SF 1136

as introduced - 90th Legislature (2017 - 2018) Posted on 02/21/2017 08:38am

A bill for an act
relating to human services; establishing an enhanced asthma care services benefit
for medical assistance; providing for medical assistance coverage of certain services
and products to reduce asthma triggers; amending Minnesota Statutes 2016, sections
256B.04, subdivision 14; 256B.0625, subdivision 31, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2016, section 256B.04, subdivision 14, is amended to read:

Subd. 14.

Competitive bidding.

(a) When determined to be effective, economical, and
feasible, the commissioner may utilize volume purchase through competitive bidding and
negotiation under the provisions of chapter 16C, to provide items under the medical assistance
program including but not limited to the following:

(1) eyeglasses;

(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
on a short-term basis, until the vendor can obtain the necessary supply from the contract
dealer;

(3) hearing aids and supplies; deleted text begin and
deleted text end

(4) durable medical equipment, including but not limited to:

(i) hospital beds;

(ii) commodes;

(iii) glide-about chairs;

(iv) patient lift apparatus;

(v) wheelchairs and accessories;

(vi) oxygen administration equipment;

(vii) respiratory therapy equipment;

(viii) electronic diagnostic, therapeutic and life-support systems; new text begin and
new text end

new text begin (ix) allergen-reducing products as described in section 256B.0625, subdivision 65,
paragraph (c);
new text end

(5) nonemergency medical transportation level of need determinations, disbursement of
public transportation passes and tokens, and volunteer and recipient mileage and parking
reimbursements; and

(6) drugs.

(b) Rate changes and recipient cost-sharing under this chapter and chapter 256L do not
affect contract payments under this subdivision unless specifically identified.

(c) The commissioner may not utilize volume purchase through competitive bidding
and negotiation for special transportation services under the provisions of chapter 16C.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 2.

Minnesota Statutes 2016, section 256B.0625, subdivision 31, is amended to read:

Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall be
made for wheelchairs and wheelchair accessories for recipients who are residents of
intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs
and wheelchair accessories for ICF/DD recipients shall be subject to the same conditions
and limitations as coverage for recipients who do not reside in institutions. A wheelchair
purchased outside of the facility's payment rate is the property of the recipient.

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics,
or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment
requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic,
or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or similar
durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with the
Medicare program's supplier and quality standards and the vendor serves primarily pediatric
patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical condition
or is generally used primarily for a medical purpose.

(e) Electronic tablets may be considered durable medical equipment if the electronic
tablet will be used as an augmentative and alternative communication system as defined
under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must
be locked in order to prevent use not related to communication.

(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must be
locked to prevent use not as an augmentative communication device, a recipient of waiver
services may use an electronic tablet for a use not related to communication when the
recipient has been authorized under the waiver to receive one or more additional applications
that can be loaded onto the electronic tablet, such that allowing the additional use prevents
the purchase of a separate electronic tablet with waiver funds.

new text begin (g) Allergen-reducing products as described in subdivision 65, paragraph (c), shall be
considered durable medical equipment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 65. new text end

new text begin Enhanced asthma care services. new text end

new text begin (a) Medical assistance covers enhanced
asthma care services and related products for a child with poorly controlled asthma, to be
provided in the child's home. To be eligible for services and products under this subdivision,
a child must:
new text end

new text begin (1) be younger than 21 years of age;
new text end

new text begin (2) have poorly controlled asthma, defined as the child having received health care for
asthma from a hospital emergency department at least once in the past year or having been
hospitalized for the treatment of asthma at least once in the past year; and
new text end

new text begin (3) receive a referral for services and products under this subdivision from a treating
health care provider.
new text end

new text begin (b) Covered services include home visits provided by a healthy homes specialist who is
credentialed by the National Environmental Health Association. A child is limited to two
home visits through 20 years of age to identify asthma triggers in the home and to provide
education on trigger-reducing products, except that a child may receive additional home
visits if:
new text end

new text begin (1) the child moves to a new home;
new text end

new text begin (2) a new asthma trigger, including tobacco smoke, enters the home; or
new text end

new text begin (3) the child's health care provider identifies a new allergy for the child, including an
allergy to mold, pests, pets, or dust mites.
new text end

new text begin (c) Covered products include allergen-reducing products that are recommended for the
child by a healthy homes specialist, certified asthma educator, public health nurse, or other
health care professional providing asthma care for the child, and proven to reduce asthma
triggers, including:
new text end

new text begin (1) encasements for mattresses, box springs, and pillows;
new text end

new text begin (2) HEPA vacuum cleaners, filters, and bags;
new text end

new text begin (3) dehumidifiers and filters;
new text end

new text begin (4) single-room air cleaners and filters;
new text end

new text begin (5) nontoxic pest control systems, including traps and starter packages of food storage
containers;
new text end

new text begin (6) damp mopping systems;
new text end

new text begin (7) if the child does not have access to a bed, a waterproof hospital-grade mattress; and
new text end

new text begin (8) for homeowners only, furnace filters.
new text end

new text begin The commissioner shall cover additional products under this paragraph as new best practices
for asthma care are identified. The commissioner shall determine the frequency with which
a child may receive a product listed in this paragraph based on the reasonable expected
lifetime of the product.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end