1.1 	A bill for an act
1.2 	relating to human services; changing health care provisions; modifying medical 
1.3 	assistance-related transportation costs, state agency claim provisions, alternative 
1.4 	services, commissioner's authorities, transitioned adults provisions, medical 
1.5 	assistance liens, commissioner's duties, and managed care contract provisions;
1.6 	amending Minnesota Statutes 2004, sections 256B.15, subdivision 1c; 256B.692, 
1.7 	subdivision 6; 514.982, subdivision 1; Minnesota Statutes 2005 Supplement, 
1.8 	sections 256B.0625, subdivisions 3f, 17; 256B.69, subdivision 23; 256L.05, 
1.9 	subdivision 2; 256L.15, subdivision 4;  Laws 2005, First Special Session chapter 
1.10 	4, article 8, section 84; repealing Minnesota Statutes 2004, section 256B.692, 
1.11 	subdivision 10.
1.12 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.13 	Section 1. Minnesota Statutes 2005 Supplement, section 256B.0625, subdivision 3f, 
1.14 	is amended to read:
1.15 		Subd. 3f.Circumcision for newborns. Newborn Circumcision is not covered, 
1.16 	unless the procedure is medically necessary or required because of a well-established 
1.17 	religious practice.

1.18 	Sec. 2. Minnesota Statutes 2005 Supplement, section 256B.0625, subdivision 17, 
1.19 	is amended to read:
1.20 		Subd. 17.Transportation costs. (a) Medical assistance covers transportation costs 
1.21 	incurred solely for obtaining emergency medical care or transportation costs incurred 
1.22 	by eligible persons in obtaining emergency or nonemergency medical care when paid 
1.23 	directly to an ambulance company, common carrier, or other recognized providers of 
1.24 	transportation services. Effective January 1, 2006, transportation costs and services are 
1.25 	covered only if the health care service obtained through the transportation is a health care 
1.26 	service covered by this chapter except that transportation to obtain pharmacy services for 
2.1 	an eligible person also covered by Medicare is covered, even if the pharmacy service 
2.2 	obtained through such transportation is fully or partially covered by Part D Medicare.
2.3 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
2.4 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
2.5 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
2.6 	transportation, or private automobile.
2.7 	The commissioner may use an order by the recipient's attending physician to certify that 
2.8 	the recipient requires special transportation services. Special transportation includes 
2.9 	driver-assisted service to eligible individuals. Driver-assisted service includes passenger 
2.10 	pickup at and return to the individual's residence or place of business, assistance with 
2.11 	admittance of the individual to the medical facility, and assistance in passenger securement 
2.12 	or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers 
2.13 	must obtain written documentation from the health care service provider who is serving 
2.14 	the recipient being transported, identifying the time that the recipient arrived. Special 
2.15 	transportation providers may not bill for separate base rates for the continuation of a trip 
2.16 	beyond the original destination. Special transportation providers must take recipients to 
2.17 	the nearest appropriate health care provider, using the most direct route available. The 
2.18 	maximum medical assistance reimbursement rates for special transportation services are:
2.19 	(1) $17 for the base rate and $1.35 per mile for services to eligible persons who 
2.20 	need a wheelchair-accessible van;
2.21 	(2) $11.50 for the base rate and $1.30 per mile for services to eligible persons who 
2.22 	do not need a wheelchair-accessible van; and
2.23 	(3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 
2.24 	services to eligible persons who need a stretcher-accessible vehicle.

