Office of the Revisor of Statutes
Minnesota Session Laws - 2004, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 198-S.F.No. 2080
An act relating to health; modifying requirements for
outpatient surgical centers; requiring reporting
requirements of diagnostic imaging facilities;
modifying procedures for the Board of Medical
Practice; appropriating money; amending Minnesota
Statutes 2002, sections 144.55, subdivisions 1, 2, 3,
5, 6, 7, by adding subdivisions; 144.651, subdivision
2; 144.653, subdivision 4; 144.698, subdivisions 1, 5;
147.091, subdivision 1; 256B.02, subdivision 7;
Minnesota Statutes 2003 Supplement, sections 144.7063,
subdivision 3; 256L.035; proposing coding for new law
in Minnesota Statutes, chapter 144.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. Minnesota Statutes 2002, section 144.55,
subdivision 1, is amended to read:
Subdivision 1. [ISSUANCE.] The state commissioner of
health is hereby authorized to issue licenses to operate
hospitals, sanitariums, outpatient surgical centers, or other
institutions for the hospitalization or care of human beings,
which are found to comply with the provisions of sections 144.50
to 144.56 and any reasonable rules promulgated by the
commissioner. The commissioner shall not require an outpatient
surgical center licensed as part of a hospital to obtain a
separate outpatient surgical center license. All decisions of
the commissioner thereunder may be reviewed in the district
court in the county in which the institution is located or
contemplated.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 2. Minnesota Statutes 2002, section 144.55, is
amended by adding a subdivision to read:
Subd. 1a. [LICENSE FEE.] The annual license fee for
outpatient surgical centers is $1,512.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 3. Minnesota Statutes 2002, section 144.55, is
amended by adding a subdivision to read:
Subd. 1b. [STANDARDS FOR NURSING CARE.] As a condition of
licensure, outpatient surgical centers must provide nursing care
consistent with nationally accepted nursing clinical standards
for perioperative nursing, including, but not limited to
Association of Operating Room Nurses and American Nurses
Association standards, which are generally accepted in the
professional nursing community.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 4. Minnesota Statutes 2002, section 144.55,
subdivision 2, is amended to read:
Subd. 2. [DEFINITION DEFINITIONS.] For the purposes of
this section, the following terms have the meanings given:
(a) "Outpatient surgical center" or "center" means a
freestanding facility organized for the specific purpose of
providing elective outpatient surgery for preexamined,
prediagnosed, low-risk patients. Admissions are limited to
procedures that utilize general anesthesia or conscious sedation
and that do not require overnight inpatient care. An outpatient
surgical center is not organized to provide regular emergency
medical services and does not include a physician's or dentist's
office or clinic for the practice of medicine, the practice of
dentistry, or the delivery of primary care.
(b) "Joint commission" means the Joint Commission on
Accreditation of Hospitals Health Care Organizations.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 5. Minnesota Statutes 2002, section 144.55,
subdivision 3, is amended to read:
Subd. 3. [STANDARDS FOR LICENSURE.] (a) Notwithstanding
the provisions of section 144.56, for the purpose of hospital
licensure, the commissioner of health shall use as minimum
standards the hospital certification regulations promulgated
pursuant to Title XVIII of the Social Security Act, United
States Code, title 42, section 1395, et seq. The commissioner
may use as minimum standards changes in the federal hospital
certification regulations promulgated after May 7, 1981, if the
commissioner finds that such changes are reasonably necessary to
protect public health and safety. The commissioner shall also
promulgate in rules additional minimum standards for new
construction.
