Minnesota Legislature
SF 3458
as introduced - 89th Legislature (2015 - 2016) Posted on 04/07/2016 10:07am
Current Version - as introduced
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A bill for an act
relating to human services; modifying medical assistance payment rates for
durable medical equipment, prosthetics, orthotics, and supplies; amending
Minnesota Statutes 2015 Supplement, section 256B.766.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
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) deleted text begin Effective July 1, 2015,deleted text end The medical assistance payment rate for durable medical
equipment, prosthetics, orthotics, or supplies shall be deleted text begin restored todeleted text end new text begin set atnew text end the January 1, deleted text begin 2008deleted text end new text begin
2015new text end , medical assistance fee schedule, new text begin adjusted to include the payment rate increases
specified in clauses (1) and (2), new text end 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. new text begin The January 1, 2015, medical assistance fee schedule shall be adjusted
as follows: (1) payment rates for durable medical equipment, prosthetics, orthotics, or
supplies, other than individually priced items, shall be increased by .... percent; and (2)
payment rates for items included in Medicare's competitive bid program as of January 1,
2015, other than individually priced items, shall be increased by an additional .... percent
from the enhanced January 1, 2015, medical assistance fee schedule rate specified in
clause (1). The commissioner shall apply the rate adjustments to the January 1, 2015,
medical assistance fee schedule specified in clauses (1) and (2) retroactively to July 1,
2015. The commissioner shall reprocess claims in the aggregate, using a single remittance
for each provider. new text end 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 EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end