Skip to main content Skip to office menu Skip to footer
Minnesota Legislature

Office of the Revisor of Statutes

SF 2667

as introduced - 91st Legislature (2019 - 2020) Posted on 03/25/2019 04:34pm

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7
1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24
2.1
2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11
2.12
2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 3.1 3.2 3.3 3.4 3.5 3.6 3.7
3.8
3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17
3.18
3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32
4.1
4.2 4.3 4.4
4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13
4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27
6.28 6.29 6.30
7.1 7.2 7.3
7.4 7.5 7.6 7.7
7.8 7.9 7.10
7.11

A bill for an act
relating to finance; appropriating money; repealing the health care access fund;
amending Minnesota Statutes 2018, sections 43A.317, subdivision 8; 144.1501,
subdivision 5; 256B.0755, subdivision 4; 295.58; 297I.05, subdivision 5; repealing
Minnesota Statutes 2018, sections 16A.724; 62U.10, subdivisions 1, 4, 8; 295.52,
subdivision 8; 295.581.

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

Section 1.

Minnesota Statutes 2018, section 43A.317, subdivision 8, is amended to read:


Subd. 8.

Premiums.

(a) Payments. Employers enrolled in the program shall pay
premiums according to terms established by the commissioner. If an employer fails to make
the required payments, the commissioner may cancel coverage and pursue other civil
remedies.

(b) Rating method. The commissioner shall determine the premium rates and rating
method for the program. The rating method for eligible small employers must meet or exceed
the requirements of chapter 62L. The rating methods must recover in premiums all of the
ongoing costs for state administration and for maintenance of a premium stability and claim
fluctuation reserve. deleted text beginOn June 30, 1999, after paying all necessary and reasonable expenses,
the commissioner must apply up to $2,075,000 of any remaining balance in the Minnesota
employees' insurance trust fund to repayment of any amounts drawn or expended for this
program from the health care access fund.
deleted text end

(c) Taxes and assessments. To the extent that the program operates as a self-insured
group, the premiums paid to the program are not subject to the taxes imposed by chapter
297I, but the program is subject to a Minnesota Comprehensive Health Association
assessment under section 62E.11.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

Sec. 2.

Minnesota Statutes 2018, section 144.1501, subdivision 5, is amended to read:


Subd. 5.

Penalty for nonfulfillment.

If a participant does not fulfill the required
minimum commitment of service according to subdivision 3, the commissioner of health
shall collect from the participant the total amount paid to the participant under the loan
forgiveness program plus interest at a rate established according to section 270C.40. The
commissioner shall deposit the money collected in the deleted text beginhealth care accessdeleted text endnew text begin generalnew text end fund to
be credited to the health professional education loan forgiveness program account established
in subdivision 2. The commissioner shall allow waivers of all or part of the money owed
the commissioner as a result of a nonfulfillment penalty if emergency circumstances
prevented fulfillment of the minimum service commitment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

Sec. 3.

Minnesota Statutes 2018, section 256B.0755, subdivision 4, is amended to read:


Subd. 4.

Payment system.

(a) In developing a payment system for integrated health
partnerships, the commissioner shall establish a total cost of care benchmark or a risk/gain
sharing payment model to be paid for services provided to the recipients enrolled in an
integrated health partnership.

(b) The payment system may include incentive payments to integrated health partnerships
that meet or exceed annual quality and performance targets realized through the coordination
of care.

deleted text begin (c) An amount equal to the savings realized to the general fund as a result of the
demonstration project shall be transferred each fiscal year to the health care access fund.
deleted text end

deleted text begin (d)deleted text endnew text begin (c)new text end The payment system shall include a population-based payment that supports care
coordination services for all enrollees served by the integrated health partnerships, and is
risk-adjusted to reflect varying levels of care coordination intensiveness for enrollees with
chronic conditions, limited English skills, cultural differences, are homeless, or experience
health disparities or other barriers to health care. The population-based payment shall be a
per member, per month payment paid at least on a quarterly basis. Integrated health
partnerships receiving this payment must continue to meet cost and quality metrics under
the program to maintain eligibility for the population-based payment. An integrated health
partnership is eligible to receive a payment under this paragraph even if the partnership is
not participating in a risk-based or gain-sharing payment model and regardless of the size
of the patient population served by the integrated health partnership. Any integrated health
partnership participant certified as a health care home under section 256B.0751 that agrees
to a payment method that includes population-based payments for care coordination is not
eligible to receive health care home payment or care coordination fee authorized under
section 62U.03 or 256B.0753, subdivision 1, or in-reach care coordination under section
256B.0625, subdivision 56, for any medical assistance or MinnesotaCare recipients enrolled
or attributed to the integrated health partnership under this demonstration.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

Sec. 4.