(b) Each hospital and outpatient surgical center shall
establish policies and procedures to prevent the transmission of
human immunodeficiency virus and hepatitis B virus to patients
and within the health care setting. The policies and procedures
shall be developed in conformance with the most recent
recommendations issued by the United States Department of Health
and Human Services, Public Health Service, Centers for Disease
Control. The commissioner of health shall evaluate a hospital's
compliance with the policies and procedures according to
subdivision 4.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 6. Minnesota Statutes 2002, section 144.55,
subdivision 5, is amended to read:
Subd. 5. [COORDINATION OF INSPECTIONS.] Prior to
conducting routine inspections of hospitals and outpatient
surgical centers, a state agency shall notify the commissioner
of its intention to inspect. The commissioner shall then
determine whether the inspection is necessary in light of any
previous inspections conducted by the commissioner, any other
state agency, or the joint commission. The commissioner shall
notify the agency of the determination and may authorize the
agency to conduct the inspection. No state agency may routinely
inspect any hospital without the authorization of the
commissioner. The commissioner shall coordinate, insofar as is
possible, routine inspections conducted by state agencies, so as
to minimize the number of inspections to which hospitals are
subject.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 7. Minnesota Statutes 2002, section 144.55,
subdivision 6, is amended to read:
Subd. 6. [SUSPENSION, REVOCATION, AND REFUSAL TO RENEW.]
(a) The commissioner may refuse to grant or renew, or may
suspend or revoke, a license on any of the following grounds:
(1) Violation of any of the provisions of sections 144.50
to 144.56 or the rules or standards issued pursuant thereto, or
Minnesota Rules, chapters 4650 and 4675;
(2) Permitting, aiding, or abetting the commission of any
illegal act in the institution;
(3) Conduct or practices detrimental to the welfare of the
patient; or
(4) Obtaining or attempting to obtain a license by fraud or
misrepresentation; or
(5) With respect to hospitals and outpatient surgical
centers, if the commissioner determines that there is a pattern
of conduct that one or more physicians who have a "financial or
economic interest", as defined in section 144.6521, subdivision
3, in the hospital or outpatient surgical center, have not
provided the notice and disclosure of the financial or economic
interest required by section 144.6521.
(b) The commissioner shall not renew a license for a
boarding care bed in a resident room with more than four beds.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 8. Minnesota Statutes 2002, section 144.55,
subdivision 7, is amended to read:
Subd. 7. [HEARING.] Prior to any suspension, revocation or
refusal to renew a license, the licensee shall be entitled to
notice and a hearing as provided by sections 14.57 to 14.69. At
each hearing, the commissioner shall have the burden of
establishing that a violation described in subdivision 6 has
occurred.
If a license is revoked, suspended, or not renewed, a new
application for license may be considered by the commissioner if
the conditions upon which revocation, suspension, or refusal to
renew was based have been corrected and evidence of this fact
has been satisfactorily furnished. A new license may then be
granted after proper inspection has been made and all provisions
of sections 144.50 to 144.56 and any rules promulgated
thereunder, or Minnesota Rules, chapters 4650 and 4675, have
been complied with and recommendation has been made by the
inspector as an agent of the commissioner.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 9. [144.565] [DIAGNOSTIC IMAGING FACILITIES.]
Subdivision 1. [UTILIZATION AND SERVICES DATA; ECONOMIC
AND FINANCIAL INTERESTS.] The commissioner shall require
diagnostic imaging facilities to annually report to the
commissioner, in the form and manner specified by the
commissioner:
(1) utilization data for each health plan company and each
public program, including workers' compensation, as follows:
(i) the number of computerized tomography (CT) procedures
performed;
(ii) the number of magnetic resonance imaging (MRI)
procedures performed; and
(iii) the number of positron emission tomography (PET)
procedures performed; and
(2) the names of all individuals with a financial or
economic interest in the facility.
Subd. 2. [COMMISSIONER'S RIGHT TO INSPECT RECORDS.] If the
report is not filed or the commissioner of health has reason to
believe the report is incomplete or false, the commissioner
shall have the right to inspect diagnostic imaging facility
books, audits, and records.
Subd. 3. [SEPARATE REPORTS.] For a diagnostic imaging
facility that is not attached or not contiguous to a hospital or
a hospital affiliate, the commissioner shall require the
information in subdivision 1 be reported separately for each
detached diagnostic imaging facility as part of the report
required under section 144.702. If any entity owns more than
one diagnostic imaging facility, that entity must report by
individual facility.
