1.1 	A bill for an act
1.2 	relating to human services; making changes to child care provider rates and parent 
1.3 	fees; eliminating certain health care co-pays; increasing the MFIP transitional 
1.4 	standard; reinstating health care benefits for certain noncitizens; repealing 
1.5 	MFIP housing and SSI penalties; appropriating money;amending Minnesota 
1.6 	Statutes 2004, sections 119B.13, by adding a subdivision; 256J.24, by adding a 
1.7 	subdivision; Minnesota Statutes 2005 Supplement, sections 119B.09, subdivision 
1.8 	1; 256D.03, subdivisions 3, 4; proposing coding for new law in Minnesota 
1.9 	Statutes, chapter 119B; repealing Minnesota Statutes 2004, sections 256B.0631, 
1.10 	subdivisions 2, 4; 256J.37, subdivision 3a; 256L.04, subdivision 10; Minnesota 
1.11 	Statutes 2005 Supplement, sections 256B.0631, subdivisions 1, 3; 256J.37, 
1.12 	subdivision 3b; Laws 2005, First Special Session chapter 4, article 3, section 19.
1.13 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.14 	Section 1. Minnesota Statutes 2005 Supplement, section 119B.09, subdivision 1, is 
1.15 	amended to read:
1.16 		Subdivision 1.General eligibility requirements for all applicants for child 
1.17 	care assistance. (a) Child care services must be available to families who need child 
1.18 	care to find or keep employment or to obtain the training or education necessary to find 
1.19 	employment and who:
1.20 	(1) have household income less than or equal to 250 percent of the federal poverty 
1.21 	guidelines, adjusted for family size, and meet the requirements of section 119B.05; 
1.22 	receive MFIP assistance; and are participating in employment and training services under 
1.23 	chapter 256J or 256K; or
1.24 	(2) have household income less than or equal to 175 200 percent of the federal 
1.25 	poverty guidelines, adjusted for family size, at program entry and less than 250 percent of 
1.26 	the federal poverty guidelines, adjusted for family size, at program exit.
1.27 	(b) Child care services must be made available as in-kind services.
2.1 	(c) All applicants for child care assistance and families currently receiving child care 
2.2 	assistance must be assisted and required to cooperate in establishment of paternity and 
2.3 	enforcement of child support obligations for all children in the family as a condition 
2.4 	of program eligibility. For purposes of this section, a family is considered to meet the 
2.5 	requirement for cooperation when the family complies with the requirements of section 
2.6 	256.741.

2.7 	Sec. 2. [119B.095] CO-PAYMENT FEE FOR FAMILIES WITH ANNUAL 
2.8 	INCOMES THAT EXCEED THE FEDERAL POVERTY LEVEL.
2.9 	(a) The monthly family co-payment fee for families with annual incomes greater than 
2.10 	the federal poverty level, adjusted for family size, is determined in paragraphs (b) and (c).
2.11 	(b) The family's annual gross income is converted into a percentage of state median 
2.12 	income (SMI) for a family of four, adjusted for family size, by dividing the family's 
2.13 	annual gross income by 100 percent of the SMI for a family of four, adjusted for family 
2.14 	size. The percentage must be carried out to the nearest 100th of a percent.
2.15 	(c) If the family's annual gross income is less than or equal to 75 percent of the 
2.16 	SMI for a family of four, adjusted for family size, the family's monthly co-payment fee 
2.17 	is the fixed percentage established for the family's income range in clauses (1) to (60), 
2.18 	multiplied by the highest possible income within that income range, divided by 12, and 
2.19 	rounded to the nearest whole dollar.

