SF 2524

as introduced - 89th Legislature (2015 - 2016) Posted on 03/11/2016 09:12am

A bill for an act
relating to human services; increasing reimbursement rates for a critical access
hospital; appropriating money; amending Minnesota Statutes 2014, section
256.969, by adding a subdivision; Minnesota Statutes 2015 Supplement, section
256B.766.

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

Section 1.

Minnesota Statutes 2014, section 256.969, is amended by adding a
subdivision to read:

new text begin Subd. 31. new text end

new text begin Payment rate adjustments for certain critical access hospitals. new text end

new text begin The
commissioner shall increase by 200 percent the medical assistance payment rate as
determined under this section for inpatient hospital services provided by publicly owned
critical access hospitals located in Mahnomen County. The commissioner may not adjust
payments made to managed care plans and county-based purchasing plans to reflect
payments under this subdivision. The commissioner may not include payments under this
subdivision in budget neutrality calculations for critical access hospitals.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for discharges occurring on or after
July 1, 2016.
new text end

Sec. 2.

Minnesota Statutes 2015 Supplement, section 256B.766, is amended to read:

256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.

(a) Effective for services provided on or after July 1, 2009, total payments for basic
care services, shall be reduced by three percent, except that for the period July 1, 2009,
through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
assistance and general assistance medical care programs, prior to third-party liability and
spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
therapy services, occupational therapy services, and speech-language pathology and
related services as basic care services. The reduction in this paragraph shall apply to
physical therapy services, occupational therapy services, and speech-language pathology
and related services provided on or after July 1, 2010.

(b) Payments made to managed care plans and county-based purchasing plans shall
be reduced for services provided on or after October 1, 2009, to reflect the reduction
effective July 1, 2009, and payments made to the plans shall be reduced effective October
1, 2010, to reflect the reduction effective July 1, 2010.

(c) Effective for services provided on or after September 1, 2011, through June 30,
2013, total payments for outpatient hospital facility fees shall be reduced by five percent
from the rates in effect on August 31, 2011.

(d) Effective for services provided on or after September 1, 2011, through June
30, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
and durable medical equipment not subject to a volume purchase contract, prosthetics
and orthotics, renal dialysis services, laboratory services, public health nursing services,
physical therapy services, occupational therapy services, speech therapy services,
eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
purchase contract, and anesthesia services shall be reduced by three percent from the
rates in effect on August 31, 2011.

(e) Effective for services provided on or after September 1, 2014, payments
for ambulatory surgery centers facility fees, hospice services, renal dialysis services,
laboratory services, public health nursing services, eyeglasses not subject to a volume
purchase contract, and hearing aids not subject to a volume purchase contract shall be
increased by three percent and payments for outpatient hospital facility fees shall be
increased by three percent. Payments made to managed care plans and county-based
purchasing plans shall not be adjusted to reflect payments under this paragraph.

(f) Payments for medical supplies and durable medical equipment not subject to a
volume purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014,
through June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies
and durable medical equipment not subject to a volume purchase contract, and prosthetics
and orthotics, provided on or after July 1, 2015, shall be increased by three percent from
the rates as determined under paragraph (i).

(g) Effective for services provided on or after July 1, 2015, payments for outpatient
hospital facility fees, medical supplies and durable medical equipment not subject to a
volume purchase contract, prosthetics and orthotics, and laboratory services to a hospital
meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4),
shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments made
to managed care plans and county-based purchasing plans shall not be adjusted to reflect
payments under this paragraph.

(h) This section does not apply to physician and professional services, inpatient
hospital services, family planning services, mental health services, dental services,
prescription drugs, medical transportation, federally qualified health centers, rural health
centers, Indian health services, and Medicare cost-sharing.

(i) Effective July 1, 2015, the medical assistance payment rate for durable medical
equipment, prosthetics, orthotics, or supplies shall be restored to the January 1, 2008,
medical assistance fee schedule, updated to include subsequent rate increases in the
Medicare and medical assistance fee schedules, and including individually priced
items for the following categories: enteral nutrition and supplies, customized and other
specialized tracheostomy tubes and supplies, electric patient lifts, and durable medical
equipment repair and service. This paragraph does not apply to medical supplies and
durable medical equipment subject to a volume purchase contract, products subject to the
preferred diabetic testing supply program, and items provided to dually eligible recipients
when Medicare is the primary payer for the item.

new text begin (j) Notwithstanding section 256B.767 and Minnesota Rules, part 9505.0455, the
commissioner shall increase by 200 percent medical assistance payments to publicly
owned critical access hospitals located in Mahnomen County for outpatient hospital facility
fees, emergency room facility fees, ambulatory surgery hospital fees, emergency services,
surgery services, basic care services, medical supplies and equipment, and prosthetics and
orthotics. The increase under this paragraph also applies to laboratory and x-ray services
performed by the hospitals. The commissioner may not adjust payments made to managed
care plans and county-based purchasing plans to reflect payments under this paragraph.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for services provided on or after
July 1, 2016.
new text end

Sec. 3. new text begin APPROPRIATION.
new text end

new text begin $....... in fiscal year 2017 is appropriated from the general fund to the commissioner
of human services for the purposes of payment rate increases under Minnesota Statutes,
sections 256.969, subdivision 31, and 256B.766, paragraph (j).
new text end