Subd. 4. [DEFINITIONS.] For purposes of this section, the
following terms have the meanings given:
(a) "Diagnostic imaging facility" means a health care
facility that provides diagnostic imaging services through the
use of ionizing radiation or other imaging technique including,
but not limited to magnetic resonance imaging (MRI) or
computerized tomography (CT) scan on a freestanding or mobile
basis.
(b) "Financial or economic interest" means a direct or
indirect:
(1) equity or debt security issued by an entity, including,
but not limited to, shares of stock in a corporation, membership
in a limited liability company, beneficial interest in a trust,
units or other interests in a partnership, bonds, debentures,
notes or other equity interests or debt instruments, or any
contractual arrangements;
(2) membership, proprietary interest, or co-ownership with
an individual, group, or organization to which patients,
clients, or customers are referred to; or
(3) employer-employee or independent contractor
relationship, including, but not limited to, those that may
occur in a limited partnership, profit-sharing arrangement, or
other similar arrangement with any facility to which patients
are referred, including any compensation between a facility and
a health care provider, the group practice of which the provider
is a member or employee or a related party with respect to any
of them.
(c) "Freestanding" means a diagnostic imaging facility
that is not located within a:
(1) hospital;
(2) location licensed as a hospital; or
(3) physician's office or clinic where the professional
practice of medicine by licensed physicians is the primary
purpose and not the provision of ancillary services such as
diagnostic imaging.
(d) "Mobile" means a diagnostic imaging facility that is
transported to various sites not including movement within a
hospital or a physician's office or clinic.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 10. Minnesota Statutes 2002, section 144.651,
subdivision 2, is amended to read:
Subd. 2. [DEFINITIONS.] For the purposes of this section,
"patient" means a person who is admitted to an acute care
inpatient facility for a continuous period longer than 24 hours,
for the purpose of diagnosis or treatment bearing on the
physical or mental health of that person. For purposes of
subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, "patient"
also means a person who receives health care services at an
outpatient surgical center. "Patient" also means a minor who is
admitted to a residential program as defined in section
253C.01. For purposes of subdivisions 1, 3 to 16, 18, 20 and
30, "patient" also means any person who is receiving mental
health treatment on an outpatient basis or in a community
support program or other community-based program. "Resident"
means a person who is admitted to a nonacute care facility
including extended care facilities, nursing homes, and boarding
care homes for care required because of prolonged mental or
physical illness or disability, recovery from injury or disease,
or advancing age. For purposes of all subdivisions except
subdivisions 28 and 29, "resident" also means a person who is
admitted to a facility licensed as a board and lodging facility
under Minnesota Rules, parts 4625.0100 to 4625.2355, or a
supervised living facility under Minnesota Rules, parts
4665.0100 to 4665.9900, and which operates a rehabilitation
program licensed under Minnesota Rules, parts 9530.4100 to
9530.4450.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 11. [144.6521] [DISCLOSURE OF FINANCIAL INTEREST.]
Subdivision 1. [DISCLOSURE.] No health care provider with
a financial or economic interest in, or an employment or
contractual arrangement that limits referral options with, a
hospital, outpatient surgical center or diagnostic imaging
facility, or an affiliate of one of these entities, shall refer
a patient to that hospital, center, or facility, or an affiliate
of one of these entities, unless the health care provider
discloses in writing to the patient, in advance of the referral,
the existence of such an interest, employment, or arrangement.
The written disclosure form must be printed in letters of
at least 12-point boldface type and must read as follows: "Your
health care provider is referring you to a facility or service
in which your health care provider has a financial or economic
interest."
Hospitals, outpatient surgical centers, and diagnostic
imaging facilities shall promptly report to the commissioner of
health any suspected violations of this section by a health care
provider who has made a referral to such hospital, outpatient
surgical center, or diagnostic imaging facility without
providing the written notice.
Subd. 2. [POSTING OF NOTICE.] In addition to the
requirement in subdivision 1, each health care provider who
makes referrals to a hospital, outpatient surgical center or
diagnostic imaging facility, or an affiliate of one of these
entities in which the health care provider has a financial or
economic interest, or has an employment or contractual
arrangement with one of these entities that limits referral
options, shall post a notice of this interest, employment, or
arrangement in a patient reception area or waiting room or other
conspicuous public location within the provider's facility.
