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HF 2680

2nd Engrossment - 86th Legislature (2009 - 2010) Posted on 02/12/2010 10:49am

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

Bill Text Versions

Engrossments
Introduction Posted on 02/03/2010
1st Engrossment Posted on 02/08/2010
2nd Engrossment Posted on 02/12/2010
Committee Engrossments
1st Committee Engrossment Posted on 02/10/2010

Current Version - 2nd Engrossment

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A bill for an act
relating to health care; establishing mental health urgent care and consultation
services; modifying the general assistance medical care program; requiring
a report; appropriating money; amending Minnesota Statutes 2008, sections
256.969, subdivision 27, by adding a subdivision; 256B.0625, subdivision 13f,
by adding a subdivision; 256D.03, subdivisions 3a, 3b; 256D.06, subdivision 7;
256L.05, subdivisions 1b, 3, 3a; 256L.07, subdivision 6; 256L.15, subdivision 4;
256L.17, subdivision 7; Minnesota Statutes 2009 Supplement, sections 256.969,
subdivisions 2b, 3a; 256B.196, subdivision 2; 256B.199; 256D.03, subdivision
3; proposing coding for new law in Minnesota Statutes, chapters 245; 256D.

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

Section 1.

new text begin [245.4862] MENTAL HEALTH URGENT CARE AND PSYCHIATRIC
CONSULTATION.
new text end

new text begin Subdivision 1. new text end

new text begin Mental health urgent care and psychiatric consultation. new text end

new text begin The
commissioner shall include mental health urgent care and psychiatric consultation
services as part of, but not limited to, the redesign of six community-based behavioral
health hospitals and the Anoka-Metro Regional Treatment Center. These services must
not duplicate existing services in the region, and must be implemented as specified in
subdivisions 3 to 7.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin For purposes of this section:
new text end

new text begin (a) Mental health urgent care includes:
new text end

new text begin (1) initial mental health screening;
new text end

new text begin (2) mobile crisis assessment and intervention;
new text end

new text begin (3) rapid access to psychiatry, including psychiatric evaluation, initial treatment,
and short-term psychiatry;
new text end

new text begin (4) nonhospital crisis stabilization residential beds; and
new text end

new text begin (5) health care navigator services which include, but are not limited to, assisting
uninsured individuals in obtaining health care coverage.
new text end

new text begin (b) Psychiatric consultation services includes psychiatric consultation to primary
care practitioners.
new text end

new text begin Subd. 3. new text end

new text begin Rapid access to psychiatry. new text end

new text begin The commissioner shall develop rapid access
to psychiatric services based on the following criteria:
new text end

new text begin (1) the individuals who receive the psychiatric services must be at risk of
hospitalization and otherwise unable to receive timely services;
new text end

new text begin (2) where clinically appropriate, the service may be provided via interactive video
where the service is provided in conjunction with an emergency room, a local crisis
service, or a primary care or behavioral care practitioner; and
new text end

new text begin (3) the commissioner may integrate rapid access to psychiatry with the psychiatric
consultation services in subdivision 4.
new text end

new text begin Subd. 4. new text end

new text begin Collaborative psychiatric consultation. new text end

new text begin (a) The commissioner shall
establish a collaborative psychiatric consultation service based on the following criteria:
new text end

new text begin (1) the service may be available via telephone, interactive video, e-mail, or other
means of communication to emergency rooms, local crisis services, mental health
professionals, and primary care practitioners, including pediatricians;
new text end

new text begin (2) the service shall be provided by a multidisciplinary team including, at a
minimum, a child and adolescent psychiatrist, an adult psychiatrist, and a licensed clinical
social worker;
new text end

new text begin (3) the service shall include a triage-level assessment to determine the most
appropriate response to each request, including appropriate referrals to other mental health
professionals, as well as provision of rapid psychiatric access when other appropriate
services are not available;
new text end

new text begin (4) the first priority for this service is to provide the consultations required under
section 256B.0625, subdivision 13j; and
new text end

new text begin (5) the service must encourage use of cognitive and behavioral therapies and other
evidence-based treatments in addition to or in place of medication, where appropriate.
new text end

new text begin (b) The commissioner shall appoint an interdisciplinary work group to establish
appropriate medication and psychotherapy protocols to guide the consultative process,
including consultation with the Drug Utilization Review Board, as provided in section
256B.0625, subdivision 13j.
new text end

new text begin Subd. 5. new text end

new text begin Phased availability. new text end

new text begin (a) The commissioner may phase in the availability
of mental health urgent care services based on the limits of appropriations and the
commissioner's determination of level of need and cost-effectiveness.
new text end

new text begin (b) For subdivisions 3 and 4, the first phase must focus on adults in Hennepin
and Ramsey Counties and children statewide who are affected by section 256B.0625,
subdivision 13j, and must include tracking of costs for the services provided and
associated impacts on utilization of inpatient, emergency room, and other services.
new text end

new text begin Subd. 6. new text end

new text begin Limited appropriations. new text end

new text begin The commissioner shall maximize use
of available health care coverage for the services provided under this section. The
commissioner's responsibility to provide these services for individuals without health care
coverage must not exceed the appropriations for this section.
new text end

new text begin Subd. 7. new text end

new text begin Flexible implementation. new text end

new text begin To implement this section, the commissioner
shall select the structure and funding method that is the most cost-effective for each county
or group of counties. This may include grants, contracts, direct provision by state-operated
services, and public-private partnerships. Where feasible, the commissioner shall make
any grants under this section a part of the integrated adult mental health initiative grants
under section 245.4661.
new text end

Sec. 2.

Minnesota Statutes 2009 Supplement, section 256.969, subdivision 2b, is
amended to read:


Subd. 2b.

Operating payment rates.

In determining operating payment rates for
admissions occurring on or after the rate year beginning January 1, 1991, and every two
years after, or more frequently as determined by the commissioner, the commissioner shall
obtain operating data from an updated base year and establish operating payment rates
per admission for each hospital based on the cost-finding methods and allowable costs of
the Medicare program in effect during the base year. Rates under the general assistance
medical care, medical assistance, and MinnesotaCare programs shall not be rebased to
more current data on January 1, 1997, January 1, 2005, for the first 24 months of the
rebased period beginning January 1, 2009. For the first deleted text beginthreedeleted text endnew text begin sixnew text end months of the rebased
period beginning January 1, 2011, rates shall new text beginnot new text endbe rebased deleted text beginat 74.25 percent of the full
value of the rebasing percentage change
deleted text end. From deleted text beginAprildeleted text endnew text begin Julynew text end 1, 2011, to March 31, 2012,
rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change.
Effective April 1, 2012, rates shall be rebased at full value. The base year operating
payment rate per admission is standardized by the case mix index and adjusted by the
hospital cost index, relative values, and disproportionate population adjustment. The
cost and charge data used to establish operating rates shall only reflect inpatient services
covered by medical assistance and shall not include property cost information and costs
recognized in outlier payments.

Sec. 3.

Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is
amended to read:


Subd. 3a.

Payments.

(a) Acute care hospital billings under the medical
assistance program must not be submitted until the recipient is discharged. However,
the commissioner shall establish monthly interim payments for inpatient hospitals that
have individual patient lengths of stay over 30 days regardless of diagnostic category.
Except as provided in section 256.9693, medical assistance reimbursement for treatment
of mental illness shall be reimbursed based on diagnostic classifications. Individual
hospital payments established under this section and sections 256.9685, 256.9686, and
256.9695, in addition to third party and recipient liability, for discharges occurring during
the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
inpatient services paid for the same period of time to the hospital. This payment limitation
shall be calculated separately for medical assistance and general assistance medical
care services. The limitation on general assistance medical care shall be effective for
admissions occurring on or after July 1, 1991. Services that have rates established under
subdivision 11 or 12, must be limited separately from other services. After consulting with
the affected hospitals, the commissioner may consider related hospitals one entity and
may merge the payment rates while maintaining separate provider numbers. The operating
and property base rates per admission or per day shall be derived from the best Medicare
and claims data available when rates are established. The commissioner shall determine
the best Medicare and claims data, taking into consideration variables of recency of the
data, audit disposition, settlement status, and the ability to set rates in a timely manner.
The commissioner shall notify hospitals of payment rates by December 1 of the year
preceding the rate year. The rate setting data must reflect the admissions data used to
establish relative values. Base year changes from 1981 to the base year established for the
rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
1. The commissioner may adjust base year cost, relative value, and case mix index data
to exclude the costs of services that have been discontinued by the October 1 of the year
preceding the rate year or that are paid separately from inpatient services. Inpatient stays
that encompass portions of two or more rate years shall have payments established based
on payment rates in effect at the time of admission unless the date of admission preceded
the rate year in effect by six months or more. In this case, operating payment rates for
services rendered during the rate year in effect and established based on the date of
admission shall be adjusted to the rate year in effect by the hospital cost index.

