4th Engrossment - 93rd Legislature (2023 - 2024) Posted on 10/25/2023 09:39am
A bill for an act
relating to state government; modifying provisions governing health care, health
insurance, health policy, the Department of Health, medical education and research
costs, health care workforce, health-related licensing boards, background studies,
human services licensing, behavioral health, economic assistance, housing and
homelessness, children and families, child care workforce, child support, child
safety, child permanency, health care affordability and delivery, human services
policy, and certified community behavioral health clinics; establishing the
Department of Children, Youth, and Families; making technical and conforming
changes; requiring reports; making forecast adjustments; appropriating money;
amending Minnesota Statutes 2022, sections 4.045; 10.65, subdivision 2; 12A.08,
subdivision 3; 13.10, subdivision 5; 13.46, subdivision 4; 13.465, subdivision 8;
15.01; 15.06, subdivision 1; 15A.0815, subdivision 2; 16A.151, subdivision 2;
43A.08, subdivision 1a; 62A.045; 62A.30, by adding subdivisions; 62A.673,
subdivision 2; 62J.03, by adding a subdivision; 62J.17, subdivision 5a; 62J.692,
subdivisions 1, 3, 4, 5, 8; 62J.824; 62J.84, subdivisions 2, 3, 4, 6, 7, 8, 9, by adding
subdivisions; 62K.10, subdivision 4; 62K.15; 62Q.01, by adding a subdivision;
62Q.021, by adding a subdivision; 62Q.55, subdivision 5; 62Q.556; 62Q.56,
subdivision 2; 62Q.675; 62Q.73, subdivisions 1, 7; 62U.01, by adding a subdivision;
62U.04, subdivisions 4, 5, 5a, 11, by adding subdivisions; 62V.05, subdivision
4a; 103I.005, subdivisions 17a, 20a, by adding a subdivision; 103I.208, subdivision
2, by adding a subdivision; 119B.011, subdivisions 2, 3, 5, 13, 15, 19a; 119B.02,
subdivision 4; 119B.025, subdivision 4; 119B.03, subdivisions 3, 4a; 119B.05,
subdivision 1; 119B.09, subdivision 7; 119B.095, subdivisions 2, 3; 119B.10,
subdivisions 1, 3; 119B.105, subdivision 2; 119B.125, subdivisions 1, 1a, 1b, 2,
3, 4, 6, 7; 119B.13, subdivisions 1, 4, 6; 119B.16, subdivisions 1a, 1c, 3; 119B.161,
subdivisions 2, 3; 119B.19, subdivision 7; 121A.335; 122A.18, subdivision 8;
144.122; 144.1481, subdivision 1; 144.1501, subdivision 2; 144.1505; 144.1506,
subdivision 4; 144.2151; 144.218, subdivisions 1, 2; 144.222; 144.225, subdivision
2; 144.2252; 144.226, subdivisions 3, 4; 144.382, by adding subdivisions; 144.55,
subdivision 3; 144.615, subdivision 7; 144.651, by adding a subdivision; 144.6535,
subdivisions 1, 2, 4; 144.69; 144.9501, subdivisions 9, 17, 26a, 26b, by adding
subdivisions; 144.9505, subdivisions 1, 1g, 1h; 144.9508, subdivision 2; 144A.06,
subdivision 2; 144A.071, subdivision 2; 144A.073, subdivision 3b; 144A.474,
subdivisions 3, 9, 12; 144A.4791, subdivision 10; 144E.001, subdivision 1, by
adding a subdivision; 144E.101, subdivisions 6, 7, 12; 144E.103, subdivision 1;
144E.35; 144G.16, subdivision 7; 144G.18; 144G.57, subdivision 8; 145.411,
subdivisions 1, 5; 145.4131, subdivisions 1, 2; 145.4134; 145.423, subdivision 1;
145.4716, subdivision 3; 145.87, subdivision 4; 145.924; 145.925; 145A.131,
subdivisions 1, 2, 5; 145A.14, by adding a subdivision; 147.02, subdivision 1;
147.03, subdivision 1; 147.037, subdivision 1; 147.141; 147A.16; 147B.02,
subdivisions 4, 7; 148.261, subdivision 1; 148.512, subdivisions 10a, 10b, by
adding subdivisions; 148.513, by adding a subdivision; 148.515, subdivision 6;
148.5175; 148.5195, subdivision 3; 148.5196, subdivision 1; 148.5197; 148.5198;
148B.392, subdivision 2; 150A.08, subdivisions 1, 5; 150A.091, by adding a
subdivision; 150A.13, subdivision 10; 151.065, subdivisions 1, 2, 3, 4, 6; 151.37,
subdivision 12; 151.555; 151.74, subdivisions 3, 4; 152.126, subdivisions 4, 5, 6;
152.28, subdivision 1; 152.29, subdivision 3a; 153A.13, subdivisions 3, 4, 5, 6, 7,
9, 10, 11, by adding subdivisions; 153A.14, subdivisions 1, 2, 2h, 2i, 2j, 4, 4a, 4b,
