SF 1492

as introduced - 90th Legislature (2017 - 2018) Posted on 03/15/2017 11:19am

A bill for an act
relating to human services; setting requirements for competitive bidding and
managed care procurement; amending Minnesota Statutes 2016, section 256B.69,
by adding a subdivision.

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

Section 1.

Minnesota Statutes 2016, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 36. new text end

new text begin Competitive bidding and procurement. new text end

new text begin (a) For a managed care organization
contract effective on or after January 1, 2019, the commissioner may utilize a competitive
price bidding program on a regional basis for nonelderly, nondisabled adults and children
enrolled in medical assistance and MinnesotaCare. The commissioner shall establish four
geographic regions in the state and shall implement competitive price bidding for the
geographic regions. The program must allow a minimum of three managed care organizations
to serve each metropolitan statistical area and may allow two plans to serve areas of the
state that are not part of a metropolitan statistical area. For purposes of this subdivision,
"managed care organization" means a demonstration provider as defined in subdivision 2,
paragraph (b).
new text end

new text begin (b) County board resolutions identifying managed care organization preferences must
be explicitly given scoring weight in the procurement process. The commissioner shall
specify in the request for proposals the scoring weight that will be given to county board
resolutions. County boards may identify priority areas for managed care organizations to
address in the proposals. The request for proposals must list these priority areas for each
county and specify the scoring weight that will be assigned to addressing priority areas.
new text end

new text begin (c) The request for proposals must specify whether a best and final offer will be requested
from managed care organizations. If a best and final offer is requested, each responding
managed care organization must be offered the opportunity to submit a best and final offer.
new text end

new text begin (d) The commissioner, when evaluating proposals, shall consider network adequacy for
dental and other services.
new text end

new text begin (e) After the managed care organizations are notified about the award determination,
but before contracts are signed, the commissioner shall provide each managed care
organization with its own scoring sheet and related information. The scoring sheet shall not
be made available to other managed care organizations until final contracts are signed.
new text end

new text begin (f) A managed care organization that is aggrieved by the commissioner's decision related
to the selection of managed care organizations to deliver services in a county or counties
may appeal the commissioner's decision using the contested case procedures in sections
14.57 to 14.62. A contested case proceeding must be initiated within 60 days after the date
on which the commissioner notifies the managed care organization that the managed care
organization was not awarded a contract or service area. After considering the appeal, the
administrative law judge must either uphold or modify the commissioner's selection of
managed care organizations. The decision of the administrative law judge constitutes the
final decision regarding the selection of managed care organizations to serve a county or
counties. A party aggrieved by the administrative law judge's decision may seek judicial
review of the decision as provided in chapter 14.
new text end

new text begin (g) The commissioner shall contract for an independent evaluation of the competitive
price bidding process. The contractor must solicit recommendations from all parties
participating in the competitive price bidding process for service delivery in calendar year
2019 on how the competitive price bidding process may be improved for service delivery
in calendar year 2020 and annually thereafter. The contractor must also annually evaluate
the performance of managed care organizations selected to deliver services. The annual
evaluation must evaluate, for service delivery in the previous calendar year, beginning with
calendar year 2019, various measures of managed care organization quality of care, customer
service, provider access, and cultural competency and must include risk-adjusted quality
scores for each managed care organization. The commissioner shall make evaluation results
available to the public on the department's Web site.
new text end