1.1 	A bill for an act
1.2 	relating to health care; requiring an interoperable electronic health records 
1.3 	system; requiring a plan to achieve universal health care; expanding the 
1.4 	definition of dependent coverage; establishing an electronic health record 
1.5 	system revolving account and loan program; modifying hospital information 
1.6 	reporting disclosures; regulating federally qualified health centers; establishing 
1.7 	health care programs outreach; establishing a primary care access initiative; 
1.8 	requiring a medical assistance co-payment for certain emergency room visits; 
1.9 	changing eligibility requirements for medical assistance; modifying general 
1.10 	assistance medical care eligibility requirements for the homeless; modifying 
1.11 	application assistance; allowing MinnesotaCare applicants to use a place of 
1.12 	public accommodation as a verified address; exempting workers' compensation 
1.13 	settlements from income eligibility; eliminating the modification to the 
1.14 	MinnesotaCare application form; increasing reimbursement for critical access 
1.15 	dental providers; extending medical assistance coverage to Medicare Part 
1.16 	D co-payments; creating grants for nonprofit dental providers with a high 
1.17 	proportion of uninsured patients; eliminating co-payments for medical assistance 
1.18 	and general assistance medical care; modifying the period of renewal for 
1.19 	MinnesotaCare; modifying the definition of employer-subsidized insurance; 
1.20 	creating a prescription drug discount program; expanding the benefit set for 
1.21 	single adults; increasing the eligibility income limit for single adults; increasing 
1.22 	the cap for inpatient hospitalization benefits for adults; modifying the definition 
1.23 	of income for self-employed farmers; removing insurance barriers for children 
1.24 	in MinnesotaCare; eliminating MinnesotaCare premiums for members of the 
1.25 	military and their families; reducing premiums for MinnesotaCare; restoring 
1.26 	family planning grants; creating a patient incentive health program; requiring 
1.27 	uniform billing forms; establishing a small employer option; affirming that every 
1.28 	resident of Minnesota has the right to affordable health care; requiring reports; 
1.29 	appropriating money;amending Minnesota Statutes 2006, sections 62E.02, 
1.30 	subdivision 7; 62J.07, subdivisions 1, 3; 62J.495; 62J.82; 62L.02, subdivision 
1.31 	11; 62Q.165, subdivisions 1, 2; 256.01, subdivision 2b; 256B.056, subdivision 
1.32 	10; 256B.0625, subdivision 30, by adding a subdivision; 256B.69, subdivision 
1.33 	2; 256B.76; 256D.03, subdivisions 3, 4; 256L.01, subdivisions 1, 4; 256L.03, 
1.34 	subdivisions 1, 3, 5; 256L.04, subdivisions 1a, 7, 10; 256L.05, subdivisions 1, 
1.35 	1b, 2, 3a, 3c; 256L.07, subdivisions 1, 2, 3, 6; 256L.09, subdivision 4; 256L.15, 
1.36 	subdivisions 1, 2, 4; 256L.17, subdivisions 2, 3, 7; Laws 2005, First Special 
1.37 	Session chapter 4, article 9, section 3, subdivision 2; proposing coding for new 
1.38 	law in Minnesota Statutes, chapters 62J; 145; 256; 256B; 256L; repealing 
1.39 	Minnesota Statutes 2006, sections 62A.301; 256B.0631; 256L.035.
2.1 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.2 	Section 1. Minnesota Statutes 2006, section 62E.02, subdivision 7, is amended to read:
2.3 		Subd. 7.Dependent. "Dependent" means a spouse or unmarried child under the 
2.4 	age of 19 years, a dependent child who is a student under the age of 25 regardless of 
2.5 	whether the dependent child is enrolled in an educational institution, or a dependent 
2.6 	child of any age who is disabled.

2.7 	EFFECTIVE DATE. This section is effective January 1, 2008.

2.8 	Sec. 2. Minnesota Statutes 2006, section 62J.07, subdivision 1, is amended to read:
2.9 		Subdivision 1.Legislative oversight. The Legislative Commission on Health 
2.10 	Care Access reviews the activities of the commissioner of health, the Health Technology 
2.11 	Advisory Committee, and all other state agencies involved in the implementation and 
2.12 	administration of this chapter, including efforts to obtain federal approval through waivers 
2.13 	and other means shall make recommendations to the legislature on how to achieve the 
2.14 	goal of universal health coverage as described in section 62Q.165. The recommendations 
2.15 	shall include a timetable in which measurable progress must be achieved toward this goal. 
2.16 	The commission shall submit to the legislature by January 15, 2008, the recommendations 
2.17 	and corresponding timetable.

2.18 	Sec. 3. Minnesota Statutes 2006, section 62J.07, subdivision 3, is amended to read:
2.19 		Subd. 3.Reports to the commission. The commissionercommissioners of 
2.20 	health, human services, commerce, and the Health Technology Advisory Committee shall 
2.21 	report on their activities annually and at other times at the request of the Legislative 
2.22 	Commission on Health Care Access. The commissioners of health, commerce, and human 
2.23 	services shall provide periodic reports to the legislative commission on the progress of 
2.24 	rulemaking that is authorized or required under this chapter and shall notify members 
2.25 	of the commission when a draft of a proposed rule has been completed and scheduled 
2.26 	for publication in the State Register. At the request of a member of the commission, 
2.27 	a commissioner shall provide a description and a copy of a proposed rule other state 
2.28 	agencies shall provide assistance and technical support to the commission at the request 
2.29 	of the commission. The commission may convene subcommittees to provide additional 
2.30 	assistance and advice to the commission.

3.1 	Sec. 4. Minnesota Statutes 2006, section 62J.495, is amended to read:
3.2 	62J.495 HEALTH INFORMATION TECHNOLOGY AND 
3.3 	INFRASTRUCTURE ADVISORY COMMITTEE.
3.4 		Subdivision 1.Establishment; members; duties Implementation. By January 
3.5 	1, 2015, all hospitals and health care providers must have in place an interoperable 
3.6 	electronic health records system within their hospital system or clinical practice setting. 
3.7 	The commissioner of health, in consultation with the Health Information Technology and 
3.8 	Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal, 
3.9 	including uniform standards to be used for the interoperable system for sharing and 
3.10 	synchronizing patient data across systems. The standards must be compatible with federal 
3.11 	efforts. The uniform standards must be developed by January 1, 2009, with a status report 
3.12 	on the development of these standards submitted to the legislature by January 15, 2008.
3.13 		Subd. 2. Health Information Technology and Infrastructure Advisory 
3.14 	Committee. (a) The commissioner shall establish a Health Information Technology 
3.15 	and Infrastructure Advisory Committee governed by section 15.059 to advise the 
3.16 	commissioner on the following matters:
3.17 	(1) assessment of the use of health information technology by the state, licensed 
3.18 	health care providers and facilities, and local public health agencies;
3.19 	(2) recommendations for implementing a statewide interoperable health information 
3.20 	infrastructure, to include estimates of necessary resources, and for determining standards 
3.21 	for administrative data exchange, clinical support programs, patient privacy requirements, 
3.22 	and maintenance of the security and confidentiality of individual patient data; and
3.23 	(3) other related issues as requested by the commissioner.
3.24 	(b) The members of the Health Information Technology and Infrastructure Advisory 
3.25 	Committee shall include the commissioners, or commissioners' designees, of health, 
3.26 	human services, administration, and commerce and additional members to be appointed 
3.27 	by the commissioner to include persons representing Minnesota's local public health 
3.28 	agencies, licensed hospitals and other licensed facilities and providers, private purchasers, 
3.29 	the medical and nursing professions, health insurers and health plans, the state quality 
3.30 	improvement organization, academic and research institutions, consumer advisory 
3.31 	organizations with an interest and expertise in health information technology, and other 
3.32 	stakeholders as identified by the Health Information Technology and Infrastructure 
3.33 	Advisory Committee.
3.34 		Subd. 2.Annual report. (c) The commissioner shall prepare and issue an annual 
3.35 	report not later than January 30 of each year outlining progress to date in implementing a 
3.36 	statewide health information infrastructure and recommending future projects.
4.1 		Subd. 3.Expiration. (d) Notwithstanding section 15.059, this sectionsubdivision 
4.2 	expires June 30, 2009 2015.

4.3 	Sec. 5. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING 
4.4 	ACCOUNT AND LOAN PROGRAM.
4.5 		Subdivision 1.Account establishment. The commissioner of finance shall 
4.6 	establish and implement a revolving account in the state government special revenue 
4.7 	fund to provide loans to physicians or physician group practices to assist in financing the 
4.8 	installation or support of an interoperable health record system. The system must provide 
4.9 	for the interoperable exchange of health care information between the applicant and, at a 
4.10 	minimum, a hospital system, pharmacy, and a health care clinic or other physician group.
4.11 		Subd. 2.Eligibility. To be eligible for a loan under this section, the applicant 
4.12 	must submit a loan application to the commissioner of health on forms prescribed by the 
4.13 	commissioner. The application must include, at a minimum:
4.14 	(1) the amount of the loan requested and a description of the purpose or project 
4.15 	for which the loan proceeds will be used;
4.16 	(2) a signed contract with a vendor;
4.17 	(3) a description of the health care entities and other groups participating in the 
4.18 	project;
4.19 	(4) evidence of financial stability and a demonstrated ability to repay the loan; and
4.20 	(5) a description of how the system to be financed interconnects or plans in the 
4.21 	future to interconnect with other health care entities and provider groups located in the 
4.22 	same geographical area.
4.23 		Subd. 3.Loans. (a) The commissioner of health may make a no interest loan 
4.24 	to a provider or provider group who is eligible under subdivision 2 on a first-come, 
4.25 	first-served basis provided that the applicant is able to comply with this section. The total 
4.26 	accumulative loan principal must not exceed $....... per loan. The commissioner of health 
4.27 	has discretion over the size and number of loans made.
4.28 	(b) The commissioner of health may prescribe forms and establish an application 
4.29 	process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable 
4.30 	application fee to cover the cost of administering the loan program.
4.31 	(c) The borrower must begin repaying the principal no later than two years from the 
4.32 	date of the loan. Loans must be amortized no later than 15 years from the date of the loan.
4.33 	(d) Repayments must be credited to the account.

5.1 	Sec. 6. Minnesota Statutes 2006, section 62J.82, is amended to read:
5.2 	62J.82 HOSPITAL CHARGEINFORMATION REPORTING DISCLOSURE.
5.3 		Subdivision 1.Required information. The Minnesota Hospital Association shall 
5.4 	develop a Web-based system, available to the public free of charge, for reporting charge 
5.5 	information the following, for Minnesota residents,:
5.6 	(1) hospital-specific performance on the measures of care developed under section 
5.7 	256B.072 for acute myocardial infarction, heart failure, and pneumonia; 
5.8 	(2) by January 1, 2009, hospital-specific performance on the public reporting 
5.9 	measures for hospital-acquired infections as published by the National Quality Forum 
5.10 	and collected by the Minnesota Hospital Association and Stratis Health in collaboration 
5.11 	with infection control practitioners; and 
5.12 	(3) charge information, including, but not limited to, number of discharges, average 
5.13 	length of stay, average charge, average charge per day, and median charge, for each of the 
5.14 	50 most common inpatient diagnosis-related groups and the 25 most common outpatient 
5.15 	surgical procedures as specified by the Minnesota Hospital Association. 
5.16 		Subd. 2.Web site. The Web site must provide information that compares 
5.17 	hospital-specific data to hospital statewide data. The Web site must be established by 
5.18 	October 1, 2006, and must be updated annually. The commissioner shall provide a link to 
5.19 	this reporting information on the department's Web site.
5.20 		Subd. 3.Enforcement. The commissioner shall provide a link to this information 
5.21 	on the department's Web site. If a hospital does not provide this information to the 
5.22 	Minnesota Hospital Association, the commissioner of health may require the hospital to 
5.23 	do so in accordance with section 144.55, subdivision 6. The commissioner shall provide a 
5.24 	link to this information on the department's Web site.

5.25 	Sec. 7. Minnesota Statutes 2006, section 62L.02, subdivision 11, is amended to read:
5.26 		Subd. 11.Dependent. "Dependent" means an eligible employee's spouse, 
5.27 	unmarried child who is under the age of 19 years, unmarried child under the age of 25 
5.28 	years who is a full-time student as defined in section 62A.301 regardless of whether 
5.29 	the dependent child is enrolled in an educational institution, dependent child of any age 
5.30 	who is disabled and who meets the eligibility criteria in section 62A.14, subdivision 2, 
5.31 	or any other person whom state or federal law requires to be treated as a dependent for 
5.32 	purposes of health plans. For the purpose of this definition, a child includes a child for 
5.33 	whom the employee or the employee's spouse has been appointed legal guardian and an 
5.34 	adoptive child as provided in section 62A.27. 