(b) For fee-for-service admissions occurring on or after July 1, 2002, the total
payment, before third-party liability and spenddown, made to hospitals for inpatient
services is reduced by .5 percent from the current statutory rates.

(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Mental health services within diagnosis related groups 424 to 432, and
facilities defined under subdivision 16 are excluded from this paragraph.

(d) In addition to the reduction in paragraphs (b) and (c), the total payment for
fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 6.0 percent
from the current statutory rates. Mental health services within diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
assistance does not include general assistance medical care. Payments made to managed
care plans shall be reduced for services provided on or after January 1, 2006, to reflect
this reduction.

(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
3.46 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care plans shall be reduced for services provided
on or after January 1, 2009, through June 30, 2009, to reflect this reduction.

(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2009, through June 30, deleted text begin2010deleted text endnew text begin 2011new text end,
made to hospitals for inpatient services before third-party liability and spenddown, is
reduced 1.9 percent from the current statutory rates. Mental health services with diagnosis
related groups 424 to 432 and facilities defined under subdivision 16 are excluded from
this paragraph. Payments made to managed care plans shall be reduced for services
provided on or after July 1, 2009, through June 30, deleted text begin2010deleted text endnew text begin 2011new text end, to reflect this reduction.

(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
for fee-for-service admissions occurring on or after July 1, deleted text begin2010deleted text endnew text begin 2011new text end, made to hospitals
for inpatient services before third-party liability and spenddown, is reduced 1.79 percent
from the current statutory rates. Mental health services with diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Payments made to managed care plans shall be reduced for services provided on or after
July 1, deleted text begin2010deleted text endnew text begin 2011new text end, to reflect this reduction.

(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
payment for fee-for-service admissions occurring on or after July 1, 2009, made to
hospitals for inpatient services before third-party liability and spenddown, is reduced
one percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments made to managed care plans shall be reduced for
services provided on or after October 1, 2009, to reflect this reduction.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 4.

Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
to read:


new text begin Subd. 26a. new text end

new text begin Psychiatric and burn services payment adjustment on or after July
1, 2010.
new text end

new text begin (a) For admissions occurring on or after July 1, 2010, the commissioner shall
increase the total payment for medical assistance fee-for-service inpatient admissions for
the diagnosis-related groups specified in paragraph (b) at any hospital that is a nonstate
public Minnesota hospital and a Level I trauma center. The rate increases shall be
established for each hospital by the commissioner at a level that uses each hospital's
voluntary payments under paragraph (c) as the nonfederal share. For purposes of this
subdivision, medical assistance does not include general assistance medical care.
new text end

new text begin (b) The rate increases provided in paragraph (a) apply to the following
diagnosis-related groups or subgroups, or any subsequent designations of such groups
or subgroups: 424 to 431, 433, 504 to 511, 521, and 523. These increases are only
available to the extent that revenue is available from the counties under paragraph (c)
for the nonfederal share.
new text end

new text begin (c) Effective July 15, 2010, in addition to any payment otherwise required under
sections 256B.19, 256B.195, 256B.196, and 256B.199, the following government entities
may make the following voluntary payments to the commissioner on an annual basis:
new text end

new text begin (1) Hennepin County, $7,000,000; and
new text end

new text begin (2) Ramsey County, $3,500,000.
new text end

new text begin The amounts in this paragraph shall be part of the designated governmental unit's portion
of the nonfederal share of medical assistance costs.
new text end

new text begin (d) The commissioner may adjust the intergovernmental transfers under paragraph
(c) and the payments under paragraph (a) based on the commissioner's determination of
Medicare upper payment limits, hospital-specific charge limits, and any limits imposed
by the federal government regarding the rate increase or the restriction in the American
Resource and Recovery Act, Public Law 111-5, regarding increased local share.
new text end

new text begin (e) This section shall be implemented upon federal approval, retroactive to July 1,
2010, for services provided on or after that date.
new text end

Sec. 5.

Minnesota Statutes 2008, section 256.969, subdivision 27, is amended to read:


Subd. 27.

Quarterly payment adjustment.

(a) In addition to any other payment
under this section, the commissioner shall make the following payments effective July
1, 2007:

(1) for a hospital located in Minnesota and not eligible for payments under
subdivision 20, with a medical assistance inpatient utilization rate greater than 17.8
percent of total patient days as of the base year in effect on July 1, 2005, a payment
equal to 13 percent of the total of the operating and property payment ratesnew text begin, except that
Hennepin County Medical Center and Regions Hospital shall not receive a payment
under this subdivision
new text end;

(2) for a hospital located in Minnesota in a specified urban area outside of the
seven-county metropolitan area and not eligible for payments under subdivision 20, with
a medical assistance inpatient utilization rate less than or equal to 17.8 percent of total
patient days as of the base year in effect on July 1, 2005, a payment equal to ten percent
of the total of the operating and property payment rates. For purposes of this clause, the
following cities are specified urban areas: Detroit Lakes, Rochester, Willmar, Alexandria,
Austin, Cambridge, Brainerd, Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids,
Wyoming, Fergus Falls, Albert Lea, Winona, Virginia, Thief River Falls, and Wadena;

(3) for a hospital located in Minnesota but not located in a specified urban area
under clause (2), with a medical assistance inpatient utilization rate less than or equal to
17.8 percent of total patient days as of the base year in effect on July 1, 2005, a payment
equal to four percent of the total of the operating and property payment rates. A hospital
located in Woodbury and not in existence during the base year shall be reimbursed under
this clause; and

(4) in addition to any payments under clauses (1) to (3), for a hospital located in
Minnesota and not eligible for payments under subdivision 20 with a medical assistance
inpatient utilization rate of 17.9 percent of total patient days as of the base year in effect
on July 1, 2005, a payment equal to eight percent of the total of the operating and property
payment rates, and for a hospital located in Minnesota and not eligible for payments
under subdivision 20 with a medical assistance inpatient utilization rate of 59.6 percent
of total patient days as of the base year in effect on July 1, 2005, a payment equal to
nine percent of the total of the operating and property payment rates. After making any
ratable adjustments required under paragraph (b), the commissioner shall proportionately
reduce payments under clauses (2) and (3) by an amount needed to make payments under
this clause.

(b) The state share of payments under paragraph (a) shall be equal to federal
reimbursements to the commissioner to reimburse expenditures reported under section
256B.199new text begin, paragraphs (a) to (d)new text end. The commissioner shall ratably reduce or increase
payments under this subdivision in order to ensure that these payments equal the amount
of reimbursement received by the commissioner under section 256B.199new text begin, paragraphs (a)
to (d)
new text end
, except that payments shall be ratably reduced by an amount equivalent to the state
share of a four percent reduction in MinnesotaCare and medical assistance payments for
inpatient hospital services. Effective July 1, 2009, the ratable reduction shall be equivalent
to the state share of a three percent reduction in these payments.new text begin Effective for federal
disproportionate share hospital funds earned on general assistance medical care payments
for services rendered on or after March 1, 2010, to June 30, 2011, the amount of the three
percent ratable reduction required under this paragraph shall be deposited in the account
established in section 256D.032.
new text end

(c) The payments under paragraph (a) shall be paid quarterly based on each hospital's
operating and property payments from the second previous quarter, beginning on July
15, 2007, or upon federal approval of federal reimbursements under section 256B.199new text begin,
paragraphs (a) to (d)
new text end
, whichever occurs later.

(d) The commissioner shall not adjust rates paid to a prepaid health plan under
contract with the commissioner to reflect payments provided in paragraph (a).

(e) The commissioner shall maximize the use of available federal money for
disproportionate share hospital payments and shall maximize payments to qualifying
hospitals. In order to accomplish these purposes, the commissioner may, in consultation
with the nonstate entities identified in section 256B.199new text begin, paragraphs (a) to (d)new text end, adjust,
on a pro rata basis if feasible, the amounts reported by nonstate entities under section
256B.199new text begin, paragraphs (a) to (d),new text end when application for reimbursement is made to the federal
government, and otherwise adjust the provisions of this subdivision. The commissioner
shall utilize a settlement process based on finalized data to maximize revenue under
section 256B.199new text begin, paragraphs (a) to (d),new text end and payments under this section.

(f) For purposes of this subdivision, medical assistance does not include general
assistance medical care.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for services rendered on or after
March 1, 2010.
new text end

Sec. 6.

Minnesota Statutes 2008, section 256B.0625, subdivision 13f, is amended to
read:


Subd. 13f.

Prior authorization.

(a) The Formulary Committee shall review and
recommend drugs which require prior authorization. The Formulary Committee shall
establish general criteria to be used for the prior authorization of brand-name drugs for
which generically equivalent drugs are available, but the committee is not required to
review each brand-name drug for which a generically equivalent drug is available.

