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SF 1737

1st Engrossment - 89th Legislature (2015 - 2016) Posted on 03/24/2016 08:16am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - 1st Engrossment

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A bill for an act
relating to human services; establishing an enhanced asthma care services benefit
for medical assistance; providing for medical assistance coverage of certain
products to reduce asthma triggers; amending Minnesota Statutes 2014, sections
256B.04, subdivision 14; 256B.0625, by adding a subdivision; Minnesota
Statutes 2015 Supplement, section 256B.0625, subdivision 31.

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

Section 1.

Minnesota Statutes 2014, section 256B.04, subdivision 14, is amended to
read:


Subd. 14.

Competitive bidding.

(a) When determined to be effective, economical,
and feasible, the commissioner may utilize volume purchase through competitive bidding
and negotiation under the provisions of chapter 16C, to provide items under the medical
assistance program including but not limited to the following:

(1) eyeglasses;

(2) oxygen. The commissioner shall provide for oxygen needed in an emergency
situation on a short-term basis, until the vendor can obtain the necessary supply from
the contract dealer;

(3) hearing aids and supplies; deleted text begin and
deleted text end

(4) durable medical equipment, including but not limited to:

(i) hospital beds;

(ii) commodes;

(iii) glide-about chairs;

(iv) patient lift apparatus;

(v) wheelchairs and accessories;

(vi) oxygen administration equipment;

(vii) respiratory therapy equipment;

(viii) electronic diagnostic, therapeutic and life-support systems;new text begin and
new text end

new text begin (ix) allergen-reducing products as described in section 256B.0625, subdivision 65,
paragraph (b), clause (3);
new text end

(5) nonemergency medical transportation level of need determinations, disbursement
of public transportation passes and tokens, and volunteer and recipient mileage and
parking reimbursements; and

(6) drugs.

(b) Rate changes and recipient cost-sharing under this chapter and chapters 256D and
256L do not affect contract payments under this subdivision unless specifically identified.

(c) The commissioner may not utilize volume purchase through competitive bidding
and negotiation for special transportation services under the provisions of chapter 16C.

Sec. 2.

Minnesota Statutes 2015 Supplement, section 256B.0625, subdivision 31,
is amended to read:


Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall
be made for wheelchairs and wheelchair accessories for recipients who are residents
of intermediate care facilities for the developmentally disabled. Reimbursement for
wheelchairs and wheelchair accessories for ICF/DD recipients shall be subject to the same
conditions and limitations as coverage for recipients who do not reside in institutions. A
wheelchair purchased outside of the facility's payment rate is the property of the recipient.

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics,
orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
enrollment requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic,
orthotic, or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or
similar durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with
the Medicare program's supplier and quality standards and the vendor serves primarily
pediatric patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical
condition or is generally used primarily for a medical purpose.

(e) Electronic tablets may be considered durable medical equipment if the electronic
tablet will be used as an augmentative and alternative communication system as defined
under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
must be locked in order to prevent use not related to communication.

(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must
be locked to prevent use not as an augmentative communication device, a recipient of
waiver services may use an electronic tablet for a use not related to communication when
the recipient has been authorized under the waiver to receive one or more additional
applications that can be loaded onto the electronic tablet, such that allowing the additional
use prevents the purchase of a separate electronic tablet with waiver funds.

new text begin (g) Allergen-reducing products provided according to subdivision 65, paragraph (b),
clause (3), shall be considered durable medical equipment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2017, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2014, section 256B.0625, is amended by adding a
subdivision to read:


new text begin Subd. 65. new text end

new text begin Enhanced asthma care services. new text end

new text begin (a) Medical assistance covers enhanced
asthma care services and related products for children with poorly controlled asthma, to
be provided in the children's homes. To be eligible for services and products under this
subdivision, a child must:
new text end

new text begin (1) be under the age of 21;
new text end

new text begin (2) have poorly controlled asthma;
new text end

new text begin (3) have received health care for the child's asthma from a hospital emergency
department at least one time in the past year or have been hospitalized for the treatment of
asthma at least one time in the past year; and
new text end

new text begin (4) receive a referral for services and products under this subdivision from a treating
health care provider.
new text end

new text begin (b) Covered services and products include:
new text end

new text begin (1) a home assessment for asthma triggers provided by a healthy homes specialist
currently credentialed by the National Environmental Health Association;
new text end

new text begin (2) targeted asthma education services in the child's home by an asthma educator
certified by the National Asthma Educator Certification Board. Asthma education services
provided under this clause include education on self-management, avoiding asthma
triggers, identifying worsening asthma symptoms, and medication uses and techniques; and
new text end

new text begin (3) allergen-reducing products that are recommended for the child by the healthy
homes specialist or the certified asthma educator and proven to reduce asthma triggers
identified in the child's home assessment, including:
new text end

new text begin (i) encasements for mattresses, box springs, and pillows;
new text end

new text begin (ii) a HEPA vacuum cleaner, filters, and bags;
new text end

new text begin (iii) a dehumidifier and filters;
new text end

new text begin (iv) single-room air cleaners and filters;
new text end

new text begin (v) nontoxic pest control systems, including traps and starter packages of food
storage containers;
new text end

new text begin (vi) a damp mopping system;
new text end

new text begin (vii) if the child does not have access to a bed, a waterproof hospital-grade mattress;
and
new text end

new text begin (viii) for homeowners only, furnace filters.
new text end

new text begin (c) A child is limited to one home assessment and one visit by a certified asthma
educator to provide education on the use and maintenance of the products listed in
paragraph (b), clause (3), except that a child may receive an additional home assessment
if the child moves to a new home; if a new asthma trigger, including tobacco smoke,
enters the home; or if the child's health care provider identifies a new allergy for the child,
including an allergy to mold, pests, pets, or dust mites. The commissioner shall determine
the frequency with which a child may receive a product listed in paragraph (b), clause (3),
based on the reasonable expected lifetime of the product.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2017, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
new text end