SF 184

as introduced - 88th Legislature (2013 - 2014) Posted on 03/18/2013 01:12pm

A bill for an act
relating to human services; establishing MinnesotaCare as the state's basic health
program; amending Minnesota Statutes 2012, sections 16A.724, subdivision
3; 256.962, subdivisions 1, 2, by adding a subdivision; 256L.01, by adding
subdivisions; 256L.02, subdivision 2, by adding subdivisions; 256L.03,
subdivisions 1, 6, by adding subdivisions; 256L.04, subdivision 7b, by adding
subdivisions; 256L.05, subdivisions 1, 2, 3, 3a, 3c, by adding a subdivision;
256L.09, subdivision 2; 256L.11, subdivision 1, by adding a subdivision;
proposing coding for new law in Minnesota Statutes, chapter 256L; repealing
Minnesota Statutes 2012, sections 256L.01, subdivisions 3, 3a, 4a, 5; 256L.02,
subdivision 3; 256L.03, subdivisions 1a, 3, 4, 5; 256L.031; 256L.04, subdivisions
1, 1b, 2a, 7, 7a, 8, 9, 13; 256L.05, subdivisions 1b, 1c, 5; 256L.06, subdivision
3; 256L.07, subdivisions 1, 2, 3, 4, 5, 8, 9; 256L.09, subdivisions 1, 4, 5, 6,
7; 256L.11, subdivisions 2a, 3, 6; 256L.12; 256L.15, subdivisions 1, 1a, 1b,
2; 256L.17, subdivisions 1, 2, 3, 4, 5.

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

Section 1.

Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:

Subd. 3.

MinnesotaCare federal receipts.

deleted text begin Receipts received as a result of federal
participation pertaining to administrative costs of the Minnesota health care reform waiver
shall be deposited as nondedicated revenue in the health care access fund. Receipts
received as a result of federal participation pertaining to grants shall be deposited in the
federal fund and shall offset health care access funds for payments to providers. deleted text end new text begin The
commissioner of Minnesota Management and Budget shall deposit all federal funding
received by Minnesota for implementation and administration of MinnesotaCare as a basic
health program, as authorized in section 1331 of the Affordable Care Act (Public Law
111-148, as amended by Public Law 111-152), into the health care access fund. Federal
funding that is received for implementing and administering MinnesotaCare as a basic
health program and deposited in the fund shall be used only for that program to purchase
health care coverage for enrollees and reduce enrollee premiums and cost-sharing or
provide additional enrollee benefits.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 2.

Minnesota Statutes 2012, section 256.962, subdivision 1, is amended to read:

Subdivision 1.

Public awareness and education.

The commissioner, in consultation
with community organizations, health plans, and other public entities experienced in
outreach to the uninsured, shall design and implement a statewide campaign to raise public
awareness on the availability of health coverage through medical assistance deleted text begin , general
assistance medical care, deleted text end and MinnesotaCare and to educate the public on the importance of
obtaining and maintaining health care coverage. The campaign shall include multimedia
messages directed to the general population.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 3.

Minnesota Statutes 2012, section 256.962, subdivision 2, is amended to read:

Subd. 2.

Outreach grants.

(a) The commissioner shall new text begin implement, and may new text end award
grants to public and private organizations, regional collaboratives, and regional health care
outreach centers deleted text begin for deleted text end new text begin to implement new text end outreach activities, including, but not limited to:

(1) providing information, applications, and assistance in obtaining coverage
through Minnesota public health care programs;

(2) collaborating with public and private entities such as hospitals, providers, health
plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to
develop outreach activities and partnerships to ensure the distribution of information
and applications and provide assistance in obtaining coverage through Minnesota health
care programs;

(3) providing or collaborating with public and private entities to provide multilingual
and culturally specific information and assistance to applicants in areas of high
uninsurance in the state or populations with high rates of uninsurance; and

(4) targeting geographic areas with high rates of (i) eligible but unenrolled children,
including children who reside in rural areas, or (ii) racial and ethnic minorities and health
disparity populations.

(b) The commissioner shall ensure that all outreach materials are available in
languages other than English.

(c) The commissioner shall establish an outreach trainer program to provide
training to designated individuals from the community and public and private entities on
application assistance in order for these individuals to provide training to others in the
community on an as-needed basis. new text begin This program shall be coordinated with any navigator,
in-person assister, or other enrollment assistance program developed to provide consumer
assistance with enrollment on the health benefits exchange.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 4.

