SF 3522

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; changing health care provisions; modifying medical
assistance-related transportation costs, state agency claim provisions, alternative
services, commissioner's authorities, transitioned adults provisions, medical
assistance liens, commissioner's duties, and managed care contract provisions;
amending Minnesota Statutes 2004, sections 256B.15, subdivision 1c; 256B.692,
subdivision 6; 514.982, subdivision 1; Minnesota Statutes 2005 Supplement,
sections 256B.0625, subdivisions 3f, 17; 256B.69, subdivision 23; 256L.05,
subdivision 2; 256L.15, subdivision 4; Laws 2005, First Special Session chapter
4, article 8, section 84; repealing Minnesota Statutes 2004, section 256B.692,
subdivision 10.

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

Section 1.

Minnesota Statutes 2005 Supplement, section 256B.0625, subdivision 3f,
is amended to read:

Subd. 3f.

Circumcision deleted text begin for newborns deleted text end .

deleted text begin Newborn deleted text end Circumcision is not covered,
unless the procedure is medically necessary deleted text begin or required because of a well-established
religious practice deleted text end .

Sec. 2.

Minnesota Statutes 2005 Supplement, section 256B.0625, subdivision 17,
is amended to read:

Subd. 17.

Transportation costs.

(a) Medical assistance covers transportation costs
incurred solely for obtaining emergency medical care or transportation costs incurred
by eligible persons in obtaining emergency or nonemergency medical care when paid
directly to an ambulance company, common carrier, or other recognized providers of
transportation services. new text begin Effective January 1, 2006, transportation costs and services are
covered only if the health care service obtained through the transportation is a health care
service covered by this chapter except that transportation to obtain pharmacy services for
an eligible person also covered by Medicare is covered, even if the pharmacy service
obtained through such transportation is fully or partially covered by Part D Medicare.
new text end

(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
transportation, or private automobile.

The commissioner may use an order by the recipient's attending physician to certify that
the recipient requires special transportation services. Special transportation includes
driver-assisted service to eligible individuals. Driver-assisted service includes passenger
pickup at and return to the individual's residence or place of business, assistance with
admittance of the individual to the medical facility, and assistance in passenger securement
or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers
must obtain written documentation from the health care service provider who is serving
the recipient being transported, identifying the time that the recipient arrived. Special
transportation providers may not bill for separate base rates for the continuation of a trip
beyond the original destination. Special transportation providers must take recipients to
the nearest appropriate health care provider, using the most direct route available. The
maximum medical assistance reimbursement rates for special transportation services are:

(1) $17 for the base rate and $1.35 per mile for services to eligible persons who
need a wheelchair-accessible van;

(2) $11.50 for the base rate and $1.30 per mile for services to eligible persons who
do not need a wheelchair-accessible van; and

(3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
services to eligible persons who need a stretcher-accessible vehicle.

Sec. 3.

Minnesota Statutes 2004, section 256B.15, subdivision 1c, is amended to read:

Subd. 1c.

Notice of potential claim.

(a) A state agency with a claim or potential
claim under this section may file a notice of potential claim under this subdivision anytime
before or within one year after a medical assistance recipient dies. The claimant shall be
the state agency. A notice filed prior to the recipient's death shall not take effect and shall
not be effective as notice until the recipient dies. A notice filed after a recipient dies
shall be effective from the time of filing.

(b) The notice of claim shall be filed or recorded in the real estate records in the
office of the county recorder or registrar of titles for each county in which any part of
the property is located. The recorder shall accept the notice for recording or filing. The
registrar of titles shall accept the notice for filing if the recipient has a recorded interest in
the property. The registrar of titles shall not carry forward to a new certificate of title any
notice filed more than one year from the date of the recipient's death.

(c) The notice must be dated, state the name of the claimant, the medical assistance
recipient's name and new text begin the last four digits of the new text end Social Security number if filed before their
death and their date of death if filed after they die, the name and date of death of any
predeceased spouse of the medical assistance recipient for whom a claim may exist, a
statement that the claimant may have a claim arising under this section, generally identify
the recipient's interest in the property, contain a legal description for the property and
whether it is abstract or registered property, a statement of when the notice becomes
effective and the effect of the notice, be signed by an authorized representative of the state
agency, and may include such other contents as the state agency may deem appropriate.

Sec. 4.

Minnesota Statutes 2005 Supplement, section 256B.69, subdivision 23, is
amended to read:

Subd. 23.

Alternative services; elderly and disabled persons.

