1.1 	A bill for an act
1.2 	relating to human services; modifying telehealth requirements; increasing medical 
1.3 	assistance reimbursement for protected transport services; establishing grants; 
1.4 	appropriating money;amending Minnesota Statutes 2022, sections 62A.673, 
1.5 	subdivisions 2, 5, 6; 256B.0625, subdivision 17.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. Minnesota Statutes 2022, section 62A.673, subdivision 2, is amended to read:
1.8 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
1.9 	have the meanings given.
1.10 	(b) "Distant site" means a site at which a health care provider is located while providing 
1.11 	health care services or consultations by means of telehealth.
1.12 	(c) "Health care provider" means a health care professional who is licensed or registered 
1.13 	by the state to perform health care services within the provider's scope of practice and in 
1.14 	accordance with state law. A health care provider includes a mental health professional 
1.15 	under section 245I.04, subdivision 2; a mental health practitioner under section 245I.04, 
1.16 	subdivision 4; a clinical trainee under section 245I.04, subdivision 6; a treatment coordinator 
1.17 	under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11, 
1.18 	subdivision 5; and a recovery peer under section 245G.11, subdivision 8.
1.19 	(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
1.20 	(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan 
1.21 	includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental 
1.22 	plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed 
1.23 	to pay benefits directly to the policy holder.
2.1 	(f) "Originating site" means a site at which a patient is located at the time health care 
2.2 	services are provided to the patient by means of telehealth. For purposes of store-and-forward 
2.3 	~~technology~~ transfer, the originating site also means the location at which a health care 
2.4 	provider transfers or transmits information to the distant site.
2.5 	(g) "Store-and-forward technology" means the technology that enables asynchronous 
2.6 	electronic transfer or transmission of a patient's medical information or data from an 
2.7 	originating site to a distant site for the purposes of diagnostic and therapeutic assistance in 
2.8 	the care of a patient.
2.9 	(h) "Telehealth" means the delivery of health care services or consultations through the 
2.10 	use of real time two-way interactive audio and visual or audio-only communications to 
2.11 	provide or support health care delivery and facilitate the assessment, diagnosis, consultation, 
2.12 	treatment, education, and care management of a patient's health care. Telehealth includes 
2.13 	the application of secure video conferencing, store-and-forward technology, and synchronous 
2.14 	interactions between a patient located at an originating site and a health care provider located 
2.15 	at a distant site. ~~Until July 1, 2023,~~ Telehealth also includes audio-only communication 
2.16 	between a health care provider and a patient ~~in accordance with subdivision 6, paragraph~~ 
2.17 	~~(b)~~ if the communication is a scheduled appointment and the standard of care for the service 
2.18 	can be met through the use of audio-only communication. Telehealth does not include 
2.19 	communication between health care providers that consists solely of a telephone conversation, 
2.20 	email, or facsimile transmission. Telehealth does not include communication between a 
2.21 	health care provider and a patient that consists solely of an email or facsimile transmission. 
2.22 	Telehealth does not include telemonitoring services as defined in paragraph (i).
2.23 	(i) "Telemonitoring services" means the remote monitoring of clinical data related to 
2.24 	the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits 
2.25 	the data electronically to a health care provider for analysis. Telemonitoring is intended to 
2.26 	collect an enrollee's health-related data for the purpose of assisting a health care provider 
2.27 	in assessing and monitoring the enrollee's medical condition or status.

2.28 	Sec. 2. Minnesota Statutes 2022, section 62A.673, subdivision 5, is amended to read:
2.29 		Subd. 5.Reimbursement for services delivered through telehealth. (a) A health carrier 
2.30 	must reimburse the health care provider for services delivered through telehealth on the 
2.31 	same basis and at the same rate as the health carrier would apply to those services if the 
2.32 	services had been delivered by the health care provider through in-person contact.
3.1 	(b) A health carrier must not deny or limit reimbursement based solely on a health care 
3.2 	provider delivering the service or consultation through telehealth instead of through in-person 
3.3 	contact.
3.4 	(c) A health carrier must not deny or limit reimbursement based solely on the technology 
3.5 	and equipment used by the health care provider to deliver the health care service or 
3.6 	consultation through telehealth, provided the technology and equipment used by the provider 
3.7 	meets the requirements of this section and is appropriate for the particular service.
3.8 	~~(d) Nothing in this subdivision prohibits a health carrier and health care provider from~~ 
3.9 	~~entering into a contract that includes a value-based reimbursement arrangement for the~~ 
3.10 	~~delivery of covered services that may include services delivered through telehealth, and~~ 
3.11 	~~such an arrangement shall not be considered a violation of this subdivision.~~