6.1 	EFFECTIVE DATE. This section is effective January 1, 2008.

6.2 	Sec. 8. Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:
6.3 		Subdivision 1.Definition. It is the commitment of the state to achieve universal 
6.4 	health coverage for all Minnesotans by the year 2010. Universal coverage is achieved 
6.5 	when:
6.6 	(1) every Minnesotan has access to a full range of quality health care services;
6.7 	(2) every Minnesotan is able to obtain affordable health coverage which pays for the 
6.8 	full range of services, including preventive and primary care; and
6.9 	(3) every Minnesotan pays into the health care system according to that person's 
6.10 	ability.

6.11 	Sec. 9. Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:
6.12 		Subd. 2.Goal. It is the goal of the state to make continuous progress toward 
6.13 	reducing the number of Minnesotans who do not have health coverage so that by January 
6.14 	1, 2000 2010, fewer than four percent of the state's population will be without health 
6.15 	coverage all Minnesota residents have access to affordable health care. The goal will be
6.16 	achieved byIn achieving this goal, a number of options shall be considered, including 
6.17 	improving access to private health coverage through insurance reforms and market 
6.18 	reforms, by making health coverage more affordable for low-income Minnesotans through 
6.19 	purchasing pools and state subsidies, and by reducing the cost of health coverage through 
6.20 	cost containment programs and methods of ensuring that all Minnesotans are paying 
6.21 	into the system according to their ability.

6.22 	EFFECTIVE DATE. This section is effective July 1, 2007.

6.23 	Sec. 10. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.
6.24 		Subdivision 1.Definitions. For purposes of this section, "federally qualified health 
6.25 	center" means an entity that is receiving a grant under United States Code, title 42, 
6.26 	section 254b, or, based on the recommendation of the Health Resources and Services 
6.27 	Administration within the Public Health Service, is determined by the secretary to meet 
6.28 	the requirements for receiving such a grant.
6.29 		Subd. 2.Allocation of subsidies. The commissioner of health shall distribute 
6.30 	subsidies to federally qualified health centers operating in Minnesota to continue, expand, 
6.31 	and improve federally qualified health center services to low-income populations. The 
6.32 	commissioner shall distribute the funds appropriated under this section to federally 
6.33 	qualified health centers operating in Minnesota as of January 1, 2007. The amount of 
7.1 	each subsidy shall be in proportion to each federally qualified health center's amount of 
7.2 	discounts granted to patients during calendar year 2006 as reported on the federal Uniform 
7.3 	Data System report in conformance with the Bureau of Primary Health Care Program 
7.4 	Expectations Policy Information Notice 98-23, except that each eligible federally qualified 
7.5 	health center shall receive at least two percent but no more than 30 percent of the total 
7.6 	amount of money available under this section.

7.7 	Sec. 11. Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:
7.8 		Subd. 2b.Performance payments. (a) The commissioner shall develop and 
7.9 	implement a pay-for-performance system to provide performance payments to medical 
7.10 	groups that demonstrate optimum care in serving individuals with chronic diseases who 
7.11 	are enrolled in health care programs administered by the commissioner under chapters 
7.12 	256B, 256D, and 256L.
7.13 	(b) The commissioner shall also develop and implement a patient incentive health 
7.14 	program to provide incentives and rewards to patients who are enrolled in health care 
7.15 	programs administered by the commissioner under chapters 256B, 256D, and 256L, and 
7.16 	who have agreed to and met personal health goals established with their primary care 
7.17 	provider to manage a chronic disease or condition, including, but not limited to, diabetes, 
7.18 	high blood pressure, and coronary artery disease.

7.19 	Sec. 12. [256.9545] PRESCRIPTION DRUG DISCOUNT PROGRAM.
7.20 		Subdivision 1.Establishment; administration. The    commissioner shall establish 
7.21 	and administer the prescription drug discount program.
7.22 		Subd. 2.Commissioner's authority. The commissioner  shall administer a drug 
7.23 	rebate program for drugs purchased  according to the prescription drug discount program. 
7.24 	The  commissioner shall execute a rebate agreement from all  manufacturers that choose to 
7.25 	participate in the program for  those drugs covered under the medical assistance program. 
7.26 	For  each drug, the amount of the rebate shall be equal to the rebate  as defined for purposes 
7.27 	of the federal rebate program in United  States Code, title 42, section 1396r-8.  The 
7.28 	rebate program  shall utilize the terms and conditions used for the federal  rebate program 
7.29 	established according to section 1927 of title  XIX of the federal Social Security Act.
7.30 		Subd. 3.Definitions. For purposes of this section,  the following terms have the 
7.31 	meanings given them.  
7.32 	(a) "Commissioner" means the commissioner of human services. 
7.33 	(b) "Covered prescription drug" means a prescription drug  as defined in section 
7.34 	151.44, paragraph (d), that is covered  under medical assistance as described in section 
8.1 	256B.0625,  subdivision 13, and that is provided by a participating  manufacturer that has a 
8.2 	fully executed rebate agreement with the  commissioner under this section and complies 
8.3 	with that agreement.
8.4 	(c) "Enrolled individual" means a person who is eligible  for the program under 
8.5 	subdivision 4 and has enrolled in the  program according to subdivision 5.
8.6 	(d) "Health carrier" means an insurance company licensed  under chapter 60A to 
8.7 	offer, sell, or issue an individual or  group policy of accident and sickness insurance as 
8.8 	defined in  section 62A.01; a nonprofit health service plan corporation  operating under 
8.9 	chapter 62C; a health maintenance organization  operating under chapter 62D; a joint 
8.10 	self-insurance employee  health plan operating under chapter 62H; a community integrated 
8.11 	service network licensed under chapter 62N; a fraternal benefit  society operating under 
8.12 	chapter 64B; a city, county, school  district, or other political subdivision providing 
8.13 	self-insured  health coverage under section 471.617 or sections 471.98 to  471.982; and a 
8.14 	self-funded health plan under the Employee  Retirement Income Security Act of 1974, as 
8.15 	amended. 
8.16 	(e) "Participating manufacturer" means a manufacturer as  defined in section 151.44, 
8.17 	paragraph (c), that agrees to  participate in the prescription drug discount program.   
8.18 	(f) "Participating pharmacy" means a pharmacy as defined in  section 151.01, 
8.19 	subdivision 2, that agrees to participate in the  prescription drug discount program.
8.20 		Subd. 4.Eligibility. (a) To be eligible for the program, an  applicant must:
8.21 	(1) be a permanent resident of Minnesota as defined in  section 256L.09, subdivision 
8.22 	4;
8.23 	(2) not be enrolled in medical assistance,  general assistance medical care, or 
8.24 	MinnesotaCare;
8.25 	(3) not be enrolled in and have currently available  prescription drug coverage under 
8.26 	a health plan offered by a  health carrier or employer or under a pharmacy benefit program 
8.27 	offered by a pharmaceutical manufacturer; and 
8.28 	(4) not be enrolled in and have currently available  prescription drug coverage 
8.29 	under a Medicare supplement policy, as  defined in sections 62A.31 to 62A.44, or 
8.30 	policies, contracts, or  certificates that supplement Medicare issued by health  maintenance 
8.31 	organizations or those policies, contracts, or  certificates governed by section 1833 or 1876 
8.32 	of the federal  Social Security Act, United States Code, title 42, section 1395,  et seq., as 
8.33 	amended.
8.34 	(b) Notwithstanding paragraph (a), clause (3), an individual who is enrolled in a 
8.35 	Medicare Part D prescription drug plan or Medicare Advantage plan is eligible for the 
8.36 	program but only for drugs that are not covered under the Medicare Part D plan or for 
9.1 	drugs that are covered under the plan, but according to the conditions of the plan, the 
9.2 	individual is responsible for 100 percent of the cost of the prescription drug. 
9.3 		Subd. 5.Application procedure. (a) Applications and  information on the program 
9.4 	must be made available at county  social services agencies, health care provider offices, and 
9.5 	agencies and organizations serving senior citizens.  Individuals  shall submit applications 
9.6 	and any information specified by the  commissioner as being necessary to verify eligibility 
9.7 	directly  to the commissioner.  The commissioner shall determine an  applicant's eligibility 
9.8 	for the program within 30 days from the  date the application is received.  Upon notice of 
9.9 	approval, the  applicant must submit to the commissioner the enrollment fee  specified in 
9.10 	subdivision 10.  Eligibility begins the month after  the enrollment fee is received by the 
9.11 	commissioner.
9.12 	(b) An enrollee's eligibility must be renewed every 12  months with the 12-month 
9.13 	period beginning in the month after the  application is approved.
9.14 	(c) The commissioner shall develop an application form that  does not exceed one 
9.15 	page in length and requires information  necessary to determine eligibility for the program.
9.16 		Subd. 6.Participating pharmacy. (a) Upon implementation  of the prescription 
9.17 	drug discount program, and until January 1,  2009, a participating pharmacy, with a 
9.18 	valid  prescription, must sell a covered prescription drug to an  enrolled individual at the 
9.19 	medical assistance rate.
9.20 	(b) After January 1, 2009, a participating pharmacy, with a valid prescription, must 
9.21 	sell a covered  prescription drug to an enrolled individual at the medical  assistance rate, 
9.22 	minus an amount that is equal to the rebate  amount described in subdivision 8, plus 
9.23 	the amount of any switch  fee established by the commissioner under subdivision 10, 
9.24 	paragraph (b).
9.25 	(c) Each participating pharmacy shall provide the  commissioner with all information 
9.26 	necessary to administer the  program, including, but not limited to, information on 
9.27 	prescription drug sales to enrolled individuals and usual and  customary retail prices.
9.28 		Subd. 7.Notification of rebate amount. The commissioner  shall notify each 
9.29 	participating manufacturer, each calendar  quarter or according to a schedule established 
9.30 	by the  commissioner, of the amount of the rebate owed on the  prescription drugs sold by 
9.31 	participating pharmacies to enrolled  individuals.
9.32 		Subd. 8.Provision of rebate. To the extent that a  participating manufacturer's 
9.33 	prescription drugs are prescribed  to a resident of this state, the manufacturer must provide 
9.34 	a  rebate equal to the rebate provided under the medical assistance  program for any 
9.35 	prescription drug distributed by the  manufacturer that is purchased at a  participating 
9.36 	pharmacy by an enrolled individual.  The participating manufacturer must  provide full 
10.1 	payment within 38 days of receipt of the state  invoice for the rebate, or according to 
10.2 	a schedule to be  established by the commissioner.  The commissioner shall deposit  all 
10.3 	rebates received into the Minnesota prescription drug  dedicated fund established under 
10.4 	subdivision 11.  The  manufacturer must provide the commissioner with any information 
10.5 	necessary to verify the rebate determined per drug.
10.6 		Subd. 9.Payment to pharmacies. Beginning January 1,  2009, the commissioner 
10.7 	shall distribute on a biweekly basis an  amount that is equal to an amount collected under 
10.8 	subdivision 8  to each participating pharmacy based on the prescription drugs  sold by that 
10.9 	pharmacy to enrolled individuals on or after  January 1, 2009.
10.10 		Subd. 10.Enrollment fee; switch fee. (a) The  commissioner shall establish an 
10.11 	annual enrollment fee that  covers the commissioner's expenses for enrollment, processing 
10.12 	claims, and distributing rebates under this program.
10.13 	(b) The commissioner shall establish a reasonable switch  fee that covers expenses 
10.14 	incurred by participating pharmacies in  formatting for electronic submission claims for 
10.15 	prescription  drugs sold to enrolled individuals.
10.16 		Subd. 11.Dedicated fund; creation; use of fund. (a) The  Minnesota prescription 
10.17 	drug dedicated fund is established as an  account in the state treasury.  The commissioner 
10.18 	of finance  shall credit to the dedicated fund all rebates paid under  subdivision 8, any 
10.19 	federal funds received for the program, all  enrollment fees paid by the enrollees, and 
10.20 	any appropriations or  allocations designated for the fund.  The commissioner of  finance 
10.21 	shall ensure that fund money is invested under section  11A.25.  All money earned by the 
10.22 	fund must be credited to the  fund.  The fund shall earn a proportionate share of the total 
10.23 	state annual investment income.
10.24 	(b) Money in the fund is appropriated to the commissioner  to reimburse participating 
10.25 	pharmacies for prescription drugs provided to enrolled individuals under  subdivision 6, 
10.26 	paragraph (b); to reimburse the commissioner for  costs related to enrollment, processing 
10.27 	claims, distributing  rebates, and for other reasonable administrative costs related to 
10.28 	administration of the prescription drug discount program; and to  repay the appropriation 
10.29 	provided by law for this section.  The  commissioner must administer the program so that 
10.30 	the costs total  no more than funds appropriated plus the drug rebate proceeds.