Minnesota Statutes 2012, section 256.962, is amended by adding a subdivision
to read:

new text begin Subd. 9. new text end

new text begin Coordination with health benefit exchange. new text end

new text begin The commissioner shall
ensure that information on coverage through state health care programs is included in
all health benefits exchange outreach and promotional activities, written materials, and
training for navigators, in-person assisters, and other individuals and entities who will
assist individuals in obtaining health coverage enrollment through the exchange.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 5.

Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
to read:

new text begin Subd. 1b. new text end

new text begin Affordable Care Act. new text end

new text begin "Affordable Care Act" means Public Law 111-148,
as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public
Law 111-152), and any amendments to, or regulations or guidance issued under, those acts.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 6.

Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Cost-sharing. new text end

new text begin "Cost-sharing" means any deductible, coinsurance, and
co-payment obligations of a MinnesotaCare enrollee.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 7.

Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
to read:

new text begin Subd. 4b. new text end

new text begin Health benefit exchange. new text end

new text begin "Health benefit exchange" or "exchange"
means the health benefit exchange established in Minnesota under section 1311 of the
Affordable Care Act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 8.

Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin MinnesotaCare. new text end

new text begin "MinnesotaCare" means a health coverage program that
meets the standards of this chapter and the requirements for a basic health program under
section 1331 of the Affordable Care Act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 9.

Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Modified adjusted gross income and household income. new text end

new text begin "Modified
adjusted gross income" and "household income" have the meanings provided in section
2002 of the Affordable Care Act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 10.

Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Participating entity. new text end

new text begin "Participating entity" means a health plan company
as defined in section 62Q.01, subdivision 4; a county-based purchasing plan established
under section 256B.692; an accountable care organization or other entity operating a
health care delivery systems demonstration project authorized under section 256B.0755;
an entity operating a county integrated health care delivery network pilot project
authorized under section 256B.0756; or a network of health care providers established to
offer services under MinnesotaCare.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 11.

Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:

Subd. 2.

Commissioner's duties.

The commissioner shall establish an office for
the state administration of this plan. The plan shall be used to provide covered health
services for eligible persons. Payment for these services shall be made to all deleted text begin eligible
providers deleted text end new text begin participating entities under contract with the commissioner new text end . The commissioner
shall adopt rules to administer the MinnesotaCare program new text begin as a basic health program in
accordance with section 1331 of the Affordable Care Act and this chapter and shall adopt
any necessary rules. Nothing in this chapter is intended to violate the requirements of the
Affordable Care Act. The commissioner shall not implement any provision of this chapter
if the provision is found to violate the Affordable Care Act new text end . The commissioner shall
establish marketing efforts new text begin and conduct outreach, as provided under section 256.962, new text end to
encourage potentially eligible persons to receive information about the program and about
other medical care programs administered or supervised by the Department of Human
Services. A toll-free telephone number must be used to provide information about medical
programs and to promote access to the covered services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 12.

Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Determination of funding adequacy. new text end

new text begin The commissioner of Minnesota
Management and Budget, in consultation with the commissioner of human services, shall
conduct an assessment of the health care access fund, as part of the state revenue and
expenditure forecast in November 2016, to determine whether state funding will be required
after December 31, 2019, in addition to the federal payments made available under section
1331 of the Affordable Care Act, for administration of the MinnesotaCare program. The
commissioners shall report the results of this assessment to the governor and legislature by
January 15, 2017, along with recommendations for continuing state revenue for the health
care access fund if state funding will continue to be required beyond December 31, 2019.
new text end

Sec. 13.

Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Federal approval. new text end

new text begin (a) The commissioner of human services shall seek
federal approval to implement the MinnesotaCare program under this chapter as a basic
health program. In any agreement with the Centers for Medicare and Medicaid Services
to operate MinnesotaCare as a basic health program, the commissioner shall seek to
include procedures to ensure that federal funding is predictable, stable, and sufficient
to sustain ongoing operation of MinnesotaCare. These procedures must address issues
related to the timing of federal payments, payment reconciliation, enrollee risk adjustment,
and minimization of state financial risk. The commissioner shall consult with the
commissioner of Minnesota Management and Budget, when developing the proposal for
establishing MinnesotaCare as a basic health program to be submitted to the Centers for
Medicare and Medicaid Services.
new text end

