1.1 	A bill for an act
1.2 	relating to state government; requiring the commissioner of management and 
1.3 	budget to issue a request for proposals and enter into a contract for dependent 
1.4 	audit verification for state employee health plans.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. STATE EMPLOYEE GROUP INSURANCE PLAN DEPENDENT 
1.7 	ELIGIBILITY VERIFICATION AUDIT SERVICES.
 1.8 		Subdivision 1.Request for proposals. By ......., 2011, the commissioner of 
1.9 	management and budget shall issue a request for proposals for a contract to provide 
1.10 	dependent eligibility verification audit services for state-paid hospital, medical, and dental 
1.11 	benefits provided to state employees and their dependents. The request for proposals 
1.12 	must require that the vendor will:
1.13 	(1) conduct a document-model dependent eligibility verification audit of all plans 
1.14 	offered under Minnesota Statutes, sections 43A.22 to 43A.31;
1.15 	(2) identify ineligible dependents covered by the plans and report those findings to 
1.16 	the commissioner and third-party administrators of the state's employee health plans, as 
1.17 	directed by the commissioner; and
1.18 	(3) implement a process for ongoing eligibility verification following the conclusion 
1.19 	of the dependent eligibility verification audit required by this section.
1.20 		Subd. 2.Additional vendor criteria. The request for proposals required by 
1.21 	subdivision 1 must require the vendor to provide the following minimum capabilities and 
1.22 	experience in performing the services described in subdivision 1:
1.23 	(1) a rules-based platform employing auto-adjudication for making objective 
1.24 	eligibility determinations;
2.1 	(2) assigned eligibility advocates to assist employees through the verification 
2.2 	process;
2.3 	(3) a formal claims and appeals process; and
2.4 	(4) experience in the performance of dependent eligibility verification audits for 
2.5 	other states.
2.6 		Subd. 3.Contract required. By ......., 2011, the commissioner must enter into 
2.7 	a contract for the services specified in subdivision 1. The contract must incorporate a 
2.8 	performance-based vendor financing option that compensates the vendor based on the 
2.9 	amount of savings generated by the work performed under the contract.