(b) Prior authorization may be required by the commissioner before certain
formulary drugs are eligible for payment. The Formulary Committee may recommend
drugs for prior authorization directly to the commissioner. The commissioner may also
request that the Formulary Committee review a drug for prior authorization. Before the
commissioner may require prior authorization for a drug:

(1) the commissioner must provide information to the Formulary Committee on the
impact that placing the drug on prior authorization may have on the quality of patient care
and on program costs, information regarding whether the drug is subject to clinical abuse
or misuse, and relevant data from the state Medicaid program if such data is available;

(2) the Formulary Committee must review the drug, taking into account medical and
clinical data and the information provided by the commissioner; and

(3) the Formulary Committee must hold a public forum and receive public comment
for an additional 15 days.

The commissioner must provide a 15-day notice period before implementing the prior
authorization.

(c) new text beginExcept as provided in subdivision 13j, new text endprior authorization shall not be required or
utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness if:

(1) there is no generically equivalent drug available; and

(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or

(3) the drug is part of the recipient's current course of treatment.

This paragraph applies to any multistate preferred drug list or supplemental drug rebate
program established or administered by the commissioner. Prior authorization shall
automatically be granted for 60 days for brand name drugs prescribed for treatment of
mental illness within 60 days of when a generically equivalent drug becomes available,
provided that the brand name drug was part of the recipient's course of treatment at the
time the generically equivalent drug became available.

(d) Prior authorization shall not be required or utilized for any antihemophilic factor
drug prescribed for the treatment of hemophilia and blood disorders where there is no
generically equivalent drug available if the prior authorization is used in conjunction with
any supplemental drug rebate program or multistate preferred drug list established or
administered by the commissioner.

(e) The commissioner may require prior authorization for brand name drugs
whenever a generically equivalent product is available, even if the prescriber specifically
indicates "dispense as written-brand necessary" on the prescription as required by section
151.21, subdivision 2.

(f) Notwithstanding this subdivision, the commissioner may automatically require
prior authorization, for a period not to exceed 180 days, for any drug that is approved by
the United States Food and Drug Administration on or after July 1, 2005. The 180-day
period begins no later than the first day that a drug is available for shipment to pharmacies
within the state. The Formulary Committee shall recommend to the commissioner general
criteria to be used for the prior authorization of the drugs, but the committee is not
required to review each individual drug. In order to continue prior authorizations for a
drug after the 180-day period has expired, the commissioner must follow the provisions
of this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 7.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:


new text begin Subd. 13j. new text end

new text begin Antipsychotic and attention deficit disorder and attention deficit
hyperactivity disorder medications.
new text end

new text begin (a) The commissioner, in consultation with the
Drug Utilization Review Board established in subdivision 13i and actively practicing
pediatric mental health professionals, must:
new text end

new text begin (1) identify recommended pediatric dose ranges for atypical antipsychotic drugs
and drugs used for attention deficit disorder or attention deficit hyperactivity disorder
based on available medical, clinical, and safety data and research. The commissioner
shall periodically review the list of medications and pediatric dose ranges and update
the medications and doses listed as needed after consultation with the Drug Utilization
Review Board;
new text end

new text begin (2) identify situations where a collaborative psychiatric consultation and prior
authorization should be required before the initiation or continuation of drug therapy
in pediatric patients including, but not limited to, high-dose regimens, off-label use of
prescription medication, a patient's young age, and lack of coordination among multiple
prescribing providers; and
new text end

new text begin (3) track prescriptive practices and the use of psychotropic medications in children
with the goal of reducing the use of medication, where appropriate.
new text end

new text begin (b) Effective July 1, 2011, the commissioner shall require prior authorization and
a collaborative psychiatric consultation before an atypical antipsychotic and attention
deficit disorder and attention deficit hyperactivity disorder medication meeting the criteria
identified in paragraph (a), clause (2), is eligible for payment. A collaborative psychiatric
consultation must be completed before the identified medications are eligible for payment
unless:
new text end

new text begin (1) the patient has already been stabilized on the medication regimen; or
new text end

new text begin (2) the prescriber indicates that the child is in crisis.
new text end

new text begin If clause (1) or (2) applies, the collaborative psychiatric consultation must be completed
within 90 days for payment to continue.
new text end

new text begin (c) For purposes of this subdivision, a collaborative psychiatric consultation must
meet the criteria described in section 245.4862, subdivision 5.
new text end

Sec. 8.

Minnesota Statutes 2009 Supplement, section 256B.196, subdivision 2, is
amended to read:


Subd. 2.

Commissioner's duties.

(a) For the purposes of this subdivision and
subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital
services upper payment limit for nonstate government hospitals. The commissioner shall
then determine the amount of a supplemental payment to Hennepin County Medical
Center and Regions Hospital for these services that would increase medical assistance
spending in this category to the aggregate upper payment limit for all nonstate government
hospitals in Minnesota. In making this determination, the commissioner shall allot the
available increases between Hennepin County Medical Center and Regions Hospital
based on the ratio of medical assistance fee-for-service outpatient hospital payments to
the two facilities. The commissioner shall adjust this allotment as necessary based on
federal approvals, the amount of intergovernmental transfers received from Hennepin and
Ramsey Counties, and other factors, in order to maximize the additional total payments.
The commissioner shall inform Hennepin County and Ramsey County of the periodic
intergovernmental transfers necessary to match federal Medicaid payments available
under this subdivision in order to make supplementary medical assistance payments to
Hennepin County Medical Center and Regions Hospital equal to an amount that when
combined with existing medical assistance payments to nonstate governmental hospitals
would increase total payments to hospitals in this category for outpatient services to
the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon
receipt of these periodic transfers, the commissioner shall make supplementary payments
to Hennepin County Medical Center and Regions Hospital.

(b) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for physicians affiliated with Hennepin County Medical
Center and with Regions Hospital. The upper payment limit shall be based on the average
commercial rate or be determined using another method acceptable to the Centers for
Medicare and Medicaid Services. The commissioner shall inform Hennepin County and
Ramsey County of the periodic intergovernmental transfers necessary to match the federal
Medicaid payments available under this subdivision in order to make supplementary
payments to physicians affiliated with Hennepin County Medical Center and Regions
Hospital equal to the difference between the established medical assistance payment for
physician services and the upper payment limit. Upon receipt of these periodic transfers,
the commissioner shall make supplementary payments to physicians of Hennepin Faculty
Associates and HealthPartners.

(c) Beginning January 1, 2010, Hennepin County and Ramsey County deleted text beginshalldeleted text end new text beginmay
new text endmake monthly new text beginvoluntary new text endintergovernmental transfers to the commissioner in deleted text beginthe followingdeleted text end
amountsdeleted text begin: $133,333 bydeleted text end new text beginnot to exceed $12,000,000 per year from new text endHennepin County
and deleted text begin$100,000 bydeleted text end new text begin$6,000,000 per year from new text endRamsey County. The commissioner shall
increase the medical assistance capitation payments to deleted text beginMetropolitan Health Plan and
HealthPartners by
deleted text end new text beginany licensed health plan under contract with the medical assistance
program that agrees to make enhanced payments to Hennepin County Medical Center or
Regions Hospital. The increase shall be in
new text endan amount equal to the annual value of the
monthly transfers plus federal financial participationdeleted text begin.deleted text endnew text begin, with each health plan receiving its
pro rata share of the increase based on the pro rata share of medical assistance admissions
to Hennepin County Medical Center and Regions Hospital by those plans. Upon the
request of the commissioner, health plans shall submit individual-level cost data for
verification purposes. The commissioner may ratably reduce these payments on a pro rata
basis in order to satisfy federal requirements for actuarial soundness. If payments are
reduced, transfers shall be reduced accordingly. Any licensed health plan that receives
increased medical assistance capitation payments under the intergovernmental transfer
described in this paragraph shall increase its medical assistance payments to Hennepin
County Medical Center and Regions Hospital by the same amount as the increased
payments received in the capitation payment described in this paragraph.
new text end

(d) The commissioner shall inform Hennepin County and Ramsey County on an
ongoing basis of the need for any changes needed in the intergovernmental transfers
in order to continue the payments under paragraphs (a) to (c), at their maximum level,
including increases in upper payment limits, changes in the federal Medicaid match, and
other factors.

(e) The payments in paragraphs (a) to (c) shall be implemented independently of
each other, subject to federal approval and to the receipt of transfers under subdivision 3.

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2009 Supplement, section 256B.199, is amended to read:


256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.

(a) Effective July 1, 2007, the commissioner shall apply for federal matching funds
for the expenditures in paragraphs (b) and (c).

(b) The commissioner shall apply for federal matching funds for certified public
expenditures as follows:

(1) Hennepin County, Hennepin County Medical Center, Ramsey County, new text beginand
new text endRegions Hospitaldeleted text begin, the University of Minnesota, and Fairview-University Medical Centerdeleted text end
shall report quarterly to the commissioner beginning June 1, 2007, payments made during
the second previous quarter that may qualify for reimbursement under federal law;

(2) based on these reports, the commissioner shall apply for federal matching
funds. These funds are appropriated to the commissioner for the payments under section
256.969, subdivision 27; and

(3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform
the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share
hospital payment money expected to be available in the current federal fiscal year.

