Skip to main content Skip to office menu Skip to footer
Minnesota Legislature

Office of the Revisor of Statutes

SF 2060

as introduced - 89th Legislature (2015 - 2016) Posted on 04/14/2015 08:28am

KEY: stricken = removed, old language.
underscored = added, new language.
Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10
1.11 1.12
1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 2.1 2.2 2.3 2.4 2.5 2.6 2.7
2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26
2.27 2.28
2.29 2.30 2.31 2.32 2.33 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 3.34 3.35 3.36 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17
4.18 4.19 4.20 4.21
4.22 4.23
4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 5.35 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22
6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30
6.31 6.32
6.33 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 7.34 7.35 7.36 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10
8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 8.33 8.34 8.35 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33
9.34 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 10.34 10.35 10.36 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22
11.23 11.24
11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 11.34 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29
12.30 12.31
12.32 12.33 12.34 12.35 13.1 13.2 13.3 13.4 13.5
13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 13.33 13.34 13.35 14.1
14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 14.33 14.34 14.35 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 15.33 15.34 15.35 15.36 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 16.34 16.35 16.36 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 17.34 17.35 17.36 18.1 18.2 18.3 18.4
18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16
18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 18.33 18.34 19.1 19.2
19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 19.33 19.34 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11
20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31
20.32 20.33 20.34 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14
21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 21.34 21.35 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11
22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 22.33 22.34 23.1 23.2 23.3 23.4
23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23
23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 23.34 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11
24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 24.33 24.34 24.35 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10
25.11 25.12
25.13 25.14 25.15 25.16
25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 25.33 25.34 26.1 26.2 26.3 26.4 26.5 26.6 26.7

A bill for an act
relating to health; guaranteeing that all necessary health care is available and
affordable for every Minnesotan; establishing the Minnesota Health Plan,
Minnesota Health Board, Minnesota Health Fund, Office of Health Quality
and Planning, ombudsman for patient advocacy, and auditor general for the
Minnesota Health Plan; requesting a 1332 waiver; authorizing rulemaking;
appropriating money;amending Minnesota Statutes 2014, sections 13.3806,
by adding a subdivision; 14.03, subdivisions 2, 3; 15A.0815, subdivision 2;
proposing coding for new law as Minnesota Statutes, chapter 62W.

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

ARTICLE 1

MINNESOTA HEALTH PLAN

Section 1.

new text begin [62W.01] HEALTH PLAN REQUIREMENTS.
new text end

new text begin In order to keep Minnesota residents healthy and provide the best quality of health
care, the Minnesota Health Plan must:
new text end

new text begin (1) ensure all Minnesota residents receive quality health care;
new text end

new text begin (2) not restrict, delay, or deny care or reduce the quality of care to hold down costs,
but instead reduce costs through prevention, efficiency, and reduction of bureaucracy;
new text end

new text begin (3) cover all necessary care, including complete mental health services, chemical
dependency treatment, prescription drugs, medical equipment and supplies, dental care,
long-term care, and home care services;
new text end

new text begin (4) allow patients to choose their own providers;
new text end

new text begin (5) set premiums based on ability to pay;
new text end

new text begin (6) focus on preventive care and early intervention to improve the health of all
Minnesota residents and reduce costs from untreated illnesses and diseases;
new text end

new text begin (7) ensure an adequate number of qualified health care professionals and facilities to
guarantee availability of, and timely access to quality care throughout the state;
new text end

new text begin (8) continue Minnesota's leadership in medical education, training, research, and
technology;
new text end

new text begin (9) provide adequate and timely payments to providers; and
new text end

new text begin (10) simplify access to health care by reducing the complexity of the funding and
payment system.
new text end

Sec. 2.

new text begin [62W.02] MINNESOTA HEALTH PLAN GENERAL PROVISIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Short title. new text end

new text begin This chapter may be cited as the "Minnesota Health Plan."
new text end

new text begin Subd. 2. new text end

new text begin Purpose. new text end

new text begin The Minnesota Health Plan shall provide all medically necessary
health care services for all Minnesota residents in a manner that meets the requirements
in section 62W.01.
new text end

new text begin Subd. 3. new text end

new text begin Definitions. new text end

new text begin As used in this chapter, the following terms have the meanings
provided:
new text end

new text begin (a) "Board" means the Minnesota Health Board.
new text end

new text begin (b) "Plan" means the Minnesota Health Plan.
new text end

new text begin (c) "Fund" means the Minnesota Health Fund.
new text end

new text begin (d) "Medically necessary" means services or supplies needed to promote health and
to prevent, diagnose, or treat a particular patient's medical condition that meet accepted
standards of medical practice within a provider's professional peer group and geographic
region.
new text end

new text begin (e) "Institutional provider" means an inpatient hospital, nursing facility, rehabilitation
facility, and other health care facilities that provide overnight care.
new text end

new text begin (f) "Noninstitutional provider" means individual providers, group practices, clinics,
outpatient surgical centers, imaging centers, and other health facilities that do not provide
overnight care.
new text end

ARTICLE 2

ELIGIBILITY

Section 1.

new text begin [62W.03] ELIGIBILITY.
new text end

new text begin Subdivision 1. new text end

new text begin Residency. new text end

new text begin All Minnesota residents are eligible for the Minnesota
Health Plan.
new text end

new text begin Subd. 2. new text end

new text begin Enrollment; identification. new text end

new text begin The Minnesota Health Board shall establish
a procedure to enroll residents and provide each with identification that may be used by
health care providers to confirm eligibility for services. The application for enrollment
shall be no more than two pages.
new text end

new text begin Subd. 3. new text end

new text begin Residents temporarily out of state. new text end

new text begin (a) The Minnesota Health Plan shall
provide health care coverage to Minnesota residents who are temporarily out of the state
who intend to return and reside in Minnesota.
new text end

new text begin (b) Coverage for emergency care obtained out of state shall be at prevailing local
rates. Coverage for nonemergency care obtained out of state shall be according to rates
and conditions established by the board. The board may require that a resident be
transported back to Minnesota when prolonged treatment of an emergency condition is
necessary and when that transport will not adversely affect a patient's care or condition.
new text end

new text begin Subd. 4. new text end

new text begin Visitors. new text end

new text begin Nonresidents visiting Minnesota shall be billed by the board
for all services received under the Minnesota Health Plan. The board may enter into
intergovernmental arrangements or contracts with other states and countries to provide
reciprocal coverage for temporary visitors.
new text end

new text begin Subd. 5. new text end

new text begin Nonresident employed in Minnesota. new text end

new text begin The board shall extend eligibility
to nonresidents employed in Minnesota under a premium schedule set by the board.
new text end

new text begin Subd. 6. new text end

new text begin Business outside of Minnesota employing Minnesota residents. new text end

new text begin The
board shall apply for a federal waiver to collect the employer contribution mandated
by federal law.
new text end

new text begin Subd. 7. new text end

new text begin Retiree benefits. new text end

new text begin (a) All persons who are eligible for retiree medical
benefits under an employer-employee contract shall remain eligible for those benefits
provided the contractually mandated payments for those benefits are made to the
Minnesota Health Fund, which shall assume financial responsibility for care provided
under the terms of the contract along with additional health benefits covered by the
Minnesota Health Plan. Retirees who elect to reside outside of Minnesota shall be eligible
for benefits under the terms and conditions of the retiree's employer-employee contract.
new text end

