SF 1492

2nd Engrossment - 90th Legislature (2017 - 2018) Posted on 03/24/2017 08:37am

A bill for an act
relating to human services; establishing legislative commission on managed care;
requiring a report.

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

Section 1. LEGISLATIVE COMMISSION ON MANAGED CARE.

Subdivision 1.

Establishment.

(a) A legislative commission is created to study and
make recommendations to the legislature on issues relating to the competitive bidding
program and procurement process for the medical assistance and MinnesotaCare contracts
with managed care organizations for nonelderly, nondisabled adults and children enrollees.

(b) For purposes of this section, "managed care organization" means a demonstration
provider as defined under Minnesota Statutes, section 256B.69, subdivision 2.

Subd. 2.

Membership.

(a) The commission consists of:

(1) four members of the senate, two members appointed by the senate majority leader
and two members appointed by the senate minority leader;

(2) four members of the house of representatives, two members appointed by the speaker
of the house and two members appointed by the minority leader; and

(3) the commissioner of human services or the commissioner's designee.

(b) The appointing authorities must make their appointments by July 1, 2017.

(c) The ranking senator from the majority party appointed to the commission shall
convene the first meeting no later than September 1, 2017.

(d) The commission shall elect a chair among its members at the first meeting.

(e) Members serve without compensation or reimbursement for expenses, except that
legislative members may receive per diem and be reimbursed for expenses as provided in
the rules governing their respective bodies.

Subd. 3.

Staff.

The commissioner of human services shall provide staff and administrative
and research services, as needed, to the commission.

Subd. 4.

Duties.

(a) The commission shall study, review, and make recommendations
on the competitive bidding process for the managed care contracts that provide services to
the nonelderly, nondisabled adults and children enrolled in medical assistance and
MinnesotaCare. When reviewing the competitive bidding process, the commission shall
consider and make recommendations on the following:

(1) the number of geographic regions to be established for competitive bidding and each
procurement cycle and the criteria to be used in determining the minimum number of
managed care organizations to serve each region or statistical area;

(2) the specifications of the request for proposals, including whether managed care
organizations must address in their proposals priority areas identified by counties;

(3) the criteria to be used to determine whether managed care organizations will be
requested to provide a best and final offer;

(4) the evaluation process that the commissioner must consider when evaluating each
proposal, including the scoring weight to be given when there is a county board resolution
identifying a managed care organization preference, and whether consideration shall be
given to network adequacy for such services as dental, mental health, and primary care;

(5) the notification process to inform managed care organizations about the award
determinations, but before the contracts are signed;

(6) process for appealing the commissioner's decision on the selection of a managed
care plan or county-based purchasing plan in a county or counties; and

(7) whether an independent evaluation of the competitive bidding process is necessary,
and if so, what the evaluation should entail.

(b) The commissioner shall consider the frequency of the procurement process in terms
of how often the commissioner should conduct the procurement of managed care contracts
and whether procurement should be conducted on a statewide basis or at staggered times
for a limited number of counties within a specified region.

(c) The commission shall review proposed legislation that incorporates new federal
regulations into managed care statutes, including the recodification of the managed care
requirements in Minnesota Statutes, sections 256B.69 and 256B.692.

(d) The commission shall study, review, and make recommendations on a process that
meets federal regulations for ensuring that provider rate increases passed by the legislature
and incorporated into the capitated rates paid to managed care organizations are recognized
in the rates paid by the managed care organizations to the providers while still providing
managed care organizations the flexibility in negotiating rates paid to their provider networks.

(e) The commission shall consult with interested stakeholders and may solicit public
testimony, as deemed necessary.

Subd. 5.

Report.

(a) The commission shall report its recommendations to the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services policy and finance by February 15, 2018. The report shall include any draft
legislation necessary to implement the recommendations.

(b) The commission shall provide preliminary recommendations to the commissioner
of human services to be used by the commissioner if the commissioner decides to conduct
a procurement for managed care contracts for the 2019 contract year.

Subd. 6.

Open meetings.

The commissioner is subject to Minnesota Statutes, section
3.055.

Subd. 7.

Expiration.

This section expires June 30, 2018.