Legislative Session number- 87

Bill Name: SF2093

3E Relating to health and human services

ARTICLE 1 - HEALTH CARE

Modifying
insurance claim denial reporting requirements; allowing medical assistance (MA)
coverage for dialysis; modifying MA reimbursement coverage for adult dental
services; expanding MA reimbursement for disabled adults dental services;
authorizing MA reimbursement for community paramedic services; allowing prepaid
health plans to waive the family deductible within existing capitation rates
under MA; requiring clinical or utilization performance targets to consider
evidence-based research; modifying certain financial reporting requirements for
managed care and county-based purchasing plans (health insurance); modifying
certain reimbursement rate criteria for critical access dental provider
services; modifying MinnesotaCare performance withholds; requiring a
cost-sharing structure recommendation, a managed care study, and a for-profit
health maintenance organizations (HMO) study; permitting evidence-based
childbirth program discontinuation; requiring provider networks report merging;
specifying savings from reporting elimination to be used for assessment payment;
repealing summary of complaints and grievances, medical necessity denials and
appeals, salary reports, and mandatory HMO participation as provider in public
programs

ARTICLE 2 - DEPARTMENT OF HEALTH

Shifting regulatory authority of
health maintenance organizations (HMO) from the commissioner of health to the
commissioner of commerce; shifting community-based health care coverage program
community-based health care initiatives management solely to the commissioner of
health; modifying health care payment reform; providing for an exemption for
naturally treated swimming pool in the city of Minneapolis from certain pool
regulations; providing for an exception to the moratorium on radiation therapy
facility construction for a facility relocated from Maplewood to Woodbury;
requiring postpartum depression information availability at WIC (Women, Infants,
and Children) sites; modifying a prior appropriation requirement for community
and family health promotion; requiring a study of radiation therapy facilities
capacity

ARTICLE 3 - CHILDREN AND FAMILY SERVICES

Providing an exception
to the absent days limit for certain children under the child care assistance
program; providing for the prevention of welfare fraud; modifying certain
electronic benefit transfer (EBT) debit cards issuance requirements for the
general assistance (GA) and Minnesota supplemental aid programs; increasing the
dollar amounts for the general assistance (GA) earned income savings account
county agency disregard and the resource limits exclusion; requiring referral to
early intervention services for younger children; modifying working family
credit expenditures claimed for TANF/MOE (temporary assistance for needy
families/maintenance of effort); requiring certain reporting

ARTICLE 4 -
CONTINUING CARE

Modifying electronic health record system revolving account
loan program eligibility; allowing certain nursing facility moratorium
exceptions; modifying long-term care services and supports reporting; requiring
the commissioner of human services to issue a mental health certification for
licensed adult foster care homes and establishing an exemption from the adult
foster care licensing moratorium; allowing an adult foster care license capacity
variance for respite services for persons with disabilities; modifying consumer
data filing set-aside requirements for developmental disabilities services and
certain background study requirements; requiring the board on aging Senior
LinkAge Line to develop referral protocols and processes to identify at-risk
seniors for long-term care options counseling; specifying an assets disregard
for employed persons with disabilities for medical assistance (MA) eligibility;
allowing a reimbursement rate monthly adjustment for MA transportation costs
outside the metropolitan area; expanding MA co-payment and deductible
requirement exceptions to include certain home and community waiver services;
requiring long-term care options counseling for assisted living residents or
legal representatives under MA and requiring waiver signature; modifying MA
individual service plan and state quality council requirements; requiring an
annual increase for new bed replacement costs; requiring moratorium exception
available money use for incremental rate increases; requiring the commissioner
of human services under the MA value-based nursing facility reimbursement system
to designate certain nursing facilities as critical access nursing facilities;
requiring nursing facility providers not participating in Medicare assignment to
refer and document dual eligible recipients, an audit of facilities not
accepting Medicare, and Medicaid denial payment under certain conditions;
providing for adult foster care voluntary closure; modifying general assistance
(GA) housing access and lease; requiring lead agencies to consult with providers
to review individual service plans; modifying local planning grants for creating
alternatives to congregate living for individuals with lower needs; requiring
the commissioner to reduce the 2011 reduction of rates for congregate living for
persons with lower needs; requiring the commissioner to seek federal approval as
part of the MA reform waiver request; allowing MA continuation for employed
persons with disabilities while waiver request is pending; allowing services for
persons receiving services under a home and community-based waiver; providing
independent living services billing; repealing a provision requiring the
commissioner of human services to provide a request line item for the nursing
home moratorium exception process, Medicare certification under nursing home
prohibited practices, continuing care contingent rate reductions, and the
intermediate care facilities for the developmentally disabled ICF/DD rate
decrease

ARTICLE 5 - MISCELLANEOUS

Establishing a temporary moratorium to
preclude employees from joining the public employee insurance program (PEIP)
administered by the department of management and budget (MMB)if the employer is
not in the program as of the date of enactment; modifying certain coverage
requirements for children's health supervision and prenatal care services
delivered by an out-of-network provider; modifying policy continuation
privileges for insured former spouses and children; requiring legislative
committee chairs to request commissioner evaluations of health benefit mandates
and a prompt report from the commissioner; requiring the commissioner of
commerce to evaluate current health benefits mandated by statutes and agency
rules in accordance with the health care cost containment evaluation process;
establishing the nurse licensure compact; modifying a prior appropriation for
the board of nursing home administrators base adjustment

ARTICLE 6 - HEALTH
AND HUMAN SERVICES APPROPRIATIONS

Appropriating money to the commissioner of
human services for continuing care, Minnesota family investment
program/diversionary work program (MFIP/DWP), general assistance (GA), group
residential, MinnesotaCare, Minnesota supplemental aid, medical assistance (MA),
child care, and disabilities grants, and for critical access nursing facilities
designation; providing a continuing care provider payment delay; appropriating
money to the commissioner of health for a radiation therapy facilities capacity
study and for the board of nursing; appropriating money to the commissioner of
commerce for various costs and to the emergency medical services regulatory
board; providing certain funds transfers

ARTICLE 7 - CONTINGENT
APPROPRIATIONS

Appropriating money to the commissioner of human services for
a residential campus for individuals with autism, continuing care, chemical and
mental health, medical assistance (MA), aging and adult services, and
disabilities grants; requiring decreased statewide licensed capacity for certain
foster care settings; delaying the wage rate reduction for relative personal
care assistants; requiring assessment results to be used in the statewide needs
determination process and setting the date of statewide licensed capacity
reduction for home and community-based waivered services for disabled persons;
modifying the dental access grant physician reimbursement reduction date;
modifying the reduction of rates for congregate living for individuals with
lower needs; delaying a personal care assistance relative care rate reduction;
requiring the commissioner of human services to develop a plan for providing
emergency medical assistance (MA); providing health coverage for cancer
treatment as an emergency condition; instructing the commissioner of human
services to develop a plan and a proposal for a residential campus for
individuals with autism; requiring studies of personal care assistance and other
unlicensed attendant services procedures and a personal care assistance service
model
(rt)