4c, 4e, 6, 9, 11, by adding a subdivision; 153A.15, subdivisions 1, 2, 4; 153A.17;
153A.175; 153A.18; 153A.20; 168B.07, subdivision 3; 245.095; 245.462,
subdivision 17; 245.4661, subdivision 9; 245.4663, subdivisions 1, 4; 245.469,
subdivision 3; 245.4889, subdivision 1; 245.4901, subdivision 4, by adding a
subdivision; 245.735, subdivisions 3, 5, 6, by adding subdivisions; 245A.02,
subdivisions 2c, 5a, 6b, 10b, by adding a subdivision; 245A.03, subdivision 2;
245A.04, subdivisions 1, 4, 7, 7a; 245A.041, by adding a subdivision; 245A.05;
245A.055, subdivision 2; 245A.06, subdivisions 1, 2, 4; 245A.07, subdivisions 1,
2a, 3; 245A.10, subdivisions 3, 4; 245A.11, by adding a subdivision; 245A.14,
subdivision 4; 245A.1435; 245A.146, subdivision 3; 245A.16, subdivisions 1, 9,
by adding subdivisions; 245A.18, subdivision 2; 245A.50, subdivisions 3, 4, 5, 6,
9; 245A.52, subdivisions 1, 3, 5, by adding a subdivision; 245A.66, by adding a
subdivision; 245C.02, subdivisions 6a, 11c, 13e, by adding subdivisions; 245C.03,
subdivisions 1, 1a, 4, 5, 5a; 245C.031, subdivisions 1, 4; 245C.04, subdivision 1;
245C.05, subdivisions 1, 2c, 4, by adding a subdivision; 245C.07; 245C.08,
subdivision 1; 245C.10, subdivisions 1d, 2, 2a, 3, 4, 5, 6, 8, 9, 9a, 10, 11, 12, 13,
14, 15, 16, 17, 20, 21; 245C.15, subdivision 2, by adding a subdivision; 245C.17,
subdivisions 2, 3, 6; 245C.21, subdivisions 1a, 2; 245C.22, subdivision 7; 245C.23,
subdivisions 1, 2; 245C.30, subdivision 2; 245C.31, subdivision 1; 245C.32,
subdivision 2; 245C.33, subdivision 4; 245D.261, subdivision 3, as added if enacted;
245E.06, subdivision 3; 245G.01, by adding a subdivision; 245G.03, subdivision
1; 245G.11, subdivision 10; 245G.13, subdivision 2; 245H.01, subdivisions 3, 5,
by adding a subdivision; 245H.02; 245H.03, subdivisions 2, 4, by adding a
subdivision; 245H.05; 245H.06, subdivisions 1, 2; 245H.07, subdivisions 1, 2;
245H.08, subdivisions 4, 5; 245H.13, subdivisions 3, 7, 9; 245I.011, subdivision
3; 245I.04, subdivisions 14, 16; 245I.05, subdivision 3; 245I.08, subdivisions 2,
3, 4; 245I.10, subdivisions 2, 3, 5, 6, 7, 8; 245I.11, subdivisions 3, 4; 245I.20,
subdivisions 5, 6, 10, 13, 14, 16; 246.54, subdivision 1a, as amended if enacted;
254B.02, subdivision 5; 254B.05, subdivisions 1, 1a; 256.01, by adding a
subdivision; 256.014, subdivisions 1, 2; 256.046, subdivisions 1, 3; 256.0471,
subdivision 1; 256.478, subdivisions 1, 2, by adding subdivisions; 256.962,
subdivision 5; 256.9655, by adding a subdivision; 256.9685, subdivisions 1a, 1b;
256.9686, by adding a subdivision; 256.969, subdivisions 2b, 9, 25, by adding a
subdivision; 256.98, subdivision 8; 256.983, subdivision 5; 256.987, subdivision
4; 256B.04, subdivisions 14, 15, by adding a subdivision; 256B.051, subdivision
5; 256B.055, subdivision 17; 256B.056, subdivision 7, by adding a subdivision;
256B.0622, subdivisions 7b, 7c, 8; 256B.0623, subdivision 4; 256B.0624,
subdivisions 5, 8; 256B.0625, subdivisions 3a, 5m, 9, 13, 13c, 13e, 13f, 13g, 16,
28b, 30, 31, 34, by adding subdivisions; 256B.0631, subdivisions 1, 3, by adding
a subdivision; 256B.064; 256B.0652, subdivision 5; 256B.0757, subdivision 4c;
256B.0941, subdivisions 2a, 3, by adding subdivisions; 256B.0946, subdivisions
4, 6; 256B.0947, subdivisions 7, 7a; 256B.27, subdivision 3; 256B.434, subdivision
4f; 256B.69, subdivision 5a, by adding subdivisions; 256B.692, subdivision 2;
256B.75; 256B.758; 256B.76, subdivision 1, as amended; 256B.761; 256B.763;
256B.764; 256D.01, subdivision 1a; 256D.02, by adding a subdivision; 256D.024,
subdivision 1; 256D.03, by adding a subdivision; 256D.06, subdivision 5; 256D.07;
256D.44, subdivision 5; 256D.63, subdivision 2; 256E.34, subdivision 4; 256E.35,
subdivisions 1, 2, 3, 4a, 6, 7; 256I.03, subdivisions 7, 13, 15, by adding a
subdivision; 256I.04, subdivisions 1, 2, 3; 256I.05, subdivisions 1a, 2; 256I.06,