10.31 	EFFECTIVE DATE. This section is effective July 1, 2007.

10.32 	Sec. 13. [256.962] MINNESOTA HEALTH CARE PROGRAMS OUTREACH.
10.33 		Subdivision 1.Public awareness and education. (a) The commissioner shall 
10.34 	design and implement a statewide campaign to raise public awareness on the availability 
10.35 	of health coverage through medical assistance, general assistance medical care, and 
11.1 	MinnesotaCare and to educate the public on the importance of obtaining and maintaining 
11.2 	health care coverage. The campaign shall include multimedia messages directed to the 
11.3 	general population and messages that are culturally specific and community-based, 
11.4 	directed to high-uninsured population areas.
11.5 	(b) The commissioner shall collaborate with public and private entities, including, 
11.6 	but not limited to, hospitals, providers, health plans, legal aid offices, pharmacies, 
11.7 	insurance agencies, and faith-based organizations to develop outreach activities and 
11.8 	partnerships to ensure the distribution of information and applications.
11.9 	(c) The commissioner shall ensure that all outreach materials are available in 
11.10 	languages other than English.
11.11 		Subd. 2.Outreach grants. The commissioner shall award grants to public and 
11.12 	private organizations to provide information, applications, and assistance in obtaining 
11.13 	coverage through Minnesota public health care programs. In awarding these grants, the 
11.14 	commissioner shall give priority to community organizations with a proven ability to 
11.15 	provide multilingual and cultural outreach efforts in areas of high-uninsured populations.
11.16 		Subd. 3. Application and assistance. (a) The Minnesota health care programs 
11.17 	application must be made available at provider offices, local human services agencies, 
11.18 	school districts, public and private elementary schools in which 25 percent or more of 
11.19 	the students receive free or reduced price lunches, community health offices, Women, 
11.20 	Infants and Children (WIC) program sites, Head Start program sites, public housing 
11.21 	councils, child care centers, early childhood education and preschool program sites, legal 
11.22 	aid offices, and libraries. The commissioner shall ensure that applications are available in 
11.23 	languages other than English and that individuals and families who need assistance due to 
11.24 	language or cultural barriers receive the necessary services.
11.25 	(b) Local human service agencies, hospitals, and health care community clinics 
11.26 	receiving state funds must provide direct assistance in completing the application form, 
11.27 	including the free use of a copy machine and a drop box for applications. Other locations 
11.28 	where applications are required to be available shall either provide direct assistance in 
11.29 	completing the application form or provide information on where an applicant can receive 
11.30 	application assistance.
11.31 	(c) Counties must offer applications and application assistance when providing 
11.32 	child support collection services.
11.33 	(d) Local public health agencies and counties that provide immunization clinics must 
11.34 	offer applications and application assistance during these clinics.
12.1 		Subd. 4.Statewide toll-free telephone number. The commissioner shall provide 
12.2 	funds to establish a statewide toll-free telephone number to provide information on public 
12.3 	and private health coverage options and sources of free and low-cost health care.
12.4 		Subd. 5.Incentive program. The commissioner shall establish an incentive 
12.5 	program for organizations that directly identify and assist potential enrollees in filling 
12.6 	out and submitting an application. For each applicant who is successfully enrolled in 
12.7 	MinnesotaCare, medical assistance, or general assistance medical care, the commissioner 
12.8 	shall pay the organization a $25 application assistance fee. The organization may provide 
12.9 	an applicant a gift certificate or other incentive upon enrollment.
12.10 		Subd. 6.School districts. (a) At the beginning of each school year, a school district 
12.11 	shall provide information to each student on the availability of health care coverage 
12.12 	through the Minnesota health care programs.
12.13 	(b) For each child who is determined to be eligible for a free or reduced priced lunch, 
12.14 	the district shall provide the child's family with an application for the Minnesota health 
12.15 	care programs and information on how to obtain application assistance.
12.16 	(c) A district shall also ensure that applications and information on application 
12.17 	assistance are available at early childhood education sites and public schools located 
12.18 	within the district's jurisdiction. 
12.19 	(d) Each district shall designate an enrollment specialist to provide application 
12.20 	assistance and follow-up services with families who are eligible for the reduced or free 
12.21 	lunch program or who have indicated an interest in receiving information or an application 
12.22 	for the Minnesota health care program.
12.23 	(e) Each school district shall provide on their Web site a link to information on how 
12.24 	to obtain an application and application assistance.
12.25 		Subd. 7.Renewal notice. (a) The commissioner shall mail a renewal notice to 
12.26 	enrollees notifying the enrollee that their eligibility must be renewed. A notice shall be 
12.27 	sent at 90 days prior to the renewal date and at 60 days prior to the renewal date.
12.28 	(b) For enrollees who are receiving services through managed care plans, the 
12.29 	managed care plan must provide a follow-up renewal call at least 60 days prior to the 
12.30 	enrollee's renewal date.
12.31 	(c) The commissioner shall include the end of coverage dates on the monthly rosters 
12.32 	of enrollees provided to managed care organizations.
12.33 		Subd. 8.MinnesotaCare small employer buy-in option. The commissioner shall 
12.34 	provide information on the small employer buy-in option for MinnesotaCare to insurance 
12.35 	agents and local chambers of commerce.

13.1 	Sec. 14. [256.963] PRIMARY CARE ACCESS INITIATIVE.
13.2 		Subdivision 1.Establishment. (a) The commissioner shall award a grant to 
13.3 	implement in Hennepin and Ramsey Counties a Web-based primary care access pilot 
13.4 	project designed as a collaboration between private and public sectors to connect, where 
13.5 	appropriate, a patient with a primary care medical home and schedule patients into 
13.6 	available community-based appointments as an alternative to nonemergency use of the 
13.7 	hospital emergency room. The grantee must establish a program that diverts patients 
13.8 	presenting at an emergency room for nonemergency care to more appropriate outpatient 
13.9 	settings. The program must refer the patient to an appropriate health care professional 
13.10 	based on the patient's health care needs and situation. The program must provide the 
13.11 	patient with a scheduled appointment that is timely, with an appropriate provider who is 
13.12 	conveniently located. If the patient is uninsured and potentially eligible for a Minnesota 
13.13 	health care program, the program must connect the patient to a primary care provider, 
13.14 	community clinic, or agency that can assist the patient with the application process. The 
13.15 	program must also ensure that discharged patients are connected with a community-based 
13.16 	primary care provider and assist in scheduling any necessary follow-up visits before 
13.17 	the patient is discharged.
13.18 	(b) The program must not require a provider to pay a fee for accepting charity care 
13.19 	patients or patients enrolled in a Minnesota public health care program.
13.20 		Subd. 2.Evaluation. (a) The grantee must report to the commissioner on a quarterly 
13.21 	basis the following information:
13.22 	(1) total number of appointments available for scheduling by specialty;
13.23 	(2) average length of time between scheduling and actual appointment; and 
13.24 	(3) total number of patients referred and whether the patient was insured or 
13.25 	uninsured.
13.26 	(b) The commissioner, in consultation with the Minnesota Hospital Association, 
13.27 	shall conduct an evaluation of the emergency room diversion pilot project and submit the 
13.28 	results to the legislature by January 15, 2009. The evaluation shall compare the number of 
13.29 	nonemergency visits and repeat visits to hospital emergency rooms for the period before 
13.30 	the commencement of the project and one year after the commencement, and an estimate 
13.31 	of the costs saved from any documented reductions.

13.32 	Sec. 15. Minnesota Statutes 2006, section 256B.056, subdivision 10, is amended to 
13.33 	read:
13.34 		Subd. 10.Eligibility verification. (a) The commissioner shall require women who 
13.35 	are applying for the continuation of medical assistance coverage following the end of the 
14.1 	60-day postpartum period to update their income and asset information and to submit 
14.2 	any required income or asset verification.
14.3 	(b) The commissioner shall determine the eligibility of private-sector health care 
14.4 	coverage for infants less than one year of age eligible under section 256B.055, subdivision 
14.5 	10, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage 
14.6 	if this is determined to be cost-effective.
14.7 	(c) The commissioner shall modify the application for Minnesota health care 
14.8 	programs to require more detailed information related to verification of assets and income, 
14.9 	and shall verify assets and income for all applicants, and for all recipients upon renewal.
14.10 	(d) The commissioner shall require Minnesota health care program recipients to 
14.11 	report new or an increase in earned income within ten days of the change, and to verify new 
14.12 	or an increase in earned income that affects eligibility within ten days of notification by 
14.13 	the agency that the new or increased earned income affects eligibility. Recipients who fail 
14.14 	to verify new or an increase in earned income that affects eligibility shall be disenrolled.

14.15 	Sec. 16. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 
14.16 	subdivision to read:
14.17 		Subd. 13i.Medicare Part D co-payments. For recipients who are enrolled in a 
14.18 	Medicare Part D prescription drug plan or Medicare Advantage plan, medical assistance 
14.19 	covers the co-payments which the recipient is responsible for under the Medicare Part D 
14.20 	prescription drug plan or Medicare Advantage plan. 

14.21 	EFFECTIVE DATE. This section is effective July 1, 2007.

14.22 	Sec. 17. Minnesota Statutes 2006, section 256B.0625, subdivision 30, is amended to 
14.23 	read:
14.24 		Subd. 30.Other clinic services. (a) Medical assistance covers rural health clinic 
14.25 	services, federally qualified health center services, nonprofit community health clinic 
14.26 	services, public health clinic services, and the services of a clinic meeting the criteria 
14.27 	established in rule by the commissioner. Rural health clinic services and federally 
14.28 	qualified health center services mean services defined in United States Code, title 42, 
14.29 	section 1396d(a)(2)(B) and (C). Payment for rural health clinic and federally qualified 
14.30 	health center services shall be made according to applicable federal law and regulation.
14.31 	(b) A federally qualified health center that is beginning initial operation shall submit 
14.32 	an estimate of budgeted costs and visits for the initial reporting period in the form and 
14.33 	detail required by the commissioner. A federally qualified health center that is already in 
14.34 	operation shall submit an initial report using actual costs and visits for the initial reporting 
15.1 	period. Within 90 days of the end of its reporting period, a federally qualified health 
15.2 	center shall submit, in the form and detail required by the commissioner, a report of 
15.3 	its operations, including allowable costs actually incurred for the period and the actual 
15.4 	number of visits for services furnished during the period, and other information required 
15.5 	by the commissioner. Federally qualified health centers that file Medicare cost reports 
15.6 	shall provide the commissioner with a copy of the most recent Medicare cost report filed 
15.7 	with the Medicare program intermediary for the reporting year which support the costs 
15.8 	claimed on their cost report to the state.
15.9 	(c) In order to continue cost-based payment under the medical assistance program 
15.10 	according to paragraphs (a) and (b), a federally qualified health center or rural health clinic 
15.11 	must apply for designation as an essential community provider within six months of final 
15.12 	adoption of rules by the Department of Health according to section 62Q.19, subdivision 
15.13 	7. For those federally qualified health centers and rural health clinics that have applied 
15.14 	for essential community provider status within the six-month time prescribed, medical 
15.15 	assistance payments will continue to be made according to paragraphs (a) and (b) for the 
15.16 	first three years after application. For federally qualified health centers and rural health 
15.17 	clinics that either do not apply within the time specified above or who have had essential 
15.18 	community provider status for three years, medical assistance payments for health services 
15.19 	provided by these entities shall be according to the same rates and conditions applicable 
15.20 	to the same service provided by health care providers that are not federally qualified 
15.21 	health centers or rural health clinics.
15.22 	(d)Effective July 1, 1999, the provisions of paragraph (c) requiring a federally 
15.23 	qualified health center or a rural health clinic to make application for an essential 
15.24 	community provider designation in order to have cost-based payments made according 
15.25 	to paragraphs (a) and (b) no longer apply.
15.26 	(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) 
15.27 	shall be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
15.28 	(f) (d) Effective January 1, 2001, each federally qualified health center and 
15.29 	rural health clinic may elect to be paid either under the prospective payment system 
15.30 	established in United States Code, title 42, section 1396a(aa), or under an alternative 
15.31 	payment methodology consistent with the requirements of United States Code, title 42, 
15.32 	section 1396a(aa), and approved by the Centers for Medicare and Medicaid Services. 
15.33 	The alternative payment methodology shall be 100 percent of costcosts as determined 
15.34 	according to by generally accepted accounting principles and annual Medicare cost 
15.35 	principles reports, including Medicaid-eligible cost add-ons.

16.1 	Sec. 18. [256B.0632] MEDICAL ASSISTANCE CO-PAYMENTS.
16.2 		Subdivision 1.Co-payment. The medical assistance benefit plan shall include a 
16.3 	$6 co-payment for nonemergency visits to a hospital-based emergency room, except as 
16.4 	provided in subdivision 2.
16.5 		Subd. 2.Exceptions. A co-payment shall not be charged to:
16.6 	(1) children under the age of 21;
16.7 	(2) pregnant women for services that relate to the pregnancy or any other medical 
16.8 	condition that may complicate the pregnancy;
16.9 	(3) recipients expected to reside for at least 30 days in a hospital, nursing facility, or 
16.10 	intermediate care facility for the developmentally disabled; and
16.11 	(4) recipients receiving hospice care.