new text begin (b) The commissioner of human services, in consultation with the commissioner
of Minnesota Management and Budget, shall work with the Centers for Medicare and
Medicaid Services to establish a process for reconciliation and adjustment of federal
payments that balances state and federal liability over time. The commissioner of human
services shall request that the secretary of health and human services hold the state, and
enrollees, harmless in the reconciliation process for the first three years, to allow the state
to develop a statistically valid methodology for predicting enrollment trends and their
net effect on federal payments.
new text end

new text begin (c) The commissioner of human services shall work with the Centers for Medicare
and Medicaid Services to obtain a federal financial match for health coverage provided
to: (1) parents, guardians, and relative caretakers with incomes greater than 200 percent,
but not exceeding 275 percent of the federal poverty guidelines; and (2) adults without
children with incomes greater than 200 percent not exceeding 250 percent of the federal
poverty guidelines, who would have been eligible under the MinnesotaCare program as it
existed on January 1, 2013. The actuarial value of this coverage must not be less than that
of coverage that would have been available to the individual under the MinnesotaCare
program as it existed on June 30, 2012. Enrollee premiums and cost-sharing requirements
must not exceed what the individual would have paid under the MinnesotaCare program
as it existed on June 30, 2012. If a federal match for this coverage is approved by the
federal government, the commissioner shall make the coverage available to eligible
persons beginning January 1, 2014.
new text end

new text begin (d) The commissioner of human services, through December 31, 2014, may modify
implementation of the terms and requirements for the MinnesotaCare program specified
in this chapter, if this is necessary to comply with the terms and conditions of federal
approval. If the commissioner modifies implementation of the terms and requirements for
MinnesotaCare under this chapter, the commissioner shall provide the governor and the
legislature with notice of implementation of the modification at least ten working days
before notifying enrollees and participating entities.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 14.

Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:

Subdivision 1.

Covered health services.

deleted text begin (a) deleted text end "Covered health services" means the
health services reimbursed under chapter 256B, with the exception of deleted text begin inpatient hospital
services, special education services, private duty nursing services, adult dental care
services other than services covered under section 256B.0625, subdivision 9, orthodontic
services, nonemergency medical transportation services, personal care assistance and case
management services, nursing home or intermediate care facilities services, inpatient
mental health services, and chemical dependency services deleted text end new text begin nursing facility services and
intermediate care facility for persons with developmental disabilities (ICF/DD) services,
and except as provided in this section new text end .

deleted text begin (b) deleted text end No public funds shall be used for coverage of abortion under MinnesotaCare
except where the life of the female would be endangered or substantial and irreversible
impairment of a major bodily function would result if the fetus were carried to term; or
where the pregnancy is the result of rape or incest.

deleted text begin (c) Covered health services shall be expanded as provided in this section.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 15.

Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Cost-sharing. new text end

new text begin (a) Except as provided in paragraph (b), the MinnesotaCare
program shall include the following cost-sharing requirements for all enrollees:
new text end

new text begin (1) $3 per brand-name prescription and $1 per generic drug prescription, subject to a
$12 per month maximum for prescription drug co-payments. No co-payments shall apply
to antipsychotic drugs when used for treatment of mental illness;
new text end

new text begin (2) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
episode of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a physician or
physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist;
new text end

new text begin (3) $3.50 for nonemergency visits to a hospital-based emergency room, except that
this co-payment shall be increased to $20 upon federal approval; and
new text end

new text begin (4) a family deductible equal to the maximum amount allowed under Code of
Federal Regulations, title 42, part 447.54.
new text end

new text begin (b) Paragraph (a), clause (2), does not apply to mental health services.
new text end

new text begin (c) The commissioner, through the contracting process under section 256L.121, may
allow participating entities to waive the family deductible described under paragraph (a),
clause (4). The value of the family deductible shall not be included in any capitation or
other payment made by the commissioner to participating entities. Participating entities
shall certify annually to the commissioner the dollar value of the family deductible.
new text end

new text begin (d) The commissioner may waive the collection of the family deductible described
under paragraph (a), clause (4), from individuals and allow long-term care and waivered
service providers to assume responsibility for payment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 16.

Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision
to read:

new text begin Subd. 4b. new text end

new text begin Loss ratio. new text end

new text begin Health coverage provided through the MinnesotaCare
program must have a medical loss ratio of at least 85 percent.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 17.

Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:

Subd. 6.

Lien.