2.20		Percent of SMI
	Percent
	
2.21	(1)
	less than 35.01
	2.20
	
2.22	(2)
	35.01 to 42.00
	2.70
	
2.23	(3)
	42.01 to 43.00
	3.75
	
2.24	(4)
	43.01 to 44.00
	4.00
	
2.25	(5)
	44.01 to 45.00
	4.25
	
2.26	(6)
	45.01 to 46.00
	4.50
	
2.27	(7)
	46.01 to 47.00
	4.75
	
2.28	(8)
	47.01 to 48.00
	5.00
	
2.29	(9)
	48.01 to 49.00
	5.25
	
2.30	(10)
	49.01 to 50.00
	5.50
	
2.31	(11)
	50.01 to 50.50
	5.75
	
2.32	(12)
	50.51 to 51.00
	6.00
	
3.1	(13)
	51.01 to 51.50
	6.25
	
3.2	(14)
	51.51 to 52.00
	6.50
	
3.3	(15)
	52.01 to 52.50
	6.75
	
3.4	(16)
	52.51 to 53.00
	7.00
	
3.5	(17)
	53.01 to 53.50
	7.25
	
3.6	(18)
	53.51 to 54.00
	7.50
	
3.7	(19)
	54.01 to 54.50
	7.75
	
3.8	(20)
	54.51 to 55.00
	8.00
	
3.9	(21)
	55.01 to 55.50
	8.30
	
3.10	(22)
	55.51 to 56.00
	8.60
	
3.11	(23)
	56.01 to 56.50
	8.90
	
3.12	(24)
	56.51 to 57.00
	9.20
	
3.13	(25)
	57.01 to 57.50
	9.50
	
3.14	(26)
	57.51 to 58.00
	9.80
	
3.15	(27)
	58.01 to 58.50
	10.10
	
3.16	(28)
	58.51 to 59.00
	10.40
	
3.17	(29)
	59.01 to 59.50
	10.70
	
3.18	(30)
	59.51 to 60.00
	11.00
	
3.19	(31)
	60.01 to 60.50
	11.30
	
3.20	(32)
	60.51 to 61.00
	11.60
	
3.21	(33)
	61.01 to 61.50
	11.90
	
3.22	(34)
	61.51 to 62.00
	12.20
	
3.23	(35)
	62.01 to 62.50
	12.50
	
3.24	(36)
	62.51 to 63.00
	12.80
	
3.25	(37)
	63.01 to 63.50
	13.10
	
3.26	(38)
	63.51 to 64.00
	13.40
	
3.27	(39)
	64.01 to 64.50
	13.70
	
3.28	(40)
	64.51 to 65.00
	14.00
	
3.29	(41)
	65.01 to 65.50
	14.30
	
4.1	(42)
	65.51 to 66.00
	14.60
	
4.2	(43)
	66.01 to 66.50
	14.90
	
4.3	(44)
	66.51 to 67.00
	15.20
	
4.4	(45)
	67.01 to 67.50
	15.50
	
4.5	(46)
	67.51 to 68.00
	15.80
	
4.6	(47)
	68.01 to 68.50
	16.10
	
4.7	(48)
	68.51 to 69.00
	16.40
	
4.8	(49)
	69.01 to 69.50
	16.70
	
4.9	(50)
	69.51 to 70.00
	17.00
	
4.10	(51)
	70.01 to 70.50
	17.30
	
4.11	(52)
	70.51 to 71.00
	17.60
	
4.12	(53)
	71.01 to 71.50
	17.90
	
4.13	(54)
	71.51 to 72.00
	18.20
	
4.14	(55)
	72.01 to 72.50
	18.50
	
4.15	(56)
	72.51 to 73.00
	18.80
	
4.16	(57)
	73.01 to 73.50
	19.10
	
4.17	(58)
	73.51 to 74.00
	19.40
	
4.18	(59)
	74.01 to 74.50
	19.70
	
4.19	(60)
	74.51 to 75.00
	20.00

4.20 	Sec. 3. Minnesota Statutes 2004, section 119B.13, is amended by adding a subdivision 
4.21 	to read:
4.22 		Subd. 8.Cost of living increase. In addition to the provider rates specified under 
4.23 	this section, the commissioner shall provide a two percent cost of living rate increase to 
4.24 	providers.