(c) The commissioner shall apply for federal matching funds for general assistance
medical care expenditures as follows:

(1) for hospital services occurring on or after July 1, 2007, general assistance medical
care expenditures for fee-for-service inpatient and outpatient hospital payments made by
the department shall be used to apply for federal matching funds, except as limited below:

(i) only those general assistance medical care expenditures made to an individual
hospital that would not cause the hospital to exceed its individual hospital limits under
section 1923 of the Social Security Act may be considered; and

(ii) general assistance medical care expenditures may be considered only to the extent
of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and

(2) all hospitals must provide any necessary expenditure, cost, and revenue
information required by the commissioner as necessary for purposes of obtaining federal
Medicaid matching funds for general assistance medical care expenditures.

(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall
apply for additional federal matching funds available as disproportionate share hospital
payments under the American Recovery and Reinvestment Act of 2009. These funds shall
be made available as the state share of payments under section 256.969, subdivision 28.
The entities required to report certified public expenditures under paragraph (b), clause
(1), shall report additional certified public expenditures as necessary under this paragraph.

new text begin (e) Effective July 15, 2010, in addition to any payment otherwise required under
sections 256B.19, 256B.195, and 256B.196, the following government entities may make
the following voluntary payments to the commissioner on an annual basis:
new text end

new text begin (1) Hennepin County, $6,200,000; and
new text end

new text begin (2) Ramsey County, $4,000,000.
new text end

new text begin (f) The sums in paragraph (e) shall be part of the designated governmental unit's
portion of the nonfederal share of medical assistance costs.
new text end

new text begin (g) Effective July 15, 2010, the commissioner shall make the following Medicaid
disproportionate share hospital payments to the hospitals on a monthly basis:
new text end

new text begin (1) to Hennepin County Medical Center, the amount of the transfer under paragraph
(e), clause (1), plus any federal matching funds available to recognize higher medical
assistance costs in institutions that provide high levels of charity care; and
new text end

new text begin (2) to Regions Hospital, the amount of the transfer under paragraph (e), clause (2),
plus any federal matching funds available to recognize higher medical assistance costs in
institutions that provide high levels of charity care.
new text end

new text begin (h) Effective July 15, 2010, after making the payments provided in paragraph
(g), the commissioner shall make the increased payments provided in section 256.969,
subdivision 26a.
new text end

new text begin (i) The commissioner shall make the payments under paragraphs (g) and (h) prior
to making any other payments under this section, section 256.969, subdivision 27, or
256B.195.
new text end

new text begin (j) The commissioner may adjust the intergovernmental transfers under paragraph
(e) and the payments under paragraph (g) based on the commissioner's determination
of Medicare upper payment limits, hospital-specific charge limits, and any limitations
imposed by the federal government regarding the rate increase or the restriction in the
American Resource and Recovery Act, Public Law 111-5, regarding increased local share.
new text end

new text begin (k) This section shall be implemented upon federal approval of the rate increase
and a federal determination that the increased transfers do not violate the restriction in
the American Resource and Recovery Act, Public Law 111-5, regarding the local share,
retroactive to admissions occurring on or after July 15, 2010.
new text end

Sec. 10.

Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, is
amended to read:


Subd. 3.

General assistance medical care; eligibility.

(a) General assistance
medical care may be paid for any person who is not eligible for medical assistance under
chapter 256B, including eligibility for medical assistance based on a spenddown of excess
income according to section 256B.056, subdivision 5, or MinnesotaCare for applicants
and recipients defined in paragraph (c), except as provided in paragraph (d), and:

(1) who is receiving assistance under section 256D.05, except for families with
children who are eligible under Minnesota family investment program (MFIP), or who is
having a payment made on the person's behalf under sections 256I.01 to 256I.06; or

(2) who is a resident of Minnesota; and

(i) who has gross countable income not in excess of 75 percent of the federal poverty
guidelines for the family size, using a six-month budget period and whose equity in assets
is not in excess of $1,000 per assistance unit. General assistance medical care is not
available for applicants or enrollees who are otherwise eligible for medical assistance but
fail to verify their assets. Enrollees who become eligible for medical assistance shall be
terminated and transferred to medical assistance. Exempt assets, the reduction of excess
assets, and the waiver of excess assets must conform to the medical assistance program in
section 256B.056, subdivisions 3 and 3d, with the following exception: the maximum
amount of undistributed funds in a trust that could be distributed to or on behalf of the
beneficiary by the trustee, assuming the full exercise of the trustee's discretion under the
terms of the trust, must be applied toward the asset maximum; or

(ii) who has gross countable income above 75 percent of the federal poverty
guidelines but not in excess of 175 percent of the federal poverty guidelines for the family
size, using a six-month budget period, whose equity in assets is not in excess of the limits
in section 256B.056, subdivision 3c, and who applies during an inpatient hospitalization.

(b) The commissioner shall adjust the income standards under this section each July
1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.

(c) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may not be paid for applicants or recipients who are adults
with dependent children under 21 whose gross family income is equal to or less than 275
percent of the federal poverty guidelines who are not described in paragraph (f).

(d) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may be paid for applicants and recipients who meet all
eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
beginning the date of application. Immediately following approval of general assistance
medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
subdivision 7
, with covered services as provided in section 256L.03 for the rest of the
six-month general assistance medical care eligibility period, until their six-month renewal.

(e) To be eligible for general assistance medical care following enrollment in
MinnesotaCare as required by paragraph (d), an individual must complete a new
application.

(f) Applicants and recipients eligible under paragraph (a), clause (2), item (i), are
exempt from the MinnesotaCare enrollment requirements in this subdivision if they:

(1) have applied for and are awaiting a determination of blindness or disability by
the state medical review team or a determination of eligibility for Supplemental Security
Income or Social Security Disability Insurance by the Social Security Administration;

(2) fail to meet the requirements of section 256L.09, subdivision 2;

(3) are homeless as defined by United States Code, title 42, section 11301, et seq.;

(4) are classified as end-stage renal disease beneficiaries in the Medicare program;

(5) are enrolled in private health care coverage as defined in section 256B.02,
subdivision 9;

(6) are eligible under paragraph (k);

(7) receive treatment funded pursuant to section 254B.02; or

(8) reside in the Minnesota sex offender program defined in chapter 246B.

(g) For applications received on or after October 1, 2003, eligibility may begin no
earlier than the date of application. For individuals eligible under paragraph (a), clause
(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
may reapply if there is a subsequent period of inpatient hospitalization.

(h) Beginning September 1, 2006, Minnesota health care program applications and
renewals completed by recipients and applicants who are persons described in paragraph
(d) and submitted to the county agency shall be determined for MinnesotaCare eligibility
by the county agency. If all other eligibility requirements of this subdivision are met,
eligibility for general assistance medical care shall be available in any month during which
MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
notice of termination for eligibility for general assistance medical care shall be sent to
an applicant or recipient. If all other eligibility requirements of this subdivision are
met, eligibility for general assistance medical care shall be available until enrollment in
MinnesotaCare subject to the provisions of paragraphs (d), (f), and (g).

(i) The date of an initial Minnesota health care program application necessary to
begin a determination of eligibility shall be the date the applicant has provided a name,
address, and Social Security number, signed and dated, to the county agency or the
Department of Human Services. If the applicant is unable to provide a name, address,
Social Security number, and signature when health care is delivered due to a medical
condition or disability, a health care provider may act on an applicant's behalf to establish
the date of an initial Minnesota health care program application by providing the county
agency or Department of Human Services with provider identification and a temporary
unique identifier for the applicant. The applicant must complete the remainder of the
application and provide necessary verification before eligibility can be determined. The
applicant must complete the application within the time periods required under the
medical assistance program as specified in Minnesota Rules, parts 9505.0015, subpart
5, and 9505.0090, subpart 2. The county agency must assist the applicant in obtaining
verification if necessary.

(j) County agencies are authorized to use all automated databases containing
information regarding recipients' or applicants' income in order to determine eligibility for
general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
in order to determine eligibility and premium payments by the county agency.

(k) General assistance medical care is not available for a person in a correctional
facility unless the person is detained by law for less than one year in a county correctional
or detention facility as a person accused or convicted of a crime, or admitted as an
inpatient to a hospital on a criminal hold order, and the person is a recipient of general
assistance medical care at the time the person is detained by law or admitted on a criminal
hold order and as long as the person continues to meet other eligibility requirements
of this subdivision.

(l) General assistance medical care is not available for applicants or recipients who
do not cooperate with the county agency to meet the requirements of medical assistance.