When the state agency provides, pays for, or becomes liable for
covered health services, the agency shall have a lien for the cost of the covered health
services upon any and all causes of action accruing to the enrollee, or to the enrollee's
legal representatives, as a result of the occurrence that necessitated the payment for the
covered health services. All liens under this section shall be subject to the provisions
of section 256.015. For purposes of this subdivision, "state agency" includes deleted text begin prepaid
health plans deleted text end new text begin participating entities, new text end under contract with the commissioner according to
deleted text begin sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based
purchasing entities under section 256B.692 deleted text end new text begin section 256L.121 new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 18.

Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
to read:

new text begin Subd. 1c. new text end

new text begin General requirements. new text end

new text begin To be eligible for coverage under MinnesotaCare,
a person must meet the eligibility requirements of this section. A person eligible for
MinnesotaCare shall not be treated as a qualified individual under section 1312 of the
Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered
through the health benefit exchange under section 1331 of the Affordable Care Act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 19.

Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
to read:

new text begin Subd. 1d. new text end

new text begin Eligible groups; income limits. new text end

new text begin (a) To be eligible under MinnesotaCare,
a person must:
new text end

new text begin (1) be a resident of Minnesota;
new text end

new text begin (2) not be eligible under medical assistance;
new text end

new text begin (3) have a household income that is greater than 133 percent but does not exceed 200
percent of the federal poverty guidelines for family size, except that a noncitizen lawfully
present in the United States, who is not eligible for the Medicaid program under title XIX
of the Social Security Act due to immigration status, may have a household income that is
less than or equal to 133 percent of the federal poverty guidelines for family size;
new text end

new text begin (4) not be eligible for minimum essential coverage, as defined in section 5000A(f)
of the Internal Revenue Code of 1986, except that a person may be eligible for an
employer-sponsored plan that is not affordable coverage, as defined in section 5000A(e)(2)
of the Internal Revenue Code of 1986; and
new text end

new text begin (5) not have attained the age of 65 as of the beginning of the plan year.
new text end

new text begin (b) The commissioner shall calculate income eligibility using modified adjusted
gross income and shall apply a standard five percent income disregard, as provided under
section 2012 of the Affordable Care Act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 20.

Minnesota Statutes 2012, section 256L.04, subdivision 7b, is amended to read:

Subd. 7b.

Annual income limits adjustment.

The commissioner shall adjust
the income limits under this section each July 1 by the annual update of the federal
poverty guidelines following publication by the United States Department of Health and
Human Services except that the income standards shall not go below those in effect on
new text begin the previous new text end July 1 deleted text begin , 2009 deleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 21.

Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:

Subdivision 1.

Application assistance and information availability.

(a)
new text begin Applicants may submit applications online, in person, by mail, or by phone in accordance
with the Affordable Care Act, and by any other means by which medical assistance
applications may be submitted. Applicants may submit applications through the health
benefit exchange or through the MinnesotaCare program. new text end Applications and application
assistance must be made available at provider offices, local human services agencies,
school districts, public and private elementary schools in which 25 percent or more of
the students receive free or reduced price lunches, community health offices, Women,
Infants and Children (WIC) program sites, Head Start program sites, public housing
councils, crisis nurseries, child care centers, early childhood education and preschool
program sites, legal aid offices, and libraries new text begin , and at any other locations at which medical
assistance applications must be made available new text end . These sites may accept applications and
forward the forms to the commissioner or local county human services agencies that
choose to participate as an enrollment site. Otherwise, applicants may apply directly to the
commissioner or to participating local county human services agencies.

(b) Application assistance must be available for applicants choosing to file an online
application new text begin through the health benefit exchange new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 22.

Minnesota Statutes 2012, section 256L.05, is amended by adding a subdivision
to read:

new text begin Subd. 1d. new text end

new text begin Streamlined application and enrollment process. new text end

new text begin The commissioner
shall work with the board of the health benefit exchange and local human services agencies
to develop a single, streamlined application and automatic enrollment process that meets
the requirements of the Affordable Care Act, including but not limited to being structured
to maximize an applicant's ability to complete the form satisfactorily, taking into account
the characteristics of individuals who qualify for MinnesotaCare and medical assistance.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 23.

Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:

Subd. 2.

Commissioner's duties.

The commissioner or county agency shall use
electronic verification new text begin through the health benefit exchange new text end 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 new text begin to the
extent permitted under the Affordable Care Act new text end . 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 new text begin any
applicable new text end premium payment under the MinnesotaCare program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 24.

Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:

Subd. 3.

Effective date of coverage.