3.12 	Sec. 3. Minnesota Statutes 2022, section 62A.673, subdivision 6, is amended to read:
3.13 		Subd. 6.Telehealth equipment. (a) A health carrier must not require a health care 
3.14 	provider to use specific telecommunications technology and equipment as a condition of 
3.15 	coverage under this section, provided the health care provider uses telecommunications 
3.16 	technology and equipment that complies with current industry interoperable standards and 
3.17 	complies with standards required under the federal Health Insurance Portability and 
3.18 	Accountability Act of 1996, Public Law 104-191, and regulations promulgated under that 
3.19 	Act, unless authorized under this section.
3.20 	(b) A health carrier must provide coverage for health care services delivered through 
3.21 	telehealth by means of the use of audio-only communication if the communication is a 
3.22 	scheduled appointment and the standard of care for that particular service can be met through 
3.23 	the use of audio-only communication. ~~Substance use disorder treatment services and mental~~ 
3.24 	~~health care services delivered through telehealth by means of audio-only communication~~ 
3.25 	~~may be covered without a scheduled appointment if the communication was initiated by~~ 
3.26 	~~the enrollee while in an emergency or crisis situation and a scheduled appointment was not~~ 
3.27 	~~possible due to the need of an immediate response. This paragraph expires July 1, 2023.~~
3.28 	(c) Notwithstanding paragraph (b), substance use disorder treatment services and mental 
3.29 	health care services delivered through telehealth by means of audio-only communication 
3.30 	may be covered without a scheduled appointment if the communication was initiated by 
3.31 	the enrollee while in an emergency or crisis situation and a scheduled appointment was not 
3.32 	possible due to the need for an immediate response.