new text begin (b) The board may establish financial arrangements with states and foreign countries
in order to facilitate meeting the terms of the contracts described in paragraph (a).
Payments for care provided by non-Minnesota providers to Minnesota retirees shall be
reimbursed at rates established by the Minnesota Health Board. Providers who accept any
payment from the Minnesota Health Plan for a covered service shall not bill the patient
for the covered service.
new text end

new text begin Subd. 8. new text end

new text begin Presumptive eligibility. new text end

new text begin (a) An individual is presumed eligible for
coverage under the Minnesota Health Plan if the individual arrives at a health facility
unconscious, comatose, or otherwise unable, because of the individual's physical or
mental condition, to document eligibility or to act on the individual's own behalf. If the
patient is a minor, the patient is presumed eligible, and the health facility shall provide
care as if the patient were eligible.
new text end

new text begin (b) Any individual is presumed eligible when brought to a health facility according
to any provision of section 253B.05.
new text end

new text begin (c) Any individual involuntarily committed to an acute psychiatric facility or to a
hospital with psychiatric beds according to any provision of section 253B.05, providing
for involuntary commitment, is presumed eligible.
new text end

new text begin (d) All health facilities subject to state and federal provisions governing emergency
medical treatment must comply with those provisions.
new text end

new text begin Subd. 9. new text end

new text begin Data. new text end

new text begin Data collected because an individual applies for or is enrolled in
the Minnesota Health Plan are private data on individuals as defined in section 13.02,
subdivision 12, but may be released to:
new text end

new text begin (1) providers for purposes of confirming enrollment and processing payments for
benefits;
new text end

new text begin (2) the ombudsman for patient advocacy for purposes of performing duties under
section 62W.12 or 62W.13; or
new text end

new text begin (3) the auditor general for purposes of performing duties under section 62W.14.
new text end

Sec. 2.

Minnesota Statutes 2014, section 13.3806, is amended by adding a subdivision
to read:


new text begin Subd. 1b. new text end

new text begin Minnesota Health Plan. new text end

new text begin Data on enrollees under the Minnesota Health
Plan are classified under sections 62W.03, subdivision 9, and 62W.13, subdivision 6.
new text end

ARTICLE 3

BENEFITS

Section 1.

new text begin [62W.04] BENEFITS.
new text end

new text begin Subdivision 1. new text end

new text begin General provisions. new text end

new text begin Any eligible individual may choose to receive
services under the Minnesota Health Plan from any participating provider.
new text end

new text begin Subd. 2. new text end

new text begin Covered benefits. new text end

new text begin Covered health care benefits in this chapter include all
medically necessary care subject to the limitations specified in subdivision 4. Covered
health care benefits for Minnesota Health Plan enrollees include:
new text end

new text begin (1) inpatient and outpatient health facility services;
new text end

new text begin (2) inpatient and outpatient professional health care provider services;
new text end

new text begin (3) diagnostic imaging, laboratory services, and other diagnostic and evaluative
services;
new text end

new text begin (4) medical equipment, appliances, and assistive technology, including prosthetics,
eyeglasses, and hearing aids, their repair, technical support, and customization needed
for individual use;
new text end

new text begin (5) inpatient and outpatient rehabilitative care;
new text end

new text begin (6) emergency care services;
new text end

new text begin (7) emergency transportation;
new text end

new text begin (8) necessary transportation for health care services for persons with disabilities or
who may qualify as low income;
new text end

new text begin (9) child and adult immunizations and preventive care;
new text end

new text begin (10) health and wellness education;
new text end

new text begin (11) hospice care;
new text end

new text begin (12) care in a skilled nursing facility;
new text end

new text begin (13) home health care including health care provided in an assisted living facility;
new text end

new text begin (14) mental health services;
new text end

new text begin (15) substance abuse treatment;
new text end

new text begin (16) dental care;
new text end

new text begin (17) vision care;
new text end

new text begin (18) prescription drugs;
new text end

new text begin (19) podiatric care;
new text end

new text begin (20) chiropractic care;
new text end

new text begin (21) acupuncture;
new text end

new text begin (22) therapies which are shown by the National Institutes of Health National Center
for Complementary and Alternative Medicine to be safe and effective;
new text end

new text begin (23) blood and blood products;
new text end

new text begin (24) dialysis;
new text end

new text begin (25) adult day care;
new text end

new text begin (26) rehabilitative and habilitative services;
new text end

new text begin (27) ancillary health care or social services previously covered by Minnesota's
public health programs;
new text end

new text begin (28) case management and care coordination;
new text end

new text begin (29) language interpretation and translation for health care services, including
sign language and Braille or other services needed for individuals with communication
barriers; and
new text end

new text begin (30) those health care and long-term supportive services currently covered under
Minnesota Statutes 2014, chapter 256B, for persons on medical assistance.
new text end

new text begin Subd. 3. new text end

new text begin Benefit expansion. new text end

new text begin The Minnesota Health Board may expand health care
benefits beyond the minimum benefits described in this section when expansion meets the
intent of this chapter and when there are sufficient funds to cover the expansion.
new text end

new text begin Subd. 4. new text end

new text begin Cost-sharing for the room and board portion of long-term care. new text end

new text begin The
Minnesota Health Board shall develop income and asset qualifications based on medical
assistance standards for covered benefits under subdivision 2, clauses (12) and (13). All
health care services for long-term care in a skilled nursing facility or assisted living facility
are fully covered but, notwithstanding section 62W.20, subdivision 6, room and board
costs may be charged to patients who do not meet income and asset qualifications.
new text end

new text begin Subd. 5. new text end

new text begin Exclusions. new text end

new text begin The following health care services shall be excluded from
coverage by the Minnesota Health Plan:
new text end

new text begin (1) health care services determined to have no medical benefit by the board;
new text end

new text begin (2) treatments and procedures primarily for cosmetic purposes, unless required to
correct a congenital defect, restore or correct a part of the body that has been altered as a
result of injury, disease, or surgery, or determined to be medically necessary by a qualified,
licensed health care provider in the Minnesota Health Plan; and
new text end

new text begin (3) services of a health care provider or facility that is not licensed or accredited
by the state, except for approved services provided to a Minnesota resident who is
temporarily out of the state.
new text end

new text begin Subd. 6. new text end

new text begin Prohibition. new text end

new text begin The Minnesota Health Plan shall not pay for drugs requiring
a prescription if the pharmaceutical companies directly market those drugs to consumers
in Minnesota.
new text end

Sec. 2.

new text begin [62W.041] PATIENT CARE.
new text end

new text begin (a) All patients shall have a primary care provider and have access to care
coordination.
new text end

new text begin (b) Referrals are not required for a patient to see a health care specialist. If a patient
sees a specialist and does not have a primary care provider, the Minnesota Health Plan
may assist with choosing a primary care provider.
new text end

new text begin (c) The board may establish a computerized registry to assist patients in identifying
appropriate providers.
new text end

ARTICLE 4

FUNDING

Section 1.

