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HF 1936

1st Engrossment - 89th Legislature (2015 - 2016) Posted on 03/23/2015 04:02pm

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

Bill Text Versions

Engrossments
Introduction Posted on 03/16/2015
1st Engrossment Posted on 03/18/2015

Current Version - 1st Engrossment

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A bill for an act
relating to human services; requiring the commissioner of human services to
contract with a vendor for eligibility verification audit services for public health
care programs.

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

Section 1. new text beginPUBLIC HEALTH CARE PROGRAM ELIGIBILITY
VERIFICATION AUDIT SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Request for proposals. new text end

new text begin By October 1, 2015, the commissioner of
human services shall issue a request for proposals for a contract to provide eligibility
verification audit services for public health care program benefits provided through the
state medical assistance and MinnesotaCare programs. The request for proposals must
require that the vendor:
new text end

new text begin (1) conduct an eligibility verification audit of all medical assistance and
MinnesotaCare enrollees that includes, but is not limited to, appropriate data matching
against relevant state and federal databases;
new text end

new text begin (2) identify any ineligible enrollees in these programs and report those findings
to the commissioner; and
new text end

new text begin (3) identify a process for ongoing eligibility verification of medical assistance
and MinnesotaCare enrollees and applicants, following the conclusion of the eligibility
verification audit required by this section.
new text end

new text begin Subd. 2. new text end

new text begin Additional vendor criteria. new text end

new text begin The request for proposals must require the
vendor to provide the following minimum capabilities and experience in performing the
services described in subdivision 1:
new text end

new text begin (1) a rules-based process for making objective eligibility determinations;
new text end

new text begin (2) assigned eligibility advocates to assist enrollees through the verification process;
new text end

new text begin (3) a formal claims and appeals process; and
new text end

new text begin (4) experience in the performance of eligibility verification audits.
new text end

new text begin Subd. 3. new text end

new text begin Contract required. new text end

new text begin By January 1, 2016, the commissioner must enter
into a contract for the services specified in subdivision 1. The contract may 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. The contract
must require the vendor to comply with enrollee data privacy requirements and to use
encryption to safeguard enrollee identity. The contract must also provide penalties for
vendor noncompliance.
new text end