Minnesota Legislature
SF 2518
1st Engrossment - 89th Legislature (2015 - 2016) Posted on 04/05/2016 08:48am
Current Version - 1st Engrossment
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A bill for an act
relating to human services; modifying county-based purchasing plan contract
negotiations; amending Minnesota Statutes 2014, sections 256B.69, subdivision
35; 256B.692, subdivisions 5, 6, 7, by adding a subdivision; 256B.694.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2014, section 256B.69, subdivision 35, is amended to
read:
Subd. 35.
Statewide procurement.
(a) For calendar year 2015, the commissioner
may extend a demonstration provider's contract under this section for a sixth year after
the most recent procurement. For calendar year 2015, section 16B.98, subdivision 5,
paragraph (b), and section 16C.05, subdivision 2, paragraph (b), shall not apply to
contracts under this section.
(b) For calendar year 2016 contracts under this section, the commissioner shall
procure through a statewide procurement, which includes all 87 counties, demonstration
providers, and participating entities as defined in section 256L.01, subdivision 7. The
commissioner shall publish a request for proposals by January 5, 2015. As part of the
procurement process, the commissioner shall:
(1) seek each individual county's input;
(2) organize counties into regional groups, and consider single counties for the
largest and most diverse counties; and
(3) seek regional and county input regarding the respondent's ability to fully and
adequately deliver required health care services, offer an adequate provider network,
provide care coordination with county services, and serve special populations, including
enrollees with language and cultural needs.
new text begin
(c) Any statewide procurement process occurring after calendar year 2016, shall not
include counties participating in a county-based purchasing plan. Procurement for these
counties shall be governed by section 256B.692, subdivision 5a.
new text end
Sec. 2.
Minnesota Statutes 2014, section 256B.692, subdivision 5, is amended to read:
Subd. 5.
County proposals.
(a) A county board that wishes to purchase or provide
health care under this section must submit a preliminary proposal that substantially
demonstrates the county's ability to meet all the requirements of this section in response
to criteria for proposals issued by the department. Counties submitting preliminary
proposals must establish a local planning process that involves input from medical
assistance recipients, recipient advocates, providers and representatives of local school
districts, labor, and tribal government to advise on the development of a final proposal
and its implementation.
(b) The county board must submit a final proposal that demonstrates the ability to
meet all the requirements of this section.
(c) For a county in which the prepaid medical assistance program is in existence, the
county board must submit a preliminary proposal at least 15 months prior to termination of
health plan contracts in that county and a final proposal six months prior to the health plan
contract termination date in order to begin enrollment after the termination. Nothing in
this section shall impede or delay implementation or continuation of the prepaid medical
assistance program in counties for which the board does not submit a proposal, or submits
a proposal that is not in compliance with this section.
new text begin
(d) Once a county or group of counties has elected to implement county-based
purchasing and continues to elect, through a procurement process, to purchase or provide
health care services as provided in this section, the commissioner shall not terminate or
fail to renew the county-based purchasing plan in that county or group of counties, except
as permitted in subdivision 6, paragraph (b).
new text end
Sec. 3.
Minnesota Statutes 2014, section 256B.692, is amended by adding a
subdivision to read:
new text begin Subd. 5a. new text end
new text begin Procurement. new text end
new text begin
(a) Procurement for a county or group of counties that has
implemented a county-based purchasing plan shall occur every five years or earlier upon
the request of the county or group of counties.
new text end
new text begin
(b) The county or group of counties shall be defined as a distinct geographic region
for the purposes of defining the procurement's service areas. The technical specifications
shall be specific to the service area and place a priority on initiatives within the region.
new text end
new text begin
(c) Requests for proposal under this procurement shall be consistent with the
requirements of section 256B.69, but shall also consider the unique nature of county-based
purchasing plans and evaluate the plans on provider network access, coordination,
and integration with the counties for the provision of health care with other local
community-based services. The existence of programs or services already developed and
in place in the counties shall be considered.
new text end
new text begin
(d) Requests for proposal shall require responders to submit a price bid as part of the
procurement, but the price bid shall not be considered as part of the evaluation criteria.