new text begin [62W.19] MINNESOTA HEALTH FUND.
new text end

new text begin Subdivision 1. new text end

new text begin General provisions. new text end

new text begin (a) The board shall establish a Minnesota
Health Fund to implement the Minnesota Health Plan and to receive premiums and
other sources of revenue. The fund shall be administered by a director appointed by the
Minnesota Health Board.
new text end

new text begin (b) All money collected, received, and transferred according to this chapter shall be
deposited in the Minnesota Health Fund.
new text end

new text begin (c) Money deposited in the Minnesota Health Fund shall be used to finance the
Minnesota Health Plan.
new text end

new text begin (d) All claims for health care services rendered shall be made to the Minnesota
Health Fund.
new text end

new text begin (e) All payments made for health care services shall be disbursed from the Minnesota
Health Fund.
new text end

new text begin (f) Premiums and other revenues collected each year must be sufficient to cover
that year's projected costs.
new text end

new text begin Subd. 2. new text end

new text begin Accounts. new text end

new text begin The Minnesota Health Fund shall have operating, capital,
and reserve accounts.
new text end

new text begin Subd. 3. new text end

new text begin Operating account. new text end

new text begin The operating account in the Minnesota Health Fund
shall be comprised of the accounts specified in paragraphs (a) to (e).
new text end

new text begin (a) Medical services account. The medical services account must be used to
provide for all medical services and benefits covered under the Minnesota Health Plan.
new text end

new text begin (b) Prevention account. The prevention account must be used solely to establish and
maintain primary community prevention programs, including preventive screening tests.
new text end

new text begin (c) Program administration, evaluation, planning, and assessment account. The
program administration, evaluation, planning, and assessment account must be used to
monitor and improve the plan's effectiveness and operations. The board may establish
grant programs including demonstration projects for this purpose.
new text end

new text begin (d) Training and development account. The training and development account
must be used to incentivize the training and development of health care providers and the
health care workforce needed to meet the health care needs of the population.
new text end

new text begin (e) Health service research account. The health service research account must be
used to support research and innovation as determined by the Minnesota Health Board,
and recommended by the Office of Health Quality and Planning and the Ombudsman for
Patient Advocacy.
new text end

new text begin Subd. 4. new text end

new text begin Capital account. new text end

new text begin The capital account must be used solely to pay for capital
expenditures for institutional providers and all capital expenditures requiring approval
from the Minnesota Health Board as specified in section 62W.05, subdivision 4.
new text end

new text begin Subd. 5. new text end

new text begin Reserve account. new text end

new text begin (a) The Minnesota Health Plan must at all times hold in
reserve an amount estimated in the aggregate to provide for the payment of all losses and
claims for which the Minnesota Health Plan may be liable and to provide for the expense
of adjustment or settlement of losses and claims.
new text end

new text begin (b) Money currently held in reserve by state, city, and county health programs must
be transferred to the Minnesota Health Fund when the Minnesota Health Plan replaces
those programs.
new text end

new text begin (c) The board shall have provisions in place to insure the Minnesota Health Plan
against unforeseen expenditures or revenue shortfalls not covered by the reserve account.
The board may borrow money to cover temporary shortfalls.
new text end

Sec. 2.

new text begin [62W.20] REVENUE SOURCES.
new text end

new text begin Subdivision 1. new text end

new text begin Minnesota Health Plan premium. new text end

new text begin (a) The Minnesota Health Board
shall:
new text end

new text begin (1) determine the aggregate cost of providing health care according to this chapter;
new text end

new text begin (2) develop an equitable and affordable premium structure based on income,
including unearned income, and a business health tax based on payroll;
new text end

new text begin (3) in consultation with the Department of Revenue, develop an efficient means of
collecting premiums and the business health tax; and
new text end

new text begin (4) coordinate with existing, ongoing funding sources from federal and state
programs.
new text end

new text begin (b) The premium structure must be based on ability to pay.
new text end

new text begin (c) On or before January 15, 2017, the board shall submit to the governor and the
legislature a report on the premium and business health tax structure established to finance
the Minnesota Health Plan.
new text end

new text begin Subd. 2. new text end

new text begin Federal receipts. new text end

new text begin All federal funding received by Minnesota including
the premium subsidies under the Affordable Care Act, Public Law 111-148, as amended
by Public Law 111-152, and as authorized by the Affordable Care Act section 1332 state
innovation waiver, is appropriated to the Minnesota Health Plan Board to be used only to
administer the Minnesota Health Plan under chapter 62W. Federal funding that is received
for implementing and administering the Minnesota Health Plan must be used only to
provide comprehensive health care for all Minnesota residents.
new text end

new text begin Subd. 3. new text end

new text begin Funds from outside sources. new text end

new text begin Institutional providers operating under
Minnesota Health Plan operating budgets may raise and expend funds from sources other
than the Minnesota Health Plan including private or foundation donors. Contributions to
providers in excess of $500,000 must be reported to the board.
new text end

new text begin Subd. 4. new text end

new text begin Governmental payments. new text end

new text begin The chief executive officer and, if required
under federal law, the commissioners of health and human services shall seek all necessary
waivers, exemptions, agreements, or legislation so that all current federal payments to
the state including federal premiums for health care are paid directly to the Minnesota
Health Plan, which shall then assume responsibility for all health care benefits and health
care services previously paid for by the subsidies under the Affordable Care Act with
those funds. In obtaining the waivers, exemptions, agreements, or legislation, the chief
executive officer and, if required, commissioners shall seek from the federal government a
contribution for health care services in Minnesota that reflects: medical inflation, the state
gross domestic product, the size and age of the population, the number of residents living
below the poverty level, and the number of Medicare and VA eligible individuals, and does
not decrease in relation to the federal contribution to other states as a result of the waivers,
exemptions, agreements, or savings from implementation of the Minnesota Health Plan.
new text end

new text begin Subd. 5. new text end

new text begin Federal preemption. new text end

new text begin (a) The board shall secure a repeal or a waiver of any
provision of federal law that preempts any provision of this chapter. The commissioners
of health and human services shall provide all necessary assistance.
new text end

new text begin (b) In the section 1332 waiver application, the board shall request to waive any of
the following provisions of the Patient Protection and Affordable Care Act, to the extent
necessary to implement this act:
new text end

new text begin (1) United States Code, title 42, sections 18021 to 18024;
new text end

new text begin (2) United States Code, title 42, sections 18031 to 18033;
new text end

new text begin (3) United States Code, title 42, section 18071; and
new text end

new text begin (4) sections 36B and 5000A of the Internal Revenue Code of 1986, as amended.
new text end

new text begin (c) In the event that a repeal or a waiver of law or regulations cannot be secured,
the board shall adopt rules, or seek conforming state legislation, consistent with federal
law, in an effort to best fulfill the purposes of this chapter.
new text end

new text begin (d) The Minnesota Health Plan's responsibility for providing care shall be secondary
to existing federal government programs for health care services to the extent that funding
for these programs is not transferred to the Minnesota Health Fund or that the transfer
is delayed beyond the date on which initial benefits are provided under the Minnesota
Health Plan.
new text end

new text begin Subd. 6. new text end

new text begin No cost-sharing. new text end

new text begin No deductible, co-payment, coinsurance, or other
cost-sharing shall be imposed with respect to covered benefits.
new text end