4.1 	Sec. 4. Minnesota Statutes 2022, section 256B.0625, subdivision 17, is amended to read:
4.2 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
4.3 	means motor vehicle transportation provided by a public or private person that serves 
4.4 	Minnesota health care program beneficiaries who do not require emergency ambulance 
4.5 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
4.6 	(b) Medical assistance covers medical transportation costs incurred solely for obtaining 
4.7 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
4.8 	emergency or nonemergency medical care when paid directly to an ambulance company, 
4.9 	nonemergency medical transportation company, or other recognized providers of 
4.10 	transportation services. Medical transportation must be provided by:
4.11 	(1) nonemergency medical transportation providers who meet the requirements of this 
4.12 	subdivision;
4.13 	(2) ambulances, as defined in section 144E.001, subdivision 2;
4.14 	(3) taxicabs that meet the requirements of this subdivision;
4.15 	(4) public transit, as defined in section 174.22, subdivision 7; or
4.16 	(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472, 
4.17 	subdivision 1, paragraph (h).
4.18 	(c) Medical assistance covers nonemergency medical transportation provided by 
4.19 	nonemergency medical transportation providers enrolled in the Minnesota health care 
4.20 	programs. All nonemergency medical transportation providers must comply with the 
4.21 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
4.22 	and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the 
4.23 	commissioner and reported on the claim as the individual who provided the service. All 
4.24 	nonemergency medical transportation providers shall bill for nonemergency medical 
4.25 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
4.26 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
4.27 	requirements outlined in this paragraph.
4.28 	(d) An organization may be terminated, denied, or suspended from enrollment if:
4.29 	(1) the provider has not initiated background studies on the individuals specified in 
4.30 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
4.31 	(2) the provider has initiated background studies on the individuals specified in section 
4.32 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
5.1 	(i) the commissioner has sent the provider a notice that the individual has been 
5.2 	disqualified under section 245C.14; and
5.3 	(ii) the individual has not received a disqualification set-aside specific to the special 
5.4 	transportation services provider under sections 245C.22 and 245C.23.
5.5 	(e) The administrative agency of nonemergency medical transportation must:
5.6 	(1) adhere to the policies defined by the commissioner;
5.7 	(2) pay nonemergency medical transportation providers for services provided to 
5.8 	Minnesota health care programs beneficiaries to obtain covered medical services;
5.9 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
5.10 	trips, and number of trips by mode; and
5.11 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
5.12 	administrative structure assessment tool that meets the technical requirements established 
5.13 	by the commissioner, reconciles trip information with claims being submitted by providers, 
5.14 	and ensures prompt payment for nonemergency medical transportation services.
5.15 	(f) Until the commissioner implements the single administrative structure and delivery 
5.16 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
5.17 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
5.18 	clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
5.19 	(g) The commissioner may use an order by the recipient's attending physician, advanced 
5.20 	practice registered nurse, physician assistant, or a medical or mental health professional to 
5.21 	certify that the recipient requires nonemergency medical transportation services. 
5.22 	Nonemergency medical transportation providers shall perform driver-assisted services for 
5.23 	eligible individuals, when appropriate. Driver-assisted service includes passenger pickup 
5.24 	at and return to the individual's residence or place of business, assistance with admittance 
5.25 	of the individual to the medical facility, and assistance in passenger securement or in securing 
5.26 	of wheelchairs, child seats, or stretchers in the vehicle.
5.27 	Nonemergency medical transportation providers must take clients to the health care 
5.28 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
5.29 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
5.30 	authorization from the local agency.
5.31 	Nonemergency medical transportation providers may not bill for separate base rates for 
5.32 	the continuation of a trip beyond the original destination. Nonemergency medical 
5.33 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
6.1 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
6.2 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
6.3 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
6.4 	services.
6.5 	(h) The administrative agency shall use the level of service process established by the 
6.6 	commissioner to determine the client's most appropriate mode of transportation. If public 
6.7 	transit or a certified transportation provider is not available to provide the appropriate service 
6.8 	mode for the client, the client may receive a onetime service upgrade.
6.9 	(i) The covered modes of transportation are:
6.10 	(1) client reimbursement, which includes client mileage reimbursement provided to 
6.11 	clients who have their own transportation, or to family or an acquaintance who provides 
6.12 	transportation to the client;
6.13 	(2) volunteer transport, which includes transportation by volunteers using their own 
6.14 	vehicle;
6.15 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
6.16 	or public transit. If a taxicab or public transit is not available, the client can receive 
6.17 	transportation from another nonemergency medical transportation provider;
6.18 	(4) assisted transport, which includes transport provided to clients who require assistance 
6.19 	by a nonemergency medical transportation provider;
6.20 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
6.21 	dependent on a device and requires a nonemergency medical transportation provider with 
6.22 	a vehicle containing a lift or ramp;
6.23 	(6) protected transport, which includes transport provided to a client who has received 
6.24 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
6.25 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
6.26 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
6.27 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
6.28 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
6.29 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
6.30 	a client in a prone or supine position.
6.31 	(j) The local agency shall be the single administrative agency and shall administer and 
6.32 	reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the 
6.33 	commissioner has developed, made available, and funded the web-based single administrative 
7.1 	structure, assessment tool, and level of need assessment under subdivision 18e. The local 
7.2 	agency's financial obligation is limited to funds provided by the state or federal government.
7.3 	(k) The commissioner shall:
7.4 	(1) verify that the mode and use of nonemergency medical transportation is appropriate;
7.5 	(2) verify that the client is going to an approved medical appointment; and
7.6 	(3) investigate all complaints and appeals.
7.7 	(l) The administrative agency shall pay for the services provided in this subdivision and 
7.8 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
7.9 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
7.10 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
7.11 	(m) Payments for nonemergency medical transportation must be paid based on the client's 
7.12 	assessed mode under paragraph (h), not the type of vehicle used to provide the service. The 
7.13 	medical assistance reimbursement rates for nonemergency medical transportation services 
7.14 	that are payable by or on behalf of the commissioner for nonemergency medical 
7.15 	transportation services are:
7.16 	(1) $0.22 per mile for client reimbursement;
7.17 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
7.18 	transport;
7.19 	(3) equivalent to the standard fare for unassisted transport when provided by public 
7.20 	transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency 
7.21 	medical transportation provider;
7.22 	(4) $13 for the base rate and $1.30 per mile for assisted transport;
7.23 	(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
7.24 	(6) $75 for the base rate for the first 100 miles and an additional $75 for trips over 100 
7.25 	miles, and $2.40 per mile for protected transport; and
7.26 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
7.27 	an additional attendant if deemed medically necessary.
7.28 	(n) The base rate for nonemergency medical transportation services in areas defined 
7.29 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
7.30 	paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
7.31 	services in areas defined under RUCA to be rural or super rural areas is:
8.1 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
8.2 	rate in paragraph (m), clauses (1) to (7); and
8.3 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
8.4 	rate in paragraph (m), clauses (1) to (7).
8.5 	(o) For purposes of reimbursement rates for nonemergency medical transportation 
8.6 	services under paragraphs (m) and (n), the zip code of the recipient's place of residence 
8.7 	shall determine whether the urban, rural, or super rural reimbursement rate applies.
8.8 	(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
8.9 	a census-tract based classification system under which a geographical area is determined 
8.10 	to be urban, rural, or super rural.
8.11 	(q) The commissioner, when determining reimbursement rates for nonemergency medical 
8.12 	transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed 
8.13 	under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

