as introduced - 87th Legislature (2011 - 2012) Posted on 03/14/2011 10:40am
Engrossments | ||
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Introduction | Posted on 03/14/2011 |
A bill for an act
relating to state government; requiring the commissioner of management and
budget to issue a request for proposals and enter into a contract for dependent
audit verification for state employee health plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
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By ......., 2011, the commissioner of
management and budget shall issue a request for proposals for a contract to provide
dependent eligibility verification audit services for state-paid hospital, medical, and dental
benefits provided to state employees and their dependents. The request for proposals
must require that the vendor will:
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(1) conduct a document-model dependent eligibility verification audit of all plans
offered under Minnesota Statutes, sections 43A.22 to 43A.31;
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(2) identify ineligible dependents covered by the plans and report those findings to
the commissioner and third-party administrators of the state's employee health plans, as
directed by the commissioner; and
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(3) implement a process for ongoing eligibility verification following the conclusion
of the dependent eligibility verification audit required by this section.
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The request for proposals required by
subdivision 1 must require the vendor to provide the following minimum capabilities and
experience in performing the services described in subdivision 1:
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(1) a rules-based platform employing auto-adjudication for making objective
eligibility determinations;
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(2) assigned eligibility advocates to assist employees through the verification
process;
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(3) a formal claims and appeals process; and
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(4) experience in the performance of dependent eligibility verification audits for
other states.
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By ......., 2011, the commissioner must enter into
a contract for the services specified in subdivision 1. The contract must incorporate a
performance-based vendor financing option that compensates the vendor based on the
amount of savings generated by the work performed under the contract.
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