2.25 	Sec. 3. Minnesota Statutes 2004, section 256B.15, subdivision 1c, is amended to read:
2.26 		Subd. 1c.Notice of potential claim. (a) A state agency with a claim or potential 
2.27 	claim under this section may file a notice of potential claim under this subdivision anytime 
2.28 	before or within one year after a medical assistance recipient dies. The claimant shall be 
2.29 	the state agency. A notice filed prior to the recipient's death shall not take effect and shall 
2.30 	not be effective as notice until the recipient dies. A notice filed after a recipient dies 
2.31 	shall be effective from the time of filing.
2.32 	(b) The notice of claim shall be filed or recorded in the real estate records in the 
2.33 	office of the county recorder or registrar of titles for each county in which any part of 
2.34 	the property is located. The recorder shall accept the notice for recording or filing. The 
2.35 	registrar of titles shall accept the notice for filing if the recipient has a recorded interest in 
3.1 	the property. The registrar of titles shall not carry forward to a new certificate of title any 
3.2 	notice filed more than one year from the date of the recipient's death.
3.3 	(c) The notice must be dated, state the name of the claimant, the medical assistance 
3.4 	recipient's name and the last four digits of the Social Security number if filed before their 
3.5 	death and their date of death if filed after they die, the name and date of death of any 
3.6 	predeceased spouse of the medical assistance recipient for whom a claim may exist, a 
3.7 	statement that the claimant may have a claim arising under this section, generally identify 
3.8 	the recipient's interest in the property, contain a legal description for the property and 
3.9 	whether it is abstract or registered property, a statement of when the notice becomes 
3.10 	effective and the effect of the notice, be signed by an authorized representative of the state 
3.11 	agency, and may include such other contents as the state agency may deem appropriate.