(a) The effective date of coverage is the
first day of the month following the month in which eligibility is approved deleted text begin and the first
premium payment has been received. As provided in section 256B.057, coverage for
newborns is automatic from the date of birth and must be coordinated with other health
deleted text end deleted text begin coverage. The effective date of coverage for eligible newly adoptive children added to a
family receiving covered health services is the month of placement. The effective date
of coverage for other new members added to the family is the first day of the month
following the month in which the change is reported. All eligibility criteria must be met
by the family at the time the new family member is added. The income of the new family
member is included with the family's gross income and the adjusted premium begins in
the month the new family member is added deleted text end .

deleted text begin (b) The initial premium must be received by the last working day of the month for
coverage to begin the first day of the following month.
deleted text end

deleted text begin (c) Benefits are not available until the day following discharge if an enrollee is
hospitalized on the first day of coverage.
deleted text end

deleted text begin (d) deleted text end new text begin (b) new text end Notwithstanding any other law to the contrary, benefits under sections
256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which
an eligible person may have coverage and the commissioner shall use cost avoidance
techniques to ensure coordination of any other health coverage for eligible persons. The
commissioner shall identify eligible persons who may have coverage or benefits under
other plans of insurance or who become eligible for medical assistance.

deleted text begin (e) The effective date of coverage for individuals or families who are exempt from
paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first day of
the month following the month in which verification of American Indian status is received
or eligibility is approved, whichever is later.
deleted text end

deleted text begin (f) deleted text end new text begin (c) new text end The effective date of coverage for children eligible under section 256L.07,
subdivision 8, is the first day of the month following the date of termination from foster
care or release from a juvenile residential correctional facility.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 25.

Minnesota Statutes 2012, section 256L.05, subdivision 3a, is amended to read:

Subd. 3a.

Renewal of eligibility.

(a) Beginning July 1, 2007, an enrollee's eligibility
must be renewed every 12 months. The 12-month period begins in the month after the
month the application is approved.

(b) Each new period of eligibility must take into account any changes in
circumstances that impact eligibility deleted text begin and premium amount deleted text end . An enrollee must provide all
the information needed to redetermine eligibility by the first day of the month that ends
the eligibility period. deleted text begin The premium for the new period of eligibility must be received as
provided in section 256L.06 in order for eligibility to continue.
deleted text end

(c) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8,
the first period of renewal begins the month the enrollee turns 21 years of age.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 26.

Minnesota Statutes 2012, section 256L.05, subdivision 3c, is amended to read:

Subd. 3c.

Retroactive coverage.

Notwithstanding subdivision 3, the effective
date of coverage shall be the first day of the month following termination from medical
assistance for families and individuals who are eligible for MinnesotaCare and who
submitted a written request for retroactive MinnesotaCare coverage with a completed
application within 30 days of the mailing of notification of termination from medical
assistance. The applicant must provide all required verifications within 30 days of the
written request for verification. deleted text begin For retroactive coverage, premiums must be paid in full
for any retroactive month, current month, and next month within 30 days of the premium
billing. General assistance medical care recipients may qualify for retroactive coverage
under this subdivision at six-month renewal.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 27.

Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:

Subd. 2.

Residency requirement.

To be eligible for health coverage under the
MinnesotaCare program, deleted text begin pregnant women, individuals, and families with children must
meet the residency requirements deleted text end new text begin individuals must be a resident of the state new text end as provided
by deleted text begin Code of Federal Regulations, title 42, section 435.403, except that the provisions of
section 256B.056, subdivision 1, shall apply upon receipt of federal approval deleted text end new text begin section
1331 of the Affordable Care Act new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 28.

Minnesota Statutes 2012, section 256L.11, subdivision 1, is amended to read:

Subdivision 1.

Medical assistance rate to be used.

deleted text begin (a) deleted text end Payment to providers
under deleted text begin sections 256L.01 to 256L.11 deleted text end new text begin this chapter new text end shall be at the same rates and conditions
established for medical assistance, except as provided in deleted text begin subdivisions 2 to 6 deleted text end new text begin this section new text end .

deleted text begin (b) Effective for services provided on or after July 1, 2009, total payments for basic
care services shall be reduced by three percent, in accordance with section 256B.766.
Payments made to managed care and county-based purchasing plans shall be reduced for
services provided on or after October 1, 2009, to reflect this reduction.
deleted text end

deleted text begin (c) Effective for services provided on or after July 1, 2009, payment rates for
physician and professional services shall be reduced as described under section 256B.76,
subdivision 1, paragraph (c). Payments made to managed care and county-based
deleted text end deleted text begin purchasing plans shall be reduced for services provided on or after October 1, 2009,
to reflect this reduction.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 29.