Subd. 3. [DEFINITION.] (a) For purposes of this section,
the following definitions apply.
(b) "Affiliate" means an entity that controls, is
controlled by, or is under common control with another entity.
(c) "Diagnostic imaging facility" has the meaning provided
in section 144.565, subdivision 4.
(d) "Employment or contractual arrangement that limits
referral options" means a requirement of, or a financial
incentive, provided to a health care provider to refer a patient
to a specific hospital, outpatient surgical center or diagnostic
imaging facility, or an affiliate of one of these entities even
if other options exist for the patient.
(e) "Freestanding" has the meaning provided in section
144.565, subdivision 4.
(f) "Financial or economic interest" means a direct or
indirect:
(1) equity or debt security issued by an entity, including,
but not limited to, shares of stock in a corporation, membership
in a limited liability company, beneficial interest in a trust,
units or other interests in a partnership, bonds, debentures,
notes or other equity interests or debt instruments, or any
contractual arrangements;
(2) membership, proprietary interest, or co-ownership with
an individual, group, or organization to which patients,
clients, or customers are referred to; or
(3) employer-employee or independent contractor
relationship, including, but not limited to, those that may
occur in a limited partnership, profit-sharing arrangement, or
other similar arrangement with any facility to which patients
are referred, including any compensation between a facility and
a health care provider, the group practice of which the provider
is a member or employee or a related party with respect to any
of them.
(g) "Health care provider" means an individual licensed by
a health licensing board as defined in section 214.01,
subdivision 2, who has the authority, within the individual's
scope of practice, to make referrals to a hospital, outpatient
surgical center, or diagnostic imaging facility.
(h) "Mobile" has the meaning provided in section 144.565,
subdivision 4.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 12. Minnesota Statutes 2002, section 144.653,
subdivision 4, is amended to read:
Subd. 4. [WITHOUT NOTICE.] One or more unannounced
inspections of each facility required to be licensed under the
provisions of sections 144.50 to 144.58 or Minnesota Rules,
chapter 4675, shall be made annually.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 13. Minnesota Statutes 2002, section 144.698,
subdivision 1, is amended to read:
Subdivision 1. [YEARLY REPORTS.] Each hospital and each
outpatient surgical center, which has not filed the financial
information required by this section with a voluntary, nonprofit
reporting organization pursuant to section 144.702, shall file
annually with the commissioner of health after the close of the
fiscal year:
(1) a balance sheet detailing the assets, liabilities, and
net worth of the hospital or outpatient surgical center;
(2) a detailed statement of income and expenses;
(3) a copy of its most recent cost report, if any, filed
pursuant to requirements of Title XVIII of the United States
Social Security Act;
(4) a copy of all changes to articles of incorporation or
bylaws;
(5) information on services provided to benefit the
community, including services provided at no cost or for a
reduced fee to patients unable to pay, teaching and research
activities, or other community or charitable activities;
(6) information required on the revenue and expense report
form set in effect on July 1, 1989, or as amended by the
commissioner in rule; and
(7) information on changes in ownership or control; and
(8) other information required by the commissioner in rule.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 14. Minnesota Statutes 2002, section 144.698,
subdivision 5, is amended to read:
Subd. 5. [COMMISSIONER'S RIGHT TO INSPECT RECORDS.] If the
report is not filed or the commissioner of health has reason to
believe the report is incomplete or false, the commissioner
shall have the right to inspect hospital and outpatient surgical
center books, audits, and records as reasonably necessary to
verify hospital and outpatient surgical center reports.
Sec. 15. Minnesota Statutes 2003 Supplement, section
144.7063, subdivision 3, is amended to read:
Subd. 3. [FACILITY.] "Facility" means a hospital or
outpatient surgical center licensed under sections 144.50 to
144.58.
[EFFECTIVE DATE.] This section is effective on the date of
full implementation of the adverse health care events reporting
system as provided in Laws 2003, chapter 99, section 7, provided
the commissioner has secured sufficient funds from nonstate
sources to operate the adverse health care events reporting
system in fiscal year 2005.
