SF 2422

1st Engrossment - 89th Legislature (2015 - 2016) Posted on 03/18/2016 09:13am

A bill for an act
relating to human services; establishing a health care program for low-income
uninsured adults and children who are ineligible for medical assistance or
MinnesotaCare; proposing coding for new law in Minnesota Statutes, chapter
256L.

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

Section 1.

new text begin [256L.30] LOW-INCOME UNINSURED HEALTH CARE PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin (a) The commissioner shall establish a program that
provides coverage to low-income uninsured adults and children.
new text end

new text begin (b) A child or adult is eligible for the program under this section if the child's or
adult's family income is equal to or less than 200 percent of the federal poverty guidelines,
adjusted for family size, and if the child or adult meets all other eligibility requirements
under this chapter, with the exception of the citizenship requirements under section
256L.04, subdivision 10.
new text end

new text begin (c) Children and adults who are eligible for medical assistance under chapter 256B
or MinnesotaCare under this chapter, or advance premium tax credits under the Affordable
Care Act, are not eligible for the program under this section.
new text end

new text begin (d) All application, navigation services, eligibility determination, enrollment,
disenrollment, and premium requirements and procedures of the MinnesotaCare program
apply to this program, except as otherwise specified in this section.
new text end

new text begin Subd. 2. new text end

new text begin Covered services. new text end

new text begin (a) The program covers the services described under
section 256L.03, except as otherwise specified in this subdivision. Children and adults with
family income of less than 138 percent of the federal poverty guidelines are also eligible for
the services covered under section 256B.0625 that are not covered under section 256L.03.
new text end

new text begin (b) The program does not cover services for an emergency medical condition that
are covered by emergency medical assistance under section 256B.06, subdivision 4,
paragraphs (e) to (h). The commissioner shall coordinate the program with the federally
subsidized emergency medical assistance program with the goal of making transitions
between the programs seamless and invisible to the enrollee to the extent possible.
new text end

new text begin Subd. 3. new text end

new text begin Premiums and cost-sharing. new text end

new text begin For children and adults who are eligible
under subdivision 1, the premium and cost-sharing provisions of the MinnesotaCare
program shall apply.
new text end

new text begin Subd. 4. new text end

new text begin Service delivery. new text end

new text begin (a) The commissioner may contract with managed
care plans, county-based purchasing plans, provider networks, nonprofit coverage
programs, counties, or health care delivery systems established under section 256B.0755
or 256B.0756 to administer the program authorized under this section and may delegate to
a contractor the responsibility of performing case reviews and authorize payment. The
commissioner may administer the program through a fee-for-service payment system
in rural areas and other regions in the state, if other delivery options are not feasible
or appropriate.
new text end

new text begin (b) The commissioner shall ensure that each eligible child and adult is provided the
opportunity to receive covered services from any essential community provider, as defined
in section 62Q.19, and that the terms of participation of the essential community provider
conform with the requirements of section 62Q.19.
new text end

new text begin Subd. 5. new text end

new text begin Information. new text end

new text begin The commissioner shall ensure that information collected
under this section is only used by the commissioner for eligibility determination, payment,
or program administration or coverage as established under this section.
new text end

Sec. 2. new text begin FEDERAL APPROVAL.
new text end

new text begin The commissioner of human services shall seek federal approval for changes to the
emergency medical assistance program to allow coverage and payment for cost-effective
community-based and outpatient services as an alternative to hospital inpatient and
emergency department services to reduce the total cost of care.
new text end