Minnesota Session Laws - 1993, Regular Session

  
    Laws of Minnesota 1993 

                         CHAPTER 20-S.F.No. 282 
           An act relating to medical assistance; modifying 
          hospital reimbursement rates; amending Minnesota 
          Statutes 1992, section 256.969, subdivisions 9, 20, 
          and by adding subdivisions. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1992, section 256.969, 
subdivision 9, is amended to read: 
    Subd. 9.  [DISPROPORTIONATE NUMBERS OF LOW-INCOME PATIENTS 
SERVED.] For admissions occurring on or after October 1, 
1992, through December 31, 1992, the medical assistance 
disproportionate population adjustment shall comply with federal 
law and shall be paid to a hospital, excluding regional 
treatment centers and facilities of the federal Indian Health 
Service, with a medical assistance inpatient utilization rate in 
excess of the arithmetic mean.  The adjustment must be 
determined as follows: 
    (1) for a hospital with a medical assistance inpatient 
utilization rate above the arithmetic mean for all hospitals 
excluding regional treatment centers and facilities of the 
federal Indian Health Service but less than or equal to one 
standard deviation above the mean, the adjustment must be 
determined by multiplying the total of the operating and 
property payment rates by the difference between the hospital's 
actual medical assistance inpatient utilization rate and the 
arithmetic mean for all hospitals excluding regional treatment 
centers and facilities of the federal Indian Health Service; and 
     (2) for a hospital with a medical assistance inpatient 
utilization rate above one standard deviation above the mean, 
the adjustment must be determined by multiplying the adjustment 
that would be determined under clause (1) for that hospital by 
1.1.  If federal matching funds are not available for all 
adjustments under this subdivision, the commissioner shall 
reduce payments on a pro rata basis so that all adjustments 
qualify for federal match.  The commissioner may establish a 
separate disproportionate population operating payment rate 
adjustment under the general assistance medical care program.  
For purposes of this subdivision medical assistance does not 
include general assistance medical care.  The commissioner shall 
report annually on the number of hospitals likely to receive the 
adjustment authorized by this section.  The commissioner shall 
specifically report on the adjustments received by public 
hospitals and public hospital corporations located in cities of 
the first class. 
    Sec. 2.  Minnesota Statutes 1992, section 256.969, is 
amended by adding a subdivision to read: 
    Subd. 9a.  [DISPROPORTIONATE POPULATION ADJUSTMENTS AFTER 
JANUARY 1, 1993.] (a) For admissions occurring between January 
1, 1993, and June 30, 1993, the adjustment under this 
subdivision shall be paid to a hospital, excluding regional 
treatment centers and facilities of the federal Indian Health 
Service, with a medical assistance inpatient utilization rate in 
excess of one standard deviation above the arithmetic mean.  The 
adjustment must be determined by multiplying the total of the 
operating and property payment rates by the difference between 
the hospital's actual medical assistance inpatient utilization 
rate and the arithmetic mean for all hospitals excluding 
regional treatment centers and facilities of the federal Indian 
Health Service, and the result must be multiplied by 1.1.  
    (b) For admissions occurring on or after July 1, 1993, the 
medical assistance disproportionate population adjustment shall 
comply with federal law and shall be paid to a hospital, 
excluding regional treatment centers and facilities of the 
federal Indian Health Service, with a medical assistance 
inpatient utilization rate in excess of one standard deviation 
above the arithmetic mean.  The adjustment must be determined by 
multiplying the operating payment rate by the difference between 
the hospital's actual medical assistance inpatient utilization 
rate and one standard deviation above the arithmetic mean for 
all hospitals excluding regional treatment centers and 
facilities of the federal Indian Health Service. 
    (c) If federal matching funds are not available for all 
adjustments under this subdivision, the commissioner shall 
reduce payments on a pro rata basis so that all adjustments 
qualify for federal match.  The commissioner may establish a 
separate disproportionate population operating payment rate 
adjustment under the general assistance medical care program.  
For purposes of this subdivision, medical assistance does not 
include general assistance medical care.  The commissioner shall 
report annually on the number of hospitals likely to receive the 
adjustment authorized by this section.  The commissioner shall 
specifically report on the adjustments received by public 
hospitals and public hospital corporations located in cities of 
the first class. 
    Sec. 3.  Minnesota Statutes 1992, section 256.969, is 
amended by adding a subdivision to read: 
    Subd. 9b.  [IMPLEMENTATION OF RATABLE REDUCTIONS.] 
Notwithstanding the provisions in subdivision 9, any ratable 
reductions required under that subdivision or subdivision 9a for 
fiscal year 1993 shall be implemented as follows: 
    (1) no ratable reductions shall be applied to admissions 
occurring between October 1, 1992, and December 31, 1992; and 
    (2) sufficient ratable reductions shall be taken from 
hospitals receiving a payment under subdivision 9a for 
admissions occurring between January 1, 1993, and June 30, 1993, 
to ensure that all state payments under subdivisions 9 and 9a 
during federal fiscal year 1993 qualify for federal match. 