Sec. 16. Minnesota Statutes 2002, section 147.091,
subdivision 1, is amended to read:
Subdivision 1. [GROUNDS LISTED.] The board may refuse to
grant a license, may refuse to grant registration to perform
interstate telemedicine services, or may impose disciplinary
action as described in section 147.141 against any physician.
The following conduct is prohibited and is grounds for
disciplinary action:
(a) Failure to demonstrate the qualifications or satisfy
the requirements for a license contained in this chapter or
rules of the board. The burden of proof shall be upon the
applicant to demonstrate such qualifications or satisfaction of
such requirements.
(b) Obtaining a license by fraud or cheating, or attempting
to subvert the licensing examination process. Conduct which
subverts or attempts to subvert the licensing examination
process includes, but is not limited to: (1) conduct which
violates the security of the examination materials, such as
removing examination materials from the examination room or
having unauthorized possession of any portion of a future,
current, or previously administered licensing examination; (2)
conduct which violates the standard of test administration, such
as communicating with another examinee during administration of
the examination, copying another examinee's answers, permitting
another examinee to copy one's answers, or possessing
unauthorized materials; or (3) impersonating an examinee or
permitting an impersonator to take the examination on one's own
behalf.
(c) Conviction, during the previous five years, of a felony
reasonably related to the practice of medicine or osteopathy.
Conviction as used in this subdivision shall include a
conviction of an offense which if committed in this state would
be deemed a felony without regard to its designation elsewhere,
or a criminal proceeding where a finding or verdict of guilt is
made or returned but the adjudication of guilt is either
withheld or not entered thereon.
(d) Revocation, suspension, restriction, limitation, or
other disciplinary action against the person's medical license
in another state or jurisdiction, failure to report to the board
that charges regarding the person's license have been brought in
another state or jurisdiction, or having been refused a license
by any other state or jurisdiction.
(e) Advertising which is false or misleading, which
violates any rule of the board, or which claims without
substantiation the positive cure of any disease, or professional
superiority to or greater skill than that possessed by another
physician.
(f) Violating a rule promulgated by the board or an order
of the board, a state, or federal law which relates to the
practice of medicine, or in part regulates the practice of
medicine including without limitation sections 148A.02, 609.344,
and 609.345, or a state or federal narcotics or controlled
substance law.
(g) Engaging in any unethical conduct; conduct likely to
deceive, defraud, or harm the public, or demonstrating a willful
or careless disregard for the health, welfare or safety of a
patient; or medical practice which is professionally
incompetent, in that it may create unnecessary danger to any
patient's life, health, or safety, in any of which cases, proof
of actual injury need not be established.
(h) Failure to supervise a physician's assistant or failure
to supervise a physician under any agreement with the board.
(i) Aiding or abetting an unlicensed person in the practice
of medicine, except that it is not a violation of this paragraph
for a physician to employ, supervise, or delegate functions to a
qualified person who may or may not be required to obtain a
license or registration to provide health services if that
person is practicing within the scope of that person's license
or registration or delegated authority.
(j) Adjudication as mentally incompetent, mentally ill or
mentally retarded, or as a chemically dependent person, a person
dangerous to the public, a sexually dangerous person, or a
person who has a sexual psychopathic personality by a court of
competent jurisdiction, within or without this state. Such
adjudication shall automatically suspend a license for the
duration thereof unless the board orders otherwise.
(k) Engaging in unprofessional conduct. Unprofessional
conduct shall include any departure from or the failure to
conform to the minimal standards of acceptable and prevailing
medical practice in which proceeding actual injury to a patient
need not be established.
(l) Inability to practice medicine with reasonable skill
and safety to patients by reason of illness, drunkenness, use of
drugs, narcotics, chemicals or any other type of material or as
a result of any mental or physical condition, including
deterioration through the aging process or loss of motor skills.
(m) Revealing a privileged communication from or relating
to a patient except when otherwise required or permitted by law.
(n) Failure by a doctor of osteopathy to identify the
school of healing in the professional use of the doctor's name
by one of the following terms: osteopathic physician and
surgeon, doctor of osteopathy, or D.O.