Minnesota Statutes 2018, section 295.58, is amended to read:


295.58 DEPOSIT OF REVENUES AND PAYMENT OF REFUNDS.

The commissioner shall deposit all revenues, including penalties and interest, derived
from the taxes imposed by sections 295.50 to 295.57 and from the insurance premiums tax
imposed by section 297I.05, subdivision 5, on health maintenance organizations, community
integrated service networks, and nonprofit health service plan corporations in the deleted text beginhealth
care access
deleted text endnew text begin generalnew text end fund. There is annually appropriated from the deleted text beginhealth care accessdeleted text endnew text begin generalnew text end
fund to the commissioner of revenue the amount necessary to make refunds under this
chapter.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

Sec. 5.

Minnesota Statutes 2018, section 297I.05, subdivision 5, is amended to read:


Subd. 5.

Health maintenance organizations, nonprofit health service plan
corporations, and community integrated service networks.

(a) A tax is imposed on health
maintenance organizations, community integrated service networks, and nonprofit health
care service plan corporations. The rate of tax is equal to one percent of gross premiums
less return premiums on all direct business received by the organization, network, or
corporation or its agents in Minnesota, in cash or otherwise, in the calendar year.

(b) The commissioner shall deposit all revenues, including penalties and interest, collected
under this chapter from health maintenance organizations, community integrated service
networks, and nonprofit health service plan corporations in the deleted text beginhealth care accessdeleted text endnew text begin generalnew text end
fund. Refunds of overpayments of tax imposed by this subdivision must be paid from the
deleted text begin health care accessdeleted text endnew text begin generalnew text end fund. There is annually appropriated from the deleted text beginhealth care accessdeleted text endnew text begin
general
new text end fund to the commissioner the amount necessary to make any refunds of the tax
imposed under this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

Sec. 6. new text beginTRANSFER.
new text end

new text begin On January 1, 2020, the commissioner of management and budget shall transfer any
balance in the health care access fund to the general fund.
new text end

Sec. 7. new text beginAPPROPRIATIONS; COMMISSIONER OF HUMAN SERVICES.
new text end

new text begin (a) $26,772,000 in fiscal year 2020 and $29,526,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of human services for MinnesotaCare.
new text end

new text begin (b) $438,848,000 in fiscal year 2020 and $438,848,000 in fiscal year 2021 are
appropriated from the general fund to the commissioner of human services for the medical
assistance program.
new text end

new text begin (c) $35,497,000 in fiscal year 2020 and $35,497,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of human services for operations related to
administration of MinnesotaCare.
new text end

Sec. 8. new text beginAPPROPRIATIONS; COMMISSIONER OF HEALTH.
new text end

new text begin (a) $244,000 in fiscal year 2020 and $244,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for health policy management.
new text end

new text begin (b) $1,476,000 in fiscal year 2020 and $1,476,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of health for the health economics program.
new text end

new text begin (c) $675,000 in fiscal year 2020 and $675,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for the health care access survey.
new text end

new text begin (d) $938,000 in fiscal year 2020 and $938,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for data management and technology.
new text end

new text begin (e) $1,819,000 in fiscal year 2020 and $1,819,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of health for administration of health care homes
under Minnesota Statutes, section 256B.0751.
new text end

new text begin (f) $2,047,000 in fiscal year 2020 and $2,047,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of health for rural health and primary care under
Minnesota Statutes, section 144.1483.
new text end

new text begin (g) $100,000 in fiscal year 2020 and $100,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for matching funds for the federal National
Health Service Program.
new text end

new text begin (h) $133,000 in fiscal year 2020 and $133,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for the international medical graduate
education program under Minnesota Statutes, section 144.1911.
new text end

new text begin (i) $529,000 in fiscal year 2020 and $529,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for health information technology under
Minnesota Statutes, section 62J.495.
new text end