(m) In determining the amount of assets of an individual eligible under paragraph
(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
an asset excluded under paragraph (a), that was given away, sold, or disposed of for
less than fair market value within the 60 months preceding application for general
assistance medical care or during the period of eligibility. Any transfer described in this
paragraph shall be presumed to have been for the purpose of establishing eligibility for
general assistance medical care, unless the individual furnishes convincing evidence to
establish that the transaction was exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair market value at the time it
was given away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial months,
shall be calculated by dividing the uncompensated transfer amount by the average monthly
per person payment made by the medical assistance program to skilled nursing facilities
for the previous calendar year. The individual shall remain ineligible until this fixed period
has expired. The period of ineligibility may exceed 30 months, and a reapplication for
benefits after 30 months from the date of the transfer shall not result in eligibility unless
and until the period of ineligibility has expired. The period of ineligibility begins in the
month the transfer was reported to the county agency, or if the transfer was not reported,
the month in which the county agency discovered the transfer, whichever comes first. For
applicants, the period of ineligibility begins on the date of the first approved application.

(n) When determining eligibility for any state benefits under this subdivision,
the income and resources of all noncitizens shall be deemed to include their sponsor's
income and resources as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
subsequently set out in federal rules.

(o) Undocumented noncitizens and nonimmigrants are ineligible for general
assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
in one or more of the classes listed in United States Code, title 8, section 1101, subsection
(a), paragraph (15), and an undocumented noncitizen is an individual who resides in
the United States without the approval or acquiescence of the United States Citizenship
and Immigration Services.

(p) Notwithstanding any other provision of law, a noncitizen who is ineligible for
medical assistance due to the deeming of a sponsor's income and resources, is ineligible
for general assistance medical care.

(q) Effective July 1, 2003, general assistance medical care emergency services end.

new text begin (r) For the period beginning March 1, 2010, and ending July 1, 2011, the general
assistance medical care program shall be administered according to section 256D.031,
unless otherwise stated.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 11.

Minnesota Statutes 2008, section 256D.03, subdivision 3a, is amended to read:


Subd. 3a.

Claims; assignment of benefits.

new text begin(a) new text endClaims must be filed pursuant to
section 256D.16. General assistance medical care applicants and recipients must apply or
agree to apply third party health and accident benefits to the costs of medical care. They
must cooperate with the state in establishing paternity and obtaining third party payments.
By accepting general assistance, a person assigns to the Department of Human Services
all rights to medical support or payments for medical expenses from another person or
entity on their own or their dependent's behalf and agrees to cooperate with the state in
establishing paternity and obtaining third party payments. The application shall contain
a statement explaining the assignment. Any rights or amounts assigned shall be applied
against the cost of medical care paid for under this chapter. An assignment is effective on
the date general assistance medical care eligibility takes effect.

new text begin (b) Effective for general assistance medical care services rendered on or after
March 1, 2010, to June 30, 2011, any medical collections, payments, or recoveries under
this subdivision shall be deposited in or credited to the account established in section
256D.032.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 12.

Minnesota Statutes 2008, section 256D.03, subdivision 3b, is amended to read:


Subd. 3b.

Cooperation.

(a) General assistance or general assistance medical care
applicants and recipients must cooperate with the state and local agency to identify
potentially liable third-party payors and assist the state in obtaining third-party payments.
Cooperation includes identifying any third party who may be liable for care and services
provided under this chapter to the applicant, recipient, or any other family member for
whom application is made and providing relevant information to assist the state in pursuing
a potentially liable third party. General assistance medical care applicants and recipients
must cooperate by providing information about any group health plan in which they may
be eligible to enroll. They must cooperate with the state and local agency in determining
if the plan is cost-effective. For purposes of this subdivision, coverage provided by the
Minnesota Comprehensive Health Association under chapter 62E shall not be considered
group health plan coverage or cost-effective by the state and local agency. If the plan is
determined cost-effective and the premium will be paid by the state or local agency or is
available at no cost to the person, they must enroll or remain enrolled in the group health
plan. Cost-effective insurance premiums approved for payment by the state agency and
paid by the local agency are eligible for reimbursement according to subdivision 6.

(b) Effective for all premiums due on or after June 30, 1997, general assistance
medical care does not cover premiums that a recipient is required to pay under a qualified
or Medicare supplement plan issued by the Minnesota Comprehensive Health Association.
General assistance medical care shall continue to cover premiums for recipients who are
covered under a plan issued by the Minnesota Comprehensive Health Association on June
30, 1997, for a period of six months following receipt of the notice of termination or
until December 31, 1997, whichever is later.

new text begin (c) Effective for general assistance medical care services rendered on or after
March 1, 2010, to June 30, 2011, any medical collections, payments, or recoveries under
this subdivision shall be deposited in or credited to the account established in section
256D.032.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 13.

new text begin [256D.031] GENERAL ASSISTANCE MEDICAL CARE.
new text end

new text begin Subdivision 1. new text end

new text begin Eligibility. new text end

new text begin (a) Except as provided under subdivision 2, general
assistance medical care may be paid for any individual who is not eligible for medical
assistance under chapter 256B, including eligibility for medical assistance based on a
spenddown of excess income according to section 256B.056, subdivision 5, and who:
new text end

new text begin (1) is receiving assistance under section 256D.05, except for families with children
who are eligible under the Minnesota family investment program (MFIP), or who is
having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
new text end

new text begin (2) is a resident of Minnesota and has gross countable income not in excess of 75
percent of federal poverty guidelines for the family size, using a six-month budget period,
and whose equity in assets is not in excess of $1,000 per assistance unit.
new text end

new text begin Exempt assets, the reduction of excess assets, and the waiver of excess assets must
conform to the medical assistance program in section 256B.056, subdivisions 3 and 3d,
except that the maximum amount of undistributed funds in a trust that could be distributed
to or on behalf of the beneficiary by the trustee, assuming the full exercise of the trustee's
discretion under the terms of the trust, must be applied toward the asset maximum.
new text end

new text begin (b) The commissioner shall adjust the income standards under this section each July
1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.
new text end

new text begin Subd. 2. new text end

new text begin Ineligible groups. new text end

new text begin (a) General assistance medical care may not be paid for
an applicant or a recipient who:
new text end

new text begin (1) is otherwise eligible for medical assistance but fails to verify their assets;
new text end

new text begin (2) is an adult in a family with children as defined in section 256L.01, subdivision 3a;
new text end

new text begin (3) is enrolled in private health coverage as defined in section 256B.02, subdivision
9;
new text end

new text begin (4) is in a correctional facility, including an individual in a county correctional or
detention facility as an individual accused or convicted of a crime, or admitted as an
inpatient to a hospital on a criminal hold order;
new text end

new text begin (5) resides in the Minnesota sex offender program defined in chapter 246B;
new text end

new text begin (6) does not cooperate with the county agency to meet the requirements of medical
assistance; or
new text end

new text begin (7) does not cooperate with a county or state agency or the state medical review team
in determining a disability or for determining eligibility for Supplemental Security Income
or Social Security Disability Insurance by the Social Security Administration.
new text end

new text begin (b) Undocumented noncitizens and nonimmigrants are ineligible for general
assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
in one or more of the classes listed in United States Code, title 8, section 1101, subsection
(a), paragraph (15), and an undocumented noncitizen is an individual who resides in the
United States without approval or acquiescence of the United States Citizenship and
Immigration Services.
new text end

new text begin (c) Notwithstanding any other provision of law, a noncitizen who is ineligible for
medical assistance due to the deeming of a sponsor's income and resources is ineligible for
general assistance medical care.
new text end

new text begin (d) General assistance medical care recipients who become eligible for medical
assistance shall be terminated from general assistance medical care and transferred to
medical assistance.
new text end

new text begin Subd. 3. new text end

new text begin Transitional MinnesotaCare. new text end

new text begin (a) Except as provided in paragraph (c),
effective March 1, 2010, all applicants and recipients who meet the eligibility requirements
in subdivision 1, paragraph (a), clause (2), and who are not described in subdivision 2
shall be enrolled in MinnesotaCare under section 256L.04, subdivision 7, immediately
following approval of general assistance medical care.
new text end

new text begin (b) If all other eligibility requirements of this subdivision are met, general assistance
medical care may be paid for individuals identified in paragraph (a) for a temporary
period beginning the date of application. Eligibility for general assistance medical care
shall continue until enrollment in MinnesotaCare is completed. Upon notification of
eligibility for MinnesotaCare, notice of termination for eligibility for general assistance
medical care shall be sent to the applicant or recipient. Once enrolled in MinnesotaCare,
the MinnesotaCare-covered services as described in section 256L.03 shall apply for the
remainder of the six-month general assistance medical care eligibility period until their
six-month renewal.
new text end

new text begin (c) This subdivision does not apply if the applicant or recipient:
new text end

new text begin (1) has applied for and is awaiting a determination of blindness or disability by the
state medical review team or a determination of eligibility for Supplemental Security
Income or Social Security Disability Insurance by the Social Security Administration;
new text end

new text begin (2) is homeless as defined by United States Code, title 42, section 11301, et seq.;
new text end

new text begin (3) is classified as an end-stage renal disease beneficiary in the Medicare program;
new text end