subdivisions 3, 6, 8, by adding a subdivision; 256I.09; 256J.01, subdivision 1;
256J.02, subdivision 2; 256J.08, subdivisions 21, 65, 71, 79; 256J.09, subdivisions
3, 10; 256J.11, subdivision 1; 256J.21, subdivisions 3, 4; 256J.26, subdivision 1;
256J.33, subdivisions 1, 2; 256J.35; 256J.37, subdivisions 3, 3a; 256J.40; 256J.42,
subdivision 5; 256J.425, subdivisions 1, 4, 5, 7; 256J.46, subdivisions 1, 2, 2a;
256J.49, subdivision 9; 256J.50, subdivision 1; 256J.521, subdivision 1; 256J.621,
subdivision 1; 256J.626, subdivisions 2, 3; 256J.751, subdivision 2; 256J.95,
subdivision 5; 256K.45, subdivisions 3, 7, by adding a subdivision; 256L.03,
subdivisions 1, 5; 256L.04, subdivision 10; 256N.24, subdivision 12; 256P.01, by
adding subdivisions; 256P.02, subdivisions 1a, 2, by adding subdivisions; 256P.04,
subdivisions 4, 8, by adding a subdivision; 256P.06, subdivision 3, by adding
subdivisions; 256P.07, subdivisions 1, 2, 3, 4, 6, 7, by adding subdivisions; 259.83,
subdivisions 1, 1a, 1b, by adding a subdivision; 260.761, subdivision 2, as amended;
260C.007, subdivisions 14, 26d; 260C.221, subdivision 1; 260C.317, subdivisions
3, 4; 260C.80, subdivision 1; 260E.01; 260E.02, subdivision 1; 260E.03,
subdivision 22, by adding subdivisions; 260E.09; 260E.14, subdivisions 2, 5;
260E.17, subdivision 1; 260E.18; 260E.20, subdivision 2; 260E.24, subdivisions
2, 7; 260E.33, subdivision 1; 260E.35, subdivision 6; 261.063; 270B.14, subdivision
1, by adding a subdivision; 297F.10, subdivision 1; 403.161, subdivisions 1, 3, 5,
6, 7; 403.162, subdivisions 1, 2, 5; 514.972, subdivision 5; 518A.31; 518A.32,
subdivisions 3, 4; 518A.34; 518A.39, subdivision 2; 518A.41; 518A.42,
subdivisions 1, 3; 518A.43, subdivision 1b; 518A.65; 518A.77; 524.5-118;
609B.425, subdivision 2; 609B.435, subdivision 2; Laws 2017, First Special
Session chapter 6, article 5, section 11, as amended; Laws 2021, First Special
Session chapter 7, article 1, section 36, as amended; article 2, section 84; article
6, section 26; article 14, section 23; article 16, sections 2, subdivision 32, as
amended; 3, subdivision 2, as amended; 28, as amended; article 17, sections 5,
subdivision 1; 6, as amended; 12, as amended; Laws 2022, chapter 99, article 1,
section 46; article 3, section 9; Laws 2023, chapter 52, article 5, section 27; article
7, sections 12; 16; 2023 S.F. No. 2934, article 9, section 2, subdivision 16, if
enacted; proposing coding for new law in Minnesota Statutes, chapters 4; 62J;
62Q; 62V; 103I; 115; 119B; 144; 144E; 145; 145A; 148; 245; 245A; 245C; 256;
256B; 256D; 256E; 256K; 256P; 260; 290; proposing coding for new law as
Minnesota Statutes, chapter 143; repealing Minnesota Statutes 2022, sections
62J.692, subdivisions 4a, 7, 7a; 62J.84, subdivision 5; 62Q.145; 62U.10,
subdivisions 6, 7, 8; 119B.011, subdivision 10a; 119B.03, subdivision 4; 137.38,
subdivision 1; 144.059, subdivision 10; 144.212, subdivision 11; 144.9505,
subdivision 3; 145.411, subdivisions 2, 4; 145.412; 145.413, subdivisions 2, 3;
145.4132; 145.4133; 145.4135; 145.4136; 145.415; 145.416; 145.423, subdivisions
2, 3, 4, 5, 6, 7, 8, 9; 145.4235; 145.4241; 145.4242; 145.4243; 145.4244; 145.4245;
145.4246; 145.4247; 145.4248; 145.4249; 153A.14, subdivision 5; 245A.22;
245C.02, subdivisions 9, 14b; 245C.031, subdivisions 5, 6, 7; 245C.032; 245C.11,
subdivision 3; 245C.30, subdivision 1a; 245C.301; 256.8799; 256.9685,
subdivisions 1c, 1d; 256.9864; 256B.011; 256B.0631, subdivisions 1, 2, 3; 256B.40;
256B.69, subdivision 5c; 256B.763; 256D.63, subdivision 1; 256I.03, subdivision
6; 256J.08, subdivisions 10, 24b, 53, 61, 62, 81, 83; 256J.30, subdivisions 5, 7, 8;
256J.33, subdivisions 3, 4, 5; 256J.34, subdivisions 1, 2, 3, 4; 256J.37, subdivision
10; 256J.425, subdivision 6; 256J.95, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11,
12, 13, 14, 15, 16, 17, 18, 19; 256P.07, subdivision 5; 259.83, subdivision 3;