16.12 	Sec. 19. Minnesota Statutes 2006, section 256B.69, subdivision 2, is amended to read:
16.13 		Subd. 2.Definitions. For the purposes of this section, the following terms have 
16.14 	the meanings given.
16.15 	(a) "Commissioner" means the commissioner of human services. For the 
16.16 	remainder of this section, the commissioner's responsibilities for methods and policies 
16.17 	for implementing the project will be proposed by the project advisory committees and 
16.18 	approved by the commissioner.
16.19 	(b) "Demonstration provider" means a health maintenance organization, community 
16.20 	integrated service network, or accountable provider network authorized and operating 
16.21 	under chapter 62D, 62N, or 62T that participates in the demonstration project according 
16.22 	to criteria, standards, methods, and other requirements established for the project and 
16.23 	approved by the commissioner. For purposes of this section, a county board, or group of 
16.24 	county boards operating under a joint powers agreement, is considered a demonstration 
16.25 	provider if the county or group of county boards meets the requirements of section 
16.26 	256B.692. Notwithstanding the above, Itasca County may continue to participate as a 
16.27 	demonstration provider until July 1, 2004. 
16.28 	(c) "Eligible individuals" means those persons eligible for medical assistance 
16.29 	benefits as defined in sections 256B.055, 256B.056, and 256B.06. Notwithstanding 
16.30 	sections 256B.055, 256B.056, and 256B.06, an individual who becomes ineligible for 
16.31 	the program because of failure to submit income reports or recertification forms in a 
16.32 	timely manner, shall remain enrolled in the prepaid health plan and shall remain eligible 
16.33 	to receive medical assistance coverage through the last day of the month following the 
16.34 	month in which the enrollee became ineligible for the medical assistance program.
17.1 	(d) "Limitation of choice" means suspending freedom of choice while allowing 
17.2 	eligible individuals to choose among the demonstration providers.

17.3 	Sec. 20. Minnesota Statutes 2006, section 256B.76, is amended to read:
17.4 	256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.
17.5 	(a) Effective for services rendered on or after October 1, 1992, the commissioner 
17.6 	shall make payments for physician services as follows:
17.7 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
17.8 	procedural coding system codes titled "office and other outpatient services," "preventive 
17.9 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
17.10 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
17.11 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
17.12 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
17.13 	30, 1992. If the rate on any procedure code within these categories is different than the 
17.14 	rate that would have been paid under the methodology in section 256B.74, subdivision 2, 
17.15 	then the larger rate shall be paid; 
17.16 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
17.17 	or (ii) 15.4 percent above the rate in effect on June 30, 1992;
17.18 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
17.19 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
17.20 	except that payment rates for home health agency services shall be the rates in effect 
17.21 	on September 30, 1992;
17.22 	(4) effective for services rendered on or after January 1, 2000, payment rates for 
17.23 	physician and professional services shall be increased by three percent over the rates in 
17.24 	effect on December 31, 1999, except for home health agency and family planning agency 
17.25 	services; and
17.26 	(5) the increases in clause (4) shall be implemented January 1, 2000, for managed 
17.27 	care.
17.28 	(b) Effective for services rendered on or after October 1, 1992, the commissioner 
17.29 	shall make payments for dental services as follows:
17.30 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 
17.31 	percent above the rate in effect on June 30, 1992;
17.32 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 
17.33 	percentile of 1989, less the percent in aggregate necessary to equal the above increases;
18.1 	(3) effective for services rendered on or after January 1, 2000, payment rates for 
18.2 	dental services shall be increased by three percent over the rates in effect on December 
18.3 	31, 1999;
18.4 	(4) the commissioner shall award grants to community clinics or other nonprofit 
18.5 	community organizations, political subdivisions, professional associations, or other 
18.6 	organizations that demonstrate the ability to provide dental services effectively to public 
18.7 	program recipients. Grants may be used to fund the costs related to coordinating access for 
18.8 	recipients, developing and implementing patient care criteria, upgrading or establishing 
18.9 	new facilities, acquiring furnishings or equipment, recruiting new providers, or other 
18.10 	development costs that will improve access to dental care in a region. In awarding grants, 
18.11 	the commissioner shall give priority to applicants that plan to serve areas of the state in 
18.12 	which the number of dental providers is not currently sufficient to meet the needs of 
18.13 	recipients of public programs or uninsured individuals. The commissioner shall consider 
18.14 	the following in awarding the grants:
18.15 	(i) potential to successfully increase access to an underserved population;
18.16 	(ii) the ability to raise matching funds;
18.17 	(iii) the long-term viability of the project to improve access beyond the period 
18.18 	of initial funding;
18.19 	(iv) the efficiency in the use of the funding; and
18.20 	(v) the experience of the proposers in providing services to the target population.
18.21 	The commissioner shall monitor the grants and may terminate a grant if the grantee 
18.22 	does not increase dental access for public program recipients. The commissioner shall 
18.23 	consider grants for the following:
18.24 	(i) implementation of new programs or continued expansion of current access 
18.25 	programs that have demonstrated success in providing dental services in underserved 
18.26 	areas;
18.27 	(ii) a pilot program for utilizing hygienists outside of a traditional dental office to 
18.28 	provide dental hygiene services; and
18.29 	(iii) a program that organizes a network of volunteer dentists, establishes a system to 
18.30 	refer eligible individuals to volunteer dentists, and through that network provides donated 
18.31 	dental care services to public program recipients or uninsured individuals;
18.32 	(5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
18.33 	shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;
18.34 	(6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000, 
18.35 	for managed care; and
19.1 	(7) effective for services provided on or after January 1, 2002, payment for 
19.2 	diagnostic examinations and dental x-rays provided to children under age 21 shall be the 
19.3 	lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.
19.4 	(c) Effective for dental services rendered on or after January 1, 2002, the 
19.5 	commissioner may, within the limits of available appropriation,shall increase 
19.6 	reimbursements to dentists and dental clinics deemed by the commissioner to be critical 
19.7 	access dental providers. Reimbursement to a critical access dental provider may be 
19.8 	increased by not more than 50 percent above the reimbursement rate that would 
19.9 	otherwise be paid to the provider. Payments to health plan companies shall be adjusted to 
19.10 	reflect increased reimbursements to critical access dental providers as approved by the 
19.11 	commissioner. In determining which dentists and dental clinics shall be deemed critical 
19.12 	access dental providers, the commissioner shall review:
19.13 	(1) the utilization rate in the service area in which the dentist or dental clinic operates 
19.14 	for dental services to patients covered by medical assistance, general assistance medical 
19.15 	care, or MinnesotaCare as their primary source of coverage;
19.16 	(2) the level of services provided by the dentist or dental clinic to patients covered 
19.17 	by medical assistance, general assistance medical care, or MinnesotaCare as their primary 
19.18 	source of coverage; and
19.19 	(3) whether the level of services provided by the dentist or dental clinic is critical to 
19.20 	maintaining adequate levels of patient access within the service area.
19.21 	In the absence of a critical access dental provider in a service area, the commissioner may 
19.22 	designate a dentist or dental clinic as a critical access dental provider if the dentist or 
19.23 	dental clinic is willing to provide care to patients covered by medical assistance, general 
19.24 	assistance medical care, or MinnesotaCare at a level which significantly increases access 
19.25 	to dental care in the service area.
19.26 	The commissioner shall annually establish a reimbursement schedule for critical 
19.27 	access dental providers and provider-specific limits on total reimbursement received 
19.28 	under the reimbursement schedule, and shall notify each critical access dental provider 
19.29 	of the schedule and limit.
19.30 	(d) The commissioner shall award special hardship grants to nonprofit dental 
19.31 	providers with a high proportion of uninsured patients that equals or exceeds 15 percent 
19.32 	of the total number of patients served by that provider and the provider does not receive 
19.33 	a financial benefit comparable to other critical access dental providers under the critical 
19.34 	access dental provider formula described in paragraph (c). The commissioner shall award 
19.35 	a grant to these providers allocated in proportion to each critical access dental provider's 
20.1 	ratio of uninsured patients to the total number of patients served by all providers who 
20.2 	qualify for a grant under this paragraph.
20.3 	(e) An entity that operates both a Medicare certified comprehensive outpatient 
20.4 	rehabilitation facility and a facility which was certified prior to January 1, 1993, that is 
20.5 	licensed under Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33 
20.6 	percent of the clients receiving rehabilitation services in the most recent calendar year are 
20.7 	medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation 
20.8 	services at rates that are 38 percent greater than the maximum reimbursement rate 
20.9 	allowed under paragraph (a), clause (2), when those services are (1) provided within the 
20.10 	comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing 
20.11 	facilities owned by the entity.
20.12 	(e)(f) Effective for services rendered on or after January 1, 2007, the commissioner 
20.13 	shall make payments for physician and professional services based on the Medicare 
20.14 	relative value units (RVU's). This change shall be budget neutral and the cost of 
20.15 	implementing RVU's will be incorporated in the established conversion factor.

20.16 	Sec. 21. Minnesota Statutes 2006, section 256D.03, subdivision 3, is amended to read:
20.17 		Subd. 3.General assistance medical care; eligibility. (a) General assistance 
20.18 	medical care may be paid for any person who is not eligible for medical assistance under 
20.19 	chapter 256B, including eligibility for medical assistance based on a spenddown of excess 
20.20 	income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in 
20.21 	paragraph (b), except as provided in paragraph (c), and:
20.22 	(1) who is receiving assistance under section 256D.05, except for families with 
20.23 	children who are eligible under Minnesota family investment program (MFIP), or who is 
20.24 	having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
20.25 	(2) who is a resident of Minnesota; and
20.26 	(i) who has gross countable income not in excess of 75 percent of the federal poverty 
20.27 	guidelines for the family size, using a six-month budget period and whose equity in assets 
20.28 	is not in excess of $1,000 per assistance unit. General assistance medical care is not 
20.29 	available for applicants or enrollees who are otherwise eligible for medical assistance but 
20.30 	fail to verify their assets. Enrollees who become eligible for medical assistance shall be 
20.31 	terminated and transferred to medical assistance. Exempt assets, the reduction of excess 
20.32 	assets, and the waiver of excess assets must conform to the medical assistance program in 
20.33 	section 256B.056, subdivision 3, with the following exception: the maximum amount of 
20.34 	undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by 
21.1 	the trustee, assuming the full exercise of the trustee's discretion under the terms of the 
21.2 	trust, must be applied toward the asset maximum;
21.3 	(ii) who has gross countable income above 75 percent of the federal poverty 
21.4 	guidelines but not in excess of 175 percent of the federal poverty guidelines for the 
21.5 	family size, using a six-month budget period, whose equity in assets is not in excess 
21.6 	of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient 
21.7 	hospitalization; or
21.8 	(iii) the commissioner shall adjust the income standards under this section each July 
21.9 	1 by the annual update of the federal poverty guidelines following publication by the 
21.10 	United States Department of Health and Human Services.
21.11 	(b) Effective for applications and renewals processed on or after September 1, 2006, 
21.12 	general assistance medical care may not be paid for applicants or recipients who are adults 
21.13 	with dependent children under 21 whose gross family income is equal to or less than 275 
21.14 	percent of the federal poverty guidelines who are not described in paragraph (e).
21.15 	(c) Effective for applications and renewals processed on or after September 1, 2006, 
21.16 	general assistance medical care may be paid for applicants and recipients who meet all 
21.17 	eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period 
21.18 	beginning the date of application. Immediately following approval of general assistance 
21.19 	medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04, 
21.20 	subdivision 7, with covered services as provided in section 256L.03 for the rest of the 
21.21 	six-monthinitial eligibility period, until their six-monthannual renewal.
21.22 	(d) To be eligible for general assistance medical care following enrollment in 
21.23 	MinnesotaCare as required by paragraph (c), an individual must complete a new 
21.24 	application.
21.25 	(e) Applicants and recipients eligible under paragraph (a), clause (1); who have 
21.26 	applied for and are awaiting a determination of blindness or disability by the state medical 
21.27 	review team or a determination of eligibility for Supplemental Security Income or Social 
21.28 	Security Disability Insurance by the Social Security Administration; who fail to meet the 
21.29 	requirements of section 256L.09, subdivision 2; who are homeless as defined by United 
21.30 	States Code, title 42, section 11301, et seq.;  who are classified as end-stage renal disease 
21.31 	beneficiaries in the Medicare program; who are enrolled in private health care coverage as 
21.32 	defined in section 256B.02, subdivision 9; who are eligible under paragraph (j); or who 
21.33 	receive treatment funded pursuant to section 254B.02 are exempt from the MinnesotaCare 
21.34 	enrollment requirements of this subdivision.
21.35 	(f) For applications received on or after October 1, 2003, eligibility may begin no 
21.36 	earlier than the date of application. For individuals eligible under paragraph (a), clause 
22.1 	(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 
22.2 	eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 
22.3 	may reapply if there is a subsequent period of inpatient hospitalization.
22.4 	(g) Beginning September 1, 2006, Minnesota health care program applications and 
22.5 	renewals completed by recipients and applicants who are persons described in paragraph 
22.6 	(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility 
22.7 	by the county agency. If all other eligibility requirements of this subdivision are met, 
22.8 	eligibility for general assistance medical care shall be available in any month during which 
22.9 	MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, 
22.10 	notice of termination for eligibility for general assistance medical care shall be sent to 
22.11 	an applicant or recipient. If all other eligibility requirements of this subdivision are 
22.12 	met, eligibility for general assistance medical care shall be available until enrollment in 
22.13 	MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
22.14 	(h) The date of an initial Minnesota health care program application necessary to 
22.15 	begin a determination of eligibility shall be the date the applicant has provided a name, 
22.16 	address, and Social Security number, signed and dated, to the county agency or the 
22.17 	Department of Human Services. If the applicant is unable to provide a name, address, 
22.18 	Social Security number, and signature when health care is delivered due to a medical 
22.19 	condition or disability, a health care provider may act on an applicant's behalf to establish 
22.20 	the date of an initial Minnesota health care program application by providing the county 
22.21 	agency or Department of Human Services with provider identification and a temporary 
22.22 	unique identifier for the applicant. The applicant must complete the remainder of the 
22.23 	application and provide necessary verification before eligibility can be determined. The 
22.24 	county agency must assist the applicant in obtaining verification if necessary.
22.25 	(i) County agencies are authorized to use all automated databases containing 
22.26 	information regarding recipients' or applicants' income in order to determine eligibility for 
22.27 	general assistance medical care or MinnesotaCare. Such use shall be considered sufficient 
22.28 	in order to determine eligibility and premium payments by the county agency.
22.29 	(j) General assistance medical care is not available for a person in a correctional 
22.30 	facility unless the person is detained by law for less than one year in a county correctional 
22.31 	or detention facility as a person accused or convicted of a crime, or admitted as an 
22.32 	inpatient to a hospital on a criminal hold order, and the person is a recipient of general 
22.33 	assistance medical care at the time the person is detained by law or admitted on a criminal 
22.34 	hold order and as long as the person continues to meet other eligibility requirements 
22.35 	of this subdivision.
23.1 	(k) General assistance medical care is not available for applicants or recipients who 
23.2 	do not cooperate with the county agency to meet the requirements of medical assistance.
23.3 	(l) In determining the amount of assets of an individual eligible under paragraph 
23.4 	(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 
23.5 	an asset excluded under paragraph (a), that was given away, sold, or disposed of for 
23.6 	less than fair market value within the 60 months preceding application for general 
23.7 	assistance medical care or during the period of eligibility. Any transfer described in this 
23.8 	paragraph shall be presumed to have been for the purpose of establishing eligibility for 
23.9 	general assistance medical care, unless the individual furnishes convincing evidence to 
23.10 	establish that the transaction was exclusively for another purpose. For purposes of this 
23.11 	paragraph, the value of the asset or interest shall be the fair market value at the time it 
23.12 	was given away, sold, or disposed of, less the amount of compensation received. For any 
23.13 	uncompensated transfer, the number of months of ineligibility, including partial months, 
23.14 	shall be calculated by dividing the uncompensated transfer amount by the average monthly 
23.15 	per person payment made by the medical assistance program to skilled nursing facilities 
23.16 	for the previous calendar year. The individual shall remain ineligible until this fixed period 
23.17 	has expired. The period of ineligibility may exceed 30 months, and a reapplication for 
23.18 	benefits after 30 months from the date of the transfer shall not result in eligibility unless 
23.19 	and until the period of ineligibility has expired. The period of ineligibility begins in the 
23.20 	month the transfer was reported to the county agency, or if the transfer was not reported, 
23.21 	the month in which the county agency discovered the transfer, whichever comes first. For 
23.22 	applicants, the period of ineligibility begins on the date of the first approved application.
23.23 	(m) When determining eligibility for any state benefits under this subdivision, 
23.24 	the income and resources of all noncitizens shall be deemed to include their sponsor's 
23.25 	income and resources as defined in the Personal Responsibility and Work Opportunity 
23.26 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
23.27 	subsequently set out in federal rules.
23.28 	(n) Undocumented noncitizens and nonimmigrants are ineligible for general 
23.29 	assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual 
23.30 	in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
23.31 	an undocumented noncitizen is an individual who resides in the United States without the 
23.32 	approval or acquiescence of the Immigration and Naturalization Service.
23.33 	(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for 
23.34 	medical assistance due to the deeming of a sponsor's income and resources, is ineligible 
23.35 	for general assistance medical care.
23.36 	(p) Effective July 1, 2003, general assistance medical care emergency services end.