8.14 	Sec. 5. APPROPRIATIONS; CHILDREN'S FIRST EPISODE OF PSYCHOSIS.
 8.15 	(a) $960,000 in fiscal year 2024 and $960,000 in fiscal year 2025 are appropriated from 
8.16 	the general fund to the commissioner of human services to implement a children's first 
8.17 	episode of psychosis grant under Minnesota Statutes, section 245.4905.
8.18 	(b) Of these appropriations, $841,000 in fiscal year 2024 and $841,000 in fiscal year 
8.19 	2025 are for grants for children's first episode of psychosis.
8.20 	(c) Of these appropriations, $119,000 in fiscal year 2024 and $119,000 in fiscal year 
8.21 	2025 are for administration.

8.22 	Sec. 6. APPROPRIATIONS; HOUSING FOR ADULTS WITH SERIOUS MENTAL 
8.23 	ILLNESS.
 8.24 	$....... in fiscal year 2024 and $....... in fiscal year 2025 are appropriated from the general 
8.25 	fund to the commissioner of human services for adult mental health grants under Minnesota 
8.26 	Statutes, section 245.4661, subdivision 9, paragraph (a), clause (2), to support increased 
8.27 	availability of housing options with supports for persons with serious mental illness.

8.28 	Sec. 7. APPROPRIATIONS; PROTECTED TRANSPORT START-UP GRANTS.
 8.29 	$....... in fiscal year 2024 and $....... in fiscal year 2025 are appropriated from the general 
8.30 	fund to the commissioner of human services to provide start-up grants to nonemergency 
9.1 	medical transportation providers to configure vehicles to meet protected transport 
9.2 	requirements.

9.3 	Sec. 8. APPROPRIATIONS; ENGAGEMENT SERVICES PILOT GRANTS.
 9.4 	$750,000 in fiscal year 2024 and $750,000 in fiscal year 2025 are appropriated from the 
9.5 	general fund to the commissioner of human services for grants to counties to establish pilot 
9.6 	projects to provide engagement services under Minnesota Statutes, section 253B.041. 
9.7 	Counties receiving grants must develop a system to respond to individual requests for 
9.8 	engagement services, conduct outreach to families and engagement services providers, and 
9.9 	evaluate the impact of engagement services in decreasing civil commitments, increasing 
9.10 	engagement in treatment, decreasing police involvement with individuals exhibiting 
9.11 	symptoms of serious mental illness, and other measures.

9.12 	Sec. 9. APPROPRIATIONS; BEHAVIORAL HEALTH NAVIGATION PORTAL 
9.13 	GRANT.
 9.14 	$....... in fiscal year 2024 and $....... in fiscal year 2025 are appropriated from the general 
9.15 	fund to the commissioner of human services for a competitive grant to an entity to establish 
9.16 	an online mental health and substance use disorder resource and referral information exchange 
9.17 	service to be called the behavioral health navigation portal. The commissioner shall develop 
9.18 	and issue a request for proposals and award a grant to a single recipient to develop the portal 
9.19 	that will function as an open source communication hub and self-referral tool that publishes 
9.20 	real-time availability for mental health and substance use disorder treatment services 
9.21 	statewide. Grant funds must be used to establish and maintain the portal, which must:
9.22 	(1) provide an open access, single point of entry;
9.23 	(2) contain password-protected, secure tools that enable service providers to define, 
9.24 	maintain, and update service and availability information and conduct treatment and discharge 
9.25 	planning;
9.26 	(3) provide regularly updated, real-time, accurate, date-stamped, searchable, and 
9.27 	transparent information to individuals searching the portal. Publicly searchable provider 
9.28 	information must include:
9.29 	(i) health insurance carrier acceptance;
9.30 	(ii) location;
9.31 	(iii) regularly maintained availability and opening information;
10.1 	(iv) community supports access points and information;
10.2 	(v) educational and public information resources; and
10.3 	(vi) service provider contact information;
10.4 	(4) include a communications hub to facilitate provider collaboration; and
10.5 	(5) incorporate data collection tools and archival reporting to inform and measure public 
10.6 	access system information, openings, responsibility, parity enforcement, service gaps, and 
10.7 	system investment priorities.