(o) Improper management of medical records, including
failure to maintain adequate medical records, to comply with a
patient's request made pursuant to section 144.335 or to furnish
a medical record or report required by law.
(p) Fee splitting, including without limitation:
(1) paying, offering to pay, receiving, or agreeing to
receive, a commission, rebate, or remuneration, directly or
indirectly, primarily for the referral of patients or the
prescription of drugs or devices;
(2) dividing fees with another physician or a professional
corporation, unless the division is in proportion to the
services provided and the responsibility assumed by each
professional and the physician has disclosed the terms of the
division;
(3) referring a patient to any health care provider as
defined in section 144.335 in which the referring physician has
a significant "financial or economic interest", as defined in
section 144.6521, subdivision 3, unless the physician has
disclosed the physician's own financial interest financial or
economic interest in accordance with section 144.6521; and
(4) dispensing for profit any drug or device, unless the
physician has disclosed the physician's own profit interest.
The physician must make the disclosures required in this clause
in advance and in writing to the patient and must include in the
disclosure a statement that the patient is free to choose a
different health care provider. This clause does not apply to
the distribution of revenues from a partnership, group practice,
nonprofit corporation, or professional corporation to its
partners, shareholders, members, or employees if the revenues
consist only of fees for services performed by the physician or
under a physician's direct supervision, or to the division or
distribution of prepaid or capitated health care premiums, or
fee-for-service withhold amounts paid under contracts
established under other state law.
(q) Engaging in abusive or fraudulent billing practices,
including violations of the federal Medicare and Medicaid laws
or state medical assistance laws.
(r) Becoming addicted or habituated to a drug or intoxicant.
(s) Prescribing a drug or device for other than medically
accepted therapeutic or experimental or investigative purposes
authorized by a state or federal agency or referring a patient
to any health care provider as defined in section 144.335 for
services or tests not medically indicated at the time of
referral.
(t) Engaging in conduct with a patient which is sexual or
may reasonably be interpreted by the patient as sexual, or in
any verbal behavior which is seductive or sexually demeaning to
a patient.
(u) Failure to make reports as required by section 147.111
or to cooperate with an investigation of the board as required
by section 147.131.
(v) Knowingly providing false or misleading information
that is directly related to the care of that patient unless done
for an accepted therapeutic purpose such as the administration
of a placebo.
(w) Aiding suicide or aiding attempted suicide in violation
of section 609.215 as established by any of the following:
(1) a copy of the record of criminal conviction or plea of
guilty for a felony in violation of section 609.215, subdivision
1 or 2;
(2) a copy of the record of a judgment of contempt of court
for violating an injunction issued under section 609.215,
subdivision 4;
(3) a copy of the record of a judgment assessing damages
under section 609.215, subdivision 5; or
(4) a finding by the board that the person violated section
609.215, subdivision 1 or 2. The board shall investigate any
complaint of a violation of section 609.215, subdivision 1 or 2.
(x) Practice of a board-regulated profession under lapsed
or nonrenewed credentials.
(y) Failure to repay a state or federally secured student
loan in accordance with the provisions of the loan.
(z) Providing interstate telemedicine services other than
according to section 147.032.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 17. Minnesota Statutes 2002, section 256B.02,
subdivision 7, is amended to read:
Subd. 7. [VENDOR OF MEDICAL CARE.] (a) "Vendor of medical
care" means any person or persons furnishing, within the scope
of the vendor's respective license, any or all of the following
goods or services: medical, surgical, hospital, ambulatory
surgical center services, optical, visual, dental and nursing
services; drugs and medical supplies; appliances; laboratory,
diagnostic, and therapeutic services; nursing home and
convalescent care; screening and health assessment services
provided by public health nurses as defined in section 145A.02,
subdivision 18; health care services provided at the residence
of the patient if the services are performed by a public health
nurse and the nurse indicates in a statement submitted under
oath that the services were actually provided; and such other
medical services or supplies provided or prescribed by persons
authorized by state law to give such services and supplies. The
term includes, but is not limited to, directors and officers of
corporations or members of partnerships who, either individually
or jointly with another or others, have the legal control,
supervision, or responsibility of submitting claims for
reimbursement to the medical assistance program. The term only
includes directors and officers of corporations who personally
receive a portion of the distributed assets upon liquidation or
dissolution, and their liability is limited to the portion of
the claim that bears the same proportion to the total claim as
their share of the distributed assets bears to the total
distributed assets.