24.1 	Sec. 22. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:
24.2 		Subd. 4.General assistance medical care; services. (a)(i) For a person who is 
24.3 	eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 
24.4 	care covers, except as provided in paragraph (c):
24.5 	(1) inpatient hospital services;
24.6 	(2) outpatient hospital services;
24.7 	(3) services provided by Medicare certified rehabilitation agencies;
24.8 	(4) prescription drugs and other products recommended through the process 
24.9 	established in section 256B.0625, subdivision 13;
24.10 	(5) equipment necessary to administer insulin and diagnostic supplies and equipment 
24.11 	for diabetics to monitor blood sugar level;
24.12 	(6) eyeglasses and eye examinations provided by a physician or optometrist;
24.13 	(7) hearing aids;
24.14 	(8) prosthetic devices;
24.15 	(9) laboratory and X-ray services;
24.16 	(10) physician's services;
24.17 	(11) medical transportation except special transportation;
24.18 	(12) chiropractic services as covered under the medical assistance program;
24.19 	(13) podiatric services;
24.20 	(14) dental services as covered under the medical assistance program;
24.21 	(15) outpatient services provided by a mental health center or clinic that is under 
24.22 	contract with the county board and is established under section 245.62;
24.23 	(16) day treatment services for mental illness provided under contract with the 
24.24 	county board;
24.25 	(17) prescribed medications for persons who have been diagnosed as mentally ill as 
24.26 	necessary to prevent more restrictive institutionalization;
24.27 	(18) psychological services, medical supplies and equipment, and Medicare 
24.28 	premiums, coinsurance and deductible payments;
24.29 	(19) medical equipment not specifically listed in this paragraph when the use of 
24.30 	the equipment will prevent the need for costlier services that are reimbursable under 
24.31 	this subdivision;
24.32 	(20) services performed by a certified pediatric nurse practitioner, a certified family 
24.33 	nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 
24.34 	nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 
24.35 	practitioner in independent practice, if (1) the service is otherwise covered under this 
24.36 	chapter as a physician service, (2) the service provided on an inpatient basis is not included 
25.1 	as part of the cost for inpatient services included in the operating payment rate, and (3) the 
25.2 	service is within the scope of practice of the nurse practitioner's license as a registered 
25.3 	nurse, as defined in section 148.171;
25.4 	(21) services of a certified public health nurse or a registered nurse practicing in 
25.5 	a public health nursing clinic that is a department of, or that operates under the direct 
25.6 	authority of, a unit of government, if the service is within the scope of practice of the 
25.7 	public health nurse's license as a registered nurse, as defined in section 148.171;
25.8 	(22) telemedicine consultations, to the extent they are covered under section 
25.9 	256B.0625, subdivision 3b; and
25.10 	(23) mental health telemedicine and psychiatric consultation as covered under 
25.11 	section 256B.0625, subdivisions 46 and 48.
25.12 	(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 
25.13 	paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 
25.14 	to inpatient hospital services, including physician services provided during the inpatient 
25.15 	hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
25.16 	(b) Effective August 1, 2005, sex reassignment surgery is not covered under this 
25.17 	subdivision.
25.18 	(c) In order to contain costs, the commissioner of human services shall select 
25.19 	vendors of medical care who can provide the most economical care consistent with high 
25.20 	medical standards and shall where possible contract with organizations on a prepaid 
25.21 	capitation basis to provide these services. The commissioner shall consider proposals by 
25.22 	counties and vendors for prepaid health plans, competitive bidding programs, block grants, 
25.23 	or other vendor payment mechanisms designed to provide services in an economical 
25.24 	manner or to control utilization, with safeguards to ensure that necessary services are 
25.25 	provided. Before implementing prepaid programs in counties with a county operated or 
25.26 	affiliated public teaching hospital or a hospital or clinic operated by the University of 
25.27 	Minnesota, the commissioner shall consider the risks the prepaid program creates for the 
25.28 	hospital and allow the county or hospital the opportunity to participate in the program in a 
25.29 	manner that reflects the risk of adverse selection and the nature of the patients served by 
25.30 	the hospital, provided the terms of participation in the program are competitive with the 
25.31 	terms of other participants considering the nature of the population served. Payment for 
25.32 	services provided pursuant to this subdivision shall be as provided to medical assistance 
25.33 	vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For 
25.34 	payments made during fiscal year 1990 and later years, the commissioner shall consult 
25.35 	with an independent actuary in establishing prepayment rates, but shall retain final control 
25.36 	over the rate methodology.
26.1 	(d) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 
26.2 	co-payments for services provided on or after October 1, 2003:
26.3 	(1) $25 for eyeglasses;
26.4 	(2) $25 for nonemergency visits to a hospital-based emergency room;
26.5 	(3) $3 per brand-name drug prescription and $1 per generic drug prescription, 
26.6 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
26.7 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
26.8 	(4) 50 percent coinsurance on restorative dental services.
26.9 	(e) Co-payments shall be limited to one per day per provider for nonpreventive visits, 
26.10 	eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of 
26.11 	general assistance medical care are responsible for all co-payments in this subdivision. 
26.12 	The general assistance medical care reimbursement to the provider shall be reduced by 
26.13 	the amount of the co-payment, except that reimbursement for prescription drugs shall not 
26.14 	be reduced once a recipient has reached the $12 per month maximum for prescription 
26.15 	drug co-payments. The provider collects the co-payment from the recipient. Providers 
26.16 	may not deny services to recipients who are unable to pay the co-payment, except as 
26.17 	provided in paragraph (f).
26.18 	(f) If it is the routine business practice of a provider to refuse service to an individual 
26.19 	with uncollected debt, the provider may include uncollected co-payments under this 
26.20 	section. A provider must give advance notice to a recipient with uncollected debt before 
26.21 	services can be denied.
26.22 	(g)(d) Any county may, from its own resources, provide medical payments for 
26.23 	which state payments are not made.
26.24 	(h)(e) Chemical dependency services that are reimbursed under chapter 254B must 
26.25 	not be reimbursed under general assistance medical care.
26.26 	(i)(f) The maximum payment for new vendors enrolled in the general assistance 
26.27 	medical care program after the base year shall be determined from the average usual and 
26.28 	customary charge of the same vendor type enrolled in the base year.
26.29 	(j)(g) The conditions of payment for services under this subdivision are the same 
26.30 	as the conditions specified in rules adopted under chapter 256B governing the medical 
26.31 	assistance program, unless otherwise provided by statute or rule.
26.32 	(k) (h) Inpatient and outpatient payments shall be reduced by five percent, effective 
26.33 	July 1, 2003. This reduction is in addition to the five percent reduction effective July 1, 
26.34 	2003, and incorporated by reference in paragraph (i) (f).
26.35 	(l)(i) Payments for all other health services except inpatient, outpatient, and 
26.36 	pharmacy services shall be reduced by five percent, effective July 1, 2003.
27.1 	(m)(j) Payments to managed care plans shall be reduced by five percent for services 
27.2 	provided on or after October 1, 2003.
27.3 	(n)(k) A hospital receiving a reduced payment as a result of this section may apply 
27.4 	the unpaid balance toward satisfaction of the hospital's bad debts.
27.5 	(o) Fee-for-service payments for nonpreventive visits shall be reduced by $3 
27.6 	for services provided on or after January 1, 2006. For purposes of this subdivision, a 
27.7 	visit means an episode of service which is required because of a recipient's symptoms, 
27.8 	diagnosis, or established illness, and which is delivered in an ambulatory setting by 
27.9 	a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 
27.10 	audiologist, optician, or optometrist.
27.11 	(p) Payments to managed care plans shall not be increased as a result of the removal 
27.12 	of the $3 nonpreventive visit co-payment effective January 1, 2006.
27.13 	(l) Recipients eligible under subdivision 3, paragraph (a), shall pay a $25 co-payment 
27.14 	for nonemergency visits to a hospital-based emergency room.

27.15 	EFFECTIVE DATE. This section is effective July 1, 2007.

27.16 	Sec. 23. Minnesota Statutes 2006, section 256L.01, subdivision 1, is amended to read:
27.17 		Subdivision 1.Scope. For purposes of sections 256L.01 to 256L.18 this chapter, 
27.18 	the following terms shall have the meanings given them. 

27.19 	Sec. 24. Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:
27.20 		Subd. 4.Gross individual or gross family income. (a) "Gross individual or gross 
27.21 	family income" for nonfarm self-employed means income calculated for the six-month
27.22 	12-month period of eligibility using the net profit or loss reported on the applicant's 
27.23 	federal income tax form for the previous year and using the medical assistance families 
27.24 	with children methodology for determining allowable and nonallowable self-employment 
27.25 	expenses and countable income.
27.26 	(b) "Gross individual or gross family income" for farm self-employed means income 
27.27 	calculated for the six-month12-month period of eligibility using as the baseline the 
27.28 	adjusted gross income reported on the applicant's federal income tax form for the previous 
27.29 	year and adding back in reported depreciation amounts that apply to the business in which 
27.30 	the family is currently engaged.
27.31 	(c) "Gross individual or gross family income" means the total income for all family 
27.32 	members, calculated for the six-month12-month period of eligibility.

