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SF 594

as introduced - 90th Legislature (2017 - 2018) Posted on 02/03/2017 09:01am

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

Current Version - as introduced

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A bill for an act
relating to human services; directing the commissioner of human services to
establish a health care delivery pilot program created by or including North
Memorial Health Care; amending Minnesota Statutes 2016, section 256B.0758.

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

Section 1.

Minnesota Statutes 2016, section 256B.0758, is amended to read:


256B.0758 HEALTH CARE DELIVERY PILOT PROGRAM.

(a) The commissioner deleted text begin maydeleted text end new text begin , by May 1, 2017, shallnew text end establish a health care delivery pilot
program to test alternative and innovative integrated health care delivery networks, including
accountable care organizations or a community-based collaborative care network created
by or including North Memorial Health Care. If required, the commissioner shall seek
federal approval of a new waiver request or amend an existing demonstration pilot project
waiver.

(b) Individuals eligible for the pilot program shall be individuals whonew text begin : (1)new text end are eligible
for medical assistance under section 256B.055new text begin or MinnesotaCare under chapter 256L; (2)
are also eligible to receive services through integrated health partnerships authorized under
section 256B.0755; and (3) meet the criteria specified in this paragraph
new text end
. new text begin Initial enrollment
shall be comprised of individuals who, as of April 30, 2017, were attributed to the North
Memorial Health Care integrated health partnership and were Medica enrollees. Secondary
enrollment shall be comprised of individuals residing in the North Memorial Health Care
service area who, as of April 30, 2017, were attributed to another integrated health partnership
and were Medica enrollees. These individuals shall no longer be served by a managed care
organization, unless North Memorial Health Care operates this demonstration project as a
managed care organization, or in partnership with a managed care organization.
new text end The
commissioner deleted text begin maydeleted text end new text begin shallnew text end identify new text begin additional new text end individuals to be enrolled in the pilot program
based on zip code or whether the individuals would benefit from an integrated health care
delivery network.

(c) In developing a payment system for the pilot programs, the commissioner shall
establish a total cost of care for the individuals enrolled in the pilot program that equals the
cost of care that would otherwise be spent for these enrollees in the prepaid medical assistance
program.

new text begin (d) The payment system for the pilot program shall be based on the payment model
specified in North Memorial Health Care's integrated health partnership contract with the
commissioner, with the following modifications:
new text end

new text begin (1) North Memorial Health Care shall receive a care coordination fee of $12 per month
for all individuals enrolled in the pilot program; and
new text end

new text begin (2) all individuals eligible for health care home care coordination payments shall be paid
according to the payment system developed under section 256B.0753, and the commissioner
shall accept submission of the registry of membership and tier levels by North Memorial
Health Care as sufficient documentation for determining payment levels.
new text end

new text begin EFFECTIVE DATE. new text end

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