(b) "Vendor of medical care" also includes any person who
is credentialed as a health professional under standards set by
the governing body of a federally recognized Indian tribe
authorized under an agreement with the federal government
according to United States Code, title 25, section 450f, to
provide health services to its members, and who through a tribal
facility provides covered services to American Indian people
within a contract health service delivery area of a Minnesota
reservation, as defined under Code of Federal Regulations, title
42, section 36.22.
(c) A federally recognized Indian tribe that intends to
implement standards for credentialing health professionals must
submit the standards to the commissioner of human services,
along with evidence of meeting, exceeding, or being exempt from
corresponding state standards. The commissioner shall maintain
a copy of the standards and supporting evidence, and shall use
those standards to enroll tribal-approved health professionals
as medical assistance providers. For purposes of this section,
"Indian" and "Indian tribe" mean persons or entities that meet
the definition in United States Code, title 25, section 450b.
[EFFECTIVE DATE.] This section is effective August 1, 2004.
Sec. 18. Minnesota Statutes 2003 Supplement, section
256L.035, is amended to read:
256L.035 [LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE
ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.]
(a) "Covered health services" for individuals under section
256L.04, subdivision 7, with income above 75 percent, but not
exceeding 175 percent, of the federal poverty guideline means:
(1) inpatient hospitalization benefits with a ten percent
co-payment up to $1,000 and subject to an annual limitation of
$10,000;
(2) physician services provided during an inpatient stay;
and
(3) physician services not provided during an inpatient
stay, outpatient hospital services, freestanding ambulatory
surgical center services, chiropractic services, lab and
diagnostic services, and prescription drugs, subject to an
aggregate cap of $2,000 per calendar year and the following
co-payments:
(i) $50 co-pay per emergency room visit;
(ii) $3 co-pay per prescription drug; and
(iii) $5 co-pay per nonpreventive physician visit.
For purposes of this subdivision, "a visit" means an
episode of service which is required because of a recipient's
symptoms, diagnosis, or established illness, and which is
delivered in an ambulatory setting by a physician or physician
ancillary.
Enrollees are responsible for all co-payments in this
subdivision.
(b) The November 2006 MinnesotaCare forecast for the
biennium beginning July 1, 2007, shall assume an adjustment in
the aggregate cap on the services identified in paragraph (a),
clause (3), in $1,000 increments up to a maximum of $10,000, but
not less than $2,000, to the extent that the balance in the
health care access fund is sufficient in each year of the
biennium to pay for this benefit level. The aggregate cap shall
be adjusted according to the forecast.
(c) Reimbursement to the providers shall be reduced by the
amount of the co-payment, except that reimbursement for
prescription drugs shall not be reduced once a recipient has
reached the $20 per month maximum for prescription drug
co-payments. The provider collects the co-payment from the
recipient. Providers may not deny services to recipients who
are unable to pay the co-payment, except as provided in
paragraph (d).
(d) If it is the routine business practice of a provider to
refuse service to an individual with uncollected debt, the
provider may include uncollected co-payments under this
section. A provider must give advance notice to a recipient
with uncollected debt before services can be denied.
[EFFECTIVE DATE.] This section is effective the day
following final enactment.
Sec. 19. [APPROPRIATIONS.]
(a) Any money received by the commissioner of health from
nonstate sources to operate the adverse health care events
reporting system in fiscal year 2005 is appropriated to the
commissioner of health for that purpose.
(b) The annual licensing fee collected under Minnesota
Statutes, section 144.55, subdivision 1a, is appropriated from
the state government special revenue fund to the commissioner of
health for the purposes of regulating outpatient surgical
centers.
Presented to the governor May 13, 2004
Signed by the governor May 15, 2004, 10:40 p.m.
Official Publication of the State of Minnesota
Revisor of Statutes