3.12 	Sec. 4. Minnesota Statutes 2005 Supplement, section 256B.69, subdivision 23, is 
3.13 	amended to read:
3.14 		Subd. 23.Alternative services; elderly and disabled persons. (a) The 
3.15 	commissioner may implement demonstration projects to create alternative integrated 
3.16 	delivery systems for acute and long-term care services to elderly persons and persons 
3.17 	with disabilities as defined in section 256B.77, subdivision 7a, that provide increased 
3.18 	coordination, improve access to quality services, and mitigate future cost increases. 
3.19 	The commissioner may seek federal authority to combine Medicare and Medicaid 
3.20 	capitation payments for the purpose of such demonstrations. Medicare funds and services 
3.21 	shall be administered according to the terms and conditions of the federal waiver and 
3.22 	demonstration provisions. For the purpose of administering medical assistance funds, 
3.23 	demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 
3.24 	of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations, with the 
3.25 	exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, items B and 
3.26 	C, which do not apply to persons enrolling in demonstrations under this section. An initial 
3.27 	open enrollment period may be provided. Persons who disenroll from demonstrations 
3.28 	under this subdivision remain subject to Minnesota Rules, parts 9500.1450 to 9500.1464. 
3.29 	When a person is enrolled in a health plan under these demonstrations and the health 
3.30 	plan's participation is subsequently terminated for any reason, the person shall be provided 
3.31 	an opportunity to select a new health plan and shall have the right to change health plans 
3.32 	within the first 60 days of enrollment in the second health plan. Persons required to 
3.33 	participate in health plans under this section who fail to make a choice of health plan shall 
3.34 	not be randomly assigned to health plans under these demonstrations. Notwithstanding 
3.35 	section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, subpart 1, item A, 
4.1 	if adopted, for the purpose of demonstrations under this subdivision, the commissioner 
4.2 	may contract with managed care organizations, including counties, to serve only elderly 
4.3 	persons eligible for medical assistance, elderly and disabled persons, or disabled persons 
4.4 	only. For persons with primary diagnoses of mental retardation or a related condition, 
4.5 	serious and persistent mental illness, or serious emotional disturbance, the commissioner 
4.6 	must ensure that the county authority has approved the demonstration and contracting 
4.7 	design. Enrollment in these projects for persons with disabilities shall be voluntary. The 
4.8 	commissioner shall not implement any demonstration project under this subdivision for 
4.9 	persons with primary diagnoses of mental retardation or a related condition, serious and 
4.10 	persistent mental illness, or serious emotional disturbance, without approval of the county 
4.11 	board of the county in which the demonstration is being implemented.
4.12 	(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
4.13 	to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 
4.14 	9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement 
4.15 	under this section projects for persons with developmental disabilities. The commissioner 
4.16 	may capitate payments for ICF/MR services, waivered services for mental retardation or 
4.17 	related conditions, including case management services, day training and habilitation and 
4.18 	alternative active treatment services, and other services as approved by the state and by the 
4.19 	federal government. Case management and active treatment must be individualized and 
4.20 	developed in accordance with a person-centered plan. Costs under these projects may not 
4.21 	exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, 
4.22 	and until two years after the pilot project implementation date, subcontractor participation 
4.23 	in the long-term care developmental disability pilot is limited to a nonprofit long-term 
4.24 	care system providing ICF/MR services, home and community-based waiver services, 
4.25 	and in-home services to no more than 120 consumers with developmental disabilities in 
4.26 	Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature 
4.27 	prior to expansion of the developmental disability pilot project. This paragraph expires 
4.28 	two years after the implementation date of the pilot project.
4.29 	(c) Before implementation of a demonstration project for disabled persons, the 
4.30 	commissioner must provide information to appropriate committees of the house of 
4.31 	representatives and senate and must involve representatives of affected disability groups 
4.32 	in the design of the demonstration projects.
4.33 	(d) A nursing facility reimbursed under the alternative reimbursement methodology 
4.34 	in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity 
4.35 	provide services under paragraph (a). The commissioner shall amend the state plan and 
4.36 	seek any federal waivers necessary to implement this paragraph.
5.1 	(e) The commissioner, in consultation with the commissioners of commerce and 
5.2 	health, may approve and implement programs for all-inclusive care for the elderly (PACE) 
5.3 	according to federal laws and regulations governing that program and state laws or rules 
5.4 	applicable to participating providers. The process for approval of these programs shall 
5.5 	begin only after the commissioner receives grant money in an amount sufficient to cover 
5.6 	the state share of the administrative and actuarial costs to implement the programs during 
5.7 	state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 
5.8 	account in the special revenue fund and are appropriated to the commissioner to be used 
5.9 	solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 
5.10 	not required to be licensed or certified as a health plan company as defined in section 
5.11 	62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county 
5.12 	and found to be eligible for services under the elderly waiver or community alternatives 
5.13 	for disabled individuals or who are already eligible for Medicaid but meet level of 
5.14 	care criteria for receipt of waiver services may choose to enroll in the PACE program. 
5.15 	Medicare and Medicaid services will be provided according to this subdivision and 
5.16 	federal Medicare and Medicaid requirements governing PACE providers and programs. 
5.17 	PACE enrollees will receive Medicaid home and community-based services through the 
5.18 	PACE provider as an alternative to services for which they would otherwise be eligible 
5.19 	through home and community-based waiver programs and Medicaid State Plan Services. 
5.20 	The commissioner shall establish Medicaid rates for PACE providers that do not exceed 
5.21 	costs that would have been incurred under fee-for-service or other relevant managed care 
5.22 	programs operated by the state.
5.23 	(f) The commissioner shall seek federal approval to expand the Minnesota disability 
5.24 	health options (MnDHO) program established under this subdivision in stages, first to 
5.25 	regional population centers outside the seven-county metro area and then to all areas of 
5.26 	the state.
5.27 	(g) Notwithstanding section 256B.0261 256B.0621, health plans providing services 
5.28 	under this section are responsible for home care targeted case management and relocation 
5.29 	targeted case management service coordination. Services must be provided according to 
5.30 	the terms of the waivers and contracts approved by the federal government.

5.31 	Sec. 5. Minnesota Statutes 2004, section 256B.692, subdivision 6, is amended to read:
5.32 		Subd. 6.Commissioner's authority. The commissioner may:
5.33 	(1) reject any preliminary or final proposal that substantially fails to meet the 
5.34 	requirements of this section, or that the commissioner determines would substantially 
5.35 	impair the state's ability to purchase health care services in other areas of the state, 
6.1 	or would substantially impair an enrollee's choice of care systems managed care 
6.2 	organizations  when reasonable choice is possible, or would substantially impair the 
6.3 	implementation and operation of the Minnesota senior health options demonstration 
6.4 	project authorized under section  256B.69, subdivision 23; and 
6.5 	(2) assume operation of a county's purchasing of health care for enrollees in medical 
6.6 	assistance and general assistance medical care in the event that the contract with the 
6.7 	county is terminated.

