1.1                          A bill for an act 
  1.2             relating to human services; providing reimbursement 
  1.3             for a video teleconferencing medical device to measure 
  1.4             vital signs of recipients of General Assistance 
  1.5             Medical Care; amending Minnesota Statutes 1994, 
  1.6             section 256D.03, subdivision 4. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 1994, section 256D.03, 
  1.9   subdivision 4, is amended to read: 
  1.10     Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 
  1.11  For a person who is eligible under subdivision 3, paragraph (a), 
  1.12  clause (3), general assistance medical care covers: 
  1.13     (1) inpatient hospital services; 
  1.14     (2) outpatient hospital services; 
  1.15     (3) services provided by Medicare certified rehabilitation 
  1.16  agencies; 
  1.17     (4) prescription drugs and other products recommended 
  1.18  through the process established in section 256B.0625, 
  1.19  subdivision 13; 
  1.20     (5) equipment necessary to administer insulin and 
  1.21  diagnostic supplies and equipment for diabetics to monitor blood 
  1.22  sugar level; 
  1.23     (6) eyeglasses and eye examinations provided by a physician 
  1.24  or optometrist; 
  1.25     (7) hearing aids; 
  1.26     (8) prosthetic devices; 
  2.1      (9) laboratory and X-ray services; 
  2.2      (10) physician's services; 
  2.3      (11) medical transportation; 
  2.4      (12) chiropractic services as covered under the medical 
  2.5   assistance program; 
  2.6      (13) podiatric services; 
  2.7      (14) dental services; 
  2.8      (15) outpatient services provided by a mental health center 
  2.9   or clinic that is under contract with the county board and is 
  2.10  established under section 245.62; 
  2.11     (16) day treatment services for mental illness provided 
  2.12  under contract with the county board; 
  2.13     (17) prescribed medications for persons who have been 
  2.14  diagnosed as mentally ill as necessary to prevent more 
  2.15  restrictive institutionalization; 
  2.16     (18) case management services for a person with serious and 
  2.17  persistent mental illness who would be eligible for medical 
  2.18  assistance except that the person resides in an institution for 
  2.19  mental diseases; 
  2.20     (19) psychological services, medical supplies and 
  2.21  equipment, and Medicare premiums, coinsurance and deductible 
  2.22  payments; 
  2.23     (20) video teleconferencing medical devices that measure 
  2.24  vital signs, such as blood pressure, pulse, and body temperature 
  2.25  which can be transmitted to a medical professional; 
  2.26     (21) medical equipment not specifically listed in this 
  2.27  paragraph when the use of the equipment will prevent the need 
  2.28  for costlier services that are reimbursable under this 
  2.29  subdivision; and 
  2.30     ~~(21)~~ (22) services performed by a certified pediatric nurse 
  2.31  practitioner, a certified family nurse practitioner, a certified 
  2.32  adult nurse practitioner, a certified obstetric/gynecological 
  2.33  nurse practitioner, or a certified geriatric nurse practitioner 
  2.34  in independent practice, if the services are otherwise covered 
  2.35  under this chapter as a physician service, and if the service is 
  2.36  within the scope of practice of the nurse practitioner's license 
  3.1   as a registered nurse, as defined in section 148.171. 
  3.2      (b) For a recipient who is eligible under subdivision 3, 
  3.3   paragraph (a), clause (1) or (2), general assistance medical 
  3.4   care covers the services listed in paragraph (a) with the 
  3.5   exception of special transportation services. 
  3.6      (c) In order to contain costs, the commissioner of human 
  3.7   services shall select vendors of medical care who can provide 
  3.8   the most economical care consistent with high medical standards 
  3.9   and shall where possible contract with organizations on a 
  3.10  prepaid capitation basis to provide these services.  The 
  3.11  commissioner shall consider proposals by counties and vendors 
  3.12  for prepaid health plans, competitive bidding programs, block 
  3.13  grants, or other vendor payment mechanisms designed to provide 
  3.14  services in an economical manner or to control utilization, with 
  3.15  safeguards to ensure that necessary services are provided.  
  3.16  Before implementing prepaid programs in counties with a county 
  3.17  operated or affiliated public teaching hospital or a hospital or 
  3.18  clinic operated by the University of Minnesota, the commissioner 
  3.19  shall consider the risks the prepaid program creates for the 
  3.20  hospital and allow the county or hospital the opportunity to 
  3.21  participate in the program in a manner that reflects the risk of 
  3.22  adverse selection and the nature of the patients served by the 
  3.23  hospital, provided the terms of participation in the program are 
  3.24  competitive with the terms of other participants considering the 
  3.25  nature of the population served.  Payment for services provided 
  3.26  pursuant to this subdivision shall be as provided to medical 
  3.27  assistance vendors of these services under sections 256B.02, 
  3.28  subdivision 8, and 256B.0625.  For payments made during fiscal 
  3.29  year 1990 and later years, the commissioner shall consult with 
  3.30  an independent actuary in establishing prepayment rates, but 
  3.31  shall retain final control over the rate methodology. 
