SF 4388

as introduced - 91st Legislature (2019 - 2020) Posted on 03/17/2020 01:45pm

A bill for an act
relating to human services; requiring the commissioner of human services to
redesign and reform the procurement process for Minnesota health care programs;
amending Minnesota Statutes 2018, section 256B.69, subdivision 3a; proposing
coding for new law in Minnesota Statutes, chapter 256B; repealing Minnesota
Statutes 2018, section 256B.692, subdivision 7.

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

Section 1.

Minnesota Statutes 2018, section 256B.69, subdivision 3a, is amended to read:

Subd. 3a.

County authority.

(a) The commissioner, when implementing the medical
assistance prepayment program within a county, must include the county board in the process
of development, approval, and issuance of the request for proposals to provide services to
eligible individuals within the proposed county. County boards must be given reasonable
opportunity to make recommendations regarding the development, issuance, review of
responses, and changes needed in the request for proposals. The commissioner must provide
county boards the opportunity to review each proposal based on the identification of
community needs under chapters 145A and 256E and county advocacy activities. If a county
board finds that a proposal does not address certain community needs, the county board and
commissioner shall continue efforts for improving the proposal and network prior to the
approval of the contract. The county board shall make recommendations regarding the
approval of local networks and their operations to ensure adequate availability and access
to covered services. The provider or health plan must respond directly to county advocates
and the state prepaid medical assistance ombudsperson regarding service delivery and must
be accountable to the state regarding contracts with medical assistance funds. The county
board may recommend a maximum number of participating health plans after considering
the size of the enrolling population; ensuring adequate access and capacity; considering the
client and county administrative complexity; and considering the need to promote the
viability of locally developed health plans. The county board or a single entity representing
a group of county boards and the commissioner shall mutually select health plans for
participation at the time of initial implementation of the prepaid medical assistance program
in that county or group of counties and at the time of contract renewal. The commissioner
shall also seek input for contract requirements from the county or single entity representing
a group of county boards at each contract renewal and incorporate those recommendations
into the contract negotiation process.

(b) At the option of the county board, the board may develop contract requirements
related to the achievement of local public health goals to meet the health needs of medical
assistance enrollees. These requirements must be reasonably related to the performance of
health plan functions and within the scope of the medical assistance benefit set. If the county
board and the commissioner mutually agree to such requirements, the department shall
include such requirements in all health plan contracts governing the prepaid medical
assistance program in that county at initial implementation of the program in that county
and at the time of contract renewal. The county board may participate in the enforcement
of the contract provisions related to local public health goals.

(c) For counties in which a prepaid medical assistance program has not been established,
the commissioner shall not implement that program if a county board submits an acceptable
and timely preliminary and final proposal under section 256B.692, until county-based
purchasing is no longer operational in that county. For counties in which a prepaid medical
assistance program is in existence on or after September 1, 1997, the commissioner must
terminate contracts with health plans according to section 256B.692, subdivision 5, if the
county board submits and the commissioner accepts a preliminary and final proposal
according to that subdivision. The commissioner is not required to terminate contracts that
begin on or after September 1, 1997, according to section 256B.692 until two years have
elapsed from the date of initial enrollment.

deleted text begin (d) In the event that a county board or a single entity representing a group of county
boards and the commissioner cannot reach agreement regarding: (i) the selection of
participating health plans in that county; (ii) contract requirements; or (iii) implementation
and enforcement of county requirements including provisions regarding local public health
goals, the commissioner shall resolve all disputes after taking into account the
recommendations of a three-person mediation panel. The panel shall be composed of one
designee of the president of the association of Minnesota counties, one designee of the
commissioner of human services, and one person selected jointly by the designee of the
commissioner of human services and the designee of the Association of Minnesota Counties.
Within a reasonable period of time before the hearing, the panelists must be provided all
documents and information relevant to the mediation. The parties to the mediation must be
given 30 days' notice of a hearing before the mediation panel.
deleted text end

deleted text begin (e) deleted text end new text begin (d) new text end If a county which elects to implement county-based purchasing ceases to
implement county-based purchasing, it is prohibited from assuming the responsibility of
county-based purchasing for a period of five years from the date it discontinues purchasing.

deleted text begin (f) deleted text end new text begin (e) new text end The commissioner shall not require that contractual disputes between county-based
purchasing entities and the commissioner be mediated by a panel that includes a
representative of the Minnesota Council of Health Plans.

deleted text begin (g) deleted text end new text begin (f) new text end At the request of a county-purchasing entity, the commissioner shall adopt a
contract reprocurement or renewal schedule under which all counties included in the entity's
service area are reprocured or renewed at the same time.

deleted text begin (h) deleted text end new text begin (g) new text end The commissioner shall provide a written report under section 3.195 to the chairs
of the legislative committees having jurisdiction over human services in the senate and the
house of representatives describing in detail the activities undertaken by the commissioner
to ensure full compliance with this section. The report must also provide an explanation for
any decisions of the commissioner not to accept the recommendations of a county or group
of counties required to be consulted under this section. The report must be provided at least
30 days prior to the effective date of a new or renewed prepaid or managed care contract
in a county.