27.33 	EFFECTIVE DATE. This section is effective July 1, 2007.

28.1 	Sec. 25. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:
28.2 		Subdivision 1.Covered health services. For individuals under section 256L.04, 
28.3 	subdivision 7, with income no greater than 75 percent of the federal poverty guidelines 
28.4 	or for families with children under section 256L.04, subdivision 1, all subdivisions of 
28.5 	this section apply. "Covered health services" means the health services reimbursed 
28.6 	under chapter 256B, with the exception of inpatient hospital services, special education 
28.7 	services, private duty nursing services, adult dental care services other than services 
28.8 	covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency 
28.9 	medical transportation services, personal care assistant and case management services, 
28.10 	nursing home or intermediate care facilities services, inpatient mental health services, 
28.11 	and chemical dependency services. Outpatient mental health services covered under the 
28.12 	MinnesotaCare program are limited to diagnostic assessments, psychological testing, 
28.13 	explanation of findings, mental health telemedicine, psychiatric consultation, medication 
28.14 	management by a physician, day treatment, partial hospitalization, and individual, family, 
28.15 	and group psychotherapy.
28.16 	No public funds shall be used for coverage of abortion under MinnesotaCare 
28.17 	except where the life of the female would be endangered or substantial and irreversible 
28.18 	impairment of a major bodily function would result if the fetus were carried to term; or 
28.19 	where the pregnancy is the result of rape or incest.
28.20 	Covered health services shall be expanded as provided in this section.

28.21 	Sec. 26. Minnesota Statutes 2006, section 256L.03, subdivision 3, is amended to read:
28.22 		Subd. 3.Inpatient hospital services. (a) Covered health services shall include 
28.23 	inpatient hospital services, including inpatient hospital mental health services and inpatient 
28.24 	hospital and residential chemical dependency treatment, subject to those limitations 
28.25 	necessary to coordinate the provision of these services with eligibility under the medical 
28.26 	assistance spenddown. Prior to July 1, 1997, the inpatient hospital benefit for adult 
28.27 	enrollees is subject to an annual benefit limit of $10,000. The inpatient hospital benefit 
28.28 	for adult enrollees who qualify under section 256L.04, subdivision 7, or who qualify 
28.29 	under section 256L.04, subdivisions 1 and 2, with family gross income that exceeds 
28.30 	175 200 percent of the federal poverty guidelines or 215 percent of the federal poverty 
28.31 	guidelines on or after July 1, 2009, and who are not pregnant, is subject to an annual 
28.32 	limit of $10,000 $20,000. 
28.33 	(b) Admissions for inpatient hospital services paid for under section 256L.11, 
28.34 	subdivision 3, must be certified as medically necessary in accordance with Minnesota 
28.35 	Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2): 
29.1 	(1) all admissions must be certified, except those authorized under rules established 
29.2 	under section 254A.03, subdivision 3, or approved under Medicare; and 
29.3 	(2) payment under section 256L.11, subdivision 3, shall be reduced by five percent 
29.4 	for admissions for which certification is requested more than 30 days after the day of 
29.5 	admission. The hospital may not seek payment from the enrollee for the amount of the 
29.6 	payment reduction under this clause. 

29.7 	Sec. 27. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
29.8 		Subd. 5.Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 
29.9 	and (c), the MinnesotaCare benefit plan shall include the following co-payments and 
29.10 	coinsurance requirements for all enrollees:
29.11 	(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 
29.12 	subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 
29.13 	$3,000 per family;
29.14 	(2) $3 per prescription for adult enrollees;
29.15 	(3) $25 for eyeglasses for adult enrollees;
29.16 	(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
29.17 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
29.18 	established illness, and which is delivered in an ambulatory setting by a physician or 
29.19 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
29.20 	audiologist, optician, or optometrist; and
29.21 	(5) $6 for nonemergency visits to a hospital-based emergency room.
29.22 	(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 
29.23 	children under the age of 21 in households with family income equal to or less than 175 
29.24 	percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to 
29.25 	parents and relative caretakers of children under the age of 21 in households with family 
29.26 	income greater than 175 percent of the federal poverty guidelines for inpatient hospital 
29.27 	admissions occurring on or after January 1, 2001.
29.28 	(c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children 
29.29 	under the age of 21.
29.30 	(d) Adult enrollees with family gross income that exceeds 175 200 percent of the 
29.31 	federal poverty guidelines or 215 percent of the federal poverty guidelines on or after July 
29.32 	1, 2009, and who are not pregnant shall be financially responsible for the coinsurance 
29.33 	amount, if applicable, and amounts which exceed the $10,000 $20,000 inpatient hospital 
29.34 	benefit limit.
30.1 	(e) When a MinnesotaCare enrollee becomes a member of a prepaid health 
30.2 	plan, or changes from one prepaid health plan to another during a calendar year, any 
30.3 	charges submitted towards the $10,000 $20,000 annual inpatient benefit limit, and any 
30.4 	out-of-pocket expenses incurred by the enrollee for inpatient services, that were submitted 
30.5 	or incurred prior to enrollment, or prior to the change in health plans, shall be disregarded.

30.6 	Sec. 28. Minnesota Statutes 2006, section 256L.04, subdivision 1a, is amended to read:
30.7 		Subd. 1a.Social Security number required. (a) Individuals and families applying 
30.8 	for MinnesotaCare coverage must provide a Social Security number. This requirement 
30.9 	does not apply to an undocumented noncitizen or nonimmigrant who is eligible for 
30.10 	MinnesotaCare.
30.11 	(b) The commissioner shall not deny eligibility to an otherwise eligible applicant 
30.12 	who has applied for a Social Security number and is awaiting issuance of that Social 
30.13 	Security number.
30.14 	(c) Newborns enrolled under section 256L.05, subdivision 3, are exempt from the 
30.15 	requirements of this subdivision.
30.16 	(d) Individuals who refuse to provide a Social Security number because of 
30.17 	well-established religious objections are exempt from the requirements of this subdivision. 
30.18 	The term "well-established religious objections" has the meaning given in Code of Federal 
30.19 	Regulations, title 42, section 435.910.

30.20 	Sec. 29. Minnesota Statutes 2006, section 256L.04, subdivision 7, is amended to read:
30.21 		Subd. 7.Single adults and households with no children. The definition of eligible 
30.22 	persons includes all individuals and households with no children who have gross family 
30.23 	incomes that are equal to or less than 175 200 percent of the federal poverty guidelines.
30.24 	Effective July 1, 2009, the definition of eligible persons includes all individuals and 
30.25 	households with no children who have gross family incomes that are equal to or less than 
30.26 	215 percent of the federal poverty guidelines.

30.27 	Sec. 30. Minnesota Statutes 2006, section 256L.04, subdivision 10, is amended to read:
30.28 		Subd. 10.Citizenship requirements. (a) Eligibility for MinnesotaCare is limited 
30.29 	to citizens or nationals of the United States, qualified noncitizens, and other persons 
30.30 	residing lawfully in the United States as described in section 256B.06, subdivision 4, 
30.31 	paragraphs (a) to (e) and (j). Undocumented noncitizens and nonimmigrants are ineligible 
30.32 	for MinnesotaCare. This paragraph does not apply to children.
31.1 	(b) For purposes of this subdivision, a nonimmigrant is an individual in one or 
31.2 	more of the classes listed in United States Code, title 8, section 1101(a)(15), and an 
31.3 	undocumented noncitizen is an individual who resides in the United States without the 
31.4 	approval or acquiescence of the Immigration and Naturalization Service. 
31.5 	(c) Families with children who are citizens or nationals of the United States must 
31.6 	cooperate in obtaining satisfactory documentary evidence of citizenship or nationality 
31.7 	according to the requirements of the federal Deficit Reduction Act of 2005, Public Law 
31.8 	109-171. State and county workers must assist applicants in obtaining satisfactory 
31.9 	documentary evidence of citizenship or nationality.

31.10 	Sec. 31. Minnesota Statutes 2006, section 256L.05, subdivision 1, is amended to read:
31.11 		Subdivision 1.Application and information availability. Applications and other 
31.12 	information application assistance must be made available to at provider offices, local 
31.13 	human services agencies, school districts, public and private elementary schools in which 
31.14 	25 percent or more of the students receive free or reduced price lunches, community health 
31.15 	offices, and Women, Infants and Children (WIC) program sites, Head Start program sites, 
31.16 	public housing councils, crisis nurseries, child care centers, early childhood education 
31.17 	and preschool program sites, legal aid offices, and libraries. These sites may accept 
31.18 	applications and forward the forms to the commissioner or local county human services 
31.19 	agencies that choose to participate as an enrollment site. Otherwise, applicants may apply 
31.20 	directly to the commissioner or to participating local county human services agencies. 
31.21 	Beginning January 1, 2000, MinnesotaCare enrollment sites will be expanded to include 
31.22 	local county human services agencies which choose to participate.

31.23 	Sec. 32. Minnesota Statutes 2006, section 256L.05, subdivision 1b, is amended to read:
31.24 		Subd. 1b.MinnesotaCare enrollment by county agencies. Beginning September 
31.25 	1, 2006, county agencies shall enroll single adults and households with no children 
31.26 	formerly enrolled in general assistance medical care in MinnesotaCare according to 
31.27 	section 256D.03, subdivision 3. County agencies shall perform all duties necessary 
31.28 	to administer the MinnesotaCare program ongoing for these enrollees, including the 
31.29 	redetermination of MinnesotaCare eligibility at six-month renewal.

31.30 	Sec. 33. Minnesota Statutes 2006, section 256L.05, subdivision 2, is amended to read:
31.31 		Subd. 2.Commissioner's duties. (a) The commissioner or county agency shall 
31.32 	use electronic verification as the primary method of income verification. If there is a 
31.33 	discrepancy between reported income and electronically verified income, an individual 
32.1 	may be required to submit additional verification. In addition, the commissioner shall 
32.2 	perform random audits to verify reported income and eligibility. The commissioner 
32.3 	may execute data sharing arrangements with the Department of Revenue and any other 
32.4 	governmental agency in order to perform income verification related to eligibility and 
32.5 	premium payment under the MinnesotaCare program.
32.6 	(b) In determining eligibility for MinnesotaCare, the commissioner shall require 
32.7 	applicants and enrollees seeking renewal of eligibility to verify both earned and unearned 
32.8 	income. The commissioner shall also require applicants and enrollees to submit the names 
32.9 	of their employers and a contact name with a telephone number for each employer for 
32.10 	purposes of verifying whether the applicant or enrollee, and any dependents, are eligible 
32.11 	for employer-subsidized coverage. Data collected is nonpublic data as defined in section 
32.12 	13.02, subdivision 9.

32.13 	Sec. 34. Minnesota Statutes 2006, section 256L.05, subdivision 3a, is amended to read:
32.14 		Subd. 3a.Renewal of eligibility. (a) Beginning January 1, 1999 July 1, 2007, an 
32.15 	enrollee's eligibility must be renewed every 12 months. The 12-month period begins in 
32.16 	the month after the month the application is approved.
32.17 	(b) Beginning October 1, 2004, an enrollee's eligibility must be renewed every 
32.18 	six months. The first six-month period of eligibility begins the month the application is 
32.19 	received by the commissioner. The effective date of coverage within the first six-month 
32.20 	period of eligibility is as provided in subdivision 3. Each new period of eligibility must 
32.21 	take into account any changes in circumstances that impact eligibility and premium 
32.22 	amount. An enrollee must provide all the information needed to redetermine eligibility by 
32.23 	the first day of the month that ends the eligibility period. The premium for the new period 
32.24 	of eligibility must be received as provided in section 256L.06 in order for eligibility to 
32.25 	continue.
32.26 	(c) For single adults and households with no children formerly enrolled in general 
32.27 	assistance medical care and enrolled in MinnesotaCare according to section 256D.03, 
32.28 	subdivision 3, the first six-month period of eligibility begins the month the enrollee 
32.29 	submitted the application or renewal for general assistance medical care.

32.30 	Sec. 35. Minnesota Statutes 2006, section 256L.05, subdivision 3c, is amended to read:
32.31 		Subd. 3c.Retroactive coverage. Notwithstanding subdivision 3, the effective 
32.32 	date of coverage shall be the first day of the month following termination from medical 
32.33 	assistance or general assistance medical care for families and individuals who are eligible 
32.34 	for MinnesotaCare and who submitted a written request for retroactive MinnesotaCare 
33.1 	coverage with a completed application within 30 days of the mailing of notification of 
33.2 	termination from medical assistance or general assistance medical care. The applicant 
33.3 	must provide all required verifications within 30 days of the written request for 
33.4 	verification. For retroactive coverage, premiums must be paid in full for any retroactive 
33.5 	month, current month, and next month within 30 days of the premium billing.

