SF 33

1st Engrossment - 87th Legislature (2011 - 2012) Posted on 01/27/2011 12:20pm

A bill for an act
relating to health; providing a statement of public policy declaring that every
resident of Minnesota has the freedom of choice in health care; making
appropriation adjustments in fiscal years 2010 and 2011; amending Minnesota
Statutes 2010, section 8.31, subdivision 1; Laws 2010, First Special Session
chapter 1, article 25, section 3, subdivisions 2, 5, 6, 7; proposing coding for
new law in Minnesota Statutes, chapter 1; repealing Minnesota Statutes 2010,
sections 256B.055, subdivision 15; 256B.0756; Laws 2010, First Special Session
chapter 1, article 16, sections 6; 7; 18; 46; 47.

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

Section 1.

new text begin [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.
new text end

new text begin Subdivision 1. new text end

new text begin Citation. new text end

new text begin This section shall be known as and may be cited as the
"Freedom of Choice in Health Care Act."
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meaning given them.
new text end

new text begin (b) "Health care service" means any service, treatment, or provision of a product for
the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise
maintain or improve physical or mental health, subject to all laws and rules regulating
health service providers and products within the state of Minnesota.
new text end

new text begin (c) "Mode of securing" means to purchase directly or on credit or by trade, or to
contract for third-party payment by insurance or other legal means as authorized by the
state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored
health care benefits under such conditions as may legally be required as a condition of
such benefits, or any combination of the same.
new text end

new text begin (d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding,
surcharge, fee, or any other imposed consequence established by law or rule of a
government or its subdivision or agency that is used to punish or discourage the exercise
of rights protected under this section.
new text end

new text begin Subd. 3. new text end

new text begin Statement of public policy. new text end

new text begin (a) The power to require or regulate a person's
choice in the mode of securing health care services, or to impose a penalty related to that
choice, is not found in the Constitution of the United States of America, and is therefore a
power reserved to the people pursuant to the Ninth Amendment, and to the several states
pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign
power to declare the public policy of the state of Minnesota regarding the right of all
persons residing in the state in choosing the mode of securing health care services.
new text end

new text begin (b) It is hereby declared that the public policy of the state of Minnesota, consistent
with our constitutionally recognized and inalienable rights of liberty, is that every person
within the state of Minnesota is and shall be free to choose or decline to choose any mode
of securing health care services without penalty or threat of penalty.
new text end

new text begin (c) The policy stated under this section shall not be applied to impair any right of
contract related to the provision of health care services to any person or group.
new text end

new text begin Subd. 4. new text end

new text begin Enforcement. new text end

new text begin (a) No public official, employee, or agent of the state of
Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or
effectuate any penalty in the state of Minnesota that violates the public policy set forth
in this section.
new text end

new text begin (b) The attorney general shall take any action as is provided in this section or section
8.31 in the defense or prosecution of rights protected under this section.
new text end

Sec. 2.

Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:

Subdivision 1.

Investigate offenses against provisions of certain designated
sections; assist in enforcement.

new text begin (a) new text end The attorney general shall investigate violations of the
law of this state respecting unfair, discriminatory, and other unlawful practices in business,
commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act
(sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition
(sections 325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to
325D.16), the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other
laws against false or fraudulent advertising, the antidiscrimination acts contained in
section 325D.67, the act against monopolization of food products (section 325D.68),
the act regulating telephone advertising services (section 325E.39), the Prevention of
Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency
exchanges and assist in the enforcement of those laws as in this section provided.

new text begin (b) The attorney general shall seek injunctive and any other appropriate relief as
expeditiously as possible to preserve the rights and property of the residents of Minnesota,
and to defend as necessary the state of Minnesota, its officials, employees, and agents in
the event that any law or regulation violating the public policy set forth in the Freedom
of Choice in Health Care Act in this section is enacted by any government, subdivision,
or agency thereof.
new text end

new text begin (c) The attorney general shall seek injunctive and any other appropriate relief
as expeditiously as possible in the event that any law or regulation violating the public
policy set forth in the Freedom of Choice in Health Care Act in this section is enacted
without adequate federal funding to the state to ensure affordable health care coverage
is available to the residents of Minnesota.
new text end

Sec. 3.

Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 2,
is amended to read:

Subd. 2. Agency Management

(a) deleted text begin Financial Operations deleted text end

deleted text begin -0- deleted text end

deleted text begin 103,000 deleted text end

deleted text begin Base Adjustment. The general fund base is
decreased by $10,000 in fiscal year 2012 and
$10,000 in fiscal year 2013.
deleted text end

deleted text begin (b) deleted text end Legal and Regulatory Operations

-0-

114,000

Base Adjustment. The general fund base is
decreased by $18,000 in fiscal year 2012 and
$18,000 in fiscal year 2013.

deleted text begin (c) deleted text end new text begin (b) new text end Management Operations

-0-

(114,000)

Base Adjustment. The general fund base is
increased by $18,000 in fiscal year 2012 and
$18,000 in fiscal year 2013.

deleted text begin (d) deleted text end new text begin (c) new text end Information Technology Operations

-0-

(2,500,000)

Base Adjustment. The general fund base is
decreased by $1,666,000 in fiscal year 2012
and $1,666,000 in fiscal year 2013.

Sec. 4.

Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 5,
is amended to read:

Subd. 5. Children and Economic Assistance Management

(a) Children and Economic Assistance Administration

-0-

-0-

Base Adjustment. The federal TANF fund
base is decreased by $700,000 in fiscal year
2012 and $700,000 in fiscal year 2013.

(b) Children and Economic Assistance Operations

-0-

deleted text begin 195,000 deleted text end new text begin 90,000 new text end

Base Adjustment. The general fund base
is deleted text begin decreased deleted text end new text begin increased new text end by deleted text begin $12,000 deleted text end new text begin $93,000
new text end in fiscal year 2012 and deleted text begin $12,000 deleted text end new text begin $93,000 new text end in
fiscal year 2013.

Sec. 5.

Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 6,
is amended to read:

Subd. 6. Health Care Grants

(a) MinnesotaCare Grants

998,000

(13,376,000)

This appropriation is from the health care
access fund.

deleted text begin Health Care Access Fund Transfer to
General Fund. The commissioner of
management and budget shall transfer
the following amounts in the following
years from the health care access fund to
the general fund: $998,000 in fiscal year
2010; $176,704,000 in fiscal year 2011;
$141,041,000 in fiscal year 2012; and
$286,150,000 in fiscal year 2013. If at any
time the governor issues an executive order
not to participate in early medical assistance
expansion, no funds shall be transferred from
the health care access fund to the general
fund until early medical assistance expansion
takes effect. This paragraph is effective the
day following final enactment.
deleted text end

MinnesotaCare Ratable Reduction.
Effective for services rendered on or after
July 1, 2010, to December 31, 2013,
MinnesotaCare payments to managed care
plans under Minnesota Statutes, section
256L.12, for single adults and households
without children whose income is greater
than 75 percent of federal poverty guidelines
shall be reduced by 15 percent. Effective
for services provided from July 1, 2010, to
June 30, 2011, this reduction shall apply to
all services. Effective for services provided
from July 1, 2011, to December 31, 2013, this
reduction shall apply to all services except
inpatient hospital services. Notwithstanding
any contrary provision of this article, this
paragraph shall expire on December 31,
2013.

(b) Medical Assistance Basic Health Care Grants - Families and Children

-0-

295,512,000

Critical Access Dental. Of the general
fund appropriation, $731,000 in fiscal year
2011 is to the commissioner for critical
access dental provider reimbursement
payments under Minnesota Statutes, section
256B.76 subdivision 4. This is a onetime
appropriation.

Nonadministrative Rate Reduction. For
services rendered on or after July 1, 2010,
to December 31, 2013, the commissioner
shall reduce contract rates paid to managed
care plans under Minnesota Statutes,
sections 256B.69 and 256L.12, and to
county-based purchasing plans under
Minnesota Statutes, section 256B.692, by
three percent of the contract rate attributable
to nonadministrative services in effect on
June 30, 2010. Notwithstanding any contrary
provision in this article, this rider expires on
December 31, 2013.

(c) Medical Assistance Basic Health Care Grants - Elderly and Disabled

-0-

(30,265,000)

(d) deleted text begin General Assistance Medical Care Grants deleted text end

deleted text begin -0- deleted text end

deleted text begin (75,389,000) deleted text end

deleted text begin (e) deleted text end Other Health Care Grants

-0-

(7,000,000)

Cobra Carryforward. Unexpended funds
appropriated in fiscal year 2010 for COBRA
grants under Laws 2009, chapter 79, article
5, section 78, do not cancel and are available
to the commissioner for fiscal year 2011
COBRA grant expenditures. Up to $111,000
of the fiscal year 2011 appropriation for
COBRA grants provided in Laws 2009,
chapter 79, article 13, section 3, subdivision
6, may be used by the commissioner for costs
related to administration of the COBRA
grants.