(a) The
commissioner may implement demonstration projects to create alternative integrated
delivery systems for acute and long-term care services to elderly persons and persons
with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
coordination, improve access to quality services, and mitigate future cost increases.
The commissioner may seek federal authority to combine Medicare and Medicaid
capitation payments for the purpose of such demonstrations. Medicare funds and services
shall be administered according to the terms and conditions of the federal waiver and
demonstration provisions. For the purpose of administering medical assistance funds,
demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations, with the
exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, items B and
C, which do not apply to persons enrolling in demonstrations under this section. An initial
open enrollment period may be provided. Persons who disenroll from demonstrations
under this subdivision remain subject to Minnesota Rules, parts 9500.1450 to 9500.1464.
When a person is enrolled in a health plan under these demonstrations and the health
plan's participation is subsequently terminated for any reason, the person shall be provided
an opportunity to select a new health plan and shall have the right to change health plans
within the first 60 days of enrollment in the second health plan. Persons required to
participate in health plans under this section who fail to make a choice of health plan shall
not be randomly assigned to health plans under these demonstrations. Notwithstanding
section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, subpart 1, item A,
if adopted, for the purpose of demonstrations under this subdivision, the commissioner
may contract with managed care organizations, including counties, to serve only elderly
persons eligible for medical assistance, elderly and disabled persons, or disabled persons
only. For persons with primary diagnoses of mental retardation or a related condition,
serious and persistent mental illness, or serious emotional disturbance, the commissioner
must ensure that the county authority has approved the demonstration and contracting
design. Enrollment in these projects for persons with disabilities shall be voluntary. The
commissioner shall not implement any demonstration project under this subdivision for
persons with primary diagnoses of mental retardation or a related condition, serious and
persistent mental illness, or serious emotional disturbance, without approval of the county
board of the county in which the demonstration is being implemented.

(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
under this section projects for persons with developmental disabilities. The commissioner
may capitate payments for ICF/MR services, waivered services for mental retardation or
related conditions, including case management services, day training and habilitation and
alternative active treatment services, and other services as approved by the state and by the
federal government. Case management and active treatment must be individualized and
developed in accordance with a person-centered plan. Costs under these projects may not
exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003,
and until two years after the pilot project implementation date, subcontractor participation
in the long-term care developmental disability pilot is limited to a nonprofit long-term
care system providing ICF/MR services, home and community-based waiver services,
and in-home services to no more than 120 consumers with developmental disabilities in
Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature
prior to expansion of the developmental disability pilot project. This paragraph expires
two years after the implementation date of the pilot project.

(c) Before implementation of a demonstration project for disabled persons, the
commissioner must provide information to appropriate committees of the house of
representatives and senate and must involve representatives of affected disability groups
in the design of the demonstration projects.

(d) A nursing facility reimbursed under the alternative reimbursement methodology
in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
provide services under paragraph (a). The commissioner shall amend the state plan and
seek any federal waivers necessary to implement this paragraph.

(e) The commissioner, in consultation with the commissioners of commerce and
health, may approve and implement programs for all-inclusive care for the elderly (PACE)
according to federal laws and regulations governing that program and state laws or rules
applicable to participating providers. The process for approval of these programs shall
begin only after the commissioner receives grant money in an amount sufficient to cover
the state share of the administrative and actuarial costs to implement the programs during
state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
account in the special revenue fund and are appropriated to the commissioner to be used
solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
not required to be licensed or certified as a health plan company as defined in section
62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county
and found to be eligible for services under the elderly waiver or community alternatives
for disabled individuals or who are already eligible for Medicaid but meet level of
care criteria for receipt of waiver services may choose to enroll in the PACE program.
Medicare and Medicaid services will be provided according to this subdivision and
federal Medicare and Medicaid requirements governing PACE providers and programs.
PACE enrollees will receive Medicaid home and community-based services through the
PACE provider as an alternative to services for which they would otherwise be eligible
through home and community-based waiver programs and Medicaid State Plan Services.
The commissioner shall establish Medicaid rates for PACE providers that do not exceed
costs that would have been incurred under fee-for-service or other relevant managed care
programs operated by the state.

(f) The commissioner shall seek federal approval to expand the Minnesota disability
health options (MnDHO) program established under this subdivision in stages, first to
regional population centers outside the seven-county metro area and then to all areas of
the state.

(g) Notwithstanding section , health plans providing services
under this section are responsible for home care targeted case management and relocation
deleted text begin targeted case management deleted text end new text begin service coordination new text end . Services must be provided according to
the terms of the waivers and contracts approved by the federal government.