  3.32     (d) The commissioner of human services may reduce payments 
  3.33  provided under sections 256D.01 to 256D.21 and 261.23 in order 
  3.34  to remain within the amount appropriated for general assistance 
  3.35  medical care, within the following restrictions. 
  3.36     For the period July 1, 1985 to December 31, 1985, 
  4.1   reductions below the cost per service unit allowable under 
  4.2   section 256.966, are permitted only as follows:  payments for 
  4.3   inpatient and outpatient hospital care provided in response to a 
  4.4   primary diagnosis of chemical dependency or mental illness may 
  4.5   be reduced no more than 30 percent; payments for all other 
  4.6   inpatient hospital care may be reduced no more than 20 percent.  
  4.7   Reductions below the payments allowable under general assistance 
  4.8   medical care for the remaining general assistance medical care 
  4.9   services allowable under this subdivision may be reduced no more 
  4.10  than ten percent. 
  4.11     For the period January 1, 1986 to December 31, 1986, 
  4.12  reductions below the cost per service unit allowable under 
  4.13  section 256.966 are permitted only as follows:  payments for 
  4.14  inpatient and outpatient hospital care provided in response to a 
  4.15  primary diagnosis of chemical dependency or mental illness may 
  4.16  be reduced no more than 20 percent; payments for all other 
  4.17  inpatient hospital care may be reduced no more than 15 percent.  
  4.18  Reductions below the payments allowable under general assistance 
  4.19  medical care for the remaining general assistance medical care 
  4.20  services allowable under this subdivision may be reduced no more 
  4.21  than five percent. 
  4.22     For the period January 1, 1987 to June 30, 1987, reductions 
  4.23  below the cost per service unit allowable under section 256.966 
  4.24  are permitted only as follows:  payments for inpatient and 
  4.25  outpatient hospital care provided in response to a primary 
  4.26  diagnosis of chemical dependency or mental illness may be 
  4.27  reduced no more than 15 percent; payments for all other 
  4.28  inpatient hospital care may be reduced no more than ten 
  4.29  percent.  Reductions below the payments allowable under medical 
  4.30  assistance for the remaining general assistance medical care 
  4.31  services allowable under this subdivision may be reduced no more 
  4.32  than five percent.  
  4.33     For the period July 1, 1987 to June 30, 1988, reductions 
  4.34  below the cost per service unit allowable under section 256.966 
  4.35  are permitted only as follows:  payments for inpatient and 
  4.36  outpatient hospital care provided in response to a primary 
  5.1   diagnosis of chemical dependency or mental illness may be 
  5.2   reduced no more than 15 percent; payments for all other 
  5.3   inpatient hospital care may be reduced no more than five percent.
  5.4   Reductions below the payments allowable under medical assistance 
  5.5   for the remaining general assistance medical care services 
  5.6   allowable under this subdivision may be reduced no more than 
  5.7   five percent. 
  5.8      For the period July 1, 1988 to June 30, 1989, reductions 
  5.9   below the cost per service unit allowable under section 256.966 
  5.10  are permitted only as follows:  payments for inpatient and 
  5.11  outpatient hospital care provided in response to a primary 
  5.12  diagnosis of chemical dependency or mental illness may be 
  5.13  reduced no more than 15 percent; payments for all other 
  5.14  inpatient hospital care may not be reduced.  Reductions below 
  5.15  the payments allowable under medical assistance for the 
  5.16  remaining general assistance medical care services allowable 
  5.17  under this subdivision may be reduced no more than five percent. 
  5.18     There shall be no copayment required of any recipient of 
  5.19  benefits for any services provided under this subdivision.  A 
  5.20  hospital receiving a reduced payment as a result of this section 
  5.21  may apply the unpaid balance toward satisfaction of the 
  5.22  hospital's bad debts. 
  5.23     (e) Any county may, from its own resources, provide medical 
  5.24  payments for which state payments are not made. 
  5.25     (f) Chemical dependency services that are reimbursed under 
  5.26  chapter 254B must not be reimbursed under general assistance 
  5.27  medical care. 
  5.28     (g) The maximum payment for new vendors enrolled in the 
  5.29  general assistance medical care program after the base year 
  5.30  shall be determined from the average usual and customary charge 
  5.31  of the same vendor type enrolled in the base year. 
  5.32     (h) The conditions of payment for services under this 
  5.33  subdivision are the same as the conditions specified in rules 
  5.34  adopted under chapter 256B governing the medical assistance 
  5.35  program, unless otherwise provided by statute or rule.