The commissioner may consider a request from the county or group of counties to include
price in the evaluation criteria.
new text end
new text begin
(e) Each county or group of counties that has elected to participate in a county-based
purchasing plan under the authority of this section shall have the authority, after reviewing
all proposals, to continue to provide health care services directly through a county-based
purchasing plan.
new text end
new text begin
(f) In each county or group of counties that elects to purchase or provide health care
services under this section, the county-based purchasing plan shall be the single plan
providing the services. If plan choice is required by federal regulation, the number of
plans shall be limited to two plans in the county with the county-based purchasing plan
being the default plan when assignments are made due to enrollees not making a plan
choice at the time of enrollment.
new text end
new text begin
(g) The requirements under this subdivision do not apply to procurement for the
MinnesotaCare program as defined in sections 256L.12 and 256L.121. The commissioner
shall coordinate the procurement of MinnesotaCare to the extent practicable with medical
assistance in accordance with this subdivision.
new text end
Sec. 4.
Minnesota Statutes 2014, section 256B.692, subdivision 6, is amended to read:
Subd. 6.
Commissioner's authority.
new text begin (a) new text end The commissioner maydeleted text begin :
deleted text end
deleted text begin (1)deleted text end reject any preliminary or final proposal that:
deleted text begin (a)deleted text end new text begin (1)new text end substantially fails to meet the requirements of this section, deleted text begin or
deleted text end
deleted text begin (b) thatdeleted text end new text begin (2)new text end the commissioner determines would substantially impair the state's
ability to purchase health care services in other areas of the state, deleted text begin or
deleted text end
deleted text begin (c)deleted text end new text begin (3)new text end would substantially impair an enrollee's choice of care systems when
reasonable choice is possible, or
deleted text begin (d)deleted text end new text begin (4)new text end would substantially impair the implementation and operation of the
Minnesota senior health options demonstration project authorized under section 256B.69,
subdivision 23deleted text begin ; and
deleted text end
deleted text begin (2) assume operation of a county's purchasing of health care for enrollees in medical
assistance in the event that the contract with the county is terminateddeleted text end .
new text begin
(b) If a county or group of counties is providing health care through a county-based
purchasing plan and the county, group of counties, or the plan substantially fails to comply
with the applicable requirements of this section or section 256B.69, or the county or group
of counties elects to cease providing health care through a county-based purchasing plan,
the commissioner may terminate the contract with the county or group of counties and
shall assume the operation of purchasing health care for enrollees covered under the
county-based purchasing plan upon the termination of the contract subject to subdivision 7.
new text end
Sec. 5.
Minnesota Statutes 2014, section 256B.692, subdivision 7, is amended to read:
Subd. 7.
Dispute resolution.
In the event the commissioner rejects a proposal
under subdivision 6, new text begin paragraph (a), or the commissioner intends to terminate the contract
with the county under subdivision 6, paragraph (b), new text end the county board new text begin or a single entity
representing a group of county boards, new text end may request the recommendation of a three-person
mediation panel. The commissioner shall resolve all disputes after taking into account the
recommendations of the mediation panel. The panel shall be composed of one designee
of the deleted text begin president of thedeleted text end Association of Minnesota Countiesnew text begin , in consultation with the
requesting county board or the single entity representing a group of county boardsnew text end , one
designee of the commissioner of human services, and one person selected jointly by the
designee of the commissioner of human services and the designee of the Association of
Minnesota Counties. Within a reasonable period of time before the hearing, the panelists
new text begin and parties to the mediation, new text end must be provided all documents and information relevant to
the mediation. The parties to the mediation must be given 30 days' notice of a hearing
before the mediation panel.
Sec. 6.
Minnesota Statutes 2014, section 256B.694, is amended to read:
256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
CONTRACT.
The commissioner shall consider, and may approve, contracting on a single-health
plan basis with deleted text begin county-based purchasing plans, or with other qualifieddeleted text end health plans that
have coordination arrangements with counties, to serve persons enrolled in state public
health care programs, in order to promote better coordination or integration of health
care services, social services and other community-based services, provided that all
requirements applicable to health plan purchasing, including those in deleted text begin sectionsdeleted text end new text begin section
new text end 256B.69 deleted text begin and 256B.692deleted text end , are satisfied.
Sec. 7. new text begin FEDERAL APPROVAL.
new text end
new text begin
The commissioner of human services shall seek all federal waiver authority
necessary to implement sections 1 to 6.
new text end
Sec. 8. new text begin EFFECTIVE DATE.
new text end
new text begin
Sections 1 to 6 are effective January 1, 2017, or upon federal approval, whichever
occurs later. Section 7 is effective the day following final enactment.
new text end