new text begin (4) receives treatment funded in section 254B.02; or
new text end

new text begin (5) fails to meet the requirements of section 256L.09, subdivision 2.
new text end

new text begin Applicants and recipients who meet any one of these criteria shall remain eligible for
general assistance medical care and shall not be required to enroll in MinnesotaCare.
new text end

new text begin (d) To be eligible for general assistance medical care following enrollment
in MinnesotaCare as required in paragraph (a), an individual must complete a new
application.
new text end

new text begin Subd. 4. new text end

new text begin Eligibility and enrollment procedures. new text end

new text begin (a) Eligibility for general
assistance medical care shall begin no earlier than the date of application. The date of
application shall be the date the applicant has provided a name, address, and Social
Security number, signed and dated, to the county agency or the Department of Human
Services. If the applicant is unable to provide a name, address, Social Security number,
and signature when health care is delivered due to a medical condition or disability, a
health care provider may act on an applicant's behalf to establish the date of an application
by providing the county agency or Department of Human Services with provider
identification and a temporary unique identifier for the applicant. The applicant must
complete the remainder of the application and provide necessary verification before
eligibility can be determined. The applicant must complete the application within the time
periods required under the medical assistance program as specified in Minnesota Rules,
parts 9505.0015, subpart 5; and 9505.0090, subpart 2. The county agency must assist the
applicant in obtaining verification if necessary.
new text end

new text begin (b) County agencies are authorized to use all automated databases containing
information regarding recipients' or applicants' income in order to determine eligibility for
general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
in order to determine eligibility and premium payments by the county agency.
new text end

new text begin (c) In determining the amount of assets of an individual eligible under subdivision 1,
paragraph (a), clause (2), there shall be included any asset or interest in an asset, including
an asset excluded under subdivision 1, paragraph (a), that was given away, sold, or
disposed of for less than fair market value within the 60 months preceding application for
general assistance medical care or during the period of eligibility. Any transfer described
in this paragraph shall be presumed to have been for the purpose of establishing eligibility
for general assistance medical care, unless the individual furnishes convincing evidence to
establish that the transaction was exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair market value at the time it
was given away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial months,
shall be calculated by dividing the uncompensated transfer amount by the average monthly
per person payment made by the medical assistance program to skilled nursing facilities
for the previous calendar year. The individual shall remain ineligible until this fixed period
has expired. The period of ineligibility may exceed 30 months, and a reapplication for
benefits after 30 months from the date of the transfer shall not result in eligibility unless
and until the period of ineligibility has expired. The period of ineligibility begins in the
month the transfer was reported to the county agency, or if the transfer was not reported,
the month in which the county agency discovered the transfer, whichever comes first. For
applicants, the period of ineligibility begins on the date of the first approved application.
new text end

new text begin (d) When determining eligibility for any state benefits under this subdivision,
the income and resources of all noncitizens shall be deemed to include their sponsor's
income and resources as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
subsequently set out in federal rules.
new text end

new text begin Subd. 5. new text end

new text begin General assistance medical care; services. new text end

new text begin (a) General assistance
medical care covers:
new text end

new text begin (1) inpatient hospital services within the limitations described in subdivision 10;
new text end

new text begin (2) outpatient hospital services;
new text end

new text begin (3) services provided by Medicare-certified rehabilitation agencies;
new text end

new text begin (4) prescription drugs and other products recommended through the process
established in section 256B.0625, subdivision 13;
new text end

new text begin (5) equipment necessary to administer insulin and diagnostic supplies and equipment
for diabetics to monitor blood sugar level;
new text end

new text begin (6) eyeglasses and eye examinations provided by a physician or optometrist;
new text end

new text begin (7) hearing aids;
new text end

new text begin (8) prosthetic devices;
new text end

new text begin (9) laboratory and x-ray services;
new text end

new text begin (10) physicians' services;
new text end

new text begin (11) medical transportation except special transportation;
new text end

new text begin (12) chiropractic services as covered under the medical assistance program;
new text end

new text begin (13) podiatric services;
new text end

new text begin (14) dental services as covered under the medical assistance program;
new text end

new text begin (15) mental health services covered under chapter 256B;
new text end

new text begin (16) prescribed medications for persons who have been diagnosed as mentally ill as
necessary to prevent more restrictive institutionalization;
new text end

new text begin (17) medical supplies and equipment, and Medicare premiums, coinsurance, and
deductible payments;
new text end

new text begin (18) medical equipment not specifically listed in this paragraph when the use of
the equipment will prevent the need for costlier services that are reimbursable under
this subdivision;
new text end

new text begin (19) services performed by a certified pediatric nurse practitioner, a certified family
nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
practitioner in independent practice, if (1) the service is otherwise covered under this
chapter as a physician service, (2) the service provided on an inpatient basis is not included
as part of the cost for inpatient services included in the operating payment rate, and (3) the
service is within the scope of practice of the nurse practitioner's license as a registered
nurse, as defined in section 148.171;
new text end

new text begin (20) services of a certified public health nurse or a registered nurse practicing in
a public health nursing clinic that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the scope of practice of the
public health nurse's license as a registered nurse, as defined in section 148.171;
new text end

new text begin (21) telemedicine consultations, to the extent they are covered under section
256B.0625, subdivision 3b;
new text end

new text begin (22) care coordination and patient education services provided by a community
health worker according to section 256B.0625, subdivision 49; and
new text end

new text begin (23) regardless of the number of employees that an enrolled health care provider
may have, sign language interpreter services when provided by an enrolled health care
provider during the course of providing a direct, person-to-person-covered health care
service to an enrolled recipient who has a hearing loss and uses interpreting services.
new text end

new text begin (b) Sex reassignment surgery is not covered under this section.
new text end

new text begin (c) Drug coverage is covered in accordance with section 256D.03, subdivision 4,
paragraph (d).
new text end

new text begin (d) The following co-payments shall apply for services provided:
new text end

new text begin (1) $25 for nonemergency visits to a hospital-based emergency room; and
new text end

new text begin (2) $3 per brand-name drug prescription, subject to a $7 per month maximum for
prescription drug co-payments. No co-payments shall apply to antipsychotic drugs when
used for the treatment of mental illness.
new text end

new text begin (e) Co-payments shall be limited to one per day per provider for nonemergency
visits to a hospital-based emergency room. Recipients of general assistance medical care
are responsible for all co-payments in this subdivision. Reimbursement for prescription
drugs shall be reduced by the amount of the co-payment until the recipient has reached the
$7 per month maximum for prescription drug co-payments. The provider shall collect
the co-payment from the recipient. Providers may not deny services to recipients who
are unable to pay the co-payment.
new text end

new text begin (f) Chemical dependency services that are reimbursed under chapter 254B shall not
be reimbursed under general assistance medical care.
new text end

new text begin (g) Inpatient hospital services that are provided in community behavioral health
hospitals operated by state-operated services shall not be reimbursed under general
assistance medical care.
new text end

new text begin Subd. 6. new text end

new text begin Coordinated care delivery option. new text end

new text begin (a) A county or group of counties may
elect to provide health care and supportive services to individuals who are eligible for
general assistance medical care under this section and who reside within the county or
counties through a coordinated care delivery option. The health care services provided
by the county must include the services described in subdivision 5 with the exception of
outpatient prescription drug coverage but including drugs administered in an outpatient
setting. Support services may include, but are not limited to, social services, outreach,
health care navigation, housing, and transportation. Counties that elect to provide health
care services through this option must ensure that the requirements of this subdivision
are met. Upon electing to provide services through this option, the county accepts the
financial risk of the delivery of the health care services described in this subdivision to
general assistance medical care recipients residing in the county for the period beginning
July 1, 2010, and ending July 1, 2011, for the fixed payments described in subdivision 10.
new text end

new text begin (b) A county that elects to provide services through this option must provide to
the commissioner the following:
new text end

new text begin (1) the names of the county or counties that are electing to provide services through
the county care delivery option; and
new text end

new text begin (2) the geographic area to be served.
new text end

new text begin (c) The county may contract with a managed care plan, an integrated delivery
system, a physician-hospital organization, or an academic health center to administer
the delivery of services through this option. Any county providing general assistance
medical care services through a county-based purchasing plan in accordance with section
256B.692 may continue to provide services through the county-based purchasing plan.
Payments to the county-based purchasing plan for the period beginning July 1, 2010, and
ending July 1, 2011, shall be paid according to subdivision 10.
new text end

new text begin (d) A county must demonstrate the ability to:
new text end

new text begin (1) provide the covered services required under this subdivision to recipients
residing within the county;
new text end

new text begin (2) provide a system for advocacy, consumer protection, and complaints and appeals
that is independent of care providers or other risk bearers and complies with section
256B.69;
new text end

new text begin (3) establish a process to monitor enrollment and ensure the quality of care provided;
and
new text end

new text begin (4) coordinate the delivery of health care services with existing homeless prevention,
supportive housing, and rent subsidy programs and funding administered by the Minnesota
Housing Finance Agency under chapter 462A.
new text end