Sec. 3.

new text begin [62W.21] SUBROGATION.
new text end

new text begin Subdivision 1. new text end

new text begin Collateral source. new text end

new text begin (a) When other payers for health care have been
terminated, health care costs shall be collected from collateral sources whenever medical
services provided to an individual are, or may be, covered services under a policy of
insurance, or other collateral source available to that individual, or when the individual
has a right of action for compensation permitted under law.
new text end

new text begin (b) As used in this section, collateral source includes:
new text end

new text begin (1) health insurance policies and the medical components of automobile,
homeowners, and other forms of insurance;
new text end

new text begin (2) medical components of worker's compensation;
new text end

new text begin (3) pension plans;
new text end

new text begin (4) employer plans;
new text end

new text begin (5) employee benefit contracts;
new text end

new text begin (6) government benefit programs;
new text end

new text begin (7) a judgment for damages for personal injury;
new text end

new text begin (8) the state of last domicile for individuals moving to Minnesota for medical care
who have extraordinary medical needs; and
new text end

new text begin (9) any third party who is or may be liable to an individual for health care services
or costs.
new text end

new text begin (c) Collateral source does not include:
new text end

new text begin (1) a contract or plan that is subject to federal preemption; or
new text end

new text begin (2) any governmental unit, agency, or service, to the extent that subrogation
is prohibited by law. An entity described in paragraph (b) is not excluded from the
obligations imposed by this section by virtue of a contract or relationship with a
government unit, agency, or service.
new text end

new text begin (d) The board shall negotiate waivers, seek federal legislation, or make other
arrangements to incorporate collateral sources into the Minnesota Health Plan.
new text end

new text begin Subd. 2. new text end

new text begin Collateral source; negotiation. new text end

new text begin When an individual who receives health
care services under the Minnesota Health Plan is entitled to coverage, reimbursement,
indemnity, or other compensation from a collateral source, the individual shall notify the
health care provider and provide information identifying the collateral source, the nature
and extent of coverage or entitlement, and other relevant information. The health care
provider shall forward this information to the board. The individual entitled to coverage,
reimbursement, indemnity, or other compensation from a collateral source shall provide
additional information as requested by the board.
new text end

new text begin Subd. 3. new text end

new text begin Reimbursement. new text end

new text begin (a) The Minnesota Health Plan shall seek reimbursement
from the collateral source for services provided to the individual and may institute
appropriate action, including legal proceedings, to recover the reimbursement. Upon
demand, the collateral source shall pay to the Minnesota Health Fund the sums it would
have paid or expended on behalf of the individual for the health care services provided by
the Minnesota Health Plan.
new text end

new text begin (b) In addition to any other right to recovery provided in this section, the board shall
have the same right to recover the reasonable value of health care benefits from a collateral
source as provided to the commissioner of human services under section 256B.37.
new text end

new text begin (c) If a collateral source is exempt from subrogation or the obligation to reimburse
the Minnesota Health Plan, the board may require that an individual who is entitled to
medical services from the source first seek those services from that source before seeking
those services from the Minnesota Health Plan.
new text end

new text begin (d) To the extent permitted by federal law, the board shall have the same right of
subrogation over contractual retiree health care benefits provided by employers as other
contracts, allowing the Minnesota Health Plan to recover the cost of health care services
provided to individuals covered by the retiree benefits, unless arrangements are made to
transfer the revenues of the health care benefits directly to the Minnesota Health Plan.
new text end

new text begin Subd. 4. new text end

new text begin Defaults, underpayments, and late payments. new text end

new text begin (a) Default,
underpayment, or late payment of any tax or other obligation imposed by this chapter shall
result in the remedies and penalties provided by law, except as provided in this section.
new text end

new text begin (b) Eligibility for health care benefits under section 62W.04 shall not be impaired by
any default, underpayment, or late payment of any premium or other obligation imposed
by this chapter.
new text end

ARTICLE 5

PAYMENTS

Section 1.

new text begin [62W.05] PROVIDER PAYMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin General provisions. new text end

new text begin (a) All health care providers licensed to
practice in Minnesota may participate in the Minnesota Health Plan and other providers as
determined by the board.
new text end

new text begin (b) A participating health care provider shall comply with all federal laws and
regulations governing referral fees and fee splitting including, but not limited to, United
States Code, title 42, sections 1320a-7b and 1395nn, whether reimbursed by federal funds
or not.
new text end

new text begin (c) A fee schedule or financial incentive may not adversely affect the care a patient
receives or the care a health provider recommends.
new text end

new text begin Subd. 2. new text end

new text begin Payments to noninstitutional providers. new text end

new text begin (a) The Minnesota Health
Board shall establish and oversee a payment system for noninstitutional providers that
promotes quality and controls cost.
new text end

new text begin (b) The board shall pay noninstitutional providers based on rates negotiated with
providers. Rates shall take into account the need to address provider shortages.
new text end

new text begin (c) The board shall establish payment criteria and methods of payment for care
coordination for patients especially those with chronic illness and complex medical needs.
new text end

new text begin (d) Providers who accept any payment from the Minnesota Health Plan for a covered
health care service shall not bill the patient for the covered health care service.
new text end

new text begin (e) Providers shall be paid within 30 business days for claims filed following
procedures established by the board.
new text end

new text begin Subd. 3. new text end

new text begin Payments to institutional providers. new text end

new text begin (a) The board shall establish annual
budgets for institutional providers. These budgets shall consist of an operating and a
capital budget. An institution's annual budget shall be negotiated to cover its anticipated
health care services for the next year based on past performance and projected changes in
prices and health care service levels.
new text end

new text begin (b) Providers who accept any payment from the Minnesota Health Plan for a covered
health care service shall not bill the patient for the covered health care service.
new text end

new text begin Subd. 4. new text end

new text begin Capital management plan. new text end

new text begin (a) The board shall periodically develop a
capital investment plan that will serve as a guide in determining the annual budgets of
institutional providers and in deciding whether to approve applications for approval of
capital expenditures by noninstitutional providers.
new text end

new text begin (b) Providers who propose to make capital purchases in excess of $500,000 must
obtain board approval. The board may alter the threshold expenditure level that triggers
the requirement to submit information on capital expenditures. Institutional providers
shall propose these expenditures and submit the required information as part of the annual
budget they submit to the board. Noninstitutional providers shall submit applications
for approval of these expenditures to the board. The board must respond to capital
expenditure applications in a timely manner.
new text end

ARTICLE 6

GOVERNANCE

Section 1.

Minnesota Statutes 2014, section 14.03, subdivision 2, is amended to read:


Subd. 2.

Contested case procedures.

The contested case procedures of the
Administrative Procedure Act provided in sections 14.57 to 14.69 do not apply to (a)
proceedings under chapter 414, except as specified in that chapter, (b) the commissioner of
corrections, (c) the unemployment insurance program and the Social Security disability
determination program in the Department of Employment and Economic Development,
(d) the commissioner of mediation services, (e) the Workers' Compensation Division in
the Department of Labor and Industry, (f) the Workers' Compensation Court of Appeals,
deleted text beginordeleted text end (g) the Board of Pardonsnew text begin, or (h) the Minnesota Health Plannew text end.

