1997 Minnesota Statutes

     256B.76 Physician and dental reimbursement. 

    (a) The physician reimbursement increase provided in 
 section 256B.74, subdivision 2, shall not be implemented.  
 Effective for services rendered on or after October 1, 1992, the 
 commissioner shall make payments for physician services as 
 follows: 

    (1) payment for level one Health Care Finance 
 Administration's common procedural coding system (HCPCS) codes 
 titled "office and other outpatient services," "preventive 
 medicine new and established patient," "delivery, antepartum, 
 and postpartum care," "critical care," Caesarean delivery and 
 pharmacologic management provided to psychiatric patients, and 
 HCPCS level three codes for enhanced services for prenatal high 
 risk, shall be paid at the lower of (i) submitted charges, or 
 (ii) 25 percent above the rate in effect on June 30, 1992.  If 
 the rate on any procedure code within these categories is 
 different than the rate that would have been paid under the 
 methodology in section 256B.74, subdivision 2, then the larger 
 rate shall be paid; 

    (2) payments for all other services shall be paid at the 
 lower of (i) submitted charges, or (ii) 15.4 percent above the 
 rate in effect on June 30, 1992; and 

    (3) all physician rates shall be converted from the 50th 
 percentile of 1982 to the 50th percentile of 1989, less the 
 percent in aggregate necessary to equal the above increases 
 except that payment rates for home health agency services shall 
 be the rates in effect on September 30, 1992. 

    (b) The dental reimbursement increase provided in section 
 256B.74, subdivision 5, shall not be implemented.  Effective for 
 services rendered on or after October 1, 1992, the commissioner 
 shall make payments for dental services as follows: 

    (1) dental services shall be paid at the lower of (i) 
 submitted charges, or (ii) 25 percent above the rate in effect 
 on June 30, 1992; and 

    (2) dental rates shall be converted from the 50th 
 percentile of 1982 to the 50th percentile of 1989, less the 
 percent in aggregate necessary to equal the above increases. 

    (c) An entity that operates both a Medicare certified 
 comprehensive outpatient rehabilitation facility and a facility 
 which was certified prior to January 1, 1993, that is licensed 
 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
 whom at least 33 percent of the clients receiving rehabilitation 
 services in the most recent calendar year are medical assistance 
 recipients, shall be reimbursed by the commissioner for 
 rehabilitation services at rates that are 38 percent greater 
 than the maximum reimbursement rate allowed under paragraph (a), 
 clause (2), when those services are (1) provided within the 
 comprehensive outpatient rehabilitation facility and (2) 
 provided to residents of nursing facilities owned by the entity. 

    HIST: 1992 c 513 art 7 s 131; 1Sp1993 c 1 art 5 s 123