new text begin (e) The commissioner may require the county to provide the commissioner with data
necessary for assessing enrollment, quality of care, cost, and utilization of services.
new text end

new text begin (f) A county that elects to provide services through this option shall be considered to
be a prepaid health plan for purposes of section 256.045.
new text end

new text begin (g) The state shall not be liable for the payment of any cost or obligation incurred
by the county or a participating provider.
new text end

new text begin Subd. 7. new text end

new text begin Health care home designation. new text end

new text begin The commissioner or a county may
require a recipient to designate a primary care provider or a primary care clinic that is
certified as a health care home under section 256B.0751.
new text end

new text begin Subd. 8. new text end

new text begin Payments; fee-for-service rate for the period between March 1,
2010, and July 1, 2010.
new text end

new text begin (a) Effective for services provided on or after March 1, 2010,
and before July 1, 2010, the payment rates for all covered services provided to general
assistance medical care recipients, with the exception of outpatient prescription drug
coverage, shall be 50 percent of the general assistance medical care payment rate in effect
on February 28, 2010.
new text end

new text begin (b) Outpatient prescription drug coverage provided on or after March 1, 2010, and
before July 1, 2010, shall be paid on a fee-for-service basis in accordance with section
256B.0625, subdivision 13e.
new text end

new text begin Subd. 9. new text end

new text begin Payments; fee-for-service rates for the period between July 1, 2010,
and July 1, 2011.
new text end

new text begin (a) Effective for services provided on or after July 1, 2010, and before
July 1, 2011, to general assistance medical care recipients residing in counties that are
not served through the coordinated care delivery option, payments shall be made by the
commissioner to providers at rates described in this subdivision.
new text end

new text begin (b) For inpatient hospital admissions provided on or after July 1, 2010, and before
July 1, 2011, the payment rate shall be:
new text end

new text begin (1) 65.6 percent of the general assistance medical care rate in effect on February
28, 2010, if the inpatient hospital services were provided in a hospital where the
fee-for-service inpatient and outpatient hospital general assistance medical care payments
to the hospital for admissions provided in calendar year 2007 totaled $1,000,000 or more
or the hospital's fee-for-service inpatient and outpatient hospital general assistance medical
care payments received for calendar year 2007 admissions was one percent or more of the
hospital's net patient revenue received for services provided in calendar year 2007; or
new text end

new text begin (2) 60 percent of the general assistance medical care rate in effect on February 28,
2010, if the inpatient hospital services were provided by a hospital that does not meet the
criteria described in clause (1).
new text end

new text begin (c) Effective for services other than inpatient hospital services and outpatient
prescription drug coverage provided on or after July 1, 2010, and before July 1, 2011,
the payment rate shall begin at 50 percent of the general assistance medical care rate
in effect on February 28, 2010.
new text end

new text begin (d) Outpatient prescription drug coverage provided on or after July 1, 2010, and
before July 1, 2011, shall be paid on a fee-for-service basis in accordance with section
256B.0625, subdivision 13e.
new text end

new text begin (e) The commissioner may adjust the rates paid under paragraphs (b) and (c) on a
quarterly basis to ensure that the total aggregate amount paid out for services provided
on a fee-for-service basis beginning March 1, 2010, and ending June 30, 2011, does not
exceed the appropriation from the general assistance medical care account established in
section 256D.032 for the general assistance medical care program.
new text end

new text begin Subd. 10. new text end

new text begin Payments; rate setting for the coordinated care delivery option. new text end

new text begin (a)
Effective for general assistance medical care services, with the exception of outpatient
prescription drug coverage, provided on or after July 1, 2010, and before July 1, 2011,
to recipients residing in counties that have elected to provide services through the
coordinated delivery care option, the commissioner shall establish quarterly prospective
fixed payments to the county. The payments must not exceed 60 percent of the county's
general assistance medical care county allocation amount as determined in paragraph (b).
These payments must not be used by the county to pay MinnesotaCare premiums for
general assistance medical care recipients or MinnesotaCare enrollees.
new text end

new text begin (b) For each county that elects to provide services in accordance with subdivision
7, the commissioner shall determine a general assistance medical care county allocation
amount that equals the total general assistance medical care payments made for recipients
residing within the county in fiscal year 2009 for all covered general assistance medical
care services with the exception of outpatient prescription drug coverage.
new text end

new text begin (c) Outpatient prescription drug coverage provided on or after July 1, 2010,
and before July 1, 2011, shall be paid on a fee-for-service basis according to section
256B.0625, subdivision 13e.
new text end

new text begin Subd. 11. new text end

new text begin Veterans medical review team. new text end

new text begin (a) To ensure the timely processing of
determinations of service-connected disabilities among veterans enrolled in the temporary
general assistance medical care program, the commissioner shall review all medical
evidence submitted by enrollees with a referral and seek additional information from
providers, applicants, and enrollees to support the determination of a service-connected
disability when necessary. Service-connected disability shall be determined according to
the regulations and policies of the United States Department of Veterans Affairs.
new text end

new text begin (b) Prior to a denial or withdrawal of a requested determination of service-connected
disability due to insufficient evidence, the commissioner shall:
new text end

new text begin (1) ensure that the missing evidence is necessary and appropriate to a determination
of service-connected disability; and
new text end

new text begin (2) assist applicants and enrollees to obtain the evidence, including, but not limited
to, medical examinations and electronic medical records.
new text end

new text begin (c) The commissioner shall provide the chairs of the legislative committees with
jurisdiction over health and human services finance and veterans affairs finance and
budget the following information on the activities of the veterans medical review team by
August 1, 2010, and provide an update by January 1, 2011:
new text end

new text begin (1) the number of applications to the veterans medical review team that were denied,
approved, or withdrawn;
new text end

new text begin (2) the average length of time from receipt of the application to a decision;
new text end

new text begin (3) the number of appeals and appeal results;
new text end

new text begin (4) for applicants, their age, health coverage at the time of application,
hospitalization history within three months of application, and whether an application for
service-connected veterans benefits is pending; and
new text end

new text begin (5) specific information on the medical certification, licensure, or other credentials
of the person or persons performing the medical review determinations and length of
time in that position.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for services rendered on or after
March 1, 2010, and before July 1, 2011.
new text end

Sec. 14.

new text begin [256D.032] GENERAL ASSISTANCE MEDICAL CARE ACCOUNT.
new text end

new text begin The general assistance medical care account is created in the special revenue fund.
Money deposited into the account is subject to appropriation by the legislature, and shall
be used only for expenditures related to the general assistance medical care program
or as provided in this act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 15.

Minnesota Statutes 2008, section 256D.06, subdivision 7, is amended to read:


Subd. 7.

SSI conversions and back claims.

(a) The commissioner of human
services shall contract with agencies or organizations capable of ensuring that clients who
are presently receiving assistance under sections 256D.01 to 256D.21, and who may be
eligible for benefits under the federal Supplemental Security Income program, apply and,
when eligible, are converted to the federal income assistance program and made eligible
for health care benefits under the medical assistance program. The commissioner shall
ensure that money owing to the state under interim assistance agreements is collected.

(b) The commissioner shall also directly or through contract implement procedures
for collecting federal Medicare and medical assistance funds for which clients converted
to SSI are retroactively eligible.

(c) The commissioner shall contract with agencies to ensure implementation of
this section. County contracts with providers for residential services shall include the
requirement that providers screen residents who may be eligible for federal benefits and
provide that information to the local agency. The commissioner shall modify the MAXIS
computer system to provide information on clients who have been on general assistance
for two years or longer. The list of clients shall be provided to local services for screening
under this section.

new text begin (d) Effective for general assistance medical care services rendered on or after
March 1, 2010, to June 30, 2011, any medical collections, payments, or recoveries under
this subdivision shall be deposited in or credited to the account established in section
256D.032.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 16.

Minnesota Statutes 2008, section 256L.05, subdivision 1b, is amended to read:


Subd. 1b.

MinnesotaCare enrollment by county agencies.

Beginning September
1, 2006, county agencies shall enroll single adults and households with no children
formerly enrolled in general assistance medical care in MinnesotaCare according to
section 256D.03, subdivision 3new text begin, or 256D.031new text end. County agencies shall perform all duties
necessary to administer the MinnesotaCare program ongoing for these enrollees, including
the redetermination of MinnesotaCare eligibility at renewal.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 17.

Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:


Subd. 3.

Effective date of coverage.

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

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

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

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

(e) The effective date of coverage for single adults and households with no children
formerly enrolled in general assistance medical care and enrolled in MinnesotaCare
according to section 256D.03, subdivision 3, new text beginor 256D.031, new text endis the first day of the month
following the last day of general assistance medical care coverage.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 18.

Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:


Subd. 3a.

Renewal of eligibility.

