SF 3010

as introduced - 92nd Legislature (2021 - 2022) Posted on 02/18/2022 09:50am

A bill for an act
relating to human services; modifying payments made to behavioral health home
providers; amending Minnesota Statutes 2020, section 256B.0757, subdivisions
1, 2, 3, 4, 5, 8.

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

Section 1.

Minnesota Statutes 2020, section 256B.0757, subdivision 1, is amended to read:

Subdivision 1.

Provision of coverage.

(a) The commissioner shall provide medical
assistance coverage of new text begin behavioral new text end health home services for eligible individuals with chronic
conditions who select a designated provider as the individual's new text begin behavioral new text end health home.

(b) The commissioner shall implement this section in compliance with the requirements
of the state option to provide new text begin behavioral new text end health homes for enrollees with chronic conditions,
as provided under the Patient Protection and Affordable Care Act, Public Law 111-148,
sections 2703 and 3502. Terms used in this section have the meaning provided in that act.

(c) The commissioner shall establish new text begin behavioral new text end health homes to serve populations with
serious mental illness who meet the eligibility requirements described under subdivision 2.
The new text begin behavioral new text end health home services provided by new text begin behavioral new text end health homes shall focus on
both the behavioral and the physical health of these populations.

Sec. 2.

Minnesota Statutes 2020, section 256B.0757, subdivision 2, is amended to read:

Subd. 2.

Eligible individual.

(a) The commissioner may elect to develop new text begin behavioral
new text end health home models in accordance with United States Code, title 42, section 1396w-4.

(b) An individual is eligible for new text begin behavioral new text end health home services under this section if
the individual is eligible for medical assistance under this chapter and has a condition that
meets the definition of mental illness as described in section 245.462, subdivision 20,
paragraph (a), or emotional disturbance as defined in section 245.4871, subdivision 15,
clause (2). The commissioner shall establish criteria for determining continued eligibility.

Sec. 3.

Minnesota Statutes 2020, section 256B.0757, subdivision 3, is amended to read:

Subd. 3.

new text begin Behavioral new text end health home services.

(a) new text begin Behavioral new text end health home services means
comprehensive and timely high-quality services that are provided by a new text begin behavioral new text end health
home. These services include:

(1) comprehensive care management;

(2) care coordination and health promotion;

(3) comprehensive transitional care, including appropriate follow-up, from inpatient to
other settings;

(4) patient and family support, including authorized representatives;

(5) referral to community and social support services, if relevant; and

(6) use of health information technology to link services, as feasible and appropriate.

(b) The commissioner shall maximize the number and type of services included in this
subdivision to the extent permissible under federal law, including physician, outpatient,
mental health treatment, and rehabilitation services necessary for comprehensive transitional
care following hospitalization.

Sec. 4.

Minnesota Statutes 2020, section 256B.0757, subdivision 4, is amended to read:

Subd. 4.

Designated provider.

new text begin Behavioral new text end health home services are voluntary and an
eligible individual may choose any designated provider. The commissioner shall establish
designated providers to serve as new text begin behavioral new text end health homes and provide the services described
in subdivision 3 to individuals eligible under subdivision 2. The commissioner shall apply
for grants as provided under section 3502 of the Patient Protection and Affordable Care Act
to establish new text begin behavioral new text end health homes and provide capitated payments to designated providers.
For purposes of this section, "designated provider" means a provider, clinical practice or
clinical group practice, rural clinic, community health center, community mental health
center, or any other entity that is determined by the commissioner to be qualified to be a
new text begin behavioral new text end health home for eligible individuals. This determination must be based on
documentation evidencing that the designated provider has the systems and infrastructure
in place to provide new text begin behavioral new text end health home services and satisfies the qualification standards
established by the commissioner in consultation with stakeholders and approved by the
Centers for Medicare and Medicaid Services.

Sec. 5.

Minnesota Statutes 2020, section 256B.0757, subdivision 5, is amended to read:

Subd. 5.

Payments.

The commissioner shall deleted text begin make payments to each designated provider
for the provision of deleted text end new text begin establish a single statewide reimbursement rate for behavioral new text end health
home services deleted text begin described in subdivision 3 to each eligible individual under subdivision 2
that selects the health home as a provider deleted text end new text begin under this section new text end . new text begin In setting this rate, the
commissioner must include input from stakeholders, including providers of the services.
The statewide reimbursement rate shall be adjusted annually by the Medicare Economic
Index.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256B.0757, subdivision 8, is amended to read:

Subd. 8.

Evaluation and continued development.

(a) For continued certification under
this section, new text begin behavioral new text end health homes must meet process, outcome, and quality standards
developed and specified by the commissioner. The commissioner shall collect data from
new text begin behavioral new text end health homes as necessary to monitor compliance with certification standards.

(b) The commissioner may contract with a private entity to evaluate patient and family
experiences, health care utilization, and costs.

(c) The commissioner shall utilize findings from the implementation of behavioral health
homes to determine populations to serve under subsequent health home models for individuals
with chronic conditions.