Sec. 2.

Minnesota Statutes 2014, section 15A.0815, subdivision 2, is amended to read:


Subd. 2.

Group I salary limits.

The salary for a position listed in this subdivision
shall not exceed 133 percent of the salary of the governor. This limit must be adjusted
annually on January 1. The new limit must equal the limit for the prior year increased
by the percentage increase, if any, in the Consumer Price Index for all urban consumers
from October of the second prior year to October of the immediately prior year. The
commissioner of management and budget must publish the limit on the department's Web
site. This subdivision applies to the following positions:

Commissioner of administration;

Commissioner of agriculture;

Commissioner of education;

Commissioner of commerce;

Commissioner of corrections;

Commissioner of health;

new text begin Chief executive officer of the Minnesota Health Plan;
new text end

Commissioner, Minnesota Office of Higher Education;

Commissioner, Housing Finance Agency;

Commissioner of human rights;

Commissioner of human services;

Commissioner of labor and industry;

Commissioner of management and budget;

Commissioner of natural resources;

Commissioner, Pollution Control Agency;

Executive director, Public Employees Retirement Association;

Commissioner of public safety;

Commissioner of revenue;

Executive director, State Retirement System;

Executive director, Teachers Retirement Association;

Commissioner of employment and economic development;

Commissioner of transportation; and

Commissioner of veterans affairs.

Sec. 3.

new text begin [62W.06] MINNESOTA HEALTH BOARD.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The Minnesota Health Board is established to
promote the delivery of high quality, coordinated health care services that enhance health;
prevent illness, disease, and disability; slow the progression of chronic diseases; and
improve personal health management. The board shall administer the Minnesota Health
Plan. The board shall oversee:
new text end

new text begin (1) the Office of Health Quality and Planning under section 62W.09; and
new text end

new text begin (2) the Minnesota Health Fund under section 62W.19.
new text end

new text begin Subd. 2. new text end

new text begin Board composition. new text end

new text begin The board shall consist of 15 members, including
a representative selected by each of the five rural regional health planning boards under
section 62W.08 and three representatives selected by the metropolitan regional health
planning board under section 62W.08. These members shall select the following:
new text end

new text begin (1) one patient member and one employer member appointed by the board members;
and
new text end

new text begin (2) five providers appointed by the board members that include one physician, one
registered nurse, one mental health provider, one dentist, and one facility director.
new text end

new text begin Subd. 3. new text end

new text begin Term and compensation; selection of chair. new text end

new text begin Board members shall
serve four years. Board members shall set the board's compensation not to exceed the
compensation of Public Utilities Commission members. The board shall select the chair
from its membership.
new text end

new text begin Subd. 4. new text end

new text begin General duties. new text end

new text begin The board shall:
new text end

new text begin (1) ensure that all of the requirements of section 62W.01 are met;
new text end

new text begin (2) hire a chief executive officer for the Minnesota Health Plan to administer all
aspects of the plan as directed by the board;
new text end

new text begin (3) hire a director for the Office of Health Quality and Planning;
new text end

new text begin (4) hire a director of the Minnesota Health Fund;
new text end

new text begin (5) provide technical assistance to the regional boards established under section
62W.08;
new text end

new text begin (6) conduct necessary investigations and inquiries and require the submission of
information, documents, and records the board considers necessary to carry out the
purposes of this chapter;
new text end

new text begin (7) establish a process for the board to receive the concerns, opinions, ideas, and
recommendations of the public regarding all aspects of the Minnesota Health Plan and
the means of addressing those concerns;
new text end

new text begin (8) conduct other activities the board considers necessary to carry out the purposes
of this chapter;
new text end

new text begin (9) collaborate with the agencies that license health facilities to ensure that facility
performance is monitored and that deficient practices are recognized and corrected in a
timely manner;
new text end

new text begin (10) adopt rules as necessary to carry out the duties assigned under this chapter;
new text end

new text begin (11) establish conflict of interest standards prohibiting providers from any financial
benefit from their medical decisions outside of board reimbursement;
new text end

new text begin (12) establish conflict of interest standards related to pharmaceutical marketing to
providers; and
new text end

new text begin (13) provide financial help and assistance in retraining and job placement to
Minnesota workers who may be displaced because of the administrative efficiencies of the
Minnesota Health Plan.
new text end

new text begin There is currently a serious shortage of providers in many health care professions,
from medical technologists to registered nurses, and many potentially displaced health
administrative workers already have training in some medical field. To alleviate these
shortages, the dislocated worker support program should emphasize retraining and
placement into health care related positions if appropriate. As Minnesota residents, all
displaced workers shall be covered under the Minnesota Health Plan.
new text end

new text begin Subd. 5. new text end

new text begin Waiver request duties. new text end

new text begin Before submitting a waiver application under
section 1332 of the Patient Protection and Affordable Care Act, Public Law Number
111-148, as amended, the board shall do the following, as required by federal law:
new text end

new text begin (1) conduct or contract for any necessary actuarial analyses and actuarial
certifications needed to support the board's estimates that the waiver will comply with the
comprehensive coverage, affordability, and scope of coverage requirements in federal law;
new text end

new text begin (2) conduct or contract for any necessary economic analyses needed to support
the board's estimates that the waiver will comply with the comprehensive coverage,
affordability, scope of coverage, and federal deficit requirements in federal law. These
analyses must include:
new text end

new text begin (i) a detailed ten-year budget plan; and
new text end

new text begin (ii) a detailed analysis regarding the estimated impact of the waiver on health
insurance coverage in the state;
new text end

new text begin (3) establish a detailed draft implementation timeline for the waiver plan; and
new text end

new text begin (4) establish quarterly, annual, and cumulative targets for the comprehensive
coverage, affordability, scope of coverage, and federal deficit requirements in federal law.
new text end

new text begin Subd. 6. new text end

new text begin Financial duties. new text end

new text begin The board shall:
new text end

new text begin (1) establish and collect premiums and the business health tax according to section
62W.20, subdivision 1;
new text end

new text begin (2) approve statewide and regional budgets that include budgets for the accounts
in section 62W.19;
new text end

new text begin (3) negotiate and establish payment rates for providers;
new text end

new text begin (4) monitor compliance with all budgets and payment rates and take action to
achieve compliance to the extent authorized by law;
new text end

new text begin (5) pay claims for medical products or services as negotiated, and may issue requests
for proposals from Minnesota nonprofit business corporations for a contract to process
claims;
new text end

new text begin (6) seek federal approval to bill other states for health care coverage provided to
residents from out-of-state who come to Minnesota for long-term care or other costly
treatment when the resident's home state fails to provide such coverage, unless a reciprocal
agreement with those states to provide similar coverage to Minnesota residents relocating
to those states can be negotiated;
new text end

new text begin (7) administer the Minnesota Health Fund created under section 62W.19;
new text end

new text begin (8) annually determine the appropriate level for the Minnesota Health Plan reserve
account and implement policies needed to establish the appropriate reserve;
new text end

new text begin (9) implement fraud prevention measures necessary to protect the operation of
the Minnesota Health Plan; and
new text end

new text begin (10) work to ensure appropriate cost control by:
new text end

new text begin (i) instituting aggressive public health measures, early intervention and preventive
care, health and wellness education, and promotion of personal health improvement;
new text end