Minnesota Statutes 2012, section 256L.11, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Rate increases. new text end

new text begin Effective for services provided on or after January 1,
2014, the commissioner of human services shall increase payments for basic care services,
physician and professional services, and dental services by … percent from the rates in
effect for the MinnesotaCare program on December 31, 2013. Payments to participating
entities established through the competitive process under section 256L.121 must reflect
this increase.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 30.

new text begin [256L.121] SERVICE DELIVERY.
new text end

new text begin Subdivision 1. new text end

new text begin Competitive bidding. new text end

new text begin (a) The commissioner of human services
shall establish a competitive process for entering into contracts with participating entities
for the offering of standard health plans through MinnesotaCare. Coverage through
standard health plans must be available to enrollees beginning January 1, 2014. Each
standard health plan must cover the health services listed in, and meet the requirements
of, section 256L.03. The competitive process must be designed to ensure enrollee access
to high-quality health care coverage options. In establishing the competitive process,
the commissioner shall incorporate applicable features of the competitive price bidding
program established under section 256B.69, subdivision 33. The commissioner, to the
extent feasible, shall seek to ensure that enrollees have a choice of coverage from more
than one participating entity within a geographic area.
new text end

new text begin (b) The competitive process must also include:
new text end

new text begin (1) negotiation for the inclusion of various innovative plan features, including:
care coordination and care management for enrollees, especially for those with chronic
conditions; incentives for the use of preventive services; requirements to include providers
who qualify as essential community providers under section 62Q.19 and providers
certified as health care homes under section 256B.0751; the use of withholds or other
financial incentives tied to achieving measures of health care quality and efficiency; and
maximizing patient involvement in health care decision making, including providing
patient incentives for appropriate utilization;
new text end

new text begin (2) allowances for differences in the health care needs of enrollees and the local
availability of, and access to, health care providers;
new text end

new text begin (3) contracting with systems that offer as many managed care and coordinated care
attributes as are feasible in the local market; and
new text end

new text begin (4) performance measures and standards for participating entities that focus on quality
of care and improved health outcomes, require the reporting of measures and standards to
the commissioner, and make information on performance and quality available to enrollees.
new text end

new text begin Subd. 2. new text end

new text begin Other requirements for participating entities. new text end

new text begin The commissioner shall
require participating entities, as a condition of contract, to document to the commissioner
the provision of culturally and linguistically appropriate services, including marketing
materials, to MinnesotaCare enrollees.
new text end

new text begin Subd. 3. new text end

new text begin Coordination with state-administered health programs. new text end

new text begin The
commissioner shall coordinate the administration of the MinnesotaCare program with
medical assistance and other state-administered health care programs to maximize
efficiency and improve the continuity of care. This includes, but is not limited to:
new text end

new text begin (1) establishing geographic areas for MinnesotaCare that are consistent with the
geographic areas of the medical assistance program, within which participating entities
may offer health plans;
new text end

new text begin (2) requiring, as a condition of participation in MinnesotaCare, participating entities
to also participate in the medical assistance program; and
new text end

new text begin (3) providing MinnesotaCare enrollees, to the extent possible, with the option to
remain in the same health plan and provider network, if they later become eligible for
medical assistance or coverage through the Minnesota health benefit exchange.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 31. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin The revisor shall remove cross-references to the repealed sections in section 32
wherever they appear in Minnesota Statutes and Minnesota Rules and make changes
necessary to correct the punctuation, grammar, or structure of the remaining text and
preserve its meaning.
new text end

Sec. 32. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2012, sections 256L.01, subdivisions 3, 3a, 4a, and 5; 256L.02,
subdivision 3; 256L.03, subdivisions 1a, 3, 4, and 5; 256L.031; 256L.04, subdivisions
1, 1b, 2a, 7, 7a, 8, 9, and 13; 256L.05, subdivisions 1b, 1c, and 5; 256L.06, subdivision
3; 256L.07, subdivisions 1, 2, 3, 4, 5, 8, and 9; 256L.09, subdivisions 1, 4, 5, 6, and 7;
256L.11, subdivisions 2a, 3, and 6; 256L.12; 256L.15, subdivisions 1, 1a, 1b, and 2; and
256L.17, subdivisions 1, 2, 3, 4, and 5, new text end new text begin are repealed effective January 1, 2014.
new text end