SF 4598

as introduced - 92nd Legislature (2021 - 2022) Posted on 05/19/2022 09:14am

A bill for an act
relating to state government; requiring coverage for self-measured blood pressure
monitoring devices; requiring related reimbursement for recipients and providers;
requiring commissioner of human services to create medical assistance data
practices and clinical oversight policy; amending Minnesota Statutes 2021
Supplement, section 256B.0625, subdivision 31; proposing coding for new law in
Minnesota Statutes, chapter 62Q.

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

Section 1.

new text begin [62Q.671] COVERAGE FOR SELF-MEASURED BLOOD PRESSURE
MONITORING DEVICES.
new text end

new text begin A health plan must cover self-measured blood pressure monitoring devices and related
services for enrollees diagnosed with uncontrolled hypertension. Coverage required under
this section is limited to one blood pressure monitoring device every three years. Health
plan coverage must include reimbursement for providers for costs associated with training
patients, transmitting blood pressure data, interpretation of readings, and costs of delivering
co-interventions.
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 31, is
amended to read:

Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall be
made for wheelchairs and wheelchair accessories for recipients who are residents of
intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs
and wheelchair accessories for ICF/DD recipients shall be subject to the same conditions
and limitations as coverage for recipients who do not reside in institutions. A wheelchair
purchased outside of the facility's payment rate is the property of the recipient.

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics,
or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment
requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic,
or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or similar
durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with the
Medicare program's supplier and quality standards and the vendor serves primarily pediatric
patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical condition
or is generally used primarily for a medical purpose.

(e) Electronic tablets may be considered durable medical equipment if the electronic
tablet will be used as an augmentative and alternative communication system as defined
under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must
be locked in order to prevent use not related to communication.

(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must be
locked to prevent use not as an augmentative communication device, a recipient of waiver
services may use an electronic tablet for a use not related to communication when the
recipient has been authorized under the waiver to receive one or more additional applications
that can be loaded onto the electronic tablet, such that allowing the additional use prevents
the purchase of a separate electronic tablet with waiver funds.

(g) An order or prescription for medical supplies, equipment, or appliances must meet
the requirements in Code of Federal Regulations, title 42, part 440.70.

(h) Allergen-reducing products provided according to subdivision 67, paragraph (c) or
(d), shall be considered durable medical equipment.

new text begin (i) Medical assistance must cover self-measured blood pressure monitoring devices and
related services for enrollees diagnosed with uncontrolled hypertension. The commissioner
shall create a policy to enable data integration, storage, and transfer and enable clinical
oversight and compliance with this paragraph. The Department of Human Services shall
amend the Medicaid state plan to include specific home blood pressure requirements for:
new text end

new text begin (1) coverage determination for uncontrolled hypertension;
new text end

new text begin (2) inclusion of a self-measured blood pressure device;
new text end

new text begin (3) replacement frequency of self-measured blood pressure devices;
new text end

new text begin (4) reimbursement for providers for costs associated with training patients, transmitting
blood pressure data, interpretation of readings, and costs of delivering co-interventions; and
new text end

new text begin (5) reimbursement for self-measured blood pressure devices and related services.
new text end