new text begin (ii) making changes in the delivery of health care services and administration that
improve efficiency and care quality;
new text end

new text begin (iii) minimizing administrative costs;
new text end

new text begin (iv) ensuring that the delivery system does not contain excess capacity; and
new text end

new text begin (v) negotiating the lowest possible prices for prescription drugs, medical equipment,
and medical services.
new text end

new text begin If the board determines that there will be a revenue shortfall despite the cost control
measures mentioned in clause (10), the board shall implement measures to correct the
shortfall, including an increase in premiums and other revenues. The board shall report to
the legislature on the causes of the shortfall, reasons for the inadequacy of cost controls,
and measures taken to correct the shortfall.
new text end

new text begin Subd. 7. new text end

new text begin Minnesota Health Board management duties. new text end

new text begin The board shall:
new text end

new text begin (1) develop and implement enrollment procedures for the Minnesota Health Plan;
new text end

new text begin (2) implement eligibility standards for the Minnesota Health Plan;
new text end

new text begin (3) arrange for health care to be provided at convenient locations, including
ensuring the availability of school nurses so that all students have access to health care,
immunizations, and preventive care at public schools and encouraging providers to open
small health clinics at larger workplaces and retail centers;
new text end

new text begin (4) make recommendations, when needed, to the legislature about changes in the
geographic boundaries of the health planning regions;
new text end

new text begin (5) establish an electronic claims and payments system for the Minnesota Health Plan;
new text end

new text begin (6) monitor the operation of the Minnesota Health Plan through consumer surveys
and regular data collection and evaluation activities, including evaluations of the adequacy
and quality of services furnished under the program, the need for changes in the benefit
package, the cost of each type of service, and the effectiveness of cost control measures
under the program;
new text end

new text begin (7) disseminate information and establish a health care Web site to provide
information to the public about the Minnesota Health Plan including providers and
facilities, and state and regional health planning board meetings and activities;
new text end

new text begin (8) collaborate with public health agencies, schools, and community clinics;
new text end

new text begin (9) ensure that Minnesota Health Plan policies and providers, including public
health providers, support all Minnesota residents in achieving and maintaining maximum
physical and mental health; and
new text end

new text begin (10) annually report to the chairs and ranking minority members of the senate
and house of representatives committees with jurisdiction over health care issues on
the performance of the Minnesota Health Plan, fiscal condition and need for payment
adjustments, any needed changes in geographic boundaries of the health planning regions,
recommendations for statutory changes, receipt of revenue from all sources, whether
current year goals and priorities are met, future goals and priorities, major new technology
or prescription drugs, and other circumstances that may affect the cost or quality of health
care.
new text end

new text begin Subd. 8. new text end

new text begin Policy duties. new text end

new text begin The board shall:
new text end

new text begin (1) develop and implement cost control and quality assurance procedures;
new text end

new text begin (2) ensure strong public health services including education and community
prevention and clinical services;
new text end

new text begin (3) ensure a continuum of coordinated high-quality primary to tertiary care to all
Minnesota residents; and
new text end

new text begin (4) implement policies to ensure that all Minnesota residents receive culturally
and linguistically competent care.
new text end

new text begin Subd. 9. new text end

new text begin Self-insurance. new text end

new text begin The board shall determine the feasibility of self-insuring
providers for malpractice and shall establish a self-insurance system and create a special
fund for payment of losses incurred if the board determines self-insuring providers would
reduce costs.
new text end

Sec. 4.

new text begin [62W.07] HEALTH PLANNING REGIONS.
new text end

new text begin A metropolitan health planning region consisting of the seven-county metropolitan
area is established. By October 1, 2016, the commissioner of health shall designate five
rural health planning regions from the greater Minnesota area composed of geographically
contiguous counties grouped on the basis of the following considerations:
new text end

new text begin (1) patterns of utilization of health care services;
new text end

new text begin (2) health care resources, including workforce resources;
new text end

new text begin (3) health needs of the population, including public health needs;
new text end

new text begin (4) geography;
new text end

new text begin (5) population and demographic characteristics; and
new text end

new text begin (6) other considerations as appropriate.
new text end

new text begin The commissioner of health shall designate the health planning regions.
new text end

Sec. 5.

new text begin [62W.08] REGIONAL HEALTH PLANNING BOARD.
new text end

new text begin Subdivision 1. new text end

new text begin Regional planning board composition. new text end

new text begin (a) Each regional board
shall consist of one county commissioner per county selected by the county board and
two county commissioners per county selected by the county board in the seven-county
metropolitan area. A county commissioner may designate a representative to act as a
member of the board in the member's absence. Each board shall select the chair from
among its membership.
new text end

new text begin (b) Board members shall serve for four-year terms and may receive per diems for
meetings as provided in section 15.059, subdivision 3.
new text end

new text begin Subd. 2. new text end

new text begin Regional health board duties. new text end

new text begin Regional health planning boards shall:
new text end

new text begin (1) recommend health standards, goals, priorities, and guidelines for the region;
new text end

new text begin (2) prepare an operating and capital budget for the region to recommend to the
Minnesota Health Board;
new text end

new text begin (3) collaborate with local public health care agencies to educate consumers and
providers on public health programs, goals, and the means of reaching those goals;
new text end

new text begin (4) hire a regional health planning director;
new text end

new text begin (5) collaborate with public health care agencies to implement public health and
wellness initiatives; and
new text end

new text begin (6) ensure that all parts of the region have access to a 24-hour nurse hotline and
24-hour urgent care clinics.
new text end

Sec. 6.

new text begin [62W.09] OFFICE OF HEALTH QUALITY AND PLANNING.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The Minnesota Health Board shall establish an
Office of Health Quality and Planning to assess the quality, access, and funding adequacy
of the Minnesota Health Plan.
new text end

new text begin Subd. 2. new text end

new text begin General duties. new text end

new text begin (a) The Office of Health Quality and Planning shall make
annual recommendations to the board on the overall direction on subjects including:
new text end

new text begin (1) the overall effectiveness of the Minnesota Health Plan in addressing public
health and wellness;
new text end

new text begin (2) access to health care;
new text end

new text begin (3) quality improvement;
new text end

new text begin (4) efficiency of administration;
new text end

new text begin (5) adequacy of budget and funding;
new text end

new text begin (6) appropriateness of payments for providers;
new text end

new text begin (7) capital expenditure needs;
new text end

new text begin (8) long-term health care;
new text end

new text begin (9) mental health and substance abuse services;
new text end

new text begin (10) staffing levels and working conditions in health care facilities;
new text end

new text begin (11) identification of number and mix of health care facilities and providers required
to best meet the needs of the Minnesota Health Plan;
new text end

new text begin (12) care for chronically ill patients;
new text end

new text begin (13) educating providers on promoting the use of advance directives with patients to
enable patients to obtain the health care of their choice;
new text end

new text begin (14) research needs; and
new text end

new text begin (15) integration of disease management programs into health care delivery.
new text end

new text begin (b) Analyze shortages in health care workforce required to meet the needs of the
population and develop plans to meet those needs in collaboration with regional planners
and educational institutions.
new text end

new text begin (c) Analyze methods of paying providers and make recommendations to improve
quality and control costs.
new text end

new text begin (d) Assist in coordination of the Minnesota Health Plan and public health programs.
new text end

new text begin Subd. 3. new text end

new text begin Assessment and evaluation of benefits. new text end

new text begin (a) The Office of Health Quality
and Planning shall:
new text end

new text begin (1) consider health care benefit additions to the Minnesota Health Plan and evaluate
them based on evidence of clinical efficacy;
new text end

new text begin (2) establish a process and criteria by which providers may request authorization to
provide health care services and treatments that are not included in the Minnesota Health
Plan benefit set, including experimental health care treatments;
new text end

new text begin (3) evaluate proposals to increase the efficiency and effectiveness of the health care
delivery system, and make recommendations to the board based on the cost-effectiveness
of the proposals; and
new text end

new text begin (4) identify complementary and alternative health care modalities that have been
shown to be safe and effective.
new text end

new text begin (b) The board may convene advisory panels as needed.
new text end

Sec. 7.