4.25 	Sec. 4. Minnesota Statutes 2005 Supplement, section 256D.03, subdivision 3, is 
4.26 	amended to read:
4.27 		Subd. 3.General assistance medical care; eligibility. (a) General assistance 
4.28 	medical care may be paid for any person who is not eligible for medical assistance under 
4.29 	chapter 256B, including eligibility for medical assistance based on a spenddown of excess 
5.1 	income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in 
5.2 	paragraph (b), except as provided in paragraph (c), and:
5.3 	(1) who is receiving assistance under section 256D.05, except for families with 
5.4 	children who are eligible under Minnesota family investment program (MFIP), or who is 
5.5 	having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
5.6 	(2) who is a resident of Minnesota; and
5.7 	(i) who has gross countable income not in excess of 75 percent of the federal poverty 
5.8 	guidelines for the family size, using a six-month budget period and whose equity in assets 
5.9 	is not in excess of $1,000 per assistance unit. Exempt assets, the reduction of excess 
5.10 	assets, and the waiver of excess assets must conform to the medical assistance program in 
5.11 	section 256B.056, subdivision 3, with the following exception: the maximum amount of 
5.12 	undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by 
5.13 	the trustee, assuming the full exercise of the trustee's discretion under the terms of the 
5.14 	trust, must be applied toward the asset maximum;
5.15 	(ii) who has gross countable income above 75 percent of the federal poverty 
5.16 	guidelines but not in excess of 175 percent of the federal poverty guidelines for the 
5.17 	family size, using a six-month budget period, whose equity in assets is not in excess 
5.18 	of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient 
5.19 	hospitalization; or
5.20 	(iii) the commissioner shall adjust the income standards under this section each July 
5.21 	1 by the annual update of the federal poverty guidelines following publication by the 
5.22 	United States Department of Health and Human Services.
5.23 	(b) Effective for applications and renewals processed on or after September 1, 2006, 
5.24 	general assistance medical care may not be paid for applicants or recipients who are adults 
5.25 	with dependent children under 21 whose gross family income is equal to or less than 275 
5.26 	percent of the federal poverty guidelines who are not described in paragraph (e).
5.27 	(c) Effective for applications and renewals processed on or after September 1, 2006, 
5.28 	general assistance medical care may be paid for applicants and recipients who meet all 
5.29 	eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period 
5.30 	beginning the date of application. Immediately following approval of general assistance 
5.31 	medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04, 
5.32 	subdivision 7, with covered services as provided in section 256L.03 for the rest of the 
5.33 	six-month eligibility period, until their six-month renewal.
5.34 	(d) To be eligible for general assistance medical care following enrollment in 
5.35 	MinnesotaCare as required by paragraph (c), an individual must complete a new 
5.36 	application.
6.1 	(e) Applicants and recipients eligible under paragraph (a), clause (1), or who have 
6.2 	applied for and are awaiting a determination of blindness or disability by the state medical 
6.3 	review team or a determination of eligibility for Supplemental Security Income or Social 
6.4 	Security Disability Insurance by the Social Security Administration, or who fail to meet 
6.5 	the requirements of section 256L.09, subdivision 2, are exempt from the MinnesotaCare 
6.6 	enrollment requirements of this subdivision.
6.7 	(f) For applications received on or after October 1, 2003, eligibility may begin no 
6.8 	earlier than the date of application. For individuals eligible under paragraph (a), clause 
6.9 	(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 
6.10 	eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 
6.11 	may reapply if there is a subsequent period of inpatient hospitalization.
6.12 	(g) Beginning September 1, 2006, Minnesota health care program applications and 
6.13 	renewals completed by recipients and applicants who are persons described in paragraph 
6.14 	(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility 
6.15 	by the county agency. If all other eligibility requirements of this subdivision are met, 
6.16 	eligibility for general assistance medical care shall be available in any month during which 
6.17 	MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, 
6.18 	notice of termination for eligibility for general assistance medical care shall be sent to 
6.19 	an applicant or recipient. If all other eligibility requirements of this subdivision are 
6.20 	met, eligibility for general assistance medical care shall be available until enrollment in 
6.21 	MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
6.22 	(h) The date of an initial Minnesota health care program application necessary to 
6.23 	begin a determination of eligibility shall be the date the applicant has provided a name, 
6.24 	address, and Social Security number, signed and dated, to the county agency or the 
6.25 	Department of Human Services. If the applicant is unable to provide a name, address, 
6.26 	Social Security number, and signature when health care is delivered due to a medical 
6.27 	condition or disability, a health care provider may act on an applicant's behalf to establish 
