SF 3238

as introduced - 86th Legislature (2009 - 2010) Posted on 03/12/2010 03:35pm

A bill for an act
relating to health; modifying the definition of an essential community provider;
amending Minnesota Statutes 2008, section 62Q.19, subdivisions 1, 2a, 5b.

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

Section 1.

Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:

Subdivision 1.

Designation.

(a) The commissioner shall designate essential
community providers. The criteria for essential community provider designation shall be
the following:

(1) a demonstrated ability to integrate applicable supportive and stabilizing services
with medical care, social services, or services provided in lieu of medical, social, or
institutional care for uninsured persons, underserved populations, and high-risk and
special needs populations, underserved, and other special needs populations; and

(2) a commitment to serve low-income and underserved populations by meeting the
following requirements:

(i) has nonprofit status in accordance with chapter 317A;

(ii) has tax exempt status in accordance with the Internal Revenue Service Code,
section 501(c)(3);

(iii) charges for services on a sliding fee schedule based on current poverty income
guidelines; and

(iv) does not restrict access or services because of a client's financial limitation;

(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
government, an Indian health service unit, or a community health board as defined in
chapter 145A;

(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
conditions; or

(5) a sole community hospital. For these rural hospitals, the essential community
provider designation applies to all health services provided, including both inpatient and
outpatient services. For purposes of this section, "sole community hospital" means a
rural hospital that:

(i) is eligible to be classified as a sole community hospital according to Code
of Federal Regulations, title 42, section 412.92, or is located in a community with a
population of less than 5,000 and located more than 25 miles from a like hospital currently
providing acute short-term services;

(ii) has experienced net operating income losses in two of the previous three
most recent consecutive hospital fiscal years for which audited financial information is
available; and

(iii) consists of 40 or fewer licensed beds.

(b) Prior to designation, the commissioner shall publish the names of all applicants
in the State Register. The public shall have 30 days from the date of publication to submit
written comments to the commissioner on the application. No designation shall be made
by the commissioner until the 30-day period has expired.

(c) The commissioner may designate an eligible provider as an essential community
provider for all the services offered by that provider or for specific services designated by
the commissioner.

(d) For the purpose of this subdivision, supportive and stabilizing services include at
a minimum, transportation, child care, cultural, and linguistic services where appropriate.

Sec. 2.

Minnesota Statutes 2008, section 62Q.19, subdivision 2a, is amended to read:

Subd. 2a.

Definition of health plan company.

For purposes of this section, "health
plan company" has the meaning given in section 62Q.01, subdivision 4, and includes a
private or governmental entity that arranges for providers or networks of providers to
provide services to enrollees covered by the health plan company. Health plan company
does not include a health plan company as defined in section 62Q.01 with fewer than
50,000 enrollees, all of whose enrollees are covered under medical assistance, general
assistance medical care, or MinnesotaCare.

Sec. 3.

Minnesota Statutes 2008, section 62Q.19, subdivision 5b, is amended to read:

Subd. 5b.

Enforcement.

For any violation of this section or any rule applicable
to an essential community provider, the commissioner may order appropriate changes in
the essential community provider's operations, suspend, modify, or revoke an essential
community provider designation. For any violation of this section or any essential
community provider rule applicable to a health plan company, the commissioner may
order the health plan company to implement changes to assure its compliance and to
compensate the essential community provider for expenses and damages caused by the
health plan company's noncompliance. The commissioner may also use the enforcement
authority specified in section 62D.17.