259.89; 260C.637; 261.28; 393.07, subdivision 11; 518A.59; Minnesota Rules,
parts 4615.3600; 4640.1500; 4640.1600; 4640.1700; 4640.1800; 4640.1900;
4640.2000; 4640.2100; 4640.2200; 4640.2300; 4640.2400; 4640.2500; 4640.2600;
4640.2700; 4640.2800; 4640.2900; 4640.3000; 4640.3100; 4640.3200; 4640.3300;
4640.3400; 4640.3500; 4640.3600; 4640.3700; 4640.3800; 4640.3900; 4640.4000;
4640.4100; 4640.4200; 4640.4300; 4640.6100; 4640.6200; 4640.6300; 4640.6400;
4645.0300; 4645.0400; 4645.0500; 4645.0600; 4645.0700; 4645.0800; 4645.0900;
4645.1000; 4645.1100; 4645.1200; 4645.1300; 4645.1400; 4645.1500; 4645.1600;
4645.1700; 4645.1800; 4645.1900; 4645.2000; 4645.2100; 4645.2200; 4645.2300;
4645.2400; 4645.2500; 4645.2600; 4645.2700; 4645.2800; 4645.2900; 4645.3000;
4645.3100; 4645.3200; 4645.3300; 4645.3400; 4645.3500; 4645.3600; 4645.3700;
4645.3800; 4645.3805; 4645.3900; 4645.4000; 4645.4100; 4645.4200; 4645.4300;
4645.4400; 4645.4500; 4645.4600; 4645.4700; 4645.4800; 4645.4900; 4645.5100;
4645.5200; 4700.1900; 4700.2000; 4700.2100; 4700.2210; 4700.2300, subparts
1, 3, 4, 4a, 5; 4700.2410; 4700.2420; 4700.2500; 5610.0100; 5610.0200; 5610.0300;
9505.0235; 9505.0505, subpart 18; 9505.0520, subpart 9b.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Minnesota Statutes 2022, section 256.01, is amended by adding a subdivision
to read:
new text begin
The commissioner shall require hospitals
and primary care providers serving medical assistance and MinnesotaCare enrollees to
develop and implement protocols to provide enrollees, when appropriate, with comprehensive
and scientifically accurate information on the full range of contraceptive options, in a
medically ethical, culturally competent, and noncoercive manner. The information provided
must be designed to assist enrollees in identifying the contraceptive method that best meets
their needs and the needs of their families. The protocol must specify the enrollee categories
to which this requirement will be applied, the process to be used, and the information and
resources to be provided. Hospitals and providers must make this protocol available to the
commissioner upon request.
new text end
new text begin
This section is effective January 1, 2024.
new text end
Minnesota Statutes 2022, section 256.0471, subdivision 1, is amended to read:
Any overpayment for assistance granted under
deleted text begin chapter 119B,deleted text end the MFIP program formerly codified under sections 256.031 to 256.0361deleted text begin ,deleted text end
and the AFDC program formerly codified under sections 256.72 to 256.871;new text begin for assistance
granted undernew text end chapters deleted text begin 256B for state-funded medical assistancedeleted text end new text begin 119Bnew text end , 256D, 256I, 256J,new text begin
andnew text end 256Kdeleted text begin , and 256Ldeleted text end new text begin ;new text end fornew text begin assistance granted pursuant to section 256.045, subdivision 10,
for state-funded medical assistance andnew text end state-funded MinnesotaCarenew text begin under chapters 256B
and 256Lnew text end ; andnew text begin for assistance granted undernew text end the Supplemental Nutrition Assistance Program
(SNAP), except agency error claims, become a judgment by operation of law 90 days after
the notice of overpayment is personally served upon the recipient in a manner that is sufficient
under rule 4.03(a) of the Rules of Civil Procedure for district courts, or by certified mail,
return receipt requested. This judgment shall be entitled to full faith and credit in this and
any other state.
new text begin
This section is effective July 1, 2023.
new text end
Minnesota Statutes 2022, section 256.9655, is amended by adding a subdivision
to read:
new text begin
(a) In paying claims under medical assistance, the
commissioner shall comply with Code of Federal Regulations, title 42, section 447.45.
