be included in the payment rate for external fixed costs beginning October 1, 2016.
Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
longer be included in the payment rate for external fixed costs beginning on October 1 of
the first year not less than two years after their effective date.

(g) The portions related to property insurance, real estate taxes, special assessments,
and payments made in lieu of real estate taxes directly identified or allocated to the nursing
facility shall be the actual amounts divided by actual resident days.

(h) The portion related to the Public Employees Retirement Association shall be
actual costs divided by resident days.

(i) The single bed room incentives shall be as determined under section 256B.431,
subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
no longer be included in the payment rate for external fixed costs beginning October 1,
2016. Single bed room incentives that take effect on or after October 1, 2014, shall no
longer be included in the payment rate for external fixed costs beginning on October 1 of
the first year not less than two years after their effective date.

(j) The payment rate for external fixed costs shall be the sum of the amounts in
paragraphs (a) to (i).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 15.

Minnesota Statutes 2012, section 256B.5012, is amended by adding a
subdivision to read:

new text begin Subd. 14. new text end

new text begin Rate increase effective July 1, 2013. new text end

new text begin For rate periods beginning on or
after July 1, 2013, the commissioner shall increase the total operating payment rate for
each facility reimbursed under this section by $....... per day. The increase shall not be
subject to any annual percentage increase.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 16.

Minnesota Statutes 2012, section 256B.69, is amended by adding a
subdivision to read:

new text begin Subd. 5l. new text end

new text begin Rate modification. new text end

new text begin For services rendered on or after July 1, 2013, to
December 31, 2014, the total payment made to managed care plans under the medical
assistance program and under MinnesotaCare for families with children shall be increased
by ... percent.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end