1.1 	A bill for an act
1.2 	relating to human services; providing coverage for vision services under 
1.3 	MinnesotaCare limited benefit set; amending Minnesota Statutes 2005 
1.4 	Supplement, section 256L.035.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. Minnesota Statutes 2005 Supplement, section 256L.035, is amended to read:
1.7 	256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE 
1.8 	ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.
1.9 	(a) "Covered health services" for individuals under section 256L.04, subdivision 
1.10 	7, with income above 75 percent, but not exceeding 175 percent, of the federal poverty 
1.11 	guideline means:
1.12 	(1) inpatient hospitalization benefits with a ten percent co-payment up to $1,000 and 
1.13 	subject to an annual limitation of $10,000;
1.14 	(2) physician services provided during an inpatient stay; and
1.15 	(3) physician services not provided during an inpatient stay; outpatient hospital 
1.16 	services; freestanding ambulatory surgical center services; chiropractic services; lab 
1.17 	and diagnostic services; diabetic supplies and equipment; vision services excluding the 
1.18 	dispensing, fitting, and adjustment of eyeglasses or contacts and eye examinations to 
1.19 	determine refractive state; and prescription drugs; subject to the following co-payments:
1.20 	(i) $50 co-pay per emergency room visit;
1.21 	(ii) $3 co-pay per prescription drug; and
1.22 	(iii) $5 co-pay per nonpreventive visit, including optometrist visit.
2.1 	The services covered under this section may be provided by a physician, physician 
2.2 	ancillary, chiropractor, psychologist, or licensed independent clinical social worker if the 
2.3 	services are within the scope of practice of that health care professional.
2.4 	For purposes of this section, "a visit" means an episode of service which is required 
2.5 	because of a recipient's symptoms, diagnosis, or established illness, and which is delivered 
2.6 	in an ambulatory setting by any health care provider identified in this paragraph, including 
2.7 	optometrists.
2.8 	Enrollees are responsible for all co-payments in this section.
2.9 	(b) Reimbursement to the providers shall be reduced by the amount of the 
2.10 	co-payment, except that reimbursement for prescription drugs shall not be reduced once a 
2.11 	recipient has reached the $20 per month maximum for prescription drug co-payments. 
2.12 	The provider collects the co-payment from the recipient. Providers may not deny services 
2.13 	to recipients who are unable to pay the co-payment, except as provided in paragraph (c).
2.14 	(c) If it is the routine business practice of a provider to refuse service to an individual 
2.15 	with uncollected debt, the provider may include uncollected co-payments under this 
2.16 	section. A provider must give advance notice to a recipient with uncollected debt before 
2.17 	services can be denied.