new text end
new text begin
(b) If the commissioner does not pay or deny a clean claim within the period provided
in paragraph (a), the commissioner must pay interest on the claim for the period beginning
on the day after the required payment date specified in paragraph (a) and ending on the date
on which the commissioner makes the payment or denies the claim.
new text end
new text begin
(c) The rate of interest paid by the commissioner under this subdivision must be 1.5
percent per month or any part of a month.
new text end
new text begin
This section is effective the day following final enactment.
new text end
Minnesota Statutes 2022, section 256.969, subdivision 2b, is amended to read:
(a) For discharges occurring on or after November
1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according
to the following:
(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
methodology;
(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology
under subdivision 25;
(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
distinct parts as defined by Medicare shall be paid according to the methodology under
subdivision 12; and
(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not
be rebased, except that a Minnesota long-term hospital shall be rebased effective January
1, 2011, based on its most recent Medicare cost report ending on or before September 1,
2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on
December 31, 2010. For rate setting periods after November 1, 2014, in which the base
years are updated, a Minnesota long-term hospital's base year shall remain within the same
period as other hospitals.
(c) Effective for discharges occurring on and after November 1, 2014, payment rates
for hospital inpatient services provided by hospitals located in Minnesota or the local trade
area, except for the hospitals paid under the methodologies described in paragraph (a),
clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
manner similar to Medicare. The base year or years for the rates effective November 1,
2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral,
ensuring that the total aggregate payments under the rebased system are equal to the total
aggregate payments that were made for the same number and types of services in the base
year. Separate budget neutrality calculations shall be determined for payments made to
critical access hospitals and payments made to hospitals paid under the DRG system. Only
the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being
rebased during the entire base period shall be incorporated into the budget neutrality
calculation.
(d) For discharges occurring on or after November 1, 2014, through the next rebasing
that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph
(a), clause (4), shall include adjustments to the projected rates that result in no greater than
a five percent increase or decrease from the base year payments for any hospital. Any
adjustments to the rates made by the commissioner under this paragraph and paragraph (e)
shall maintain budget neutrality as described in paragraph (c).
(e) For discharges occurring on or after November 1, 2014, the commissioner may make
additional adjustments to the rebased rates, and when evaluating whether additional
adjustments should be made, the commissioner shall consider the impact of the rates on the
following:
(1) pediatric services;
(2) behavioral health services;
(3) trauma services as defined by the National Uniform Billing Committee;
(4) transplant services;
(5) obstetric services, newborn services, and behavioral health services provided by
hospitals outside the seven-county metropolitan area;
(6) outlier admissions;
(7) low-volume providers; and
(8) services provided by small rural hospitals that are not critical access hospitals.
(f) Hospital payment rates established under paragraph (c) must incorporate the following:
(1) for hospitals paid under the DRG methodology, the base year payment rate per
admission is standardized by the applicable Medicare wage index and adjusted by the
hospital's disproportionate population adjustment;
(2) for critical access hospitals, payment rates for discharges between November 1, 2014,
and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
October 31, 2014;
(3) the cost and charge data used to establish hospital payment rates must only reflect
inpatient services covered by medical assistance; and
(4) in determining hospital payment rates for discharges occurring on or after the rate
year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per
discharge shall be based on the cost-finding methods and allowable costs of the Medicare
program in effect during the base year or years. In determining hospital payment rates for
discharges in subsequent base years, the per discharge rates shall be based on the cost-finding
methods and allowable costs of the Medicare program in effect during the base year or
years.
(g) The commissioner shall validate the rates effective November 1, 2014, by applying
the rates established under paragraph (c), and any adjustments made to the rates under
paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the
total aggregate payments for the same number and types of services under the rebased rates
are equal to the total aggregate payments made during calendar year 2013.
(h) Effective for discharges occurring on or after July 1, 2017, and every two years
thereafter, payment rates under this section shall be rebased to reflect only those changes
in hospital costs between the existing base year or years and the next base year or years. In
any year that inpatient claims volume falls below the threshold required to ensure a
statistically valid sample of claims, the commissioner may combine claims data from two
consecutive years to serve as the base year. Years in which inpatient claims volume is
reduced or altered due to a pandemic or other public health emergency shall not be used as
a base year or part of a base year if the base year includes more than one year. Changes in
costs between base years shall be measured using the lower of the hospital cost index defined
in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per
claim. The commissioner shall establish the base year for each rebasing period considering
the most recent year or years for which filed Medicare cost reports are availablenew text begin , except
that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019new text end .
The estimated change in the average payment per hospital discharge resulting from a
scheduled rebasing must be calculated and made available to the legislature by January 15
of each year in which rebasing is scheduled to occur, and must include by hospital the
differential in payment rates compared to the individual hospital's costs.
(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates
for critical access hospitals located in Minnesota or the local trade area shall be determined
using a new cost-based methodology. The commissioner shall establish within the
methodology tiers of payment designed to promote efficiency and cost-effectiveness.
Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
the total cost for critical access hospitals as reflected in base year cost reports. Until the
next rebasing that occurs, the new methodology shall result in no greater than a five percent
decrease from the base year payments for any hospital, except a hospital that had payments
that were greater than 100 percent of the hospital's costs in the base year shall have their
rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and
after July 1, 2016, covered under this paragraph shall be increased by the inflation factor
in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not
be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the
following criteria:
(1) hospitals that had payments at or below 80 percent of their costs in the base year
shall have a rate set that equals 85 percent of their base year costs;
(2) hospitals that had payments that were above 80 percent, up to and including 90
percent of their costs in the base year shall have a rate set that equals 95 percent of their
base year costs; and
(3) hospitals that had payments that were above 90 percent of their costs in the base year
shall have a rate set that equals 100 percent of their base year costs.
(j) The commissioner may refine the payment tiers and criteria for critical access hospitals
to coincide with the next rebasing under paragraph (h). The factors used to develop the new
methodology may include, but are not limited to:
(1) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's charges to the medical assistance program;
(2) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;
(3) the ratio between the hospital's charges to the medical assistance program and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;
(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
(5) the proportion of that hospital's costs that are administrative and trends in
administrative costs; and
(6) geographic location.
new text begin
This section is effective July 1, 2023.
new text end
Minnesota Statutes 2022, section 256.969, subdivision 9, is amended to read:
(a) For admissions
occurring on or after July 1, 1993, the medical assistance disproportionate population
adjustment shall comply with federal law and shall be paid to a hospital, excluding regional
treatment centers and facilities of the federal Indian Health Service, with a medical assistance
inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined
as follows:
(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic
mean for all hospitals excluding regional treatment centers and facilities of the federal Indian
Health Service but less than or equal to one standard deviation above the mean, the
adjustment must be determined by multiplying the total of the operating and property
payment rates by the difference between the hospital's actual medical assistance inpatient
utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers
and facilities of the federal Indian Health Service; and
(2) for a hospital with a medical assistance inpatient utilization rate above one standard
deviation above the mean, the adjustment must be determined by multiplying the adjustment
that would be determined under clause (1) for that hospital by 1.1. The commissioner shall
report annually on the number of hospitals likely to receive the adjustment authorized by
this paragraph. The commissioner shall specifically report on the adjustments received by
public hospitals and public hospital corporations located in cities of the first class.
(b) Certified public expenditures made by Hennepin County Medical Center shall be
considered Medicaid disproportionate share hospital payments. Hennepin County and
Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning
July 1, 2005, or another date specified by the commissioner, that may qualify for
reimbursement under federal law. Based on these reports, the commissioner shall apply for
federal matching funds.
(c) Upon federal approval of the related state plan amendment, paragraph (b) is effective
retroactively from July 1, 2005, or the earliest effective date approved by the Centers for
Medicare and Medicaid Services.
(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid
in accordance with a new methodology using 2012 as the base year. Annual payments made
under this paragraph shall equal the total amount of payments made for 2012. A licensed
children's hospital shall receive only a single DSH factor for children's hospitals. Other
DSH factors may be combined to arrive at a single factor for each hospital that is eligible
for DSH payments. The new methodology shall make payments only to hospitals located
in Minnesota and include the following factors:
(1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the
base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000
fee-for-service discharges in the base year shall receive a factor of 0.7880;
(2) a hospital that has in effect for the initial rate year a contract with the commissioner
to provide extended psychiatric inpatient services under section 256.9693 shall receive a
factor of 0.0160;
(3) a hospital that has received medical assistance payment for at least 20 transplant
services in the base year shall receive a factor of 0.0435;
(4) a hospital that has a medical assistance utilization rate in the base year between 20
percent up to one standard deviation above the statewide mean utilization rate shall receive
a factor of 0.0468;
(5) a hospital that has a medical assistance utilization rate in the base year that is at least
one standard deviation above the statewide mean utilization rate but is less than two and
one-half standard deviations above the mean shall receive a factor of 0.2300; and
(6) a hospital that is a level one trauma center and that has a medical assistance utilization
rate in the base year that is at least two and deleted text begin one-halfdeleted text end new text begin one-quarternew text end standard deviations above
the statewide mean utilization rate shall receive a factor of 0.3711.
(e) For the purposes of determining eligibility for the disproportionate share hospital
factors in paragraph (d), clauses (1) to (6), the medical assistance utilization rate and
discharge thresholds shall be measured using only one year when a two-year base period
is used.
(f) Any payments or portion of payments made to a hospital under this subdivision that
are subsequently returned to the commissioner because the payments are found to exceed
the hospital-specific DSH limit for that hospital shall be redistributed, proportionate to the
number of fee-for-service discharges, to other DSH-eligible non-children's hospitals that
have a medical assistance utilization rate that is at least one standard deviation above the
mean.