Sec. 5.

Minnesota Statutes 2004, section 256B.692, subdivision 6, is amended to read:

Subd. 6.

Commissioner's authority.

The commissioner may:

(1) reject any preliminary or final proposal that substantially fails to meet the
requirements of this section, or that the commissioner determines would substantially
impair the state's ability to purchase health care services in other areas of the state,
or would substantially impair an enrollee's choice of deleted text begin care systems deleted text end new text begin managed care
organizations new text end when reasonable choice is possible, or would substantially impair the
implementation and operation of the Minnesota senior health options demonstration
project authorized under section 256B.69, subdivision 23; and

(2) assume operation of a county's purchasing of health care for enrollees in medical
assistance and general assistance medical care in the event that the contract with the
county is terminated.

Sec. 6.

Minnesota Statutes 2005 Supplement, section 256L.05, subdivision 2, is
amended to read:

Subd. 2.

Commissioner's duties.

(a) The commissioner or county agency shall
use electronic verification as the primary method of income verification. If there is a
discrepancy between reported income and electronically verified income, an individual
may be required to submit additional verification. In addition, the commissioner shall
perform random audits to verify reported income and eligibility. The commissioner
may execute data sharing arrangements with the Department of Revenue and any other
governmental agency in order to perform income verification related to eligibility and
premium payment under the MinnesotaCare program.

(b) In determining eligibility for MinnesotaCare, the commissioner shall require
applicants and enrollees seeking renewal of eligibility to verify both earned and unearned
income. The commissioner shall also require applicants and enrollees to deleted text begin submit the names
of their employers and a contact name with a telephone number for each employer for
purposes of verifying deleted text end new text begin verify new text end whether the applicant or enrollee, and any dependents, are
eligible for employer-subsidized coverage new text begin , as defined in section 256L.07, subdivision 2.
Verification of access to employer-subsidized coverage shall be provided on a Minnesota
health care program form completed and signed by the employer, or other employer issued
documentation new text end . Data collected is nonpublic data as defined in section 13.02, subdivision 9.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2006.
new text end

Sec. 7.

Minnesota Statutes 2005 Supplement, section 256L.15, subdivision 4, is
amended to read:

Subd. 4.

Exception for transitioned adults.

new text begin The new text end county deleted text begin agencies deleted text end new text begin of financial
responsibility new text end shall pay deleted text begin premiums deleted text end new text begin a premium of $7.10 for each month described in section
256L.05, subdivision 3, paragraph (e), new text end for single adults and households with no children
formerly enrolled in general assistance medical care and enrolled in MinnesotaCare
according to section 256D.03, subdivision 3, until six-month renewal. The county deleted text begin agency deleted text end new text begin
of financial responsibility new text end has the option of continuing to pay premiums new text begin under subdivision
2, paragraph (a), new text end for these enrollees past the first six-month renewal period.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 1, 2006.
new text end

Sec. 8.

Minnesota Statutes 2004, section 514.982, subdivision 1, is amended to read:

Subdivision 1.

Contents.

A medical assistance lien notice must be dated and
must contain:

(1) the full name, new text begin new text end last known address, and new text begin the last four digits of the new text end Social Security
number of the medical assistance recipient;

(2) a statement that medical assistance payments have been made to or for the
benefit of the medical assistance recipient named in the notice, specifying the first date
of eligibility for benefits;

(3) a statement that all interests in real property owned by the persons named in the
notice may be subject to or affected by the rights of the agency to be reimbursed for
medical assistance benefits; and

(4) the legal description of the real property upon which the lien attaches, and
whether the property is registered property.

Sec. 9.

Laws 2005, First Special Session chapter 4, article 8, section 84, is amended to
read:

Sec. 84. deleted text begin SOLE-SOURCE OR deleted text end SINGLE-PLAN MANAGED CARE
CONTRACT.

Notwithstanding Minnesota Statutes, section 256B.692, subdivision 6, the
commissioner of human services shall deleted text begin not reject deleted text end new text begin consider new text end a county-based purchasing
health plan proposal that requires county-based purchasing on a deleted text begin sole-source or deleted text end single-plan
basis if the implementation of the deleted text begin sole-source or deleted text end single-plan purchasing proposal does
not limit an enrollee's provider choice or access to services. deleted text begin The commissioner shall
request federal approval, if necessary, to permit or maintain a sole-source or single-plan
purchasing option even if choice is available in the area. deleted text end

Sec. 10. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2004, section 256B.692, subdivision 10, new text end new text begin is repealed.
new text end