33.6 	Sec. 36. Minnesota Statutes 2006, section 256L.07, subdivision 1, is amended to read:
33.7 		Subdivision 1.General requirements. (a) Children enrolled in the original 
33.8 	children's health plan as of September 30, 1992, children who enrolled in the 
33.9 	MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, 
33.10 	article 4, section 17, and children who have family gross incomes that are equal to or 
33.11 	less than 150 percent of the federal poverty guidelines are eligible without meeting 
33.12 	the requirements of subdivision 2 and the four-month requirement in subdivision 3, as 
33.13 	long as they maintain continuous coverage in the MinnesotaCare program or medical 
33.14 	assistance. Children who apply for MinnesotaCare on or after the implementation date 
33.15 	of the employer-subsidized health coverage program as described in Laws 1998, chapter 
33.16 	407, article 5, section 45, who have family gross incomes that are equal to or less than 150 
33.17 	percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to 
33.18 	be eligible for MinnesotaCare.
33.19 	(b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, 
33.20 	whose income increases above 275 percent of the federal poverty guidelines, are no 
33.21 	longer eligible for the program and shall be disenrolled by the commissioner. Individuals 
33.22 	enrolled in MinnesotaCare under section 256L.04, subdivision 7, whose income increases 
33.23 	above 175 200 percent of the federal poverty guidelines or 215 percent of the federal 
33.24 	poverty guidelines on or after July 1, 2009, are no longer eligible for the program and 
33.25 	shall be disenrolled by the commissioner. For persons disenrolled under this subdivision, 
33.26 	MinnesotaCare coverage terminates the last day of the calendar month following the 
33.27 	month in which the commissioner determines that the income of a family or individual 
33.28 	exceeds program income limits.
33.29 	(c) (b)  Notwithstanding paragraph (b) (a), children may remain enrolled in 
33.30 	MinnesotaCare if ten percent of their gross individual or gross family income as defined 
33.31 	in section 256L.01, subdivision 4, is less than the annual premium for a six-month
33.32 	policy with a $500 deductible available through the Minnesota Comprehensive Health 
33.33 	Association. Children who are no longer eligible for MinnesotaCare under this clause shall 
33.34 	be given a 12-month notice period from the date that ineligibility is determined before 
34.1 	disenrollment. The premium for children remaining eligible under this clause shall be the 
34.2 	maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
34.3 	(d) Notwithstanding paragraphs (b) and (c), parents are not eligible for 
34.4 	MinnesotaCare if gross household income exceeds $25,000 for the six-month period 
34.5 	of eligibility.

34.6 	Sec. 37. Minnesota Statutes 2006, section 256L.07, subdivision 2, is amended to read:
34.7 		Subd. 2.Must not have access to employer-subsidized coverage. (a) To be 
34.8 	eligible, a family or individual an adult must not have access to subsidized health coverage 
34.9 	through an employer and must not have had access to employer-subsidized coverage 
34.10 	through a current employer for 18 months prior to application or reapplication. A family 
34.11 	or individual An adult whose employer-subsidized coverage is lost due to an employer 
34.12 	terminating health care coverage as an employee benefit during the previous 18 months 
34.13 	is not eligible.
34.14 	(b) This subdivision does not apply to a family or individual an adult who was 
34.15 	enrolled in MinnesotaCare within six months or less of reapplication and who no longer 
34.16 	has employer-subsidized coverage due to the employer terminating health care coverage 
34.17 	as an employee benefit.
34.18 	(c) For purposes of this requirement, subsidized health coverage means health 
34.19 	coverage for which the employer pays at least 50 percent of the cost of coverage for 
34.20 	the employee or dependent, or a higher percentage as specified by the commissioner. 
34.21 	Children are eligible for employer-subsidized coverage through either parent, including 
34.22 	the noncustodial parent. The commissioner must treat employer contributions to Internal 
34.23 	Revenue Code Section 125 plans and any other employer benefits intended to pay 
34.24 	health care costs as qualified employer subsidies toward the cost of health coverage for 
34.25 	employees for purposes of this subdivision.
34.26 	(d) Notwithstanding paragraph (c), if an employer-subsidized health plan requires 
34.27 	the employee to pay more than eight percent of the employee's family gross income in 
34.28 	co-payments, deductibles, or coinsurance, the health coverage offered shall not constitute 
34.29 	employer-subsidized coverage for purposes of determining eligibility for MinnesotaCare.
34.30 	(e) This subdivision does not apply to children.

34.31 	Sec. 38. Minnesota Statutes 2006, section 256L.07, subdivision 3, is amended to read:
34.32 		Subd. 3.Other health coverage. (a) Families and individualsAdults enrolled in the 
34.33 	MinnesotaCare program must have no health coverage while enrolled or for at least four 
34.34 	months prior to application and renewal. Children enrolled in the original children's health 
35.1 	plan and children in families with income equal to or less than 150 percent of the federal 
35.2 	poverty guidelines, who have other health insurance, are eligible if the coverage:
35.3 	(1) lacks two or more of the following:
35.4 	(i) basic hospital insurance;
35.5 	(ii) medical-surgical insurance;
35.6 	(iii) prescription drug coverage;
35.7 	(iv) dental coverage; or
35.8 	(v) vision coverage;
35.9 	(2) requires a deductible of $100 or more per person per year; or
35.10 	(3) lacks coverage because the child has exceeded the maximum coverage for a 
35.11 	particular diagnosis or the policy excludes a particular diagnosis.
35.12 	The commissioner may change this eligibility criterion for sliding scale premiums in 
35.13 	order to remain within the limits of available appropriations. The requirement of no health 
35.14 	coverage This paragraph does not apply to newborns children.
35.15 	(b) Medical assistance, general assistance medical care, and the Civilian Health and 
35.16 	Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under 
35.17 	United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or 
35.18 	health coverage for purposes of the four-month requirement described in this subdivision.
35.19 	(c) For purposes of this subdivision, an applicant or enrollee who is entitled to 
35.20 	Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social 
35.21 	Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to 
35.22 	have health coverage. An applicant or enrollee who is entitled to premium-free Medicare 
35.23 	Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility 
35.24 	for MinnesotaCare.
35.25 	(d) Applicants who were recipients of medical assistance or general assistance 
35.26 	medical care within one month of application must meet the provisions of this subdivision 
35.27 	and subdivision 2.
35.28 	(e) Cost-effective health insurance that was paid for by medical assistance is not 
35.29 	considered health coverage for purposes of the four-month requirement under this 
35.30 	section, except if the insurance continued after medical assistance no longer considered it 
35.31 	cost-effective or after medical assistance closed.

35.32 	Sec. 39. Minnesota Statutes 2006, section 256L.07, subdivision 6, is amended to read:
35.33 		Subd. 6.Exception for certain adults. Single adults and households with 
35.34 	no children formerly enrolled in general assistance medical care and enrolled in 
36.1 	MinnesotaCare according to section 256D.03, subdivision 3, are eligible without meeting 
36.2 	the requirements of this section until six-month renewal.

36.3 	Sec. 40. Minnesota Statutes 2006, section 256L.09, subdivision 4, is amended to read:
36.4 		Subd. 4.Eligibility as Minnesota resident. (a) For purposes of this section, a 
36.5 	permanent Minnesota resident is a person who has demonstrated, through persuasive and 
36.6 	objective evidence, that the person is domiciled in the state and intends to live in the 
36.7 	state permanently.
36.8 	(b) To be eligible as a permanent resident, an applicant must demonstrate the 
36.9 	requisite intent to live in the state permanently by:
36.10 	(1) showing that the applicant maintains a residence at a verified address other than a 
36.11 	place of public accommodation, through the use of evidence of residence described in 
36.12 	section 256D.02, subdivision 12a, paragraph (b), clause (1) (2); 
36.13 	(2) demonstrating that the applicant has been continuously domiciled in the state for 
36.14 	no less than 180 days immediately before the application; and
36.15 	(3) signing an affidavit declaring that (A) the applicant currently resides in the state 
36.16 	and intends to reside in the state permanently; and (B) the applicant did not come to the 
36.17 	state for the primary purpose of obtaining medical coverage or treatment.
36.18 	(c) A person who is temporarily absent from the state does not lose eligibility for 
36.19 	MinnesotaCare. "Temporarily absent from the state" means the person is out of the state 
36.20 	for a temporary purpose and intends to return when the purpose of the absence has been 
36.21 	accomplished. A person is not temporarily absent from the state if another state has 
36.22 	determined that the person is a resident for any purpose. If temporarily absent from the 
36.23 	state, the person must follow the requirements of the health plan in which the person is 
36.24 	enrolled to receive services.

36.25 	Sec. 41. Minnesota Statutes 2006, section 256L.15, subdivision 1, is amended to read:
36.26 		Subdivision 1.Premium determination. (a) Families with children and individuals 
36.27 	shall pay a premium determined according to subdivision 2.
36.28 	(b) Pregnant women and children under age two are exempt from the provisions 
36.29 	of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment 
36.30 	for failure to pay premiums. For pregnant women, this exemption continues until the 
36.31 	first day of the month following the 60th day postpartum. Women who remain enrolled 
36.32 	during pregnancy or the postpartum period, despite nonpayment of premiums, shall be 
36.33 	disenrolled on the first of the month following the 60th day postpartum for the penalty 
36.34 	period that otherwise applies under section 256L.06, unless they begin paying premiums. 
37.1 	(c) Members of the military and their families who meet the eligibility criteria 
37.2 	for MinnesotaCare upon eligibility approval made within 24 months following the end 
37.3 	of the member's tour of active duty shall have their premiums paid by the commissioner. 
37.4 	The effective date of coverage for an individual or family who meets the criteria of this 
37.5 	paragraph shall be the first day of the month following the month in which eligibility is 
37.6 	approved. This exemption shall apply for 12 months. 

37.7 	EFFECTIVE DATE. This section is effective July 1, 2007, or upon federal 
37.8 	approval, whichever is later.

37.9 	Sec. 42. Minnesota Statutes 2006, section 256L.15, subdivision 2, is amended to read:
37.10 		Subd. 2.Sliding fee scale; monthly gross individual or family income. (a) The 
37.11 	commissioner shall establish a sliding fee scale to determine the percentage of monthly 
37.12 	gross individual or family income that households at different income levels must pay 
37.13 	to obtain coverage through the MinnesotaCare program. The sliding fee scale must be 
37.14 	based on the enrollee's monthly gross individual or family income. The sliding fee scale 
37.15 	must contain separate tables based on enrollment of one, two, or three or more persons. 
37.16 	The sliding fee scale begins with a premium of 1.5 percent of monthly gross individual or 
37.17 	family income for individuals or families with incomes below the limits for the medical 
37.18 	assistance program for families and children in effect on January 1, 1999, and proceeds 
37.19 	through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. 
37.20 	These percentages are matched to evenly spaced income steps ranging from the medical 
37.21 	assistance income limit for families and children in effect on January 1, 1999, to 275 
37.22 	percent of the federal poverty guidelines for the applicable family size, up to a family size 
37.23 	of five. The sliding fee scale for a family of five must be used for families of more than 
37.24 	five. Effective October 1, 2003, the commissioner shall increase each percentage by 0.5 
37.25 	percentage points for enrollees with income greater than 100 percent but not exceeding 
37.26 	200 percent of the federal poverty guidelines and shall increase each percentage by 1.0 
37.27 	percentage points for families and children with incomes greater than 200 percent of 
37.28 	the federal poverty guidelines. The sliding fee scale and percentages are not subject to 
37.29 	the provisions of chapter 14. If a family or individual reports increased income after 
37.30 	enrollment, premiums shall be adjusted at the time the change in income is reported.
37.31 	(b) Children in Families whose gross income is above 275 percent of the federal 
37.32 	poverty guidelines shall pay the maximum premium. The maximum premium is defined 
37.33 	as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare 
37.34 	cases paid the maximum premium, the total revenue would equal the total cost of 
37.35 	MinnesotaCare medical coverage and administration. In this calculation, administrative 
38.1 	costs shall be assumed to equal ten percent of the total. The costs of medical coverage 
38.2 	for pregnant women and children under age two and the enrollees in these groups shall 
38.3 	be excluded from the total. The maximum premium for two enrollees shall be twice the 
38.4 	maximum premium for one, and the maximum premium for three or more enrollees shall 
38.5 	be three times the maximum premium for one.
38.6 	(c) After calculating the percentage of premium each enrollee shall pay under 
38.7 	paragraph (a), eight percent shall be added to the premium.

38.8 	EFFECTIVE DATE. This section is effective July 1, 2007.

38.9 	Sec. 43. Minnesota Statutes 2006, section 256L.15, subdivision 4, is amended to read:
38.10 		Subd. 4.Exception for transitioned adults. County agencies shall pay premiums 
38.11 	for single adults and households with no children formerly enrolled in general assistance 
38.12 	medical care and enrolled in MinnesotaCare according to section 256D.03, subdivision 3, 
38.13 	until six-month renewal for six months. The county agency has the option of continuing to 
38.14 	pay premiums for these enrollees past the first six-monthsix months until the 12-month 
38.15 	renewal period.