6.28 	the date of an initial Minnesota health care program application by providing the county 
6.29 	agency or Department of Human Services with provider identification and a temporary 
6.30 	unique identifier for the applicant. The applicant must complete the remainder of the 
6.31 	application and provide necessary verification before eligibility can be determined. The 
6.32 	county agency must assist the applicant in obtaining verification if necessary.
6.33 	(i) County agencies are authorized to use all automated databases containing 
6.34 	information regarding recipients' or applicants' income in order to determine eligibility 
6.35 	for general assistance medical care or MinnesotaCare. Such use shall be considered 
6.36 	sufficient in order to determine eligibility and premium payments by the county agency.
7.1 	(j) General assistance medical care is not available for a person in a correctional 
7.2 	facility unless the person is detained by law for less than one year in a county correctional 
7.3 	or detention facility as a person accused or convicted of a crime, or admitted as an 
7.4 	inpatient to a hospital on a criminal hold order, and the person is a recipient of general 
7.5 	assistance medical care at the time the person is detained by law or admitted on a criminal 
7.6 	hold order and as long as the person continues to meet other eligibility requirements 
7.7 	of this subdivision.
7.8 	(k) General assistance medical care is not available for applicants or recipients who 
7.9 	do not cooperate with the county agency to meet the requirements of medical assistance.
7.10 	(l) In determining the amount of assets of an individual eligible under paragraph 
7.11 	(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 
7.12 	an asset excluded under paragraph (a), that was given away, sold, or disposed of for 
7.13 	less than fair market value within the 60 months preceding application for general 
7.14 	assistance medical care or during the period of eligibility. Any transfer described in this 
7.15 	paragraph shall be presumed to have been for the purpose of establishing eligibility for 
7.16 	general assistance medical care, unless the individual furnishes convincing evidence to 
7.17 	establish that the transaction was exclusively for another purpose. For purposes of this 
7.18 	paragraph, the value of the asset or interest shall be the fair market value at the time it 
7.19 	was given away, sold, or disposed of, less the amount of compensation received. For any 
7.20 	uncompensated transfer, the number of months of ineligibility, including partial months, 
7.21 	shall be calculated by dividing the uncompensated transfer amount by the average monthly 
7.22 	per person payment made by the medical assistance program to skilled nursing facilities 
7.23 	for the previous calendar year. The individual shall remain ineligible until this fixed period 
7.24 	has expired. The period of ineligibility may exceed 30 months, and a reapplication for 
7.25 	benefits after 30 months from the date of the transfer shall not result in eligibility unless 
7.26 	and until the period of ineligibility has expired. The period of ineligibility begins in the 
7.27 	month the transfer was reported to the county agency, or if the transfer was not reported, 
7.28 	the month in which the county agency discovered the transfer, whichever comes first. For 
7.29 	applicants, the period of ineligibility begins on the date of the first approved application.
7.30 	(m) When determining eligibility for any state benefits under this subdivision, 
7.31 	the income and resources of all noncitizens shall be deemed to include their sponsor's 
7.32 	income and resources as defined in the Personal Responsibility and Work Opportunity 
7.33 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
7.34 	subsequently set out in federal rules.
7.35 	(n) (1) An undocumented noncitizens and nonimmigrants are noncitizen or a 
7.36 	nonimmigrant is  ineligible for general assistance medical care other than emergency 
8.1 	services. For purposes of this subdivision, a nonimmigrant is an individual in one or 
8.2 	more of the classes listed in United States Code, title 8, section 1101(a)(15), and an 
8.3 	undocumented noncitizen is an individual who resides in the United States without the 
8.4 	approval or acquiescence of the Immigration and Naturalization Service.
8.5 	(2) This paragraph does not apply to a child under age 18; to a Cuban or Haitian 
8.6 	entrant as defined in Public Law 96-422, section 501(e)(1) or (2)(a); or to a noncitizen 
8.7 	who is aged, blind, or disabled as defined in Code of Federal Regulations, title 42, 
8.8 	sections 435.520, 435.530, 435.531, 435.540, and 435.541, who cooperates with United 
8.9 	States Citizenship and Immigration Services to pursue any applicable immigration status, 
8.10 	including citizenship, that would qualify the individual for medical assistance with federal 
8.11 	financial participation. 
8.12 	(3) For purposes of this paragraph, "emergency services" has the meaning given in 
8.13 	Code of Federal Regulations, title 42, section 440.255(b)(1), except that it also means 
8.14 	services rendered because of suspected or actual pesticide poisoning. 
8.15 	(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for 
8.16 	medical assistance due to the deeming of a sponsor's income and resources, is ineligible 
8.17 	for general assistance medical care.
8.18 	(p) Effective July 1, 2003, general assistance medical care emergency services end.