(g) An additional payment adjustment shall be established by the commissioner under
this subdivision for a hospital that provides high levels of administering high-cost drugs to
enrollees in fee-for-service medical assistance. The commissioner shall consider factors
including fee-for-service medical assistance utilization rates and payments made for drugs
purchased through the 340B drug purchasing program and administered to fee-for-service
enrollees. If any part of this adjustment exceeds a hospital's hospital-specific disproportionate
share hospital limit, the commissioner shall make a payment to the hospital that equals the
nonfederal share of the amount that exceeds the limit. The total nonfederal share of the
amount of the payment adjustment under this paragraph shall not exceed $1,500,000.
Minnesota Statutes 2022, section 256.969, subdivision 25, is amended to read:
(a) Long-term hospitals shall be paid on a per diem
basis.
(b) For admissions occurring on or after April 1, 1995, a long-term hospital as designated
by Medicare that does not have admissions in the base year shall have inpatient rates
established at the average of other hospitals with the same designation. For subsequent
rate-setting periods in which base years are updated, the hospital's base year shall be the
first Medicare cost report filed with the long-term hospital designation and shall remain in
effect until it falls within the same period as other hospitals.
new text begin
(c) For admissions occurring on or after July 1, 2023, long-term hospitals must be paid
the higher of a per diem amount computed using the methodology described in subdivision
2b, paragraph (i), or the per diem rate as of July 1, 2021.
new text end
new text begin
This section is effective July 1, 2023.
new text end
Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to
read:
new text begin
(a) The commissioner must provide
separate reimbursement to hospitals for long-acting reversible contraceptives provided
immediately postpartum in the inpatient hospital setting. This payment must be in addition
to the diagnostic related group reimbursement for labor and delivery and shall be made
consistent with section 256B.0625, subdivision 13e, paragraph (e).
new text end
new text begin
(b) The commissioner must require managed care and county-based purchasing plans
to comply with this subdivision when providing services to medical assistance enrollees.
If, for any contract year, federal approval is not received for this paragraph, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this provision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this paragraph
applies must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed the amount equal
to any increase in rates that results from this provision. This paragraph expires if federal
approval is not received for this paragraph at any time.
new text end
new text begin
This section is effective January 1, 2024.
new text end
Minnesota Statutes 2022, section 256B.04, subdivision 14, is amended to read:
(a) When determined to be effective, economical, and
feasible, the commissioner may utilize volume purchase through competitive bidding and
negotiation under the provisions of chapter 16C, to provide items under the medical assistance
program including but not limited to the following:
(1) eyeglasses;
(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
on a short-term basis, until the vendor can obtain the necessary supply from the contract
dealer;
(3) hearing aids and supplies;
(4) durable medical equipment, including but not limited to:
(i) hospital beds;
(ii) commodes;
(iii) glide-about chairs;
(iv) patient lift apparatus;
(v) wheelchairs and accessories;
(vi) oxygen administration equipment;
(vii) respiratory therapy equipment;
(viii) electronic diagnostic, therapeutic and life-support systems; and
(ix) allergen-reducing products as described in section 256B.0625, subdivision 67,
paragraph (c) or (d);
(5) nonemergency medical transportation level of need determinations, disbursement of
public transportation passes and tokens, and volunteer and recipient mileage and parking
reimbursements; deleted text begin and
deleted text end
(6) drugsdeleted text begin .deleted text end new text begin ; and
new text end
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(7) quitline services as described in section 256B.0625, subdivision 68, paragraph (c).
new text end
(b) Rate changes and recipient cost-sharing under this chapter and chapter 256L do not
affect contract payments under this subdivision unless specifically identified.
(c) The commissioner may not utilize volume purchase through competitive bidding
and negotiation under the provisions of chapter 16C for special transportation services or
incontinence products and related supplies.
new text begin
This section is effective January 1, 2024.
new text end
Minnesota Statutes 2022, section 256B.055, subdivision 17, is amended to read:
new text begin (a) new text end Medical assistance may
be paid for a person under 26 years of age who was in foster care under the commissioner's
responsibility on the date of attaining 18new text begin , 19, or 20new text end years of age, and who was enrolled in
medical assistance under the state plan or a waiver of the plan while in foster care, in
accordance with section 2004 of the Affordable Care Act.
new text begin
(b) Medical assistance may be paid for a person under 26 years of age who was in foster
care and enrolled in any state's Medicaid program as provided by Public Law 115-271,
section 1002.
new text end
new text begin
(c) The commissioner shall seek federal waiver approval under United States Code, title
42, section 1315, to include youth who were in a state's foster care program and who turned
age 18 prior to January 1, 2023, without regard to potential eligibility under a Medicaid
mandatory group.
new text end
new text begin
This section is effective the day following final enactment.
new text end
Minnesota Statutes 2022, section 256B.0622, subdivision 8, is amended to read:
(a) Payment for intensive residential treatment
services and assertive community treatment in this section shall be based on one daily rate
per provider inclusive of the following services received by an eligible client in a given
calendar day: all rehabilitative services under this section, staff travel time to provide
rehabilitative services under this section, and nonresidential crisis stabilization services
under section 256B.0624.