38.16 	Sec. 44. Minnesota Statutes 2006, section 256L.17, subdivision 2, is amended to read:
38.17 		Subd. 2.Limit on total assets. (a) Effective July 1, 2002, or upon federal approval, 
38.18 	whichever is later, in order to be eligible for the MinnesotaCare program, a household of 
38.19 	two or more persons must not own more than $20,000 in total net assets, and a household 
38.20 	of one person must not own more than $10,000 in total net assets.
38.21 	(b) For purposes of this subdivision, assets are determined according to section 
38.22 	256B.056, subdivision 3c, except that workers' compensation settlements received due to 
38.23 	a work-related injury shall not be considered. 
38.24 	(c) State-funded MinnesotaCare is not available for applicants or enrollees who are 
38.25 	otherwise eligible for medical assistance but fail to verify assets. Enrollees who become 
38.26 	eligible for federally funded medical assistance shall be terminated from state-funded 
38.27 	MinnesotaCare and transferred to medical assistance.

38.28 	Sec. 45. Minnesota Statutes 2006, section 256L.17, subdivision 3, is amended to read:
38.29 		Subd. 3.Documentation. (a) The commissioner of human services shall require 
38.30 	individuals and families, at the time of application or renewal, to indicate on a checkoff 
38.31 	form developed by the commissioner whether they satisfy the MinnesotaCare asset 
38.32 	requirement. This form must include the following or similar language: "To be eligible for 
38.33 	MinnesotaCare, individuals and families must not own net assets in excess of $30,000 
39.1 	for a household of two or more persons or $15,000 for a household of one person, not 
39.2 	including a homestead, household goods and personal effects, assets owned by children, 
39.3 	vehicles used for employment, court-ordered settlements up to $10,000, individual 
39.4 	retirement accounts, and capital and operating assets of a trade or business up to $200,000. 
39.5 	Do you and your household own net assets in excess of these limits?"
39.6 	(b) The commissioner may require individuals and families to provide any 
39.7 	information the commissioner determines necessary to verify compliance with the asset 
39.8 	requirement, if the commissioner determines that there is reason to believe that an 
39.9 	individual or family has assets that exceed the program limit.

39.10 	Sec. 46. Minnesota Statutes 2006, section 256L.17, subdivision 7, is amended to read:
39.11 		Subd. 7.Exception for certain adults. Single adults and households with 
39.12 	no children formerly enrolled in general assistance medical care and enrolled in 
39.13 	MinnesotaCare according to section 256D.03, subdivision 3, are exempt from the 
39.14 	requirements of this section until six-month renewal.

39.15 	Sec. 47. [256L.20] MINNESOTACARE OPTION FOR SMALL EMPLOYERS.
39.16 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms 
39.17 	have the meanings given them.
39.18 	(b) "Dependent" means an unmarried child who is under the age of 21 and who is 
39.19 	not eligible for employer-subsidized health coverage. 
39.20 	(c) "Eligible employee" means an employee who works at least 20 hours per week 
39.21 	for an eligible employer. Eligible employee does not include an employee who works 
39.22 	on a temporary or substitute basis or who does not work more than 26 weeks annually. 
39.23 	Coverage of an eligible employee includes the employee's spouse if the spouse does not 
39.24 	have access to employer-subsidized health coverage. 
39.25 	(d) "Eligible employer" means a business that employs at least two, but not more 
39.26 	than 50, eligible employees, the majority of whom are employed in the state, and includes 
39.27 	a municipality that has 50 or fewer employees. 
39.28 	(e) "Employer-subsidized health coverage" has the meaning given under section 
39.29 	256L.07, subdivision 2, paragraph (c).
39.30 	(f) "Maximum premium" has the meaning given under section 256L.15, subdivision 
39.31 	2, paragraph (b), except that the cost of medical coverage for single adults and households 
39.32 	without children formerly enrolled in general assistance medical care and enrolled in 
39.33 	MinnesotaCare in accordance with section 256D.03, subdivision 3, paragraph (c), are 
39.34 	excluded from the total cost when determining the maximum premium.
40.1 	(g) "Participating employer" means an eligible employer who meets the requirements 
40.2 	in subdivision 3 and applies to the commissioner to enroll its eligible employees and their 
40.3 	dependents in the MinnesotaCare program.
40.4 	(h) "Program" means the MinnesotaCare program. 
40.5 		Subd. 2.Application and renewal procedures. (a) Eligible employees and their 
40.6 	dependents may enroll in MinnesotaCare through their employer if their employer meets 
40.7 	the requirements of subdivision 3. The commissioner shall establish procedures for an 
40.8 	eligible employer to participate in the program. The commissioner shall provide an 
40.9 	employer with applications for each eligible employee. The employee must fill out the 
40.10 	application and submit it to the employer. The employer must submit the completed 
40.11 	applications to the commissioner. The commissioner shall determine eligibility for the 
40.12 	program and determine the premiums owed by the employer for each eligible employee. 
40.13 	The commissioner may require eligible employees to provide income verification to 
40.14 	determine premiums.
40.15 	(b) The effective date of coverage is in accordance with section 256L.05, subdivision 
40.16 	3.
40.17 	(c) An employer's eligibility must be renewed every 12 months. At that time, all 
40.18 	eligible employees enrolled in the program regardless of their enrollment date must 
40.19 	reapply.
40.20 	(d) A participating employer must inform the commissioner of any changes in its 
40.21 	employees and premiums must be adjusted accordingly beginning the first day of the 
40.22 	month following the month in which the change is reported. An employer's premiums 
40.23 	shall not be adjusted due to a change in an employee's income until the next renewal 
40.24 	period. Eligible employees hired after enrollment must fill out an application and submit 
40.25 	the application to the commissioner. Employees who terminate their employment with 
40.26 	the participating employer shall remain enrolled in the program until the last day of the 
40.27 	month in which employment is terminated. A terminating employee may remain in the 
40.28 	MinnesotaCare program if the employee meets the eligibility requirements of enrollment 
40.29 	described in sections 256L.01 to 256L.18.
40.30 		Subd. 3.Employer requirements.  In order to participate, an eligible employer 
40.31 	must meet the following requirements:
40.32 	(1) agree to contribute toward the cost of the premium for the employee, the 
40.33 	employee's spouse, and the employee's dependents according to subdivision 4; 
40.34 	(2) certify that each eligible employee was informed of the availability of coverage 
40.35 	through the program and that at least 75 percent of its eligible employees are planning to 
40.36 	or are enrolled in the program; and
41.1 	(3) have not provided employer-subsidized health coverage as an employee benefit 
41.2 	during the previous 12 months, as defined in section 256L.07, subdivision 2, paragraph (c). 
41.3 		Subd. 4.Premiums. (a) The premium for coverage provided under this section is 
41.4 	equal to the maximum premium as defined in subdivision 1 regardless of the income 
41.5 	of the eligible employee.
41.6 	(b) For eligible employees without dependents with a gross family income equal to 
41.7 	or less than 200 percent of the federal poverty guidelines or 215 percent of the federal 
41.8 	poverty guidelines on or after July 1, 2009, and for eligible employees with dependents 
41.9 	whose gross family income is equal to or less than 275 percent of the federal poverty 
41.10 	guidelines, the participating employer shall pay 50 percent of the premium established 
41.11 	under paragraph (a) for the eligible employee, the employee's spouse, and any dependents, 
41.12 	if applicable. 
41.13 	(c) For eligible employees without dependents with a gross family income over 200 
41.14 	percent of the federal poverty guidelines or 215 percent of the federal poverty guidelines 
41.15 	on or after July 1, 2009, and for eligible employees with dependents with a gross family 
41.16 	income over 275 percent of the federal poverty guidelines, the participating employer shall 
41.17 	pay the full cost of the premium established under paragraph (a) for the eligible employee, 
41.18 	the employee's spouse, and any dependents, if applicable. The participating employer may 
41.19 	require the employee to pay a portion of the cost of the premium so long as the employer 
41.20 	pays at least 50 percent. If the employer requires the employee to pay a portion of the 
41.21 	premium, the employee shall pay the portion of the cost to the employer. 
41.22 	(d) The commissioner shall collect premium payments from participating employers 
41.23 	for eligible employees, spouses, and dependents who are covered by the program as 
41.24 	provided under this section. All premiums collected shall be deposited in the health care 
41.25 	access fund. 
41.26 	(e) Nonpayment of premiums by a participating employer will result in the 
41.27 	disenrollment of all eligible employees, spouses, and dependents from the program 
41.28 	effective the end of the month in which the premium was due.
41.29 		Subd. 5.Coverage. The coverage offered to those enrolled in the program under 
41.30 	this section shall include all health services described under section 256L.03 and all 
41.31 	co-payments and coinsurance requirements under section 256L.03 shall apply.
41.32 		Subd. 6.Enrollment. For purposes of enrollment under this section, income 
41.33 	eligibility limits established under sections 256L.04 and 256L.07, asset limits established 
41.34 	under section 256L.17, and the barriers established under section 256L.07, subdivision 2 
41.35 	or 3, do not apply to applicants eligible for this program unless specified in this section. 
41.36 	The residency requirement under section 256L.09 shall apply.
42.1 		Subd. 7.Outreach. The commissioner shall provide information on the availability 
42.2 	of this buy-in option for small employers and application forms to entities that provide 
42.3 	insurance information to small employers, including, but not limited to, insurance agents 
42.4 	and chambers of commerce. The commissioner shall establish an assistance fee of $25 per 
42.5 	enrolled employee for such entities that assist eligible employers and their employees in 
42.6 	applying to the program.

42.7 	Sec. 48. Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2, 
42.8 	is amended to read:

42.942.10
	Subd. 2.Community and Family Health 
Improvement

42.11	Summary by Fund
	
42.12	General
	40,413,000
	40,382,000
	
42.13
42.14	State Government 
Special Revenue
	141,000
	128,000
	
42.15	Health Care Access
	3,510,000
	3,516,000
	
42.16	Federal TANF
	6,000,000
	6,000,000
	
42.17 	FAMILY PLANNING BASE 
42.18 	REDUCTION. Base level funding for 
42.19 	the family planning special projects grant 
42.20 	program is reduced by $1,877,000 each 
42.21 	year of the biennium beginning July 1, 
42.22 	2007, provided that this reduction shall 
42.23 	only take place upon full implementation of 
42.24 	the family planning project section of the 
42.25 	1115 waiver. Notwithstanding Minnesota 
42.26 	Statutes, section 145.925, the commissioner 
42.27 	shall give priority to community health care 
42.28 	clinics providing family planning services 
42.29 	that either serve a high number of women 
42.30 	who do not qualify for medical assistance 
42.31 	or are unable to participate in the medical 
42.32 	assistance program as a medical assistance 
42.33 	provider when allocating the remaining 
42.34 	appropriations. Notwithstanding section 15, 
42.35 	this paragraph shall not expire.
43.1 	SHAKEN BABY VIDEO. Of the 
43.2 	state government special revenue fund 
43.3 	appropriation, $13,000 in 2006 is 
43.4 	appropriated to the commissioner of health 
43.5 	to provide a video to hospitals on shaken 
43.6 	baby syndrome. The commissioner of health 
43.7 	shall assess a fee to hospitals to cover the 
43.8 	cost of the approved shaken baby video and 
43.9 	the revenue received is to be deposited in the 
43.10 	state government special revenue fund.

43.11 	Sec. 49. ADMINISTRATIVE SIMPLIFICATION.
 43.12 	All health care providers and health plans that contract with the state of Minnesota 
43.13 	to provide health care services either through the health care programs administered 
43.14 	under Minnesota Statutes, chapters 256B, 256D, and 256L, or through the state employee 
43.15 	group insurance program administered under Minnesota Statutes, chapter 43A, must 
43.16 	use and accept the uniform billing forms and coding requirements established by the 
43.17 	Administrative Uniformity Committee by January 1, 2009.

43.18 	Sec. 50. APPROPRIATION.
 43.19 	(a) $....... is appropriated from the health care access fund to the commissioner of 
43.20 	human services for the biennium beginning July 1, 2007, for the purpose of Minnesota 
43.21 	health care programs outreach grants and the enrollment incentive programs under 
43.22 	Minnesota Statutes, section 256.962.
43.23 	(b) $1,156,000 is appropriated each fiscal year beginning July 1, 2007, from the 
43.24 	general fund to the commissioner of health for family planning grants under Minnesota 
43.25 	Statutes, section 145.925.
43.26 	(c) $....... is appropriated for the biennium beginning July 1, 2007, from the general 
43.27 	fund to the commissioner of human services for the critical access dental providers 
43.28 	reimbursement rates under Minnesota Statutes, section 256B.76, paragraph (c).
43.29 	(d) $....... is appropriated for the biennium beginning July 1, 2007, from the general 
43.30 	fund to the commissioner of health for the subsidies for federally qualified health centers 
43.31 	under Minnesota Statutes, section 145.9269.
43.32 	(e) $....... is appropriated for the biennium beginning July 1, 2007, from the general 
43.33 	fund to the commissioner of human services for the patient incentive health program 
43.34 	established in Minnesota Statutes, section 256.01, subdivision 2b, paragraph (b).

44.1 	Sec. 51.  REPEALER.
 44.2 	Minnesota Statutes 2006, sections 62A.301; 256B.0631; and 256L.035, are repealed.