Sec. 6.

Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 7,
is amended to read:

Subd. 7. Health Care Management

(a) Health Care Administration

-0-

deleted text begin 391,000 deleted text end new text begin 224,000 new text end

Fiscal Note Report. Of this appropriation,
$50,000 in fiscal year 2011 is for a transfer to
the commissioner of Minnesota Management
and Budget for the completion of the human
services fiscal note report in article 5.

PACE Implementation Funding. For fiscal
year 2011, $145,000 is appropriated from
the general fund to the commissioner of
human services to complete the actuarial and
administrative work necessary to begin the
operation of PACE under Minnesota Statutes,
section 256B.69, subdivision 23, paragraph
(e). Base level funding for this activity shall
be $130,000 in fiscal year 2012 and $0 in
fiscal year 2013.

Minnesota Senior Health Options
Reimbursement. Effective July 1, 2011,
federal administrative reimbursement
resulting from the Minnesota senior
health options project is appropriated
to the commissioner for this activity.
Notwithstanding any contrary provision, this
provision expires June 30, 2013.

Utilization Review. Effective July 1,
2011, federal administrative reimbursement
resulting from prior authorization and
inpatient admission certification by a
professional review organization shall be
dedicated to, and is appropriated to, the
commissioner for these activities. A portion
of these funds must be used for activities
to decrease unnecessary pharmaceutical
costs in medical assistance. Notwithstanding
any contrary provision of this article, this
paragraph expires June 30, 2013.

Certified Public Expenditures. (1) The
entities named in Minnesota Statutes, section
256B.199, paragraph (b), clause (1), shall
comply with the requirements of that statute
by promptly reporting on a quarterly basis
certified public expenditures that may qualify
for federal matching funds. Reporting under
this paragraph shall be voluntary from July 1,
2010, to December 31, 2010. Upon federal
enactment of an extension to June 30, 2011,
of the enhanced federal medical assistance
percentage (FMAP) originally provided
under Public Law 111-5, reporting under
this paragraph shall also be voluntary from
January 1, 2011, to June 30, 2011.

(2) To the extent that certified public
expenditures reported in compliance
with paragraph (1) earn federal matching
payments that exceed $8,079,000 in fiscal
year 2012 and $18,316,000 in fiscal year
2013, the excess amount shall be deposited
in the health care access fund. For each fiscal
year after fiscal year 2013, the commissioner
shall forecast in November the amount
of federal payments anticipated to match
certified public expenditures reported in
compliance with paragraph (a). Any federal
match earned in a fiscal year in excess of
the amount forecasted in November shall be
deposited to the health care access fund.

(3) Notwithstanding any contrary provision
of this article, this rider shall not expire.

Poverty Guidelines. Notwithstanding
Minnesota Statutes, sections 256B.56,
subdivision 1c; 256D.03, subdivision 3;
or 256L.04, subdivision 7b, the poverty
guidelines for medical assistance, general
assistance medical care, and MinnesotaCare
from July 1, 2010, through June 30, 2011,
shall not be lower than the poverty guidelines
issued by the Secretary of Health and Human
Services on January 23, 2009. This section
shall have no effect on the revision of poverty
guidelines for the Minnesota health care
programs that would be in effect starting on
July 1, 2011. This paragraph is effective the
day following final enactment.

Base Adjustment. The general fund base
is decreased by deleted text begin $222,000 deleted text end new text begin $55,000 new text end in fiscal
year 2012 and deleted text begin $352,000 deleted text end new text begin $185,000 new text end in fiscal
year 2013.

(b) Health Care Operations

Appropriations by Fund
General	-0-	deleted text begin 186,000 deleted text end new text begin new text end new text begin 27,000 new text end
Health Care Access	-0-	deleted text begin 218,000 deleted text end new text begin 291,000 new text end

The general fund appropriation is a onetime
appropriation in fiscal year 2011.

Base Adjustment. The health care access
fund base for health care operations is
decreased by deleted text begin $812,000 deleted text end new text begin $280,000 new text end in fiscal
year 2012 and deleted text begin $944,000 deleted text end new text begin $274,000 new text end in fiscal
year 2013.

Sec. 7. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2010, sections 256B.055, subdivision 15; and 256B.0756, new text end new text begin are
repealed.
new text end

new text begin (b) new text end new text begin Laws 2010, First Special Session chapter 1, article 16, sections 6; 7; 18; 46;
and 47, new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 28, 2011.
new text end