8.19 	Sec. 5. Minnesota Statutes 2005 Supplement, section 256D.03, subdivision 4, is 
8.20 	amended to read:
8.21 		Subd. 4.General assistance medical care; services. (a)(i) For a person who is 
8.22 	eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 
8.23 	care covers, except as provided in paragraph (c):
8.24 	(1) inpatient hospital services;
8.25 	(2) outpatient hospital services;
8.26 	(3) services provided by Medicare certified rehabilitation agencies;
8.27 	(4) prescription drugs and other products recommended through the process 
8.28 	established in section 256B.0625, subdivision 13;
8.29 	(5) equipment necessary to administer insulin and diagnostic supplies and equipment 
8.30 	for diabetics to monitor blood sugar level;
8.31 	(6) eyeglasses and eye examinations provided by a physician or optometrist;
8.32 	(7) hearing aids;
8.33 	(8) prosthetic devices;
8.34 	(9) laboratory and X-ray services;
8.35 	(10) physician's services;
9.1 	(11) medical transportation except special transportation;
9.2 	(12) chiropractic services as covered under the medical assistance program;
9.3 	(13) podiatric services;
9.4 	(14) dental services as covered under the medical assistance program;
9.5 	(15) outpatient services provided by a mental health center or clinic that is under 
9.6 	contract with the county board and is established under section 245.62;
9.7 	(16) day treatment services for mental illness provided under contract with the 
9.8 	county board;
9.9 	(17) prescribed medications for persons who have been diagnosed as mentally ill as 
9.10 	necessary to prevent more restrictive institutionalization;
9.11 	(18) psychological services, medical supplies and equipment, and Medicare 
9.12 	premiums, coinsurance and deductible payments;
9.13 	(19) medical equipment not specifically listed in this paragraph when the use of 
9.14 	the equipment will prevent the need for costlier services that are reimbursable under 
9.15 	this subdivision;
9.16 	(20) services performed by a certified pediatric nurse practitioner, a certified family 
9.17 	nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 
9.18 	nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 
9.19 	practitioner in independent practice, if (1) the service is otherwise covered under this 
9.20 	chapter as a physician service, (2) the service provided on an inpatient basis is not included 
9.21 	as part of the cost for inpatient services included in the operating payment rate, and (3) the 
9.22 	service is within the scope of practice of the nurse practitioner's license as a registered 
9.23 	nurse, as defined in section 148.171;
9.24 	(21) services of a certified public health nurse or a registered nurse practicing in 
9.25 	a public health nursing clinic that is a department of, or that operates under the direct 
9.26 	authority of, a unit of government, if the service is within the scope of practice of the 
9.27 	public health nurse's license as a registered nurse, as defined in section 148.171;
9.28 	(22) telemedicine consultations, to the extent they are covered under section 
9.29 	256B.0625, subdivision 3b; and
9.30 	(23) mental health telemedicine and psychiatric consultation as covered under 
9.31 	section 256B.0625, subdivisions 46 and 48.
9.32 	(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 
9.33 	paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 
9.34 	to inpatient hospital services, including physician services provided during the inpatient 
9.35 	hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
10.1 	(b) Effective August 1, 2005, sex reassignment surgery is not covered under this 
10.2 	subdivision.
10.3 	(c) In order to contain costs, the commissioner of human services shall select 
10.4 	vendors of medical care who can provide the most economical care consistent with high 
10.5 	medical standards and shall where possible contract with organizations on a prepaid 
10.6 	capitation basis to provide these services. The commissioner shall consider proposals by 
10.7 	counties and vendors for prepaid health plans, competitive bidding programs, block grants, 
10.8 	or other vendor payment mechanisms designed to provide services in an economical 
10.9 	manner or to control utilization, with safeguards to ensure that necessary services are 
10.10 	provided. Before implementing prepaid programs in counties with a county operated or 
10.11 	affiliated public teaching hospital or a hospital or clinic operated by the University of 
10.12 	Minnesota, the commissioner shall consider the risks the prepaid program creates for the 
10.13 	hospital and allow the county or hospital the opportunity to participate in the program in a 
10.14 	manner that reflects the risk of adverse selection and the nature of the patients served by 
10.15 	the hospital, provided the terms of participation in the program are competitive with the 
10.16 	terms of other participants considering the nature of the population served. Payment for 
10.17 	services provided pursuant to this subdivision shall be as provided to medical assistance 