new text begin (j) $231,000 in fiscal year 2020 and $231,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for all payer claims database public use files
under Minnesota Statutes, section 62U.04.
new text end

new text begin (k) $2,656,000 in fiscal year 2020 and $2,656,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of health for health care transformation.
new text end

new text begin (l) $180,000 in fiscal year 2020 and $180,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for chronic conditions outcomes reporting.
new text end

new text begin (m) $1,000,000 in fiscal year 2020 and $1,000,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of health for medical education and research
costs grants under Minnesota Statutes, section 62J.692.
new text end

new text begin (n) $3,240,000 in fiscal year 2020 and $3,240,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of health for health professional education loan
forgiveness programs under Minnesota Statutes, section 144.1501.
new text end

new text begin (o) $250,000 in fiscal year 2020 and $250,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for community clinic grants under Minnesota
Statutes, section 145.9268.
new text end

new text begin (p) $300,000 in fiscal year 2020 and $300,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for rural hospital transition grants under
Minnesota Statutes, section 144.147.
new text end

new text begin (q) $1,000,000 in fiscal year 2020 and $1,000,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of health for greater Minnesota residency grants
under Minnesota Statutes, section 144.1912.
new text end

new text begin (r) $300,000 in fiscal year 2020 and $300,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for health care intern grants under Minnesota
Statutes, section 144.1464.
new text end

new text begin (s) $219,000 in fiscal year 2020 and $219,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for federally qualified health center grants
under Minnesota Statutes, section 145.9269.
new text end

new text begin (t) $867,000 in fiscal year 2020 and $867,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for international medical residency grants
under Minnesota Statutes, section 144.1911.
new text end

new text begin (u) $63,000 in fiscal year 2020 and $63,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for grants to safety net providers under
Minnesota Statutes, section 145.929, subdivision 1, for dental services.
new text end

new text begin (v) $219,000 in fiscal year 2020 and $219,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for grants to safety net providers under
Minnesota Statutes, section 145.929, subdivision 2, for mental health services.
new text end

new text begin (w) $725,000 in fiscal year 2020 and $725,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for grants to safety net hospitals under
Minnesota Statutes, section 145.929, subdivision 3.
new text end

new text begin (x) $14,634,000 in fiscal year 2020 and $14,634,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of health for the statewide health improvement
program grants under Minnesota Statutes, section 145.986.
new text end

new text begin (y) $2,945,000 in fiscal year 2020 and $2,945,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of health for administration of the statewide
health improvement program under Minnesota Statutes, section 144.148.
new text end

new text begin (z) $68,000 in fiscal year 2020 and $68,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of health for the information clearinghouse under
Minnesota Statutes, section 62J.2930.
new text end

Sec. 9. new text beginAPPROPRIATION; UNIVERSITY OF MINNESOTA.
new text end

new text begin $2,157,000 in fiscal year 2020 and $2,157,000 in fiscal year 2021 are appropriated from
the general fund to the University of Minnesota for primary care education initiatives.
new text end

Sec. 10. new text beginAPPROPRIATION; LEGISLATIVE COORDINATING COMMISSION.
new text end

new text begin $128,000 in fiscal year 2020 and $128,000 in fiscal year 2021 are appropriated from the
general fund to the Legislative Coordinating Commission.
new text end

Sec. 11. new text beginAPPROPRIATION; COMMISSIONER OF REVENUE.
new text end

new text begin $....... in fiscal year 2020 and $....... in fiscal year 2021 are appropriated from the general
fund to the commissioner of revenue for administration of taxes under Minnesota Statutes,
section 297I.05.
new text end

Sec. 12. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 16A.724; 62U.10, subdivisions 1, 4, and 8; 295.52,
subdivision 8; and 295.581,
new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

APPENDIX

Repealed Minnesota Statutes: 19-4715

16A.724 HEALTH CARE ACCESS FUND.

Subdivision 1.

Creation of fund.

A health care access fund is created in the state treasury. The fund is a direct appropriated special revenue fund. The commissioner shall deposit to the credit of the fund money made available to the fund. Notwithstanding section 11A.20, after June 30, 1997, all investment income and all investment losses attributable to the investment of the health care access fund not currently needed shall be credited to the health care access fund.

Subd. 2.

Transfers.