new text begin [62W.10] ETHICS AND CONFLICT OF INTEREST.
new text end

new text begin (a) All provisions of section 43A.38 apply to employees and the chief executive
officer of the Minnesota Health Plan, the members and directors of the Minnesota Health
Board, the regional health boards, the director of the Office of Health Quality and
Planning, the director of the Minnesota Health Fund, and the ombudsman for patient
advocacy. Failure to comply with section 43A.38 shall be grounds for disciplinary action
which may include termination of employment or removal from the board.
new text end

new text begin (b) In order to avoid the appearance of political bias or impropriety, the Minnesota
Health Plan chief executive officer shall not:
new text end

new text begin (1) engage in leadership of, or employment by, a political party or a political
organization;
new text end

new text begin (2) publicly endorse a political candidate;
new text end

new text begin (3) contribute to any political candidates or political parties and political
organizations; or
new text end

new text begin (4) attempt to avoid compliance with this subdivision by making contributions
through a spouse or other family member.
new text end

new text begin (c) In order to avoid a conflict of interest, individuals specified in paragraph (a) shall
not be currently employed by a medical provider or a pharmaceutical, medical insurance,
or medical supply company. This paragraph does not apply to the five provider members
of the board.
new text end

Sec. 8.

new text begin [62W.11] CONFLICT OF INTEREST COMMITTEE.
new text end

new text begin (a) The board shall establish a conflict of interest committee to develop standards
of practice for individuals or entities doing business with the Minnesota Health Plan,
including but not limited to, board members, providers, and medical suppliers. The
committee shall establish guidelines on the duty to disclose the existence of a financial
interest and all material facts related to that financial interest to the committee.
new text end

new text begin (b) In considering the transaction or arrangement, if the committee determines
a conflict of interest exists, the committee shall investigate alternatives to the proposed
transaction or arrangement. After exercising due diligence, the committee shall
determine whether the Minnesota Health Plan can obtain with reasonable efforts a more
advantageous transaction or arrangement with a person or entity that would not give
rise to a conflict of interest. If this is not reasonably possible under the circumstances,
the committee shall make a recommendation to the board on whether the transaction
or arrangement is in the best interest of the Minnesota Health Plan, and whether the
transaction is fair and reasonable. The committee shall provide the board with all material
information used to make the recommendation. After reviewing all relevant information,
the board shall decide whether to approve the transaction or arrangement.
new text end

Sec. 9.

new text begin [62W.12] OMBUDSMAN OFFICE FOR PATIENT ADVOCACY.
new text end

new text begin Subdivision 1. new text end

new text begin Creation of office; generally. new text end

new text begin (a) The Ombudsman Office for
Patient Advocacy is created to represent the interests of the consumers of health care. The
ombudsman shall help residents of the state secure the health care services and health care
benefits they are entitled to under the laws administered by the Minnesota Health Board
and advocate on behalf of and represent the interests of enrollees in entities created by
this chapter and in other forums.
new text end

new text begin (b) The ombudsman shall be a patient advocate appointed by the governor, who
serves in the unclassified service and may be removed only for just cause. The ombudsman
must be selected without regard to political affiliation and must be knowledgeable about
and have experience in health care services and administration.
new text end

new text begin (c) The ombudsman may gather information about decisions, acts, and other matters
of the Minnesota Health Board, health care organization, or a health care program. A
person may not serve as ombudsman while holding another public office.
new text end

new text begin (d) The budget for the ombudsman's office shall be determined by the legislature and
is independent from the Minnesota Health Board. The ombudsman shall establish offices
to provide convenient access to residents.
new text end

new text begin (e) The Minnesota Health Board has no oversight or authority over the ombudsman
for patient advocacy.
new text end

new text begin Subd. 2. new text end

new text begin Ombudsman's duties. new text end

new text begin The ombudsman shall:
new text end

new text begin (1) ensure that patient advocacy services are available to all Minnesota residents;
new text end

new text begin (2) establish and maintain the grievance process according to section 62W.13;
new text end

new text begin (3) receive, evaluate, and respond to consumer complaints about the Minnesota
Health Plan;
new text end

new text begin (4) establish a process to receive recommendations from the public about ways to
improve the Minnesota Health Plan;
new text end

new text begin (5) develop educational and informational guides according to communication
services under section 15.441, describing consumer rights and responsibilities;
new text end

new text begin (6) ensure the guides in clause (5) are widely available to consumers and specifically
available in provider offices and health care facilities; and
new text end

new text begin (7) prepare an annual report about the consumer perspective on the performance of
the Minnesota Health Plan, including recommendations for needed improvements.
new text end

Sec. 10.

new text begin [62W.13] GRIEVANCE SYSTEM.
new text end

new text begin Subdivision 1. new text end

new text begin Grievance system established. new text end

new text begin The ombudsman shall establish a
grievance system for all complaints. The system shall provide a process that ensures
adequate consideration of Minnesota Health Plan enrollee grievances and appropriate
remedies.
new text end

new text begin Subd. 2. new text end

new text begin Referral of grievances. new text end

new text begin The ombudsman may refer any grievance that
does not pertain to compliance with this chapter to the federal Centers for Medicare and
Medicaid Services or any other appropriate local, state, and federal government entity
for investigation and resolution.
new text end

new text begin Subd. 3. new text end

new text begin Submittal by designated agents and providers. new text end

new text begin A provider may join
with, or otherwise assist, a complainant to submit the grievance to the ombudsman.
A provider or an employee of a provider who, in good faith, joins with or assists a
complainant in submitting a grievance is subject to the protections and remedies under
sections 181.931 to 181.935.
new text end

new text begin Subd. 4. new text end

new text begin Review of documents. new text end

new text begin The ombudsman may require additional
information from health care providers or the board.
new text end

new text begin Subd. 5. new text end

new text begin Written notice of disposition. new text end

new text begin The ombudsman shall send a written
notice of the final disposition of the grievance, and the reasons for the decision, to the
complainant, to any provider who is assisting the complainant, and to the board, within 30
calendar days of receipt of the request for review unless the ombudsman determines that
additional time is reasonably necessary to fully and fairly evaluate the relevant grievance.
The ombudsman's order of corrective action shall be binding on the Minnesota Health
Plan. A decision of the ombudsman is subject to de novo review by the district court.
new text end

new text begin Subd. 6. new text end

new text begin Data. new text end

new text begin Data on enrollees collected because an enrollee submits a complaint
to the ombudsman are private data on individuals as defined in section 13.02, subdivision
12, but may be released to a provider who is the subject of the complaint or to the board
for purposes of this section.
new text end

