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SF 4029

as introduced - 91st Legislature (2019 - 2020) Posted on 03/06/2020 08:35am

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

Current Version - as introduced

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A bill for an act
relating to human services; revising implementation provisions relating to the
substance use disorder waiver demonstration project; amending Minnesota Statutes
2019 Supplement, section 256B.0759, subdivisions 3, 4.

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

Section 1.

Minnesota Statutes 2019 Supplement, section 256B.0759, subdivision 3, is
amended to read:


Subd. 3.

Provider standards.

(a) The commissioner deleted text beginshalldeleted text endnew text begin mustnew text end establish requirements
for participating providers that are consistent with the federal requirements of the
demonstration project.

(b) A participating residential provider must obtain applicable licensure under chapters
245F and 245G or other applicable standards for the services provided and must:

(1) deliver services in accordance with standards published by the commissioner pursuant
to paragraph (d);

(2) maintain formal patient referral arrangements with providers delivering step-up or
step-down levels of care in accordance with ASAM standards; and

(3) deleted text beginprovide or arrange fordeleted text endnew text begin offernew text end medication-assisted treatment services deleted text beginif requested by
a client for whom an effective medication exists
deleted text endnew text begin on site or facilitate access to
medication-assisted treatment services off site
new text end.

(c) A participating outpatient provider must obtain applicable licensure under chapter
245G or other applicable standards for the services provided and must:

(1) deliver services in accordance with standards published by the commissioner pursuant
to paragraph (d); and

(2) maintain formal patient referral arrangements with providers delivering step-up or
step-down levels of care in accordance with ASAM standards.

(d) If the provider standards under chapter 245G or other applicable standards conflict
or are duplicative, the commissioner may grant variances to the standards if the variances
do not conflict with federal requirements. The commissioner deleted text beginshalldeleted text endnew text begin mustnew text end publish service
components, service standards, and staffing requirements for participating providers that
are consistent with ASAM standards and federal requirements by October 1, 2020.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2019 Supplement, section 256B.0759, subdivision 4, is amended
to read:


Subd. 4.

Provider payment rates.

(a) Payment rates for participating providers must
be increased for services provided to medical assistance enrollees. To receive a rate increase,
participating providers must meet demonstration project requirements and provide evidence
of formal referral arrangements with providers delivering step-up or step-down levels of
care.

(b) For substance use disorder services under section 254B.05, subdivision 5, paragraph
(b), clause (8), provided on or after deleted text beginJanuarydeleted text endnew text begin Julynew text end 1, 2020, payment rates must be increased
by 15 percent over the rates in effect on December 31, deleted text begin2020deleted text endnew text begin 2019new text end.

(c) For substance use disorder services under section 254B.05, subdivision 5, paragraph
(b), clauses (1), (6), new text beginand new text end(7), and deleted text begin(10)deleted text endnew text begin adolescent treatment programs that are licensed as
outpatient treatment programs according to sections 245G.01 to 245G.18
new text end, provided on or
after January 1, 2021, payment rates must be increased by ten percent over the rates in effect
on December 31, 2020.

new text begin (d) Effective January 1, 2021, and contingent on annual federal approval, managed care
plans and county-based purchasing plans must reimburse providers of the substance use
disorder services meeting the criteria described in paragraph (a) who are employed by or
under contract with the plan an amount that is at least equal to the fee-for-service base rate
payment for the substance use disorder services described in paragraphs (b) and (c). The
commissioner must monitor the effect of this requirement on the rate of access to substance
use disorder services and residential substance use disorder rates. If for any contract year
federal approval is not received due to the provisions of this paragraph, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this provision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this paragraph
applies must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed the amount equal
to any increase in rates that results from this provision. This paragraph expires if federal
approval is not received at any time due to the provisions of this paragraph.
new text end

new text begin EFFECTIVE DATE. new text end

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