(a) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund, effective for the biennium beginning July 1, 2007, the commissioner of management and budget shall transfer the excess funds from the health care access fund to the general fund on June 30 of each year, provided that the amount transferred in fiscal year 2016 shall not exceed $48,000,000, the amount in fiscal year 2017 shall not exceed $122,000,000, and the amount in any fiscal biennium thereafter shall not exceed $244,000,000. The purpose of this transfer is to meet the rate increase required under Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision 6.

(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if necessary, the commissioner shall reduce these transfers from the health care access fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer sufficient funds from the general fund to the health care access fund to meet annual MinnesotaCare expenditures.

Subd. 3.

MinnesotaCare federal receipts.

All federal funding received by Minnesota for implementation and administration of MinnesotaCare as a basic health program, as authorized in section 1331 of the Affordable Care Act, Public Law 111-148, as amended by Public Law 111-152, is appropriated to the commissioner of human services to be used only for the MinnesotaCare program under chapter 256L. Federal funding that is received for implementing and administering MinnesotaCare as a basic health program shall be used only for that program to purchase health care coverage for enrollees and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits.

Subd. 4.

MinnesotaCare funding.

The commissioner of human services may expend money appropriated from the health care access fund for MinnesotaCare in either year of the biennium.

62U.10 HEALTH CARE TRANSFER, SAVINGS, AND REPAYMENT.

Subdivision 1.

Health care access fund transfer.

On June 30, 2009, the commissioner of management and budget shall transfer $50,000,000 from the health care access fund to the general fund.

Subd. 4.

Repayment of transfer.

When accumulated savings accruing to state-administered health care programs, as calculated under subdivision 3, meet or exceed $50,000,000, the commissioner of health shall certify that event to the commissioner of management and budget. In the next fiscal year following the certification, the commissioner of management and budget shall transfer $50,000,000 from the general fund to the health care access fund. The amount necessary to make the transfer is appropriated from the general fund to the commissioner of management and budget.

Subd. 8.

Transfers.

When accumulated annual savings accruing to state-administered health care programs, as calculated under subdivision 7, meet or exceed $50,000,000 for all health indicators in aggregate statewide, the commissioner of health shall certify that event to the commissioner of management and budget, no later than December 15 of each year. In the next fiscal year following the certification, the commissioner of management and budget shall transfer $50,000,000 from the general fund to the health care access fund. This transfer shall repeat in each fiscal year following subsequent certifications of additional cumulative savings, up to $50,000,000 per year. The amount necessary to make the transfer is appropriated from the general fund to the commissioner of management and budget.

295.52 TAXES IMPOSED.

Subd. 8.

Contingent reduction in tax rate.

(a) By December 1 of each year, beginning in 2011, the commissioner of management and budget shall determine the projected balance in the health care access fund for the biennium.

(b) If the commissioner of management and budget determines that the projected balance in the health care access fund for the biennium reflects a ratio of revenues to expenditures and transfers greater than 125 percent, and if the actual cash balance in the fund is adequate, as determined by the commissioner of management and budget, the commissioner, in consultation with the commissioner of revenue, shall reduce the tax rates levied under subdivisions 1, 1a, 2, 3, and 4, for the subsequent calendar year sufficient to reduce the structural balance in the fund. The rate may be reduced to the extent that the projected revenues for the biennium do not exceed 125 percent of expenditures and transfers. The new rate shall be rounded to the nearest one-tenth of one percent. The rate reduction under this paragraph expires at the end of each calendar year and is subject to an annual redetermination by the commissioner of management and budget.

(c) For purposes of the analysis defined in paragraph (b), the commissioner of management and budget shall include projected revenues, notwithstanding the repeal of the tax imposed under this section effective January 1, 2020.

295.581 PROHIBITION ON NON-MINNESOTACARE TRANSFERS FROM FUND.

Notwithstanding any law to the contrary, and notwithstanding section 645.33, money in the health care access fund shall be appropriated only for purposes that are consistent with past and current MinnesotaCare appropriations in Laws 1992, chapter 549; Laws 1993, chapter 345; Laws 1994, chapter 625; and Laws 1995, chapter 234, or for initiatives that are part of the section 1115 of the Social Security Act health care reform waiver submitted to the federal Centers for Medicare and Medicaid Services by the commissioner of human services as appropriated in Laws 1995, chapter 234.