    Sec. 4.  Minnesota Statutes 1992, section 256.969, 
subdivision 20, is amended to read: 
    Subd. 20.  [INCREASES IN MEDICAL ASSISTANCE INPATIENT 
PAYMENTS; CONDITIONS.] (a) Medical assistance inpatient payments 
shall increase 20 percent for inpatient hospital originally paid 
admissions, excluding Medicare crossovers, that occurred between 
July 1, 1988, and December 31, 1990, if:  (i) the hospital had 
100 or fewer Minnesota medical assistance annualized paid 
admissions, excluding Medicare crossovers, that were paid by 
March 1, 1988, for the period January 1, 1987, to June 30, 1987; 
(ii) the hospital had 100 or fewer licensed beds on March 1, 
1988; (iii) the hospital is located in Minnesota; and (iv) the 
hospital is not located in a city of the first class as defined 
in section 410.01.  For purposes of this paragraph, medical 
assistance does not include general assistance medical care. 
    (b) Medical assistance inpatient payments shall increase 15 
percent for inpatient hospital originally paid admissions, 
excluding Medicare crossovers, that occurred between July 1, 
1988, and December 31, 1990, if:  (i) the hospital had more than 
100 but fewer than 250 Minnesota medical assistance annualized 
paid admissions, excluding Medicare crossovers, that were paid 
by March 1, 1988, for the period January 1, 1987, to June 30, 
1987; (ii) the hospital had 100 or fewer licensed beds on March 
1, 1988; (iii) the hospital is located in Minnesota; and (iv) 
the hospital is not located in a city of the first class as 
defined in section 410.01.  For purposes of this paragraph, 
medical assistance does not include general assistance medical 
care. 
    (c) Medical assistance inpatient payment rates shall 
increase 20 percent for inpatient hospital originally paid 
admissions, excluding Medicare crossovers, that occur on or 
after October 1, 1992, if:  (i) the hospital had 100 or fewer 
Minnesota medical assistance annualized paid admissions, 
excluding Medicare crossovers, that were paid by March 1, 1988, 
for the period January 1, 1987, to June 30, 1987; (ii) the 
hospital had 100 or fewer licensed beds on March 1, 1988; (iii) 
the hospital is located in Minnesota; and (iv) the hospital is 
not located in a city of the first class as defined in section 
410.01.  For a hospital that qualifies for an adjustment under 
this paragraph and under subdivision 9, 9a, or 22, the hospital 
must be paid the adjustment under subdivision subdivisions 9, 
9a, and 22, as applicable, plus any amount by which the 
adjustment under this paragraph exceeds the adjustment under 
subdivision 9 those subdivisions.  For this paragraph, medical 
assistance does not include general assistance medical care. 
    (d) Medical assistance inpatient payment rates shall 
increase 15 percent for inpatient hospital originally paid 
admissions, excluding Medicare crossovers, that occur after 
September 30, 1992, if:  (i) the hospital had more than 100 but 
fewer than 250 Minnesota medical assistance annualized paid 
admissions, excluding Medicare crossovers, that were paid by 
March 1, 1988, for the period January 1, 1987, to June 30, 1987; 
(ii) the hospital had 100 or fewer licensed beds on March 1, 
1988; (iii) the hospital is located in Minnesota; and (iv) the 
hospital is not located in a city of the first class as defined 
in section 410.01.  For a hospital that qualifies for an 
adjustment under this paragraph and under subdivision 9, 9a, or 
22, the hospital must be paid the adjustment under subdivision 
subdivisions 9, 9a, and 22, as applicable, plus any amount by 
which the adjustment under this paragraph exceeds the adjustment 
under subdivision 9 those subdivisions.  For purposes of this 
paragraph, medical assistance does not include general 
assistance medical care. 
    Sec. 5.  Minnesota Statutes 1992, section 256.969, is 
amended by adding a subdivision to read: 
    Subd. 22.  [HOSPITAL PAYMENT ADJUSTMENT.] For admissions 
occurring from January 1, 1993, until June 30, 1993, the 
commissioner shall adjust the medical assistance payment paid to 
a hospital, excluding regional treatment centers and facilities 
of the federal Indian Health Service, with a medical assistance 
inpatient utilization rate in excess of the arithmetic mean.  
The adjustment must be determined as follows: 
    (1) for a hospital with a medical assistance inpatient 
utilization rate above the arithmetic mean for all hospitals 
excluding regional treatment centers and facilities of the 
federal Indian Health Service, the adjustment must be determined 
by multiplying the total of the operating and property payment 
rates by the difference between the hospital's actual medical 
assistance inpatient utilization rate and the arithmetic mean 
for all hospitals excluding regional treatment centers and 
facilities of the federal Indian Health Service; and 
    (2) for a hospital with a medical assistance inpatient 
utilization rate above one standard deviation above the mean, 
the adjustment must be determined by multiplying the adjustment 
under clause (1) for that hospital by 1.1.  Any payment under 
this clause must be reduced by the amount of any payment 
received under subdivision 9a.  For purposes of this 
subdivision, medical assistance does not include general 
assistance medical care. 
     Sec. 6.  [HEALTH MAINTENANCE ORGANIZATION REIMBURSEMENT.] 
    Effective January 1, 1993, the commissioner of human 
services shall adjust rates paid to a health maintenance 
organization under contract with the commissioner to reflect 
rate increases provided in section 5.  The adjustment must be 
made on a nondiscounted hospital-specific basis. 
    Sec. 7.  [EFFECTIVE DATE.] 
    Sections 1 to 6 are effective retroactive to January 1, 
1993. 
    Presented to the governor March 30, 1993 
    Signed by the governor March 31, 1993, 3:36 p.m.