Sec. 11.

new text begin [62W.14] AUDITOR GENERAL FOR THE MINNESOTA HEALTH
PLAN.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin There is within the Office of the Legislative Auditor
an auditor general for health care fraud and abuse for the Minnesota Health Plan who is
appointed by the legislative auditor.
new text end

new text begin Subd. 2. new text end

new text begin Duties. new text end

new text begin The auditor general shall:
new text end

new text begin (1) investigate, audit, and review the financial and business records of individuals,
public and private agencies and institutions, and private corporations that provide services
or products to the Minnesota Health Plan, the costs of which are reimbursed by the
Minnesota Health Plan;
new text end

new text begin (2) investigate allegations of misconduct on the part of an employee or appointee
of the Minnesota Health Board and on the part of any provider of health care services
that is reimbursed by the Minnesota Health Plan, and report any findings of misconduct
to the attorney general;
new text end

new text begin (3) investigate fraud and abuse;
new text end

new text begin (4) arrange for the collection and analysis of data needed to investigate the
inappropriate utilization of these products and services; and
new text end

new text begin (5) annually report recommendations for improvements to the Minnesota Health
Plan to the board.
new text end

Sec. 12.

new text begin [62W.15] MINNESOTA HEALTH PLAN POLICIES AND
PROCEDURES; RULEMAKING.
new text end

new text begin Subdivision 1. new text end

new text begin Exempt rules. new text end

new text begin The Minnesota Health Plan policies and procedures
are exempt from the Administrative Procedure Act but, to the extent authorized by law to
adopt rules, the board may use the provisions of section 14.386, paragraph (a), clauses (1)
and (3). Section 14.386, paragraph (b), does not apply to these rules.
new text end

new text begin Subd. 2. new text end

new text begin Rulemaking procedures. new text end

new text begin (a) Whenever the board determines that a rule
should be adopted under this section establishing, modifying, or revoking a policy or
procedure, the board shall publish in the State Register the proposed policy or procedure
and shall afford interested persons a period of 30 days after publication to submit written
data or comments.
new text end

new text begin (b) On or before the last day of the period provided for the submission of written
data or comments, any interested person may file with the board written objections to the
proposed rule, stating the grounds for objection and requesting a public hearing on those
objections. Within 30 days after the last day for filing objections, the board shall publish
in the State Register a notice specifying the policy or procedure to which objections have
been filed and a hearing requested and specifying a time and place for the hearing.
new text end

new text begin Subd. 3. new text end

new text begin Rule adoption. new text end

new text begin Within 60 days after the expiration of the period provided
for the submission of written data or comments, or within 60 days after the completion
of any hearing, the board shall issue a rule adopting, modifying, or revoking a policy or
procedure, or make a determination that a rule should not be adopted. The rule may contain
a provision delaying its effective date for such period as the board determines is necessary.
new text end

Sec. 13.

Minnesota Statutes 2014, section 14.03, subdivision 3, is amended to read:


Subd. 3.

Rulemaking procedures.

(a) The definition of a rule in section 14.02,
subdivision 4
, does not include:

(1) rules concerning only the internal management of the agency or other agencies
that do not directly affect the rights of or procedures available to the public;

(2) an application deadline on a form; and the remainder of a form and instructions
for use of the form to the extent that they do not impose substantive requirements other
than requirements contained in statute or rule;

(3) the curriculum adopted by an agency to implement a statute or rule permitting
or mandating minimum educational requirements for persons regulated by an agency,
provided the topic areas to be covered by the minimum educational requirements are
specified in statute or rule;

(4) procedures for sharing data among government agencies, provided these
procedures are consistent with chapter 13 and other law governing data practices.

(b) The definition of a rule in section 14.02, subdivision 4, does not include:

(1) rules of the commissioner of corrections relating to the release, placement, term,
and supervision of inmates serving a supervised release or conditional release term, the
internal management of institutions under the commissioner's control, and rules adopted
under section 609.105 governing the inmates of those institutions;

(2) rules relating to weight limitations on the use of highways when the substance
of the rules is indicated to the public by means of signs;

(3) opinions of the attorney general;

(4) the data element dictionary and the annual data acquisition calendar of the
Department of Education to the extent provided by section 125B.07;

(5) the occupational safety and health standards provided in section 182.655;

(6) revenue notices and tax information bulletins of the commissioner of revenue;

(7) uniform conveyancing forms adopted by the commissioner of commerce under
section 507.09;

(8) standards adopted by the Electronic Real Estate Recording Commission
established under section 507.0945; deleted text beginor
deleted text end

(9) the interpretive guidelines developed by the commissioner of human services to
the extent provided in chapter 245Adeleted text begin.deleted text endnew text begin; or
new text end

new text begin (10) policies and procedures adopted by the Minnesota Health Board under chapter
62W.
new text end

ARTICLE 7

IMPLEMENTATION

Section 1. new text beginAPPROPRIATION.
new text end

new text begin $....... is appropriated in fiscal year 2016 from the general fund to the Minnesota
Health Fund under the Minnesota Health Plan to provide start-up funding for the
provisions of this act.
new text end

Sec. 2. new text beginEFFECTIVE DATE AND TRANSITION.
new text end

new text begin Subdivision 1. new text end

new text begin Notice and effective date. new text end

new text begin This act is effective the day following final
enactment. The commissioner of management and budget shall notify the chairs of the
house of representatives and senate committees with jurisdiction over health care when the
Minnesota Health Fund has sufficient revenues to fund the costs of implementing this act.
new text end

new text begin Subd. 2. new text end

new text begin Timing to implement. new text end

new text begin The Minnesota Health Plan must be operational
within two years from the date of final enactment of this act.
new text end

new text begin Subd. 3. new text end

new text begin Prohibition. new text end

new text begin On and after the day the Minnesota Health Plan becomes
operational, a health plan, as defined in Minnesota Statutes, section 62Q.01, subdivision 3,
may not be sold in Minnesota for services provided by the Minnesota Health Plan.
new text end

new text begin Subd. 4. new text end

new text begin Transition. new text end

new text begin (a) The commissioners of health and human services shall
prepare an analysis of the state's capital expenditure needs for the purpose of assisting
the board in adopting the statewide capital budget for the year following implementation.
The commissioners shall submit this analysis to the board.
new text end

new text begin (b) The following timelines shall be implemented:
new text end

new text begin (1) the commissioner of health shall designate the health planning regions utilizing
the criteria specified in Minnesota Statutes, section 62W.07, three months after the date
of enactment of this act;
new text end

new text begin (2) the regional boards shall be established six months after the date of enactment
of this act; and
new text end

new text begin (3) the Minnesota Health Board shall be established nine months after the date of
enactment of this act; and
new text end

new text begin (4) the commissioner of health, or the commissioner's designee, shall convene the
first meeting of each of the regional boards and the Minnesota Health Board within 30
days after each of the boards has been established.
new text end