(b) Except as indicated in paragraph (c), payment will not be made to more than one
entity for each client for services provided under this section on a given day. If services
under this section are provided by a team that includes staff from more than one entity, the
team must determine how to distribute the payment among the members.
(c) The commissioner shall determine one rate for each provider that will bill medical
assistance for residential services under this section and one rate for each assertive community
treatment provider. If a single entity provides both services, one rate is established for the
entity's residential services and another rate for the entity's nonresidential services under
this section. A provider is not eligible for payment under this section without authorization
from the commissioner. The commissioner shall develop rates using the following criteria:
(1) the provider's cost for services shall include direct services costs, other program
costs, and other costs determined as follows:
(i) the direct services costs must be determined using actual costs of salaries, benefits,
payroll taxes, and training of direct service staff and service-related transportation;
(ii) other program costs not included in item (i) must be determined as a specified
percentage of the direct services costs as determined by item (i). The percentage used shall
be determined by the commissioner based upon the average of percentages that represent
the relationship of other program costs to direct services costs among the entities that provide
similar services;
(iii) physical plant costs calculated based on the percentage of space within the program
that is entirely devoted to treatment and programming. This does not include administrative
or residential space;
(iv) assertive community treatment physical plant costs must be reimbursed as part of
the costs described in item (ii); and
(v) subject to federal approval, up to an additional five percent of the total rate may be
added to the program rate as a quality incentive based upon the entity meeting performance
criteria specified by the commissioner;
(2) actual cost is defined as costs which are allowable, allocable, and reasonable, and
consistent with federal reimbursement requirements under Code of Federal Regulations,
title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
Budget Circular Number A-122, relating to nonprofit entities;
(3) the number of service units;
(4) the degree to which clients will receive services other than services under this section;
and
(5) the costs of other services that will be separately reimbursed.
(d) The rate for intensive residential treatment services and assertive community treatment
must exclude room and board, as defined in section 256I.03, subdivision 6, and services
not covered under this section, such as partial hospitalization, home care, and inpatient
services.
(e) Physician services that are not separately billed may be included in the rate to the
extent that a psychiatrist, or other health care professional providing physician services
within their scope of practice, is a member of the intensive residential treatment services
treatment team. Physician services, whether billed separately or included in the rate, may
be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
is used to provide intensive residential treatment services.
(f) When services under this section are provided by an assertive community treatment
provider, case management functions must be an integral part of the team.
(g) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payors.
(h) The rates for existing programs must be established prospectively based upon the
expenditures and utilization over a prior 12-month period using the criteria established in
paragraph (c). The rates for new programs must be established based upon estimated
expenditures and estimated utilization using the criteria established in paragraph (c).
new text begin
(i) Effective for the rate years beginning on and after January 1, 2024, rates for assertive
community treatment, adult residential crisis stabilization services, and intensive residential
treatment services must be annually adjusted for inflation using the Centers for Medicare
and Medicaid Services Medicare Economic Index, as forecasted in the fourth quarter of the
calendar year before the rate year. The inflation adjustment must be based on the 12-month
period from the midpoint of the previous rate year to the midpoint of the rate year for which
the rate is being determined.
new text end
deleted text begin (i)deleted text end new text begin (j)new text end Entities who discontinue providing services must be subject to a settle-up process
whereby actual costs and reimbursement for the previous 12 months are compared. In the
event that the entity was paid more than the entity's actual costs plus any applicable
performance-related funding due the provider, the excess payment must be reimbursed to
the department. If a provider's revenue is less than actual allowed costs due to lower
utilization than projected, the commissioner may reimburse the provider to recover its actual
allowable costs. The resulting adjustments by the commissioner must be proportional to the
percent of total units of service reimbursed by the commissioner and must reflect a difference
of greater than five percent.
deleted text begin (j)deleted text end new text begin (k)new text end A provider may request of the commissioner a review of any rate-setting decision
made under this subdivision.
new text begin
This section is effective January 1, 2024, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Minnesota Statutes 2022, section 256B.0625, subdivision 9, is amended to read:
(a) Medical assistance coversnew text begin medically necessarynew text end dental
services.
deleted text begin
(b) Medical assistance dental coverage for nonpregnant adults is limited to the following
services:
deleted text end
deleted text begin
(1) comprehensive exams, limited to once every five years;
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deleted text begin
(2) periodic exams, limited to one per year;
deleted text end
deleted text begin
(3) limited exams;
deleted text end
deleted text begin
(4) bitewing x-rays, limited to one per year;
deleted text end
deleted text begin
(5) periapical x-rays;
deleted text end
deleted text begin
(6) panoramic x-rays, limited to one every five years except (1) when medically necessary
for the diagnosis and follow-up of oral and maxillofacial pathology and trauma or (2) once
every two years for patients who cannot cooperate for intraoral film due to a developmental
disability or medical condition that does not allow for intraoral film placement;
deleted text end
deleted text begin
(7) prophylaxis, limited to one per year;
deleted text end
deleted text begin