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

(b) Each new period of eligibility must take into account any changes in
circumstances that impact eligibility and premium amount. An enrollee must provide all
the information needed to redetermine eligibility by the first day of the month that ends
the eligibility period. If there is no change in circumstances, the enrollee may renew
eligibility at designated locations that include community clinics and health care providers'
offices. The designated sites shall forward the renewal forms to the commissioner. The
commissioner may establish criteria and timelines for sites to forward applications to the
commissioner or county agencies. The premium for the new period of eligibility must be
received as provided in section 256L.06 in order for eligibility to continue.

(c) For single adults and households with no children formerly enrolled in general
assistance medical care and enrolled in MinnesotaCare according to section 256D.03,
subdivision 3
,new text begin or 256D.031,new text end the first period of eligibility begins the month the enrollee
submitted the application or renewal for general assistance medical care.

(d) An enrollee who fails to submit renewal forms and related documentation
necessary for verification of continued eligibility in a timely manner shall remain eligible
for one additional month beyond the end of the current eligibility period before being
disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the
additional month.

Sec. 19.

Minnesota Statutes 2008, section 256L.07, subdivision 6, is amended to read:


Subd. 6.

Exception for certain adults.

Single adults and households with
no children formerly enrolled in general assistance medical care and enrolled in
MinnesotaCare according to section 256D.03, subdivision 3, new text beginor 256D.031, new text endare eligible
without meeting the requirements of this section until renewal.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 20.

Minnesota Statutes 2008, section 256L.15, subdivision 4, is amended to read:


Subd. 4.

Exception for transitioned adults.

County agencies shall pay premiums
for single adults and households with no children formerly enrolled in general assistance
medical care and enrolled in MinnesotaCare according to section 256D.03, subdivision 3,
new text begin or 256D.031, new text enduntil six-month renewal. The county agency has the option of continuing to
pay premiums for these enrollees.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 21.

Minnesota Statutes 2008, section 256L.17, subdivision 7, is amended to read:


Subd. 7.

Exception for certain adults.

Single adults and households with
no children formerly enrolled in general assistance medical care and enrolled in
MinnesotaCare according to section 256D.03, subdivision 3, new text beginor 256D.031, new text endare exempt
from the requirements of this section until renewal.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 22. new text beginDRUG REBATE PROGRAM.
new text end

new text begin The commissioner of human services shall continue to administer a drug rebate
program for drugs purchased for persons eligible for the general assistance medical care
program in accordance with Minnesota Statutes, sections 256.01, subdivision 2, paragraph
(cc), and 256D.03. The rebate revenues collected under the drug rebate program for
persons eligible for the general assistance medical care program shall be deposited in the
general assistance medical care account in the special revenue fund established under
Minnesota Statutes, section 256D.032.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010, and expires June
30, 2011.
new text end

Sec. 23. new text beginPROVIDER PARTICIPATION.
new text end

new text begin For purposes of Minnesota Statutes, section 256B.0644, the reference to the general
assistance medical care program shall include the temporary general assistance medical
care program established under Minnesota Statutes, section 256D.031. In meeting the
requirements of Minnesota Statutes, section 256B.0644, a provider must accept new
patients regardless of the Minnesota health care program the patient is enrolled in and may
not refuse to accept patients enrolled in one Minnesota health care program and continue
to accept patients enrolled in other Minnesota health care programs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 24. new text beginTEMPORARY SUSPENSION.
new text end

new text begin (a) For the period beginning March 1, 2010, to June 30, 2011, the commissioner
of human services shall not implement or administer Minnesota Statutes 2008, section
256D.03, subdivisions 6 and 9; Minnesota Statutes 2009 Supplement, section 256D.03,
subdivision 4; or Minnesota Statutes 2008, section 256B.692; and Minnesota Statutes
2009 Supplement, section 256B.69, as they apply to the general assistance medical care
program unless specifically continued in Minnesota Statutes, section 256D.031.
new text end

new text begin (b) Notwithstanding paragraph (a), outpatient prescription drug coverage shall
continue to be provided under Minnesota Statutes, section 256D.03.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010, and expires July 1,
2011.
new text end

Sec. 25. new text beginCOORDINATED CARE DELIVERY ORGANIZATION
DEMONSTRATION PROJECT.
new text end

new text begin The commissioner of human services shall develop, and present to the legislature
by December 15, 2010, a plan to establish a demonstration project to deliver inpatient
hospital, primary care, and specialist services to general assistance medical care enrollees
through coordinated care delivery organizations, beginning January 1, 2012. Each
coordinated care delivery organization must deliver coordinated care through at least one
hospital and one physician group practice, and may include counties and other health
care providers. The coordinated care delivery organization must provide inpatient
hospital services to general assistance medical care enrollees eligible for the program
under Minnesota Statutes, section 256D.03 or 256D.031. The coordinated care delivery
organization must accept responsibility for the quality of care and must assume financial
risk for the services provided. The plan must include:
new text end

new text begin (1) financial incentives for coordinated care delivery organizations to reduce the
growth in the volume and cost of services provided, while maintaining or improving
the quality of care;
new text end

new text begin (2) recommendations for the delivery of services not provided through a coordinated
care delivery organization and coordination of outpatient and inpatient health care services;
new text end

new text begin (3) recommendations as to the size and scope of the demonstration project and
whether participation would be mandatory or voluntary for general assistance medical
care enrollees; and
new text end

new text begin (4) recommendations for managing financial risk within a coordinated care delivery
organization.
new text end

Sec. 26. new text beginAPPROPRIATION TRANSFERS.
new text end

new text begin (a) Of the general fund appropriation to the commissioner of human services for
health care management in Laws 2009, chapter 79, article 13, section 3, subdivision
7, as amended by Laws 2009, chapter 173, article 2, section 1, $3,300,000 for health
care administration and $4,100,000 for health care operations shall be transferred on
March 1, 2010, to the fund established in Minnesota Statutes, section 256D.032. These
amounts are appropriated to the commissioner for the administration and operation of the
general assistance medical care program under Minnesota Statutes, section 256D.031. For
purposes of consistent cost allocation and accounting, the commissioner may transfer the
amounts appropriated for program administration and operation to the general fund.
new text end

new text begin (b) Of the general fund appropriation to the commissioner of human services for
general assistance medical care grants in fiscal year 2010 in Laws 2009, chapter 79, article
13, section 3, subdivision 6, paragraph (d), as amended by Laws 2009, chapter 173, article
2, section 1, $44,000,000 shall be transferred on March 1, 2010, to the fund established
in Minnesota Statutes, section 256D.032, and any unexpended amount not used for
general assistance medical care expenditures incurred prior to March 1, 2010, does not
cancel and shall be transferred to the fund established in Minnesota Statutes, section
256D.032, by January 1, 2011.
new text end

new text begin (c) The commissioner of finance shall transfer $169,733,000 in fiscal year 2011
and $12,979,000 in fiscal year 2012, from the general fund to the fund established in
Minnesota Statutes, section 256D.032.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 27. new text beginAPPROPRIATION REDUCTION; TRANSFER.
new text end

new text begin (a) The general fund appropriation to the commissioner of human services for
children and community services grants in Laws 2009, chapter 79, article 13, section 3,
subdivision 4, as amended by Laws 2009, chapter 173, article 2, section 1, subdivision 4,
is reduced by $11,560,000 in fiscal year 2011 and is reduced by $1,062,000 in fiscal year
2012. The general fund base for children and community service grants is increased by
$11,560,000 per year for fiscal years 2012 and 2013. The general fund base for children
and community service grants is further increased by $1,062,000 for fiscal year 2013. This
$1,062,000 increase is onetime.
new text end

new text begin (b) The general fund appropriation to the commissioner of human services for adult
mental health grants in Laws 2009, chapter 79, article 13, section 3, subdivision 8, as
amended by Laws 2009, chapter 173, article 2, section 1, subdivision 8, is reduced by
$11,560,000 in fiscal year 2011 and is reduced by $1,062,000 in fiscal year 2012. The
general fund base for adult mental health grants is increased by $11,560,000 per year in
fiscal years 2012 and 2013. The general fund base for adult mental health grants is further
increased by $1,062,000 for fiscal year 2013. This $1,062,000 increase is onetime.
new text end

new text begin (c) $23,120,000 shall be transferred in fiscal year 2011 from the general fund to
the general assistance medical care account established in Minnesota Statutes, section
256D.032.
new text end

new text begin (d) $2,124,000 shall be transferred in fiscal year 2012 from the general fund to
the general assistance medical care account established in Minnesota Statutes, section
256D.032. $2,124,000 shall be transferred in fiscal year 2013 from the general assistance
medical care account established in Minnesota Statutes, section 256D.032, to the general
fund.
new text end

Sec. 28. new text beginAPPROPRIATIONS.
new text end

new text begin $....... for the period from March 1, 2010, to June 30, 2010, and $....... for fiscal
year 2011 is appropriated from the account established in Minnesota Statutes, section
256D.032, to the commissioner of human services for the general assistance medical care
program established in Minnesota Statutes, section 256D.031.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end