1998 Minnesota Statutes

     125A.744 Statewide data management system to maximize 
  medical assistance reimbursement. 

    Subdivision 1.    Definition.  For purposes of this 
 section, cooperative unit has the meaning given in section 
 123A.24, subdivision 2. 

    Subd. 2.    Statewide data management system.  The 
 commissioner of children, families, and learning, in cooperation 
 with the commissioner of human services, shall develop a 
 statewide data management system using the educational data 
 reporting system or other existing data management system for 
 school districts and cooperative units to use to maximize 
 medical assistance reimbursement for health and health-related 
 services provided under individual education plans and 
 individual family service plans.  The system must be 
 appropriately integrated with state and local existing and 
 developing human services and education data systems.  The 
 statewide data management system must enable school district and 
 cooperative unit staff to: 

    (1) establish medical assistance billing systems or improve 
 existing systems; 

    (2) understand the appropriate medical assistance billing 
 codes for services provided under individual education plans and 
 individual family service plans; 

    (3) comply with the Individuals with Disabilities Education 
 Act, Public Law Number 105-17; 

    (4) contract with billing agents; and 

    (5) carry out other activities necessary to maximize 
 medical assistance reimbursement. 

    Subd. 3.    Implementation.  Consistent with section 
 256B.0625, subdivision 26, school districts may enroll as 
 medical assistance providers or subcontractors and bill the 
 department of human services under the medical assistance fee 
 for service claims processing system for special education 
 services which are covered services under chapter 256B, which 
 are provided in the school setting for a medical assistance 
 recipient, and for whom the district has secured informed 
 consent consistent with section 13.05, subdivision 4, paragraph 
 (d), and section 256B.77, subdivision 2, paragraph (p), to bill 
 for each type of covered service.  A school district is not 
 eligible to enroll as a home care provider or a personal care 
 provider organization for purposes of billing home care services 
 under section 256B.0627 until the commissioner of human services 
 issues a bulletin instructing county public health nurses on how 
 to assess for the needs of eligible recipients during school 
 hours.  To use private duty nursing services or personal care 
 services at school, the recipient or responsible party must 
 provide written authorization in the care plan identifying the 
 chosen provider and the daily amount of services to be used at 
 school.  Medical assistance services for those enrolled in a 
 prepaid health plan shall remain the responsibility of the 
 contracted health plan subject to their network, credentialing, 
 prior authorization, and determination of medical necessity 
 criteria.  The commissioner of human services shall adjust 
 payments to health plans to reflect increased costs incurred by 
 health plans due to increased payments made to school districts 
 or new payment or delivery arrangements developed by health 
 plans in cooperation with school districts. 

    HIST: 1998 c 397 art 11 s 3; 1998 c 398 art 2 s 2