6.8 	Sec. 6. Minnesota Statutes 2005 Supplement, section 256L.05, subdivision 2, is 
6.9 	amended to read:
6.10 		Subd. 2.Commissioner's duties. (a) The commissioner or county agency shall 
6.11 	use electronic verification as the primary method of income verification. If there is a 
6.12 	discrepancy between reported income and electronically verified income, an individual 
6.13 	may be required to submit additional verification. In addition, the commissioner shall 
6.14 	perform random audits to verify reported income and eligibility. The commissioner 
6.15 	may execute data sharing arrangements with the Department of Revenue and any other 
6.16 	governmental agency in order to perform income verification related to eligibility and 
6.17 	premium payment under the MinnesotaCare program.
6.18 	(b) In determining eligibility for MinnesotaCare, the commissioner shall require 
6.19 	applicants and enrollees seeking renewal of eligibility to verify both earned and unearned 
6.20 	income. The commissioner shall also require applicants and enrollees to submit the names 
6.21 	of their employers and a contact name with a telephone number for each employer for 
6.22 	purposes of verifying verify whether the applicant or enrollee, and any dependents, are 
6.23 	eligible for employer-subsidized coverage, as defined in section 256L.07, subdivision 2. 
6.24 	Verification of access to employer-subsidized coverage shall be provided on a Minnesota 
6.25 	health care program form completed and signed by the employer, or other employer issued 
6.26 	documentation. Data collected is nonpublic data as defined in section 13.02, subdivision 9.

6.27 	EFFECTIVE DATE. This section is effective July 1, 2006.

6.28 	Sec. 7. Minnesota Statutes 2005 Supplement, section 256L.15, subdivision 4, is 
6.29 	amended to read:
6.30 		Subd. 4.Exception for transitioned adults. The county agencies of financial 
6.31 	responsibility  shall pay premiums a premium of $7.10 for each month described in section 
6.32 	256L.05, subdivision 3, paragraph (e),  for single adults and households with no children 
6.33 	formerly enrolled in general assistance medical care and enrolled in MinnesotaCare 
6.34 	according to section 256D.03, subdivision 3, until six-month renewal. The county agency
7.1 	of financial responsibility  has the option of continuing to pay premiums under subdivision 
7.2 	2, paragraph (a),  for these enrollees past the first six-month renewal period.

7.3 	EFFECTIVE DATE. This section is effective September 1, 2006.

7.4 	Sec. 8. Minnesota Statutes 2004, section 514.982, subdivision 1, is amended to read:
7.5 		Subdivision 1.Contents. A medical assistance lien notice must be dated and 
7.6 	must contain:
7.7 	(1) the full name, last known address, and the last four digits of the Social Security 
7.8 	number of the medical assistance recipient;
7.9 	(2) a statement that medical assistance payments have been made to or for the 
7.10 	benefit of the medical assistance recipient named in the notice, specifying the first date 
7.11 	of eligibility for benefits;
7.12 	(3) a statement that all interests in real property owned by the persons named in the 
7.13 	notice may be subject to or affected by the rights of the agency to be reimbursed for 
7.14 	medical assistance benefits; and
7.15 	(4) the legal description of the real property upon which the lien attaches, and 
7.16 	whether the property is registered property.

7.17 	Sec. 9. Laws 2005, First Special Session chapter 4, article 8, section 84, is amended to 
7.18 	read:
7.19 	Sec. 84.  SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE  
7.20 	CONTRACT.
7.21 	
7.22 	Notwithstanding Minnesota Statutes, section 256B.692,  subdivision 6, the 
7.23 	commissioner of human services shall not  reject consider a county-based purchasing 
7.24 	health plan proposal that  requires county-based purchasing on a sole-source or single-plan  
7.25 	basis if the implementation of the sole-source or single-plan  purchasing proposal does 
7.26 	not limit an enrollee's provider choice  or access to services.  The commissioner shall 
7.27 	request federal  approval, if necessary, to permit or maintain a sole-source or  single-plan 
7.28 	purchasing option even if choice is available in the  area. 
7.29 	

7.30 	Sec. 10.  REPEALER.
 7.31 	Minnesota Statutes 2004, section 256B.692, subdivision 10, is repealed.