10.18 	vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For 
10.19 	payments made during fiscal year 1990 and later years, the commissioner shall consult 
10.20 	with an independent actuary in establishing prepayment rates, but shall retain final control 
10.21 	over the rate methodology.
10.22 	(d) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 
10.23 	co-payments for services provided on or after October 1, 2003:
10.24 	(1) $25 for eyeglasses;
10.25 	(2) $25 for nonemergency visits to a hospital-based emergency room;
10.26 	(3) $3 per brand-name drug prescription and $1 per generic drug prescription, 
10.27 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
10.28 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
10.29 	(4) 50 percent coinsurance on restorative dental services.
10.30 	(e) Co-payments shall be limited to one per day per provider for nonpreventive visits, 
10.31 	eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of 
10.32 	general assistance medical care are responsible for all co-payments in this subdivision. 
10.33 	The general assistance medical care reimbursement to the provider shall be reduced by 
10.34 	the amount of the co-payment, except that reimbursement for prescription drugs shall not 
10.35 	be reduced once a recipient has reached the $12 per month maximum for prescription 
10.36 	drug co-payments. The provider collects the co-payment from the recipient. Providers 
11.1 	may not deny services to recipients who are unable to pay the co-payment, except as 
11.2 	provided in paragraph (f).
11.3 	(f) If it is the routine business practice of a provider to refuse service to an individual 
11.4 	with uncollected debt, the provider may include uncollected co-payments under this 
11.5 	section. A provider must give advance notice to a recipient with uncollected debt before 
11.6 	services can be denied.
11.7 	(g)  (d) Any county may, from its own resources, provide medical payments for 
11.8 	which state payments are not made.
11.9 	(h)(e) Chemical dependency services that are reimbursed under chapter 254B must 
11.10 	not be reimbursed under general assistance medical care.
11.11 	(i)(f) The maximum payment for new vendors enrolled in the general assistance 
11.12 	medical care program after the base year shall be determined from the average usual and 
11.13 	customary charge of the same vendor type enrolled in the base year.
11.14 	(j)(g) The conditions of payment for services under this subdivision are the same 
11.15 	as the conditions specified in rules adopted under chapter 256B governing the medical 
11.16 	assistance program, unless otherwise provided by statute or rule.
11.17 	(k)(h) Inpatient and outpatient payments shall be reduced by five percent, effective 
11.18 	July 1, 2003. This reduction is in addition to the five percent reduction effective July 1, 
11.19 	2003, and incorporated by reference in paragraph (i) (f).
11.20 	(l) (i) Payments for all other health services except inpatient, outpatient, and 
11.21 	pharmacy services shall be reduced by five percent, effective July 1, 2003.
11.22 	(m) (j) Payments to managed care plans shall be reduced by five percent for services 
11.23 	provided on or after October 1, 2003.
11.24 	(n) (k) A hospital receiving a reduced payment as a result of this section may apply 
11.25 	the unpaid balance toward satisfaction of the hospital's bad debts.
11.26 	(o) Fee-for-service payments for nonpreventive visits shall be reduced by $3 
11.27 	for services provided on or after January 1, 2006. For purposes of this subdivision, a 
11.28 	visit means an episode of service which is required because of a recipient's symptoms, 
11.29 	diagnosis, or established illness, and which is delivered in an ambulatory setting by 
11.30 	a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 
11.31 	audiologist, optician, or optometrist.
11.32 	(p) Payments to managed care plans shall not be increased as a result of the removal 
11.33 	of the $3 nonpreventive visit co-payment effective January 1, 2006.

11.34 	Sec. 6. Minnesota Statutes 2004, section 256J.24, is amended by adding a subdivision 
11.35 	to read:
12.1 		Subd. 5b.Cost of living increase. The commissioner shall provide a ten percent 
12.2 	cost of living increase to the cash portion of the transitional standard.

12.3 	Sec. 7. APPROPRIATION.
 12.4 	$....... is appropriated from the tax relief account under Minnesota Statutes, section 
12.5 	16A.1522, subdivision 4, for the biennium ending June 30, 2007, to the commissioner of 
12.6 	human services for the purposes of sections 1 to 4 and 6.

12.7 	Sec. 8.  REPEALER.
 12.8 	(a) Minnesota Statutes 2004, sections 256B.0631, subdivisions 2 and 4; 256J.37, 
12.9 	subdivision 3a; and 256L.04, subdivision 10, are repealed.
12.10 	(b) Minnesota Statutes 2005 Supplement, sections 256B.0631, subdivisions 1 and 3; 
12.11 	and 256J.37, subdivision 3b, are repealed.
12.12 	(c) Laws 2005, First Special Session chapter 4, article 3, section 19, is repealed.