Sec. 2.

new text begin [256B.695] PROCUREMENT DESIGN AND REFORM.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Managed care organization" means a demonstration provider as defined under
section 256B.69, subdivision 2.
new text end

new text begin (c) "Minnesota health care program" means a public health care program administered
by the commissioner of human services under this chapter and chapter 256L.
new text end

new text begin (d) "Responder" means a managed care organization that responds to the request for
proposals issued by the commissioner of human services as part of the procurement process
for Minnesota health care programs.
new text end

new text begin Subd. 2. new text end

new text begin Procurement process; determine best practices. new text end

new text begin (a) In compliance with state
and federal law, the commissioner of human services, in consultation with the commissioner
of administration, shall redesign and reform the procurement process for participation in
Minnesota health care programs. The purpose of the redesign and reform is to make the
procurement process more transparent for all responders.
new text end

new text begin (b) The commissioner, in consultation with the commissioner of administration, shall
review best practices from the Department of Administration's procurement process and
determine how the experience and expertise of the Department of Administration may
enhance the procurement process used by the commissioner of human services for Minnesota
health care programs.
new text end

new text begin Subd. 3. new text end

new text begin Communication objectives. new text end

new text begin (a) In redesigning the procurement process, the
commissioner shall improve communication with potential responders by:
new text end

new text begin (1) outlining the goals and objectives of the specific procurement and clarifying specific
procurement processes for potential responders prior to the start of the procurement process;
new text end

new text begin (2) publishing the goals, objectives, and a clear and consistent scoring methodology for
all components of the request for proposal at least 30 days prior to the start of the procurement
process; and
new text end

new text begin (3) applying the scoring methodology consistently.
new text end

new text begin (b) For purposes of this subdivision, the start of the procurement process refers to the
date the procurement process is published in the State Register.
new text end

new text begin Subd. 4. new text end

new text begin Process improvement. new text end

new text begin (a) In redesigning the procurement process, the
commissioner shall improve the integrity and efficiency of the process by:
new text end

new text begin (1) requesting feedback from potential responders and stakeholders and working closely
to implement responders' and stakeholders' recommendations into the procurement process;
new text end

new text begin (2) building adequate time into the procurement process so that potential problems that
are not appeal-related can be addressed without disrupting the procurement process;
new text end

new text begin (3) notwithstanding section 13.591, subdivision 3, providing each responder with the
responder's detailed quantitative and qualitative scoring data and evaluative comments when
notified by the commissioner of the commissioner's intent to contract or not contract with
the responder;
new text end

new text begin (4) allowing responders to make an actuarially sound best and final offer related to a
cost bid if the bid is included in the procurement;
new text end

new text begin (5) making all scores and evaluation materials, including detailed quantitative and
qualitative scoring data and evaluative comments, publicly available at the time the contracts
are signed, and keep all procurement materials nonpublic if the request for proposals is
canceled, consistent with section 13.591, subdivision 3, paragraph (b), with the exception
that responders will be able to receive their own scoring and evaluative comments;
new text end

new text begin (6) notifying all responders when a lawsuit or administrative appeal related to the
procurement is filed; and
new text end

new text begin (7) authorizing the Office of Administrative Hearings to hear appeals.
new text end

new text begin (b) The commissioner shall:
new text end

new text begin (1) require future schedules for the procurement process to occur on a rolling basis, with
each procurement cycle lasting at least five years;
new text end

new text begin (2) require contracts resulting from the procurement process to be at least two years in
length; and
new text end

new text begin (3) allow parties to the contract to enter into contract amendments for items to account
for rate changes to maintain actuarial soundness, statutorily required changes, and material
contact changes.
new text end

new text begin Subd. 5. new text end

new text begin Fairness in procurement process. new text end

new text begin In redesigning the procurement process,
the commissioner shall ensure equal opportunity for all responders by:
new text end

new text begin (1) requiring that all responders have an equal opportunity to administratively appeal
procurement results or any other issue through the Office of Administrative Hearings; and
new text end

new text begin (2) requiring adequate time in the procurement process to accommodate administrative
appeals without interrupting the procurement process.
new text end

Sec. 3. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, section 256B.692, subdivision 7, new text end new text begin is repealed.
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

APPENDIX

Repealed Minnesota Statutes: 20-7895

256B.692 COUNTY-BASED PURCHASING.

Subd. 7.

Dispute resolution.

In the event the commissioner rejects a proposal under subdivision 6, the county board may request the recommendation of a three-person mediation panel. The commissioner shall resolve all disputes after taking into account the recommendations of the mediation panel. The panel shall be composed of one designee of the president of the Association of Minnesota Counties, one designee of the commissioner of human services, and one person selected jointly by the designee of the commissioner of human services and the designee of the Association of Minnesota Counties. Within a reasonable period of time before the hearing, the panelists must be provided all documents and information relevant to the mediation. The parties to the mediation must be given 30 days' notice of a hearing before the mediation panel.